Wikipedia swwiki https://sw.wikipedia.org/wiki/Mwanzo MediaWiki 1.47.0-wmf.9 first-letter Media Maalum Majadiliano Mtumiaji Majadiliano ya mtumiaji Wikipedia Majadiliano ya Wikipedia Faili Majadiliano ya faili MediaWiki Majadiliano ya MediaWiki Kigezo Majadiliano ya kigezo Msaada Majadiliano ya msaada Jamii Majadiliano ya jamii Lango Majadiliano ya lango Wikichanzo Majadiliano ya Wikichanzo TimedText TimedText talk Module Module talk Event Event talk 0 72 1578148 1577343 2026-07-02T22:10:59Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578148 wikitext text/x-wiki {{tafsiri kompyuta}} [[Picha:JMR-Memphis1.jpg|thumb|200px|right|[[Mwanamke wa Haki]] ni ishara ya idara ya sheria.<ref>Hamilton, Marci. ''[http://books.google.com/books?id=Ox4_vqFCjcEC&pg=PA296&dq=%22lady+justice%22+symbol&lr=&as_brr=3&ei=uXb8Se-IC4GuyATlm5SPBg God vs. the Gavel]'', page 296 (Cambridge University Press 2005): “The symbol of the judicial system, seen in courtrooms throughout the United States, is blindfolded Lady Justice.”</ref><ref>Fabri, Marco. ''[http://books.google.com/books?id=AwwH0F8iC9QC&pg=PA137&dq=%22lady+justice%22+symbol&lr=&as_brr=3&ei=uXb8Se-IC4GuyATlm5SPBg The challenge of change for judicial systems]'', page 137 (IOS Press 2000): “the judicial system is intended to be apolitical, its symbol being that of a blindfolded Lady Justice holding balanced scales.”</ref> [[Haki]] inaonyeshwa kama [[mungu jike]] ambaye anabeba ishara [[tatu]] za [[utawala wa kisheria]]: [[upanga]] unaoashiria nguvu ya mahakama; [[mizani]] zinazoashiria upimaji wa madai yanayoshindana; na [[kitambaa]] kinachofunika macho kuashiria kutofanya upendeleo.<ref>Luban, ''Law's Blindfold'', 23</ref>]] '''Sheria''' (kutoka [[neno]] la [[Kiarabu]]; kwa [[Kiingereza]] ''law'' <ref>from [[Old English]] ''lagu'' "Words of Mel"; ''legal'' comes from [[Latin]] ''legalis'', from ''[[translating "law" to other European languages|lex]]'' "law", "statute" ([http://www.etymonline.com/index.php?search=law&searchmode=none Law], Online Etymology Dictionary; [http://www.merriam-webster.com/dictionary/legal Legal], Merriam-Webster's Online Dictionary)</ref>) ni [[mfumo]] wa [[kanuni]], ambazo kwa kawaida hutekelezwa kupitia seti ya [[taasisi]] maalumu.<ref>Robertson, ''Crimes against humanity'', 90; see "[[analytical jurisprudence]]" for extensive debate on what law is; in ''[[The Concept of Law]]'' Hart argued law is a "system of rules" (Campbell, ''The Contribution of Legal Studies'', 184); Austin said law was "the command of a sovereign, backed by the threat of a sanction" (Bix, [http://plato.stanford.edu/entries/austin-john/#3 John Austin]); Dworkin describes law as an "interpretive concept" to achieve [[justice]] (Dworkin, ''Law's Empire'', 410); and Raz argues law is an "authority" to mediate people's interests (Raz, ''The Authority of Law'', 3–36).</ref> Inaunda [[siasa]], [[uchumi]] na [[jamii]] kwa njia mbalimbali na huratibu mahusiano baina ya [[watu]]. [[Sheria ya mkataba]] huongoza kila kitu, kuanzia kununua [[tiketi]] ya [[basi]] hadi [[biashara]] katika [[Soko|masoko]]. [[Sheria ya mali]] inafafanua [[haki]] na [[wajibu]] unaohusiana na uhamisho wa jina la mali ya binafsi na [[mali ya kweli]]. [[Sheria ya hifadhi]] inatumika kwa mali yanayotumika kwa uwekezaji na usalama wa kifedha, huku [[sheria ya kukiuka wajibu]] inaruhusu madai ya [[fidia]] ikiwa haki au mali za mtu zinafanyiwa madhara. Ikiwa madhara ni kinyume cha sheria, [[sheria ya jinai]] inatoa mbinu zinazoweza kutumiwa na [[taifa]] ili kumshtaki mhusika. [[Sheria ya kikatiba]] inatoa utaratibu wa utungaji wa sheria, ulinzi wa [[haki za kibinadamu]] na [[uchaguzi]] wa wawakilishi wa kisiasa. [[Sheria ya utawala]] inatumika kuangalia upya maamuzi ya [[vyombo vya serikali]], huku [[sheria ya kimataifa]] inatawala shughuli baina ya [[nchi]] huru zinazohusu mambo kama vile [[biashara]], vikwazo vya kimazingira na hatua za [[Jeshi|kijeshi]]. Akiandika mnamo [[350 K.K.]], [[mwanafalsafa]] wa [[Ugiriki ya Kale]] [[Aristotle]] alisema, "[[Utawala wa sheria]] ni bora kuliko utawala wa mtu yeyote binafsi."<ref>"it is more proper that law should govern than any one of the citizens: upon the same principle, if it is advantageous to place the supreme power in some particular persons, they should be appointed to be only guardians, and the servants of the laws." (Aristotle, ''Politics'' [[s:Politics (Aristotle)/Book 3#3:16|3.16]]).</ref> Mifumo ya sheria inaelezea [[haki]] na majukumu kwa njia mbalimbali. Tofauti ya jumla inaweza kufanywa kati ya maeneo yanayotawaliwa na [[mfumo wa sheria ya kiraia]], ambayo huandika sheria zao, na yale yanayofuata [[sheria za kawaida]], ambapo sheria haijaundwa kwa utaratibu maalumu. Katika baadhi ya nchi, [[sheria ya dini]] bado hutumika kama sheria maalum. Sheria ni chanzo kikuu cha uchunguzi wa kitaalam, wa [[historia ya sheria]], [[falsafa ya sheria]], [[uchambuzi wa kiuchumi wa sheria]] au [[somo la kijamii kuhusu sheria]]. Sheria pia huibua masuala muhimu na magumu kuhusu [[usawa]], [[uadilifu]] na [[haki]]. "Katika usawa wake wa ajabu", alisema mwandishi [[Anatole France]] mnamo mwaka [[1894]], "sheria inakataza matajiri na mafukura kulala chini ya madaraja, kuombaomba barabarani na kuiba mikate."<ref>The original French is: "La loi, dans un grand souci d'égalité, interdit aux riches comme aux pauvres de coucher sous les ponts, de mendier dans les rues et de voler du pain" (France, ''The Red Lily'', [http://www.online-literature.com/anatole-france/red-lily/8/ Chapter VII]).</ref> Katika [[demokrasia]] ya kawaida, taasisi za msingi za kutafsiri na kuunda sheria ni matawi matatu makuu ya [[utawala]], ambayo ni [[mahakama]] isiyo na upendeleo, [[bunge]] na [[serikali]] yenye kuwajibika. Ili kutekeleza na kutumia nguvu za kufanya sheria ifuatwe na kutoa huduma kwa umma, urasimu wa serikali, [[jeshi]] na [[polisi]] ni muhimu. Vyombo hivyo vyote vya dola viliundwa na kutawaliwa na sheria, [[taaluma ya kisheria]] iliyo huru na [[jamii]] yenye bidii zinajulisha na kusaidia maendeleo. == Masomo ya sheria == Mifumo yote ya kisheria inahusu na masuala ya msingi, lakini kila taifa inaainisha na kubainisha masomo yake ya kisheria kwa njia mbalimbali. Tofauti ya kawaida ni kuwa "[[sheria ya umma]]" (maneno yanayohusika kwa karibu na [[taifa]], na kuhusisha sheria ya kikatiba, kitawala na ya jinai), na "[[sheria ya kibinafsi]]" (inayohusisha mkataba, [[sheria ya kukiuka wajibu]] na mali).<ref>Although many scholars argue that "the boundaries between public and private law are becoming blurred", and that this distinction has become mere "folklore" (Bergkamp, ''Liability and Environment'', 1–2).</ref> Katikamifumo ya [[sheria ya kirai(mfumo wa sheria)|sheria ya kirai]] , mkataba na kukiuka wajibu zinapatikana chini ya [[sheria ya majukumu]] huku sheria ya hifadhi inapatikana chini ya serkali za halali au [[Mkataba wa Hague wa Sheria inayotumika kwa Hifadhi na kwa jinsi ya Kuzijua|mikataba ya kimataifa]]. Sheria ya Kimataifa, kikatiba, kitawala, jinai, mkataba, kukiuka wajibu na mali na [[sheria ya hifadhi|hifadhi]] zinatambulika kama "masomo msingi ya jadi",<ref>E.g. in England these seven subjects, with EU law substituted for international law, make up a "qualifying law degree". For criticism, see [[Peter Birks]]' poignant comments attached to a previous version of the [http://webjcli.ncl.ac.uk/articles1/birks1.html#appendix Notice to Law Schools].</ref> ingawa kuna [[Sheria#Masomo zaidi|masomo zaidi]] ambayo yanaweza kuwa na umuhimu mkubwa zaidi wa kiutendaji. === Sheria ya Kimataifa === {{Main|Sheria ya umma ya kimataifa|Mgongano wa sheria|Sheria ya Umoja wa Ulaya}} [[Picha:Naciones Unidas 3.jpg|right|thumb|Ikitoa katiba ya sheria ya kimataifa ya umaa, mfumo wa [[Umoja wa Mataifa]] ulikubaliwa wakati wa [[Vita Vikuu vya Pili vya Dunia]]]] Sheria ya kimataifa inaweza kuashiria mambo matatu: sheria ya umma ya kimataifa, sheria ya kibinafsi ya kimataifa au mgongano wa sheria na sheria ya mashirika makubwa ya kimataifa. * '''[[Sheria ya Umma ya Kimataifa]]''' inajihusisha na uhusiano kati ya mataifa uhuru. [[Vyanzo vya sheria ya kimataifa|Vyanzo]] vya maendeleo ya sheria ya umma ya kimataifa ni [[Desturi(sheria)|desturi]], mwenendo na mikataba kati ya nchi huru [[Mikataba ya Geneva]]. Sheria ya umma ya kimataifa inaweza kutengezwa na [[mashirika ya kimataifa]], kama vile [[Umoja wa Mataifa]] (ambao ilianzishwa baada ya kushindwa kwa [[Shirikisho la Kimataifa]] kuzuia [[Vita vya Vikuu vya Pili vya Dunia]]),<ref>[http://www.un.org/aboutun/history.htm History of the UN], United Nations. [[Winston Churchill]] (''The Hinge of Fate'', 719) comments on the League of Nations' failure: "It was wrong to say that the League failed. It was rather the member states who had failed the League."</ref> [[Shirika la Kimataifa la Ajira]], [[Shirika la Kimataifa la Biashara]], au [[Shirika la Fedha la Kimataifa]]. Sheria ya kimatifa ya umma ina hadhi maalum kama sheria kwa sababu hakuna kikozi cha kimataifa cha polisi, na mahakama (kama vile [[Mahakama ya Kimataifa ya Haki]] kama tawi la kimsingi la Umoja wa Mataifa la mahakama) halina uwezo wa kuadhibu kutokutii.<ref>The prevailing manner of enforcing international law is still essentially "self help"; that is the reaction by states to alleged breaches of international obligations by other states (Robertson, ''Crimes against Humanity'', 90; Schermers-Blokker, ''International Institutional Law'', 900–901).</ref> Hata hivyo, miili michache, kama vile WTO, ina mifumo yenye ufanisi ya utatuzi wa kudumu na utatuzi wa mogogoro inayoambatana na vikwazo vya kibiashara.<ref>Petersmann, ''The GATT/WTO Dispute Settlement System'', 32</ref> * '''[[Mgongano wa sheria]]''' (au "sheria ya kibinafsi ya kimataifa" katika nchi za [[sheria ya kiraia]]) unahusisha [[maeneo ya kimamlaka ya kisheria]] ya mgogoro wa kisheria baina ya watu wa kibinafsi unafaa kusikizwa na sheria za maeneo gani ya kimamlaka ya kisheria ndiyo inayofaa kutumika. Leo, biashra zinazidi kuwa na uwezo wa kusongeza minyororo ya ugavi ya [[mtaji]] na [[ajira]] kuvuka mipaka, na pia kufanya biashara na kampuni za nchi za ng'ambo, hivyo kulifanya swali kuhusu nchi ipi ndiyo inayomamlaka ya kisheria kuwa muhimu zaidi. Idadi kubwa zaidi ya biashara zinachagua usuluhishi wa kibiashara chini ya [[Tuzo la Mkataba wa Utambuzi na Utendaji wa Masuluhisho ya Kimataifa|Mkataba wa New York wa mnamo mwaka1958]].<ref>Redfem, ''International Commercial Arbitration'', 68–69</ref> * '''[[Sheria ya Umoja wa Ulaya]]''' ndiyo ya kwanza, kufikia sasa, ambayo ni mfano wa [[sheria kuu ya kimataifa]]. Kutokana na mwenendo wa kuongezeka kwa ushirikiano wa kiuchumi Duniani, mikataba mingi ya kikanda — hasa ya [[Umoja wa Nchi za Amerika Kusini]] — zimeanza kuufuata mfano kama huu. Katika Umoja wa Ulaya, nchi huru zimekusanya mamlaka yao katika mfumo wa mahakama na [[Bunge la Ulaya|taasisi za kisiasa]]. Taasisi hizi zinapewa uwezo wa kutekeleza kanuni za kisheria dhidi ya au kwa nchi wanachama na raia katika namna ambayo haiwezekani kupitia sheria ya umma ya kimataifa.<ref>Schermers–Blokker, ''International Institutional Law'', 943</ref> Kama [[Mahakama ya Ulaya ya Haki]] yalivyosema katika miaka ya 1960, sheria ya Umoja wa Umoja wa Ulaya hujumiusha "muundo mpya wa sheria ya kimataifa" kwa ajili ya faida inayotegemeana ya kijamii na kiuchumi wa nchi zote wanachama.<ref>See the [http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:61962J0026:EN:HTML C-26/62 ''Van Gend en Loos v Nederlanse Administratie Der Belastingen''], and [http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:61964J0006:EN:HTML ''Flaminio Costa v E.N.E.L.''] decisions of the European Court.</ref> === Sheria ya kikatiba na ya kiutawala === {{Main|Sheria ya kikatiba|Sheria ya kiutawala}} [[Picha:Declaration of Human Rights.jpg|thumb|[[Azimio la Haki za Kibinadamu na za Raia]], ambalo kanuni zake bado zini thamani ya kikatiba]] Sheria ya kikatiba na kiutawala zinasimamia mambo ya nchi. [[Sheria ya kikatiba]] inahusisha uhusiano baina ya serikali, bunge na mahakama na [[haki za kibinadamu]] au [[uhuru wa kiraia]] wa watu binafsi dhidi ya nchi. Maeneo mengi ya kisheria, kama vile [[Sheria ya Marekani|Marekani]] na [[Sheria ya Ufaransa|Ufaransa]], zina katiba moja iliyoandikwa kwa makini, iliyo na [[Muswada wa Haki]]. Katiba chache kama vile [[Sheria la Uingereza|Uingereza]], hazina hati kama hiyo."Katiba" kwa ufupi ni zile sheria ambazo zinajumuisha [[mwili wa kisiasa]], kutoka [[kanuni]], [[sheria za uamuzi]] na [[Mkataba wa kikatiba(utamaduni wa kisiasa)|mkataba]]. Kesi kwa jina ''[[Entick dhidi ya Carrington]]''<ref>''[[Entick v Carrington]]'' (1765) 19 Howell's State Trials 1030; [1765] [http://www.bailii.org/ew/cases/EWHC/KB/1765/J98.html 95 ER 807]</ref> ilionyesha wazi kanuni ya kikatiba inayotokana na sheria ya kawaifa. Nyumba ya Bwana Entick ilifanyiwa upekekuzi na Afisa mmoja wa polisi aliyeitwa Carrington. Wakati Bwana Entick alipolalamika mbele ya mahakama, Afisa Carrington alidokeza kwamba kibali kutoka waziri wa Serikali, [[George Montague-Dunk, ali wa pili wa Halifax|Ali wa Halifax]], kilikuwa na mamlaka halali. Hata hivyo, hakukuwa na sheria iliyoandikwa au mamlaka ya kimahakama ambayo yalitoa uwezo huo.Hakimu mkuu, [[Charles Pratt, Ali wa kwanza wa Camden|Bwana Camden]], alisema, <blockquote>Mwisho mkubwa, ambao ulifanya watu kuingia katika jamii, ilikuwa kupata mali. Haki hiyo imetunzwa na ni takatifu na haiwezi kuondolewa wakati wowote, ambapo haijaondolewa au kufupishwa na sheria fulani ya umma kwa manufaa ya wote...Hakuna sababau inayoweza kupatikana au kutolewa, kimya cha vitabu ni mamlaka dhidi ya mshtakiwa, na aliyeathiriwa lazima atendewe haki.<ref>{{cite web | url=http://www.constitution.org/trials/entick/entick_v_carrington.htm | title=Entick v Carrington | work=19 Howell’s State Trials 1029 (1765) | publisher=Constitution Society | location=[[Marekani|US]] | accessdate=2008-11-13}}</ref></blockquote> Kanuni ya kimsingi ya kikatiba, ilitokana na [[Citabu viwili mbili kuhusu Serikali|John Locke]], inadokeza ya kwamba mtu binafsi anaweza kufanya isipokuwa kile ambacho kimekataliwa kisheria.<ref>Locke, ''The Second Treatise'', [[s:Two Treatises of Government/The Second Treatise of Government: An Essay Concerning the True Origin, Extent, and End of Civil Government#2:9|Chapter 9, section 124]]</ref><ref>Tamanaha, ''On the Rule of Law'', 47</ref> Sheria ya utawala ndiyo mbinu msingi ya kufanya mashirika ya umma yawajibike. Watu wanaweza kutumia [[mapitio ya kimahakama]] kwa matendo au uamuzi uliofanywa na za halmashauri za mitaa, huduma za umma au wizara za serikali, kuhakikisha kuwa zinazingatia sheria. Mahakama ya kwanza ya maalum ya kiutawala yalikuwa mahakama ya ''[[Council of State (France)|Conseil d'État]]'' yaliyoundwa mnamo mwaka wa 1799, wakati [[Napoleon Bonaparte]] alipochukua mamlaka nchini Ufaransa.<ref name="A75">Auby, ''Administrative Law in France'', 75</ref> === Sheria ya jinai === {{Main|Sheria ya jinai}} Sheria ya jinai, inayojulikana pia kama sheria ya kuadhibu, inahusisha makosa na adhabu.<ref>[[Cesare, Marquis of Beccaria|Cesare Beccaria]]'s seminal treatise of 1763–1764 is titled ''On Crimes and Punishments'' (''[[Dei delitti e delle pene]]'').</ref> Kwa hivyo inapima ufafanuzi wa adhabu ya makosa yaliyopatikana kuwa na madhara yanaonekana kuwa na uwezo wa kusababisha uharibifu lakini, kwa undani, haifanyi uamuzi wa kimaadili kumhusu mkosaji wala kuwekea jamii vikwazo ambavyo vinakataza watu kimwili wasifanye makoa mwanzoni.<ref name="W2">Brody, Acker and Logan, ''Criminal Law'', 2; Wilson, ''Criminal Law'', 2</ref> Investigating, apprehending, charging, and trying suspected offenders is regulated by the law of [[criminal procedure]].<ref name="Br2">Brody, Acker and Logan, ''Criminal Law'', 2</ref> Kesi ya kidhana ya uhalifu inatokana na ushahidi, [[Mzigo wa Ushahidi|kuzidi shaka ya kuridhisha]], kuwa mtu ana hatia ya mambo mawili. Kwanza, mshtakiwa lazima awe amefanya kitendo ambacho kinatazamwa na jamii kuwa hatia, au ''[[actus reus]]'' (kitendo cha hatia).<ref>See e.g. Brody, Acker and Logan, ''Criminal Law'', 205 about ''[[Robinson v California]]'', 370 U.S. 660 (1962).</ref> Pili, lazima mshtakiwa awe na [[dhamira (jinai)|dhamira ya kufanya uharibifu]] ya kufanya kitendoo fulani cha jinai, au ''[[mens rea]]'' (akili ya hatia). Hata hivyo, kwa kile kinachojulikana kama hatia za "[[Dhima kali (jinai)|dhima kali]]", ''actus reus'' haitoshi.<ref>See e.g. Feinman, ''Law 111'', 260–261 about ''[[Powell v Texas]]'', 392 U.S. 514 (1968).</ref> Mifumo ya jinai ya utamaduni wa sheria ya raia zinatofautisha kati ya nia katika dhana pana (''dolus directus'' na ''dolus eventualis''), na uzembe. Uzembe hauna jukumu la jinai isipokuwa ambapo hatia fulani una adhabu yake maalum.<ref>Dörmann, Doswald-Beck and Kolb, ''Elements of War Crimes'', 491</ref><ref>Kaiser, ''Leistungsstörungen'', 333</ref> [[Picha:SalemWitchcraftTrial.jpg|thumb|left|Picha inayoonyesha [[kesi]] ya uhalifu, kwa sababu ya [[uchawi]] katika eneo la [[Kesi za wachawi za Salem|Salem]]]] Mifano ya uhalifu ni [[mauaji]], [[kushambulia]], [[udanganyifu]] na [[wizi]]. Katika mifano maalum utetezi unaweza kutumika kwa vitendo maalum, kama zile kuuwa ili [[nadharia ya utetezi wa kibinafsi|utetezi wa kibinafasi]], au katika nyakati maalum kujitetea kuwa [[utetezi wa wazimi|wazimu]]. Mfano mwingine ni katika kesi ya karne ya 19 ya ''[[Jamhuri dhidi ya Dudley na Stephens]]'', iliyopima utetezi wa "[[kimahitaji]]". Meli ya ''Mignonette'', iliyokuwa ikisafiri kutoka mji wa [[Southampton]] kuelekea mji wa [[Sydney]], ilizama. Wafanyikazi watatu wa meli hiyo na Richard Parker, kijana aliyekuwa na umri wa miaka 17, walibaki katika meli iliyoundwa na vijiti. Walikuwa na njaa na kijana yule alikuwa karibu kufa. Kwa sababu ya kuwa na njaa iliyokithiri, wafanyikazi hao walimuuwa kijana yule na kumla. Wafanyikazi hao waliokolewa, lakini wakafikishwa mahakamani huku wakiwa na hatia ya mauaji. Walijitetea kwa kusema kwamba ilihitajika kwa lazima kwa wao kumuuwa kijana yule ili kuyaokoa maisha yao. [[John Coleridge, Baroni wa Kwanza Coleridge|Bwana Coleridge]], akieleza kukataa kukubwa, aliamua, "kuhifadhi maisha ya kibinafsi ni, kwa kuzungumza kijumla, wajibu, lakini inaweza kuwa jukumu kuu kuyatoa maisha hayo kama kafara." Wanaume hao walihukumiwa [[kunyongwa|nyonga]], lakini maoni ya umma uliunga mkono haki ya wafanyikazi wale wa meli kuyaokoa maisha yao. Mwishowe, [[Ufalme]] ulipunguza hukumu zao hadi miezi sita gerezani.<ref>About ''[[R v Dudley and Stephens]]'' [1884] [http://www.justis.com/titles/iclr_bqb14040.html 14 QBD 273 DC] {{Wayback|url=http://www.justis.com/titles/iclr_bqb14040.html |date=20050228224504 }}, see Simpson, ''Cannibalism and the Common Law'', 212–217, 229–237</ref> Makosa ya jinai yanatambulika si tu kama makosa dhidi ya waathirika binafsi, lakini jamii pia.<ref name="W2" /> Taifa, kawaida likisaidiwa na polisi, huongoza mashitaka, basi hiyo ndiyo sababu mbona katika nchi zenye sheria ya kawaida kesi hutajwa kama "''Watu'' dhidi ya..." au "''Jamhuri'' (kwa [[Ufalme|"Rex"]] au [[Malkia reginanti|Regina]]) dhidi ya..." Pia, [[jopo la waamuzi]] ambao hutokana na raia wa kawaida hutumika kuamua hatia ya washitakiwa kutokna na pointi zinazoweza kubainika ukweli: jopo la waamuzi haliwezi kubadilisha kanuni za kisheria. Baadhi ya nchi zilizostawi bado hutumia [[adhabu ya kifo]] kwa matendo ya jinai lakini adhabu ya kawaida ya uhalifu itakuwa ni [[gereza|kufungwa gereza]], [[faini]] usimamizi wa taifa (kama vile probesheni), au [[huduma ya kijamii]]. Sheria ya kisasa ya jinai imeathiriwa vilivyo na sayansi ya jamii, hasa kuhusu [[hukumu(sheria)|kuhukumu]], utafiti wa kisheria, kuunda sheria, na [[kuwasaidia wahalifu kurekesha mwenedo wao]].<ref>Pelser, ''Criminal Legislation'', 198</ref> Katika ngazi ya kimataifa, nchi 108 [[Mktaba wa Sheria ya Roma ya Mahakama ya Kimataifa ya Jinai|wanachama]] wa [[Mahakama ya Kimataifa ya Jinai]], ambayo ilianzishwa kuwahukumu watu kwa [[hatia dhidi ya ubinadamu]].<ref>[https://web.archive.org/web/20040605155639/http://www.icc-cpi.int/statesparties.html The States Parties to the Rome Statute], International Criminal Court</ref> === Sheria ya mkataba === {{Main|Mkataba}} [[Picha:carbolic smoke ball co.jpg|thumb|Tangazo maarufu la kampuni ya Carbolic Smoke Ball lidai kuwa lingeweza kutibu [[homa]]. Mahakama yaliamua kuwa tangazo hilo lilikuwa [[mkataba wa mtu yeyote]]]] Sheria ya mkataba inahusu ahadi zinazowezwa kutendwa, na inaweza kuandikwa kwa ufupi katika maneno ya Kilatini''[[pacta sunt servanda]]'' (ahadi lazima zitimizwe).<ref>Wenberg, ''Pacta Sunt Servanda'', 775</ref> Katika maeneo ya kimamlaka ya sheria ya kawaida, vipengele vitatu muhimu kuhusu utengenezaji wa mkataba vinahitajika: [[kutoa na kukubali]], [[kutilia maanani]] na nia ya kutengeneza uhusiano wa kisheria.Katika kesi ya ''[[Carlill shisi ya Kampuni ya Carbolic Smoke Ball]]'' kampuni ya matibabu ilitangaza kuwa dawa yake mpya ya ajabu, smokeball, ingewatibu watu kutokana na mafua, na ikiwa haingefaulu kuwatibu, wanunuzi wangepata [[paundi za Kistaling'i|£]] 100. Watu wengi waliwasilisha kesi mahakamani ili wapate £100 zao wakati dawa hiyo iliposhindwa kuwatibu. Ikiogopa [[kufilisika]], Kampuni ya Carbolic ilijitetea kwa kusema kuwa tangazo lile lilikuwa mzaha tu, na kwa hivyo halikuwa toleo lenye nguvu za kisheria. Lilikuwa [[karibisho]], mchezo tu. Lakini mahakama ya rufaa yaliamua kuwa kwa [[mtu mwenye kufikiria kwa kawaida]] kampuni ya Carbolic ilikuwa imefanya toleo. Watu walikuwa wametoa kusudi la kununua bidhaa ile kwa kupitia "shida bayana" ya kutumia bidhaa yenye hitilafu. "Soma tangazo vile utakavyo, na ulibadilishe tangazo hilo vile utakavyo", alisema [[Nathaniel Lindley, Baroni Lindley|Hakimu Lindley]], "haa kuna ahadi maalum ilitajwa katika lugha isyokuwa na utata wowote".<ref name="CCSBCE">About ''[http://www.justis.com/titles/iclr_r9321042.html Carlill v Carbolic Smoke Ball Company] {{Wayback|url=http://www.justis.com/titles/iclr_r9321042.html |date=20041205104916 }}'' [[Case citation|[1893] 1 QB 256]], and the element of consideration, see Beale and Tallon, ''Contract Law'', 142–143</ref> "Kutilia maanani" knaonyesha ukweli kwamba vyama vyote katika mkataba vimebadilisha kitu fulani chenye maana. Baadhi ya mifumo ya sheria ya kawaida, ikiwemo Australi, zinasonga mbali kutoka dhana ya kutilia maanani kama mojawapo ya mahitaji ya mkataba. Dhana ya "[[estoppel]]" au ''culpa in contrahendo'', inaweza kutumika kuunda wajibu wakati mazungumzo kabla ya kuingia mkataba<ref>''[[Austotel v Franklins]]'' (1989) 16 NSWLR 582</ref> Katika maeneo ya kisheria ya kiraia, kutilia maanani si lazima kwa mkataba kuwa na nguvu ya kisheria.<ref>e.g. In Germany, [http://dejure.org/gesetze/BGB/311.html § 311 Abs. II] [[Bürgerliches Gesetzbuch|BGB]]</ref> Nchini Ufaransa, mkataba wa kawaida unasemekana kutokea ambapo "kukutana kwa akili" au kwa "kuwa na nia zinazowiana". [[Sheria ya Ujerumani|Ujerumani]] ina mtazamio maalum kuhusu mikataba, ambayo inayusisha sheria ya mali. [[Kanuni ya dhana ya kiakili]] (''Abstraktionsprinzip'' wanayoitumia, inamaanisha kuwa wajibu wa kibinafsi wa mkataba unaundwa kando na jina la mwenye mali yanayokabidhiwa. Wakati ambapo mikataba inavunjwa kwa sababu fulani (kwa mfano mnunuzi wa gari amelewa kiasi kwamba hana uwezo wa kisheria wa kufanya mkataba)<ref>[http://dejure.org/gesetze/BGB/105.html § 105 Abs. II] [[Bürgerliches Gesetzbuch|BGB]]</ref> Wajibu wa kimkataba wa kulipa unaweza kuvunjwa tofauti na jina la mwenye gari. Sheria ya [[kutajirika kusio kwa haki]], badala ya sheria tya mkataba, basi inatumika kurudisha jina kwa mmiliki halali.<ref>Smith, ''The Structure of Unjust Enrichment Law'', 1037</ref> === Sheria ya ukiukaji wa wajibu === {{Main|Ukiukaji wa wajibu}} Sheria ya ukiukaji wa wajibu, ambayo wakati mwingine huitwa [[kosa la jinai]], ni makosa ya raia. Kuwa na kosa la ukiukaji wa wajibu, mtu lazima awe amekiuka wajibu aliukwa anafaa kumtendea mty mwingine, au kukiuka haki fulani ya awali ya kisheria. [[Bolton dhidi ya Stone|mfano]] unaweza kuwa kumgonga mtu kimakosa na mpira wa mchezo wa kriketi.<ref>''[[Bolton v Stone]]'' [1951] AC 850</ref> Chini ya sheria ya [[uzembe]], ambayo ndiyo aina ya ukiukaji wa wajibu maarufu zaidi, mtu aliyepatwa na madhara anaweza kuomba fidia kwa ya majeraha yake kutoka kwa mtu mwenye uwajibikaji. Kanuni za uzembe zinaonyeshwa na kesi ya ''[[Donoghue dhidi ya Stevenson]]''.<ref name="DvS">''[[Donoghue v Stevenson]]'' ([[Case citation#England and Wales|[1932] A.C. 532, 1932 S.C. (H.L.) 31, [1932] All ER Rep 1]]). See the original text of the case in [http://www.leeds.ac.uk/law/hamlyn/donoghue.htm UK Law Online] {{Wayback|url=http://www.leeds.ac.uk/law/hamlyn/donoghue.htm |date=20070216044953 }}.</ref> Rafiki mmoja wa Bi. Donoghue aliagiza chupa isiyopenyeka nuru la [[pombe ya tangawizi]] (iliyokusudiwa kutumika na Bi. Donoghue) katika mkahawa katika eneo la [[Paisley]]. Baada ya kunya kunya nusu ya bia ile , Bi, Donoghue alimimina iliyosalia katika bilauri. Mabaki yaliyooza ya konokono yalielea juu ya pombe. Alidai kuwa alipigwa na bumbuwazi, na kupata ugonjwa wa kuchomeka ndani ya matumbo, na ilimbidi kumpeleka mtengenezaji pombe kwa kuruhusu kinywaji kuchafuka ovyo. [[Nyumba ya Mabwana]] iliamua kwamba mtengezaji pombe aliwajibika kwa ugonjwa wa Bi. Donoghue. [[Bwana Atkin]] alikuwa na mtazamo maalum wa kimaadili, na akasema, <blockquote>Dhima ya upuuzaji ... bila shaka ina msingi wake katika mawazo ya kijumla ya umma kuhusu makosa ya kimaadili amabyo mkosaji lazima alipe ... Kanuni ya kuwa unafaa kumpenda adui yako, kisheria inakuwa, haufai kumjeruhi jirani yako; na swali la wakili, nani ndiye jirani yangu? linapokea jibu lenye vikwazo. Lazima uwe na uwangalifu wa kuepuka na vitendo au visa ambapo hautendi lolote inapofaa, ambavyo unaweza kutazamia kuwa vikamjeruhi jirani yako.<ref>''[[Donoghue v Stevenson]]'' [1932] AC 532, 580</ref></blockquote> Huu ulikuwa msingi wa kanuni nne za upuuzaji; (1) Bwana Stevenson alimdai Bi. Donoghue [[wajibu wa kujali]] wa kuuza vinywaji salama (2) yeye [[Kuvuna kwa jukumu katika Sheria ya Kiingereza|alivunja]] wajibu wake wa kujali (3) madhara hayangefanyika [[usababishaji (sheria)|isipokuwa kwa]] kuvunja kwake kwa wajibu wa kujali na (4) tendo lake lilikuwa [[sababau ya karibu]], au haikuwa tokeo la [[Umbali katika Sheria ya Kiingereza|mbali]], la madhara yaliyompata mtu fulani.<ref name="DvS" /> Mfano mwingine wa ukikaji wa wajibu unaweza kuwa wa jirani ambaye anapiga kelele nyingi sana na na mashine katika nyumbani kwake.<ref name="Sturges">''[[Sturges v Bridgman]]'' (1879) 11 Ch D 852</ref> Chini ya dai la [[kero]] kelele hiyo inaweza kukomeshwa. Ukiukaji wa wajibu pia inaweza kuhusisha vitendo vya kimakusudi, kama vile [[ushambulizi (ukiukaji wa wajibu)|ushambulizi]], [[vita(ukiukaji wa wajibu)|vita]] au [[kuvuka na kuingia katka maeneo yaliyopigwa marufuku]]. Sheria ya ukiukaji wa wajibu inayofahamika vyema ni ile ya [[kumharibia mtu jina]], ambayo inafanyika, kwa mfano, wakati gazeti linapochapisha madai yasiyokuwa na msingi ambayo yanaharibu sifa ya mwanasiasa fulani.<ref>e.g. concerning a British politician and the Iraq War, ''[[George Galloway v Telegraph Group Ltd]]'' [2004] EWHC 2786</ref> Ukiukaji wa wajibu ambao ni mbaya zaidi ni zile wa kiuchumi, ambao huwa msingi wa [[sheria ya ajira]] katika baadhi ya nchi kwa kufanya vyama vya kibiashara kuwa na dhima kwa sababu ya migomo,<ref>''[[Taff Vale Railway Co v Amalgamated Society of Railway Servants]]'' [1901] AC 426</ref> Wakati ambapo amri ya kisheria haipatiani kinga.<ref>In the UK, [[Trade Union and Labour Relations (Consolidation) Act 1992]]; c.f. in the U.S., [[National Labor Relations Act]]</ref> === Sheria ya mali === {{Main|Sheria ya mali}} [[Picha:South Sea Bubble.jpg|thumb|Picha ya [[Bubujiko la Bahari ya Kusini]], mojawapo ya majanga ya kiuchumi yalilotokana na [[uvumi]]. Janga hilo la kiuchumi lilisababisha kuundwa kwa kanuni kali kuhusu uuzaji wa hisa.<ref>Harris, ''The Bubble Act'', 610-627</ref>]] Sheria ya [[mali]] inatawala vitu vya thamani ambavyo watu huvitambua kama 'vyao'. [[Mali ya kweli]] wakati mwingine huitwa 'mali isiyohamishika' inahusu umiliki wa ardhi na vitu vilivyojikita katika ardhi hiyo.<ref>eg ''[[Hunter v Canary Wharf Ltd]]'' [1997] [http://www.publications.parliament.uk/pa/ld199697/ldjudgmt/jd970424/hunter01.htm 2 All ER 426]</ref> [[Mali ya kibinafsi]], inaashiria mambo mengineyo; vyombo vinavyowezwa kusongeshwa, kama vile tarakilishi, magari, mapambo na mikate au turathi haki, kama vile [[hisa (fedha)|akiba na hisa]]. Haki ya ''[[in rem]]'' ni haki ya kipande maalum cha mali, ikitofautishwa na haki ''[[in personam]]'' ambayo inaruhusu fidia kwa hasara, lakini si kwa kurudishiwa kitu fulani. Sheria ya ardhi inajumuisha msingi wa aina nyingi za sheria za mali, na ndiyo ngumu zaidi. Inahusisha [[mogeji]], [[mikataba ya kukodisha]], [[leseni]], [[maagano]], [[ruhusa]] na mifumo ya kisheria kwa usajili wa ardhi. Kanuni kuhusu [[matumizi ya ardhi]] ya kibinafsi chini ya [[haki miliki]], [[kampuni (law)|sheria ya kampuni]], [[sheria ya hifadhi|hifadhi]] na [[sheria ya biashara]]. Mfano wa kesi msingi ya ya sheria nyingii za mali ni ''[[Armory v Delamirie]]''.<ref>''[[Armory v Delamirie]]'' (1722) 93 ER 664, 1 Strange 505</ref> Kijana wa [[kufagia chimni]] alipata pambo lenye mawe ya thamani. Alichukua pambo lile kwa muundaji wa vifaa vya dhahabu ili thamani yake ikadiriwe. Mwanafunzi wa muundaji wa vifaa vya dhahabu aliangalia pambo lile, akaiba mawe yale ya thamani, ma kumuambia kijana yule kuwa thamani yake ilkuwa [[Nusu peni (Pesa ya Uingereza)|nusu peni]] tatu na kuwa angeinunua. Kijana yule alimwambia kuwa angepenga arudishiwe pambo lile, kwa hivyo mwanafunzi wa muundaji vifaa alimrudishia pambo, lakini bila mawe yale ya thamani. Kijana yule alimpeleka mtengenezaji wa vifaa vya dhahabu kotini kwa jaribio la mwanafunzi wake kumdanganya. [[Bwana Hakimu Mkuu Pratt]] aliamua kuwa ingawa kijana hangesemekana kuwa mumiliki wa pambo lile, angefaa kutazamwa kama mpataji aliyefaa ("mpataji muwekaji") hadi mumiliki wa kiasili anapopatikana. Kwa kweli mwanafunzi na kijana yule wote walikuwa na haki ya ''[[Umiliki (sheria)|umiliki]]'' wa pambo lile (dhana ya kiufundi, inayomaanisha kuwa kitu fulani ''kingeweza'' kumilikiwa na mtu fulani), lakini nia ya kijana yule ya kumiliki ilitazamiwa kuwa bora zaidi, kwa sababu ingeweza kudhihirishwa kuwa ya kwanza katika wakati. Umiliki unaweza kuwa sehemu tisa kwa kumi ya sheria, lakini si yote. Kesi hii hutumika kudhihirisha mtazamo wa mali katika maeneo ya kisheria ya kawaida, kuwa mtu anayeweza kuonyesha dai bora zaidi la kipande cha mali, dhidi ya chama kingine, ndiye mumiliki.<ref>Matthews, ''The Man of Property'', 251–274</ref> Kwa kulinganisha, mbinu ya kiklasiki ya sheria ya raia kuhusu mali, iliendelezwa na [[Friedrich Carl von Savigny]], ni kuwa ni haki nzuri dhidi ya Ulimwengu. Wajibu, kama mkataba na ukiukaji wa wajibu hutazamwa kama haki nzuri dhidi ya watu binafsi.<ref>Savigny, ''Das Recht des Besitzes'', [http://dlib-pr.mpier.mpg.de/m/kleioc/0010/exec/bigpage/%22235083_00000057%22 25] {{Wayback|url=http://dlib-pr.mpier.mpg.de/m/kleioc/0010/exec/bigpage/%22235083_00000057%22 |date=20080418181513 }}</ref> Dhana ya mali inaibua maswala mengi zaidi ya kifalsafa na kisiasa. Locke alidokeza kwamba "maisha, uhuru na nyumba" zetu ni mali yetu kwa sababu tunamiliki mali yetu na [[Nadharia ya ajira ya mali|tunachangayana ajira yetu]] na mazingira yetu.<ref>Locke, ''[[s:Two Treatises of Government/The Second Treatise of Government: An Essay Concerning the True Origin, Extent, and End of Civil Government|Second Treatise on Civil Government]]'', Chap. IX. Of the Ends of Political Society and Government. Chapter 9, section 123.</ref> === Usawa na amana === {{Main|Usawa (sheria)|sheria ya amana}} [[Picha:Microcosm of London Plate 022 - Court of Chancery, Lincoln's Inn Hall edited.jpg|thumb|[[Mahakama ya Chancery]], London, mwanzoni mwa karne ya 19]] Usawa na amana ni mwili wa sheria ulioibuka nchini Uingereza kando na "shera ya kawaida". Sheria ya kawaida ilisimamiwa na mahakimu. [[Bwana Chansela]] kwa upnade mwingine, kama muwekaji dhamiri wa mfalme, angeweza kupuuza sheria iliyotengenezwa na hakimu ikiwa alifikiria kuwa ilikuwa sawa kufanya hivyo.<ref>McGhee, ''Snell's Equity'', 7</ref> Hili lilimaanisha kuwa usawa ulianza kufanya kazi zaidi kupitia [[Malengo ya usawa|kanuni]] bali si sheria ambazo hazikubadilika. Kwa mfano, ambapo mifumo ya sheria ya kawaida au sheria ya raia haiwaruhusu watu kugawa umiliki wa kutoka kwa udhibiti wa kipande kimoja cha mali, usawa unaruhusu hili kupitia mpango unaoitwa 'amana'. Kudhibitiwa kwa mali na 'wenye amana' ambapo kwa upande mwingine umiliki 'wenye manufaa' (au 'yenye usawa') wa mali ya amana inashikiliwa na watu wanojulikana kama 'wadhamini'. Wadhamini wana wajibu kwa walengwa wao wa kuyachuna vyema mali waliyokabidhiwa.<ref>c.f. ''[[Bristol and West Building Society v Mothew]]'' [1998] Ch 1</ref> Katika kesi ya awali ya ''[[Keech dhidi ya Sandford]]''<ref>''[[Keech v Sandford]]'' (1726) Sel Cas Ch 61</ref> mtoto alirithi haki ya [[kokodisha]] katika [[Soko la Romford|soko]] katika eneo la [[Ramford]], mjini London. Bw, Sandford alikabidhiwa mali hayo hadi wakati ambapo mtoto angekomaa. Lakini kabla ya hapo, kipindi cha kukodisha kilikwisha. Kabaila alikuwa (inaonekana) amemwambia Bw. Sandford kuwa hakutaka mtoto yule awe na kukodisha kupya. Lakini bado kabaila alikuwa amefurahi (inaonekana) kumpa Bw. Sandford fursa ya kukodisha. Bw Sandford aliichukua. Wakati ambapo mtoto (sasa Bw. Keech) alikuwa mkubwa, alimpeleka Bw. Sandford mahakamani kwa faida aliyokuwa akipata kwa kupata kukodisha kwa soko. Bw. Sandford alifaa kuaminika, lakini alijiweka katika nafasi ya [[mgongano wa maslahi]]. [[Bwana Kansela]], [[Peter King, Baroni wa Kwanza Mfalme|Bwana Mfalme]], alikubali na kumuamuru Bw. Sandford kutoa faida ile na kumlipa Bw. Keech. Aliandika, {{quote|Ninaona vizuri sana kuwa, ikiwa mdhamini, akikataa kufanya kukodesha upya, anaweza kuwa na kukodesha kwake mwenyewe mali chache ya kiamana yangesajiliwa upya ... Hili linaweza kuonekana kuwa gumu sana, kuwa mdhamini ndiye mtu wa kipekee kwa binadamu wote ambaye hatakuwa na kukodisha; lakini ni bora kanuni ifuatiliwe na isipuuzwe wakati wowote.}} Bila shaka, Bwana Mfalme LC alikuwa na wasiwasi kwamba wadhamini huenda wakatumia fursa ya kutumia mali ya amana wenyewe badala ya kuyachunga. Wadadisi wa kibiashara wanaotumia hifadhi walikuwa wamesababisha [[Mbubujiko wa Bahari ya Kusini|kuaguka kwa soko la hisa]] katika siku hizo. Wajibu mkali kwa wadhamini ulijumuishwa katika sheria ya serikali na kutumika kwa wakurugenzi wa makampuni na [[maafisa watendaji wakuu]]. Mfano mwingine wa jukumu la mdhamini unaweza kuwa kuwekeza mali vizuri au kuiuza.<ref>''[[Nestle v National Westminster Bank plc]]'' [1993] 1 WLR 1260</ref> Hii hasa ndiyo kesi kwa fedha za [[pensheni]] , aina muhimu kwa zote ya amana, ambapo wawekezaji ndio wadhamini wa akiba za watu hadi [[wastaafu]]. Lakini amana pia zinaweza kuundwa kwa [[hisani ya amana|madhumuni ya hisani]], mifano maarufu ikiwa [[Makavazi ya Uingereza]] au [[Shirika la Rockefeller]]. === Utaalamu zaidi === Sheria huenea mbali kuliko masomo ya msingi hadi karibu kila eneo la maisha. Ngazi tatu zimetajwa hapa ili kurahisiha majadiliano, ingawa masomo mbalimbali hufanana na kutegemeana. ;Sheria na jamii [[Picha:Unison strike rally Oxford 20060328.jpg|thumb|Chama cha wafanyikazi kilichoundwa na kikundi cha [[UNISON]] walipogoma]] * '''[[Sheria ya ajira]]''' ni somo la uhusiano wa mara tatu wa kiwandani kati ya mfanyikazi, muajiri na [[chama cha wafanyikazi]]. Hili linahusisha kupunguza [[kufanya biashara]] kwa pamoja, na haki ya [[kugoma]]. Sheria ya kuajiriwa kwa binafsi inaashiria haki za maeneo ya kazi, kama zile [[usalama wa kazi]], [[afya na usalama]] au [[mshahara wa chini zaidi]]. * '''[[Haki za kibinadamu]]''', [[Haki za kiraia na kisiasa|haki za kiraia]] na [[sheria ya haki za kibinadamu]] ni maeneo muhimu katika kumhakikishia kila mtu uhuru na haki za kimsingi, Haya yanapatikana katika maadiko kama vile [[Azimio la Ulimwenguni la Haki za Kibinadamu]], [[Mkataba wa Ulaya wa Haki za Kibinadamu]] (iliyoanzisha [[Mahakama ya Ulaya ya Haki za Kibinadamu]]) na [[Mswada wa Marekani wa Haki|Mswada wa Marekani wa Haki za Kibinadamu]]. [[Mkataba wa Lisbon]] unafanya [[Mkataba wa Haki za Msingi za Umoja wa Ulaya]] uwe na nguvu za kisheria katika nchi zote wanachama isipokuwa [[Polandi na Uingereza]].<ref>[https://web.archive.org/web/20080910001253/http://www.lawsociety.org.uk/documents/downloads/guide_to_treaty_of_lisbon.pdf A Guide to the Treaty of Lisbon], The Law Society</ref> * '''[[Utaratibu wa Kiraia]]''' na '''[[utaratibu wa jinai]]''' unahusisha kanuni ambazo mahakama lazima yafuate kadiri [[trial]] na rufaa zinapoendelea. Yote yanahusu haki ya raia kupata [[kuhukumiwa kwa haki]] au kesi yake kusikizwa kwa haki. * '''[[Ushahidi (sheria)|Ushahidi]]'''. Sheria ya ushahidi inahusu vifaa vinavyofaa kutumika mahakamani ili kesi ijengwe. * '''[[Sheria ya Uhamiaji]]''' na '''[[sheria ya utaifa]]''' zinahusu haki za wageni kuishi na kufanya kazi katika taifa ambalo si lao na kupata na kupoteza [[uraia]]. Yote yanahusu [[haki ya hifadhi]] na shida ya watu [[wasiokuwa na nchi]] * '''[[Usalama wa Kijamii]]'''. Sheria ya usalama wa kijamii inahusu haki za watu kuwa na bima ya kijamii, kama vile pesa zinazopewa watafuta kazi au faida za makazi. * '''[[Sheria ya familia]]''' inahusu kesi za [[ndoa]] na [[talaka]] proceedings, haki za watoto na haki za kuwa na mali na pesa ikiwa wenye kufanya ndoa watatengana. ;Sheria na biashara * '''[[Sheria ya kikampuni]]''' ilitokana na sheria ya amana, ikitegemea kanuni ya kutenganisha umiliki na udhibiti.<ref>Berle, ''Modern Corporation and Private Property''</ref> Sheria ya kisasa ya [[kampuni (sheria)|kampuni]] ilianza na [[Sheria ya Kampuni za Pamoja za Akiba ya mwaka 1856]], iliyopitishwa nchini Uingereza, ambayo iliwapa wawekezaji mbinu rahisi ya usajili ili kupata [[dhima ya kupimika]] chini ya dhana ya [[Mtu wa kisheria|mtu tofauti]] wa kampuni. * '''[[Sheria ya kibiashara]]''' inahusu mkataba tata wa mkataba na mali. Sheria ya [[shirika (sheria)|shirika]], [[sheria ya bima]], [[bili za kubadilishana]], [[ufilisi]] na [[Sheria ya kuufungwa kwa biashara]] na sheria ya uuzaji zote ni muhimu, na zinarudi nyuma hadi dhana ya ''[[Mfanyibiashara wa sheria|Lex Mercatoria]]'' ya zama za kati. [[Sheria ya Kuuza Bidhaa na Ukahaba wa Watoto ya Mwaka 1979|Sheria ya Kuuza Bidhaa]] ya Uingereza na [[Kodi Sawa ya Biashara]] ya Marekani ni mifano ya kanuni za kibiashara ya sheria ya kawaida * '''[[Sheria ya maji]]''' na '''[[Mkataba wa Umoja wa Mataifa kuhusu Sheria ya Maji|Sjeria ya Maji]]''' zinaweka muundo msingi wa biashara huru na biashara Duniani kote Baharini, ambapo yamo nje ya eneo la udhibiti wa nchi fulani. Makampuni ya meli yanafanya kazi kwa kutumia kanuni za kawaida za sheria ya biashara, ambazo zimefanywa kuwa jumla kwa soko la kimataifa. Sheria ya maji inajumuisha masuala muhimu kama vile kama vile [[kuokoa vifaa kutoka baharini]], [[Lien#|lieni za maji]], na majeraha kwa abiria. * '''[[Miliki Sheria]]''' inalenga aims at safeguarding creators and other producers of intellectual goods and services. These are legal rights ([[copyright]]s, [[trademark]]s, [[patent]]s, and [[related right]]s) which result from intellectual activity in the industrial, literary and artistic fields.<ref>WIPO, ''Intellectual Property'', 3</ref> * '''[[Fidia]]''' inashughulika na kupata mapato ya mtu mwingine, bali si [[fidia]] kwa hasara ya kibinafsi * '''[[Kutajirika isipofaa]]''' ndiyo nguzo ya tatu ya sheria ya raia (pamoja na mkataba na ukiukaji wa wajibu). Wakati ambapo mtu fulani ametajirishwa isipofaa (au kuna "kutokuwepo kwa msingi" wa biashara) kwa gharama ya mawingine, tukio hili linazalisha haki ya fidia ili kugeuza faida hiyo. ;Sheria na vikwazo [[Picha:1930-67B.png|thumb| Sakafu ya biashara ya [[Soko la Hisa la New York]] baada ya [[kuanguka kwa Wall Street mnamo mwaka wa 1929]], kabla ya sheria kali zaidi za [[vikwazo vya kibenki]] vilipoanza kutumika]] * '''[[Sheria ya kodi]]''' inahusu kanuni kuhusu [[kodi ya thamani iliyoongezwa]], [[kodi ya kampuni]], [[kodi ya mapato]]. * '''[[Kanuni za kibenki|Sheria za kibenki]]''' na [[kanuni za kifedha]] zinaweka viwango vya chini zaidi kuhusu idadi ya mtaji ambao benki zinaweza kuwa nao, na sheria kuhusu utendaji bora wa uwekezaji. Hili ni kwa minajili ya kuhakikisha ulinzi dhidi ya taabu za kiuchumi, kama vile[[Kunguka kwa soko la Wall Street mnamo mwaka wa 1929]]. * '''[[Vikwazo]]''' vinashughulika na utoaji wa [[huduma za umma]] na usimamizi wa [[vifaa vya umma]].'''[[Sheria ya maji]]''' ni mfano mmoja. Hasa tangu [[ubinafshaji]] uwe maarufu na uchukue usimamizi wa huduma kutoka kwa sheria ya umma, makampuni ya kibinafsi ambayo hapo yalikuwa yakifanya kazi iliyodhitiwa na serikali hapo awali yamefungwa na vyeo mbalimbali vya wajibu wa kijamii. [[Sera za Nishati|Nishati]], [[Ofgem|gesi]], [[sera za mawasiliano|mawasiliano]] na [[sheria ya maji|maji]] zinadhibitiwa na viwanda katika nchi nyingi za [[Shirika la Muungano wa Maendeleo ya Kiuchumi|OECD]]. * '''[[Sheria ya mashindano]]''', nchini Marekani inajulikana kama sheria [[dhidi ya amana]], ni eneo linalozidi kubadilika ambalo lilianza katika kutokana na amri za [[Roma ya Kale|Kirumi]] dhidi ya [[kuweka bei]] na mafundisho ya Uingereza ya [[biashara ya makini]]. Sheria ya kisasa ya mashindano inatokana na sheria za Marekani dhidi ya biashara za magendo na dhidi ya ukiritimba ([[Sheria ya Sherman]] na [[Sheria ya Clyaton]]) ya mwisho wa karne ya 20. Inatumika kudhibiti biashara zinazojaribu kutumia ushawishi wao wa kiuchumi kubadilisha biashra za sokoni bila kujali [[maslahi ya mnunuzi]]. * '''[[Kumlinda mnunuzi|Sheria ya mnunuzi]]''' inaweza kujumuisha chochote kuanzia kanuni kuhusu [[vifungu vya mikataba]] ambavyo si sawa hadi maelekezo kuhusu bima ya mizigo ya ndege. * '''[[Sheria ya mazingira]]''' inazidi kuwa muhimu, hasa katika mwanga wa [[Itifaki ya Kyoto]] na hatari inayoweza kutokana na [[mabadiliko ya hali ya anga]]. Ulinzi wa kimazingira pia intumika kuwaadhibu [[uharibifu wa mazingira|wanaoharibu mazingira]] katika mifumo ya kisheria ya kiinchi == Mifumo ya sheria == {{Main|Mifumo ya sheria duniani}} Kwa ujumla, mifumo ya kisheria inaweza kugawanywa kati ya mifumo ya kisheria ya kiraia na mifumo ya kisheria ya kawaida.<ref>Modern scholars argue that the significance of this distinction has progressively declined; the numerous [[legal transplants]], typical of modern law, result in the sharing by modern legal systems of many features traditionally considered typical of either common law or civil law (Mattei, ''Comparative Law and Economics'', 71)</ref> Maneno "sheria ya kiraia" yanayoashiria mfumo wa kisheria hayapaswi kuchanganyishwa na "sheria ya kiraia" kama kundi la masomo ya kisheria ambayo ni tofauti na [[sheria ya umma]] au ya jinai. Aina ya tatu ya mfumo wa kisheria—inayokubalika bado na baadhi ya nchi ambazo zina [[utengano wa kanisa na taifa]]—ni sheria sheria ya kidini, ambayo ina msingi wake katika [[maandiko ya kidini]]. Aina ya mfumo amabo nchi inatumia kutawala mara nyingi kudhamiriwa na historia yake, uhusiano wake na nchi zingine au kushikilia kwake kwa viwango vya kimataifa. [[Vyanzo vya sheria|Vyanzo]] ambavyo maneneo fulani ya kisheria hutumia kama kama zenye uwezo wa kuwa nguvu za kisheria ndizo sifa fafanuzi za mfumo wowote wa kisheria. Hata hivyo, uainishaji ni jambo la umbo kuliko maana, kwani sheria sawa mara nyingi hutawala. === Sheria ya kiraia === {{Main|Sheria ya kiraia}} [[Picha:Code Civil 1804.png|thumb|Ukurasa wa kwanza wa toleo la mwaka wa 1804 la [[Sheria za Kinapoleoni]]]] Sheria ya kiraia ni mfumo wa kisheria unaotumika katika nchi nyingi Duniani. Katika sheria ya kiraia vyanzo vinavyotambulika kama kuwa na mamlaka, ni, haswa, uundaji wa sheria—haswa [[Kuandika sheria (sheria)|sheria zilizoandikwa]] katika [[katiba]] au [[amri]] zinazopitishwa na serikali—na tamaduni.<ref>Civil law jurisdictions recognise custom as "the other source of law"; hence, scholars tend to divide the civil law into the broad categories of "written law" (''ius scriptum'') or legislation, and "unwritten law" (''ius non scriptum'') or custom. Yet they tend to dismiss custom as being of slight importance compared to legislation (Georgiadis, ''General Principles of Civil Law'', 19; Washofsky, ''Taking Precedent Seriously'', 7).</ref> Sheria za kuandikwa zinapatikana hata katika miaka mingi ya awali , huku mfano mmoja ukiwa [[Sheria ya Hammurabi|Codex Hammurabi]] ya [[sheria ya Kibebeli|Kibabeli]]. Mifumo ya sheria za kiraia ya kisasa inatokana na mazoezi ya kisheria ya [[Dola la Kirumi]] ambalo maadiko yake yalipatikana katika Ulaya ya [[Zama za Kati]]. Sheria ya Kirumu katika siku za [[Jamhuri ya Kiruma]] na Dola la Kirumi lilitegemea sana utaratibu, na ilikosa daraja la kitaaluma.<ref>Gordley-von Mehren, ''Comparative Study of Private Law'', 18</ref> Badala uake mtu wa kawaida aliyeitwa, ''iudex'', alichagukiwa kufanya uamuzi. Kesi za awali hazikuripotiwa, kwa hivyo sheria yoyote yenye msingi katika kesi iliyoibuka ilifichwa na hata kutotambulika.<ref>Gordley-von Mehren, ''Comparative Study of Private Law'', 21</ref> Kila kesi ilikuwa ilimuliwe upya kutokana na sheria za nchi, ambayo ni sawa na kupungua kwa umuhimu (kinadharia) wa uamuzi wa mahakimu kwa kesi za siku za usoni kwa mufumo ya kisheria siku za leo. Katika kipindi cha karne ya 6 NK katika [[Dola la Kibaizanti|Dola la Mashariki la Roma]], Kaisari [[Justinian I]] aliandika na kuzikusanya pamoja sheria ambazo zilikuwa zinapatikana hapo awali katika Roma, ambapo kile kilichobakia kilikuwa sehemu moja juu ya ishirini ya kiwango cha maandiko ya kisheria kutoka awali.<ref>Stein, ''Roman Law in European History'', 32</ref> Hili ikawa inafahamika kama ''[[Corpus Juris Civilis]]''. Kwa mujibu wa mwanahistoria mmoja wa kisheria, "Justinian alitazama kwa uangalifu hadi miaka ya dhahabu ya nyuma ya sheria ya Kirumi na alilenga kuirejesha hadi upeo wake wa karne tatu za awali."<ref>Stein, ''Roman Law in European History'', 35</ref> Wakati uo huo, Ulaya ya Magharibi ilitumbukia polepole katika [[Zama za Giza]], na haikuwa hadi karne ya 11ambapo wasomi katika [[Chuo Kikuu cha Bologna]] walipoyagundua upya maandiko yaliyokuwa yamepotea na kuyatumia kuzitafsiri sheria zao.<ref>Stein, ''Roman Law in European History'', 43</ref> Maandiko ya sheria za kiraia yenye msingi unaofanana kwa karibu na sheria ya Kirumu, sambamba na ushawishi mchache kutoka [[sheria za kidini]] kama vile [[sheria ya Kikanoni]] na [[Sharia|sheria ya Kiislamu]],<ref name>Badr, ''Islamic Law'', 187–198 [196–8]</ref><ref name="Makdisi"/> iliendelea kuenea kote baranii Ulaya hadi [[Zama za Kutaalamika|Kutaalmika]]; kisha, katika karne ya 19, Ufaransa, na [[Sheria iliyoandikwa ya Kiraia]], na Ujerumani, [[Bürgerliches Gesetzbuch]], zilifanya sheria zao zilizokuwa zimeandikwa kuwa za kisasa. Sheria hizi mbili zilizoandikwa zilisukuma vilivyo si tu mifumo ya kisheria ya nchi katika Bara Ulaya (kama vile Ugiriki), lakini pia tamaduni za kisheria za [[Sheria ya Ujapani|Ujapani]] na [[Korea ya Kusini|Kikorea]].<ref>Hatzis, ''The Short-Lived Influence of the Napoleonic Civil Code in Greece'', 253–263</ref><ref>Demirgüç-Kunt -Levine, ''Financial Structures and Economic Growth'', 204</ref> Leo, cnhi ambazo zina mifumo ya kisheria ya kiraia ni kama vile [[Sheria ya Urusi|Urusi]] na [[Sheria ya Demokrasia ya watu ya Uchina|Uchina]] na maeneo mengi ya Marekani ya [[Marekani ya Kati|Kati]] na [[Sheria ya Marekani ya Kusini|Marekani ya Kilatini]].<ref>[https://www.cia.gov/library/publications/the-world-factbook/fields/2100.html The World Factbook — Field Listing – Legal system] {{Wayback|url=https://www.cia.gov/library/publications/the-world-factbook/fields/2100.html |date=20181226012138 }}, CIA</ref> Marekani inafuata sheria ya kawaida inayofafanuliwa hapa chini. === Sheria ya kawaida na usawa === {{Main|Sheria ya kawaida}} [[Picha:King John signing the Great Charter (Magna Carta) by English School.png|thumb|Mfalme Yohana wa Uingereza anatia sahini Magna Carta]] Sheria ya kawaida na usawa ni mifumo ya kisheria ambapo uamuzi wa mahakama yanakubalika wazi kuwa vyanzo vya sheria."Mafundisho ya utangulizi", au ''[[stare decisis]]'' (Kilatini kwa "kusimama kwa uamuzi") unamaanisha kuwa sumauzi unaofanywa na mahakama yenye mamlaka kubwa yanafunga mahakama yenye mamlaka ya chini. Mifumo ya kisheria ya kawaida hutumia amri mara chache sana, zinazopitishwa na bunge, lakini huenda zikafanya jaribio ambalo si la kitaratibu kuandika sheria zao kuliko katika "mfumo wa sheria wa kiraia". Sheria ya kawaida ina asili yake nchini Uingereza na imerithiwa na karibu nchi zote ambazo hapo awali zilihusika na [[Dola la Uingereza]] (isipokuwa Malta, [[sHERIA YA|Scotland]], na jimbo la Marekani la [[Sheria ya Louisiana|Louisiana]], na jimbo la Kanada la [[sheria ya Quebec|Quebec]]). Katika Uingereza wakati wa zama za kati, [[Ushindi wa Norman dhidi ya Uingereza|ushindi wa Norman]] ulisababisha kuungana kwa desturi mbalimbali za kikabila na hivyo basi kuunda sheria ya "kawaida" ya nchi yote. Labda ikisukumwa na [[Sheria ya Kiislamu|mazoea ya kisheria ya Kiislamu]] wakati wa [[Krusedi]],<ref name=Makdisi>Makdisi, ''The Islamic Origins'', 1635–1739</ref> sheria ya kawaida iliendelea ambapo Mfalme wa Kiingereza alikuwa amefanywa kuwa dhaifu na gharama kubwa ya vita vywa kudhibiti sehemu kubwa za Ufaransa. [[Yohana wa Uingereza|Mfalme Yohana]] alikuwa amelazimishwa na mabaroni wake kutia saini hati iliyoweka vikwazo kwa mamlaka yake ya kupisha sheria. "Mkataba huu mkuu" au ''[[Magna Carta]]'' wa mwaka 1215 pia ulihitaji jopo la mahakimu wa Mfalme kufanya mikutano yao ya kimahakama na uamuzi wao katika "mahali maalum" badala ya kutoa haki ya kibepari katika maeneo yaliyokuwa magumu kutabiri kote.<ref>[http://www.fordham.edu/halsall/source/magnacarta.html Magna Carta] {{Wayback|url=http://www.fordham.edu/halsall/source/magnacarta.html |date=20140910155351 }}, Fordham University</ref> Kundi la mahakimu walsomi na waliokolea walipata jukumu muhimu katika kuunda sheria chini ya mfumo huu, na ikilinganishwa na wenzao Barani Ulaya mahakama ya Uingereza ilikuwa na urasimu mwingi zaidi. Kwa mfano, mnamo mwaka wa 1297, wakati ambapo mahakama kuu ya Ufaransa yalikuwa na mahakimu hamsini na wawili, [[Mahakama ya Uingereza ya Maombi ya Kawaida]] yalikuwa na watano.<ref>Gordley-von Mehren, ''Comparative Study of Private Law'', 4</ref> Mahakama haya yenye nguvu na yaliyoshikamana yalisababisha mfumo wa kikiritimba.<ref>Gordley-von Mehren, ''Comparative Study of Private Law'', 3</ref> Kufuatana na hilo, kadiri wakati ulivyopita, idadi iliyoongezeka ya raia waliomba Mfalme kupuuza sheria ya kawaida, na kwa niaba ya Mfalme [[Bwana Chansela]] alitoa uamuzi kufanya kile ambacho ni sawa kwa kila kesi. Kuanzia wakati wa [[Thomas More]], wakili wa kwanza kuteuliwa kama Bwana Chansela, mwili wa kimfumo wa usawa uliongezeka kando ya sheria ya kawaida yenye ukiritimba, na ilianzisha [[Mahakama yake ya Chancery]]. Mwanzoni, usawa ulikosolewa kuwa ulikosa kukosa utaratibu, na kuwa ulibadilika kulingana na urefu wa mguu wa Chansela.<ref>Pollock (ed) ''Table Talk of [[John Selden]]'' (1927) 43; "Equity is a roguish thing. For law we have a measure... equity is according to the conscience of him that is Chancellor, and as that is longer or narrower, so is equity. 'Tis all one as if they should make the stadard for the measure a Chancellor's foot."</ref> Lakini baada ya muda iliunda [[Kanuni za usawa|kanuni]], hasa chini ya [[John Scott, Ali wa kwanza wa Eldon|Bwana Eldon]].<ref>''[[Gee v Pritchard]]'' (1818) 2 Swans. 402, 414</ref> Katika karne ya 19 mifumo hiyo miwili iliunganishwa pamoja. Katika kuendeleza sheria ya kawaida na usawa, waandishi wa kitaaluma wamekuwa na jukumu muhimu. [[William Blackstone]], kuanzia kipindi cha 1760, alikuwa mwanachuoni wa kwanza kuelezea na kufunza usawa.<ref>Blackstone, Commentaries on the Laws of England, [http://www.yale.edu/lawweb/avalon/blackstone/bk1ch1.htm Book the First – Chapter the First] {{Wayback|url=http://www.yale.edu/lawweb/avalon/blackstone/bk1ch1.htm |date=20130329045450 }}</ref> Lakini kwa kuelezea tu, wasomi walitafuta melezo na miunso msingi walibadilisha polepole jinisi sheria ilivyofanya kazi.<ref>Gordley-von Mehren, ''Comparative Study of Private Law'', 17</ref> === Sheria ya kidini === {{Main|Sheria ya kidini}} Sheria ya kidini inatokana na maagizo ya [[dini]]. Baadhi ya mifano ni [[Halakha]] ya [[Uyahudi|Kiyahudi]] na [[Sharia]] ya [[Uislamu]] — ambazo zote mbili zinamaanisha "njia ya kufuata" — huku [[sheria za Kanisa]] za [[Ukristo]] nazo hutumika katika [[madhehebu]] machache, kama vile [[Kanisa Katoliki]], [[Kanisa la Kiorthodoksi]] na la [[Anglikana]]. Mara nyingi dini inadai kutobadilika kwa sheria, kwa sababu [[neno la Mungu]] haliwezi kufanyiwa marekebisho wala kupingwa na mahakimu au serikali. Hata hivyo mfumo fasaha wa sheria kwa jumla unahitaji upanuzi upande wa [[binadamu]]. Kwa mfano, [[Torati]] au Vitabu Vitano vya [[Musa]] katika [[Agano la Kale]]. Vitabu hivyo vina kanuni na sheria za msingi za Uyahudi, ambayo baadhi ya jamii ya Kiisraeli huchagua kutumia. [[Halakha]] ni kanuni ya sheria za Kiyahudi inayofanya muhtasari wa baadhi ya ufafanuzi wa kitabu cha [[Talmud]]. Hata hivyo, [[Sheria za Israeli]] zinaruhusu [[mlalamikaji]] kuchagua mbinu za kidini ikiwa tu anataka. Mfano mwingine ni [[Korani]] ambayo ina sheria, na inakuwa kama chanzo cha sheria zaidi kupitia ufafanuzi,<ref>Glenn, ''Legal Traditions of the World'', 159</ref> ''[[Qiyas]]'' (kulinganisha), ''[[Ijma]]'' (kufikia muafaka) na [[yaliyokwishatokea]]. Hili hasa hupatikana katika mkusanyo wa sheria na falsafa ya kisheria inayojulikana kama [[Sharia]] na [[Fiqh]]. [[Picha:1879-Ottoman Court-from-NYL.png|thumb|left|Kesi katika [[Dola la Ottoman]], mwaka [[1879]], wakati sheria ya kidini ilitumika chini ya [[Mecelle]].]] Hadi [[karne ya 18]], Sharia ilitekelezwa kote katika [[Ulimwengu wa Kiislamu]] katika mfumo ambao haukuwa umeandikwa kwa ufasaha, huku sheria ya [[Mecelle]] ya [[Dola la Ottoman]] katika [[karne ya 19]] ilikuwa ya kwanza kuandika vipengele vya Sharia. Tangu miaka ya kati ya 1940, majaribio yamefanywa, katika nchi nyingi, kufanya sheria hizo zifanane zaidi na hali na dhana za kisasa.<ref name="AA">Anderson, ''Law Reform in the Middle East'', 43</ref><ref>Giannoulatos, ''Islam'', 274–275</ref> Katika nyakati za sasa, mifumo ya kisheria katika mataifa mengi ya Kiislamu hutegemea sheria za kiraia na sheria ya kawaida na pia sheria na tamaduni za Kiislamu. Katiba za baadhi ya nchi za Kiislamu, kama vile [[Misri]] na [[Afghanistan]], zinatambua [[Uislamu]] kama sheria ya taifa, hivyo kuyafanya mabunge katika nchi hizo yasiwe na budi kufuata Sharia.<ref>Sherif, ''Constitutions of Arab Countries'', 157–158</ref> [[Saudia]] inatambua Korani kama katiba, na inatawaliwa kwa msingi wa sheria ya Kiislamu.<ref name = Jurist>[http://jurist.law.pitt.edu/world/saudiarabia.htm Saudi Arabia] {{Wayback|url=http://jurist.law.pitt.edu/world/saudiarabia.htm |date=20060830232216 }}, Jurist</ref> [[Iran]] pia imeshuhudia kurudi kwa sheria ya Kiislamu katika mfumo wake wa kisheria baada ya mwaka [[1979]].<ref>Akhlagi, ''Iranian Commercial Law'', 127</ref> Katika miongo michache iliyopita, mojawapo ya tofauti kuu ya harakati ya [[mwamko wa Kiislamu]] imekuwa wito wa kuirejesha Sharia, wito ambao umeibua kiasi kikubwa cha maandishi na kuathiri [[siasa]] duniani.<ref name="H1">Hallaq, ''The Origins and Evolution of Islamic Law'', 1</ref> == Nadharia ya sheria == === Historia ya Sheria === {{Main|Historia ya sheria}} [[Picha:Milkau Oberer Teil der Stele mit dem Text von Hammurapis Gesetzescode 369-2.jpg|thumb|Mfalme [[Hammurabi]] anaonyeshwa [[Sheria ya Hammurabi|mkusanyiko wa sheria]] na mungu wa jua wa Kimesopotamia [[Shamash]], ambaye pia anatambulika kama mungu wa haki]] Historia ya sheria inashikamana kwa karibu na [[maendeleo]] ya [[ustaarabu]]. Sheria ya [[Misri ya Kale]], iliyorudi nyuma mbali hadi mnamo [[3000 KK]], ilikuwa na mkusanyiko wa sheria ambao huenda ulikuwa umegawanjwa katika vitabu kumi na viwili. Ilizingatia dhana ya [[Ma'at]], iliyokuwa na sifa ya mapokeo, [[hotuba]] za [[kushawishi]], usawa wa kijamii na [[uaminifu]].<ref>{{cite encyclopedia|last=Théodoridés|title = law | encyclopedia = Encyclopedia of the Archaeology of Ancient Egypt}}</ref><ref>VerSteeg, ''Law in ancient Egypt''</ref> Kufikia [[karne ya 22 KK]], [[mtawala]] wa zamani wa [[Wasumeri|Kisumeri]], [[Ur-Nammu]] alikuwa ameandaa [[Mkusanyiko wa sheria wa Ur-Nammu|mkusanyiko wa sheria]], ambao ulihusisha kauli za [[Mjadala|kimjadala]] ("ikiwa ... basi ..."). Kufikia mwaka wa [[1760 KK]], Mfalme [[Hammurabi]] aliboresha zaidi [[Sheria ya Babeli]], kwa kuikusanya na kujandika katika [[jiwe]] kubwa. Hammurabi aliweka nakala kadhaa za jiwe lile kote katika [[milki ya Babeli]] kama [[stelae]], ili watu wote waitazame; hii ilikuja kufahamika kama [[Mkusanyiko wa Sheria za Hammurabi]]. Nakala iliyobaki ambayo haijaharibika sana wa stelae hizi iligunduliwa katika [[karne ya 19]] na [[Waingereza]] wasomi wa mambo ya [[Assyria|milki ya Assyria]], na tangu wakati huo imenakiliwa upya na kutafsiriwa katika [[lugha]] mbalimbali, zikiwemo [[Kiingereza]], [[Kijerumani]] na [[Kifaransa]].<ref>Richardson, ''Hammurabi's Laws'', 11</ref> [[Agano la Kale]] lilianza mnamo [[1280 KK]], na linachukua umbo la [[amri]] za [[Maadili|kimaadili]] kama mapendekezo ya [[jamii]] nzuri. [[Miji-dola|Mji-dola]] wa [[Ugiriki ya Kale]], [[Atheni ya Kale]] kuanzia [[karne ya 8 KK]] ilikuwa jamii ya kwanza kuwa na msingi wake katika kuhusisha raia kwa upana; isipokuwa [[wanawake]] na daraja la [[watumwa]]. Hata hivyo, [[Atheni]] haikuwa na sayansi ya kisheria, na hapakuwa na neno la "sheria" isipokuwa kama dhana ya kiakili tu.<ref>Kelly, ''A Short History of Western Legal Theory'', 5–6</ref> Bado [[sheria ya Ugiriki wa Kale]] ilikuwa na uvumbuzi mkubwa wa [[Katiba ya Waatheni|kikatiba]] katika kuendeleza [[Demokrasia ya Atheni|demokrasia]].<ref>Ober, ''The Nature of Athenian Democracy'', 121</ref> [[Sheria ya Kirumi]] ilisukumwa sana na [[falsafa]] ya Kigiriki, lakini maelezo yake ya kina yaliendelezwa na wanasheria wa kitaaluma, na yalikuwa magumu sana.<ref>Kelly, ''A Short History of Western Legal Theory'', 39</ref><ref>Stein, ''Roman Law in European History'', 1</ref> Katika kipindi cha karne zilizopita kati ya kupanda na kushuka kwa [[Dola la Roma]], sheria imebadilishwa ili kukabiliana na hali za kijamii zilizokuwa zikibadilika, na ilikusanywa na kuandkiwa vilivyo wakati wa utawala wa [[kaisari]] [[Justinian I]].<ref name="St107">Kama mfumo wa kisheria, Sheria ya Kirumi imeathiri moja kwa moja sheria za duniani kote. Pia ni sehemu ya msingi ya mkusanyiko wa sheria wa nchi nyingi za [[Bara|barani]] [[Ulaya]], na imekuwa muhimu katika kuunda kwa dhana ya utamaduni sawa Ulaya (Stein, ''Sheria ya Kirumi katika Historia ya Ulaya'', 2, 104–107).</ref> Ingawa ilipungua kwa umuhimu mwanzoni mwa [[Karne za Kati]], Sheria ya Kirumi iligunduliwa upya wakati wa [[karne ya 11]] ambapo wasomi walianza kutafiti mkusanyiko wa sheria za Kirumi na kuyatumia mawazo yao. Katika Uingereza ya Zama za Kati, mahakimu wa Mfalme waliunda mwili wa [[utangulizi]], ambao baadaye ulijulikana kama [[sheria ya kawaida]]. ''[[Sheria ya biashara]]'' ya Ulaya mzima iliundwa ili kuwapa [[wafanyabiashara]] uwezo wa kufanya biashara kwa kutumia viwango sawa vya mazoezi; badala ya kutumia sheria za kimtaa zenye pande nyingi. Hiyo ''Lex Mercatoria'', mtangulizi wa sheria ya kisasa ya biashara, ilihimiza [[uhuru wa mkataba]] na kuwekwa mbali kwa mali.<ref>Sealey-Hooley, ''Commercial Law'', 14</ref> Kadiri [[utaifa]] ulipozidi katika [[karne za 18]] na 19, ndipo ''Lex Mercatoria'' ilipozidi kujumuishwa katika sheria za kimanispaa za nchi mbalimbali chini ya mkusanyiko mpya wa sheria za kiraia. [[Mkusanyiko wa Sheria za Napoleoni]] na sheria za [[Bürgerliches Gesetzbuch|Kijerumani]] ulikuwa na ushawishi mkubwa zaidi. Ikitofautishwa na sheria ya kawaida ya Uingereza, ambayo ina idadi kubwa ya sheria za kesi, mikusanyiko ya sheria katika vitabu vidogo ni rahisi kuuza nje ili mahakimu waweze kuitumia. Hata hivyo, hivi leo kuna ishara kuwa sheria ya kiraia na sheria ya kawaida zinazidi kukaribiana.<ref>Mattei, ''Comparative Law and Economics'', 71</ref> Sheria ya Umoja wa Ulaya imekusanywa katika mikataba, lakini huendelezwa kupitia utangulizi unaofanywa na [[Mahakama ya Ulaya ya Haki]]. [[Picha:Constitution of India.jpg|thumb|left|[[Katiba ya nchi ya Uhindi]] ndiyo katiba ndefu zaidi iliyoandikwa kwa nchi, ikiwa na Ibara 444, Ibara 12 ndogo, na marekebisho mengi na maneno 117,369]] [[Sheria ya Kiislamu]] na [[Fiqh|falsafa ya sheria]] zilianza katika kipindi cha Zama za Kati.<ref name="Badr">Badr, ''Islamic Law'', 187–198</ref> Mbinu ya kisheria ya utangulizi na kufikiria kupitia mlinganisho (''[[Qiyas]]'') iliyotumika katika sheria ya mapema ya Kiislamu ilifanana na na ile ya baadaye ya mfumo wa [[Sheria ya Uingereza|Sheria ya Kawaida ya Uingereza]].<ref name=Gamal>Justice Gamal Moursi Badr argues that Islamic law may "be called a [[lawyer]]'s law if common law is a [[judge]]'s law"(Badr, ''Islamic Law'', 187–198, El-Gamal, ''Islamic Finance'', 16).</ref> Hii ilitumika hasa katika shule ya [[Maliki]] ya sheria ya Kiislamu iliyopatikana sana katika eneo la Afrika Kasakazini, [[Al-Andalus|Uhispania wa Kiislamu]] na baadaye [[Sicily ya Kiemereti]]. Kati ya karne za 8 na 11, sheria ya Maliki iliendeleza [[taasisi]] nyingi zilizokuwa sambamba na taasisi za baadaye za sheria ya kawaida.<ref>The "royal English contract protected by the action of debt is identified with the Islamic ''Aqd'', the English [[assize of novel disseisin]] is identified with the Islamic ''Istihqaq'', and the English jury is identified with the Islamic ''Lafif''". Other parallels include "the [[scholastic method]], the license to teach" (''[[Ijazah]]''), the "[[law school]]s known as [[Inns of Court]] in England and ''[[Madrasah|Madrasas]]'' in Islam", and the [[Agency (law)|agency]] (''[[Hawala]]'') and [[trust law]] (''[[Waqf]]'') (Gaudiosi, ''The Influence of the Islamic Law '', 1231–1261; Makdisi, ''The Islamic Origins'', 1635–1739).</ref> Sheria ya kale ya [[Sheria ya Uhindi|Uhindi]] na [[Sheria ya uchina|Uchina]] zinawakilisha mapokeo tofauti ya sheria, na kihistoria yamekuwa na [[shule]] huru za kinadharia na mazoezi. ''[[Arthashastra]]'', ambayo pengine iliandikwa mnamo [[100]] [[BK]] (ingawa ina maandiko ya awali kidogo), na ''[[Manusmriti]]'' (100–[[300]]) yalikuwa mikataba ya uanzilishaji nchini Uhindi, na ilikuwa na maandiko yanayofikiriwa kuwa wongofu wenye mamlaka wa kisheria.<ref>For discussion of the composition and dating of these sources, see Olivelle, ''Manu's Code of Law'', 18-25.</ref> Falsafa kuu ya Manu ilikuwa kuvumiliana na [[Mfumo wa Viama Vingi (falsafa ya kisheria)|Mfumo wa Vyama Vingi]], na ilitajwa kote katika eneo la Asia ya Kusini Mashariki.<ref>Glenn, ''Legal Traditions of the World'', 276</ref> Mapokeo haya ya [[Uhindi|Kihindu]], pamoja na sheria ya Kiislamu, yalibadilishwa na na sheria ya kawaida wakati ambapo Uhindi ilifanywa kuwa sehemu ya [[Dola la Uingereza]].<ref>Glenn, ''Legal Traditions of the World'', 273</ref> [[Malaysia]], [[Brunei]], [[Singapore]] na [[Hong Kong]] pia ilianza kutumia sheria ya kawaida, Mapokeo ya sheria ya [[Asia ya Kusini]] yanaangazia mkusanyiko maalum wa ushawishi wa kidunia na kidIni.<ref>Glenn, ''Legal Traditions of the World'', 287</ref> [[Ujapani]] ilikuwa nchi ya kwanza kuufanya mfumo wake wa sheria uwe wa kisasa sambamba na ule wa nchi za magharibi, kwa kuagiza sehemu za mkusanyiko wa sheria za [[Mkusanyiko wa Sheria|Ufaransa]], lakini hasa mkusanyiko wa sheria za Kijerumani.<ref>Glenn, ''Legal Traditions of the World'', 304</ref> Hili lilionyesha kwa kiwango fulani hadhi ya Ujerumani kama nguvu yenye uwezo mkubwa zaidi katika kipindi cha mwisho cha karne ya 19. Pia, [[sheria ya mapokeo ya Uchina]] ilifungua njia kwa kubadilishwa na nchi za magharibi kuelekea miaka ya mwisho ya [[Nasaba ya Qing|nasaba ya Ch'ing]] kupitia njia ya mkusanyiko wa sheria tatu za kibinaFsi zilizokuwa na msingi katika muundo wa Ujapani wa sheria ya Ujerumani.<ref>Glenn, ''Legal Traditions of the World'', 305</ref> Leo sheria ya [[Taiwan]] inabaki na mshikamano wa karibu zaidi na mkusanyiko wa sheria kutoka kipindi hicho, kwa sababu ya mgawanyiko kati ya wanataifa wa [[Chiang Kai-shek]], ambao walitoroka kutoka sehemu hiyo, na [[wakomunisti]] wa [[Mao Zedong]] waliopata ushindi wa kudhibiti bara mnamo mwaka wa [[1949]]. Muundombinu wa sasa wa Jamhuri ya Watu wa Uchina ilishawishika pakubwa na [[Sheria ya Kisoshalisti]] ya [[Umoja wa Kisovyeti]], inayopea sheria ya utawala umuhimu mwingi kuliko haki za sheria ya kibinafsi.<ref>Glenn, ''Legal Traditions of the World'', 307</ref> Kwa sababu ya kuongezeka kwa kasi kwa viwanda, leo Uchina inapitia machakato wa wa marekebisho, angalau katika nyanja ya haki za kiuchumi, ikiwa si haki za kijamii na kisiasa. Sheria mpya ya mkataba ya mwaka wa 1999 ilikuwa ishara ya kusonga mbali na kuwa na utawala mwingi.<ref>Glenn, ''Legal Traditions of the World'', 309</ref> Isitoshe, baada ya mazungumzo yaliyodumu miaka kumi na mitano, mnamo mwaka 2001 Uchina ilijiunga na [[Shirika la Biashara Duniani]].<ref>Farah, ''Five Years of China WTO Membership'', 263–304</ref> === Falsafa ya sheria === {{Main|Falsafa ya sheria}} [[Falsafa]] ya sheria kwa kawaida inaitwa jurisprudensi. Jurisprudensi unaozidi kuongezka wenyewe ni [[falsafa ya kisiasa]], na unauliza "sheria inafaa kuwa nini?", huku jurisprudensia ya uchambuzi inauliza "sheria ni nini?". Jibu la [[utumikaji|kiutumikaji]] la [[John Austin (mwanafalsafa wa kisheria)|John Austin]] linajibu kuwa sheria ni "amri, zinazoandamana na matishio ya vkwazo, kutoka kwa mtawala, ambaye watu wote wamezoea kumtii".<ref name="jap">Bix, [http://plato.stanford.edu/entries/austin-john/#3 John Austin]</ref> Mawakili wa [[sheria ya kimaumbile]] kwa upande mwingine, kama vile [[Jean-Jacques Rousseau]], wanadokeza kwamba sheria inaangazia sheria isiyobadilika ya tabia ya kimaumbile. Dhana ya "sheria ya kimaumbile" iliibuka katika [[falsafa ya Kigiriki]] ya zamani kwa wakati mmoja na kwa pamoja na dhana ya haki, na iliingia mkondo wa [[utamaduni wa Magharibi]] kupitia maandiko ya [[Thomas Aquinas]] na maoni ya [[Falsafa ya mapema ya Kiislamu|mwanafalsafa wa Kiislamu]] na mwanasheria [[Averroes]].<ref>Roeber, ''What the Law Requires'', 887</ref><ref>Stone, ''Human Law and Human Justice'', 14, 51</ref> [[Hugo Grotius]], mwanzilishi wa mfumo uliotegemea dhana za kiakili pekee ya sheria ya kimaumbile, alidokeza kuwa sheria inatokana na msukumo wa kijamii—jinsi Aristotle alivyokuwa amesema—na kufikiria.<ref>[[Fritz Berolzheimer]], ''The World's Legal Philosophies'', 115–116</ref> [[Immanuel Kant]] aliamini kuwa amri ya kimaadili inahitaji sheria "zichaguliwe kana kwamba zinafaa kushikilia kama sheria za ilimwenguni kote za kimaumbile".<ref>[[Immanuel Kant|Kant, Immanuel]], ''Groundwork of the Metaphysics of Morals'', 42 (par. 434)</ref> [[Jeremy Bentham]] na mwanafunzi wake Austin, wakimfuata [[David Hume]], waliamini kuwa hili liliongeza utata wa [[Utata wa kilicho-na kinachofaa kuwepo|"kilicho" na kile ambacho "kinafaa kuwepo"]]. Bentham na Austin walisisitiza kuwe na sheria ya [[Uchanya wa sheria|uchanya]]; na kuwa sheria ya kweli ni tofauti kabisa na "maadili".<ref>Green, [http://plato.stanford.edu/entries/legal-positivism/ Legal Positivism]</ref> Kant pia alikosolewa na [[Friedrich Nietzsche]], ambaye alikataa kanuni ya usawa, huku akiamini kuwa sheria hutokana na [[nia kwa nguvu]], na haiwezi fanywa kuwa ya "kimaadili" au "utovu wa nidhamu".<ref>Nietzsche, ''Zur Genealogie der Moral'', Second Essay, 11</ref><ref>Kazantzakis, ''Friedrich Nietzsche and the Philosophy of Law'', 97–98</ref><ref>Linarelli, ''Nietzsche in Law's Cathedral'', 23–26</ref> Mnamo mwaka wa 1934, mwanafalsafa wa Kiaustria, [[Hans Kelsen]], alizidi na mapokeo ya uchanya katika kitabu chake ''[[Nadharia Safi ya Sheria]]''.<ref>Marmor, [http://plato.stanford.edu/entries/lawphil-theory/ The Pure Theory of Law]</ref> Kelsen aliamini kuwa ingawa sheria ni tofauti na maadili, inapewa "ukawaida"; kumaanisha kuwa tunfaa kuitii. Ingawa sheria ni taarfa chanya za "ni" (k.m. faini ya kuendesha kwa kurudi nyuma katika barabara kuu ''ni'' [[Euro|€]]500); hii sheria inatuelezea kile "tunachofaa" kutenda. Kwa hivyo kila mfumo wa sheria unaweza kudadisiwa kuwa na kanuni ya msingi (''[[Grundnorm]]'') ianyotupea amri ya kutii. Mpinzani mkuu wa Kelsen, [[Carl Schmitt]], alikataa uchanya na dhana ya [[utawala wa sheria]] kwa sababu hakukubali umuhimu wa kanuni za kidhana za Uchanya badala ya mitazamo na uamuzi bayana wa kisiasa.<ref name=">Bielefeldt, ''Carl Schmitt's Critique of Liberalism'', 25–26</ref> Kwa hiyo, Schmitt alipendekeza falsafa ya sheria ya maalum ([[hali ya dharura]]), ambayo ilikanusha kuwa kanuni za kisheria zingezunguka uzoefu wote wa kisiasa.<ref name="F171">Finn, ''Constitutions in Crisis'', 170–171</ref> [[Picha:Jeremy Bentham by Henry William Pickersgill detail.jpg|thumb|Nadharia za Bentham za utumikiaji zilibaki kimya katika sheria hadi karne ya 20]] Baadaye katika karne ya 20, [[H. L. A. Hart]] alimshambulia Austin kwa kurahisisha kwake kwa suala hilo na Kelsen kwa kutunga kwake kwa mambo ya kihadithi katika kitabu cha ''[[Dhana ya Sheria]]''.<ref>Bayles, ''Hart's Legal Philosophy'', 21</ref> Hart alidokeza kuwa sheria ni mfumo wa kanuni, zilizogawanywa kuwa (kanuni za maadili) ambazo ndizo za kimsingi na sheria za upili (zinazowalenga maafisa kusimamia kanuni msingi). Kanuni za upili zimegawanywa zaidi kuwa sheria za uamuzi (kutatua migogoro ya kisheria), kanuni za mabadiliko (zinazoruhusu sheria kuwa tofauti) na sheria ya utambuzi(inayoruhusu sheria kutambulika kama halali). Wawili kati ya wanafunzi wa Hart waliendeleza mjadala: Ktaika kitabu chake ''Dola la Sheria'', [[Ronald Dworkin]] alimshabulia Hart na wachanya kwa kukataa kwao la kufanya sheria iwe suala la kimaadili. Dworkin anadokeza kuwa sheria ni dhana ya "[[utafsirishaji (sheria)|kitafsiri]]",<ref>Dworkin, ''Law's Empire'', 410</ref> inayowataka mahakimu kupata suluhisho bora zaidi kwa mgogoro wa kisheria, kwa mujibu wa mila zao. [[Joseph Raz]], kwa upande mwingine, anawataka alitetea mtazamo wa kichanya na kukosoa mtazamo wa Hart wa "nadharia laini ya kijamii" katika kitabu chake ''Mamlaka ya Sheria''.<ref name="jra">Raz, ''The Authority of Law'', 3–36</ref> Raz anadokeza kuwa sheria ni mamlaka, yanayotambulika kupitia vyanzo vya kijamii na bila kurejelea hoja za kimaadili. Katika maoni yake, uainishaji wowote wa kanuni zozote zaidi ya majukumu yao kama vifaa vya kimamlaka katika upatanisha ni bora yaachiwe [[elimu ya jamii]], badala ya falsafa ya sheria.<ref>Raz, ''The Authority of Law'', 37 etc.</ref> === Uchambuzi wa kiuchumi wa sheria === {{Main|Sheria na uchumi}} Katika karne ya 18 [[Adam Smith]] aliwasilisha msingi wa kifalsafa wa kuelezea uhusiano kati ya sheria na uchumi.<ref>According to Malloy (''Law and Economics'', 114), Smith established "a classical liberal philosophy that made individuals the key referential sign while acknowledging that we live not alone but in community with others".</ref> Taaluma hiyo ilitokana na mchango wa ukosoaji dhidi ya vyama vya wafanyikazi na [[sheria dhidi ya amana]] nchini Marekani. Watetezi wa taaluma hii waliokuwa na ushawishi mkubwa zaidi, kama vile [[Richard Posner]] na [[Oliver E. Williamson|Oliver Williamson]] na kinachojulikana kama [[Shule ya Chicago (uchumi)|Shule ya Chicago]] ya wanauchumi na mawakili ikiwemo [[Milton Friedman]] na [[Gary Becker]], kwa jumla ni watetezi wa [[uouguzaji wa udhibiti]] na [[ubinafsishaji]], na ni maadui wa udhibiti wa serikali au kile wanachokiona kuwa vikwazo dhidi ya unedeshaji wa ma[[soko huru]].<ref>Jakoby, ''Economic Ideas and the Labour Market'', 53</ref> [[Picha:Richard-A-Posner.jpg|thumb|left|[[Richard Posner]], mmoja wa watetezi wa [[Chuo cha Chicago (uchumi)|Chuo cha Chicago]], huandika blogu pamoja na [[Gary Becker]] mwanauchumi ambaye ni mshindi wa [[Tuzo la Benki ya Uswidi]].<ref>{{cite web |url=http://www.becker-posner-blog.com/ |title=The Becker-Posner Blog |accessdate=2007-02-03 |archive-date=2011-02-23 |archive-url=https://web.archive.org/web/20110223220214/http://www.becker-posner-blog.com/ |url-status=dead }}</ref>]] Mchambuzi maarufu zaidi wa kiuchumi wa sheria ni mshindi wa [[Tujo la Nobel la Uchumi|Tuzo la Nobel]] la mnamo 1991 [[Ronald Coase]], ambaye makala yake makuu ya kwanza, ''[[Hali ya Kampuni]]'' (1937), kulidokeza sababu za kuwepo kwa makampuni mbalimbali (makampuni, ubia, n.k.) ndiyo kuwepo kwa [[gharama za biashara]].<ref>Coase, ''The Nature of the Firm'', 386–405</ref> [[Homo economicus|Binadamu ambao hufikiria kawaida]] hufanya biashara kupitia mikataba ya bilaterala katika masoko wazi hadi wakati ambapo gharama ya biashara kunamaanisha kuwa kutumia makampuni ya kihalmasahhuri ili kuzalisha bidha ni ya ufanisi mwingi zaidi.Makala yake makuu ya pili, ''[[Shida ya Gharama ya Kijamii]]'' (1960), yalidokeza kuwa tunaishi katika Dunia bila gharama za kibiashara, watu ambao [[kuongea kuhusu gharama|huongea kuhusu gharama]] pamoja wanatengeneza mgao sawa wa rasilimali, buila kujali jinsi mahakama yanavyoweza kuamua katika migogoro kuhusu mali.<ref>Coase, ''The Problem of Social Cost'', 1–44</ref> Coase alitumia mfano wa kesi ya [[kero]] iliyoitwa ''[[Sturges dhidi ya Bridgman]]'', ambapo mtengenezaji peremende ambaye alipiga kelele nyingi na daktari mtulivu walikuwa majirani na walienda mahakamani ili wajue nani kati yao ndiye angefa kuhama.<ref name="Sturges"/> Coase alisema kuwa bila kujali ikiwa hakimu aliamua kuwa mtengenezaji peremende angefaa kuwacha kutumia mashine zake, au ikiwa ingembidi daktari kuvumilia kelele ile, wote wawili wangefikia mapatano ya pamoja kuhusu nani ndiye angefaa kuhama ambayo yanafikia matokeo sawa na mgawanyo wa rasilimali. Ni kuwepo tu kwa [[bei za biashara]] kunaoweza kuzuia hili.<ref>Coase, ''The Problem of Social Cost'', IV, 7</ref> Kwa hivyo sheria infaa kutazamia kile ambacho ''huenda kikafanyika'', na kuongozwa na ufumbuzi wenye [[ufanisi (uchumi)|ufanisi]]. Wenye kuunda mipango serikalini wanaamini wazo kwamba sheria na vikwazo si muhimu au zenye ufanisi katika kuwasaidia watu.<ref>Coase, ''The Problem of Social Cost'', V, 9</ref> Coase na wengine kama yeye walitaka mabadiliko ya mbinu, ili kuweka mzigo wa ushahidi katika serikali iliyokuwa ikiingilia soko, kwa kuchambua gharama za hatua.<ref>Coase, ''The Problem of Social Cost'', VIII, 23</ref> === Elimujamii ya sheria === {{Main|Elimujamii ya sheria}} Somo la kijamii la sheria ni taaluma pana ya masomo inayotazama mwingiliano kati ya sheria na jamii na inahusiana kwa karibu na falsafa ya sheria, uchambuzi wa kiuchumi wa sheria na masomo maalum zaidi kama [[somo la jinai]].<ref name="Jary">Jary, ''Collins Dictionary of Sociology'', 636</ref> Taasisi za [[ujenzi wa jamii]] na mifumo ya kisheria ni maeneo muhimu ya uchunguzi wa taaluma hii. Mwanzoni, wananadharia wa kisheria walishuku taaluma hii. Kelesen alimshambuliwa mmoja wa waanzilishi wake, [[Eugen Ehrlich]], ambaye alitaka kuweka wazi tofauti kati ya sheria ya uchanya, ambayo mawakili wanajifunza na kutumia, na aina zingine za 'sheria' au kanuni za kijamii zinazodhibiti maisha ya kila siku, na kwa jumla kuzuiwa migogoro isiwafikie mawakili mahakamani.<ref>Rottleuthner, ''La Sociologie du Droit en Allemagne'', 109</ref><ref>Rottleuthner, ''Rechtstheoritische Probleme der Sociologie des Rechts'', 521</ref> [[Picha:Max Weber 1917.jpg|thumb|left|[[Max Weber]] mnamo mwaka wa 1917, Weber alianza kazi yake kama wakili, na antazamwa kama mmoja wa waanzilishi wa somo la jamii na somo la jamii la kisheria]] Katika kipindi cha mwaka 1900 [[Max Weber]] alifafanua mbinu yake ya "kisayansi" ya sheria, huku akitambua "umbo la kimantiki ya sheria" kama aina ya utawala, ambao si chanzo cha watu lakini kwa dhana za kiakili.<ref>Rheinstein, ''Max Weber on Law and Economy in Society'', 336</ref> [[Mamalaka ya kimantiki ya sheria|Umantiki wa kisheria]] yalikuwa maneno yake aliyoyatumia kuelezea mwili wa sheria zinazoeleweka na zinazoweza kuhesabika na zilikuwa hatua ya kwanza ya maendeleo ya kisasa ya kisiasa na taifa la ukiritimba la kisasa na kuibuka sambamba na [[ubepari]].<ref name="Jary"/> Msomi mwingine wa somo la jamii, [[Émile Durkheim]], aliandika katika ''Mgawanyo wa Ujira na Jamii'' kuwa kadiri jamii inavyozidi kuwa kubwa, ndivyo mwili wa sheria ya kiraia unaohusika hasa na fidia unapozidi kukuwa kwa gharama ya sheria za jinai na vikwazo vya kisheria.<ref>Johnson, ''The Blackwell Dictionary of Sociology, 156</ref> Wasomi wengine wa somo la jamii ni [[Hugo Sinzheimer]], [[Theodor Geiger]], [[Georges Gurvitch]] na [[Leon Petrażycki]] Barani Ulaya, na [[William Graham Sumner]] nchini Marekani<ref>Gurvitch, ''Sociology of Law'', 142</ref><ref>Papachristou, ''Sociology of Law'', 81–82</ref> == Taasisi za kisheria == Sheria si mwili wa kanuni zisizobadilika bali ni "machakato badilifu wa kanuni zinazobadilishwa kila wakati, kuundwa, na kupewa umbo ili kuambatana na hali fulani."<ref>Hamilton and Spiro, ''The Dynamics of Law'', 3</ref> Mabadiliko yanafanywa kila wakati na taasisi mbalimbali katika jamii. Taasisi kuu za sheria katika [[Demokrasia huru]] ni [[Mahakama huru]], [[Haki ya jinai|mifumo ya haki]], [[bunge]], serikali yenye [[uwajibikaji]], na ukiritimba wenye uwezo na usiokuwa na ufisadi , kiksoi cha polisi, [[kudhibitiwa kwa jeshi na raia]] na taaluma ya kisheria yenye nguvu inayohakikisha watu wanapta haki na jamii ya kiraia mbalimbali—neno linalotumika kuashiria taasisi za kijamii, jamii na ushirikiano unaunda msingi wa kisiasa wa sheria.<ref>Jakobs, ''Pursuing Equal Opportunities'', 5–6</ref><ref>Karkatsoulis, ''The State in Transition'', 275 etc.</ref> John Locke, katika ''[[Maandiko Mawili kuhusu Serikali]]'', na [[Charles de Secondat, Baron de Montesquieu|Baron de Montesquieu]] katika ''[[Roho ya Sheria]]'', walitetea [[mgawanyo wa madaraka]] kati ya miili ya kisiasa ya bunge na serikali.<ref>[[Montesquieu]], ''The Spirit of Laws'', [http://www.constitution.org/cm/sol_11.htm#006 Book XI: Of the Laws Which Establish Political Liberty, with Regard to the Constitution, Chapters 6–7]</ref> Kanuni yao ilikuwa kuwa hakuna mtu anayefaa kuwa na uwezo wa kuchukua mamlaka yote ya [[Taifa huru|taifa]], ikitofautishwa na nadharia ya [[uimla]] ya [[Thomas Hobbes]]' ''[[Leviathan (book)|Leviathan]]''.<ref name="H17">Thomas Hobbes, ''Leviathan'', [https://carvercantin.com/thomas-hobbes-leviathan-xvii/ XVII]</ref> [[Max Weber]] na wengine walibadilisha mawazo kuhusu taifa. Jeshi la kisasa, upolisi na mamalaka ya ukiritimba juu ya masiha ya raia wa kawaida husababisha matatizo maalum ya uwajibikaji ambayo waandishi wa awali kama vile Locke au Montesquieu hawangeweza kutabiri. Mashirika ya kisasa ya kimataifa huzingatia umuhimu wa utawala wa sheria na [[utawala mzuri]], huku waandishi wengine hutafiti uhsusiano kati ya utawala wa sheria na utawala wa ufanisi katika nchi za kisasa.<ref>Curtin–Wessel, ''Good Governance'', 73</ref><ref>Fukuyama, ''State-Building'', 132</ref> === Mahakama === {{Main|Mahakama}} Mahakama ni idadi ya [[mahakimu]] wanaosikiza migogoro ili kuamua matokeo. Nchi nyingi zina mfumo wa mahakama ya [[rufaa]], yanayojibu kwa mamlaka makuu ya kisheria. Nchini Marekani haya ni [[Mahakama Kuu ya Marekani]];<ref>[https://web.archive.org/web/20000711024627/http://www.supremecourtus.gov/about/briefoverview.pdf A Brief Overview of the Supreme Court], Supreme Court of the United States</ref> nchini Australia, [[Mahakama Kuu ya Australia]]; nchini Uingereza , ni [[Mahakama Kuu ya Uingereza]]<ref>{{Rejea tovuti |url=http://www.supremecourt.gov.uk/ |title=Nakala iliyohifadhiwa |accessdate=2010-01-15 |archiveurl=https://web.archive.org/web/20091016151227/http://www.supremecourt.gov.uk/ |archivedate=2009-10-16 }}</ref> (tangu tarehe1 Oktoba 2009; hapo awali yalikuwa, [[Nyumba ya Mabwana]]);<ref>[https://web.archive.org/web/20000711024627/http://www.supremecourtus.gov/about/briefoverview.pdf House of Lords Judgements], House of Lords</ref> nchini Ujerumani ni ''[[Bundesverfassungsgericht]]''; nchini Ufaransa ni ''[[Cour de cassation (Ufaransa)|Cour de Cassation]]''.<ref>[http://www.bundesverfassungsgericht.de/entscheidungen.html Entscheidungen des Bundesverfassungsgerichts] {{Wayback|url=http://www.bundesverfassungsgericht.de/entscheidungen.html |date=20061121164330 }}, Bundesverfassungsgericht</ref><ref>[http://www.courdecassation.fr/jurisprudence_publications_documentation_2/ Jurisprudence, publications, documentation] {{Wayback|url=http://www.courdecassation.fr/jurisprudence_publications_documentation_2/ |date=20070209144055 }}, Cour de cassation</ref> Kwa nchi nyingi za Ulaya Mahakama ya Ulaya ya Haki nchini Luxembourg inaweza kuukataa umauzi wa kitaifa, wakati ambapo sheria ya Umoja wa Ulaya inafaa. Mahakama ya Ulaya ya Haki za Kibinadamu inayopatikana Strasbourg inawaruhusu raia wa nchi wanachama za [[Baraza la Ulaya]] kuleta kesi zao zinzohusiana na haki za kibinadamu mbele yake.<ref>Goldhaber, ''European Court of Human Rights'', 1–2</ref> Baadhi ya nchi huruhusu mamlaka yao makuu ya mahakama kukataa sheria wanayopata kuwa [[kinyume na katiba]]. Katika kesi ya ''[[Roe dhidi ya Wade]]'', Mahakama Kuu ya Marekani ilipindua sheria ya jimbo la Texas iliyopiga marufuku kutoa msaada kwa wanawake wenye nia ya [[Kuavya mimba]].<ref>''[[Roe v Wade]]'' (1973) [http://caselaw.lp.findlaw.com/scripts/getcase.pl?navby=CASE&court=US&vol=410&page=113 410 U.S. 113] Retrieved 2007-01-26</ref> [[Marekebisho ya Kumi na Nne ya Katiba ya Marekani|Marekebisho ya Kumi na Nne]] ya katiba ya Marekani yalikuwa yametafsiriwa kuwapa ya [[faragha]], na kwa hivyo haki ya mwanamke kuchagua kuavya mimba. Mahakama kinadharia yamefundwa na katiba, kama tu miili ya bunge. Katika nchi nyingi, mahakimu wana uwezo tu wa [[utafsiri (sheria)|kutafsiri]] katiba na sheria zingine zote. Lakini katika nchi zasheria ya kawaida, ambapo mambo si ya kikatiba, mahakama pia yanweza kuunda sheria chini ya [[mafundisho ya utangulizi]]. Uingereza, Finland na New Zealand hutumia dhana ya [[uhuru wa bunge]], ambapo mahakama ambayo hayajachaguliwa hayawezi kupindua sheria iliyopitishwa na bunge la kidemokrasia.<ref>Dicey, ''Law of the Constitution'', 37–82</ref> Katika [[Ukomiunisti|nchi za kikomiunisti]], kama vile Uchina, mahakama mara nyingi hutazamwa kama sehemu ya serikali, au kuwa chini ya bunge; taasisi za kiserikali na watendaji mbalimbali basi wana ushawishi tofauti kwa mahakama.<ref>E.g., the court president is a political appointee (Jensen–Heller, ''Introduction'', 11–12). About the notion of "judicial independence" in China, see Findlay, ''Judiciary in the PRC'', 282–284</ref> Katika nchi za Kiislamu, mahakama mara nyingi huchunguza ikiwa sheria za nchi zinafuata Sharia: [[Mahakama Kuu ya Kikatiba ya Misri]] inaweza kuoinga sheria kama hizo,<ref name="ReferenceA">Sherif, ''Constitutions of Arab Countries'', 158</ref> Na nchini Iran [[Baraza la Ulinzi]] linahakikisha uwiano wa sheria zinazopitishwa na "vigezo vya Uislamu".<ref name="ReferenceA"/><ref>Rasekh, ''Islamism and Republicanism'', 115–116</ref> === Bunge === {{Main|Bunge}} [[Picha:European-parliament-brussels-inside.JPG|thumb|Chumba cha mjadala cha [[Bunge la Ulaya]]]] Mifano maarufu ya bunge ni [[Majumba ya Bunge]] mjini London, [[Bunge la Marekani|Kongresi]] mjini Washingtin D.C., [[Bundestag]] mjini Berlin na [[Duma]] nchini Moscow, [[Bunge la Italia|Parlamento Italiano]] mjini Roma na [[Bunge la Ufaransa|''Assemblée nationale'']] mjini Paris. Kwa kanuni ya serikali wakilishi watu hupigia kura wanasiasa ili watimize ''matakwa'' yao. Ingawa nchi kama Israeli, Ugiriki, Uswidi na Uchina zina [[nyumba moja ya bunge]], nchi nyingi zina [[nyumba mbili za bunge]], kumaanisha kuwa zina nyumba mbili za kibunge zinazochaguliwa tofauti. Katika 'nyumba ya chini' wanasiasa wanachaguliwa kuwakilisha [[Eneo wakilishi bungeni|maeneo wakilishi bungeni]]. 'Nymba ya juu' kawaida huchaguliwa kuwakilisha majimbo katika mfumo wa [[Jamhuri ya majimbo|majimbo]] (kama vile nchii Australia, Ujerumani au Marekani) au upigaji kura tofauti katika katika mfumo wa umoja (kama vile nchini Ufaransa). Nchini Uingereza nyumba ya juu inachaguliwa na na serikali kama [[Nyumba ya mabwana|nyumba ya marudio]]. Ukosoaji mmoja wa mifumo yenye nyumba mbili yenye nyumba mbili zilizochaguliwa ni kuwa nyumba ya juu na ya chini huenda zikafanana. Utetezi wa tangu jadi wa mifumo ya nyumba mbili nni kuwa chumba cha juu huwa kama nyumba ya marekebisho. Hili linaweza kupunguza uonevu na dhuluma katika hatua ya kiserikali'', 101</ref> Ili kupitisha sheria, idadi kubwa ya [[Wabunge]] lazima [[wapige kura]] ili [[muswada (sheria inayopendekezwa)]] upitishwe katika kila nyumba. Kawaida kutakuwa na kusoma kwingi na marekebesho mengi yaliyopendekezwa na makundi tofaiti ya kisiasa. Ikiwa nchi ina katiba inayofuatiliwa vyema, idadi maalum ya mabadiliko katika katiba yanahitajika, hivyo kufanya iwe gumu kubadilisha sheria. Serikali kwa kawaida huongoza mchakato huo, ambao unaweza kujumuisha [[Wabunge]] (k.m. nchini Uingereza na Ujerumani). Lakini katika mfumo wa kiraisi, serikali inachagua [[Baraza la mawaziri (serikali)|baraza la mawaziri]] kutawala kutoka kwa washirika wake [[kisiasa]] ikiwa wamechaguliwa au la (k.m. nchini Marekani au Brazili), na jukumu la bunge linapunguza liwe [[kukubali]] au [[kukataa]].<ref>About "cabinet accountability" in both presidential and parliamentary systems, see Shugart–Haggard, ''Presidential Systems'', 67 etc.</ref> === Serikali === {{Main|Serikali}} [[Picha:Dmitry Medvedev 2 April 2009-1.jpg|right|thumb| Mikutano ya [[G20]] inahusisha wawakilishi wa serikali ya kila nchi]] Mtendaji katika mfumo wa kisheria hutumika kama kituo cha [[serikali]] cha [[mamlaka]] ya kisiasa. Katika [[mfumo wa kibunge]], kama vile nchini Uingereza, Italia, Ujerumani na Ujapani, mtendaji hujulikana kama [[Baraza (serikali)|serikali]], na huwa na wanachama wa bunge. Mtendaji huchaguliwa na [[Waziri Mkuu]] au [[Chansela]], ambaye ofisi yake ina nguvu za chini ya [[Kura ya kutokuwa na imani|imani]] ya bunge. Kwa sababu uchaguzi wenye watu wengi huteua vyama vya kisiasa kutawala, kiongozi a chama anaweza kubadilika katika kipindi kabla ya uchaguzi mwingine. [[Mkuu wa Taifa]] ni kando na mtendaji, na kimfano hupitisha sheria na huwa kama mwakilishi wa nchi. Baadhi ya mifano ni [[Rais wa Ujerumani]] (anayeapishwa na Bunge); [[Malkia wa Uingereza]] (wadhifa wa [[kurithi]]), na [[Rais wa Austria]] (anachaguliwa kwa kura ya wengi). Mfano mwingine muhimu ni [[mfumo wa kirais]], unaopatikana nchini Ufaransa, Marekani na Urusi. Katika mifumo ya kirais, mtrndaji huwa kama mkuu wa taifa na mkuu wa serikali, na ana nguvu za kuchagua baraza la mawaziri pekee yake. Chini ya mfumo wa kirais, tawi la mtendaji ni kando na bunge ambapo haiwajibiki mbele ya bunge.<ref>Haggard, ''Presidents, Parliaments and Policy'', 71</ref><ref>Olson, ''The New Parliaments of Central and Eastern Europe'', 7</ref> Ingawa jukumu la mtendaji ni tofauti toka nchi moja hado nyingine, kawaida itapendekeza wingi wa sheria, na kupendekeza ajenda ya serikali. Katika mifumo ya kirais, mtendaji mara nyingi ana nguvu za kukataa sheria. Mara nyingi mtendaji katika mifumo yote ana wajibu wa [[sera za mahusiano ya nje]], jeshi na polisi na urasimu. [[Mawaziri]] au maafisa wengine wanasimamia ofisi za nchi, kama vile [[Waziri wa nje|wizara ya nje]] au [[Waziri wa ndani|wizara ya ndani]]. Uchaguzi wa mtendaji tofauti kwa hivyo ina uwezo wa kupindua mtazamo wa nchi nzima wa serikali. === Jeshi na polisi === {{Main|Jeshi|Polisi}} [[Picha:US Customs and Border Protection officers.jpg|thumb|Maafisa wa [[Marekani wa Forodha na Ulinzi wa Mipaka]]]] Ingawa mashirika ya kijeshi yamekuwepo kwa muda mrefu kama serikali yenyewe, dhana la kikosi cha polisi kilicho tayari ni dhana ya kisasa. Mfumo wa [[Uingereza ya Zama za Kati]] ya [[mahakama ya jinai]] ya kusafiri, au [[Mahakama ya assize|assize]], ilitumia [[kesi za maonyesho]] na unyongaji hadharani kufanya jamii ziwe na hofu na hivyo kudumisha udhibiti.<ref>See, eg ''[[Tuberville v Savage]]'' (1669), 1 Mod. Rep. 3, 86 Eng. Rep. 684, where a knight said in a threatening tone to a layman, "If it were not assize time, I would not take such language from you."</ref> Polisi wa kwanza wa kisasa pengine walikuwa wale wa Paris wa karne ya 17, katika mahakama ya [[Louis XIV wa Ufaransa|Louis XIV]],<ref>[http://www.history.com/encyclopedia.do?articleId=219522 History of Police Forces], History.com Encyclopedia</ref> ingawa Polisi wa Mkoa wa Paris ndio wanadai kuwa wao ndio waliokuwa wa kwanza kuvaa sare.<ref>[http://www.prefecture-police-paris.interieur.gouv.fr/documentation/bicentenaire/theme_expo4.htm Des Sergents de Ville et Gardiens de la Paix à la Police de Proximité] {{Wayback|url=http://www.prefecture-police-paris.interieur.gouv.fr/documentation/bicentenaire/theme_expo4.htm |date=20080506215949 }}, La Préfecture de Police</ref> Weber yu maarufu kwa kudokeza kwamba taifa ni lile ambalo linadhibiti kihalali utumizi wa kipekee wa vurugu.<ref name="mwp154">Weber, [[s:Politics as a Vocation|Politics as a Vocation]]</ref><ref>Weber, ''The Theory of Social and Economic Organisation'', 154</ref> Majeshi na askari wanalinda usalama kufuatana na amri ya serikali au mahakama. Maneno [[taifa lililopangarayika]] yanaashiria taifa ambalo haliwezi kutekeleza au kulazimisha sera; askari wao na majeshi hawana uwezo wa kulinda usalama na amani na jamii inaelekea [[vurugu pekee]], wakati serikali inapokosekana.<ref>In these cases sovereignty is eroded, and often warlords acquire excessive powers (Fukuyama, ''State-Building'', 166–167).</ref> === Urasimu === {{Main|Urasimu}} [[Picha:UN Headquarters 2.jpg|thumb| Makao makuu ya [[Umoja wa Mataifa]] mjini New York yana watumishi wa kiserikali wanaotoa huduma kwa mataifa wanachama 192 ya shirika hilo.]] Asili ya neno "Urasimu" kwa Kiingereza (bureaucracy) ni neno la Kifaransa la "ofisi" (''bureau'') na neno la [[Kigiriki cha Zamani]] cha "nguvu" (''kratos'').<ref>[http://www.etymonline.com/index.php?search=bureaucracy&searchmode Bureaucracy], Online Etymology Dictionary</ref> Kama tu wanajeshi na polisi, watumishi wa mfumo wa kisheria wa serikali na miili inayounda urasimu wake hufuata maagizo ya Mtendaji. Mojawapo ya marejeo kwa dhana yalifanywa [[Friedrich Melchior, baron von Grimm|Baron de Grimm]], mwandishi wa Kijerumani aliyeishi nchini Ufaransa. Mnamo mwaka wa 1765 aliandika, <blockquote>Roho halisi ya sheria nchini Ufaransa ni urasimu amabo marehemu Monsieur de Gournay alikuwa akilalamika sana kuhusu; hapa ofisi, makarani, makatibu, wasimamizi na ''wanaonuia kufanya kazi fulani'' hawaapishwi kufaidi maslahi ya umma, kwa hakika maslahi ya ummayanaonekana kuanzishwa ili ofisi hizo ziwepo.<ref>Albrow, ''Bureaucracy'', 16</ref></blockquote> Wasiwasi kuhusu "utawala wa kiofisi" bado ni kawaida, na utendaji wa watumishi wa umma kawaida hutofautishwa na wa [[kampuni za kibinafsi]] zinazoendeshwa na lengo la [[faida]].<ref>Mises, ''Bureaucracy'', II, [http://www.mises.org/etexts/mises/bureaucracy/section2.asp Bureaucratic Management]</ref> Kwa kweli kampuni za kibinafsi, hasa zile kubwa, pia zina urasimu.<ref name="K367">Kettl, ''Public Bureaucracies'', 367</ref> Mtazamo mbaya wa "[[urasimu]]" kando, huduma za umma kama vile elimu, afya na shughuli za polisi au [[uchukuzi wa umma]] ni kazi muhimu nchi hivyo basi kufanya urasimu wa umma chanzo cha nguvu za serikali.<ref name="K367" /> Akiandika mapema katika karne ya 20, Max Weber aliamini kuwa sifa muhimu ya nchi iliyoendelea ilikuwa imekuwa msaada wake wa kirasimu.<ref name="mwp393">Weber, ''Economy and Society'', I, 393</ref> Weber aliandika kuwa sifa za kawaida za urasimu wa kisasa ni kuwa maafisa wanafafanua lengo lake, wigo wa kazi umefungwa na kanuni, usimamizi unajumuisha wataalamu wa wataalamu wa kitaaluma, amabo ambao husimamia kuanzia juu kuenda chini, wakiwasiliana kupitia kuandika na kufunga uwezo wa wafanyikazi wa umma kufanya watakavyo kwa kutumia kanuni.<ref>Kettl, ''Public Bureaucracies'', 371</ref> === Taaluma ya sheria === {{Main|Taaluma ya sheria}} [[Picha:Quentin_Massys_-_Portrait_of_a_Man_-_National_Gallery_of_Scotland.jpg|thumb|Katika mifumo ya sheria ya kiraia kama ile ya Ufaransa, Ujerumani, Italia, Uhispania na Ugiriki, kuna aina maalum ya [[Karani wa sheria ya kiraia]], afisaa wa umma mwenye ufunzi wa kisheria, anayelipwa fidia na wanaofanya biasharaa.<ref>Hazard–Dondi, ''Legal Ethics'', 22</ref> Hii ni picha ya karne ya 16 ya karani wa sheria ya kiraia kama huyo ya mchoraji wa Kiflemi [[Quentin Massys]].]] Hitimisho la utawala wa sheria ni kuwepo kwa taaluma ya kisheria yenye uhuru wa kutosha wa kuweza kuomba mamlaka ya mahakama huru; haki ya usaidizi kusaidiwa na [[wakili]] mahakamani uanatokana na hitimisho hili—nchini Uingereza kazi ya wakili inatofautishwa na ile ya mshauri wa kisheria.<ref>Hazard–Dondi, ''Legal Ethics'', 1</ref> Kama mahakama ya Ulaya ya Haki za Binadamu yanavyosema, sheria inafaa kupatikana na kila mtu na waty wanfaa kutabiri jinsi sheria itakavyowaathiri.<ref>''[[The Sunday Times v The United Kingdom]]'' [1979] [http://www.worldlii.org/eu/cases/ECHR/1979/1.html ECHR 1 at 49] {{Wayback|url=http://www.worldlii.org/eu/cases/ECHR/1979/1.html |date=20060916131454 }} Case no. 6538/74</ref> Ili kudumisha utaaluma, [[zoezi la sheria]] kawaida linachungwa na serikali au mwili huru kama vile [[chama cha mawikili]], [[baraza la mawakili]] au [[jamii ya sheria]]. Mawakili wa kisasa wanapata utambulisho maalum wa kisheria kupitia taratibu maalum za kisheria (k.m. mafanikio katika mitihani), yanahitajika na sheria ili kuwa na cheti maalum (elimi ya kisheria inayompa mwanafunzi [[Shahada ya Sheria]], [[Shahada ya Sgeria ya Kiraia]], au [[Shahada]] ya [[Juris Doctor]]<ref>Higher academic degrees may also be pursued. Examples include a [[Master of Laws]], a [[Master of Legal Studies]] or a [[Doctor of Laws]].</ref>), na zinawekwa ofisini kwa kutumia fomu za kisheria za kuapishwa ([[kukubaliwa katika baraza la mawakili]]). Nchi nyingi za Kiisalmu zina sheria sawa kuhusu elimu ya kisheria na taaluma ya kisheria, lakini zingine bado zinaruhusu mawakili wenye mafunzo katika sheria ya Kiislamu ya jadi katika taaaluma ua sheria katika mahakama ya hadhi ya kibinasfi.<ref>Ahamd, [https://web.archive.org/web/20081001195205/http://www.macalester.edu/~ahmad/Lawyers.pdf Lawyers: Islamic Law]</ref> Nchini Uchina na katika nchi zingine za ulimwengu unaoendelea hakuna watu wa kutosha wenye mafunzo ya kisheria kufanya kazi katika mifumo ya mahakama iliyopo katika nchi hizo, na, kufuatana na hilo, viwango rasmi si vikali sana.<ref>Hazard–Dondi, ''Legal Ethics'', 22–23</ref> Baada ya kupata kukubalika, wakili mara nyingi atafanya kazi katika [[kampuni ya sheria]], katika [[vyumba (sheria)|vyumba]] kama wakili wa kipekee, katika wadhifa wa kiserikali au katika shirika la kibinafsi kama [[mshauri]] wa ndani. Isitoshe wakili anaweza kuwa [[|utafiti wa kisheria|mtafiti wa kisheria]] anayepeana uatafiti wa kisheria unapoitishwa kupitia maktaba, huduma ya kibiashara au kazi isiyokuwa na muajiri mmoja. Watu wengi wenye mafunzo katika sheria walitumia utafiti wao katika taaluma nyingine tofauti kabisa. Adhimu kwa zoezi la sheria katika mapokeo ya sheria ya kawaida ni utafiti wa kisheria kujua hali ya wakati wa sasa wa sheria. Hili linahushisha kuchunguza [[ripoti za sheria|ripoti za kesi]], [[majarida ya kisheria]] na sheria. Zoezi la sheria pia inahusu kuandika hati kama vile [[kuiitia]] kwa mahakama, [[brifu [sheria)|brifu]], mikataba, au [[amana]]. Majadiliano na ujuzu wa [[kusuluhisha migogoro]] (ikijumuisha mbinu za [[Mbinu za Masuluhisho ya Kimbadala|ADR]]) pia ni muhimi kwa zoezi la sheria, ikitegemea na aina ya taaluma.<ref>Fine, ''The Globalisation of Legal Education'', 364</ref> === Mashirika ya kijamii === {{Main|Mashirika ya kijamii}} [[Picha:1963 march on washington.jpg|thumb|Maandamano mjini Washington D.C. wakati wa [[Harakati za Haki za Kiraia za Wamarekani wenye asili ya Kiafrika (1955–1968)|Harakati ya Haki za Kiraia ya Marekani]] mnamo mwaka wa 1963]] Dhana ya [[Kiripablikani wakati kulipokuwa na madaraja mbalimbali ya kijamii]] ya "mashirika ya kijamii" ilianzia wakati wa Hobbes na Locke.<ref>Warren, ''Civil Society'', 3–4</ref> Locke aliona mashirika ya kijamii kama watu wenye "sheria sawa na mahakama [[kurejelea]] , yenye mamlaka ya kuamua utata baina yao."<ref>Locke, ''[[s:Two Treatises of Government/The Second Treatise of Government: An Essay Concerning the True Origin, Extent, and End of Civil Government|Second Treatise]]'', Chap. VII, Of Political or Civil_Society. Chapter 7, section 87</ref> Mwanafalsafa wa Kijerumani [[Georg Wilhelm Friedrich Hegel]] alitofautisha "taifa" na "mashirika ya kijamii" (''burgerliche Gesellschaft'') katika kitabu chake ''[[Vipengele vya Falsafa ya Sawa]]''.<ref>Hegel, ''Elements of the Philosophy of Right'', 3, II, [http://www.marxists.org/reference/archive/hegel/works/pr/prcivils.htm 182]; Karkatsoulis, ''The State in Transition'', 277–278</ref> Hegel aliamini kuwa [[mashirika ya kijamii]] na [[Taifa huru|taifa]] zilikuwa kinyume kabisa, katika mpangilio wa nadharia yake ya historia. Taifa la kisasa lenye pande hizi mbili–mashirika ya kijamii lilizaliwa tena katika nadharia za [[Alexis de Tocqueville]] na [[Karl Marx]].<ref>(Pelczynski, ''The State and Civil Society'', 1–13; Warren, ''Civil Society'', 5–9)</ref><ref>{{cite journal | last = Zaleski | first = Pawel | authorlink = | coauthors = | title = Tocqueville on Civilian Society. A Romantic Vision of the Dichotomic Structure of Social Reality | journal = Archiv für Begriffsgeschichte | volume = 50 | issue = | pages = | publisher = Felix Meiner Verlag | location = | year = 2008 | url = | issn = | doi = | id = | accessdate = }} </ref> Siku hizi katika nadharia ya wakati wa baada ya kisasa za mashirika la kijamii lazima iwe chanzo cha sheria, kwa kuwa msingi ambapo watu wanaunda maoni na kushwishi yale wanayoamini sheria inafaa kuwa. Kama wakili wa Kiaustralia na mwandishi [[Geoffrey Robertson QC]] alivyoandika kuhusu sheria ya kimataifa, <blockquote>... mojawapo ya vyanzo vyake vya kisasa inapatikana katika majibu ya kawaida ya wanaume na wanawake, na mashirika yasiyo ya kiserikali, amabyo wengi huunga, kwa ukiukaji wa haki za kibinadamu amabyo wengi huona kwenye runinga wakiwa sebuleni nyumbani mwao.<ref>Robertson, ''Crimes Against Humanity'', 98–99</ref></blockquote> [[Uhuru wa kujieleza]], [[uhuru wa kujumuika]] na sheria zingine nyingi za kibinafsi zinawaruhusu watu kukusanyika, kujadili, kukosoa na kufanya serikali zao kuwajibika, ambapo msingi wa [[demokrasia ya majadiliano]] inaibuka. Watu wanapozidi kujihusisha mamlaka ya kisheria na na kuwa na uwezo wa kubadilisha jinsi mamlaka ya kisiasa yanapotumika maishani mwao; ndivyo sheria inapozidi kuwa [[Uhalali (kisiasa)|halali]] kwa watu. Taasisi ambazo ni za kawaida sana za mashirika ya kijamii ni masoko ya kibiashra, kampuni zenye malengo ya kupata faida, familia, [[vyama vya kibiashara]], hospitali, vyuo vikuu, shule, mashirika ya msaada, [[vilabu vya kujadili]], [[mashirika yasiyokuwa ya kiserikali]], vitongoji, makanisa, na vyama vya kidini.<ref>There is no clear legal definition of the civil society, and of the institutions it includes. Most of the institutions and bodies who try to give a list of institutions (such as the [[European Economic and Social Committee]]) exclude the political parties. For further information, see Jakobs, ''Pursuing Equal Opportunities'', 5–6; Kaldor–Anheier–Glasius, ''Global Civil Society'', ''[http://www.lse.ac.uk/Depts/global/Publications/Yearbooks/2003/2003Chapter1a.pdf passim] {{Wayback|url=http://www.lse.ac.uk/Depts/global/Publications/Yearbooks/2003/2003Chapter1a.pdf |date=20070817130457 }}'' (PDF); Karkatsoulis, ''The State in Transition'', 282–283.</ref> {{-}} == Tazama pia == {{portal}} {{Main|Muhtasari wa sheria}} * [[Haki za kibinadamu]] * [[Uchumi]] * [[Historia]] * [[Sayansi ya Kisiasa]] * [[Falsafa]] == Tanbihi == {{Marejeo|2}} https://www.path-2-happiness.com/sw == Marejeo == ; Printed sources: * {{cite encyclopedia|last=Ahmad|first=Ahmad Atif|title=Lawyers: Islamic Law|encyclopedia=Oxford Encyclopedia of Legal History|publisher=Oxford University Press|url=http://www.macalester.edu/~ahmad/Lawyers.pdf|format=PDF|archiveurl=https://web.archive.org/web/20081001195205/http://www.macalester.edu/~ahmad/Lawyers.pdf|archivedate=2008-10-01|access-date=2010-01-15}}{{Wayback|url=http://www.macalester.edu/~ahmad/Lawyers.pdf |date=20090326034212 }} * {{cite book|last=Akhlaghi|first=Behrooz|title=The Sharīʻa in the Constitutions of Afghanistan, Iran, and Egypt|year=2005|isbn=3-161-48787-7|publisher=Mohr Siebeck|editor=Yassari, Nadjma|chapter=Iranian Commercial Law and the New Investment Law FIPPA}} * {{cite book|last=Albrow|first=Martin|publisher=Palgrave Macmillan|location=London|title=Bureaucracy (Key Concepts in Political Science)|url=https://archive.org/details/bureaucracy0000mart|year=1970|isbn=0-333-11262-8}} * {{cite journal|last=Anderson |first=J.N.D.|year=1956|month=Januari |title=Law Reform in the Middle East journal=International Affairs (Royal Institute of International Affairs 1944—) |volume=32 |issue=1 |pages=43–51|url=http://www.jstor.org/pss/2607811 |accessdate=2007-03-04 |doi=10.2307/2607811}} * {{Cite wikisource|Constitution of the Athenians|[[Aristotle]]}}. 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system|url=https://www.cia.gov/library/publications/the-world-factbook/fields/2100.html|publisher=[[CIA]]|accessdate=2007-10-13|archivedate=2018-12-26|archiveurl=https://web.archive.org/web/20181226012138/https://www.cia.gov/library/publications/the-world-factbook/fields/2100.html}} {{Refend}} == Viungo vya nje == {{sisterlinks|Law}} * [http://www.law.com/ Legal news and information network for attorneys and other legal professionals] * [http://jurispedia.org/ Encyclopaedic project of academic initiative] {{Wayback|url=http://jurispedia.org/ |date=20210408132428 }} in [[Jurispedia]] * [http://www.lawserver.com/ Legal articles, news, and interactive maps] {{Wayback|url=http://www.lawserver.com/ |date=20130302152628 }} * [http://www.worldlii.org/ WorldLII - World Legal Information Institute] {{Wayback|url=http://www.worldlii.org/ |date=20200922075055 }} * [http://www.commonlii.org/ CommonLII - Commonwealth Legal Information Institute]{{Dead link|date=May 2026 |bot=InternetArchiveBot |fix-attempted=yes }} * [http://www.asianlii.org/ AsianLII - Asian Legal Information Institute (AsianLII)] {{Wayback|url=http://www.asianlii.org/ |date=20210417174626 }} * [http://www.austlii.edu.au/ AustLII - Australasian Legal Information Institute] * [http://www.bailii.org/ BaiLII - British and Irish Legal Information Institute] * [http://www.canlii.org/ CanLII - Canadian Legal Information Institute] * [http://www.nzlii.org/ NZLII - New Zealand Legal Information Institute] {{Wayback|url=http://www.nzlii.org/ |date=20210417174640 }} * [http://www.paclii.org/ PacLII - Pacific Islands Legal Information Institute] {{Wayback|url=http://www.paclii.org/ |date=20040103005659 }} [[Jamii:Sheria| ]] [[Jamii:Elimu jamii]] [[Jamii:Historia]] [[Jamii:Falsafa]] mp96yi23fvxw3y8x1yw31h0ekj96u2k 0 1169 1578176 1498070 2026-07-02T23:52:08Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578176 wikitext text/x-wiki [[Picha:Mohammed_kaaba_1315.jpg|thumb|350px|Mtume Muhammed jinsi alivyotengeneza [[Kaaba]] huko [[Makka]] - picha mnamo mwaka 1315 kutoka Asia ya Kati]] [[Picha:Siyer-i_Nebi_151b.jpg|thumb|350px|Mtume Muhammed jinsi alivyosali mbele ya Kaaba - (katika picha za Kiosmani uso wa mtume hufichwa mara nyingi tangu karne ya 16 BK)]] '''Muhammad''' (''kwa [[Kiarabu]] "Mwenye kusifika sana"; jina kamili kwa kirefu ni ''<br />محمد بن عبد الله بن عبد ﺍﻟﻤﻄﻠﺐ ﺍﻟﻬﺎﺷﻤﻲ '' Muhammad bin 'Abd Allāh bin 'Abd al-Muţţalib al-Hāshimī''; [[570]] hivi - [[8 Juni]] [[632]]) anaaminika katika [[dini]] ya [[Uislamu]] kuwa ni [[mtume]] wa mwisho wa [[Mungu]] ([[Allah]]) kwa [[binadamu]]. == Utoto wake == Muhammad alizaliwa yatima kwani baba yake alifariki kabla yeye hajazaliwa. Hakuishi sana na mama yake (Amina), kwa kuwa naye alifariki dunia Muhammad akiwa na umri wa miaka sita. Baadaye akachukuliwa na babu yake [[Abdul Muttalib]] na kuishi naye kwa muda wa miaka miwili, kisha babu yake naye akafariki. Kazi ya kumlea Muhammad ilimwangukia ami yake Abu Talib ambaye ndiye aliyeishi naye mpaka ukubwa na kumuoza na kumpa himaya wakati alipoanza kazi ya kufikisha ujumbe wa Mwenyezi Mungu kwa watu. Kadiri ya hadithi za Kiislamu, ilipokua karibu atadhihiri Mtume ma[[padri]] wa [[Ukristo|Kinasara]] na ma[[kuhani]] wa [[Uyahudi|Kiyahudi]] waliokuwa wakikaa [[Bara Arabu]] walikuwa wakiwatahayarisha majirani wao wa Kiarabu waliokuwa wakiabudu [[sanamu]], wakiwaambia: “Karibu ataletwa Mtume katika nchi yenu hii, abatilishe hii [[ibada]] yenu mbovu ya sanamu”. Walipoambiwa hivi wale [[Waarabu]] waliwauliza jina la Mtume huyo, wakawajibu kuwa jina lake litakuwa Muhammad. Kwa hivyo kila mwenye kusadiki hayo alimwita mwanawe Muhammad. Lakini hayakusikilizana majina haya ila kwa baadhi ya Waarabu waliokua wakikaa [[Shamu]] tu na [[Najran]] ([[Yaman]]) ambako mapadri wengi walikaa, na vilevile katika [[Madina]] ambayo nusu ya wakazi wake walikuwa Wayahudi. Hata lilipoanza kutangaa jina la Mtume, waliokuwa wamekwisha kuitwa kwa jina hilo walikuwa wachache tu Bara Arabu nzima. Inasemekana Mtume aliinukia tangu utotoni kwake juu ya sifa zake nzuri na [[ukomavu]] wa [[akili]] ya kiutu uzima, hakupata kufanya vitendo vya utoto umri wake, wala kuazimia kuvifanya ila mara mbili tu, ambazo mara mbili zote hizo Mwenyezi Mungu alimhifadhi navyo. Kitendo chenyewe alichokiazimia kukifanya mara mbili zote hizo na Mwenyezi Mungu akamhifadhi nacho ni kutaka kwenda kukesha katika [[ngoma]] za [[arusi]] mbili za marafiki wake waliooa katika [[mji]] wa [[Makka]]. Lakini Mungu alimpa usingizi mkubwa katika masiku yote hayo mawili hata hakuweza kufumbua jicho, wala kunyanyua miguu kwenda mahali. Hajapata kuhudhuria hata mara moja katika ibada za kuabudu sanamu wala kula chakula kilichochinjwa kwa ajili yao. Moyo wake ulichukizwa na hayo na mambo mengine yaliyo mabaya. Tangu udogo wake Mtume aliondokea na sifa nzuri ambazo hapana hata mmoja katika hirimu zake aliyekuwa nazo zote. Kila sifa zinazohesabiwa kuwa ni njema na Waislamu ndizo alizokuwa nazo tangu utoto wake. Mkewe [[Aisha]] alipoombwa kutaja kidogo sifa za Mtume, alisema hivi: “Sifa zake ni zile sifa nzuri zinazosifiwa na [[Kurani]]” na katika Kurani zimetajwa chungu ya sifa zilizo nzuri. Mtume mara nyingi alikuwa akisema: “Sikupata kufanya hata siku moja yale mambo waliyokuwa wakiyafanya makafiri”. Kwa hivyo yeye hakupata kuabudu sanamu, kulewa, kuzini, kucheza kamari wala hakumdhulumu mtu kitu chake na kama haya. Lakini alikuwa msemakweli, mwaminifu, mpole na mwenye haya na sifa nyingi nyinginezo bora kama hizi. Watu wa Makka walikuwa wakimsifu kwa tabia zake, hata wakampa jina la Muhammad Al-Amin (mwaminifu). Alikuwa hatajikani ila kwa jina la Al-Amin. Wakubwa na wadogo walikuwa wakimheshimu na kumpa amana zao kuwawekea, hata baada ya [[utume]]. == Hali yake kabla ya kupewa utume == Makureshi ni watu wa [[biashara]], kila Kureshi alipata kufanya kazi hii. Safari moja baadhi yao walipokuwa wakienda Yaman katika biashara zao, baba yake mdogo wa pili Bwana Zubeyr alimshauri ikiwa atapenda kusafiri. Mtume aliridhia akenda naye mpaka Yaman, wakakaa huko muda wa siku tatu tu kisha wakarejea, wakati huu Mtume alikuwa mtoto wa miaka tisa. Hata alipotimia miaka 12 mwaka [[582]], alisafiri tena pamoja na baba yake mdogo mwingine, Bwana Abu Talib; safari hii waliazimia kwenda Shamu, lakini walipofika [[Busra]] – mji wa kusini kabisa katika nchi ya Shamu – walikutana na padri jina lake Bahyra ambaye alimkataza asisogee na mwanawe zaidi kuliko hapo, akamwambia: “Mtoto huyu namwona ana alama zote za Mtume aliyetabiriwa kuwa atakuja, basi naona ni hatari kubwa akienda Shamu, asije akauawa na Wayahudi huko. Nakusihi sana urejee naye, au umpe mtu mwaminifu arejee naye, nawe uende katika biashara zako”. Abu Talib alimpa mtu arejee naye Makka naye akaendelea na safari yake. Huyu padri Bahyra alikuwa mwanachuoni wa Kinasara, na alimbashiri Mtume lakini hakuwahi kumwamini alipoanza utume, ila mwanafunzi wake Salman Al-Farsy Mwajemi mara alipopata habari ya kupata utume wake alisilimu, na aliusaidia [[Uislamu]] katika mambo mengi. Baada ya kutimia miaka 15 Mtume aliingia katika kufanya biashara ndogondogo yeye na mwenziwe Saib bin Yazid, lakini biashara yao walikuwa wakiifanyia katika miji iliyokuwa karibu na Makka tu. Alipata sifa kubwa ya [[uaminifu]] na [[ukweli]] katika biashara zake hizi. Mshirika wake huyu alisilimu siku ilipotekwa Makka, na Mtume alifurahi sana kwa kusilimu rafiki yake huyu. == Kuanza utume == {{Islam}} Muhammad hakuwa akihudhuria sikukuu za [[Wapagani]] tangu kufahamu kwake. Alikuwa akipenda kukaa peke yake. Kufanya haya kulikuwa kukimwonjesha raha kubwa kuliko kutoka mbele za watu akaona yale mambo yao mabaya aliyokuwa akiyachukia. Kila usiku ukicha alikuwa akizidi kuyachukia. Lakini alikuwa hajui la kufanya. Hata alipotimiza miaka 38 hakuweza tena kustahimili kuona zile ibada za sanamu na tabia mbovu walizokuwa nazo wenziwe, ilivyokuwa hana la kufanya katika kuzizuia, alifanya shauri kuuacha mji wa Makka na kwenda porini kukaa. Akapata [[pango]] zuri katika [[Jabal Hira]] Kaskazini ya Makka, inapata [[maili]] 3 toka huko Makka. Akawa akikaa huko kwenye Jabal Hira kwa muda wa wiki nyingi, kisha hurejea Makka kuja kumtazama mkewe, wanawe na jamaa zake wengine, na vile vile kwa ajili ya kuchukua chakula kinapokuwa kimekwisha. Wakati mwingine akikaa siku nyingi sana huko porini hata humpasa mkewe [[Khadija]] kwenda kumsikiliza na mara nyingine alikuwa akifuatana naye, pamoja na watoto wao. Alidumu katika hali hii muda wa miaka miwili na kitu. Baadaye alisimulia kuwa katika mwezi wa Ramadhani 17, Jumatatu katika mwaka wa 40 unusu wa umri wake alimuona mtu kamsimamia mbele yake bila ya kumuona wapi katokea, akamwambia: “Soma”. Mtume akamjibu: “Mimi sijui kusoma kwani sijapata kujizunza”. Akaja, akamkamata, akambana, akamwambia tena: “Soma”. Mtume akamjibu jawabu yake ileile. Hata mara ya tatu akamwambia: “Soma – Iqraa Bismi Rabbik - ” akamsomea sura ya 96 mpaka kati yake, kisha Mtume akaisoma kama alivyosomewa. Hii ndiyo sura ya kwanza kushuka katika Kurani, ingawa haijawekwa mwanzo. Mara yule mtu ([[malaika]]) akaondoka machoni pake asimwone kaenda wapi, naye akarejea kwake [[hofu]] imemshika. Alipofika nyumbani, Khadija alidhani ana [[homa]], akamfunika nguo gubigubi akakaa mbele yake akimsikiliza anavyoweweseka. Homa ilipomwachia alimweleza Khadija yote yaliyomtokea, naye akamtuliza moyo wake, akamyakinishia ya kuwa hapana lolote baya litakalomzukia. Mara Bibi huyu akaondoka akaenda kwa jamaa yake Waraqa bin Naufal akampa habari yote iliyompata mumewe. Naye akamwamrisha amwite, na Mtume akaenda akamweleza habari yake yote. Bwana Waraqa akamwambia: “Huyo ndiye [[Jibril]] aliyemshukia [[Nabii]] [[Musa]] na Nabii [[Isa]]. Basi jibashirie kuwa wewe ni Mtume wa Umma huu! Nami natamani kuwa hai nikuone unavyosimama kuwatengeneza jamaa zako, Inshaalla nitakuwa mkono wako wa kulia!”. Wakarejea kwao hofu yote imemtoka Baada ya kuazimia kuwa hatakwenda tena kule pangoni. Pale pale akaondoka akenda pangoni mwake ili aonane na malaika tena, ingawa alikaa huko muda mrefu. Siku ile ya kupata Utume inawafiki mwezi wa Desemba [[610]]. Huyu Waraqa hakuwa akiabudu [[dini]] ya sanamu bali alikuwa Mkristo, alipokuwa akisoma vitabu aliona kutatokea Mtume mwingine, ndiyo maana alipohadithiwa habari ile mara moja akaamini kuwa aliyemjia Mtume ni Jibril. == Maisha yake Makka == Muhammad aliishi Makka kwa muda wa miaka 53, arubaini (40) katika hiyo akiwa ni mtu wa kawaida kabla ya kupewa utume, na 13 akiwa ni mjumbe wa Mwenyezi Mungu. Maisha yake Makka yalikuwa ya taabu tangu utotoni mwake, kwani alizaliwa yatima kisha alipokuwa katika ujana wake alikuwa akifanya kazi ya kuchunga mbuzi na kondoo wa watu wa Makka kwa vijipesa kidogo mpaka alipofika umri wa miaka ishirini na tano akapata kazi ya kumfanyia biashara Khadija, bibi mtukufu wa Kikureshi ambaye baadaye alikuja kuwa mkewe, na kuzaa naye aghlabu ya watoto wake. == Miaka 13 ya utume Makka == Katika miaka 13 aliyoyaishi hapo Makka baada ya kupewa utume, Muhammad alipata kila aina ya mateso na masumbuko, juu ya nafsi yake na juu ya wafuasi wake, naye alisubiri na kustahimili kila aina ya taabu na shida kwa ajili ya Mola wake, mpaka Mwenyezi Mungu alipompa amri ya kuhama mji huo na kuelekea Madina. Katika muda huu alipokuwa Makka, wengi katika jamaa zake na watu wa makabila mengine wa matabaka mbalimbali za jamii waliingia dini yake. Mwaka [[622]] Wakureshi, wakiona hasara katika mafungamano yao na Waarabu wengine wenye kuabudu miungu mingi, kwa dukuduku zao zilimfanya Muhammad ahame pamoja na sahibu wake [[Abubakar]] Assiddiq na wafuasi wake 70 hivi akaishi Yathrib, mji ambao ulikaliwa na Waarabu na Wayahudi pamoja na ambao baadaya ukaitwa Madinat al-Nabi (yaani Mji wa Nabii, kifupi [[Madina]]). Mwaka huo ukawa wa kwanza katika [[Kalenda ya Kiislamu]] inayotumika tangu wakati wa [[halifa]] 'Omar ibn al-Khattàb hadi leo. == Kuhamia Madina na mwanzo wa Umma == Mtume Muhammad, baada ya kupewa amri ya kuguria [[Madina]], aliondoka na kuhamia mji huo ambao ulimpokea na kumkubali na kumsaidia na kumtukuza na kumlinda na maadui. Ingawa [[Wayahudi]] wa Madina walikataa kumsadiki kuwa nabii kama wale wa [[Biblia]], aliendelea kuhubiri huko na tangu mwaka wa kwanza alitunga Hati ya Agano iliyokubaliwa na Wamadina wote: ndiyo asili ya [[Umma]], jamii ya waumini. Mtume Muhammad aliishi Madina kwa muda wa miaka 10 mingine akitangaza dini ya Mwenyezi Mungu na huko watu wengi na makabila mbali mbali ya Kiarabu yaliingia dini ya Uislamu kwa makundi makundi. Wakati huohuo alianza kushambulia misafara ya Wamakka wapagani na kuwashinda kwanza huko Badr (624), akashindwa huko Uhud (625), hatimaye akapata ushindi mkuu huko Madina katika vita vya handaki (627): hapo alifukuza na hatimaye akaangamiza kama wasaliti Wayahudi wote wa Madina na wanaume wote wa Waqurayza, wakati wanawake wao pamoja na watoto wakauzwa kama watumwa huko [[Syria]]. Mwaka 630 Muhammad akiwa na nguvu za kutosha aliweza kurudi Makka na kuiteka, akairudisha [[Kaaba]] ambayo ndiyo kibla cha Waislamu wote ulimwenguni katika mambo ya [[Sala]] na [[Hija]]. Hata hivyo akarudi kuishi Madina na kutoka huko akaeneza kazi yake ya kisiasa na ya kidini katika [[Hijaz]] yote. Baada ya ushindi wake huko Hunayn dhidi ya Waawazin na wenzao, aliteka au kusilimisha vijiji mbalimbali vya maana upande wa uchumi au wa vita kwa mfululizo wa mapigano kwenye Wadi al-qura. Kwa jumla alihudhuria [[vita]] 27, akiua kwa mkono wake mtu mmoja tu. Akiendelea kuishi Madina, alinadhimu kwa [[Sharia]] na hukumu nyingi maisha ya jamii ya Waislamu huko, na kuweka chanzo cha dola ya kiislamu ulimwenguni. Sharia na hukumu hizo zinapatikana katika kitabu kitakatifu cha ([[Kurani]]), ambacho leo Waislamu wote ulimwenguni wananadhimu maisha yao kulingana nacho. == Wake zake == Ingawa Kurani inaruhusu wake 4 tu, Muhammad alisema ana idhini ya kuvuka kiwango hicho. Jumla alioa wake 11, ambao majina yao yamepangwa hapa chini kufuatana na tarehe ya ndoa. 1. Khadija binti Khuwaylid (tangu 595 hadi kifo chake Januari 620) ambaye aliwahi kuolewa na waume wawili na kuwazalia watoto 5. Katika maisha mazuri ya ndoa alimzalia Muhamad mabinti 4 (Ruqayya, Umm Khulthūm, Zaynab na Fatima), mbali na watoto 2 wa kiume (Qàsim na ‘Abd Allah) ambao lakini walikufa wakiwa bado wadogo. 2. Sawda binti Zam’a (tangu Machi 620) aliyewahi kuolewa na mume mmoja. 3. Aysha binti Abu Bakr (tangu Januari 623) aliyeolewa na Mohamed akiwa na umri wa miaka 9. 4. Hafsa binti Umar (tangu Novemba 624), aliyewahi kuolewa na mume mmoja. 5. Zaynab binti Khuzayma (tangu Juni 625 hadi kifo chake Agosti 625). 6. Hindi Umm Salama binti Abi Umayya (tangu Februari 626), aliyewahi kuolewa na mume mmoja na kuachiwa watoto wengi. Alikuwa mtoto wa kambo wa shangazi ya Mohamed. 7. Zaynab binti Jahsh (tangu Juni 626) aliyeachwa na mume wake. Alikuwa binamu wa Mohamed. 8. Juwayriya binti Al Harith (tangu Desemba 626). 9. Ramla Umm Habība binti Abi Sufyan (tangu Agosti 628) alipoachana na mumewe aliyeingia Ukristo. 10. Safiyya binti Huyay (tangu Septemba 628) ambaye alikuwa Myahudi akatekwa nyara katika vita vya Khybar. 11. Maymuna binti Harith (tangu Februari 629) aliyekuwa na umri wa miaka 51. Kati yao, wa kwanza tu alimzalia Muhammad watoto, lakini wana wote walifariki kabla ya baba yao, isipokuwa Fatma aliyekufa miezi sita baada yake. Aliwaoa pia, lakini bila ya kulala nao, Asma’ binti Al Nu‘man (mkoma) na ‘Amra binti Yazid (aliyekataa katakata ndoa hiyo akapewa mara talaka). Mbali na wake rasmi, Kurani inaruhusu kuwa na masuria wasio na idadi (dhāt al-yamīn, "waliomilikiwa na mkono wa kuume", yaani watumwa, hasa waliotekwa vitani). Muhammad alikuwa nao 16: kati yao Marya (Mkristo) alimzalia mtoto wa kiume: Ibrahim, aliyefariki mdogo sana, kwa huzuni kubwa ya baba yake aliyemfuata kaburini muda mfupi baadaye. ==Marejeo== * Kadhi Sheikh Abdulla Saleh Farsy, Maisha ya Nabii Muhammad - Mulla Karimjee Mulla Mohamedbhai & Son, Zanzibar 1942 == Viungo vya nje == <div class="references-small"> ;Visivyotolewa na Waislamu * [http://www.britannica.com/eb/article-9105853/Muhammad Muhammad], article on ''Enyclopaedia Britannica Online'' * [http://www.pbs.org/muhammad Muhammad: Legacy of a Prophet - PBS Site] * [http://www.upf.tv/upf06/Projects/MuhammadDocumentary/tabid/175/Default.aspx Muhammad: Legacy of a Prophet - UPF (Producer's Site)] {{Wayback|url=http://www.upf.tv/upf06/Projects/MuhammadDocumentary/tabid/175/Default.aspx |date=20090205025734 }} * [http://encarta.msn.com/encyclopedia_761553918/Muhammad_(prophet).html/ Encarta Encyclopedia] {{Wayback|url=http://encarta.msn.com/encyclopedia_761553918/Muhammad_(prophet).html/ |date=20060623201920 }} * [http://31.1911encyclopedia.org/M/MA/MAHOMET.htm 1911 Encyclopedia article on Mahomet] * [http://www.answering-islam.org.uk/Books/Muir/Life1/index.htm William Muir: The Life of Mahomet] * [http://www.gutenberg.org/etext/1091 The Hero as Prophet] A passionate championship of Prophet Muhammad as a Hegelian agent of reform. by Carlyle, Thomas (1795-1881) On Heroes and the Heroic in History. Lincoln, Nebraska: University of Nebraska Press, 1966. ;Vilivyoandikwa na Waislamu * [http://www.witness-pioneer.org/vil/Books/SM_tsn/index.htm Ar-Raheeq Al-Makhtum (The Sealed Nectar)] {{Webarchive|url=http://webarchive.loc.gov/all/20011214185113/http://www.witness-pioneer.org/vil/books/sm_tsn/index.htm |date=2001-12-14 }} * [http://comp.uark.edu/~muslim/publications/Ar-Raheeq%20Al-Makhtum.pdf PDF version of Ar-Raheeq Al-Makhtum] {{Wayback|url=http://comp.uark.edu/~muslim/publications/Ar-Raheeq%20Al-Makhtum.pdf |date=20070205094211 }} * [http://www.witness-pioneer.org/vil/Books/MH_LM/default.htm The Life of Muhammad] {{Wayback|url=http://www.witness-pioneer.org/vil/Books/MH_LM/default.htm |date=20070809201742 }} by Muhammad Husayn Haykal * [http://www.usc.edu/dept/MSA/fundamentals/prophet/ About the Prophet Muhammad (University of Southern California)] {{Wayback|url=http://www.usc.edu/dept/MSA/fundamentals/prophet/ |date=20060612062303 }} </div> ==Kujisomea== {{refbegin|30em}} * {{cite journal|journal = [[signs (journal)|Signs]]|author = Ahmed, Leila|title = Women and the Advent of Islam|url = https://archive.org/details/sim_signs_summer-1986_11_4/page/n52|volume = 11|date = Summer 1986|pages = 665–91|doi = 10.1086/494271|issue = 4}} * {{cite book|author=Ali, Kecia|title=The Lives of Muhammad|url=http://books.google.com/books?id=-oWYBAAAQBAJ&pg=PA1|date= 2014|publisher=Harvard University Press|isbn=978-0-674-74448-6}} * {{cite book | author-link = Muhammad Mohar Ali|author = Ali, Muhammad Mohar | year = 1997 | title = The Biography of the Prophet and the Orientalists | publisher = King Fahd Complex for the Printing of the Holy Qur'an | isbn = 9960-770-68-0 |url = http://www.islamhouse.com/p/51772}} * {{cite book | last=Armstrong| first= Karen| authorlink = Karen Armstrong| year = 1992 | title = [[Muhammad: A Biography of the Prophet]] | publisher = Harpercollins | isbn = 0-06-250886-5 |url = }} * {{cite book | last=Awde | first=Nicholas| title= Women in Islam: An Anthology from the Quran and Hadith| publisher=Routledge | year=2000 | isbn=0-7007-1012-4}} * {{cite book | last=Ballard | first=Harold Wayne |author2=Donald N. 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Donner|title=Narratives of Islamic Origins: The Beginnings of Islamic Historical Writing | url=https://archive.org/details/narrativesofisla0000donn | publisher=Darwin Press | year = 1998 | isbn=0-87850-127-4}} * {{cite book | last=Ernst | first=Carl | authorlink=Carl Ernst | year = 2004 | title = Following Muhammad: Rethinking Islam in the Contemporary World | url=https://archive.org/details/followingmuhamma0005erns | publisher = University of North Carolina Press | isbn = 0-8078-5577-4}} * {{cite book | last=Esposito | first=John | authorlink=John Esposito | year=1998 | title=Islam: The Straight Path | url=https://archive.org/details/islamstraightpat0000espo | publisher=Oxford University Press | isbn=0-19-511233-4}} * {{cite book | last=Esposito | first=John | year=1999 | title=The Islamic Threat: Myth Or Reality? | url=https://archive.org/details/islamicthreatmyt00espo | publisher=Oxford University Press | isbn=0-19-513076-6}} * {{cite book | last=Esposito | first=John | year=2002 | title=What Everyone Needs to Know About Islam | url=https://archive.org/details/whateveryoneneed0000espo | publisher=Oxford University Press | isbn=0-19-515713-3}} * {{cite book | last=Farah | first=Caesar | authorlink=Caesar E. Farah | title=[[Islam: Beliefs and Observances]] | publisher=Barron's Educational Series | year=1994 | edition=5th | isbn=978-0-8120-1853-0}} * {{cite book | last=Glubb | first=John Bagot | authorlink=John Bagot Glubb | title=The Life and Times of Muhammad | publisher=Hodder & Stoughton | origyear=1970| year=2002 | isbn=0-8154-1176-6}} * {{cite book | last=Goldman | first=Elizabeth | authorlink=Elizabeth Goldman | title=Believers: spiritual leaders of the world | url=https://archive.org/details/believersspiritu00gold | publisher=Oxford University Press | year=1995 | isbn=0-19-508240-0}} * {{cite book | last=Goldman| first=Ann |author2=Richard Hain|author3=Stephen Liben | title= Oxford Textbook of Palliative Care for Children| url=https://archive.org/details/oxfordtextbookof0000unse_g7j0| publisher=Oxford University Press | year=2006 | isbn=0-19-852653-9}} * {{cite book | last=Haaren| first=John Henry |author2=Addison B. Poland| title=Famous Men of the Middle Ages| url=https://archive.org/details/famousmenmiddle00haargoog| publisher=University Publishing Company | year=1904 | isbn=1-882514-05-X}} * Al-Hibri, Azizah Y. (2003). "An Islamic Perspective on Domestic Violence". ''27 Fordham International Law Journal'' 195. * {{cite book | last=Holt | first=P. M. | authorlink=P. M. Holt | author2=Ann K. S. Lambton | author3=Bernard Lewis| author3-link=Bernard Lewis | title=The Cambridge History of Islam (Paperback) | year=1977 | publisher=Cambridge University Press | isbn=978-0-521-29135-4}} * {{cite book | last=Hourani | first=Albert | authorlink=Albert Hourani |author2=Ruthven, Malise |authorlink2=Malise Ruthven | title=A History of the Arab Peoples | year=2003 | publisher=Belknap Press; Revised edition | isbn=978-0-674-01017-8}} * {{cite book | last=ibn Isa |first=Muhammad (Imam Tirmidhi) | authorlink=Imam Tirmidhi | title=Syama'il Muhammadiyah: KeanggunanMu Ya Rasulullah | year=2011 | publisher=PTS Islamika Sdn. Bhd. | location=Malaysia | isbn=978-967-3-66064-3 | page=388 | language=Arabic with Malay translation | type=Hardcover}} * {{cite book | last=Ishaq | first=Ibn | authorlink=Ibn Ishaq | coauthor=[[Alfred Guillaume|Guillaume, Alfred]], ed. | title=The Life of Muhammad: A Translation of Ibn Ishaq's Sirat Rasul Allah | url=https://archive.org/details/lifeofmuhammadtr0000ibnh | publisher=Oxford University Press | year=2002 | isbn=978-0-19-636033-1}} * {{cite book | last=Jacobs | first=Louis| authorlink=Louis Jacobs|title=The Jewish Religion: A Companion | url=https://archive.org/details/jewishreligionco0000jaco | publisher=Oxford University Press | year=1995 | isbn=0-19-826463-1}} * {{cite book | last=Kelsay | first=John| authorlink=John Kelsay|title=Islam and War: A Study in Comparative Ethics | url=https://archive.org/details/islamwarstudyinc0000kels | publisher=Westminster John Knox Press | year=1993 | isbn=0-664-25302-4}} * {{cite book | last=Khan | first=Majid Ali | authorlink=Majid Ali Khan | title=Muhammad The Final Messenger | publisher=Islamic Book Service, New Delhi, 110002 (India) | year=1998 | isbn=81-85738-25-4}} * {{cite book | last=Kochler | first=Hans | authorlink=Hans Köchler | title=Concept of Monotheism in Islam & Christianity | url=https://archive.org/details/conceptofmonothe0000unse | publisher=I.P.O. | year=1982 | isbn=3-7003-0339-4}} * {{cite book | last = Lapidus| first = Ira | title = A History of Islamic Societies | url = https://archive.org/details/historyofislamic0000lapi_t2d2| publisher = Cambridge University Press | year = 2002 | edition = 2nd | isbn = 978-0-521-77933-3}} * {{cite book | last=Larsson| first=Göran | title= Ibn Garcia's Shu'Ubiyya Letter: Ethnic and Theological Tensions in Medieval Al-Andalus| publisher=Brill Academic Publishers | year=2003 | isbn=90-04-12740-2}} * {{cite book | last=Lewis | first=Bernard | authorlink=Bernard Lewis | origyear=1993| year=2002 | title=[[The Arabs in History]] | publisher=Oxford University Press | isbn=0-19-280310-7}} * {{cite book | last=Lewis | first=Bernard | authorlink=Bernard Lewis | title=[[Race and Slavery in the Middle East|Race and Slavery in the Middle East: An Historical Enquiry]] | publisher=Oxford University Press, USA | edition=Reprint | year=1992 | isbn=978-0-19-505326-5}} * {{cite news | last=Lewis | first=Bernard | title=Islamic Revolution |date=21 January 1998 | publisher=The New York Review of Books | url=http://www.nybooks.com/articles/archives/1988/jan/21/islamic-revolution/}} * {{cite book | last=Lings | first=Martin | authorlink=Martin Lings | title=[[Muhammad: His Life Based on the Earliest Sources]] | publisher=Islamic Texts Society.| year=1983 | isbn=978-0-946621-33-0}} US edn. by Inner Traditions International, Ltd. * {{cite book | last = Madelung | first = Wilferd | authorlink = Wilferd Madelung | title = [[The Succession to Muhammad|The Succession to Muhammad: A Study of the Early Caliphate]] | publisher = Cambridge University Press | year = 1997 | isbn = 0-521-64696-0}} * {{cite book | last=Momen| first=Moojan | authorlink=Moojan Momen | title=An Introduction to Shi'i Islam: The History and Doctrines of Twelver Shiʻism | url=https://archive.org/details/introductiontosh0000unse_d5k7| publisher=Yale University Press| year=1985 | isbn=0-300-03531-4}} * {{cite book | last=Neusner| first=Jacob | title=God's Rule: The Politics of World Religions | url=https://archive.org/details/godsrulepolitics0000unse| publisher=Georgetown University Press| year=2003 | isbn=0-87840-910-6}} * {{cite book | last=Nigosian | first=S. A. | authorlink=S. A. Nigosian | title= Islam:Its History, Teaching, and Practices | url=https://archive.org/details/islamitshistoryt0000nigo | publisher=Indiana University Press | year=2004 | isbn=0-253-21627-3}} * {{cite book | last=Ordoni | first=Abu Muhammad |author2=Muhammad Kazim Qazwini | title=[[Fatima the Gracious]] |publisher=Ansariyan Publications |year=1992| asin=B000BWQ7N6}} * {{cite book | last=Peters | first=Francis Edward | authorlink=F. E. Peters | year=2003 | title=Islam: A Guide for Jews and Christians| url=https://archive.org/details/islamguideforjew00fepe | publisher=Princeton University Press | isbn=0-691-11553-2}} * {{cite book | last=Peters | first=Francis Edward | year=2003b | title=The Monotheists: Jews, Christians, and Muslims in Conflict and Competition| url=https://archive.org/details/monotheistsjewsc00pete_0 | publisher=Princeton University Press | id=ASIN: B0012385Z6 | isbn=0-691-11461-7}} * {{cite book | last=Peters | first=Francis Edward | authorlink=F. E. Peters | year=1994 | title=Muhammad and the Origins of Islam| url=https://archive.org/details/muhammadorigins00pete | publisher=SUNY Press | isbn=0-7914-1876-6}} * {{cite journal|journal = [[International Journal of Middle East Studies]]|author = Peters, F. E.|title = [[The Quest of the Historical Muhammad (Peters)|The Quest of the Historical Muhammad]]|volume = 23|number = |year = 1991|pages = 291–315|doi =10.1017/S0020743800056312|issue = 3 }} * {{cite book | last=Peterson | first=Daniel | authorlink=Daniel C. Peterson | year=2007 | title=Muhammad, Prophet of God| url=https://archive.org/details/muhammadpropheto0000pete | publisher=Wm. B. Eerdmans Publishing Company | isbn=0-8028-0754-2}} * {{cite book | last=Rahman | first=Fazlur | authorlink=Fazlur Rahman | year=1979 | title= Islam | url=https://archive.org/details/isbn_9780226702810 | publisher= University of Chicago Press | isbn=0-226-70281-2}} * {{cite book | last=Ramadan | first=Tariq | authorlink=Tariq Ramadan | year=2007 | title= In the Footsteps of the Prophet: Lessons from the Life of Muhammad | url=https://archive.org/details/infootstepsofpro00rama | publisher=Oxford University Press | isbn=0-19-530880-8}} * {{cite book | last = Razwi | first = Ali Asgher | title =A Restatement of the History of Islam and Muslims | url = https://archive.org/details/restatementofhis0000razw | publisher = World Federation of K S I Muslim Communities Islamic Centre | year = 1997 | isbn = 0-9509879-1-3}} * {{cite book | last=Reeves | first=Minou | authorlink=Minou Reeves | title=Muhammad in Europe: A Thousand Years of Western Myth-Making | url=https://archive.org/details/muhammadineurope0000mino | year=2003 | publisher=NYU Press | isbn=978-0-8147-7564-6}} * {{cite book | last=Robinson | first=David | title=Muslim Societies in African History | url=https://archive.org/details/muslimsocietiesi0000robi | publisher=Cambridge University Press | year=2004 | isbn=0-521-82627-6}} * {{cite book | author-link=Maxime Rodinson|author=Rodinson, Maxime | title=Muhammad: Prophet of Islam | publisher=Tauris Parke Paperbacks | year=2002 | isbn=1-86064-827-4}} * {{cite book | last=Rue | first=Loyal | authorlink=Loyal Rue | title=Religion Is Not about God: How Spiritual Traditions Nurture Our Biological | url=https://archive.org/details/religionisnotabo0000ruel | publisher=Rutgers | year=2005 | isbn=0-8135-3955-2}} * {{cite book | last=Serin | first=Muhittin | title= Hattat Aziz Efendi | publisher=Istanbul | year=1998 | isbn=975-7663-03-4 | oclc=51718704}} * {{cite book | last=Sikand |first=Yoginder |title=Muslims in India since 1947: Islamic perspectives on inter-faith relations | url=https://archive.org/details/muslimsinindiasi0000sika |publisher=RoutledgeCurzon |location=London |year=2004 |isbn=0-415-31486-0}} * {{cite book | last = Tabatabae | first = Sayyid Mohammad Hosayn | authorlink = Allameh Tabatabaei | title = [[Tafsir al-Mizan|AL-MIZAN:AN EXEGESIS OF THE QUR'AN]], translation by S. Saeed Rizvi| publisher = WOFIS| isbn =964-6521-14-2}} * {{cite book | last=Teed | first=Peter | title= A Dictionary of Twentieth Century History | url=https://archive.org/details/dictionaryoftwen00teed | publisher=Oxford University Press | year=1992 | isbn=0-19-211676-2}} * {{cite book | last=Turner | first=Colin | title= Islam: The Basics | url=https://archive.org/details/islambasics0000turn | publisher=Routledge | year=2005 | isbn=0-415-34106-X}} * {{cite book | last=Watt | first=W. Montgomery | authorlink=William Montgomery Watt | title=Muhammad: Prophet and Statesman | url=https://archive.org/details/muhammadprophets0000watt | publisher=Oxford University Press | year=1961 | isbn=0-19-881078-4}} (New edition 1974) * {{cite book | last=Watt | first=W. Montgomery | title=[[Muhammad at Medina (book)|Muhammad at Medina]] | publisher=Oxford University Press | year=1956 | isbn=0-19-577307-1}} * {{cite book | last=Watt | first=W. Montgomery| title=[[Muhammad at Mecca (book)|Muhammad at Mecca]] | publisher=Oxford University Press | year=1953 | id=ASIN: B000IUA52A | isbn=0-19-577277-6}} * {{cite journal |last1 = Weil |first1 = Gustav |authorlink1= Gustav Weil |last2 = Sanders |first2 = Frank K. |last3 = Dunning |first3 = Harry W. | year = 1895 |title = An Introduction to the Quran I |url = https://archive.org/details/sim_biblical-world_1895-03_5_3/page/181 |journal = The Biblical World |publisher = The University of Chicago Press |volume = 5 |issue = 3 |pages = 181–191 |jstor = 3135387 |doi = 10.1086/471621}} * {{cite journal |last1 = Weil |first1 = Gustav |authorlink1= Gustav Weil |year = 1895 |title = An Introduction to the Quran II |url = https://archive.org/details/sim_biblical-world_1895-04_5_4/page/273 |journal = The Biblical World |publisher = The University of Chicago Press |volume = 5 |issue = 4 |pages = 273–286 | jstor = 3135160 |doi = 10.1086/471639}} {{refend}} ===Kamusi elezo=== {{refbegin}} * {{cite encyclopedia | editor=William H. McNeill, Jerry H. Bentley, David Christian | encyclopedia=Berkshire Encyclopedia of World History | publisher=Berkshire Publishing Group | year=2005 | isbn=978-0-9743091-0-1}} * {{cite encyclopedia | editor=Richard C. Martin, Said Amir Arjomand, Marcia Hermansen, Abdulkader Tayob, Rochelle Davis, John Obert Voll | encyclopedia=Encyclopedia of Islam & the Muslim World | publisher=MacMillan Reference Books | year=2003 | isbn=978-0-02-865603-8}} * {{cite encyclopedia | editor=P. J. Bearman, Th. Bianquis, [[Clifford Edmund Bosworth|C. E. Bosworth]], E. van Donzel, [[Wolfhart Heinrichs|W. P. Heinrichs]] | encyclopedia=[[Encyclopaedia of Islam]] Online | publisher=Brill Academic Publishers | issn=1573-3912}} * {{cite encyclopedia | editor=Lindsay Jones | encyclopedia=Encyclopedia of Religion | publisher=MacMillan Reference Books | edition=2nd | year=2005 | isbn=978-0-02-865733-2}} * {{cite encyclopedia | editor=Jane Dammen McAuliffe | encyclopedia=[[Encyclopedia of the Qur'an]] | publisher=Brill Academic Publishers | year=2005 | isbn=978-90-04-12356-4}} * {{cite encyclopedia | encyclopedia=Encyclopedia of World History | publisher=Oxford University Press | year=1998 | isbn=0-19-860223-5}} * {{cite encyclopedia | encyclopedia=The New Encyclopædia Britannica | publisher=Encyclopædia Britannica, Incorporated | edition=Rev | year=2005 | isbn=978-1-59339-236-9}} {{refend}} {{BD|570|632}} [[Jamii:Muhammad]] [[Jamii:Uislamu]] [[Jamii:Watu wa Kurani]] [[Jamii:Mitume katika Uislamu]] 1o72n0zihmy9w6a0bln9xgubqrpmmje 0 1751 1578082 1446198 2026-07-02T18:49:49Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578082 wikitext text/x-wiki [[Picha:Der-Kilimandscharo.jpg|thumb|Kilimanjaro mnamo 1911]] [[Picha:ETH-BIB-Blick ins Kraterloch des Kibo aus 6500 m Höhe-Kilimanjaroflug 1929-30-LBS MH02-07-0119.tif|thumb|Picha ya kwanza ya angani ya Kibo iliyochukuliwa na Walter Mittelholzer mnamo 1929]] [[Picha:Elephants at Amboseli national park against Mount Kilimanjaro.jpg|thumb|Tembo kwenye Hifadhi ya Kitaifa ya Amboseli dhidi ya Mlima Kilimanjaro]] [[Picha:Moshi panorama edit1.jpg|thumb|Mlima Kilimanjaro kama unavyoonekana kutoka manispaa ya Moshi katika Mkoa wa Kilimanjaro]] [[Picha:Kilimanjaro 3D - version 1.gif|thumb|mfano wa kilele cha mlima kilimanjaro]] [[Picha:Kilimanjaro 2006-08-13.JPG|thumb|250px|Mlima Kilimanjaro unavyoonekana kutoka [[Moshi (mji)|Moshi]]]] [[Picha:Kibo summit of Mt Kilimanjaro 001.JPG|thumb|250px|Kilele cha Kibo kwenye mlima Kilimanjaro]] '''Kilimanjaro''' ni [[jina]] la [[mlima]] mrefu kuliko yote [[Bara|barani]] [[Afrika]]. Mlima huo uko nchini [[Tanzania]] katika [[Mkoa wa Kilimanjaro]]. Una [[urefu]] wa [[mita]] 5,895 ([[futi]] 19,340). Hali halisi Kilimanjaro ni zaidi ya mlima tu, ni kama [[Safu ya milima|safu ndogo ya milima]] mitatu: Kibo, Mawenzi na Shira. Hiyo mitatu inaonekana kama vilele vitatu vya mlima mmoja, hivyo si vibaya kusema Kilimanjaro ni mlima. [[Jiolojia|Kijiolojia]] Kilimanjaro ni [[volkeno]] iliyolala kwa sasa. Kwenye [[kilele]] cha [[Kibo]] [[gesi]] bado inatoka. Kumbukumbu ya wenyeji ina habari ya [[mlipuko]] mnamo [[mwaka]] [[1730]]. Kilele cha juu cha Kibo kinaitwa [[Uhuru]]. Mtu wa kwanza kufika kileleni hapo alikuwa [[Johannes Kinyala Lauwo]] kutoka [[Marangu]] aliyewaongoza [[Wajerumani]] [[Hans Meyer]] na [[Ludwig Purtscheller]] [[tarehe]] [[6 Oktoba]] [[1889]] wakati wa [[ukoloni]] wa [[Afrika ya Mashariki ya Kijerumani|Ujerumani]]. Wakati ule waliita ncha ya juu "Kaiser-Wilhelm-Spitze" ''(kwa [[Kijerumani]]: Kilele cha Kaisari Wilhelm)'' kwa heshima ya [[Kaisari]] wa [[Ujerumani]]. Kibo ina [[theluji]] na [[barafuto]] ndogo kadhaa. ==Jina== [[File:German East Africa MKL Bd. 14 1890 (128624470).jpg|thumb|350px|Ramani ya 1890 inayoonyesha jina "''Kilima-Ndscharo''" katika [[Afrika ya Mashariki ya Kijerumani]].]] [[Asili]] ya jina "Kilimanjaro" haijulikani kikamilifu. Vyanzo vya kimaandishi vinajulikana tangu takriban mwaka [[1860]] ambapo [[wapelelezi]] [[Wazungu]] walitumia jina hilo katika taarifa zao wakidai "Kilimanjaro" ni jina la [[Kiswahili]].<ref name="Krapf">{{cite book | author1=Johann Ludwig Krapf | author2=Ernest George Ravenstein | title=Travels, Researches, and Missionary Labours, During an Eighteen Years' Residence in Eastern Africa: Together with Journeys to Jagga, Usambara, Ukambani, Shoa, Abessinia and Khartum, and a Coasting Voyage from Nombaz to Cape Delgado | url=http://books.google.com/books?id=z78NAAAAQAAJ&pg=PA255 | year=1860 | publisher=Trübner and Company, Paternoster Row. | page=255}}</ref> Pamoja na umbo hili kulikuwa pia na tahajia ya sehemu mbili ama "Kilima-Njaro"<ref>{{cite web | url=http://words.fromoldbooks.org/Wood-NuttallEncyclopaedia/k/kilima-njaro.html | title=Kilima-Njaro | publisher=fromoldbooks.org | work=1907 Nuttall Encyclopædia of General Knowledge | date=1907 | accessdate=16 July 2015 | author=James Wood}}</ref> au kwa namna ya Kijerumani “Kilima-Ndscharo”. [[Johann Ludwig Krapf]] aliandika mnamo [[1860]] kuwa [[Waswahili]] kwenye [[pwani]] waliita mlima huo "Kilimanjaro". Alisema pia ya kwamba hao Waswahili walieleza maana yake kuwa ama “mlima mkubwa” au “mlima wa misafara” ingawa mwenyewe hakukubali maelezo hayo. Kwa elezo la mwisho "Kilima" kilimaanisha "mlima" na "Jaro" labda "misafara".<ref name="Krapf"/> [[Jim Thompson]] aliandika mnamo [[1885]] kuwa jina Kilima-Njaro lilichukuliwa mara nyingi kuwa na maana ya "mlima mkubwa" lakini mwenyewe alipendelea maelezo tofauti yaliyosema "mlima mweupe". <ref>[http://books.google.com/books?id=9PETAAAAIAAJ&pg=PA116#v=onepage&q&f=false ''Through Masai land: a journey of exploration among the snowclad volcanic mountains and strange tribes of eastern equatorial Africa'', authored by Johann Ludwig Krapf and Ernest George Ravenstein, Low, Marston, Searle, & Rivington, London, 1887]</ref> "Njaro" ni Kiswahili cha Zamani kwa "ng’ara".<ref>{{cite web | url=http://www2.jpl.nasa.gov/srtm/tanzania.htm#PIA03355 | title=Perspective with Landsat Overlay | publisher=California Institute of Technology | work=SRTM TANZANIA IMAGES | accessdate=16 July 2015}}</ref> Vivyo hivyo [[Krapf]] aliandika ya kwamba aliwahi kuwatembela [[Wakamba]] mnamo [[1849]] walioita mlima “Kima jaJeu” yaani mlima mweupe <ref>{{cite book | author1=Johann Ludwig Krapf | author2=Ernest George Ravenstein | title=Travels, Researches, and Missionary Labours, During an Eighteen Years' Residence in Eastern Africa: Together with Journeys to Jagga, Usambara, Ukambani, Shoa, Abessinia and Khartum, and a Coasting Voyage from Nombaz to Cape Delgado | url=http://books.google.com/books?id=z78NAAAAQAAJ&pg=PA544 | year=1860 | publisher=Trübner and Company, Paternoster Row. | page=544}}</ref> Leo hii Wakamba wangesema “Kiima Kyeu” na elezo hili limekubaliwa na [[watafiti]] mbalimbali. Wengine huona ya kwamba ni Wazungu wasiojua Kiswahili vema waliochanganya “mlima” na “Kilima”. Wengine wamejaribu kuona msingi wa jina katika [[lugha]] ya [[Kichagga]]. Hapo wanadai uwezekano kuwa "Kileman" limetokana na [[neno]] la Kichagga "kileme" linalomaanisha “kinachoshinda” au neno "kilelema" linalomaanisha "kilichokuwa vigumu, kilichoshindikana". Katika hoja hiyo "Jaro" imetokana na Kichagga “njaare” (aina ya [[Ndege (mnyama)|ndege]], au kufuatana na wengine [[chui]]) au kutoka neno “jyaro” ([[msafara]]). Elezo lingine ni kwamba [[Wachagga]] walisema mlima huo hauwezi kupandwa "kilemanjaare" au "kilemajyaro" na [[wapagazi]] au wafasiri kutoka pwani waliichukua kuwa jina la mlima na kutafsiri vile kwa Wazungu. Tangu [[miaka ya 1880]] mlima umekuwa sehemu ya [[Afrika ya Mashariki ya Kijerumani]] ukaitwa "Kilima-Ndscharo" kwa Kijerumani.<ref>Briggs, Philip (1996): "Guide to Tanzania; 2nd edition." Bradt Guides.</ref> Tarehe [[6 Oktoba]] [[1889]] [[Hans Meyer]] alikuwa mtu wa kwanza anayejulikana kupanda mlima na kufika hadi kilele cha Kibo. Alichagua jina la "Kaiser-Wilhelm-Spitze" ("Ncha ya [[Kaisari Wilhelm II|Kaisari Wilhelm]]"<ref> Haieleweki kama alitoa jina kwa heshima ya [[Kaisari Wilhelm I]] (aliyeunganisha Ujerumani) au [[Mwana|mwanawe]] [[Kaisari Wilhelm II]] (aliyekuwa [[mtawala]] tangu mwaka [[1888]] tu)</ref>).<ref>{{cite conference | url=http://icaci.org/files/documents/ICC_proceedings/ICC2003/Papers/110.pdf | title=GERMAN CONTRIBUTIONS TO THE CARTOGRAPHY OF SOUTH WEST AND EAST AFRICA FROM MID 19th CENTURY TO WORLD WAR I | publisher=University of Technology Darmstadt | accessdate=16 July 2015 | author=Demhardt, I.J.}}</ref> Jina hilo lilitumika hadi [[Tanzania]] ilipoundwa mwaka [[1964]],<ref>{{cite journal | title=Further Notes on the Kibo Inner Crater and Glaciers of Kilimanjaro and Mount Kenya | url=https://archive.org/details/sim_geographical-journal_nov-dec-1945_106_5-6/page/n72 | author=P. C. Spink | journal=The Geographical Journal | year=1945 | volume=106 | issue=5-6 | pages=213 | doi=10.2307/1788958 | jstor=1788958}}</ref> na kilele kubadilishiwa jina kuwa "Uhuru", likiwa na maana ya "Kilele cha Uhuru" <ref>{{cite journal | url=http://www.alpinejournal.org.uk/Contents/Contents_1965_files/AJ%201965%20320-330%20Dangar%20Alpine%20Notes.pdf | title=Dangar Alpine Notes | author=D. F. O. Dangar | journal=The Alpine Journal | year=1965 | volume=70 | issue=310-311 | pages=328}}</ref> ==Jiolojia ya mlima na tabia za kijiografia== Kilimanjaro inapanda hadi mita 4877 juu ya [[tambarare]] karibu na [[Moshi (mji)|mji wa Moshi]] uliopo miguuni pake. Hii inafanya kilele chake kuwa mita 5895 juu ya [[uwiano wa bahari]].<ref name="UNESCO">{{cite web | url=http://whc.unesco.org/en/list/403 | title=Kilimanjaro National Park | publisher=UNESCO World Heritage Centre | work=World Heritage List | accessdate=16 July 2015}}</ref> Kilimanjaro ni volkeno ya [[rusu]] iliyojengwa na rusu za [[majivu]], [[zaha]] na [[mata]] nyingine. Ni volkeno ndefu kuliko zote [[duniani]] nje ya [[Amerika Kusini]]. <ref name="HighVolc">{{cite web | url=http://www.volcanolive.com/kilimanjaro.html | title=Mt Kilimanjaro Volcano | publisher=Volcano Live - John Seach | accessdate=22 November 2015}}</ref> Vilele vitatu vya kivolkeno juu ya Kilimanjaro ni * Kibo iliyo juu zaidi * Mawenzi yenye [[kimo]] cha mita 5149<ref>{{cite web | url=http://www.peakware.com/peaks.html?pk=2084 | title=Mawenzi | publisher=Interactive Outdoors, Inc | work=Peakware | accessdate=16 July 2015 | archivedate=2016-03-04 | archiveurl=https://web.archive.org/web/20160304192427/http://www.peakware.com/peaks.html?pk=2084 }}</ref> * Shira yenye urefu wa mita 4005.<ref name="Kaser">{{cite journal | url=https://www.geo.umass.edu/climate/tanzania/pubs/cullen_etal_2006_grl.pdf | title=Kilimanjaro Glaciers: Recent areal extent from satellite data and new interpretation of observed 20th century retreat rates | author=Nicolas J. Cullen, Thomas Mölg, Georg Kaser, Khalid Hussein, Konrad Steffen, and Douglas R. Hardy | journal=Geophysical Research Letters | year=2006 | volume=33 | issue=16 | doi=10.1029/2006GL027084 | format=PDF | bibcode=2006GeoRL..3316502C}}</ref> Vyote vitatu vina [[kasoko]]. Mawenzi na Shira ni [[volkeno zimwe]] lakini Kibo ni volkeno iliyolala, ila inaweza kuwaka tena. <ref name="NonnottePhilippe">{{cite journal | author1=Nonnotte, Philippe | author2=Hervé Guillou | author3 = Bernard Le Gall | author4 = Mathieu Benoit | author5 = Joseph Cotten | author6 = Stéphane Scaillet | title=New K-Ar age determinations of Kilimanjaro volcano in the North Tanzanian diverging rift, East Africa | journal=Journal of Volcanology and Geothermal Research | year=2008 | volume=173 | issue=1-2 | pages=99–112 | accessdate=29 July 2015 | doi=10.1016/j.jvolgeores.2007.12.042 | url=http://hal.univ-brest.fr/file/index/docid/304458/filename/Nonnotte_et_al.J.Volc.Geoth.Res-08.pdf}}</ref> Uhuru ni sehemu ya juu kwenye ukingo wa [[kasoko]] ya Kibo. [[Taasisi]] ya [[Tanzania National Parks Authority]] <ref name="TNP">{{cite web | url=http://www.tanzaniaparks.com/kili.html | title=Mount Kilimanjaro National Park | publisher=Tanzania National Parks | work=Tanzania National Parks | accessdate=16 July 2015 | archivedate=2012-09-23 | archiveurl=https://web.archive.org/web/20120923032157/http://www.tanzaniaparks.com/kili.html | =https://web.archive.org/web/20120923032157/http://www.tanzaniaparks.com/kili.html }}</ref> na [[UNESCO]] zinataja [[kimo]] cha Uhuru Peak kuwa mita 5895. Kimo hicho kimetokana na [[upimaji]] uliofanyika wakati wa [[ukoloni]] wa [[Uingereza]] mwaka [[1952]]. <ref name="Digital">{{cite web | url=http://ceur-ws.org/Vol-1142/paper12.pdf | title=The New Digital Orthometric Elevation Model of Kilimanjaro | publisher=CEUR Workshop Proceedings | accessdate=16 July 2015 | author=Pascal Sirguey, Nicolas J. Cullen and Jorge Filipe Dos Santos}}</ref> Tangu upimaji ule kimo cha mlima kimepimwa tena: kinaonyesha kuwa mlima unapungua polepole. Kipimo kilikuwa mita 5892 mwaka [[1999]] na mita 5891 mwaka [[2014]].<ref name="Digital"/> Muundo wa ndani wa Kilimanjaro haujulikani sana kwa sababu hadi sasa haujatokea [[mmomonyoko]] mkubwa unaoweza kufunua ndani yake.<ref name="Preliminary">{{cite journal | url=http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=4713936&fileId=S0016756800066590 | title=Preliminary Notes on the Geology of Kilimanjaro | author=W. H. Wilcockson | journal=Geological Magazine | year=1956 | volume=93 | issue=3 | pages=218–228 | doi=10.1017/S0016756800066590}}</ref> ===Shira=== Kilele cha kale zaidi ni Shira iliyoanza kutema moto takriban miaka milioni 2.5 iliyopita ikaacha miaka milioni 1.9 iliyopita. Wakati ule upande wa kaskazini wa mzingo wa kasoko ulipinduka. <ref name="NonnottePhilippe"/> Leo hii Shira ina tambarare pana kwenye kilele chake kwenye kimo cha mita 3800; inawezekana hii kiasili ilikuwa [[kaldera]] iliyojaa lava. Mabaki ya mzingo wa kaldera yamepungua sana kutokana na mmomonyoko. Kabla ya kutoa moto na kutokea kwa mmomonyoko kimo cha Shira kilikuwa kati ya mita 4,900 na 5,200. Mata yake ni hasa lava pamoja na kiasi cha [[piroklasti]]. <ref name="NonnottePhilippe"/><ref name="Preliminary"/><ref name="JohnBarryDawson">{{cite book | author=John Barry Dawson | title=The Gregory Rift Valley and Neogene-recent Volcanoes of Northern Tanzania | url=http://books.google.com/books?id=Om2oMjXK3R4C&pg=PA56|year=2008|publisher=Geological Society of London | isbn=978-1-86239-267-0|page=56}}</ref> ===Mawenzi=== Mawenzi na Kibo zilianza kulipuka (kutoa moto) takriban miaka milioni iliyopita.<ref name="NonnottePhilippe"/> Zimetengwa na tambarare ( "Saddle Plateau") kwenye kimo cha mita 4400.<ref name="AnAscentOfKilimanjaro">{{cite journal | url=http://www.jstor.org/stable/1780513?seq=3#page_scan_tab_contents | title=An Ascent of Kilimanjaro | author=C. Gillman | journal=The Geographical Journal | year=1923 | volume=61 | issue=1 | doi=10.2307/1780513 | registration=yes | jstor=10.2307/1780513 | pages=1–21}}</ref>{{rp|3}} Miamba ya kijana kwenye Mawenzi ilitokea miaka 448,000 iliyopita. <ref name="NonnottePhilippe"/> Mawenzi huwa na [[mgongo]] wenye [[umbo]] la [[kiatu]] cha [[farasi]] mwenye [[ncha]] kali na kufunguka upande wa kaskazini-magharibi. Mgongo unakatwa na [[Bonde|mabonde]] kadhaa na upande wa mashariki wa mlima umepungua kutokana na mmomonyoko. Mawenzi huwa na kilele cha pili kinachojulikana kwa jina la “Neumann Tower” chenye mita 4425.<ref name="NonnottePhilippe"/><ref name="Preliminary"/><ref name="JohnBarryDawson"/> ===Kibo=== Kibo ni [[pia]] ya kivolkeno yenye kimo kirefu ikiwa na [[upana]] wa kilomita 15 kwenye "Saddle Plateau". Ililipuka mara ya mwisho miaka 150,000 na 200,000 iliyopita na [[mlipuko wa volkeno|mlipuko]] huo ulifanya kasoko kwenye kilele cha Kibo cha sasa. Hadi leo gesi inatoka kwenye [[Shimo|mashimo]] ardhini.<ref name="NonnottePhilippe"/><ref name="Preliminary"/><ref name="JohnBarryDawson"/> Kibo huwa na pia kwenye kilele chake chenye [[umbo]] kamili. Kuna [[kaldera]] yenye upana wa kilomita 2.5 na ndani yake pia iko kasoko ya Reusch. Jina hilo lilitolewa na [[serikali]] ya [[Tanganyika]] mwaka [[1954]] kwa heshima ya Mjerumani [[Gustav Otto Richard Reusch]] alipopanda mlima mara ya 25. <ref>{{cite web | url=http://cvgs.cu-portland.edu/history/biographies/bio.cfm?id=529 | title=Gustav Otto Richard Reusch | publisher=The Center for Volga German Studies at Concordia University | work=Biographies | accessdate=16 July 2015 | archivedate=2015-10-24 | archiveurl=https://web.archive.org/web/20151024111716/http://cvgs.cu-portland.edu/history/biographies/bio.cfm?id=529 }}</ref><ref>{{cite book | author=Richard Leider | title=The Power of Purpose: Find Meaning, Live Longer, Better | url=http://books.google.com/books?id=_s4B9LI7BX0C&pg=PA12 | date=10 May 2010 | publisher=Berrett-Koehler Publishers|isbn=978-1-60509-527-1 | page=12}}</ref> Ndani ya kasoko ya Reusch kuna shimo refu linalojulikana kwa jina la “ash pit” (shimo la majivu).<ref>{{cite web | url=http://volcano.oregonstate.edu/kilimanjaro | title=Kilimanjaro | publisher=Oregon State University | work=Volcano World | accessdate=16 July 2015}}</ref> Wakati wa mlipuko wa mwisho uliotokea miaka 100,000 iliyopita sehemu za mzingo wa kasoko ziliporomoka na kuacha pengo kubwa. <ref>{{cite book | author=Alex Stewart | title=Kilimanjaro: A Complete Trekker's Guide: Preparations, practicalities and trekking routes to the 'Roof of Africa' | url=http://books.google.com/books?id=28N6F2wBSM8C&pg=PA97 | date=23 April 2012 | publisher=Cicerone Press Limited | isbn=978-1-84965-622-1 | page=100}}</ref> Kibo huwa na pia za kando zaidi ya 250 ambazo ni mashimo ambako gesi, [[zaha]] na [[piroklasti]] zilitoka kwenye pande za mlima wakati wa kuwa [[volkeno hai]]. Zilitokea miaka 150,000 hadi 200,000 iliyopita <ref name="NonnottePhilippe"/>. Zinapatikana hadi [[Ziwa Chala]] na [[Taita-Taveta County|Taveta]] upande wa kusini-mashariki na hadi [[Lengurumani]] upande wa kaskazini-magharibi. Zaha iliyotoka katika pia hizo za kando ilifunika sehemu kubwa ya pande za mlima. [[Wamaasai]] wana kumbukumbu ya kuwa [[Ziwa Chala]] upande wa mashariki wa Kibo lilikuwa mahali pa [[kijiji]] kimoja kilichoharibika na mlipuko wa volkeno. [[Maji]] yatoka mlimani kwa njia ya [[mito]] na [[kijito|vijito]] hasa upande wa kusini unaopokea [[mvua]] zaidi hasa juu ya mita 1200. Chini ya kimo hicho maji kwenye [[mito]] inapungua kutokana na mvukizo na matumizi ya [[binadamu]]. Mito ya [[Lumi (mto) |Lumi]] na [[Pangani (mto)|Pangani]] inabeba maji ya Kilimanjaro kuelekea mashariki na kusini. <ref>{{cite book | author=William Dubois Newmark | title=The Conservation of Mount Kilimanjaro | url=http://books.google.com/books?id=0Is9h1vm90AC&pg=PA22 | year=1991 | publisher=IUCN | isbn=978-2-8317-0070-0 | pages=105–106}}</ref> [[File:Mount Kilimanjaro peeking through the clouds.jpg|thumb|Mlima Kilimanjaro ukitokea kati ya mawingu.]] ==Tabianchi== [[Tabianchi]] ya Kilimanjaro inaathiriwa na kimo cha mlima kinachoruhusu kufika kwa [[upepo]] kutoka [[bahari]] wenye [[unyevu]] mwingi na wakati mmoja pia upepo za juu sana. Tabia nyingine ni hali yake ya kuwa mlima wa juu sana peke yake bila jirani ya karibu sana. Mlima huwa na mfumo wa upepo ambako [[mchana]] upepo unaelekea juu na wakati wa [[usiku]] kuna upepo unaotelemka kutoka juu. Hii inatokea zaidi upande wa kusini kuliko upande wa kaskazini kwa sababu tako la mlima ni pana zaidi upande wa kusini na mitelemko yake inaelekea zaidi hivyo kuathiri tabianchi zaidi. <ref name="AnAscentOfKilimanjaro"/>. Kilimanjaro huwa na [[majira]] mawili ya mvua, moja ya [[Machi]] hadi [[Mei]] na nyingine mnamo mwezi wa [[Novemba]]. Mitelemko ya kaskazini hupokea mvua chache kulingana na mitelemko ya kusini.<ref name="PlantEcology"/> Sehemu za chini za mtelemko wa kusini hupokea [[milimita]] za [[mvua]] 800 – 900 kwa mwaka. Kiwango hiki kinaongezeka kwa milimita 1,500 hadi 2,000 kwenye kimo cha mita 1,500 na hadi juu ya milimita 3,000 kwenye ukanda wa msitu kwa mita 2,000 hadi 2,300. Juu zaidi [[usimbishaji]] unapungua tena hadi milimita 200.<ref name="PlantEcology2">{{cite journal | url=http://www.researchgate.net/profile/Hemp_Andreas/publication/227232425_Introduced_plants_on_Kilimanjaro_tourism_and_its_impact/links/0a85e53be4703e41aa000000.pdf | title=Introduced plants on Kilimanjaro: tourism and its impact | author=Andreas Hemp | journal=Plant Ecology | year=2007 | volume=197 | issue=1 | pages=17–29 | doi=10.1007/s11258-007-9356-z}}</ref>{{rp|18}} [[Halijoto]] kwenye kilele ina wastani ya [[sentigredi]] -7 yaani [[jalidi]]. Halijoto juu ya ngao ya [[barafu]] upande wa kaskazini wakati wa usiku huwa na wastani wa sentigredi -9 na wakati wa mchana -4. Viwango vya chini vya -15 hadi -27 vimepimiwa pia.<ref name="SinghSingh2011">{{cite book | author1=Vijay P. Singh | author2=Pratap Singh | author3=Umesh K. Haritashya | title=Encyclopedia of Snow, Ice and Glaciers | url=http://books.google.com/books?id=mKKtQR4T-1MC&pg=PA673 | date=1 July 2011 | publisher=Springer Science & Business Media | isbn=978-90-481-2641-5}}</ref>{{rp|674}} [[Usimbishaji]] wa theluji unaweza kutokea wakati wowote lakini kwa kawaida hutokea Zaidi wakati wa majira ya mvua. (Novemba–Desemba na Machi–Mei).<ref name="SinghSingh2011"/>{{rp|673}} Usimbishaji wote kwenye kilele ni hasa theluji au mchnganyiko wa tehluji na mvua kwenye kiwango cha milimita 250 hadi 500 kwa mwaka na kuvukiza haraka.<ref name="TraceElements"/> ==Barafu na barafuto== [[File:Snow and Ice on Kilimanjaro-1993.jpg|300px|thumb|right|[[Theluji]] na barafu katika kilele cha mlima Kilimanjaro, 1993.]] Mlima Kilimanjaro hujulikana kuwa kuwa ni mlima wa Afrika mwenye kofia ya [[barafu]] ya kudumu. Pamoja na Kilimanjaro kuna sehemu mbili nyingine tu barani Afrika, ni [[Ruwenzori]] na [[Mlima Kenya]]. Lakini kiasi cha barafu imepungua kwa kipindi cha zaidi ya miaka 100. Mwingereza P.C. Spink aliona mwaka 1944 ya kwamba barafu ilipungua sana kulingana na taarifa aliyojua kutoka mpandaji wa kwanza Hans Meyer. Baina 1912 eneo la ngao ya barafu limepungua kutoka [[kilomita za mraba]] 12 hadi 1.85 km² kwenye mwaka 2009. Hii inalingana na kupunguzwa [[asilimia]] 85%. Sababu kuu ya mabadiliko haya ni kupungukiwa kwa kiwango cha [[usimbishaji]] katika mazingira ya mlima tangu mwisho wa karne ya 19. Maana Kilimanjaro ni mlima wa juu vile ya kwamba mvua wote (pamoja na ukungu na usimbishaji mwingine) unaofika kwenye kilele chake utaganda na kuwa theluji. Theluji inayokaa muda mrefu tena katika ganda nene itakuwa barafu. Lakini wakati uleule mishale ya jua zinasababisha kupotea kwa theluji na barafu kwa njia ya [[uvukizaji]]. Kwa jumla kuongezeka au kupungukiwa kwa barafu kwenye kimo hiki ni swali la kiasi cha mvua na usimbishaji mwingine zinazofika hapa. Leo hii kuna barafuto kwenye Kibo pekee pamoja na mabaki ya ngao ya barafu kwenye tambarare ya kilele na kwenye mitelemko ya Kibo. <ref>Brian Vastag: ''The melting snows of Kilimanjaro.'' In: ''[[Nature]].'' 2009, {{DOI|10.1038/news.2009.1055}}.</ref><ref>Georg Kaser, Douglas R. Hardy u.&nbsp;a.: ''Modern glacier retreat on Kilimanjaro as evidence of climate change: observations and facts.'' In: ''International Journal of Climatology.'' 24, 2004, S.&nbsp;329, {{DOI|10.1002/joc.1008}}.</ref><ref>Thomas Mölg: ''Solar-radiation-maintained glacier recession on Kilimanjaro drawn from combined ice-radiation geometry modeling.'' In: ''[[Journal of Geophysical Research]].'' 108, 2003, {{DOI|10.1029/2003JD003546}}.</ref><ref>Thomas Mölg: ''Ablation and associated energy balance of a horizontal glacier surface on Kilimanjaro.'' In: ''Journal of Geophysical Research.'' 109, 2004, {{DOI|10.1029/2003JD004338}}.</ref><ref>N. J. Cullen, P. Sirguey, T. Mölg, G. Kaser, M. Winkler, S. J. Fitzsimons: ''A century of ice retreat on Kilimanjaro: the mapping reloaded.'' The Cryosphere Discuss., 2012, 6, 4233-4265, {{doi|10.5194/tcd-6-4233-2012}}.</ref> http://www.jstor.org/stable/1788958?seq=1#page_scan_tab_contents Hii ngao ya barafu bado iko kwa sababu Kilimanjaro ni mlima usio na vilele vikali unaofika juu ya kimo cha mstari wa jeledi. Kasoko ya Kibo imepita na kukata ngao hiyo. <ref name="AnAscentOfKilimanjaro"/>{{rp|5}} Siku hizi hakuna miendo ya maana inayoonekana kwenye barafuto za kilele kwa sababu unene wao imepungua mno..<ref name="TraceElements"/> Utafiti wa kijiolojia umeonyesha ya kwamba kulikuwa na vipindi vitano vya upanuzi wa barafuto katika miaka 500,000 iliyopita vilivyofuatwa na vipindi vya kupungua. <ref>{{cite journal | url=http://www.researchgate.net/profile/Bryan_Mark/publication/227643102_Quaternary_glaciation_in_Africa_key_chronologies_and_climatic_implications/links/00b7d52d451e477c9b000000.pdf | title=Quaternary glaciation in Africa: Key chronologies and climatic implications | author=Bryan G. Mark and Henry A. Osmaston | journal=Journal of Quaternary Science | year=2008 | volume=23 | pages=589–608 | doi=10.1002/jqs.1222}}</ref> Ngao ya barafu mfululizo ilifunika mlima wote hadi kimo cha mita 3,200 miaka 24,000 – 25,000 iliyopita wakati [[barafuto]] kote duniani zilienea sana. <ref name="Kaser"/><ref name="Glaciers of Middle East"/> Kuna dalili ya kwamba barafu yote mlimani iliwahi kupotea kabisa takriban miaka 11,500 iliyopita kutokana na ukame dunaini wakati ule.<ref name="TraceElements">{{cite journal | url=http://www.researchgate.net/profile/Natalie_Kehrwald/publication/261331494_Deglaciated_areas_of_Kilimanjaro_as_a_source_of_volcanic_trace_elements_deposited_on_the_ice_cap_during_the_late_Holocene/links/0f317533e6b1d43308000000.pdf | title=Deglaciated areas of Kilimanjaro as a source of volcanic trace elements deposited on the ice cap during the late Holocene | author=P. Gabrielli, D. R. Hardy, N. Kehrwald, M. Davis, G. Cozzi, C. Turetta, C. Barbante, L. G. Thompson | journal=Quaternary Science Reviews | year=2014 | volume=93 | issue=1 | pages=1–10 | doi=10.1016/j.quascirev.2014.03.007}}</ref> Kuongezeka kwa usimbishaji wakati wa [[Holoseni]] (miaka 11,500 iliyopita) kumeruhusu kurudi kwa barafu mlimani. <ref name="TraceElements"/> barafuto ziliweza kudumisha kipindi cha ukame miaka 4,000 iliyopita. <ref name="TraceElements"/><ref name="unabated">{{cite journal | author=L. G. Thompson, H. H. Brecher, E. Mosley-Thompson, D. R. Hardy, B. G. Mark | title=Glacier loss on Kilimanjaro continues unabated | journal=[[Proceedings of the National Academy of Sciences]] | volume=106 | issue=47 | pages=19770–5 | year=2009 | doi=10.1073/pnas.0906029106 | url=http://www.pnas.org/content/106/47/19770.full | access-date=2016-04-01 | archive-date=2021-02-08 | archive-url=https://web.archive.org/web/20210208123238/https://www.pnas.org/content/106/47/19770.full | dead-url=yes }}</ref> Wakati wa kutembelewa mara ya kwanza katika miaka ya 1880, kilele cha Kibo kilifunikwa kabisa kwa ngao ya barafu yenye eneo la kilomita za mraba 20 hivi na mikondo ya [[barafuto]] iliendelea wenye mitelemko ya kando. Isipokuwa pia ya kati, kaldera yote ilifunikwa na barafu.<ref name="Kaser"/><ref name="Glaciers of Middle East">{{cite web | last=Young | first=James A. T. | title=Glaciers of the Middle East and Africa | url=http://pubs.usgs.gov/pp/p1386g/africa.pdf | work=U.S. Geological Professional Survey | publisher=U.S. Department of the Interior | pages=G61, G58, G59 G62 | accessdate=16 August 2012}}</ref> [[File:Kilimanjaro-1938-uwm.png|thumb|300px|Kilele cha Kibo kilivyoonekana kutoka angani mwaka 1938.]] Imetazamiwa ya kwamba barafuto kwenye mitelemko ilirudi nyuma haraka kuanzia 1912 hadi 1953, na polepole zaidi tangu wakati ule. Inaendelea kupungua nah ii inaonyesha ya kwamba bado hakuna uwiano kati ya kiasi cha mvua kinachofika kwenye kilele na uvukizaji nah ii inaonyesha mabadiliko ya tabianachi yanayoendelea. <ref name="Kaser"/> Pamoja na kufunika eneo dogo zaidi, yaani kujikaza, barafuto pia zimepungua unene kutokana na kuyeyuka na uvukizaji. <ref name="unabated"/><ref name="TraceElements"/> Mabadiliko haya kwenye barafuto za Kilimanjaro zinalingana na mabadiliko yanayoonekana kwenye barafuto kote duniani. <ref name="unabated"/> At the current rate, most of the ice on Kilimanjaro will disappear by 2040 and "it is highly unlikely that any ice body will remain after 2060".{{rp|430}} Kama barafu juu ya Kilimanjaro ingepotea kabisa hii isingekuwa tatizo kubwa kwa maji yanayopatikana katika maeneo yanayozunguka mlima. Kiasi cha barafu juu ya mlima ni kidogo sana kuliko kiasi cha maji yanayohifadhiwa na misitu kwenye mitelemko ya mlima chini zaidi. Misitu hii ni chanzo cha maji yanayotiririke chini katika mito na vijito vya mlima mkubwa.<ref>{{cite journal | url=http://lindseynicholson.org/wp-content/uploads/2011/07/Moelg-et-al.-2013.pdf | title=East African glacier loss and climate change: Corrections to the UNEP article ‘‘Africa without ice and snow’’ | author=Georg Kaser, Thomas Mölg, Nicolas J. Cullen, Douglas R. Hardy, Michael Winkler, Rainer Prinz, and Lindsey Nicholson | volume=6 | pages=1–6}}</ref> ==Uoto== Kuna [[misitu]] asilia zinazofunika takriban kilomita ya mraba 1,000 kwenze mlima<ref name="PlantEcology">{{cite journal | url=http://www.researchgate.net/profile/Hemp_Andreas/publication/227311322_Continuum_or_zonation_Altitudinal_gradients_in_the_forest_vegetation_of_Mt._Kilimanjaro/links/543b57b60cf24a6ddb976f7e.pdf | title=Continuum or zonation? Altitudinal gradients in the forest vegetation of Mt. Kilimanjaro | author=Andreas Hemp | journal=Plant Ecology | year=2006 | volume=184 | issue=1 | pages=27–42 | doi=10.1007/s11258-005-9049-4}}</ref> . Sehemu ya chini hulimwa kwa kupanda [[mahindi]], [[maharagwe]] na [[alizeti]], pia [[ngano]] upande wa magharibi. Kuna mabaki ya uoto wa [[savana]] ya awali yenye miti kama ''[[Acacia]]'', ''[[Combretum]]'', ''[[Terminalia]]'' na ''[[Grewia]]''. Kuanzia kimo cha mita 1000 hadi mita 1800 kuna kilimo cha kahawa kwa namna ya kidesturi ya "[[Wachaga]] inayopanda miti na mazao kwa pamoja. Uoto asilia umebaki pekee katika mabonde majkali yasiyoweza kutumiwa kwa kilimo <ref name="MaundiCrater">{{cite journal | url=http://www.sciencedirect.com/science/article/pii/S0277379112000637 | title=Vegetation, climate and fire-dynamics in East Africa inferred from the Maundi crater pollen record from Mt Kilimanjaro during the last glacial–interglacial cycle | author=Lisa Schüler, Andreas Hemp, Wolfgang Zech, Hermann Behling | journal=Quaternary Science Reviews | year=2012 | volume=39 | pages=1–13 | doi=10.1016/j.quascirev.2012.02.003 | via=ScienceDirect}}</ref> na hapa ni tofauti na uoto kwenye maeneo ya juu zaidi. Kuanzia kimo cha mita 1000 hadi mita 1800 kuna kilimo cha kahawa kwa namna ya kidesturi ya "[[Wachaga]] inayopanda miti na mazao kwa pamoja. Uoto asilia umebaki pekee katika mabonde majkali yasiyoweza kutumiwa kwa kilimo <ref name="MaundiCrater">{{cite journal | url=http://www.sciencedirect.com/science/article/pii/S0277379112000637 | title=Vegetation, climate and fire-dynamics in East Africa inferred from the Maundi crater pollen record from Mt Kilimanjaro during the last glacial–interglacial cycle | author=Lisa Schüler, Andreas Hemp, Wolfgang Zech, Hermann Behling | journal=Quaternary Science Reviews | year=2012 | volume=39 | pages=1–13 | doi=10.1016/j.quascirev.2012.02.003 | via=ScienceDirect}}</ref> na hapa ni tofauti na uoto kwenye maeneo ya juu Zaidi. Kwenye mitelemko ya kusini penye mvua nyingi kuna misitu ya mvua yenye miti aina ya ''[[Ocotea usambarensis]]'' pamoja na [[kangaga]] na [[epipythi]]. Juu zaidi penye ukungu wa kudumu kuna ''[[Podocarpus latifolius]]'', ''[[Hagenia abyssinica]]'' na ''[[Erica excelsa]]'' pamoja na [[kuvumwani]]. Upande wa kaskazini ulio kavu zaidi pana misitu ya [[mizeituni]], ''[[Croton (plant)|Croton]]''-''[[Mlungu-mbago]]'' (Calodendrum), ''[[Cassipourea]]'' (Mugome na Msikundazi) na ''[[Juniperus]]'' (Mtarakwa) kadri kimo kinaongezeka. Juu zaidi kati ya mita 3,100 na 3,900 hufuata kanda la vichaka vya ''[[Erica]]'' ([[mdamba]]) na juu yake kunamajanimajani tu kama ''[[Helichrysum]]'' hadi mita 4500.<ref name="PlantEcology2"/><ref>{{cite book | author1=L. A. Bruijnzeel | author2=F. N. Scatena | author3=L. S. Hamilton | title=Tropical Montane Cloud Forests: Science for Conservation and Management | url=http://books.google.com/books?id=N6FkwMnSX8EC&pg=PA134 | date=6 January 2011 | publisher=Cambridge University Press | isbn=978-1-139-49455-7 | pages=136}}</ref> Utafiti kwenye kasoko ya Maundi kwenye kimo cha mita 2780 umeonyesha ya kwamba uoto wa Kilimanjaro ulibadilika katika mwendo wa karne na milenia. Wakati wa baridi kwenye enzi ya barafu miaka 42,000 – 30,000 iliyopita misitu ilishuka chini na kanda la mdamba lilitokea takriban mita 1,500 chini ya hali yake ya sasa..<ref name="MaundiCrater"/> ==Wanyama== Hakuna wanyama wakubwa wengi waliobaki mlimani. Wanapatikana hasa kwenye misitu na sehemu za chini mlimani. [[Tembo]] na [[nyati wa Afrika|nyati]] wanaweza kuwa na hatari kwa watalii wanaopanda mlima na pia kwa wakulima. [[Pongo]], [[vinyonga]], [[digidigi]], [[Paa (Bovidae)|paa]], [[Nguchiro]], nyani mbalimbali kama [[mbega]], [[komba]], [[chui]], [[Chozi (ndege)|chozi]] na [[ngiri]] wametazamiwa pia. [[Punda milia]] na [[fisi]] wanapatikana mara chache kweye tambarare juu ya Shira.<ref>{{cite book | author=Cameron M. Burns | title=Kilimanjaro & East Africa: A Climbing and Trekking Guide | url=http://books.google.com/books?id=bwZfkrl2ygQC&pg=PA7 | year=2006 | publisher=The Mountaineers Books | isbn=978-0-89886-604-9 | page=50}}</ref> Kuna spishi chache zinazopatikana Kilimanjaro pekee hizi ni pamoja na “[[Kirukanjia (mamalia)|kirukanjia]] wa Kilimanjaro”<ref>{{cite web | url=http://www.iucnredlist.org/details/5577/0 | title=Crocidura monax | publisher=International Union for Conservation of Nature and Natural Resources | work=IUCN Red List of Threatened Species | accessdate=August 15, 2015 | archivedate=2016-04-24 | archiveurl=https://web.archive.org/web/20160424202247/http://www.iucnredlist.org/details/5577/0 }}</ref> na spishi ya kinyonga kinachoitwa [[Kinyongia tavetana]].<ref>{{cite web | url=http://reptile-database.reptarium.cz/species?genus=Kinyongia&species=tavetana | title=Kinyongia tavetana (STEINDACHNER, 1891) | publisher=Zoological Museum Hamburg | work=The Reptile Database | accessdate=15 August 2015}}</ref> ==Tazama pia== * [[Orodha ya volkeno nchini Tanzania]] * [[Orodha ya milima ya Tanzania]] * [[Orodha ya milima ya Afrika]] * [[Orodha ya milima]] {{Vilele saba vya mabara}} ==Marejeo== <references/> ==Viungo vya nje== {{commons|Category:Kilimanjaro}} * [http:////www.tanzaniaparks.com/kili.html/ Mount Kilimanjaro National Park] * [http:////www.easytravelgear.com/hiking-in-africa/ Mount Kilimanjaro National Park] * [http://earthobservatory.nasa.gov/IOTD/view.php?id=3054 NASA Earth Explorer page] * [http://www.mountain-forecast.com/peaks/Mount-Kilimanjaro/forecasts/5963 Weather forecase for Mount Kilimanjaro (19,565 feet)] * [http://www.kilimanjaro.cc/glacial-recession.htm Glacial Recession on Kilimanjaro (pictures of southern icefields)] {{Wayback|url=http://www.kilimanjaro.cc/glacial-recession.htm |date=20110215100701 }} * [http://www.kilicam.com Mount Kilimanjaro live webcam] * [https://web.archive.org/web/20141107022451/http://www.ewpnet.com/kilimanjaro/flora/index.htm Kilimanjaro flora picture gallery] * [http://collections.lib.uwm.edu/cdm/search/collection/agsafrica/searchterm/Kilimanjaro%20%28mountain%29/field/all/mode/exact/conn/and/cosuppress/ Aerial photographs of Mount Kilimanjaro, 1937-38] * [http://news.bbc.co.uk/2/hi/uk_news/magazine/7919100.stm How hard is it to climb Mount Kilimanjaro?] *[http://www.cepf.net/Documents/Final_LovettRuffoGereau_FieldGuide.pdf Field Guide to the Moist Forest Trees of Tanzania] {{Wayback|url=http://www.cepf.net/Documents/Final_LovettRuffoGereau_FieldGuide.pdf |date=20100621062907 }} Jon C. Lovett, Chris K. Ruffo & Roy E. Gereau, Miti ya milima ya Tanzania {{DEFAULTSORT:Kilimanjaro}} [[Jamii:Milima ya Tanzania]] [[Jamii:Milima ya Afrika]] [[Jamii:Volkeno za Afrika]] [[Jamii:Mkoa wa Kilimanjaro]] [[Jamii:Volkeno za Tanzania]] [[Jamii:Afrocine 2019-Tanzania]] o775g6woan1zevgq4ljh623po7h3ysc 0 1790 1577949 1569081 2026-07-02T12:53:31Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577949 wikitext text/x-wiki [[File:Daressalaam.flac|thumb|Dar Es Salaam]] {{about|[[Mkoa wa Dar es Salaam]]}} {{Infobox Settlement |jina_rasmi = Dar es Salaam |picha_ya_makazi = Dar es salaam Skyline from the sea.jpg |maelezo_ya_picha = Jiji la Dar es Salaam |picha_ya_bendera = |ukubwa_ya_bendera = 100px |picha_ya_nembo = Nembo Dar es Salaam.png |ukubwa_ya_nembo = |picha_ya_ramani = Tanzania DarEsSalaam location map.svg <!-- Ngazi ya serikali ------------------> |ngazi_ya_serikali = [[Nchi]] |jina_la_serikali = [[Tanzania]] |ngazi_ya_serikali1 = [[:Jamii:Mikoa ya Tanzania|Mkoa]] |jina_la_serikali1 = [[Mkoa wa Dar es Salaam|Dar es Salaam]] |ngazi_ya_serikali2 = Tarafa |jina_la_serikali2 = 12 |ngazi_ya_serikali3 = Kata |jina_la_serikali3 = 102 |ngazi_ya_serikali4 = Mitaa |jina_la_serikali4 = 565 <!-- Siasa -----------------> |aina_ya_serikali = Jiji |cheo_cha_kiongozi = Mstahiki Meya |jina_la_kiongozi = Omary S. Kumbilamoto |cheo_cha_kiongozi1 = Mkurugenzi wa Jiji |jina_la_kiongozi1 = Jumanne K. Shauri |marejeleo_ya_serikali ={{r|DSM}} <!-- Idadi ya Wakazi -----------------------> |wakazi_kwa_ujumla = 5383728 |idadi_wakazi_mwaka = 2022 |marejeo_ya_wakazi ={{r|Sensa_2012|p=74}} |msimbo_posta = 11xxx |kodi_ya_simu = 022 |kanda_muda = [[Saa za Afrika Mashariki|EAT]] |tofauti_ya_UTC = +3 |iso_namba = TZ-02 |tovuti = {{URL|http://www.dcc.go.tz/ |Halmashauri ya Jiji la Dar es Salaam}} |majiranukta = {{coord|6|48|0|S|39|17|0|E|region:TZ|display=inline}} }} '''Dar es Salaam''' ni [[jiji]] kubwa kuliko yote nchini [[Tanzania]]. Pia ni [[jina]] la [[Mkoa wa Dar es Salaam|mkoa wake]]. Dar es Salaam ni [[mji]] mkongwe na wenye watu wengi zaidi katika [[Jumuia ya Afrika Mashariki]]. Katika Tanzania ndio mji wenye vitega uchumi vingi na ndio mji unaoangaliwa na watu wengi.Dar es Salaam pia ni [[Orodha ya Bandari za Afrika|bandari ya pili kwa ukubwa]] katika [[Afrika Mashariki]]. Ni [[mji mkuu]] wa ki[[biashara]] wa Tanzania wakati [[Dodoma]] ni [[mji mkuu]] wa Tanzania (kinadharia tangu mwaka [[1973]]). Mpango wa kuhamishia [[serikali]] [[mji]]ni Dodoma unaendelea kwa kasi chini ya [[rais]] [[John Magufuli]], japokuwa bado [[ofisi]] kadhaa za [[serikali]], ikiwa ni pamoja na [[Ikulu]], zipo Dar es Salaam. Mji una wakazi wapatao 5,383,728 kwa [[hesabu]] ya [[sensa]] iliyofanyika katika mwaka wa 2022<ref>{{Rejea tovuti |url=https://assengaonline.com/2022/11/05/matokeo-ya-sensa-2022-tanzania/ |title=Nakala iliyohifadhiwa |accessdate=2022-11-07 |archive-date=2022-11-07 |archive-url=https://web.archive.org/web/20221107141245/https://assengaonline.com/2022/11/05/matokeo-ya-sensa-2022-tanzania/ |url-status=dead }}</ref>. == Jina == [[Picha:Dar_es_Salaam_(Aerial).jpg|thumbnail|right|280px|Picha kutoka angani ya Mkoa wa Dar es Salaam.]]Jina la Dar es Salaam linatoka katika [[Kurani|Kurani]] ambako linamaanisha mahali patulivu au hata paradiso. Surah Al-Anam ([https://quran.com/6:127/tafsirs/en-tafsir-maarif-ul-quran Korani 6:127]) ina maneno لَهُمْ دَارُ‌ السَّلَامِ عِندَ رَ‌بِّهِمْ ''lahum dāru as-salāmi `inda rabbihim''<ref>[https://www.quran-online.com/quran-phonetic/surah-al-anam-phonetic-6.html Surah Al-Anam phonetic]</ref> yanayomaanisha "Hao watapata nyumba ya salama kwa Mola Mlezi wao."<ref>Tarjuma ya Quran Tukufu kwa Kiswahili [https://www.iium.edu.my/deed/quran/swahili/6.html 6.Suurat An'aam, 127] {{Wayback|url=https://www.iium.edu.my/deed/quran/swahili/6.html |date=20221003080350 }} ya Sheikh Ali Muhsin Al-Barwani</ref> . Jina linafanywa na maneno mawili ya Kiarabu; '''دار''' ''dar'' inayomaanisha "nyumba, jengo, makazi, eneo", "es" ni silabi ya kuunganisha sehemu za jina linalounganishwa na maneno mawili<ref>Hapa imebadilishwa kutoka "el" kuwa "es" kwa sababu ya "S" inayofuata</ref>, '''سلام''' ''salaam'' inamaanisha "amani, raha, usalama". [[File:Panorama of some streets in Dar es Salaam.jpg|thumb|270px|right|Sehemu ya Dar es Salaam.]]Mara nyingi jina limetafsiriwa kama "Bandari ya Amani" lakini hii ni kosa kutokana na kuchanganya maneno ya Kiarabu <big>دار</big> "dar" (nyumba) na <big>بندر</big> "bandar" (bandari) maana kwa matamshi ya Kiswahili tofauti ya tahajia katika Kiarabu haitambuliki. Jina la Daressalaam limetumiwa kwa maumbo tofauti kwa mahali mbalimbali katika mazingira ya Kiislamu, kwa mfano huko [[Brunei Darussalaam]], [[:en:Dar El Salam|Dar El Salam (Misri)]], [[:en:Dar os Salam|Dar os Salam (Iran)]], pia kama majina ya taasisi mbalimbali. == Historia == {{main|Historia ya Dar es Salaam}} Katika eneo la jiji hili zamani kulikuwa [[kijiji|vijiji]] kadhaa <ref>https://www.mwananchi.co.tz/mw/habari/kitaifa/dar-kutoka-mji-wa-neema-na-afya-hadi-mji-wa-amani-4779764</ref>. [[Sultani]] [[Seyyid Majid]] wa [[Zanzibar]] aliamua kujenga ikulu ya pili barani kando ya [[Mzizima]] akachagua jina "Dar es Salaam". Hadi leo kuna majengo mawili yaliyobaki ya vyanzo hivi ambayo ni [[Boma la Kale, Dar es Salaam|Boma la Kale]] na [[Nyumba ya Atiman]]. Dar es Salaam ilichaguliwa na [[wakoloni]] [[Ujerumani|Wajerumani]] kuwa [[mji mkuu]] wa [[Afrika ya Mashariki ya Kijerumani]] kwa sababu ya [[bandari asilia]] yenye mdomo mpana wa [[mto Kurasini]]. Hivyo kuanzia mwaka [[1891]] Dar es Salaam ilichukua nafasi ya [[Bagamoyo]] kama [[makao makuu]] ya [[utawala]]. Bandari pamoja na [[ujenzi]] wa [[reli ya kati]] kwenda [[Kigoma]] tangu mwaka [[1904]] viliimarisha nafasi ya mji ulioendelea kama mji mkuu baada ya [[Tanzania bara]] ya leo kuwa [[eneo lindwa]] la [[Tanganyika]] chini ya [[Uingereza]]. ==Utawala== Utawala wa Dar es Salaam uliona mabadiliko kadhaa ambapo mwanzoni mji ulitawaliwa na halmashauri yake na baadaye serikali ya kitaifa ilichukua utawala mikononi mwake au kuukabidhi kwa tume ya serikali<ref>[https://www.mwananchi.co.tz/mw/habari/kitaifa/faida-hasara-kuvunjwa-jiji-la-dar-es-salaam-3303604 Faida, hasara kuvunjwa Jiji la Dar es Salaam], gazeti a Mwananchi 25.02.2021</ref>. Mwaka 2000 eneo la jiji liligawanywa kwa mamlaka tofauti ambazo mwanzoni zilikuwa nne, ambazo zilikuwa manisipaa za Ilala, Temeke na Kinondoni. Baadaye Ubungo na Kigamboni zilikuwa manisipaa za pekee, kila moja na halmashauri yake. Kwa jiji lote Halmashauri ya Jiji la Dar es Salaam iliundwa. Kwa hiyo hadi 2021 Dar es Salaam ilikuwa na Halmashauri 6. *Halmashauri ya Jiji la Dar es Salaam *Halmashauri ya [[Manispaa ya Ilala]] *Halmashauri ya [[Wilaya ya Kigamboni|Manispaa ya Kigamboni]] *Halmashauri ya [[Manispaa ya Kinondoni]] *Halmashauri ya [[Wilaya ya Temeke|Manispaa ya Temeke]] *Halmashauri ya [[Manispaa ya Ubungo]] Kwenye Februari 2021 Halmashauri ya Dar es Salaam ilivunjwa na serikali, na Ilala ilibadilishwa jina kuwa Dar es Salaam<ref>[https://www.thecitizen.co.tz/tanzania/news/president-magufuli-officially-dissolves-dar-es-salaam-city-council--3303208 President Magufuli officially dissolves Dar es Salaam City Council] {{Wayback|url=https://www.thecitizen.co.tz/tanzania/news/president-magufuli-officially-dissolves-dar-es-salaam-city-council--3303208 |date=20210225124152 }}, gazeti The Citizen 25.02.2021</ref>. == Wakazi na uchumi == Dar es Salaam inakadiriwa kuwa na wakazi wapatao milioni tatu. Ingawa [[Dodoma (mji)|Dodoma]] inafahamika kama ndio [[mji mkuu]] wa Tanzania, Dar es Salaam ndiko ziliko [[ikulu]], [[balozi|mabalozi]], [[shirika|mashirika]] ya kimataifa, n.k. [[Uwanja wa ndege]] mkuu wa Tanzania uko pia mjini hii ni [[Uwanja wa ndege wa kimataifa wa Julius Nyerere]]. [[Bandari]] ya Dar es Salaam katika [[bahari ya Hindi]], ndio bandari kubwa nchini Tanzania inayojihusisha na [[usafirishaji]] na [[uingizaji]] wa [[bidhaa]] mbalimbali za [[kilimo]], [[ufugaji]], [[ujenzi]], [[gari|magari]], [[dawa|madawa]], n.k. Kiutawala, Dar es Salaam imegawanywa katika [[manisipaa]] za [[Temeke]], [[Ilala]], [[Kinondoni]], [[Kigamboni]] na [[Ubungo]]. ==Wakazi na uchumi== [[File:Nyerere Bridge - Kigamboni .jpg|thumb|Nyerere Bridge huko Kigamboni, Dar es Salaam, ni [[daraja]] pekee la [[Afrika Mashariki]] lisilo na [[nguzo]] majini.]] Dar es Salaam ni mji unaosemekana kuwa mkubwa kuliko yote kwa sababu ya maendeleo mbalimbali ya viwanda, uwepo wa bahari, uwepo wa sehemu mbalimbali za kihistoria n.k. ==Huduma za jiji== Huduma ya [[maji]] Dar es Salaam imekuwa na [[tatizo]] kubwa katika kudhibiti mfumo wa [[maji taka]] katika mkoa wa Dar es Salaam kwa muda mrefu. Tangu shirika la maji DAWASCO (Dar es Salaam Water Supply Company) lilipowekwa rasmi kama shirika husika katika kuratibu [[utaratibu]] mzima wa [[mfumo wa maji safi]] na maji taka, kumekuwa na nafuu kidogo tu, lakini baada ya muda, liliibuka tatizo la kuibiwa kwa ma[[bomba]] na [[uharibifu]] wa vyanzo mbalimbali vya maji. ==Elimu== Kwenye suala hili la [[elimu]] [[vijana]] wanatakiwa kupewa elimu; hasa vijana wa mitaani wasioingiza kipato inabidi wapewe elimu kwa [[kazi]] fulani ili waweze kuajiriwa na kulipa faida [[taifa]] kwa kuingizia kipato na kukuza [[uchumi]] wa taifa. Mfano wa kazi hizo ni kama [[ujenzi]] wa [[nyumba]] n.k. == Picha == <gallery> {{Wide image|Dar es Salaam Panorama edit2.jpg|3000px|View of Dar es Salaam showing the city center, Posta, and the slums}} Image:DarEsSalaam-SamoraMachelAvenue.jpg|Samora Machel Avenue ikiwa na N.I.C. House Image:DarEsSalaam-Skyline.jpg|Feri ya kuvuka Kigamboni, huku nyumba za jiji zikionekana ng'ambo ya bandari asilia [[File:Dar es Salaam in 1930s.JPG|320x240px|thumbnail|left|Dar es Salaam miaka ya 1930.]] </gallery> ==Marejeo== {{marejeo|refs= <ref name=Sensa_2012>{{Rejea tovuti |url=http://tanzania.countrystat.org/fileadmin/user_upload/countrystat_fenix/congo/docs/Census%20General%20Report-2012PHC.pdf |title=Ripoti ya Sensa 2012 |accessdate=2022-07-03 |archiveurl=https://web.archive.org/web/20220326183741/http://tanzania.countrystat.org/fileadmin/user_upload/countrystat_fenix/congo/docs/Census%20General%20Report-2012PHC.pdf |archivedate=2022-03-26 |language=en |url-status=live}}</ref> <ref name="DSM">{{Rejea tovuti |url=http://www.dcc.go.tz/ |title=Halmashauri ya Jiji la Dar es Salaam |archiveurl=https://web.archive.org/web/20220921095439/http://www.dcc.go.tz/ |archivedate=21 Septemba 2022 |language=sw |url-status=live}}</ref> }} ==Tazama pia== * [[Orodha ya miji ya kale ya Waswahili]] == Viungo vya nje == {{commons cat|Dar es Salaam}} * {{en}} [http://jp1.estis.net/includes/file.asp?site=chip&file=12C88AF9-65B0-4C84-B3AD-E2642199873F DAR ES SALAAM CITY PROFILE] {{Wayback|url=http://jp1.estis.net/includes/file.asp?site=chip&file=12C88AF9-65B0-4C84-B3AD-E2642199873F |date=20060518032339 }} * [http://www.theeastafrican.co.ke/magazine/-/434746/479582/-/view/printVersion/-/bkst8sz/-/index.html Mohamed Said: Mwalimu in 1950s Dar (East African October 12 2008 - inasimulia maisha ya Nyerere Dar es Salaam pamoja na habari nyingi za jiji wakati wa miaka ya 1950)] {{Wayback|url=http://www.theeastafrican.co.ke/magazine/-/434746/479582/-/view/printVersion/-/bkst8sz/-/index.html |date=20110315021926 }} [[Jamii:Miji ya Tanzania]] [[Jamii:Dar es Salaam| ]] [[Jamii:miji ya kale ya Waswahili]] 1hm7o8snf1v9huof9t4esh29acpgf7l 0 1792 1578023 1485587 2026-07-02T14:36:14Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578023 wikitext text/x-wiki {{Infobox mji |jina_rasmi = Nairobi |picha_ya_bendera = Flag of Nairobi.svg |ukubwa_ya_bendera = 100px |picha_ya_nembo = Coat of Arms of Nairobi.svg |ukubwa_ya_nembo = 100px |picha_ya_mandhari = {{multiple image | border = infobox | total_width = 250 | perrow = 1/2/2/2/1 | caption_align = center | image1 = | caption1 = Skyline of Nairobi | image2 = KICC-.JPG | caption2 = [[Kenyatta International Convention Centre|KICC]] | image3 = The Nairobi Expressway in Chiromo.jpg | caption3 = [[Nairobi Expressway]] | image4 = | caption4 = [[Britam Tower]] | image5 = | caption5 = [[Upper Hill, Nairobi|Upper Hill]] | image6 = Lascar Statue of Dedan Kimathi Waciuri (4540820430).jpg | caption6 = [[Dedan Kimathi]] Statue | image7 = | caption7 = [[Jomo Kenyatta International Airport]] | image8 = | caption8 = One Africa Place | image9 = | caption9 = Skyline of Nairobi }} |maelezo_ya_picha = Mji wa Nairobi |aina_ya_makazi = Jiji |nchi= [[File:Flag of Kenya.svg|30px]] [[Kenya]] |utaifa= Nairobi |subdivision_type1 = [[:en:Counties of Kenya|Kaunti]] |subdivision_name1 = [[:en:Nairobi County|Nairobi]] |kiongozi_kichwa1 = Gavana |kiongozi_jina1 = Johnson Sakaja |idadi_ya_wakazi_kwa_mwak = 2019 |idadi_ya_watu_aina_1 = Kaunti |idadi_ya_watu_1 = 4,397,073 |idadi_ya_watu_aina_2 = Metro |msongamano = 6,800 |idadi_ya_watu_2 = 5,541,000 |tovuti = [http://www.nairobi.go.ke/ nairobi.go.ke] |eneo_jumla_km2 = 696.1 |pato_la_taifa_mwaka= |pato_la_taifa = {{increase}} $90.1 bilioni (PPP)</br>{{increase}} $35.0 bilioni (Nominal) |pato_la_taifa_capita= $18,958 (PPP) $7,291 (Nominal) |hdi = 0.771 <ref>{{Cite Web|title=Nairobi city County Hdi|url=https://statskenya.co.ke/at-stats-kenya/about/human-development-index-in-kenya-hdi-by-county/114/|accessdate=2025-02-02}}</ref> |mwaka_wa_hdi = 2024 |orodha_ya_hdi = 1st |tovuti = https://nairobi.go.ke }} [[Picha:25332612.nairoboi013.JPG|thumb|260px|[[Sanamu]] ya Jomo Kenyatta.]] '''Nairobi''' ni [[mji mkuu]] na jiji kubwa zaidi la [[Kenya]], lililoko katika sehemu ya kusini-kati ya nchi. Jina lake limetokana na usemi wa Kimaasai <i>"Enkare Nairobi," </i>maana yake "maji baridi," likirejelea Mto Nairobi unaopita katikati ya jiji. Kwa idadi ya watu inayokadiriwa kuwa takriban milioni 4.5 ndani ya jiji na zaidi ya milioni 10 katika eneo la mji mkuu(Metro), Nairobi ni kitovu kikuu cha uchumi katika [[Afrika Mashariki]]. Inahudumu kama kituo muhimu cha [[fedha|kifedha]], [[biashara]], na usafiri, ikiwa na makao makuu ya mashirika mengi ya kimataifa, kampuni za kimataifa, na mashirika ya Umoja wa Mataifa, ikiwa ni pamoja na Shirika la Mazingira la Umoja wa Mataifa (UNEP). [[Lugha]] zote za Kenya huzungumzwa Nairobi, lakini hasa ni [[Kiingereza]] na [[Kiswahili]] pamoja na [[Sheng]]. ==Eneo la jiji la Nairobi== [[File:Nairobi County in Nairobi Metro.png|thumb|Kaunti ya Nairobi (nyekundu) ndani ya jiji kuu la Nairobi (kijani).]] Nairobi yenyewe iko ndani ya eneo la [[jiji]] la Nairobi (kwa [[Kiingereza]]: ''Greater Nairobi Metropolitan region)'' lililoundwa na [[kaunti]] 4 kati ya jumla ya [[Kaunti za Kenya|47 za Kenya]]. Kaunti hizo ni: {| class="sortable wikitable" |- ! Eneo || Kaunti || Eneo lake (km<sup>2</sup>) || Idadi ya wakazi<br>Sensa 2009 || Jiji/Mii/Manisipaa kwenye kaunti |- | Nairobi ya Kati || [[Kaunti ya Nairobi]] || align="right" |694.9||align="right"|3,138,369|| Nairobi |- | Eneo la Kaskazini || [[Kaunti ya Kiambu]] || align="right" |2,449.2||align="right"|1,623,282|| [[Kiambu]], [[Thika]], [[Limuru]], [[Ruiru]], [[Karuri]], [[Kikuyu, Kenya|Kikuyu]], [[Kahawa]] |- | Eneo la Kusini || [[Kaunti ya Kajiado]] || align="right" |21,292.7||align="right"|687,312|| [[Kajiado]], Olkejuado, Bissil, [[Ngong, Kenya|Ngong]], [[Kitengela]], [[Kiserian]], [[Ongata Rongai]] |- | Eneo la Mashariki || [[Kaunti ya Machakos]] || align="right" |5,952.9||align="right"|1,098,584|| [[Kangundo]]-[[Tala, Kenya|Tala]], [[Machakos]], [[Athi River]] |- | '''''Jumla'''''|| Eneo la Jiji la Nairobi || align="right"|30,389.7||align="right"|6,547,547|| |} Chanzo: [http://www.scribd.com/doc/36672705/Kenya-Census-2009/ Kenya Census] Eneo hilo linazalisha [[asilimia]] 60 za [[pato la taifa]]. == Mazingira na hali ya hewa == Nairobi iko kilomita 150 upande wa kusini ya [[ikweta]] kwenye nyanda za juu za Kenya kando la mto Nairobi. Nairobi imeanzishwa mahali ambako nchi [[tambarare]] ya [[mto Athi]] inaanza kupanda juu hadi [[milima ya Ngong]] na vilima vingina vinyvyofanya ukuta wa mashariki wa [[Bonde la Ufa]]. [[Kitovu]] cha Nairobi kiko zipatao [[m]] 1624 juu ya [[UB]]. Sehemu za mashariki za jiji ziko bado kwenye tambarare, na sehemu za magharibi ziko kwenye mtelemko unaopanda hadi mita 1800 kwenye mpaka wa jiji na mita 2000 juu ya UB kwenye nje ya jiji huko [[Limuru]]. [[Hali ya hewa]] haina [[joto]] kali. [[Halijoto]] ya wastani ni 20,5[[°C]] mwezi wa [[Machi]], na 16,8°C mwezi wa [[Julai]]. Wakati wa Juni na Julai usiku unaweza kuwa baridi halijoto ikishuka chini ya [[sentigredi]] 10. [[Mvua]] nyingi hunyesha mwezi Machi ([[mm]] 199), [[kiangazi]] kina mm 14 tu wakati wa Julai. == Historia == === Chanzo kwenye kambi la reli=== Nairobi ilianzishwa na [[Waingereza]] mwaka [[1899]] kama kambi ya kujenga [[Reli ya Uganda]]. [[Njia ya reli]] ilikuwa imefika kutoka Mombasa ikaonekana ya kwamba kuanzia hapa kasi ya [[ujenzi]] itachelewa kutokana na ugumo na eneo la Bonde la Ufa na mitelemko yake mikali. Mahali palikuwa karibu katikati ya [[Mombasa]] na [[Kampala]], palikuwa na [[maji]] pakaonekana panafaa kwa kituo njiani. Hasahasa ilionekana [[tabianchi]] ya [[nyanda za juu]] ilifaa [[Afya|kiafya]] kwa Waingereza walioteswa na [[joto]] la [[pwani]] na kwenye [[nyanda za chini]]. Kitangulizi cha Nairobi kilikuwa kituo kidogo kilichoanzishwa mwaka [[1896]] kando ya [[mto Nairobi]] na wakala Mwingereza wa reli kwa kusudi la kuajiri [[wafanyakazi]] wazalendo kwa ujenzi wa reli. Mwaka uliofuata [[1897]] wakaguzi walioandaa njia ya reli walipiga kambi karibu naye.<ref>Christine Stephanie Nicholls, Red Strangers, uk. 37 f.</ref> === Mji mkuu wa koloni=== Njia ya reli ilifika kwenye kambi tarehe [[30 Mei]] [[1899]]. Hapo idadi ya wafanyakazi - hasa [[Wahindi]] - iliongezeka sana na kambi lilikuwa kubwa ya ma[[hema]] na [[ghala]] za vifaa vya ujenzi. Mwezi wa Juni mizigo ya [[mabati]] ilifika kutoka Mombasa - tayari kwa reli - na majengo ya kudumu yalianza kutengenezwa katika mazingira ya eneo la [[Kituo cha Reli Nairobi|kituo cha reli cha leo]]. Mwezi wa Agosti [[kamishna]] Mwingereza wa jimbo la [[Ukamba]]<ref>Ukamba ilikuwa moja kati ya majimbo 4 ya [[Afrika ya Mashariki ya Kiingereza]] (iliyokuwa koloni la Kenya tangu mwaka 1920) na makao makuu yalikuwepo Machakos</ref> aliamuliwa kuhamisha makao makuu yake Nairobi kutoka [[Machakos]] akajenga [[boma]] lake kwenye eneo la Moi Avenue, mbali na reli jinsi inavyoonekana hadi leo kwenye majengo ya [[polisi]] ya kihistoria yanayotazama [[Bustani ya Jivanji]]<ref>Kituo cha polisi (Nairobi Central Police Station) iko mahali pa boma lile la kwanza</ref>. [[Barabara]] kuu ya kwanza ilikuwa "Station Road" <ref>ikaitwa baadaye Government Road, leo hii ni Moi Avenue</ref> kandokando ya Mtaa wa Tom Mboya wa leo iliyoitwa Victoria Street ikawa mahali pa [[duka|maduka]] na [[hoteli]] za kwanza zilizoendeshwa na [[Wazungu]] na baadaye pia na Wahindi kadhaa. Soko la Wahindi maskini likuwa kando. Kwenye sehemu kati ya mitaa ya [[Haile Selassie]] na Harambee kulikuwa na makazi ya kwanza ya wafanyakazi. Mwaka uleule wa 1899 ofisi kuu ya reli ikapelekwa huko kutoka Mombasa kwa shabaha ya kurahisisha mawasiliano. Pale mwanzoni kulikuwa na wasiwasi kuhusu chaguo la mahali; baada ya [[mvua]] kali sehemu ya mahema na vibanda vilipatikana katikati ya ziwa la matope. [[Magonjwa]] yalisambaa na baada ya [[epidemia]] ya [[tauni]] soko la Wahindi Lilichomwa na kuhamishwa sehemu nyingine. Majaribio ya kukausha kinamasi yaliendelea kwa miaka kadhaa hadi kufaulu. Kutokana na usumbufu wa matope maafisa wa ngazi ya juu walijenga nyumba zao kwenye [[kilima]] cha karibu kilichojulikana kama Nairobi Hill. Mwaka 1905 Waingereza walihamisha [[ofisi kuu]] ya [[serikali]] yao ya [[ukoloni|kikoloni]] kutoka Mombasa kwenda Nairobi, ambayo ikawa hivyo [[makao makuu]] ya [[Afrika ya Mashariki ya Kiingereza]] (''British East Africa'', baadaye ''Kenya Colony''). [[Uchumi]] wa mji ulitegemea pale mwanzoni hasahasa mahitaji ya utawala wa serikali na reli na [[utalii]]; [[matajiri]] wengi kutoka pande zote za dunia waliFIka kwa kusudi la kuwinda [[wanyama]] wakubwa <ref>Kama wale maarufu "Big Five" yaani [[tembo]], [[simba]], [[nyati]], [[kifaru]] na [[chui]]</ref> wakivutwa na wingi wa wanyama kwenye nyanda za juu na usafiri rahisi kwa reli. Baadaye ardhi katika mazingira ya mji ilitolewa kwa [[walowezi]] Wazungu na [[kilimo cha biashara]] kilianza kuchangia. Kiasili Nairobi ilikuwa imepangwa kwa ajili ya Wazungu wa reli na serikali pamoja na Wahindi; Waafrika hawakupewa makazi isipokuwa [[Bweni|mabweni]] ya wanfanyakazi wa reli na vibanda vya wafanyakazi wasaidizi kandokando ya nyumba za mabwana wao. Lakini Waingereza waliajiri [[askari]] kutoka [[Sudan]] na [[Somalia]] katika [[jeshi]] na polisi, na hao walifuatwa na wafanyabiashara kutoka kwao. [[Wapagazi]] na askari kutoka sehemu mbalimbali za Afrika ya Mashariki walifika Nairobi kikazi na wengine waliamua kubaki. [[Mitaa ya vibanda]] iliota haraka nje ya mji wenyewe, mingine ilibomolewa haraka, mingine iliweza kubaki. Mnamo [[1921]] kulikuwa na Waafrika 12,000 waliokaa katika mitaa ya Waafrika iliyoitwa Mombasa, Masikini, Kaburini, Kariokor, Kibera, Pumwani na Pangani. === Tangu uhuru=== Mwaka 1963 ikawa mji mkuu wa [[nchi huru]] ya Kenya ikaendelea kukua haraka. == Nairobi ya leo == [[File:The_modern_skyline_of_Nairobi.jpg|thumb|Nairobi leo: New Central Bank Tower (140 m), Teleposta Towers (120 m), Kenyatta International Conference Centre (105 m), NSSF Building (103 m), I&M Bank Tower (100 m), Government Office Conference Hall (98 m)[http://www.greenskychaser.com/blog/wp-content/uploads/2011/03/800px-Nairobi_Skyline.jpg].]] Nairobi imeibuka kuwa mmojawapo kati ya miji mikubwa katika bara la Afrika. Mashirika mengi makubwa [[duniani]] yamefungua [[ofisi]] zao zinazoshuhudia eneo la Afrika ya Mashariki na [[Afrika ya Kati]]. Mojawapo ya mashirika haya ni ofisi za tawi la [[Umoja wa Mataifa]] (United Nations), [[UNEP]]. Kunazo pia ofisi za [[balozi|mabalozi]] wa nchi mbalimbali duniani. Nairobi, kama miji mingi mikubwa, ina matatizo mengi yanayotokea kwa sababu ya ukubwa wake. Watamaduni walioupanga mji wa Nairobi hawakutegemea kuwa utatanuka hivyo. [[Wataalamu]] wengi wametoa maonyo mengi kuhusu ukubwa wa mji huu na uwezo wake wa kuwahudumia wakazi wote ambao wanazidi kuongezeka kila mwaka. Nairobi imewavutia wakazi wengi, wote wakiwa na [[hamu]] ya kujitafutia [[riziki]] yao. Ijapokuwa wapo wanaofanikiwa, wengi wao hujipata wameangulia patupu wakaachwa bila [[pesa]] au hali ya kujikimu. Jambo hili limepelekea kuwepo kwa wakazi wa maeneo yasiyotengwa wananchi, maarufu kama 'slums' kwa Kimombo. Eneo kubwa zaidi jijini Nairobi ni Kibera. Eneo hili lina ukubwa wa kilomita 2 kwa 2 na wakazi takribani milioni moja. Eneo hili halina mipango yoyote ya kuruhusu [[binadamu]] kuishi lakini [[umaskini]] umewavutia wengi kuishi kule. Kunayo pia matatizo ya [[ujambazi]] na [[utekaji nyara]] wa [[magari]]. Matatizo haya yamesababisha watu wengi kutoupendelea mji wa Nairobi. {| border="1" cellspacing="0" cellpadding="5" | valign="top" | {| ! style="background:#efefef;" | &nbsp; &nbsp; &nbsp; &nbsp; Mwaka &nbsp; &nbsp; &nbsp; &nbsp; ! style="background:#efefef;" | Wakazi |- | [[1906]] || align="right" | 11.500 |- | [[1911]] || align="right" | 14.000 |- | [[1921]] || align="right" | 24.300 |- | [[1926]] || align="right" | 29.900 |- | [[1929]] || align="right" | 32.900 |- | [[1931]] || align="right" | 47.800 |- | [[1939]] || align="right" | 61.300 |- | [[1944]] || align="right" | 108.900 |- | [[1948]] || align="right" | 119.000 |- | [[1955]] || align="right" | 186.000 |- |} | valign="top" | {| ! style="background:#efefef;" | &nbsp; &nbsp; &nbsp; &nbsp; Mwaka &nbsp; &nbsp; &nbsp; &nbsp; ! style="background:#efefef;" | Wakazi |- | [[1957]] || align="right" | 221.700 |- | [[1960]] || align="right" | 251.000 |- | [[1962]] || align="right" | 266.800 |- | [[1965]] || align="right" | 380.000 |- | [[1969]] || align="right" | 509.300 |- | [[1979]] || align="right" | 827.775 |- | [[1989]] || align="right" | 1.324.570 |- | [[1995]] || align="right" | 1.810.000 |- | [[1999]] || align="right" | 2.143.254 |- | [[2005]] || align="right" | 2.750.561 |- | [[2009]] || align="right" | 3.138.369 |} |} {{wide image|Nairobi panorama from westlands.jpg|1400px|<center>Picha ya Nairobi kutoka [[Westlands]]</center>}} ===Maeneo bunge=== [[File:Kenyatta International Conference Centre.jpg|thumb|right|[[Kenyatta International Convention Centre]] na [[Times Tower]].]] Kaunti ya Nairobi imegawanywa katika maeneo bunge 17 na [[kata]] 85.<ref name="test">[http://www.iebc.or.ke/index.php/resources/downloads/item/final-constituencies-and-wards-description www.iebc.or.ke] {{webarchive|url=https://web.archive.org/web/20130319001043/http://www.iebc.or.ke/index.php/resources/downloads/item/final-constituencies-and-wards-description|date=19 March 2013}}</ref> {| class="wikitable" |- ! style="width:160px;"| Maeneo bunge ! Kata |- ! [[Eneo bunge la Westlands|Westlands]] | [[Kitisuru]]{{·}} [[Parklands/Highridge]]{{·}} [[Karura]]{{·}} [[Kangemi]]{{·}} [[Mountain View, Nairobi|Mountain View]] |- ! [[Eneo bunge la Dagoretti Kaskazini|Dagoretti North]] | [[Kilimani (Nairobi)|Kilimani]]{{·}} [[Kawangware]]{{·}} [[Gatina, Kenya|Gatina]]{{·}} [[Kileleshwa]]{{·}} [[Kabiro]] |- ! [[Eneo bunge la Dagoretti Kusini|Dagoretti South]] | [[Mutu-ini]]{{·}} [[Ngand'o]]{{·}} [[Riruta]]{{·}} [[Uthiru/Ruthimitu]]{{·}} [[Waithaka]] |- ! [[Eneo bunge la Lang'ata|Langata]] | [[Karen, Kenya|Karen]]{{·}} [[Nairobi West]]{{·}} [[Ngumo]]{{·}} [[South C]]{{·}} [[Nyayo Highrise]] · [[Otiende]] {{·}} [[Sunvalley]] I/II · [[St.Mary's Hospital, Nairobi|St.Mary's Hospital]]· [[Royal Park, Nairobi|Royal Park]] |- ! [[Eneo bunge la Kibra|Kibra]] | [[Laini Saba]]{{·}} [[Lindi, Nairobi|Lindi]]{{·}} [[Makina]]{{·}} [[Woodley/Kenyatta Golf Course]]{{·}} [[Sarang'ombe]] |- ![[Eneo bunge la Roysambu|Roysambu]] | [[Roysambu]]{{·}} [[Garden Estate, Nairobi|Garden Estate]]{{·}} [[Muthaiga]]{{·}} [[Ridgeways, Nairobi|Ridgeways]]{{·}} [[Githurai]]{{·}} [[Kahawa West]]{{·}} [[Zimmermann]]{{·}} [[Kahawa, Nairobi|Kahawa]] |- ! [[Eneo bunge la Kasarani|Kasarani]] | [[Clay City]]{{·}} [[Mwiki (Nairobi)|Mwiki]]{{·}} [[Kasarani]]{{·}} [[Njiru]]{{·}} [[Ruai]] |- ![[Eneo bunge la Ruaraka|Ruaraka]] | [[Babadogo]]{{·}} [[Utalii, Nairobi|Utalii]]{{·}} [[Mathare North]]{{·}} [[Lucky Summer]]{{·}} [[Korogocho]] |- ![[Eneo bunge la Embakasi Kusini|Embakasi South]] | [[Imara Daima]]{{·}} [[Kwa Njenga]]{{·}} [[Kwa Reuben]]{{·}} [[Pipeline, Nairobi|Pipeline]]{{·}} [[Kware, Nairobi|Kware]] |- ![[Eneo bunge la Embakasi Kaskazini|Embakasi North]] | [[Kariobangi Kaskazini]]{{·}} [[Dandora Area I]]{{·}} [[Dandora Area II]]{{·}} [[Dandora Area III]]{{·}} [[Dandora Area IV]] |- ![[Eneo bunge la Embakasi ya Kati|Embakasi Central]] | [[Kayole North]]{{·}} [[Kayole North Central]]{{·}} [[Kayole South]]{{·}} [[Komarock]]{{·}} [[Matopeni/Spring Valley]] |- ![[Eneo bunge la Embakasi Mashariki|Embakasi East]] | [[Upper Savanna]]{{·}} [[Lower Savanna]]{{·}} [[Embakasi]]{{·}} [[Utawala, Nairobi|Utawala]]{{·}} [[Mihang'o]] |- ![[Eneo bunge la Embakasi Magharibi|Embakasi West]] | [[Umoja I]]{{·}} [[Umoja II]]{{·}} [[Mowlem]]{{·}} [[Kariobangi Kusini]] |- ! [[Eneo bunge la Makadara|Makadara]] | [[Maringo/Hamza]]{{·}} [[Viwandani, Nairobi|Viwandani]]{{·}} [[Harambee, Nairobi|Harambee]]{{·}} [[Makongeni]]{{·}} [[Mbotela (Nairobi)|Mbotela]]{{·}} [[Bahati, Nairobi|Bahati]] |- ! [[Eneo bunge la Kamukunji|Kamukunji]] | [[Pumwani]]{{·}} [[Eastleigh North]]{{·}} [[Eastleigh South]]{{·}} [[Moi Air Base|Airbase]]{{·}} [[California, Nairobi|California]] |- ! [[Eneo bunge la Starehe|Starehe]] | [[Nairobi Central]]{{·}} [[Ngara, Nairobi|Ngara]]{{·}} [[Pangani, Nairobi|Pangani]]{{·}} [[Ziwani/Kariokor]]{{·}} [[Landimawe]]{{·}} [[Nairobi South]] |- ! [[Eneo bunge la Mathare|Mathare]] | [[Hospital, Nairobi|Hospital]]{{·}} [[Mabatini, Nairobi|Mabatini]]{{·}} [[Huruma, Nairobi|Huruma]]{{·}} [[Ngei]]{{·}} [[Mlango Kubwa]]{{·}} [[Kiamaiko]] |} ==Tazama pia== * [[Orodha ya miji ya Kenya]] == Marejeo == <references/> ==Viungo vya nje== {{Lango|Kenya}} {{commons}} * [https://books.google.com/books?id=7XQdt37BJ6cC&printsec=frontcover&dq=Christine+Stephanie+Nicholls,+Red+Strangers&hl=de&sa=X&ved=0ahUKEwj1uMnIo6nMAhUBCCwKHV6wCNQQuwUIJDAA#v=onepage&q=Christine%20Stephanie%20Nicholls%2C%20Red%20Strangers&f=false Red Strangers: The White Tribe of Kenya], Christine Stephanie Nicholls, Timewell Press, 2005 (Google Books, imetazamwa Aprili 2 {{en}} * [http://www.nairobi.go.ke/ Tovuti rasmi ya Nairobi] {{Wayback|url=http://www.nairobi.go.ke/ |date=20130427045807}} {{en}} * [http://www.uonbi.ac.ke Chuo Kikuu cha Nairobi] {{en}} {{nairobi}} {{kaunti za Kenya}} {{list of African capitals}} [[Jamii:Nairobi| ]] [[Jamii:Miji ya Kenya]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Kaunti ya Nairobi]] [[Jamii:Kenya]] 3zoskjnavwddg9ret4pfg0w2xxbu9li 0 1861 1578021 1521139 2026-07-02T14:35:20Z Riccardo Riccioni 452 /* Tanbihi */ 1578021 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Monrovia |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Liberia]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 1,021,762 |website = }} [[Picha:Liberia, Africa - panoramio (256).jpg|thumbnail|right|100px|Monrovia]] [[Picha:Monrovia_Street.jpg|thumbnail|right|100px|Mji mkuu wa Liberia, Monrovia]] '''Monrovia''' ni [[mji mkuu]] wa [[Liberia]]. Kwa mujibu wa [[sensa]] ya mwaka 2008, mji huu ulikuwa na wakazi wapatao 1,021,762. ==Historia== Eneo uliko [[mji]] huo mwanzoni liliitwa na mabaharia [[Wareno]] Cape Mesurado walipowasilia katika [[miaka ya 1560]]. Wakati huo tayari kulikuwa na wakazi wakiishi hapo. Mji ulianza kujengwa mwaka 1822 na chama cha [[American Colonization Society]] ikiwa ni makazi ya watu waliokombolewa toka utumwani nchini [[Marekani]].<ref>{{Rejea tovuti |url=http://www.wdl.org/en/item/446/ |title=Nakala iliyohifadhiwa |accessdate=2013-06-02 |archive-date=2020-05-18 |archive-url=https://web.archive.org/web/20200518201022/https://www.wdl.org/en/item/446/ |url-status=dead }}</ref> Jina Monrovia lilitokana na jina la [[Rais]] wa Marekani [[James Monroe]]. Watu wa kwanza kuhamia Monrovia toka nchini Marekani waliwasili mwaka 1822 katika [[Kisiwa cha Sherboro]] nchini [[Sierra Leone]]. Wahamiaji wengi walifariki baada ya kuwasili Monrovia. Mkutano wa kutunga [[katiba]] ya Liberia wa American Colonization Society ulifanyikia Monrovia mwaka 1845. ==Uchumi== Uchumi wa Monrovia unategemea zaidi bandari yake na madini ya chuma. Bidhaa kama vile [[saruji]], [[mafuta]], [[matofali]], [[vigae]], [[samani]], na [[kemikali]] zinatengenezwa Monrovia. ==Tazama pia== * [[Orodha ya miji ya Liberia]] == Tanbihi == <references/> {{commons|Category:Monrovia|Monrovia}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Liberia]] [[Jamii:Miji ya Liberia]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Monrovia| ]] c1hhjgp58ur42rnnc8ztqzp341fkm0s 0 1899 1578173 1527835 2026-07-02T23:35:06Z InternetArchiveBot 41439 Add 8 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578173 wikitext text/x-wiki [[Picha:Hiv budding.jpg| thumb |Namba virusi vya UKIMWI vinavyotoka katika [[seli]].]] '''Upungufu wa Kinga Mwilini''' (kwa kifupi '''UKIMWI'''; [[kifupisho]] cha [[Kiingereza]] '''AIDS''') ni [[ugonjwa]] unaotokana na [[virusi]] ambavyo kwa [[Kiswahili]] vinaitwa kifupi [[VVU]] ("Virusi vya UKIMWI"; kwa Kiingereza: HIV, yaani "Human Immunodeficiency Virus") na vinashambulia [[mwili]] kwa kuondoa nguvu zake za kupambana na [[maambukizi nyemelezi]] yanayosababisha [[maradhi]]. Ukimwi ni ugonjwa hatari sana katika [[maisha]] ya [[binadamu]] kwa kuwa husababisha [[kifo|vifo]] (yaani kupotea kwa [[uhai]] wa watu hao). Kwa mujibu wa [[Shirika la Afya Duniani]], kufikia mwaka [[2014]] ugonjwa huu umeua watu [[milioni]] 39, hasa kati ya wanaoishi [[Bara|barani]] [[Afrika]] upande wa [[kusini]] kwa [[Sahara]]. Kwa [[mwaka]] [[2015]] pekee wamefariki watu milioni 1.2 na kati yao [[watoto]] wengi. UKIMWI umekuwa na madhara makubwa katika [[jamii]], kama ugonjwa wa mwili na kama chanzo cha [[Ubaguzi wa watu wanaoishi na UKIMWI|ubaguzi]]. Kuna sintofahamu kuhusu UKIMWI kama vile kwamba eti, unaweza kusambazwa kwa kugusana tu bila [[ngono]]. Ugonjwa huu pia unasababisha [[madhara ya kiuchumi]] ambayo ni makubwa, hasa kwa nchi maskini. Hadi hivi sasa, UKIMWI hauna [[chanjo]] wala [[tiba]], lakini ugonjwa huu unaweza kuepukika kwa kuachana na ngono, ambayo ndiyo husababisha sana ugonjwa huu. Pia, watu wanaweza kujikinga kutokana na ugonjwa huu kwa kuepuka kuchangia vifaa au vitu vyenye [[ncha]] kali. Kimsingi zaidi ni kwamba ugonjwa huo umetokana na kuenezwa hasa na [[maadili]] mabovu. Dhidi yake watu wanahitaji kuelewa tangu [[Utoto|utotoni]] na [[Ujana|ujanani]] maana ya [[jinsia]] na [[maisha]] kwa jumla, kwamba vinadai [[upendo]], [[nidhamu]] na [[uwajibikaji]], si kufuata [[tamaa]] tofautitofauti daima<ref>{{cite web|url=http://www.catholicnewsagency.com/news/thirty-years-after-aids-discovery-appreciation-growing-for-catholic-approach/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+catholicnewsagency%2Fdailynews+%28CNA+Daily+News%29|title=Thirty years after AIDS discovery, appreciation growing for Catholic approach |publisher=Catholicnewsagency.com|date=June 5, 2011 |accessdate=November 1, 2011}}</ref>. Tarehe [[1 Desemba]] kila [[mwaka]] ni [[Siku ya Ukimwi duniani|siku ya UKIMWI duniani]]. ==Maana ya jina== '''UKIMWI''' ni kifupisho cha "'''Upungufu wa Kinga Mwilini'''" *'' Upungufu'' maana yake UKIMWI unaharibu uwezo wa [[mwili]] kupambana na magonjwa. Si UKIMWI moja kwa moja unaoweza kuua lakini mashambulio ya magonjwa ambayo kwa kawaida yasingekuwa tatizo kubwa. *'' Kinga'' inahusu [[mfumo wa kingamwili]] ambao ni uwezo wa mwili kujitetea dhidi ya [[ugonjwa]]. *'' Mwili'' usio na kinga unapatwa na matatizo mbalimbali kwa sababu mfumo wa kinga umeharibika, na hauwezi kupigana na ugonjwa wowote. [[Jina]] la Kiingereza ni '''AIDS = Acquired Immuno Deficiency Syndrome'''. * acquired - maana mtu hawezi kuwa na hali hii kiasili, ameipata * immuno - hii inataja ya kwamba tatizo linahusu "immune system" yaani mfumo wa kingamwili * deficiency - inamaanisha ya kwamba kuna kasoro * syndrome - ni mkusanyiko wa matatizo ya kiafya; ilhali kingamwili haufanyi kazi tena, mgonjwa anaathiriwa na magonjwa mbalimbali na kuonyesha [[dalili]] za magonjwa hayo yote. ==Mfumo wa kingamwili na VVU== Kila mtu huwa na [[Mfumo wa kingamaradhi|mfumo wa kingamwili]] ndani yake. [[Seli]] za ulinzi zinazunguka mwilini na kutafuta [[vidubini]] vya nje vinavyoweza kuleta mvurugo na zinaviharibu. Kati ya seli hizi za [[ulinzi]] ni [[seli nyeupe za damu]] (lukosaiti) ambazo ni muhimu sana. Ukimwi unasababishwa na VVU. Kama virusi vyote, VVU vinaingia katika mwili kwa kusudi la kuzaa. Virusi haviwezi kuzaa peke yake: vinahitaji seli vinapoweza kuingia ndani yake na kutumia mfumo wa seli kwa kunakili [[DNA]] yake. Kwa kawaida virusi vinashambuliwa na mfumo wa kingamwili na kuharibika. Lakini VVU vina tabia mbili za pekee ambazo zinavifanya vvya hatari hasa: * vinafaulu mara nyingi kuepukana na seli za ulinzi mwilini * vinaingia hasahasa katika seli nyeupe za damu za aina "seli za T". VVU vikianza kuongezeka katika seli nyeupe ya damu vinadhoofisha na hatimaye kuharibu seli hii. Maana yake VVU vinashambulia moja kwa moja seli ambazo ni sehemu ya kingamwili na zinazohusika kukinga mwili. Kuenea kwa VVU mwilini kunapunguza idadi ya seli za ulinzi na hivyo kupunguza kiwango cha kingamwili. Baada ya kupungua kwa kingamwili vidubini vingine vinaendelea kufika mwilini lakini sasa vinaenea zaidi kwa sababu seli za ulinzi zimekuwa chache. Kila [[ambukizo]] linaendelea kwa muda mrefu zaidi na hivyo mwili kwa jumla unateswa kwa muda mrefu zaidi. Kadiri Ukimwi unavyoendelea vipindi vya magonjwa vinakuwa virefu zaidi na nguvu za mwili zinapunguapungua. Katika ngazi za mwisho [[idadi]] ya maambukizo inazidi uwezo wa mwili wa kupambana nayo na hapo mtu unakaribia kifo. == Dalili == UKIMWI ni [[ugonjwa]] wa [[mfumo wa kingamwili]] wa [[binadamu]] unaosababishwa na virusi vya ukosefu wa kinga mwilini.<ref name="pmid11396444">{{Rejea jarida|author=Sepkowitz KA|title=AIDS—the first 20 years|journal=N. Engl. J. Med.|volume=344|issue=23| pages=1764–72|year=2001|month=June|pmid=11396444|doi=10.1056/NEJM200106073442306}}</ref>Mwanzoni, baada ya kuambukizwa, mtu anaweza kukumbwa na kipindi kifupi cha [[maradhi]] ya aina ya [[mafua]]. Kwa kawaida, hali hii hufuatwa na kipindi kirefu kisicho na [[dalili]]. Ugonjwa huu huendelea kutatiza [[kingamwili]] jinsi unavyozidi, hivyo kumfanya mtu kuwa katika hatari zaidi ya kupata [[maambukizi]], ikiwa ni pamoja na [[maambukizi nyemelezi]], na [[kansa]] ambayo kwa kawaida hayawaathiri watu walio na kingamwili njema. Kuna awamu tatu kuu za maambukizi ya VVU: maambukizi makali, awamu fiche na UKIMWI.<ref name=M121>Mandell, Bennett, and Dolan (2010). Chapter 121.</ref><ref name=AIDS2010GOV>{{cite web|title=Stages of HIV|url=http://aids.gov/hiv-aids-basics/diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/|work=U.S. Department of Health & Human Services|accessdate=13 June 2012|date=Dec 2010|archiveurl=https://web.archive.org/web/20120513062533/http://www.aids.gov/hiv-aids-basics/diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/|archivedate=2012-05-13}}</ref> === Maambukizi makali === [[File:Symptoms of acute HIV infection.svg|thumb|alt=Mchoro wa kiwiliwili cha binadamu kinachoonyesha dalili zinazotokea mara nyingi za maambukizi makali ya VVU|275px|Dalili kuu za maambukizi makali ya VVU]] Kipindi cha kwanza kufuatia maambukizi ya VVU huitwa VVU vikali, VVU vya kimsingi au dalili kali za kudhibiti virusi. <ref name=M121/><ref name=WHOCase2007/> Watu wengi hupata [[maradhi ya mfano wa mafua]] au [[mononyukleosi ambukizi|maambukizi ya mfano wa mononukleosi]] wiki 2 - 4 baada ya kuambukizwa ilhali wengine hawana dalili zozote kuu.<ref>{{cite book|title=Diseases and disorders.|year=2008|publisher=Marshall Cavendish|location=Tarrytown, NY|isbn=978-0-7614-7771-6|page=25|url=http://books.google.ca/books?id=-HRJOElZch8C&pg=PA25}}</ref><ref name=M118/>Dalili hutokea katika asilimia 40-90 ya visa vyote na mara nyingi hujumuisha [[homa]], [[limfadenopathia|tezi kubwa na chungu za limfu]], [[faringitisi|inflamesheni ya koo]], [[upele]], maumivu ya kichwa, na/au vidonda vya kinywa na sehemu za uzazi.<ref name=WHOCase2007/><ref name=M118/>Upele huu, unaotokea katika asilimia 20 - 50 ya visa, hutokea katika kiwiliwili, na kwa kawaida huwa wa [[makiulopapula]].<ref name=Deut2010/> Baadhi ya watu pia hupata [[maambukizi nyemelezi]] katika awamu hii.<ref name=WHOCase2007/>Dalili za tumboni na utumboni kama vile kichefuchefu, kutapika au [[kuharisha]] zinaweza kutokea, sawa na dalili za kinuroni za [[niuropathia ya pembeni]] au [[sindromu ya Guillain-Barre]].<ref name=M118/> Muda ya dalili hutofautiana, ingawa kwa kawaida huwa wiki 1 - 2.<ref name=M118/> Kufuatia sifa zake za kutokuwa dalili maalum, hizi mara nyingi haziwezi kutambulika kama dalili za maambukizi ya VVU. Hata visa vinavyotambuliwa na [[daktari]] wa [[familia]] au katika [[hospitali]] mara nyingi hutambulika vibaya kama baadhi ya visababishi vingi vya [[magonjwa ambukizi]] yaliyo na dalili zinazoingiliana. Kwa hivyo, inapendekezwa kuchunguza VVU katika watu wanaoonyesha homa isiyoelezeka ambao wanaweza kuwa na vipengele hatari vya kuambukizwa.<ref name=M118>Mandell, Bennett, and Dolan (2010). Chapter 118.</ref> === Awamu fiche === Dalili za kwanza hufuatwa na awamu fiche (VVU visivyo na dalili au VVU vya muda mrefu).<ref name=AIDS2010GOV/>Bila ya matibabu, awamu hii ya pili ya historia asilia ya maambukizi ya VVU inaweza kudumu kutoka miaka 3 <ref>{{cite book|last=Evian|first=Clive|title=Primary HIV/AIDS care: a practical guide for primary health care personnel in a clinical and supportive setting|year=2006|publisher=Jacana|location=Houghton [South Africa]|isbn=978-1-77009-198-6|page=29|url=http://books.google.ca/books?id=WauaC7M0yGcC&pg=PA29|edition=Updated 4th}}</ref> hadi zaidi ya miaka 20;<ref>{{cite book|first=J. W. A. J. Reeders; P. C. Goodman (ed.). With contributions by J. Bedford|title=Radiology of AIDS|year=2001|publisher=Springer|location=Berlin [u.a.]|isbn=978-3-540-66510-6|page=19|url=http://books.google.ca/books?id=xmFBtyPGOQIC&pg=PA19}}</ref> (wastani wa miaka 8).<ref>{{cite book|last=Elliott|first=Tom|title=Lecture Notes: Medical Microbiology and Infection|year=2012|publisher=John Wiley & Sons|isbn=978-1-118-37226-5|page=273|url=http://books.google.ca/books?id=M4q3AyDQIUYC&pg=PA273}}</ref>Ingawa kwa kawaida mwanzoni kuna dalili chache, au hata zisiwemo, karibu mwishoni mwa awamu hii, watu wengi hupatwa na homa, kukonda, matatizo ya tumbo na utumbo, na maumivu ya misuli. <ref name=AIDS2010GOV/>Kati ya asilimia 50 na 70 ya wagonjwa pia hupata [[limfadenopathia]] ya mwili wote inayorejea, ambayo hudhihirika kwa uvimbe usio na kisababishi na usio chungu wa zaidi ya kikundi kimoja cha tezi za [[limfu]] (ila katika sehemu za uzazi) kwa zaidi ya miezi 3 hadi 6.<ref name=M121/> Ingawa watu wengi walioambukizwa [[VVU-1]] wana kiwango cha virusi kinachoweza kutambulika, na ambacho bila matibabu kitaendelea na kuwa UKIMWI, idadi ndogo (5%) huwa na kiwango kikubwa cha seli za CD4<SUP>+</SUP>([[seli saidizi za T]]) bila [[Udhibiti wa VVU/UKIMWI|matibabu ya kudhibiti virusi]] kwa zaidi ya miaka 5. <ref name=M118/><ref name=LT2010/>Watu hao huainishwa kama wadhibiti wa VVU au watu wasioendeleza kwa muda mrefu, ilhali wale ambao pia hudumisha kiwango cha chini au kisichotambulika cha virusi bila matibabu hujulikana kama "wadhibiti hodari" au "wagandamizaji hodari" <ref name=LT2010>{{cite journal|last=Blankson|first=JN|title=Control of HIV-1 replication in elite suppressors|journal=Discovery medicine|date=2010 Mar|volume=9|issue=46|pages=261–6|pmid=20350494}}</ref>. === Ukosefu wa Kinga Mwilini=== [[File:Symptoms of AIDS.svg|thumb|275px|alt=Mchoro wa kiwiliwili cha binadamu kinachoonyesha dalili zinazotokea mara nyingi za maambukizi makali ya UKIMWI|Dalili kuu za maambukizi makali ya UKIMWI.]] Ukosefu wa Kinga Mwilini (UKIMWI) hufasiliwa kwa msingi wa kiwango cha seli za CD4 <SUP>+</SUP> cha chini ya seli 200 kwa kila µL au kutokea kwa magonjwa maalumu yanayohusiana na maambukizi ya VVU. <ref name=M118/> Bila matibabu maalum, takriban nusu ya watu walioambukizwa VVU hupata UKIMWI katika muda wa miaka 10.<ref name=M118/>Hali zinazotokea mara nyingi zaidi kudhihirisha uwepo wa UKIMWI ni [[numonia ya numosistisi]] (40%), [[kakeksi]] kwa muundo wa dalili dhoofishi za VVU (20%) na [[kandidiasi ya umio]].<ref name=M118/>Dalili nyingine ni pamoja na maambukizi ya [[njia ya pumzi]]<ref name=M118/>. [[Maambukizi nyemelezi]] yanaweza kusababishwa na [[bakteria]], [[virusi]], [[kuvu]] na [[vimelea]] ambavyo kwa kawaida hudhibitiwa na mfumo wa kingamwili.<ref name=Holmes>{{Rejea jarida|author=Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA|title= Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa|url=https://archive.org/details/sim_clinical-infectious-diseases_2003-03-01_36_5/page/n153|journal=Clin. Infect. Dis.|year=2003|pages=656–662|volume=36|issue=5|pmid=12594648|doi=10.1086/367655}}</ref>Maambukizi yanayotokea hutegemea, kwa upande mmoja, aina ya [[viumbehai]] vinavyopatikana kwa wingi katika [[mazingira]] ya mtu.<ref name=M118/>Maambukizi hayo yanaweza kudhuru karibu kila [[mfumo wa kibayolojia|mfumo wa viungo]].<ref name=Complications2011>{{cite journal|last=Chu|first=C|coauthors=Selwyn, PA|title=Complications of HIV infection: a systems-based approach|url=https://archive.org/details/sim_american-family-physician_2011-02-15_83_4/page/395|journal=American family physician|date=2011-02-15|volume=83|issue=4|pages=395–406|pmid=21322514}}</ref> Watu walio na UKIMWI wako katika hatari kuu zaidi ya kupata saratani nyingi zinazosababishwa na virusi, kama vile: [[Sakoma ya Kaposi]], [[limfoma ya Burkitt]], [[limfoma ya mfumo mkuu wa neva]] na [[saratani ya seviksi]].<ref name=Deut2010/>Sakoma ya Kaposi ndiyo saratani inayotokea mara nyingi, yaani katika asilimia 10 hadi 20 ya watu wenye VVU.<ref name=M169>Mandell, Bennett, and Dolan (2010). Chapter 118.</ref>Saratani inayoifuata ni limfoma, ambayo imesababisha vifo vya karibu 16% ya watu wanaoishi na UKIMWI, na ndiyo dalili ya kwanza ya UKIMWI katika asilimia 3 - 4 ya watu.<ref name=M169/>Saratani hizi mbili huhusishwa na [[virusi vya hepesi]] ya binadamu aina ya 8.<ref name=M169/>Saratani ya seviksi hutokea mara nyingi zaidi katika watu walio na UKIMWI kwa sababu ya jinsi inavyohusiana na [[virusi vya papiloma ya binadamu]].<ref name=M169/> Isitoshe, watu hao mara nyingi huwa na dalili za kimfumo, kama vile homa ya muda mrefu, [[jasho la usiku|jasho]] (hasa usiku), tezi za limfu zilizofura, ubaridi, udhaifu na [[kupoteza uzito]].<ref>{{cite web|title=AIDS|url=http://www.nlm.nih.gov/medlineplus/ency/article/000594.htm|work=MedlinePlus|publisher=A.D.A.M.|accessdate=14 June 2012}}</ref>Kuharisha ni dalili nyingine inayotokea katika takriban 90% ya watu wenye UKIMWI.<ref>{{cite journal|author=Sestak K |title=Chronic diarrhea and AIDS: insights into studies with non-human primates |journal=Curr. HIV Res. |volume=3 |issue=3 |pages=199–205 |year=2005 |month=July |pmid=16022653 |doi= 10.2174/1570162054368084|url=}}</ref> == Lini na wapi VVU vilianza == UKIMWI huchukuliwa kama [[janga]] — yaani [[mlipuko wa ugonjwa]] katika eneo kubwa, na ambao ungali unaenea.<ref name=Kallings/> UKIMWI ulitambuliwa mara ya kwanza na Vituo vya Kuzuia na Kudhibiti Magonjwa huko Marekani mwaka [[1981]]<ref name=M169/>, ilhali kisababishi chake - VVU - kilitambuliwa mwanzoni mwa [[muongo]] huo nchini huko. <ref>{{Rejea jarida|author=Gallo RC|title=A reflection on HIV/AIDS research after 25 years|journal= Retrovirology|volume=3|page=72|year=2006|pmid=17054781|doi=10.1186/1742-4690-3-72|url=http://www.retrovirology.com/content/3//72|pmc=1629027}}</ref> Matukio ya kwanza yalikuwa katika kikundi kidogo cha [[Uraibu|waraibu]] wa dawa za kudungia na [[wanaume]] [[shoga]] wasiokuwa na visababishi bayana vya udhaifu wa kingamwili na walioonyesha dalili za [[numonia]] ya ''[[Pneumocystis carinii]]'', maambukizi nyemelezi yanayotokea kwa nadra na maarufu katika watu wenye kingamwili dhaifu sana.<ref name=MMWR2>{{Rejea jarida| author=Gottlieb MS| title=Pneumocystis pneumonia—Los Angeles. 1981| journal=Am J Public Health| volume=96| issue=6| pages=980–1; discussion 982–3| year=2006| pmid=16714472| url=http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm| accessdate=March 31, 2009| pmc=1470612| archiveurl=https://web.archive.org/web/20090422042240/http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm| archivedate=2009-04-22| deadurl=no}}</ref> Punde baadaye, idadi isiyotarajiwa ya mashoga wakapata [[Sakoma ya Kaposi]] (SK), [[saratani ya ngozi]] iliyokuwa nadra sana hapo awali.<ref name="pmid7287964">{{cite journal|author=Friedman-Kien AE|title=Disseminated Kaposi's sarcoma syndrome in young homosexual men|journal=J. Am. Acad. Dermatol.|volume=5|issue=4|pages=468–71|year=1981|month=October|pmid=7287964|doi=10.1016/S0190-9622(81)80010-2|url=https://archive.org/details/sim_american-academy-of-dermatology-journal_1981-10_5_4/page/468}}</ref><ref name="pmid6116083">{{cite journal|author=Hymes KB|title=Kaposi's sarcoma in homosexual men-a report of eight cases|journal=Lancet|volume=2|issue=8247|pages=598–600|year=1981|month=September|pmid=6116083|doi=|url=https://archive.org/details/sim_the-lancet_1981-09-19_2_8247/page/n4|author-separator=,|author2=Cheung T|author3=Greene JB|display-authors=3|last4=Prose|first4=NS|last5=Marcus|first5=A|last6=Ballard|first6=H|last7=William|first7=DC|last8=Laubenstein|first8=LJ}}</ref>Visa vingine vingi vya NPC na SK vilitokea huku vikitahadharisha Vituo vya Kudhibiti na Kuzuia Magonjwa nchini Marekani, hivyo kikosi cha kiutendaji kikaundwa ili kuudhibiti mzuko huu.<ref name="Basavapathruni_2007">{{cite journal | title=Reverse transcription of the HIV-1 pandemic | url=https://archive.org/details/sim_faseb-journal_2007-12_21_14/page/3795 | last1=Basavapathruni |first1=A | last2=Anderson | first2=KS | journal=The FASEB Journal |year=2007 | month=December | volume=21 | issue=14 |pages=3795–3808 | doi=10.1096/fj.07-8697rev | pmid=17639073}}</ref> Katika siku za kwanza, kituo hicho hakikuwa na jina rasmi la ugonjwa huu, mara nyingi wakitumia majina ya magonjwa mengine yaliyohusishwa nao, kwa mfano, [[limfadenopathi]], jina ambalo baadaye wavumbuzi wa VVU waliviita virusi hivi.<ref name=MMWR1982a>{{Rejea jarida | author=Centers for Disease Control (CDC) |title=Persistent, generalized lymphadenopathy among homosexual males|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/00001096.htm | journal=MMWR Morb Mortal Wkly Rep. | year=1982 |pages=249–251 | volume=31| issue=19 | pmid=6808340 | accessdate =August 31, 2011}}</ref><ref name=Barre>{{Rejea jarida|author=Barré-Sinoussi F | title=Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS) |url=https://archive.org/details/sim_science_1983-05-20_220_4599/page/n103 | journal=Science | year=1983 | pages=868–871 | volume=220 | issue=4599 | pmid=6189183 |doi=10.1126/science.6189183 | bibcode=1983Sci...220..868B| author-separator=,| author2=Chermann JC| author3=Rey F|display-authors=3| last4=Nugeyre| first4=M.| last5=Chamaret| first5=S| last6=Gruest| first6=J| last7=Dauguet| first7=C|last8=Axler-Blin| first8=C| last9=Vezinet-Brun| first9=F }}</ref> Wavumbuzi pia walitumia “Sakoma ya Kaposi na Maambukizi nyemelezi”, jina lililokuwa la kikosi cha kiutendaji kilichoanzishwa mwaka wa 1981.<ref name=MMWR1982b>{{Rejea jarida | author=Centers for Disease Control (CDC) | title=Opportunistic infections and Kaposi's sarcoma among Haitians in the United States |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/00001123.htm | journal=MMWR Morb Mortal Wkly Rep. | year=1982 |pages=353–354; 360–361 | volume=31 | issue=26 | pmid=6811853 | accessdate =August 31, 2011}}</ref> Wakati mmoja, Kituo cha Kudhibiti na Kuzuia Magonjwa kiliunda msemo "ugonjwa wa 4H", kwani [[sindromu]] hii ilionekana kuwaathiri watu wa [[Haiti]], mashoga (homosexuals), wenye [[hemofilia]] na watumiaji wa [[heroini]].<ref name=SciRep470b>{{cite web| publisher=[[American Association for the Advancement of Science]]| date=July 28, 2006| url=http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf| title=Making Headway Under Hellacious Circumstances| accessdate=June 23, 2008| format=PDF| archivedate=2008-06-24| archiveurl=https://web.archive.org/web/20080624235131/http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf| =https://web.archive.org/web/20080624235131/http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf}}</ref> Katika vyombo vikuu vya habari liliundwa neno "[[GRID]]" (lililosimamia "gay-related immune deficiency", yaani "ukosefu wa kinga uliohusishwa na mashoga".<ref name=Altman>{{Rejea habari |author=Altman LK |url=http://www.nytimes.com/1982/05/11/science/new-homosexual-disorder-worries-health-officials.html?scp=1&sq=New%20homosexual%20disorder%20worries%20officials&st=cse | title=New homosexual disorder worries health officials | work=The New York Times | date=May 11, 1982 | accessdate =August 31, 2011}}</ref> Hata hivyo, baada ya kutambua kuwa VVU havikuwaathiri jamii ya mashoga pekee,<ref name=MMWR1982b/> ilibainika kuwa neno GRID lilikuwa likipotosha, hivyo neno UKIMWI likaanzishwa kwenye mkutano mnamo Julai 1982.<ref name=Kher>{{Rejea habari| author=Kher U| title=A Name for the Plague| work=Time| date=July 27, 1982| url=http://www.time.com/time/80days/820727.html| accessdate=March 10, 2008| archiveurl=https://web.archive.org/web/20080307015307/http://www.time.com/time/80days/820727.html| archivedate=2008-03-07| deadurl=no}}</ref> Kufikia Septemba 1982, Kituo cha Kudhibiti na Kuzuia Magonjwa kilianza kuuita UKIMWI.<ref name=MMWR1982c>{{Rejea jarida | author=Centers for Disease Control (CDC) | title=Update on acquired immune deficiency syndrome (AIDS)—United States| journal=MMWR Morb Mortal Wkly Rep. | year=1982 | pages=507–508; 513–514 | volume=31 | issue=37 | pmid=6815471}}</ref> [[File:Robert Gallo.jpg|thumb|Alt=Mwanaume aliyevalia shati nyeupe na tai, huku akizingizirwa na wanawake watatu na vifaa vya maabara|Robert Gallo, mzinduzi mwenza wa VVU katika miaka ya kwanza ya 1980, akiwa pamoja na (kushoto kwenda kulia) Sandra Eva, Sandra Colombini, na Ersell Richardson.]] Mnamo 1983, vikundi viwili tofauti vya watafiti vilivyoongozwa na [[Robert Gallo]] na [[Luc Montagnier]] bila kutegemeana vilitangaza kuwa [[retrovirusi]] mpya ilikuwa ikiwaambukiza wagonjwa wa UKIMWI, hivyo wakachapisha matokeo yao katika [[jarida]] la ''[[Science (jarida)|Science]]''.<ref name=Gallo>{{cite journal | author=RC Gallo, PS Sarin, EP Gelmann, M Robert-Guroff, E Richardson, VS Kalyanaraman, D Mann, GD Sidhu, RE Stahl, S Zolla-Pazner, J Leibowitch, and M Popovic |journal=Science |title=Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS) | url=https://archive.org/details/sim_science_1983-05-20_220_4599/page/n100 |year=1983 | pages=865–867 | volume=220 | doi=10.1126/science.6601823 | pmid=6601823 | issue=4599|bibcode = 1983Sci...220..865G }}</ref><ref name=Montagnier >{{cite doi|10.1126/science.6189183}}</ref> Gallo alidai kuwa virusi vilivyokuwa vimetambuliwa kwa mara ya kwanza na kikundi chake kilikuwa sawa katika [[muundo wa virusi|umbo]] na [[virusi vya binadamu vya limfotrophia-T]]. Kikundi cha Gallo kiliviita virusi hivi HTLV-III. Wakati huohuo, kikundi cha Montagnier kilitambua virusi kutoka kwa mgonjwa aliyekuwa na [[uvimbe]] wa [[tezi za limfu]] kwenye [[shingo]] na [[asthenia|udhaifu wa mwili]] ambazo ni dalili mbili bainifu za UKIMWI. Huku wakikanusha ripoti ya kikundi cha Gallo, Montagnier na wenzake walionyesha kuwa viini vya [[protini]] vya virusi hivyo vilikuwa tofauti na HTLV-I kiukingamwili. Kikundi cha Montagnier kiliviita virusi walivyovitambua virusi vinavyohusishwa na limfadenopathi.<ref name="Basavapathruni_2007"/> Virusi hivi vilibainika kuwa sawa mwaka wa 1986 na kubadilishwa na kuitwa VVU.<ref>{{cite book|last=Aldrich|first=ed. by Robert|title=Who's who in gay and lesbian history.|year=2001|publisher=Routledge|location=London|isbn=9780415229746|pages=154|url=http://books.google.ca/books?id=9KA7_1s6w-QC&pg=PA154|coauthors=Wotherspoon, Garry}}</ref> Leo [[wanasayansi]] wengi wanaamini VVU-1 na VVU-2 vimetokana na [[jamii ya sokwe]] huko [[Afrika Magharibi]] na [[Afrika ya Kati|ya Kati]] mwishoni mwa [[karne ya 19]] au mwanzoni mwa [[karne ya 20]], wakati virusi vya [[SIV]] kutoka kwa [[nyani]] au [[sokwe]] vilikwenda kwa binadamu.<ref name=Orgin2011>{{cite journal|last=Sharp|first=PM|coauthors=Hahn, BH|title=Origins of HIV and the AIDS Pandemic|journal=Cold Spring Harbor perspectives in medicine|date=2011 Sep|volume=1|issue=1|pages=a006841|pmid=22229120|doi=10.1101/cshperspect.a006841|pmc=3234451}}</ref> VVU-1 vinaaminika kutoka kusini mwa [[Cameroon]] kupitia kugeuka kwa VSVU(cpz), (virusi vya sokwe vinavyosababisha ukosefu wa kinga mwilini) vinavyoambukiza sokwe wa mwituni (VVU-1 hutokana na mzuko wa magonjwa ya VSVUcpz katika [[nususpishi]] ya sokwe iitwayo ''[[Pan]] troglodytes troglodytes'').<ref name="pmid9989410">{{cite journal |author=Gao F |title=Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes |journal=Nature |volume=397 |issue=6718|pages=436–41 |year=1999 |month=February |pmid=9989410|doi=10.1038/17130 |url=https://archive.org/details/sim_nature-uk_1999-02-04_397_6718/page/436|bibcode = 1999Natur.397..436G |author-separator=, |author2=Bailes E |author3=Robertson DL|display-authors=3 |last4=Chen|first4=Yalu |last5=Rodenburg |first5=Cynthia M. |last6=Michael |first6=Scott F.|last7=Cummins |first7=Larry B. |last8=Arthur |first8=Larry O. |last9=Peeters |first9=Martine }}</ref><ref name=Keele>{{cite journal | author=Keele, B. F., van Heuverswyn, F., Li, Y. Y., Bailes, E., Takehisa, J., Santiago, M. L., Bibollet-Ruche, F., Chen, Y., Wain, L. V., Liegois, F., Loul, S., Mpoudi Ngole, E., Bienvenue, Y., Delaporte, E., Brookfield, J. F. Y., Sharp, P. M., Shaw, G. M., Peeters, M., and Hahn, B. H. | title=Chimpanzee Reservoirs of Pandemic andNonpandemic HIV-1 | url=https://archive.org/details/sim_science_2006-07-28_313_5786/page/523 | journal=Science | date=28 July 2006| volume=313 | issue=5786 | pages=523–6 | doi = 10.1126/science.1126531 | pmc=2442710 | pmid=16728595|bibcode = 2006Sci...313..523K }}</ref> Virusi vinavyohusiana kwa karibu na VVU-2 ni VSVU(smm) ambavyo ni virusi vya [[mangabi mwenye masizi]] (''Cercocebus atys atys''), [[tumbili]] wa kale anayeishi Afrika Magharibi (kutoka [[kusini]] mwa [[Senegali]] hadi [[magharibi]] mwa [[Côte d'Ivoire]]).<ref name="Reeves" /> [[Tumbili wa kisasa]] kama vile [[tumbili wa Usiku|tumbili bundi]] wana ukinzani wa maambukizi ya [[VVU-1]] kwa sababu ya [[uunganishaji jeni|uunganishaji]] wa [[jeni]] [[mbili]] zinazokinzana na virusi.<ref name=Goodier>{{cite journal | author=Goodier, J., and Kazazian, H. | title=Retrotransposons Revisited: The Restraint and Rehabilitation of Parasites | url=https://archive.org/details/cell_2008-10-03_135_1/page/23 | journal=Cell |year=2008 | pages=23–35 | volume=135 | issue=1 | doi = 10.1016/j.cell.2008.09.022 | pmid=18854152}}(subscription required)</ref> VVU-2 inadhaniwa kuruka kizuizi cha spishi katika angalau matukio matatu tofauti, hivyo kupelekea vikundi vitatu vya virusi hivi ambavyo ni M, N na O. <ref name=Kalish2005>{{cite journal |author=Kalish ML |title=Central African hunters exposed to simian immunodeficiency virus |journal=Emerg Infect Dis |volume=11 |issue=12 |pages=1928–30 |year=2005 |pmid=16485481|doi=10.3201/eid1112.050394 |author-separator=, |author2=Wolfe ND |author3=Ndongmo CD |author4=McNicholl J|author5=Robbins KE |display-authors=5 |last6=Aidoo |first6=Michael |last7=Fonjungo |first7=Peter N. |last8=Alemnji|first8=George |last9=Zeh |first9=Clement |pmc=3367631}}</ref> Kuna ushahidi kuwa wanadamu wanaoshughulikia [[nyama za mwituni]] kwa kuwinda au kuziuza, kwa kawaida hupata VSVU.<ref name=Kalish2005/>Hata hivyo, virusi hivyo ni dhaifu na hukandamizwa na mfumo wa kingamwili baada ya wiki kadhaa za kuambukizwa. Inadhaniwa kuwa maambukizi kadhaa ya virusi hivyo kutoka kwa mtu hadi mwingine katika mfululizo wa haraka huhitajika ili vipate wakati unaotosha kubadilika na kuwa VVU.<ref name=Marx2001>{{cite journal |author=Marx PA, Alcabes PG, Drucker E |title=Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa |volume=356 |issue=1410 |pages=911–20 |year=2001 |pmid=11405938 |journal=Philos Trans R Soc Lond B Biol Sci |pmc=1088484 |doi=10.1098/rstb.2001.0867 |url=http://rstb.royalsocietypublishing.org/content/356/1410/911.full.pdf |archive-date=2012-03-09 |access-date=2017-04-01 |archive-url=https://web.archive.org/web/20120309105853/http://rstb.royalsocietypublishing.org/content/356/1410/911.full.pdf |url-status=dead }}</ref> Zaidi ya hayo, kwa sababu ya kiwango chake kidogo cha kuambukiza kutoka kwa mtu hadi mwingine, virusi hivyo vinaweza tu kuenea katika wingi wa watu iwapo kuna njia moja au mbili za hatari ya kuambukizana ya kiwango cha juu. Njia hizi zinadhaniwa kutokuwepo barani Afrika kabla ya karne ya 20. Njia maalumu za hatari kubwa ya maambukizi zinazoruhusu virusi hivi kubadilika ili kuweza kuishi katika wanadamu na kuenea katika jamii yote hutegemea wakati uliopendekezwa wa kuvuka kutoka kwa mnyama hadi mwanadamu. Tafiti za kijeni za virusi hivi zinadokeza kuwa chanzo cha hivi karibuni zaidi cha VVU-1 ya kikundi M kilitokea mnamo 1910. <ref name=Worobey2008>{{cite journal|last1=Worobey |first1=Michael |last2=Gemmel |first2=Marlea |last3=Teuwen |first3=Dirk E. |last4=Haselkorn|first4=Tamara |last5=Kunstman |first5=Kevin |last6=Bunce |first6=Michael |last7=Muyembe |first7=Jean-Jacques|last8=Kabongo |first8=Jean-Marie M. |last9=Kalengayi |first9=Raphaël M. |title=Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960 |journal=Nature |volume=455 |issue=7213 |pages=661–4 |year=2008 |pmid=18833279| doi=10.1038/nature07390|url=http://www.nature.com/nature/journal/v455/n7213/pdf/nature07390.pdf |bibcode = 2008Natur.455..661W }} (subscription required)</ref> Wanaotaja kipindi hicho maalumu huhusisha mzuko wa janga la VVU na kuibuka kwa [[ukoloni]] na ukuaji wa [[miji]] mikubwa ya kikoloni ya Afrika, huku ukisababisha mabadiliko ya jamii pamoja na kiwango kikubwa cha [[uasherati]], uenezi wa [[ukahaba]] na matukio mengi ya [[vidonda vya viungo vya uzazi]] (kama vile [[kaswende]]) katika miji iliyochipuka.<ref name=Sousa2010>{{cite journal |last1=Sousa |first1=João Dinis de|last2=Müller |first2=Viktor |last3=Lemey |first3=Philippe |last4=Vandamme |first4=Anne-Mieke |last5=Vandamme|first5=Anne-Mieke |title=High GUD Incidence in the Early 20th Century Created a Particularly Permissive Time Window for the Origin and Initial Spread of Epidemic HIV Strains |journal=PLoS ONE |volume=5 |issue=4 |pages=e9936 |year=2010|pmid=20376191 |pmc=2848574|doi=10.1371/journal.pone.0009936|url=http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0009936|editor1-last=Martin |editor1-first=Darren P.}}</ref> Ingawa viwango vya uambukizaji wakati wa ngono ya kupitia [[uke]] viko chini katika hali ya kawaida, kuna ongezeko kubwa iwapo mmoja wa wapenzi hao ana [[ugonjwa wa zinaa]] unaosababisha vidonda vya [[viungo vya uzazi]]. Miji ya kikoloni ya [[Miaka ya 1900|miaka ya kwanza ya 1900]] ilijulikana kwa maambukizi ya viwango vya juu kutokana na ukahaba na [[vidonda vya viungo vya uzazi]], hivi kwamba, kufikia mwaka [[1928]], 45% ya [[wanawake]] wakazi wa mashariki mwa [[Kinshasa]] walidhaniwa kuwa makahaba. Kufikia mwaka [[1933]], takriban 15% ya wakazi wote wa mji huo walikuwa wameambukizwa aina mojawapo ya kaswende.<ref name=Sousa2010 /> Maoni mengine yanadokeza kuwa hatua zisizo salama za [[uuguzi]] barani Afrika katika miaka ya baada ya [[Vita vya pili vya dunia]], kama vile kutumia tena na tena [[sindano]] zisizosafishwa kuchanja [[umati]], [[antibayotiki]] na kampeni dhidi ya [[malaria]] ndizo njia za kwanza zilizoruhusu virusi hivyo kujibadilisha vikiwa ndani ya wanadamu kisha kuenea.<ref name=Marx2001 /><ref name=Chitnis2000>{{cite journal |last1=Chitnis |first1=Amit |last2=Rawls |first2=Diana |last3=Moore |first3=Jim|title=Origin of HIV Type 1 in Colonial French Equatorial Africa? |journal=AIDS Research and Human Retroviruses|volume=16 |issue=1 |pages=5–8 |year=2000 |pmid=10628811 |doi=10.1089/088922200309548}}(subscription required)</ref><ref name=McNeil>{{cite news |author=[[Donald G. McNeil, Jr.]] |coauthors= |title=Precursor to H.I.V. Was in Monkeys for Millennia |url=http://www.nytimes.com/2010/09/17/health/17aids.html?_r=1&src=me&ref=general|quote=Dr. Marx believes that the crucial event was the introduction into Africa of millions of inexpensive, mass-produced syringes in the 1950s.&nbsp;... suspect that the growth of colonial cities is to blame. Before 1910, no Central African town had more than 10,000 people. But urban migration rose, increasing sexual contacts and leading to red-light districts.|work=[[New York Times]] |date=September 16, 2010 |accessdate=2010-09-17 }}</ref> Visa vilivyonakiliwa vyema vya VVU katika mwanadamu ni vya mwaka [[1959]] katika eneo la nchi ya [[Jamhuri ya Kidemokrasia ya Kongo|Kongo]].<ref name=Zhu>{{cite journal|author=Zhu, T., Korber, B. T., Nahmias, A. J., Hooper, E., Sharp, P. M. and Ho, D. D.|title=An African HIV-1 Sequence from 1959 and Implications for the Origin of the epidemic|journal=Nature|year=1998|pages=594–7|volume=391|issue=6667|pmid=9468138|doi=10.1038/35400|url=http://www.nature.com/nature/journal/v391/n6667/full/391594a0.html|bibcode = 1998Natur.391..594Z }}</ref> Kuna uwezekano kuwa virusi hivyo vilikuwemo huko Marekani mwaka [[1966]],<ref>{{cite news | last = Kolata | first = Gina |title = Boy's 1969 Death Suggests AIDS Invaded U.S. Several Times | publisher = The New York Times | date = 28 October 1987 | url = http://query.nytimes.com/gst/fullpage.html?res=9B0DEFD6173AF93BA15753C1A961948260&sec=health&pagewanted=all | accessdate = 11 February 2009}}</ref>lakini maambukizi mengi yanayotokea nje ya [[Kusini kwa Sahara]] yanaweza kufuatiliwa hadi kwa mtu mmoja aliyeambukizwa na VVU katika nchi ya [[Haiti]] na kisha kuyapeleka maambukizi hayo nchini Marekani takriban mwaka [[1969]].<ref name="Thomas_Gilbert">{{cite journal |last1=Gilbert |first1=M. Thomas P. |last2=Rambaut |first2=Andrew |last3=Wlasiuk |first3=Gabriela |last4=Spira |first4=Thomas J. |last5=Pitchenik |first5=Arthur E. |last6=Worobey |first6=Michael |title=The emergence of HIV/AIDS in the Americas and beyond |journal=PNAS |date=November 20, 2007 |volume=104 |issue=47 |pages=18566–18570 |url=http://www.pnas.org/content/104/47/18566.full.pdf |format=PDF |doi=10.1073/pnas.0705329104 |pmid=17978186 |pmc=2141817 |bibcode=2007PNAS..10418566G |access-date=2017-04-01 |archive-date=2015-09-24 |archive-url=https://web.archive.org/web/20150924144548/http://www.pnas.org/content/104/47/18566.full.pdf |dead-url=yes }}</ref> Janga hili kisha lilienea kwa haraka katika vikundi vilivyo katika hatari kubwa ya kuambukizwa (mwanzoni ilikuwa ni wanaume waliofanya ngono na wanaume). Kufikia mwaka [[1978]], maambukizi ya VVU-1 katika mashoga wenyeji wa [[New York]] na [[San Francisco]] yalikadiriwa kuwa 5%, kuonyesha kuwa maelfu ya watu nchini Marekani tayari walikuwa wameambukizwa.<ref name="Thomas_Gilbert" /> ==Uambukizaji== VVU husambaa hasa kupitia njia tatu kuu: [[ngono]] (ikiwa ni pamoja na [[ulawiti]] na hata [[ngono ya mdomoni]]), kuingiliana na viowevu vya mwili vilivyoambukizwa (hasa [[kuongezewa damu]] au kudungwa [[sindano]]) na [[usambazaji wima|kutoka kwa mama hadi mtoto]] wakati wa [[ujauzito]], kuzaa au kunyonyesha<ref name=TransmissionM2007>{{cite book|last=Markowitz|first=edited by William N. Rom ; associate editor, Steven B.|title=Environmental and occupational medicine|year=2007|publisher=Wolters Kluwer/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-6299-1|page=745|url=http://books.google.ca/books?id=H4Sv9XY296oC&pg=PA745|edition=4th}}</ref>Baadhi ya [[viowevu vya mwili]], kama vile [[mate]] na [[machozi]], havisambazi VVU.<ref name=CDCtransmission>{{cite web|publisher=[[Centers for Disease Control and Prevention]]|year=2003|url=http://www.cdc.gov/HIV/pubs/facts/transmission.htm|title=HIV and Its Transmission|accessdate=May 23, 2006|archiveurl=https://web.archive.org/web/20050204141148/http://www.cdc.gov/HIV/pubs/facts/transmission.htm|archivedate=2005-02-04}}</ref> === Kupitia ngono === Kufanya [[ngono zembe]] kumepelekea visa vingi zaidi vya maambukizi ya VVU kote ulimwenguni, huku mwingiliano baina ya watu wa [[jinsia]] tofauti ukichangia visa zaidi ya mwingiliano wa mashoga kote ulimwenguni (kwa sababu mashoga ni wachache zaidi).<ref name=TransmissionM2007/> Hata hivyo, mtindo wa usambazaji hutofautiana pakubwa baina ya mataifa mbalimbali. Nchini Marekani, visa vingi zaidi vya usambazaji wa kingono vilitokea katika [[wanaume]] wanaofanya ngono na wanaume (kwa sababu huko ushoga umeenea zaidi)<ref name=TransmissionM2007/>huku idadi hii ikichangia 64% ya visa vyote vipya.<ref name=TransmissionCDC2012>{{cite web|title=HIV in the United States: An Overview|url=http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/us_overview.htm|work=Center for Disease Control and Prevention|date=March 2012}}</ref> Kuhusu ngono zembe baina ya watu wa jinsia tofauti, makadirio ya hatari ya kusambazwa kwa VVU kwa kila kitendo cha ngono yanaonekana kuwa zaidi kwa mara 10 katika mataifa yasiyostawi kuliko mataifa yaliyostawi.<ref name=Boily2009/>Katika mataifa yasiyostawi, hatari ya usambazaji wa mwanamke hadi mwanamume imekadiriwa kuwa 0.38% kwa kila kitendo, huku usambazaji wa mwanamume hadi mwanamke ukiwa 0.30%; makadirio mbadala katika mataifa yaliyostawi ni 0.04% kwa kila kitendo katika usambazaji wa mwanamke hadi mwanamume, na 0.08% kwa kila kitendo katika maambukizi ya mwanamume hadi mwanamke.<ref name=Boily2009/> Hatari ya kuambukizwa kutokana na ngono ya kinyeo (ulawiti) iko juu sana, ikikadiriwa kuwa 1.4{{ndash}}1.7% kwa kila kitendo (katika ngono ya watu wa jinsia moja na tofauti pia).<ref name=Boily2009/><ref>{{cite journal|last=Beyrer|first=C|coauthors=Baral, SD; van Griensven, F; Goodreau, SM; Chariyalertsak, S; Wirtz, AL; Brookmeyer, R|title=Global epidemiology of HIV infection in men who have sex with men.|url=https://archive.org/details/sim_the-lancet_july-28-august-3-2012_380_9839/page/367|journal=Lancet|date=2012 Jul 28|volume=380|issue=9839|pages=367-77|pmid=22819660}}</ref> Ingawa hatari ya kuambukizwa kupitia [[ngono ya mdomoni]] iko chini, bado ipo. <ref>{{cite journal|last=Yu|first=M|coauthors=Vajdy, M|title=Mucosal HIV transmission and vaccination strategies through oral compared with vaginal and rectal routes|journal=Expert opinion on biological therapy|date=2010 Aug|volume=10|issue=8|pages=1181–95|pmid=20624114|doi=10.1517/14712598.2010.496776|pmc=2904634}}</ref>Hatari ya kila kitendo imekadiriwa kuwa 0{{ndash}}0.04% kwa ngono pokezi ya mdomoni.<ref name=Dosekun2010>{{cite journal|last=Dosekun|first=O|coauthors=Fox, J|title=An overview of the relative risks of different sexual behaviours on HIV transmission|journal=Current opinion in HIV and AIDS|date=2010 Jul|volume=5|issue=4|pages=291–7|pmid=20543603|doi=10.1097/COH.0b013e32833a88a3}}</ref><ref>{{cite book|last=Stürchler|first=Dieter A.|title=Exposure a guide to sources of infections|year=2006|publisher=ASM Press|location=Washington, DC|isbn=9781555813765|pages=544|url=http://books.google.ca/books?id=MWa5or3Xa9EC&pg=PA544}}</ref> kwa kuwa visa vichache vimeripotiwa.<ref>{{cite book|last=al.]|first=edited by Richard Pattman ... [et|title=Oxford handbook of genitourinary medicine, HIV, and sexual health|year=2010|publisher=Oxford University Press|location=Oxford|isbn=9780199571666|pages=95|url=http://books.google.ca/books?id=Jm1H4EeULmYC&pg=PA95|edition=2nd ed.}}</ref> Katika miktadha inayohusisha [[ukahaba]] kote ulimwenguni, hatari ya maambukizi ya mwanamke hadi mwanamume imekadiriwa kuwa 2.4% kwa kila kitendo, huku maambukizi ya mwanamume kwa mwanamke yakiwa 0.08% kwa kila kitendo.<ref name=Boily2009>{{cite journal|author=Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, Alary M |title=Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies|journal=The Lancet Infectious Diseases|volume=9|issue=2|pages=118–129|year=2009|month=February|pmid=19179227|doi=10.1016/S1473-3099(09)70021-0}}</ref> Hatari ya kuambukizwa huongezeka katika wingi wa [[magonjwa ya zinaa]]<ref name=CochraneSTI2012>{{cite journal|last=Ng|first=BE|coauthors=Butler, LM; Horvath, T; Rutherford, GW|title=Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2011-03-16|issue=3|pages=CD001220|pmid=21412869|doi=10.1002/14651858.CD001220.pub3|editor1-last=Butler|editor1-first=Lisa M}}</ref> na [[vidonda vya uzazi]].<ref name=Boily2009/>Vidonda vya sehemu za uzazi vimekisiwa kuongeza hatari hadi mara tano. <ref name=Boily2009/> Maambukizi mengine ya zinaa, kama vile [[kisonono]], [[klamidia]], [[trikomoniasi]], [[vaginosi ya kibakteria]], huhusishwa na aghalabu ongezeko dogo la hatari ya kuambukizwa.<ref name=Dosekun2010/> [[Wingi wa virusi]] kwa mtu aliyeambukizwa ni suala kuu la hatari katika usambazaji wa kingono na pia wa kutoka kwa mama hadi mtoto.<ref>{{cite journal|last=Anderson|first=J|title=Women and HIV: motherhood and more|journal=Current opinion in infectious diseases|date=2012 Feb|volume=25|issue=1|pages=58–65|pmid=22156896|doi=10.1097/QCO.0b013e32834ef514}}</ref> Katika miezi 2.5 ya kwanza baada ya kuambukizwa VVU, uwezo wa mtu kuambukiza ni mara 12 zaidi kwa sababu ya wingi wa virusi. <ref name=Dosekun2010/> Iwapo mtu yuko katika awamu za mwisho za VVU, viwango vya kuambukizana ni takriban mara 8 zaidi.<ref name=Boily2009/> [[Usadomasoki|Ngono shari]] inaweza kuwa suala linalochangia ongezeko la hatari ya kuambukizwa. <ref>{{cite journal|last=Klimas|first=N|coauthors=Koneru, AO; Fletcher, MA|title=Overview of HIV|url=https://archive.org/details/sim_psychosomatic-medicine_2008-06_70_5/page/523|journal=Psychosomatic Medicine|date=2008 Jun|volume=70|issue=5|pages=523–30|pmid=18541903|doi=10.1097/PSY.0b013e31817ae69f}}</ref> [[Ubakaji]] pia unaaminika kuongezeka hatari ya kusambaza VVU kwa sababu ni nadra [[kondomu]] kutumika, huwa na uwezekano wa kujeruhiwa ukeni au kinyeo, na pia kuna uwezekano wa magonjwa ya zinaa yanayoambatana na VVU. <ref>{{cite journal|last=Draughon|first=JE|coauthors=Sheridan, DJ|title=Nonoccupational post exposure prophylaxis following sexual assault in industrialized low-HIV-prevalence countries: a review|journal=Psychology, health & medicine|year=2012|volume=17|issue=2|pages=235–54|pmid=22372741|doi=10.1080/13548506.2011.579984}}</ref> ===Viowevu vya mwili === [[File:AIDS Poster If You're Dabbling in Drugs 1989.jpg|thumb|alt=Bango la rangi nyeusi na jipya la kijana wa Kiafrika akiwa na taulo kwenye mkono wa kushoto iliyo na maneno "Kucheza na madawa ni kucheza na maisha" juu yake|Bango la mwaka 1989 likisisitiza tishio la UKIMWI unaohusiana na kutumia madawa ya kulevya.]] Njia ya pili maarufu zaidi ya usambazaji wa VVU ni kupitia kwa [[damu]] na mazao yake.<ref name=TransmissionM2007/> Usambazaji wa kupitia damu unaweza kuwa kupitia sindano inayotumiwa na watu wengi wanapoongezwa viowevu mwilini, majeraha ya sindano, kuongezwa damu chafu au mazao ya damu, au kudungwa kwa vifaa visivyotakaswa. Hatari inayotokana na kutumia sindano baina ya watu wengi wakati wa [[kudungwa dawa]] ni kati ya 0.63-2.4% kwa kila kitendo, wastani wake ukiwa 0.8%<ref name=Risk2006>{{cite journal|last=Baggaley|first=RF|coauthors=Boily, MC; White, RG; Alary, M|title=Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis|journal=AIDS (London, England)|date=2006-04-04|volume=20|issue=6|pages=805–12|pmid=16549963|doi=10.1097/01.aids.0000218543.46963.6d}}</ref> Hatari ya kuambukizwa VVU kwa sindano iliyotumiwa na mtu aliyeambukizwa VVU hukadiriwa kuwa 0.3% (takriban mara 1 kwa 133) kwa kila kitendo, ilhali hatari inayofuatia [[tando za ute]] kuingiliana na damu iliyoambukizwa ni 0.09% (takriban 1 kwa 1000) kwa kila kitendo.<ref name=AFP2007>{{cite journal|last=Kripke|first=C|title=Antiretroviral prophylaxis for occupational exposure to HIV|url=https://archive.org/details/sim_american-family-physician_2007-08-01_76_3/page/375|journal=American family physician|date=2007-08-01|volume=76|issue=3|pages=375–6|pmid=17708137}}</ref> Nchini Marekani, watu wanaodungwa dawa ndani ya [[misuli]] walichangia 12% ya visa vyote vipya vya VVU mwaka wa 2009, <ref name=TransmissionCDC2012/> huku 80% ya watu katika sehemu fulani wanaodungwa dawa wakiwa wameambukizwa VVU. <ref name=TransmissionM2007/> [[Kuongezewa damu]] iliyoambukizwa huchangia maambukizi kwa takriban 93% ya visa vyote.<ref name=Risk2006/>Katika mataifa yaliyostawi, hatari ya kuambukizwa VVU kutokana na kuongezewa damu iko chini sana (chini ya 1 kwa 500,000) ambapo viwango vya juu vya kuchagua mtu atakayetoa damu na pia upimaji VVU hufanywa.<ref name=TransmissionM2007/> Kule Uingereza, hatari iliyoripotiwa ni 1 kwa milioni 5.<ref>{{cite web|title=Will I need a blood transfusion?|work=NHS patient information|year=2011|url=http://hospital.blood.co.uk/library/pdf/2011_Will_I_Need_English_v3.pdf|publisher=National Health Services|accessdate=August 29, 2012}}</ref> Hata hivyo, katika mataifa yenye mapato ya chini, [[nusu]] tu ya damu inayoongezwa huwa imepimwa vyema (kufikia mwaka wa 2008). <ref name=UN2011Seventy>UNAIDS 2011 pg. 60–70</ref>Inakadiriwa kuwa hadi 15% ya maambukizi ya VVU katika maeneo hayo hutokana na kuongeza damu au mazao ya damu yaliyoambukizwa, hii ikiwa ni asilimia 5 - 10 ya maambukizi ya ulimwengu mzima. <ref name=TransmissionM2007/><ref name=WHO070401>{{cite web |publisher=[[World Health Organization|WHO]] |year=2001 |url=http://www.who.int/inf-pr-2000/en/pr2000-25.html |title=Blood safety&nbsp;... for too few |accessdate=January 17, 2006 |archivedate=2005-01-17 |archiveurl=https://web.archive.org/web/20050117092135/http://www.who.int/inf-pr-2000/en/pr2000-25.html }}</ref> Sindano za tiba zisizo salama huchangia pakubwa katika kueneza UKIMWI katika eneo la Kusini kwa Sahara. Mnamo 2007, kati ya 12% na 17% ya maambukizi katika eneo hilo yalichangiwa na matumizi ya sindano hizo.<ref>{{cite journal|last=Reid|first=SR|title=Injection drug use, unsafe medical injections, and HIV in Africa: a systematic review|journal=Harm reduction journal|date=2009-08-28|volume=6|page=24|pmid=19715601|doi=10.1186/1477-7517-6-24|pmc=2741434}}</ref> [[Shirika la Afya Duniani]] linakadiria hatari ya kuambukizwa kupitia sindano hizo barani Afrika kuwa 1.2%. Hatari kuu huhusishwa na taratibu vamizi, kusaidiwa kuzaa na utunzaji wa [[meno]] katika sehemu hii ya dunia. Watu wanaochanja au kuchanjwa [[chale]], [[chale za mwili]] na [[kutia kovu]] hudhaniwa kuwa katika hatari ya kuambukizwa, ingawa hakuna visa vilivyothibitishwa ambavyo vimenakiliwa.<ref name=CDCBasics2012>{{cite web|title=Basic Information about HIV and AIDS|url=http://www.cdc.gov/hiv/topics/basic/|work=Center for Disease Control and Prevention|date=April 2012}}</ref> Haiwezekani [[mbu]] au wadudu wengine kusambaza VVU. <ref>{{cite web|url=http://www.rci.rutgers.edu/%7Einsects/aids.htm|title=Why Mosquitoes Cannot Transmit AIDS [HIV virus&#93;|publisher=Rci.rutgers.edu|date=|accessdate=2010-07-28|archiveurl=https://web.archive.org/web/20140329183346/http://www.rci.rutgers.edu/~insects/aids.htm|archivedate=2014-03-29|=https://web.archive.org/web/20140329183346/http://www.rci.rutgers.edu/~insects/aids.htm}}</ref> Mtu anaweza pia kupata VVU kwa kuchanga [[sindano]] na wenzake. Hii ina maana ya kutumia sindano ambayo haijawahi kusafishwa baada ya mtu mwingine kuitumia. Baadhi ya watu ambao, kinyume cha [[sheria]], huchukua madawa ya kulevya kama [[heroin]] na [[cocaine]] huchukua dawa hizo kwa sindano. Baadhi yao wanachanga sindano moja. Kama mmojawao ana virusi ya UKIMWI na anashirikisha sindano yake, anaweza kuambukiza HIV kwa watu wengine. === Mama hadi mtoto === VVU vinaweza kusambazwa kutoka kwa mama hadi mtoto wakati wa ujauzito, kuzaa au kunyonyesha.<ref name=Mother2010/><ref name="fluids of transmission">{{cite web|url=http://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/fluids-of-transmission/|title=Fluids of transmission|date=1 November 2011|work=AIDS.gov|publisher=United States Department of Health and Human Services|accessdate=14 September 2012|archivedate=2013-04-03|archiveurl=https://web.archive.org/web/20130403053447/http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/fluids-of-transmission/}}</ref> Njia hii ni ya tatu kwa umaarufu wa kusambaza VVU kote duniani.<ref name=TransmissionM2007/> Bila matibabu, hatari ya kusambazwa wakati wa au baada ya kuzaliwa ni takriban 20%, na 35% kwa watoto wanaonyonya.<ref name=Mother2010/>Kufikia mwaka wa 2008, usambazaji wima ulichangia takriban 90% ya visa vya VVU katika watoto.<ref name=Mother2010/> Hatari ya kusambazwa kutoka kwa mama hadi mtoto inaweza kupunguzwa hadi 1% kwa kutumia matibabu mwafaka.<ref name=Mother2010/> Matibabu ya kukinga hujumuisha mama kutumia dawa za kudhibiti virusi wakati wa ujauzito na kuzaa, kuchagua [[kuzaa kwa kupasuliwa]], kutonyonyesha na kumpa mtoto dawa za kudhibiti VVU.<ref name=MTC2007>{{cite journal|last=Thorne|first=C|coauthors=Newell, ML|title=HIV|journal=Seminars in fetal & neonatal medicine|date=2007 Jun|volume=12|issue=3|pages=174–81|pmid=17321814|doi=10.1016/j.siny.2007.01.009}}</ref>Hata hivyo, idadi kubwa ya mbinu hizi hazipatikani katika mataifa yanayostawi.<ref name=MTC2007/> Iwapo damu itachafua [[chakula]] wakati wa mtoto kutafuna, itaongeza hatari ya kuambukiza.<ref name=CDCBasics2012/> == VVU na UKIMWI == ===Virusi vyenyewe=== [[File:HI-virion-structure en.svg|thumb|alt= Muundo wa duara ulio na miundo ya rangi ya waridi inayochipuka kutoka kwake, na michoro kadhaa ndani ya duara hii ikionyesha vipengele tofauti vya virusi |Mchoro unaoonyesha muundo wa virusi vya VVU]] VVU ndivyo kisababishi cha mkusanyiko wa magonjwa yanayojulikana kijumla kama VVU/UKIMWI. VVU ni [[retrovirusi]] ambavyo hasa huambukiza vipengele vya [[mfumo wa kingamwili]] ya binadamu kama vile seli za CD4<SUP>+</SUP>T, [[makrofaji]] na [[seli za dendraiti]]. Virusi hivi huharibu seli za CD4<SUP>+</SUP> T moja kwa moja au vinginevyo.<ref name=Alimonti>{{Rejea jarida |author=Alimonti JB, Ball TB, Fowke KR | title=Mechanisms of CD4+ T lymphocyte cell death in human immunodeficiency virus infection and AIDS | journal=J. Gen. Virol. | year=2003 | pages=1649–1661 | volume=84 | issue=7 | pmid=12810858 |doi=10.1099/vir.0.19110-0}}</ref> VVU ni mshirika wa [[jenasi]] ya ''[[Lentivirus]]'',<ref name=ICTV61.0.6>{{cite web | author=[[International Committee on Taxonomy of Viruses]] | publisher=[[National Institutes of Health]] | year=2002 | url=http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61060000.htm | archiveurl=https://web.archive.org/web/20060418135608/http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61060000.htm | title=61.0.6. Lentivirus | accessdate=2012-06-25 | archivedate=2006-04-18 }}</ref> sehemu ya [[Familia (biolojia)|familia]] ya [[Retroviridae]].<ref name=ICTV61.>{{cite web |author=International Committee on Taxonomy of Viruses |publisher=National Institutes of Health |year=2002 |url=http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61000000.htm |title=61. Retroviridae |archiveurl=https://web.archive.org/web/20060629180810/http://ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61000000.htm |accessdate=2012-06-25 |archivedate=2006-06-29 }}</ref> Virusi vyote vya lenti huwa na sifa sawa za [[mofolojia (bayolojia)|kimofolojia]] na [[biolojia]]. Spishi nyingi za [[mamalia]] huambukizwa na virusi vya lenti, ambavyo haswa huwa ndivyo visababishi vya maradhi ya muda mrefu yaliyo na [[kipindi cha kupevuka]] kirefu.<ref name=Levy>{{cite journal | author=Lévy, J. A. | title=HIV pathogenesis and long-term survival | journal=AIDS | year=1993 | pages=1401–10| volume=7 | issue=11 | pmid=8280406 | doi=10.1097/00002030-199311000-00001}}</ref>Virusi vya lenti husambazwa kama [[virusi vya RNA]] chanya za uzi mmoja [[hisia]] zilizo ndani ya kigamba. Inapoingia ndani ya seli iliyolengwa, [[jenomu]] ya [[RNA]] ya virusi hugeuzwa (hubadilishwa kinakala) na kuwa [[DNA]] ya nyuzi mbili ambayo husafirishwa pamoja na jenomu ya virusi katika chembe ya virusi vile. DNA ya virusi inayoundika huingia katika kiini cha seli ambapo huchangamana na seli ya DNA kwa kutumia [[integresi]] iliyofasiliwa kama virusi, na pia vipengele husika vya kiini kikuu.<ref name="JASmith">{{cite journal | author= Smith, Johanna A.; Daniel, René (Division of Infectious Diseases, Center for Human Virology, Thomas Jefferson University, Philadelphia)|title= Following the path of the virus: the exploitation of host DNA repair mechanisms by retroviruses |journal=ACS Chem Biol|volume=1|issue=4 |pages= 217–26 |year= 2006 |pmid= 17163676 |doi=10.1021/cb600131q |url= }}</ref> Vinapochangamana na DNA ya seli, virusi hivi vinaweza kuingia katika [[kipindi cha kupevuka|awamu fiche]], hivyo kuwezesha virusi hivi pamoja na seli inayovipokea kuepuka kutambuliwa na mfumo wa kingamwili.<ref>{{cite book|last=Martínez|first=edited by Miguel Angel|title=RNA interference and viruses : current innovations and future trends|year=2010|publisher=Caister Academic Press|location=Norfolk|isbn=9781904455561|pages=73|url=</ref> Aina mbili [[Aina ndogo za VVU|za VVU]] zimetambulika: VVU-1 na VVU-2. VVU-1 ni virusi vilivyotambulika kwanza (na ambavyo mwanzoni vilijulikana pia kama LAV au HTLV-III). Virusi hivi vina [[sumu kali]], vyenye [[uambukizaji|kuambukiza]],<ref>{{cite journal | title=Comparison of HIV-1 and HIV-2 infectivity from a prospective cohort study in Senegal | last=Gilbert | first=PB |journal=Statistics in Medicine | date=28 February 2003| volume=22 |issue=4 | pages=573–593 | pmid=12590415 |doi=10.1002/sim.1342 | last2=McKeague | first2=IW | last3=Eisen | first3=G |last4=Mullins | first4=C | last5=Guéye-Ndiaye| first5=A | last6=Mboup | first6=S | last7=Kanki | first7=PJ |display-authors=1}}</ref> na ndivyo visababishi vikuu vya visa vingi vya maambukizi ya VVU kote ulimwenguni. Kiwango cha chini zaidi cha uambukizaji wa VVU-2 ikilinganishwa na VVU-1 huonyesha kuwa watu wachache zaidi walio katika hatari ya VVU-2 wataambukizwa kila wanapokumbana na virusi hivi. VVU-2 hupatikana zaidi [[Afrika Magharibi]] kwa sababu ya uwezo wake wa chini wa kuambukiza.<ref name="Reeves">{{cite journal | author=Reeves, J. D. and Doms, R. W | title=Human Immunodeficiency Virus Type 2 | journal=J. Gen. Virol. |year=2002 | pages=1253–65 | volume=83 | issue=Pt 6 | pmid=12029140 | doi=10.1099/vir.0.18253-0}}</ref> [[File:HIV-budding-Color.jpg|thumb|alt= Kifaa kikubwa cha duara cha rangi ya buluu, na kifaa chekundu kilichounganishwa nacho. Vifaa vyote viwili vina madoa ya kijani yaliyotapakaa juu yake.|[[Darubini ya elektroni ya ukaguzi|Mikrografu ya elektroni ya ukaguzi]] wa VVU-1, vya rangi ya kijani, vinavyochipuka kutoka kwa [[limfositi]] iliyokaguliwa.]] Baada ya virusi kuingia mwilini, kuna kipindi cha [[kugawanyika kwa virusi]], hali inayopelekea wingi wa virusi katika damu ya pembeni. Katika kipindi cha kwanza cha maambukizi, kiwango cha VVU kinaweza kufika milioni kadhaa za chembe za virusi kwa kila [[mililita]] ya damu.<ref name=Piatak>{{cite journal | author=Piatak, M., Jr, Saag, M. S., Yang, L. C., Clark, S. J., Kappes, J. C., Luk, K. C., Hahn, B. H., Shaw, G. M. and Lifson, J.D. | title=High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR |journal=Science | year=1993 |pages=1749–1754 |volume=259 |issue=5102 | pmid=8096089 | doi=10.1126/science.8096089|bibcode = 1993Sci...259.1749P }}</ref> Mwitikio huu huandamana na kiwango kikubwa cha kushuka kwa idadi ya seli za CD4<sup>+</sup> T zinazozunguka. [[Viremia]] kali mara nyingi huhusishwa na kuwezeshwa kwa [[seli za T angamizi|CD8<sup>+</sup> seli za T]], ambazo huangamiza seli zilizoambukizwa VVU na kisha kuhusishwa na kuzalishwa kwa zindiko, au [[kuzalishwa kwa zindiko mpya]]. Mwitikio wa seli za CD8<sup>+</sup> T huchukuliwa kuwa muhimu katika kudhibiti viwango vya virusi, ambavyo hupanda na kushuka, huku viwango vya seli za CD4<sup>+</sup> T vikirejea. Mwitikio bora wa seli za CD8<sup>+</sup> T umehusishwa na kupungua kwa mwendo wa ugonjwa na pia prognosi bora zaidi, ingawa mwitikio huu hauondoi virusi.<ref name=Pantaleo1998>{{cite journal| author=Pantaleo G, Demarest JF, Schacker T, Vaccarezza M, Cohen OJ, Daucher M, Graziosi C, Schnittman SS, Quinn TC, Shaw GM, Perrin L, Tambussi G, Lazzarin A, Sekaly RP, Soudeyns H, Corey L, Fauci AS. | title=The qualitative nature of the primary immune response to HIV infection is a prognosticator of disease progression independent of the initial level of plasma viremia | journal=Proc Natl Acad Sci U S A. | year=1997 |pages=254–258 | volume=94 | issue=1 | pmid=8990195 | doi=10.1073/pnas.94.1.254|pmc=19306|bibcode = 1997PNAS...94..254P }}</ref> Pathofisiolojia ya UKIMWI ni tata.<ref name="pmid8040596">{{Rejea jarida| author=Guss DA| title=The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1| journal=J Emerg Med| volume=12| issue=3|pages=375–84| year=1994| pmid=8040596| doi=10.1016/0736-4679(94)90281-X}}</ref> Mwishowe, VVU husababisha UKIMWI kwa kuharibu [[seli T saidizi|CD4<sup>+</sup>seli za T]]. Hali hii hudhoofisha mfumo wa kingamwili hivyo kuwezesha [[mambukizi vamizi]]. Seli za T ni muhimu kwa mwitikio wa kingamwili, hivyo bila ya seli hizi, mwili hauwezi kukabiliana na maambukizi wala kuharibu seli za saratani. Utendakazi wa kuharibiwa kwa seli za CD4<sup>+</sup> T hutofautiana katika awamu kali na za muda mrefu.<ref name="pmid16679064">{{Rejea jarida|author=Hel Z, McGhee JR, Mestecky J |title=HIV infection: first battle decides the war |journal=Trends Immunol. |volume=27 |issue=6 |pages=274–81 |year=2006 |month=June |pmid=16679064|doi=10.1016/j.it.2006.04.007 |url=https://archive.org/details/sim_trends-in-immunology_2006-06_27_6/page/274}}</ref> Katika awamu kali, lisisi ya seli inayosababishwa na VVU, na pia kuangamizwa kwa [[seli za T angamizi]] huchangia katika kuharibiwa kwa seli za CD4<sup>+</sup> T, ingawa [[apoptosi]] pia inaweza kuchangia hali hii. Katika awamu ya muda mrefu, matokeo ya uwezeshaji wa kijumla wa kingamwili ukiandamana na udhaifu wa pole pole wa uwezo wa mfumo wa kingamwili kuzalisha seli mpya za T hukisiwa kuchangia kupungua kwa pole pole kwa idadi ya seli za CD4<sup>+</sup> T. <ref>{{cite book|author=Arie J. Zuckerman et al. (eds)|title=Principles and practice of clinical virology|year=2007|publisher=Wiley|location=Hoboken, N.J.|isbn=978-0-470-51799-4|page=905|url=http://books.google.ca/books?id=4il2mF7JG1sC&pg=PA905|edition=6th}}</ref> Ingawa dalili za udhaifu wa kingamwili kama ulivyo katika UKIMWI hazitokei kwa miaka mingi baada ya kuambukizwa, kiwango kikubwa cha kuharibika kwa seli za CD4<sup>+</sup> T hutokea katika wiki za kwanza baada ya kuambukizwa, hasa katika ute wa utumbo, ambao huwa na kiwango kikubwa cha limfosaiti zote za mwili.<ref name="pmid15365095">{{Rejea jarida|author=Mehandru S, Poles MA, Tenner-Racz K, Horowitz A, Hurley A, Hogan C, Boden D, Racz P, Markowitz M|title=Primary HIV-1 infection is associated with preferential depletion of CD4<sup>+</sup> T cells from effector sites in the gastrointestinal tract |journal=J. Exp. Med. |volume=200 |issue=6 |pages=761–70 |year=2004 |month=September|pmid=15365095 |doi=10.1084/jem.20041196 |url= |pmc=2211967}}</ref> Sababu ya kiwango hiki kikubwa cha kuharibiwa kwa seli za CD4<sup>+</sup> T ni kuwa kiwango kikubwa cha seli za ute za CD4<sup>+</sup> T huzalisha protini ya [[CCR5]] inayotumika na VVU kama [[kipokezi kishiriki]] ili kuweza kufikia seli hizo, ilhali kipande kidogo tu cha seli za CD4<sup>+</sup> T katika mkondo wa damu hufanya hivyo.<ref name="pmid15365096">{{Rejea jarida|author=Brenchley JM, Schacker TW, Ruff LE, Price DA, Taylor JH, Beilman GJ, Nguyen PL, Khoruts A, Larson M, Haase AT, Douek DC |title=CD4<sup>+</sup> T cell depletion during all stages of HIV disease occurs predominantly in the gastrointestinal tract |journal=J. Exp. Med. |volume=200 |issue=6|pages=749–59 |year=2004 |month=September |pmid=15365096 |doi=10.1084/jem.20040874 |url= |pmc=2211962}}</ref> VVU hutafuta na kuharibu CCR5 inayotolesha seli za CD4<sup>+</sup> T katika awamu kali ya maambukizi. <ref name=Julio2011>{{cite book|last=editor|first=Julio Aliberti,|title=Control of Innate and Adaptive Immune Responses During Infectious Diseases.|publisher=Springer Verlag|location=New York, NY|isbn=978-1-4614-0483-5|page=145|url=http://books.google.ca/books?id=TKMpo5aINVIC&pg=PA145|year=2011}}</ref> Mwitikio mkubwa wa kingamwili hatimaye huyadhibiti maambukizi hayo kisha kuanzisha awamu fiche ya kiutambuzi. Seli za CD4<sup>+</sup> T katika tishu za ute husalia zikiwa zimeathiriwa sana. <ref name=Julio2011/> Ugawanyikaji endelevu wa VVU husababisha hali ya uwezeshaji wa kijumla wa kingamwili, ambao hudumu katika awamu yote ya muda mrefu.<ref name="pmid18161758">{{Rejea jarida|author=Appay V, Sauce D |title=Immune activation and inflammation in HIV-1 infection: causes and consequences|journal=J. Pathol. |volume=214 |issue=2 |pages=231–41 |year=2008 |month=January |pmid=18161758 |doi=10.1002/path.2276|url=https://archive.org/details/sim_journal-of-pathology_2008-01_214_2/page/231}}</ref> Uwezeshaji wa kingamwili, ambao hutambulika kwa ongezeko la uwezeshaji wa hali ya seli za kingamwili na kutoleshwa kwa [[saitokini]] inayosababisha inflemesheni, husababishwa na utendakazi wa [[zao la jeni]] na mwitikio wa kingamwili dhidi ya ugawanyikaji wa VVU unaoendelea. Uwezeshaji wa kingamwili pia huhusishwa na kuharibika kwa mfumo wa uchunguzi wa kingamwili wa kizuizi cha ute wa tumbo na utumbo, hali inayosababishwa na kuangamizwa kwa seli za CD4<sup>+</sup> T za ute katika awamu kali ya ugonjwa huu.<ref name="pmid17115046">{{Rejea jarida|author=Brenchley JM, Price DA, Schacker TW, Asher TE, Silvestri G, Rao S, Kazzaz Z, Bornstein E, Lambotte O, Altmann D, Blazar BR, Rodriguez B, Teixeira-Johnson L, Landay A, Martin JN, Hecht FM, Picker LJ, Lederman MM, Deeks SG, Douek DC |title=Microbial translocation is a cause of systemic immune activation in chronic HIV infection |journal=Nat. Med. |volume=12 |issue=12 |pages=1365–71 |year=2006 |month=December |pmid=17115046|doi=10.1038/nm1511 |url=}}</ref> Hivyo si kila mtu aliye na VVU ana UKIMWI. Wakati watu wanapata VVU, wanaweza kuwa na [[afya]] kwa miaka mpaka akakutwa na aina maalumu ya magonjwa na vipimo vya [[damu]] vikionyesha kuwa ina idadi ndogo sana ya [[seli nyeupe za damu]] ambazo ndizo zinazopambana na maambukizi. Kuna maradhi ambayo kwa kawaida ni ishara kwamba mtu ana UKIMWI kwa kuwa watu wenye afya njema hawapati magonjwa haya, kwa sababu mfumo wa kinga mwilini una nguvu ya kutosha ya kupigana na magonjwa hayo. Hivyo kupata ugonjwa wa aina hiyo ni ishara kwamba mfumo wa kinga umeharibika. Baadhi ya magonjwa hayo ni: * [[Sarkoma ya Kaposi]] - aina ya [[kansa]] ambayo kwa kawaida huathiri [[ngozi]] (mara nyingi husababisha vi[[donda]] vyekundu au [[zambarau]], au ma[[jeraha]] juu ya ngozi). Wakati mwingine huathiri tu ngozi, bali pia mifumo mingine katika mwili. * [[Retinitis]] - [[virusi]] zinashambulia nyuma ya [[jicho]]. * [[Pneumocystis carinii]] ([[kifupi]] PCP) - aina ya [[pneumonia]], [[magonjwa ya kuambukiza]] ya [[mapafu]]. PCP ni maambukizi ya kawaida kwa wagonjwa wa UKIMWI. * [[Toxoplasmosis]] - ugonjwa unaosababishwa na [[vimelea]], ambao unaweza kusababisha matatizo katika mifumo ya [[ubongo]] na mingine katika mwili. * [[Kansa ya kizazi]] - ambayo huwa inaenea. ==Utambuzi== [[File:Hiv-timecourse.png|thumb|alt=Grafu iliyo na mistari miwili. Mstari wa buluu unapanda kuelekea kulia kisha kushuka kuelekea kushoto huku ukipanda kidogo katikati. Mstari wa pili mwekundu unapanda kutoka sufuri hadi juu sana, kisha kushuka hadi chini halafu kupanda pole pole hadi juu tena |300px| Grafu ya ujumla ya uhusiano wa nakala za VVU (wingi wa virusi) na viwango vya seli za CD4<SUP>+</SUP> T katika wastani wa kipindi cha maambukizi yasiyotibiwa ya VVU.{{legend-line|blue solid 2px|CD4<sup>+</sup> T Lymphocyte count (cells/mm³)}} {{legend-line|red solid 2px|HIV RNA copies per mL of plasma}}]] VVU hutambuliwa kupitia uchunguzi wa kimaabara kisha kuainishwa kiawamu kwa msingi wa uwepo wa dalili au ishara fulani.<ref name=WHOCase2007/> Watu walio katika hatari kubwa ya kuambukizwa hupendekezwa kupimwa VVU, ikiwa ni pamoja na mtu yeyote aliye na ugonjwa wa zinaa<ref name=Deut2010/> Katika maeneo mengi ya ulimwengu, 1/3 ya watu wenye VVU hutambua kuwa wameambukizwa katika awamu za mwishoni mwa ugonjwa huu wakati UKIMWI au ukosefu mkuu wa kingamwili umekuwa wazi.<ref name=Deut2010/> === Uchunguzi wa VVU === Watu wengi walioambukizwa VVU huzalisha [[zindiko]] maalum (yaani [[uzalishaji zindiko mpya|kuzalisha zindiko mpya]]) katika wiki 3 hadi 12 tangu maambukizi ya kwanza. <ref name=M118/> Utambuzi wa VVU vya kimsingi hufanywa kabla ya kuzalishwa kwa zindiko mpya kwa kupima [[RNA]] ya VVU au [[antijeni ya P24 #vipimo vya antijeni|antijeni ya p24]].<ref name=M118/> Matokeo chanya yanayopatikana kwa kupima [[msururu wa athari za polima|MAP]] au zindiko huthibitishwa kwa zindiko au MAP tofauti.<ref name=WHOCase2007/> Vipimo vya zindiko kwa watoto wa umri wa chini ya miezi 18&nbsp; kwa kawaida huwa kasoro kwa sababu ya uwepo endelevu wa [[Kingamwili Kimya ya Mama#Kingamwili kimya iliyopokezwa kiasilia|zindiko za mama]].<ref name=ChildDiag2010>{{cite journal|last=Kellerman|first=S|coauthors=Essajee, S|title=HIV testing for children in resource-limited settings: what are we waiting for?|journal=PLoS medicine|date=2010 Jul 20|volume=7|issue=7|pages=e1000285|pmid=20652012|doi=10.1371/journal.pmed.1000285|pmc=2907270}}</ref> Kwa hivyo, maambukizi yanaweza kutambulika tu kwa vipimo vya MAP vya VVU, RNA au DNA, au kupitia kupima uwepo wa antijeni ya p24.<ref name=WHOCase2007/>Sehemu kubwa ya ulimwengu haina uwezo wa kupata vipimo bora vya MAP huku watu wa sehemu nyingi wakisubiri hadi dalili za watoto wao kuendelea au watoto hao kukua hadi kuwa na uwezo wa kupimwa kikamilifu.<ref name=ChildDiag2010/> Kufikia mwaka wa 2007-2009 katika eneo la Kusini mwa Jangwa la Sahara, kati ya asilimia 30-70 ya watu walikuwa wakifahamu hali yao ya VVU.<ref name=UN2011Eighty>UNAIDS 2011 pg. 70–80</ref> Mnamo mwaka wa 2009, kati ya asilimia 4-42 ya watu hawa walipimwa. <ref name=UN2011Eighty/> Takwimu hizi zinaonyesha ongezeko kubwa kutoka miaka ya awali.<ref name=UN2011Eighty/> ===Uainishaji wa maambukizi ya VVU=== Mifumo miwili mikuu ya uainishaji hutumika kuainisha VVU na magonjwa husika kwa ajili ya [[uchunguzi wa magonjwa|uchunguzi]]: mfumo wa uainishaji wa magonjwa wa [[Shirika la Afya Duniani]],<ref name=WHOCase2007/> na [[mfumo wa VKM]] wa uainishaji wa maambukizi ya VVU.<ref name=CDCCase2008/> The [[Vituo vya Kukinga na Kudhibiti Magonjwa|VKM]] hutumika zaidi katika mataifa yaliyostawi. Kwa vile mfumo wa uainishaji wa SAD hauhitaji vipimo vya mahabara, mfumo huu ni mwafaka kwa mataifa yanayostawi ambayo kwa kawaida yana upungufu wa vifaa, ambapo unaweza pia kutumika kuongoza udhibiti wa kimatibabu. Ingawa mifumo hii miwili ni tofauti, yote huwezesha ulinganishaji kwa ajili ya malengo ya kitakwimu.<ref name=M121/><ref name=WHOCase2007/><ref name=CDCCase2008/> Shirika la Afya Duniani lilipendekeza ufasili wa UKIMWI mara ya kwanza mwaka wa 1986.<ref name=WHOCase2007/> Tangu hapo, ufasili wa Shirika hili umedurusiwa na kurefushwa mara kadhaa, toleo la hivi karibuni likiwa la mwaka wa 2007. <ref name=WHOCase2007>{{cite book|title=WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children.|pages=6–16|url=http://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf|format=PDF|year=2007|publisher=World Health Organization|location=Geneva|isbn=978-92-4-159562-9}}</ref> Mfumo wa SAD hutumia vikundi vifuatavyo: * Maambukizi ya kimsingi ya VVU: Yanaweza kuwa bila dalili au yakihusishwa na sindromu kali ya retrovirusi. <ref name=WHOCase2007/> * Awamu ya I: Maambikizi ya VVU huwa [[bila dalili]] yakiwa na kiwango cha seli za CD4<SUP>+</SUP> T (ambacho pia huitwa kiwango cha CD4) cha zaidi ya 500/uL.<ref name=WHOCase2007/> Maambukizi haya yanaweza kujumuisha kuvimba kwa tezi za mwili wote.<ref name=WHOCase2007/> * Awamu ya II: Dalili ndogo zinaweza kuhusisha kiwango cha chini cha kudhihirika kwa [[tando za ute|za tando za ute]] na maambukizi yanayorejea ya [[sehemu ya juu ya njia ya pumzi]]. Kiwango cha seli za CD4 cha chini ya 500/uL..<ref name=WHOCase2007/> *Awamu ya III: Dalili kuu zinazoweza kujumuisha hali ya [[kuharisha]][[ya muda mrefu (kimatibabu)|ya muda mrefu]] isiyo na kisababishi maalum kwa zaidi ya mwezi mmoja, maambukizi makali ya bakteria ikiwa ni pamoja na tiibii ya mapafu na pia kiwango cha seli za CD4 cha chini ya 350/uL. <ref name=WHOCase2007/> *Awamu ya IV ya UKIMWI: dalili kali zinazojumuisha [[toksoplasmosi]] ya ubongo, [[ukungu]] wa [[umio]], [[Vetebra ya trakea|trakea]], [[bronkasi| bronkasi]] au [[mapafu]] na [[sakoma ya Kaposi]]. Kiwango cha seli za CD4 cha chini ya 500/uL..<ref name=WHOCase2007/> Kituo cha Kukinga na Kudhibiti Magonjwa cha Marekani pia kilianzisha mfumo wa uainishaji wa VVU, kilichoudurusu mwaka wa 2008.<ref name=CDCCase2008>{{cite journal|last=Schneider|first=E|coauthors=Whitmore, S; Glynn, KM; Dominguez, K; Mitsch, A; McKenna, MT; Centers for Disease Control and Prevention, (CDC)|title=Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years--United States, 2008|journal=MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control|date=2008-12-05|volume=57|issue=RR–10|pages=1–12|pmid=19052530}}</ref> Katika mfumo huu, maambukizi ya VVU yameainishwa kulingana na kiwango cha CD4 na dalili za kiutambuzi, <ref name=CDCCase2008/> nayo hueleza maambukizi kwa awamu tatu: *Awamu ya 1: Kiwango cha CD4 cha seli ≥ 500&nbsp;/uL na hakuna hali zinazoashiria UKIMWI *Awamu ya 2: Kiwango cha seli za CD4 200 hadi 500&nbsp;/uL na hakuna hali zinazoashiria UKIMWI *Awamu ya 3: Kiwango cha seli za CD4≤ 200&nbsp;cells/uL au hali zinazoashiria UKIMWI. *Tashwishi: iwapo habari iliyopo haitoshi kufanya uainishaji uliopo juu Kwa sababu za kiuchunguzi, utambuzi wa UKIMWI hubakia iwapo baada ya matibabu kiwango cha seli za CD4<SUP>+</SUP> T kitapanda zaidi ya 200 kwa kila µL ya damu au iwapo maradhi mengine yanayoashiria UKIMWI yataponywa.<ref name="M121"/> == Matibabu == Hakuna tiba au [[chanjo dhidi ya VVU|chanjo]]; hata hivyo, matibabu ya kudhibiti [[virusi]] yanaweza kupunguza mwendo wa ugonjwa huu na huenda yakapelekea [[urefu]] wa [[maisha]] kuwa karibu na kawaida. Ingawa [[matibabu]] ya kupunguza makali hupunguza hatari ya kifo na matatizo yanayotokana na ugonjwa huu, matibabu haya ni ya bei ghali, hivyo yanaweza kuhusishwa na madhara mbadala. Kuna dawa za kusaidia watu wenye UKIMWI. Hizi zinaitwa ''dawa za kurefusha maisha''. Dawa za kurefusha maisha haziwezi kutibu UKIMWI. Hii ina maana kwamba haziwezi kufanya virusi vyote kuondoka mwili wa mtu. Lakini zinaweza kuwasaidia watu kupambana na virusi vya UKIMWI kwa mifumo yao ya kinga kufanya kazi vizuri zaidi. Hivyo dawa za kurefusha maisha si tiba kabili kwa virusi ya UKIMWI. Watu wenye VVU/UKIMWI ambao huchukua dawa za kurefusha maisha wanaweza kuishi muda mrefu, bila kupata maradhi yanayothibitisha UKIMWI. Lakini baada ya muda mrefu, virusi za HIV zisizouawa na dawa hizo hujifunza jinsi ya kupambana nazo na hivyo zinakuwa ''sugu'' kwa dawa hizo. Wakati mwingine VVU ni sugu kwa dawa moja, lakini dawa nyingine inaweza kutumika. Ili kupunguza uwezekano wa upinzani kutokea, watu wenye UKIMWI huchukua dawa zaidi ya moja kwa wakati mmoja. Wanaweza kuchukua madawa 2-4 kwa mara moja. Hii wakati mwingine inaitwa ''cocktail'' ya UKIMWI. Lakini baada ya muda mrefu, VVU kujifunza kuwa sugu kwa dawa nyingi. Hapo hakuna zaidi ya kuwatibu. Hivyo [[wanasayansi]] kuendelea kujaribu kupata dawa mpya ya kupambana na VVU. Dawa [[tano]] muhimu za wenye VVU ni: * D4T (stavudine) * 3TC (Lamivudine) * NVP (nevirapine) * AZT (zidovudine) * EFZ (efavirenz) Bila dawa hizo, kwa kawaida mtu mwenye VVU anaweza akaishi miaka 9-11. == Njia za kujikinga na UKIMWI == [[Picha: Red Ribbon.svg|thumb|haki|Utepe mwekundu, ishara ya mapambano dhidi ya UKIMWI.]] [[File:AIDS Clinic, McLeod Ganj, 2010.jpg|thumb|alt=Onyesho la jumba la ghorofa mbili lililo na mabango kadhaa yanayohusiana na kuzuia UKIMWI |Matibabu ya UKIMWI, [[McLeod Ganj]], Himachel Pradesh, India, 2010]] Kuna njia nyingi za watu kupambana na [[janga]] hilo. Kuzuia maambukizi ya VVU, hasa kupitia [[kondomu]] na miradi ya kubadilishabadilisha sindano, ni mikakati mikuu inayotumika kudhibiti kuenea kwa ugonjwa huu. Lakini wengine wanahoji kwamba bila kubadili tabia, [[teknolojia]] peke yake haitaweza kushinda ugonjwa huo. === Chanjo === Njia bora ya kuzuia VVU ni wazo la kuwa na [[chanjo]]. Wanasayansi wengi wanatafuta [[chanjo ya VVU]] ili kuokoa [[uhai]] wa mamilioni ya watu, lakini kufikia mwaka [[2012]], hakuna chanjo mwafaka dhidi ya VVU/UKIMWI.<ref>{{cite news|title=The quest for an HIV vaccine|url=http://www.unaids.org/en/resources/presscentre/featurestories/2012/may/20120518vaccinesday/|date=May 18, 2012|author=UNAIDS|accessdate=2017-04-01|archivedate=2012-05-24|archiveurl=https://web.archive.org/web/20120524051113/http://www.unaids.org/en/resources/presscentre/featurestories/2012/may/20120518vaccinesday/}}</ref>Jaribio moja la chanjo ya [[RV 144]] iliyotolewa mwaka 2009 lilipelekea kupunguza hatari ya kuambukiza kwa takriban 30%, hivyo kuchochea matarajio ya jamii ya utafiti ya kutengeneza chanjo mwafaka zaidi.<ref>{{cite journal|last=Reynell|first=L|coauthors=Trkola, A|title=HIV vaccines: an attainable goal?|journal=Swiss medical weekly|date=2012-03-02|volume=142|pages=w13535|pmid=22389197|doi=10.4414/smw.2012.13535}}</ref> Majaribio zaidi ya chanjo ya RV 144 yanaendelea.<ref>{{cite web| author = U.S. Army Office of the Surgeon General| title = HIV Vaccine Trial in Thai Adults| publisher = ClinicalTrials.gov| date = March 21, 2011| accessdate = June 28, 2011| url =http://clinicaltrials.gov/ct2/show/NCT00223080}}</ref><ref>{{cite web| author = U.S. Army Office of the Surgeon General|title = Follow up of Thai Adult Volunteers With Breakthrough HIV Infection After Participation in a Preventive HIV Vaccine Trial| publisher = ClinicalTrials.gov| date = June 2, 2010| url =http://www.clinicaltrials.gov/ct2/show/NCT00337181}}</ref> ===Kondomu=== Vitendo vya kijinsia ni njia kuu ya kupata VVU. Kama watu wanatumia [[kondomu]] wanapofanya mapenzi, kuna nafasi ndogo zaidi ya kuambukizana VVU, lakini [[ukweli]] kamili ni kwamba hakuna [[ngono salama]] kwa hakika. Matumizi ya [[kondomu]] ya kila mara hupunguza hatari ya kuambukizana UKIMWI kwa takriban 80% katika muda mrefu wa usoni.<ref>{{cite journal|last=Crosby|first=R|coauthors=Bounse, S|title=Condom effectiveness: where are we now?|journal=Sexual health|date=2012 Mar|volume=9|issue=1|pages=10–7|pmid=22348628|doi=10.1071/SH11036}}</ref> Iwapo mwenzi mmoja ameambukizwa, kutumia kondomu kila mara hupelekea viwango vya chini ya 1% kwa mwaka vya huyo mwingine kuambukizwa.<ref name=WHOCondoms>{{cite web| publisher=[[World Health Organization|WHO]]| month=August |year=2003|url=http://www.wpro.who.int/mediacentre/factsheets/fs_200308_Condoms/en/index.html | title=Condom Facts and Figures|accessdate=January 17, 2006 }}</ref> Kuna ushahidi mdogo unaoonyesha kuwa [[kondomu za wanawake]] una kiwango sawa cha kinga.<ref>{{cite journal|last=Gallo|first=MF|coauthors=Kilbourne-Brook, M; Coffey, PS|title=A review of the effectiveness and acceptability of the female condom for dual protection|journal=Sexual health|date=2012 Mar|volume=9|issue=1|pages=18–26|pmid=22348629|doi=10.1071/SH11037}}</ref> ===Dawa za ukeni=== Kutumia mafuta ya ukeni yanaliyo na [[tenofovir]] muda mfupi kabla ya ngono hukisiwa kupunguza viwango vya maambukizi kwa takriban 40% miongoni mwa wanawake wa Kiafrika.<ref name=VagGel2012>{{cite journal|last=Celum|first=C|coauthors=Baeten, JM|title=Tenofovir-based pre-exposure prophylaxis for HIV prevention: evolving evidence|journal=Current opinion in infectious diseases|date=2012 Feb|volume=25|issue=1|pages=51–7|pmid=22156901|doi=10.1097/QCO.0b013e32834ef5ef|pmc=3266126}}</ref> Kinyume na hili, matumizi ya [[spemisidi]] [[nonoxynol-9]] yanaweza kuongeza hatari ya kuambukizwa kwa sababu ya uwezo wake wa kuleta mwasho wa uke na [[rektamu]].<ref>{{cite journal|last=Baptista|first=M|coauthors=Ramalho-Santos, J|title=Spermicides, microbicides and antiviral agents: recent advances in the development of novel multi-functional compounds|journal=Mini reviews in medicinal chemistry|date=2009-11-01|volume=9|issue=13|pages=1556–67|pmid=20205637|doi=10.2174/138955709790361548}}</ref> ===Tohara=== [[Tohara]] katika eneo la [[Kusini kwa Sahara]] "hupunguza uambukizaji wa VVU katika wanaume wanaohusiana na wanawake kimapenzi kwa kati ya 38% na 66% kwa muda wa miezi 24". <ref>{{cite journal|last=Siegfried|first=N|coauthors=Muller, M; Deeks, JJ; Volmink, J|title=Male circumcision for prevention of heterosexual acquisition of HIV in men|journal=Cochrane database of systematic reviews (Online)|date=2009-04-15|issue=2|pages=CD003362|pmid=19370585|doi=10.1002/14651858.CD003362.pub2|editor1-last=Siegfried|editor1-first=Nandi}}</ref> Kwa msingi wa tafiti hizi, mashirika ya SAD na UNAIDS yalipendekeza tohara kama mbinu ya kuzuia uambukizaji VVU kutoka kwa mwanamke hadi mwanamume mwaka 2007.<ref>{{cite web |title=WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention |publisher=World Health Organization |date=Mar 28, 2007 |url=http://www.who.int/mediacentre/news/releases/2007/pr10/en/index.html |accessdate=2017-04-01 |archivedate=2011-07-03 |archiveurl=https://web.archive.org/web/20110703140439/http://www.who.int/mediacentre/news/releases/2007/pr10/en/index.html }}</ref> Haijabainika wazi iwapo njia hii huzuia uambukizaji kutoka kwa mwanamume hadi mwanamke<ref>{{cite journal|last=Larke|first=N|title=Male circumcision, HIV and sexually transmitted infections: a review|url=https://archive.org/details/sim_british-journal-of-nursing_2010-05-27_19_10/page/n11|journal=British journal of nursing (Mark Allen Publishing)|date=2010 May 27 – Jun 9|volume=19|issue=10|pages=629–34|pmid=20622758}}</ref><ref>{{cite journal|last=Eaton|first=L|coauthors=Kalichman, SC|title=Behavioral aspects of male circumcision for the prevention of HIV infection|journal=Current HIV/AIDS reports|date=2009 Nov|volume=6|issue=4|pages=187–93|pmid=19849961|doi=10.1007/s11904-009-0025-9}}(subscription required)</ref> na iwapo mbinu hii ina manufaa katika [[mataifa yaliyostawi]] na haijabainika miongoni mwa mashoga.<ref>{{cite journal|last=Kim|first=HH|coauthors=Li, PS, Goldstein, M|title=Male circumcision: Africa and beyond?|journal=Current opinion in urology|date=2010 Nov|volume=20|issue=6|pages=515–9|pmid=20844437|doi=10.1097/MOU.0b013e32833f1b21}}</ref><ref>{{cite journal|last=Templeton|first=DJ|coauthors=Millett, GA, Grulich, AE|title=Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men|journal=Current opinion in infectious diseases|date=2010 Feb|volume=23|issue=1|pages=45–52|pmid=19935420|doi=10.1097/QCO.0b013e328334e54d}}</ref><ref>{{Rejea jarida | last1 = Wiysonge | first1 = CS. | last2 = Kongnyuy | first2 = EJ. | last3 = Shey | first3 = M. | last4 = Muula | first4 = AS.|last5 = Navti | first5 = OB. | last6 = Akl | first6 = EA. | last7 = Lo | first7 = YR. | title = Male circumcision for prevention of homosexual acquisition of HIV in men | journal = Cochrane Database Syst Rev |volume = | issue = 6 | pages = CD007496 | month = | year = 2011 | doi = 10.1002/14651858.CD007496.pub2 | pmid = 21678366 | editor1-last = Wiysonge |editor1-first = Charles Shey }}</ref> Baadhi ya wataalamu wanahofia kuwa dhana ya kiwango cha chini cha hatari miongoni mwa wanaume waliotahiriwa inaweza kupelekea mienendo hatari zaidi, hivyo wanapinga faida ya mbinu hii katika kukinga.<ref>{{Rejea jarida|author=Eaton LA, Kalichman S |title=Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies |journal=Curr HIV/AIDS Rep |volume=4 |issue=4|pages=165–72 |year=2007|month=December|pmid=18366947|pmc=2937204 |doi=10.1007/s11904-007-0024-7}}</ref> Wanawake waliofanyiwa [[ukeketaji]] wana hatari zaidi ya kuambukizwa.<ref>{{Rejea jarida|author=Utz-Billing I, Kentenich H|title=Female genital mutilation: an injury, physical and mental harm |journal=J Psychosom Obstet Gynaecol|volume=29|issue=4 |pages=225–9|year=2008 |month=December |pmid=19065392 |doi=10.1080/01674820802547087 |url=}}</ref> ===Mawaidha na elimu=== Njia muhimu ya kuzuia VVU/UKIMWI ni [[elimu]] kwa kuwa hiyo inawezesha kuelewa maana ya [[jinsia]] na kukwepa sababu za maambukizi yake. Ni kwamba watu wanaweza kupata VVU kutokana na [[ngono]] na kutokana na [[damu]]. Watoto wanaweza pia kupata VVU kutoka kwa [[mama]] zao (wakati wa kukua ndani ya akina mama wajawazito na wakati wa kunyonya [[maziwa]] ya mama.) Kuna baadhi ya watu ambao hawataki watu wajue kuhusu kondomu na sindano safi, au hawataki wawe na kondomu au sindano safi. Hao wanaamini kuwa watu wakijua kuhusu kondomu na kuwa na kondomu watafanya ngono zaidi na hivyo kuzidisha maambukizi badala ya kuyapunguza kwa sababu kinga hiyo si madhubuti. Vilevile wanaamini kuwa watu wakiwa na sindano safi watatumia dawa za kulevya zaidi. Wengi wa wanaodhani hivyo ni pia kwa sababu ya [[dini]] zao kukataza [[uzinifu]] na [[ulevi]] kama tabia zinazoharibu binadamu binafsi na jamii kwa jumla. Hao huhimiza [[upendo]] na [[uaminifu]] katika [[ndoa]], [[usafi wa moyo]] na utunzaji wa afya. Miradi inayohimiza [[kujinyima ngono]] haijatambulika inaathiri vipi hatari ya kupata VVU.<ref>{{cite journal |author= Underhill K, Operario D, Montgomery P |title= Abstinence-only programs for HIV infection prevention in high-income countries |journal=Cochrane Database of Systematic Reviews |issue=4 |pages= CD005421|year=2008|pmid= 17943855|doi=10.1002/14651858.CD005421.pub2|url=http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD005421/frame.html|editor1-last= Operario|editor1-first= Don}}</ref> Ushahidi wa manufaa ya [[elimu ya rika]] pia hautoshi.<ref>{{cite journal|last=Tolli|first=MV|title=Effectiveness of peer education interventions for HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people: a systematic review of European studies|journal=Health education research|date=2012-05-28|pmid=22641791|doi=10.1093/her/cys055}}</ref> [[Elimu ya ngono]] inayotolewa [[Shule|shuleni]] inaweza kupunguza mitindo hatari,<ref>{{cite journal|last=Ljubojević|first=S|coauthors=Lipozenčić, J|title=Sexually transmitted infections and adolescence|journal=Acta dermatovenerologica Croatica : ADC|year=2010|volume=18|issue=4|pages=305–10|pmid=21251451}}</ref> lakini inaweza pia kuchochea wanafunzi wakajaribu wenyewe ngono. [[Vijana]] wengi wanajihusisha katika vitendo hatari licha ya kufahamu kuhusu VVU/UKIMWI, huku wakipuuza hatari ya kuambukizwa.<ref name="Patel2008">{{Rejea jarida| author=Patel VL, Yoskowitz NA, Kaufman DR, Shortliffe EH | title=Discerning patterns of human immunodeficiency virus risk in healthy young adults | journal=Am J Med | year=2008 | pages=758–764 |volume=121|issue=4 | pmid=18724961 |doi=10.1016/j.amjmed.2008.04.022 | pmc=2597652 }}</ref> ===Dawa kabla ya hatari=== Asilimia 96 ya watu walikingwa dhidi ya maambukizi iwapo wenzi wao walioambukizwa walipata mapema dawa za kudhibiti VVU<ref>National Institute of Allergy and Infectious Diseases (NIAID), [http://www.niaid.nih.gov/news/newsreleases/2011/Pages/HPTN052.aspx "Treating HIV-infected People with Antiretrovirals Protects Partners from Infection"], NIH News, 2011 May</ref><ref>{{cite journal|last=Anglemyer|first=A|coauthors=Rutherford, GW; Baggaley, RC; Egger, M; Siegfried, N|title=Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples|journal=Cochrane database of systematic reviews (Online)|date=2011-08-10|issue=8|pages=CD009153|pmid=21833973|doi=10.1002/14651858.CD009153.pub2|editor1-last=Rutherford|editor1-first=George W}}</ref> Proflaksisi ya kabla ya hatari pamoja na kipimo cha kila siku cha dawa ya [[tenofovir]] (ikiwa na au bila [[emtricitabine]]) ni mwafaka kwa vikundi fulani, ikijumuisha: mashoga, wachumba wa wenye VVU na vijana wa Afrika wanaovutiwa na watu wa jinsia tofauti. <ref name=VagGel2012/> Hadhari za jumla katika mandhari ya utunzaji wa afya zinaaminika kufaulu kupunguza hatari ya VVU.<ref>{{Rejea jarida|title=Recommendations for prevention of HIV transmission in health-care settings|journal=MMWR|volume=36 |issue=Suppl 2 |pages=1S–18S |year=1987|month=August|pmid=3112554|url=http://www.cdc.gov/MMWR/PREVIEW/MMWRHTML/00023587.htm |author1= Centers for Disease Control (CDC)}}</ref> Matumizi ya dawa zinazodungwa mishipani ni kipengele muhimu cha hatari, hivyo mikakati ya [[kupunguza madhara]] kama vile [[miradi ya kubadilisha sindano]] na [[matibabu ya kubadilisha opioidi]] yanaonekana kufaulu kupunguza hatari.<ref name=Kurth2011>{{cite journal|last=Kurth|first=AE|coauthors=Celum, C; Baeten, JM; Vermund, SH; Wasserheit, JN|title=Combination HIV prevention: significance, challenges, and opportunities|journal=Current HIV/AIDS reports|date=2011 Mar|volume=8|issue=1|pages=62–72|pmid=20941553|doi=10.1007/s11904-010-0063-3|pmc=3036787}}</ref> ===Dawa baada ya hatari=== Vipimo vya dawa za kudhibiti VVU zinazotolewa kati ya saa 48 hadi 72 baada ya hatari kwa damu yenye VVU au viowevu vya uzazi hujulikana kama proflaksisi ya baada ya hatari.<ref name=Prevention2012/> Matumizi ya dawa moja ya [[zidovudine]] hupunguza mara tano hatari ya kupata VVU kutokana na jeraha la sindano.<ref name=Prevention2012>{{cite journal |author= |title=HIV exposure through contact with body fluids |journal=Prescrire Int|volume=21 |issue=126 |pages=100–1, 103–5 |year=2012 |month=April |pmid=22515138 |doi= |url= |author1= [No authors listed]}}</ref> Matibabu hupendekezwa baada ya [[ubakaji]] iwapo mshukiwa anatambulika kuwa na VVU lakini yanakumbwa na utata iwapo hali yake haijulikani.<ref name=NEJM2011Sex>{{cite journal|last=Linden|first=JA|title=Clinical practice. Care of the adult patient after sexual assault|url=https://archive.org/details/sim_new-england-journal-of-medicine_2011-09-01_365_9/page/834|journal=The New England Journal of Medicine|date=2011-09-01|volume=365|issue=9|pages=834–41|pmid=21879901|doi=10.1056/NEJMcp1102869}}</ref> Taratibu za matibabu ya sasa hutumia [[lopinavir/ritonavir]] na [[lamivudine/zidovudine]] au [[emtricitabine/tenofovir]] na yanaweza kupunguza hatari zaidi.<ref name=Prevention2012/> Kwa kawaida, muda wa matibabu huwa wiki nne <ref name=CochranePEP2007>{{cite journal|last=Young|first=TN|coauthors=Arens, FJ; Kennedy, GE; Laurie, JW; Rutherford, G|title=Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure|journal=Cochrane database of systematic reviews (Online)|date=2007-01-24|issue=1|pages=CD002835|pmid=17253483|doi=10.1002/14651858.CD002835.pub3|editor1-last=Young|editor1-first=Taryn}}</ref>na mara nyingi huhusishwa na athari kali (zidovudine ikiwa na takriban 70% ya visa, ikijumuisha 24% kichefuchefu, 22% uchovu, 13% mafadhaiko na 9% maumivu ya kichwa.<ref name=AFP2007/> === Kuzuia maambukizi ya mama kwa mtoto === Hatua za kuzuia kusambaza VVU kutoka kwa mama hadi mtoto zinaweza kupunguza kiwango cha maambukizi kwa asilimia 92-99.<ref name=Mother2010>{{cite journal|last=Coutsoudis|first=A|coauthors=Kwaan, L; Thomson, M|title=Prevention of vertical transmission of HIV-1 in resource-limited settings|journal=Expert review of anti-infective therapy|date=2010 Oct|volume=8|issue=10|pages=1163–75|pmid=20954881|doi=10.1586/eri.10.94}}</ref><ref name=Kurth2011/> Kimsingi, hatua hizi hujumuisha kutumia mwungano wa dawa za kudhibiti VVU katika ujauzito na baada ya kuzaa, na pia [[kunywesha kwa chupa]] badala ya [[kunyonyesha]].<ref name=Mother2010/><ref>{{cite journal|last=Siegfried|first=N|coauthors=van der Merwe, L; Brocklehurst, P; Sint, TT|title=Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2011-07-06|issue=7|pages=CD003510|pmid=21735394|doi=10.1002/14651858.CD003510.pub3|editor1-last=Siegfried|editor1-first=Nandi}}</ref>Ikiwa itakubaliwa kulisha, inafaidi, inawezekana kumudu gharama yake, na ni salama, kina mama hawapaswi kuwanyonyesha watoto wao. Hata hivyo, iwapo haiwezekani, kina mama hushauriwa kunyonyesha tu katika miezi ya kwanza.<ref>{{cite web |url=http://www.who.int/hiv/mediacentre/Infantfeedingconsensusstatement.pf.pdf |format=PDF |year=2006 |accessdate=March 12, 2008 |title=WHO HIV and Infant Feeding Technical Consultation Held on behalf of the Inter-agency Task Team (IATT) on Prevention of HIV – Infections in Pregnant Women, Mothers and their Infants –Consensus statement |date=October 25–27, 2006 |archiveurl=https://web.archive.org/web/20080409065845/http://www.who.int/hiv/mediacentre/Infantfeedingconsensusstatement.pf.pdf |archivedate=2008-04-09 |deadurl=no }}</ref> Ikiwa kunyonyesha pekee kutatekelezwa, kumpa mtoto proflaksisi ya kudhibiti VVU kwa muda mrefu zaidi hupunguza hatari ya kuambukizwa.<ref>{{cite journal|last=Horvath|first=T|coauthors=Madi, BC; Iuppa, IM; Kennedy, GE; Rutherford, G; Read, JS|title=Interventions for preventing late postnatal mother-to-child transmission of HIV|journal=Cochrane database of systematic reviews (Online)|date=2009-01-21|issue=1|pages=CD006734|pmid=19160297|doi=10.1002/14651858.CD006734.pub2|editor1-last=Horvath|editor1-first=Tara}}</ref> ===Dawa za kudhibiti virusi === [[File:Abacavir (Ziagen) 300mg.jpg|thumb|alt=Tembe mbili za manjano za umbo la mstatili ambapo mojawapo ya alama za GX623 inaonekana|''[[Abacavir]]'' – kifanani cha nukliosidi kinachozuia kugeuzwa kwa nakala (KNKN)]] Kwa sasa hakuna tiba au [[chanjo ya VVU]] mwafaka. Matibabu hujumuisha dawa tendi za kudhibiti VVU za kiwango cha juu zinazopunguza mwendo wa ugonjwa huu.<ref name=LE2011>{{cite journal|last=May|first=MT|coauthors=Ingle, SM|title=Life expectancy of HIV-positive adults: a review|journal=Sexual health|date=2011 Dec|volume=8|issue=4|pages=526–33|pmid=22127039|doi=10.1071/SH11046}}</ref> Kufikia mwaka 2010, zaidi ya watu milioni 6.6&nbsp; wa nchi za mapato ya chini na ya kati walikuwa wakitumia dawa hizo.<ref name=UN2019Ten/> Matibabu pia huhusisha hatua za kuzuia na kutibu maambukizi nyemelezi. Chaguo za kisasa za KNKN ni michanganyiko ya angalau dawa tatu za angalau aina au "vikundi" viwili vya ajenti za [[dawa za kudhibiti VVU]].<ref name=WHOTx2010Pg19/> Mwanzoni, matibabu kwa kawaida huhusisha kizuizi kisicho cha nukliosidi kinachozuia kugeuzwa kwa nakala (KKNKN) pamoja na vidonge viwili vya kifanani cha nukliosidi kinachozuia kugeuzwa kwa nakala (KNKN).<ref name=WHOTx2010Pg19/> KNKN kwa kawaida hujumuisha: [[zidovudine]] (AZT) au [[tenofovir]] (TDF) na [[lamivudine]] (3TC) au [[emtricitabine]] (FTC).<ref name=WHOTx2010Pg19/> Mwungano wa ajenti zinazojumuisha kizuizi cha protisi (KP) hutumika utaratibu huu ukipoteza utendakazi.<ref name=WHOTx2010Pg19/> Wakati wa kuanzisha matumizi ya dawa za kudhibiti VVU ni mada ambayo ingali inajadiliwa.<ref name=Deut2010/><ref>{{cite journal|last=Sax|first=PE|coauthors=Baden, LR|title=When to start antiretroviral therapy—ready when you are?|journal=The New England Journal of Medicine|date=2009-04-30|volume=360|issue=18|pages=1897–9|pmid=19339713|doi=10.1056/NEJMe0902713}}</ref> Shirika la Afya Duniani, miongozo ya [[Ulaya]] na pia Marekani hupendekeza dawa za kudhibiti VVU kwa vijana waliobalehe, watu wazima na kina mama wajawazito walio na kiwango cha CD4 cha chini ya 350/uL au walio na dalili, bila kuzingatia kiwango chao cha CD4.<ref name=Deut2010/><ref name=WHOTx2010Pg19>{{cite book|title=Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach|year=2010|publisher=World Health Organization|isbn=978-92-4-159976-4|pages=19–20|url=http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf|access-date=2017-04-01|archive-date=2012-07-09|archive-url=https://web.archive.org/web/20120709184257/http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf|url-status=dead}}</ref>Hali hii huwezeshwa na ukweli kwamba kuanzisha matibabu wakati huu hupunguza hatari ya kifo.<ref name=CochraneART2010>{{cite journal|last=Siegfried|first=N|coauthors=Uthman, OA; Rutherford, GW|title=Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults|journal=Cochrane database of systematic reviews (Online)|date=2010-03-17|issue=3|pages=CD008272|pmid=20238364|doi=10.1002/14651858.CD008272.pub2|editor1-last=Siegfried|editor1-first=Nandi}}</ref> Isitoshe, Marekani imependekeza matibabu hayo kwa watu wote wenye VVU bila kuzingatia kiwango cha CD4 au dalili, ingawa inatoa pendekezo hili ikiwahofia watu wenye kiwango cha juu cha CD4.<ref name=Guidelines2009>{{cite book|last=Panel on Antiretroviral Guidelines for Adults and Adolescents|first=|title=Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents|url=http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf|date=2009-12-01|publisher=United States Department of Health and Human Services|page=i|access-date=2017-04-01|archive-date=2009-01-13|archive-url=https://web.archive.org/web/20090113181125/http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf|dead-url=yes}}</ref> Shirika la Afya Duniani pia linapendekeza matibabu kwa watu wenye maambukizi nyongeza ya kifua kikuu na [[hepatitisi B]] tendi ya muda mrefu.<ref name=WHOTx2010Pg19/> Matibabu yanapoanzishwa, inapendekezwa yaendelezwe bila "kupumzika".<ref name=Deut2010/> Watu wengi hutambuliwa punde tu baada ya wakati ambao matibabu yalipaswa kuanzishwa.<ref name=Deut2010/> Katika matibabu, matokeo yanayotarajiwa ni kiwango cha HIV-RNA ya plasma ya muda mrefu cha chini ya nakala 50/mL.<ref name=Deut2010>{{cite journal|last=Vogel|first=M|coauthors=Schwarze-Zander, C; Wasmuth, JC; Spengler, U; Sauerbruch, T; Rockstroh, JK|title=The treatment of patients with HIV|journal=Deutsches Ärzteblatt international|date=2010 Jul|volume=107|issue=28–29|pages=507–15; quiz 516|pmid=20703338|doi=10.3238/arztebl.2010.0507|pmc=2915483}}</ref>Viwango vya kuthibitisha ikiwa matibabu ni mwafaka hupendekezwa kwanza baada ya wiki nne na punde viwango hivi vinaposhuka chini ya nakala 50/mL. Vipimo vya kila baada ya miezi 3-6 kwa kawaida huwa mwafaka.<ref name=Deut2010/> Udhibiti usio mwafaka huchukuliwa kuwa zaidi ya nakala 400/mL.<ref name=Deut2010/> Kulingana na kigezo hiki, matibabu huwa mwafaka kwa zaidi ya 95% ya watu katika mwaka wa kwanza.<ref name=Deut2010/> Manufaa ya matibabu hujumuisha upungufu wa hatari ya kuendelezwa kwa VVU na kupunguka kwa hatari ya kifo.<ref>{{cite journal|last=When To Start|first=Consortium|coauthors=Sterne, JA; May, M; Costagliola, D; de Wolf, F; Phillips, AN; Harris, R; Funk, MJ; Geskus, RB; Gill, J; Dabis, F; Miró, JM; Justice, AC; Ledergerber, B; Fätkenheuer, G; Hogg, RS; Monforte, AD; Saag, M; Smith, C; Staszewski, S; Egger, M; Cole, SR|title=Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies|journal=Lancet|date=2009-04-18|volume=373|issue=9672|pages=1352–63|pmid=19361855|doi=10.1016/S0140-6736(09)60612-7|pmc=2670965}}</ref>Katika mataifa yaliyostawi matibabu pia huboresha afya ya mwili na ya akili.<ref>{{cite journal|last=Beard|first=J|coauthors=Feeley, F; Rosen, S|title=Economic and quality of life outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review|journal=AIDS care|date=2009 Nov|volume=21|issue=11|pages=1343–56|pmid=20024710|doi=10.1080/09540120902889926}}</ref> Matibabu hupelekea kupunguza kwa 70% hatari ya kupata kifua kikuu.<ref name=WHOTx2010Pg19/> Manufaa ya nyongeza hujumuisha upungufu wa hatari ya kusambazwa kwa ugonjwa huu hadi kwa wenzi kingono, na upungufu wa kusambazwa kwa maambukizi kutoka kwa mama hadi mtoto. <ref name=WHOTx2010Pg19/> Ubora wa matibabu hutegemea pakubwa maafikiano.<ref name=Deut2010/> Sababu za kutoafikiana hujumuisha: ufikiaji duni wa huduma za kimatibabu,<ref>{{cite journal|last=Orrell|first=C|title=Antiretroviral adherence in a resource-poor setting|journal=Current HIV/AIDS reports|date=2005 Nov|volume=2|issue=4|pages=171–6|pmid=16343374|doi=10.1007/s11904-005-0012-8}}</ref>huduma duni za kijamii, [[ugonjwa wa akili]] na [[uraibu wa madawa]].<ref>{{cite journal|last=Malta|first=M|coauthors=Strathdee, SA; Magnanini, MM; Bastos, FI|title=Adherence to antiretroviral therapy for human immunodeficiency virus/acquired immune deficiency syndrome among drug users: a systematic review|url=https://archive.org/details/sim_british-journal-of-addiction_2008-08_103_8/page/1242|journal=Addiction (Abingdon, England)|date=2008 Aug|volume=103|issue=8|pages=1242–57|pmid=18855813|doi=10.1111/j.1360-0443.2008.02269.x}}</ref> Isitoshe, utata wa utaratibu wa matibabu (kufuatia idadi ya tembe na idadi ya marudio ya kumeza tembe) na [[athari kali]] zinaweza kusababisha kutoafikiana kwa kimakusudi.<ref>{{cite journal|last=Nachega|first=JB|coauthors=Marconi, VC; van Zyl, GU; Gardner, EM; Preiser, W; Hong, SY; Mills, EJ; Gross, R|title=HIV treatment adherence, drug resistance, virologic failure: evolving concepts|journal=Infectious disorders drug targets|date=2011 Apr|volume=11|issue=2|pages=167–74|pmid=21406048}}</ref>Hata hivyo, viwango vya uafikiano ni sawa katika nchi zinazostawi na zilizostawi<ref>{{cite journal|last=Nachega|first=JB|coauthors=Mills, EJ; Schechter, M|title=Antiretroviral therapy adherence and retention in care in middle-income and low-income countries: current status of knowledge and research priorities|journal=Current opinion in HIV and AIDS|date=2010 Jan|volume=5|issue=1|pages=70–7|pmid=20046150|doi=10.1097/COH.0b013e328333ad61}}</ref> Matukio makuu huhusishwa na ajenti inayotumika.<ref name=Montessori2004/> Baadhi ya visa vinavyotokea mara nyingi hujumuisha: [[lipodistrofi inayohusishwa na VVU|sindromu ya lipodistofi]], [[dislipidemia]] na [[kisukari tamu]] hasa pamoja na vizuizi vya protisi.<ref name=M121/> Dalili zingine zinazotokea mara nyingi hujumuisha: [[kuhara]],<ref name=Montessori2004>{{cite journal| author=Montessori, V., Press, N., Harris, M., Akagi, L., Montaner, J. S. |title=Adverse effects of antiretroviral therapy for HIV infection | journal=CMAJ |year=2004 | pages=229–238 |volume=170 | issue=2 |pmid=14734438 | pmc=315530}}</ref><ref name="Burgoyne2008">{{Rejea jarida|author=Burgoyne RW, Tan DH|title=Prolongation and quality of life for HIV-infected adults treated with highly active antiretroviral therapy (HAART): a balancing act|journal=J. Antimicrob. Chemother. |volume=61 |issue=3 |pages=469–73|year=2008 |month=March|pmid=18174196|doi=10.1093/jac/dkm499</ref> na ongezeko la hatari ya [[ugonjwa wa moyo na mishipa]].<ref>{{cite journal|last=Barbaro|first=G|coauthors=Barbarini, G|title=Human immunodeficiency virus & cardiovascular risk|journal=The Indian journal of medical research|date=2011 Dec|volume=134|issue=6|pages=898–903|pmid=22310821|doi=10.4103/0971-5916.92634|pmc=3284097}}</ref> Hata hivyo, athari kali huwa katika matibabu mapya yaliyopendekezwa.<ref name=Deut2010/> Gharama huenda ikawa tatizo kwani baadhi ya dawa huwa ghali<ref>{{cite journal|last=Orsi|first=F|coauthors=d'almeida, C|title=Soaring antiretroviral prices, TRIPS and TRIPS flexibilities: a burning issue for antiretroviral treatment scale-up in developing countries|journal=Current opinion in HIV and AIDS|date=2010 May|volume=5|issue=3|pages=237–41|pmid=20539080|doi=10.1097/COH.0b013e32833860ba}}</ref>. Hata hivyo, hadi mwaka wa 2010, 47% ya watu waliohitaji dawa hizo walikuwa wakizitumia katika nchi zinazostawi na za mapato ya wastani<ref name=UN2019Ten/> Dawa fulani zinaweza kuhusishwa na [[ulemavu wa kuzaliwa]] hivyo hazifai kutumiwa na wanawake wanaopanga kupata watoto.<ref name=Deut2010/> Matibabu yanayopendekezewa watoto hutofautiana kidogo na ya watu wazima. Katika nchi zinazoendelea, kufikia mwaka wa 2010, 23% ya watoto waliohitaji dawa hizi walikuwa wakizitumia.<ref name=UN2011ONESIXTY>UNAIDS 2011 uk. 150-160</ref> Shirika la Afya Duniani na Marekani inapendekeza matibabu kwa watoto wote wa umri wa chini ya miezi 12.<ref name=USKID2011/><ref name=WHOKID2010>{{cite book|title=Antiretroviral therapy for HIV infection in infants and children|year=2010|publisher=World Health Organization|isbn=978-92-4-159980-1|page=2|url=http://whqlibdoc.who.int/publications/2010/9789241599801_eng.pdf|access-date=2017-04-01|archive-date=2014-02-24|archive-url=https://web.archive.org/web/20140224081130/http://whqlibdoc.who.int/publications/2010/9789241599801_eng.pdf|dead-url=yes}}</ref>Marekani hupendekeza matibabu kwa watoto wa umri wa mwaka 1-5 walio na kiwango cha VVU-RNA cha zaidi ya nakala 100,000&nbsp;/mL na kwa walio zaidi ya miaka mitano watibiwe iwapo kiwango cha CD4 ni chini ya 500/ul.<ref name=USKID2011>{{cite web|title=Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection|url=http://aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf|work=The Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children|format=PDF|date=Aug 11,2011|accessdate=2017-04-01|archivedate=2013-02-16|archiveurl=https://web.archive.org/web/20130216214548/http://www.aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf}}</ref> ===Kuzuia maambukizi nyemelezi=== Mikakati ya kuzuia maambukizi nyemelezi hufaa watu wengi wenye VVU/UKIMWI. Matibabu ya dawa za kudhibiti virusi huboresha na kupunguza hatari ya kupata maambukizi nyemelezi kwa wakati huo na baadaye.<ref name=Montessori2004/>[[Chanjo]] dhidi ya [[hepatitisi]] A na B hupendekezwa kwa watu walio katika hatari ya VVU kabla ya maambukizi, ingawa yanaweza kutolewa baada ya kuambukizwa.<ref name=Laurence>{{Rejea jarida | author=Laurence J | title=Hepatitis A and B virus immunization in HIV-infected persons | journal=AIDS Reader | year=2006 | pages=15–17 | volume=16 | issue=1|pmid=16433468}}</ref> Kinga ya [[Trimethoprim/sulfamethoxazole]] kati ya wiki 4-6 na kukoma kunyonyesha watoto waliozaliwa na mama mwenye VVU hupendekezwa katika sehemu zenye upungufu wa raslimali.<ref name=UN2011ONESIXTY/> Pia inapendekezwa kuzuia PCP kiwango cha CD4 kikiwa chini ya 200&nbsp;/uL na kwa wenye PCP au waliokuwa nayo awali.<ref name=PCP2011>{{cite journal|last=Huang|first=L|coauthors=Cattamanchi, A; Davis, JL; den Boon, S; Kovacs, J; Meshnick, S; Miller, RF; Walzer, PD; Worodria, W; Masur, H; International HIV-associated Opportunistic Pneumonias (IHOP), Study; Lung HIV, Study|title=HIV-associated Pneumocystis pneumonia|journal=Proceedings of the American Thoracic Society|date=2011 Jun|volume=8|issue=3|pages=294–300|pmid=21653531|doi=10.1513/pats.201009-062WR|pmc=3132788}}</ref> Watu wenye ugandamizaji wa kingamwili pia hushauriwa kupata kinga ya [[toksoplasmosisi]] na [[Kriptokokasi|Meninjitisi ya kriptokokasi]].<ref name=PEPpocketguide>{{cite web | publisher=[[United States Department of Health and Human Services|Department of Health and Human Services]] | date=February 2, 2007 | url=http://www.guideline.gov/summary/summary.aspx?ss=14&doc_id=6223&string=infected+AND+patients | title=Treating opportunistic infections among HIV-infected adults and adolescents. Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. | accessdate=2017-04-01 | archiveurl=https://archive.today/20121212000558/http://www.guideline.gov/browse/archive.aspx | archivedate=2012-12-12 | =https://archive.today/20121212000558/http://www.guideline.gov/browse/archive.aspx }}</ref> Mikakati mwafaka ya kinga imepunguza kiwango cha maambukizi kwa 50% katika miaka 1992-1997.<ref name=InfectionBook2008/> ===Matibabu mbadala=== Takriban 60% ya watu wenye VVU nchini Marekani hutumia mbinu mbalimbali za [[matibabu mbadala]].<ref name="pmid18608078">{{Rejea jarida|author=Littlewood RA, Vanable PA |title=Complementary and alternative medicine use among HIV-positive people: research synthesis and implications for HIV care |journal=AIDS Care |volume=20 |issue=8 |pages=1002–18 |year=2008 |month=September |pmid=18608078 |pmc=2570227|doi=10.1080/09540120701767216 |url=https://archive.org/details/sim_aids-care_2008-09_20_8/page/1002}}</ref> Ubora wa matibabu hayo hata hivyo haujathibitishwa.<ref name="pmid15969772">{{Rejea jarida|author=Mills E, Wu P, Ernst E |title=Complementary therapies for the treatment of HIV: in search of the evidence |journal=Int J STD AIDS |volume=16 |issue=6 |pages=395–403 |year=2005|month=June |pmid=15969772 |doi=10.1258/0956462054093962 |url=}}</ref> Kwa kuzingatia [[Lishe na VVU/UKIMWI|ushauri wa kilishe na UKIMWI]], kuna ushahidi unaoonyesha manufaa ya nyongeza za [[virutubishi vidogo]].<ref name="Irlam"/> Ushahidi wa manufaa ya nyongeza za [[seleniamu]] unaonyesha kuwa manufaa yake si mengi sana.<ref>{{cite journal|last=Stone|first=CA|coauthors=Kawai, K; Kupka, R; Fawzi, WW|title=Role of selenium in HIV infection|url=https://archive.org/details/sim_nutrition-reviews_2010-11_68_11/page/671|journal=Nutrition Reviews|date=2010 Nov|volume=68|issue=11|pages=671–81|pmid=20961297|doi=10.1111/j.1753-4887.2010.00337.x|pmc=3066516}}</ref> Kuna ushahidi mdogo kuwa nyongeza ya [[vitamini A]] kwa watoto hupunguza vifo na kuboresha ukuaji.<ref name=Irlam/> Nyongeza ya [[vitamini]] nyingi kwa kina mama wajawazito wenye [[lishe duni]] na wanaonyonyesha imeboresha [[afya]] ya kina mama na watoto barani Afrika<ref name=Irlam>{{cite journal|last=Irlam|first=JH|coauthors=Visser, MM; Rollins, NN; Siegfried, N|title=Micronutrient supplementation in children and adults with HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2010-12-08|issue=12|pages=CD003650|pmid=21154354|doi=10.1002/14651858.CD003650.pub3|editor1-last=Irlam|editor1-first=James H}}</ref> Kutumia virutubishi vidogo ndani ya lishe katika viwango vya [[Kiwango cha Matumizi ya kila Siku|KMS]] kwa watu wazima wenye VVU kumependekezwa na [[Shirika la Afya Duniani]].<ref>{{cite journal|last=Forrester|first=JE|coauthors=Sztam, KA|title=Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?|journal=The American journal of clinical nutrition|date=2011 Dec|volume=94|issue=6|pages=1683S–1689S|pmid=22089440|doi=10.3945/ajcn.111.011999|pmc=3226021}}</ref><ref name='WHO_nutrients'>{{Rejea kitabu | last = [[World Health Organization]] | title = Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation | date = 2003-05 | location = Geneva | url = http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf | id = | isbn = | accessdate = March 31, 2009 | archiveurl = https://web.archive.org/web/20090325030154/http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf | archivedate = 2009-03-25 | deadurl = no }}</ref> SAD linasema kuwa [[takwimu]] kadhaa zimeonyesha nyongeza ya vitamini A, zinki na ayoni inaweza kuwaathiri pakubwa watu wazima walio na VVU.<ref name='WHO_nutrients' /> Hakuna ushahidi wa kutosha kuonyesha manufaa ya [[miti shamba]].<ref>{{Rejea jarida|author=Liu JP, Manheimer E, Yang M|title=Herbal medicines for treating HIV infection and AIDS |journal=Cochrane Database Syst Rev|issue=3 |pages=CD003937|year=2005 |pmid=16034917 |doi=10.1002/14651858.CD003937.pub2|url=|editor1-last=Liu|editor1-first=Jian Ping}}</ref> ==Matarajio ya kuishi== [[File:HIV-AIDS world map-Deaths per million persons-WHO2012.svg|upright=1.3|thumb|Idadi ya vifo kutokana na UKIMWI kati ya watu milioni 1 mwaka 2012 {{refbegin|3}}{{legend|#ffff20|0}}{{legend|#ffe820|1–4}}{{legend|#ffd820|5–12}}{{legend|#ffc020|13–34}}{{legend|#ffa020|35–61}}{{legend|#ff9a20|62–134}}{{legend|#f08015|135–215}}{{legend|#e06815|216–458}}{{legend|#d85010|459-1,402}}{{legend|#d02010|1,403–5,828}}{{refend}}]] [[File:HIV-AIDS world map - DALY - WHO2004.svg|thumb|Alt=Ramani ya ulimwengu ambapo sehemu yake kubwa ni ya rangi ya manjano au ya chungwa isipokuwa Kusini kwa Sahara ambapo kuna rangi nyekundu au nyekundu nzito|[[Miaka ya kulemaza]] ya VVU kwa kila wakaazi 100,000&nbsp; kufikia 2004. {{Multicol}} {{legend|#b3b3b3|<small>no data</small>}} {{legend|#ffff65|<small>≤&nbsp;10</small>}} {{legend|#fff200|<small>10–25</small>}} {{legend|#ffdc00|<small>25–50</small>}} {{legend|#ffc600|<small>50–100</small>}} {{legend|#ffb000|<small>100–500</small>}} {{legend|#ff9a00|<small>500–1000</small>}} {{Multicol-break}} {{legend|#ff8400|<small>1000–2500</small>}} {{legend|#ff6e00|<small>2500–5000</small>}} {{legend|#ff5800|<small>5000–7500</small>}} {{legend|#ff4200|<small>7500-10000</small>}} {{legend|#ff2c00|<small>10000-50000</small>}} {{legend|#cb0000|<small>≥&nbsp;50000</small>}} {{Multicol-end}}]] Katika sehemu nyingi ulimwenguni UKIMWI umekuwa [[ugonjwa wa muda mrefu]], si ugonjwa mkali tu.<ref name=Knoll2007/> [[Prognosi]] ni tofauti katika watu mbalimbali, na kiwango cha CD4 pamoja na wingi wa virusi huwa muhimu katika kutabiri matokeo.<ref name=M118/> Wastani wa muda wa kuishi baada ya kuambukizwa unakadiriwa kuwa kati ya miaka 9-1&nbsp; bila matibabu, ikitegemea aina ya VVU.<ref name=UNAIDS2007>{{cite web| author = [[Joint United Nations Programme on HIV/AIDS|UNAIDS]], [[World Health Organization|WHO]]| month = December| year = 2007| title = 2007 AIDS epidemic update| url = http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf| accessdate = 2008-03-12| format = PDF| archivedate = 2008-05-27| archiveurl = https://web.archive.org/web/20080527201701/http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf}}</ref> Baada ya utambuzi wa UKIMWI, iwapo matibabu hayapo, uwezo wa kuishi huwa kati ya miezi 6-19.<ref name=Morgan2>{{Rejea jarida | author=Morgan D, Mahe C, Mayanja B, Okongo JM, Lubega R, Whitworth JA| title=HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries? | journal=AIDS | year=2002 | pages=597–632 | volume=16 | issue=4 | pmid=11873003 |doi=10.1097/00002030-200203080-00011}}</ref><ref>{{Rejea jarida|title=Progression and mortality of untreated HIV-positive individuals living in resource-limited settings: update of literature review and evidence synthesis|author=Zwahlen M, Egger M|url=http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf|format=PDF|year=2006|accessdate=March 19, 2008|version=UNAIDS Obligation HQ/05/422204|archiveurl=https://web.archive.org/web/20080409065844/http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf|archivedate=2008-04-09|deadurl=no|journal=}}</ref> [[KKNKN]] na uzuiaji mwafaka wa Maambukizi nyemelezi hupunguza kima cha vifo kwa 80% na kuongeza matarajio ya urefu wa maisha hadi miaka 20-50 kwa mtu mzima wa kimo aliyetambuliwa na maambukizi karibuni.<ref name=Knoll2007>{{cite journal |journal= Int J Dermatol |year=2007 |volume=46 |issue=12 |pages=1219–28 |title= Current status of HIV infection: a review for non-HIV-treating physicians |author= Knoll B, Lassmann B, Temesgen Z|pmid=18173512|doi=10.1111/j.1365-4632.2007.03520.x}}</ref><ref name=LifeExpecr2008>{{cite journal |journal= Lancet|year=2008 |volume=372|issue=9635 |pages=293–9 |title=Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies | author= Antiretroviral Therapy Cohort Collaboration |pmid=18657708 |doi=10.1016/S0140-6736(08)61113-7 |pmc= 3130543 }}</ref><ref name=Schack2006>{{cite journal | author=Schackman BR, Gebo KA, Walensky RP, Losina E, Muccio T, Sax PE, Weinstein MC, Seage GR 3rd, Moore RD, Freedberg KA. |title=The lifetime cost of current HIV care in the United States | url=https://archive.org/details/sim_medical-care_2006-11_44_11/page/990 | journal=Med Care | year=2006 |pages=990–997 | volume=44 | issue=11 | pmid=17063130 |doi=10.1097/01.mlr.0000228021.89490.2a}}</ref> Hii ni kati ya 2/3<ref name=LifeExpecr2008/> na karibu na kiwango cha umma.<ref name=Deut2010/><ref>{{cite journal|last=van Sighem|first=AI|coauthors=Gras, LA; Reiss, P; Brinkman, K; de Wolf, F; ATHENA national observational cohort, study|title=Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals|journal=AIDS (London, England)|date=2010-06-19|volume=24|issue=10|pages=1527–35|pmid=20467289|doi=10.1097/QAD.0b013e32833a3946}}</ref> Matibabu huwa hayafaulu yanapoanzishwa yakiwa yamechelewa katika prognosi,<ref name=Deut2010/> kwa mfano, matibabu yakianzishwa kufuatia utambuzi katika kiwango cha UKIMWI, matarajio ya urefu wa maisha huwa miaka~10–40.<ref name=Deut2010/><ref name=Knoll2007/> Wasipotibiwa, nusu ya watoto wachanga wanaozaliwa na VVU hufa kabla ya miaka miwili.<ref name=UN2011ONESIXTY/> Sababu kuu ya vifo vinavyotokana na VVU/UKIMWI ni [[Maambukizi nyemelezi]] na [[saratani]] ambayo mara nyingi hutokana na matatizo endelevu ya mfumo wa kingamwili.<ref name=InfectionBook2008>{{cite book|last=Smith|first=[edited by] Blaine T.|title=Concepts in immunology and immunotherapeutics|year=2008|publisher=American Society of Health-System Pharmacists|location=Bethesda, Md.|isbn=978-1-58528-127-5|page=143|url=http://books.google.ca/books?id=G46DrdlxNJAC&pg=PA143|edition=4th}}</ref><ref name=Cancer2005>{{cite journal|last=Cheung|first=MC|coauthors=Pantanowitz, L; Dezube, BJ|title=AIDS-related malignancies: emerging challenges in the era of highly active antiretroviral therapy|journal=The oncologist|date=2005 Jun–Jul|volume=10|issue=6|pages=412–26|pmid=15967835|doi=10.1634/theoncologist.10-6-412}}</ref> Hatari ya saratani huonekana kuongezeka ikiwa kiwango cha CD4 kitashuka chini ya 500/uL.<ref name=Deut2010/> Kiwango cha kuendelea kwa ugonjwa wa kiutambuzi hutofautiana pakubwa katika watu mbalimbali na kimedhihirika kuathiriwa na vipengele kadhaa, kama vile uhatarisho na utendaji wa kingamwili;<ref name=Tang>{{Rejea jarida | author=Tang J, Kaslow RA | title=The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy | journal=AIDS | year=2003 |pages=S51–S60 | volume=17 | issue=Suppl 4 | pmid=15080180 | doi=10.1097/00002030-200317004-00006}}</ref> uwezo wa kufikia [[huduma ya afya]] na uwepo wa [[maambukizi pacha]];<ref name=Morgan2/><ref name=Lawn>{{cite journal | author=Lawn SD |title=AIDS in Africa: the impact of co-infections on the pathogenesis of HIV-1 infection | journal=J. Infect. Dis. |year=2004 | pages=1–12 |volume=48 | issue=1| pmid=14667787</ref> pamoja na aina ya (au za) virusi husika.<ref name=Campbell>{{cite journal | author=Campbell GR |title=The glutamine-rich region of the HIV-1 Tat protein is involved in T-cell apoptosis | journal=J. Biol. Chem. | year=2004 |pages=48197–48204 | volume=279 | issue=46 | pmid=15331610 |doi=10.1074/jbc.M406195200 | author-separator=, |author2=Pasquier E | author3=Watkins J | display-authors=3 | last4=Bourgarel-Rey | first4=V | last5=Peyrot | first5=V |last6=Esquieu | first6=D | last7=Barbier | first7=P | last8=De Mareuil | first8=J | last9=Braguer |first9=D}}</ref><ref name=Campbell2>{{cite journal | author=Campbell GR, Watkins JD, Esquieu D, Pasquier E, Loret EP, Spector SA | title=The C terminus of HIV-1 Tat modulates the extent of CD178-mediated apoptosis of T cells | journal=J. Biol. Chem. | year=2005 | pages=38376–39382 | volume=280 | issue=46 |pmid=16155003 | doi=10.1074/jbc.M506630200}}</ref> Maambukizi pacha ya [[kifua kikuu]] ni mojawapo ya visababishi vikuu vya vifo vya watu wenye VVU/UKIMWI, huku yakipatikana katika 1/3 ya watu walioambukizwa VVU na husababisha 25% ya vifo vinavyohusiana na VVU.<ref>{{cite web|title=Tuberculosis|url=http://www.who.int/mediacentre/factsheets/fs104/en/|work=Fact sheet 104|publisher=World Health Organization|date=March 2012|accessdate=August 29, 2012}}</ref> VVU pia ni kipengele kikuu zaidi cha hatari ya kifua kikuu.<ref name=WHO2011>{{cite web|title=Global tuberculosis control 2011|author=World Health Organization|url=http://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf|year=2011|ISBN=978 92 4 156438 0|accessdate=August 29, 2012}}</ref> [[Hepatitisi C]] ni maambukizi mengine pacha yanayotokea mara nyingi, ambapo kila ugonjwa huongeza uendeleaji wa ugonjwa mwingine<ref>{{cite book|last=Pennsylvania|first=Editors, Raphael Rubin, M.D., Professor of Pathology, David S. Strayer, M.D., Ph.D., Professor of Pathology, Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University Philadelphia, Pennsylvania ; Founder and Consulting Editor, Emanuel Rubin, M.D., Gonzalo Aponte Distinguished Professor of Pathology, Chairman Emeritus of the Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,|title=Rubin's pathology : clinicopathologic foundations of medicine|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-60547-968-2|page=154|url=http://books.google.ca/books?id=wb2TzY9AgJ0C&pg=PA154|edition=Sixth|year=2011}}</ref> Saratani zinazotokea mara nyingi zaidi ambazo huhusishwa na VVU ni [[sakoma ya Kaposi]] na [[limfoma isiyo ya Hodgkin]].<ref name=Cancer2005/> Hata wakitibiwa kwa dawa za kudhibiti VVU, watu walio na VVU huenda wakakumbwa na [[matatizo ya kiniuroni ya ufahamu]],<ref name="Woods2009">{{cite pmid|19462243 }}</ref> [[osteoporosi]],<ref name="Brown2006">{{cite pmid|17086056}}</ref> [[nuropathia ya pembeni|nuropathia]],<ref name="Nicholas2007">{{Rejea jarida|author=Nicholas PK|title=Symptom management and self-care for peripheral neuropathy in HIV/AIDS |journal=AIDS Care | volume=19|issue=2|pages=179–89 |year=2007 |month=February |pmid=17364396|doi=10.1080/09540120600971083|url=https://archive.org/details/sim_aids-care_2007-02_19_2/page/179|author-separator=,|author2=Kemppainen JK|author3=Canaval GE|display-authors=3|last4=Corless|first4=I. B.|last5=Sefcik|first5=E. F.|last6=Nokes|first6=K. M.|last7=Bain|first7=C. A.|last8=Kirksey|first8=K. M.|last9=Sanzero Eller|first9=L.}}</ref> saratani,<ref name="Boshoff2002">{{Rejea jarida| author=Boshoff C, Weiss R |title=AIDS-related malignancies | journal=Nat. Rev. Cancer | year=2002 | pages=373–382 | volume=2 | issue=5 |pmid=12044013 | doi=10.1038/nrc797 }}</ref><ref name="Yarchoan2005">{{Rejea jarida| author=Yarchoan R, Tosato G, Little RF | title=Therapy insight: AIDS-related malignancies – the influence of antiviral therapy on pathogenesis and management | journal=Nat. Clin. Pract. Oncol. |year=2005 | pages=406–415 | volume=2 |issue=8 | pmid=16130937 | doi=10.1038/ncponc0253 }}</ref><!-- Boshoff2002 and Yarchoan2005 cover cancer --> [[nefropathi]],<ref name="Post2009">{{cite pmid|19106702}}</ref> na [[ugonjwa wa moyo na mishipa]] baada ya muda mrefu.<ref name="Burgoyne2008" /> Haijulikani ikiwa hali hizi hutokana na kuambukizwa kwa VVU kwenyewe au ni athari kali za matibabu yake. == Watu wangapi wana UKIMWI? == [[Picha: AIDS cases worldwide 1979-1995.png|haki|thumb|Idadi ya watu duniani wenye VVU miaka 1979-1995.]] [[File:AIDS and HIV prevalence 2008.svg|thumb|upright=1.2|alt= A map of the world where most of the land is colored green or yellow except for sub Saharan Africa which is colored red|[[Asilimia]] ya watu wenye umri wa miaka 15–49 walioambukizwa nchi kwa nchi ([[2011]]).<ref>{{cite web|title=AIDSinfo|url=http://www.unaids.org/en/dataanalysis/datatools/aidsinfo/|work=UNAIDS|accessdate=4 March 2013}}</ref>{{Col-begin}} {{Col-break}} {{legend|#787878|<small>No data</small>}} {{legend|#94bf8b|<small><0.10</small>}} {{legend|#f4e2ba|<small>0.10–0.5</small>}} {{legend|#eaca83|<small>0.5–1</small>}} {{Col-break}} {{legend|#f07568|<small>1–5</small>}} {{legend|#ff4800|<small>5–15</small>}} {{legend|#b00000|<small>15–50</small>}} {{col-end}}]] VVU/UKIMWI ni [[janga]] la kimataifa.<ref name=Cohen2008>{{cite journal|last=Cohen|first=MS|coauthors=Hellmann, N; Levy, JA; DeCock, K; Lange, J|title=The spread, treatment, and prevention of HIV-1: evolution of a global pandemic|journal=The Journal of clinical investigation|date=2008 Apr|volume=118|issue=4|pages=1244-54|pmid=18382737|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276790/|accessdate=17 September 2012}}</ref> Kufikia mwaka [[2018]] walau watu wapatao 37,900,000 walikuwa wakiishi na VVU<ref name=UN2019Ten>"Global HIV & AIDS statistics — 2019 fact sheet". www.unaids.org. UNAIDS. Archived from the original on December 4, 2019. Retrieved December 21, 2019.</ref> na kila mwaka watu milioni 2 wengine wanambukizwa<ref name=UNAIDS2015>{{cite web|title=Fact sheet 2015|url=http://www.unaids.org/sites/default/files/media_asset/20150901_FactSheet_2015_en.pdf|website=UNAIDS|accessdate=1 February 2016}}</ref><ref name=UN2013>{{cite web|title=UNAIDS reports a 52% reduction in new HIV infections among children and a combined 33% reduction among adults and children since 2001|url=http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/september/20130923prunga/|work=UNAIDS|accessdate=October 7, 2013|archivedate=2013-10-01|archiveurl=https://web.archive.org/web/20131001090619/http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/september/20130923prunga/}}</ref>. Zaidi ya nusu ni wanawake na milioni 2.6 ni watoto chini ya miaka 15.<ref name=UN2019Ten/> Hata hivyo watu wengi wenye VVU hawajui kuwa navyo<ref>{{cite journal|last=Centers for Disease Control and Prevention|first=(CDC)|title=HIV surveillance—United States, 1981–2008|journal=MMWR. Morbidity and mortality weekly report|date=June 3, 2011|volume=60|issue=21|pages=689–93|pmid=21637182}}</ref>. Kwa sababu hiyo, idadi halisi ya watu wanaoishi na VVU haijulikani. Hali hii ilisababisha karibu vifo milioni 1.8 mwaka 2010 ikilinganishwa na milioni 3.1 katika mwaka 2001.<ref name=UN2019Ten/> Kwa jumla watu 32,000,000 wameshakufa kwa ugonjwa huo<ref name=UN2019Ten/>. Wengi kati ya watu wenye VVU huishi Afrika kusini kwa Sahara (20,600,000). Wengi kati ya watoto ambao hufariki dunia kutokana na UKIMWI pia wanaishi barani Afrika. Katika mwaka wa 2010, kadirio la 68% (milioni 22.9&nbsp;) la visa vyote vya VVU na 66% ya vifo (milioni 1.2&nbsp;) vilitokea katika eneo hili.<ref name=UN2011Thirty>UNAIDS 2011 pg. 20–30</ref> Hii inamaanisha kuwa karibu 5% ya watu wazima wana virusi hivi<ref name=UN2011Fifty>UNAIDS 2011 pg. 40–50</ref> na vinaaminika kuwa kisababishi cha 10% ya vifo vyote vya watoto.<ref name=M117>Mandell, Bennett, and Dolan (2010). Sura ya 117.</ref> Wanawake wa eneo hili huchangia karibu 60% ya visa vyote tofauti na maeneo mengine.<ref name=UN2011Thirty/> [[Afrika Kusini]] ina idadi kubwa zaidi ya watu wenye VVU ulimwenguni kote, ikiwa ni watu milioni 5.9&nbsp;.<ref name=UN2011Thirty /> Kiwango cha [[matarajio ya urefu wa maisha]] kimepungua katika nchi zilizoathirika zaidi kutokana na VVU; kwa mfano, mwaka wa 2006, ilikadiriwa kuwa kiwango hiki kilipungua kutoka miaka 65 hadi 35 nchini [[Botswana]].<ref name=Kallings>{{Rejea jarida|journal= J Intern Med |year=2008|volume=263|issue=3|pages=218–43 |title= The first postmodern pandemic: Miaka 25 ya VVU |author= Kallings LO|doi=10.1111/j.1365-2796.2007.01910.x|pmid=18205765|url=http://doi.org/10.1111/j.1365-2796.2007.01910.x}}(subscription required)</ref> [[Asia Kusini]] na [[Asia Kusini Mashariki|Kusini Mashariki]] ni eneo la pili lililoathirika zaidi; mwaka wa 2010, eneo hili lilikuwa na kadirio la visa milioni 4&nbsp; au 12% ya watu wote wanaoishi na VVU, hivyo kupelekea vifo vya takriban watu 250,000.<ref name=UN2011Fifty/> Takriban milioni 2.4&nbsp; ya visa hivi viko India<ref name=UN2011Thirty/> Ukithiri wa VVU uko chini katika maeneo ya Uropa Magharibi na Kati ikifikia 0.2% na [[Mashariki mwa Asia]] ikiwa na 0.1%.<ref name=UN2011Fifty/> Mwaka wa 2008 nchini Marekani, takriban watu milioni 1.2 walikuwa wakiishi na VVU, hivyo kupelekea takriban vifo 17,500. Kituo cha Kudhibiti na Kuzuia Magonjwa kilikadiria kuwa, mwaka wa 2008, 20% ya Wamarekani waliokuwa na VVU hawakujua hali yao. <ref name=USAEPI2011>{{cite journal|last=Centers for Disease Control and Prevention|first=(CDC)|title=HIV surveillance—United States, 1981–2008|journal=MMWR. Morbidity and mortality weekly report|date=2011-06-03|volume=60|issue=21|pages=689–93|pmid=21637182}}</ref> Nchini Uingereza, kufikia 2009 kulikuwa na takriban visa 86,500 vilivyopelekea vifo 516.<ref>{{cite book|title=HIV in the United Kingdom: Ripoti ya 2010|year=2010|url=http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1287145367237|author=Health Protection Agency|access-date=2017-04-01|archive-date=2011-01-19|archive-url=https://web.archive.org/web/20110119155546/http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287145367237|dead-url=yes}}</ref> Nchini Kanada, kufikia 2008 kulikuwa na visa 65,000 vilivyopelekea vifo 53.<ref>{{cite book|last=Surveillance|title=HIV and AIDS in Canada : surveillance report to December 31, 2009|year=2010|publisher=Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Surveillance and Risk Assessment Division|location=Ottawa|isbn=978-1-100-52141-1|url=http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf|coauthors=riques, Risk Assessment Division = Le VIH et le sida au Canada : rapport de surveillance en date du 31 décembre 2009 / Division de la surveillance et de l'évaluation des|archiveurl=https://web.archive.org/web/20120119164919/http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf|archivedate=2012-01-19|access-date=2017-04-01|dead-url=yes|=https://web.archive.org/web/20120119164919/http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf}}</ref> ==Jamii na utamaduni== === Unyanyapaa === [[File:Ryan White.jpg|thumb|alt=Mvulana baleghe akitabasamu akipigwa picha huku mkono wa mwingine ukiwa uemeegemeshwa begani mwake|[[Ryan White]] alipelekea kuwa [[mtoto wa uhamasisho]] wa VVU baada ya kufukuzwa shuleni kwa sababu alikuwa ameambukizwa.]] [[Unyanyapaa]] dhidi ya watu walio na UKIMWI zipo kote ulimwenguni kwa namna mbalimbali, zikiwemo kutengwa, kukataliwa na jamii, ubaguzi na kuepuka watu walioambukizwa VVU, kulazimishwa kupimwa VVU bila [[idhini]] au ulinzi wa [[usiri]], vurugu dhidi ya watu walioambukizwa au waliodhaniwa kuambukizwa VVU; na [[karantini]] ya watu waliombukizwa VVU.<ref name=UNAIDS2006Ch4>{{Rejea kitabu|publisher =[[Joint United Nations Programme on HIV/AIDS|UNAIDS]]| year = 2006| title = 2006 Report on the global AIDS epidemic| chapter = The impact of AIDS on people and societies| chapterurl =http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH04_en.pdf| accessdate =June 14, 2006| format= PDF| isbn =92-9173-479-9}}</ref> Vurugu zinazohusiana na unyanyapaa au hofu ya vurugu huzuia watu wengi kupima VVU, kurudia matokeo ya vipimo na kutotafuta matibabu. Hali hizi hugeuza ugonjwa wa muda mrefu unaoweza kudhibitiwa kuwa hukumu ya kifo na kuendeleza ueneaji wa VVU.<ref name=Ogden>{{cite web | author = Ogden J, Nyblade L | publisher = [[International Center for Research on Women]] | year = 2005 | title = Common at its core: HIV-related stigma across contexts | url = http://www.icrw.org/docs/2005_report_stigma_synthesis.pdf | format = PDF | accessdate = February 15, 2007 | archiveurl = https://www.webcitation.org/6FEwkK8ZU?url=http://www.icrw.org/publications/common-its-core-hiv-related-stigma-across-contexts | archivedate = 2013-03-19 | = https://www.webcitation.org/6FEwkK8ZU?url=http://www.icrw.org/publications/common-its-core-hiv-related-stigma-across-contexts }}</ref> Unyanyapaa dhidi ya watu wanaoishi na UKIMWI, umegawanywa zaidi katika vikundi vitatu kama ifuatavyo: * ''Unyanyapaa Mkuu wa UKIMWI ''-mawazo ya woga na wasiwasi unaoweza kuhusishwa na ugonjwa wowote aunaoua au kuambukiza.<ref name=Herek1999>{{Rejea jarida| author=Herek GM, Capitanio JP| journal=American Behavioral Scientist| year=1999| url=http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf| format=PDF| title=AIDS Stigma and sexual prejudice| accessdate=March 27, 2006| volume=42| issue=7| pages=1130–1147| doi=10.1177/0002764299042007006| archive-date=2006-04-09| archive-url=https://web.archive.org/web/20060409034211/http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf| dead-url=yes| =https://web.archive.org/web/20060409034211/http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf}}</ref> * '' Unyanyapaa wa kiishara wa UKIMWI ''-kutumia VVU/UKIMWI kuonyesha mitazamo fulani dhidi ya vikundi vya jamii au mitindo ya maisha inayohusishwa na ugonjwa huu.<ref name=Herek1999 /> * Unyanyapaa wa kihisani wa UKIMWI''- Unyanyapaa dhidi ya watu wanaohusishwa na suala la VVU/UKIMWI au watu walio na VVU.<ref name=Snyder>{{Rejea jarida|author=Snyder M, Omoto AM, Crain AL |title=Punished for their good deeds: stigmatization for AIDS volunteers |url=https://archive.org/details/sim_american-behavioral-scientist_1999-04_42_7/page/1175 |journal=American Behavioral Scientist | year=1999 | pages=1175–1192 | volume=42 | issue=7|doi=10.1177/0002764299042007009}}</ref> Mara nyingi, unyanyapaa wa UKIMWI huonyeshwa pamoja na unyanyapaa wa aina moja au nyingine, hasa unyanyapaa unaohusiana na ushoga, [[uasherati]], ukahaba na kutumia dawa za kulevya.<ref>{{cite book|last=Sharma|first=A.K.|title=Population and society|publisher=Concept Pub. Co.|location=New Delhi|isbn=9788180698187|pages=242|url=http://books.google.ca/books?id=sE-VDhEuxmsC&pg=PA242}}</ref> Katika nchi nyingi zilizostawi, kuna uhusiano kati ya UKIMWI na ushoga.<ref name=Herek2002>{{cite journal|last=Herek|first=GM|coauthors=Capitanio, JP; Widaman, KF|title=HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999|url=https://archive.org/details/sim_american-journal-of-public-health_2002-03_92_3/page/371|journal=American journal of public health|date=2002 Mar|volume=92|issue=3|pages=371–7|pmid=11867313|pmc=1447082|doi=10.2105/AJPH.92.3.371}}</ref><ref name=Herek1999/>Hata hivyo, njia kuu ya kuenea kwa UKIMWI ulimwenguni kote inabakia kuwa maambukizi kati ya wanaume na wanawake, kwa kuwa ndio ngono ya kawaida. <ref>{{cite journal|last=De Cock|first=KM|coauthors=Jaffe, HW; Curran, JW|title=The evolving epidemiology of HIV/AIDS.|journal=AIDS (London, England)|date=2012 Jun 19|volume=26|issue=10|pages=1205-13|pmid=22706007}}</ref> === Athari za kiuchumi === [[File:Life expectancy in some Southern African countries 1958 to 2003.png|thumb|alt=Grafu inayoonyesha mistari kadhaa inayopanda ikifuatiwa na kushuka kwa ghafla kwa mistari hii kuanzia miaka ya katikati mwa 1980 hadi miaka ya 1990|Mabadiliko katika matarajio ya urefu wa maisha katika baadhi ya nchi za Afrika zilizoathiriwa zaidi. {{legend-line|red solid 2px|Botswana}}{{legend-line|darkgreen solid 2px|Zimbabwe}}{{legend-line|blue solid 2px|Kenya}}{{legend-line|black solid 2px|South Africa}}{{legend-line|grey solid 2px|Uganda}}]] VVU/UKIMWI huathiri [[uchumi]] wa watu na nchi.<ref name=M117/> [[Pato la ndani la uzalishaji]] la nchi zilizoathiriwa zaidi limepungua kufuatia ukosefu wa [[rasilimali ya kibinadamu]].<ref name=M117/><ref name="Bell-et-al-2003">{{Rejea jarida|author=Bell C, Devarajan S, Gersbach H|year=2003|url=http://econ.worldbank.org/external/default/main?pagePK=64165259&theSitePK=478060&piPK=64165421&menuPK=64166093&entityID=000160016_20031110113834|title=The long-run economic costs of AIDS: theory and an application to South Africa|accessdate=April 28, 2008|version=World Bank Policy Research Working Paper No. 3152|format=PDF|journal=|archive-date=2013-06-05|archive-url=https://web.archive.org/web/20130605151302/http://econ.worldbank.org/external/default/main?pagePK=64165259&theSitePK=478060&piPK=64165421&menuPK=64166093&entityID=000160016_20031110113834|dead-url=yes}}</ref>Bila [[lishe bora]], huduma za afya na dawa, watu wengi hufariki kutokana na matatizo yanayohusiana na UKIMWI. Kando ya kutoweza kufanya kazi, watu hao pia huhitaji kiwango kikubwa cha huduma za afya. UKIMWI hupunguza idadi ya watu wanaoweza kulipa [[ushuru]] Kwa kuwaathiri hasa vijana, hivyo kupunguza [[raslimali]] zilizopo za [[matumizi ya serikali|matumizi ya umma]] kama vile [[huduma za elimu]] na afya ambazo hazihusiki na UKIMWI. Hali hii husababisha upungufu wa [[pesa]] za nchi na wa ukuaji wa uchumi. Hali hii kisha hupelekea upungufu wa ukuaji wa msingi wa ushuru, athari ambayo huongezeka iwapo kuna matumizi zaidi katika matibabu, mafunzo (ili kuchukua nafasi ya [[wafanyakazi]] wanaougua), kuwalipa wafanyakazi wagonjwa na kuwatunza mayatima wa UKIMWI. Hali hii hutokea hasa iwapo ongezeko kubwa la vifo vya watu wazima litapelekea kubadilika kwa [[wajibu]] wa kuwatunza mayatima hawa kutoka kwa [[familia]] hadi kwa [[serikali]].<ref name=Greener /> Katika kiwango cha familia, UKIMWI husababisha upungufu wa mapato na pia ongezeko la matumizi katika huduma za afya. Utafiti katika nchi ya [[Côte d'Ivoire]] ulionyesha kuwa familia zilizo na mgonjwa aliye na VVU/UKIMWI zilitumia pesa mara mbili zaidi ya familia nyingine. Matumizi hayo ya ziada pia hupelekea kiwango kidogo zaidi cha mapato ya kutumia katika elimu au [[uwekezaji]] wa kibinafsi au wa kifamilia.<ref name="WBank">{{Rejea jarida| author=Over M| title=The macroeconomic impact of AIDS in Sub-Saharan Africa, Population and Human Resources Department| publisher=The World Bank| year=1992| url=http://www.worldbank.org/aidsecon/macro.pdf| format=PDF| accessdate=May 3, 2008| archiveurl=https://web.archive.org/web/20080527201655/http://www.worldbank.org/aidsecon/macro.pdf| archivedate=2008-05-27| deadurl=no| journal=}}</ref> === Mayatima === [[Picha: Africa HIV-AIDS 2002.png | haki | frame |Asilimia ya watu waliokuwa wanaishi na VVU katika Afrika miaka 1999-2001]] [[Picha:Ukimwi Afrika 2011.png|350px|thumb|Asilimia ya watu waliokuwa wanaishi na VVU Afrika mnamo mwaka 2011]] Watu wengi ambao wanakufa kutokana na UKIMWI, hasa katika [[Afrika]], huacha watoto ambao bado ni hai, na ambao wanaweza wanahitaji msaada na huduma. Inakadiriwa kuwa kufikia mwaka wa 2007, diadi ya watoto [[yatima kutokana na UKIMWI]] &nbsp;milioni 12.<ref name=M117/> Wengi wao hutunzwa na [[Bibi|nyanya]] na [[babu]] [[wazee]]. <ref name=Greener>{{Rejea kitabu| author = Greener R| year = 2002| title = State of The Art: UKIMWI na Uchumi| chapter = AIDS and macroeconomic impact| editor = S, Forsyth (ed.)| pages = 49–55| publisher = IAEN| url = http://pdf.usaid.gov/pdf_docs/PNACP969.pdf| access-date = 2017-04-01| archive-date = 2012-10-12| archive-url = https://web.archive.org/web/20121012090520/http://pdf.usaid.gov/pdf_docs/PNACP969.pdf| dead-url = yes}}</ref> === Dini na UKIMWI === Mada kuhusu dini na UKIMWI imekuwa ikikumbwa na utata mwingi katika miaka thelathini iliyopita, hasa kwa sababu baadhi ya viongozi wa dini wametangaza hadharani kwamba wanapinga utumiaji kondomu.<ref>{{cite web|url=http://www.news-medical.net/health/AIDS-Stigma.aspx |title=AIDS Stigma |publisher=News-medical.net|accessdate=November 1, 2011}}</ref> Mashirika mengine ya dini yamedai kuwa maombi yanatosha kutibu VVU/UKIMWI. Mwaka 2011, BBC iliripoti kuwa baadhi ya makanisa huko [[London]] yalikuwa yakidai kuwa maombi yanatibu UKIMWI. Kituo cha Utafiti wa Afya ya Kiuzazi na VVU cha [[Manispaa ya Hackney, London|Hackney]] kiliripoti kuwa watu wengi waliachma kutumia matibabu, wakati mwingine kwa kushauriwa na [[wachungaji]] wao. Jambo hili lilipelekea vifo vya watu wengi.<ref name=BBC18102011>{{cite news|url=http://www.bbc.co.uk/news/uk-england-london-14406818|title=Church HIV prayer cure claims 'cause three deaths'|date=October 18, 2011|accessdate=October 18, 2011|publisher=BBC News}}</ref> [[Synagogue Church Of All Nations]] ilitangaza ''maji ya upako'' ili kuwezesha [[uponyaji]] kutoka kwa [[Mungu]], ingawa ilikana kuwa iliwashauri watu kukoma kutumia matibabu.<ref name=BBC18102011 /> ===Katika vyombo vya habari=== Kimojawapo kati ya visa maarufu zaidi vya UKIMWI kilikuwa cha Mmarekani [[Rock Hudson]], [[muigizaji]] shoga aliyekuwa ameoa kisha kutalaki hapo awali. Hudson alifariki tarehe [[2 Oktoba]] [[1985]] baada ya kutangaza ana VVU tarehe [[25 Julai]] mwaka huohuo. Yeye alikuwa ametambuliwa kuwa na ugonjwa huo mwaka 1984.<ref>{{cite web|url=http://www.history.com/this-day-in-history/rock-hudson-announces-he-has-aids |title=Rock Hudson announces he has AIDS – History.com This Day in History – 7/25/1985 |publisher=History.com |accessdate=November 1, 2011}}</ref> Mgonjwa mashuhuri kutoka Uingereza mwaka huo alikuwa [[Nicholas Eden]] [[mwanasiasa]] shoga na [[mwana]] wa [[Waziri Mkuu]], [[marehemu]] [[Anthony Eden]].<ref>{{cite web|last=Coleman |first=Brian|url=http://www.newstatesman.com/blogs/brian-coleman/2007/06/lady-thatcher-gay-tory |title=Thatcher the gay icon|work=New Statesman |date=June 25, 2007 |accessdate=November 1, 2011}}</ref> Tarehe [[24 Novemba]] [[1991]], virusi hivi vilipelekea kifo cha mwanamuziki wa aina ya [[muziki wa rock]], Mwingereza [[Freddie Mercury]]. Mercury, aliyeongoza [[bendi]] iliyojulikana kama [[Queen (bendi)|Queen]] alifariki kutokana na magonjwa yanayohusiana na UKIMWI baada ya kujulikana kuwa na ugonjwa huo siku iliyopita tu.<ref>{{cite news|url=http://news.bbc.co.uk/onthisday/hi/dates/stories/november/24/newsid_2546000/2546945.stm |title=November 24, 1991: Giant of rock dies |work=BBC On This Day |publisher=BBC News |date= |accessdate=November 1, 2011}}</ref> Hata hivyo, Mercury alikuwa ametambuliwa kuwa na ugonjwa huo mwaka 1987.<ref>{{cite web|url=http://www.nndb.com/people/521/000044389/|title=Freddie Mercury |publisher=Nndb.com |accessdate=November 1, 2011}}</ref> Kimojawapo kati ya visa maarufu zaidi vilivyotokana na ngono kati ya watu wa jinsia tofauti ni kile cha [[Arthur Ashe]], [[mchezaji]] [[tenisi]] Mmarekani. Ashe alitambuliwa kuwa na VVU tarehe [[31 Agosti]] [[1988]]; baada ya kuambukizwa alipokuwa akiongezewa damu akifanyiwa [[upasuaji wa moyo]] awali [[miaka ya 1980]]. Vipimo zaidi katika saa 24 baada ya utambuzi wa kwanza vilionyesha kuwa Ashe alikuwa na UKIMWI, lakini hakuwambia watu kuhusu utambuzi huu hadi Aprili [[1992]].<ref>{{cite web |last=Bliss |first=Dominic |url=http://www.itennisstore.com/Tennis-Latest-News/FROZEN-IN-TIME--ARTHUR-ASHE-by-Dominic-Bliss.aspx |title=Frozen In Time: Arthur Ashe |work=iTENNISstore.com |accessdate=June 25, 2012 |archive-date=2013-07-30 |archive-url=https://web.archive.org/web/20130730170201/http://www.itennisstore.com/Tennis-Latest-News/FROZEN-IN-TIME--ARTHUR-ASHE-by-Dominic-Bliss.aspx |url-status=dead }}</ref> Ashe alifariki kutokana na UKIMWI akiwa na umri wa miaka 49 tarehe [[6 Februari]] [[1993]].<ref>{{cite news | url=http://www.independent.co.uk/news/tributes-to-arthur-ashe-1471622.html | title=Tributes to Arthur Ashe | location=London | work=The Independent | date=February 8, 1993 | accessdate=July 24, 2012 | archivedate=2013-03-19 | archiveurl=https://www.webcitation.org/6FEwqou9b?url=http://www.independent.co.uk/news/tributes-to-arthur-ashe-1471622.html }}</ref> Picha ya [[Therese Frare]] ikionyesha [[mwanaharakati]] wa ushoga [[David Kirby]] akifariki kutokana na UKIMWI huku akizungukwa na familia yake, ilipigwa Aprili mwaka wa 1990. ''[[LIFE magazine]]'' ilisema kuwa picha hiyo ilikuja kufahamika kama picha ''maarufu zaidi kuwahi kuhusishwa na janga la UKIMWI/VVU.'' Picha hiyo iliyochapishwa na [[gazeti]] hilo ilishinda [[tuzo]] la [[World Press Photo]], kisha kupata umaarufu ulimwenguni kote baada ya kutumiwa na [[Benetton Group|United Colors of Benetton]] katika kampeni ya utangazaji ya mwaka 1992.<ref>{{cite web|last=Cosgrove|first=Ben|title=Behind the Picture: Picha Iliyobadilisha Sura ya Ukimwi|url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|work=LIFE magazine|accessdate=16 August 2012|archivedate=2013-03-19|archiveurl=https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|=https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1}}</ref> === Ukanushaji, njama na hila === Kikundi kidogo cha watu kingali kinakana uhusiano wa VVU na UKIMWI, <ref name=Duesberg>{{cite journal|author=Duesberg, P. H.| title=HIV is not the cause of AIDS|url=https://archive.org/details/sim_science_1988-07-29_241_4865/page/n9| journal=Science | year=1988 | pages=514, 517 | volume=241 |issue=4865| pmid=3399880 | doi=10.1126/science.3399880|bibcode = 1988Sci...241..514D }}{{cite journal| author=Cohen, J.| title=The Controversy over HIV and AIDS| journal=Science | year=1994 | pages=1642–1649 | volume=266 | issue=5191|url=http://www.sciencemag.org/feature/data/cohen/266-5191-1642a.pdf| format = PDF| doi=10.1126/science.7992043|pmid=7992043| accessdate=2009-03-31 | bibcode=1994Sci...266.1642C}}</ref> uwepo wa VVU au ubora wa vipimo vya VVU na njia za matibabu.<ref name=Kalichman>{{cite book|author=Kalichman, Seth|authorlink=Seth Kalichman|title=Denying AIDS: Njama Nadhira, Itikadi na Msiba wa Mwanadamu|publisher=Copernicus Books ([[Springer Science+Business Media]])|location=New York|year=2009|pages=|isbn=978-0-387-79475-4| url =http://books.google.com/?id=_mtDBCDwxugC&printsec=frontcover&q=}}</ref><ref name=SmithNovella>{{cite journal|author=Smith TC, Novella SP|title=HIV Denial in the Internet Era|journal=PLoS Med.|volume=4|issue=8|pages=e256|year=2007|month=August|pmid=17713982|doi=10.1371/journal.pmed.0040256|url=http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040256&ct=1&SESSID=3d4baa1a64e57d8ff33e9d41eb2335a1|accessdate=2009-11-07|pmc=1949841|archive-date=2008-05-06|archive-url=https://web.archive.org/web/20080506012410/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040256&ct=1&SESSID=3d4baa1a64e57d8ff33e9d41eb2335a1|dead-url=yes}}</ref> Madai hayo, yanayojulikana kama [[ukanaji UKIMWI]], yamechunguzwa na kukataliwa na jamii ya kisayansi.<ref name=consensus>{{cite web| author=Various| publisher=[[National Institute of Allergy and Infectious Diseases]]|date=Last updated January 14, 2010|url=http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/howHIVCausesAIDS/Pages/HIVcausesAIDS.aspx| title= Resources and Links, HIV-AIDS Connection| accessdate = 2009-02-22}}</ref>Hata hivyo, madai hayo yana athari kuu kisiasa, hasa nchini [[Afrika Kusini]]. Hatua ya serikali ya nchi hiyo kukubali kirasmi ukanaji wa UKIMWI ilipelekea mwitikio usiofaa wa janga hili, na imelaumiwa kupelekea visa vingi vya maambukizi ya VVU na mamia ya maelfu ya vifo ambavyo vingeepukwa.<ref>{{cite journal |author=Watson J |title=Scientists, activists sue South Africa's AIDS 'denialists' |journal=Nat. Med. |volume=12 |issue=1 |page=6 |year=2006 |pmid=16397537|doi=10.1038/nm0106-6a}}</ref><ref>{{cite journal |author=Baleta A |title=S Africa's AIDS activists accuse government of murder |url=https://archive.org/details/sim_the-lancet_2003-03-29_361_9363/page/n47 |journal=Lancet |volume=361 |issue=9363 |page=1105 |year=2003 |pmid=12672319|doi=10.1016/S0140-6736(03)12909-1}}</ref><ref>{{cite journal |author=Cohen J |title=South Africa's new enemy|url=https://archive.org/details/sim_science_2000-06-23_288_5474/page/2168 |journal=Science |volume=288 |issue=5474 |pages=2168–70 |year=2000 |pmid=10896606|doi=10.1126/science.288.5474.2168}}</ref> [[Urusi]] ulianzisha [[Operesheni INFEKTION]], uhamasisho wa ulimwengu mzima kueneza habari kuwa VVU/UKIMWI ulitengenezwa na Marekani. Takwimu zinaonyesha kuwa idadi kubwa ya watu wanaamini na wanaendelea kuamini madai hayo. Kuna aina nyingi za [[dhana potovu kuhusu VVU na UKIMWI]]. Dhana tatu kuu ni kwamba UKIMWI unaweza kusambazwa kwa kumgusa mtu, kuwa ngono na [[bikira]] itatibu UKIMWI na kuwa VVU vinaweza tu kuambukiza mashoga na watumiaji wa madawa. Dhana nyingine potovu ni kuwa tendo lolote la ngono ya kinyeo kati ya mashoga wasioambukizwa linaweza kupelekea maambukizi.<ref>{{Rejea kitabu| author=Blechner MJ| title=Hope and mortality: psychodynamic approaches to AIDS and HIV| url=https://archive.org/details/hopemortalitypsy0000unse|publisher=Analytic Press| location=Hillsdale, NJ| year=1997| isbn=0-88163-223-6| unused_data=ISBN status=May be invalid– please double check}}</ref><ref>{{Rejea jarida|author=Kirby DB, Laris BA, Rolleri LA |title=Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world |journal=J Adolesc Health |volume=40|issue=3 |pages=206–17 |year=2007|month=March |pmid=17321420 |doi=10.1016/j.jadohealth.2006.11.143 |url=https://archive.org/details/sim_journal-of-adolescent-health_2007-03_40_3/page/206}}</ref> ==Utafiti unavyoendelea== Utafiti wa kuboresha matibabu ya kisasa unajumuisha kupunguza madhara ya ziada ya dawa zilizopo, kurahisisha kanuni za kutumia dawa na kuboresha ubora na kuamua utaratibu bora wa kanuni ili kudhibiti ukinzani wa dawa. Hata hivyo, chanjo pekee ndiyo inayodhaniwa kuweza kusitisha janga hili. Hii ni kwa sababu chanjo ni ya bei nafuu, hivyo [[Taifa linalostawi|mataifa yanayostawi]] yanaweza kuimudu, na haitahitaji matibabu ya kila siku.<ref name=Ferrantelli>{{cite journal|author=Ferrantelli F, Cafaro A, Ensoli B |title=Nonstructural HIV proteins as targets for prophylactic or therapeutic vaccine|journal=Curr. Opin. Biotechnol. |volume=15 |issue=6 |pages=543–56|year=2004|month=December|pmid=15560981 |doi=10.1016/j.copbio.2004.10.008}}</ref> Hata hivyo, baada ya miaka 20 ya utafiti, imekuwa vigumu kupata chanjo dhidi ya VVU-1,<ref name=Ferrantelli/><ref>{{Rejea jarida|author=Karlsson Hedestam GB, Fouchier RA, Phogat S, Burton DR, Sodroski J, Wyatt RT |title=The challenges of eliciting neutralizing antibodies to HIV-1 and to influenza virus |journal=Nat. Rev. Microbiol. |volume=6 |issue=2 |pages=143–55 |year=2008|month=February |pmid=18197170 |doi=10.1038/nrmicro1819}}</ref> hivyo tiba bado haijapatikana. === Upandikizaji seli kuu=== Mwaka wa 2007, Timothy Ray Brown,<ref name=ghivberlin>{{cite news|title=German HIV patient cured after stem cell transplant|url=http://www.belfasttelegraph.co.uk/news/world-news/german-hiv-patient-cured-after-stem-cell-transplant-15030473.html|accessdate=December 15, 2010|newspaper=[[Belfast Telegraph]]|date=December 15, 2010}}</ref> mwanaume wa umri wa miaka 40 aliyekuwa na VVU, pia anayejulikana kama "the Berlin Patient" alipewa huduma ya [[upandikizaji seli kuu za damu|pandikizo la seli kuu]] kama mojawapo ya matibabu ya [[lukemia sugu ya mieloidi]] (LSM).<ref name = Blood>{{cite journal|last=Allers|first=K|coauthors=Hütter, G; Hofmann, J; Loddenkemper, C; Rieger, K; Thiel, E; Schneider, T|title=Evidence for the cure of HIV infection by CCR5Δ32/Δ32 stem cell transplantation|journal=Blood|date=2011-03-10|volume=117|issue=10|pages=2791–9|pmid=21148083|doi=10.1182/blood-2010-09-309591}}</ref>Pandikizo la pili lilifanyika mwaka uliofuata baada ya kuugua tena. Mfadhili alichanguliwa sio tu kwa kuwa ana [[antijeni ya leukositi ya binadamu|upatanifu wa kijeni]] lakini pia kwa kuwa alikuwa na [[utangamano]] wa kubadilika kwa [[CCR5-Δ32]] ambayo huwezesha ukinzani dhidi ya maambukizi ya VVU.<ref name="Wall Street Journal 2008">{{cite news | author=Mark Schoofs | title=A Doctor, a Mutation and a Potential Cure for AIDS | url=http://online.wsj.com/article/SB122602394113507555.html | accessdate=2008-11-09|publisher=The Wall Street Journal| date=November 7, 2008}}</ref><ref name=Huetter2009>{{cite journal |author=Hütter G, Nowak D, Mossner M, Ganepola S, Ganepola A, Allers K, Schneider T, Hofmann J, Kücherer C, Blau O, Blau IW, Hofmann WK, Thiel E |title=Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation |journal=N Engl J Med |volume=360 |issue=7 |pages=692–698 |year=2009 |pmid=19213682 |doi=10.1056/NEJMoa0802905 |url=http://content.nejm.org/cgi/content/abstract/360/7/692 |accessdate=2009-03-31 |archive-date=2009-02-13 |archive-url=https://web.archive.org/web/20090213112056/http://content.nejm.org/cgi/content/abstract/360/7/692 |dead-url=yes }}</ref> Baada ya miezi 20 bila matibabu ya dawa za kudhibiti VVU, iliripotiwa kuwa viwango vya VVU kwenye damu ya Brown [[uboho]] na matumbo vilikuwa chini ya kiwango cha kutambulika.<ref name=Huetter2009/>Virusi hivi vilibakia katika kiwango hicho kwa miaka mitatu baada ya upandikizo wa kwanza.<ref name=Blood/>Ingawa watafiti na baadhi ya wachambuzi wanasema kuwa matokeo haya ni tiba, wengine wao wanadokeza kuwa virusi hivi vinaweza kuwa vimejificha ndani ya tishu<ref name=NEJMLevy/>kama vile ubongo (unaotumika kama [[ufiche wa virusi|hifadhi]]).<ref>{{cite journal|last=Nath|first=A|coauthors=Clements, JE|title=Eradication of HIV from the brain: reasons for pause|journal=AIDS (London, England)|date=2011-03-13|volume=25|issue=5|pages=577–80|pmid=21160414|doi=10.1097/QAD.0b013e3283437d2f}}(subscription required)</ref> Matibabu ya seli kuu yamebakia chini ya [[utafiti wa kiafya |kuchunguzwa]] kwa sababu ya asili yake ya [[ushahidi wa kinadharia|kinadharia]], ugonjwa wenywe na hatari ya kufa inayohusishwa na upandikizaji wa seli kuu na ugumu wa kupata wafadhili mwafaka.<ref name=NEJMLevy>{{cite journal |author=Levy JA |title=Not an HIV Cure, but Encouraging New Directions |journal=N Engl J Med |volume=360 |issue=7 |pages=724–725 |year=2009 |doi=10.1056/NEJMe0810248 |url=http://content.nejm.org/cgi/content/full/360/7/724 |accessdate=2009-03-31 |pmid=19213687 |archive-date=2009-02-15 |archive-url=https://web.archive.org/web/20090215235206/http://content.nejm.org/cgi/content/full/360/7/724 |dead-url=yes }}</ref><ref>{{Cite pmid|21331536}}(subscription required)</ref> === Matibabu ya kuboresha kingamwili === Matibabu saidizi za kudhibiti uigaji wa virusi, [[matibabu ya kingamwili,|matibabu ya kingamwili]] zinazoweza kusaidia kuboresha mfumo wa kingamwili zilizochunguzwa awali, na juhudi zinazoendelea ni pamoja na [[Interleukin-2|IL-2]] na [[Interleukin-7|IL-7]].<ref name="Tincati-2009">{{cite journal|last=Tincati|first=C|coauthors=d'Arminio Monforte, A; Marchetti, G|title=Immunological mechanisms of interleukin-2 (IL-2) treatment in HIV/AIDS disease|journal=Current molecular pharmacology|date=2009 Jan|volume=2|issue=1|pages=40–5|pmid=20021444|doi=10.2174/1874467210902010040}}</ref> Kutofaulu kwa chanjo kadhaa kukinga dhidi ya maambukizi ya VVU na kuendelea kwa UKIMWI kumepelekea mwelekeo mpya wa kuzingatia taratibu za kibayolojia zinazosababisha ufiche wa VVU. Kipindi kifupi cha matibabu ya kuunganisha dawa za kudhibiti VVU na dawa zinazolenga hifadhi fiche siku moja kinaweza kutokomeza maambukizi ya VVU.<ref name =Bowman>{{cite journal | author=Bowman MC, Archin NM, Margolis DM. | title=Pharmaceutical approaches to eradication of persistent HIV infection | journal=Expert Reviews in Molecular Medicine |year=2009| volume=11 | issue=e6 | pmid=19208267 |doi=10.1017/S1462399409000970 | pages=e6 }}</ref>Watafiti wamegundua [[abusaimu]] inayoweza kuharibu eneo la kufungia protini ya [[gp120]] CD4. Protini hii hupatikana katika aina zote za VVU kwa sababu ndiyo ncha ambapo [[seli za B|limfosaiti za B]] hujishikisha kisha kuafikiana kwa mfumo wa kingamwili.<ref>{{Rejea jarida|author=Planque S, Nishiyama Y, Taguchi H, Salas M, Hanson C, Paul S |title=Catalytic antibodies to HIV: Physiological role and potential clinical utility |journal=Autoimmun Rev |volume=7 |issue=6 |pages=473–9 |year=2008 |month=June|pmid=18558365|doi=10.1016/j.autrev.2008.04.002 |url= |pmc=2527403}}</ref> == Tanbihi == {{Reflist}} ==Marejeo== * {{cite book | editor1-last = Mandell | editor1-first = Gerald L. | editor2-last = Bennett | editor2-first =John E.| editor3-last = Dolin | editor3-first = Raphael |title=Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases | year=2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA|isbn=978-0-443-06839-3 | edition = 7th }} * {{cite book|author=[[Joint United Nations Programme on HIV/AIDS]] (UNAIDS) |title=Global HIV/AIDS Response, Epidemic update and health sector progress towards universal access|year=2011|publisher=Joint United Nations Programme on HIV/AIDS|url=http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20111130_UA_Report_en.pdf}} == Viungo vya nje == {{Commons category|AIDS}} * {{Dmoz|Health/Conditions_and_Diseases/Immune_Disorders/Immune_Deficiency/AIDS/|HIV/AIDS}} * [http://aidsinfo.nih.gov/ AIDSinfo] {{Wayback|url=http://aidsinfo.nih.gov/ |date=20110225133251 }} – HIV/AIDS Treatment Information, U.S. Department of Health and Human Services * [Http://www.who.int/3by5/en/ Shirika la Afya Duniani Mashirika 3 na 5 Initiative] * [Http://www.accessmed-msf.org/index.asp Médecins Sans Frontières: Kampeni ya upatikanaji wa madawa muhimu] {{Wayback|url=http://www.accessmed-msf.org/index.asp |date=20050812004522 }} * [Http://www.who.int/hiv/en/ WHO Mpango wa VVU / UKIMWI] * [Http://www.aegis.org/en/ Elimu UKIMWI Mfumo wa Taarifa za Global] * [Http://www.aidsinfo.nih.gov/ Kutoka Taasisi ya Taifa ya Marekani ya Afya] {{Wayback|url=http://www.aidsinfo.nih.gov/ |date=20210322035857 }} * [Http://content.nejm.org/cgi/content/full/353/8/749 New England Journal of Medicine Ibara "Ruhusu dhidi ya Wagonjwa? Kurefusha maisha Tiba katika India"] {{Wayback|url=http://content.nejm.org/cgi/content/full/353/8/749 |date=20090501234727 }} * [Http://www.aidsportal.org AIDSPortal maarifa mtandao] * [http://www.unaids.org/en/ Tovuti ya Shirika la Umoja wa Mataifa la Masuala ya Ukimwi, UNAIDS] {{Wayback|url=http://www.unaids.org/en/ |date=20130210215850 }} * [http://hivinsite.ucsf.edu HIV InSite] {{Wayback|url=http://hivinsite.ucsf.edu/ |date=20191213225029 }} * [http://www.sida.fr/ sida.fr • un centre pour les malades du SIDA • infos • tèmoignages • actualités] [[Jamii:Dalili]] [[Jamii:Ukimwi]] ddp3x2mpi0q0v3f5ymwv3w321d4gzg1 0 2368 1578005 1410275 2026-07-02T14:20:22Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578005 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Kampala |picha_ya_satelite = KampalaSkyline.jpg |maelezo_ya_picha = Kitovu cha mji wa Kampala |pushpin_map = Uganda |pushpin_map_caption = Mahali pa mji wa Kampala katika Uganda |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Uganda]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = [[Wilaya za Uganda|Wilaya]] |subdivision_name2 = [[Wilaya ya Kampala|Kampala]] |wakazi_kwa_ujumla = 1 353 236 |latd=0 |latm=18 |lats=49 |latNS=N |longd=32 |longm=34 |longs=52 |longEW=E |website = [http://www.kcc.go.ug/ www.kcc.go.ug] }} [[Picha:Kampalamontage.png|thumbnail|right|280px|Sehemu za Mji wa Kampala]] '''Kampala''' ni [[mji mkuu]] na mkubwa wa [[Uganda]], pia mojawapo ya [[wilaya]] za nchi ulioka karibu na [[ziwa]] kubwa la [[Nyanza Viktoria]], [[mita]] kama 1,189 juu ya [[UB]].Kampala ina wakazi 1,875,834 mnamo 2024. Jiji kuu lake lina watu kadiri Milioni 6.8. Kampala ndio kitovu cha uchumi cha Uganda likiwa pato la taifa kadiri dola bilioni 13 za Marekani UNDIO, UNEP, Benki ya Uchumi na East Africa Development Bank (EADB) zina [[ofisi]] hapa. ==Jina== [[Jina]] la Kampala limetokana na msemo wa [[Kiganda]] "Kasozi K'Empala" wenye maana ya "kilima cha swala" kwa sababu [[wafalme]] wa [[Buganda]] walipenda kuwinda katika eneo hili. == Historia == Kampala ni mji ulioanza kukua sehemu za vilima mbalimbali upande wa [[kaskazini]] wa [[Entebbe]]. [[Kitovu]] cha kwanza kilikuwa [[nyumba]] ya kifalme kwenye [[kilima]] cha [[Kasubi]] iliyojengwa na [[Kabaka]] [[Mutesa I]] wa [[Buganda]] mnamo mwaka [[1882]]. Baada ya [[kifo]] chake Mutesa ikawa [[kaburi]] la kifalme. [[Ikulu]] mpya ya Kabaka [[Mwanga II]] ikajengwa karibu kwenye kilima cha Mengo. Mwaka [[1890]] mwakilishi wa [[Kampuni ya Kifalme ya Uingereza kwa Afrika ya Mashariki]] (IBEA, kifupi kwa ''Imperial British East Africa Company''), [[Frederick Lugard]] aliingilia [[vita vya wenyewe kwa wenyewe]] kati ya [[Waganda]] [[Waprotestanti]], [[Wakatoliki]] na [[Waislamu]], akajenga boma juu ya kilima kilichoitwa "Kampala" kikawa kitovu cha makao ya [[Wazungu]] katika mji mpya. [[Wamisionari]] wakapewa na Kabaka nafasi ya kujenga [[Kanisa|makanisa]] na nyumba zao kwenye vilima mbalimbali: Namirembe ikawa kilima cha Waanglikana, Rubaga kilima cha Wakatoliki. Waislamu walikuwa na eneo lao hasa kwenye kilima cha Kibuli. Maeneo hayo yote yaliunganika pamoja kuwa mji wa Kampala. Kati ya [[1900]] hadi [[1905]] Kampala ikawa [[makao makuu]] ya [[utawala]] wa kikoloni wa [[Uingereza]] uliohamishwa baadaye kwenda [[Entebbe]]. Baada ya [[uhuru]] ikawa mji mkuu wa kitaifa wa Uganda. Utawala wa [[Idi Amin]] na vita vya kumpindua [[1979]] uliharibu mengi, kwanza tabaka la [[wafanyabiashara]] [[Wahindi]] pamoja na nguvu ya kiuchumi, baadaye pia [[Jengo|majengo]]. Tangu kufufuka kutoka nyakati mbaya za [[udikteta]] na vita, Kampala imeanza kukua tena. == Wakazi == {| style="align:center;border:1px solid black" |- ! Mwaka || Wakazi |- | Sensa 1959 || 46.000 |- | Sensa 1980 || 458.503 |- | Sensa 1991 || 774.241 |- | Sensa 2002 || 1.208.544 |- | Sensa 2005 || 1.353.236 |- | Makadirio 2015 || 1.803.936 |} == Makerere == Kampala ina [[Chuo Kikuu cha Makerere|Chuo Kikuu]] katika mtaa wa Makerere kilichokuwa chuo kikuu cha kwanza katika [[Afrika ya Mashariki]] na mahali pa mafunzo kwa viongozi wengi wa Kiafrika upande wa [[siasa]], [[utamaduni]] na [[uchumi]]. ==Marejeo== {{reflist}} == Viungo vya nje == {{Commons cat|Kampala}} * [http://www.kcc.go.ug Tovuti rasmi] {{Wayback|url=http://www.kcc.go.ug/ |date=20091212052157 }} {{Makao makuu ya wilaya za Uganda}} {{list of African capitals}} {{mbegu-jio-Uganda}} [[Jamii:Miji ya Uganda]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Kampala| ]] [[Jamii:Ziwa Viktoria]] [[Jamii:Africa Wiki Challenge 2021 in Tanzania]] orfgp86stdhorqpzuany6g0cb04jte5 0 2644 1577976 1574890 2026-07-02T13:26:49Z Riccardo Riccioni 452 /* Marejeo ya nje */ 1577976 wikitext text/x-wiki [[Picha:Abuja_Collage.jpg|thumbnail|right|280px|Sehemu za Mji wa Abuja]] {{Infobox Settlement |jina_rasmi = Jiji la Abuja |picha_ya_satelite = Abuja.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Nigeria]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Locator Map Abuja-Nigeria.png|right|thumb|250px|Mahali pa Abuja kule Nigeria]] '''Abuja''' ni [[mji mkuu]] wa [[Nigeria]]. Idadi ya wakazi wake imekadiriwa kuwa watu 178,462 [https://web.archive.org/web/20061117025513/http://www.world-gazetteer.com/wg.php?x=&men=gcis&lng=en&dat=32&geo=-158&srt=npan&col=aohdq&pt=c&va=x]. Mwaka wa 1976, serikali ya Nigeria iliamua kuanzisha mji mkuu mpya badala ya [[Lagos]]. Wakachagua katikati ya nchi, na mipango ya ujenzi ikaundwa chini ya makampuni matatu ya Marekani: PRC Corporation; Wallace, McHarg, Roberts na Todd; na Archisystems. Mipango hiyo ikabadilishwa baadaye na [[Kenzo Tange]], msanifu majengo maarufu wa [[Japani]]. Abuja ikatangazwa rasmi kuwa mji mkuu wa Nigeria tarehe 12 Desemba 1991. Iko mahali pa 9, 10, Kaskazini na 7, 10, Mashariki. [http://earth-info.nga.mil/gns/html/cntry_files.html] {{Wayback|url=http://earth-info.nga.mil/gns/html/cntry_files.html |date=20110325175559 }} Balozi za nchi nyingi zikahamishwa Abuja kutoka Lagos. == Historia == Sifa muhimu ya Abuja ni [[Mlima wa Aso]] ambao ni mwamba ulio na urefu wa mita 400. Upande wa kusini wa mlima huo, kuna [[Ikulu]] ya [[Rais]], [[Bunge]] la Nigeria, [[Mahakama Kuu]] na sehemu nyingi za mji. Majengo maarufu mengine ni Msikiti wa Taifa (''Nigerian National Mosque'') na Kanisa Kuu la Madhehebu (''National Ecumenical Centre Cathedral''). Kuna kiwanja cha ndege cha kimataifa (''Nnamdi Azikiwe International Airport''), karibu na Mlima wa Zuma. Sehemu nyingine za mji hazijajengwa ilivyopangwa, na majengo mengi yanaendelea kujengwa. Mji wa Abuja unagombea kuwa mahali pa [[Michezo ya Jumuiya ya Madola]] kwa mwaka wa 2014 (''2014 Commonwealth Games''). == Marejeo ya nje == * [http://www.fct.gov.ng/ Official site of Nigeria's Federal Capital Territory (FCT) and City of Abuja] {{Wayback|url=http://www.fct.gov.ng/ |date=20060509165241 }} * [http://omcea.be/195304,abuja,nigeria,capitol/ Makala ya WorldPress inayohusu mabadiliko kwenye Abuja] {{Wayback|url=http://omcea.be/195304,abuja,nigeria,capitol/ |date=20070927091941 }} * [http://www.fct.gov.ng/NR/rdonlyres/CA6FA9F5-EF96-4F79-84DB-3E654C67388C/0/release_on_commonwealth_game_2014.pdf/ Abuja Bid Announcement] {{Wayback|url=http://www.fct.gov.ng/NR/rdonlyres/CA6FA9F5-EF96-4F79-84DB-3E654C67388C/0/release_on_commonwealth_game_2014.pdf/ |date=20070311000254 }} * [http://www.proav.de/photopages/abuja// Picha za Abuja] {{Wayback|url=http://www.proav.de/photopages/abuja// |date=20060426202147 }} {{list of African capitals}} [[Jamii:Miji ya Nigeria]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Abuja| ]] jc2y8tscthfezo6s4ub4tpew7jffgre 0 2647 1578038 1336960 2026-07-02T14:43:13Z Riccardo Riccioni 452 1578038 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Windhoek |picha_ya_satelite = Satellitenbild Windhoek.jpg |settlement_type = Jiji |pushpin_map = Namibia |pushpin_map_caption = Mahali pa mji wa Windhoek katika Namibia |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Namibia]] |subdivision_type1 = [[Mikoa ya Namibia|Mikoa]] |subdivision_name1 = [[Mkoa wa Khomas]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 400.000 |latd=22 |latm=34 |lats=12 |latNS=S |longd=17 |longm=5 |longs=1 |longEW=E |website = [http://www.windhoekcc.org.na www.windhoekcc.org.na] }} [[Picha:Windhoek-269058_1920.jpg|thumbnail|right|280px|Sehemu ya Mji wa Windhoek]] [[Picha:Windhoek-Skyline.jpg|thumb|right|300px|Kitovu cha mji wa Windhoek]] [[Picha:Windhoek ende 19 jahrhundert.jpg|thumb|300px|right|Windhoek mwishoni mwa 19 karne]] [[Picha:Windhuk stamp.jpg|thumb|300px|right|170px|Mihuri kwa Kijerumani South Afrika Magharibi postmarked ''Windhuk'']] '''Windhoek''' ni [[mji mkuu]] wa [[Namibia]], na idadi ya wakazi wake ni takriban 230,000. Mji huu ni kituo muhimu kwa biashara ya ngozi za kondoo. Zamani ulikuwa makao makuu ya mtemi wa kabila la [[Nama]] aliyewashinda kabila la [[Waherero]] wakati wa karne ya 19. Mwaka wa 1885, nchi ilivamiwa na wakoloni kutoka [[Ujerumani]], na mji wa Windhoek ukawa makao makuu ya serikali ya ukoloni mwaka wa 1892. Wakati wa [[Vita Kuu ya Kwanza ya Dunia]] nchi ilivamiwa na majeshi ya Makaburu kutoka [[Afrika ya Kusini]] ambao wametawala nchi ya Namibia hadi mwaka wa 1990. Namibia ilipopata uhuru, mji wa Windhoek ukawa mji mkuu wa Jamhuri ya Namibia. {{list of African capitals}} {{mbegu-jio-Namibia}} [[Jamii:Miji ya Namibia]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Namibia]] [[Jamii:Windhoek| ]] l4xdmqxsi0psw7thf892bizjbqf93dm 0 2650 1578013 1142799 2026-07-02T14:23:53Z Riccardo Riccioni 452 /* Marejeo ya nje */ 1578013 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Lusaka |picha_ya_satelite = Lusaka.jpg |pushpin_map = Zambia |pushpin_map_caption = Mahali pa mji wa Lusaka katika Zambia |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Zambia]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 1 300 000 |latd=15 |latm=24 |lats=59 |latNS=S |longd=28 |longm=16 |longs=55 |longEW=E |website = }} [[Picha:Kafue round about.jpg|thumb|left|Lusaka]] [[Picha:ZM-Lusaka.png|right|thumb|225px|Mahali pa Lusaka katika nchi ya Zambia]] '''Lusaka''' ni [[mji mkuu]] wa [[Zambia]]. Jiji la Lusaka liko Kusini ya Kati ya Zambia, na mahali pake ni 15°25' Kusini, 28°17' Mashariki [http://earth-info.nga.mil/gns/html/cntry_files.html] {{Wayback|url=http://earth-info.nga.mil/gns/html/cntry_files.html |date=20110325175559 }}. Iko futi 4200 (au mita 1400) juu ya [[UB]]. Idadi ya wakazi wake imekadiriwa kuwa watu 1,391,000 (mwaka wa 2000). Mji wa Lusaka ulianzishwa mwaka wa 1905 na wakoloni Wazungu kwenye mahali pa kijiji ambacho mwenyekiti wake aliitwa Lusaaka. Kwa vile Lusaka iko katikati ya nchi, mwaka wa 1935 wakoloni Waingereza walihamishia mji mkuu wao wa [[Rhodesia ya Kaskazini]] huko kutoka mji wa [[Livingstone, Zambia|Livingstone]]. Baada ya kupata uhuru, Lusaka ikaendelea kama mji mkuu wa Zambia hadi hivi sasa. Lusaka hufikika kupitia kiwanja cha ndege cha kimataifa (''Lusaka International Airport''), au kupitia garimoshi kwenye njia ya reli inayoelekea kutoka mji wa Livingstone kwenda mji wa [[Kitwe]]. == Tazama pia == * [[Orodha ya miji ya Zambia]] == Marejeo ya nje == * [http://www.zambiatourism.com/travel/cities/lusaka.htm Zambia Tourism page on Lusaka] * [http://www.zambiatourism.com/travel/maps/lusakacity.htm Ramani ya Lusaka] {{list of African capitals}} {{Mbegu-jio-Zambia}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Zambia]] [[Jamii:Lusaka| ]] [[Jamii:Zambia]] l0wl24d13frpiyx8zp5htnrmsorkww4 0 2738 1577957 1433205 2026-07-02T12:59:08Z Riccardo Riccioni 452 1577957 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Jibuti |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Jibuti]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:An_aerial_view_of_Djibouti_City.jpg|thumbnail|right|280px|Picha ya Angani ya Mji wa Jibuti]] [[Picha:DjiboutiCity-Djibouti.png|right|175px|ramani ya jibuti, mji jibuti]] '''Jibuti''' (kwa [[Kiarabu]] جيبوتي) ni [[mji mkuu]] na [[mji]] mkubwa nchini [[Jibuti]] ukiwa na wakazi 400,000. Mji wenyewe uko kwenye [[rasi]] inayogawa [[Ghuba ya Aden]] kutoka [[Ghuba ya Tadjoura]], 11°36' [[kaskazini]], 43°10' [[mashariki]] (11.60, 43.1667). ==Historia== Mji huo ulianzishwa na [[Ufaransa]] kama [[bandari]] mwaka wa [[1888]], ukawa mji mkuu mwaka wa [[1891]], ukiandamwa na [[Tadjoura]]. Msafiri mmoja mwandishi alielezea mji Jibuti kama mji ulio na [[shida]] ya kujitambulisha, alisema ya kwamba "mji wa kudumu kwa taifa la wahamiaji, ni mji wa Kiafrika uliotengenezwa kama makao ya Kiulaya na pia kama [[Hong Kong]] wa Kifaransa kwa [[Bahari ya Shamu]]." Mji pamoja na bandari ulianzishwa kwa sababu mahali pake pana umuhimu wa kijeshi kwa kuwa uko karibu na [[mlango wa bahari]] wa [[Bab el Mandeb]] ulio [[njia]] ya kuingia [[Bahari ya Shamu]] kutoka [[Bahari Hindi]] na kuelekea [[mfereji wa Suez]]. Wakati wa [[ukoloni]] ulikuwa muhimu kwa [[Ufaransa]] kwa sababu [[meli]] zake ziliweza kupumzika hapa na kuongeza [[maji]] na [[makaa]] njiani kati ya [[Mediteranea]] na makoloni ya Kifaransa huko [[Vietnam]] na kandokando yake. ==Hali ya sasa== Mji umepangwa na Wafaransa na sehemu mbili: moja kwa ajili ya [[afisa|maafisa]] Wafaransa na nyingine kama makazi kwa ajili ya [[Waafrika]]. Kaskazini mashariki kuna bandari inayotumika kwa [[biashara]] za kimataifa, [[uvuvi]] wa [[samaki]] na [[feri]] inayoenda [[Obock]] na [[Tadjoura]]. [[Hulka]] za mji wa Jibuti ni [[mapwa]] kwa [[pwani]] ya magharibi na [[soko]] kubwa la kati, na [[uwanja wa michezo]] wa [[taifa]], [[Jumba la Rais]] na [[Msikiti Hamouli]]. [[Treni|Gari la moshi]] laenda hadi [[Addis Ababa]], na pia mji huu, wasafiri wa [[Ndege (uanahewa)|ndege]] hushukia [[Uwanja wa Ndege wa Jibuti-Ambouli]] ==Tazama pia== * [[Orodha ya miji ya Jibuti]] == Viungo vya nje == * [http://maps.google.com/maps?ll=11.558304,43.145714&spn=0.166014,0.234180&t=k&hl=en Satellite picture by Google Maps] (ramani na picha za makala ya Google) {{mbegu-jio-Afrika}} [[Jamii:Jibuti]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Afrika]] [[Jamii:Miji ya Jibuti]] [[Jamii:Jibuti (mji)| ]] p0rynrcr1w6q2ui4v63c43b5sdqzsa8 1578002 1577957 2026-07-02T14:19:10Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578002 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Jibuti |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Jibuti]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:An_aerial_view_of_Djibouti_City.jpg|thumbnail|right|280px|Picha ya Angani ya Mji wa Jibuti]] [[Picha:DjiboutiCity-Djibouti.png|right|175px|ramani ya jibuti, mji jibuti]] '''Jibuti''' (kwa [[Kiarabu]] جيبوتي) ni [[mji mkuu]] na [[mji]] mkubwa nchini [[Jibuti]] ukiwa na wakazi 400,000. Mji wenyewe uko kwenye [[rasi]] inayogawa [[Ghuba ya Aden]] kutoka [[Ghuba ya Tadjoura]], 11°36' [[kaskazini]], 43°10' [[mashariki]] (11.60, 43.1667). ==Historia== Mji huo ulianzishwa na [[Ufaransa]] kama [[bandari]] mwaka wa [[1888]], ukawa mji mkuu mwaka wa [[1891]], ukiandamwa na [[Tadjoura]]. Msafiri mmoja mwandishi alielezea mji Jibuti kama mji ulio na [[shida]] ya kujitambulisha, alisema ya kwamba "mji wa kudumu kwa taifa la wahamiaji, ni mji wa Kiafrika uliotengenezwa kama makao ya Kiulaya na pia kama [[Hong Kong]] wa Kifaransa kwa [[Bahari ya Shamu]]." Mji pamoja na bandari ulianzishwa kwa sababu mahali pake pana umuhimu wa kijeshi kwa kuwa uko karibu na [[mlango wa bahari]] wa [[Bab el Mandeb]] ulio [[njia]] ya kuingia [[Bahari ya Shamu]] kutoka [[Bahari Hindi]] na kuelekea [[mfereji wa Suez]]. Wakati wa [[ukoloni]] ulikuwa muhimu kwa [[Ufaransa]] kwa sababu [[meli]] zake ziliweza kupumzika hapa na kuongeza [[maji]] na [[makaa]] njiani kati ya [[Mediteranea]] na makoloni ya Kifaransa huko [[Vietnam]] na kandokando yake. ==Hali ya sasa== Mji umepangwa na Wafaransa na sehemu mbili: moja kwa ajili ya [[afisa|maafisa]] Wafaransa na nyingine kama makazi kwa ajili ya [[Waafrika]]. Kaskazini mashariki kuna bandari inayotumika kwa [[biashara]] za kimataifa, [[uvuvi]] wa [[samaki]] na [[feri]] inayoenda [[Obock]] na [[Tadjoura]]. [[Hulka]] za mji wa Jibuti ni [[mapwa]] kwa [[pwani]] ya magharibi na [[soko]] kubwa la kati, na [[uwanja wa michezo]] wa [[taifa]], [[Jumba la Rais]] na [[Msikiti Hamouli]]. [[Treni|Gari la moshi]] laenda hadi [[Addis Ababa]], na pia mji huu, wasafiri wa [[Ndege (uanahewa)|ndege]] hushukia [[Uwanja wa Ndege wa Jibuti-Ambouli]] ==Tazama pia== * [[Orodha ya miji ya Jibuti]] == Viungo vya nje == * [http://maps.google.com/maps?ll=11.558304,43.145714&spn=0.166014,0.234180&t=k&hl=en Satellite picture by Google Maps] (ramani na picha za makala ya Google) {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Jibuti]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Afrika]] [[Jamii:Miji ya Jibuti]] [[Jamii:Jibuti (mji)| ]] jq0q5f0tp7iafb0q57d7gerc7h60oxi 0 2740 1577944 1386673 2026-07-02T12:48:25Z Riccardo Riccioni 452 /* Viungo via nnje */ 1577944 wikitext text/x-wiki [[Picha:Asmara Montage.png|thumbnail|right|200px|Muonekano wa Mji wa Asmara]] {{Infobox Settlement |jina_rasmi = Jiji la Asmara |picha_ya_satelite = Asmara-Panorama.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Eritrea]] |subdivision_type1 = [[:en:Regions of Eritrea|Eneo]] |subdivision_name1 = [[:en:Maekel Region|Maekel]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} '''Asmara''' (pia '''Asmera''') ni [[mji mkuu]] na makazi makubwa nchini [[Eritrea]], watu 579,000 wakiwa wanaishi mjini humu. [[Nguo]], nyama, [[pombe]], [[viatu]] na [[seramiki]] ni mojawapo ya vifaa vinavyotoka mji wa Asmara. Asmara yenyewe kijiografia iko 15°20' kaskazini, 38°55' mashariki (15.333, 38.91667). Mji umo katika orodha ya [[urithi wa dunia]] ya [[UNESCO]]. == Historia == Asmara ilianza kutoka vijiji vinne [[karne ya 12]] kama [[eneo la biashara]] na baadaye kama mji wa [[Ras Alula]]. Ilitawaliwa na [[Waitalia]] tangu mwaka [[1889]] na kuwa Mji Mkuu [[1897]] wa [[koloni]] la Eritrea. Miaka ya 1930 Waitalia waligeuza mji kwa majengo mapya; Asmara iliitwa na Waitalia "Piccola Roma" (Roma mdogo). Siku hizi majengo makubwa zaidi ya Asmara ni ya Kiitalia, na maduka bado yana majina ya [[Kiitalia]], mfano - "Bar Vittoria", "Pasticceria moderna", "Casa del formaggio", "Ferramenta". Siku za vita vya uhuru wa Eritrea kutoka [[Ethiopia]], [[Uwanja wa ndege wa Asmara]] ulikuwa mhimu sana, Waethiopia walitumia uwanja huo kupata silaha kutoka ng'ambo. Mji wa mwisho kuanguka kwa [[Jeshi ya ukombozi wa Eritrea]] ulitekwa mwaka [[1990]] na kusalimishwa na [[Jeshi ya Ethiopian]] bila vita mnamo [[24 Mei]] [[1991]]. == Hulka == Mji wenyewe una [[makumbusho]] na unajulikana kwa majengo ya [[karne ya 20]], [[sanaa ya Deco]], [[sinema Impero]], [[Ujenzi wa Kubisti|Kubisti]], [[Pensheni Afrika]], [[Kanisa kuu]] la [[Tewahedo]], [[Nyumba ya Opera]], [[ujenzi wa umbele]], [[jengo la Fiat Tagliero]], [[jengo la neo-Romanesque]], kanisa kuu la [[Kanisa Katoliki]] na [[ujenzi wa kupendeza]]. Asmara pia ni nyumbani kwa [[Chuo kikuu cha Asmara]] na [[gome]] ya [[karne ya 19]]. Kituo cha ndege, [[Uwanja wa Kimataifa wa Asmara]], kimeungana pia na bandari ya [[Massawa]] kwa [[Reli ya Eritrea]]. Asmara ni makao makuu ya [[Patriarki]] wa [[Kanisa la Kiorthodoksi la Eritrea]], lililokubaliwa na Patriarki wa [[Aleksandria]] ([[Misri]]) kuwa linajitegemea tangu mwaka [[1993]] na kuongozwa na Patriarki wake tangu mwaka [[1998]], sawa na [[Kanisa la Kiorthodoksi la Ethiopia]] ambalo pia linakiri umoja wa nafsi wa [[Yesu Kristo]] ([[Tewahedo]]). == Uchambuzi == * Edward Denison, Guang Yu Ren, Naigzy Gebremedhin and Guang Yu Ren - ''Asmara: Africa's Secret Modernist City'' (2003) ISBN 1-85894-209-8 (Siri ya Afrika Mji wa kisasa) == Viungo vya nje == {{Commons}} * [http://www.asmera.nl/asmara.htm Historia ya Asmara] (makala nzuri kwa intaneti) * [http://www.holmeinafrica.com HolmeInAfrica] {{Wayback|url=http://www.holmeinafrica.com/ |date=20111214044220 }} wawili wa VSO wajitoi waliishi mwaka mmoja Asmara, Eritrea {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Eritrea]] [[Jamii:Eritrea]] [[Jamii:Asmara| ]] [[Jamii:Urithi wa Dunia]] 1bjh2nq0sucwi2h3b3zq1rrh5ipsoph 1577980 1577944 2026-07-02T13:30:22Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577980 wikitext text/x-wiki [[Picha:Asmara Montage.png|thumbnail|right|200px|Muonekano wa Mji wa Asmara]] {{Infobox Settlement |jina_rasmi = Jiji la Asmara |picha_ya_satelite = Asmara-Panorama.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Eritrea]] |subdivision_type1 = [[:en:Regions of Eritrea|Eneo]] |subdivision_name1 = [[:en:Maekel Region|Maekel]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} '''Asmara''' (pia '''Asmera''') ni [[mji mkuu]] na makazi makubwa nchini [[Eritrea]], watu 579,000 wakiwa wanaishi mjini humu. [[Nguo]], nyama, [[pombe]], [[viatu]] na [[seramiki]] ni mojawapo ya vifaa vinavyotoka mji wa Asmara. Asmara yenyewe kijiografia iko 15°20' kaskazini, 38°55' mashariki (15.333, 38.91667). Mji umo katika orodha ya [[urithi wa dunia]] ya [[UNESCO]]. == Historia == Asmara ilianza kutoka vijiji vinne [[karne ya 12]] kama [[eneo la biashara]] na baadaye kama mji wa [[Ras Alula]]. Ilitawaliwa na [[Waitalia]] tangu mwaka [[1889]] na kuwa Mji Mkuu [[1897]] wa [[koloni]] la Eritrea. Miaka ya 1930 Waitalia waligeuza mji kwa majengo mapya; Asmara iliitwa na Waitalia "Piccola Roma" (Roma mdogo). Siku hizi majengo makubwa zaidi ya Asmara ni ya Kiitalia, na maduka bado yana majina ya [[Kiitalia]], mfano - "Bar Vittoria", "Pasticceria moderna", "Casa del formaggio", "Ferramenta". Siku za vita vya uhuru wa Eritrea kutoka [[Ethiopia]], [[Uwanja wa ndege wa Asmara]] ulikuwa mhimu sana, Waethiopia walitumia uwanja huo kupata silaha kutoka ng'ambo. Mji wa mwisho kuanguka kwa [[Jeshi ya ukombozi wa Eritrea]] ulitekwa mwaka [[1990]] na kusalimishwa na [[Jeshi ya Ethiopian]] bila vita mnamo [[24 Mei]] [[1991]]. == Hulka == Mji wenyewe una [[makumbusho]] na unajulikana kwa majengo ya [[karne ya 20]], [[sanaa ya Deco]], [[sinema Impero]], [[Ujenzi wa Kubisti|Kubisti]], [[Pensheni Afrika]], [[Kanisa kuu]] la [[Tewahedo]], [[Nyumba ya Opera]], [[ujenzi wa umbele]], [[jengo la Fiat Tagliero]], [[jengo la neo-Romanesque]], kanisa kuu la [[Kanisa Katoliki]] na [[ujenzi wa kupendeza]]. Asmara pia ni nyumbani kwa [[Chuo kikuu cha Asmara]] na [[gome]] ya [[karne ya 19]]. Kituo cha ndege, [[Uwanja wa Kimataifa wa Asmara]], kimeungana pia na bandari ya [[Massawa]] kwa [[Reli ya Eritrea]]. Asmara ni makao makuu ya [[Patriarki]] wa [[Kanisa la Kiorthodoksi la Eritrea]], lililokubaliwa na Patriarki wa [[Aleksandria]] ([[Misri]]) kuwa linajitegemea tangu mwaka [[1993]] na kuongozwa na Patriarki wake tangu mwaka [[1998]], sawa na [[Kanisa la Kiorthodoksi la Ethiopia]] ambalo pia linakiri umoja wa nafsi wa [[Yesu Kristo]] ([[Tewahedo]]). == Uchambuzi == * Edward Denison, Guang Yu Ren, Naigzy Gebremedhin and Guang Yu Ren - ''Asmara: Africa's Secret Modernist City'' (2003) ISBN 1-85894-209-8 (Siri ya Afrika Mji wa kisasa) == Viungo vya nje == {{Commons}} * [http://www.asmera.nl/asmara.htm Historia ya Asmara] (makala nzuri kwa intaneti) * [http://www.holmeinafrica.com HolmeInAfrica] {{Wayback|url=http://www.holmeinafrica.com/ |date=20111214044220 }} wawili wa VSO wajitoi waliishi mwaka mmoja Asmara, Eritrea {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Eritrea]] [[Jamii:Eritrea]] [[Jamii:Asmara| ]] [[Jamii:Urithi wa Dunia]] rowp8beucxjuk9eftx1yk108canp6cn 0 2751 1578001 1243884 2026-07-02T14:18:51Z Riccardo Riccioni 452 /* Viungo vya Nje */ 1578001 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jamestown |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Saint Helena]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:02 Last view of Jamestown St Helena June1970.jpg|300px|thumb|Jamestown mwaka [[1970]] inavyoonekana kutoka baharini]] [[Picha:Saint helena sm98.png|thumb|300px|right|Jamestown kisiwani [[Saint Helena]].]] '''Jamestown''' ni [[bandari]] na [[mji mkuu]] wa [[eneo la ng'ambo la Uingereza]] linaloundwa na [[Kisiwa|visiwa]] vidogo vya [[Saint Helena]], [[Ascension]] na [[funguvisiwa]] la [[Tristan da Cunha]]. Mji uko kisiwani St. Helena katika [[bahari ya Atlantiki]] takriban [[km]] 1.868 kutoka pwani ya [[Angola]]. [[Idadi]] ya wakazi inakaribia 1,000. Mji wenyewe ni hasa barabara moja yenye nyumba za aina ya ujenzi wa kikoloni cha Kiingereza. ==Historia== Jamestown ilianzishwa mwaka [[1659]] na [[Kampuni ya Kiingereza ya India ya Mashariki]]. Miaka ya nyuma bandari ya Jamestown ilikuwa kituo muhimu cha safari za [[jahazi]] kubwa kati ya Uingereza, [[Afrika Kusini]] na [[India]]. Jina limetokana na jina la mfalme [[James II]] wa [[Uingereza]] na [[Uskoti]] (James VII kama mfalme wa Uskoti). Zamani wafanyabiashara wengi walipeleka dhahabu yao hadi St. Helena kwa sababu kisiwa kilikuwa na sifa ya kuwa mahali pa usalama kwa kutunza dhahabu. Haya yote imepungua hadi kupotea kabisa kwa sababu za mabadiliko ya teknolojia za benki na pia ya usafiri. Leo hii kuna meli tu ya [[RMS St Helena]] inayofika takriban mara 2 kwa mwezi ikitumia siku 4-5 kwa ajili ya safari hadi Afrika Kusini. Idadi ya wakazi wa Jamestown imeendelea kupungua. == Viungo vya Nje == * {{cite web|url=http://www.btinternet.com/~sa_sa/st_helena/st_helena_jamestown.html|title=St Helena - Jamestown|archiveurl=https://archive.today/20110604234722/http://www.btinternet.com/~sa_sa/st_helena/st_helena_jamestown.html|archivedate=2011-06-04|accessdate=2006-12-16}} {{list of African capitals}} [[Jamii:Saint Helena]] [[Jamii:Miji Mikuu Afrika]] fctzz1i38x780k5nvzrfhfvwq94z9n3 0 2785 1577974 1426748 2026-07-02T13:25:11Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577974 wikitext text/x-wiki [[Picha:Addis Ababa montage.jpg|thumbnail|right|300px|Jiji la Addis Ababa]] {{Infobox Settlement |jina_rasmi = Jiji la Addis Ababa |picha_ya_satelite = ET Addis asv2018-01 img07 Light Rail.jpg |pushpin_map = Ethiopia |pushpin_map_caption = Mahali pa mji wa Addis Ababa katika Ethiopia |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Ethiopia]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 3,352,000 |latd=9 |latm=1 |lats=48 |latNS=N |longd=38 |longm=44 |longs=24 |longEW=E |website = [http://www.addisababacity.gov.et/ www.addisababacity.gov.et] }} [[Picha:Ethiopia.png|thumbnail|right|260px|Ramani ya Ethiopia ikionyesha Addis Ababa ilipo.]] [[Picha:Addisababanasa.jpg|thumbnail|right|260px|Addis Ababa, inavyoonekana kutoka angani.]] [[Picha:Ethiopia 3.jpg|thumbnail|right|Zaidi ya asilimia 51 ni wanawake.]] '''Addis Ababa''' (pia '''Addis Abeba'''; kwa [[Kiamhara]] አዲስ አበባ, "Ua Jipya"; kwa [[Kioromo]] ''Finfinne'') ni [[mji mkuu]] wa [[Ethiopia]] na wa [[Umoja wa Afrika]]. Ina hadhi ya mji wa kujitawala (''ras gez astedader'') kama [[jimbo la Ethiopia]]. [[Mji]] wenyewe una watu kutoka [[kabila|makabila]] 80, wakiongea [[lugha]] 80, na jamii za [[Waislamu]] na [[Wakristo]]. Addis Ababa iko [[mita]] 2,500 juu ya [[usawa wa bahari]] kwa {{coor d|9.03|N|38.74|E|city(2757729)}}). <ref>{{Rejea tovuti |url=http://earth-info.nga.mil/gns/html/cntry_files.html | title = World-Gazeteer|accessdate=2006-05-14 |archiveurl=https://web.archive.org/web/20110325175559/http://earth-info.nga.mil/gns/html/cntry_files.html |archivedate=2011-03-25 }}</ref> Mwaka [[2016]], idadi ya wakazi ilikuwa 3,352,000 <ref>{{Rejea tovuti |url=http://www.world-gazetteer.com/wg.php?x=1120021314&men=gpro&lng=en&gln=xx&dat=32&geo=-73&srt=npan&col=aohdq&pt=c&va=&geo=356529874 | title = World-Gazeteer|accessdate=2006-05-14 |archivedate=2007-10-01 |archiveurl=https://web.archive.org/web/20071001011529/http://www.world-gazetteer.com/wg.php?x=1120021314&men=gpro&lng=en&gln=xx&dat=32&geo=-73&srt=npan&col=aohdq&pt=c&va=&geo=356529874 }}</ref>, na kwa hiyo Addis Ababa ndio mji mkubwa nchini. Eneo hii lilichaguliwa na [[Malkia]] [[Taytu Betul]] na mji kuanzishwa mwaka wa [[1886]] na mume wake, [[Mfalme]] [[Menelik II wa Ethiopia|Menelik II]], na sasa mji huu una umma milioni nne, na asilimia nane ya ukuzi wa uchumi. Mji huu uko kwenye [[Mlima Entoto]] na ni makazi maalum ya [[Chuo Kikuu cha Addis Ababa]]. Chuo Kikuu cha Addis Ababa kilijulikana kama Chuo Kikuu cha [[Haile Selassie I]], kutokana na jina la Mfalme wa mwisho wa Ethiopia, ambaye alitoa jumba la mfalme (Jumba Guenete Leul) liwe makao maalum ya Chuo Kikuu cha Addis Ababa mwaka wa 1961. == Historia == Addis Ababa ilianzishwa na Mfalme wa Ethiopia [[Menelik wa Pili|Menelik II]]. Menelik, kama mfalme wa [[Shewa]], aligundua mlima Entoto kama kambi nzuri sana ya jeshi ili kumiliki upande wa kusini, na mwaka wa [[1879]] alitembea kwa mibomoko ya kale ya mji huu, na kuona [[kanisa]] ambalo [[ujenzi]] haukuwa umemalizwa, kuthibati kuwa Waethiopia waliishi katika mji huu kabla ya [[vita]] za [[Ahmad ibn Ibrahim al-Ghazi|Ahmad Gragn]]. Masilahi ya Menelik wa pili yaliongezeka, [[mke]] wake alipoanza kazi ya ujenzi wa kanisa eneo la Entoto, na Menelik kuamrisha kanisa la pili eneo hilo. Lakini eneo hilo halikutua kuwa mji haraka kwa sababu ya ukosefu wa [[kuni]] na [[maji]], na makazi hasa yalianzia katika bonde kusini mwa mlima mwaka wa [[1886]]. Mwanzo, [[Malkia]] Taytu alijijengea [[nyumba]] karibu na "Filwoha", [[Chemchemi (maana)|chemchem]] moto iliyo na [[madini]], ambayo yajulikana na wenyeji [[Waoromo]] kama Finfinne, Malkia Taytu na watumishi Washowan wa kifalme walipenda sana kuoga kwa maji hayo yaliyo na madini. Washarifu wengine na watumishi na mali yao, wao pia walikaa sehemu hii, na Menelik kuongeza jumba la mke wake, ili iwe Jumba Rasmi la Miliki ambayo ndio makazi rasmi ya serikali Addis Ababa mpaka leo. Menelik wa pili kaanza Addis Ababa kama Mji Mkuu wa Ethiopia. Mojawapo ya maendeleo Menelik alifanya ni kama kupanda [[miti]] ya [[mkaratusi]] kwa mitaa kando ya [[barabara]]. Mwaka wa [[1936]], [[jeshi]] la [[Waitalia]] lilitwaa Addis Ababa kwa [[Vita vya Pili vya Italia na Uhabeshi]], na kuifanya mji mkuu wa [[Afrika Mashariki ya Kiitalia]]. Addis Ababa iliongozwa na [[gavana]] kutoka mwaka wa 1936 mpaka [[1939]]. Baadaye Waitalia walipingwa na [[wazalendo]] wa Ethiopia na pia kushindwa vitani na Waethiopia kwa usaidizi wa [[Waingereza]] katika [[Vita vya Pili vya Dunia Afrika Mashariki|kampeni ya Afrika Mashariki]] na pia [[ukombozi wa Ethiopia]], Mfalme [[Haile Selassie]] alirudi Addis Ababa tarehe [[5 Mei]] [[1941]], baada ya miaka mitano kamili, na kuanza kazi ya kuendeleza mji mkuu wake. Mfalme Haile Selassie alisaidia kuanzisha [[OAU|Organizesheni ya Umoja wa Afrika]] mwaka [[1963]] akaikaribisha kuwa na [[makao makuu]] mjini. Ilipogeuka kuwa [[Umoja wa Afrika]] mwaka [[2002]], makao yakabaki yaleyale. ==Tazama pia== * [[Orodha ya miji ya Ethiopia]] == Marejeo == {{reflist}} == Viungo vya nje == {{commons|Category:Addis Abeba|Addis Abeba}} * {{wikivoyage}} {{en}} * [http://www.addisababacity.gov.et/ Tovuti rasmi] {{Wayback|url=http://www.addisababacity.gov.et/ |date=20140724161217 }} * [http://www.citymayors.com/mayors/addis_mayor.html Support for Mayor’s overhaul of Addis Ababa] * [http://www.ethiopar.net/English/basinfo/infoadds.html Addis Ababa City Council] {{Wayback|url=http://www.ethiopar.net/English/basinfo/infoadds.html |date=20070607162404 }} * [http://www.macalester.edu/courses/geog61/kshively/intro.html Introduction to Addis Ababa] {{Wayback|url=http://www.macalester.edu/courses/geog61/kshively/intro.html |date=20070209083024 }} {{Mikoa ya Ethiopia}} {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Ethiopia]] [[Jamii:Ethiopia]] [[Jamii:Addis Ababa| ]] [[Jamii:Majimbo ya Ethiopia]] l7vmtiap85ryjbsm7ign37o89d71w45 0 2789 1577994 1567120 2026-07-02T14:16:21Z Riccardo Riccioni 452 /* Marejeo */ 1577994 wikitext text/x-wiki {{Infobox settlement |jina_rasmi = Jiji la Dodoma <!-- Picha na ramani -----------> |picha_ya_makazi = Beautiful sunset in Dodoma University Tanzania.jpg |maelezo_ya_picha = |ramani_pini = Tanzania<!-- jina la nchi --> |maelezo_ramani_pini = <!-- Ngazi ya serikali ------------------> |ngazi_ya_serikali = [[Nchi]]<!-- [[Nchi]] --> |jina_la_serikali = [[Tanzania]]<!-- jina la nchi --> |ngazi_ya_serikali1 = [[:Jamii:Mikoa ya Tanzania|Mkoa]] |jina_la_serikali1 = [[Mkoa wa Dodoma]] |ngazi_ya_serikali2 = Halmashauri |jina_la_serikali2 = Halmashauri ya jiji la Dodoma |ngazi_ya_serikali3 = Kata |jina_la_serikali3 = 41 |ngazi_ya_serikali4 = Mitaa |jina_la_serikali4 = 222 <!-- Siasa -----------------> |aina_ya_serikali = Halmashauri ya jiji |cheo_cha_kiongozi = Mstahiki Meya |jina_la_kiongozi = Davis G. Mwamfupe |cheo_cha_kiongozi1 = Mkurugenzi wa Jiji |jina_la_kiongozi1 = Joseph C. Mafuru |tarehe_iliyoanzishwa = 1980 |maelezo_serikali = |marejeleo_ya_serikali ={{r|Dodoma}} |majiranukta = {{coord|6|10|23|S|35|44|31|E|region:TZ|display=inline}} <!-- Idadi ya Wakazi -----------------------> |idadi_wakazi_mwaka = 2022 |wakazi_kwa_ujumla = 765179 |marejeo_ya_wakazi = https://www.nbs.go.tz |msimbo_posta = 411xx |kodi_ya_simu = 026 |kanda_muda = [[Saa za Afrika Mashariki|EAT]] |tofauti_ya_UTC = +3 |tovuti = {{URL|https://dodomacc.go.tz/ |Halmashauri ya Jiji la Dodoma}} }} [[Picha:Tanzania CIA map.gif|thumb|Mkuwa wa Dodoma]] '''[[Dodoma]]''' {{Audio-IPA|Dodoma_Audio.ogg|Matamshi}} ni [[mji mkuu]] wa [[Tanzania]] na pia ni [[Jiji]].Ilitangazwa kuwa [[mji mkuu]] wa [[Tanzania]] mwaka [[1973]], lakini mnamo [[tarehe]] [[26 Aprili]] [[2018]] katika maadhimisho ya [[miaka]] 54 ya muungano wa [[Tanganyika]] na [[Zanzibar]], [[rais]] wa [[Jamhuri ya Muungano wa Tanzania]] wa awamu ya tano [[John Magufuli]] aliupandisha hadhi na kutangaza rasmi kuwa Dodoma ni [[Jiji]].<ref>https://www.ikulu.go.tz/index.php/media/press_release# {{Wayback|url=https://www.ikulu.go.tz/index.php/media/press_release |date=20180302165126 }} tovuti ya ikulu iliangaliwa tar 26 April 2018</ref><ref>https://globalpublishers.co.tz/rais-magufuli-atangaza-dodoma-kuwa-jiji-video iliangaliwa 26 Aprili 2018</ref> <ref>https://www.youtube.com/watch?v=FPqrlspV0zI iliangaliwa 26 Aprili 2018</ref><ref>https://www.youtube.com/watch?v=TWdZAa_-syQ iliangaliwa 26 Aprili 2018</ref><ref>https://www.habarileo.co.tz/index.php/habari-za-kitaifa/24212-dodoma-yasubiri-baraka-kuwa-jiji {{Wayback|url=https://www.habarileo.co.tz/index.php/habari-za-kitaifa/24212-dodoma-yasubiri-baraka-kuwa-jiji |date=20180426213538 }} iliangaliwa 26 Aprili 2018</ref> Ofisi kuu za wizara na taasisi nyingi za [[serikali]] hatimaye zilihamia Dodoma katika miaka [[2016]] - [[2019]].<ref>http://www.mwananchi.co.tz/habari/Serikali-kuhamia-Dodoma/1597578-3295558-wvnu7h/index.html</ref><ref>{{Rejea tovuti |url=https://swahilitimes.com/picha-serikali-yahamia-dodoma-kwa-kutumia-magari-ya-jeshi/ |title=Nakala iliyohifadhiwa |accessdate=2018-04-26 |archiveurl=https://web.archive.org/web/20170126104045/http://swahilitimes.com/picha-serikali-yahamia-dodoma-kwa-kutumia-magari-ya-jeshi/ |archivedate=2017-01-26 }}</ref> Jiji hili pia ni [[makao makuu]] ya [[Mkoa wa Dodoma]] na eneo lake linahesabiwa kama '''Wilaya ya Dodoma''' yenye [[postikodi]] [[namba]] '''41100'''<ref>{{Rejea tovuti |url=https://www.tcra.go.tz/images/documents/postcode/dodoma.pdf |title=Nakala iliyohifadhiwa |accessdate=2017-10-07 |archiveurl=https://web.archive.org/web/20200321135312/https://www.tcra.go.tz/images/documents/postcode/dodoma.pdf |archivedate=2020-03-21 }}</ref>. Eneo la mji liko [[mita]] 1135 juu ya usawa wa bahari [[UB]]. Wakati wa [[sensa]] iliyofanyika mwaka wa [[2012]], mji wa Dodoma ulikuwa na wakazi wapatao 410,956 waishio humo.{{r|Sensa_2012|p=17}} Mwaka [[2022]] walihesabiwa 765,179 <ref>https://www.nbs.go.tz</ref>. == Asili ya jina == Neno "Dodoma" linasemekana kumetokana na [[neno]] la [[Kigogo]] "dodomia" kufuatilia historia kwamba zamani kuna [[tembo]] alikuja pale mjini akakita [[wayo|nyayo]] zake ardhini akiacha alama ya nyayo zake zimedidimia. == Historia == Dodoma ilianzishwa mwaka 1910<ref>Deutsches Kolonial-Lexikon (1920), vol I, uk. 529 ff., makala "Eisenbahnen" ( I. Deutsch-Ostafrika, b) Mittellandbahn)([http://www.ub.bildarchiv-dkg.uni-frankfurt.de/Bildprojekt/Lexikon/php/suche_db.php?suchname=Eisenbahnen online hapa] {{Wayback|url=http://www.ub.bildarchiv-dkg.uni-frankfurt.de/Bildprojekt/Lexikon/php/suche_db.php?suchname=Eisenbahnen |date=20210610014712 }})</ref> wakati wa [[Afrika ya Mashariki ya Kijerumani|ukoloni wa Kijerumani]] kama kituo kwenye reli ya kati penye [[karahana]] ya reli. Tangu mwaka [[1912]] imekuwa makao makuu ya [[Mkoa wa Dodoma (DOA)|Mkoa wa Dodoma wa D.O.A.]]. Mwaka [[1913]] Dodoma ilikuwa na [[posta]], [[simu]], [[hoteli]] na [[duka|maduka]] 26 (moja ya [[Mzungu]], mengine ya [[Wahindi]] na [[Waarabu]]). Kikosi cha [[polisi]] kilikuwa na [[askari]] 59. Dodoma imeendelea kuwa mji mdogo mpaka kutangazwa kuwa mji mkuu. Azimio hili lilileta [[ujenzi]] wa maofisi kadhaa ya [[serikali]]. Kwa ujumla uhamisho ulichelewa kwa sababu mbalimbali; sababu muhimu ni ya kwamba watumishi wa serikali na [[wanasiasa]] walio wengi hawakupenda kuondoka katika [[jiji]] halisi na kuhamia mji ambao ni mbali sana na [[mazingira]] waliyoyazoea. Pia matatizo ya [[fedha|kifedha]] yalisaidia kutangaza nia ya kuhamia lakini kubaki palepale. Hali halisi [[bunge]] lilikuwa linakutana Dodoma lakini makao ya kikazi ya serikali ya Tanzania yalibaki [[Dar Es Salaam]] pamoja na [[ikulu]] ya [[rais]] hadi mwaka [[2016]]. Ndipo kwa amri ya rais mpya, [[John Magufuli]], sehemu kubwa ya ofisi za [[wizara]] zimepelekwa Dodoma. Ofisi nyingi zimejengwa katika kata ya [[Mtumba]], takriban kilomita 30 utoka kitovu cha jiji<ref>[https://www.thecitizen.co.tz/news/1840340-5309466-9rei7r/index.html President Magufuli: I’ve finally moved to Dodoma]; Citizen 13.10.2019, lookup Juni 2022</ref>. ==Uchumi== [[Uchumi|Kiuchumi]] ni [[kitovu]] cha kilimo na [[biashara]] ya [[karanga]], [[maharagwe]], [[alizeti]] na [[mizabibu]], pamoja na [[mifugo]] na [[kuku]]. Pia Dodoma ni mji unaosifika kwa ulimaji wa [[zabibu]] na uvunaji wa [[ubuyu]]. ==Elimu== [[Elimu]] inahitaji kuboreshwa, hasa maeneo ya [[Kijiji|vijijini]], maana ndio mji mkuu: hivyo kunahitajika kuboreshwe zaidi. == Mawasiliano == [[Mawasiliano]] ni mazuri kwa [[barabara]] ya [[lami]] kuanzia mji wa Dodoma kwenda [[Morogoro (mji)|Morogoro]] - [[Dar Es Salaam]], pamoja na njia kuu kuelekea Tanzania ya Magharibi - [[Rwanda]] - [[Kongo]] na barabara ya kale ya "[[Cape Town]] - [[Cairo]]" inayopitia Dodoma kutoka kaskazini ([[Arusha (mji)|Arusha]] - [[Kondoa]]) kwenda kusini ([[Iringa (mji)|Iringa]]). Barabara nyingine ni za [[udongo]] tu. Kuna pia njia ya [[reli ya kati]] kutoka Dar es Salaam kwenda [[Kigoma]] yenye matatizo ya mara kwa mara. Dodoma ina [[uwanja wa ndege]] wa kitaifa na [[vyuo vikuu]], kikiwemo kile kikubwa zaidi [[Afrika Mashariki]]. Dodoma kuna makao makuu ya [[Kanisa la Biblia Publishers]] pamoja na [[Emmaus Shule ya Biblia]]. ==Picha== <gallery class="float-right" perrow="3" widths="250px"> File:Nyerere Square in Dodoma.jpg|Uwanja wa [[Nyerere]] File:University of Dodoma.jpg|[[Chuo Kikuu cha Dodoma]] File:000 1333 Dodoma Cathedral.JPG|[[Kanisa Kuu]] la [[Anglikana]] File:Klb_dodoma.jpg|Kanisa la [[Biblia]] </gallery> == Tazama pia == {{Lango|Tanzania}} * [[Chuo Kikuu cha Dodoma]] ==Marejeo== {{marejeo|refs= <ref name=Sensa_2012>{{Rejea tovuti |url=http://tanzania.countrystat.org/fileadmin/user_upload/countrystat_fenix/congo/docs/Census%20General%20Report-2012PHC.pdf |title=Ripoti ya Sensa 2012 |accessdate=2022-07-03 |archiveurl=https://web.archive.org/web/20220326183741/http://tanzania.countrystat.org/fileadmin/user_upload/countrystat_fenix/congo/docs/Census%20General%20Report-2012PHC.pdf |archivedate=2022-03-26 |language=en |url-status=live}}</ref> <ref name="Dodoma">{{Rejea tovuti |url=https://dodomacc.go.tz/ |title=Halmashauri ya Jiji la Dodoma |archiveurl=https://web.archive.org/web/20220619023750/https://www.dodomacc.go.tz/ |archivedate=21 Juni 2022 |language=sw |url-status=live}}</ref> }} {{Kata za Wilaya ya Dodoma mjini}} {{list of African capitals}} [[Jamii:Dodoma|*]] [[Jamii:Miji ya Tanzania]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:wilaya ya Dodoma Mjini]] dboz5n8wrm71s5cn32n029hgx5z6bxk 0 2800 1578035 1334131 2026-07-02T14:42:01Z Riccardo Riccioni 452 /* Tazama pia */ 1578035 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Tripoli |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Libya]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:LibyaTarabulus.png|thumb|Mahali ilipo Tripoli katika [[ramani]] ya Libya.]] <small>''Kwa miji mingine inayoitwa "Tripoli" tazama makala ya maana [[Tripoli]]''</small> '''Tripoli''' ni [[mji mkuu]] wa [[Libya]]. [[Jina]] la [[Kiarabu]] ni '''طرابلس''' (''tarāblus'') au '''طرابلس الغربية''' (''tarābulus al-gharbiyya'' - Tripoli ya Magharibi kwa sababu ya [[Tripoli ya mashariki]] huko [[Lebanon]]) lina [[asili]] ya lugha ya [[Kigiriki]] (Τρίπολη) likimaanisha "miji mitatu". Tripoli ina wakazi 1,150,990 ambayo ni zaidi ya [[robo]] [[moja]] ya wakazi wote wa Libya na inaendelea kukua haraka. [[Jiji]] hilo liko [[ufuko|ufukoni]] mwa [[bahari]] ya [[Mediteranea]] likiwa na [[hali ya hewa]] ya wastani. Mwezi [[Agosti]] inafika [[halijoto]] ya [[sentigredi]] 28,1°, [[Januari]] sentigredi 12,1°. Miezi ya [[baridi]] kuna [[mvua]], [[Juni]] hadi Agosti ni [[majira]] ya [[kiangazi]]. Tripoli ina [[bandari]] kubwa kabisa ya Libya na pia ni [[kitovu]] cha [[serikali]], [[biashara]] na [[viwanda]]. Tripoli ni mji wa kale ambao bado [[historia]] yake imetunzwa ikionyesha mabaki ya historia yake ndefu tangu enzi za [[Wafinisia]], [[Waroma]], [[Waarabu]], [[Hispania|Wahispania]], [[Uturuki|Waturuki]] na [[Italia|Waitalia]]. == Picha za Tripoli == <gallery> Image:Tripolilibyanasa.jpg|Tripoli na bandari yake inavyoonekana kutoka angani Image:Grand Hotel Tripoli.jpg|Hoteli Al Kabir (Grand Hotel) Image:Modern Tripoli.jpg|Majengo ya kisasa </gallery> ==Tazama pia== * [[Orodha ya miji ya Libya]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Libya]] [[Jamii:Miji ya Libya]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya pwani ya Mediteranea]] [[Jamii:Tripoli (Libya)| ]] q4ppbyi725acrts757vlnye476vyact 0 2804 1578020 1065795 2026-07-02T14:35:00Z Riccardo Riccioni 452 /* Tazama pia */ 1578020 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Mogadishu |picha_ya_satelite = |pushpin_map = Somalia |pushpin_map_caption = Mahali pa mji wa Mogadishu katika Somalia |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Somalia]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 2 590 000 |latd=2 |latm=2 |lats=34 |latNS=N |longd=45 |longm=20 |longs=18 |longEW=E |website = }} [[Picha:An abandoned MOGADISHU Street known as the Green Line, Jan 1993.JPEG|thumb|300px|right|Barabara ya Mogadishu inayotenganisha sehemu za kaskazini na kusini za mji pamoja na maeneo ya vikosi tofauti ya wanamgambo (1993).]] [[Picha:Black Hawk Down Super64 over Mogadishu coast.jpg|thumb|right|[[Helikopta]] ya Marekani juu ya [[bandari]] ya Mogadishu 1993.]] '''Mogadishu''' (kwa [[Kisomali]] Muqdisho; kwa [[Kiitalia]] Mogadiscio) ni [[mji mkuu]] wa [[Somalia]]. Iko ufukoni wa [[Bahari Hindi]] ikiwa na wakazi [[milioni]] 2.590 ([[2017]]). ==Historia== Mogadishu imeundwa mnamo [[mwaka]] [[900]] [[BK]] ikawa [[mji]] wa [[kaskazini]] kabisa wa [[utamaduni]] wa [[Waswahili]] kwenye [[pwani]] ya [[Afrika ya Mashariki]]. Ilikuwa sehemu ya [[biashara]] ya kimataifa ya Waswahili jinsi inavyonekana kutokana na [[sarafu]] za kale za [[Uchina]], [[Sri Lanka]] na [[Vietnam]] zilizokutwa na [[wanaakiolojia]] katika [[ardhi]] yake. [[Msafiri]] [[Mwarabu]] [[Ibn Battuta]] alitembelea Mogadishu mnamo mwaka [[1300]] akaona [[tajiri|matajiri]] akataja "watu wanene wengi". Mji ulikuwa na vipindi vya kujitegemea na vipindi vya kutawaliwa na nchi za nje katika [[historia]] yake. Mnamo mwaka [[1500]] [[Wareno]] walikuwa mabwana wake. Tangu katikati ya [[karne ya 19]] Mogadishu ilikuwa chini ya [[sultani]] wa [[Zanzibar]]. Mwaka [[1892]] sultani alikodisha mji kwa [[Italia]] iliyoinunua kutoka kwake mwaka [[1905]] ukawa mji mkuu wa [[koloni]] la [[Somalia ya Kiitalia]]. Wakati wa [[Vita Kuu ya Pili ya Dunia]] mji ulivamiwa na [[Waingereza]] mwaka [[1941]] waliourudisha kwa Italia mwaka [[1954]]. Tangu [[uhuru]] ([[1960]]) Mogadishu ikawa mji mkuu wa Somalia. Mwaka [[1990]] [[dikteta]] [[Siad Barre]] alipinduliwa halafu Mogadishu pamoja na nchi yote iliingia katika [[vita vya wenyewe kwa wenyewe]]. [[Wanajeshi]] wa [[Marekani]] walijaribu mwaka [[1993]] kurudisha hali ya usalama kwa niaba ya [[Umoja wa Mataifa]] lakini walikuta upinzani mkali kutoka kwa vikundi vya [[wanamgambo]] Wasomalia. Baada ya kupoteza askari Marekani iliondoka tena. Hali ya vita imeendelea hadi mwaka [[2012]], na kwa muda mrefu nchi ikiwa haina [[serikali]] wala [[bunge]] na [[uharamia]] ulishamiri. ==Tazama pia== * [[Orodha ya miji ya Somalia]] {{list of African capitals}} {{mbegu-jio-Somalia}} [[Jamii:Somalia]] [[Jamii:Miji ya Somalia]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Mogadishu| ]] rj29yj07aduhxa0o48nreipsbvp6kby 0 2808 1578037 1434156 2026-07-02T14:42:49Z Riccardo Riccioni 452 /* Tazama pia */ 1578037 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Victoria |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Shelisheli]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 22,881 |website = }} [[Picha:Victoria (Seychelles).jpg|thumb|300px|right|Mji wa Victoria]] [[Picha:BigBenVictoriaSeychelles.JPG|thumb|left|Mbele: mfano mdogo wa mnara wa "Big Ben" wa London katika mji wa Victoria; nyuma jengo la wizara ya sheria]] '''Victoria''' ni [[mji mkuu]] na [[mji]] mkubwa wa [[Shelisheli]]. Uko kwenye [[kisiwa]] cha [[Mahe]] ikiwa na wakazi 22,881 (2005). [[Bandari]] ya Victoria ni [[kitovu]] cha [[biashara]] ya kimataifa cha nchi. ==Tazama pia== * [[Orodha ya miji ya Shelisheli]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Shelisheli]] [[Jamii:Victoria (Shelisheli)| ]] kp1gksynz7v8kg882zph4nhccf35uzy 0 2811 1577979 1194051 2026-07-02T13:29:36Z Riccardo Riccioni 452 1577979 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Antananarivo |picha_ya_satelite = Antananarivo (atamari).jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Madagaska]] |subdivision_type1 = [[Mikoa ya Madagaska|Mkoa]] |subdivision_name1 = [[Analamanga]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 1 403 449 |website = [http://www.antananarivo.mg/ www.antananarivo.mg] }} [[Picha:MG-Antananarivo.png|thumb|right|125px|Mahali Antananarivo iko Madagaska]] [[Picha:Antananarivo Rova-Palast.jpg|thumb|260px|Antananarivo, Madagaska]] [[Picha: Lake Anosy, Central Antananarivo, Capital of Madagascar, Photo by Sascha Grabow.jpg|thumbnail|right|200px|Antananarivo kati, pia [[ziwa Anosy]].]] '''Antanànarìvo''' (matamshi [An/ta/na/ri/vo]) ni [[Mji Mkuu]] wa [[Madagaska]], kwa [[Mkoa wa Antananarivo]], wakazi 1,403,449 ([[2001]] sensa). Pia mji huu wajulikana kwa jina la [[Kifaransa]] kama '''Tananarive''' ama kwa kifupi ni '''Tana'''. Antanànarivo iko kati ya kisiwa kulingana na usabaa wa kisiwa, lakini ni maili 90 kutoka pwani ya magharibi. Mji mwenyewe una kituo cha amri, kinachojengwa juu ya milima na mabonde marefu yenye miamba na nyembamba. Hii milima na mabonde imesambaa kusini na kaskazini kama 2-½ maili, ikigawa kaskazini kwa njiapanda, na kukwea mahali juu zaidi pakiwa 690 ft. juu ya viwanja dhihirifu za mchele upande wa magharibi, ambazo zenyewe zimo 4060 ft. juu ya [[usawa wa bahari]]. Mji huu ni mji mkubwa nchini Madagaska na ni kituo cha amri ya serikali, mawasiliano, na kituo cha uchumi. Mahali Mji huu uko ni 18°55' Kusini, 47°31' Magharibi (-18.916667, 47.516667) [http://earth-info.nga.mil/gns/html/cntry_files.html] {{Wayback|url=http://earth-info.nga.mil/gns/html/cntry_files.html |date=20110325175559 }}, Maili 135 Magharibi-kusini magharibi ya Tamatave, ni bandari ya kisiwa hiki, ambayo imeungwa kwa reli, na kwa maili 60 kwa pwani kuna jahazi za kusafirisha. Viwanda vyahusu utolezi wa kuunda [[sigara]], na [[nguo]]. Antananarivo ilianza pengine mwaka wa [[1625]]. Kwa muda mrefu machifu wa kijiji cha Hova pekee, waliweza kujipa Uhuru kutoka sehemu nyingine za Madagaska, na kwa hivyo Antananarivo kuwa mji wa maana, na baadaye kuwa mji asili kwa kuongezeka wa wakazi 80,000. Mwaka wa [[1793]] mji huu ulifanywa uwe mji mkuu wa Wafalme wa [[Merina]]. Kushindwa kwa Mfalme [[Radama (wa kwanza)]] iliifanya Antananarivo iwe mji mkuu wa Madagaska yote. Mwaka wa [[1869]] majengo yote kwa mji asili, yalikuwa ya mbao ama nyazi, na hata hivyo mji wenyewe ulikuwa na Jumba za kifalme kubwa, kubwa zaidi ikiwa 120 ft. kwenda juu. Hili jumba lilataji sehemu ya bonde la kati; na jumba hili kubwa zaidi, dari na minara yake imepaa juu, na kwahivyo kuonekana kutoka sehemu zote. Kutoka uwanzo wa mawe na tofali, mji wote umejengwa na sasa kuna majengo ya aina nyingi na ya kuhifadhi, Jumba la Kifalme, Nyumba ambazo zilikuwa za Waziri mkuu na masharifu, makazi ya kifaransa, Kathidro ya Aglikan na Katoliki wa Kiromathe, Kanisa kadhaa za mawe na nyingine za matofali, Chuo, Shule, hospitali, Mahakama ya Sheria na Majengo ya Serikali, na nyumba nyingine za kuishi. Mji huu ulitekwa na [[Ufaransa|Wafaransa]] mwaka wa [[1895]] na kuwekwa kwa koloni ya eneo ya Madagaska. Kutoka ukoloni wa ufaransa barabara njema zilitengenezwa kwa mji, ngazi pana za kupaa kwa eneo ya mabonde zimeunganisha sehemu zile ziko kwa ukwea zaidi na ziwezi kuundwa barabara za kawaida, na sehemu ya kati inayoitwa ''Andohalo'', ni sehemu nzuri sana, ambayo inajia za kutembea na daraja za ukwea ambazo ni shamba za maua na miti. Hifadhi zimewekwa karibu na makazi ya watu, na upandaji wa miti na mashamba ya uhifadhi eneo nyingi za mji zaipatia mji urembo na utulifu. Maji ya patikana kwa chemchem chini ya milima lakini maji mengi yatoka kwa mto Ikopa, ambao mto huo wapitia kando ya Mji kusini na magharibi. Mji wenyewe umelindwa na Vigome viwili ambazo zilijengwa kwa mlima mashariki na kusini-magharibi. Pia kathidro ya Anglikani na katoliki ya kiroma, kuna Kanisa zaidi ya hamsini mjini na eneo za mji, na hata Miskiti za kiislamu. Antananarivo ni nyumbani kwa [[Chuo Kikuu cha Madagascar]] na Chuo cha Ambatobe ([[Collège Rural d'Ambatobe]]). ''Antanànarìvo'' yamaanisha "Mji wa Maelfu" (''arivo''=Elfu). Miaka ya ukoloni na hata miaka iliyofuatia Uhuru wa Madagaska, Antananarivo iliitwa '''Tananarive''. == Viungo vya nje == {{Commons}} * [http://www.antananarivo.mg/ Tovuti rasmi] {{Wayback|url=http://www.antananarivo.mg/ |date=20070330230740 }} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Madagaska]] [[Jamii:Analamanga]] [[Jamii:Antananarivo| ]] f2d0ziocli35bpd4zxdjnu4wkyjkqs8 0 2812 1578028 1433653 2026-07-02T14:38:01Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578028 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Port Louis |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Morisi]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[File:Coat of arms of Port Louis, Mauritius.svg|thumb|200px]] [[Picha:Port_Louis_Museum.jpg|thumbnail|200px|[[Jumba la Makumbusho|Makumbusho]] ya Port Louis]] [[Picha:Mauritius-Port Louis District.svg|thumb|Mahali pa wilaya ya Port-Louis katika kisiwa cha Morisi]] '''Port Louis''' ni [[mji mkuu]] wa [[jamhuri]] ya [[Morisi]]. Ukiwa na wakazi 170,000 ni [[mji]] mkubwa wa [[taifa]] hilo la [[Kisiwa|visiwani]] katika [[Bahari Hindi]]. Kiwanja cha ndege cha kimataifa cha Sir [[Seewoosagur Ramgoolam]] kipo km 30 kusini kwa mji. Kutoka Port Louis kuna [[feri]] kwenda [[Saint-Denis (Reunion)|Saint-Denis]], mji mkuu wa [[Réunion]]. Kuna [[Kiwanda|viwanda]] vya nguo na vitambaa pia vya kemikali na dawa. [[Benki]] ziko nyingi. Kwa jumla Port Louis ni mji ambao wenyeji wana hali ya maisha iliyo juu kushinda miji mingine ya [[Afrika]]. ==Tazama pia== * [[Orodha ya miji ya Morisi]] ==Viungo vya nje== * [http://www.mauritius.tours.online.fr/port.louis.htm] {{Wayback|url=http://www.mauritius.tours.online.fr/port.louis.htm |date=20070813070211 }} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Morisi]] [[Jamii:Port Louis| ]] [[Jamii:Miji ya Morisi]] 5szilfy4rmoso35xb9oscik9itnacbz 0 2820 1577970 1259364 2026-07-02T13:13:36Z Riccardo Riccioni 452 /* Tazama pia */ 1577970 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Wagadugu |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Burkina Faso]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 2,453,496 |website = }} [[Picha:ouagadougou_place_nations_unies.JPG|thumb|250px|Barabara katika kitovu cha Wagadugu karibu na uwanja wa Umoja wa Mataifa.]] '''Wagadugu''' (kwa [[Kifaransa]] huandikwa '''Ouagadougou''') ni [[mji mkuu]] wa [[Burkina Faso]], na pia [[mji]] mkubwa kabisa wa nchi hiyo na wa [[mkoa wa Centre, Burkina Faso|mkoa wa Centre]]. [[Mwaka]] [[2019]] [[idadi]] ya wakazi ilikuwa [[milioni]] 2,453,496, lakini mji unakua haraka. Wagadugu iko katika [[jimbo la Kadiogo]]. Kuna [[ofisi]] za [[serikali]] na viwanda kadhaa vya nguo na vyakula. Mji ni pia [[kitovu]] cha [[usafiri]] na [[mawasiliano]]. Kuna kiwanja cha kimataifa cha ndege na njia ya [[reli]] kwenda [[Abidjan]] ([[Côte d'Ivoire]]), halafu [[barabara]] za kwenda [[Lome]] ([[Togo]]), [[Bamako]] ([[Mali]]), [[Niamey]] ([[Niger]]), [[Accra]] ([[Ghana]]). Wagadugu ina [[chuo kikuu]] kilichokuwa chuo cha mwanahistoria maarufu [[Joseph Ki-Zerbo]]. Tamasha la kimataifa la filamu za Afrika ([[FESPACO]]) hufanyiwa Wagadugu. ==Tazama pia== * [[Orodha ya miji ya Burkina Faso]] {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Burkina Faso]] [[Jamii:Burkina Faso]] [[Jamii:Ouagadougou| ]] [[Jamii:Centre, Burkina Faso]] 7h6t5qme4tobppvn7tsacj4vpn0pj4j 1578027 1577970 2026-07-02T14:37:46Z Riccardo Riccioni 452 /* Tazama pia */ 1578027 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Wagadugu |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Burkina Faso]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 2,453,496 |website = }} [[Picha:ouagadougou_place_nations_unies.JPG|thumb|250px|Barabara katika kitovu cha Wagadugu karibu na uwanja wa Umoja wa Mataifa.]] '''Wagadugu''' (kwa [[Kifaransa]] huandikwa '''Ouagadougou''') ni [[mji mkuu]] wa [[Burkina Faso]], na pia [[mji]] mkubwa kabisa wa nchi hiyo na wa [[mkoa wa Centre, Burkina Faso|mkoa wa Centre]]. [[Mwaka]] [[2019]] [[idadi]] ya wakazi ilikuwa [[milioni]] 2,453,496, lakini mji unakua haraka. Wagadugu iko katika [[jimbo la Kadiogo]]. Kuna [[ofisi]] za [[serikali]] na viwanda kadhaa vya nguo na vyakula. Mji ni pia [[kitovu]] cha [[usafiri]] na [[mawasiliano]]. Kuna kiwanja cha kimataifa cha ndege na njia ya [[reli]] kwenda [[Abidjan]] ([[Côte d'Ivoire]]), halafu [[barabara]] za kwenda [[Lome]] ([[Togo]]), [[Bamako]] ([[Mali]]), [[Niamey]] ([[Niger]]), [[Accra]] ([[Ghana]]). Wagadugu ina [[chuo kikuu]] kilichokuwa chuo cha mwanahistoria maarufu [[Joseph Ki-Zerbo]]. Tamasha la kimataifa la filamu za Afrika ([[FESPACO]]) hufanyiwa Wagadugu. ==Tazama pia== * [[Orodha ya miji ya Burkina Faso]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Burkina Faso]] [[Jamii:Burkina Faso]] [[Jamii:Ouagadougou| ]] [[Jamii:Centre, Burkina Faso]] chch4vjdil7gsmc2lz9r4wtna0gxy7n 0 2827 1577987 1432972 2026-07-02T14:13:07Z Riccardo Riccioni 452 /* Tazama pia */ 1577987 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Bisau |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Guinea Bisau]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 387,909 |website = }} [[Picha:Guinea-Bissau Bissau.png|thumb|right|260px|Mahali pa Bisau nchini Guinea-Bisau]] [[Picha: Palácio_Presidencial_em_Bissau_(2).jpg|thumbnail|right|280px|Ikulu ya Bisau, Guinea]] '''Bisau''' ni [[mji mkuu]] wa nchi ya [[Guinea Bisau]] ukiwa na wakazi 387,909 <ref>{{cite web| url = http://citypopulation.de/GuineaBissau.html| title = Guinea-Bissau: Regions, Cities & Urban Localities – Population Statistics, Maps, Charts, Weather and Web Information}}</ref>. Bisau ni [[mji]] mkubwa wa nchi na [[kitovu]] wa [[utawala]], [[biashara]] na [[Kiwanda|viwanda]]. [[Biashara]] ya nje inayopita [[bandari]] ya Bisau hasa ni ubao, karanga, mafuta ya [[mawese]] na mpira. Bissau iko katika pwani ya Atlantiki kwenye [[delta]] ya [[mto]] [[Geba]]. Mji ulianzishwa na [[Ureno|Wareno]] mwaka 1687 kama [[boma]], bandari na kituo cha biashara. ==Tazama pia== * [[Orodha ya miji ya Guinea-Bissau]] ==Tanbihi== {{marejeo}} {{Commons|Bissau}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Guinea Bisau]] [[Jamii:Guinea Bisau]] [[Jamii:Bisau| ]] 916eerxbynn2hnnwrzhyktmkk3sx41w 0 2831 1577968 1434154 2026-07-02T13:10:03Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577968 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Sao Tome |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Sao Tome na Principe]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Sao-tome-u-principe-karte-politisch-sao-tome.png|400px|thumb|Mji wa Sao Tome kwenye kisiwa cha Sao Tome.]] [[Picha:Sao_tome_se.jpg|thumb|[[Kanisa kuu]].]] [[Picha:Sao_tome_fort.jpg|thumb|[[Boma]] la São Sebastião.]] [[Picha:Sao_tome_palace.jpg|thumb|[[Ikulu]] ya [[Rais]].]] '''Sao Tome''' ni [[mji mkuu]] wa [[nchi ya visiwa]] ya [[Sao Tome na Principe]], karibu na [[Afrika ya Magharibi]]. [[Jina]] limetokana na lile la [[Kireno]] la [[Mtakatifu Thoma]]. [[Mji]] ulianzishwa na [[Wareno]] mwaka [[1485]] kwenye [[pwani]] ya [[kaskazini]]-[[mashariki]] ya [[kisiwa]] [[Sao Tome (kisiwa)|chenye jina lilelile]] katika [[ghuba ya Guinea]]. Mji ulikuwa na wakazi 56,166 mwaka [[2005]]. Kuna [[uwanja wa ndege]] wa kimataifa na [[viwanda]] kadhaa ya ma[[tofali]], [[sabuni]] na [[vinywaji]]. Sao Tome ina [[shule za msingi]] hadi [[sekondari]], ma[[kanisa]], [[hospitali]] ya pekee nchini, vituo vya [[TV]] na [[redio]]. ==Tazama pia== * [[Orodha ya miji ya Sao Tome na Principe]] ==Viungo vya nje== {{Commons|São Tomé}} *{{dmoz|Regional/Africa/Sao_Tome_and_Principe|Sao Tome and Principe}} *[http://www.saotome.st www.saotome.st] - Facts about the country, how to get there, where to stay, what to do, images etc. *Local travel agency Navetur-Equatour - information&pictures http://www.navetur-equatour.st/ {{Wayback|url=http://www.navetur-equatour.st/ |date=20170419141618 }} {{Coord|0|20|10|N|6|40|53|E|type:city(56166)_region:ST}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Sao Tome na Principe]] [[Jamii:Sao Tome na Principe]] [[Jamii:Sao Tome (mji)]] mhnlc6157pxh5l3cjj3jy34vgm53iiv 1578034 1577968 2026-07-02T14:41:33Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578034 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Sao Tome |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Sao Tome na Principe]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Sao-tome-u-principe-karte-politisch-sao-tome.png|400px|thumb|Mji wa Sao Tome kwenye kisiwa cha Sao Tome.]] [[Picha:Sao_tome_se.jpg|thumb|[[Kanisa kuu]].]] [[Picha:Sao_tome_fort.jpg|thumb|[[Boma]] la São Sebastião.]] [[Picha:Sao_tome_palace.jpg|thumb|[[Ikulu]] ya [[Rais]].]] '''Sao Tome''' ni [[mji mkuu]] wa [[nchi ya visiwa]] ya [[Sao Tome na Principe]], karibu na [[Afrika ya Magharibi]]. [[Jina]] limetokana na lile la [[Kireno]] la [[Mtakatifu Thoma]]. [[Mji]] ulianzishwa na [[Wareno]] mwaka [[1485]] kwenye [[pwani]] ya [[kaskazini]]-[[mashariki]] ya [[kisiwa]] [[Sao Tome (kisiwa)|chenye jina lilelile]] katika [[ghuba ya Guinea]]. Mji ulikuwa na wakazi 56,166 mwaka [[2005]]. Kuna [[uwanja wa ndege]] wa kimataifa na [[viwanda]] kadhaa ya ma[[tofali]], [[sabuni]] na [[vinywaji]]. Sao Tome ina [[shule za msingi]] hadi [[sekondari]], ma[[kanisa]], [[hospitali]] ya pekee nchini, vituo vya [[TV]] na [[redio]]. ==Tazama pia== * [[Orodha ya miji ya Sao Tome na Principe]] ==Viungo vya nje== {{Commons|São Tomé}} *{{dmoz|Regional/Africa/Sao_Tome_and_Principe|Sao Tome and Principe}} *[http://www.saotome.st www.saotome.st] - Facts about the country, how to get there, where to stay, what to do, images etc. *Local travel agency Navetur-Equatour - information&pictures http://www.navetur-equatour.st/ {{Wayback|url=http://www.navetur-equatour.st/ |date=20170419141618 }} {{Coord|0|20|10|N|6|40|53|E|type:city(56166)_region:ST}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Sao Tome na Principe]] [[Jamii:Sao Tome na Principe]] [[Jamii:Sao Tome (mji)]] bxh29gqxlrjs6vtoyfzpa82a32y0z55 0 2835 1578030 1432894 2026-07-02T14:38:42Z Riccardo Riccioni 452 /* Tazama pia */ 1578030 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Praia |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Cabo Verde]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Praia aerialview.jpg|thumbnail|300px|Praia inavyoonekana kutoka ndege.]] '''Praia''' ni [[mji mkuu]] wa [[jamhuri]] ya [[Cabo Verde]] iko [[kisiwa|kisiwani]] [[Santiago (Cabo Verde)|Santiago]]. Praia ikiwa na wakazi 159,000 hivi ([[2017]]) ni [[mji]] mkubwa kabisa pamoja na kuwa [[kitovu]] cha [[uchumi]] cha nchi. Biasharanje inayopitia katika [[bandari]] ya Praia ni hasa [[kahawa]], [[miwa]] na [[matunda]]. Kuna [[uwanja wa ndege]] wa kimataifa. ==Tazama pia== * [[Orodha ya miji ya Cabo Verde]] {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Cabo Verde]] [[Jamii:Praia (Cabo Verde)| ]] [[Jamii:Miji ya Cabo Verde]] 1v6htlsfr52vq8mh0uevbr43mjqzoxg 0 2837 1577977 1463528 2026-07-02T13:27:27Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577977 wikitext text/x-wiki [[Picha: A_drone_footage_of_Accra_central,_Ghana.jpg|thumb|Mji mkuu wa Ghana, Accra]] {{Infobox Settlement |jina_rasmi = Jiji la Accra |picha_ya_satelite = Central accra-2.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Ghana]] |subdivision_type1 = [[:en:Regions of Ghana|Mkoa]] |subdivision_name1 = [[:en:Greater Accra Region|Greater Accra]] |subdivision_type2 = [[:en:Districts of Ghana|Wilaya]] |subdivision_name2 = [[:en:Accra Metropolis District|Accra Metropolis]] |wakazi_kwa_ujumla = 2,270,000 (1910) |website = [http://www.ama.ghanadistricts.gov.gh/ ama.ghanadistricts.gov.gh] }} [[Picha:Ghana-karte-politisch-greater-accra.png|thumb|right|260px|Mahali pa Accra katika [[Ghana]]]] [[Picha:Labadi beach.jpg|thumb|right|260px|Labadi Beach]] [[Picha:Downtown accra.jpg|thumb|right|260px|Accra mjini]] '''Accra''' ni [[mji mkuu]] wa [[Ghana]] ukiwa na wakazi 1 650 000<ref>[http://www.statoids.com/ygh.html Statoids, Districts of Ghana (~2002) {{en}}]</ref>. Accra ni [[kitovu]] cha [[uchumi]], [[biashara]] na [[mawasiliano]] ya nchi. Iko ndani ya [[mkoa wa Accra Kuu]]. ==Historia== Accra ilianzishwa na [[Waga (kabila)|Waga]] katika [[karne ya 15]] [[BK]] kama kituo cha [[biashara]] na [[Wareno]]. Wareno walijenga [[boma]] kwa ajili ya biashara hiyo na [[Waswidi]], [[Waholanzi]], [[Wafaransa]], [[Waingereza]] na [[Wadenmark]] walifuata. Eneo la Accra ya leo liliendelea kuwa [[mji]] kati ya boma tatu za [[Uingereza]] ([[Jamestown (Ghana)|Jamestown]]), [[Denmark]] ([[Osu (Ghana)|Osu]]) na [[Uholanzi]] ([[Ussherstown]]). Maeneo hayo matatu leo ni kitovu cha mji wa kisasa. Baada ya Waingereza kushinda [[Waashanti]], Accra ikawa mji mkuu wa [[koloni]] la [[Pwani la dhahabu]]. Mji uliendelea kukua baada ya kujengwa kwa [[reli]] na [[bandari]]. Katika [[miaka ya 1940]] Accra ilikuwa pia mwanzo wa [[upinzani]] dhidi ya Waingereza ulioleta [[uhuru]] wa Ghana [[mwaka]] [[1956]]. Leo hii Accra imepata mji [[pacha]] wa karibu wa [[Tema]] baada ya kuhamishwa kwa [[viwanda]] na [[bandari]] kwenda Tema inayounganishwa na Accra yenyewe kwa [[reli]] na [[barabara kuu]]. == Marejeo == {{reflist}} == Viungo vya nje == {{Commons}} * [http://www.ama.ghanadistricts.gov.gh/ Tovuti rasmi] {{Wayback|url=http://www.ama.ghanadistricts.gov.gh/ |date=20070928000020 }} * [http://www.andycarvin.com/archives/2005/07/accra_taxi_ride.html Accra Taxi Ride] {{Wayback|url=http://www.andycarvin.com/archives/2005/07/accra_taxi_ride.html |date=20060715005551 }} - video inayoonyesha safari ya Taxi katika Accra {{en}} * [http://www.moxon.net/ghana/accra.html Mark Moxon, Travel Writer] - Makala kuhusu ziara katika Accra mwaka 2002 (na picha) {{en}} {{GhanaLargestCities}} {{list of African capitals}} {{mbegu-jio-Ghana}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Ghana]] [[Jamii:Ghana]] [[Jamii:Accra| ]] asxn4zm3vs52hu6j4vqe7rvkceff6ey 0 2848 1577965 1433206 2026-07-02T13:07:05Z Riccardo Riccioni 452 /* Tazamia pia */ 1577965 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Moroni |picha_ya_satelite = Moroni-Harbour.jpg |maelezo_ya_picha = Kitovu cha mji wa Moroni |settlement_type = Jiji |pushpin_map = Komori |pushpin_map_caption = Mahali pa mji wa Moroni katika [[Komori]] |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Komori]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |latd=11 |latm=41 |lats=35 |latNS=S |longd=43 |longm=15 |longs=15 |longEW=E |website = }} [[Picha: Moroni-Harbour.jpg|thumbnail|right|280px|Moroni, Komori.]] [[Picha:Moroni, Comoros.jpg|thumb|right]] [[Picha:KM-Grande Comore-Moroni.png|thumb|right|175px|Mahali pa Moroni kisiwani Ngazija]] '''Moroni''' (kwa [[Mwandiko wa Kiarabu]]: ''' موروني''') ni [[mji mkuu]] pia [[mji]] mkubwa wa [[Komori]] wenye wakazi 60,200. Mji uko upande wa [[magharibi]] wa [[kisiwa]] cha [[Ngazija]] (Grande Comore). Kuna [[bandari]] kwa [[usafiri]] kwa [[meli]] kwenda visiwa vingine vya [[Bahari Hindi]] pia [[bara]] la [[Afrika ya Mashariki]] pamoja na uwanja wa kimataifa wa ndege. [[Anwani ya kijiografia]] ni 11°45′S 43°12′E. == Historia == Moroni ilikuwa mji mkuu wa [[Usultani]] wa Bambao uliokuwa [[dola]] lenye kipaumbele kisiwani hadi kuja kwa [[ukoloni]] wa [[Ufaransa]]. == Tazamia pia == * [[Orodha ya miji ya Komori]] {{Mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Komori]] [[Jamii:miji ya Komori]] [[Jamii:Moroni]] 3c8gpf0mkdebw7xxkef9vhu8liyz7mv 1578022 1577965 2026-07-02T14:35:36Z Riccardo Riccioni 452 /* Tazamia pia */ 1578022 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Moroni |picha_ya_satelite = Moroni-Harbour.jpg |maelezo_ya_picha = Kitovu cha mji wa Moroni |settlement_type = Jiji |pushpin_map = Komori |pushpin_map_caption = Mahali pa mji wa Moroni katika [[Komori]] |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Komori]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |latd=11 |latm=41 |lats=35 |latNS=S |longd=43 |longm=15 |longs=15 |longEW=E |website = }} [[Picha: Moroni-Harbour.jpg|thumbnail|right|280px|Moroni, Komori.]] [[Picha:Moroni, Comoros.jpg|thumb|right]] [[Picha:KM-Grande Comore-Moroni.png|thumb|right|175px|Mahali pa Moroni kisiwani Ngazija]] '''Moroni''' (kwa [[Mwandiko wa Kiarabu]]: ''' موروني''') ni [[mji mkuu]] pia [[mji]] mkubwa wa [[Komori]] wenye wakazi 60,200. Mji uko upande wa [[magharibi]] wa [[kisiwa]] cha [[Ngazija]] (Grande Comore). Kuna [[bandari]] kwa [[usafiri]] kwa [[meli]] kwenda visiwa vingine vya [[Bahari Hindi]] pia [[bara]] la [[Afrika ya Mashariki]] pamoja na uwanja wa kimataifa wa ndege. [[Anwani ya kijiografia]] ni 11°45′S 43°12′E. == Historia == Moroni ilikuwa mji mkuu wa [[Usultani]] wa Bambao uliokuwa [[dola]] lenye kipaumbele kisiwani hadi kuja kwa [[ukoloni]] wa [[Ufaransa]]. == Tazamia pia == * [[Orodha ya miji ya Komori]] {{list of African capitals}} {{Mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Komori]] [[Jamii:miji ya Komori]] [[Jamii:Moroni]] o8bpg4e2vh7j4h4f2npbux0dznfhic4 0 2946 1578009 1414463 2026-07-02T14:22:30Z Riccardo Riccioni 452 /* Tazama pia */ 1578009 wikitext text/x-wiki [[Picha:Malawi-Lilongwe.png|right|115px|Mahali Lilongwe iliko kwa ramani ya Malawi]] '''Lilongwe''' ni [[mji mkuu]] wa [[Malawi]] wenye wakazi 597,619 ([[sensa]] ya [[mwaka]] [[2003]]). Yenyewe iko kusini magharibi mwa nchi, magharibi mwa [[Mto Malawi]] karibu na mpaka wa Malawi na [[Msumbiji]] na [[Zambia]]. Lilongwe mahali pake ni {{coor dm|13|59|S|33|47|E}} (-13.98333, 33.78333). [http://earth-info.nga.mil/gns/html/cntry_files.html] {{Wayback|url=http://earth-info.nga.mil/gns/html/cntry_files.html |date=20110325175559 }} == Historia == Mji huo ulianza kama kijiji kwa ufuo wa Mto Malawi na kuwa Kituo cha amri ya wakoloni Waingereza kwa mwanzo wa karne 1900. Yasemekana kwamba, Lilongwe ilisaidia sana kama kituo cha serikali ya wakoloni kwa sababu Lilongwe ilikuwa kwa ruti ya kusini na kaskazini ambayo iliwezesha utawala wa Rhodesia ya kaskazini inayojulikana sasa kama [[Zambia]]. Mji wa Lilongwe baadaye ukawa mji wa pili kwa ukubwa Malawi. Mwaka wa 1974, Mji mkuu wa nchi ulihamishwa kutoka Zomba (mji ambao sasa ni wa tatu kwa ukubwa nchini Malawi), hadi kwa mji namba mbili kwa ukubwa, Lilongwe. == Wilaya == Mji wenyewe una wilaya nyingi ambazo zajulikana kama eneo, mbila kati ya mji kuwa eneo iliopewa namba. Eneo zenyewe hazijapewa namba kulingana vile eneo zimepakana. Maeneo yaliyojulikana: * Eneo 1: Mji wa Wakale (Kati) * Eneo 2: Mji wa Wakale (Kaskazini mwa A1) - Karibu na Mji wakati * Eneo 3: Mji wa Wakale (Magharibi mwa A1) - Ufuo wa Magharibi, Mto Lilongwe * Eneo 4: Mji wa Wakale (Mashariki mwa A2) - Ufuo wa Magharibi, Mto Lilongwe == Usafiri == Kuna mabasi na motokaa za abiria zinazosafirisha watu kwa miji ya kale, katikati ya Mji wenyewe na pia Kiwanja cha denge. Mataksi yapatikana rahisi kutoka kwa na taksi kwa jia inayoitwa Presidential Way, kaskazini mwa maduka za soko zilizokati ya Mji. == Jumla == Lilongwe inao [[Wakazi Wakigeni]] na kwa hivyo waweza kupata chakula za kutoka ng'ambo kwa maduka. Kuna chuo cha ukulima mjini Lilongwe. Wakati wa mvua hasa ni Oktoba na Aprili. Wakati wa ukame ni kuanzia Aprili hadi Oktoba. Kati ya muda huu wa ukame, Juni na Julai kuna baridi na Agosti kukizidi na upepo na vumbi. == Uchumi == Viwanda hasa ni kama za tumbako, chai, sukari, utolezi wa vyumo vilivyo siagwa, simiti na vyakula. Ukulima ni kama wa tumbako, miwa, mipamba, chai, mahindi, viazi, mikota, mihogo, mituta, na pia kwa wanyama ni kama ng'ombe, mbuzi. Mashamba ya ukulima ni kama 34% za nchi. Vifaa vinavyouzwa kwa nchi za kigeni ni tumbako, chai, sukari, pamba, kahawa, chungu na mbao. Vifaa vinavyonunuliwa kutoka nchi za kigeni ni vyakula, mafuta, vifaa vilivyoundwa, vifaa vya utumizi na vifaa vya usafirishaji. Madini na mali ni kama simiti, madini ya yuranimu ambayo hayajachimbwa, makaa ya miamba, madini ya shabu au alumini. Mambo ya mazingira; ukataji wa miti; mmomonyoko wa udongo; ujanaba wa maji, maji ya siwa (ya choo), takataka za viwanda; samaki kupunguka kwa kuaribu eneo za yai za samaki. ==Tazama pia== * [[Orodha ya miji ya Malawi]] {{list of African capitals}} [[Jamii:Miji ya Malawi]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Lilongwe]] [[Jamii:Malawi]] qkmk6u7awl1ytoh25ia1iul6rq4or5k 0 3202 1577995 1434329 2026-07-02T14:16:45Z Riccardo Riccioni 452 /* Tazama pia */ 1577995 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Freetown |picha_ya_satelite = Freetown.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Sierra Leone]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:QEIIQuayPhoto.jpg|thumbnail|right|200px|Muonekano wa Mji wa Freetown]] '''Freetown''' ni [[mji mkuu]] pamoja na [[bandari]] kubwa na [[kitovu]] cha [[uchumi]] wa nchi ya [[Sierra Leone]]. Uko kando ya [[Atlantiki]] kwenye rasi ya Freetown. Idadi ya wakazi ni 1,070,000. ==Historia== Mji uliundwa mwaka [[1787]] kwa ajili ya [[watumwa]] wenye asili ya [[Afrika]] waliowekwa huru. Ndiyo asili ya jina "Freetown" linalomaanisha "Mji wa watu huru". Ulikuwa mji mkuu wa koloni la [[Uingereza]] katika Afrika ya Magharibi kati ya miaka 1808 hadi 1874. Hadi leo [[Wakreoli]] ambao ni wazao wa watumwa waliopewa uhuru kama walowezi ni tabaka la pekee Freetown wakionekana kwa utamaduni na lugha ya pekee. Katika miaka ya 1990 mji ulikuwa mahali pa mapigano kati ya wanamgambo na askari za [[ECOWAS]]. == Uchumi == Uchumi wa Freetown unategemea hasa [[bandari]]. Kuna pia viwanda vya sigara, vya kutengeneza petroli, vya chakula na za kusafisha [[almasi]]. ==Tazama pia== * [[Orodha ya miji ya Sierra Leone]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Sierra Leone]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Sierra Leone]] [[Jamii:Freetown| ]] 91avbajg0rvpi1jexrdlsio4p6oq4vr 0 3212 1577990 1267123 2026-07-02T14:13:56Z Riccardo Riccioni 452 /* Vitabu */ 1577990 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Brazzaville |picha_ya_satelite = Mosobrazza.png |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Jamhuri ya Kongo]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Centre ville brazza.jpg|thumb|left|upright|Brazzaville.]] [[Picha:Kinshasa & Brazzaville - ISS007-E-6305 lrg.jpg|thumb|right|[[Kinshasa]], Brazzaville na [[mto Kongo]].]] '''Brazzaville''' ni [[mji mkuu]] wa [[Jamhuri ya Kongo]]. Una wakazi 2,308,000 ([[mwaka]] [[2019]]) ambao ni sawa na 40[[%]] ya wananchi wote. Uko kando ya [[mto Kongo]] ukitazamana na [[mji]] wa [[Kinshasa]] ng'ambo ya [[mto]]. Brazzaville una [[bandari]] kwenye mto Kongo na mwanzo wa [[reli]] kuelekea [[pwani]]. ==Historia== [[Jina]] la Brazzaville limetokana na [[Ufaransa|Mfaransa]] [[Pierre Brazza|Pierre Savorgnan de Brazza]] aliyenunua hapa ardhi kutoka kwa [[chifu]] [[Makoko]] na kujenga kituo kilichokua na kuwa mji baadaye. Tangu mwaka [[1898]] Brazzaville ulikuwa mji mkuu wa [[Kongo ya Kifaransa]] ukawa na wakazi 5,000 mnamo [[1900]] walioongezeka kuwa [[lakhi]] moja mwaka [[1950]]. Mwaka [[1940]] Brazzaville ulikuwa kwa muda mfupi mji mkuu wa [[Ufaransa Huru]] yaani [[Ufaransa]] usio chini ya [[Ujerumani]] hadi kuhamia kwa [[serikali]] hiyo kwenda [[Algiers]]. == Vitabu == * Maria Petringa. ''Brazza, A Life for Africa'' (2006). ISBN 978-1-4259-1198-0 {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Jamhuri ya Kongo]] [[Jamii:Brazzaville| ]] [[jamii:mto Kongo]] 4y0ffml4fvlcl5ddthrdzfyl9gqaa24 0 3238 1578006 1434160 2026-07-02T14:20:52Z Riccardo Riccioni 452 /* Tazama pia */ 1578006 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Khartoum |picha_ya_satelite = Jami el kebir,Khartum.jpg |pushpin_map = Sudan |pushpin_map_caption = Mahali pa mji wa Khartoum katika Sudan |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Sudan]] |subdivision_type1 = Majimbo |subdivision_name1 = Khartoum |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 2 090 001 |latd=15 |latm=35 |lats=35 |latNS=N |longd=32 |longm=32 |longs=8 |longEW=E |website = }} [[Picha:Su-map.png|thumb|left|240px|Khartoum on map of Sudan]] '''Khartoum''' ('''الخرطوم''' al-Khartūm) ni [[mji mkuu]] wa [[Sudan]] na pia mji mkuu wa eneo la shirikisho la Khartoum. [[Mji]] uko mahali mito ya [[Nile nyeupe]] na [[Nile ya buluu]] inapokutana. Kisheria "Khartoum" ni eneo tu mashariki ya Nile nyeupe na kusini ya Nile ya buluu lakini hali halisi Khartoum pamoja na miji ya [[Omdurman]] na [[Bahri]] ni kama mji mmoja mkubwa sana unaounganishwa na [[daraja|madaraja]] kadhaa. == Mandhari== [[Picha:Sudan Khartoum View with Traffic 2003.jpg|thumb|Msongamano wa magari kwenye kitovu cha {{PAGENAME}}]] [[Picha:Ramani Sudan Khartoum.png|thumb|Ramani ya Khartoum pamoja na Omdurman na Bahri]] [[Picha:Khartoum 32.53706E 15.60754N.jpg|thumb|Picha ya angani ya {{PAGENAME}} na Omdurman na Bahri]] [[Picha:Nil scene.jpg|thumb|Mto Nile mbele ya {{PAGENAME}} mnamo mwaka 1910]] [[Picha:Sudan Khartoum backstreet 28jul2005.jpg|thumb|Mtaa mdogo wa Khartum]] == Wakazi == Khartoum ina wakazi 2,090,000 mjini penyewe pamoja na [[Omdurman]] na [[Bahri]] idadi ya wakazi inaweza kufika kati ya milioni 6 hadi 8 (kadirio la mwaka 2006). Kuongezeka kwa idadai ya wakazi: {| ! style="background:#efefef;" | Mwaka ! style="background:#efefef;" | Wakazi <br />(Khartoum penyewe) ! style="background:#efefef;" | Wakazi <br />(miji yote mitatu) |- | 1956 || align="right" | 93.100 || align="right" | 245.800 |- | 1973 (sensa) || align="right" | 333.906 || align="right" | 748.300 |- | 1983 (sensa) || align="right" | 476.218 || align="right" | 1.340.646 |- | 1993 (sensa) || align="right" | 947.483 || align="right" | 2.919.773 |- | 2006 (kadirio) || align="right" | 2.090.001 || align="right" | 7.830.479 |} == Historia == === Historia ya awali === Khartoum ilianzishwa mwaka 1820/21 na mtawala wa [[Misri]] [[Mehmed Ali]] kama kambi la jeshi mahali mito miwili ya Nile inapokutana. Wafanyabiashara wenyeji na Wamisri hawakuchelewa kujenga karibu. Kituo kipya ikawa kitovu cha biashara kwa ajili ya maeneo makubwa ya Sudan, hasa biashara ya [[meno ya ndovu]], [[mpira wa miti]], [[manyoya ya mbuni]] kwa ajili ya masoko ya [[Ulaya]] na watumwa kwa ajili ya masoko ya [[Misri]], [[Uturuki]] na [[Uarabuni]]. Sehemu kubwa ya karne ya 19 Khartoum ilikuwa na nyumba ndogo za udongo na mitaa nyembamba. Nyumba kubwa za pekee zilikuwa [[ikulu]] ya gavana wa Misri, [[msikiti]] mkuu, [[kanisa]] la [[Wakopti]], misioni ya Wakatoliki tangu 1847 na nyumba kadhaa ya wafanyabiashara Wagiriki na wazungu wengine. Palikuwa na ofisi za kibalozi za Austria na Uingereza. Idadi ya wakazi ilifikia takriban 50,000 ambao wengi walikuwa Waarabu na watumwa Waafrika. Wakati wa mtawala wa Misri [[Ismail Pascha]] Khartoum ikawa mji mkuu wa Sudan na makao ya gavana mkuu aliyekuwa Mwingerezea [[Gordon]]. Dhidi utawala wa Misri na Mwingereza Gordon kama gavana ilitokea ghasia na mapinduziy a Kiislamu. Jeshi la [[Muhammad Ahmad ibn Abd Allah Al-Mahdi]] iliteka Khartoum. Mahdi Muhammad hakutaka kukaa kwenye "mji wa makafiri" akajenga mji mpya wa Omdurman "mji wa waumini" ng'ambo ya mto Nile uliokuwa mji mkuu wa dola la mahdi 1885 - 1898. Mwaka 1898 Waingereza chini ya jenerali [[Kitchener]] kwa kushirikiana na Wamisri walirudi Sudan na kumaliza utawala wa mahdi wakajenga Khartoum upya. === Historia ya kisasa === Wakati wa uhuru 1956 Khartoum ikawa mji mkuu wa Sudan huru. Katika miaka tangu 1970 wakazi waliongezeka sana kutokana na wakimbizi waliokimbia vita ya wenyewe kwa wenyewe katika nchi za jirani kama [[Chad]], [[Eritrea]], [[Ethiopia]] na [[Uganda]], pia wakimbizi kutoka vita ya [[Sudan ya Kusini]]. Wakimbizi hawa walijenga mitaa mikubwa ya vibanda. Tar. 20. Agosti 1998 Khartoum ilisha,buliwa na ndege za kivita za [[Marekani]] kwa sababu Waamerika waliamini ya kwamba kiwanda fulani kilikuwa mahali pa kutengenezea silaha za kikemia kwa ajili ya [[Osama bin Laden]]. Imejulikana baadaye ya kwamba kiwanda hiki kilikuwa cha madawa tu, Marekani ilifaulu kuondoa uwezo wa Sudan wa kutengeneza Aspirin yake. Mwaka 2005 viongozi wa Sudan ya Kusini waliweza kufika Sudan baada ya mapatano ya amani kati ya serikali ya Khartoum na Jeshi la ukombozi wa Sudan Kusini. Walipewa vyeo mbalimbali katika serikali mpya. Baada ya kifo cha kiongozi wa Sudan ya Kusini [[John Garang]] katika ajali ya ndege palitokea ghasia kali mwanzo wa Agosti 2005. == Maendeleo ya mji == Tangu mapatano ya amani kuhusu Sudan ya Kusini kuna mipango mikubwa ya kujenga kitovu kipya ya kibiashara kwa ajili ya Khartoum ni mradi wa "Al-Mogran". Kuna matumaini ya kwamba amani itawezesha nchi kutumia mapato kutokana na mafuta nchini kwa ajili ya miradi ya maendeleo. Lakini wakati uleule vita ya jimbo la Darfur inaleta wasiwasi tena. Khartoum ina vyuo vikuu vinne. ==Tazama pia== * [[Orodha ya miji ya Sudan]] {{list of African capitals}} {{mbegu-jio-Sudan}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Sudan]] [[Jamii:Sudan]] [[Jamii:Nile]] [[Jamii:Khartoum| ]] l4iszyuyg38ht62xb73buzraeo8tcq7 0 3249 1578004 1516309 2026-07-02T14:19:59Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578004 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Kairo |picha_ya_satelite = Kairo 001.jpg |maelezo_ya_picha = Kitovu cha mji wa Kairo |picha_ya_bendera = Flag of Cairo.svg |ukubwa_ya_bendera = 100px |picha_ya_nembo = |ukubwa_ya_nembo = |pushpin_map = |pushpin_map_caption = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Misri]] |subdivision_type1 = [[Mikoa ya Misri|Mkoa]] |subdivision_name1 = [[Mkoa wa Kairo|Kairo]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |latd=30 |latm=03 |lats= |latNS=N |longd=31 |longm=22 |longs= |longEW=E |website = [http://www.cairo.gov.eg/ www.cairo.gov.eg] }} [[Picha:Large Cairo Landsat.jpg|thumb|260px|'''Kairo''' jinsi inavyoonekana kutoka angani - '''njano''' ni rangi ya [[jangwa]], '''kijani-nyeusi''' ni rangi ya mashamba kwenye bonde la [[Nile]] linalopanuka kuwa [[delta]] na rangi ya '''kijivu''' ni nyumba za Kairo]] '''Kairo''' (kwa Kiarabu: القاهرة, al-Qāhira, "mwenye ushindi") ni [[mji mkuu]] wa [[Misri]] na mojawapo ya miji mikubwa na ya [[historia|kihistoria]] zaidi [[dunia|duniani]]. Iko kando ya [[mto Nile]], mji huu ni kitovu cha [[siasa|kisiasa]], [[uchumi|kiuchumi]], na [[utamaduni|kitamaduni]] cha nchi ya [[Misri]]. Kairo ni mojawapo ya miji yenye watu wengi zaidi barani Afrika na ni mji wa 15 kwa ukubwa duniani kwa idadi ya watu. Historia ya Kairo inahusiana sana na ustaarabu wa kale wa [[Misri ya Kale|Misri]], na mji huu umejikita katikati ya tamaduni nyingi, na hasa kutokana na karibu na miji ya kale ya [[Memphis]] na [[Giza]]. Kwa sasa, Kairo ni jiji lenye mchanganyiko wa usanifu wa kisasa na wa [[historia|kihistoria]], ambapo majumba ya kisasa ya biashara yanakutana na makaburi ya kale, misikiti, makanisa, na vivutio vingine vya [[historia|kihistoria]]. Kairo yenyewe inakadiriwa kuwa na wakazi 10,230,350 <ref>Walikuwa 7,902,085 mwaka 2011 wakati wa sensa, taz. [http://www.citypopulation.de/php/egypt-admin.php?adm1id=01 Al-Qāhirah (Governorate) 2011]</ref>, kanda ya jiji pamoja na mitaa ya nje na mapembizo ni 15,628,325 <ref>[http://www.citypopulation.de/php/egypt-greatercairo.php Wakazi wa Kairo Kubwa] walihesabiwa katika sensa ya 2011 kuwa 15,628,325.</ref>. ==Jiografia== [[File:View from Cairo Tower 31march2007.jpg|thumb|right|Sehemu ya kusini ya kisiwa cha Gezira kilichopo ndani ya mto Nile, Opera ya Kairo (jengo jeupe) na nyuma kitovu cha mji pamoja na meidani ya Tahrir ng'ambo ya mto.]] [[File:Cairo Nile River.jpg|thumb|right|Mto [[Nile]] unapita mjini Kairo.]] [[File:Zamalek Arial.jpg|thumb|right|Kisiwa cha Gezira katikati ya jiji.]] Kairo iko kwenye sehemu ya [[kaskazini]] ya [[Misri]], takriban [[kilomita]] 160 [[kusini]] kwa [[pwani]] ya [[bahari]] ya [[Mediteranea]]. Mji ulikua kando ya [[mto Nile]], mahali ambako unatoka katika [[bonde]] unamovuka [[jangwa]] na kujigawa kuwa na [[delta]] pana hadi baharini. Jinsi ilivyo kwenye majiji mengi makubwa, wenyeji hutofautisha kati ya mji asilia wenyewe na jiji kubwa kwa jumla. Mji wa Kairo wenyewe una eneo la [[km2]] 453 tu, uko upande wa [[mashariki]] wa mto pamoja na [[visiwa]] viwili ndani ya mto; jiji pamoja na vitongoji limepanuka pande zote mbili kuelekea ndani ya jangwa.<ref>{{cite web |url=http://www.cairo.gov.eg/C17/C8/Cairo%20Maps/default.aspx |publisher=Cairo Governorate |accessdate=10 September 2009 |title=Cairo Maps |deadurl=yes |archiveurl=https://web.archive.org/web/20090419130737/http://www.cairo.gov.eg/C17/C8/Cairo%20Maps/default.aspx |archivedate=2009-04-19 |=https://web.archive.org/web/20090419130737/http://www.cairo.gov.eg/C17/C8/Cairo%20Maps/default.aspx }}</ref><ref name="citypop">{{cite web|url=http://www.citypopulation.de/Egypt.html |publisher=City Population |last=Brinkhoff |first=Thomas |accessdate=12 September 2009 |title=Egypt: Governorates & Cities}}</ref> Katika [[karne ya 19]] mto Nile ulibanwa na [[handaki]] na [[mifereji]]. Hadi wakati ule mifuriko na mabadiliko kwenye mwendo wake walitokea mara kwa mara. [[Historia]] hii ya mabadilko ya mwendo wa mto ni sababu ya kwamba mitaa mipya ya mji iko karibu na mto wenyewe mahali ambako zamani wangeogopa kujenga, ni mitaa ya [[Garden City (Kairo)|Garden City]], [[Kairo mjini]] na [[Zamalek]].<ref name="riverbank">{{cite web | url = http://geography.about.com/od/egyptmaps/a/cairo-geography.htm | title = Ten Facts about Cairo, Egypt | author = Amanda Briney | date = 20 February 2011 | work = Geography of Cairo | publisher = About.com | accessdate = 14 July 2012 | archivedate = 2012-03-28 | archiveurl = https://web.archive.org/web/20120328101627/http://geography.about.com/od/egyptmaps/a/cairo-geography.htm }}</ref> Kusini mwa Kairo ya leo kuna [[Kairo ya Kale]] penye mabaki ya miji iliyotangulia hapa kama vile [[Babyloni ya Misri]] (enzi ya [[Bizanti]], kabla ya [[uvamizi]] wa [[Waarabu]] [[Waislamu]]) na [[Fustat]] (mji mkuu wa kwanza wa Kiislamu nchini Misri). Sehemu za [[Bulaq]] ziko leo upande wa kaskazini ya mji wenyewe zilianzishwa kama eneo la [[bandari]] ya mtoni mnamo [[karne ya 16]]. [[Boma]] la Kairo ([[ar.]] ''qale salah ad din'') inaonyesha mahali ambako mji wa Kairo ulianzishwa na [[Wafatimi]]. Upande wa magharibi wa mji wa Kairo uliathiriwa na mpangilio wa jiji wa kimagharibi ukiwa na [[barabara]] pana, nyanja mbalimbali na [[nyumba]] za kisasa. Upande wa mashariki una zaidi mitaa midogomidogo, nyumba za kienyeji na kujaa watu wengi mno. ===Tabianchi ya Kairo=== Kairo iko katika kanda yenye [[tabianchi]] ya [[nusutropiki]]. Tabianchi kwa jumla ni [[yabisi]]. Hata hivyo wakati mwingine [[hewa]] yenye [[unyevu]] inaweza kufika kwa sababu bahari iko karibu. [[Halijoto]] ya [[wastani]] mwakani ni [[sentigredi]] 21.7. Kiwango cha [[mvua]] ni [[milimita]] 24,7 pekee. [[Mwezi (wakati)|Mwezi]] wenye [[joto]] zaidi ni [[Julai]] mwenye wastani wa sentigredi 28, na mwezi baridi ni [[Januari]] yenye wastani wa sentigredi 13,9. [[Usimbishaji]] ni mdogo; wastani wa mwaka ni milimita 24,7 pekee unaotiririka katika miezi wa [[Novemba]] hadi [[Machi]] pekee. Wakati wa Disemba [[2013]] Kairo iliona [[theluji]] mara ya kwanza baada ya miaka mingi sana<ref>Samenow, Jason (13 December 2013). "[http://www.washingtonpost.com/blogs/capital-weather-gang/wp/2013/12/13/rare-snow-in-cairo-jerusalem-paralyzed-in-historic-snow/ Biblical snowstorm: Rare flakes in Cairo, Jerusalem paralyzed by over a foot]". The Washington Post.</ref>. ==Kanda ya Jiji== [[Kanda ya Jiji]] inajumlisha Kairo pamoja na miji jirani, vitongoji na mapembizo. [[Idadi]] ya wakazi kwa jumla iko kati ya [[milioni]] 15 hadi 16. Kiutawala kanda ya jiji inajumlisha [[mkoa wa Kairo]] na sehemu ya [[mikoa]] miwili yaani [[mkoa wa Giza|Giza]] na [[mkoa wa Qalyubia|Qalyubia]]. Miji ya pekee muhimu zaidi katika kanda hii ni * Kairo * [[Giza (Misri)|Giza]] * [[Helwan]], pamoja [[Mji wa 15 Mei]] * [[Shubra El-Kheima]] * [[Mji wa 6 Oktoba]] * [[Mji wa Badr]] * [[Kairo mpya]] * [[Heliopolis Mpya]] * [[Mji wa Basus]] Kuna mipango ya kujenga jiji jipya upande wa mashariki wa Kairo litakalokuwa mji mkuu mpya wa Misri.<ref>"[http://www.bbc.com/news/business-31874886 Egypt unveils plans to build new capital east of Cairo]". BBC News. 13 March 2015. Retrieved 14 March 2015.</ref> ===Usafiri=== [[File:محطة روض الفرج-القاهرة.jpg|thumb|left|[[Metro ya Kairo]]]] [[File:Nasr road.jpg|thumb|Barabara Kuu mjini]] [[File:Cairo Transport Authority.JPG|thumb|left|Mabasi ya manispaa]] [[File:Ramses-Station.jpg|thumb|left|Kituo cha Metro Ramses]] [[Usafiri]] ndani ya Kairo na [[kanda ya jiji]] huenda kwa kutumia barabara, [[njia za reli]], [[reli ya chini ya ardhi]] inayoitwa "metro" na [[feri]] kwenye mto. Kuna [[magari]] mengi ya binafsi, [[teksi]] na [[Basi|mabasi]] ambayo ni ya [[umma]] au ya binafsi. Njia nyingi za mabasi na reli ya metro zinakutana kwenye Midan Ramses <ref name=TravelCairo>{{Rejea kitabu|title=Travel Cairo|year=2007|publisher=MobileReference|isbn=978-1-60501-055-7|url=https://books.google.com.tw/books?id=50O9dQlwreYC&pg=PT44&lpg=PT44&dq=cairo,+specifically+ramses+square,+is+the+centre+of+almost+the+entire+egyptian+transportation+network&source=bl&ots=xVe8a_96AL&sig=m80pe2fMggr7VUi5LuONGLJXPqw&hl=zh-TW&sa=X&ei=9c4LUPmLPILmmAXCwryfCg&redir_esc=y#v=onepage&q&f=false|access-date=2016-05-06|archive-date=2016-03-02|archive-url=https://web.archive.org/web/20160302145138/https://books.google.com.tw/books?id=50O9dQlwreYC&pg=PT44&lpg=PT44&dq=cairo,+specifically+ramses+square,+is+the+centre+of+almost+the+entire+egyptian+transportation+network&source=bl&ots=xVe8a_96AL&sig=m80pe2fMggr7VUi5LuONGLJXPqw&hl=zh-TW&sa=X&ei=9c4LUPmLPILmmAXCwryfCg&redir_esc=y#v=onepage&q&f=false|dead-url=yes}}</ref> Usafiri ndani ya Kairo ni mashuhuri kwa ugumu wake kutokana na wingi wa watu na magari.<ref>{{cite web|url=http://weekly.ahram.org.eg/2006/779/feature.htm |title=Al-Ahram Weekly &#124; Features &#124; Reaching an impasse |publisher=Weekly.ahram.org.eg |date=1 February 2006 |accessdate=5 May 2009 |deadurl=yes |archiveurl=https://web.archive.org/web/20090518104145/http://weekly.ahram.org.eg/2006/779/feature.htm |archivedate=18 May 2009 }}</ref> [[Picha:CAIRO METRO.jpg|300px|thumb|Ramani ya Metro ya Kairo]] [[Metro ya Kairo]] ("مترو") ni jina la reli ya chini ya [[ardhi]]. Ni usafiri wa haraka pale njia zake zinapofika. [[behewa|Mabehewa]] yake yanaweza kujaa mno wakati wa [[saa]] za kwenda [[Kazi|kazini]] na kurudi. Kila treni ya metro huwa na magari wawili yaliyotengwa kwa ajili ya [[wanawake]] pekee, ni gari la nne na la tano, lakini hata hivyo wakinamama wako huru kupanda kila behewa wanapotaka. Metro hii ina njia tatu zenye [[urefu]] wa kilomita 77.9 na kuna vituo 61 zinazohudumiwa<ref>{{Rejea tovuti |url=http://cairometro.gov.eg/UIPages/History.aspx |title=Tovuti rasmi |accessdate=2016-05-06 |archiveurl=https://web.archive.org/web/20180923193003/http://cairometro.gov.eg/UIPages/History.aspx |archivedate=2018-09-23 }}</ref>. Kuna [[tramu]] katika sehemu za ([[Heliopolis (Kairo)|Heliopolis]] na [[mji wa Nasr]]) lakini ile katika Kairo mjini ilifungwa miaka mingi iliyopita. Kuna mtandao mkubwa wa barabara kati ya Kairo mjii, sehemu nyngine za kanda ya jiji na miji ya nje. Kuna barabara ya [[duara]] inayopita nje ya jiji. [[Daraja|Madaraja]] mengi yanalenga kurahisisha mwendo ndani ya jiji ingawa kwenye saa za msongamano watu hukaa sana kwenye foleni za magari. ==Dini== Zamani Kairo ilikuwa mji wenye wakazi wengi wa [[tamaduni]] na [[dini]] mbalimbali; hadi leo [[Maabadi|nyumba zao za ibada]] ni kama kumbukubu ya [[historia]] hiyo. Maelfu ya [[Wagiriki wa Misri]] waliondoka nchini baada ya [[mapinduzi]] ya mwaka [[1952]]. [[Wayahudi]] pia walianza kuona [[ubaguzi]] mkali na madhulumu tangu [[Mapambano_kati_ya_Israeli_na_Palestina#Kuundwa_kwa_Dola_la_Israeli|vita ya Israeli na Waarabu wa 1948]] wakaondoka. Leo hii kuna Wayahudi chini ya 100 waliobaki Misri baada ya historia ya miaka 2,500. Siku hizi wakazi walio wengi ni [[Waislamu]] [[Wasunni]] (takriban 90[[%]]). Wengine ni hasa [[Wakristo]] [[Wakopti]]. Upande wa Uislamu kuna [[misikiti]] mingi na idadi yake inaendelea kuongezeka. [[Chuo Kikuu cha Al-Azhar]] kinapatikana mjini tangu mwaka [[969]]: ni [[taasisi]] ambayo [[utalaamu]] wake unaheshimiwa na kuangaliwa kati wa Wasunni wengi duniani. Upande wa Wakopti [[kiongozi]] wao [[Papa Pope Tawadros II]] anakaa Kairo. [[Kanisa la Mtakatifu Marko mjini Kairo]] ni [[kanisa]] kubwa la pili kwenye [[bara]] la [[Afrika]]. [[Sinagogi|Masingagogi]] ya Kiyahudi yanaweza kutembelewa na [[watalii]] lakini hakuna tena [[ibada]] ya kawaida kutokana na idadi ndogo ya Wayahudi waliobaki. Vurugu za kisiasa za miaka iliyopita ilileta pia magongano kati ya wafuasi wa dini, hasa kati ya Waislamu wenye [[itikadi kali]] na Wakristo. <ref>{{cite web|url=http://www.lepoint.fr/monde/egypte-24-coptes-tues-par-les-forces-de-l-ordre-au-caire-10-10-2011-1382636_24.php |title=Égypte : 24 coptes tués par les forces de l'ordre au Caire – Le Point |publisher=Lepoint.fr |accessdate=12 March 2013}}</ref> == Tazama pia == * [[Piramidi za Giza]] ziko karibu na Kairo * [[Orodha ya miji ya Misri]] ===Mji mingine mikubwa ya Afrika=== * [[Lagos]], [[Nigeria]] - milioni 8 * [[Cairo]], [[Misri]] - milioni 5.1 * [[Kinshasa]], [[Jamhuri ya Kidemokrasia ya Kongo]] - milioni 4.9 ==Marejeo== <references/> == Viungo vya nje == {{Commons|Cairo}} * [http://www.cairo.gov.eg/ Tovuti rasmi] * [http://www.cairo.yatb.info/ Cairo] {{Wayback|url=http://www.cairo.yatb.info/ |date=20070221124548 }} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Misri]] [[Jamii:Miji ya Misri]] [[Jamii:Nile]] [[Jamii:Kairo| ]] mtnvn3lppu4wvfgjkggbk9pem50hr1k 0 3346 1578017 1182407 2026-07-02T14:33:39Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578017 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Maputo |picha_ya_satelite =Delagoa_bay.jpg |maelezo_ya_picha = Bahari ya Maputo kutoka NASA |pushpin_map = Msumbiji |pushpin_map_caption = Mahali pa Jiji la Maputo katika Msumbiji |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Msumbiji]] |subdivision_type1 = [[Mikoa ya Msumbiji|Mkoa]] |subdivision_name1 = [[Maputo|Maputo Mjini]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 1200000 |latd=25 |latm=58 |lats=00 |latNS=S |longd=32 |longm=35 |longs=00 |longEW=E |website = }} [[Picha:Maputo.jpg|thumb|300px|left|Maputo inavyoonekana kutoka bahari]] [[Picha:Lourenco-Marques-pc-c1905.jpg|260px|thumb|Barabara kuu ya Lourenço-Marquès (leo: Maputo) mwaka 1905]] '''Maputo''' ni [[mji mkuu]] wa [[Msumbiji]]. Hadi 1976 ilijulikana kwa jina la [[Kireno]] la Lourenço-Marquès. Serikali mpya ya Msumbiji huru chini ya rais [[Samora Machel]] iliipa jina jipya la Maputo. Mji una wakazi 1,200,000 (pamoja na mitaa ya nje: 1,800,000). Uchumi wake unategemea sana bandari yake kwenye hori ya Maputo ya [[Bahari Hindi]]. Mito miwili inaishia kwenye hori ni [[Tembe (mto)|Tembe]] na [[Maputo (mto)|Maputo]]. == Viungo vya nje == * [http://maputo.visitusinmaputo.com {{Wayback|url=http://maputo.visitusinmaputo.com/ |date=20200821153639 }} Utalii Maputo [[Kin]]] {{Mikoa ya Msumbiji}} {{list of African capitals}} {{mbegu-jio-Msumbiji}} [[Jamii:Msumbiji]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Msumbiji]] [[Jamii:Mikoa ya Msumbiji]] [[Jamii:Maputo| ]] arpzph51povxqbczakxg50m5ocupzrl 0 3375 1578007 1527494 2026-07-02T14:21:14Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578007 wikitext text/x-wiki {{Infobox Settlement |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Rwanda]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 600 000 |latd=1 |latm=56 |lats=38 |latNS=S |longd=30 |longm=3 |longs=34 |longEW=E |website = }} [[Picha:Kigali.jpg|thumb|Jiji la Kigali, Rwanda]] '''Kigali''' ni [[mji mkuu]] wa [[Rwanda]] na pia mji mkubwa kuliko mingine yote nchini. Iko karibu sana na mstari wa [[ikweta]] kwenye kimo cha 1400 - 1600 [[m]] juu ya [[UB]]. Hali ya hewa ni ya wastani hakuna baridi kali wala joto kali. Kigali ina wakazi 600,000. == Historia == Kigali ilianzishwa wakati wa ukoloni wa Kijerumani mwaka 1907 kama kituo cha mwakilishi wa Afrika ya Mashariki Mjerumani Richard Kandt. Wakati wa [[Vita Kuu ya Kwanza ya Dunia]] ilivamiwa na Wabelgiji ikawa sehemu ya eneo lao na kukabidhiwa Rwanda na Burundi chini ya utawala wa [[Ubelgiji]]. Baada ya kugawa kwa Rwanda-Burundi kuwa nchi mbili za Rwanda na Burundi, Kigali ikawa mji mkuu wa Rwanda mwaka 1962. Mauaji ya Watutsi ya mwaka 1994 yalianza Kigali. Mji ulipungukiwa wakazi 100,000 wakati ule. == Uchumi == Misingi ya uchumi ya Kigali ni biashara ya kahawa, mifugo na [[Bustani]]. == Mawasiliano == Kigali ina uwanja wa ndege wa kimataifa uitwao Kigali International Airport. Kuna barabara kwenda Burundi na Uganda. Bildung == Tazama pia == * [[Orodha ya miji ya Rwanda]] ==Viungo vya nje== {{commonscat}} {{list of African capitals}} {{Mbegu-jio-Afrika}} [[Jamii:Rwanda| ]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Rwanda]] [[Jamii:Kigali| ]] gy3h5bbs43l893xmufxp7rwvci2hfu3 0 3378 1578119 1198625 2026-07-02T20:36:48Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578119 wikitext text/x-wiki [[Picha:LocationRuandaUrundi.png|thumb|Mahali pa Ruanda-Urundi kando la Kongo ya Kibelgiji]] [[Picha:Ruanda Urundi 1.jpg|thumb|Ramani ya Ruanda-Urundi wakati wa ukoloni]] [[Picha:Kisanga-mijn_Ruandese_arbeiders_einde-jaren_1920.JPG|thumbnail|right|280px| Wafanyakazi wahamiaji wa kiruanda katika mgodi wa Kisanga huko Katanga(Kongo ya Ubelgij)]] '''Ruanda-Urundi''' ni jina la zamani kwa ajili ya nchi za [[Rwanda]] na [[Burundi]]. Zote mbili zilikuwa sehemu ya [[Afrika ya Mashariki ya Kijerumani]] hadi 1916. Wakatu wa [[Vita Kuu ya Kwanza ya Dunia]] jeshi la [[Force Publique|Force Publique la Ubelgiji]] kutoka Kongo lilivamia maeneo yake; katika ugawaji wa koloni ya Kijerumani maeneo yale yalikubaliwa na Uingereza kubaki upande wa Ubelgiji. Baadaye zilikabidhiwa na [[Shirikisho la Mataifa]] kama [[eneo la kudhaminiwa]] kwa [[Ubelgiji]]. Ubelgiji ilitawala nchi zote mbili kama eneo moja la "Ruanda - Urundi". Hali halisi ziliangaliwa kwa muda mrefu kama eneo la nyongeza la [[Kongo ya Kibelgiji]]. Lakini hali yake katika [[sheria ya kimataifa]] kuwa [[eneo la kudhaminiwa]] iliizuia kuunganishwa rasmi na koloni ile kubwa. Nchi zote mbili zilitawaliwa kwa mfumo wa "utawala usio moja kwa moja" ihali Wabelgiji walitumia watawala wa jadi. Wafalme hao waliotwa Mwami walitoka kimapokeo katika kundi la [[Watutsi]] ilhali idadi kubwa ya wananchi walihesabiwa katika kundi la [[Wahutu]]. Makundi haya hayakuwa makabila tofauti maana walikuwa na lugha na utamaduni wa pamoja; walikuwa zaidi matabaka katika jamii ambayo yaliwahi kuanza karne kadhaa zilizopita kama makabila tofauti lakini zimeshaunganika kiutamaduni; hata hivyo yalikuwa tofauti kiuchumi kwa mkazo wa [[ufugaji]] upande wa Watutsi na [[ukulima]] upande wa Watutsi. Hata hivyo iliwezekana kwa Mhutu kupata [[ng'ombe]] wengi na kuitwa Mtutsi, na Mtutsi maskini kuanza kulima akitazamiwa kuwa Mhutu. Kisiasa tofauti ilisababishwa na mfumo wa utawala wa mwami (mfalme) aliyepaswa kuteuliwa kutoka familia za Watutsi. Katika kipindi cha ukoloni uhusiano baina ya Watutsi na Wahutu ulibadilika kwa sababu wakoloni walitazama Watusi kuwa watu wa mbari wa juu. Waliimarisha tofauti kwa kuanzisha mfumo wa kuorodhesha na kutoa vitambulisho kwa wananchi ambako kila mtu aliandikishwa ama kama Mtutsi au Mhutu, na hivyo njia ya kuhama kundi ilifungwa. Wakipendelea Watutsi idadi ya Wahutu walioteuliwa kuwa mchifu wa maeneo ilipungua, hasa upande wa Rwanda. Katika miaka ya 1950 elimu ya kisasa ilifanya Wahutu kudai haki za kisiasa sawa na Wahutu. Mwaka 1959 upinzani wa Wahutu dhidi ya utawala wa Watutsi uliendelea kwenye mapinduzi katika Rwanda ambako Mwami alipinduliwa na mauaji ya wapinzani wa kisiasa yalifanya Watutsi zaidi ya 100,000 kukimbia katika nchi jirani. Wakati huohuo uhusiano baina ya makundi ndani ya Burundi haukuonyesha mafarakano makali vile bado na mfalme wa Burundi alilenga kutengwa kwa Burundi na Rwanda. Wakati wa mwisho wa utawala wa kikoloni kwenye mwaka 1961 sehemu zote mbili ziliachana na kuingia katika uhuru kama nchi mbili za Rwanda na Burundi. Burundi huru ilianza kama ufalme, ilhali Rwanda imeshakuwa jamhuri. == Kujisomea == *Samson, Anne (2016).{{cite web|ref={{harvid|1914–1918 Online Encyclopedia|2016}}|last1=Samson|first1=Anne|title=Ruanda and Urundi|url=https://encyclopedia.1914-1918-online.net/article/ruanda_and_urundi|website=1914-1918 Online: International Encyclopedia of the First World War|accessdate=28 January 2019|date=2016}} *{{cite book|url=https://archive.org/details/isbn_9781890951344|title=The Great Lakes of Africa: Two Thousand Years of History|last=Chrétien|first=Jean-Pierre|date=2003|publisher=Zone Books|isbn=9781890951344|edition=English trans.|location=New York|url-access=registration}} *{{cite book|title=Le Burundi sous administration Belge: la période du mandat, 1919-1939|last=Gahama|first=Joseph|date=1983|publisher=Karthala|isbn=9782865370894|edition=2nd rev.|location=Paris}} *{{cite book|title=Ruanda-Urundi 1884-1919|last=Louis|first=William Roger|date=1963|publisher=Clarendon Press|location=Oxford|authorlink=William Roger Louis}} *{{cite book|title=The Cohesion of Oppression: Clientship and Ethnicity in Rwanda, 1860-1960|last=Newbury|first=Catharine|date=1994|publisher=Columbia University Press|isbn=9780231062572|location=New York}} *{{cite book|title=The Guardians: The League of Nations and the Crisis of Empire|url=https://archive.org/details/guardiansleagueo0000pede|last1=Pedersen|first1=Susan|date=2015|publisher=Oxford University Press|isbn=978-0-19-957048-5|location=Oxford|ref=harv}} *{{cite book|title=Le Rwanda sous le régime du mandat belge, 1916-1931|last1=Rumiya|first1=Jean|date=1992|publisher=Éd. L'Harmattan|isbn=9782738405401|location=Paris}} *{{cite book|title=Tussen mandaat en kolonie: Rwanda, Burundi en het Belgische bestuur in opdracht van de Volkenbond (1916-1932)|last1=Vijgen|first1=Ingeborg|date=2005|publisher=Acco|isbn=9789033456213|location=Leuven}} *{{cite journal|last1=Botte|first1=Roger|date=1985|title=Rwanda and Burundi, 1889-1930: Chronology of a Slow Assassination|url=https://archive.org/details/international-journal-of-african-historical-studies_1985_18_2/page/289|journal=The International Journal of African Historical Studies|volume=18|issue=2|pages=289–314|doi=10.2307/217744|jstor=217744}} * {{cite book|title=Defeat is the Only Bad News: Rwanda under Musinga, 1896-1931|last1=Des Forges|first1=Alison|date=2014|publisher=University of Wisconsin Press|isbn=9780299281434|location=Madison|authorlink=Alison Des Forges}} [[Jamii:Historia ya Ubelgiji]] [[Jamii:Historia ya Rwanda]] [[Jamii:Historia ya Burundi]] [[Jamii:Historia ya Afrika]] aiw323xm2brh0gf0qoe4c8ic9l7n4i7 0 3381 1578008 1481342 2026-07-02T14:22:04Z Riccardo Riccioni 452 /* Mji */ 1578008 wikitext text/x-wiki [[Picha:Libreville.jpg|thumbnail|right|280px|Muonekano wa Mji wa Libreville]] {{Infobox Settlement |jina_rasmi = Jiji la Libreville |picha_ya_satelite = Libreville1.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Gabon]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Localisation de Libreville au Gabon.png|260px|thumbnail|Mahali pa Libreville mkoani Estuaire]] [[Picha:Chancery Building, Libreville, Gabon.jpg|right|thumbnail|260px|Nyumba ya uchansella mjini Libreville]] '''Libreville''' ni [[mji mkuu]] na mji mkubwa nchini [[Gabon]]. Iko kwenye pwani la Atlantiki kiasi ndani ya mdomo wa [[mto Komo]] au [[mto Gabon]]. Kuna bandari. Libreville ina wakazi 578,000 (2005). Jina la “Libreville” lina maana ya “mji huru” au “mji wa watu huru” kutokana na historia yake. == Historia == Libreville ilianzishwa na [[Ufaransa|Wafaransa]] kama kituo cha biashara kwa jina la Gabon kufuatana na mto uliopo baada ya kununua ardhi tangu 1839 [[BK]]. Wakati ule wenyeji wa eneo walikuwa hasa Wampongwe. 1843 Wafaransa walijenga boma la Fort Aumale kama bandari ya kijeshi. Mwaka 1848 idadi ya wakazi iliongezeka ghafla kwa watumwa waliowekwa huru. Wakati ule meli za kijeshi za Ufaransa zilishirikiana na [[Waingerezea]] katika majaribio ya kukomesha [[biashara ya watumwa]]. Walikamata meli ya [[L'Elizia]] na kupeleka mzigo wake wa watumwa Gabon walipopewa uhuru. Wakati ule kituo kilipanuka kuwa mji mdogo ukapewa jina la [[Libreville]] kwa kuiga mji wa “[[Freetown]]” huko [[Sierra Leone]] ambako Waingerezea waliwahi kupangisha watumwa waliopewa uhuru. Tangu 1866 ikawa makao makuu ya jimbo la Gabon. katika karne ya 20 ikawa bandari kuu ya [[Afrika ya Ikweta ya Kifaransa]] ikaendelea kukua polepole. Tangu uhuru wa Gabon mwaka 1960 imekuwa mji mkuu wa nchi hii. == Mji == Kuna mitaa ndani ya mji ya Batterie IV, Quartier Louis, Mont-Bouët, Nombakélé, Glass (Uzunguni), Olaumi (mtaa wa viwanda) na Lalala. Mtaa wa Owendo kusini ya mji pana bandari na kituo cha reli. Libreville ina makumbusho ya kitaifa yenye vinyago vingi vya utamaduni wa wananchi. Soko kuu ni Marché du Mont-Bouët mashariki ya kitovu cha mji. Libreville kuna vyuo vikuu vya Université Omar Bongo (UOB), Université des Sciences de la Santé, Chuo cha Ufundi Omar Bongo Ondimba Technical School na taasisi mbalimbali ndogo. Uwanja wa ndege wa kimataifa kiko nje ya mji. {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Gabon]] [[Jamii:Gabon]] [[Jamii:Libreville| ]] k3qgvzwavzdl29q2r95kjw92ei6texr 0 3388 1578014 1433108 2026-07-02T14:31:50Z Riccardo Riccioni 452 /* Tanbihi */ 1578014 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Malabo |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Guinea ya Ikweta]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 155,963 |website = }} [[Picha:Bioko Norte in Equatorial Guinea 2020.svg|250px|thumb|Mahali pa Malabo mkoani Bioko Norte.]] [[Picha:Malabo (16486980296).jpg|thumbnail|right|280px|Sehemu ya Mji wa Malabo.]] '''Malabo''' ni [[mji mkuu]] wa [[Guinea ya Ikweta]] wenye wakazi 155,963 ([[2005]]). Uko mwambaoni mwa [[Atlantiki]] kwenye pwani ya kaskazini ya [[kisiwa]] cha [[Bioko]] (zamani: Fernando Po). ==Historia== Mji ulianzishwa kwa jina la Port Clarence mwaka 1827 na Waingereza waliokuwa wamekodi kisiwa cha Fernado Po kutoka kwa [[Wahispania]]. Uingereza ulitumia kisiwa kama kituo cha jeshi la uanamaji lilizozunguka Atlantiki kwa shabaha ya kukomesha [[biashara ya watumwa]]. Waingereza walipeleka huko [[watumwa]] waliopatikana kwenye [[meli]] za biashara ya watumwa. Mwaka 1843 Waingereza walihamisha kituo chao cha kijeshi kwenda [[Sierra Leone]] na sehemu ya watumwa wa zamani waliopewa [[uhuru]] wao walibaki, wengine wakafuatana na Waingereza kwenda Sierra Leone. Wahispania walirudi polepole wakabadilisha jina la mji kuwa Santa Isabel. Tangu uhuru wa Guinea ya Ikweta mwaka [[1968]] Santa Isabel ikawa mji mkuu. Wakati wa [[udikteta]] wa [[rais]] [[Francisco Macías Nguema]] jina lilibadilishwa kuwa Malabo. Idadi ya wakazi ilipungua sana kutokana na utawala wa kidikteta, wengi walikimbia kama wanachi kwa ujumla. Tangu mwisho wa Macias Nguema idadi imeongezeka tena lakini bado dalili ya uharibifu uliotokea zinaonekana. Pamoja na hasara hizo Malabo ni kitovu cha kiuchumi cha nchi. Mazao ya [[kakao]], [[kahawa]] na [[Ubao|mbao]] yanapelekwa huko kwa meli na kuuzwa nje. ==Tanbihi== * [[Orodha ya miji ya Guinea ya Ikweta]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Guinea ya Ikweta]] [[Jamii:Guinea ya Ikweta]] [[Jamii:Malabo| ]] tgs9f4f957avmj1jisikzo54xuj9wuy 0 3395 1577999 1337524 2026-07-02T14:18:08Z Riccardo Riccioni 452 /* Tanbihi */ 1577999 wikitext text/x-wiki [[Picha:Harare from the Kopje.jpg|thumb|350px|right|Harare inavyoonekana kutoka kilima cha Kopje]] [[Picha:Province of Harare (adm) 300px.svg|right|350px|Map of Zimbabwe with the province highlighted]] '''Harare''' (zamani: '''Salisbury''') ni [[mji mkuu]] wa [[Zimbabwe]] pia [[mji]] mkubwa nchini ukiwa [[kitovu]] cha [[utawala]] na [[uchumi]]. Uko kwenye kimo cha [[mita]] 1,500 juu ya [[UB]]. [[Idadi]] ya wakazi imehesabiwa kufika 1,492,000<ref>https://www.citypopulation.de/en/zimbabwe/cities/</ref>, pamoja na mitaa ya nje hadi 3,120,000. Mtaa wa nje ulio mkubwa ni [[Chitungwiza]] yenye wakazi 340,000 kusini kwa [[uwanja wa ndege]] wa kimataifa. == Historia == Mji ulianzishwa mwaka [[1890]] [[BK]] kama kambi la jeshi la binafsi la [[Cecil Rhodes]]. Tangu kuwa makao ya kudumu mji ulipewa jina la Salisbury kutokana na [[Lord Salisbury]] aliyekuwa waziri mkuu wa Uingereza miaka ile akamsaidia Cecil Rhodes kazika mipango yake ya kupanusha ukoloni katika Afrika ya Kusini. Salisbury ilipata cheo cha mji mwaka 1935 ikawa mji mkuu wa Maungano ya Rhodesia na Unyasa mwaka 1953 hadi 1963. Baada ya uhuru wa Zimbabwe jina la Salisbury ilibadilishwa mwaka 1982 kwa heshima ya chifu wa Washona Neharawa kuwa Harare. Tangu 2002 mji uliathiriwa vibaya na matatizo ya kisiasa nchini Zimbabwe. Vyama vya upinzani vilipata kura nyingi mjini kushinda serikali ya [[Robert Mugabe]] katika chaguzi za kisiasa. Serikali ikalipiza kisasi kwa kufuta Halmashauri ya Mji. Mwaka 2005 serikali ilibomoa mitaa ya vibanda katika kempeni ya [[Operation Murambatsvina]] (Mradi wa "kuondoa takataka"). Lakhi za watu walifukuzwa katika nyumba zao na biashara zao zikabomolewa. Wapinzani waliona kampeni hii kama jaribio la kupunguza idadi ya wafuasi wao katika mji mkuu. ==Tazama pia== * [[Orodha ya miji ya Zimbabwe]] ==Tanbihi== {{reflist}} {{jiografia ya Zimbabwe}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Zimbabwe]] [[Jamii:Zimbabwe]] [[Jamii:Harare| ]] 37zfaxwk7zamq7f3o57n95rl95xa7ko 0 3401 1578012 1203275 2026-07-02T14:23:19Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578012 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Luanda |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Angola]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[File:View_over_Luanda,_Angola.jpg|thumb|Mandhari kutoka juu]] [[Picha:Angola karte.png|thumb|Luanda katika Angola]] [[Picha:Luanda 13.23266E 8.80761S.jpg|thumb|Luanda inavyoonekana kutoka angani]] '''Luanda''' (kirefu: ''São Paulo de Luanda'': pia ''Loanda'') ni [[mji mkuu]] pia [[mji]] mkubwa wa [[Angola]] ikiwa na wakazi 2,487,484 (katika rundu la jiji 7,805,000) wanaongezeka haraka kutoka ndani na nje ya nchi na ya [[bara]] la [[Afrika]]. == Jiografia == Mji wa Luanda uko [[Mkoa wa Luanda|mkoani Luanda]], [[kaskazini]] ya [[mdomo]] wa [[mto]] [[Cuanza]] [[mwambaoni]] pa [[Atlantiki]]. == Historia == Mji ulianzishwa na [[Wareno]] [[mwaka]] [[1575]] [[BK]] kwa [[jina]] la ''São Paulo de Luanda''. Umekuwa mji mkuu wa Angola tangu mwaka [[1627]]. Hadi mwaka [[1850]] Luanda ilikuwa [[kitovu]] cha [[biashara ya watumwa]] kwenda [[Brazil]]. Wakati wa [[uhuru]] mwaka [[1975]] [[walowezi]] wengi Wareno waliondoka mjini. [[Vita ya wenyewe kwa wenyewe]] katika Angola kati ya miaka [[1974]] - [[2002]] ilileta hasara pia kwa mji mkuu. == Wakazi == Kati ya wakazi, walio wengi kabisa ni [[Waafrika]] wa [[Kabila|makabila]] kama vile [[Waovimbundu]], [[Wakimbundu]] na [[Wakongo]]. [[Lugha rasmi]] ni [[Kireno]] lakini [[lugha]] nyingi za [[Kibantu]] zinatumika pia. == Uchumi == Luanda ni [[bandari]] muhimu nchini pia mwanzo wa [[reli]] kwenda [[Malange]]. == Viungo vya nje == {{Commons|Category:Luanda|Luanda}} * [http://www.luandamap.com www.luandamap.com - Ramani ya Luanda] {{Wayback|url=http://www.luandamap.com/ |date=20190517174623 }} {{list of African capitals}} {{mbegu-jio-Angola}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Angola]] [[Jamii:Luanda]] cxy2lu0onc2v3dv0pg7y6jikvy2xcb3 0 3415 1577989 1306146 2026-07-02T14:13:37Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577989 wikitext text/x-wiki [[Picha:Bloemfontein, Free State, South Africa (20351086709).jpg|thumbnail|right|280px|Muonekano wa Mji wa Bloemfontein]] {{Infobox Settlement |jina_rasmi = Jiji la Bloemfontein |picha_ya_satelite = Bloemfontein FS ZA.jpg |pushpin_map = Afrika Kusini |pushpin_map_caption = Mahali pa mji wa Bloemfontein katika Afrika Kusini |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Afrika Kusini]] |subdivision_type1 = [[:Jamii:Majimbo ya Afrika Kusini|Majimbo]] |subdivision_name1 = [[Dola Huru]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |latd=29 |latm=9 |lats=0 |latNS=S |longd=26 |longm=13 |longs=48 |longEW=E |website = [http://www.bloemfontein.co.za/ www.bloemfontein.co.za] }} [[Picha:Bloemfontein panorama.jpg|thumb|Bloemfontein wakati wa mchana]] '''Bloemfontein''' (tamka: "Blumfontain" - Kiholanzi/Kiafrikaans "chemchemi ya maua") ni kati ya [[mji mkuu|miji mikuu]] mitatu ya [[Afrika Kusini]] pamoja na [[Pretoria]] na [[Cape Town]]. Jina la Kisotho ni '''Mangaung''' linalomaanisha "kwa duma". Bloemfountain ni makao ya [[Mahakama Kuu]] ya Afrika Kusini pia mju mkuu wa mkoa wa [[Vrystaat]] (au: Free State - "Dola huru"). Mji uko kwenye uwanja wa juu wenye kimo cha 1,395 [[m]] juu ya [[UB]]. Mji mwenyewe una takriban wakazi 500,000. Kuna mji wa pili wa [[Mangaung]] wa wakazi 650,000 uliojengwa wakati wa utawala wa ubaguzi wa rangi kwa ajili ya watu weusi. == Tazama pia == * [[Chuo Kikuu cha Dola Huru]] == Viungo vya nje == {{Commons}} * [http://www.bloemfontein.co.za/ Tovuti rasmi] {{Wayback|url=http://www.bloemfontein.co.za/ |date=20171129012934 }} {{list of African capitals}} {{mbegu-jio-AfrikaKusini}} [[Jamii:Miji ya Afrika Kusini]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Dola Huru]] [[Jamii:Bloemfontein| ]] dgd64rv9asjwidndg3ilh6s19i4enpt 0 3423 1578031 1095778 2026-07-02T14:39:03Z Riccardo Riccioni 452 1578031 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Pretoria |picha_ya_satelite = Montage of Pretoria.jpg |picha_ya_bendera = Flag of Pretoria, South Africa.svg |ukubwa_ya_bendera = 100px |picha_ya_nembo = Pretoria coa.jpg |ukubwa_ya_nembo = |pushpin_map = Afrika Kusini |pushpin_map_caption = Mahali pa mji wa Pretoria katika Afrika Kusini |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Afrika Kusini]] |subdivision_type1 = [[:Jamii:Majimbo ya Afrika Kusini|Majimbo]] |subdivision_name1 = [[Gauteng]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |latd=25 |latm=43 |lats=48 |latNS=S |longd=28 |longm=13 |longs=12 |longEW=E |website = [http://www.tshwane.gov.za/ www.tshwane.gov.za] }} [[Picha:CentralPretoria.jpg|thumb|left|Kitovu cha mji wa Pretoria.]] [[Picha:Union House Pretoria.jpg|thumb|left|Ikulu ya ''Union House'']] '''Pretoria''' ni moja kati ya [[mji mkuu|miji mikuu]] mitatu ya [[Afrika Kusini]] na [[makao makuu]] ya [[serikali]]. Miji mikuu mingine ni [[Cape Town]] kama makao ya [[Bunge]] na [[Bloemfontein]] kama makao ya [[Mahakama Kuu]]. Pretoria iko [[kaskazini]] mwa jimbo la [[Gauteng]] katika [[bonde]] la [[milima ya Magalies]] kwenye [[kimo]] cha [[m.]] 1,370. [[Umbali]] na [[Johannesburg]] ni [[km.]] 56. Ni sehemu ya [[Jiji]] la [[Tshwane]]. Jina la Pretoria ni la kumkumbusha [[jenerali]] wa [[Makaburu]] [[Andries Pretorius]] aliyeshinda [[Wazulu]] kwenye [[mapigano ya Mto wa Damu]] (Blood River) mwaka [[1838]]. Kuna majadiliano kama jina la Pretoria libadilishwe pia kuwa "Tshwane". Pamoja na [[ofisi]] za serikali kuna [[Chuo Kikuu|vyuo vikuu]], hasa [[:en:University of Pretoria|Chuo Kikuu cha Pretoria]]. [[:en:University of South Africa|Chuo Kikuu cha Afrika Kusini]] ni chuo kikubwa cha masomo kwa njia ya [[barua]]. Pretoria ndio [[mji]] pekee wenye watu weupe ([[Wazungu]]) wengi kuliko mji wowote [[duniani]] nje ya [[Ulaya]]. {{list of African capitals}} {{mbegu-jio-AfrikaKusini}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Gauteng]] [[Jamii:Miji ya Afrika Kusini]] [[Jamii:Pretoria| ]] ljsd8knhge2q0b9iv2fh5zz8cr1esbs 0 3430 1578029 1396254 2026-07-02T14:38:25Z Riccardo Riccioni 452 /* Viungo vya Nje */ 1578029 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Porto Novo |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Benin]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Axe principal à Porto-Novo.jpg|thumbnail|right|280px|Sehemu ya Mji wa Porto Novo]] [[Picha:Benin-karte-politisch-oueme.png|thumb|250px|Porto Novo katika Benin]] '''Porto Novo''' ([[Kireno]] kwa: "Bandari mpya" - inaitwa na wenyeji pia '''Hogbonou''' na '''Adjache''') ni [[mji mkuu]] rasmi wa [[Benin]]. Ni mji wa bandari kwenye kidaka cha [[Atlantiki]]. Mwaka 2002 Porto Novo ilikuwa na wakazi 223,552 (sensa 2002) na mji wa pili katika Benin. Hapa ni [[ikulu]] ya rais na makao ya [[bunge]] lakini [[wizara]] nyingi zina ofisi zao mjini [[Cotonou]]. === Historia === Jina la kihistoria ni Ajache. Kwa jina hili mji ulikuwa mji mkuu wa ufalme wa Aja. Wareno walijenga kituo cha biashara ya watumwa wakaiita "Porto Novo - bandari mpya". Mwaka 1863 ufalme ulikubali ulinzi wa Ufaransa kwa hofu ya Waingerezea. 1883 eneo lake likawa sehemu ya koloni ya Kifaransa ya Dahomey na mwaka 1900 mji mkuuw a koloni yote. Wafalme wa Porto Novo waliendelea kuwa na makao mjini hadi kifo cha mfalme wa mwisho Alohinto Gbeffa mwaka 1976. Tangu mwisho wa utumwa huko [[Brazil]] Waafrika wa Brazil walirudi wakifika Porto Novo na kukaa hapa. Hivyo athira za Brazil zimeonekana katika utamaduni wa mji, hasa katika ujenzi na chakula. == Viungo vya Nje == * [http://www.benintourisme.com/en/interne.php?idrub=10&id=79 Official Republic of Benin tourism site for Porto-Novo] {{Wayback|url=http://www.benintourisme.com/en/interne.php?idrub=10&id=79 |date=20070409034549 }} * [http://www.gouv.bj/en/benin/tourisme/porto.php Official Benin government website information about Porto-Novo] {{Wayback|url=http://www.gouv.bj/en/benin/tourisme/porto.php |date=20061005064316 }} * [http://www.porto-novo.biz/php/intro.php porto-novo.biz] {{Wayback|url=http://www.porto-novo.biz/php/intro.php |date=20070930002423 }} * [http://archnet.org/library/images/thumbnails.tcl?location_id=3357 Images of the Central Mosque of Porto-Novo] {{Wayback|url=http://archnet.org/library/images/thumbnails.tcl?location_id=3357 |date=20070312202425 }} * [http://www.virtualmuseum.ca/Exhibitions/Instruments/Anglais/measa_j_txt04a_en.html Adjogan] {{Wayback|url=http://www.virtualmuseum.ca/Exhibitions/Instruments/Anglais/measa_j_txt04a_en.html |date=20110604040756 }} {{list of African capitals}} [[Jamii:Miji ya Benin]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Porto Novo| ]] [[Jamii:Benin]] tuuoqqknf6twg4o70luiahvfqtjn60k 0 3443 1577991 1431216 2026-07-02T14:14:49Z Riccardo Riccioni 452 1577991 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Cape Town |picha_ya_satelite = Cape Town Montage.png |picha_ya_bendera = |ukubwa_wa_picha = 100px |picha_ya_nembo = Capetown coa.jpg |seal_size = |pushpin_map = Afrika Kusini |pushpin_map_caption = Mahali pa mji wa Cape Town katika Afrika Kusini |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Afrika Kusini]] |subdivision_type1 = [[Majimbo ya Afrika Kusini|Majimbo]] |subdivision_name1 = [[Rasi Magharibi]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |latd=33 |latm=55 |lats=48 |latNS=S |longd=18 |longm=27 |longs=36 |longEW=E |website = [http://www.capetown.gov.za/ www.capetown.gov.za] }} [[Picha:Table Mountain DanieVDM.jpg|thumbnail|right|280px|Mlima wa Meza]] [[Picha:Cape Town and Robben Island seen from Table Mountain.jpg|thumb|400px|Cape Town inavyoonekana kutoka [[Mlima wa Meza]] (nyuma baharini [[Robben Island]] alipofungwa [[Nelson Mandela]]) ]] [[Picha:Table Mountain from harbour.jpg|thumb|400px|[[Mlima wa Meza]] ni ishara ya mji]] '''Cape Town''' (yaani "Mji wa rasi", kwa [[Kiafrikaans]]: '''Kaapstad'''; kwa [[Kixhosa]]: '''iKapa''') ni [[mji]] mkubwa wa tatu wa [[Afrika Kusini]] na mmoja kati ya [[mji mkuu|miji mikuu]] mitatu ya nchi ikiwa ni makao ya [[Bunge]]. Pia ni mji mkuu wa jimbo la [[Rasi Magharibi]] (Western Cape / Wes-Kaap). Ni sehemu ya [[Jiji]] la Cape Town. Eneo lake ni [[km²]] 1,644 lenye wakazi 2,375,910 (mwaka 2005). [[Jina]] la mji limetokana na [[Rasi ya Tumaini Jema]] iliyoko karibu na mji upande wa [[kusini]]. ==Jiografia== Cape Town ni mji ambako [[bahari ya Hindi]] hukutana na [[Bahari ya Atlantiki]]. Uko kwenye [[latitudo]] ya 33.55° S (sawa na [[Sydney]] na [[Buenos Aires]]) na [[longitudo]] ya 18.25° E. [[Ishara]] ya mji ni [[Mlima wa Meza]] unaotazama hori ya Cape Town ukitenganisha [[kitovu]] cha mji na makazi ya [[Cape Flats]]. Kitovu cha mji kiko kati ya mlima na [[bahari]], sehemu yenye [[umbo]] kama la [[bakuli]]. Upande wa kusini iko rasi yenyewe, kama [[ulimi]] wa nchi wenye milimamilima kwa [[urefu]] wa [[kilomita]] 40. Ng'ambo ya mlima kuna [[tambarare]] ya Cape Flats na hapo ni sehemu maskini zaidi za mji zenye wakazi wengi. Cape Town ina [[uwanja wa ndege]] wa kimataifa mkubwa wa pili nchini. Ni mji wa Afrika Kusini unaotembelewa na [[watalii]] kushinda miji mingine yote. Wengi wanaona iko kati ya miji inayopendeza hasa kote duniani. [[Kisiwa]] cha [[Robben Island]] kilikuwa mahali pa [[gereza]] alikofungwa [[Nelson Mandela]]; leo ni [[makumbusho]] yanayotembelewa na maelfu wa watalii kila mwaka. Cape Town ni mji pekee Afrika ya Kusini wenye muingiliano mkubwa wa watu kutoka sehemu mbalimbali duniani, hivyo kuufanya mji wenye mchanganyiko wa tamaduni nyingi kuliko yote Afrika Kusini. Ukipita mitaa ya [[Wynberg]] utakutana na watu wengi wanaoongea [[lugha]] ya [[Kiswahili]] kutoka [[Tanzania]], [[Kenya]], [[Burundi]] na [[Jamhuri ya Kidemokrasia ya Kongo]]. Kiswahili ndiyo lugha kubwa ya kigeni ya Kiafrika inayozungumzwa Cape Town. ==Historia== Ni mji wa kwanza ulioanzishwa katika eneo la Afrika Kusini hivyo huitwa mara nyingi "Mji Mama" wa nchi. Kihistoria mji ulianzishwa kama kituo cha mapumziko kwenye njia ya safari za [[meli]] kati ya [[Uholanzi]] na [[Koloni|makoloni]] yake huko [[Asia]], hasa [[Indonesia]] ya leo. Kutoka zamani za [[historia ya awali]] kuna ushuhuda wa [[Akiolojia|kiakiolojia]] wa kuwepo kwa watu waliopamba [[pango|mapango]] ya makazi kwenye [[zama za mawe]]. Taarifa za kihistoria zinaanza baada ya [[Vasco da Gama]] kugundua njia ya kupita Afrika upande wa kusini kutoka Atlantiki kwenda Bahari Hindi mwaka [[1497]]. Katika [[karne]] iliyofuata [[baharia|mabaharia]] [[Wareno]], [[Wafaransa]], [[Wadenmark]], [[Waholanzi]] na [[Waingereza]] walipumzika katika hori ya Table Bay wakisafiri kati ya [[Ulaya]] na Asia. Walikuta huko [[Khoikhoi]] waliovua [[samaki]], kuwinda [[sili]], kukusanya [[konokono]] za baharini na kufuga [[ng'ombe]]<ref>[https://books.google.de/books?id=U55eucC8XzMC&pg=PA5&dq=cape+town+khoikhoi&hl=en&sa=X&ved=0ahUKEwjc_uHmtNHQAhVDGZoKHfU3CaAQuwUIJTAB#v=onepage&q=cape%20town%20khoikhoi&f=false Emile Boonzaier, The Cape Herders: A History of the Khoikhoi of Southern Africa] uk. 54; Publisher: Ohio University Press January 1, 1997; ISBN-10: 0821411748; ISBN-13: 978-0821411742, imeangaliwa 30.11.2016 kupitia google books</ref>. Walitafuta [[vyakula]] hasa [[nyama]] kutoka wenyeji hao wakibadilishana nao [[chuma]], [[shaba]] au [[tumbaku]]. [[Kampuni ya Kiholanzi ya India ya Mashariki]] iliamua kuanzisha hapa kituo kwa [[jahazi]] zilizopita kwenye [[rasi]] katika safari ndefu. Kampuni hiyo ilimtuma [[Jan van Riebeeck]] kusudi aanzishe [[kijiji]] ambako vyakula vitalimwa kwa ajili ya mabaharia njiani. [[Walowezi]] Waholanzi pamoja na [[Wajerumani]] na Wafaransa walifuata. Mwanzoni ilikuwa vigumu kupata walowezi na Waholanzi waliona wenyeji [[Khoikhoi]] wakikataa kuwafanyia kazi. Hivyo waliamua kuleta [[watumwa]] kutoka [[visiwa]] vya [[Indonesia]] na [[Madagaska]]. Ndio mwanzo wa jumuiya muhimu ya [[Waislamu]] wa Cape Town.<ref>{{Rejea tovuti|url=http://www.sahistory.org.za/pages/governence-projects/slavery/slavery.htm | title = Slavery and early colonisation , South African History Online|publisher=Sahistory.org.za | date = 22 Septemba 1927|accessdate=17 March 2011}}</ref> Van Riebeeck na [[Gavana|magavana]] waliomfuata walipeleka [[mimea]] mingi, hasa [[mazao]] kutoka Ulaya na Asia kwa eneo la rasi. Mimea hii ya nje ilibadilisha [[uoto asilia]] hadi leo. Kati ya mimea hii kuna [[mizabibu]], [[nafaka]], [[karanga]], [[viazi]] na miti ya [[matunda]] kama [[mitofaa]] au [[milimau]].<ref>Pooley, S. ‘Jan van Riebeeck as Pioneering Explorer and Conservator of Natural Resources at the Cape of Good Hope (1652–62),’ Environment and History 15 (2009): 3–33. {{doi|10.3197/096734009X404644}}</ref> [[File:Aernout Smit Table Bay, 1683 William Fehr Collection Cape Town.jpg|thumb|Table Bay na meli za [[Dutch East India Company]], [[1683]] hivi.]] [[File:Cape Town in 1800.jpg|thumbnail|Cape Town ilivyoweza kuonekana mwaka [[1800]].]] [[Utawala]] wa Waholanzi ulidumu miaka 150. Mnamo [[1795]], wakati wa [[vita]] zilizofuata [[mapinduzi ya Ufaransa]], [[jeshi]] la Kifaransa liliingia [[Uholanzi]]. Jamhuri mpya ya Kiholanzi ilifuata [[siasa]] ya Ufaransa na baadaye ya mtawala wake [[Napoleon Bonaparte]]. Hapo [[Uingereza]], [[adui]] wa [[mapinduzi]], ilichukua hatua za kutwaa maeneo ya ng'ambo yaliyokuwa chini ya Ufaransa. Hivyo jeshi la Uingereza lilivamia Cape Town. Tangu mwaka [[1814]] rasi ilikuwa koloni la [[Uingereza]]. Mji wa Cape Town ulikuwa mji mkuu wa [[Koloni ya Rasi]]. Tangu mwaka [[1853]] Cape Town ilikuwa pia mahali pa bunge la kwanza wakati koloni la Rasi ilipewa [[haki ya kujitawala]]. Kila [[mwanamume]], bila [[ubaguzi wa rangi]], mwenye [[mali]] ya thamani ya [[pauni]] 25 aliweza kupiga [[kura]]. Baadaye sharti la [[elimu ya msingi]] liliongezwa. Katika [[karne ya 20]] [[haki]] hiyo ilifutwa kwa [[Waafrika]] wakati wa kuanzishwa kwa siasa ya [[Apartheid]].<ref>{{Rejea tovuti |last = Bell |first = Charles | title = A painting of the arrival of Jan van Riebeeck in Table Bay |publisher = |url = http://www.rosebuds.co.za/Toere/Cape%20Town.htm |doi = |accessdate = 11 April 2011 |archivedate = 2011-12-30 |archiveurl = https://web.archive.org/web/20111230184319/http://www.rosebuds.co.za/Toere/Cape%20Town.htm }}</ref><ref>{{Rejea kitabu |last = McCracken |first = J.L. | title = The Cape Parliament, 1854-1910 |year = 1967 |publisher= Clarendon Press, Oxford, 1967 |url = https://archive.org/details/capeparliament180000mccr |doi =}} </ref> Cape Town ulikuwa mji mkubwa wa Afrika Kusini hadi kupatikana kwa [[dhahabu]] katika eneo la [[Johannesburg]] kuanzia [[1887]]. Mwaka [[1910]] [[Muungano wa Afrika Kusini]] ulianzishwa baada ya ushindi wa Uingereza juu ya [[jamhuri]] za [[Makaburu]]. Hapo Cape Town ilikuwa mji mkuu wa bunge la Muungano. Baada ya ushindi wa [[Chama cha kisiasa|Chama]] cha NP, siasa ya apartheid ilianzishwa pia katika jimbo la Rasi na Cape Town. [[Serikali]] mpya ililenga hasa kuunda [[mtaa|mitaa]] ndani ya mji iliyotenganishwa kufuatana na [[rangi]] na mbari za watu. Hivyo kama eneo lilitangazwa "nyeupe" Waafrika, [[Wamalay]] na [[Wahindi]] walipaswa kuondoka, [[nyumba]] zao zikabomolewa. Mfano mashuhuri wa siasa hii ulikuwa historia ya [[District Six, Cape Town|District Six]]. Mwaka [[1965]] ilitangazwa eneo kwa watu weupe tu nyumba zote zikabomolewa na watu 60,000 walifukuzwa. <ref>{{Rejea tovuti|url=http://www.southafrica.info/ess_info/sa_glance/history/districtsix.htm|publisher=SouthAfrica.info| title = Recalling District Six| date = 19 Agosti 2003}}</ref> [[Gereza]] la [[Robben Island]] ambalo lipo kwenye kisiwa baharini kilomita kadhaa nje ya Cape Town ilikuwa mashuhuri kwa sababu viongozi wengi wa mapambano ya kupinga ubaguzi wa rangi walifungwa hapa, pamoja na [[Nelson Mandela]]. Tangu [[1994]] mji huu ulipambana na matatizo ya [[madawa ya kulevya]] na [[jinai]]. Wakati huohuo [[utalii]] umepanuka sana na Cape Town ikawa inatembelewa na wageni wengi kutoka pande zote za dunia. ==Wakazi== [[File:Cape Town population density map.svg|thumb|Msongamano wa watu mjini Cape Town {{Columns |col1 = {{legend|#ffffcc|<1 /km²}} {{legend|#ffeda0|1–3 /km²}} {{legend|#fed976|3–10 /km²}} {{legend|#feb24c|10–30 /km²}} {{legend|#fd8d3c|30–100 /km²}} |col2= {{legend|#fc4e2a|100–300 /km²}} {{legend|#e31a1c|300–1000 /km²}} {{legend|#bc0026|1000–3000 /km²}} {{legend|#800026|>3000 /km²}}}}]] [[File:Cape Town dominant language map.svg|thumb|Ugawaji wa lugha za kwanza mjini Cape Town (2011) {{legend|#8dd3c7|[[Kiafrikaans]]}}{{legend|#ffffb3|[[Kiingereza]]}}{{legend|#fb8072|[[Kixhosa]]}}{{legend|#d0d0d0|Eneo la mchanganyiko}}]] Kufuatana na [[sensa]] ya mwaka [[2011]] jiji lote lina wakazi 3,740,026. Tangu sensa ya 2001 idadi hii imekua [[asilimia]] 2.6 kila mwaka. Uhusiano wa [[jinsia]] ni 69 maana yake kuna [[wanawake]] wengi kidogo kuliko wanaume. Asilimia 42.4 ya wakazi wanajiita "[[Coloured]]" (yaani mchanganyiko au [[chotara]]), asilimia 38.6 Waafrika weusi, asilimia 15.7 "White South African" na 1.4% kuwa "Indian South African". Mwaka [[1944]] ni asilimia 47 waliohesabiwa kuwa watu weupe na 46 kuwa "Coloured", chini ya 6% Waafrika Weusi na 1% Waasia.<ref>Rebekah Lee (2009). "''African women and apartheid: migration and settlement in urban South Africa''". I.B. Tauris. p.205. ISBN 1-84511-819-7</ref> Wakiulizwa kuhusu [[lugha ya kwanza]] 35.7% walisema [[Kiafrikaans]], 29.8% [[Kixhosa]] na 28.4% [[Kiingereza]]. 24.8% za wakazi wote ni [[watoto]] chini ya [[umri]] wa miaka 15 ilhali 5.5% ni [[wazee]] wenye miaka 65 au zaidi. ==Tanbihi== {{reflist}} == Viungo vya nje == {{Commons|Cape Town|Cape Town}} ;Government * [http://www.capetown.gov.za/ Official website of the City of Cape Town] * [http://www.capegateway.gov.za/ Cape Gateway, official website of Western Cape Province] {{Wayback|url=http://www.capegateway.gov.za/ |date=20060711051503 }} ;Habari * [http://www.iol.co.za/ ''Independent Online''] ** [http://www.argus.co.za/ ''Cape Argus''] {{Wayback|url=http://www.argus.co.za/ |date=20060720115701 }} ** [http://www.capetimes.co.za/ ''Cape Times''] * [http://www.dieburger.com ''Die Burger''] {{Wayback|url=http://www.dieburger.com/ |date=20000915104025 }} ;Mengine * [http://www.capeinfo.com/ CapeInfo.com - Comprehensive information on Cape Town] {{Wayback|url=http://www.capeinfo.com/ |date=20060618132809 }} {{list of African capitals}} {{mbegu-jio-AfrikaKusini}} [[Jamii:Miji ya Afrika Kusini]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Rasi ya Magharibi]] [[Jamii:Cape Town| ]] crtxbbeszie8w001vpfesktyaeclqzj 0 3452 1577986 1210875 2026-07-02T14:12:23Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577986 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Banjul |picha_ya_satelite = Banjul King Fahad Mosque.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Gambia]] |subdivision_type1 = [[:en:Divisions of Gambia|Mji]] |subdivision_name1 = Banjul |subdivision_type2 = [[:en:Districts of the Gambia|Wilaya]] |subdivision_name2 = Banjul |wakazi_kwa_ujumla = 357 238 |website = }} [[Picha:Banjul-King-Fahad-Mosque-2007.jpg|thumbnail|right|280px|Muonekano wa Mji wa Banjul]] [[Picha:Gambia map division 1.png|thumb|right|260px|Mahali pa Banjul katika Gambia]] [[Picha:Banjul-mercat.jpg|thumb|right|260px|Banjul mjini]] [[Picha:Gambia banjul arch22.JPG|thumb|right|260px|Geti ya ''Arch 22'' ya kuingia mji wa Banjul]] '''Banjul''' ni [[mji mkuu]] wa [[Gambia]]. [[Mji]] wenyewe una wakazi 34,828 pekee<ref>[http://www.statoids.com/ygm.html Statoids, Districts of Gambia, (2003), see ''Banjul District'' {{en}}]</ref> lakini pamoja na mitaa ya nje ni zaidi ya [[nusu]] [[milioni]]. Banjul iko kwenye [[kisiwa]] cha Mt. Mariamu (au: Kisiwa cha Banjul) [[Mdomo|mdomoni]] mwa [[mto Gambia]] unapoishia katika [[bahari]] ya [[Atlantiki]]. == Historia == [[Waingereza]] walianzisha mji [[mwaka]] [[1816]] [[BK]] kama kituo cha [[biashara]] na kituo cha kijeshi cha kukomesha [[biashara ya watumwa]]. [[Jina]] la mji lilikuwa "Bathurst" kufuatana na [[Henry Bathurst]] aliyekuwa [[waziri]] wa [[koloni|makoloni]] wakati ule. Mwaka [[1965]] Bathurst ilikuwa mji mkuu wa nchi huru ya Gambia. Mwaka [[1973]] jina lilibadilishwa kuwa Banjul. Tarehe [[22 Julai]] [[1994]] palikuwa na [[mapinduzi]] wa kijeshi yaliyoanzisha [[utawala]] wa [[Rais]] [[Yahaya Jammeh]]. Geti la mji "Arch 22" lilijengwa kama kumbukumbu ya mapinduzi haya. == Uchumi == Banjul ni [[kitovu]] cha utawala na biashara katika Gambia. [[Mawasiliano]] ndani ya nchi ni hasa kwa njia ya [[feri]] kwenye mto Gambia hadi mji wa [[Barra]]. Msingi wa [[uchumi]] ni [[kilimo]], hasa [[karanga]], [[nta]], [[mawese]] na [[ngozi]] zinasafirishwa kutoka [[bandari]] ya Banjul. Banjul ina [[uwanja wa ndege]] wa kimataifa. ==Tazama pia== * [[Orodha ya miji ya Gambia]] == Marejeo == {{reflist}} :<small>[http://www.statoids.com/ugm.html Wakazi ya Infobox - Statoids, Gambia Divisions, 2003, see ''Banjul Division'' {{en}}]</small> ==Viungo vya nje== {{Commons}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji ya Gambia]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Gambia]] [[Jamii:Banjul| ]] kmb7vul6b2y97me1cvv1zw3ge8w5ngq 0 3457 1578025 1434087 2026-07-02T14:37:06Z Riccardo Riccioni 452 /* Viungo vya Nje */ 1578025 wikitext text/x-wiki {{Databox}} [[Picha:Niamey night.jpg|thumb|350px|Niamey wakati wa usiku]] '''Niamey''' ni [[mji mkuu]] wa [[Niger]]. Uko mwambaoni mwa [[Niger (mto)|mto Niger]]. Ukiwa na wakazi 1,803,000 hivi (2018) Niamey ni [[mji]] mkubwa wa Niger na [[kitovu]] cha kiutawala, kiuchumi na kiutamaduni. Kilimo katika mazingira ya mji kina karanga kama mazao ya sokoni; kuna viwanda vya matofali, saruji na nguo. ==Historia== Niamey ilikuwa [[kijiji]] kikaanza kukua tangu [[Ufaransa]] ulipojenga huko kituo cha kijeshi [[miaka ya 1890]] [[BK]]. Mwaka 1926 ikawa mji mkuu wa [[koloni]] la Niger. Mwaka 1930 ulikuwa na wakazi 3,000, wakati wa uhuru mwaka 1960 na wakazi 30,000 na mnamo 1980 na wakazi 250,000. ==Tazama pia== * [[Orodha ya miji ya Niger]] == Viungo vya Nje == * [http://maps.google.com/maps?ll=13.522110,2.122421&spn=0.166014,0.234180&t=k&hl=en Satellite picture by Google Maps] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Niger]] [[Jamii:Mto Niger]] [[Jamii:Niamey| ]] [[Jamii:Niger]] r9lmu1sumb9dfv578s1xw8ialyz1lwt 0 3462 1577984 1433272 2026-07-02T14:11:36Z Riccardo Riccioni 452 /* Viungo vya Nje */ 1577984 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Bamako |picha_ya_satelite = Bamako 037.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Mali]] |subdivision_type1 = [[:en:Regions of Mali|Mkoa]] |subdivision_name1 = [[:en:Bamako Capital District|Bamako Capital District]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Bamako et fleuve Niger.jpg|thumbnail|260px|Bamako na [[mto Niger]]]] [[Picha:Mali-Bamako.png||thumbnail|left|260px|Bamako nchini Mali]] [[Picha:Hilltop view over Bamako.jpg|right|thumb|260px|Bamako kutoka mlimani]] [[Picha:People working at a Garbage Field in Bamako - 14th February 2005.jpg|thumb|260px|Watu huchunguza takataka shambani Bamako]] [[Picha:Sotrumas in Bamako - 12th February 2005.jpg|right|thumb|250px|[[Matatu]] au [[daladala]] za Bamako huitwa "sotruma".]] '''Bamako''' ni [[mji mkuu]] wa [[Mali]] pamoja na kuwa [[mji]] mkubwa nchini ikiwa na wakazi 4,227,569 mwaka 2022. Uko mwambaoni mwa [[mto Niger]] kusini mwa nchi. == Historia == Bamako ilianzishwa kama mji katika [[karne ya 17]] [[BK]] na machifu wa [[kabila]] la [[Niare]] [[Seribadian Niaré]] na [[Soumba Coulibaly]]. Jina la asili lilikuwa "Bammako" ([[Kibambara]]: ''"bwawa la mamba"''). Bamako ilikuwa soko muhimu pamoja na mji wa elimu ya Kiislamu katika Dola la Mali. Wakati wa karne ya 19 sifa zake zilikuwa zimepungua. Mwaka 1883 Wafaransa walikuta kijiji kikubwa cha watu 600 chenye kuta za ulinzi. Wakati wa ukoloni Bamako ikawa makao makuu ya koloni la [[Senegal ya Juu-Niger]] mwaka 1899 halafu mji mkuu wa [[Sudan ya Kifaransa]] mwaka 1920. Ikulu ya Koulouba ilijengwa 1907 kama makao makuu ya gavana ikawa ikulu ya rais baada ya uhuru. Mwaka 1904 Bamako iliunganishwa na reli ya [[Dakar]] - [[Niger]]. Majengo mengine ya siku zile yalikuwa kanisa kuu la katoliki mwaka 1927, daraja la kwanza juu ya mto Niger 1947 na misikiti mkuu mwaka 1948. Mwaka 1955 Bamako ilipewa cheo cha mji kufuatana na sheria ya kifaransa. Meya mwafrika wa kwanza alikuwa [[Modibo Keïta]] mwaka 1956. Tarehe 22 Septemba 1960 Mali ikapata uhuru wake Bamako ikawa mji mkuu wa jamhuri. == Majengo == Majengo mazuri mjini ni maktaba ya kitaifa, mnara ya Tour BCEAO, msikiti kuu na daraja la mfalme Fahd (Pont du Roi Fahd). Hata makumbusho ya kitaifa, makumbusho ya Muso Kunda, makumbusho ya mkoa wa Bamako, zoo ya Bamako na kilima cha "Point G" chenye uchoraji wa mwambani zinapendeza vilevile. Kuna uwanja wa ndege cha kimataifa na reli ya kwenda [[Koulikoro]] katika mashariki ya Mali na Dakar ([[Senegal]]). ==Tazama pia== * [[Orodha ya miji ya Mali]] == Viungo vya Nje == {{Commons}} * [http://www.bamako-culture.org/ Bamako-culture.org (Kifaransa)] {{Wayback|url=http://www.bamako-culture.org/ |date=20080621103815 }} * [http://www.cites.tv/citesdumonde/destinations.php?idDest=11 Bamako at ''Cités du Monde'' (Kifaransa)] {{Wayback|url=http://www.cites.tv/citesdumonde/destinations.php?idDest=11 |date=20050204141609 }} * [http://mrzine.monthlyreview.org/bamako.html The Bamako Appeal] {{Wayback|url=http://mrzine.monthlyreview.org/bamako.html |date=20070312050904 }} * [http://travel2.nytimes.com/2006/04/02/travel/02mali.html?ex=1144641600&en=5d9d61a127019b74&ei=5070&emc=eta1/ Makala kuhusu muziki wa Mali toka New York Times] * [http://www.nytimes.com/2006/04/02/travel/02music.html/ Makala zinazohusu muziki toka New York Times] {{list of African capitals}} [[Jamii:Mali]] [[Jamii:Miji ya Mali]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Mto Niger]] [[Jamii:Bamako| ]] [[Jamii:Mahali pa Urithi wa Dunia katika Afrika]] t10fel648vxaod2wlfd023vywu767vs 0 3474 1578036 1260800 2026-07-02T14:42:22Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578036 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Tunis |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Tunisia]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 602,560 |website = }} [[Picha:Tunis Place de la Victoire.JPG|thumb|260px|right|Place de la Victoire (Uwanja wa ushindi) mjini Tunis]] [[Picha:Tunis satellite.jpg|thumb|260px|right|Picha ya Tunis kutoka angani]] '''Tunis''' (kwa [[Kiarabu]]: '''تونس ''') ni [[mji mkuu]] wa [[Tunisia]] na [[mji]] mkubwa nchini ikiwa na wakazi 602,560 ([[mwaka]] 2022) ambao pamoja na wakazi wa mitaa ya nje wanafikia jumla ya [[milioni]] 2.7. Mji uko ufukoni mwa [[Mediteranea]], karibu na [[Karthago]] ya Kale. Mji wa kale ([[Medina ya Tunis]]) umeorodheshwa na [[UNESCO]] kama [[Urithi wa Dunia]]. ==Tazama pia== * [[Orodha ya miji ya Tunisia]] * [[Orodha ya Urithi wa Dunia katika Afrika]] {{wide image|Lac nuit 02.jpg|800px|Mandhari ya Tunis usiku|alt=Tunis City}} == Viungo vya nje == {{commons|Tunis|Tunis}} * [http://lexicorient.com/tunisia/tunis.htm Lexicorient] {{Wayback|url=http://lexicorient.com/tunisia/tunis.htm |date=20101124133120 }} * [http://www.andycarvin.com/archives/2005/12/the_bardo_museu.html Video tour] {{Wayback|url=http://www.andycarvin.com/archives/2005/12/the_bardo_museu.html |date=20060323095400 }} ya makumbusho ya Bardo * [http://www.andycarvin.com/archives/2005/11/strolling_throu_1.html Video of Tunis Medina] {{Wayback|url=http://www.andycarvin.com/archives/2005/11/strolling_throu_1.html |date=20060323094745 }} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Tunisia]] [[Jamii:Miji ya pwani ya Mediteranea]] [[Jamii:Mahali pa Urithi wa Dunia katika Afrika]] [[Jamii:Tunisia]] [[Jamii:Tunis| ]] cq5g8xj4s5og8m0op1gun383bldzcau 0 3476 1578032 1321613 2026-07-02T14:40:12Z Riccardo Riccioni 452 1578032 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Rabat |picha_ya_satelite = |picha_ya_mji = |jina_rasmi = Jiji la Rabat, Morocco |picha_ya_bendera = |ukubwa_ya_bendera = 100px |picha_ya_nembo = |ukubwa_ya_nembo = |pushpin_map = Moroko |pushpin_map_caption = Mahali pa mji wa Rabat katika Moroko |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Moroko]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 627 000 |latd=34 |latm=1 |lats=20 |latNS=N |longd=6 |longm=50 |longs=4 |longEW=W |website = http://www.rabat.ma/ }} [[Picha:Rabat Sale 6.83595W 34.02950N.jpg|thumb|300px|Picha ya angani ya Rabat]] '''Rabat''' ([[Kiarabu]] '''الرباط''' ''Ar-Ribat'') ni [[mji mkuu]] wa [[Moroko]] na mji mkubwa wa pili nchini baada ya [[Casablanca]] ikiwa na wakazi 1,622,860 ([[2004]]) pamoja na [[Sale (mji)|Sale]]. Jina lenyewe la "ribat" linadokeza kwa asili ya mji kuwa boma la kijeshi. Rabat iko mwambanoni wa [[Atlantiki]] kwenye mdomo wa mto [[Bou Regreg]]. Ng'ambo ya mto iko Sale ambayo ni mji pacha. Miji yote miwili ina viwanda vya nguo, vyakula na za ujenzi. Utalii pamoja na mabalozi ya nchi nyingi walioko Rabat kwa mfalme wanaongeza misingi ya uchimu wa mji. == Historia == Mji wa kwanza katika eneo la Rabat ya leo ulikuwa [[Chellah]]. Maghofu yake ni kando la mji wa kisasa ufukoni wa mto Bou Regreg. Mwaka 40 [[KK]] Waroma wakauvamia na kkufanya mji wa Kiroma wa Sala Colonia. Kuanzia mnamo mwaka 250 [[BK]] mji ulikuwa chini ya watawala wa Ki[[berber]]. Hadi mwaka 1146 mji wa kale ulikuwa umeshapungua sana labda hata bila watu kwa sababu mwaka ule mtawala wa [[Wamuwahid]] [[Abd al-Mu'min]] alijenga "ribat" yaani boma la mpakani kilomita kadhaa kutoka majengo ya Chellah yaliyotumika kama machimbo ya mawe ya kujengea. [[Picha:Rabat tour Hassan.jpg|thumb|Mnara wa Hassan]] Mjukuu wake [[Ya'qub al-Mansur]] alihamisha mji mkuu wake hapa. Alianzisha majengo makubwa lakini alikufa labla ya kuyatimiza. Mnara wa Hassan umebaki hadi leo. Baada ya kifo chake makao ya mfalme yalihamishwa kwenda [[Fez]] mji ulipungua hadi kuwa na nyumba pekee yenye watu 100 mwaka 1515 [[BK]]. Katika karne ya 17 BK miji ya Rabat na Sale ilijitegemea kuwa pamoja dola ndogo la [[Jamhuri ya Bou Regreg]] 1627 hadi 1818. Maisha ya wenyeji ilikuwa hasa [[uharamia]] baharini wakishambulia hasa jahazi za Wakristo hadi kuingizwa kwa eneo katika Ufalme wa Moroko. Wafaransa walipovamia Moroko 1912 na kuifanya nchi lindwa wakapeleka makao makuu tena Rabat kwa sanbabu za usalama. Sultani [[Yusef wa Moroko|Moulay Yusef]] aliwafuata na kuhamisha ikulu yake Rabat vilevile. Wakati wa uhuru mwaka 1956 Mfalme [[Mohammed V]] aliamua Rabat iwe mji mkuu wa kudumu. == Wenyeji wa Rabat == * [[Younes El Aynaoui]] (* 12.09. 1971), mcheza tennis * [[Dominique de Villepin]] (* 14.11. 1953), Waziri Mkuu wa Ufaransa (2005/6) == Marejeo == * [http://www.africatravelling.net/morocco/rabat/rabat_history.htm Travel in Rabat-History] {{Wayback|url=http://www.africatravelling.net/morocco/rabat/rabat_history.htm |date=20051110051239 }} == Viungo vya Nje == * [http://lexicorient.com/morocco/rabat.htm Entry in Lexicorient] {{Wayback|url=http://lexicorient.com/morocco/rabat.htm |date=20050206205604 }} * [http://www.rabatcity.tk rabatcit] {{Wayback|url=http://www.rabatcity.tk/ |date=20210725001534 }} for more information {{list of African capitals}} [[Jamii:Moroko]] [[Jamii:Miji ya Moroko]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Rabat| ]] or7ncsndd0wcgon4hn65afjltd36juy 0 3483 1577996 1544336 2026-07-02T14:17:15Z Riccardo Riccioni 452 /* Marejeo */ 1577996 wikitext text/x-wiki {{vyanzo}} [[Picha: Grandpalm_Gaborone_Botswana.jpg|thumb| Mji wa Gaborone]] '''Gaborone''' ni [[mji mkuu]] wa [[Botswana]] ukiwa na wakazi 246,325 (mwaka 2022), asilimia 10 ya wakazi wote wa nchi hiyo. Uko kusini-mashariki ya nchi. ==Historia== Mji huu ulianzishwa kwenye makao ya chifu Kgosi Gaborone wa BaTlokwa. Waingereza walijenga kituo kidogo cha kiutawala kando ya kijiji cha chifu. Makao haya madogo yalikua ghafla wakati wa uhuru wa Botswana ilipoamuliwa kujenga mji mkuu mpya. [[Botswana]] iliwahi kuwa na mji wake mkuu wa kikoloni ndani ya eneo la [[Afrika Kusini]] katika mji wa Mafeking ilitawaliwa na [[Uingereza]] kwa jina la "Bechuanaland Protectorate." Uhuru ulipokaribia viongozi waliona haja ya kuwa na mji mkuu ndani ya Botswana wakaamua kupanua Gaborone. Katika muda mfupi wa miaka mitatu mnamo 1965 - 1967 pekee mji mpya ukajengwa mwenye majengo ya bunge, serikali, kituo cha umeme, shule, hospitali, polisi, posta, benki, maduka, kanisa, hoteli, kiwanda cha bia, uwanja wa michezo na nyumba 1000. Leo hii Gaborone ni mji wa kisasa kabisa inayoonyesha maendeleo ya kiuchumi wa Botswana. Jumuiya ya Maendeleo ya [[Afrika Kusini]] (Southern African Development Community (SADC)) ina makao makuu yake Gaborone. Kuna pia Chuo Kikuu cha [[Botswana]]. == Marejeo == {{marejeo}} {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Botswana]] [[Jamii:Botswana]] 5krhuoj1z7ryq04k8l4o442t708zkap 0 3493 1578011 1259051 2026-07-02T14:23:02Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578011 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Lome |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Togo]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Imagelomé20.jpg|thumb|]] '''Lomé''' ni [[mji mkuu]] wa [[Togo]] katika [[Afrika ya Magharibi]] pia [[mji]] mkubwa wa nchi hiyo pamoja na kuwa [[kitovu]] chake cha kiutawala na kiuchumi ukiwa na wakazi wanaokadiriwa kuwa 796,000 (mwaka 2006). Iko mwambaoni mwa [[Ghuba ya Guinea]] ya [[Atlantiki]] kwenye [[pwani]] fupi ya Togo yenye [[upana]] wa km 52 pekee. Mji uko karibu na mpaka wa [[Ghana]]. == Historia ya Lome == Wakazi wa eneo la Lome walikuwa [[Waewe]] tangu [[karne ya 18]] [[BK]]. Jina la Lome limetokana na neno la Kiewe la "alos" linalomaanisha mti mdogo unaokua katika misitu ya pwani. Kabla ya kukua kwa Lome kitovu cha biashara ilikuwapo mji wa [[Aneho]]. Mwisho wa [[karne ya 19]] wafanyabiashara walianzisha soko kwenye pwani la kupokea bidhaa kutoka meli bila kulipa ushuru kwa Waingereza katika [[Ghana]] ("Koloni ya [[Pwani la Dhahabu]]") jirani. Mwaka 1880 Waafrika Chico na [[Octaviano Olympio]] walifika kama wawakilishi wa kampuni ya biashara ya Kiingereza "A. and F. Swanzy" na kujenga ghala. Misafara ya [[Wahausa]] iliingia kutoka kaskazini kubeba bidhaa kwao wakajenga kambi la kudumu. Wafanyabiashara waliendelea kujenga makao yao hapa hivyo kuanzisha mji mwambaoni kati yao pia makampuni ya Kijerumani. Serikali ya koloni la Ghana ya Kiingereza haikupendezwa na mashindano ya kiuchumi. Waewe walijisikia hatarini kuvamiwa na Waingereza jirani. Baada ya jaribio la Waingereza kuvamia Aneho kutoka Kitta (Ghana) chifu Mlapa tar. 5.07. 1884 alifanya mkataba wa ulinzi na konsuli Mjerumani [[Gustav Nachtigal]]. Mkataba huu ulukiwa mwanzo wa koloni ya [[Togo ya Kijerumani]]. Baada ya kuimarika kwa ukoloni wao Wajerumani walipeleka makao makuu ya utawala wao Lome tarehe 6.03.1897. Wakati ule mji ulikuwa na wakazi 2,000. Tangu 1904 bandari ilipatikana iliyofuatwa na reli kwenda Aneho (1905), [[Kpalime]] (1907) na [[Atakpame]] (1909). Hadi mwaka 1914 mji ulikuwa na wakazi 8,000 tayari wakati wa mwanzo wa [[Vita Kuu ya Kwanza ya Dunia]]. Wajerumani hawakuwa na uwezo kutetea koloni yao wakaikabidhi kwa Uingereza tar. 27. Agosti 1914 waliogawana eneo na Ufaransa mwaka 1916. Sehemu kubwa pamoja na Lome ikawa chini ya Ufaransa kama [[maeneo la kukabidhiwa|eneo la kukabidhiwa]] kwa amri ya [[Shirikisho la Mataifa]]. Mji uliendelea kukua haraka, ukawa na wakazi 15,000 mwaka 1930 na 30,000 mwaka 1950. Wakati wa uhuru mwaka 1960 Lome ikawa mji mkuu wa nchi huru ya Togo ikiwa na wakazi 80,000 walioongezeka kuwa 200,000 hadi 1970. == Uchumi == Biashara ya nje ni hasa [[kahawa]], [[kokoa]], [[kopra]] na [[mawese]]. Kuna kiwanda cha petroli. Msingi wa biashara ni bandari. ==Tazama pia== * [[Orodha ya miji ya Togo]] == Viungo vya nje == * [http://etudesafricaines.revues.org/document88.html The Olympio family] * [http://www.togo-confidentiel.com/texte/Info&Service/Lom%E9_et_sites.htm Map of Lomé] {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Togo]] [[Jamii:Togo]] [[Jamii:Lome| ]] 4t5qiz6petlzpzn6teiatsnjocc2egn 0 3503 1578039 1303668 2026-07-02T14:43:39Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578039 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Yaounde |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Kamerun]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Kamerun-ramani ya kisiasa.png|300px|right|thumb|Mahali pa Yaoundé katika Kamerun]] [[Picha:Centre_Province_Yaoundé_002.JPG|300px|thumb|Yaoundé]] '''Yaoundé''' ni [[mji mkuu]] na [[mji]] mkubwa wa pili nchini [[Kamerun]] baada ya [[Douala]]. Ina wakazi 1,299,369 ([[2021]]<ref name=GEONames>{{cite web|url=https://www.geonames.org/search.html?q=&country=CM|website=GEO Names|title=Kamerun|access-date=May 23, 2021}}</ref> == Jiografia == Mji uko kwenye kimo cha 730 [[m]] juu ya [[UB]] katika vilima vya Kamerun ya magharibi takriban 160 km kutoka mwambao wa [[Atlantiki]]. Hali ya hewa ni ya kitropiki; halijoto ina wastani ya 23.3 C°. Mvua hunyesha Septemba / Oktoba na Aprili / Mei. == Historia == Yaounde ilianzishwa mwaka 1888 [[BK]] na wanfanya biashara Wajerumani. Baada ya Vita Kuu ya Kwanza ya Dunia na mgawanyo wa nchi ikawa sehemu ya Kamerun ya Kifaransa na mji mkuu wa koloni kuanzia mwaka 1922. Wakati wa uhuru mwaka 1961 ilikuwa mji kuu wa Kamerun yote pamoja na sehemu zilizokuwa chini ya Uingereza. == Uchumi == Yaounde ni kitovu cha usafiri na mawasiliano ya nchi. Kuna viwanda vya tumbako, vyakula, vioo na ubao. Yaounde ni kitovu cha biashara kwa ajili ya kilimo cha kahawa, kakao, nguta na raba katika mazingira ya mji. Kuna pia migodi ya [[dhahabu]] na metali ya [[titani]]. == Waliozaliwa Yaounde == * [[Roger Milla]] (20 Februari 1952) mchezaji mpira wa miguu * [[Franck Songo'o]] (14 Mei 1987) mchezaji mpira wa miguu ==Tazama pia== * [[Orodha ya miji ya Kamerun]] ==Tanbihi== {{reflist}} == Viungo vya nje == * [http://www.uninet.cm/ Chuo Kikuu cha Yaounde] {{Wayback|url=http://www.uninet.cm/ |date=20060624005250 }} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Kamerun]] [[Jamii:Kamerun]] [[Jamii:Yaounde| ]] tkocjw3ruw46ggsq1kul4c93k0sdfmf 0 3509 1578019 1432924 2026-07-02T14:34:36Z Riccardo Riccioni 452 1578019 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Mbabane |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Eswatini]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Wz-map of Eswatini.gif|300px|right]] [[Picha: Mbabane.jpg|thumb|Mbabane, mji mkuu wa Eswatini]] '''Mbabane''' ni [[mji mkuu]] wa [[Eswatini]] ikiwa na wakazi 76,218 (2005). [[Ofisi]] za [[serikali]] ziko huko lakini [[bunge]] na [[jumba]] la [[mfalme]] yako mjini [[Lobamba]]. [[Mji]] uko kwenye [[milima]] ya [[Mdimba]] kwenye [[kimo]] cha [[mita]] 1200 juu ya [[UB]]. == Historia == Mji ulianzishwa na [[Waingereza]] [[mwaka]] [[1902]] [[BK]] baada ya [[vita]] dhidi ya [[makaburu]] ukawa [[makao makuu]] ya kiutawala ya eneo la Uswazi. [[Jina]] limetokana na [[chifu]] [[Mbabane Kunene]] aliyekuwa mkuu wa sehemu ile wakati wa kuunda mji. == Uchumi == Nguvu ya kiuchumi ya Mbabane ni [[migodi]] ya karibu ya [[bati]] na [[dhahabu]]. ==Tazama pia== * [[Orodha ya miji ya Eswatini]] == Viungo vya nje== * [http://www.swazi.com/mbabane2000/ Maelezo kuhusu Mbabane (Kiing.)] {{Wayback|url=http://www.swazi.com/mbabane2000/ |date=20060614090521 }} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Eswatini]] [[Jamii:Mbabane| ]] [[Jamii:Eswatini]] 9luyohl0x4gyod2y3xfg0gi10zteanj 0 3520 1578040 1274634 2026-07-02T14:44:15Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578040 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Yamoussoukro |picha_ya_satelite = Yakro basilique05.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = {{flag|Cote d'Ivoire}} |subdivision_type1 = [[Majimbo za Cote d'Ivoire|Jimbo]] |subdivision_name1 = [[Jimbo la Yamoussoukro|Yamoussoukro]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 355,573 |website = [http://yamoussoukro.org/en/index.htm yamassoukro.org/en/] }} [[Picha:Iv-map.png|thumb|260px|Yamoussoukro katika [[Côte d'Ivoire]]]] [[Picha:Yamoussoukro.jpg|thumb|260px|right|Kituo cha mabasi Yamoussoukro, kanisa kuu nyuma]] '''Yamoussoukro''' ni [[mji mkuu]] rasmi wa [[Cote d'Ivoire]] tangu 1983 ilipochukua nafasi hii kutoka [[Abidjan]] inayoendelea kuwa mji mkubwa na kitovu cha kiuchumi pia kiutamaduni na makao ya ofisi nyingi za serikali. Iko takriban 230&nbsp;km kutoka pwani karibu na kitovu cha nchi. Kuna wakazi 355,573 (mwaka 2014). == Historia ya mji == Chanzo cha Yamoussoukro ni kijiji kidogo kilichoitwa N'Gokro. Imeteuliwa kuwa mji mkuu na kukua kwa sababu ni mahali pa kuzaliwa kwa rais wa kwanza wa nchi [[Félix Houphouët-Boigny]]. Mwanzo wa [[ukoloni wa Kifaransa]] kijiji cha N'Gokro ilikuwa chini ya chifu wa kike Yamousso. Mwaka 1909 kabila la eneo hili liliasi dhidi ya Wafaransa lakini sehemu ya machifu pamoja na Yamousso waliwashauri wenzao kupatana na Wafaransa tena. Tendo hili lilisababishwa Wafaransa kuhamisha kituo chao cha kiutawala wa eneo kwenda N'Gokro wakiita Yamoussoukro kwa heshima ya chifu yake. Aliyekuwa rais baadaye Félix Houphouët-Boigny alizaliwa Yamoussoukro mwaka 1905. 1939 akawa chifu wa mahali akaendelea kujishughulisha na siasa na kuita mikutano wa machifu akiwaalika kwake kijijini. Baada ya kuwa rais wa Cote d'Ivoire mwaka 1960 aliamuru tangu mwaka 1964 kazi nyingi zifanywe kwake nyumbani kama ujenzi wa ikulu yake ya pili, majengo mengine ya umma, barabara, kituo cha umeme, viwanda, uwanja wa michezo na mengi mengine. Kelele ya ujenzi ilikuwa Kanisa Kuu la Yamoussoukro lililojengwa kwa mfano wa [[Kanisa la Mt. Petro]] huko [[Roma]] lakini kubwa kuliko kanisa lile linalotumikwa na [[Papa]] mwenyewe. Mwaka 1983 ilitangazwa rasmi kuwa mji mkuu lakini ofisi nyingi za serikali na wizara bado zimebaki Abidjan. ==Tazama pia== * [[Orodha ya miji ya Cote d'Ivoire]] ==Viungo vya nje== {{Commons}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Cote d'Ivoire]] [[Jamii:Yamoussoukro| ]] [[Jamii:Cote d'Ivoire]] 9coq33pb0xr14jkep2qyzn6j3zu7kk5 0 3521 1577992 1499095 2026-07-02T14:15:13Z Riccardo Riccioni 452 /* Tazama pia */ 1577992 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Conakry |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Guinea]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Guinea.png|thumb|right|250px|Conakry katika Guinea.]] [[Faili:Entre principal du palais du peuple conakry.jpg|thumb|250x250px|Jumba la Watu mjini Conakry]] '''Conakry''' (pia: Konakry) ni [[mji mkuu]] wa [[Guinea]] wenye wakazi 1,660,973 (mwaka 2014). [[Mji]] una [[bandari]] mwambaoni mwa [[Ghuba ya Guinea]] ya [[Atlantiki]]. == Historia == Chanzo cha Conakry ni kwenye [[kisiwa]] cha Tombo kilicho karibu sana na [[rasi]] ya [[Kaloum]]. Mji ulianzishwa baada ya kisiwa hicho kuhamishwa kutoka utawala wa [[Uingereza]] kwenda chini ya [[Ufaransa]]. Wafaransa waliunganisha mwaka 1887 vijiji vinne vya Conakry, Boulbinet, Krutown na Tombo. Mwaka 1889 Conakry ilikuwa makao makuu ya utawala wa koloni ya « Mito ya Kusini (Rivières du Sud) » na tangu 1891 ya Guinea ya Kifaransa ikakua kwa sababu ya bandari yake hasa baada ya kujengwa kwa reli kwenda Kankan. == Conakry leo == Leo kisiwa cha Tumbo kimeunganishwa na rasi ya Kaloum kwa [[barabara]]. Mji umeenea kufunika rasi yote. Kuna beledi tano mjini ambayo ni Kaloum (kitovu cha mji), Dixinn (penye chuo kikuu na balozi nyingi), Ratoma (penye vilabu na mabaa), Matam na Matoto penye uwanja wa ndege wa Gbessia. Mahali pa kuangaliwa ni [[Jumba la Makumbusho|makumbusho]] ya kitaifa, masoko, jengo la Jumba la Watu, [[msikiti]] mkuu na visiwa vya Los. ==Tazama pia== * [[Orodha ya miji ya Guinea]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji ya Guinea]] [[Jamii:Guinea]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Conakry| ]] aoanyjzhjt6akkdqgmmr1cqg6f4g7ol 0 3524 1577985 1432531 2026-07-02T14:12:00Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577985 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Bangui |picha_ya_satelite = Ubangi river near Bangui.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Jamhuri ya Afrika ya Kati]] |subdivision_type1 = [[:en:Prefectures of the Central African Republic|Mkoa]] |subdivision_name1 = [[:en:Bangui Autonomous Commune|Bangui Autonomous Commune]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha: Bangui_collage.png|thumb|Mji wa Bangui, Afrika ya kati]] [[Picha:Bangui Autonomous Commune Central African Republic locator.png|thumbnail|260px|right|Bangui katika Jamhuri ya Afrika ya Kati]] [[Picha:Bangui 18.45905E 4.41140N.jpg|thumbnail|260px|right|Bangui inavyoonekana kutoka angani]] '''Bangui''' ni [[mji mkuu]] wa [[Jamhuri ya Afrika ya Kati]]. Mji uko mwambaoni mwa [[mto Ubangi]]; ng'ambo ya mto uko mji wa [[Zongo]] katika [[Jamhuri ya Kidemokrasia ya Kongo]]. Una wakazi 531,763<ref>[http://www.statoids.com/ucf.html Statoids, Central African Republic (2003) {{en}}]</ref> Kuna viwanda vya nguo, vyakula, bira, viatu na sabuni. BiAshara ya nje inalenga wateja wa pamba, ubao, kahawa na katani. ==Tazama pia== * [[Orodha ya miji ya Jamhuri ya Afrika ya Kati]] == Marejeo == {{reflist}} == Viungo vya nje == {{Commons}} * [http://www.univ-bangui.info/ Tovuti rasmi ya Chuo Kikuu cha Bangui] {{Wayback|url=http://www.univ-bangui.info/ |date=20120216214707 }} {{fr}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Jamhuri ya Afrika ya Kati]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Jamhuri ya Afrika ya Kati]] [[Jamii:Bangui| ]] rp1fkxprb71d8ob2yuk2v5zs2zcvi1h 0 3643 1578026 1433369 2026-07-02T14:37:29Z Riccardo Riccioni 452 /* Tanbihi */ 1578026 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Nouakchott |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Mauritania]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Mr-map.png|thumb|250px|Mahali pa Nouakchott nchini Mauretania.]] [[Picha:Nouakchott SandDunesEncroaching.jpg|thumb|250px|[[Matuta ya mchanga]] kando ya Nouakchott.]] '''Nouakchott''' ([[Kiarabu]]: '''نواكشوط''') ni [[mji mkuu]] wa [[Mauritania]]. Uko mwambaoni mwa [[Atlantiki]] magharibi mwa nchi. Idadi ya wakazi imekadiriwa kupita milioni moja. == Historia == Hadi 1958 Nouakchott ilikuwa [[kijiji]] kidogo cha wavuvi. Imekua tangu [[uhuru]]. Wakati wa [[ukoloni]] Mauritania haikuhesabiwa kama eneo la pekee: ilikuwa sehemu tu ya [[Afrika ya Magharibi ya Kifaransa]] yenye mji mkuu wa [[Saint-Louis]] huko [[Senegal]]. Baada ya azimio la kugawa eneo la Kifaransa katika Afrika ya Magharibi Nouakchott ikateuliwa kuwa mji mkuu ujao na mradi wa [[ujenzi]] ulilenga kuongeza idadi ya wakazi hadi kufikia watu 15,000. Baada ya uhuru mwaka [[1962]] mji ukawa mji mkuu wa Mauritania. Katika [[miaka ya 1970]] idadi ya wakazi iliongezeka sana kutokana na [[ukame]] uliofukuza watu wengi [[shamba|mashambani]], kati ya miaka [[1969]] na [[1980]] kutoka wakazi 20,000 kufikia 150,000. Siku hizi mju una tatizo zito la uhaba wa [[maji]] kwa wakazi wake wengi. ==Tazama pia== * [[Orodha ya miji ya Mauritania]] ==Tanbihi== {{marejeo}} {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Mauritania]] [[Jamii:Nouakchott| ]] [[Jamii:Mauritania]] h2sbrvk21uaut52tvrbs5qc9u02v5si 0 3645 1578018 1433224 2026-07-02T14:34:01Z Riccardo Riccioni 452 /* Tazama pia */ 1578018 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Maseru |picha_ya_satelite = Maseru from Parliament Hill.jpg |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Lesotho]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:Maseru_Leotho_main_south.jpg|thumb|300px|Barabara kuu ya kuelekea kusini ya Maseru]] [[Picha:LocationMaseru.png|thumb|260px|Maseru katika Lesotho]] '''Maseru''' ni [[mji mkuu]] wa [[Lesotho]] na mji mkubwa ukiwa na wakazi 330,760 ([[2016]]). Maseru iko kwa [[mto]] [[Caledon]] (Mohokare). [[Chuo Kikuu cha Lesotho]] na kiwanja cha kimataifa cha ndege ni karibu na mji. == Historia == Ilikuwa kituo kidogo cha [[biashara]] ilipoteuliwa na chifu [[Moshoeshoe I]] wa [[Wasotho]] kuwa mji mkuu wake mwaka [[1869]]. Tangu mwaka [[1884]] hadi [[1966]] ilikuwa mji mkuu wa [[nchi lindwa]] ya "[[Basutoland]]" chini ya [[Uingereza]]. Mwaka 1966 ikawa mji mkuu wa Lesotho huru. == Uchumi == Kuna viwanda vya kutengenezea mishumaa na matandiko ya zulia. Kuna pia viwanda vya vitambaa kwa ajili ya [[soko]] la [[Marekani]]. ==Tazama pia== * [[Orodha ya miji ya Lesotho]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Lesotho]] [[Jamii:Lesotho]] [[Jamii:Maseru| ]] g6qaubiz11gqqtusgwpkqtl03wjrj48 0 3648 1578024 1394653 2026-07-02T14:36:36Z Riccardo Riccioni 452 /* Viungo vya Nje */ 1578024 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la N'Djamena |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Chad]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 1,093,492 |website = }} '''Ndjamena''' ni [[mji mkuu]] pia [[mji]] mkubwa kabisa nchini [[Chad]] ikiwa na wakazi 1,093,492 mnamo [[mwaka]] [[2013]].<ref>[https://www.oecd-ilibrary.org/development/cahiers-de-l-afrique-de-l-ouest_20743556 Cahiers de l'Afrique de l'Ouest Dynamiques de l'Urbanisation Africaine 2020: Africapolis, Une Nouvelle Géographie Urbaine]. OECD. 20 fevereiro 2020</ref> Ndani ya [[Manispaa|manisipaa]] kuna hara au [[Mtaa|mitaa]] kumi. == Jina == Zamani mji ulijulikana kwa [[jina]] la "Fort Lamy". Tangu mwaka [[1973]] jina limekuwa Ndjamena, N'Djaména, N'Djamena au Ndjaména. == Jiografia == Mji wa Ndjamena uko mahali ambako [[Mto|mito]] ya [[Chari]] na [[Logone]] inaungana. Ng'ambo ya mto uko mji wa [[Kousseri]] nchini [[Kamerun]]. == Historia == Ndjamena ilianzishwa na [[Ufaransa|Mfaransa]] [[Émile Gentil]] [[tarehe]] [[29 Mei]] [[1900]] kama kambi ya kijeshi ikiitwa '''Fort-Lamy''' kama [[kumbukumbu]] ya [[kamanda]] [[Amédée-François Lamy]] aliyeuawa [[vita|vitani]] kwenye mapigano ya Kousseri siku chache kabla ya kuanzishwa kwa Fort Lamy<ref>Roman Adrian Cybriwsky, ''Capital Cities around the World: An Encyclopedia of Geography, History, and Culture'', ABC-CLIO, USA, 2013, p. 208</ref><ref name="inpictures">{{cite book|url=https://books.google.com/books?id=kkB1GaR2SXEC&pg=PT19|title=Chad in Pictures|last=Zurocha-Walske|first=Christine|publisher=Twenty-First Century Books|year=2009|isbn=978-1-57505-956-3|page=17|access-date=2015-11-15|archive-url=https://web.archive.org/web/20160430061439/https://books.google.com/books?id=kkB1GaR2SXEC&pg=PT19|archive-date=2016-04-30|url-status=live}}</ref> . Jina lilibadilishwa na rais [[François Tombalbaye]] kuwa Ndjamena mwaka 1973. Wakati wa [[vita ya wenyewe kwa wenyewe]] ya Chad 1979 / 1980 mji uliharibika na wakazi wengi waliondoka mjini lakini katika miaka ya baadaye wengine wengi waliingia.<ref>Samuel Decalo, ''Historical Dictionary of Chad'', Scarecrow, 1987, pp. 229–230</ref> == Wakazi == Mji ulikua sana na haraka. Huduma za [[maji]], [[umeme]] na makao havitoshi tena. '''<small>Mwaka * Idadi ya Wakazi</small>''' * [[1937]] : 9 976 * [[1940]] : 12 552 * [[1947]] : 18 375 * [[1968]] : 126 483 * [[1993]] : 529 555 * [[2005]] : 721 000 '''Makabila na vikundi mjini mwaka 1993''':<br /> * [[Waarabu wa Chad]] : 11,08 % * Ngambay : 16,41 % * Hadjeray : 9,15 % * Daza : 6,97 % * Bilala : 5,83 % * Kanembou : 5,80 % * Maba : 4,84 % * Kanouri : 4,39 % * Gor : 3,32 % * Kouka : 3,20 % * Sar : 2,24 % * Barma : 2,10 % == Uchumi == Ndjamena ni [[kitovu]] cha [[uchumi]] wa Chad. == Elimu == Ndjamena ina [[Chuo|vyuo]] na [[shule]] mbalimbali kama vile. '''Shule za [[Elimu ya sekondari|Sekondari]] (Lycée) :''' * Lycée [[Félix Éboué]] (ya serikali) * Lycée technique commercial (ya seriali) * Lycée du Sacré-Cœur (binafsi - kikatoliki) * Lycée-Collège évangélique (binafsi kiprotestant) * Lycée Ibnou - Cinna (Kifaransa - Kiarabu) * Lycée Roi Faycal (Kiarabu) * Lycée [[Kuwait|Koweitien]] (Kiarabu) * Lycée d'Amérigue (ya serikali) * Lycée de Farcha (ya serikali) * Lycée Technique Industrielle * Lycée du Pont de Chagoua * Lycée de Waliya * Lycée de La Liberté * Lycée de la Gendarmerie, etc. '''[[Chuo Kikuu|Vyuo Vikuu]] (Université) :''' * [[Université de Ndjamena]] (ya serikali) :créée en [[1970]] * Université Roi Fayçal (binafsi - kiislamu) '''Taasisi za [[elimu ya juu]] (École Supérieure) :''' * ISSED - Institut Supérieur des Sciences de l'Éducation * ENAM - École Nationale d'Administration et de Magistrature * EIE - École Supérieure d'Électronique et d'Informatique * ENASS - École Nationale des Sciences Infirmières et Sociales * INJS - Institut Supérieur de la Jeunesse et des Sports * ENS - École Normale Supérieure * ENTP - École Nationale des Travaux Publics * ISTAP - Institut Supérieur des Techniques Appliquées == Marejeo == {{Marejeo}} == Viungo vya Nje == * [http://maps.google.com/maps?ll=12.117040,15.075817&spn=0.078044,0.123081&z=4&t=k&hl=fr Image satellite Google Maps] {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Chad]] [[Jamii:Miji ya Chad]] [[Jamii:N'Djamena| ]] mhyvdhtm399zq9aihn84biqfl1h9w7l 0 3655 1577993 912046 2026-07-02T14:15:44Z Riccardo Riccioni 452 /* Walizaliwa Dakar */ 1577993 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Dakar |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Senegal]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:National assembly (Dakar, Senegal).jpg|250px|thumb|right|Jengo la Bunge (Assemblée Nationale)]] [[Picha:Dakar_map.jpg|280px|right|Ramani ya mitaa ya Dakar]] '''Dakar''' ni [[mji mkuu]] wa [[Senegal]] ikiwa na wakazi 2,352,000. Iko kwenye rasi la Verde ambalo ni pembe la magharibi ya [[Afrika]]. Bandari yake ina nafasi nzuri kwa biashara na [[Ulaya]] na [[Amerika]]. Mji ulianzishwa na [[Ufaransa|Wafaransa]] mwaka 1857 walipoondoka kisiwa cha [[Goree]] kuhamia bara. Ukapata bandari ya biashara na pia bandari ya kijeshi halafu ukawa mwanzo wa reli katika Senegal. Mwaka 1902 Dakar ilikuwa mji mkuu wa Afrika ya Magharibi ya Kifaransa badala ya [[Saint-Louis]]. Kati 1959 hadi 1960 ilikuwa mji mkuu wa [[Shirikisho la Mali]], baadaye mji mkuu wa Senegal. Kisiwa cha Goree ambacho sasa ni sehemu ya mji kilikuwa kati ya vituo muhimu vya [[biashara ya watumwa]]. Boma la Fort D'Estrees [[Gorée]] kisiwani humo lilikuwa gereza la watumwa kabla ya kupelekwa kwenye meli na leo ni makumbusho. == Waliozaliwa Dakar == * [[Youssou N'Dour]], mwimbaji ya mwanamuziki * [[Patrick Vieira]], mchezaji mpira wa miguu Mfaransa {{list of African capitals}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Senegal]] [[Jamii:Senegal]] [[Jamii:Dakar| ]] iz5nugtbcgh16rnjb1r84m9xk2bdpzb 0 3661 1577978 1324617 2026-07-02T13:27:50Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577978 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Aljeri |picha_ya_satelite = Algeri01.jpg |picha_ya_bendera = |ukubwa_ya_bendera = 100px |picha_ya_nembo = Algiers-COA.svg |ukubwa_ya_nembo = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Aljeria]] |subdivision_type1 = [[:en:Provinces of Algeria|Jimbo]] |subdivision_name1 = [[Jimbo la Aljeri]] |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} '''Aljeri''' ([[Kiarabu]]: '''مدينة الجزائر''', ''madīnat al-djazā'ir,'' "mji wa visiwa"; [[Kifaransa]]: ''Alger'') ni [[mji mkuu]] pia mji mkubwa kabisa wa nchi ya [[Aljeria]] ikiwa na wakazi [[milioni]] 2 (mwaka 2005), pamoja na mitaa ya nje takriban milioni 5. Iko [[Mwambao|mwambaoni]] mwa [[bahari]] ya [[Mediteranea]]. Aljeri ni makao ya [[serikali]] na [[kitovu]] cha [[uchumi]], [[biashara]], [[utamaduni]] na [[mawasiliano]] nchini. Kasbah yake imeorodheshwa na [[UNESCO]] kama [[Urithi wa Dunia]]. [[Picha:Sm Bombardment of Algiers, August 1816-Luny.jpg|thumb|right|260px|Waingereza walivamia meli za maharamia Aljeri mnamo Agosti 1816.]] [[Picha:Algeri04.jpg|thumb|260px|Majengo ya nyakati za ukoloni.]] [[Picha:Algeri08.jpg|thumb|right|260px|Mtaa wa Aljeri mwambaoni.]] [[Picha:Algeri06.jpg|right|thumb|260px|Uwanja wa "Mashahidi wa Uhuru".]] [[Picha:Algiersnasa.jpg|right|260px|Aljeri inavyoonekana kutoka angani.|alt=Algiers inavyoonekana kutoka angani.]] == Historia == Mji ulianzishwa kama [[koloni]] la [[Wafinisia]] katika [[karne ya 4 KK]]. Mahali palifaa kutokana na visiwa vinne vidogo vilivyokuwepo karibu na mwambao (lakini katika [[karne ya 17]] [[BK]] viliunganishwa na bara). Baada ya kuenea kwa [[Dola la Roma]] ikawa mji wa Icosium na kuvamiwa na [[Waarabu]] [[Waislamu]] mwaka [[702]]. [[Waberber]] wa [[kabila]] la Beni Mezghenna walikaa katika eneo hili. Mwaka [[960]] kiongozi wa Kiberber [[Buluggin ibn Ziri]] aliyekuwa [[gavana]] wa [[makhalifa]] wa [[Fatimiya]] wa [[Misri]] aliteua mahali pa Icosium na kujenga [[boma]] hapa. Mji uliitwa sasa "Al-djazair-Mezghenna" yaani "visiwa vya Beni Mezghenna". Ndiyo [[asili]] ya [[jina]] la leo "Al djaza'ir (الجزائر)" yaani "visiwa". Katika [[karne]] zilizofuata mji ulivamiwa na [[watawala]] [[Wamurabitun]] na [[Wamuwahidun]] kutoka [[Moroko]]. Baadaye ukawa chini ya [[Sultani|masultani]] wa Aljeria ya Kaskazini. Mnamo mwaka [[1302]] [[Uhispania]] ilifaulu kushika visiwa vidogo mwambaoni kwa miaka kadhaa hadi kufukuzwa tena na mharamia [[Barbarossa]] aliyeteka mji kwa niaba ya Sultani wa [[Uturuki]]. Tangu [[karne ya 16]] BK Aljeri ikawa mji wa kujitawala ndani ya [[Dola la Uturuki]]. Imekuwa mara kwa mara [[makao makuu]] ya [[uharamia|maharamia]] wa Mediteranea ya magharibi. Maharamia hao walishambulia [[jahazi]] za [[Wakristo]] kama [[Waitalia]], [[Wafaransa]], [[Wahispania]] na kadhalika na kuteka [[abiria]] pamoja na [[Baharia|mabaharia]]. Waliuzwa kama [[watumwa]] au kurudishwa kwao baada ya kulipiwa [[pesa]]. Maharamia waliweza pia kushambulia miji ya Wakristo mwambaoni mwa Mediteranea na kutwaa wakazi kama watumwa. Hali hiyo ilisababisha tena na tena majaribio ya nchi za [[Ulaya]] kuvamia Aljeri lakini bila kufaulu hadi [[karne ya 19]]. Mwaka [[1815]] [[Marekani]] ilishambulia Aljeri baada ya kupotea [[meli]] na [[raia]] kwa maharamia wa mji; mwaka [[1816]] [[Waingereza]] pamoja na [[Waholanzi]] walishambulia tena kwa kusudi la kulinda meli na raia zao. Walifaulu kumlazimisha mtawala wa Aljeri atie [[sahihi]] [[mkataba]] wa kutochukua tena watumwa kutoka nchi za Ulaya ingawa [[biashara]] hii iliendelea kwa siri hata baadaye. Mwaka [[1830]] Wafaransa walivamia mji na kuanzisha utawala uliokuwa mwanzo wa ukoloni wa Kifaransa katika Aljeria. Wafaransa walipanua na kubadilisha mji wa Kiarabu na Kiberber. Katika karne ya 19 Wafaransa wengi walihamia Aljeria hadi Aljeri ilikuwa mji mwenye wakazi wengi Wafaransa kuliko wenyeji waliokaa hasa katika mji wa kale ulioitwa "Kasbah". Wafaransa waliozaliwa Aljeria walijiita "pieds noir" (miguu myeusi). Wakati wa [[Vita Kuu ya Pili ya Dunia]] Aljeria ilikuwa chini ya [[serikali]] ya Kifaransa katika maeneo yasiyovamiwa na [[Ujerumani]] hadi kuingiliwa na [[wanajeshi]] Wamarekani na Waingereza mwaka [[1942]]. Baadaye ikawa mji mkuu wa "[[Ufaransa Huru]]" hadi mwisho wa [[vita]]. Tangu [[uhuru]] wa Aljeria ([[1962]]) Aljeri imekuwa mji mkuu wa Aljeria. Akina pieds noir walio wengi waliondoka wakihofia uchungu baada ya [[vita vya ukombozi]]. == Marejeo == {{marejeo}} ==Viungo vya nje== {{Commons}} {{mbegu-jio-Algeria}} {{list of African capitals}} [[Jamii:Algeria]] [[Jamii:Miji ya Algeria]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya pwani ya Mediteranea]] [[Jamii:Algiers| ]] [[Jamii:Miji ya Dola la Roma]] 3xde2wh2sifko4etdt7fcgv4g2gi5pc 0 3673 1578015 1385639 2026-07-02T14:32:24Z Riccardo Riccioni 452 1578015 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Momoju |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Mayotte]], [[Ufaransa]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:2004 12 12 18-24-04 rose sea in mamoudzou mayotte island.jpg|thumb|right|250px|Bahari mbele ya Momoju pamoja na jahazi za mapunziko wakati wa jioni.]] '''Momoju''' ni [[mji mkuu]] wa [[eneo la ng’ambo la Ufaransa]] la kisiwa cha [[Mayotte]]. Iko kwenye kisiwa kikuu cha [[Maore (kisiwa)|Maore]]. Kuna takribani wakazi 45,000. == Utawala == Mji una vijiji sita pamoja na kitovu cha mji mwenyewe, ndivyo [[Kaweni]] (hapa kuna viwanda), [[Mtsapere]], [[Pasamainti]], [[Vahibe]], [[Tsoundzou I na Tsoundzou II]]. Eneo lake hutawaliwa katika wilaya tatu za Momoju I, Momoju II na Momoju III. == Wakazi == {| align="left" rules="all" cellspacing="0" cellpadding="4" style="border: 1px solid #999; border-right: 2px solid #999; border-bottom:2px solid #999; background: #f3fff3" |+ style="font-weight: bold; font-size: 1.1em; margin-bottom: 0.5em"| Mabadiliko ya idadi ya wakazi |-style="background: #ddffdd" ! [[1991]] !! [[1997]] !! [[2002]] |- | align=center| 20 307 || align=center| 32 733 || align=center| 45 485 |- | colspan=6 align=center| <small>Namba kamili zimepatikana tangu [[1991]] |} <br /><br /><br /><br /><br /><br /> {| align="left" rules="all" cellspacing="0" cellpadding="4" style="border: 1px solid #999; border-right: 2px solid #999; border-bottom:2px solid #999; background: #f3fff3" |+ style="font-weight: bold; font-size: 1.1em; margin-bottom: 0.5em"| Wakazi katika vijiji |-style="background: #ddffdd" ! Village !! [[1997]] !! [[2002]] |- | align=center| Kavani || align=center| 3 948 || align=center| 5 488 |- | align=center| Kaweni || align=center| 6 206 || align=center| 9 604 |- | align=center| '''Momoju''' || align=center| 5 666 || align=center| 6 533 |- | align=center| Mtsapere || align="center" | 6 979 || align=center| 10 495 |- | align=center| Pasamainti || align="center" | 5 173 || align=center| 6 008 |- | align=center| Tsountsou I || align="center" | 2 093 || align=center| 3 058 |- | align=center| Tsountsou II || align="center" | 574 || align=center| 1 063 |- | align=center| Vahibe || align="center" | 2 135 || align=center| 3 236 |} == Viungo vya Nje == * [http://www.insee.fr/fr/insee_regions/reunion/zoom/mayotte/recensements/poplegale.htm Communes de Mayotte sur le site de l'Insee] {{list of African capitals}} [[Jamii:Mayotte]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Momoju| ]] llsv4mbkxluzrorl2z7o89j8uamj22w 0 3680 1578033 1024567 2026-07-02T14:41:14Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578033 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Saint-Denis |picha_ya_nembo = Blason St-Denis Réunion DOM.svg |ukubwa_ya_nembo = |picha_ya_satelite = Réunion-Saint-Denis.png |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Réunion]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 197464 |latd= 20|latm=52 |lats=44 |latNS=S |longd= 55|longm= 26|longs= 53|longEW=E |website = [http://www.saintdenis.re/ www.saintdenis.re] }} [[Picha:Saint-Denis Reunion city and mosque dsc07313.jpg|right|250px|thumb|Kitovu cha Saint-Denis na misikiti ya Noor-e-Islam]] [[Picha:Mairie-saint-denis.JPG|thumb|250px|right|Nyumba ya manisipaa na nguzo ya ushindi]] '''Saint-Denis''' (au '''Saint-Denis de la Réunion''') ni [[mji mkuu]] wa [[eneo la ng’ambo la Ufaransa]] (kwa [[Kifaransa]]: "département d'outre-mer") la [[Réunion]] ambayo ni [[kisiwa]] kimojawapo cha [[funguvisiwa]] la [[Maskarena]] katika [[Bahari Hindi]]. Saint-Denis ni pia [[mji]] mkubwa wa kisiwa ukiwa na wakazi 131,557 ([[mwaka]] [[1999]]). == Historia == Saint-Denis ilianzishwa na [[Mfaransa]] [[Étienne Régnault]] mnamo mwaka [[1669]] ikawa mji mkuu wa kisiwa mwaka [[1738]]. Saont-Denis ni [[makao makuu]] ya [[Dayosisi|jimbo]] la [[Kanisa Katoliki]] ambalo zamani lilienea kutoka pwani za [[Somalia]] hadi [[Madagaska]] pamoja na visiwa vyote vya Bahari Hindi. Kwa msingi huo [[askofu]] wake alituma kisiwani [[Zanzibar]] (leo nchini [[Tanzania]]) [[wamisionari]] wa kwanza wa [[karne ya 19]] ambao wamekuwa chanzo cha [[Kanisa]] hilo [[Afrika Mashariki]]. Mwaka [[1860]] Zanzibar ilitengwa pamoja na [[pwani]] ya Afrika ya Mashariki kuwa jimbo dogo la pekee, sawa na ilivyokuwa kwa [[Madagaska]] tangu mwaka [[1841]].<ref>[http://www.catholic-hierarchy.org/diocese/dsdlr.html Diocese of Saint-Denis-de-La Réunion, Dioecesis S. Dionysii Reunionis], tovuti ya .catholic-hierarchy.org, iliangaliwa Februari 2018</ref> == Usafiri == Kuna [[kiwanja cha ndege]] cha [[Aéroport de la Réunion Roland Garros]] ambayo ni [[geti]] la kisiwa kwa [[safari]] za kimataifa. [[Bandari]] kuu ya kisiwa iko Pointe-des-Galets nje ya mji. ==Tazama pia== *[[Saint-Denis]], mji wa Ufaransa karibu na Paris ==Tanbihi== <references/> == Viungo vya nje == * [http://www.ville-saintdenis-reunion.fr/ Ukurasa rasmi wa mji] (Kifaransa) {{list of African capitals}} [[Jamii:Réunion]] [[Jamii:Miji ya Ufaransa]] [[Jamii:Miji Mikuu Afrika]] 9uarqw0dz9b4oe641fy7vsfr4tm0vyi 0 5614 1578198 1520303 2026-07-03T02:42:04Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578198 wikitext text/x-wiki {{Jedwali la nchi | jina_rasmi = Muungano wa Madola ya Meksiko | jina_asili = ''Estados Unidos Mexicanos'' (Kihispania) | bendera = Flag of Mexico.svg | nembo = Coat of arms of Mexico.svg | kaulimbiu = | wimbo = ''Himno Nacional Mexicano''<br>"Wimbo wa Taifa wa Meksiko" | ramani = Mexico (orthographic projection).svg | mji_mkubwa_na_mkuu = [[Mexico (mji)]] | majiranukta1 = 19°26′K | majiranukta2 = 99°08′M | lugha_rasmi = [[Kihispania]] | lugha3 = 68 lugha za asili | kiongozi1 = Claudia Sheinbaum | kiongozi2 = Gerardo Fernández Noroña | cheo_kiongozi1 = [[Rais]] | cheo_kiongozi2 = [[Rais]] wa [[Seneti]] | muundo_uhuru = '''Historia''' | tukio1 = Mwanzo wa Vita ya Uhuru | tukio2 = Tangazo la Uhuru | tukio3 = Katiba ya sasa | tukio4 = | tukio1_tarehe = 16 Septemba 1810 | tukio2_tarehe = 27 Septemba 1821 | tukio3_tarehe = 5 Februari 1917 | tukio4_tarehe = | eneo_jumla = 1,972,550 | cheo_eneo = 13 | maji = 1.58% | ardhi = | watu_kadirio = 131,946,900 | mwaka_kadirio = 2025 | msongamano = 61 | pato_ppp = {{increase}} $3.408 trilioni | pato_ppp_kwa_mtu = {{increase}} $25,557 | cheo_plt_kawaida_kwa_mtu = 70 | plt = {{decrease}} $1.818 trilioni | mwaka_pato = 2025 | pato_kwa_mtu = {{decrease}} $13,630 | cheo_plt_kawaida = 12 | cheo_plt_kawaida_kwa_mtu = 63 | mwaka_maendeleo = 2023 | maendeleo = {{increase}} 0.789 {{katikati}} | gini = 40.2 | mwaka_gini = 2022 | fedha = [[Peso ya Meksiko]] (MXN) | majira_saa = UTC−8 hadi −5<br>UTC−7 hadi −5 (DST) | udereva = Kushoto | msimbo_simu = 52 | tld = .mx }} '''Meksiko''', rasmi '''Muungano wa Madola ya Meksiko'''' (kwa [[Kihispania]]: ''Los Estados Unidos Mexicanos''), ni [[nchi]] katika [[Amerika ya Kaskazini]]. Inapakana na [[Marekani]] upande wa kaskazini, [[Guatemala]] na [[Belize]] upande wa kusini, [[Bahari ya Karibi]] upande wa mashariki, na [[Bahari ya Pasifiki]] upande wa magharibi. Meksiko ina eneo la takriban kilomita za mraba 1,964,375, na ni miongoni mwa nchi kubwa zaidi [[dunia|duniani]]. Ina mandhari mbalimbali kuanzia jangwa la Chihuahua hadi misitu ya mvua ya Yucatán, na historia tajiri inayojumuisha [[ustaarabu]] wa kale kama [[Wamaya]] na [[Waazteki]]. Ina idadi ya watu inayokadiriwa kuwa zaidi ya milioni 126 (2024), na hivyo kuwa nchi ya 10 kwa idadi ya watu duniani. Mji mkuu na mji mkubwa zaidi wa [[Meksiko (mji)|mji wa Meksiko]] ni Mexico City, ambao pia ni kitovu cha [[siasa]], [[uchumi]], na [[utamaduni]] wa [[taifa]] hilo. Licha ya changamoto kama ukosefu wa usawa wa [[jamii|kijamii]] na usalama, Meksiko ni moja ya nchi zenye [[uchumi]] mkubwa barani [[Amerika]], na ni mwanachama wa mashirika muhimu kama [[Umoja wa Mataifa]], [[G20]], na Jumuiya ya Nchi za Amerika (OAS). == Historia == Nchi jinsi ilivyo leo imeundwa na wakoloni Wa[[hispania]] walioivamia kuanzia mwaka [[1519]] na kuvunja [[utawala]] wa milki za wenyeji kama [[Azteki]] na [[Maya]]. ===Kabla ya uvamizi wa Hispania=== Watu wa kwanza waliofika huko kutoka kaskazini walikuwa [[Waindio]], wajukuu wa wahamiaji walioingia [[Amerika]] kutoka [[Asia ya Kaskazini]]. Hakuna uhakika kufika huko kulitokea lini: labda miaka 10,000 iliyopita<ref>[https://books.google.com/books?id=Qxp-GWiDPioC&pg=PA386#v=onepage&q&f=false Michael S. Werner (January 2001). Concise Encyclopedia of Mexico. Taylor & Francis. pp. 386–. ISBN 978-1-57958-337-8]</ref>. Hao Waindio walikuwa [[wakulima]] hodari sana na [[mazao]] mbalimbali ambayo leo ni msingi wa [[chakula]] kote [[duniani]] yalianzishwa na kupandishwa nao, yakiwa pamoja na [[mahindi]], [[mboga]] na [[nyanya]]. [[Kilimo]] cha mahindi hukadiriwa kilianzishwa takriban mnamo mwaka [[9000 KK]]<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC122905/ A single domestication for maize shown by multilocus microsatellite genotyping, Proc Natl Acad Sci U S A. 2002 Apr 30; 99(9): 6080–6084. doi: 10.1073/pnas.052125199]</ref><ref>{{Rejea tovuti |url=http://learn.genetics.utah.edu/content/selection/corn |title="The Evolution of Corn". University of Utah HEALTH SCIENCES. Retrieved 2 January 2016 |accessdate=2016-03-20 |archive-date=2016-04-01 |archive-url=https://web.archive.org/web/20160401040226/http://learn.genetics.utah.edu/content/selection/corn/ |url-status=dead }}</ref>. [[Picha:20041229-Olmec Head (Museo Nacional de Antropología).jpg|250px|thumbnail|left|Sanamu ya kichwa ya Kiolmeki]] Kilimo kiliweka msingi kwa [[Kijiji|vijiji]] na [[jamii]] zilizoshirikiana katika maeneo makubwa. [[Miji]] ya kwanza inajulikana kuanzia takriban mwaka [[1500 KK]]. Staarabu mbalimbali zilistawi na kukua katika maeneo ya pwani ([[Waolmeki]], Wamaya) na katika [[nyanda za juu]] za Mexico ya kati ([[Wazapoteki]], [[Wamixeki]], [[Watolteki]], Waazteki). ====Waolmeki==== Ustaarabu wa kwanza unaojulikana ulikuwa wa [[Waolmeki]] baina ya 1500 KK na [[400 KK]]. Habari zao zinajulikana kutokana na [[akiolojia]] na mabaki ya miji na [[sanaa]] yao. Waolmeki walijenga miji wakaacha mifano ya sanaa yenye kiwango cha juu. Waliishi katika kanda la pwani la Mexiko katika majimbo ya leo ya [[Veracruz (jimbo)|Veracruz]] na [[Tabasco (jimbo)|Tabasco]]. Ni watu wa kwanza katika Mexiko wanaojulikana kubuni [[mwandiko]] na [[kalenda]], [[mchezo]] wa [[mpira]] na [[ujenzi]] wa [[piramidi]] za [[hekalu]]. Walikuwa hodari sana kuchonga [[sanamu]] ya [[Jiwe|mawe]], hasa [[Kichwa|vichwa]] vikubwa vyenye [[urefu]] WA zaidi ya [[mita]] 3. Walifaulu kuunda sanaa hii bila kujua vifaa vya [[metali]]. [[Picha:Zacuelu2.jpg|thumbnail|Hekalu - piramidi ya Kimaya]] [[Picha:Madrid Codex 9.jpg|thumbnail|150px|Ukurasa kutoka kitabu cha Kimaya - maandishi ya hiroglifi]] Sanamu nyingine inayorudirudi ni mtu-jagwaa inayounganisha sehemu ya [[maumbile]] ya [[binadamu]] na [[jagwa]]. Takriban mwaka 400–[[300 KK]] miji yao iliachwa na wakazi; hakuna uhakika ni nini iliyosababisha mwisho wa ustaarabu huu. ====Wamaya==== Upande wa [[mashariki]] wa Waolmeki ustaarabu wa [[Wamaya]] ulianza tangu takriban mwaka [[2000 KK]]. Wamaya walikalia [[rasi]] ya [[Yucatan]] pamoja na Guatemala na Belize ya leo. Waliishi katika vijiji na miji iliyojitegemea na kugombana kati yao mara kwa mara. Wamaya walibuni mwandiko wa [[hiroglifi]] wenye [[alama]] nyingi kupita maandishi mengine katika [[Amerika ya Kale]] na kutunga [[vitabu]]. Waliendeleza pia [[hisabati]], wakijua [[namba]] "[[sifuri]]" na kuboresha mfumo wa kalenda. Walikuwa hodari sana katika [[astronomia]] yaani [[elimu]] ya [[nyota]]. Walipamba miji yao kwa [[Jengo|majengo]] makubwa na mazuri na kuwa [[wafanyabiashara]] hodari. Sanaa yao ilijua [[uchongaji]] wa mawe na pia [[uchoraji]]. Jamii ya Wamaya ilifikia kiwango cha juu kuanzia mwaka [[500 KK]] wakati miji mikubwa ya kwanza ilipotokea. Mnamo mwaka [[800]] [[BK]] jamii za Wamaya katika Yucatan ziliporomoka; [[wataalamu]] wengi huamini ya kwamba mabadiliko ya [[ekolojia]] na [[halihewa]] pamoja na kuchoka kwa [[rutuba]] ya [[ardhi]] yalisababisha kutoka kwa watu katika makazi ya awali. Lakini ustaarabu huu uliona tena kipindi cha kustawi katika maeneo mengine hadi kuja kwa Wahispania. Miji mbalimbali ya Wamaya iliendelea kujitetea dhidi ya wavamizi na [[Nojpeten]], mji wa mwisho wa kujitegemea ulitekwa mwaka [[1696]] tu. ==== Teotihuacan ==== [[Picha:View from Pyramide de la luna.jpg|thumbnail|[[Barabara]] ya mahekalu na piramidi ya jua mjini Teotihuacan]] [[Teotihuacan]] ilikuwa mji mkubwa katika nyanda za juu, karibu na Mexico City ya leo. Kuanzia mwaka [[100 KK]] hadi takriban [[550]] BK ilikuwa mji mkubwa wa Amerika, pia moja kati ya miji mikubwa duniani na [[kitovu]] cha [[utamaduni]] kilichoathiri staarabu zote za Mexiko. "Teotihuacan" ilikuwa [[jina]] la Waazteki kwa mji huu, jina la kienyeji halikuhifadhiwa. Maana ya jina ni "mahali pa kuzaliwa kwa [[miungu]]". Wakati wa [[maendeleo]] yake mji ulikuwa na eneo la [[kilomita za mraba]] 30 ukiwa na wakazi angalau 150,000, labda hata 250,000 walioishi humo<ref>{{Rejea tovuti |url=http://www.dartmouth.edu/~izapa/M-15.pdf |title=Architecture, Astronomy, and Calendrics in Pre- Columbian Mesoamerica, Vincent H. Malmstrom |accessdate=2016-03-21 |archivedate=2006-11-03 |archiveurl=https://web.archive.org/web/20061103080118/http://www.dartmouth.edu/~izapa/M-15.pdf }}</ref>. Hakuna uhakika ni akina nani waliojenga Teotohuacan. Mji wote ulipangwa kwa kufuata [[barabara]] mbili zilizoelekea kaskazini-kusini na mashariki-magharibi. Hekalu kubwa na piramidi zinaonyesha umuhimu wa [[dini]], na mabaki ya [[nyumba]] za wakubwa na watu wa kawaida yanaruhusu kupata [[picha]] ya jamii iliyoishi hapa. Teotohuacan ilikuwa kitovu cha [[biashara]] ya misafara ya mbali na pia ya elimu. Ukubwa wa mji unaonyesha kiwango cha juu cha [[utawala]] na [[ushirikiano]] kati ya watu wake. Katika [[karne ya 6]] BK sehemu kubwa ya majengo iliharibika na kuchomwa. Hakuna uhakika kama hii ilikuwa tokeo la uvamizi kutoka nje au vurugu au [[mapinduzi]] ndani ya mji. Baada ya maharibio yale mji ulianza kurudi nyuma na idadi ya watu kupungua. Mnamo mwaka [[750]] BK watu wote waliondoka: ni [[ghofu|maghofu]] ya majengo makubwa tu yaliyobaki<ref>[http://www.metmuseum.org/toah/hd/teot/hd_teot.htm Teotihuacan, Department of Arts of Africa, Oceania, and the Americas, The Metropolitan Museum of Art October 2001]</ref>. ====Milki ya Azteki==== [[Picha:Tlacochcalcatl.jpg|thumbnail|Askari wa Azteki]] Kuanzia mwaka 1325 kabila la [[Azteki]] likaunda mji wa [[Tenochtitlan]] kwenye kisiwa cha [[ziwa la Tezcoco]]. Waazteki wakaendelea kuunda milki kubwa lililoeena na kutawala sehmu kubwa ya nyanda za juu za Mexiko. Msingi wa milki yao ilikuwa ushirikiano na mji miwili jirani iliyounda mwungano wa pande tatu lakini Waazteki waliendelea kuwa mshiriki mkuu na mtawala wa Tenochtitlan hatimaye alikuwa mtawala mkuu. Walishambulia maeneo ya miji na makabila jirani na kuwalazimisha kulipa kadi kwao. Kama walikubali kutoa kodi kila mwaka na pia kushiriki katika vita za milki watawala wa kienyeji waliruhusiwa kuendelea na utawala wa ndani. Dini yao iliweka uzito kwa sadaka za binadamu waliochinjwa kwenye mahekalu ya miungu yao. Waliunda mfumo wa mikataba ya vita na milki nyingine ambako walikutana kwa mapigano yaliyo kubaliwa awali kwa shabaha ya kukamata wafungwa wengi iwezekanavyo na kuwatoa kama sadaka kwa miungu hekaluni baadaye. ====Uvamizi wa Wahispania==== Mwaka 1519 Mhispania [[Hernan Cortez]] alifika kwenye pwani la Mexiko. Katika miaka iliyofuata alifaulu kuendelea hadi mji wa Tenochtitlan akiongozana na kundi la Wahispania mamia kadhaa. Cortez aliweza kuungana na miji na makabila ya Waindio waliochoka utawala wa Azteki na kumpa askari za usaidizi. Mwaka 1520 waliingia Tenochtitlan kama wageni wa mfalme [[Montezuma II]] wakaendelea kumkamata lakini baada ya kifo cha mfalme walifukuzwa wakakimbia kwa matatizo katika "usiku wa huzuni" (Kihisp. ''noche triste''). Waazteki walidhoofishwa sana kutokana na [[epidemia]] ya ugonjwa wa [[ndui]]<ref>Ndui ilikuwa ugonjwa iliyokuwa kawaida katika Ulaya wakati ule lakini ilikuwa ugonjwa mgeni kwa wenyeji wa Amerika ambao walikosa kinga dhidi yake; hivyo ilikuwa kati ya magonjwa wa kuambukizwa kutoka Ulaya yaiyoua Waindio wengi katika karne zilizofuata.</ref>. Cortez aliweza kukusanya jeshi kubwa la Waindio waliopinga Waazteki akavamia na kuharibu Tenochtitlan mwaka 1521 na kwenye magofu ya mji huu alianzisha mji mpya wa [[Mexico City]] (Kihisp. ''Ciudad de Mexico''). ===Ukoloni=== [[Image:Virgen de guadalupe1.jpg|250px|thumb|Jinsi Bikira Maria alivyomtokea Juan Diego kwenye kilima Tepeyac, Mexico City.]] Baada ya Hispania kuteka sehemu kubwa ya nchi mwaka 1521, liliundwa [[koloni]] la [[Hispania Mpya]] chini ya makamu wa mfalme. Bila kujali [[ukatili]] wa Wahispania, [[Waindio]] walijiunga haraka na [[Kanisa Katoliki]] kuhusiana na [[njozi]] ya mwenzao [[Juan Diego]] aliyetokewa na [[Bikira Maria]] huko [[Guadalupe, Mexico City|Guadalupe]] ([[12 Desemba]] [[1531]]), wakachanganyikana na wavamizi na kufanya [[taifa]] jipya lenye sura ya [[chotara|kichotara]], kiasi kwamba wengi wanajiona "mestizos" (machotara) hata wasipokuwa na [[damu]] mchanganyiko. ===Tangu uhuru hadi leo=== Baada ya [[karne]] tatu na baada ya [[vita]] vya [[ukombozi]], mwaka 1821 wakazi walijipatia [[uhuru]] kwa jina la Mexico. ====Vita ya uhuru ==== Mfano wa [[Vita ya uhuru wa Marekani|uhuru wa Marekani]] mwaka [[1776]] ulikuwa na athira pia kati ya wasomi wenyeji wa Mexiko. Jamii ya kikoloni iliundwa juu ya [[ubaguzi]] kati ya Kreoli (walowezi wenye asili ya Hispania bila mchanganyiko na Waindio), Mestizos (asilimia kubwa ya wenyeji waliotokana na [[ndoa]] za [[wanaume]] Wahispania na [[wanawake]] Waindio) na Waindio wenyewe. Lakini vyeo vyote vya juu, kama maafisa wa juu wa serikali, vilipatikana pekee kwa watu waliozaliwa Hispania na kutumwa Mexiko. Mawazo ya uhuru yalianza kupatikana kati ya Kreoli na Mestizos wa matabaka ya juu. Chanzo cha vita ya uhuru kilikuwa mabadiliko katika [[Ulaya]]. [[Napoleon Bonaparte|Napoleon]] mtawala wa [[Ufaransa]] alimkamata mfalme [[Ferdinand VII]] wa Hispania akamlazimisha kujiuzulu na kumpa [[kaka]] yake [[Yosefu Napoleon]] [[ufalme wa Hispania]]. Hatua hii ilifuatwa na wimbi la uasi nchini Hispania dhidi ya mfalme Mfaransa. Katika Hispania Mpya (Mexico) kamati za miji kadhaa zilizoongozwa na Kreoli ziliapa kumfuata mfalme mfungwa halali pekee. Kamati Kuu ya Mexiko City ilitaka kuanzisha bunge la pekee kwa sababu Hispania haikuwa tena na serikali halali. Mfalme mdogo (gavana mkuu) alikubali. Viongozi wengine walitangaza ilhali mfalme halali hayuko tena sasa, nguvu yote iko mkononi mwa wananchi. Hapo Wahispania katika koloni walioshika vyeo vikuu waliamua kumpindua mfalme mdogo na kuwakamata viongozi wa Kreoli. Uasi ulifaulu lakini vikundi vidogo vya wapinzani wa uhuru kutoka Hispania waliendelea kukutana nchini na kukusanya viongozi. Hatimaye [[padre]] Kreoli [[Miguel Hidalgo y Costilla]] alikusanya jeshi la [[wanamgambo]] [[wakulima]] Waindio na Kreoli akapigana na jeshi lililokuwa chini ya mamlaka ya maofisa Wahispania. Miguel Hidalgo alishindwa na kuuawa, lakini hii ilikuwa chanzo cha uasi mkubwa ambao Wakreoli na wakulima Waindio walipigana na jeshi lililofuata amri ya Wahispania katika koloni. Mwaka kiongozi wa upande wa migambo ya uhuru Guerrero na jenerali wa jeshi la serikali [[Agustin de Iturbide]] walikutana wakapatana kuungana. Vikosi vingi vya jeshi la kikoloni vilihamia upande wao. Gavana mpya aliyefika kutoka Hispania aliamua kukubali uhuru uliotangazwa tarehe [[28 Septemba]] [[1821]]. Iturbide alikuwa [[rais]] wa kwanza na baadaye kwa kipindi kifupi [[Kaisari]] wa Mexiko hadi kujiuzulu mwaka [[1823]]: hapo Mexiko ikaendelea kuwa [[jamhuri]]. ====Karne ya 19==== [[Picha:Mexico's Territorial Evolution.png|300px|thumbnail|Maeneo yaliyoongezwa, yaliyotengwa au kujitenga na Mexiko tangu uhuru wa mwaka 1821: A) Maeneo yaliyotwaliwa na Marekani (nyekundu, kichungwa, nyeupe), Chiapas kuchukuliwa kutoka Guatemala (buluu), eneo la Yucatan lililotwaliwa (nyekundu) na maeneo ya Shirikisho la Amerika ya Kati ([[zambarau]]).]] Katika miaka iliyofuata nchi haikupata msimamo imara kisiasa wala kiuchumi. Serikali mara nyingi zilikuwa hafifu na kubadilishana. Vikundi vya [[ushikiliaji ukale]] na [[uliberali]] vilipigana hadi kuingia katika [[vita ya wenyewe kwa wenyewe]]. Mwaka wa uhuru maeneo ya kusini yalijitenga na kuwa [[Shirikisho la Amerika ya Kati]] lililofarakana baadaye kuwa nchi za [[Guatemala]], [[Honduras]], [[El Salvador]], [[Nikaragua]] na [[Costa Rica]]. Mwaka [[1835]] Marekani ilijaribu kununua maeneo ya [[Texas]] na [[Kalifornia]] lakini Meksiko ilikataa. Hata hivyo utawala wa Mexiko kuhusu maeneo haya ya kaskazini yake ulikuwa hafifu na wa juujuu tu, Waindio walijitegemea hali halisi nje ya miji michache. Hivyo serikali ya Mexiko ilikaribisha walowezi kutoka Marekani kuhamia Texas. Hao walowezi wenye utamaduni wa [[Kiingereza]]-Kimarekani walitangaza uhuru wao mwaka [[1836]] wakaunda [[Jamhuri ya Texas]] iliyochukuliwa na Marekani mwaka [[1845]] kuwa jimbo lake. Hatua hii ilisababisha [[Vita ya Marekani na Mexiko]] ya miaka [[1846]]–[[1848]]. Mexiko ikashindwa na kaskazini yote ikawa sehemu ya Marekani ([[Kalifornia]], [[New Mexico]], [[Arizona]], [[Nevada]], [[Utah]] na [[Colorado]], jumla [[theluthi]] moja ya eneo lake lote. Mexiko ilishambuliwa mara mbili na [[Ufaransa]] kutokana na madai juu ya [[madeni]] ya taifa kwa [[raia]] au [[benki]] za nje. Kwenye [[vita ya keki]] ([[1838]]-[[1839]]) Ufaransa ilidai fidia kwa uharibifu uliotokea katika duka la keki la Mfaransa mjini Mexiko na [[manowari]] za Ufaransa zilishambulia bandari za Mexiko hadi rais wake kukubali deni hili. Mashambulio makubwa zaidi yalifuata mwaka [[1861]]. Mexiko ilishindwa kulipa madeni kwa mataifa ya nje. Ufaransa chini ya [[Napoleon III]] iliamua kufanya Mexiko nusu-koloni yake; jeshi la Ufaransa ilivamia nchi, kufukuza serikali na kumweka [[Mwaustria]] [[Maximilian I wa Mexiko|Maximilian I]] kama "Kaisari wa Mexiko". Serikali ya rais [[Benito Juarez]] ilipinga uvamizi huu kwa njia ya vita ya wanamgambo na mwaka [[1866]] Wafaransa walipaswa kuondoka tena, Maximilian aliuawa mwaka [[1867]]. ====Karne ya 20==== Utawala wa rais [[Porfirio Díaz]] uliendelea kwa miaka zaidi ya 30 na kuwasha moto ya [[mapinduzi ya Mexiko]] alipojaribu kushinda tena kwa udanganyifu mwaka [[1910]]. Miaka hadi 1921 [[vita ya wenyewe kwa wenyewe]] iliharibu sehemu kubwa za nchi. Kuna makadirio ya kwamba wananchi milioni 1,5 (kati ya milioni 15) waliuawa na zaidi ya 200,000 walikuwa [[wakimbizi]], hasa kwenda Marekani<ref>[http://www.hist.umn.edu/~rmccaa/missmill/mxrev.htm Robert McCaa, "Missing millions: the human cost of the Mexican Revolution." Mexican Studies 19#2 (2001)]</ref>. Mwaka [[1917]] katiba mpya ya nchi ilitolewa na mkutano wa bunge maalumu. Katiba hii ilikuwa katiba ya kwanza duniani kutangaza [[haki za kijamii]]. Hizo haki zililenga kutunza na kuboresha hali ya wananchi wenye maisha magumu kama wafanyakazi na wakulima dhidi ya [[ubepari|mabepari]] na wenye mashamba makubwa<ref>[https://books.google.com.mx/books?id=rwaNmEXho5QC&q=%22out+social+rights%22&hl=es-419#v=snippet&q=%22out%20social%20rights%22&f=false Akhtar Majeed, Ronald Lampman Watts, and Douglas Mitchell Brown (2006). Distribution of powers and responsibilities in federal countries. McGill-Queen's Press. p. 188. ISBN 0-7735-3004-5.]</ref>. Katiba hii iliweka mamlaka nyingi mikononi mwa rais wa taifa anayechaguliwa na wananchi wote kwa kipindi kimoja cha miaka 6, halafu hawezi kuchaguliwa tena. Shabaha nyingine ya vifungu katika katiba ilikuwa kupunguza uwezo wa Kanisa Katoliki kuathiri siasa na jamii na hatimaye kukomesha [[imani]] hiyo. Siasa hii dhidi ya [[Ukristo]] iliendelea chini ya rais Calles na kusababisha kipindi kingine cha vita vya wenyewe kwa wenyewe miaka ya [[1926]]-[[1929]]. Katika mapigano hayo yaliyoitwa ''[[La Cristiada]]'' wakulima wengi walichukua silaha kwa jina la [[Kristo]] [[Kristo Mfalme|Mfalme]] dhidi ya jeshi la serikali ili kutetea [[uhuru wa dini]], wakipinga kufungwa kwa [[Kanisa|makanisa]], kuzuiwa [[ibada]] mbalimbali za hadhara na kuuawa kwa mapadre kama [[Mtakatifu]] [[Kristofa Magallanes]] na wenzake. Vita hivyo vilisababisha vifo 250,000 na idadi hiyohiyo ya wakimbizi waliojisalimisha Marekani. Baada ya mapinduzi mamlaka ilichukuliwa na Chama cha kitaifa cha mapinduzi (Partido Nacional Revolucionario PNR) kilichoendelea kutawala kwa miaka 71 kuanzia 1929 hadi [[2000]]. == Watu == Wakazi ni 129,875,529: wengi wao ni ma[[chotara]] wenye [[damu]] ya [[Wahindi wekundu]] (31/55% hivi) na [[Wazungu]] (42/65% hivi). Wenye asili ya [[Ulaya]] tu ni 9/18%. Wenye asili ya [[Afrika]] ni 2%. Ni nchi ya kwanza duniani kwa wingi wa watu wanaotumia [[lugha]] ya [[Kihispania]] ambayo ni [[lugha ya taifa]], lakini wengine (9.8/14.9%) wanaendelea kutumia lugha asilia tangu kabla ya [[ukoloni]] kama vile [[Nahuatl]], [[Yukatek]] [[Maya]], [[Mixtek]] na [[Zapoteki|Zapotek]]. Nchini wanaishi Wamarekani milioni 1, halafu [[wahamiaji]] wengine kutoka Amerika ya Kati, [[Lebanon]], nchi nyingine za [[Asia]] n.k. Kinyume chake, Wameksiko 13 milioni wako Marekani, na raia wengine 23 milioni wa nchi hiyo wana asili ya Meksiko. Upande wa [[dini]] walio wengi ni wafuasi wa [[Yesu Kristo]] katika [[Kanisa Katoliki]] (77.7%) au [[madhehebu]] mengine (11.2%). Ni nchi ya pili duniani kwa wingi wa Wakatoliki, baada ya [[Brazil]], na karibu [[nusu]] kati yao wanashiriki [[ibada]] kila [[wiki]]. Wasio na dini ni 8.1%. == Majimbo ya Mexiko == # [[Aguascalientes (jimbo)|Aguascalientes]] # [[Baja California (jimbo)|Baja California]] # [[Baja California Sur]] # [[Campeche (jimbo)|Campeche]] # [[Chiapas]] # [[Chihuahua (jimbo)|Chihuahua]] # [[Coahuila]] # [[Colima (jimbo)|Colima]] # [[Durango (jimbo)|Durango]] # [[Guanajuato (jimbo)|Guanajuato]] # [[Guerrero (jimbo)|Guerrero]] # [[Hidalgo (jimbo)|Hidalgo]] # [[Jalisco]] # [[Mexico (jimbo)|Mexico]] # [[Michoacán]] # [[Morelos]] # [[Nayarit]] # [[Nuevo León]] # [[Oaxaca (jimbo)|Oaxaca]] # [[Puebla (jimbo)|Puebla]] # [[Querétaro (jimbo)|Querétaro]] # [[Quintana Roo]] # [[San Luis Potosí (jimbo)|San Luis Potosí]] # [[Sinaloa]] # [[Sonora (jimbo)|Sonora]] # [[Tabasco (jimbo)|Tabasco]] # [[Tamaulipas]] # [[Tlaxcala (jimbo)|Tlaxcala]] # [[Veracruz (jimbo)|Veracruz]] # [[Yucatán (jimbo)|Yucatán]] # [[Zacatecas (jimbo)|Zacatecas]] [[Picha:Mx-map.png|thumb|400px|Ramani ya Mexiko]] [[Picha:Tulum-Seaside-2010.jpg|thumb|300px]] [[Picha:Castillo de Chapultepec.jpg|thumb|300px]] [[Picha:Cancun Riu Balcony - Flickr - Joe Parks.jpg|thumb|300px]] [[Picha:Cabo San Lucas Los Arcos 2.jpg|thumb|300px]] ==Tazama pia== * [[Orodha ya nchi kufuatana na wakazi]] * [[Orodha ya milima ya Meksiko]] ==Tanbihi== {{marejeo}} ==Marejeo== {{Refbegin|30em}} * Camp, Roderic A. ''Politics in Mexico: Democratic Consolidation Or Decline?'' (Oxford University Press, 2014) * Davis, Diane. ''Urban leviathan: Mexico City in the twentieth century'' (Temple University Press, 2010) *{{cite journal | last1 = Domínguez | first1 = Jorge I | year = 2004 | title = The Scholarly Study of Mexican Politics | url =https://archive.org/details/sim_mexican-studies_summer-2004_20_2/page/377| journal = Mexican Studies / Estudios Mexicanos | volume = 20 | issue = 2| pages = 377–410 }} * Edmonds-Poli, Emily, and David Shirk. ''Contemporary Mexican Politics'' (Rowman and Littlefield 2009) *Kirkwood, Burton. ''The History of Mexico'' (Greenwood, 2000) [http://www.questia.com/PM.qst?a=o&d=15456726 online edition] {{Wayback|url=http://www.questia.com/PM.qst?a=o&d=15456726 |date=20091224124206 }} *{{Rejea kitabu|first=Enrique| last=Krauze| authorlink=Enrique Krauze| title=Mexico: Biography of Power: A history of Modern Mexico 1810–1996| publisher=Harper Perennial| location=New York| year=1998| isbn=0-06-092917-0| page=896 }} *{{Rejea kitabu| editor1-first=Michael C.| editor1-last=Meyer| editor2-first=William H.| editor2-last=Beezley| title=The Oxford History of Mexico| url=https://archive.org/details/isbn_9780195112283| publisher=Oxford University Press| year=2000| isbn=0-19-511228-8| page=[https://archive.org/details/isbn_9780195112283/page/n149 736]}} * Levy, Santiago. ''Good intentions, bad outcomes: Social policy, informality, and economic growth in Mexico'' (Brookings Institution Press, 2010) * Meyer, Michael C., William L. Sherman, and Susan M. Deeds. ''The Course of Mexican History'' (7th ed. Oxford U.P., 2002) [http://www.questia.com/PM.qst?a=o&d=113260662 online edition] {{Wayback|url=http://www.questia.com/PM.qst?a=o&d=113260662 |date=20110202103530 }} * {{Rejea kitabu |last=Russell |first=Philip |title=The history of Mexico: from pre-conquest to present |url=http://www.routledge.com/books/details/9780415872379/ |accessdate=July 9, 2010 |year=2010 |publisher=[[Routledge]] |isbn=978-0-415-87237-9 }} * Tannenbaum, Frank. ''Mexico: the struggle for peace and bread'' (2013) * Werner, Michael S. ed. ''Encyclopedia of Mexico: History, Society & Culture'' (2 vol 1997) 1440pp [http://www.questia.com/PM.qst?a=o&d=98882479 online edition] {{Wayback|url=http://www.questia.com/PM.qst?a=o&d=98882479 |date=20100124111608 }} ** Werner, Michael S. ed. '' Concise Encyclopedia of Mexico'' (2001) 850pp; a selection of unrevised articles {{Refend}} ==Viungo vya nje== *{{Official website|http://en.presidencia.gob.mx/|name=The Presidency of Mexico}} *[http://www.visitmexico.com/en-i0/ Mexico Tourism Official Website | VisitMexico] {{Wayback|url=http://www.visitmexico.com/en-i0/ |date=20120604062931 }} *{{CIA World Factbook link|mx|Mexico}} *[http://ucblibraries.colorado.edu/govpubs/for/mexico.htm Mexico] {{Wayback|url=http://ucblibraries.colorado.edu/govpubs/for/mexico.htm |date=20080607085229 }} from ''UCB Libraries GovPubs'' *{{Dmoz|Regional/North_America/Mexico}} *[http://news.bbc.co.uk/2/hi/americas/country_profiles/1205074.stm Mexico] from the [[BBC News]] *[http://www.britannica.com/EBchecked/topic/379167/Mexico Mexico] at ''[[Encyclopædia Britannica]]'' *{{Wikiatlas|Mexico}} *[http://www.ifs.du.edu/ifs/frm_CountryProfile.aspx?Country=MX Key Development Forecasts for Mexico] from [[International Futures]] *[http://www.conservapedia.com/Mexico_by_World_Painters Mexico by World Painters.] [[Jamii:Mexiko| ]] [[Jamii:Nchi zinazotumia Kihispania]] [[Jamii:Amerika ya Kaskazini]] [[Jamii:Nchi za G20]] rfvmee9k2a9149mdpnjrbxrrbuutt0p 14 8130 1577940 907175 2026-07-02T12:43:02Z Riccardo Riccioni 452 1577940 wikitext text/x-wiki {{Commonscat|Dar es Salaam}} [[Jamii:Miji ya Tanzania]] 0mw67nk12xsrsjcdonk2s6ddi67yq4v 0 8720 1577951 1432927 2026-07-02T12:54:20Z Riccardo Riccioni 452 /* Tazama pia */ 1577951 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Lobamba |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Eswatini]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:SZ-Lobamba.png|thumb|right|Mahali pa Lobamba nchini Eswatini.]] '''Lobamba''' ni kati ya [[Mji mkuu|miji mikuu]] miwili ya [[Eswatini]]. Lobamba ni mji mkuu wa [[mfalme]] na pia makao ya [[bunge]] la nchi. [[Serikali]] inakaa [[Mbabane]]. Lobamba inaona [[sherehe]] kubwa ya kitaifa kila [[mwaka]] ni [[ngoma]] ya [[Umhlanga]] au ngoma ya [[mafunjo]] ambako [[wasichana]] wanachukuwa mafunzo na kuzipeleka kwa [[ikulu]] ya [[ntombi]] ([[mama]] wa mfalme). Ni kawaida ya kwamba mfalme anaweza kumteua [[mke]] mpya kati ya wasichana hawa wakicheza. [[Jengo|Majengo]] maalumu ni pamoja na ikulu, boma la kifalme, jumba la mama wa mfalme, Makumbusho wa Kitaifa ya Uswazi, Bunge na makumbusho ya mfalme [[Sobhuza II]]. ==Tazama pia== * [[Orodha ya miji ya Eswatini]] {{mbegu-jio-Afrika}} [[Jamii:Miji ya Eswatini]] [[Jamii:Miji Mikuu Afrika|Eswatini]] [[Jamii:Lobamba| ]] lwvkewh7fz84ufndv642stp5g9q89w9 1578010 1577951 2026-07-02T14:22:46Z Riccardo Riccioni 452 /* Tazama pia */ 1578010 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Lobamba |picha_ya_satelite = |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Eswatini]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = |website = }} [[Picha:SZ-Lobamba.png|thumb|right|Mahali pa Lobamba nchini Eswatini.]] '''Lobamba''' ni kati ya [[Mji mkuu|miji mikuu]] miwili ya [[Eswatini]]. Lobamba ni mji mkuu wa [[mfalme]] na pia makao ya [[bunge]] la nchi. [[Serikali]] inakaa [[Mbabane]]. Lobamba inaona [[sherehe]] kubwa ya kitaifa kila [[mwaka]] ni [[ngoma]] ya [[Umhlanga]] au ngoma ya [[mafunjo]] ambako [[wasichana]] wanachukuwa mafunzo na kuzipeleka kwa [[ikulu]] ya [[ntombi]] ([[mama]] wa mfalme). Ni kawaida ya kwamba mfalme anaweza kumteua [[mke]] mpya kati ya wasichana hawa wakicheza. [[Jengo|Majengo]] maalumu ni pamoja na ikulu, boma la kifalme, jumba la mama wa mfalme, Makumbusho wa Kitaifa ya Uswazi, Bunge na makumbusho ya mfalme [[Sobhuza II]]. ==Tazama pia== * [[Orodha ya miji ya Eswatini]] {{list of African capitals}} {{mbegu-jio-Afrika}} [[Jamii:Miji ya Eswatini]] [[Jamii:Miji Mikuu Afrika|Eswatini]] [[Jamii:Lobamba| ]] m0x9j52vzgbrh3h0dmphh4it7zp1505 0 11293 1577955 1270185 2026-07-02T12:56:24Z Riccardo Riccioni 452 /* Tazama pia */ 1577955 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Hargeisa |picha_ya_satelite = HargeisaDrone.jpg |picha_ya_bendera = Flag of Hargeisa.svg |picha_ya_nembo = Hargeisa local council logo.png |ukubwa_ya_nembo = 100px |pushpin_map = Somaliland |pushpin_map_caption = Mahali pa mji wa Hargeisa katika Somaliland |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Somaliland]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 760,000 |latd=9 |latm=33 |lats=47 |latNS=N |longd=44 |longm=4 |longs=3 |longEW=E |website = |image_map=HargeisaDrone.jpg}} '''Hargeisa''' (kwa [[Kisomalia]]: Hargeysa; kwa [[Kiarabu]]: '''هرجيسا''') ni [[mji mkuu]] wa [[Somaliland]] iliyojitenga na [[Somalia]] [[mwaka]] [[1991]]. Iliwahi kuwa [[mji]] mkuu wa [[Somalia ya Kiingereza]] kuanzia [[1941]] hadi [[1960]]. Kati ya 1960 hadi [[1991]] ilikuwa [[mji]] mkubwa wa pili wa [[Somalia]]. Mji uko katika [[bonde]] kwenye [[kimo]] cha [[mita]] 1260 [[juu ya UB]]. Kimo kinasababisha [[hali ya hewa]] ya kupoa yaani hakuna [[joto]] kali jinsi ilivyo kwenye [[pwani]] ya Somaliland upande wa [[Ghuba ya Aden]]. [[Umbali]] na [[bandari]] ya [[Berbera]] ni [[km]] 160 kwa [[barabara]]. [[Idadi]] ya wakazi hukadiriwa kuwa 760,000 ([[2015]]). ==Historia== Hargeisa kilikuwa ni kituo cha kijeshi cha [[Waosmani]] na Wa[[misri]] walipotawala [[Somalia]] ya Kaskazini. Tangu [[1884]] Waingereza walichukua nafasi ya [[Misri]]. Wakati wa [[Vita Kuu ya Pili ya Dunia]] [[1940]] [[Italia]] ilivamia Hargeisa pamoja na [[Somalia ya Kiingereza]] kutoka [[Ethiopia]]. Baada ya kuwafukuza Waitalia mnamo mwaka [[1941]] Waingereza walihamisha mji mkuu wa koloni kutoka [[Berbera]] kwenda Hargeisa. Mnamo mwaka [[1960]] Hargeisa ilikuwa mji wa Somalia mpya baada ya maungano ya Somaliland na [[Somalia]] katika Kusini. Katika miaka ya mwisho wa serikali ya [[dikteta]] [[Siad Barre]] Hargeisa ilikuwa kitovu cha upinzani wa watu wa kaskazini dhidi ya serikali ya [[Mogadishu]]. Mwaka [[1988]] mji uliharibiwa na mabomo ya jeshi la anga la Barre na watu 50,000 waliuawa. Somalia ilipoporomoka baada ya kifo cha Barre kuanzia mwaka [[1990]] eneo la Somaliland ikajitenga na [[Somalia]]. Hargeisa imeona kipidi kirefu cha utulivu na usalama ikaendelea kukua na kustawi. ==Picha== <gallery style="text-align:center;" mode="packed"> File:Hargeisa street.jpg|thumb|300px|Mtaa wa Hargeisa. File:Hargeisa capital of Somaliland.jpg|Mtazamo wa angani wa Hargeisa. File:Hargaysa3.jpg|Hargeisa. File:Naasa Hablood - Virgin's Breast Mountain, Hargeisa, Somalilanad.jpg|Milima ya Naasa Hablood kando ya Hargeisa. File:Hargeysa plane monument.jpg|Kumbukumbu ya vita katika kitovu cha Hargeisa. File:Hargeisa capital 4.jpg|Hargeisa capital. </gallery> ==Tazama pia== * [[Orodha ya miji ya Somalia]] {{mbegu-jio-Somaliland}} [[Jamii:Miji ya Somalia]] [[Jamii:Miji ya Somaliland]] s68yj2h7unbr5aewh3oucpyr4pjnco1 1578000 1577955 2026-07-02T14:18:29Z Riccardo Riccioni 452 /* Tazama pia */ 1578000 wikitext text/x-wiki {{Infobox Settlement |jina_rasmi = Jiji la Hargeisa |picha_ya_satelite = HargeisaDrone.jpg |picha_ya_bendera = Flag of Hargeisa.svg |picha_ya_nembo = Hargeisa local council logo.png |ukubwa_ya_nembo = 100px |pushpin_map = Somaliland |pushpin_map_caption = Mahali pa mji wa Hargeisa katika Somaliland |settlement_type = Jiji |subdivision_type = [[Madola|Nchi]] |subdivision_name = [[Somaliland]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |wakazi_kwa_ujumla = 760,000 |latd=9 |latm=33 |lats=47 |latNS=N |longd=44 |longm=4 |longs=3 |longEW=E |website = |image_map=HargeisaDrone.jpg}} '''Hargeisa''' (kwa [[Kisomalia]]: Hargeysa; kwa [[Kiarabu]]: '''هرجيسا''') ni [[mji mkuu]] wa [[Somaliland]] iliyojitenga na [[Somalia]] [[mwaka]] [[1991]]. Iliwahi kuwa [[mji]] mkuu wa [[Somalia ya Kiingereza]] kuanzia [[1941]] hadi [[1960]]. Kati ya 1960 hadi [[1991]] ilikuwa [[mji]] mkubwa wa pili wa [[Somalia]]. Mji uko katika [[bonde]] kwenye [[kimo]] cha [[mita]] 1260 [[juu ya UB]]. Kimo kinasababisha [[hali ya hewa]] ya kupoa yaani hakuna [[joto]] kali jinsi ilivyo kwenye [[pwani]] ya Somaliland upande wa [[Ghuba ya Aden]]. [[Umbali]] na [[bandari]] ya [[Berbera]] ni [[km]] 160 kwa [[barabara]]. [[Idadi]] ya wakazi hukadiriwa kuwa 760,000 ([[2015]]). ==Historia== Hargeisa kilikuwa ni kituo cha kijeshi cha [[Waosmani]] na Wa[[misri]] walipotawala [[Somalia]] ya Kaskazini. Tangu [[1884]] Waingereza walichukua nafasi ya [[Misri]]. Wakati wa [[Vita Kuu ya Pili ya Dunia]] [[1940]] [[Italia]] ilivamia Hargeisa pamoja na [[Somalia ya Kiingereza]] kutoka [[Ethiopia]]. Baada ya kuwafukuza Waitalia mnamo mwaka [[1941]] Waingereza walihamisha mji mkuu wa koloni kutoka [[Berbera]] kwenda Hargeisa. Mnamo mwaka [[1960]] Hargeisa ilikuwa mji wa Somalia mpya baada ya maungano ya Somaliland na [[Somalia]] katika Kusini. Katika miaka ya mwisho wa serikali ya [[dikteta]] [[Siad Barre]] Hargeisa ilikuwa kitovu cha upinzani wa watu wa kaskazini dhidi ya serikali ya [[Mogadishu]]. Mwaka [[1988]] mji uliharibiwa na mabomo ya jeshi la anga la Barre na watu 50,000 waliuawa. Somalia ilipoporomoka baada ya kifo cha Barre kuanzia mwaka [[1990]] eneo la Somaliland ikajitenga na [[Somalia]]. Hargeisa imeona kipidi kirefu cha utulivu na usalama ikaendelea kukua na kustawi. ==Picha== <gallery style="text-align:center;" mode="packed"> File:Hargeisa street.jpg|thumb|300px|Mtaa wa Hargeisa. File:Hargeisa capital of Somaliland.jpg|Mtazamo wa angani wa Hargeisa. File:Hargaysa3.jpg|Hargeisa. File:Naasa Hablood - Virgin's Breast Mountain, Hargeisa, Somalilanad.jpg|Milima ya Naasa Hablood kando ya Hargeisa. File:Hargeysa plane monument.jpg|Kumbukumbu ya vita katika kitovu cha Hargeisa. File:Hargeisa capital 4.jpg|Hargeisa capital. </gallery> ==Tazama pia== * [[Orodha ya miji ya Somalia]] {{list of African capitals}} {{mbegu-jio-Somaliland}} [[Jamii:Miji ya Somalia]] [[Jamii:Miji ya Somaliland]] mqfey5kmhy7emg7f3dcnx6jytmao1sr 0 13947 1578219 1575797 2026-07-03T03:50:40Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578219 wikitext text/x-wiki {{Infobox disease | Name = Stroke | Image = MCA Territory Infarct.svg | Caption = [[CT scan]] of the brain showing a right-[[brain hemisphere|hemispheric]] [[ischemic]] stroke. | DiseasesDB = 2247 | ICD10 = {{ICD10|I|61||i|60}}-{{ICD10|I|64||i|60}}ner | ICD9 = {{ICD9|434.91}} | OMIM = 601367 | MedlinePlus = 000726 | eMedicineSubj = neuro | eMedicineTopic = 9 | eMedicine_mult = {{eMedicine2|emerg|558}} {{eMedicine2|emerg|557}} {{eMedicine2|pmr|187}} | MeshID = D020521 }} '''Kiharusi''' (kwa [[Kiingereza]] ''stroke'') ni [[ugonjwa]] unaoleta hali ya [[mwili]] kupooza kutokana na matatizo kwenye [[mishipa ya damu]] inayolisha [[ubongo]]. Katika [[tiba]] kiharusi ni upotevu wa uwezo wa ubongo unaoendelea haraka. Sababu yake ni [[tatizo]] katika [[mshipa|mishipa]] inayopeleka [[damu]] kwenda ubongo. Matatizo hayo ni ama kuzibwa ama kupasuka kwa mishipa ya damu. [[Seli]] za ubongo hufa haraka zisipopata [[oksijeni]] na [[lishe]] ya kawaida ambayo yote haya hufika kwa njia ya damu. Kiharusi ni hali ya dharura inayoweza kutibiwa kama tatizo linatambuliwa na kutibiwa haraka. Lisipotibiwa husababisha viwango mbalimbali vya kipooza mwilini. [[Shinikizo la juu la damu]], [[kisukari]], [[chakula]] chenye [[mafuta]] mengi au kuvuta [[sigara]] huongeza hatari ya kupatwa na kiharusi. ==Ufasiri na dalili== Kiharusi, ambacho pia hujulikana kama '''ajali ya ubongo na mishipa''' ('''CVA'''), '''chukizo la ubongo na mishipa''' chukizo ('''CVI'''), au '''shambulizi la ubongo''', ni pale ambapo hali duni ya [[mfumo wa usambazaji|mtiririko wa damu]] kwenye [[ubongo]] husababisha kufa kwa [[kiini uhai (biolojia)|kiini uhai]].<!-- <ref name=HLB2014W/> --> Kuna aina mbili za kiharusi: [[kiharusi cha iskemia|cha iskemia]] kufuatia ukosefu wa mtiririko wa damu na [[cha kuvuja damu]] kufuatia kuvuja damu.<!-- <ref name=HLB2014W/> --> Hali hizi husababisha kutofanya kazi vyema kwa sehemu ya ubongo.<ref name=HLB2014W>{{cite web|title=What Is a Stroke?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/stroke|website=http://www.nhlbi.nih.gov/|accessdate=26 February 2015|date=March 26, 2014}}</ref> Dalili zinaweza kujumuisha [[hemiplejia|ukosefu wa uwezo wa kusogeza viungo]] au [[hemiparesisi|ukosefu wa hisia kwenye sehemu moja ya mwili]], ugumu wa [[afasia ya usikivu|kufahamu]] au [[afasia ya uwasilishaji|kuzungumza]], hisia za [[kizunguzungu|kana kwamba dunia inazunguka]] au [[hemianopsia sawia|ukosefu wa uwezo wa kuona katika sehemu moja]] na kadhalika.<ref name=Donnan2008/><ref name=HLB2014S/> Kwa kawaida, lakini si kila mara, dalili hutokea haraka.<!-- <ref name=HLB2014S/> --> Dalili zikidumu chini ya saa moja au mbili, hali hii hujulikana kama [[shambulizi la muda mfupi la iskemia]] (TIA).<ref name=HLB2014S>{{cite web|title=What Are the Signs and Symptoms of a Stroke?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/signs|website=http://www.nhlbi.nih.gov|accessdate=27 February 2015|date=March 26, 2014}}</ref> Kiharusi cha kuvuja damu pia kinaweza kuhusishwa na hali kali ya [[maumivu ya kichwa]].<ref name=HLB2014S/> Dalili za kiharusi zinaweza kuwa za kudumu.<ref name=HLB2014W/> Matatizo ya muda mrefu yanaweza kujumuisha [[niumonia]] au kupoteza uwezo wa kudhibiti kibofu.<ref name=HLB2014S/> == Visababishi, utambuzi na pathofisiolojia == [[Kipengele cha hatari]] kikuu cha kiharusi ni [[shinikizo la juu la damu]].<ref name=HLB2014C>{{cite web|title=Who Is at Risk for a Stroke?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/atrisk|website=http://www.nhlbi.nih.gov|accessdate=27 February 2015|date=March 26, 2014}}</ref> Vipengele vingine vya hatari ni pamoja na [[kvuta tumbako]], [[unene]], [[hipakolesterolemia|wingi wa kolesteroli ya damu]], [[kisukari tamu |kisukari]], TIA ya awali, na [[mipigo ya moyo isiyo ya kawaida]] na kadhalika.<ref name=Donnan2008/><ref name=HLB2014C/> Kiharusi cha iskemia kwa kawaida husababishwa na kuzibwa kwa mshipa wa damu.<ref name=HLB2014T/> Kiharusi cha kuvuja damu husababishwa na kuvuja damu moja kwa moja kwenye ubongo au kwenye [[mwanya wa fuvu la kichwa|mwanya unaozunguka ubongo]].<ref name=HLB2014T>{{cite web|title=Types of Stroke|url=http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/types|website=http://www.nhlbi.nih.gov|accessdate=27 February 2015|date=March 26, 2014}}</ref><ref name=Feigin05>{{cite journal | author = Feigin VL, Rinkel GJ, Lawes CM, Algra A, Bennett DA, van Gijn J, Anderson CS | title = Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies | journal = Stroke | volume = 36 | issue = 12 | pages = 2773–80 | year = 2005 | pmid = 16282541 | doi = 10.1161/01.STR.0000190838.02954.e8 | url = http://stroke.ahajournals.org/cgi/content/full/36/12/2773 }}</ref> Damu inaweza kuvuja kufuatia [[kuvimba kwa msihipa ya ubongo]].<ref name=HLB2014T/> Kwa kawaida utambuzi hufanywa kwa [[upigaji picha wa kimatibabu]] kama vile [[mchanganuo wa CT]] or [[mchanganuo wa MRI]] pamoja na [[uchunguzi wa kimwili]].<!-- <ref name=HLB2014D/> --> Vipimo vingine kama vile [[elektrokadiogramu]] (ECG) na vipimo vya damu hufanywa ili kubaini vipengele vya hatari na kuondoa visababishi tarajiwa.<!-- <ref name=HLB2014D/> --> [[Viwango vya chini vya damu]] vinaweza kusababisha dalili sawa.<ref name=HLB2014D>{{cite web|title=How Is a Stroke Diagnosed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/diagnosis|website=http://www.nhlbi.nih.gov|accessdate=27 February 2015|date=March 26, 2014}}</ref> == Kinga na tiba == Kinga inajumuisha kupunguza vipengele vya hatari na pengine kutumia [[aspirin]], [[dawa za kupunguza kolesteroli]], [[upasuaji wa kupunguza uwezekano wa kiharusi|upasuaji wa kufungua mishipa ya ubongo]] kwa wagonjwa walio na matatizo ya [[kupunguka kwa wembamba wa mishipa ya ubongo|kupunguka kwa wembamba]], na [[warfarin]] kwa watu walio na hali ya [[mipigo ya moyo isiyo ya kawaida]].<ref name=Donnan2008/> Kwa kawaida kiharusi huhitaji matibabu ya dharura.<ref name=HLB2014W/> Kiharusi cha iskemia kikitambuliwa katika saa tatu hadi nne na nusu kinaweza kutibiwa kwa dawa inayooweza [[thrombolysisi|kuvunjavunja tone gumu la damu]].<!-- <ref name=Donnan2008/> --> Aspirin inapaswa kutumiwa.<!-- <ref name=Donnan2008/> --> Baadhi ya matukio ya kiharusi cha kuvuja damu yanaweza kutibiwa kwa [[upasuaji wa niuroni|upasuaji]].<!-- <ref name=Donnan2008/> --> Matibabu ya kujaribu kurejesha utendakazi hujulikana kama [[urekebishaji wa kiharusi]] na kwa kawaida hufanywa katika [[kitengo cha kiharusi]]; hata hivyo, vitengo hivi ni vichache katika sehemu nyingi duniani.<ref name=Donnan2008>{{cite journal | author = Donnan GA, Fisher M, Macleod M, Davis SM | title = Stroke | url = https://archive.org/details/sim_the-lancet_may-10-16-2008_371_9624/page/1612 | journal = Lancet | volume = 371 | issue = 9624 | pages = 1612–23 | date = May 2008 | pmid = 18468545 | doi = 10.1016/S0140-6736(08)60694-7 }}</ref> == Uenezi == Mwaka [[2010]], takriban watu milioni 17 walipata kiharusi na watu milioni 33 walikuwa wamepata kiharusi awali na walikuwa wangali hai.<!-- <ref name=Fei2013/> --> Kati ya 1990 na 2010, idadi ya visa vya kiharusi vilivyotokea kila mwaka vilipungua kwa takriban 10% katika [[mataifa yaliyostawi]] na kuongezeka kwa 10% katika [[mataifa yanayostawi]].<ref name=Fei2013/> Mwaka wa 2013, kiharusi kilikuwa cha pili kikuu cha kifo baada ya [[ugonjwa wa ateri ya moyo]], kikisababisha vifo milioni 6.4&nbsp; (12% ya idadi jumla).<ref name=GDB2013/> Takriban vifo milioni 3.3 vilisababishwa na kiharusi cha iskemia huku vifo milioni 3.2 vikisababishwa na kiharusi cha kuvuja damu.<ref name=GDB2013>{{cite journal|last1=GBD 2013 Mortality and Causes of Death|first1=Collaborators|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=17 December 2014|pmid=25530442|doi=10.1016/S0140-6736(14)61682-2}}</ref> Takriban nusu ya idadi ya watu walio na kiharusi huishi kwa muda wa chini ya nusu mwaka.<ref name=Donnan2008/> Kwa kijumla, thuluthi tatu ya visa vya kiharusi vilitokea kwa watu wa umri wa zaidi ya miaka 65.<ref name=Fei2013>{{cite journal | author = Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M, Venketasubramanian N, Barker-Collo S, Lawes CM, Wang W, Shinohara Y, Witt E, Ezzati M, Naghavi M, Murray C | title = Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010 | url = https://archive.org/details/sim_the-lancet_january-18-24-2014_383_9913/page/245 | journal = Lancet | volume = 383 | issue = 9913 | pages = 245–54 | year = 2014 | pmid = 24449944 | doi = 10.1016/S0140-6736(13)61953-4 }}</ref> ==Viungo vya nje== *[http://www.ninds.nih.gov/health_and_medical/disorders/stroke.htm Stroke]{{Wayback|url=http://www.ninds.nih.gov/health_and_medical/disorders/stroke.htm |date=20090908023050 }}'' * [http://www.canadianstrokenetwork.ca Canadian Stroke Network] {{Wayback|url=http://www.canadianstrokenetwork.ca/ |date=20210414211148 }} * [http://www.rcsn.org Registry of the Canadian Stroke Network] {{Wayback|url=http://www.rcsn.org/ |date=20060527010447 }} * [http://www.medicine.mcgill.ca/strokengine/ StrokEngine] {{Wayback|url=http://www.medicine.mcgill.ca/strokengine/ |date=20060213210917 }} (McGill University, [[Montreal|Montreal, Quebec]], Canada) Focuses on stroke rehabilitation and interventions * [http://www.doctorslounge.com/primary/articles/stroke_risk/index.htm Cerebrovascular disease and risk of stroke] {{Wayback|url=http://www.doctorslounge.com/primary/articles/stroke_risk/index.htm |date=20080517055949 }} * {{cite web | title=What Happens During a Stroke | url=http://health-net-now.blogspot.com/2007/04/stroke-what-happens-during-stroke.html | publisher=NLM | accessdate=2007-04-15 | archivedate=2007-12-14 | archiveurl=https://web.archive.org/web/20071214142119/http://health-net-now.blogspot.com/2007/04/stroke-what-happens-during-stroke.html }} video * [http://www.strokeassociation.org/presenter.jhtml?identifier=1200037 American Stroke Association] {{Wayback|url=http://www.strokeassociation.org/presenter.jhtml?identifier=1200037 |date=20091021203912 }} * [http://www.stroke.org/home National Stroke Association] * [http://www.heartandstroke.ca Heart and Stroke Foundation of Canada] * [http://www.stroke.org.uk The Stroke Association] UK * [http://www.americanheart.org/presenter.jhtml?identifier=3053 "Heart Attack, Stroke and Cardiac Arrest Warning Signs," from the American Heart Association] * [http://www.nasam.org National Stroke Association of Malaysia] ==Marejeo== <references /> [[Category:Magonjwa]] [[Jamii:Ubongo]] [[Jamii:Damu]] [[Jamii:Tiba]] n8l9miz0nby1hqwicn1b77bynxul8l7 0 14006 1578135 1224501 2026-07-02T21:39:13Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578135 wikitext text/x-wiki [[Picha:Museo archeologico di Firenze, statuia funeraria da Chianciano, V sec. a.c. 2.JPG|thumb|right|[[Sanamu]] ya [[baba]] na [[mama]] wa [[nyumba]] Waetruski ([[makumbusho]] ya [[Firenze]]).]] [[Picha:Etruskischer Meister 001.jpg|thumb|250px|right|Mpiga [[muziki]] kutoka [[kaburi]] la Kietruski|300px]] '''Waetruski''' walikuwa [[taifa]] maalumu katika [[Italia]] ya kale. Waliishi katika [[Italia ya Kati]] na kuanzisha [[mji]] wa [[Roma]]. Mwanzo wa [[ustaarabu]] wao ulikuwa mnamo [[mwaka]] [[800 KK]] ukaishia katika miaka ya mwisho ya [[Jamhuri ya Roma]]. Waliacha mabaki ya [[utamaduni]] wenye mifano bora ya [[uchoraji]] na [[ujenzi]]. Utamaduni wao ulipotea katika [[mazingira]] ya Kiroma. == Historia == [[Wataalamu]] wengine huamini kuwa walihamia Italia kutoka [[Anatolia]], lakini [[utafiti]] wa hivi karibuni<ref>https://www.science.org/doi/10.1126/sciadv.abi7673</ref> umethibitisha kuwa ni wenyeji wa Italia, si tofauti sana na [[Walatini]]. Inawezekana walifikiriwa kutokea [[Mashariki]] kwa sababu tu waliathiriwa sana na [[ustaarabu]] wa [[Wagiriki]]. [[Mwandiko]] wao uliotunzwa [[ukuta|ukutani]] mwa [[Kaburi|makaburi]] wasomeka kirahisi kwa sababu ulifuata [[alfabeti]] ya [[Kigiriki]] pamoja na athira ya [[Wafinisia]] wa [[Mediteranea]] ya [[magharibi]]. Hata hivyo [[lugha]] ya [[Kietruski]] si rahisi kuielewa kwa sababu [[msamiati]] ni wa pekee; hadi sasa ni takriban [[Neno|maneno]] 200 tu yanayoeleweka. Kwa jumla si mojawapo ya [[Lugha za Kihindi-Kiulaya|lugha za Kihindi-Kiulaya]]; labda ni lugha ya wakazi asili ya eneo hilo, kabla ya kufikiwa na watu kutoka [[Ulaya Mashariki]]. Waetruski walianzisha [[Mji|miji]] 12 waliohusiana kama [[shirikisho]]. Inaaminika ya kwamba misingi ya mji wa [[Roma]] ni ya Kietruski pia. [[Wafalme]] wa kwanza wa Roma walikuwa wa asili ya Kietruski. Hivyo hadi mwaka [[396]] Roma ilikuwa chini ya athira ya Waetruski. Mwaka ule [[jeshi]] la Roma likateka na kuangamiza mji wa [[Veiji]] na kumaliza kipaumbele ya Waetruski katika Italia. Miji kadhaa ya Kietruski ilifanya mikataba ya Roma ikapewa [[uraia]] wa Kiroma hadi mwaka [[90 KK]]. Baadaye utamaduni wa Kietruski ulianza kupotea wakati watu walipoacha kutumia lugha yao, kuhusiana pia na [[uhamiaji]] mkubwa kutoka [[mashariki]] mwa [[Bahari ya Kati]] (labda [[askari]] na [[watumwa]]). ==Tanbihi== {{reflist}} ==Marejeo== * {{cite journal |last1=Antonio |first1=Margaret L. |last2=Gao |first2=Ziyue |display-authors=1 |date=November 8, 2019 |title=Ancient Rome: A genetic crossroads of Europe and the Mediterranean |url=https://archive.org/details/science_2019-11-08_366_6466/page/708 |journal=[[Science (journal)|Science]] |publisher=[[American Association for the Advancement of Science]] |volume=366 |issue=6466 |pages=708–714 |doi=10.1126/science.aay6826 }} * Philipp Ammon: <nowiki>''</nowiki>Ruma Rasna – Die etruskischen Wurzeln Roms<nowiki>''</nowiki>. <nowiki>http://www.academia.edu/28000848/Ruma_Rasna_Die_etruskischen_Wurzeln_Roms</nowiki> ==Marejeo mengine== * Bartoloni, Gilda (ed). ''Introduzione all'Etruscologia'' (in Italian). Milan: Hoepli, 2012. * [[Sinclair Bell]] and Carpino A. Alexandra (eds). ''A Companion to the Etruscans'', Oxford; Chichester; Malden, MA: Wiley Blackwell, 2016. * [[Giuliano Bonfante|Bonfante, Giuliano]] and [[Larissa Bonfante|Bonfante Larissa]]. ''The Etruscan Language: An Introduction''. Manchester: Manchester University Press, 2002. * Bonfante, Larissa. ''Out of Etruria: Etruscan Influence North and South''. Oxford: B.A.R., 1981. * Bonfante, Larissa. ''Etruscan Life and Afterlife: A Handbook of Etruscan Studies''. Detroit: Wayne State University Press, 1986. * Bonfante, Larissa. ''Etruscan Myths''. London: British Museum Press, 2006. * [[Dominique Briquel|Briquel, Dominique]]. ''Les Étrusques, peuple de la différence'', series Civilisations U, éditions Armand Colin, Paris, 1993. * Briquel, Dominique. ''La civilisation étrusque'', éditions Fayard, Paris, 1999. * [[Nancy Thomson de Grummond|De Grummond, Nancy T]]. (2014). ''Ethnicity and the Etruscans''. In McInerney, Jeremy (ed.). ''A Companion to Ethnicity in the Ancient Mediterranean''. Chichester, UK: John Wiley & Sons, Inc. pp.&nbsp;405–422. * [[Sybille Haynes|Haynes, Sybille]]. ''Etruscan Civilization: A Cultural History.'' Los Angeles: J. Paul Getty Museum, 2000. * Izzet, Vedia. ''The Archaeology of Etruscan Society''. New York: Cambridge University Press, 2007. * Naso, Alessandro (ed). ''Etruscology'', Berlin, Boston: De Gruyter, 2017. * [[Massimo Pallottino|Pallottino, Massimo]]. ''Etruscologia''. Milan: Hoepli, 1942 (English ed., ''The Etruscans''. [[David Ridgway (scholar)|David Ridgway]], editor. Bloomington, IN: Indiana University Press, 1975). * Shipley, Lucy. ''The Etruscans: Lost Civilizations'', London: Reaktion Books, 2017. * [[Christopher Smith (academic)|Smith, C]]. ''The Etruscans: a very short introduction '', Oxford: Oxford University Press, 2014. * Spivey, Nigel. ''Etruscan Art''. New York: Thames and Hudson, 1997. * [[Judith Swaddling|Swaddling, Judith]] and Philip Perkins. ''Etruscan by Definition: The Culture, Regional, and Personal Identity of the Etruscans: Papers in Honor of Sybille Haynes''. London: British Museum, 2009. * [[Turfa, Jean MacIntosh]] (ed). ''The Etruscan World''. London: Routledge, 2013. * Turfa, Jean MacIntosh. ''The Etruscans''. In Farney, Gary D.; Bradley, Gary (eds.). ''The Peoples of Ancient Italy''. Berlin: De Gruyter. pp.&nbsp;637–672. ===Miji na mahali=== * [https://web.archive.org/web/20060508054703/http://www.eng.archeopg.arti.beniculturali.it/canale.asp?id=499 (Soprintendenza per i Beni Archeologici dell'Umbria) "The Cai Cutu Etruscan tomb"] An undisturbed late Etruscan family tomb, reused between the 3rd and 1st century BC, reassembled in the National Archeological Museum of Perugia * [https://web.archive.org/web/20090922211541/http://archive.cyark.org/hypogeum-of-the-volumnis-info Hypogeum of the Volumnis digital media archive] ([[creative commons]]-licensed photos, laser scans, panoramas), data from a [[University of Ferrara]]/[[CyArk]] research partnership ==Viungo vya nje== {{Commons category|Etruscans}} {{Wikiquote}} * {{cite web |url=https://www.academia.edu/5957978 |title=Etruscan weapons and warfare |archive-url=https://web.archive.org/web/20160130043903/http://www.academia.edu/5957978/The_Art_of_the_Etruscan_Armourer |archive-date=30 January 2016 |access-date=3 November 2017 |url-status=dead |df=dmy-all |accessdate=2021-09-25 |archivedate=2016-01-30 |archiveurl=https://web.archive.org/web/20160130043903/http://www.academia.edu/5957978/The_Art_of_the_Etruscan_Armourer }} * {{cite web |url=http://www.usc.edu/dept/LAS/wsrp/educational_site/uscarc/Pendant.shtml |title=Etruscan Lion Plaque Pendant |archive-url=https://web.archive.org/web/20170509232347/http://www.usc.edu/dept/LAS/wsrp/educational_site/uscarc/Pendant.shtml |archive-date=9 May 2017 |access-date=2 February 2002 |url-status=live |df=dmy-all |accessdate=2021-09-25 |archivedate=2017-05-09 |archiveurl=https://web.archive.org/web/20170509232347/http://www.usc.edu/dept/LAS/wsrp/educational_site/uscarc/Pendant.shtml }} * {{cite web|url=http://www.civilization.org.uk/intermezzo/etruscans|title=The place of the Etruscans in world civilisation|accessdate=2021-09-25|archivedate=2021-06-06|archiveurl=https://web.archive.org/web/20210606193432/http://www.civilization.org.uk/intermezzo/etruscans/}} {{mbegu-historia}} [[Jamii:Historia ya Italia]] [[Jamii:Roma ya Kale]] [[Jamii:Toscana]] 74xzywzyw6jkjvrhsr95vqxi905ueek 0 14734 1578174 1574294 2026-07-02T23:38:44Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578174 wikitext text/x-wiki [[Picha:Clement alexandrin.jpg|thumb|Klemens wa Aleksandria (150-211/216).]] '''Titus Flavius Clemens''' (anayejulikana zaidi kama '''Klemens wa Aleksandria'''; kwa [[Kigiriki]]: Κλήμης Αλεξανδρεύς, Klemes Alexandreus; [[Athens]], [[150]] hivi; [[Aleksandria]], [[215]] hivi) alikuwa [[mwanafalsafa]] na [[mwanateolojia]] wa [[Ukristo]] katika [[mji]] wa [[Aleksandria]] ([[Misri]]) mwanzoni mwa [[karne ya 3]]<ref>https://dacb.org/stories/egypt/clement-of-alex/</ref>. Huhesabiwa kati ya walimu muhimu wa [[Kanisa]] la kwanza. Anaheshimiwa na [[Waorthodoksi wa Mashariki]], [[Waanglikana]] na wengineo kama [[mtakatifu]]. [[Sikukuu]] yake huadhimishwa [[tarehe]] [[4 Desemba]]<ref>https://catholicsaints.info/saint-clement-of-alexandria/</ref>. ==Maisha== [[File:Klementos Alexandreos ta heuriskomena.tif|thumb|Opera omnia, 1715]] Klemens alikuwa mwenyeji wa [[Ugiriki]] aliyezaliwa katika [[familia]] ya [[wapagani]] matajiri mjini [[Athens]]. Baada ya kupokea [[imani]] ya Kikristo, alisafiri akitembelea walimu Wakristo katika nchi mbalimbali kama vile Ugiriki, [[Italia]] na [[Palestina]] hadi Misri. Huko alipewa nafasi ya kufundisha kwenye [[Chuo cha Kikristo cha Aleksandria]] akishirikiana na mwanzilishi wake [[Panteno]]. Jitihada ya Klemens ilikuwa kupatanisha imani ya Kikristo na dhana za [[falsafa]] ya Kigiriki. Alifaulu kufafanua Ukristo kwa wasomi wapagani na kuvuta wengi kwenye imani yake mpya. Klemens alikuwa ndiye mwalimu wa [[Origene]]. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] *[[Mababu wa Kanisa]] ==Tanbihi== {{reflist}} ==Maandishi== *[http://www.documentacatholicaomnia.eu/20_30_0150-0207-_Clemens_Alessandrinus,_Sanctus.html [[Opera Omnia]] by [[Migne]] [[Patrologia Graeca]] with analytical indexes and concordances] *[http://www.piney.com/MuClement.html#P2694_785619 Clement's Protrepticus] {{Wayback|url=http://www.piney.com/MuClement.html#P2694_785619 |date=20130516035028 }} *[http://www.ccel.org/fathers2/ANF-02/anf02-50.htm#TopOfPage Clement's Stromateis] *[http://www.ccel.org/fathers2/ANF-02/anf02-52.htm Clement's Paedagogus] *[http://www.tertullian.org/fathers2/ANF-02/anf02-77.htm#P10196_2863283 Hypotyposes] ==Marejeo ya Kiswahili== * Maurice Soseleje, Kalendari yetu – Maisha ya Watakatifu – Toleo la pili – ed. Benedictine Publications Ndanda Peramiho – Peramiho 1986 – ISBN 9976-63-112-X, uk. 92-93 ==Marejeo ya lugha nyingine== *{{cite book|last=Ashwin-Siejkowski|first=Piotr|title=Clement of Alexandria on trial: the evidence of "heresy" from Photius' Bibliotheca|year=2010|publisher=BRILL|location=Leiden|isbn=978-90-04-17627-0}} *{{cite book|last=Berger|first=Teresa|title=Gender Differences and the Making of Liturgical History: Lifting a Veil on Liturgy's Past. Teresa Berger|url=https://archive.org/details/genderdifference0000berg|year=2011|publisher=Ashgate Publishing|location=London|isbn=978-1-4094-2698-1}} *{{cite journal|last=Bucur|first=Bogdan G.|title=The Other Clement of Alexandria: Cosmic Hierarchy and Interiorized Apocalypticism|url=https://archive.org/details/vigiliae-christianae_2006_60_3/page/253|journal=Vigiliae Christianae|year=2006|month=August|volume=60|issue=3|pages=251–268|jstor=20474764}} *{{cite book|last=Burrus|first=Virginia|title=Late Ancient Christianity|url=https://archive.org/details/lateancientchris0002virg|year=2010|publisher=Fortress Press|location=Philadelphia|isbn=978-0-8006-9720-4}} *{{cite book|last=Clark|first=Elizabeth Ann|title=Reading renunciation: asceticism and Scripture in early Christianity|url=https://archive.org/details/readingrenunciat0000clar|year=1999|publisher=Princeton University Press|location=Princeton|isbn=978-0-691-00512-6}} *{{cite journal|last=Daniélou|first=Jean|title=Les traditions secrètes des Apôtres|journal=Eranos Jahrbuch|year=1962|issue=31}} *{{cite book|last=Droge|first=Arthur J.|title=Homer or Moses?: early Christian interpretations of the history of culture|url=https://archive.org/details/homerormosesearl0000drog|year=1989|publisher=Mohr Siebeck|location=Tuebingen|isbn=978-3-16-145354-0}} *{{cite book|last=Ferguson|first=John|title=Clement of Alexandria|url=https://archive.org/details/clementofalexand00ferg|year=1974|publisher=Ardent Media|location=New York|isbn=978-0-8057-2231-4}} *{{cite book|last=Grant|first=Robert McQueen|title=Gods and the One God|year=1988|publisher=Westminster John Knox Press|location=Louisville|isbn=978-0-664-25011-9}} *{{cite book|last=Hägg|first=Henny Fiskå|title=Clement of Alexandria and the beginnings of Christian apophaticism|year=2006|publisher=Oxford University Press|location=Oxford|isbn=978-0-19-928808-3}} *{{cite book|last=Heid|first=Stefan|title=Celibacy in the early Church: the beginnings of a discipline of obligatory continence for clerics in East and West|url=https://archive.org/details/celibacyinearlyc0000heid|year=2000|publisher=Ignatius Press|location=San Francisco|isbn=978-0-89870-800-4}} *{{cite book|last=Itter|first=Andrew C.|title=Esoteric teaching in the Stromateis of Clement of Alexandria|url=https://archive.org/details/esotericteaching0097itte|year=2009|publisher=BRILL|location=Leiden|isbn=978-90-04-17482-5}} *{{cite book|last=Irvine|first=Martin|title=The Making of Textual Culture: 'Grammatica' and Literary Theory 350–1100|year=2006|publisher=Cambridge University Press|location=Cambridge|isbn=978-0-521-03199-8}} *{{cite book|last=de Jáuregui|first=Miguel Herrero|title=Orphism and Christianity in late antiquity|year=2010|publisher=Walter de Gruyter|location=Berlin|isbn=978-3-11-020633-3}} *{{cite book|last=Karavites|first=Peter|title=Evil, freedom, and the road to perfection in Clement of Alexandria|url=https://archive.org/details/evilfreedomroadt0000kara|year=1999|publisher=BRILL|location=Ledien|isbn=978-90-04-11238-4}} *{{cite book|last=Kaye|first=John|title=Some account of the writings and opinions of Clement of Alexandria|url=https://archive.org/details/someaccountofwr00kaye|year=1835|publisher=J.G. & F. Rivington|location=London}} *{{cite book|last=Kochuthara|first=Shaji George|title=The concept of sexual pleasure in the Catholic moral tradition|year=2007|publisher=Gregorian University Press|location=Rome|isbn=978-88-7839-100-0}} *{{cite book|last=Ma|first=Wonsuk (ed.)|title=The spirit and spirituality: essays in honour of Russell P. Spittler, Volume 4|year=2004|publisher=Continuum International Publishing Group|location=New York|isbn=978-0-8264-7162-8}} *{{cite book|last=Murphy|first=Mable Gant|title=Nature allusions in the works of Clement of Alexandria|year=1941|publisher=The Catholic University of America Press|location=Washington D.C.}} *{{cite book|last=Ogliari|first=Donato|title=Gratia et certamen: the relationship between grace and free will in the discussion of Augustine with the so-called semipelagians|url=https://archive.org/details/gratiaetcertamen0000ogli|year=2003|publisher=Peeters Publishers|location=Leuven|isbn=978-90-429-1351-6}} *{{cite journal|last=Outler|first=Albert C.|title=The "Platonism" of Clement of Alexandria|url=https://archive.org/details/sim_journal-of-religion_1940-07_20_3/page/217|journal=The Journal of Religion|year=1940|month=July|volume=20|issue=3|pages=217–240}} *{{cite journal|last=Osborn|first=Eric|title=Arguments for Faith in Clement of Alexandria|url=https://archive.org/details/vigiliae-christianae_1994-03_48_1/page/1|journal=Vigiliae Christianae|year=1994|month=March|volume=48|issue=1|pages=1–24}} *{{cite book|last=Osborn|first=Eric|title=Clement of Alexandria|url=https://archive.org/details/clementofalexand0000eric|year=2008|publisher=Cambridge University Press|location=Cambridge|isbn=978-0-521-09081-0}} *{{cite book|last=Schaff|first=Philip (ed.)|title=Nicene and Post-Nicene Fathers Volume I – Eusebius: Church History, Life of Constantine the Great, Oration in Praise of Constantine|year=2007|publisher=Cosimo|isbn=978-1-60206-508-6}} *{{cite journal|last=Seymour|first=Charles|title=On Choosing Hell|journal=Religious Studies|year=1997|month=September|volume=3|issue=33|pages=249–266|jstor=20008103}} *{{cite book|title=International Theological Commission, Volume 2|url=https://archive.org/details/textsdocuments190000unse_t2x6|year=2009|publisher=Ignatius Press|location=San Francisco|isbn=978-1-58617-226-8|first=Michael (ed.)|last= Sharkey}} *{{cite book|last=Verhey|first=Allen|title=The Christian Art of Dying: Learning from Jesus|url=https://archive.org/details/christianartofdy0000verh|year=2011|publisher=William B. Eerdmans Publishing Company|location=Grand Rapids|isbn=978-0-8028-6672-1}} *{{cite book|last=Young|first=Richard A.|title=Is God a vegetarian?: Christianity, vegetarianism, and animal rights|url=https://archive.org/details/isgodvegetarianc0000youn|year=1999|publisher=Open Court Publishing|location=Chicago|isbn=978-0-8126-9393-5}} ==Viungo vya nje== *[http://www.newadvent.org/cathen/04045a.htm "Clement of Alexandria"] by Francis P. Havey, in the [[Catholic Encyclopedia]], 1908. *Reinhold Koltz, ''Titi Flaui Clementis Alexandrini opera omnia'' (E.B. Schwickerti, Lipsiae 1831), Vol. [http://books.google.gr/books?id=iaoBAAAAYAAJ&printsec=frontcover&dq=%CF%84%CE%B5%CF%84%CF%81%CE%AC%CE%B3%CF%81%CE%B1%CE%BC%CE%BC%CE%BF%CE%BD+%CF%8C%CE%BD%CE%BF%CE%BC%CE%B1&cad=5#v=onepage&q=&f=false 1], [http://books.google.gr/books?id=JSsQAAAAYAAJ&printsec=frontcover&dq=editions:06C8OSvn_pp7dryfXjE#v=onepage&q=&f=false 2], [http://books.google.gr/books?id=RSsQAAAAYAAJ&printsec=frontcover&dq=editions:06C8OSvn_pp7dryfXjE#v=onepage&q=&f=false 3], and [http://books.google.gr/books?id=lisQAAAAYAAJ&printsec=frontcover&dq=editions:06C8OSvn_pp7dryfXjE#v=onepage&q=&f=false 4]. *[http://www.bennozuiddam.com/The%20role%20and%20view%20of%20Scripture%20in%20Clemens%20of%20Alexandria.pdf The role and view of Scripture in Clement of Alexandria] {{Wayback|url=http://www.bennozuiddam.com/The%20role%20and%20view%20of%20Scripture%20in%20Clemens%20of%20Alexandria.pdf |date=20140319062649 }} {{DEFAULTSORT:Klemens wa Aleksandria}} [[Jamii:Waliozaliwa 150]] [[Jamii:Waliofariki 215]] [[Jamii:Watu wa Ugiriki ya Kale]] [[Jamii:Wanateolojia wa Ugiriki]] [[Jamii:Wanateolojia wa Misri]] [[Jamii:Mababu wa Kanisa]] [[Jamii:Watakatifu wa Ugiriki]] [[Jamii:Watakatifu wa Misri]] g2fh9yiib5j48j4aekaq53k9sfxe1vt 0 15868 1578053 1497131 2026-07-02T16:38:29Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578053 wikitext text/x-wiki [[Faili:Red White Blood cells.jpg|thumb|right|Picha ya darubini ya elektroni ya ukaguzi (SEM) ya seli nyekundu ya kawaida ya damu, chembe za kugandisha damu, na seli nyeupe za damu.]] [[Faili:Blutkreislauf.png|thumb|Mzunguko wa damu: Nyekundu = yenye oksijeni Buluu = bila oksijeni]] [[Faili:Humanbood600x.jpg|thumb|right|Damu ya binadamu iliyokuzwa mara 600]] [[Faili:320frogblood600x2.jpg|thumb|right|Damu ya chura iliyokuzwa mara 600]] [[Faili:320fishblood600x2.jpg|thumb|right|Damu ya samaki iliyokuzwa mara 600]] [[Faili:Bleeding finger.jpg|thumb||Damu ikitoka kwenye kidonda]] '''Damu''' (kutoka [[neno]] la [[Kiarabu]]) ni [[kiowevu]] katika [[mwili]] wa [[binadamu]] na [[wanyama]]. Inazunguka mwilini ndani ya [[mishipa ya damu]] ikisukumwa na [[moyo]] kwa lengo la kumwezesha kuishi. Kazi ya [[tishu]] hiyo ni kupeleka [[lishe]] na [[oksijeni]] kwa [[seli]] za mwili na kutoa [[daioksaidi ya kaboni]] pamoja na [[uchafu]] mwingine kutoka seli. Ndani ya damu kuna [[utegili (damu)|utegili]] (kwa [[Kiingereza]] ''plasma'') ambao ni kiowevu chake pamoja na [[seli za damu]] [[nyekundu]] na [[nyeupe]]. [[Seli nyekundu]] hubeba oksijeni wakati daioksaidi ya kaboni hubebwa na utegili. [[Seli nyeupe]] ni kama walinzi wa mwili wa kupambana na [[magonjwa]]. Pia kuna [[chembe sahani]]. Mtu mzima huwa na damu [[lita]] 6 mwilini. ==Muundo wa damu== Kati ya [[Vertebrata|viumbe wenye uti wa mgongo]], damu imetengenezwa kwa seli za damu zinazoelea katika [[Kiowevu|umajimaji]] unaoitwa [[plasma ya damu]]. Plasma, inayoundwa kwa 55% ya giligili ya damu, ambayo hasa ni maji (90% kwa kiasi), <ref>{{cite web | url = http://www.fi.edu/learn/heart/blood/blood.html | title = Blood – The Human Heart | accessdate = 19 March 2009 | author = The Franklin Institute Inc. | archivedate = 2009-03-05 | archiveurl = https://web.archive.org/web/20090305043654/http://www.fi.edu/learn/heart/blood/blood.html }}</ref> na ina [[protini]], [[glukosi]], [[ioni]] za [[madini]], [[homoni]], [[Dioksidi kabonia|dioksidi ya kaboni]] (Plasma ikiwa ndiyo chombo kikuu cha usafirishaji wa bidhaa taka), [[chembe za kugandisha damu]] na seli za damu zenyewe. Seli za damu zilizo kwenye damu hasa ni seli nyekundu za damu (zinazofahamika pia kama RBC yaani Red Blood Cells au erithrosaiti) na seli nyeupe za damu, zikiwa pamoja na lukosaiti na chembe za kugandisha damu. Seli nyingi zaidi katika damu za wanyama wenye [[uti wa mgongo]] ni seli nyekundu za damu. Seli hizi zina himoglobini, protini yenye [[Chuma|madini ya chuma]], ambayo huwezesha usafirishaji wa [[oksijeni]] kwa kujiunganisha kwa hali ya kujirudia na gesi hii ya kupumua na kuongeza kwa kiasi kikubwa umumunyifu wake katika damu. Kwa upande mwingine, dioksidi ya kaboni inasafirishwa karibu kabisa nje ya seli ikiwa imeyeyushwa ndani ya plazma kama ioni ya bikaboneti. Damu ya wanyama wenye uti wa mgongo huwa nyekundu yenye kung'aa wakati ambapo himoglobini yake imewekewa oksijeni. Wanyama wengine, kama vile [[krusteshia]] na [[moluska]], hutumia hemosianini kubeba oksijeni, badala ya himoglobini. [[Wadudu]] na baadhi ya moluska hutumia ugiligili unaoitwa hemolimfu badala ya damu, tofauti ikiwa kwamba hemolimfu haipatikani katika mfumo wa [[usambazaji]] uliofungwa. Katika wadudu wengi, "damu" hii haina molekuli zinazobeba oksijeni kama vile himoglobini kwa sababu miili yao ni midogo na hivyo mfumo wao wa kupumua unatosha kusambaza oksijeni. Wanyama wenye uti wa mgongo na walio pia na [[taya]] wana [[Mfumo wa kingamaradhi]] unaotegemea kwa kiasi kikubwa seli nyeupe za damu. Seli hizo husaidia kupinga maambukizi na [[vimelea]]. Chembe za kugandisha damu ni muhimu katika ugandishaji wa damu. <ref>{{cite book | last = Maton | first = Anthea | coauthors = Jean Hopkins, Charles William McLaughlin, Susan Johnson, Maryanna Quon Warner, David LaHart, Jill D. Wright | title = Human Biology and Health | url = https://archive.org/details/humanbiologyheal00scho | publisher = Prentice Hall | year = 1993 | location = Englewood Cliffs, New Jersey, USA | isbn = 0-13-981176-1}} </ref> [[Arithropodi|Athropodi]], zinazotumia himolimfu, zina hemosaiti kama sehemu ya mfumo wao wa kinga. Damu inasambazwa mwilini kupitia mishipa ya damu kutokana na usukumaji wa [[Moyo|moyo.]] Katika wanyama wenye [[mapafu]], damu kutoka kwa ateri hubeba oksijeni kutoka kwa hewa iliyovutwa hadi kwenye tishu za mwili, na damu kutoka kwa vena hubeba dioksidi ya kaboni, bidhaa taka zinazotokana na umetaboli, zinazozalishwa na [[seli]], kutoka kwa tishu hadi kwa [[mapafu]] ili zitolewe. Istilahi za uuguzi zinazohusiana na damu mara nyingi huanza kwa ''hemo-'' au ''hemato-'' (pia inaandikwa ''haemo-'' na ''haemato-'') kutoka neno la [[Kigiriki cha Kale]] αἷμα, ''haima'' yenye maana ya "damu". Kwa upande wa [[anatomia]] na [[histolojia]], damu inafikiriwa kama muundo maalum wa tishu unganifu, kutokana na asili yake ya mifupa na uwepo wa nyuzi zenye mfumo wa fibrinojeni. ==Kazi== [[Faili:1GZX Haemoglobin.png|right|thumb|Himoglobinikijani = kikundi cha heme nyekundu &amp; buluu = visehemu vya protini]] [[Faili:Heme.svg|right|thumb|Heme]] Damu hufanya kazi nyingi muhimu katika mwili, zikiwemo: * Upelekaji wa [[oksijeni]] kwenye tishu (zilizoungana na himoglobini, ambayo hubebwa kwenye seli nyekundu) * Ugavi wa virutubishi kama vile glukosi, amino asidi, na asidi zenye mafuta (zilizoyeyushwa kwenye damu au zimeungana na protini za plazma (kwa mfano, lipidi za damu) * Uondoaji wa taka kama vile [[Dioksidi kabonia|dioksidi ya kaboni]], urea, na asidi ya maziwa yaliyochachuka * Kazi za kukinga mwili, ikiwa ni pamoja na mzunguko wa seli nyeupe za damu, na utambuzi wa vifaa vya nje kupitia zindiko * Kuganda, ambayo ni sehemu moja ya utaratibu wa kujirekebisha kwa mwili (ambapo damu huganda wakati mtu anapokatwa ili kuziba kutoka kwa damu) * Kazi za mjumbe, ikiwa ni pamoja na usafirishaji wa homoni na kutoa ishara ya uharibifu wa tishu * Udhibiti wa [[Thamani pH|pH]](kiwango cha uasidi au ualikali) mwilini * Udhibiti wa kiwango cha joto mwilini * Kazi za mwendo wa maji ==Vipengele vya damu ya binadamu== [[Faili:Blut-EDTA.jpg|upright|thumb|Neli mbili za EDTA-damu isiyoganda. Neli ya kushoto: baada ya kusimama, RBC zinakusanyika katika sehemu ya chini ya neli. Neli ya kulia: yenye damu mbichi iliyotoka kutolewa.]] Damu inachangia 8% ya [[uzito]] wa mwili wa binadamu,<ref name="alberts_table">{{Rejea tovuti|url=http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Search&db=books&doptcmdl=GenBookHL&rid=mboc4.table.4143|title=Leukocyte functions and percentage breakdown|accessdate=2007-04-14|publisher=NCBI Bookshelf|year=2005|author=Alberts, Bruce|work=Molecular Biology of the Cell}}</ref> ulio na uzito wastani wa 1060 kg/ m <sup>3,</sup> inakaribiana sana na uzito wa maji safi ya 1000 kg/m<sup>3.</sup> <ref>{{cite web | url = http://hypertextbook.com/facts/2004/MichaelShmukler.shtml | title = Density of Blood | accessdate = 2006-10-04 | year = 2004 | work=The Physics Factbook|last=Shmukler|first=Michael }}</ref> Mtu mzima wa kadiri ana kiasi cha damu cha kama [[lita]] 5 (1.3 gal), linalojumuisha plazma na aina kadhaa za seli (zinazoitwa mara kwa mara ''chembedamu);'' elementi hizi zilizoundwa kutoka kwa damu ni chembechembe nyekundu (seli nyekundu za damu), lukosaiti (seli nyeupe za damu), na thrombositi (chembe za kugandisha damu). Kwa kiasi, seli nyekundu za damu huchangia takribani 45% ya damu yote, plazma takribani 54.3%, na seli nyeupe takribani 0.7%. Damu yote (plazma na seli) huonyesha sifa zisizofuata sheria za giligili za [[Newton Issack|Newton]]; sifa zake za kutiririka hubadilika ili kutiririka ipasavyo kupitia mishipa midogo ya damu kwa upinzani mdogo zaidi kuliko plazma ikiwa peke yake. Aidha, kama himoglobini yote ya binadamu ingekuwa huru katika plazma badala ya kuwekwa kwenye RBCs, giligili za mzunguko ungenata sana na kufikia kiwango ambapo unazuia utendakazi bora wa mfumo wa moyo na mishipa. ===Seli=== [[Mikrolita]] moja ya damu ina: *''Chembechembe nyekundu za damu'' milioni 4.7 hadi 6.1 (za kiume), milioni 4.2 hadi 5.4 (za kike): <ref>{{cite web |url = http://www.nlm.nih.gov/medlineplus/ency/article/003644.htm#Normal%20Values |title = Medical Encyclopedia: RBC count|publisher = Medline Plus|accessdate = 18 November 2007 }}</ref> Katika [[mamalia]] wengi, seli nyekundu za damu zilizokomaa zinakosa kiini na oganeli. Zina himogloboni za damu na husambaza oksijeni. Seli nyekundu za damu (pamoja na seli za vyombo vya endotheli na seli nyingine) pia zimetiwa alama na glaikoprotini ambazo zinatambulisha aina za damu tofauti. Kiwango cha damu kinachomilikiwa na seli nyekundu za damu kinajulikana kama hematokriti, na kwa kawaida ni takriban 45% ya damu. Ukubwa wa eneo la seli zote nyekundu za damu katika mwili wa binadamu zikiwekwa pamoja utakuwa takribani mara 2,000 kubwa zaidi ya sehemu ya nje ya mwili.<ref>{{cite book |author=Robert B. Tallitsch; Martini, Frederic; Timmons, Michael J. |title=Human anatomy |publisher=Pearson/Benjamin Cummings |location=San Francisco |year=2006 |page=529 |isbn=0-8053-7211-3 |edition=5th}}</ref> *''Lukosaiti 4,000 hadi 11,000:'' <ref name="Ganong WF">{{cite book |author=Ganong, William F. |title=Review of medical physiology |url=https://archive.org/details/reviewmedicalphy00gano |publisher=Lange Medical Books/McGraw-Hill |location=New York |year=2003 |page=[https://archive.org/details/reviewmedicalphy00gano/page/n517 518] |isbn=0-07-121765-7 |edition=21}}</ref> Seli nyeupe za damu ni sehemu ya mfumo wa kinga; zinaangamiza na kuondoa seli nzee au potovu na mabaki ya chembechembe, na pia hushambulia vikolezo vinavyoleta maambukizi (visababisha magonjwa) na dutu za kigeni. Kansa ya lukosaiti inaitwa lukemia. *''Thrombosaiti 200,000 hadi 500,000:'' <ref name="Ganong WF"></ref> thrombosaiti, ambazo pia hujulikana kama chembe za kugandisha damu, zina jukumu kugandisha damu (ugandishaji). Hubadilisha fibrinojeni iwe fibrini. Fibrini hii inaunda wavu ambayo seli nyekundu za damu hukusanyika juu yake na kuganda na hii kuzuia damu zaidi kutoka kwenye mwili na pia husaidia kuzuia bakteria kuingia mwili. {| class="wikitable" align="right" |+ Maumbile ya damu ya kawaida |- !Kigezo !Thamani |- | Hematokriti | 45 ± 7 (38-52%) kwa wanaume<br>42 ± 5 (37-47%) kwa wanawake |- | [[Thamani pH|pH]] | 7.35-7.45 |- | wigo besi | -3 Na 3 |- | P [[Oksijeni|O <sub>2</sub>]] | 10-13 kPa (8-10 mm Hg) |- | P [[Dioksidi kabonia|CO <sub>2</sub>]] | 4.8-5.8 kPa (35-45 mm Hg) |- | HCO <sub>3</sub> <sup>-</sup> | 21-27 mm |- | Ulowesh(w)aji wa Oksijeni | Iliyowekwa oksijeni: 98-99%<br>Iliyoondolewa Oksijeni: 75% |} ===Plazma=== Takribani 55% ya damu yote ni plazma ya damu, giligili ambalo ni chombo cha majimaji cha damu ambalo lina [[rangi]] ya [[manjano]] ya [[nyasi]]. Kiasi cha jumla cha plazma ya damu katika mwili wa binadamu wastani ni [[lita]] 2.7 hadi 3.0. Kimsingi, ni mchanganyiko wa [[maji]] (92%) na [[protini]] (8%) na viwango vidogo vya vitu vingine. Plazma hueneza virutubishi vilivyoyeyushwa, kama vile [[glukosi]], [[asidi za amino]], na asidi zenye mafuta (zilizoyeyushwa kwenye damu au zilizoshikana na protini za plazma), na huondoa bidhaa za taka, kama vile [[Dioksidi kabonia|oksidi ya kaboni]], [[urea]], na asidi ya maziwa yaliyochachuka. Sehemu nyingine muhimu ni pamoja na: * Albumini ya majimaji ya damu * Vipengele vya kugandisha damu (ili kuwezesha ugandishaji) * Globulini zinazokinga maradhi (kingamwili) * Chembe za lipoprotini * [[Protini]] nyingine * Elektrolaiti mbalimbali (hasa [[Natiri|sodiamu]] na kloridi) Neno ''seramu (majimaji ya damu)'' inarejelea plazma ambayo imetolewa protini za kuganda. Nyingi kati ya protini zilizobaki ni albumini na globulini zinazokinga [[maradhi]]. ===Kadiri ndogo ya thamani za pH=== [[Thamani pH|pH]] ya damu inadhibitiwa ili ibaki katika kadiri ndogo ya 7.35 hadi 7.45, na hivyo kuifanya alikalini kiasi. <ref name="Waugh">{{cite book|last1=Waugh|first1=Anne|last2=Grant|first2=Allison|title=Anatomy ans Physiology in Health and Illness|publisher=Churchill Livingstone Elsevier|date=2007|edition=Tenth |pages=22|chapter=2|isbn=978 0 443 10102 1}}</ref> <ref name="ReferenceA">{{MerckManual|12|157|a||Acid-Base Regulation and Disorders}}</ref> Damu iliyo na pH chini ya 7.35 ni ya asidi mno, huku pH ya damu iliyo juu ya 7.45 ni ya alkali mno. pH ya damu, sehemu ya shinikizo la oksijeni (po <sub>2),</sub> sehemu ya shinikizo la dioksidi ya kaboni (pCO <sub>2),</sub> na <sub>3</sub> HCO zinadhibitiwa kwa makini kupitia taratibu kadhaa za homiostasisi, ambazo hutumia uwezo wao hasa kupitia mfumo wa upumuaji na mfumo wa mkojo ili kudhibiti usawa wa msingi wa asidi na kupumua. Gesi ya damu ya ateri itapima vitu hivi. Plazma pia huzungusha homoni na kupeleka ujumbe wao kwa tishu mbalimbali. Orodha ya kadiri za kurejelea za kawaida za elektrolaiti mbalimbali ni ndefu. Mifupa hasa huathiriwa na pH ya damu kwa kuwa mara kwa mara hutumika kama chanzo cha madini kwa kukinga pH. Kula kiasi kikubwa cha protini za wanyama na protini ya mimea huhusishwa na kupotea kwa mifupa kwa [[wanawake]]. <ref>{{cite journal |author=Sellmeyer DE, Stone KL, Sebastian A, Cummings SR |title=A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group |journal=Am. J. Clin. Nutr. |volume=73 |issue=1 |pages=118–22 |year=2001 |month=January |pmid=11124760 |doi= |url=http://www.ajcn.org/cgi/content/full/73/1/118}}</ref> ===Damu katika wanyama wenye uti wa mgongo wasio binadamu=== Damu ya binadamu inafanana na ile ya mamalia, ingawa maelezo sahihi kuhusu idadi ya seli, ukubwa, muundo wa protini na kadhalika, huwa tofauti kiasi kati ya aina tofauti ya mamalia. Hata hivyo, kati ya wanyama wenye uti wa mgongo wasio katika kategoria ya mamalia, kuna tofauti kadhaa muhimu: <ref name="VB">{{cite book |author=Romer, Alfred Sherwood|author2=Parsons, Thomas S.|year=1977 |title=The Vertebrate Body |url=https://archive.org/details/vertebratebody0000rome_a5a9|publisher=Holt-Saunders International |location= Philadelphia, PA|pages= [https://archive.org/details/vertebratebody0000rome_a5a9/page/404 404]–406|isbn= 0-03-910284-X}}</ref> * Seli za damu za wanyama wenye uti wa mgongo wasio mamalia zimetandazwa na zina umbo la yai, na huhifadhi viini vya seli zao * Kuna tofauti kubwa katika aina na idadi ya seli nyeupe za damu; kwa mfano, asidofili kwa jumla hupatikana zaidi kuliko kwa binadamu * Chembe za kugandisha damu zinapatikana tu kwa mamalia; katika wanyama wengine wenye uti wa mgongo, seli ndogo, zenye kiini, za spindu zinashughulikia kuganda kwa damu badala yake ==Fiziolojia== ===Mfumo wa moyo na mishipa=== [[Faili:Diagram of the human heart (cropped).svg|thumb|Mzunguko wa damu kupitia moyo wa binadamu]] {{main|Mfumo wa mzunguko wa damu}} Damu husambazwa mwilini kupitia vyombo vya damu kwa msukumo wa [[moyo]]. Kwa binadamu, damu husukumwa kutoka ventrikuli thabiti ya kushoto ya moyo na kupitia ateri hadi tishu za pembeni na hurudi kwa atiria ya moyo kupitia mshipa. Baadaye huingia kwenye ventrikali ya kulia kupitia ateri ya mapafu na husukumwa kwa [[mapafu]] na kurudi kwenye atiria ya kushoto kupitia mshipa wa mapafu. Damu kisha inaingia katika ventrikali ya kushoto ili isambazwe tena. Damu ya ateri hubeba oksijeni kutoka kwa hewa iliyovutwa ndani hadi kwa seli zote za mwili, na damu ya vena hubeba dioksidi ya kaboni, bidhaa taka ya metaboli ya [[seli]], hadi kwa mapafu ili itolewe nje. Hata hivyo, tofauti moja ni ile ya ateri ya mapafu, iliyo na damu isiyo na oksijeni zaidi mwenye mwili, huku vena za zikiwa na damu yenye oksijeni. Mtiririko wa ziada wa kurudi unaweza kutokana na kusongezwa kwa misuli ya kiunzi cha mifupa ambazo zinaweza kubana vena na kusukuma damu kupitia vali katika vena kuelekea ateri ya kulia. Mzunguko wa damu ulielezwa kwa umaarufu na William Harvey katika mwaka wa 1628. <ref>{{cite web|title = [[Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus]]|url = http://www.rarebookroom.org/Control/hvyexc/index.html|first = William|last = Harvey|authorlink = William Harvey|language = Latin|year = 1628|accessdate = 2014-06-01|archive-date = 2010-11-27|archive-url = https://web.archive.org/web/20101127002138/http://rarebookroom.org/Control/hvyexc/index.html|url-status = dead}}</ref> ===Uzalishaji na uchakaaji wa seli za damu=== Katika wanyama wenye uti wa mgongo, seli mbalimbali za damu huundwa katika uboho kupitia mchakato unaoitwa hematopoiesia, unaohusisha erithropoesisi, uzalishaji wa seli nyekundu za damu, na mielopesisi, uzalishaji wa seli nyeupe za damu na chembe za kugandisha damu. Wakati wa utotoni, karibu kila mfupa wa binadamu huzalisha seli nyekundu za damu. Katika utu uzima, uzalishaji wa seli nyekundu za damu unafanywa na mifupa mikubwa pekee: miili ya wanyama wenye uti wa mgongo, mfupa wa kidari (sternum), ya mbavu, ya fupanyonga, na mifupa ya sehemu za juu za mikono na miguu. Tukiongezea katika kipindi cha utotoni, tezi la thaimasi, linalopatikana katika mediastinamu, ni chanzo muhimu cha limfosaiti. <ref>{{cite book |author=Williams, Peter W.; Gray, Henry David |title=Gray's anatomy |url=https://archive.org/details/graysanatomy0000gray_m7a1 |publisher=C. Livingstone |location=New York |year=1989 |isbn=0-443-02588-6 |edition=37th}}</ref> Sehemu ya damu yenye protini (ikiwemo protini za kugandisha) huzalishwa hasa na ini, huku homoni zikizalishwa na tezi za mfumo wa mwili na sehemu ya majimaji hudhibitiwa na haipothalamasi na kudumishwa na [[figo]]. Erithrosaiti zenye afya zina maisha ya plazma ya takribani siku 120 kabla hazijadunishwa na wengu, na seli za Kupffer katika [[ini]]. Ini pia huondoa baadhi ya protini, lipidi, na amino asidi. Figo huondoa bidhaa taka na kuzipeleka kwenye mkojo. ===Usafirishaji wa oksijeni === [[Faili:Oxyhaemoglobin dissociation curve.png|thumb|Pindo msingi la uloweshwaji wa himoglobini unasongezwa upande wa kulia katika hali ya kiwango cha juu cha asidi (kiwango cha juu zaidi cha dioksidi ya kaboni) na upande wa kushoto katika hali ya kiwango cha chini cha asidi (kiwango cha chini zaidi cha dioksidi ya kaboni)]] Kadiri 98.5% ya [[Oksijeni|oksijeni]] katika sampuli ya damu ya ateri katika binadamu mwenye [[afya]] anayepumua kwa kanieneo ya [[bahari]] hushikanishwa kikemikali pamoja na Hgb (Himoglobini). Kadiri 1.5% imeyeyushwa kimwili katika majimaji zingine za damu na haijaunganishwa na Hgb. Molekuli ya himoglobini ndiyo kisafirishaji kikuu cha oksijeni katika miili ya mamalia na aina nyingine nyingi (kwa wanyama wenye mfumo tofauti, angalia hapo chini). Himoglobini ina uwezo wa kuunganisha oksijeni wa kati ya 1.36 na 1.37 ml O <sub>2</sub> kwa gramu ya Himoglobini, <ref>{{cite journal |author=Dominguez de Villota ED, Ruiz Carmona MT, Rubio JJ, de Andrés S |title=Equality of the in vivo and in vitro oxygen-binding capacity of haemoglobin in patients with severe respiratory disease |journal=Br J Anaesth |volume=53 |issue=12 |pages=1325–8 |year=1981 |month=December |pmid=7317251 |doi= 10.1093/bja/53.12.1325|url=https://archive.org/details/sim_british-journal-of-anaesthesia_1981-12_53_12/page/1325}}</ref> ambayo huongeza ujumla wa uwezo wa oksijeni ya damu mara sabini, <ref name="brsphys">{{cite book |author=Costanzo, Linda S. |title=Physiology |url=https://archive.org/details/physiology00cost_0 |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2007 |pages= |isbn=0-7817-7311-3 |oclc= |doi= |accessdate=}}</ref> ikilinganishwa na ikiwa oksijeni pekee ingebebwa kwa umumunyifu wake wa O 0.03 mL kwa lita <sub>2</sub> ya damu kwa sehemu ya shinikizo ya mmHg ya oksijeni (takriban 100 mmHg katika ateri). <ref name="brsphys"></ref> Isipokuwa ateri za mapafu na kitovu na vena zao husika, ateri hubeba damu yenye oksijeni kutoka kwa [[moyo]] na kuipeleka kwa mwili kupitia viateri na mishipa ya damu, ambapo oksijeni hutumika; baadaye, venali, na mishipa hubeba damu isiyo na oksijeni na kuirudisha kwa moyo. Katika hali ya kawaida kwa binadamu anayepumzika, himoglobini kwenye damu inayotoka kwenye mapafu ina ukolezo wa kama 98-99% wa oksijeni. Kwa mtu mzima mwenye afya anayepumzika, damu ''isiyo na oksijeni'' inayorudi kwenye mapafu bado ina ukolezo wa takribani 75%. <ref>{{Rejea tovuti |url=http://home.hia.no/~stephens/ventphys.htm |title=Upitishaji hewa safi na Utendaji wa Uvumilivu |accessdate=2014-06-01 |archiveurl=https://web.archive.org/web/20100323054138/http://home.hia.no/~stephens/ventphys.htm |archivedate=2010-03-23 }}</ref> <ref>[http://groups.msn.com/TransplantSupportLungHeartLungHeart/oxygen2.msnw Msaada kuhusu upandikizaji- Mapafu, Moyo/Mapafu, Moyo] {{Wayback|url=http://groups.msn.com/TransplantSupportLungHeartLungHeart/oxygen2.msnw |date=20040224085741 }} vikundi vya MSN</ref> Ongezeko la matumizi ya oksijeni wakati wa mazoezi yanayoendelea hupunguza uloweshwaji wa oksijeni kwenye damu ndani ya vena, ambayo inaweza kufikia chini ya 15% katika mwanariadha aliyepitia mafunzo; ingawa kiwango cha kupumua na mtiririko wa damu huongezeka ili kuifidia, uloweshwaji wa oksijeni kwenye damu ndani ya ateri unaweza kushuka hadi 95% au chini zaidi chini ya hali hii. <ref>{{cite journal |author=Mortensen SP, Dawson EA, Yoshiga CC, ''et al.'' |title=Limitations to systemic and locomotor limb muscle oxygen delivery and uptake during maximal exercise in humans |journal=J. Physiol. (Lond.) |volume=566 |issue=Pt 1 |pages=273–85 |year=2005 |month=July |pmid=15860533 |pmc=1464731 |doi=10.1113/jphysiol.2005.086025 }}</ref> Uloweshwaji wa oksijeni ulio chini hivi ni hatari kwa mtu aliyepumzika (kwa mfano, wakati wa upasuaji akiwa ametiwa ganzi. Haipoksia inayoendelea (uwekaji oksijeni ulio chini ya 90%), ni hatari kwa afya, na haipoksia kali (uloweshwaji wa chini ya 30%) unaweza kusababisha kifo ghafla. <ref>{{Rejea tovuti |url=http://www.manbit.com/PAC/chapters/P30.cfm |title=Mwongozo wa 'St George' kuhusu Katheta ya Ateri ya Mapafu |accessdate=2014-06-01 |archiveurl=https://web.archive.org/web/20100925053056/http://manbit.com/PAC/chapters/P30.cfm |archivedate=2010-09-25 }}</ref> Kijusi, kinachopokea oksijeni kupitia kondo, kinafikia kiwango cha chini zaidi cha shinikizo la oksijeni (kama 21% ya kiwango kinachopatikana katika mapafu ya mtu mzima), na hivyo, vijusi huzalisha aina nyingine ya himoglobini yenye mvuto wa juu zaidi kwa oksijeni (Himoglobini F ) ili kufanya kazi katika hali hii. <ref>[43] ^ [https://web.archive.org/web/19990502195422/http://members.aol.com/Bio50/LecNotes/lecnot20.html Ubebaji wa Oksijeni katika Damu - Sehemu za juu kulingana na bahari]</ref> ===Usafirishaji wa dioksidi ya kaboni=== Wakati damu inapotiririka kupitia mishipa, dioksidi ya kaboni huenea kutoka kwa tishu hadi kwenye damu. Kiasi kingine cha dioksidi ya kaboni huyeyushwa kwenye damu. Sehemu ya CO <sub>2</sub> huathiriwa na himoglobini na protini zingine na kuunda michanganyiko ya kaboni na amino. Dioksidi ya kaboni iliyobaki inabadilishwa kuwa bikaboneti na ioni za haidrojeni kupitia kitendo cha RBC cha kiondoa maji cha kaboni. Kiasi kikubwa cha dioksidi ya kaboni kinasafirishwa kupitia damu katika muundo wa ioni za bikaboneti. [[Dioksidi kabonia|Dioksidi ya kaboni]] (CO <sub>2),</sub> bidhaa kuu taka kutoka kwa seli hubebwa katika damu ikiwa hasa imeyeyushwa kwenye plazma, kwa kiasi sawa na bikaboneti (HCO <sub>3</sub> <sup>-)</sup> na asidi ya kaboni (H <sub>2</sub> CO <sub>3).</sub> 86-90% ya CO <sub>2</sub> katika mwili hubadilishwa kuwa asidi ya kaboni, ambayo inaweza kubadilika haraka kuwa bikaboneti, ulinganifu wa kemikali ukiwa muhimu katika ukingaji wa pH ya plazma. <ref name="veq"> [http://www.biology.arizona.edu/biochemistry/problem_sets/medph/intro.html Biology.arizona.edu]. Oktoba 2006. ''Uwiano wa kliniki wa viwango vya pH: bikaboneti kama kinga.'' </ref> [[Thamani pH|pH]] ya damu huwekwa katika kadiri ndogo (pH ya kati ya 7.35 na 7.45). <ref name="ReferenceA"></ref> ===Usafirishaji wa ioni za haidrojeni=== Kiasi fulani cha oksihimoglobini hupoteza oksijeni na kuwa dioksihimoglobini. Dioksihimoglobini huunganisha idadi kubwa ya ioni za haidrojeni kwa kuwa ina mvuto zaidi kwa haidrojeni zaidi kuliko oksihimoglobini. ===Mfumo wa limfatiki=== {{main|Mfumo wa limfu}} Kwa mamalia, damu ina ulinganifu na limfatiki, ambayo huendelea kuundwa katika tishu kutoka kwa damu na kwa uchujaji wa kupita kiasi wa mshipa mdogo wa damu. Limfatiki hukusanywa kupitia mfumo wa vyombo vidogo vya limfatiki na kuelekezwa kwa mchirizi wa kifua, ambayo huielekeza katika machafu katika mshipa wa subklavia wa kushoto ambapo limfatiki huungana na mfumo wa mzunguko wa damu. ===Udhibiti wa joto=== Mzunguko wa damu husafirisha joto, katika mwili na marekebisho haya ni sehemu muhimu ya udhibiti wa joto. Kuongeza mtiririko wa damu hadi kwenye sehemu ya juu (kwa mfano, wakati wa msimu wa joto au zoezi linalotumia nguvu) husababisha ngozi kupata joto, na hivyo kusababisha upoteaji wa joto kwa kasi. Kwa upande mwingine, wakati kiwango cha halijoto cha nje ni cha chini, utiririkaji wa damu kwa ncha na upande wa juu wa ngozi hupunguka na ili kuzuia joto upoteaji wa joto na husambazwa zaidi kwa viungo muhimu vya mwili. ===Kazi ya Nguvumaji=== Uzuiaji wa mtiririko wa damu pia unaweza kutumika katika tishu maalum kusababisha ujazaji kwa damu unaosababisha usimikaji wa tishu hiyo, mifano ni tishu ya usimikaji katika uume na kisimi. Mfano mwingine wa kazi ya nguvumaji ni buibui inayoruka, ambapo damu iliyolazimishwa kuelekea kwenye miguu chini ya shinikizo husababisha inyooke kwa nguvu na hivyo kuifanya iruke, bila haja ya kuwa na miguu minene yenye misuli. <ref>{{cite encyclopedia |url = http://www.britannica.com/eb/topic-559817/spider |encyclopedia = Encyclopedia Britannica online|title = Spiders: circulatory system|accessdate= 2007-11-25}}</ref> ===Wanyama wasio na uti wa mgongo=== Kati ya [[wadudu]], damu (ambayo inaitwa vizuri zaidi hemolimfu) haihusishwi katika usafirishaji wa oksijeni (mianya inayoitwa bomba za pumzi huruhusu oksijeni kutoka kwa hewa kuenea moja kwa moja hadi kwenye tishu). Damu ya wadudu husafirisha virutubisho hadi kwenye tishu na huondoa bidhaa taka katika mfumo wazi. Wanyama wengine wasio na uti wa mgongo hutumia protini za kupumua ili kuongeza uwezo wa kubeba oksijeni. Himoglobini ndiyo protini ya kupumua inayopatkana sana katika mazingira asili. Himosianini (buluu) ina [[shaba]] na inapatikana katika krasteshia na moluska. Inadhaniwa kwamba tuniketi (mnyama wa baharini anayetoa maji kupitia tundu mbili anapoguswa) anaweza kutumia vanabini ([[protini]] zenye [[Vanadi|vanadiamu)]] kwa [[pigmenti]] ya kupumua (kijani-ng'avu, buluu, au rangi ya machungwa). Kati ya wanyama wengi wasio na uti wa mgongo, protini hizi za kubeba oksijeni huyeyuka kwa urahisi katika damu; kati ya wanyama wenye uti wa mgongo zinapatikana katika seli maalumu nyekundu za damu, zinazoruhusu ukolezi wa juu zaidi wa pigmenti za kupumua bila kuongeza mnato au kuharibu viungo vinavyochuja damu kama vile figo. [[Minyoo]] wakubwa huwa na himoglobini zisizo za kawaida zinazowaruhusu kuishi katika mazingira yasiyo ya kawaida. Himoglobini hizi pia hubeba salfaidi ambazo kwa kawaida ni hatari kwa wanyama wengine. ==Rangi== ===Himoglobini=== [[Faili:Bleeding finger.jpg|thumb|Damu ya mishipa kutoka kwenye kidole kinachotoa damu]] [[Faili:Bloodbags.jpg|thumb|Damu ya vena iliyokusanywa wakati wa uchangaji wa damu]] Himoglobini ndiyo chanzo kikuu cha rangi ya damu katika wanyama wenye uti wa mgongo. Kila molekuli ina makundi manne ya heme, na mwingiliano wao na molekuli mbalimbali hubadili rangi halisi. Kati ya wanyama wenye uti wa mgongo na viumbe vingine vinavyotumia himoglobini, damu ya ateri na damu kutoka kwa mishipa ni mwekundu wenye kung'aa, kwa kuwa oksijeni huipa kikundi cha heme rangi nyekundu iliyokoza. Damu isiyo na oksijeni huwa ni nyekundu iliyokoza zaidi; hii inapatikana katika vena, na inaweza kuonekana wakati wa uchangiaji wa damu na wakati sampuli za damu kutoka kwa vena zinapochukuliwa. Damu iliyopata yenye sumu ya monoksidi ya kaboni ni nyekundu inayoyong'aa, kwa sababu monoksidi ya kaboni husababisha uundaji wa kaboksihimoglobini. Katika sumu ya sianidi, mwili haiwezi kutumia oksijeni, kwa hivyo damu ya vena bado hubaki ikiwa na oksijeni na hivyo kuongeza wekundu. Ingawa damu yenye himoglobini kamwe haiwi na rangi ya buluu, kuna hali kadhaa na magonjwa ambapo rangi ya makundi ya heme hufanya ngozi ionekane ikiwa na rangi ya buluu. Ikiwa heme imewekewa oksijeni, methimoglobini, ambayo ni ya kahawia zaidi na haiwezi kusafirisha oksijeni, inaundwa. Katika hali isiyo ya kawaida ya salfahemoglobinemia, sehemu ya himoglobini ya ateri huwekwa oksijeni, na huonekana kuwa na rangi nyekundu iliyokoza na rangi ya bluu (sainosisi). Vena katika ngozi huonekana kuwa na rangi ya bluu kutokana na sababu mbalimbali ambazo hutegemea rangi ya damu kwa kiwango kidogo pekee. Kujitokeza kwa sehemu nyeupe kwenye ngozi na uchakataji maono ya rangi pia huchangia. <ref>{{cite journal|last=Kienle|first=Alwin|authorlink=|coauthors=Lothar Lilge, I. Alex Vitkin, Michael S. Patterson, Brian C. Wilson, Raimund Hibst, and Rudolf Steiner|date=March 1, 1996|title=Why do veins appear blue? A new look at an old question|journal=Applied Optics|volume=35|issue=7|pages=1151–60|url=http://www.imt.liu.se/edu/courses/TBMT36/pdf/blue.pdf|format=PDF|doi=10.1364/AO.35.001151|access-date=2014-06-01|archive-date=2012-02-10|archive-url=https://web.archive.org/web/20120210145120/https://www.imt.liu.se/edu/courses/TBMT36/pdf/blue.pdf|dead-url=yes}}</ref> [[Mjusi]] katika kundi la ''Prasinohaema'' huwa na damu ya kijani kutokana na mkusanyiko wa bidhaa taka inayoitwa bilivedini. <ref>{{cite journal |author=Austin CC, Perkins SL |title=Parasites in a biodiversity hotspot: a survey of hematozoa and a molecular phylogenetic analysis of Plasmodium in New Guinea skinks |url=https://archive.org/details/journal-of-parasitology_2006-08_92_4/page/770 |journal=J. Parasitol. |volume=92 |issue=4 |pages=770–7 |year=2006 |pmid=16995395 |doi=10.1645/GE-693R.1}}</ref> ===Himosianini=== Damu ya moluska wengi - ikiwa ni pamoja na [[sefalopodi]] na [[gastropodi]] - pamoja na baadhi ya wadudu, kama vile kaa aina ya Horseshoe, yenye rangi ya buluu, kwa kuwa ina protini za himosianini zenye ukolezi wa kama gramu 50 kwa lita. <ref name="AHC 2004 p276-7"></ref> Himosianini huwa haina rangi wakati haina oksijeni na ni buluu iliyokoza wakati inapoongezewa oksijeni. Damu inayozunguka ndani ya viumbe hawa, ambao kwa ujumla huishi katika mazingira baridi yenye mivuto ya chini ya oksijeni, huwa ni rangi ya kijivu-nyeupe hadi manjano hafifu, <ref name="AHC 2004 p276-7">{{cite book |url = http://books.google.com/?id=0OSAKny-6M4C&printsec=frontcover#PRA1-PA276,M1| first = Carl N |last = Shuster|editor = Shuster, Carl N, Jr; Barlow, Robert B; Brockmann, H. Jane |title = The American Horseshoe Crab|chapter = Chapter 11: A blue blood: the circulatory system|publisher =[[Harvard University Press]]|year = 2004|isbn = 0674011597 |pages = 276–7 }}</ref> na hugeuka kuwa buluu iliyokoza wakati inapoachwa wazi kwa oksijeni iliyo kwenye hewa, kama ilivyo wakati vinatoka damu. <ref name="AHC 2004 p276-7"></ref> Hii ni kutokana na mabadiliko ya rangi ya himosianini wakati inapoongezewa oksijeni. <ref name="AHC 2004 p276-7"></ref> Himosianini hubeba oksijeni katika giligili iliyo nje ya seli, ambayo ni tofauti na usafirishaji wa oksijeni ndani ya seli kwa mamalia kupitia himolobini katika RBC. <ref name="AHC 2004 p276-7"></ref> ==Maradhi== ===Matatizo makuu ya kiafya=== * Matatizo ya kiwango ** Jeraha linaweza kusababisha upotezaji wa damu kupitia kutoka damu. <ref>{{cite web|url = http://www.fi.edu/learn/heart/blood/blood.html|title = Blood - The Human heart|publisher = The Franklin Institute|accessdate = 19 March 2009|archivedate = 2009-03-05|archiveurl = https://web.archive.org/web/20090305043654/http://www.fi.edu/learn/heart/blood/blood.html}}</ref> Mtu mzima mwenye afya anaweza kupoteza karibu 20% ya kiasi cha damu (1 L) kabla ya dalili ya kwanza, kutotulia, kuanza, na 40% ya kiasi cha damu(2 L) kabla ya mshtuko. Thrombosaiti ni muhimu kwa ugandishaji na uundaji wa madonge ya damu, ambayo inaweza kusimamisha upotezaji wa damu. Majeraha mabaya kwa viungo vya ndani au kwa mifupa yanaweza kusababisha kutokwa na damu kwa ndani, ambayo wakati mwingine unaweza kuwa kali. ** Kuishiwa maji mwilini kunaweza kupunguza kiasi cha damu kwa kupunguza kiwango cha katika damu. Mara nadra, hii inaweza kusababisha mshtuko (isipokuwa katika kesi kali sana) lakini huweza kusababisha kupungua kwa shinikizo la damu kunakosababishwa na kusimama na kuzirai. * Matatizo ya mzunguko ** Mshtuko ni upiliziaji usio bora wa tishu, na unaweza kusababishwa na hali mbalimbali ikiwa ni pamoja na kupoteza damu, maambukizi, kupunguka kwa uwezo wa moyo wa kusukuma damu. ** Atherosklerosisi hupunguza mtiririko wa damu kupitia ateri, kwa sababu atheroma huziweka ateri kwenye mistari na kuzifanya nyembamba zaidi. Atheroma huendelea kuongezeka kulingana na umri na kuendelea kwake kunaweza kuhusishwa na sababu nyingi ikiwa ni pamoja na kuvuta sigara, shinikizo la damu, lipidi za ziada zinazozunguka (haipalipidemia), na [[kisukari]]. ** Ugandaji unaweza kuunda mvilio, ambao unaweza kuzuia [[tezi]]. ** Matatizo ya mchanganyko wa damu, kitendo cha kusukuma damu cha moyo, au wembamba wa mishipa ya damu kunaweza kuleta matokeo mengi ikiwa ni pamoja na haipoksia (ukosefu wa oksijeni) ya tishu zinazotolewa. Neno ''[[iskemia]]'' linarejelea tishu ambayo imefunikwa na damu, na ''infarction'' inarejelea kukufa kwa tishu (nekrosisi), ambako kunaweza kutokea wakati ugavi wa damu umezibwa (au ni duni sana). ===Matatizo ya kihematolojia=== * Upungufu wa damu mwilini ** Idadi ndogo ya seli nyekundu ([[anemia]]) inaweza kusababishwa na kutoka damu, matatizo ya damu kama vile thalasemia, au ukosefu wa virutubishi, na inaweza kuhitaji kuongezewa damu. Nchi kadhaa zina benki ya damu zinazokidhi mahitaji ya damu kwa damu inayoweza kuongezewa. Mtu anayepokea damu lazima awe na aina ya damu iliyo sambamba na ile ya mtoaji damu. ** [[Anemia Selimundu]] * Matatizo ya kuenea upesi kwa seli ** [[Lukemia]] ni kikundi cha [[saratani]] za tishu zinazounda damu. ** Uzalishaji wa seli nyingi nyekundu usiohusiana na kansa (erithremia) au uzalishaji wa chembe nyingi za kugandisha damu (thrombosaitosisi muhimu) kunaweza kusababisha kansa. ** Dalili za Mayelodisplastiki huhusisha uzalishaji duni wa jamii ya seli moja au zaidi. * Matatizo ya ugandishaji ** [[Himofilia]] ni ugonjwa wa kijenetikia unaosababisha utendakazi mbaya katika mojawapo kati ya mifumo ya ugandishaji wa damu. Hii inaweza kuruhusu majeraha ambayo kwa kawaida sio makuu yawe ya kutisha maisha, lakini kwa kawaida zaidi husababisha hemarthrosisi, au utokaji wa damu katika mianya ya maungo, ambao unaweza kusababisha ulemavu. ** Utendakazi mbaya au idadi ndogo ya chembe za kugandisha damu pia unaweza kusababisha ugonjwa wa kugandisha (magonjwa ya kutokwa damu). ** Hali ya kugandishwa damu (ugonjwa wa kuvilia) hutokana na kasoro katika udhibiti wa chembe za kugandisha damu au utendakazi wa kigandiza damu, na unaweza kusababisha mvilio. * Magonjwa ya kuambukizwa kwa damu ** Damu ni chombo kikubwa cha maambukizi. [[Virusi]] vya HIV vinavyosababisha [[UKIMWI]] huambukizwa kupitia mgusano na damu, [[shahawa]], au majimaji mengine yanayotoka mwilini mwa mtu aliyekwishaambukizwa. [[Homa ya manjano]] aina ya B na C husambazwa hasa kwa njia ya mgusano na damu. Kutokana na maambukizi yanayotokana na damu, vitu vilivyo na damu huchukuliwa kama bayohatari. ** Maambukizi ya bakteria kwenye damu ni uwepobakteria au sepsisi. Kuambukizwa virusi ni viremia. [[Malaria]] na [[malale]] ni maambukizi ya damu yanayotokana na [[vimelea]]. ===Usumisho wa monoksidi ya kaboni=== Dutu zingine bali na oksijeni zinaweza kuungana na himoglobini, wakati mwingine hali hii inaweza kuleta madhara yasiyoweza kubadilishwa kwa mwili. [[Monoksidi ya kaboni]], kwa mfano, ni hatari sana inapobebwa hadi kwenye damu kupitia mapafu kwa kuvuta pumzi, kwa sababu monoksidi ya kaboni hushikana kabisa na himoglobini na kuunda himoglobini kaboksili, hivi kwamba himoglobini kidogo zaidi ina uhuru wa kuungana na oksijeni, na hivyo kiwango cha chni zaidi cha oksijeni kinaweza kusafirishwa katika damu. Hali hii huweza kusababisha kukosekana kwa hewa kwa njia fichu. Moto katika chumba kilichofungwa na kisicho na tundu za kuingiza hewa ni hatari sana, kwa kuwa kinaweza kukusanya monoksidi ya kaboni katika hewa. Kiasi fulani cha monoksidi ya kaboni huungana na himoglobini wakati wa uvutaji wa [[tumbaku]]. ==Madawa ya tiba== ===Bidhaa za damu=== {{see|Utoaji damu}} Damu ya kuongezewa hutolewa kutoka kwa binadamu kwa [[uchangaji wa damu]] na kuhifadhiwa katika [[benki ya damu]]. Kuna aina nyingi za damu katika binadamu, mfumo wa kikundi cha damu cha ÅBO, pamoja na mfumo wa kikundi cha damu cha Rhesasi, ndiyo muhimu zaidi. Kuongezewa damu ya kikundi kisichokubaliana na kikundi kingine cha damu kunaweza kusababisha matatizo makali, ambayo mara nyingi ni mabaya, kwa hivyo ulinganishaji mtambuko hufanywa ili kuhakikisha kuwa bidhaa ya damu iliyo sambamba inaongezewa. Bidhaa zigine za damu zinazotolewa ndani ya vena ni chembe za kugandisha damu, plazma ya damu, krayopresipiteti, na vikolezo vya sababu maalum za kuganda. ===Utoaji wa ndani ya vena=== Aina nyingi za madawa (kutoka [[Antibaotiki|viua vijisumu]] hadi tibakemo) hutolewa ndani ya vena, kwa kuwa hazifyonzwi kwa urahisi au vya kutosha na njia ya utumbo. Baada ya upotezaji wa damu nyingi, michanganyiko iliyotegenezwa inayojulikana kama vipanua plazma vinaweza kutolewa ndani ya vena, ama michanganyiko ya chumvi (NaCl, KCl, CaCl <sub>2</sub> n.k ..) katika viwango vya ukolezi vya kifisiolojia, au michanganyiko ya koloidi, kama vile dekstrani, albumini ya majimaji ya damu ya binadamu, au plazma-bichi iliyoganda. Katika hali hizi za dharura, kipanuzi cha plazma ni bora zaidi kwa michakato hii ya kuokoa maisha kuliko kuongezewa damu, kwa sababu metaboli ya seli nyekundu za damu zilizoongezwa hazianzi upya mara baada ya kuongezewa. ===Uondoaji wa damu=== Katika matibabu yenye misingi ya kisasa, uondoaji damu hutumika kudhibiti magonjwa yasiyo ya kawaida, ikiwa ni pamoja na hemokromatosia na kuongezeka kwa chembe nyekundu za damu. Hata hivyo, uondoaji wa damu na unyonyaji damu zilikuwa njia maarufu ambazo zilikuwa hazijahalalishwa zilizotumika hadi karne ya 19, kwa kuwa magonjwa mengi yalidhaniwa kimakosa kuwa yalitokana na kiwango cha juu cha damu, kulingana na matibabu ya Hippocrates. ==Historia== ===Tiba rasmi ya Ugiriki=== Katika tiba rasmi ya [[Ugiriki]], damu ilihusishwa na [[hewa]], [[majira ya kuchipua]], na [[silika ya uchangamfu]] ''(sanguine)''. Pia iliaminika kuwa zilizalishwa na [[ini]] pekee. ===Tiba ya Hipokrati=== Katika tiba ya [[Hippokrates|Hipokrati]], damu ilichukuliwa kama moja ya viowevu vinne, vingine vikiwa [[kohozi]], [[nyongo njano]], na [[nyongo nyeusi]]. ==Utamaduni na imani za dini== Kutokana na umuhimu wake katika [[maisha]], damu inahusishwa na idadi kubwa ya [[imani]]. Moja kati ya zile kuu zaidi ni matumizi ya damu kama [[alama]] ya mahusiano ya [[familia]] kupitia kuzaliwa / [[uzazi]]; kuwa na "uhusiano wa damu" ni kuhusiana kwa uzazi au [[nasaba]], badala ya [[ndoa]]. Hii huhusiana kwa karibu na [[ukoo]], na misemo kama vile "damu ni nzito kuliko maji", "damu mbaya" na pia "ndugu wa damu." Damu husisitizwa sana katika [[dini]] za Kiyahudi na Kikristo kwa sababu [[Walawi (Biblia)|Walawi]] 17:11 inasema "maisha ya [[Kiumbehai|kiumbe]] yamo katika damu." Fungu hili ni sehemu ya [[sheria]] ya Kilawi inayopinga unywaji wa damu au ulaji wa [[nyama]] ambayo bado ina damu ndani yake badala ya kuimwaga nje. Marejeleo ya [[hadithi]] kuhusu damu mara nyingine yanaweza kushikanishwa na hali ya kutoa [[uhai]], inavyodhihirika katika matukio kama vile kujifungua, ikilinganishwa na damu ya [[jeraha]] au [[kifo]]. ===Waaustralia asili=== Katika [[desturi]] za wakazi asili wa [[Australia]], [[ngeu]] (hasa nyekundu) na damu, zote zikiwa na kiwango cha juu cha [[chuma]] na ambazo zinadhaniwa kuwa Maban (zenye nguvu za [[uchawi]]) hupakwa kwenye miili ya [[wachezaji]] wakati wa [[tambiko|matambiko]]. Kama [[Robert Lawlor]] anavyosema:<blockquote> Katika tamaduni na sherehe nyingi za Aborijini, ngeu nyekundu hupakwa katika sehemu zote za miili uchi za wachezaji. Katika sherehe za siri na takatifu za kiume, damu iliyoondolewa kutoka kwenye vena za mikono ya mshiriki hubadilishwa na kusuguliwa juu ya miili yao. Ngeu nyekundu pia hutumiwa kwa njia sawa na hii katika sherehe zisizo za siri. Damu pia hutumika kushikilia manyoya ya ndege kwenye miili ya watu. Manyoya ya ndege huwa na protini ambayo ina kiwango cha juu cha hisi ya magnetiki. <ref>{{cite book |author=Lawlor, Robert |title=Voices of the first day: awakening in the Aboriginal dreamtime |url=https://archive.org/details/voicesoffirstday0000lawl |publisher=Inner Traditions International |location=Rochester, Vt |year=1991 |pages=[https://archive.org/details/voicesoffirstday0000lawl/page/102 102]–3 |isbn=0-89281-355-5 }}</ref></blockquote> Lawlor anasema kuwa damu inayotumika kwa njia hii inaaminika na watu hawa kuwa inawaunganisha wachezaji na [[dunia]] yenye nguvu isiyoonekana ya wakati wa [[ndoto]]. Lawlor maeneo haya yenye nguvu zisizoonekana na maeneo ya [[sumaku]], kwa kuwa chuma ina sumaku. ===Upagani katika Indo-Uropa=== Kati ya ma[[kabila]] ya kundi la [[lugha]] zinazohusiana na [[Kijerumani]] (kama vile Anglo-Saksoni na Normani), damu ilitumika wakati wa kutoa [[dhabihu]] zao zilizoitwa ''the Blóts''. Damu hii ilikuwa inaaminika kuwa ina uwezo wa chanzo chake, na baada ya kuua mnyama, damu ilinyunyizwa kwenye kuta, juu ya [[sanamu]] za [[miungu]], kwa washiriki wenyewe. Kitendo hiki cha kunyunyiza damu kiliitwa ''bleodsian'' kwa [[Kiingereza cha kale]], na [[istilahi]] hii ilikopwa na [[Kanisa Katoliki]] na kuwa ''kubariki'' na ''[[baraka]].'' Neno la [[Kihiti]] lenye maana ya damu, ''ishar'' lilihusiana na maneno "[[kiapo]]" na "kiunganishi":, tazama [[Ishara]]. [[Ugiriki ya Kale|Wagiriki wa Kale]] waliamini kuwa damu ya miungu, ''ichor,'' ilikuwa ni [[madini]] ambayo ilikuwa [[sumu]] kwa binadamu. ===Uyahudi=== Katika [[Uyahudi]], damu haiwezi kuliwa hata kwa kiasi kidogo (Walawi 3:17 na mahali pengine); jambo hili linajitokeza katika sheria za Kiyahudi kuhusu [[lishe]] (Kashrut). Damu huondolewa kutoka kwenye [[nyama]] kwa kuweka [[chumvi]] na kuilowesha nyama kwenye maji. Matambiko nyingine ya damu yanahusu kufunika damu ya [[ndege]] na mawindo baada ya uchinjaji (Walawi 17:13); sababu iliyotolewa na [[Torati]] ni: "Kwa kuwa uhai wa wanyama uko ndani ya damu yake" (Walawi 17:14). Pia ikiwa mtu wa imani halisi ya Kiyahudi amekufa kwa njia ya kinyama, sheria za kidini zinaamuru kuwa damu yake ikusanywe na izikwe pamoja na [[mwili]]. Jambo muhimu zaidi ni kwamba kwenye [[Pasaka]] Wayahudi wanapaswa kuchinja [[mwanakondoo]] [[dume]] na kupaka milango yao kwa damu yake kama kinga. Ndivyo walivyofanya tangu kale, hasa katika [[Musa]] kuwatoa [[Misri]]. ===Ukristo=== {{main|Ekaristi}} Kwa Wakristo [[damu ya Kristo]] husadikiwa kuwa njia pekee ya [[upatanisho]] kwa ajili ya [[dhambi]] ([[1Yoh]] 1:7; [[Ufu]] 1:5): ndiye mwanakondoo wa kweli ambaye damu yake inawapa nguvu ya kumshinda [[shetani]] (Ufu 12:11). Katika damu hiyo Mungu alifanya na watu [[agano jipya]] la [[milele]], kama alivyotangaza Yesu mwenyewe katika [[karamu ya mwisho]] na [[Mitume wa Yesu|mitume]] wake. Baadhi ya [[madhehebu]] ya [[Ukristo]], yakiwa ni pamoja na Kanisa Katoliki, [[Waorthodoksi]], [[Waorthodoksi wa Mashariki]] na [[Kanisa la Asiria]] la Mashariki hufundisha kwamba, baada ya kuwekwa [[wakfu]], [[divai]] ya [[Ekaristi]] hubadilika na kuwa damu ya [[Yesu]]. Hivyo, katika divai takatifu, Yesu anakuwa yupo kiroho na kimwili. Mafundisho hayo yana misingi yake katika [[Karamu ya mwisho]], kama ilivyoandikwa katika [[Injili]] nne za [[Biblia ya Kikristo]], ambapo Yesu aliwaambia wanafunzi wake kuwa [[mkate]] walioula ni mwili wake, na divai ni damu yake. "[[Kikombe]] hiki ni [[agano jipya]] katika damu yangu, inayomwagika kwa ajili yenu." ([[Lk|Luka]] 22:20). [[Teolojia]] ya [[Walutheri]] hufunza kuwa mwili na damu ziko pamoja "katika, pamoja na, na chini ya" mkate na divai ya [[sherehe]] ya Ekaristi. Aina nyingine za [[Uprotestanti]], hasa [[Wapresbiteri] na [[Wamethodisti]], hufundisha kuwa divai ni alama tu ya damu ya Kristo, ambaye yuko kiroho lakini hayuko kimwili. Upande wa damu ya wanyama, mitume na [[Mzee|wazee]] wa [[Kanisa]] katika [[Mtaguso wa Yerusalemu]] ([[49]] hivi) walipiga marufuku kwa Wakristo kunywa damu, pengine kwa sababu hii ilikuwa amri aliyopewa [[Nuhu]] ([[Mwanzo (Biblia)|(Mwanzo]] 9:4, tazama [[Sheria ya Nuhu]]). [[Amri]] hii iliendelea kufuatwa na Waorthodoksi huko Mashariki, ingawa [[wataalamu]] wa [[Biblia ya Kikristo]] wanaonyesha kwamba katazo hilo, na mengine matatu yaliyoendana nalo, yalitolewa tu ili [[Wakristo wa Kiyahudi]] wasikwazike katika kushirikiana na [[Wakristo wa mataifa]] wasiojisikia kubanwa na masharti yote ya [[Torati]]. ===Uislamu=== Ulaji wa vyakula vyenye damu ni [[haramu]] kulingana na [[sheria za Kiislamu]] kuhusu lishe. Hii inatokana na taarifa katika [[Kurani]], Sura Al-Ma'ida (05:03): "Vilivyoharimishiwa (kama chakula) ni: nyama ya mnyama aliyefariki, damu, nyama ya [[nguruwe]], na lolote ambalo limetajiwa juu yake jina la mwingine bali na [[Allah]]." Damu inachukuliwa kama chafu, na katika Uislamu, [[usafi]] ni sehemu ya imani, hivyo kuna mbinu maalum za kupata hali ya usafi wa kimwili na kitambiko mara tu utokaji damu unapofanyika. Sheria maalum na amri zinahusu [[hedhi]], kutokwa na damu baada ya kuzaa na kutokwa na damu kusio kwa kawaida kwenye [[uke]]. ===Mashahidi wa Yehova=== Kulingana na [[tafsiri]] yao ya maandiko, kama vile Matendo 15:28-29 ("Endelea kujitenga ... na damu."), [[Mashahidi wa Yehova]] hawali damu wala kukubali kuongezewa damu yote au sehemu kuu za damu: seli nyekundu za damu, chembechembe nyeupe za damu, chembe za kugandisha damu (thrombositi), na plazma. Wanachama wanaweza kujiamulia binafsi ikiwa watakubali taratibu za matibabu zinazohusisha damu yao wenyewe au [[dutu]] ambazo zinagawanywa zaidi kutoka kwa sehemu nne kuu.<ref>''The Watchtower'' Juni 15, 2004, ukurasa wa 22, "Be Guided by the Living God" (Kuongozwa na Mungu aliye hai)</ref> ===Tamaduni za Kichina na Kijapani=== Katika tamaduni maarufu ya [[Uchina]], mara kwa mara inasemekana kuwa, ikiwa [[pua]] la mtu limetoa kiasi kidogo cha damu, hii inamaanisha kuwa ana [[hamu]] ya [[ngono]]. Jambo hili huonekana mara nyingi katika [[filamu]] za lugha ya [[Kichina]] na [[Hong Kong]] na pia katika [[utamaduni]] wa [[Japani]] zinazotaniwa katika anime ([[katuni]] hai za [[sinema]] za Kijapani) na manga (hadithi za katuni za Kijapani zilizochapishwa). Wahusika, hasa [[wanaume]], mara nyingi huonyeshwa wakitokwa na damu kwenye pua ikiwa wamuona mtu aliye uchi au mwenye mavazi kidogo, au kama wamekuwa na mawazo au ndoto za kiashiki; hii inatokana na dhana kwamba shinikizo la damu ya wanaume hupanda kwa kiwango kikubwa wanapopata [[ashiki]]. <ref>Sheria ya Anime #40 kwa jina lingine ''Sheria'' ''ya Sanguination '' kwa [http://www.abcb.com/laws/index.htm ABCB.com] , The Anime Cafe.</ref> ===Kashfa za damu=== Makundi mbalimbali ya kidini na makundi mengine yamepewa shutuma za uongo kuwa yanatumia damu ya binadamu katika matambiko; shutuma hizo zinajulikana kama kashfa za damu. Aina maarufu sana ya kashfa hii ni kashfa ya damu dhidi ya Wayahudi. Ingawa hakuna tambiko inayohusisha damu ya binadamu katika sheria au desturi za Kiyahudi, [[uongo]] wa aina hii (mara nyingi unaohusiana na mauaji ya watoto) ulitumika sana katika [[Zama za Kati]] kuhalalisha mateso dhidi ya Wayahudi. ===Hekaya kuhusu wanyonya damu=== Wanyonya damu ni viumbe vya [[visasili]] vinavyokunywa damu moja kwa moja ili viendelee kuishi, na hupendelea zaidi damu ya binadamu. Tamaduni kote duniani huwa na visasili vya aina hii, kwa mfano 'kisasili cha Nosferatu', binadamu anayepata kuhukumiwa na asiyekufa kwa kunywa damu ya wengine, inatokana na [[elimu]] ya [[mila]] na desturi za jamii za [[Ulaya Mashariki]]. Kupe, ruba, mbu za kike, [[popo]] zinazonyonya damu, na viumbe vingine vingi vya kiasili hunywa damu, lakini ni popo pekee anaohusishwa na wanyonya damu. Hii haina uhusiano na popo wanyonyaji damu, ambao ni viumbe vya [[Amerika]] iliogunduliwa na [[Wazungu]] baada tu ya utungaji wa visasili vya [[Ulaya]]. ==Matumizi== ===Katika sayansi-tumizi=== Mabaki ya damu yanaweza kuwasaidia wapelelezi wa mahakama kutambua [[silaha]], kuunda upya kitendo cha uhalifu, na kuwahusisha watuhumiwa na uhalifu. Kupitia uchambuzi wa sampuli ya damu, habari za mahakama pia zinaweza kupatikana kutoka kwa usambazaji wa nafasi katika sampuli za damu. Uchambuzi wa mabaki ya damu pia ni mbinu inayotumika katika [[akiolojia]]. ===Katika sanaa=== Damu ni mojawapo kati ya ugiligili wa mwili ambao umetumika katika sanaa. <ref>[http://artscad.com/A.nsf/Opra/SRVV-6MDNX5 "Nostalgia"] {{Wayback|url=http://artscad.com/A.nsf/Opra/SRVV-6MDNX5 |date=20090108093007 }} Kazi ya sanaa katika damu</ref> Hasa, katika maonyesho ya mtendaji wa Viennese Hermann Nitsch, Franko B, Lennie Lee, Ron Athey, Yang Zhichao, na Kira O `Reilly, pamoja na upigaji picha wa Andres Serrano, zimehusisha damu kama kipengele kikuu cha kuona. Marc Quinn ameunda sanamu kwa kutumia damu iliyogandishwa, ikiwa ni pamoja na umbo la kichwa chake mwenyewe uliotengenezwa kwa kutumia damu yake mwenyewe. ===Katika ukoo na historia ya familia=== Neno ''damu,'' hutumika katika jamii kuashiria ''ukoo'' na asili ya mtu. Maneno mengine ambapo damu hutumika katika muktadha wa historia ya familia ni ''damu ya buluu'' (kutoka tabaka la viongozi), ''damu ya kifalme'', ''damu mchanganyiko'' (ya kutoka mbari tofauti) na ''jamaa wa damu'' (yaani ndugu). ==Tazama pia== * [[Damu bandia]] * [[Himofobia]] (Kuogopa damu) * [[Kupima damu]] * [[Shinikizo la damu]] * [[Utoaji damu]] ==Marejeo == {{marejeo}} ==Viungo vya nje== {{wiktionary}} {{commonscat|Blood|position=left}} [[Jamii:Damu]] [[Jamii:Dini]] [[Jamii:Mwili]] 8y6ji90dfoykcbsy9ioxhhn5qkel0b4 0 15871 1578168 1564486 2026-07-02T23:21:32Z InternetArchiveBot 41439 Add 4 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578168 wikitext text/x-wiki [[Picha:Malaria.jpg|thumb|Protista ya plasmodium jinsi inavyoonekana kwa [[hadubini]]: ndiyo inayosababisha malaria]] '''Malaria''' ni [[ugonjwa wa kuambukiza]] ambao unaenezwa na [[mbu]] wa [[jenasi]] ''[[Anopheles]]'' na kusababishwa na [[kidubini]] aina ya [[protisti]] ''[[Plasmodium]]''. Kutokana na uenezi wake katika nchi zinazotumia [[Kiswahili]], mara nyingi [[ugonjwa]] huo huitwa "[[homa]]" tu, ingawa homa ni [[dalili]] yake mojawapo tu, pia kuna magonjwa mengi yanayosababisha homa. Malaria inatokea katika maeneo ya [[tropiki|kitropiki]] na yanayokaribia tropiki ikiwa ni pamoja na sehemu za [[Amerika]], [[Asia]] na [[Afrika]]. Mwaka [[2015]] [[duniani]] kulikuwa na [[maambukizi]] [[milioni]] 214 ya malaria, <ref>[http://www.cdc.gov/malaria/facts.htm Malaria Facts.] ''Centers for Disease Control and Prevention.'' </ref> na watu 438,000 walikufa, wengi wao (90%) wakiwa [[Bara|barani]] [[Afrika]], hasa [[watoto]] wachanga katika mataifa ya [[kusini kwa Sahara]]. <ref>"Malaria Fact sheet N°94". WHO. Retrieved 2 February 2016.</ref> Malaria ni mojawapo ya magonjwa yaliyoenea sana na ni tatizo kuu la [[afya ya umma]]. Kwa kawaida huhusishwa na [[umaskini]], lakini pia ni sababu ya [[umaskini]] <ref>{{Rejea tovuti|url=http://ftp.iza.org/dp2997.pdf|format=PDF|title=Malaria: Disease Impacts and Long-Run Income Differences|publisher=[[Institute for the Study of Labor]]|accessdate=2008-12-10}}</ref> na kikwazo kikubwa kwa [[maendeleo]] ya [[uchumi]]. [[Spishi]] [[tano]] za [[vimelea]] vya Plasmodium huweza kumwambukiza [[binadamu]]; aina iliyo mbaya zaidi husababishwa na Plasmodium falciparum. Malaria inayosababishwa na ''[[Plasmodium vivax]], [[Plasmodium ovale]]'' na ''[[Plasmodium malariae]]'' husababisha ugonjwa usio shadidi sana kwa binadamu na aghalabu haijui. Spishi ya tano, ''[[Plasmodium knowlesi]]'', husababisha malaria kwa [[nyani]] aina ya [[makaku]] lakini inaweza pia kumwambukiza binadamu. [[Kundi]] hilo la spishi za ''Plasmodium'' linalosababisha ugonjwa kwa binadamu hujulikana kama ''vimelea vya malaria''. Kwa kawaida, watu hupata ugonjwa wa malaria kwa kung'atwa na [[mbu]] wa kike wa jamii ya ''[[Anopheles]]'' aliyeambukizwa. Mbu aina ya Anopheles pekee ndio wanaoweza kusambaza malaria, na ni lazima wawe wameambukizwa kupitia [[damu]] waliyofyonza kutoka kwa mtu aliyeambukizwa. Mbu akimng'ata mtu aliyeambukizwa, huchukua kiasi kidogo cha [[damu]]: damu hiyo huwa na vimelea vya malaria. [[Wiki]] moja baadaye, wakati mbu anapofyonza mlo wake mwingine wa damu, vimelea hivyo huchanganyika na [[mate]] ya mbu na kuingia katika [[mfumo wa damu]] ya anayeng'atwa. Vimelea hivyo huzaa ndani ya [[seli nyekundu za damu]], na kusababisha dalili kama vile [[anemia]], [[maumivu]] kidogo ya [[kichwa]], shida ya kupumua, [[takikadia]], n.k., aidha kuna dalili nyingine za jumla kama vile homa, [[baridi]], [[kichefuchefu]], [[mafua]], na katika hali mbaya zaidi [[kupoteza fahamu]] na hata [[kifo]]. Maambukizi ya malaria yanaweza kupunguzwa kwa kuzuia kung'atwa na [[mbu]] kutumia [[vyandarua]], [[dawa za kuzuia wadudu]], au hatua za kudhibiti maenezi ya mbu kama vile kunyunyizia [[dawa za kuua wadudu]] ndani ya [[nyumba]] na kupiga mifereji kuondoa [[maji]] yaliyosimama ambapo mbu hutaga [[mayai]] yao. Majaribio yamefanywa kuibuka na [[chanjo ya malaria]] bila mafanikio makuu, pamoja na kuibua mbinu za udhibiti wa kiajabu zaidi, kama vile kubadili [[kiini tete|viini tete]] vya mbu ili kuwafanya sugu kwa vimelea pia umefikiriwa. <ref>{{cite journal |author=Yoshida S, Shimada Y, Kondoh D, ''et al.'' |title=Hemolytic C-type lectin CEL-III from sea cucumber expressed in transgenic mosquitoes impairs malaria parasite development |journal=PLoS Pathog. |volume=3 |issue=12 |pages=e192 |year=2007 |pmid=18159942 |doi=10.1371/journal.ppat.0030192 |url=http://www.plospathogens.org/article/info:doi/10.1371/journal.ppat.0030192}}</ref> Ingawa [[utafiti]] unaendelea, hakuna [[chanjo]] iliyopatikana hadi sasa inayotoa ulinzi wa hali ya juu dhidi ya malaria <ref>{{Rejea tovuti |url=http://content.nejm.org/cgi/content/full/NEJMoa0807381 |title=RTS,S vaccine protection rate |accessdate=2009-11-19 |archivedate=2009-11-08 |archiveurl=https://web.archive.org/web/20091108200359/http://content.nejm.org/cgi/content/full/NEJMoa0807381 }}</ref>; mwaka 2015 ile pekee iliyoruhusiwa kutumika nje ya majaribio ni RTS,S, ambayo inatolewa kwa kudunga [[sindano]] mara nne, na hata hivyo ina ufanisi mdogo (26%-50%) kulingana na chanjo nyingine. Hivyo dawa za kuzuia lazima zitumiwe bila kukoma ili kupunguza hatari ya kuambukizwa. Madawa hayo ya kuzuia maambukizi mara nyingi huwa ghali mno kwa watu wengi wanaoishi katika maeneo ambapo ugonjwa huu hupatikana kwa wingi. [[Watu wazima]] wengi wanaoishi katika maeneo ambayo ugonjwa huo umeenea huwa na maambukizi ya muda mrefu ambayo hujitokeza mara kwa mara, na pia huwa na [[kinga]] kidogo; kinga hiyo hupunguka kadiri muda unavyosonga; watu wazima kama hao wanaweza kuambukizwa malaria kali ikiwa wameishi muda mrefu katika maeneo ambapo ugonjwa huo haujaenea. Wanashauriwa kuchukua tahadhari kamili wanaporejea katika maeneo ambapo ugonjwa huo umeenea. Maambukizi ya malaria hutibiwa kwa kutumia [[dawa ya malaria]], kama vile [[kwinini]] au vizalika vya [[atemisinin]]. Hata hivyo, vimelea vimekuwa sugu kwa nyingi ya dawa hizo. Kwa hiyo, katika baadhi ya maeneo ya dunia, dawa chache tu ndizo zilizo na uwezo wa kutibu malaria kwa ufanisi. == Ishara na dalili == [[Picha:Symptoms of Malaria.png|thumb|Dalili kuu za malaria.<ref>WebMD Dalili za malaria Ilisashishwa Mwisho: 16 Mei 2007</ref>]] Dalili za malaria ni pamoja na homa, kutetemeka, [[athralgia]] (maumivu ya kifundo), [[kutapika]], [[anemia]] (inayosababishwa na kuachana kwa chembechembe nyekundu za damu), hemoglobinuria, kuharibika kwa [[retina]], <ref>{{cite journal |author=Beare NA, Taylor TE, Harding SP, Lewallen S, Molyneux ME |title=Malarial retinopathy: a newly established diagnostic sign in severe malaria |journal=Am. J. Trop. Med. Hyg. |volume=75 |issue=5 |pages=790–7 |pmid=17123967 |pmc=2367432 |url=http://www.ajtmh.org/cgi/pmidlookup?view=long&pmid=17123967 |date= 1 Novemba 2006 |month=Nov |day=01 }}</ref> na [[mtukutiko wa maungo]]. Dalili tambulika za malaria hutokea kwa namna ya mzunguko wa [[baridi]] ya ghafla ikifuatiwa na [[kutetemeka]], kisha homa na kutokwa [[jasho]] kunakodumu kwa saa nne hadi sita: dalili hizo hujitokeza kila baada ya siku mbili kwa maambukizi ya ''P. vivax'' na ''P. ovale'', huku ikijitokeza kila baada ya siku tatu kwa ''P. malariae.'' <ref name="RBMarmenia">[http://www.malaria.am/eng/pathogenesis.php Malaria life cycle &amp; pathogenesis.] {{Wayback|url=http://www.malaria.am/eng/pathogenesis.php |date=20080118084209 }} Malaria katika Armenia. Ilitumiwa 31 Oktoba 2006.</ref> ''P. falciparum'' yaweza kuwa na homa inayojitokeza kila baada ya saa 36-48 au homa isiyoshadidi lakini inayoendelea. Kwa sababu zisizofahamika vyema, lakini ambazo zinaweza kuhusiana na shinikizo ya hali ya juu katika [[fuvu la kichwa]], watoto walio na malaria mara nyingi hudhihirisha [[mkao usiokuwa wa kawaida]], ishara ya uharibifu wa [[ubongo]]. <ref name="Idro ">{{cite journal | last =Idro | first =R | authorlink = | coauthors =Otieno G, White S, Kahindi A, Fegan G, Ogutu B, Mithwani S, Maitland K, Neville BG, Newton CR | title = Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria| journal =Malaria Journal | volume =4 | issue =57 | pages = 57| publisher = | date = | url = | pmc = 1326205 | doi = 10.1186/1475-2875-4-57| pmid =16336645 | accessdate =2007-01-21}} </ref> Imegunduliwa kuwa malaria husababisha matatizo ya kutambua, hasa kwa watoto. Husababisha kuenea sana kwa [[anemia]] katika kipindi cha kukua haraka kwa ubongo na pia uharibifu wa moja kwa moja wa ubongo. Uharibifu huo wa [[nyurolojia|kinurolojia]] hutokana na malaria ya ubongo ambayo ni hatari mno kwa watoto. <ref>{{cite journal |author=Boivin MJ |title=Effects of early cerebral malaria on cognitive ability in Senegalese children |journal=J Dev Behav Pediatr |volume=23 |issue=5 |pages=353–64 |year=2002 |month=Oktoba |pmid=12394524 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0196-206X&volume=23&issue=5&spage=353 |access-date=2009-11-19 |archive-date=2011-07-18 |archive-url=https://web.archive.org/web/20110718072406/http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0196-206X&volume=23&issue=5&spage=353 |dead-url=yes }}</ref> <ref> {{cite journal |author=Holding PA, Snow RW |title=Impact of Plasmodium falciparum malaria on performance and learning: review of the evidence |journal=Am. J. Trop. Med. Hyg. |volume=64 |issue=1-2 Suppl |pages=68–75 |year=2001 |pmid=11425179 |doi= |url=http://www.ajtmh.org/cgi/content/abstract/64/1_suppl/68 |format= }} - ^{[http://scholar.google.co.uk/scholar?hl=en&amp;lr=&amp;q=intitle%3AImpact+of+Plasmodium+falciparum+malaria+on+performance+and+learning%3A+review+of+the+evidence&amp;as_publication=Am.+J.+Trop.+Med.+Hyg.&amp;as_ylo=2001&amp;as_yhi=2001&amp;btnG=Search Orodha tafuta))]} </ref> malaria ya ubongo huhusishwa na weupe wa retina, <ref>{{cite journal|author=Maude RJ, Hassan MU, Beare NAV|title=Severe retinal whitening in an adult with cerebral malaria|journal=Am J Trop Med Hyg|volume=80|issue=6|year=2009|page=881|url=http://www.ajtmh.org/cgi/content/full/80/6/881|pmid=19478242|pages=881|month=Jun|day=01}}</ref> ambayo inaweza kuwa na manufaa kama ishara ya kutofautisha malaria na visababishi vingine vya homa. <ref>{{cite journal|author=Beare NAV, Taylor TE, Harding SP, Lewallen S, Molyneux ME|year=2006|title=Malarial retinopathy: a newly established diagnostic sign in severe malaria|journal=Am J Trop Med Hyg|volume=75|pages=790–797|pmid=17123967|issue=5}}</ref> {| class="wikitable" |- ! Spishi ! Mwonekano ! Dalili katika vipindi vinavyolingana ! Hudumu katika ini? |- | ''[[Plasmodium vivax]]'' | [[Picha:Plasmodium vivax 01.png|center|200px]] | kila baada ya siku tatu | ndio |- | ''[[Plasmodium ovale]]'' | [[Picha:Plasmodium ovale 01.png|center|200px]] | Kila baada ya siku tatu | ndio |- | ''[[Plasmodium falciparum]]'' | [[Picha:Plasmodium falciparum 01.png|center|200px]] | kila baada ya siku tatu | hapana |- | ''[[Plasmodium malariae]]'' | [[Picha:Mature Plasmodium malariae schizont PHIL 2715 lores.jpg|center|200px]] | kila baada ya siku nne | hapana |} Malaria kali husababishwa takriban kipekee na maambukizi ya ''P. falciparum'': kwa kawaida hujitokeza kati ya siku 6-14 baada ya kuambukizwa. <ref name="Trampuz">{{cite journal | author = Trampuz A, Jereb M, Muzlovic I, Prabhu R | title = Clinical review: Severe malaria | url= | pmc=270697 | journal = Crit Care | volume = 7 | issue = 4 | pages = 315–23 | year = 2003 | pmid = 12930555 | doi = 10.1186/cc2183}}</ref> Madhara ya ugonjwa wa malaria kali ni pamoja na [[kukosa fahamu]] na kifo ikiwa haitatibiwa-watoto wachanga na wanawake wajawazito hasa wamo hatarini. [[Splenomegali]] (kupanuka kwa wengu), [[maumivu makali ya kichwa]], [[iskemia ya ubongo]], [[hepatomegali]] (kupanuka kwa ini), [[hypoglisimia]], na hemoglobinuria na [[kufeli kwa figo]] huweza kutokea. Kufeli kwa figo kunaweza kusababisha [[homa ya mkojo wa damu]], ambapo hemoglobin kutoka katika chembechembe nyekundu za damu zilizosambaratika huvuja na kuingia katika mkojo. Malaria kali inaweza kuendelea kwa kasi na kusababisha kifo katika mudaa wa masaa kadhaa au masiku. <ref name="Trampuz"/> Katika hali mbaya zaidi ya ugonjwa huo viwango vya vifo vinaweza kuzidi 20%, hata kuwe na utunzi wa hali ya juu na matibabu. <ref>{{cite journal | author = Kain K, Harrington M, Tennyson S, Keystone J | title = Imported malaria: prospective analysis of problems in diagnosis and management | url = https://archive.org/details/sim_clinical-infectious-diseases_1998-07_27_1/page/142 | journal = Clin Infect Dis | volume = 27 | issue = 1 | pages = 142–9 | year = 1998 | pmid = 9675468 | doi = 10.1086/514616}}</ref> Katika maeneo ambapo ugonjwa huo umeenea, mara nyingi matibabu si ya kuridhisha na kiwango cha jumla cha vifo vinavyosababishwa na malaria huwa kimoja kati visa kumi. <ref>{{cite journal | author = Mockenhaupt F, Ehrhardt S, Burkhardt J, Bosomtwe S, Laryea S, Anemana S, Otchwemah R, Cramer J, Dietz E, Gellert S, Bienzle U | title = Manifestation and outcome of severe malaria in children in northern Ghana | journal = Am J Trop Med Hyg | volume = 71 | issue = 2 | pages = 167–72 | year = 2004 | pmid = 15306705}}</ref> Baada ya muda mrefu, matatizo ya kukua yamerekodiwa kwa watoto ambao wameugua malaria kali. <ref name="carter2005">{{cite journal | author=Carter JA, Ross AJ, Neville BG, Obiero E, Katana K, Mung'ala-Odera V, Lees JA, Newton CR | title=Developmental impairments following severe falciparum malaria in children | url=https://archive.org/details/sim_tropical-medicine-and-international-health_2005-01_10_1/page/n4 | journal=Trop Med Int Health | year=2005 | volume=10 | pages=3–10 | pmid=15655008 | doi = 10.1111/j.1365-3156.2004.01345.x | issue=1}}</ref> Malaria ya muda mrefu hutokana na ''P. vivax'' na ''P. ovale,'' lakini si katika ''P. falciparum.'' Hapa, ugonjwa huo unaweza kujitokeza tena miezi au miaka baada ya kuambukizwa kutokana na uwepo wa vimelea fiche katika [[ini]]. Kwa hivo, kueleza kuwa malaria imetibiwa kwa kutazama kutokuwepo kwa vimelea katika damu kunaweza kupotosha. Kipindi kirefu zaidi kati ya kuambukizwa vimelea na kujitokeza kwa dalili za ugonjwa kimeripotiwa kwa ''P. vivax'' kuwa miaka 30. <ref name="Trampuz"/> Inakadiriwa kuwa moja kati ya visa vitano vya malaria vinavyosababishwa na ''P. vivax'' katika maeneo ya [[hari]] huhusiana na [[kujihifadhi kwa vijimelea]] vya hipnoziti (yaani, dalili hujitokeza mwaka unaofuata kung'atwa na mbu). <ref>{{cite journal | author = Adak T, Sharma V, Orlov V | title = Studies on the Plasmodium vivax relapse pattern in Delhi, India | journal = Am J Trop Med Hyg | volume = 59 | issue = 1 | pages = 175–9 | year = 1998 | pmid = 9684649}}</ref> == Sababu == [[Picha:Malaria.jpg|thumb|Spora ya Plasmodium huzunguka sitoplazimu ya seli epitheliumu ya utumbo wa kati ya mbu katika rangi hii bandia ya mikrografia eltroniki.]] === Vimelea vya malaria === Vimelea vya malaria ni wa [[jenasi]] ya ''[[Plasmodium]]'' (Faila Apicomplexa). Katika binadamu malaria husababishwa na ''P. falciparum, P. malariae, P. ovale, P. vivax'' na ''P. knowlesi.'' <ref>{{cite journal |author=Mueller I, Zimmerman PA, Reeder JC |title=Plasmodium malariae and Plasmodium ovale--the "bashful" malaria parasites |url=https://archive.org/details/sim_trends-in-parasitology_2007-06_23_6/page/278 |journal=Trends Parasitol. |volume=23 |issue=6 |pages=278–83 |year=2007 |month=Juni |pmid=17459775 |doi=10.1016/j.pt.2007.04.009}}</ref> <ref>{{cite journal |author=Singh B, Kim Sung L, Matusop A, ''et al.'' |title=A large focus of naturally acquired Plasmodium knowlesi infections in human beings |url=https://archive.org/details/sim_the-lancet_2004-03-27_363_9414/page/n24 |journal=Lancet |volume=363 |issue=9414 |pages=1017–24 |year=2004 |month=Machi |pmid=15051281 |doi=10.1016/S0140-6736(04)15836-4}}</ref> ''P. falciparum'' ndiyo iliyoenea zaidi na huchangia takriban 80% ya maambukizi yote ya malaria, na pia inahusishwa na karibu 90% ya vifo vinavyotokana na malaria. <ref>{{cite journal | author = Mendis K, Sina B, Marchesini P, Carter R | title = The neglected burden of Plasmodium vivax malaria | url = http://www.ajtmh.org/cgi/reprint/64/1_suppl/97.pdf | journal = Am J Trop Med Hyg | volume = 64 | issue = 1-2 Suppl | pages = 97–106 | year = 2001 | pmid = 11425182 | format = PDF | access-date = 2009-11-19 | archive-date = 2009-03-26 | archive-url = https://web.archive.org/web/20090326131917/http://www.ajtmh.org/cgi/reprint/64/1_suppl/97.pdf | dead-url = yes }}</ref> Vimelea vya spishi ya ''Plasmodium'' huambukiza pia ndege, mitambaazi, nyani, sokwe na panya. <ref>{{cite journal | author = Escalante A, Ayala F | title = Phylogeny of the malarial genus Plasmodium, derived from rRNA gene sequences | url = https://archive.org/details/sim_proceedings-of-the-national-academy-of-sciences-usa_1994-11-22_91_24/page/11373 | doi= 10.1073/pnas.91.24.11373 | journal = Proc Natl Acad Sci USA | volume = 91 | issue = 24 | pages = 11373–7 | year = 1994 | pmid = 7972067}}</ref> Kumedhibitishwa maambukizi kadhaa ya wanadamu na [[Wiktionary:simian|spishi zinazoambukiza nyani]] malaria, yaani ''P. knowlesi, P. inui, P. cynomolgi,'' <ref>{{cite book | last=Garnham | first=PCC | year=1966 | title=Malaria parasites and other haemosporidia | publisher=Blackwell Scientific Publications|location=Oxford }}</ref> ''P. simiovale, P. brazilianum, P. schwetzi'' na ''P. simium'', hata hivyo, isipokuwa kwa ''P. knowlesi,'' hizo nyingine hazina umuhimu kwa afya ya umma. <ref>{{cite journal|title=''Plasmodium knowlesi:'' Finally being recognized|url=https://archive.org/details/sim_journal-of-infectious-diseases_2009-04-15_199_8/page/n12|journal=J Infect Dis|year=2009|volume=199|pages=1107–1108|doi=10.1086/597415|pmid=19284287|last1=Collins|first1=WE|last2=Barnwell|first2=JW|issue=8|author1=&Amp, Collins W.E.|author2=Barnwell, J.W.}}</ref> Ingawa [[malaria ya ndege]] inaweza kuua [[kuku]] na [[batamzinga]], ugonjwa huu hausababishi hasara kubwa kiuchumi kwa wafugaji wa kuku. <ref>Investing in Animal Health Research to Alleviate Poverty. Taasisi ya Utafiti wa Mifugo ya kimataifa. Permin A. na Madsen M. (2001) [http://www.ilri.cgiar.org/InfoServ/Webpub/fulldocs/investinginanimal/Book1/media/PDF_Appendix/Appendix8.pdfLiterature Appendix 2: review on disease occurance and imparct (smallholder poultry).] {{Wayback|url=http://www.ilri.cgiar.org/InfoServ/Webpub/fulldocs/investinginanimal/Book1/media/PDF_Appendix/Appendix8.pdfLiterature |date=20110718022608 }} Ilitumika 29 Oktoba 2006</ref> Hata hivyo, tangu kuingizwa kiajali na binadamu imeeneza ugonjwa na kuua idadi kubwa ya ndege wa [[Hawaii]], ambao walikuwa wamekua katika mazingira bila kimelea hicho na kwa hivyo hawakuwa na kinga yoyote dhidi yake. <ref>{{cite journal |author=Atkinson CT, Woods KL, Dusek RJ, Sileo LS, Iko WM |title=Wildlife disease and conservation in Hawaii: pathogenicity of avian malaria (''Plasmodium relictum'') in experimentally infected iiwi (''Vestiaria coccinea'') |journal=Parasitology |volume=111 Suppl |issue= |pages=S59–69 |year=1995 |pmid=8632925 |doi=10.1017/S003118200007582X}}</ref> == Taratibu == === Mzunguko wa maisha ya ''Plasmodium'' na vekta wa mbu === Kimelewa cha msingi (mahsusi) cha kimelea hicho na [[njia ya uenezi]] na [[vekta]] zake ni [[mbu]] jike wa jenasi ya ''[[Anopheles]]'', binadamu na wanyama wengine wenye uti wa mgongo ni vimelewa wa ziada. Kwanza mbu wachanga humeza vimelea kwa kufyonza damu ya mwanadamu aliyeambukizwa kisha mbu huyo wa aina ya''Anopheles'' hubeba [[mbegu za vimelea]] za ''Plasmodium'' katika [[matezi ya mate]] yao. Mbu huambukizwa baada ya kufyonza damu kutoka kwa binadamu aliyeambukizwa. Baada ya kumezwa, [[gameti]] za vimelea viliyofyonzwa pamoja na damu hujigawanya kwa msingi wa [[mbegu]] za kiume au za kike na kisha kuungana katika utumbo wa mbu. Hii hubuni [[ukineti]] inayopenya wambo wa utumbo wa mbu na kuzalisha [[uusisi]] katika ukuta wa utumbo. Uusisi inapopasuka, inatoa spora(sporozoites)vinayohama katika mwili wa mbu kuelekea katika matezi ya mate ya mbu, ambapo huwa tayari kumwambukiza binadamu mwingine. Aina hii ya maambukizi wakati mwingine hujulikana kama uhamisho kituo wa kabla(anterior station transfer). Spora huingizwa ndani ya ngozi, pamoja na mate, wakati mbu anapofyonza mlo wake mwingine wa damu. Mbu jike tu ndio hufyonza damu, hivyo mbu wa kiume hawasambazi ugonjwa huo. Mbu jike wa jenasi ya ''Anopheles'' hupendelea kutafuta mlo usiku. Huanza kutafuta mlo [[giza]] linapoanza kuingia na kuendelea usiku kucha mpaka watakapopata mlo. Vimelea vya malaria pia vinaweza kuambukizwa kupitia kuongezwa damu, ingawa hii ni nadra. === Pathojenesisi === [[Picha:MalariacycleBig.jpg|thumb|right|Mzunguko wa maisha ya vimelea vya malaria katika mwili wa binadamu. Mbu anamwambukiza mtu kwa kufyonza mlo damu. Kwanza, spora huingia katika mfumo wa damu, na kuhamia ini. Huambukiza chembechembe za ini (hepatosaiti), ambapo huzaana kuwa merozoiti, kurarua chembe za ini, na kujipenyeza kurudi katika mfumo wa damu. Kisha, merozoiti huambukiza chembechembe nyekundu za damu, ambapo hukua katika umbo pete, kisha trofozoiti (awamu ya kula), kisha skizonti (awamu ya kula), kisha kurejea kuwa merozoitiVijiumbe vinayoitwa gameti pia huzalishwa, ambayo, kama ikivyonzwa na mbu, vitamwambukiza mdudu huyo na kuendelea na mzunguko wa uhai.]] Malaria katika binadamu hupevuka katika awamu mbili: awamu ya eksoirithasitika na erithrasiti. Awamu ya eksoirithasitika inahusisha maambukizi ya mfumo wa ini, huku awamu ya erithrasiti inahusisha maambukizo ya seli nyekundu za damu. Mbu aliyeambukizwa anapodunga ngozi ya binadamu kufyonza mlo wa damu, [[spora]] katika mate ya mbu huingia katika mfumo wa damu ya binadamu na kuhamia katika [[ini]]. Katika muda wa dakika 30 ya kuwa mwilini mwa binadamu, spora huambukiza [[seli za ini]], kujizidisha kwa uzazi nafsi na bila kusababisha dalili za ugonjwa kwa muda wa kati ya siku 6 na 15. Mara zinapoingia katika ini viumbe hivyo huzaana kwa maelfu ya [[merozoiti]], ambazo, baada ya kupasuka kwa seli ya kimelewa wao, hujipenyeza ndani ya damu na kuambukiza [[chembechembe nyekundu za damu]], na hivyo [[kuanza]] awamu ya erithrasiti katika mzunguko wa maisha. <ref>[https://web.archive.org/web/20090318200741/http://www.sma.org/pdfs/objecttypes/smj/91C48D32-BCD4-FF25-565C69314AF7EB48/1196.pdf Bledsoe, GH (]</ref> Vimelea hutoka katika ini bila kutambulika kwa kujizungusha kwenye kiwambo cha seli ya ini ya kimelewa aliyeambukizwa. <ref name="sturm2006">{{cite journal | author=Sturm A, Amino R, van de Sand C, Regen T, Retzlaff S, Rennenberg A, Krueger A, Pollok JM, Menard R, Heussler VT | title=Manipulation of host hepatocytes by the malaria parasite for delivery into liver sinusoids | url=https://archive.org/details/sim_science_2006-09-01_313_5791/page/1286 | journal=Science | year=2006 | volume=313 | pages=1287–1490 | pmid=16888102 | doi = 10.1126/science.1129720 | issue=5791 }}</ref> Ndani ya chembechembe nyekundu za damu, vimelea huendelea kuongezeka, kwa uzazi nafsi, mara nyingine hujipenyeza nje ya chembe wenyeji na kuvamia chembechembe nyekundu zilizokuwa hazijaambukizwa. Mizunguko kadhaa kama hiyo ya kujiongezea nguvu hutokea. Kwa hivyo, maelezo yanayofahamika ya kukumbwa na homa ya ghafla hutokea wakati merozoiti wanapojipenyeza na kuambukiza chembechembe nyekundu za damu. Baadhi ya spora za ''P. vivax'' na ''P. ovale'' hazikui moja kwa moja kuwa merozoiti katika awamu ya eksoirithasitika, badala yake huzalisha hipnozoiti zinazobakia bwete kwa kipindi cha kati ya miezi kadhaa (aghalabu miezi 6-12) hadi urefu wa mpaka miaka mitatu. Baada ya kipindi cha kuwa bwete, vimelea hivyo hujiamilisha na kuzalisha merozoiti. Hipnozoiti zanahusika na kipindi kirefu cha kati ya kuambukizwa na cha maradhi, na kurejea tena kwa ugonjwa katika aina hizi mbili za malaria. Kimelea cha malaria kwa kiwango fulani hulindwa dhidi ya kushambuliwa na [[mfumo wa kinga mwili]] kwa sababu katika kipindi cha mzunguko wa maisha kinapoishi katika mwili wa mwanadamu, hukaa ndani ya ini na chembechembe nyekundu za damu na haionekani kwa urahisi kwa ufuatiliaji wa kinga mwili. Hata hivyo, chembechembe za damu zilizoambukizwa na zilizo katika mzunguko wa damu huharibiwa katika [[wengu]]. Ili kuepuka hali hii vimelea vya ''P. falciparum'' hutandaza [[protini]] inayonata juu ya chembechembe za damu zilizoambukizwa, hii husababisha chembechembe hizo kukwama kwenye kuta za mishipa ndogo ya damu, hivyo basi kutenga vimelea hivyo na mzunguko wa jumla na wengu. Hali hii ya "kunata" ni sababu kuu inayochangia matizo ya [[kutokwa damu]]wakati wa malaria. [[Vena ndogo za endotheliumu]] (matawi madogo kabisa katika mzunguko wa damu) zinaweza kuzibwa na mkusanyiko wa chembechembe hizo za damu zilizoambukizwa. Kuzibwa kwa mishipa hii husababisha dalili kama zinazohusishwa na malaria ya kondo ya nyuma na malaria ya ubongo. Katika malaria ya ubongo chembechembe nyekundu za damu zilizotengwa zinaweza kuvunja [[kizuizi cha damu na ubongo]] hali inayoweza kupelekea kukosa fahamu. <ref>{{cite journal | author = Adams S, Brown H, Turner G | title = Breaking down the blood-brain barrier: signaling a path to cerebral malaria? | url = https://archive.org/details/sim_trends-in-parasitology_2002-08_18_8/page/360 | journal = Trends Parasitol | volume = 18 | issue = 8 | pages = 360–6 | year = 2002 | pmid = 12377286 | doi = 10.1016/S1471-4922(02)02353-X}}</ref> Ingawa protini gandishi ya uso wa chembechebe nyekundu za damu (iitwayo PfEMP1, yaani ''Plasmodium falciparum'' erythrocyte membrane protini 1) ziko wazi kwa mfumo wa kinga, hazisaidii kama kinga nzuri kwa minajili ya chanjo kwa sababu ya utofauti wao uliokithiri; kuna angalau aina 60 za protini ndani ya kimelea kimoja na ina tofauti zaidi katika jamii ya vimelea. <ref name="Chen"/> Kimelea hicho hujigeuza kati ya mchanganyiko mkubwa wa protini gandishi za uso PfEMP1, hivyo basi kuwa hatua moja mbele ya mfumo wa kinga unaoitafuta. Baadhi ya merozoiti hugeuka kuwa [[gameti]] za kiume au za kike. Mbu anapong'ata ngozi ya mtu aliyeambukizwa, mara moja huwa na uwezo kufyonza gameti zilizo damuni. Muunganiko wa mbegu za kiume na kike za vimelea hutokea katika utumbo wa mbu, na hivyo kumfanya mbu kuwa [[kimelea]] cha [[msingi]] wa ugonjwa huo. Spora mpya hukua na kusafiri kuelekekea katika tezi ya mate ya mbu, na hivyo kukamilisha mzunguko. [[Wanawake]] [[Ujauzito|wajawazito]] hasa huwa kivutio kwa mbu, <ref>{{cite journal | author = Lindsay S, Ansell J, Selman C, Cox V, Hamilton K, Walraven G | title = Effect of pregnancy on exposure to malaria mosquitoes | url = https://archive.org/details/sim_the-lancet_2000-06-03_355_9219/page/n54 | journal = Lancet | volume = 355 | issue = 9219 | pages = 1972 | year = 2000 | pmid = 10859048 | doi = 10.1016/S0140-6736(00)02334-5}}</ref> malaria kwa wanawake wajawazito ni kisababishi kikuu cha [[uzazimfu]], vifo vya watoto wachanga na uzaaji wa watoto wasio na uzito unaostahili, <ref>{{cite journal | author = van Geertruyden J, Thomas F, Erhart A, D'Alessandro U | title = The contribution of malaria in pregnancy to perinatal mortality | url = http://www.ajtmh.org/cgi/content/full/71/2_suppl/35 | journal = Am J Trop Med Hyg | volume = 71 | issue = 2 Suppl | pages = 35–40 | date = 1 Agosti 2004 | pmid = 15331817 | month = Aug | day = 01 | access-date = 2009-11-19 | archive-date = 2010-04-03 | archive-url = https://web.archive.org/web/20100403200936/http://www.ajtmh.org/cgi/content/full/71/2_suppl/35 | dead-url = yes }}</ref> hasa katika maambukizi ya ''P. falciparum'', lakini pia kutokana na maambukizi ya spishi nyingine, kama vile ''P. vivax.'' <ref name="rodriguezmorales2006">{{cite journal | author=Rodriguez-Morales AJ, Sanchez E, Vargas M, Piccolo C, Colina R, Arria M, Franco-Paredes C | title=Pregnancy outcomes associated with Plasmodium vivax malaria in northeastern Venezuela | journal=Am J Trop Med Hyg | year=2006 | volume=74 | pages=755–757 | pmid = 16687675 | issue=5}}</ref> == Uaguzi == [[Picha:Plasmodium falciparum 02.jpg|thumb|Mpako wa damu kutoka P. falciparum iliyokuzwa (K1 Strain). Chembechembe kadhaa nyekundu za damu zilizo na awamu ya pete ndani yazo. Karibu katikati kuna schizont na kushoto kuna trofozoiti.]] Tangu Charles Laveran alipokiona kwa mara ya kwanza kimelea cha malaria katika damu mwaka wa 1880, <ref name="Sutherland2009">{{cite journal|author=Sutherland CJ, Hallett R|title=Detecting malaria parasites outside the blood|url=https://archive.org/details/sim_journal-of-infectious-diseases_2009-06-01_199_11/page/n10|journal=J Infect Dis|year=2009|volume=199|issue=11|pages=1561–1563|doi=10.1086/598857|pmid=19432543|last1=Sutherland|first1=CJ|last2=Hallett|first2=R}}</ref> msingi wa uaguzi wa malaria umekuwa uchunguzi wa damu kwa hadubini. Homa na mshtuko wa mwili huchukuliwa kimakosa kama aina ya malaria kali sana barani Afrika kiasi cha kutoshughulikia magonjwa mengine hatari. Katika maeneo ambapo malaria imeenea [[uwepo wa vimelea]] damuni hakutoshi kutoa uaguzi wa malaria kali kwa sababu uwepo wa vimelea unaweza kusababishwa na maradhi mengine yanayolingana na malaria. Uchunguzi wa hivi karibuni unapendekeza kuwa [[upimaji mwanga katika retina]] ni njia bora ya kuagua malaria (uwezo wa kijumla wa kupitisha mwangaza wa 95% na uwezo wa bainifu wa 90%) zaidi ya mbinu za kutegemea dalili au maabara katika utofautishaji baina ya malaria na magonjwa mengine.{ {1/} Ingawa damu ni sampuli inayotumiwa mara nyingi kufanya uaguzi, mate na mkojo vimechunguzwa kama sampuli mbadala, inayoingiwa na vimelea chache. <ref name="Sutherland2009"/> === Uaguzi wa dalili === Maeneo yasiyoweza kumudu angaa vipimo sahili vya kimaabara aghalabu hutegemea historia ya dalili za homa ambazo mgonjwa ataeleza kuamua kutoa tiba ya malaria. Kwa kutumia damu iliyopakwa Gemsa kutoka kwa watoto nchini Malawi, utafiti ulionyesha kwamba wakati uaguzi wa dalili (joto la mjiko, weupe wa shina la ukucha, na kupanuka kwa wengu) zilipotumika kama ishara ya tiba, badala ya kutumia dalili anazoeleza mgonjwa,kiwango cha uaguzi sahihi kiliongezeka kutoka 21 % hadi 41% na kutoa matibabu ya malaria kusikohitajika kukapungua vikubwa. <ref name="Redd S, Kazembe P, Luby S, Nwanyanwu O, Hightower A, Ziba C, Wirima J, Chitsulo L, Franco C, Olivar M 2006 80"> {{cite journal |author=Redd S, Kazembe P, Luby S, Nwanyanwu O, Hightower A, Ziba C, Wirima J, Chitsulo L, Franco C, Olivar M |title=Clinical algorithm for treatment of Plasmodium falciparum malaria in children |journal=Lancet |volume=347 |issue=8996 | pages = 80 | year = 2006 |pmid=8551881 | doi = 10.1016/S0140-6736(96)90404-3}}</ref> === Uchunguzi hadubini wa filmu za damu === {{Details3|[[Plasmodium falciparum|P. falciparum]], [[Plasmodium vivax|P. vivax]], [[Plasmodium ovale|P. ovale]], [[Plasmodium malariae|P. malariae]]|individual parasites}} Njia ya kiiktisadi zaidi, inayopendelewa, na ya kuaminika kwa uaguzi wa malaria ni uchunguzi hadubini wa [[filmu]] za [[damu]] kwa sababu kila moja ya spishi nne za vimelea huwa na sifa bainifu. Kwa kawaida, aina mbili za filmu ya damu hutumika. Filmu nyembamba ni sawa na filmu ya damu za kawaida na huruhusu utambulisho wa spishi kwa sababu mwonekano wa vimelea huhifadhiwa vyema katika maandalizi hayo. Filmu nzito humruhusu mhadubini kuchunguza kiasi kikubwa cha damu na ni karibu mara kumi na moja rahisi kuonekana kuliko filmu nyembamba, kwa hivyo kutambua viwango vya chini ya maambukizi ni rahisi kwa kutumia filmu nzito, lakini mwonekano wa vimelea huwa umepotoa zaidi na hivyo kutofautisha kati ya spishi mbalimbali kunaweza kuwa vigumu zaidi. Kwa kuzingatia faida na mapungufu ya filmu nzito na nyembamba, ni muhimu kutumia filmu hizi mbili wakati wa kutafuta uaguzi bainifu. <ref name="warhurst1996">{{cite journal | author=Warhurst DC, Williams JE | title=Laboratory diagnosis of malaria | url=https://archive.org/details/sim_journal-of-clinical-pathology_1996-07_49_7/page/n6 | journal=J Clin Pathol | year=1996 | volume=49 | pages=533–38 |pmid=8813948 | doi = 10.1136/jcp.49.7.533 | issue=7}}</ref> Kutoka kwa filamu nzito, mhadubini anaweza kuchunguza viwango vya vimelea (au [[uwepo wa vimelea)]] hadi kiwango cha chini cha 0.0000001% cha chembechembe nyekundu za damu. Utambuzi wa spishi unaweza kuwa vigumu kwa sababu trofozoiti ("umbo pete") za mapema maishani mwa vimelea zote hufanana na kamwe haiwezekani kutambua spishi kwa msingi wa umbo pete moja; utambulisho wa spishi hutegemea trofozoiti kadhaa. === Uchunguzi nyanjani === Katika maeneo ambapo uchunguzi hadubini haupatikani, au ambapo wafanyakazi wa maabara hawana uzoefu katika uaguzi wa malaria, kuna [[vipimo antijeni]] ambavyo vinahitaji tone tu la damu. <ref>{{cite journal | author=Pattanasin S, Proux S, Chompasuk D, Luwiradaj K, Jacquier P, Looareesuwan S, Nosten F | title=Evaluation of a new Plasmodium lactate dehydrogenase assay (OptiMAL-IT) for the detection of malaria | journal=Transact Royal Soc Trop Med | year=2003 | volume=97 | pages=672–4 | pmid=16117960 | doi=10.1016/S0035-9203(03)80100-1 | issue=6}}</ref> Vipimo vya imunokromatografia (pia huitwa: Uaguzi Haraka wa Malaria, Uchanganuzi wa Kukamata Antijeni au "Dipsticks") vimetengenezwa, kusambazwa na kujaribiwa nyanjani. Vipimo hivi hutumia damu inayotolewa kidoleni au damu ya vena, kipimo kamilufu huchukua jumla ya dakika 15-20, na maabara haihitajiki. Upeo chini wa vipimo vya uaguzi haraka upo katika vimelea 100 / μl ya damu ikilinganishwa na uchunguzi hadubini kutumia filmu nzito ambapo upeo huo ni 5. Vipimo vya uaguzi haraka vya kwanza vilitumia ''P. falciparum'' [[glutamate dehydrogenase]] kama antijeni. <ref>{{cite journal | author=Ling IT., Cooksley S., Bates PA., Hempelmann E., Wilson RJM. | title=Antibodies to the glutamate dehydrogenase of Plasmodium falciparum | journal=Parasitology | year=1986 | volume=92, | pages=313–24 | pmid=3086819 | doi=10.1017/S0031182000064088 }}</ref> Nafasi ya PGluDH ilichukuliwa na ''P.falciparum'' lactate dehydrogenase, aina moja ya 33 kDa [[oxidoreductase]] [EC 1.1.1.27]. Ndicho kimeng'enya cha mwisho katika njia ya [[glaikoliti]], na ni muhimu kwa uzalishaji [[ATP]] na pia ni mojawapo ya kimeng'enya kinachopatikana kwa wingi katika ''P.falciparum.'' PLDH haiendelei kuwa katika damu bali humalizika karibu wakati mmoja na vimelea kufuatia matibabu yaliyofanikiwa. Kutokuwepo kwa antijeni baada ya tiba hufanya upimaji wa pLDH muhimu katika kutabiri ikiwa matibabu hayakufaulu. Kwa jinsi hii, pLDH ni sawa na pGluDH. Uchanganuzi wa OptiMAL-IT unaweza kutofautisha kati ya ''P. falciparum'' na ''P. vivax'' kwa sababu ya tofauti ya kiantijeni kati ya kimeng'enya chao pLDH. === Mbinu za kimolekyuli === Mbinu za kimolekyuli hupatikana katika baadhi ya maabara za kimatibabu na asei za uchanganuzi wa papo kwa hapo (kwa mfano, [[QT-NASBA]] inayotumia mmenyuko endelevu wa polimeresi ) <ref>{{cite journal | title=Detection and identification of human Plasmodium species with real-time quantitative nucleic acid sequence-based amplification | author=Mens PF, Schoone GJ, Kager PA, Schallig HDFH. | journal=Malaria Journal | year=2006 | volume=5 | issue=80 | doi=10.1186/1475-2875-5-80 | pages=80 | pmid=17018138 | last1=Mens | first1=PF | last2=Schoone | first2=GJ | last3=Kager | first3=PA | last4=Schallig | first4=HD }}</ref>zinaendelea kuandaliwa kwa matumaini ya kuzisambaza katika maeneo ambapo ugonjwa huo umeenea. === Vipimo haraka vya antijeni === OptiMAL-IT inaweza kuchunguza kwa umadhubuti uwepo wa vimelea vya P. falciparum hadi chini ya 0.01% na vimelea visivyo falciparum hadi 0.1%. ''Para'' check-PF huweza kuchunguza vimelea chini ya 0.002% lakini haiwezi kutofautisha kati ya malaria inayoambukizwa na ''falciparum'' na isiyoambukizwa na ''falciparum''. Asidi za viiniseli vya vimelea hugunduliwa kutumia [[mmenyuko endelevu wa polimeresi]]. Mbinu hii ni sahihi zaidi kuliko uchunguzi hadubini. Hata hivyo, ni ghali, na inahitaji maabara maalumu. Pia, uwepo wa vimelea si lazima uwiane na kukua kwa ugonjwa, hasa wakati kimelea kinaweza kujigandisha katika kuta za mishipa ya damu. Kwa hivyo, vifaa zaidi vilivyo na uwezo wa kupima mabadiliko madogo na visivyohitaji teknolojia ya hali ya juu vinafaa kubuniwa ili kugundua uwepo wa vimelea vya viwango vya chini nyanjani. <ref> {{cite journal |author=Redd S, Kazembe P, Luby S, Nwanyanwu O, Hightower A, Ziba C, Wirima J, Chitsulo L, Franco C, Olivar M |title=Clinical algorithm for treatment of Plasmodium falciparum malaria in children |journal=Lancet |volume=347 |issue=8996 |pages=80 |year=2006 |pmid=8551881 |doi=10.1016/S0140-6736(96)90404-3}}</ref> == Kuzuia == [[Picha:Anopheles albimanus mosquito.jpg|thumb|Mbu aina ya Anopheles Albimanus afyonza mkono wa binadamu. Mbu huyu ni vekta wa malaria na udhibiti wa mbu ni njia madhubuti sana ya kupunguza matukio ya malaria.]] Mbinu zinazotumiwa kuzuia kuenea kwa ugonjwa, au kulinda watu katika maeneo ambapo malaria imeenea ni pamoja na madawa ya kuzuia ugonjwa, kutokomeza mbu, na uzuiaji kung'atwa na mbu. Kuendelea kuwepo kwa malaria katika eneo kunahitaji; mseto wa idadi kubwa ya binadamu, idadi kubwa ya mbu katika eneo moja, na viwango vya juu vya maambukizi kutoka kwa binadamu hadi kwa mbu na kutoka kwa mbu hadi kwa binadamu. Ikiwa hali hizi zote zitapunguzwa kwa viwango vya kutosha, bila shaka kimelea cha malaria kitatoweka kutoka katika eneo hilo, kama ilivyotokea [[Amerika ya Kaskazini, Ulaya]] sehemu kubwa ya [[Mashariki ya Kati]]. Hata hivyo, vimelea visipotokomezwa kutoka dunia nzima, vinaweza kujisitawisha tena ikiwa hali itarejea kuwa inayofaa kuzaana kwao. Nchi nyingi zinashuhudia ongezeko la idadi ya maambukizi ya malaria kutokana na usafiri na uhamaji mwingi. Kwa sasa, hakuna [[kinga]] inayozuia malaria lakini utafiti unaendelea. Watafiti wengi wanasema kuwa kinga ya malaria inaweza kuwa nafuu zaidi kuliko tiba ya ugonjwa huo kwa muda mrefu, lakini mtaji unaohitajika ni wa juu sana kwa watu wengi maskini duniani. Mshauri wa kiuchumi [[Jeffrey Sachs]] anakadiria kwamba malaria inaweza kudhibitiwa kwa msaada wa dola za Amerika bilioni 3 kila mwaka. Imesemekana kuwa, ili kufikia [[Malengo ya Maendeleo ya Milenia]], pesa lazima zielekezwe kutoka katika juhudi za kutibu [[VVU]] / [[UKIMWI]] na kuelekezwa kuzuia malaria, ambayo kwa kiasi sawa cha fedha kutakuwa na manufaa makubwa kwa chumi za Afrika. Usambazaji wa ufadhili inatofautiana miongoni mwa mataifa. Nchi zenye idadi kubwa ya watu hazipokei kiasi sawa cha msaada. Nchi 34 zilizopokea msaada wa chini ya $ 1 kwa kila mtu kila mwaka ni baadhi ya mataifa maskini zaidi barani Afrika. [[Brazili]], [[Eritrea]], [[India]] na [[Vietnam]], tofauti na nchi nyingine zinazoendelea, zimefanikiwa kupunguza tatizo la malaria. Sababu zilizopelekea mafanikio katika mataifa hayo ni pamoja na mazingira mazuri ya nchi, mpangilio mahususi wa kiufundi unaotumia zana faafu kuwafikia walengwa, kufanya uamuzi kwa misingi ya utafiti, uongozi tendaji katika ngazi zote za serikali, kushirikisha jamii, ugatuzi wa utekelezaji na udhibiti wa fedha, wafanyikazi wa kiufundi na wa usimamizi wenye ujuzi katika ngazi ya taifa na nyanjani, kujishughulisha moja kwa moja kiufundi na kivitendo kwa mashirika wafadhili na fedha za kutosha na zinazopatikana kwa urahisi. <ref>{{cite journal | author = Barat L | title = Four malaria success stories: how malaria burden was successfully reduced in Brazil, Eritrea, India, and Vietnam | journal = Am J Trop Med Hyg | volume = 74 | issue = 1 | pages = 12–6 | year = 2006 | pmid = 16407339}}</ref> === Udhibiti Vekta === Juhudi za kukomesha malaria na kutokomeza mbu zimefanikiwa katika baadhi ya maeneo. Kitambo malaria ilikuwa ugonjwa wa kawaida [[Amerika]] na [[Ulaya kusini]] lakini juhudi za kudhibiti vekta, pamoja na matibabu na ufuatiliaji wa binadamu walioambukizwa, ulikomesha ugonjwa huo katika maeneo hayo. Katika baadhi ya maeneo, kukomesha mitiririsho kwenye maeneo chepechepe ambapo mbu huzaliana na kuimarisha usafi kuliwezesha hali hiyo. Malaria ilitokomezwa kutoka kaskazini mwa Marekani mapema katika karne ya 20 kwa mbinu kama hizo, na matumizi ya [[kiuadudu]] cha [[DDT]] yaliutokomeza kutoka Kusini kufikia mwaka wa 1951. <ref name="CDChistory"> http://www.cdc.gov/malaria/history/eradication_us.htm Centers for Disease Control. ''Eradication of Malaria in the United States (1947-1951)'' 2004.</ref> Katika mwaka wa 2002, kuliripotiwa matukio 1059 ya malaria nchini Amerika, ikiwa ni pamoja na vifo vinane, lakini kati ya hayo yote, matukio matano tu ya ugonjwa huo yaliambukizwa ndani ya Amerika. Kabla ya kuvumbuliwa kwa kiuadudu cha DDT,maeneo kadhaa ya kitropiki pia yalitokomeza au kudhibiti malaria kwa kuondoa au kusumisha maeneo ya mbu kuzaliana au maji ambamo lava huishi, kwa mfano kwa kumwaga au kujaza mafuta mahali maji yamesimama. Mbinu hizi hazijatumika vilivyo barani Afrika kwa zaidi ya nusu karne. <ref>{{cite journal | author = Killeen G, Fillinger U, Kiche I, Gouagna L, Knols B | title = Eradication of Anopheles gambiae from Brazil: lessons for malaria control in Africa? | journal = Lancet Infect Dis | volume = 2 | issue = 10 | pages = e192 | year = 2002 | pmid = 12383612 | doi = 10.1016/S1473-3099(02)00397-3}}</ref> Katika [[miaka ya 1950]] na [[Miaka ya 1960|1960]] kulikuwa na juhudi kubwa za afya ya umma kutokomeza ugonjwa wa malaria duniani kwa kulenga maeneo ambako malaria ilikuwa imeenea. <ref>{{cite news | author=Gladwell, Malcolm.|date=2001-07-02 | title=The Mosquito Killer | url=http://www.gladwell.com/2001/2001_07_02_a_ddt.htm | publisher=The New Yorker}}</ref> Hata hivyo, juhudi hizi hazijafaulu kutokomeza malaria katika sehemu nyingi zinazoendelea duniani, tatizo hilo limeenea zaidi barani Afrika. [[Mbinu ya kutasisha mdudu]] inajitokeza kama mbinu ya kudhibiti mbu. Maendeleo kuelekea transijeni, au wadudu waliogeuzwa vinasaba, zinaonyesha kwamba mbu mwitu wanaweza kubadilishwa kuwa sugu kwa malaria. Watafiti katika [[Imperial College London]] walibuni mbu wa kwanza wa malaria ulimwenguni aliyegeuzwa vinasaba, <ref>Imperial College, London, [http://www.ic.ac.uk/templates/text_3.asp?P=1911 "Scientists create first transgenic malaria mosquito",] {{Wayback|url=http://www.ic.ac.uk/templates/text_3.asp?P=1911 |date=20060926003820 }} 2000/06/22.</ref> huku spishi wa kwanza sugu kwa Plasmodium akizinduliwa na watafiti kutoka [[Case Western Reserve University Ohio]] mwaka wa 2002. <ref name="ito2002">{{cite journal | author=Ito J, Ghosh A, Moreira LA, Wimmer EA, Jacobs-Lorena M | title=Transgenic anopheline mosquitoes impaired in transmission of a malaria parasite | url=https://archive.org/details/sim_nature-uk_2002-05-23_417_6887/page/386 | journal=Nature | year=2002 | volume=417 | pages=387–8 | pmid=12024215 | doi = 10.1038/417452a | issue=6887}}</ref> Mafanikio ya kubadilisha kizazi cha sasa na kizazi kilicho na vinasaba vipya, yanategemea mfumo kadhaa, kama vile vipengele vinavyoweza kubadilishwa kuruhusu nadharia nyingine za [[jenetikia]] mbali na ya [[Mendel]]. Hata hivyo, mbinu hii ina matatizo mengi na mafanikio yako mbali mno. <ref> Knols et al., 2007</ref> Mbinu nyingine ya usoni zaidi ya kudhibiti vekta ni uwezekano wa kutumia [[mwanga]] wa [[leza]] kuua mbu wanaoruka. <ref>{{cite web |url=http://online.wsj.com/article/SB123680870885500701.html |title=Rocket Scientists Shoot Down Mosquitoes With Lasers |publisher=WSJ.com |author=Robert Guth |accessdate=8 Julai 2009}}</ref>Pia inadaiwa kuwa harufu ya ndege wafugwao ikiwapo kuku huweza kuwafukuza wadudu warukao ikiwamo mbu wa malaria<ref>{{Citation|last=HANS|first=RAPHAEL|title=HARUFU YA KUKU HUFUKUZA MALARIA|url=https://afyazetu360.blogspot.com/2017/08/harufu-ya-kuku-hufukuza-malaria.html|work=A-Z 360|language=en-US|access-date=2018-10-27|archive-date=2019-07-14|archive-url=https://web.archive.org/web/20190714045326/http://afyazetu360.blogspot.com/2017/08/harufu-ya-kuku-hufukuza-malaria.html|url-status=dead}}</ref> === Madawa ya kuzuia === Madawa mengi ambayo hutumiwa kutibu malaria, yanaweza kutumika kuzuia. Kwa ujumla, dawa hizi hutumiwa kila siku au kila wiki, katika kipimo cha chini kuliko inavyofaa kutumiwa kutibabu mtu ambaye kweli ameambukizwa ugonjwa huo. Matumizi ya madawa ya kuzuia ni nadra kwa wakazi wa maeneo ambapo malaria imeenea, matumizi hayo kawaida huwa kwa wageni wa muda mfupi na wasafiri wanaotembelea maeneo ya malaria. Hii ni kutokana na gharama ya madawa hayo, [[athari]] mbaya kutokana na matumizi ya muda mrefu, na kwa sababu baadhi ya madawa madhubuti ya kupambana na malaria hayapatikani kwa rahisi nje ya mataifa tajiri. [[Kwinini]] ilianza kutumika kama dawa ya kuzuia malaria (profilaksis) katika karne ya 17. Kubuniwa kwa madawa mbadala fanisi zaidi kama vile [[kwinakrini]], [[klorokwini]] na [[primakwini]] katika [[karne ya 20]], kulipunguza kutegemewa kwa kwinini. Siku hizi, kwinini bado inatumiwa katika kutibu malaria sugu inayoambukizwa na ''Plasmodium falciparum'' pamoja na kutibu [[malaria ya ubongo]], lakini kwa kawaida haitumiki kama kizuia malaria. Madawa ya kisasa yanayotumiwa kuzuia ni pamoja na [[mefloqine]] ''(Lariam),'' [[doxycycline/0} (inapatikana kwa urahisi), na mchanganyiko wa atovaquone na proguanil hydrochloride ya {0{/0} (Malarone).|doxycycline/0} (inapatikana kwa urahisi), na mchanganyiko wa [[atovaquone]] na proguanil hydrochloride ya {0{/0} ''(Malarone).'' Chaguo la dawa gani litumike hutegemea vimelea vilivyo [[sugu]] katika eneo hilo, athari ya dawa hiyo na maswala mengine. Dawa ya prophylactic haianzi kufanya kazi mara moja baada ya kumezwa, kwa hivyo watu wanaopanga kutembelea maeneo ambapo malaria imeenea kawaida huanza kutumia dawa hiyo wiki moja au mbili kabla ya kutembelea sehemu hizo na ni lazima waendeleae kuzitumia kwa wiki 4 baada ya kuondoka (isipokuwa atovaquone proguanil inayohitaji kuanza kutumiwa siku 2 kabla ya kusafiri na kuendelea siku 7 baadaye ya kuondoka). Matumizi ya madawa ya kuzuia malaria katika maeneo ambapo mbu wanaoambukiza malaria wanapatikana yanaweza kufanya mwili kuwa sugu katika kupata malaria. <ref>[http://content.nejm.org/cgi/content/abstract/361/5/468 Roestenberg M, et al.] {{Wayback|url=http://content.nejm.org/cgi/content/abstract/361/5/468 |date=20090802093941 }}[http://content.nejm.org/cgi/content/abstract/361/5/468 ''Protection against a Malaria Challenge by Sporozoite Inoculation.'' ] {{Wayback|url=http://content.nejm.org/cgi/content/abstract/361/5/468 |date=20090802093941 }} New England J. Med. 361:468, 30 Julai 2009</ref> === Unyunyizaji majumbani === Unyunyizaji majumbani (IRS) ni hali ya kunyunyizia viuadudu kwenye kuta za ndani ya nyumba katika maeneo yaliyoathirika na malaria. Baada ya kufyonza, spishi nyingi za mbu hupumzika juu ya kitu kilicho karibu huku akimeng'enya mlo wake wa damu, kwa hivyo iwapo kuta za majumba zitanyunyuziwa viuadudu, mbu wanaopumzika huenda wakauawa kabla kumng'ata mhasiriwa mwingine, na kumhamishia vimelea vya malaria Kiuadudu cha kwanza kilichotumika katika unyunyizaji majumbani (IRS) kilikuwa [[DDT]]. <ref name="CDChistory"/> Ingawa awali kilitumika kupambana na malaria pekee, matumizi yake yalienea kwa haraka na kuingia katika [[kilimo]]. Baada ya muda, dawa ya DDT ilianza kutumika hasa kwa lengo la kudhibiti wadudu kuliko kama dawa ya kuzuia ugonjwa kuenea na kutokana na matumizi haya makubwa katika kilimo kulizuka mbu sugu katika maeneo mengi. Usugu wa mbu wa aina ya Anopheles dhidi ya DDT unaweza kufananishwa na usugu wa bakteria kwa viuavijasumu. Matumizi ya kupindukia ya sabuni za kuua bakteria na viuavijasumu dhidi ya bakteria yalisabisha usugu kwa bakteria kwa viuavijasumu, sawa na jinsi unyunyizaj wa DDT wa kupundukia kwa mimea ulipelekea usugu wa mbu wa Anopheles kwa DDT. Katika miaka ya 1960, uenezaji wa habari kuhusu madhara ya matumizi ya kiholela ya DDT uliongezeka, jambo ambalo lilipelekea matumizi ya DDT katika kilimo kupigwa marufuku katika nchi nyingi katika miaka ya 1970. Kwa kuwa matumizi ya DDT katika kilimo yamepungua au kupigwa marufuku kwa muda, DDT sasa inaweza kuwa njia ya kufaa kama hatua ya kudhibiti ugonjwa. Ingawa matumizi ya DDT kudhibiti malaria hayajawahi kupigwa marufuku na kwamba kuna viuadudu vingine vingi vinavyoweza kutumika kunyunyiza, baadhi ya wanaharakati wamedai kwamba marufuku haya yamesababisha vifo vya mamilioni ya watu katika nchi za kitropiki ambapo DDT iliwahi kuwa madhubuti katika kudhibiti malaria. Fauka ya hayo, matatizo mengi yanayokurubishwa na matumizi ya DDT yanatokana na matumizi yake kwa viwango pana katika kilimo, wala si matumizi yake katika [[afya ya umma]]. <ref name="pmid17111979">{{cite journal |author=Tia E, Akogbeto M, Koffi A, ''et al.'' |title=[Pyrethroid and DDT resistance of Anopheles gambiae s.s. (Diptera: Culicidae) in five agricultural ecosystems from Côte-d'Ivoire] |language=French |journal=Bulletin de la Société de pathologie exotique (1990) |volume=99 |issue=4 |pages=278–82 |year=2006 |pmid=17111979 |doi=}}</ref> [[Shirika la Afya Duniani]] (WHO) kwa sasa linashauri matumizi ya aina 12 tofauti za viuadudu katika operesheni za kunyunyiza. Hizi ni pamoja na matumizi ya DDT na msururu wa vibadala (kama vile pyrethroids [[Permethrin]] na [[deltamethrin]]), ili kupambana na malaria katika maeneo ambapo mbu wamekuwa sugu kwa DDT ili kupunguza kasi ya mabadiliko kuelekea usugu. <ref>[http://whqlibdoc.who.int/hq/2006/WHO_HTM_MAL_2006.1112_eng.pdf Indoor Residual Spraying: Use of Indoor Residual Spraying for Scaling Up Global Malaria Control and Elimination.] {{Wayback|url=http://whqlibdoc.who.int/hq/2006/WHO_HTM_MAL_2006.1112_eng.pdf |date=20160122134004 }} Shirika la Afya Duniani, 2006.</ref> Matumizi haya ya viwango vidogo vya DDT katika afya ya umma yanaruhusiwa chini ya [[Mkataba wa Stolckholm wa Usimamizi wa Taka za Kemikali Zinazodumu katika Mazingira kwa Muda Mrefu]] (POPs), ambao unapiga marufuku matumizi ya DDT katika kilimo. <ref>[http://www.who.int/malaria/docs/10thingsonDDT.pdf 10 Things You Need to Know about DDT Use under The Stockholm Convention]</ref> Hata hivyo, kwa sababu ya [[historia]] yake, nchi nyingi zilizoendelea zimewekea vikwazo matumizi ya DDT hata kwa viwango vidogo. <ref>[http://www.pops.int/ The Stockholm Convention on persistent organic pollutants]</ref> <ref>{{cite news | last= Rosenberg | first= Tina |title= "What the world needs now is DDT" | publisher= New York Times |date= 2007-04-11 | url= http://query.nytimes.com/gst/fullpage.html?sec=health&res=9F0DEEDA1738F932A25757C0A9629C8B63 | accessdate= 2008-11-03}}</ref> Tatizo mojawapo la aina zote za unyunyizaji wa viuadudu majumbani ni [[usugu]] unaotokana na mabadiliko ya mbu. Kulingana na utafiti uliochapishwa kuhusu Mosquito Behavior and Vector Control, spishi wa mbu wanaoathiriwa na IRS ni wale wanaopumzika na kuishi majumbani (endophilic), kutokana na mwasho unasababishwa na dawa za kunyunyizia, vizazi vyao wanabadilika kuelekea spishi wanaopumzika na kuishi nje (exophilic), kumaanisha hawaathiriki - ikiwa wanaathirika kwa vyovyote - na IRS, na kufanya mbinu hii kuwa isiyofaa kwa kiasi fulani katika kujilinda. === Vyandarua vya mbu na matandiko === {{Main|Chandarua}} Vyandarua vya mbu husaidia kutenga watu na mbu na kupunguza maambukizi na usambazaji wa malaria kwa kiwango kikubwa. Vyandarua si vizuizi kamilifu na mara nyingi hutiwa kiuadudu kilichotengenezwa kuua mbu kabla apate muda wa kutafuta upenyu wa kuingia ndani ya chandarua. Vyandarua vilivyotiwa dawa (Insectcide-Treated-Neta;ITN) vinakadiriwa kuwa na ufanisi mara mbili zaidi ya vyandarua visivyotiwa dawa, <ref name="hull2006"/> na hutoa ulinzi zaidi ya 70% ikilinganishwa na kutotumia chandarua. <ref>{{cite journal |author=Bachou H, Tylleskär T, Kaddu-Mulindwa DH, Tumwine JK |title=Bacteraemia among severely malnourished children infected and uninfected with the human immunodeficiency virus-1 in Kampala, Uganda |journal=BMC Infect. Dis. |volume=6 |issue= |pages=160 |year=2006 |pmid=17090299 |pmc=1660577 |doi=10.1186/1471-2334-6-160 |url=}}</ref>. Ingawa vyandarua vilivyotiwa dawa, ITN vimedhibitishwa kuwa na ufanisi dhidi ya malaria, chini ya 2% ya watoto katika miji ya mataifa ya Afrika iliyo Kusini kwa Sahara wanalindwa na ITN. Kwa sababu mbu wa ''[[Anopheles]]'' hufyonza damu usiku, njia inayopendekezwa ni kuning'iniza neti katikati ya kitanda hivi kwamba inafunika kitanda chote. Usambazaji wa vyandarua vilivyotiwa viuadudu kama vile [[Pamethrin]] au deltamethrin umeonyesha kuwa ni mbinu madhubuti mno katika kuzuia malaria, na pia ni mojawapo ya mbinu yenye gharama nafuu zaidi. Vyandarua hivi vinaweza kupatikana kwa dola zipatazo 2,50-$ 3,50 (kati ya euro 2-3 ) kutoka kwa [[Umoja wa Mataifa]], Shirika la Afya Duniani (WHO) na mashirika mengine. Vyandarua vilivyotiwa dawa (ITN) vimedhibitishwa kuwa mbinu yenye gharama nafuu zaidi katika kuzuia malaria na ni sehemu ya Malengo ya Maendeleo ya Milenia (Millennium Development Goals;MDGs) za WHO. Kwa ufanisi zaidi, vyandarua lazima vitiwe viuadudu kila baada ya miezi sita. Mchakato huu hukumbwa na tatizo la ukosefu wa vifaa muhimu katika maeneo ya vijijini. Kuna teknolojia mpya kama Olyset au DawaPlus inayowezesha neti kudumu kwa muda mrefu(Long- Lasting Insecticide nets;LLIN),ambapo vyandarua hivyo hutoa viuadudu kwa takriban miaka 5, <ref>[http://www.voanews.com/english/archive/2004-11/2004-11-23-voa30.cfm?CFID=15461499&amp;CFTOKEN=28007413 New Mosquito Nets Could Help Fight Malaria in Africa]</ref> na hugharimu takribani US $ 5.50. Vyandarua hivi huwalinda wanaovotumia na kuua mbu wanaogusa chandarua hicho. Watu wanaolala katika chumba kimoja na hawajajifunika kwa chandarua pia hupata ulinzi wa kiasi fulani. Huku usambazaji wa vyandarua vya mbu ukiwa sehemu muhimu ya mbinu za kuzuia malaria, uelimishaji na uhamasishaji wa jamii kuhusu hatari za ugonjwa wa malaria huambatanishwa na kampeni za usambazaji ili kuhakikisha kuwa watu wanaopokea vyandarua wanajua jinsi ya kuvitumia. Kampeni za "Hang Up" kama zinazofanywa na wanaojitolea kuhudumu na shirika la [[Kimataifa]] la [[Red Cross]] na la [[Red Crescent Movement]] hushirikisha kutembelea miji ambayo ilipokea vyandarua ifikapo mwisho wa kampeni au kabla tu ya msimu wa mvua kuhakikisha kwamba chandarua kinatumika vizuri na kwamba watu walio hatarini zaidi ya kuambukizwa, kama watoto wachanga na wazee, wanalala chini neti. Utafiti uliofanywa na [[CDC]] nchini [[Sierra Leone]] ulionyesha ongezeko la asilimia 22 katika utumiaji wa chandarua kufuatia kutembelewa kibinafsi na mtu wa kujitolea anayeishi katika jamii hiyo. Utafiti nchini [[Togo]] ulionyesha hali bora sawa na hukSierra Leoneo. <ref>{{Rejea tovuti |url=http://www.ifrc.org/what/health/diseases/malaria/156800-Malaria-Report-EN-LR.pdf |title=International Federation of Red Cross and Red Crescent Societies (200) "The winning formula - World Malaria Day Report 2009" |accessdate=2009-11-19 |archivedate=2009-08-09 |archiveurl=https://web.archive.org/web/20090809050332/http://www.ifrc.org/what/health/diseases/malaria/156800-Malaria-Report-EN-LR.pdf }}</ref> Gharama ya kutibu malaria huwa juu ikilinganishwa na mapato ya mgonjwa,na basi ugonjwa huo husababisha hali ya mtu kupoteza riziki yake. Mara nyingi vyandarua huwa ghali kwa watu katika nchi zinazoendelea, hasa kwa wengi walio hatari ya kuambukizwa. Mtu 1 tu katiya watu 20 huwa na chandarua cha mbu barani Afrika. <ref name="hull2006"/> Vyandarua pia husambazwa wakati wa kampeni za kutoa chanjo kwa kutumia vocha za ruzuku, kama vile wakati wa kampeni za kuwachanja watoto dhidi ya [[surua]]. Utafiti uliofanywa miongoni mwa [[wakimbizi]] wa [[Afghanistani]] nchini [[Pakistan]] ulibainisha kuwa kutia dawa ya permethrin kwenye matandiko na [[buibui]] (pamoja na [[hijabu]]) huwa na athari sawa na hali ya kutumia chandarua kilichotiwa dawa, lakini bei yake ni nafuu. <ref>{{cite journal | author = Rowland M, Durrani N, Hewitt S, Mohammed N, Bouma M, Carneiro I, Rozendaal J, Schapira A | title = Permethrin-treated chaddars and top-sheets: appropriate technology for protection against malaria in Afghanistan and other complex emergencies | journal = Trans R Soc Trop Med Hyg | volume = 93 | issue = 5 | pages = 465–72 | year = 1999| pmid = 10696399 | doi = 10.1016/S0035-9203(99)90341-3}}</ref> Mbinu nyingine mbadala hutumia spora za kuvu [[Beauveria bassiana]] kunyunyizia kuta na vyandarua ili kuua mbu. Japo baadhi ya mbu wamekua sugu kwa kemikali, haijapatikana kuwa wamekuwa sugu kwa maambukizi ya kuvu. <ref name="bbcfungus">[http://news.bbc.co.uk/1/hi/health/4074212.stm "Fungus 'may help malaria fight'",] ''BBC News,'' 2005/06/09</ref> === Chanjo === {{main|Chanjo ya Malaria}} Kingamaradhi (au, kwa usahihi zaidi, kuhimili malaria) hutokea kawaida, lakini baada ya maambukizi yaliyorudiwarudiwa na aina nyingi za malaria. <ref>{{cite journal|author=Färnert A, Williams TN, Mwangi TW, ''et al.''|title=Transmission‐dependent tolerance to multiclonal ''Plasmodium falciparum'' infection|url=https://archive.org/details/sim_journal-of-infectious-diseases_2009-10-01_200_7/page/n167|journal=J Infect Dis|year=2009|volume=200|issue=7|pages=1166–1175|doi=10.1086/605652|pmid=19702508|last1=Färnert|first1=A|last2=Williams|first2=TN|last3=Mwangi|first3=TW|last4=Ehlin|first4=A|last5=Fegan|first5=G|last6=Macharia|first6=A|last7=Lowe|first7=BS|last8=Montgomery|first8=SM|last9=Marsh|first9=K}}</ref> [[Chanjo]] ya malaria inaendelea kufanyiwa utafiti na, hakuna chanjo madhubuti iliyopatikana hadi sasa. Ufafiti wa kwanza ulioonyesha uwezekano wa kupatikana kwa chanjo ya malaria ulifanyika mwaka wa 1967 kwa kumchanja panya na [[spora hai zilizodhoofishwa kwa mnunurisho]], na ilitoa kinga kwa takriban 60% ya panya baadaye walipodungwa kwa spora hai zinazoweza kuambukiza. <ref name="Nussenzweig1967">{{cite journal |author=Nussenzweig R, Vanderberg J, Most H, Orton C |title=Protective immunity produced by the injection of x-irradiated sporozoites of plasmodium berghei |url=https://archive.org/details/sim_nature-uk_1967-10-14_216_5111/page/n78 |journal=Nature |volume=216 |issue=5111 |pages=160–2 |year=1967 | pmid = 6057225 | doi = 10.1038/216160a0}}</ref> Tangu 1970, kumekuwa na juhudi za kubuni chanjo kwa binadamu kutumia mikakati sawa na hiyo. Ilibainishwa kwamba mtu anaweza kupata kinga dhidi ya maambukizo ya ''P. falciparum'' ikiwa atang'atwa zaidi ya mara 1,000 na mbu walioambukizwa, ambao pia wamenunurishwa. <ref name="Hoffman2002">{{cite journal |author=Hoffman SL, Goh LM, Luke TC, ''et al.'' |title=Protection of humans against malaria by immunization with radiation-attenuated Plasmodium falciparum sporozoites |url=https://archive.org/details/sim_journal-of-infectious-diseases_2002-04-15_185_8/page/n164 |journal=J. Infect. Dis. |volume=185 |issue=8 |pages=1155–64 |year=2002 |pmid=11930326| doi = 10.1086/339409 |last12=Stoute |first12=JA |last13=Church |first13=LW |last14=Sedegah |first14=M |last15=Heppner |first15=DG |last16=Ballou |first16=WR |last17=Richie |first17=TL}}</ref> Imekubaliwa kwa ujumla kwamba ni vigumu kutumia mkakati kama huo kutoa chanjo kwa watu walio hatarini kuambukizwa. Badala yake, kazi nyingi zimefanywa kujaribu kuelewa michakato ya [[kiimyunolojia]] inayotoa kinga baada ya kuchanjwa kwa spora iliyonunurishwa. Baada ya utafiti wa chanjo kwa panya mwaka wa 1967, <ref name="Nussenzweig1967"/> ilichukuliwa kinadharia kwamba spora zilizodungwa zilikuwa zikitambuliwa na mfumo wa kingamwili, ambao kwa upande wake ulikuwa ukiunda [[mazindikomwili]] (antibodies) dhidi ya vimelea. Ilidhibitishwa kwamba mfumo wa kingamwili ulikuwa ukibuni mazindikomwili dhidi ya protini ya [[circumsporozoite]] (CSP) iliyokuwa imeizunguka spora. <ref>{{cite journal |author=Zavala F, Cochrane A, Nardin E, Nussenzweig R, Nussenzweig V |title=Circumsporozoite proteins of malaria parasites contain a single immunodominant region with two or more identical epitopes |url=https://archive.org/details/sim_journal-of-experimental-medicine_1983-06_157_6/page/1947 |journal=J Exp Med |volume=157 |issue=6 |pages=1947–57 |year=1983 | doi = 10.1084/jem.157.6.1947 |pmid=6189951 |unused_data=|i pmid = 6189951}}</ref> Aidha, mazindikomwili dhidi ya CSP yalizuia spora kuzivamia seli za ini (hepatocytes). <ref>{{cite journal |author=Hollingdale M, Nardin E, Tharavanij S, Schwartz A, Nussenzweig R |title=Inhibition of entry of Plasmodium falciparum and P. vivax sporozoites into cultured cells; an in vitro assay of protective antibodies |url=https://archive.org/details/sim_journal-of-immunology_1984-02_132_2/page/909 |journal=J Immunol |volume=132 |issue=2 |pages=909–13 |year=1984 | pmid = 6317752}}</ref> Hivyo basi CSP ilichaguliwa kama protini iliyokuwa na uwezekano zaidi wa kubuni chanjo dhidi ya spora ya malaria. Ni kwa sababu hizi za kihistoria ambapo chanjo zilizo na msingi katika CSP ni nyingi miongoni mwa chanjo za malaria. Kwa sasa, kuna aina tofauti za chanjo zinazokaguliwa. Chanjo inayolenga vimelea kabla havijafikia damu (pre-erythrocytic), hasa chanjo ambazo misingi yake ni CSP, huchangia pakubwa la tafiti za chanjo ya malaria. Aina nyingine za tafiti za chanjo zinajumuisha: zile zinazotafuta kuweka kinga katika awamu ya kuambukizwa kwa damu; zinazotafuta kuepuka pathologia kali zaidi ya malaria kwa kuzuia kushikamana kwa vimelea katika [[mishipa]] ya damu au na [[chanjo dhidi ya uenezi]] utakaokomesha kukua kwa vimelea mwilini mwa mbu baada ya mbu kufyonza damu ya mtu aliyeambukizwa. <ref name="Matuschewski2006">{{cite journal |author=Matuschewski K |title=Vaccine development against malaria |journal=Curr Opin Immunol |volume=18 |issue=4 |pages=449–57 |year=2006 | pmid = 16765576 | doi = 10.1016/j.coi.2006.05.004}}</ref> Inatarajiwa kwamba matokeo ya utafiti wa mpangilio wa [[jinomu]] ya ''P. falciparum'' uliomalizika mwaka wa 2002 <ref> http://www.nature.com/nature/journal/v419/n6906/full/nature01097.html</ref>, yatatoa mwelekeo kuhusu dawa au chanjo mpya. <ref>{{cite journal | author = Gardner M, Hall N, Fung E, ''et al.'' | title = Genome sequence of the human malaria parasite Plasmodium falciparum | journal = Nature | volume = 370 | issue = 6906 | pages = 1543 | year = 2002 | pmid = 12368864 | doi = 10.1038/nature01097 | last12 = James | first12 = K | last13 = Eisen | first13 = JA | last14 = Rutherford | first14 = K | last15 = Salzberg | first15 = SL | last16 = Craig | first16 = A | last17 = Kyes | first17 = S | last18 = Chan | first18 = MS | last19 = Nene | first19 = V | last20 = Shallom | first20 = SJ | last21 = Suh | first21 = B | last22 = Peterson | first22 = J | last23 = Angiuoli | first23 = S | last24 = Pertea | first24 = M | last25 = Allen | first25 = J | last26 = Selengut | first26 = J | last27 = Haft | first27 = D | last28 = Mather | first28 = MW | last29 = Vaidya | first29 = AB | last30 = Martin | first30 = DM | last31 = Fairlamb | first31 = AH | last32 = Fraunholz | first32 = MJ | last33 = Roos | first33 = DS | last34 = Ralph | first34 = SA | last35 = Mcfadden | first35 = GI | last36 = Cummings | first36 = LM | last37 = Subramanian | first37 = GM | last38 = Mungall | first38 = C | last39 = Venter | first39 = JC | last40 = Carucci | first40 = DJ | last41 = Hoffman | first41 = SL | last42 = Newbold | first42 = C | last43 = Davis | first43 = RW | last44 = Fraser | first44 = CM | last45 = Barrell | first45 = B}}</ref> Chanjo ya kwanza ambayo imebuniwa na kufanyiwa majaribio nyanjani, ni SPf66, iliyoandaliwa na [[Manuel Elkin Patarroyo]] mwaka 1987. Inatoa mchanganyiko wa mazindikomwili chanjo kutoka kwa spora (kutumia marudio ya CS) na vimelea vya merozoiti. Katika awamu ya kwanza ya majaribio umadhubuti wa 75% ulipatikana na chanjo ikaonekana kuhimiliwa vizuri na watafitiwa na ilikuwa na uwezo wa kuanzisha kingamwili. Awamu za IIb na III ya majaribio haikuridhisha sana, umadhubuti ulishuka kwa kiwango cha kati ya 38.8% na 60.2%. Jaribio lilifanyika Tanzania mwaka wa 1993 na kuonyesha umadhubuti wa 31% baada ya kufuatilia wahusika kwa mwaka, hata hivyo hivi karibuni (ingawa kuna utata) utafiti uliofanywa nchini Gambia haukuonyesha madhara yoyote. Licha ya muda mrefu na tafiti nyingi zilizofanywa, bado haijulikani jinsi chanjo ya SPf66 hutoa kinga; kwa hivyo inawezekana isiwe ufumbuzi wa tatizo la malaria. CSP ndiyo chanjo nyingine iliyobuniwa na ilionekana kuwa ingepitia majaribio. Pia msingi wake ni protini inayozunguka spora (circumsporoziote), lakini zaidi ya hivyo imeunganika na protini (Asn-Ala-Pro15Asn-Val-ASP-Pro) 2-Leu-arg (R32LR) kwa kufungamanisha elekroni pamoja na ''[[Pseudomonas aeruginosa]]'' tovin(A9) iliyosafishwa. Hata hivyo katika hatua za awali ukosefu kamili wa kinga kwa waliochanjwa ulidhihirika miongoni mwa waliochanjwa. Kundi la watafitiwa lililopewa dawa ya majaribio nchini Kenya lilikuwa na kiwango cha matukio ya maambukizi cha 82% huku kundi ambalo halikupewa chanjo likiwa na kiwango cha maambukizi cha 89%. Chanjo hiyo ililenga kuongeza seli za limfosayti T kwa waliochanjwa, hali ambayo haikutokea. Umadhubuti wa chanjo ya Patarroyo umetiliwa shaka huku baadhi ya wanasayansi wa Marekani wakiandika katika [[The Lancet]] (1997) kwamba "chanjo hiyo si madhubuti na ni lazima itupiliwe mbali" huku raia huyo wa [[Kolombia]] akiwatuhumu kuwa na "kiburi" na kupuuzilia mbali madai yao na kuongeza kuwa wanafanya hivyo kwa sababu yeye anatoka katika taifa linaloendelea. RTS, S/AS02A ni chanjo ambayo imebuniwa kwa ubia kati ya Mchakato wa PATH wa kutafuta Chanjo ya Malaria (PATH Malaria Vaccine Initiative) (unaofadhiliwa na Wakfu wa Gates, kampuni ya GlaxoSmithKline, na Walter Reed Army Institute of Research <ref>{{cite journal |author=Heppner DG, Kester KE, Ockenhouse CF, ''et al.'' |title=Towards an RTS,S-based, multi-stage, multi-antigen vaccine against falciparum malaria: progress at the Walter Reed Army Institute of Research |journal=Vaccine |volume=23 |issue=17-18 |pages=2243–50 |year=2005 |pmid=15755604 |doi=10.1016/j.vaccine.2005.01.142 |last12=Angov |first12=E |last13=Cummings |first13=JF |last14=Leach |first14=A |last15=Hall |first15=BT |last16=Dutta |first16=S |last17=Schwenk |first17=R |last18=Hillier |first18=C |last19=Barbosa |first19=A |last20=Ware |first20=LA |last21=Nair |first21=L |last22=Darko |first22=CA |last23=Withers |first23=MR |last24=Ogutu |first24=B |last25=Polhemus |first25=ME |last26=Fukuda |first26=M |last27=Pichyangkul |first27=S |last28=Gettyacamin |first28=M |last29=Diggs |first29=C |last30=Soisson |first30=L |last31=Milman |first31=J |last32=Dubois |first32=MC |last33=Garçon |first33=N |last34=Tucker |first34=K |last35=Wittes |first35=J |last36=Plowe |first36=CV |last37=Thera |first37=MA |last38=Duombo |first38=OK |last39=Pau |first39=MG |last40=Goudsmit |first40=J |last41=Ballou |first41=WR |last42=Cohen |first42=J}}</ref> Katika chanjo hiyo, sehemu ya CSP imeunganishwa na "S [[antigen]]" ya [[Virusi vya homa ya manjano B]]; {0 protini hii ya {0} mseto hudungwa pamoja na [[ajuvanti]] AS02A. <ref name="Matuschewski2006"/> Mnamo Oktoba 2004, watafiti wa RTS, S/AS02A walitangaza matokeo ya [[Awamu ya majaribio ya IIb]], iliyoonyesha chanjo hiyo ilipunguza hatari ya maambukizi kwa takribani 30% na ukali wa maambukizi kwa zaidi ya 50%. Utafiti huo uliwahusisha zaidi ya watoto 2,000 wa [[Msumbiji]]. <ref>{{cite journal |author=Alonso PL, Sacarlal J, Aponte JJ, ''et al.'' |title=Efficacy of the RTS,S/AS02A vaccine against Plasmodium falciparum infection and disease in young African children: randomised controlled trial |url=https://archive.org/details/sim_the-lancet_october-16-22-2004_364_9443/page/1411 |journal=Lancet |volume=364 |issue=9443 |pages=1411–20 |year=2004 |pmid=15488216 |doi=10.1016/S0140-6736(04)17223-1 |last12=Aide |first12=P |last13=Ofori-Anyinam |first13=O |last14=Navia |first14=MM |last15=Corachan |first15=S |last16=Ceuppens |first16=M |last17=Dubois |first17=MC |last18=Demoitié |first18=MA |last19=Dubovsky |first19=F |last20=Menéndez |first20=C |last21=Tornieporth |first21=N |last22=Ballou |first22=WR |last23=Thompson |first23=R |last24=Cohen |first24=J}}</ref> Majaribio yaliyofuata ya chanjo ya RTS, S/AS02A yalilenga usalama na umadhubuti wa kutoa chanjo hiyo kwa watoto. Katika mwezi wa Oktoba 2007, watafiti walitangaza matokeo ya [[awamu ya majaribio ya I / IIb]] yaliofanywa kwa watoto 214 wa Msumbiji wa kati ya umri wa miezi 10 na miezi 18 ambao walipokea vipimo kamili vitatu vya chanjo iliyopunguza maambukizi kwa 62% bila madhara makubwa isipokuwa tu uchungu wa kudungwa sindano. <ref>{{cite journal |author=Aponte JJ, Aide P, Renom M, ''et al.'' |title=Safety of the RTS,S/AS02D candidate malaria vaccine in infants living in a highly endemic area of Mozambique: a double blind randomised controlled phase I/IIb trial |journal=Lancet |volume=370 |issue=9598 |pages=1543–51 |year=2007 |month=Novemba |pmid=17949807 |doi=10.1016/S0140-6736(07)61542-6 |url= |last12=Vekemans |first12=J |last13=Sigauque |first13=B |last14=Dubois |first14=MC |last15=Demoitié |first15=MA |last16=Sillman |first16=M |last17=Savarese |first17=B |last18=Mcneil |first18=JG |last19=Macete |first19=E |last20=Ballou |first20=WR |last21=Cohen |first21=J |last22=Alonso |first22=PL}}</ref> === Njia nyinginezo === Elimu kuhusu utambuaji dalili za malaria umepunguza idadi ya maambukizi katika baadhi ya maeneo ya nchi zinazoendelea kwa hadi kiasi cha 20%. Kutambua ugonjwa huo katika hatua za mapema pia kunaweza kuondoa hatari ya ungonjwa huo. Elimu pia inaweza kuwafundisha watu kufunika maeneo ambapo maji yamesimama, kwa mfano tangi ya maji ambayo ni sehemu bora ya kuzaliana kwa vimelea na mbu, hivyo kupunguza hatari ya maambukizi kwa watu. Hii hasa hutekelezwa katika maeneo ya miji ambako kuna sehemu kubwa zilizo na idadi ya watu wengi wanaoishi pamoja, kuna uwezekano wa maambukizi kutokea katika maeneo hayo. [[Mradi]] wa [[Kudhibiti Malaria]] sasa unatumia muda ambapo watu hujitolea kote duniani wanapokuwa hawafanyi kazi (tazama [[Volunteer computing]] and [[BOINC]]) ili kujaribu modeli za madhara ya kiafya na mienendo ya maambukizi ili kupata njia bora au mchanganyiko wa mbinu kudhibiti malaria. Mbinu hii ya kuchanganua modeli hutegemea utumizi mpana wa kompyuta kwa sababu ya idadi kubwa ya watu kutoka sehemu mbalimbali walio na vigezo anuwai vya kibayolojia na sababu za kijamii zinazoathiri kuenea kwa ugonjwa. Inatarajiwa kuwa itachukua miezi michache kutumia nguvu za waliojitolea wanaotumia kompyuta ikilinganishwa na miaka 40 ambayo ingechukua kutumia rasilimali walizonazo sasa wanasayasi waliobuni mpango huo. <ref>{{cite web | title=What is Malariacontrol.net | publisher=AFRICA@home | url=http://africa-at-home.web.cern.ch/africa%2Dat%2Dhome/malariacontrol.html | accessdate=2007-03-11 | archiveurl=https://web.archive.org/web/20070315221605/http://africa-at-home.web.cern.ch/africa-at-home/malariacontrol.html | archivedate=2007-03-15 }}</ref> Mfano wa umuhimu wa modeli za kompyuta katika kupangilia michakato ya [[kutokomeza]] ugonjwa wa malaria ni ulio katika chapisho la Aguas na wengine. Walibainisha kuwa kutokomeza malaria kunategemea sana kupata na kutibu idadi kubwa ya watu katika maeneo ambapo malaria imeenea na malaria isiyoonyesha dalili za ugonjwa (asymptomatic), ambayo huwa kama hifadhi ya maambukizi. <ref>{{cite journal |author=Águas R, White LJ, Snow RW, Gomes MG |title=Prospects for malaria eradication in sub-Saharan Africa |journal=PLoS ONE |volume=3 |issue=3 |pages=e1767 |year=2008 |pmid=18335042 |pmc=2262141 |doi=10.1371/journal.pone.0001767 |url=}}</ref> Vimelea vya malaria haviathiri wanyama na hivyo kutokomeza ugonjwa huo kutoka kwa binadamu kunatarajiwa kufanikiwa . Hatua nyingine kwa ajili ya kudhibiti ugonjwa wa malaria ni pamoja na kutoa dawa kwa waathiriwa wengi na [[kinga]] ya muda. == Tiba == Maambukizi ya ''P. falciparum'' hai ni hali ya [[dharura]] ya kiafya inayomhitaji muathiriwa [[kulazwa hospitalini]]. Maambukizi ya ''P. vivax, P. ovale'' au ''P. malariae'' mara nyingi huweza kutibiwa huku mgonjwa akiruhusiwa kurudi nyumbani. Matibabu ya malaria hujumlisha utoaji wa huduma za kiusaidizi pamoja na madawa maalum ya malaria. Mgonjwa wa malaria akitibiwa vizuri, anaweza kupata afueni kamili. <ref>[156] ^ [http://www.cdc.gov/malaria/faq.htm#treatment If I get malaria, will I have it for the rest of my life?] uchapishaji la CDC, Ilitumika 14 Novemba 2006</ref> === Madawa ya malaria === {{main|Dawa za malaria}} Kuna aina kadhaa ya madawa yanayotumika kutibu malaria. {0Aina ya Chloroquine{/0} ina bei nafuu sana, hadi hivi majuzi, ilikuwa madhubuti sana, jambo lililoifanya kuwa dawa ya malaria iliyopendelewa na wengi kwa miaka mingi katika sehemu nyingi za dunia. Hata hivyo, usugu wa ''Plasmodium falciparum'' kwa dawa ya Chloroquine kumeenea hivi karibuni kutoka Asia hadi Afrika, na kuifanya isiweze kutibu aina nyingi za Plasmodium hatari katika maeneo mengi ya dunia yaliyoathirika. {1/ Katika maeneo ambapo klorokwini bado ni madhubuti kuponyesha inabakia kuwa chaguzi ya kwanza. Kwa bahati mbaya, usugu dhidi ya chloroquine unahusishwa na usugu kwa madawa mengine kama [[quinine]] na [[amodaquine.]] <ref>{{cite journal | author=Tinto H, Rwagacondo C, Karema C, ''et al.'' | title=In-vitro susceptibility of ''Plasmodium falciparum'' to monodesethylamodiaquine, dihydroartemsinin and quinine in an area of high chloroquine resistance in Rwanda | journal=Trans R Soc Trop Med Hyg | volume=100 | issue=6 | pages=509–14 | doi=10.1016/j.trstmh.2005.09.018 | year=2006 | pmid=16337665 | last1=Tinto | first1=H | last2=Rwagacondo | first2=C | last3=Karema | first3=C | last4=Mupfasoni | first4=D | last5=Vandoren | first5=W | last6=Rusanganwa | first6=E | last7=Erhart | first7=A | last8=Van Overmeir | first8=C | last9=Van Marck | first9=E }}</ref> Kuna dutu nyingine kadhaa zinatumiwa kutibu, na kwa kiasi, kuzuia [[(Prophylaxis).]] Madawa mengi yanaweza kutumiwa kwa madhumuni hayo mawili; dozi kubwa hutumiwa kutibu malaria. Kutolewa kwao kunategemea sana marudio ya matukio ya vimelea kuwa sugu katika eneo ambapo dawa inatumika. Dawa moja inayochunguzwa kwa madhumuni ya kutumiwa kama dawa ya malaria, hasa kutibu vimelea sugu ni [[beta blocker propranolol]]. Propranolol imepatikana kuwa na uwezo wa kuzuia Plasmodium kuingia katika chembechembe nyekundu za damu na kuanzisha maambukizi, vilevile huzuia vimelea kuzaana. Utafiti wa Desemba 2006 uliofanywa na [[Chuo Kikuu cha Northwestern]] ulipendekeza kuwa propranolol inaweza kupunguza dozi za dawa zinazotumika sasa kuwa na udhibiti mkuu dhidi ya P. falciparum kwa kiwango cha 5 - hadi 10, na kupendekeza jukumu la dawa mchanganyiko. <ref>{{cite journal |author=Murphy S, Harrison T, Hamm H, Lomasney J, Mohandas N, Haldar K |title=Erythrocyte G protein as a novel target for malarial chemotherapy |journal=PLoS Med |volume=3 |issue=12 |pages=e528 |year=2006 | month=Desemba | pmid=17194200 | doi= 10.1371/journal.pmed.0030528}}</ref> Madawa ya malaria yanayopatikana kwa sasa ni pamoja na: <ref>[http://www.cdc.gov/travel/malariadrugs.htm Prescription drugs for malaria] Ilipatikana 27 Februari 2007.</ref> * [[Artemether]] - [[lumefantrine]] (Kutibu tu, majina ya kibiashara ni ''[[Coartem]]'' na ''Riamet)'' * [[Artesunate]] - [[amodiaquine]] (Kutibu tu) * [[Artesunate]] - [[mefloquine]] (Kutibu tu) * [[Artesunate]] - [[Sulfadoxine]] / [[pyrimethamine]] (Kutibu tu) * [[Atovaquone]] - [[proguanil]], jina la kibiashara [[Malarone]] (Kutibu na kuzuia) * [[Quinine]] (Kutibu tu) * [[Chloroquine]] (Kutibu na kukinga; manufaa sasa yamepunguzwa kutokana na usugu) * [[Cotrifazid]] (Kutibu na kuzuia) * [[Doxycycline]] (Kutibu na kuzuia) * [[Mefloquine]], jina la kibiashara Lariam (Kutibu na kuzuia) * [[Primaquine]] (Tiba kwa ''P. vivax'' na ''P. ovale'' tu, si ya kuzuia) * [[Proguanil]] (Kuzuia tu) * [[Sulfadoxine]] - [[pyrimethamine]] (Kutibu; hutumika kuzuia kwa wanawake wajawazito walio na nusu-kinga katika nchi ambazo ugonjwa umeenea huitwa "Intermittent Preventive Treatment" - IPT) * [[Hydroxychloroquine]], jina la kibiashara Plaquenil (Kutibu na kuzuia) Utengenezaji wa madawa uliwezeshwa na kufanikiwa kwa [[ukuzaji]] wa vimelea vya ''Plasmodium falciparum''. <ref name="Trager1976">{{cite journal | author= Trager W, Jensen JB | title=Human malaria parasites in continuous culture | url= https://archive.org/details/sim_science_1976-08-20_193_4254/page/n53 | journal=Science| year=1976| volume=193 |issue=4254| pages=673–5 | pmid=781840| doi=10.1126/science.781840}}</ref> Hii ilifanikisha kujaribiwa kwa madawa mapya maabarani. Dutu kutoka katika mmea ''[[Artemisia annua]],'' ulio na msombo wa [[artemisinin]] au vizalika sanisi vyake (dutu isiyohusiana na kwinini), hutoa umadhubuti wa zaidi ya 90%, lakini kutolewa kwao hakutimizi mahitaji. <ref>{{cite journal | author = Senior K | title = Shortfall in front-line antimalarial drug likely in 2005 | journal = Lancet Infect Dis | volume = 5 | issue = 2 | pages = 75 | year = 2005 | pmid = 15702504}}</ref> Utafiti mmoja nchini [[Rwanda]] ulionyesha kuwa watoto waliokuwa na maambukizi yasiyo kali ya P. falciparum walionyesha dalili na ishara chache za kuwa na vimelea katika siku ya 28 ya baada ya matibabu wakati walipopewa mchanganyiko wa amodiaquine na [[artesunate]], badala ya kutolewa pekee (AU = 0.34). Hata hivyo, kuongezeka kwa usugu dhidi ya amodiaquine katika kipindi hiki cha utafiti pia ulibainisha. <ref> {{cite journal |author=Rwagacondo C, Karema C, Mugisha V, Erhart A, Dujardin J, Van Overmeir C, Ringwald P, D'Alessandro U |title=Is amodiaquine failing in Rwanda? Efficacy of amodiaquine alone and combined with artesunate in children with uncomplicated malaria |url=https://archive.org/details/sim_tropical-medicine-and-international-health_2004-10_9_10/page/1091 |journal=Trop Med Int Health |volume=9 |issue=10 |pages=1091–8 |year=2004 |pmid=15482401 | doi = 10.1111/j.1365-3156.2004.01316.x}}</ref> Kuanzia mwaka wa 2001, [[Shirika la Afya Duniani]] limependekeza kutumiwa kwa dawa mseto ya [[artemisinin]] combination therapy (ACT) kama tiba ya kwanza kwa malaria isiyo kali katika maeneo ambapo kuna usugu kwa madawa ya awali. Hivi karibuni WHO imetoa [http://www.who.int/malaria/docs/TreatmentGuidelines2006.pdf miongozo ya tiba ya malaria] inayopendekeza aina nne tofauti za ACT. Ijapokuwa nchi nyingi, zikiwa ni pamoja na mataifa mengi ya Afrika, zimejumuisha mabadiliko hayo katika sera zao rasmi kuhusu matibabu ya malaria, gharama kubwa bado ni kikwazo katika utekelezaji wa ACT. Kwa sababu ACT hugharamu hadi mara ishirini ya dawa za zamani, zimebakia ghali kwa nchi nyingi ambako maleria imeenea. Kuna utata kuhusu sehemu ambayo artemisisn hulenga, ingawa tafiti za hivi karibuni zinadokeza kwamba [[SERCA]], aina ya kalsiamu ambayo huelekezwa katika [[endoplasmic reticulum]] inaweza kuhusishwa na usugu wa artemisinin. <ref>{{cite journal | author = Eckstein-Ludwig U, Webb R, Van Goethem I, East J, Lee A, Kimura M, O'Neill P, Bray P, Ward S, Krishna S | title = Artemisinins target the SERCA of Plasmodium falciparum | url = https://archive.org/details/sim_nature-uk_2003-08-21_424_6951/page/n115 | journal = Nature | volume = 424 | issue = 6951 | pages = 957–61 | year = 2003 | pmid = 12931192 | doi = 10.1038/nature01813}}</ref> Vimelea vya malaria vinaweza kuwa sugu dhidi ya artemisinin na usugu unaweza kuletwa na mgeuko palepale wa SERCA. <ref>{{cite journal | author = Uhlemann A, Cameron A, Eckstein-Ludwig U, Fischbarg J, Iserovich P, Zuniga F, East M, Lee A, Brady L, Haynes R, Krishna S | title = A single amino acid residue may determine the sensitivity of SER`CAs to artemisinins | journal = Nat Struct Mol Biol | volume = 12 | issue = 7 | pages = 628–9 | year = 2005 | pmid = 15937493 | doi = 10.1038/nsmb947}}</ref> Hata hivyo, tafiti nyingine zinadokeza kuwa mitokondria ndiyo inayolengwa sana na artemisinin na analogi zake. <ref>{{cite journal | author = Li W, Mo W, Shen D, Sun L, Wang J, Lu S, Gitschier J, Zhou B | title = Yeast model uncovers dual roles of mitochondria in action of artemisinin | journal = PLoS Genet | volume = 1 | issue = 3 | pages = e36 | year = 2005 | pmid = 16170412 | doi = 10.1371/journal.pgen.0010036}}</ref> Ingawa kuna dawa madhubuti za malaria, ugonjwa huo unaendelea kuwa tishio kwa watu wanaoishi katika maeneo ambapo umeenea na wasioweza kupata dawa hizo madhubuti vyema mapema. Upatikanaji wa madawa na vituo vya afya, pamoja na gharama ya madawa, ni pingamizi kubwa. [[Médecins Sans Frontières]] inakadiria kwamba gharama ya kutibu mtu aliyeambukizwa malaria katika nchi ambapo ugonjwa huo umeenea ilikuwa kati ya $ 0.25 na 2.40 $ kwa kila dozi katika mwaka 2002. Karibu watu milioni moja hufa kila mwaka kwa sababu ya kutoweza kununua dawa sahihi za malaria. <ref>{{cite web |url=http://news.yahoo.com/s/nm/20091102/hl_nm/us_malaria_drugs_1 |title=Millions die because of high malaria drug prices - Yahoo! News |format= |work= |accessdate=}}</ref> === Madawa ghushi === Madawa ghushi [[changamano]] yamepatikana katika nchi kadhaa za Asia kama vile [[Kambodia]], <ref>{{cite journal | author=Lon CT, Tsuyuoka R, Phanouvong S, ''et al.'' | title=Counterfeit and substandard antimalarial drugs in Cambodia | year=2006 | journal=Trans R Soc Trop Med Hyg | volume=100 | issue=11 | pages=1019–24 | doi=10.1016/j.trstmh.2006.01.003 | pmid=16765399 }}</ref> [[Uchina]], <ref>{{cite web | author=U. S. Pharmacopeia | title=Fake antimalarials found in Yunan province, China | url=http://www.uspdqi.org/pubs/other/FakeAntimalarialsinChina.pdf | accessdate=2006-10-06 | year=2004 | format=PDF | archiveurl=https://web.archive.org/web/20060909112739/http://www.uspdqi.org/pubs/other/FakeAntimalarialsinChina.pdf | archivedate=2006-09-09 }}</ref> [[Indonesia]], [[Laos]], [[Thailand]], [[Vietnam]] na yametuhumiwa kusababisha vifo vingi ambavyo vingeepukwa katika nchi hizo. {3/ [[WHO]] imesema kwamba tafiti zimeonyesha kuwa hadi 40% ya madawa ya malaria yaliyo na msingi wa [[artesunate]] ni bandia, hasa katika kanda ya Greater [[Mekong]] na kuanzisha mpango wa kutoa onyo haraka kupitia habari kuhusu madawa ghushi kuripotiwa kwa kasi kwa mamlaka husika katika nchi shiriki. <ref>{{cite web | author=Jane Parry | title=WHO combats counterfeit malaria drugs in Asia | url=http://www.bmj.com/cgi/content/full/330/7499/1044-d | accessdate=2008-07-19 | year=2005}}</ref> Hakuna njia ya kuaminika kwa madaktari au watu wa kawaida kugundua dawa bandia bila msaada wa maabara. Makampuni yanajaribu kukabiliana na kuendelea kuwepo kwa dawa ghushi kwa kutumia teknolojia mpya kutoa usalama kutoka uzalishaji hadi usambazaji. == Uenezi == {{main|Maradhi ya ufukara|Maradhi ya tropiki}} [[File:Malaria world map-Deaths per million persons-WHO2012.svg|thumb|upright=1.3|left|Vifo kutokana na malaria mwaka 2012 (asilimilioni){{refbegin|3}}{{legend|#ffff20|0-0}}{{legend|#ffa020|1-2}}{{legend|#ff9a20|3-54}}{{legend|#f08015|55-325}}{{legend|#e06815|326-679}}{{legend|#d85010|680-949}}{{legend|#d02010|950-1,358}}{{refend}}]] Malaria husababisha karibu visa milioni 250 vya homa na takriban vifo nusu milioni kila mwaka. <ref name="wmr08"> WHO 2005 [http://www.who.int/malaria/mediacentre/wmr2008/ World Malaria Report 2008]</ref> Idadi kubwa ya visa hutokea kwa watoto chini ya umri wa miaka 5; <ref name="greenwood2005">{{cite journal | author=Greenwood BM, Bojang K, Whitty CJ, Targett GA | title=Malaria | url=https://archive.org/details/sim_the-lancet_april-23-29-2005_365_9469/page/1487 | journal=Lancet | year=2005 | volume=365 | pages=1487–1498 | pmid = 15850634 | doi = 10.1016/S0140-6736(05)66420-3 | issue=9469}}</ref> wanawake wajawazito hasa pia huwa hatarini. Licha ya jitihada za kupunguza maambukizi na kuongeza matibabu, kumekuwa na mabadiliko madogo katika maeneo ambapo hatari ya ungojwa huu upo tangu mwaka 1992. <ref>{{cite journal | author = Hay S, Guerra C, Tatem A, Noor A, Snow R | title = The global distribution and population at risk of malaria: past, present, and future | journal = Lancet Infect Dis | volume = 4 | issue = 6 | pages = 327–36 | year = 2004 | pmid = 15172341 | doi = 10.1016/S1473-3099(04)01043-6}}</ref> Kwa hakika, ikiwa maambukizi ya malaria yataendelea kuongezeka kama ilivyo sasa, kiwango cha vifo kinaweza kuongezeka mara mbili katika miaka ishirini ijayo. <ref name="Breman"/> Takwimu sahihi hazijulikani kwa sababu kesi nyingi hutokea katika maeneo ya vijijini ambako watu hawana huduma za hospitali au pesa za kuwawezesha kupata huduma za afya. Kwa sababu hiyo, visa vingi havijarekodiwa.. <ref name="Breman">{{cite journal | author = Breman J | title = The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden | url = http://www.ajtmh.org/cgi/content/abstract/64/1_suppl/1 | journal = Am J Trop Med Hyg | date = 1 Januari 2001 | volume = 64 | issue = 1-2 Suppl | pages = 1–11 | pmid = 11425172 | month = Jan | day = 01 | access-date = 2009-11-19 | archive-date = 2010-07-08 | archive-url = https://web.archive.org/web/20100708013818/http://www.ajtmh.org/cgi/content/abstract/64/1_suppl/1 | dead-url = yes }}</ref> Ingawa maambukizi ya pamoja ya VVU na malaria husababisha ongezeko la vifo, hili si tatizo kuu likilinganishwa na maambukizi ya pamoja ya VVU/[[kifua kikuu]], kwa sababu magonjwa hayo mawili huathiri rika mbili tofauti, huku malaria ikiwa imeenea miongoni mwa watoto ,kifua kikuu kimeenea miongoni mwa watu wazima. <ref>{{cite journal | author = Korenromp E, Williams B, de Vlas S, Gouws E, Gilks C, Ghys P, Nahlen B | title = Malaria attributable to the HIV-1 epidemic, sub-Saharan Africa | url=http://www.cdc.gov/ncidod/EID/vol11no09/05-0337.htm | journal = Emerg Infect Dis | volume = 11 | issue = 9 | pages = 1410–9 | year = 2005 | pmid = 16229771}}</ref> Ingawa maambukizi ya pamoja ya VVU/malaria huleta dalili zisizo kali zaidi zikilinganishwa na maambukizi ya pamoja ya VVU na TB, VVU na malaria huchangia kuenea kwa kila mmojawapo. Athari hii hutokana na malaria kuongeza [[wingi]] wa [[virusi]] mwilini huku VVU ikiongeza uwezekano wa mtu kuambukizwa malaria. <ref>{{cite journal |author=Abu-Raddad L, Patnaik P, Kublin J |title=Dual infection with HIV and malaria fuels the spread of both diseases in sub-Saharan Africa |url=https://archive.org/details/sim_science_2006-12-08_314_5805/page/1602 |journal=Science |volume=314 |issue=5805 |pages=1603–6 |year=2006 | pmid = 17158329 | doi = 10.1126/science.1132338}}</ref> Kwa sasa malaria imeenea katika ukanda wote wa [[ikweta]], katika maeneo ya [[Amerika]], sehemu nyingi za [[Asia]], na sehemu kubwa ya [[Afrika]], hata hivyo, ni katika mataifa ya Afrika kusini kwa Sahara ambapo 90% ya vifo vya malaria hutokea. <ref>{{cite web | author = Layne SP | title = Principles of Infectious Disease Epidemiology / | work = EPI 220 | publisher = UCLA Department of Epidemiology | url = http://www.ph.ucla.edu/epi/layne/Epidemiology+220/07.malaria.pdf | accessdate = 2007-06-15 | format = PDF | archivedate = 2006-02-20 | archiveurl = https://web.archive.org/web/20060220083223/http://www.ph.ucla.edu/epi/layne/Epidemiology+220/07.malaria.pdf }}</ref> Usambaaji kijiografia wa malaria ndani ya maeneo makubwa ni changamano, maeneo yaliyo na malaria na yasiyo na malaria aghalabu hupakana.<ref name="greenwood2002">{{cite journal | author=Greenwood B, Mutabingwa T | title=Malaria in 2002 | url=https://archive.org/details/sim_nature-uk_2002-02-07_415_6872/page/n138 | journal=Nature | year=2002 | volume=415 | pages=670–2 | pmid = 11832954 | doi = 10.1038/415670a | issue=6872}}</ref> Katika maeneo kame, mikurupuko ya malaria inaweza kutabiriwa kwa kiasi cha usahihi kwa kutazama ramani ya mvua. <ref>{{cite journal | author = Grover-Kopec E, Kawano M, Klaver R, Blumenthal B, Ceccato P, Connor S | title = An online operational rainfall-monitoring resource for epidemic malaria early warning systems in Africa | url= | journal = Malar J | volume = 4 | issue = | pages = 6 | year = 2005 | pmc = 548290 | pmid = 15663795 | doi = 10.1186/1475-2875-4-6}}</ref> Malaria imeenea zaidi katika maeneo ya vijijini kuliko miji; hii ni tofauti na [[homa ya kidingapopo]] ambayo inaenea zaidi katika mijini.<ref>{{cite journal |author=Van Benthem B, Vanwambeke S, Khantikul N, Burghoorn-Maas C, Panart K, Oskam L, Lambin E, Somboon P |title=Spatial patterns of and risk factors for seropositivity for dengue infection | url=http://www.ajtmh.org/cgi/content/full/72/2/201 |journal=Am J Trop Med Hyg |volume=72 |issue=2 |pages=201–8 |date= 1 Februari 2005 | pmid = 15741558 |month=Feb |day=01 }}</ref> Kwa mfano, miji ya [[Vietnam, Laos]] na [[Kambodia]] kimsingi haina malaria, lakini ugonjwa huo upo katika maeneo mengi vijijini. <ref>{{cite journal |author=Trung H, Van Bortel W, Sochantha T, Keokenchanh K, Quang N, Cong L, Coosemans M |title=Malaria transmission and major malaria vectors in different geographical areas of Southeast Asia |journal=Trop Med Int Health |volume=9 |issue=2 | pages = e473 |year=2004 | pmid = 15040560 | doi = 10.1046/j.1365-3156.2003.01179.x}}</ref> Tofauti na hivyo,katika Afrika malaria ipo katika maeneo ya mijini na vijijini, ingawa hatari yake ni ndogo katika miji. <ref>{{cite journal |author=Keiser J, Utzinger J, Caldas de Castro M, Smith T, Tanner M, Singer B |title=Urbanization in sub-saharan Africa and implication for malaria control | url=http://www.ajtmh.org/cgi/content/full/71/2_suppl/118 |journal=Am J Trop Med Hyg |volume=71 |issue=2 Suppl |pages=118–27 |date= 1 Agosti 2004 |pmid=15331827 |month=Aug |day=01 }}</ref> [[Uenezi]] wa malaria duniani haujakadiriwa tangu miaka ya 1960. Hata hivyo, wakfu wa [[Wellcome Trust]], ya Uingereza, umefadhili mradi wa[[Malaria Atlas Project]] <ref>{{cite journal | author = Hay SI, Snow RW | title = The Malaria Atlas Project: Developing Global Maps of Malaria Risk | doi = 10.1371/journal.pmed.0030473 | journal = PLoS Medicine | volume = 3 | issue = 12 | pages = e473 | year = 2006 |pmid=17147467 |pmc=1762059 }}</ref> kurekebisha hili, inatoa njia ya kisasa na imara zaidi ya kutathmini [[]]madhara/0} ya ugonjwa wa malaria sasa na baadaye . == Historia == {{main|Historia ya malaria}} Malaria imewaambukiza binadamu kwa zaidi ya miaka 50,000, na ''Plasmodium'' huenda imekuwa [[kijasumu]] kwa binadamu tangu spishi hiyo ilipoanza kuishi. <ref>{{cite journal | author = Joy D, Feng X, Mu J, ''et al.'' | title = Early origin and recent expansion of Plasmodium falciparum | url = https://archive.org/details/sim_science_2003-04-11_300_5617/page/n126 | journal = Science | volume = 300 | issue = 5617 | pages = 318–21 | year = 2003 | pmid = 12690197 | doi = 10.1126/science.1081449 | last12 = Su | first12 = XZ}}</ref> Vimelea vinavyohusiana kwa karibu na vimelea vya malaria kwa binadamu vinapatikana miongoni mwa sokwe kwa wingi. <ref>{{cite journal | author = Escalante A, Freeland D, Collins W, Lal A | title = The evolution of primate malaria parasites based on the gene encoding cytochrome b from the linear mitochondrial genome | url = https://archive.org/details/sim_proceedings-of-the-national-academy-of-sciences-usa_1998-07-07_95_14/page/8124 | doi= 10.1073/pnas.95.14.8124 | journal = Proc Natl Acad Sci USA | volume = 95 | issue = 14 | pages = 8124–9 | year = 1998 | pmid = 9653151}}</ref> Maelezo kuhusu homa za kipekee za malaria yamenakiliwa katika maandiko ya kihistoria, kuanzia mwaka 2700 KK huko Uchina. <ref>{{cite journal | author = Cox F | title = History of human parasitology | url=https://archive.org/details/sim_clinical-microbiology-reviews_2002-10_15_4/page/595| pmc = 126866 | journal = Clin Microbiol Rev | volume = 15 | issue = 4 | pages = 595–612 | year = 2002 | pmid = 12364371 | doi = 10.1128/CMR.15.4.595-612.2002}}</ref> Neno malaria lina usuli wake katika[[Kiitaliano cha enzi ya kati:]] ''mala aria'' - [["hewa mbaya";]] ugonjwa huo zamani uliitwa ''ague'' au ''Marsh fever'' kutokana na ukuruba wake na mabwawa na maeneo ya kinamasi. <ref>[http://www.cdc.gov/ncidod/EID/vol6no1/reiter.htm From Shakespeare to Defoe: Malaria in England in the Little Ice Age.] Paul Reiter. ''Centers for Disease Control and Prevention, San Juan, Puerto Rico.'' </ref> Kuna nyakati ambapo visa vya malaria vilikuwa vingi [[Ulaya]] na [[Amerika Kaskazini]], ambako sasa ugongwa huo [[haujaenea]] <ref>[http://www.cambridge.org/catalogue/catalogue.asp?isbn=9780511254819&amp;ss=exc Vector- and Rodent-Borne Diseases in Europe and North America.] Norman G. Gratz. ''World Health Organisation, Geneva.'' </ref> ingawa unaweza kuletwa na mgeni aliyesafiri kutoka nchi nyingine . Tafiti za kisayansi kuhusu malaria zilipata mafanikio muhimu ya kwanza mwaka 1880, wakati daktari wa jeshi la Ufaransa [[Constantine Alphonse Laveran]] aliyekuwa akifanya kazi katika hospitali ya kijeshi nchini [[Algeria]] alipotambua kwa mara ya kwanza vimelea ndani ya [[chembechembe nyekundu za damu]] ya watu waliokuwa wakiugua malaria. Kwa hiyo, alipendekeza kwamba ugonjwa wa malaria unasababishwa na kiumbe huyo, mara ya kwanza kabisa ambapo kijiumbe mwenye seli moja (Protista) alitambuliwa kusababisha ugonjwa. <ref>{{cite web | title = Biography of Alphonse Laveran | publisher = The Nobel Foundation | url = http://nobelprize.org/nobel_prizes/medicine/laureates/1907/laveran-bio.html | accessdate = 2007-06-15}} Nobel foundation. Ilitumika 25 Oktoba 2006</ref> Kwa sababu hii na vumbuzi nyingine za baadaye , alipokea [[Tuzo ya Nobel ya Tiba]] mwaka 1907. Kimelea cha malaria kiliitwa ''Plasmodium'' na wanasayansi wa Kiitalia [[Ettore]] [[Marchiafava]] na [[Angelo Celli]]. <ref>{{cite web| title = Ettore Marchiafava| work = | url = http://www.whonamedit.com/doctor.cfm/2478.html| accessdate = 2007-06-15| archive-date = 2019-03-28| archive-url = https://web.archive.org/web/20190328043634/http://www.whonamedit.com/doctor.cfm/2478.html| url-status = dead}}</ref> Mwaka mmoja baadaye, [[Carlos Finlay]], daktari wa [[Kuba]] aliyekuwa akitibu wagonjwa wa [[homa ya manjano]] huko [[Havana]], alitoa ushahidi madhubuti kuwa mbu walihusika katika kusambaza ugonjwa huo miongoni mwa binadamu. <ref>{{cite journal |author=Tan SY, Sung H |title=Carlos Juan Finlay (1833–1915): of mosquitoes and yellow fever |journal=Singapore Med J |volume=49 |issue=5 |pages=370–1 |year=2008 |month=Mei |pmid=18465043 |url=http://smj.sma.org.sg/4905/4905ms1.pdf|format=PDF}}</ref> Kazi hii ilifuata mapendekezo ya awali ya [[Yosia C. Nott]], <ref>{{cite journal |author=Chernin E |title=Josiah Clark Nott, insects, and yellow fever |journal=Bull N Y Acad Med |volume=59 |issue=9 |pages=790–802 |year=1983 |month=Novemba |pmid=6140039 |pmc=1911699 |url=}}</ref> na [[Patrick Manson]] kuhusu maambukizi ya [[homa ya mitoki]]. Hata hivyo, ilikuwa Mwingereza [[Sir Ronald Ross]] aliyekuwa akifanya kazi katika [[Presidency General Hospital]] [[Calcutta]], ambaye hatimaye katika mwaka wa 1898 alidhibitisha kuwa malaria inasambazwa na mbu. Alifanya hivyo kwa kuonyesha kwamba spishi fulani za mbu husambaza malaria kwa ndege na kuchuja vimelea vya malaria kutoka katika matezi ya mate ya mbu ambao walikuwa wamefyonza ndege waliokuwa wameambukizwa. <ref>{{cite web | title = Biography of Ronald Ross | publisher = The Nobel Foundation | url = http://nobelprize.org/nobel_prizes/medicine/laureates/1902/ross-bio.html | accessdate = 2007-06-15}}</ref> Kwa kazi hii Ross alipokea Tuzo ya Nobel ya Tiba mwaka wa 1902. Baada ya kujiuzulu kutoka Indian Medical Service, Ross alifanya kazi katika chuo kilichokuwa kipya cha [[Liverpool School of Tropical Medicine]] na kuelekezwa juhudi za kudhibiti malaria katika nchi za [[Misri, Panama, Ugiriki]] na [[Morishash.]] <ref>{{cite web | title = Ross and the Discovery that Mosquitoes Transmit Malaria Parasites| work = CDC Malaria website | url = http://www.cdc.gov/malaria/history/ross.htm | accessdate = 2007-06-15}}</ref> Matokeo ya Ross na Finlay baadaye yalithibitishwa na bodi ya matibabu iliyoongozwa na [[Walter Reed]] mwaka 1900, na mapendekezo yake kutekelezwa na [[William C. Gorgas]] katika [[hatua za kiafya zilizorchukuliwaatibiwa]] wakati wa ujenzi wa [[Mfereji wa Panama.]] Kazi hii ya afya ya umma iliokoa maisha ya maelfu ya wafanyakazi na ikasaidia kubuni mbinu zilizotumika katika kampeni za afya ya umma dhidi ya ugonjwa huu baadaye . Tiba ya kwanza madhubuti dhidi ya malaria ilitoka katika gome ya [[mti]] wa [[mkwinini]] ambayo ina [[kwinini.]] Mti huu hukua kwenye miteremko ya [[Andes]], hasa [[Peru.]] Dawa iliyoundwa kutokana na bidhaa hii asili ilitumiwa na wenyeji wa [[Peru]] kudhibiti malaria, [[Wajesuti]] walieneza matumizi haya hadi Ulaya katika miaka ya 1640, ambapo ilikubalika kwa haraka. <ref>{{cite journal | author = Kaufman T, Rúveda E | title = The quest for quinine: those who won the battles and those who won the war | journal = Angew Chem Int Ed Engl | volume = 44 | issue = 6 | pages = 854–85 | year = 2005 | pmid = 15669029 | doi = 10.1002/anie.200400663}}</ref> Hata hivyo, ilikuwa hadi 1820 ambapo kiambato tendi, kwinini, ilipofyonzwa kutoka gome ya mti, kuchujwa na kupewa jina na wanakemia wa Kifaransa [[Pierre Joseph Pelletier]] na [[Joseph Bienaimé Caventou.]] <ref>{{cite journal |author=Kyle R, Shampe M |title=Discoverers of quinine |journal=JAMA |volume=229 |issue=4 | pages = e320 |year=1974 |pmid=4600403 | doi = 10.1001/jama.229.4.462}}</ref> Mapema katika karne ya 20, kabla [[viuavijasumu]] kuvumbuliwa, [[Julius Wagner-Jauregg]] aligundua kwamba wagonjwa wa [[kaswende]] wangeweza kutibiwa kwa kuambukizwa kimakusudi kwa vimelea vya malaria; homa iliyosababishwa iliua [[spirochete]] za malaria, hatimaye [[kwinini]] ingetolewa kudhibiti malaria. Ingawa baadhi ya wagonjwa walikufa kutokana na malaria, hii ilidhaniwa kuwa afadhali kuliko kifo ambacho hakinge epukika kutokana na kaswende. <ref>{{cite journal | author = Raju T | title = Hot brains: manipulating body heat to save the brain | doi= 10.1542/peds.2005-1934 | journal = Pediatrics | volume = 117 | issue = 2 | pages = e320–1 | year = 2006 | pmid = 16452338 |url=http://pediatrics.aappublications.org/cgi/content/full/117/2/e320}}</ref> Ingawa awamu ya maisha ya kimelea katika damu na katika mbu katika hatua ya mzunguko wa maisha ya kimelea cha malaria iligunduliwa karne ya 19 na mapema karne ya 20, ilikuwa katika miaka ya 1980 ambapo awamu fiche ya kimelea hicho katika ini ilipoonekana. <ref>{{cite journal | author = Krotoski W, Collins W, Bray R, ''et al.'' | title = Demonstration of hypnozoites in sporozoite-transmitted Plasmodium vivax infection | journal = Am J Trop Med Hyg | volume = 31 | issue = 6 | pages = 1291–3 | year = 1982 | pmid = 6816080}}</ref> <ref>{{cite journal | author = Meis J, Verhave J, Jap P, Sinden R, Meuwissen J | title = Malaria parasites--discovery of the early liver form | url = https://archive.org/details/sim_nature-uk_1983-03-31_302_5907/page/n73 | journal = Nature | volume = 302 | issue = 5907 | pages = 424–6 | year =1983 | pmid = 6339945 | doi = 10.1038/302424a0}}</ref> Ugunduzi huu wa awamu fiche ya kimelea hatimaye ulieleza kwa nini watu wangeweza kuonekana wamepona malaria lakini wakaugua tena miaka baada ya vimelea kutoweka katika mfumo wa damu. === Shinikizo la kubadilisha jeni za malaria === {{main|Mageuko ya spishi}} Malaria inakisiwa kuwa na[[shinikizo kubwa kwa jieni ya binadamu]] katika siku za hivi karibuni. <ref name="Kwiatkowski_2005">{{cite journal |author=Kwiatkowski DP |title=How malaria has affected the human genome and what human genetics can teach us about malaria |url=https://archive.org/details/sim_american-journal-of-human-genetics_2005-08_77_2/page/171 |journal=Am J Hum Genet. |volume=77 |issue=2 |pages=171–92 |year=2005 |month=Agosti |pmid=16001361 |pmc=1224522 |doi=10.1086/432519 }}</ref> Hii ni kutokana na [[vifo vingi]] na [[maradhi]] yanayosababishwa na malaria, hasa spishi ya ''[[P. falciparum]]''. ==== Ugonjwa wa seli mundu ==== [[Picha:Paludisme - Frequence statistique.png|thumb|right|Matukio na vyanzo vya visa vya malaria mwaka 1996. <ref>Http://www3.chu-rouen.fr/Internet/services/sante_voyages/pathologies/paludisme/monde/frequence/ {{Wayback|url=http://www3.chu-rouen.fr/Internet/services/sante_voyages/pathologies/paludisme/monde/frequence/ |date=20100619103234 }} CHU Hôpitaux de Rouen. Fréquence et tillhörighet des cas de paludisme.</ref>]] Athari iliyotafitiwa sana ya vimelea vya malaria kwa jinomu ya binadamu ni ya ugonjwa wa damu wa kinasaba yaani [[ugonjwa wa seli mundu]]. Seli mundu husababisha ugonjwa, lakini hata walioathirika kwa kiwango kidogo kwa seli mundu huwa na kinga ya kutosha dhidi ya malaria. Katika maradhi ya seli mundu, kuna mabadiliko katika jeni ya ''HBB'', ambayo husimba viwango vidogo vya haemoglobin viitwavyo beta-globini. Aleli ya kawaida husimba [[glutamate]] katika sehemu ya sita ya protini ya beta-globini, ilihali aleli ya seli mundu husimba [[valine.]] Mabadiliko haya kutoka asidi amino inayoyeyuka majini hadi isiyoyeyuka majini husababisha kushikana kwa molekyuli za hemoglobini na upolimishaji wa hemoglobini ambao husababisha kuharibika kwa maumbo ya chembechembe nyekundu za damu kuwa katika umbo la "mundu". Chembe chembe kama hizo zilizoharibika umbo huondolewa haraka kutoka kwa damu, hasa katika wengu, ambapo huharibiwa na kuchakatwa tena. Katika hatua ya merozoiti kwenye mzunguko wa uhai wao, vimelea vya malaria huishi ndani ya chembechembe nyekundu za damu, na umetaboli wavyo hubadili kemia ya ndani ya chembe chembe nyekundu za damu. Seli zilizoambukizwa kwa kawaida huishi hadi vimelea vizaane, lakini, ikiwa chembechembe nyekundu zina mchanganyiko wa mundu na hemoglobini ya kawaida, kuna uwezekano wa seli hizo kuangamizwa kabla vimelea kuzaa. Hivyo basi, watu walio na maumbo ya aina mbili ya seli nyekundu lakini moja ndiyo [[inayotambaa]] yaani aleli iliyogeuka, ijulikanayo kama seli mundu, wanaweza kuwa na kiwango cha chini cha anemia kisicho na athari kubwa, lakini pia uwezekano wa wao kuambukizwa na malaria huwa umepunguzwa kwa kiwango kikubwa. Huu ni mfano wa kipekee wa faida inayotokana na hali ya kuwa na namna mbili za jeni moja ([[heterozygote]]). Watu walio na jeni ya aina moja ya damu iliyobadilika kabisa ([[Homozygous]]) huwa na ugonjwa kamili wa seli mundu ambao ni nadra kuishi zaidi ya umri wa kubaleghe. Hata hivyo, katika maeneo ambapo malaria [[imeenea]], [[maenezi]] ya jeni inayosababisha seli mundu ni takribani 10%. Uwepo wa jeni nne zinazotoshelezana kwa pamoja ([[haplotype]]) za hemoglobini mundu unaashiria kwamba kumekuwa na mabadiliko ya [[kujitegemea]] ya jeni angalau mara nne katika maeneo ambayo malaria imeenea, hii inaonyesha faida ya mabadiliko katika maeneo hayo yaliyoathiriwa. Aidha kuna mabadiliko mengine ya jeni ya HBB yanayosababisha molekyuli za hemoglobini zilizo na uwezo wa kutoa kinga sawa na hiyo dhidi ya maambukizi ya malaria. Mabadiliko hayo husababisha hemoglobini ya aina za HbE na HbC, ambazo kwa kawaida hupatikana [[Kusini Mashariki mwa Asia]] na [[Afrika Magharibi]], kwa usanjari huo. ==== Thalasemia ==== Mabadiliko mengine yaliyothibitishwa yanayopatikana katika jinomu ya binadamu yanayohusiana na ugonjwa wa malaria ni yanayohusika katika kusababisha matatizo ya damu yajulikanayo kama [[thalasemia.]] Utafiti uliofanywa [[Sardinia]] na [[Papua New Guinea]]umeonyesha kwamba [[ueneaji wa jeni]] ya [[β-thalasemia]] unahusiana na kiwango cha kuenea kwa malaria miongoni mwa watu wa eneo fulani. Utafiti uliofanyiwa watoto zaidi ya 500 nchini [[Liberia]] ulibainisha kwamba wale waliokuwa na β-thalasemia walikuwa kiwango cha 50% cha kinga dhidi ya dalili za malaria. Tafiti nyingine kama hizo zimegundua uhusiano baina ya maenezi ya jeni na ueneaji wa malaria katika aina ya α + ya α-thalasemia. Inakadiriwa kuwa jeni hizi pia [[zimechaguliwa]] katika mfululizo wa mabadiliko ya binadamu. ==== Antijeni za Duffy ==== [[Antijeni za Duffy]] ni [[antijeni]] zinazopatikana kwenye chembechembe nyekundu za damu na seli nyingine katika mwili na hufanya kazi kama kipokezi cha [[kemokini]]. Antijeni hiyo ya Duffy hudhihirika kwenye chembechembe za damu kwa kusimbwa na jeni za Fy (Fya, Fyb, Fyc nk). Kimelea cha malaria cha ''[[Plasmodium vivax]]'' hutumia antijeni za Duffy kuingia kwenye seli za damu. Hata hivyo, antijeni za Duffy zisidhihirike kwenye chembechembe nyekundu za damu (Fy-/Fy-). Aina hizi za [[muundojeni]] hutoa kinga kamili dhidi ya maambukizi ya kimelea cha ''P. vivax''. Muundojeni huu ni nadra sana miongoni mwa wakazi wa Ulaya, Asia na Marekani, lakini hupatikana katika takribani wakazi wote wa kiasili wa Afrika Magharibi na Kati. <ref>{{cite journal |author=Carter R, Mendis KN |title=Evolutionary and historical aspects of the burden of malaria |url=http://cmr.asm.org/cgi/content/full/15/4/564?view=long&pmid=12364370#RBC%20Duffy%20Negativity |journal=Clin. Microbiol. Rev. |volume=15 |issue=4 |pages=564–94 |year=2002 |pmid=12364370 |doi=10.1128/CMR.15.4.564-594.2002 |access-date=2009-11-19 |archive-date=2009-01-16 |archive-url=https://web.archive.org/web/20090116020425/http://cmr.asm.org/cgi/content/full/15/4/564?view=long&pmid=12364370#RBC%20Duffy%20Negativity |dead-url=yes }}</ref> Hii inafikiriwa kusababishwa na kukumbana sana na vimelea vya ''P. vivax'' katika [[Afrika]] vikwi vichache vilivyopita. ==== G6PD ==== [[Glucose-6-phosphate dehydrogenase]] (G6PD) ni [[kimeng'enya]] ambacho huzuia athari za [[msongo]] unaotokana na [[uoksidishaji]] chembechembe nyekundu za damu. Hata hivyo, upungufu wa kimeng'enya hicho kwa sababu za kijenetiki huongeza kinga dhidi ya malaria kali. ==== HLA na interleukin-4 ==== [[HLA-B53]] inahusishwa na kupunguzwa kwa hatari ya malaria kali. Molekyuli ya [[MHC]] hii huwawasilisha hatua ya [[ini]] na [[antijeni za spora]] kwa [[seli za T]] Interleukin-4, inayosimbwa na IL4, huzalishwa na seli za T zinazochochewa na hukuza kuzaana na utofautishaji seli B ambazo huzalisha zindikomwili. Utafiti uliofanywa miongoni mwa jamii ya Fulani wa Burkina Faso, ambao huwa na visa vya maambukizi ya malaria vichache na viwango vya juu vya zindikomwili dhidi ya malaria kuliko jamii jirani, uligundua kuwa aleli ya IL4-524 T inahusishwa na viwango vya juu vya zindikomwili dhidi ya antijeni za malaria, hali ambayo inaongeza uwezakano hii inaweza kuwa sababu ongezeko la kinga dhidi ya malaria. <ref>{{cite journal |author=Verra F, Luoni G, Calissano C, Troye-Blomberg M, Perlmann P, Perlmann H, Arcà B, Sirima B, Konaté A, Coluzzi M, Kwiatkowski D, Modiano D |title=IL4-589C/T polymorphism and IgE levels in severe malaria |journal=Acta Trop. |volume=90 |issue=2 |pages=205–9 |year=2004 |pmid=15177147 | doi = 10.1016/j.actatropica.2003.11.014 |last12=Modiano |first12=D}}</ref> ==== Usugu Kusini mwa Asia ==== Vilima vya chini ya Mlima Himalaya na [[mabonde ya Terai ama ya Doon]] nchini [[Nepal]] na [[India]] huwa na visa vingi vya malaria kutokana na hali ya hewa ya joto na vinamasi vinavyohimiliwa wakati wa kiangazi na chemichemi inayotiririka kutoka vilima vya juu. Misitu iliyokuwa na malaria ilitunzwa kimakusudi na watawala wa Nepal kama mbinu ya kujihami. Binadamu waliojaribu kuishi katika eneo hili walikufa kwa wingi kuliko katika nyanda za juu zaidi au sehemu kame [[Tambarare za Ganges]], hata hivyo, [[wenyeji wa Tharu]] walikuwa wameishi katika eneo hili kwa muda mrefu kiasi cha kuwa na kinga kupitia kwa mabadiliko katika jeni nyingi. [[Ndoa]]za tabaka au kabila zilionekana kufungia hali hiyo mingoni mwa wenyeji wa Tharu. Vinginevyo jeni hizi pengine zingekuwa zimesambaa karibu kote Kusini mwa Asia na kwingineko kwa sababu ya thamani yao dhahiri na kutokuwa na madhara ikilinganishwa na Anemia ya Seli Mundu. == Jamii na utamaduni == [[File:Saving Lives with SMS for Life.jpg|thumb|right|Kliniki ya Malaria nchini Tanzania.]] Malaria si ungonjwa unaohusishwa tu na umaskini bali pia husababisha umaskini na ni kikwazo kikubwa kwa [[maendeleo ya kiuchumi.]] Maeneo ya hali ya joto yameathirika zaidi, hata hivyo kiwango cha athari kamili ya malaria hufika katika baadhi ya maeneo yenye joto la wastani na misimu isiyotabirika Ugonjwa huu umehusishwa na athari mbaya za kiuchumi katika maeneo ambayo umeenea sana. Mwishoni mwa karne ya 19 na mapema katika karne ya 20, ugonjwa huu ndio uliosababisha kudorora kwa uchumi kwa majimbo ya kusini mwa Marekani. <ref name="humphreys">{{cite book|last=Humphreys|first=M|title=Malaria: Poverty, Race, and Public Health in the United States|url=https://archive.org/details/malariapovertyra0000hump|publisher=Johns Hopkins University Press|date=2001|pages=[https://archive.org/details/malariapovertyra0000hump/page/n256 256]|isbn=0-8018-6637-5}}</ref>. Ulinganisho wa Pato wastani la Taifa kwa kila mtu mnamo mwaka 1995, iliyorekebishwa kuzingatia tofauti za [[uwezo wa kununua]], kati ya nchi zilizo na zisizo na malaria ulionyesha tofauti za aina tano($ 1.526 dola dhidi ya $ 8.268 USD). Katika nchi ambazo malaria inapatikana kwa wingi, Pato Wastani la Taifa kwa kila mtu limeongezeka (kati ya 1965 na 1990) kwa 0.4% tu kwa kila mwaka, ikilinganishwa na 2.4% kwa kila mwaka katika nchi nyingine. <ref name="sachs2002">{{cite journal | author=Sachs J, Malaney P | title=The economic and social burden of malaria | url=https://archive.org/details/sim_nature-uk_2002-02-07_415_6872/page/n150 | journal=Nature | year=2002 | volume=415 | pages=680–5 | pmid = 11832956 | doi = 10.1038/415680a | issue=6872}}</ref> Umaskini ni kisababishi na athari, hata hivyo, kwa sababu maskini hawana uwezo wa kifedha kuzuia au kutibu ugonjwa huo. Watu wa pato la chini nchini Malawi katika mwaka wa (1994) walitumia 32% ya pato lao la kila mwaka katika kugharamia ugonjwa huu ikilinganishwa na 4% ya watu wa pato la chini. Kijumla, athari ya kiuchumi ya malaria kwa Afrika inakadiriwa kugharimu dola za kimarekani $ billion 12 kila mwaka. Athari za kiuchumi ni pamoja na gharama za huduma za afya, siku za kazi kupotea kutokana na ugonjwa huu, siku kupotezwa katika elimu, uzalishaji kupungua kutokana na uharibifu wa ubongo kufuatia malaria ya ubongo, na hasara ya uwekezaji na utalii. <ref name="greenwood2005"/> Katika baadhi ya nchi zilizo athiriwa sana na malaria, ugonjwa huu hugharimu hadi 40% ya fedha zilizotengwa kwa matumizi ya afya ya umma, kati ya 30-50% ya wagongwa waliolazwa, na hadi 50% ya wagonjwa wanaotibiwa na kuruhusiwa kurudi nyumbani. <ref>{{cite web| author=Roll Back Malaria WHO partnership| title=Economic costs of malaria| url=http://www.rollbackmalaria.org/cmc_upload/0/000/015/363/RBMInfosheet_10.pdf| publisher=[[World Health Organization|WHO]]| accessdate=2009-09-18| archiveurl=https://web.archive.org/web/20091229044311/http://www.rollbackmalaria.org/cmc_upload/0/000/015/363/RBMInfosheet_10.pdf| archivedate=2009-12-29}}</ref> == Marejeo == {{Marejeo}} == Viungo vya nje == * [http://www.who.int/malaria/ WHO site on malaria] * [http://www.rollbackmalaria.org/gmap/ Global Malaria action plan] {{Wayback|url=http://www.rollbackmalaria.org/gmap/ |date=20100411074836 }} * [http://www.map.ox.ac.uk/ Malaria Atlas Project] {{Wayback|url=http://www.map.ox.ac.uk/ |date=20150330171641 }} * [http://www.mmv.org Medicines for Malaria Venture (MMV)] * [http://www.rollbackmalaria.org/wmr2005/ World Malaria Report 2005] {{Wayback|url=http://www.rollbackmalaria.org/wmr2005/ |date=20120313215247 }} * [http://doctorswithoutborders.org/news/issue.cfm?id=2395 Madaktari Wasiokuwa na Mipaka / Doctors Without Borders - ''Malaria'' ] kurasa za habari * [http://www.nlm.nih.gov/medlineplus/malaria.html Medline Plus - ''Malaria'' ] [[Jamii:Malaria]] dojoqrnqs4qo6c171hqklh5wrxl1uon 0 16586 1578109 1545389 2026-07-02T20:11:37Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578109 wikitext text/x-wiki [[Image:Zuccone Donatello OPA Florence.jpg|thumb|right|180px|[[Sanamu ya Habakuki]] iliyotengenezwa na [[Donatello]], [[Museo dell'Opera del Duomo (Florence)|Museo dell'Opera del Duomo]], [[Florence]].]] '''Habakuki''' ni [[jina]] la [[nabii]] wa [[Israeli ya Kale]] na pia la [[kitabu]] kinacholeta habari zake katika [[Tanakh]] (yaani [[Biblia ya Kiebrania]]), na kwa hiyo pia katika [[Agano la Kale]], sehemu ya kwanza ya [[Biblia ya Kikristo]]. ==Muda na mada== Wakati alipofanya [[kazi]] nabii [[Yeremia]] aliishi pia Habakuki ([[600 KK|600 hivi K.K.]]), aliyeandika kitabu kifupi ambamo alithubutu kumuuliza [[Mungu]] kwa nini anaadhibu [[Israeli]] vikali kwa [[mikono]] ya watu wabaya kuliko wao. Jibu ni kwamba [[Mwenyezi Mungu]] ana [[njia]] zake ambazo anaandaa [[ushindi]] wa [[haki]]: hivyo mwadilifu ataishi kwa [[imani]] yake (1:12-2:4). Usemi huo ukaja kutumika sana katika [[Agano Jipya]]. [[Mtume Paulo]] ameufanya msingi wa msimamo wake kuwa [[wokovu]] unapatikana kwa imani, si kwa kujitahidi kutekeleza masharti yote ya [[Torati]]. ==Ufafanuzi== Kama vitabu vingine vyote vya [[Biblia]], hiki pia kinatakiwa kisomwe katika mfululizo wa [[historia ya wokovu]] ili kukielewa kadiri ya maendeleo ya [[ufunuo]] wa [[Mungu]] kwa [[binadamu]]. ==Marejeo== {{refbegin|2}} * {{cite book | last=Achtemeier | first=Elizabeth | year=1993 | chapter=Habbakuk, The Book of | title=The Oxford Companion to the Bible | url=https://archive.org/details/isbn_9780195046458 | editor1-last=Metzger | editor1-first=Bruce M. | editor2-last=Coogan | editor2-first=Michael D. | location=New York | publisher=Oxford University Press | isbn=0-19-504645-5 | pages=[https://archive.org/details/isbn_9780195046458/page/265 265]–266 | ref=harv }} * {{cite book | last=Andersen | first=Francis I. | year=2001 | title=Habbakuk | url=https://archive.org/details/galatiansnewtran0025unse | series=The Anchor Bible | location=New York | publisher=Doubleday | isbn=0-385-08396-3 | ref=harv }} * {{cite book | last=Bailey | first=Waylon | year=1998 | chapter=Habakkuk | title=Micah, Nahum, Habakkuk, Zephaniah | series=The New American Commentary | volume=20 | location=Nashville, TN | publisher=Broadman & Holman Publishers | isbn=0-8054-0120-2 | ref=harv }} * {{cite book | last=Baker | first=David W. | year=1988 | title=Nahum, Habakkuk and Zephaniah | url=https://archive.org/details/nahumhabakkukzep0000bake | series=Tyndale Old Testament Commentaries | location=Downers Grove, IL | publisher=Inter-Varsity Press | isbn=0-87784-249-3 | ref=harv }} * {{cite book | last=Barber | first=Cyril J. | year=1985 | title=Habakkuk and Zephaniah | url=https://archive.org/details/habakkukzephania0000barb | series=Everyman's Bible Commentary | location=Chicago | publisher=Moody Press | isbn=0-8024-2069-9 | ref=harv }} * {{cite book | last=Ben Zvi | first=Ehud | editor1-last=Berlin | editor1-first=Adele | editor2-last=Brettler | editor2-first=Marc Zvi | year=2004 | chapter=Habakkuk | title=The Jewish Study Bible | url=https://archive.org/details/isbn_9780195297515 | location=Oxford | publisher=Oxford University Press | isbn=978-0-19-529751-5 | pages=[https://archive.org/details/isbn_9780195297515/page/1226 1226]–1233 | ref=harv }} * {{cite journal | last=Betteridge | first=Walter R. | year=1903 | title=The interpretation of the prophecy of Habakkuk | url=https://archive.org/details/sim_american-journal-of-theology_1903-10_7_4/page/647 | journal=The American Journal of Theology | volume=7 | issue=4 | pages=647–661 | ref=harv }} * {{cite book | last=Brettler | first=Marc Zvi | editor1-last=Berlin | editor1-first=Adele | editor2-last=Brettler | editor2-first=Marc Zvi | year=2004 | chapter=Nevi'im | title=The Jewish Study Bible | url=https://archive.org/details/isbn_9780195297515 | location=Oxford | publisher=Oxford University Press | isbn=978-0-19-529751-5 | pages=[https://archive.org/details/isbn_9780195297515/page/451 451]–461 | ref=harv }} * {{cite book | last=Brownlow | first=Leroy | year=1961 | chapter=Habakkuk | title=The Old Testament Books and their Messages in the Christian Age | location=Fort Worth | series=Second Annual Fort Worth Christian College Lectureship | publisher=The Manney Company | pages=439–453 | ref=harv }} * {{cite book | last=Bruce | first=F. F. | authorlink=F. F. Bruce | editor-last=McComiskey | year=2009 | chapter=Habakkuk | editor-first=Thomas Edward | title=The Minor Prophets: An Exegetical and Expository Commentary | location=Grand Rapids, MI | publisher=Baker Academic | pages=831–896 | isbn=978-0-8010-3631-6 | ref=harv }} * {{cite book | last=Chisholm | first=Robert B., Jr. | year=1990 | chapter=Habakkuk | title=Interpreting the Minor Prophets | url=https://archive.org/details/interpretingmino0000chis | location=Grand Rapids, MI | publisher=Academie Books | isbn=0-310-30801-1 | pages=[https://archive.org/details/interpretingmino0000chis/page/183 183]–199 | ref=harv }} * {{cite book | last1=Clark | first1=David J. | last2=Hatton | first2=Howard A. | year=1989 | title=A Translator’s Handbook on The Books of Nahum, Habakkuk and Zephaniah | url=https://archive.org/details/translatorshandb0000clar_m5c6 | location=New York | publisher=United Bible Societies | isbn=0-8267-0141-8 | lastauthoramp=y | ref={{sfnref|Clark|Hatton|1989}} }} * {{cite book | last=Coffman | first=James Burton | year=1982 | title=Nahum, Habakkuk, Zephaniah, and Haggai | edition=revised | series=Commentary on the Minor Prophets | volume=3 | location=Abilene, TX | publisher=ACU Press | isbn=0-915547-46-5 | pages=61–116 | ref=harv }} * {{cite book | last1=Coggins | first1=Richard | last2=Han | first2=Jin H. | year=2011 | title=Six Minor Prophets Through the Centuries | url=https://archive.org/details/sixminorprophets0000cogg | series= Blackwell Bible Commentaries | publisher=Wiley-Blackwell | isbn=978-1-4051-7675-0 | ref={{sfnref|Coggins|Han|2011}} }} * {{cite book | editor1-last=Cross | editor1-first=F. L. | editor2-last=Livingston | editor2-first=E. A. | year=2005 | title=The Oxford Dictionary of the Christian Church | url=https://archive.org/details/oxforddictionary0000unse_o5w8 | edition=3rd | location=New York | publisher=Oxford University Press | isbn=0-19-280290-9 | lastauthoramp=y | ref={{sfnref|Cross|2005}} }} * {{cite book | editor-last=Driver | editor-first=S. R. | year=1906 | title=The Minor Prophets: Nahum, Habakkuk, Zephaniah, Haggai, Zechariah, Malachi | series=The Century Bible | location=Edinburgh | publisher=T. C. & E. C. Jack, Ltd | ref={{sfnref|Driver|1906}} }} * {{cite web | last=Gigot | first=F. | year=1910 | title=Habacuc (Habakkuk) | work=The Catholic Encyclopedia | location=New York | publisher=Robert Appleton Company | accessdate=2100-12-19 | at=New Advent | url=http://www.newadvent.org/cathen/07097a.htm }} * {{cite book | last=Gowan | first=Donald E. | year=1976 | title=The Triumph of Faith in Habakkuk | url=https://archive.org/details/triumphoffaithin00gowa | location=Atlanta | publisher=John Knox Press | isbn=0-8042-0195-1 | ref=harv }} * {{cite journal | last=Haak | first=Robert D. | year=1988 | title="Poetry" in Habakkuk 1:1–2:4? | url=https://archive.org/details/sim_journal-of-the-american-oriental-society_july-september-1988_108_3/page/437 | journal=Journal of the American Oriental Society | volume=108 | issue=3 | pages=437–444 | ref=harv }} * {{cite book | last=Hailey | first=Homer | authorlink=Homer Hailey | year=1972 | chapter=Habakkuk | title=A Commentary on the Minor Prophets | url=https://archive.org/details/commentaryonmino0000hail | location=Grand Rapids, MI | publisher=Baker Book House | isbn=0-8010-4049-3 | pages=[https://archive.org/details/commentaryonmino0000hail/page/271 271]–296 | ref=harv }} * {{cite book | last=Harris | first=J. G. | year=1966 | title=The Qumran Commentary on Habakkuk | series=Contemporary Studies in Theology | location=London | publisher=A. R. Mowbray & Co | pages=22–30 | ref=harv }} * {{cite book | last=Henderson | first=Ebenezer| authorlink=Ebenezer Henderson | year=1980 | origyear=First published 1858 | title=The Twelve Minor Prophets | url=https://archive.org/details/twelveminorproph0000hend | series=Thornapple Commentaries | location=Grand Rapids, MI | publisher=Baker Book House | isbn=0-8010-4217-8 | ref=harv }} * {{cite book | last=Hirsch | first=Emil G. | authorlink=Emil G. Hirsch | year=1906 | chapter=Habakkuk, Book of | title=Jewish Encyclopedia | url=http://www.jewishencyclopedia.com/articles/6976-habakkuk-book-of | ref=harv }} * {{cite book | last1=Hirsch | first1=Emil G. | last2=Blau | first2=Ludwig | last3=Kohler | first3=Kaufmann | last4=Schmidt | first4=Nathaniel | year=1906 | chapter=Bible Canon | title=Jewish Encyclopedia | url=http://www.jewishencyclopedia.com/articles/3259-bible-canon | lastauthoramp=y | authormask=7 | ref={{sfnref|Hirsch|Blau|Kohler|Schmidt|1906}} }} * {{cite book | last=Humbert | first=Paul | year=1944 | title=Problèmes du Livre d'Habacuc | series=Mémoires de l'Université de Neuchatel, '''18''' | location=Neuchatel | publisher=Secrétariat de l'Université | isbn=0-8042-0195-1 | ref=harv }} * {{cite journal | last=Irving | first=T. Johnstone | year=1908 | title=Habakkuk | url=https://archive.org/details/sim_biblical-world_1908-01_31_1/page/51 | journal=The Biblical World | volume=31 | issue=1 | pages=51–61 | ref=harv }} * {{cite journal | last=Irwin | first=William A. | year=1956 | title=The mythological background of Habakkuk, chapter 3 | url=https://archive.org/details/sim_journal-of-near-eastern-studies_1956-01_15_1/page/47 | journal=Journal of Near Eastern Studies | volume=15 | issue=1 | pages=47–50 | ref=harv }} * {{cite book | last=Johnson | first=Robert L. | year=1969 | title=The Letter of Paul to the Galatians | series=The Living Word Commentary | location=Abilene, TX | publisher=ACU Press | isbn=0-915547-29-5 | ref=harv }} * {{cite book | last=Kachelman | first=John L., Jr. | year=2000 | title=Habakkuk: When God Seems So Silent | publisher=Freed-Hardeman University Press | ref=harv }} * {{cite journal | last=Kelly | first=Fred T. | year=1902 | title=The strophic structure of Habakkuk | url=https://archive.org/details/sim_american-journal-of-semitic-languages-and-literatures_1902-01_18_2/page/94 | journal=The American Journal of Semitic Languages and Literatures | volume=18 | issue=2 | pages=94–119 | ref=harv }} * {{cite book | last1=LaSor | first1=William Sanford | authorlink=William Sanford La Sor | last2=Hubbard | first2=David Allan | last3=Bush | first3=Frederic Wm. | year=1982 | title=Old Testament Survey: The Message, Form, and Background of the Old Testament | location=Grand Rapids, MI | publisher=Wm. B. Eerdmans | isbn=0-8028-3556-2 | lastauthoramp=y | ref={{sfnref|LaSor|Hubbard|Bush|1982}} }} * {{cite book | last=Lehrman | first=S. M., Rabbi | year=1948 | chapter=Habakkuk | title=The Twelve Prophets | url=https://archive.org/details/twelveprophetshe0008unse | editor=A. Cohen | location=London | publisher=The Soncino Press | pages=[https://archive.org/details/twelveprophetshe0008unse/page/209 210]–220 | ref=harv }} * {{cite book | last=Leslie | first=E. A. | year=1962 | chapter=Habakkuk | title=The Interpreter's Dictionary of the Bible: An Illustrated Encyclopedia | editor=[[George Arthur Buttrick|Buttrick, George Arthur]], et al | location=Nashville, TN | publisher=Abingdon Press | isbn=0-687-19271-4 | volume=2 | pages=503–505 | ref=harv }} * {{cite book | last=Lloyd-Jones | first=D. Martyn | authorlink=Martyn Lloyd-Jones | year=1966 | origyear=First published 1953 | title=From Fear to Faith: Studies in the Book of Habakkuk | location=Leicester, UK | publisher=Inter-Varsity Press | isbn=0-85110-332-4 | ref=harv }} * {{cite book | last=McGee | first=J. Vernon | year=1991 | title=Nahum and Habakkuk | series=Thru the Bible Commentary Series | location=Nashville, TN | publisher=Thomas Nelson Publishers | isbn=0-7852-1033-4 | ref=harv }} * {{cite book | last=Moore | first=Carey A. | year=1977 | title=Daniel, Esther and Jeremiah: The Additions | url=https://archive.org/details/danielestherjere00tari | series=The Anchor Bible | location=Garden City, NY | publisher=Doubleday & Company | isbn=0-385-04702-9 | ref=harv }} * {{cite book | last=Neusner | first=Jacob | year=1994 | title=Introduction to Rabbinic Literature | url=https://archive.org/details/introductiontora0000neus | series=The Anchor Bible Reference Library | location=New York | publisher=Doubleday | isbn=0-385-47093-2 | ref=harv }} * {{cite book | last=Patterson | first=Richard D. | year=2003 | title=An Exegetical Commentary: Nahum, Habbakuk, Zephaniah | publisher=Biblical Studies Press | url=http://bible.org/series/exegetical-commentary-nahum-habakkuk-zephaniah | isbn=0-7375-0019-0 | ref=harv }} * {{cite book | last=Pusey | first=E. B. | authorlink= Edward Bouverie Pusey | year=1950 | origyear=First published 1860 | title=The Minor Prophets: A Commentary | volume=2 | location=Grand Rapids, MI | publisher=Baker Book House | ref=harv }} * {{cite book | last=Robertson | first=O. Palmer | year=1990 | title=The Books of Nahum, Habakkuk, and Zephaniah | url=https://archive.org/details/booksofnahumhaba0000robe | series=The New International Commentary on the Old Testament | location=Grand Rapids, MI | publisher=Wm. B. Eerdmans | isbn=978-0-8028-2532-2 | ref=harv }} * {{cite book | last=Smith | first=Ralph L. | year=1984 | chapter=Habakkuk | title=Micah–Malachi | series=Word Biblical Commentary | volume=32 | location=Waco, TX | publisher=Words Books | isbn=0-8499-0231-2 | pages=92–117 | ref=harv }} * {{cite book | last=Széles | first=Mária Eszenyei | year=1987 | title=Wrath and Mercy: A Commentary on the Books of Habakkuk and Zephaniah | others=trans. George A. F. Knight | series=International Theological Commentary | location=Grand Rapids, MI | publisher=Wm. B. Eerdmans | isbn=0-8028-0242-7 | ref=harv }} * {{cite journal | last1=Walker | first1=H. H. | last2=Lund | first2=N. W. | year=1934 | title=The literary structure of the book of Habakkuk | url=https://archive.org/details/sim_journal-of-biblical-literature_1934-12_53_4/page/355 | journal=Journal of Biblical Literature | volume=53 | issue=4 | pages=355–370 | lastauthoramp=y | ref={{sfnref|Walker|Lund|1934}} }} * {{cite book | editor=Whelpton, George | year=1916 | chapter=song 279 | title=The Church Hymnal | url=https://archive.org/details/churchhymnalabo00whelgoog | location=New York | publisher=The Century Co | ref={{sfnref|Whelpton|1916}} }} * {{cite book | editor=Wiegand, John P. | year=1992 | chapter=song 685 | title=Praise for the Lord | url=https://archive.org/details/praiseforlord0000wieg | location=Nashville, TN | publisher=Praise Press | isbn=0-89098-119-1 | ref={{sfnref|Wiegland|1992}} }} * {{cite book | last1=Wise | first1=Michael | last2=Abegg | first2=Martin, Jr. | last3=Cook |first3=Edward | year=1996 | title=The Dead Sea Scrolls: A New Translation | url=https://archive.org/details/isbn_9780060692001 | location=San Francisco | publisher=HarperSanFrancisco | isbn=0-06-069200-6 | pages=[https://archive.org/details/isbn_9780060692001/page/114 114]–122 | lastauthoramp=y | ref={{sfnref|Wise|Abegg|Cook|1996}} }} {{refend}} ==Viungo vya Nje== * [http://dss.collections.imj.org.il/habakkuk The Commentary on Habakkuk Scroll], ''The Digital Dead Sea Scrolls'', hosted by the [[Israel Museum]], Jerusalem. * [http://www.powerofchange.org/storage/docs/habakkuk_intro.pdf A Brief Introduction to The Prophecy of Habakkuk for Contemporary Readers] {{Wayback|url=http://www.powerofchange.org/storage/docs/habakkuk_intro.pdf |date=20111009182923 }} (Christian Perspective) * [http://www.ibs.org/niv/studybible/habakkuk.php Introduction to the book of Habakkuk] {{Wayback|url=http://www.ibs.org/niv/studybible/habakkuk.php |date=20080801154610 }} from the [[NIV Study Bible]] {{Biblia AK}} {{mbegu-Biblia}} {{DEFAULTSORT:Habakuki}} [[Category:Vitabu vya Agano la Kale]] 3r42vflsccr7aq6tad4hbe26ze9kt6s 0 16625 1578206 1545335 2026-07-03T03:08:47Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578206 wikitext text/x-wiki [[Image:Zuccone Donatello OPA Florence.jpg|thumb|right|180px|[[Sanamu ya Habakuki]] iliyotengenezwa na [[Donatello]], [[Museo dell'Opera del Duomo (Florence)|Museo dell'Opera del Duomo]], [[Florence]].]] '''Habakuki''' alikuwa [[nabii]] wa [[Israeli ya Kale]] aliyeishi na kufanya [[kazi]] wakati mmoja na nabii [[Yeremia]] ([[karne ya 7 KK]]). Mbele ya [[uovu]] na [[ukatili]] wa [[binadamu]] alitabiri [[hukumu]] ya [[Mungu]], lakini pia [[huruma]] [[Huruma ya Mungu|yake]]<ref>https://www.santiebeati.it/dettaglio/92470</ref>. Hababuki aliandika [[kitabu]] kifupi ambamo alithubutu kumuuliza [[Mwenyezi Mungu]] kwa nini anaadhibu [[Israeli]] vikali kwa [[mikono]] ya [[watu]] wabaya kuliko wao. Jibu ni kwamba [[Mwenyezi Mungu]] ana [[njia]] zake ambazo anaandaa [[ushindi]] wa [[haki]]: hivyo mwadilifu ataishi kwa [[imani]] yake (1:12-2:4). [[Misemo|Usemi]] huo ukaja kutumika sana katika [[Agano Jipya]]. [[Mtume Paulo]] ameufanya [[msingi]] wa msimamo wake kuwa [[wokovu]] unapatikana kwa imani, si kwa kujitahidi kutekeleza masharti yote ya [[Torati]]. Tangu kale anaheshimiwa kama [[mtakatifu]]. [[Sikukuu]] yake huadhimishwa [[tarehe]] [[2 Desemba]]<ref>[[Martyrologium Romanum]]</ref><ref>https://catholicsaints.info/habakkuk-the-prophet/</ref>. ==Tazama pia== *[[Watakatifu wa Agano la Kale]] *[[Orodha ya Watakatifu Wakristo]] *[[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{reflist}} ==Marejeo== {{refbegin|2}} * {{cite book | last=Achtemeier | first=Elizabeth | year=1993 | chapter=Habbakuk, The Book of | title=The Oxford Companion to the Bible | url=https://archive.org/details/isbn_9780195046458 | editor1-last=Metzger | editor1-first=Bruce M. | editor2-last=Coogan | editor2-first=Michael D. | location=New York | publisher=Oxford University Press | isbn=0-19-504645-5 | pages=[https://archive.org/details/isbn_9780195046458/page/265 265]–266 | ref=harv }} * {{cite book | last=Andersen | first=Francis I. | year=2001 | title=Habbakuk | url=https://archive.org/details/galatiansnewtran0025unse | series=The Anchor Bible | location=New York | publisher=Doubleday | isbn=0-385-08396-3 | ref=harv }} * {{cite book | last=Bailey | first=Waylon | year=1998 | chapter=Habakkuk | title=Micah, Nahum, Habakkuk, Zephaniah | series=The New American Commentary | volume=20 | location=Nashville, TN | publisher=Broadman & Holman Publishers | isbn=0-8054-0120-2 | ref=harv }} * {{cite book | last=Baker | first=David W. | year=1988 | title=Nahum, Habakkuk and Zephaniah | url=https://archive.org/details/nahumhabakkukzep0000bake | series=Tyndale Old Testament Commentaries | location=Downers Grove, IL | publisher=Inter-Varsity Press | isbn=0-87784-249-3 | ref=harv }} * {{cite book | last=Barber | first=Cyril J. | year=1985 | title=Habakkuk and Zephaniah | url=https://archive.org/details/habakkukzephania0000barb | series=Everyman's Bible Commentary | location=Chicago | publisher=Moody Press | isbn=0-8024-2069-9 | ref=harv }} * {{cite book | last=Ben Zvi | first=Ehud | editor1-last=Berlin | editor1-first=Adele | editor2-last=Brettler | editor2-first=Marc Zvi | year=2004 | chapter=Habakkuk | title=The Jewish Study Bible | url=https://archive.org/details/isbn_9780195297515 | location=Oxford | publisher=Oxford University Press | isbn=978-0-19-529751-5 | pages=[https://archive.org/details/isbn_9780195297515/page/1226 1226]–1233 | ref=harv }} * {{cite journal | last=Betteridge | first=Walter R. | year=1903 | title=The interpretation of the prophecy of Habakkuk | url=https://archive.org/details/sim_american-journal-of-theology_1903-10_7_4/page/647 | journal=The American Journal of Theology | volume=7 | issue=4 | pages=647–661 | ref=harv }} * {{cite book | last=Brettler | first=Marc Zvi | editor1-last=Berlin | editor1-first=Adele | editor2-last=Brettler | editor2-first=Marc Zvi | year=2004 | chapter=Nevi'im | title=The Jewish Study Bible | url=https://archive.org/details/isbn_9780195297515 | location=Oxford | publisher=Oxford University Press | isbn=978-0-19-529751-5 | pages=[https://archive.org/details/isbn_9780195297515/page/451 451]–461 | ref=harv }} * {{cite book | last=Brownlow | first=Leroy | year=1961 | chapter=Habakkuk | title=The Old Testament Books and their Messages in the Christian Age | location=Fort Worth | series=Second Annual Fort Worth Christian College Lectureship | publisher=The Manney Company | pages=439–453 | ref=harv }} * {{cite book | last=Bruce | first=F. F. | authorlink=F. F. Bruce | editor-last=McComiskey | year=2009 | chapter=Habakkuk | editor-first=Thomas Edward | title=The Minor Prophets: An Exegetical and Expository Commentary | location=Grand Rapids, MI | publisher=Baker Academic | pages=831–896 | isbn=978-0-8010-3631-6 | ref=harv }} * {{cite book | last=Chisholm | first=Robert B., Jr. | year=1990 | chapter=Habakkuk | title=Interpreting the Minor Prophets | url=https://archive.org/details/interpretingmino0000chis | location=Grand Rapids, MI | publisher=Academie Books | isbn=0-310-30801-1 | pages=[https://archive.org/details/interpretingmino0000chis/page/183 183]–199 | ref=harv }} * {{cite book | last1=Clark | first1=David J. | last2=Hatton | first2=Howard A. | year=1989 | title=A Translator’s Handbook on The Books of Nahum, Habakkuk and Zephaniah | url=https://archive.org/details/translatorshandb0000clar_m5c6 | location=New York | publisher=United Bible Societies | isbn=0-8267-0141-8 | lastauthoramp=y | ref={{sfnref|Clark|Hatton|1989}} }} * {{cite book | last=Coffman | first=James Burton | year=1982 | title=Nahum, Habakkuk, Zephaniah, and Haggai | edition=revised | series=Commentary on the Minor Prophets | volume=3 | location=Abilene, TX | publisher=ACU Press | isbn=0-915547-46-5 | pages=61–116 | ref=harv }} * {{cite book | last1=Coggins | first1=Richard | last2=Han | first2=Jin H. | year=2011 | title=Six Minor Prophets Through the Centuries | url=https://archive.org/details/sixminorprophets0000cogg | series= Blackwell Bible Commentaries | publisher=Wiley-Blackwell | isbn=978-1-4051-7675-0 | ref={{sfnref|Coggins|Han|2011}} }} * {{cite book | editor1-last=Cross | editor1-first=F. L. | editor2-last=Livingston | editor2-first=E. A. | year=2005 | title=The Oxford Dictionary of the Christian Church | url=https://archive.org/details/oxforddictionary0000unse_o5w8 | edition=3rd | location=New York | publisher=Oxford University Press | isbn=0-19-280290-9 | lastauthoramp=y | ref={{sfnref|Cross|2005}} }} * {{cite book | editor-last=Driver | editor-first=S. R. | year=1906 | title=The Minor Prophets: Nahum, Habakkuk, Zephaniah, Haggai, Zechariah, Malachi | series=The Century Bible | location=Edinburgh | publisher=T. C. & E. C. Jack, Ltd | ref={{sfnref|Driver|1906}} }} * {{cite web | last=Gigot | first=F. | year=1910 | title=Habacuc (Habakkuk) | work=The Catholic Encyclopedia | location=New York | publisher=Robert Appleton Company | accessdate=2100-12-19 | at=New Advent | url=http://www.newadvent.org/cathen/07097a.htm }} * {{cite book | last=Gowan | first=Donald E. | year=1976 | title=The Triumph of Faith in Habakkuk | url=https://archive.org/details/triumphoffaithin00gowa | location=Atlanta | publisher=John Knox Press | isbn=0-8042-0195-1 | ref=harv }} * {{cite journal | last=Haak | first=Robert D. | year=1988 | title="Poetry" in Habakkuk 1:1–2:4? | url=https://archive.org/details/sim_journal-of-the-american-oriental-society_july-september-1988_108_3/page/437 | journal=Journal of the American Oriental Society | volume=108 | issue=3 | pages=437–444 | ref=harv }} * {{cite book | last=Hailey | first=Homer | authorlink=Homer Hailey | year=1972 | chapter=Habakkuk | title=A Commentary on the Minor Prophets | url=https://archive.org/details/commentaryonmino0000hail | location=Grand Rapids, MI | publisher=Baker Book House | isbn=0-8010-4049-3 | pages=[https://archive.org/details/commentaryonmino0000hail/page/271 271]–296 | ref=harv }} * {{cite book | last=Harris | first=J. G. | year=1966 | title=The Qumran Commentary on Habakkuk | series=Contemporary Studies in Theology | location=London | publisher=A. R. Mowbray & Co | pages=22–30 | ref=harv }} * {{cite book | last=Henderson | first=Ebenezer| authorlink=Ebenezer Henderson | year=1980 | origyear=First published 1858 | title=The Twelve Minor Prophets | url=https://archive.org/details/twelveminorproph0000hend | series=Thornapple Commentaries | location=Grand Rapids, MI | publisher=Baker Book House | isbn=0-8010-4217-8 | ref=harv }} * {{cite book | last=Hirsch | first=Emil G. | authorlink=Emil G. Hirsch | year=1906 | chapter=Habakkuk, Book of | title=Jewish Encyclopedia | url=http://www.jewishencyclopedia.com/articles/6976-habakkuk-book-of | ref=harv }} * {{cite book | last1=Hirsch | first1=Emil G. | last2=Blau | first2=Ludwig | last3=Kohler | first3=Kaufmann | last4=Schmidt | first4=Nathaniel | year=1906 | chapter=Bible Canon | title=Jewish Encyclopedia | url=http://www.jewishencyclopedia.com/articles/3259-bible-canon | lastauthoramp=y | authormask=7 | ref={{sfnref|Hirsch|Blau|Kohler|Schmidt|1906}} }} * {{cite book | last=Humbert | first=Paul | year=1944 | title=Problèmes du Livre d'Habacuc | series=Mémoires de l'Université de Neuchatel, '''18''' | location=Neuchatel | publisher=Secrétariat de l'Université | isbn=0-8042-0195-1 | ref=harv }} * {{cite journal | last=Irving | first=T. Johnstone | year=1908 | title=Habakkuk | url=https://archive.org/details/sim_biblical-world_1908-01_31_1/page/51 | journal=The Biblical World | volume=31 | issue=1 | pages=51–61 | ref=harv }} * {{cite journal | last=Irwin | first=William A. | year=1956 | title=The mythological background of Habakkuk, chapter 3 | url=https://archive.org/details/sim_journal-of-near-eastern-studies_1956-01_15_1/page/47 | journal=Journal of Near Eastern Studies | volume=15 | issue=1 | pages=47–50 | ref=harv }} * {{cite book | last=Johnson | first=Robert L. | year=1969 | title=The Letter of Paul to the Galatians | series=The Living Word Commentary | location=Abilene, TX | publisher=ACU Press | isbn=0-915547-29-5 | ref=harv }} * {{cite book | last=Kachelman | first=John L., Jr. | year=2000 | title=Habakkuk: When God Seems So Silent | publisher=Freed-Hardeman University Press | ref=harv }} * {{cite journal | last=Kelly | first=Fred T. | year=1902 | title=The strophic structure of Habakkuk | url=https://archive.org/details/sim_american-journal-of-semitic-languages-and-literatures_1902-01_18_2/page/94 | journal=The American Journal of Semitic Languages and Literatures | volume=18 | issue=2 | pages=94–119 | ref=harv }} * {{cite book | last1=LaSor | first1=William Sanford | authorlink=William Sanford La Sor | last2=Hubbard | first2=David Allan | last3=Bush | first3=Frederic Wm. | year=1982 | title=Old Testament Survey: The Message, Form, and Background of the Old Testament | location=Grand Rapids, MI | publisher=Wm. B. Eerdmans | isbn=0-8028-3556-2 | lastauthoramp=y | ref={{sfnref|LaSor|Hubbard|Bush|1982}} }} * {{cite book | last=Lehrman | first=S. M., Rabbi | year=1948 | chapter=Habakkuk | title=The Twelve Prophets | url=https://archive.org/details/twelveprophetshe0008unse | editor=A. Cohen | location=London | publisher=The Soncino Press | pages=[https://archive.org/details/twelveprophetshe0008unse/page/209 210]–220 | ref=harv }} * {{cite book | last=Leslie | first=E. A. | year=1962 | chapter=Habakkuk | title=The Interpreter's Dictionary of the Bible: An Illustrated Encyclopedia | editor=[[George Arthur Buttrick|Buttrick, George Arthur]], et al | location=Nashville, TN | publisher=Abingdon Press | isbn=0-687-19271-4 | volume=2 | pages=503–505 | ref=harv }} * {{cite book | last=Lloyd-Jones | first=D. Martyn | authorlink=Martyn Lloyd-Jones | year=1966 | origyear=First published 1953 | title=From Fear to Faith: Studies in the Book of Habakkuk | location=Leicester, UK | publisher=Inter-Varsity Press | isbn=0-85110-332-4 | ref=harv }} * {{cite book | last=McGee | first=J. Vernon | year=1991 | title=Nahum and Habakkuk | series=Thru the Bible Commentary Series | location=Nashville, TN | publisher=Thomas Nelson Publishers | isbn=0-7852-1033-4 | ref=harv }} * {{cite book | last=Moore | first=Carey A. | year=1977 | title=Daniel, Esther and Jeremiah: The Additions | url=https://archive.org/details/danielestherjere00tari | series=The Anchor Bible | location=Garden City, NY | publisher=Doubleday & Company | isbn=0-385-04702-9 | ref=harv }} * {{cite book | last=Neusner | first=Jacob | year=1994 | title=Introduction to Rabbinic Literature | url=https://archive.org/details/introductiontora0000neus | series=The Anchor Bible Reference Library | location=New York | publisher=Doubleday | isbn=0-385-47093-2 | ref=harv }} * {{cite book | last=Patterson | first=Richard D. | year=2003 | title=An Exegetical Commentary: Nahum, Habbakuk, Zephaniah | publisher=Biblical Studies Press | url=http://bible.org/series/exegetical-commentary-nahum-habakkuk-zephaniah | isbn=0-7375-0019-0 | ref=harv }} * {{cite book | last=Pusey | first=E. B. | authorlink= Edward Bouverie Pusey | year=1950 | origyear=First published 1860 | title=The Minor Prophets: A Commentary | volume=2 | location=Grand Rapids, MI | publisher=Baker Book House | ref=harv }} * {{cite book | last=Robertson | first=O. Palmer | year=1990 | title=The Books of Nahum, Habakkuk, and Zephaniah | url=https://archive.org/details/booksofnahumhaba0000robe | series=The New International Commentary on the Old Testament | location=Grand Rapids, MI | publisher=Wm. B. Eerdmans | isbn=978-0-8028-2532-2 | ref=harv }} * {{cite book | last=Smith | first=Ralph L. | year=1984 | chapter=Habakkuk | title=Micah–Malachi | series=Word Biblical Commentary | volume=32 | location=Waco, TX | publisher=Words Books | isbn=0-8499-0231-2 | pages=92–117 | ref=harv }} * {{cite book | last=Széles | first=Mária Eszenyei | year=1987 | title=Wrath and Mercy: A Commentary on the Books of Habakkuk and Zephaniah | others=trans. George A. F. Knight | series=International Theological Commentary | location=Grand Rapids, MI | publisher=Wm. B. Eerdmans | isbn=0-8028-0242-7 | ref=harv }} * {{cite journal | last1=Walker | first1=H. H. | last2=Lund | first2=N. W. | year=1934 | title=The literary structure of the book of Habakkuk | url=https://archive.org/details/sim_journal-of-biblical-literature_1934-12_53_4/page/355 | journal=Journal of Biblical Literature | volume=53 | issue=4 | pages=355–370 | lastauthoramp=y | ref={{sfnref|Walker|Lund|1934}} }} * {{cite book | editor=Whelpton, George | year=1916 | chapter=song 279 | title=The Church Hymnal | url=https://archive.org/details/churchhymnalabo00whelgoog | location=New York | publisher=The Century Co | ref={{sfnref|Whelpton|1916}} }} * {{cite book | editor=Wiegand, John P. | year=1992 | chapter=song 685 | title=Praise for the Lord | url=https://archive.org/details/praiseforlord0000wieg | location=Nashville, TN | publisher=Praise Press | isbn=0-89098-119-1 | ref={{sfnref|Wiegland|1992}} }} * {{cite book | last1=Wise | first1=Michael | last2=Abegg | first2=Martin, Jr. | last3=Cook |first3=Edward | year=1996 | title=The Dead Sea Scrolls: A New Translation | url=https://archive.org/details/isbn_9780060692001 | location=San Francisco | publisher=HarperSanFrancisco | isbn=0-06-069200-6 | pages=[https://archive.org/details/isbn_9780060692001/page/114 114]–122 | lastauthoramp=y | ref={{sfnref|Wise|Abegg|Cook|1996}} }} {{refend}} ==Viungo vya nje== * [http://dss.collections.imj.org.il/habakkuk The Commentary on Habakkuk Scroll], ''The Digital Dead Sea Scrolls'', hosted by the [[Israel Museum]], Jerusalem. * [http://www.powerofchange.org/storage/docs/habakkuk_intro.pdf A Brief Introduction to The Prophecy of Habakkuk for Contemporary Readers] {{Wayback|url=http://www.powerofchange.org/storage/docs/habakkuk_intro.pdf |date=20111009182923 }} (Christian Perspective) * [http://www.ibs.org/niv/studybible/habakkuk.php Introduction to the book of Habakkuk] {{Wayback|url=http://www.ibs.org/niv/studybible/habakkuk.php |date=20080801154610 }} from the [[NIV Study Bible]] {{mbegu-mtu-Biblia}} {{DEFAULTSORT:Habakuki}} [[Jamii:waliozaliwa karne ya 7 KK]] [[Jamii:Watakatifu wa Israeli]] [[Category:Manabii wa Agano la Kale]] jgmvf2s7hbhbpqo5flhv4wvqnzkk8sd 0 16628 1578186 1514835 2026-07-03T01:52:21Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578186 wikitext text/x-wiki [[Picha:Map Israel Judea 926 BC-fr.svg|thumb|300px|Ramani ya Israeli ya Kale mnamo mwaka 926 wakati wa kugawiwa kwa ufalme wa pamoja<br />kijani kilichokolea: Ufalme wa Israeli na makabila yake (kaskazini)<br />kijani cheupe: Ufalme wa Yuda na makabila yake (kusini); <br />Philistie: nchi ya Wafilisti]] '''Israeli ya Kale''' ni [[taifa]] la [[Binadamu|watu]] walioitwa mwanzoni [[Wanaisraeli]] na baadaye pia [[Wayahudi]]. Ndilo taifa teule la [[Mwenyezi Mungu]] ([[YHWH]]) katika [[Tanakh]] au [[Biblia ya Kiebrania]] (kwa hiyo pia katika [[Agano la Kale]] lililo sehemu ya kwanza ya [[Biblia ya Kikristo]]. [[historia|Kihistoria]] waliishi katika nchi iliyoitwa [[Kanaani]], halafu [[Israeli]] (baadaye pia [[Palestina]]) kuanzia mnamo [[1200 KK]] hadi [[mwaka]] [[70]] [[BK]] [[Waroma wa Kale]] walipovamia na kuharibu [[Yerusalemu]], ambao tena mwaka [[135]] waliwafukuza wote kutoka nchi yao. == Historia == Historia ya Israeli ya Kale inaanza tangu kupatikana kwa taifa hilo katika nchi yake inayoitwa Israeli. Kufuatana na masimulizi ya Agano la Kale taifa la Israeli lilianzishwa na Wanaisraeli waliotoka [[Misri]] chini ya uongozi wa [[Musa]] na kuvamia Kanaani mnamo mwaka [[1200 KK]] chini ya [[Yoshua]]. [[Wataalamu]] wengine wa kisasa wanaona kwamba taifa lilitokea hasa ndani ya nchi kwa kuungana kwa vikundi mbalimbali. [[Muungano]] huo wa vikundi na ma[[kabila]] ukawa taifa na kuunda ufalme wa kwanza wa Israeli wakati wa [[mfalme]] [[Sauli]] aliyefuatwa na [[Daudi]] na mwanae [[Suleimani]]. Baada ya [[kifo]] cha Suleimani likatokea [[farakano]] na jina la "Israeli" likatumiwa na ufalme wa kaskazini, wakati [[mji mkuu]] wa kale [[Yerusalemu]] ukaendelea kama mji mkuu wa [[ufalme wa Yuda]]. Falme zote mbili zilishindwa katika [[vita]] na kuanzia mwaka [[587 KK]] hapakuwa tena na dola la kujitegemea, bali eneo lilikuwa chini ya falme mbalimbali kama vile [[Babiloni]], [[Uajemi]] na [[Ugiriki wa Kale]]. Lakini [[harakati]] za [[Wamakabayo]] za kurudisha [[uhuru]] uliweza kuwafukuza [[Wagiriki]] na kuanzisha ufalme wa Kiyahudi kati ya [[140 KK]] hadi [[4 KK]]. Hata hivyo kuanzia mwaka [[63 KK]] ufalme huo uliwekwa chini ya [[ulinzi]] wa [[Dola la Roma]] na polepole kugawiwa na hatimaye kuwa jimbo la Kiroma (tangu [[70 BK]]). [[Maangamizi ya Yerusalemu]] mwaka 70 BK huhesabiwa kama mwisho wa Israeli ya Kale. Wataalamu wengine wanaona tayari uvamizi wa mji wa 587 KK na Wababeli kama mwisho wa kipindi hiki na kuangalia kipindi kati ya 587 KK hadi 70 BK kama kipindi kipya. ==Israeli wakati wa [[Yesu]]== Wakati wa [[Agano Jipya]], [[mji]] wa Yerusalemu, pamoja na nchi ya Israeli/Palestina, vilikuwa chini ya Dola la Roma, ambalo lilitawala maeneo yote yanayozunguka [[bahari]] ya [[Mediteranea]]. Mkuu wa Dola alikuwa na cheo cha "[[Kaisari]]" akikaa mjini [[Roma]] ([[Italia]]). Waroma walidai [[utiifu]] na [[kodi]] za mataifa na makabila yote yaliyokuwa chini yao. Lakini hawakuwa na neno juu ya [[utamaduni]] na [[dini]] za nchi hizo. Utawala wa Kiroma ulirahisisha [[biashara]] na [[uchumi]] pamoja na [[mawasiliano]] katika maeneo haya yote. Waroma hawakuwa na mitambo ya [[injini]] lakini walikuwa wataalamu wa [[uhandisi]]. Walikuwa hodari sana kujenga [[barabara]] na [[nyumba]] za [[ghorofa]]. Majengo kadhaa waliyoyajenga husimama mpaka leo. [[Magofu]] ya miji yao yanaonekana leo hii kuanzia [[Misri]] na [[Algeria]] hadi [[Ujerumani]] na [[Asia]]. [[Wasanii]] wao walichonga [[sanamu]] za [[mawe]] za kudumu. Israeli/Palestina ilikuwa na [[serikali]] yake ya Kiyahudi lakini pia na [[liwali]] au [[gavana]] wa Kiroma. Waroma walizima kwa ukali majaribio yote ya kupindua utawala wao. Wayahudi katika Israeli walijaribu mara mbili kuwafukuza Waroma nchini: miaka [[66]]-[[73]] na [[135]] BK. Kila safari Waroma walilipiza [[kisasi]], wakichoma [[moto]] miji na vijiji na kuwafanya wananchi kuwa [[watumwa]] au kuwaua kabisa. ==Vyanzo== {{refbegin|2}} * {{Rejea kitabu|last=Albertz|first=Rainer|title=A History of Israelite Religion, Volume I: From the Beginnings to the End of the Monarchy|publisher=Westminster John Knox Press|year=1994 |url=https://books.google.com/books?id=yvZUWbTftSgC&pg=RA1-PA145|isbn=978-0-664-22719-7}} * {{Rejea kitabu|last=Albertz|first=Rainer|title=A History of Israelite Religion, Volume II: From the Exile to the Maccabees|publisher=Westminster John Knox Press|year=1994 |url=https://books.google.com/books?id=exjyhvRy7YUC|isbn=978-0-664-22720-3}} * {{Rejea kitabu|last=Albertz|first=Rainer|title=Israel in Exile: The History and Literature of the Sixth Century B.C.E|publisher=Society of Biblical Literature|date=2003a|url=https://books.google.com/books?id=Xx9YzJq2B9wC&q=Rainer+Albertz,+%22Israel+in+exile%22|isbn=978-1-58983-055-4}} * {{Rejea kitabu|editor-last=Avery-Peck|editor-first=Alan|editor-last2=Neusner|editor-first2=Jacob|display-editors=1|title=The Blackwell Companion to Judaism|publisher=Blackwell|year=2003|url=https://books.google.com/books?id=asYoIwz9z2UC&pg=PA230|isbn=978-1-57718-059-3}} * {{Rejea kitabu|last=Barstad|first=Hans M.|author-link=Hans M. Barstad|title=History and the Hebrew Bible|publisher=Mohr Siebeck|year=2008|url=https://books.google.com/books?id=zqJxkKy-cMMC|isbn=978-3-16-149809-1}} * {{Rejea kitabu|last=Becking|first=Bob|chapter=Law as Expression of Religion (Ezra 7–10)|editor-last=Albertz|editor-first=Rainer|editor-last2=Becking|editor-first2=Bob|title=Yahwism After the Exile: Perspectives on Israelite Religion in the Persian Era|publisher=Koninklijke Van Gorcum|date=2003b|url=https://books.google.com/books?id=hwExATCqwvwC|isbn=978-90-232-3880-5}} * {{Rejea kitabu|last=Bedford|first=Peter Ross|title=Temple Restoration in Early Achaemenid Judah|publisher=Brill|year=2001|url=https://books.google.com/books?id=MOd320e710IC&q=Osarsiph|isbn=978-90-04-11509-5}} * {{Rejea kitabu|last=Ben-Sasson|first=H.H.|title=A History of the Jewish People|publisher=Harvard University Press|year=1976|isbn=978-0-674-39731-6}} * {{Rejea kitabu|last=Blenkinsopp|first=Joseph|title=Ezra-Nehemiah: A Commentary|publisher=Eerdmans|year=1988|url=https://books.google.com/books?id=3PvirfZkfvQC&q=Ezra-Nehemiah:+A+Commentary++By+Joseph+Blenkinsopp|isbn=978-0-664-22186-7}} * {{Rejea kitabu|last=Blenkinsopp|first=Joseph|chapter=Bethel in the Neo-Babylonian Period|editor-last=Blenkinsopp|editor-first=Joseph|editor-last2=Lipschits|editor-first2=Oded|title=Judah and the Judeans in the Neo-Babylonian Period|publisher=Eisenbrauns|year=2003|url=https://books.google.com/books?id=R65fhpcUFcgC|isbn=978-1-57506-073-6}} * {{Rejea kitabu|last=Blenkinsopp|first=Joseph|title=Judaism, the First Phase: The Place of Ezra and Nehemiah in the Origins of Judaism|publisher=Eerdmans|year=2009|url=https://books.google.com/books?id=m1V1DeBS6P0C&q=Judaism,+the+first+phase:+the+place+of+Ezra+and+Nehemiah|isbn=978-0-8028-6450-5}} * {{cite journal |last1=Broshi |first1=Magen |last2=Finkelstein |first2=Israel |year=1992 |title=The Population of Palestine in Iron Age II |url=https://archive.org/details/sim_bulletin-of-the-american-schools-of-oriental-research_1992-08_287/page/46 |journal=BASOR |issue=287 |pages=47–60 |doi=10.2307/1357138|jstor=1357138}} * {{Rejea kitabu|last=Cahill|first=Jane M.|chapter=Jerusalem at the Time of the United Monarchy|editor-last=Vaughn|editor-first=Andrew G.|editor-last2=Killebrew|editor-first2=Ann E.|title=Jerusalem in Bible and Archaeology: The First Temple Period|publisher=Sheffield|year=1992|url=https://books.google.com/books?id=yYS4VEu08h4C|isbn=978-1-58983-066-0}} * {{Rejea kitabu|editor-last=Coogan|editor-first=Michael D.|title=The Oxford History of the Biblical World|publisher=Oxford University Press|year=1998|url=https://books.google.com/books?id=zFhvECwNQD0C|isbn=978-0-19-513937-2}} * {{Rejea kitabu|last=Davies|first=Philip R.|title=In Search of Ancient Israel|publisher=Sheffield|year=1992|url=https://books.google.com/books?id=pMcM8GGO_n8C|isbn=978-1-85075-737-5}} * {{Rejea kitabu|last=Davies|first=Philip R.|chapter=The Origin of Biblical Israel|editor-last=Amit|editor-first=Yaira|editor-last2=Ben Zvi|editor-first2=Ehud|editor-last3=Finkelstein|editor-first3=Israel|editor-last4=Lipschits|editor-first4=Oded|display-editors=1|title=Essays on Ancient Israel in its Near Eastern Context: A Tribute to Nadav Na'aman|publisher=Eisenbrauns|year=2006|chapter-url=https://books.google.com/books?id=Ku4OKVrEd4MC&pg=PA467|isbn=978-1-57506-128-3}} * {{Rejea jarida|last=Davies |first=Philip R. |title=The Origin of Biblical Israel |journal=[[Journal of Hebrew Scriptures]] |issue=47 |volume=9 |year=2009 |url=http://www.arts.ualberta.ca/JHS/Articles/article_47.htm |url-status=dead |archive-url=https://web.archive.org/web/20080528230034/http://www.arts.ualberta.ca/JHS/Articles/article_47.htm |archive-date=28 May 2008}} * {{cite book |last=Dever |first=William G. |chapter=From Tribe to Nation: State Formation Processes in Ancient Israel |editor-last=Mazzoni |editor-first=Stefania |title=Nuove fondazioni nel vicino oriente antico: Realtà e ideologia |pages=213–229 |location=Pisa |publisher=Giardini |year=1994}} * {{Rejea kitabu |last=Dever|first=William G. |author-link= William G. Dever |title=Who Were the Early Israelites and Where Did They Come From?|publisher=Eerdmans|year=2003|url=https://books.google.com/books?id=8WkbUkKeqcoC|isbn=978-0-8028-0975-9}} * {{Rejea kitabu |last=Dever |first=William G. |title=Did God Have a Wife?: Archaeology and Folk Religion in Ancient Israel|publisher=Eerdmans|year=2005|url=https://books.google.com/books?id=6AOE9sxg3bMC|isbn=978-0-8028-2852-1}} * {{Rejea kitabu |last= Dever |first= William G. |title= Beyond the Texts: An Archaeological Portrait of Ancient Israel and Judah |publisher= SBL Press |year= 2017 |isbn= 978-0-88414-217-1 |url= https://books.google.com/books?id=mog6DwAAQBAJ}} * {{Rejea kitabu|editor-last=Dunn|editor-first=James D.G.|editor-last2=Rogerson|editor-first2=John William|title=Eerdmans commentary on the Bible|publisher=Eerdmans|year=2003|url=https://books.google.com/books?id=2Vo-11umIZQC&pg=PA153|isbn=978-0-8028-3711-0}} * {{Rejea kitabu|last=Edelman|first=Diana|chapter=Ethnicity and Early Israel|editor-last=Brett|editor-first=Mark G.|title=Ethnicity and the Bible|publisher=Brill|year=2002|chapter-url=https://books.google.com/books?id=RfFRhC4FpZkC&pg=PA45|isbn=978-0-391-04126-4}} * {{cite book |last=Faust |first=Avraham |title=Israel's Ethnogenesis: Settlement, Interaction, Expansion and Resistance |publisher=Equinox |year=2006 |location=London}} * {{cite journal |last=Faust |first=Avraham |year=2008 |title=Settlement and Demography in Seventh-Century Judah and the Extent and Intensity of Sennacherib's Campaign |url=https://archive.org/details/palestine-exploration-quarterly_2008-11_140_3/page/168 |journal=Palestine Exploration Quarterly |volume=140 |issue=3 |pages=168–194 |doi=10.1179/174313008X341528}} * {{cite book |last1=Finkelstein |first1=Israel |title=The Bible Unearthed: Archaeology's New Vision of Ancient Israel and the Origin of Its Sacred Texts |url=https://archive.org/details/bibleunearthedar00fink |last2=Silberman |first2=Neil Asher |publisher=Touchstone |year=2002 |isbn=0684869136}} * {{cite book |last=Finkelstein |first=Israel |title=The Forgotten Kingdom: The Archaeology and History of Northern Israel |publisher=Society of Biblical Literature |year=2013 |isbn=978-1-58983-911-3 |series=Ancient Near East Monographs |volume=5}} * {{cite journal |author1-first=Israel |author1-last=Finkelstein |author2-first=Yuval |author2-last=Gadot |author3-first=Dafna |author3-last=Langgut |title=The Unique Specialised Economy of Judah under Assyrian Rule and its Impact on the Material Culture of the Kingdom |journal=Palestine Exploration Quarterly |year=2021 |volume=154 |issue=4 |pages=261–279 |doi=10.1080/00310328.2021.1949531}} * {{cite journal |last=Garfinkel |first=Yosef |year=2017 |editor-last=Schroer |editor-first=Silvia |editor2-last=Münger |editor2-first=Stefan |title=Khirbet Qeiyafa in the Shephelah: Data and Interpretations |journal=Khirbet Qeiyafa in the Shephelah: Papers Presented at a Colloquium of the Swiss Society for Ancient Near Eastern Studies Held at the University of Bern, September 6, 2014 |location=Fribourg, Switzerland / Göttingen, Germany |publisher=Academic Press / Vandenhoeck & Ruprecht |pages=5–59}} * {{cite journal |last=Garfinkel |first=Yosef |year=2023 |title=Early City Planning in the Kingdom of Judah: Khirbet Qeiyafa, Beth Shemesh 4, Tell en-Naṣbeh, Khirbet ed-Dawwara, and Lachish V |journal=Jerusalem Journal of Archaeology |volume=4 |issue= |pages=87–107 |jstor=|doi=10.52486/01.00004.4}} * {{Rejea kitabu|last=Gnuse|first=Robert Karl|title=No Other Gods: Emergent Monotheism in Israel|publisher=Sheffield Academic Press|year=1997|url=https://books.google.com/books?id=0Kf1ZwDifdAC|isbn=978-1-85075-657-6}} * {{Rejea kitabu|last=Golden|first=Jonathan Michael|title=Ancient Canaan and Israel: An Introduction|publisher=Oxford University Press|date=2004a|url=https://books.google.com/books?id=EResmS5wOnkC&q=Ancient+Canaan+and+Israel:+An+Introduction++By+Jonathan+M+Golden|isbn=978-0-19-537985-3}} * {{Rejea kitabu|last=Golden|first=Jonathan Michael|title=Ancient Canaan and Israel: New Perspectives|publisher=ABC-CLIO|date=2004b|url=https://books.google.com/books?id=yTMzJAKowyEC&pg=PA62|isbn=978-1-57607-897-6}} * {{Rejea kitabu|last=Grabbe|first=Lester L.|title=A History of the Jews and Judaism in the Second Temple Period|publisher=T&T Clark International|year=2004|url=https://books.google.com/books?id=VK2fEzruIn0C|isbn=978-0-567-04352-8}} * {{Rejea kitabu|editor-last=Grabbe|editor-first=Lester L.|title=Israel in Transition: From Late Bronze II to Iron IIa (c. 1250–850 B.C.E.)|publisher=T&T Clark International|year=2008|url=https://books.google.com/books?id=tR0Qpz2zRogC|isbn=978-0-567-02726-9}} * {{cite book |last=Grabbe |first=Lester L. |title=Ancient Israel: What Do We Know and How Do We Know It? |publisher=Bloomsbury T&T Clark |year=2017 |isbn=978-0-567-67043-4 |edition=Rev |location=London |pages=}} * {{cite book |last=Grabbe |first=Lester L. |title=The Dawn of Israel: A History of Canaan in the Second Millennium BCE |publisher=Bloomsbury T&T Clark |year=2022 |isbn=9780567663221 |location=London}} * {{cite book |last=Kelle |first=Brad E. |chapter=The Early Monarchy and the Stories of Saul, David, and Solomon | editor-last=Niditch | editor-first=Susan | title=The Wiley Blackwell Companion to Ancient Israel |publisher=John Wiley & Sons Ltd |year=2016 |pages=176–196 |isbn=9780470656778 |doi=10.1002/9781118774199.ch10 | url=https://onlinelibrary.wiley.com/doi/10.1002/9781118774199.ch10}} * {{Rejea kitabu|last=Killebrew|first=Ann E.|title=Biblical Peoples and Ethnicity: An Archaeological Study of Egyptians, Canaanites, and Early Israel, 1300–1100 B.C.E|publisher=Society of Biblical Literature|year=2005|url=https://books.google.com/books?id=VtAmmwapfVAC|isbn=978-1-58983-097-4}} * {{cite book |last=Killebrew |first=Ann E. |title='I Will Speak the Riddles of Ancient Times': Archaeological and Historical Studies in Honor of Amihai Mazar on the Occasion of his Sixtieth Birthday |publisher=Eisenbrauns |year=2006 |editor1-last=Maeir |editor1-first=Aren M. |location=Winona Lake, IN |pages=555–572 |chapter=The Emergence of Ancient Israel: The Social Boundaries of a “Mixed Multitude” in Canaan |editor2-last=de Miroschedji |editor2-first=Pierre}} * {{Rejea kitabu|last1=King|first1=Philip J.|last2=Stager|first2=Lawrence E.|title=Life in Biblical Israel|publisher=Westminster John Knox Press|year=2001|isbn=978-0-664-22148-5|url=https://archive.org/details/lifeinbiblicalis0000king|url-access=registration}} * {{cite book |last=Knoppers |first=Gary |title=Jews and Samaritans: The Origins and History of Their Early Relations |url=https://archive.org/details/jewssamaritansor0000knop |publisher=Oxford University Press |year=2013 |isbn=978-0195329544}} * {{Rejea kitabu|last=Kottsieper|first=Ingo|chapter=And They Did Not Care to Speak Yehudit|editor-last=Lipschits|editor-first=Oded|editor-last2=Knoppers|editor-first2=Gary N.|editor-last3=Albertz|editor-first3=Rainer|display-editors=1|title=Judah and the Judeans in the Fourth Century B.C.E.|publisher=Eisenbrauns|year=2006|chapter-url=https://books.google.com/books?id=6NsxZRnxE70C&pg=PA75|isbn=978-1-57506-130-6}} * {{Rejea kitabu|last=Kuhrt|first=Amélie|title=The Ancient Near East c. 3000–330&nbsp;BC|publisher=Routledge|year=1995|url=https://books.google.com/books?id=V_sfMzRPTgoC&q=Am%C3%A9lie+Kuhrt+The+ancient+Near+East|isbn=978-0-415-16763-5}} * {{Rejea kitabu|last=Lehman|first=Gunnar|chapter=The United Monarchy in the Countryside|editor-last=Vaughn|editor-first=Andrew G.|editor-last2=Killebrew|editor-first2=Ann E.|title=Jerusalem in Bible and Archaeology: The First Temple Period|publisher=Sheffield|year=1992|url=https://books.google.com/books?id=yYS4VEu08h4C|isbn=978-1-58983-066-0}} * {{Rejea kitabu|last=Lemaire|first=André|author-link=André Lemaire|chapter=Nabonidus in Arabia and Judea During the Neo-Babylonian Period|editor-last=Blenkinsopp|editor-first=Joseph|editor-last2=Lipschits|editor-first2=Oded|title=Judah and the Judeans in the Neo-Babylonian Period|publisher=Eisenbrauns|year=2003|url=https://books.google.com/books?id=R65fhpcUFcgC&q=Judah+and+the+Judeans+in+the+neo-Babylonian+period|isbn=978-1-57506-073-6}} * {{Rejea kitabu|last=Lemche|first=Niels Peter|title=The Israelites in History and Tradition|publisher=Westminster John Knox Press|year=1998|url=https://books.google.com/books?id=JIoY7PagAOAC|isbn=978-0-664-22727-2}} * {{Rejea kitabu|last=Lipschits|first=Oded|title=The Fall and Rise of Jerusalem|publisher=Eisenbrauns|year=2005|url=https://books.google.com/books?id=78nRWgb-rp8C&q=Lipschitz,+Oded+fall+and+rise|isbn=978-1-57506-095-8}} * {{Rejea kitabu|last1=Lipschits|first1=Oded|first2=David|last2=Vanderhooft|chapter=Yehud Stamp Impressions in the Fourth Century B.C.E.|editor-last=Lipschits|editor-first=Oded|editor-last2=Knoppers|editor-first2=Gary N.|editor-last3=Albertz|editor-first3=Rainer|display-editors=1|title=Judah and the Judeans in the Fourth Century B.C.E.|publisher=Eisenbrauns|year=2006|chapter-url=https://books.google.com/books?id=6NsxZRnxE70C&pg=PA75|isbn=978-1-57506-130-6}} * {{cite book |last=Lipschits |first=Oded |title=Judah in the Biblical Period: Historical, Archaeological and Biblical Studies – Selected Essays |publisher=De Gruyter |year=2024 |isbn=9783110484236 |series=Beihefte zur Zeitschrift für die alttestamentliche Wissenschaft |volume=497}} * {{cite book |last=Maeir |first=Aren M. |chapter=Iron Age I Philistines: Entangled Identities in a Transformative Period |editor1=Yasur-Landau, Assaf |editor2=Cline, Eric H. |editor3=Rowan, Yorke |title=The Social Archaeology of the Levant: From Prehistory to the Present |publisher=Cambridge University Press |year=2018 |pages=320 |doi=10.1017/9781316661468.018 |isbn=978-1-107-15668-5}} * {{Rejea kitabu|last=Mazar|first=Amihay|chapter=The Divided Monarchy: Comments on Some Archaeological Issues|editor-last=Schmidt|editor-first=Brian B.|title=The Quest for the Historical Israel|publisher=Society of Biblical Literature|year=2007|url=https://books.google.com/books?id=jpbngoKHg8gC|isbn=978-1-58983-277-0}} * {{Rejea kitabu |last=Magness |first=Jodi |title=The Archaeology of the Holy Land: From the Destruction of Solomon's Temple to the Muslim Conquest |url=https://archive.org/details/archaeologyofhol0000magn |publisher=Cambridge University Press |year=2012 |isbn=978-1-139-01383-3}} * {{Rejea kitabu |last=Magness |first=Jodi |url=https://global.oup.com/academic/product/jerusalem-through-the-ages-9780190937805 |title=Jerusalem Through The Ages: From Its Beginnings To The Crusades |publisher=Oxford University Press |year=2024 |isbn=978-0-19-093780-5 |series= |volume= |location=New York, NY |pages= |chapter=}} * {{cite book |last1=Meyers |first1=Eric M. |last2=Rogerson |first2=John |title=The Cambridge Companion to the Bible |url=https://archive.org/details/cambridgecompani0000john |chapter=The World of the Hebrew Bible |editor1-last=Chilton |editor1-first=Bruce |editor2-last=Kee |editor2-first=Howard Clark |editor3-last=Meyers |editor3-first=Eric M. |editor4-last=Rogerson |editor4-first=John |editor5-last=Levine |editor5-first=Amy-Jill |editor6-last=Saldarini |editor6-first=Anthony J. |publisher=Cambridge University Press |year=1997 |pages=[https://archive.org/details/cambridgecompani0000john/page/2 3]–28 |isbn=9780521481441}} * {{Rejea kitabu|last=McNutt|first=Paula|title=Reconstructing the Society of Ancient Israel|publisher=Westminster John Knox Press|year=1999|url=https://books.google.com/books?id=hd28MdGNyTYC&pg=PA33|isbn=978-0-664-22265-9}} * {{Rejea kitabu|last=Middlemas|first=Jill Anne|title=The Troubles of Templeless Judah|publisher=Oxford University Press|year=2005|url=https://books.google.com/books?id=Jrpx-op_-XkC&q=lester+grabbe+1995|isbn=978-0-19-928386-6}} * {{Rejea kitabu|last1=Miller|first1=James Maxwell|author-link1=J. Maxwell Miller (biblical scholar)|last2=Hayes|first2=John Haralson|title=A History of Ancient Israel and Judah|publisher=The Westminster Press|location=Philadelphia|year=1986|isbn=978-0-664-21262-9|url=https://archive.org/details/historyofancient00mill}} * {{Rejea kitabu|last=Niehr|first=Herbert|chapter=Religio-Historical Aspects of the Early Post-Exilic Period|editor-last=Becking|editor-first=Bob|editor-last2=Korpel|editor-first2=Marjo Christina Annette|title=The Crisis of Israelite Religion: Transformation of Religious Tradition in Exilic and Post-Exilic Times|publisher=Brill|year=1999|url=https://books.google.com/books?id=lak_YWjCjDMC|isbn=978-90-04-11496-8}} * {{Rejea kitabu|last=Nodet|first=Étienne|title=A Search for the Origins of Judaism: From Joshua to the Mishnah|publisher=Sheffield Academic Press|year=1999 |url=https://books.google.com/books?id=rE49wYHz5YUC|isbn=978-1-85075-445-9}} * {{Rejea jarida |last=Rainey |first=Anson |year=2008 |title=Shasu or Habiru: Who Were the Early Israelites? |journal=Biblical Archaeology Review |volume=34 |issue=6 |pages=51–55}} * {{Rejea kitabu |last=Roberts |first=J. J. M. |url=https://doi.org/10.1002/9781118774199.ch11 |title=The Wiley Blackwell Companion to Ancient Israel |publisher=John Wiley & Sons |year=2016 |isbn=9781118774199 |editor-last=Niditch |editor-first=Susan |pages=197–212 |chapter=The Divided Monarchy|doi=10.1002/9781118774199.ch11}} * {{Rejea kitabu|last=Smith|first=John Arthur|title=Music in Religious Cults of the Ancient Near East|publisher=Routledge|year=2021|url=https://www.routledge.com/Music-in-Religious-Cults-of-the-Ancient-Near-East/Smith/p/book/9780367486358?srsltid=AfmBOooS8ghp_rf1d6fxLk64blJbSqZ32TTDvjAs695ggQ_MVa4Sjlgu|isbn=9780367486358}} * {{Rejea kitabu|last=Smith|first=Mark S.|title=The Early History of God|publisher=Eerdmans|year=2002 |url=https://books.google.com/books?id=1yM3AuBh4AsC|isbn=978-0-8028-3972-5}} * {{Rejea kitabu|last=Soggin|first=Michael J.|title=An Introduction to the History of Israel and Judah|publisher=Paideia|year=1998|url=https://books.google.com/books?id=Dzw_H5GhkfYC|isbn=978-0-334-02788-1}} * {{Rejea kitabu|last=Stager|first=Lawrence E.|chapter=Forging an Identity: The Emergence of Ancient Israel|editor-last=Coogan|editor-first=Michael D.|title=The Oxford History of the Biblical World|publisher=Oxford University Press|year=1998|url=https://books.google.com/books?id=zFhvECwNQD0C|isbn=978-0-19-513937-2}} * {{Rejea kitabu |last1=Stiebing |first1=William H. |title=Ancient Near Eastern History and Culture |last2=Helft |first2=Susan N. |publisher=Routledge |year=2023 |isbn=9780367744250 |edition=4th}} * {{Rejea kitabu|last=Thompson|first=Thomas L.|title=Early History of the Israelite People|publisher=Brill|year=1992|url=https://archive.org/details/earlyhistoryofis00thom|url-access=registration|isbn=978-90-04-09483-3}} * {{Rejea jarida |last=Ussishkin |first=David |title=The 'Lachish Reliefs' and the City of Lachish |url=https://archive.org/details/sim_israel-exploration-journal_1980_30_3-4/page/174 |journal=Israel Exploration Journal |year=1980 |volume=30 |pages=174–195}} * {{Rejea kitabu|last=Van der Toorn|first=Karel|title=Family Religion in Babylonia, Syria, and Israel|publisher=Brill|year=1996|url=https://books.google.com/books?id=VSJWkrXfbLQC&q=Family+religion+in+Babylonia,+Syria,+and+Israel|isbn=978-90-04-10410-5}} * {{Rejea kitabu|last1=Van der Toorn|first1=Karel|last2=Becking|first2=Bob|last3=Van der Horst|first3=Pieter Willem|title=Dictionary of Deities and Demons in the Bible|publisher=Koninklijke Brill|year=1999|edition=2d|url=https://books.google.com/books?id=yCkRz5pfxz0C&q=Dictionary+of+Deities|isbn=978-0-8028-2491-2}} * {{Rejea kitabu|last=Wylen|first=Stephen M.|title=The Jews in the Time of Jesus: An Introduction|publisher=Paulist Press|year=1996|url=https://archive.org/details/jewsintimeofjesu0000wyle|url-access=registration|isbn=978-0-8091-3610-0}} {{refend}} ==Marejeo mengine== * {{cite book | last1=Arnold | first1=Bill T. | last2=Hess | first2=Richard S. | title=Ancient Israel's History: An Introduction to Issues and Sources | publisher=Baker Academic | year=2014 | isbn=978-1-4412-4634-9 | url=https://books.google.com/books?id=aTpBBAAAQBAJ}} * {{cite book | last=Brettler | first=Marc Zvi | title=The Creation of History in Ancient Israel | publisher=Routledge | year=1998 | isbn=978-0-415-19407-5 | url=https://books.google.com/books?id=xvfCESeU_hwC&pg=PA196}} * {{cite book | last=Cook | first=Stephen L. | title=The Social Roots of Biblical Yahwism | publisher=Society of Biblical Lit | year=2004 | isbn=978-1-58983-098-1 | url=https://books.google.com/books?id=4LEA7FnNi-kC}} * {{cite book | last1=Seminar | first1=Oxford Old Testament | last2=Day | first2=John | title=In Search of Pre-Exilic Israel | publisher=A&C Black | year=2004 | isbn=978-0-567-08206-0 | url=https://books.google.com/books?id=yM_X2yzRLx4C}} * {{cite book | last=Frevel | first=Christian | title=History of Ancient Israel | publisher=SBL Press | year=2023 | isbn=978-1-62837-514-5 | url=https://books.google.com/books?id=Yvy6EAAAQBAJ}} * {{cite book | last=Hess | first=Richard S. | title=Israelite Religions: An Archaeological and Biblical Survey | publisher=Baker Academic | year=2007 | isbn=978-1-4412-0112-6 | url=https://books.google.com/books?id=2jNoqNRDYDUC}} * {{cite book | last1=Keimer | first1=Kyle H. | last2=Pierce | first2=George A. | title=The Ancient Israelite World | publisher=Taylor & Francis | year=2022 | isbn=978-1-000-77324-8 | url=https://books.google.com/books?id=4beREAAAQBAJ}} * {{cite book | last1=Kelle | first1=Brad E. | last2=Strawn | first2=Brent A. | title=The Oxford Handbook of the Historical Books of the Hebrew Bible | publisher=Oxford University Press | year=2020 | isbn=978-0-19-026116-0 | url=https://books.google.com/books?id=7y4DEAAAQBAJ}} * {{cite book | last1=Knauf | first1=Ernst Axel | last2=Niemann | first2=Hermann Michael | title=Geschichte Israels und Judas im Altertum | publisher=De Gruyter | year= 2021 | isbn=978-3-11-041168-3 | doi=10.1515/9783110411683 | language = de}} * {{cite book | last=Lemche | first=Niels Peter | title=The Old Testament Between Theology and History: A Critical Survey | publisher=Westminster John Knox Press | year= 2008 | isbn=978-0-664-23245-0 | url=https://books.google.com/books?id=RWqLVc7ccG0C}} * {{cite book | last=Levine | first=Lee I. | title=Jerusalem: Portrait of the City in the Second Temple Period (538 B.C.E. ? 70 C.E.) | publisher=Jewish Publication Society | year= 2002 | isbn=978-0-8276-0750-7 | url=https://books.google.com/books?id=gqL8C_JBEm0C&pg=PA196}} * {{cite book | last=Naʼaman | first=Nadav | title=Ancient Israel and Its Neighbors: Interaction and Counteraction | publisher=Eisenbrauns | year=2005 | isbn=978-1-57506-108-5 | url=https://books.google.com/books?id=1RgRPAkLqLUC}} * {{cite book | last=Niditch | first=Susan | title=The Wiley Blackwell Companion to Ancient Israel | publisher=John Wiley & Sons |year= 2016 | isbn=978-0-470-65677-8 | url=https://books.google.com/books?id=-eMACgAAQBAJ}} * {{cite book | last=Sparks | first=Kenton L. | title=Ethnicity and Identity in Ancient Israel: Prolegomena to the Study of Ethnic Sentiments and Their Expression in the Hebrew Bible | publisher=Eisenbrauns |year=1998 | isbn=978-1-57506-033-0 | url=https://books.google.com/books?id=KztVonFGqcsC}} * {{cite book | last=Vanderkam | first=James C. | title=An Introduction to Early Judaism | publisher=Wm. B. Eerdmans Publishing | year= 2022 | isbn=978-1-4674-6405-5 | url=https://books.google.com/books?id=1cuAEAAAQBAJ}} == Viungo vya nje == * [http://www.dinur.org/resources/resourceCategoryDisplay.aspx?categoryID=411&rsid=478 Biblical History] {{Wayback|url=http://www.dinur.org/resources/resourceCategoryDisplay.aspx?categoryID=411&rsid=478 |date=20100302125929 }} The Jewish History Resource Center - Project of the Dinur Center for Research in Jewish History, The Hebrew University of Jerusalem * [http://www.newadvent.org/cathen/08344a.htm Catholic Encyclopedia: Jerusalem (Before A.D. 71)] * [http://www.jnul.huji.ac.il/dl/maps/pal/html/ Holy land Maps] {{Wayback|url=http://www.jnul.huji.ac.il/dl/maps/pal/html/ |date=20090822042539 }} [[Jamii:Historia ya Israeli]] [[Jamii:Historia ya Biblia]] t7nrqw1ofmasj6nfo7z9jwov3wvv69y 0 16757 1578124 1528841 2026-07-02T21:02:35Z InternetArchiveBot 41439 Add 13 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578124 wikitext text/x-wiki '''Vijasumu''' (kutoka [[Kiyunani]] βακτήριον, baktērion, yaani "kifimbo", kutokana na [[umbo]] la vijasumu vya kwanza kugundulika; pia: '''bakteria''') ni [[viumbehai]] wadogo sana aina ya [[vidubini]]. [[Mwili]] wa vijasumu huwa na [[seli]] moja tu. Huonekana kwa [[hadubini]] tu na kwa sababu hiyo hawakujulikana katika [[karne]] za kale. {{Uainishaji (Mimea) | rangi = lightgrey | jina = Bakteria | picha = Clostridium botulinum.jpg | upana_wa_picha = 250px | maelezo_ya_picha = Bakteria aina ya ''Clostridium botulinum'' katika [[hadubini]] | domeni = [[Bakteria]] | subdivision = Faili *'''[[Gram positive]] / haina utando wa nje''' [[Actinobacteria]] (ina guanini na sitosini nyingi)<br /> [[Firmicutes]] (ina guanini na sitosini chache)<br> [[Tenericutes]] (haina ganda la nje) *'''[[Gram negative]] / ina utando wa nje''' [[Aquificae]]<br/> [[Deinococcus-Thermus]]<br/> [[Fibrobacteres]]–[[Chlorobi]]/[[Bacteroidetes]] ([[Sphingobacteria (phylum)|kundi la FCB]])<br/> [[Fusobacteria]]<br /> [[Gemmatimonadetes]]<br /> [[Nitrospirae]]<br /> [[Planctomycetes]]–[[Verrucomicrobia]]/[[Chlamydiae]] ([[Planctobacteria|kundi la PVC]])<br/> [[Proteobacteria]]<br /> [[Spirochaete]]s<br /> [[Synergistetes]] *'''Isiyoainishwa''' [[Acidobacteria]]<br /> [[Chloroflexi (phylum)|Chloroflexi]]<br /> [[Chrysiogenetes]]<br /> [[Cyanobacteria]]<br /> [[Deferribacteraceae|Deferribacteres]]<br /> [[Dictyoglomi]]<br /> [[Thermodesulfobacteria]]<br /> [[Thermotogae]] }} [[Picha:E. coli Bacteria (7316101966).jpg|thumb|180px|Bakteria ya [[Escherichia coli]] ziliongezwa ukubwa mara 25,000.]] Kuna aina nyingi sana za vijasumu na [[idadi]] yao ni kubwa kushinda viumbe vingine vyote [[duniani]]. Huishi kwenye [[ardhi]] na kwenye [[maji]], ziko pia [[Hewa|hewani]] zinaposukumwa na [[upepo]]. Aina nyingi huishi ndani ya viumbe vikubwa zaidi. [[Mwanadamu]] huwa na bakteria nyingi ndani ya [[utumbo]] wake ambazo ni za lazima kwa [[mmeng'enyo]] wa [[chakula]]. Hata katika [[ngozi]] kuna bakteria nyingi ambazo zinakinga mwili dhidi ya vidubini vilivyo tishio. Lakini bakteria nyingine katika [[mazingira]] huweza kusababisha [[Ugonjwa|magonjwa]] na sehemu kubwa ya [[magonjwa ya kuambukiza]] yametokana na bakteria. Bakteria huzaa kwa njia ya kujigawa na kuwa bakteria mbili ambazo ni sawa na seli asilia. Bakteria ya kawaida huwa na [[kipenyo]] cha [[µm]] 1. ==Historia ya elimu vijasumu== {{main|Mikrobiolojia}} [[File:Jan Verkolje - Antonie van Leeuwenhoek.jpg|thumb|240px|right|Antonie van Leeuwenhoek, mwanamikrobiolojia wa kwanza na mtu wa kwanza aliyeona bakteria kwa darubini.]] Bakteria waligunduliwa mara ya kwanza na [[Antonie van Leeuwenhoek]] [[mwaka]] wa [[1676]], kwa kutumia [[hadubini|hadubini ya lensi moja]] ya muundo wake mwenyewe.<ref>{{cite journal |author=Porter JR |title=Antony van Leeuwenhoek: tercentenary of his discovery of bacteria |journal=Bacteriological Reviews |volume=40 |issue=2 |pages=260–9 |year=1976 |month=June |pmid=786250 |pmc=413956 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=786250}}</ref> Aliwaita "animalcules" na alichapisha habari za [[utafiti]] wake kwenye msururu wa [[barua]] kwa Shirika la Muungano wa Mfalme. Jina ''bacteriam'' lililetwa miaka mingi baadaye, na Christian Gottfried Ehrenberg katika mwaka wa 1838.<ref>{{cite web | url = http://www.etymonline.com/index.php?term=bacteria | title = Etymology of the word "bacteria" | work = Online Etymology dictionary | accessdate = 2006-11-23}}</ref> Mwaka [[1859]] [[Louis Pasteur]] alionyesha kuwa mchakato wa kuchachusha unasababishwa na ukuaji wa vijiumbe, na kwamba ukuaji huu si wa kizazi cha kujianzia. ([[Hamira]] na [[kuvu]], ambazo kwa kawaida zinahusishwa na uchachushaji, si bakteria, ila ukungu.) Pamoja na mwenzake, [[Robert Koch]], Pasteur alikuwa wa kwanza kuitetea nadharia ya kijidudu ya ugonjwa.<ref>{{cite web | url = http://biotech.law.lsu.edu/cphl/history/articles/pasteur.htm#paperII | title = Pasteur's Papers on the Germ Theory | publisher = LSU Law Center's Medical and Public Health Law Site, Historic Public Health Articles | accessdate = 2006-11-23}}</ref> Robert Koch alikuwa [[mwanzilishi]] wa [[taaluma]] ya [[uuguzi]] wa [[mikrobiolojia]] na alishughulikia [[kipindupindu]], [[kimeta]] na [[kifua kikuu]]. Katika utafiti wake wa kifua kikuu, Koch hatimaye alithibitisha nadharia ya kijidudu, ambayo ilimfanya atunukiwe [[Tuzo ya Nobel ya Tiba|Tuzo]] la [[Tuzo ya Nobel ya Tiba|Nobel]] mwaka wa [[1905]].<ref>{{cite web | url = http://nobelprize.org/nobel_prizes/medicine/laureates/1905/ | title = The Nobel Prize in Physiology or Medicine 1905 | publisher = Nobelprize.org | accessdate = 2006-11-22}}</ref> Katika madai yake, Koch aliweka vigezo vya kutathmini kama kiumbe ndicho husababisha ugonjwa, na madai haya yanatumika mpaka leo hii.<ref>{{cite journal |author=O'Brien S, Goedert J |title=HIV causes AIDS: Koch's postulates fulfilled |journal=Curr Opin Immunol |volume=8 |issue=5 |pages=613–618 |year=1996 |pmid=8902385 |doi=10.1016/S0952-7915(96)80075-6}}</ref> Ingawa katika [[karne ya 19]] ilijulikana kwamba bakteria ndio chanzo cha magonjwa mengi, hakuna [[matibabu]] yoyote ya viuabakteria yaliyopatikana.<ref>{{cite journal |author=Thurston A |title=Of blood, inflammation and gunshot wounds: the history of the control of sepsis |journal=Aust N Z J Surg |volume=70 |issue=12 |pages=855–61 |year=2000 |pmid=11167573 |doi=10.1046/j.1440-1622.2000.01983.x}}</ref> Katika mwaka wa [[1910]], [[Paul Ehrlich]] alitengeneza [[kiuavijasumu]] cha kwanza, kwa kubadilisha [[rangi]] ambazo kwa kuchagua zilitia mawaa ''Treponema pallidum'', spirokaeti ambayo husababisha [[kaswende]] katika mchanganyiko wa ambao uliua kisababishi magonjwa.<ref>{{cite journal |author=Schwartz R |title=Paul Ehrlich's magic bullets |url=https://archive.org/details/sim_new-england-journal-of-medicine_2004-03-11_350_11/page/1078 |journal=N Engl J Med |volume=350 |issue=11 |pages=1079–80 |year=2004|pmid = 15014180 |doi=10.1056/NEJMp048021}}</ref> Ehrlich alikuwa ametuzwa [[Tuzo la Nobel]] mwaka [[1908]] kwa kazi yake kuhusu [[elimu ya kingamaradhi]], na alianzisha matumizi ya madoa ili kuchunguza na kubaini bakteria, na kazi yake ilijikita kwenye misingi ya [[doa la Gram]] na [[doa la Ziehl-Neelsen]].<ref>{{cite web | url = http://nobelprize.org/nobel_prizes/medicine/laureates/1908/ehrlich-bio.html | title = Biography of Paul Ehrlich | publisher = Nobelprize.org | accessdate = 2006-11-26}}</ref> Mafanikio makubwa katika utafiti wa bakteria yalikuwa kutambuliwa kwa [[Carl Woese]] mwaka [[1977]] kwamba [[Archaea|akea]] walitokana na mabadiliko tofauti na yale ya bakteria.<ref>{{cite journal |author=Woese C, Fox G |title=Phylogenetic structure of the prokaryotic domain: the primary kingdoms |journal=Proc Natl Acad Sci USA |volume=74 |issue=11 |pages=5088–5090 |year=1977|pmid = 270744 |doi=10.1073/pnas.74.11.5088 |pmc=432104}}</ref> [[Uanishaji]] huu mpya wa jamii ya filojenetiki ulikitwa kwenye misingi ya kufululizwa kwa [[ribosomu]] [[RNA]] 16S, ukagawa [[prokaryota]] katika makundi mawili yenye mageuko tofauti, kama mojawapo ya sehemu ya mifumo ya vikoa vitatu.<ref name="Woese">{{cite journal |author=Woese CR, Kandler O, Wheelis ML |title=Towards a natural system of organisms: proposal for the domains Archaea, Bacteria, and Eucarya |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=87 |issue=12 |pages=4576–9 |year=1990 |month=June |pmid=2112744 |doi=10.1073/pnas.87.12.4576 |pmc=54159}}</ref> ==Asili na mabadiliko ya awali== {{main|Mageuko ya spishi}} Asili ya bakteria wa sasa ilikuwa vijiumbe vya seli moja ambavyo ndivyo [[viumbehai]] wa kwanza duniani, takriban miaka [[bilioni]] 4 iliyopita. Karibu miaka bilioni 3 iliyopita, viumbe wote walikuwa hawawezi kuonekana kwa [[macho]], na bakteria na akea walikuwa ndio aina kubwa za viumbehai duniani.<ref>{{cite journal |author=Schopf J |title=Disparate rates, differing fates: tempo and mode of evolution changed from the Precambrian to the Phanerozoic |journal=Proc Natl Acad Sci USA |volume=91 |issue=15 |pages=6735–42 |year=1994 |pmid=8041691 |pmc=44277 |doi=10.1073/pnas.91.15.6735}}</ref><ref>{{cite journal |author=DeLong E, Pace N |title=Environmental diversity of bacteria and archaea |journal=Syst Biol |volume=50 |issue=4 |pages=470–78 |year=2001|pmid = 12116647 |doi=10.1080/106351501750435040}}</ref> Ingawa [[Kisukuku|visukuku]] vya bakteria vipo, kama vile [[stromatoliti]], ukosefu wao wa [[umbo]] maalumu unazuia kutumiwa katika uchunguzi wa [[historia]] ya mabadiliko ya bakteria, au kueleza lini [[spishi]] ya bakteria maalumu ilianza. Hata hivyo, mpangilio wa [[jeni]] unaweza kutumiwa kuelezea upya [[filojeni]] ya bakteria, na utafiti huo unaonyesha kuwa bakteria wa kwanza walitokana na [[nasaba]] ya akea / eukaryota.<ref>{{cite journal |author=Brown JR, Doolittle WF |title=Archaea and the prokaryote-to-eukaryote transition |journal=Microbiology and Molecular Biology Reviews |volume=61 |issue=4 |pages=456–502 |year=1997 |month=December |pmid=9409149 |pmc=232621 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=9409149}}</ref> Huenda asili ya bakteria wa hivi karibuni na ya akea ilikuwa [[haipathamofili]] iliyoishi miaka bilioni 2.5 hadi 3.2 iliyopita. <ref>{{cite journal |author=Di Giulio M |title=The universal ancestor and the ancestor of bacteria were hyperthermophiles |url=https://archive.org/details/sim_journal-of-molecular-evolution_2003-12_57_6/page/721 |journal=J Mol Evol |volume=57 |issue=6 |pages=721–30 |year=2003 |pmid=14745541 |doi=10.1007/s00239-003-2522-6}}</ref><ref>{{cite journal |author=Battistuzzi FU, Feijao A, Hedges SB |title=A genomic timescale of prokaryote evolution: insights into the origin of methanogenesis, phototrophy, and the colonization of land |journal=BMC Evolutionary Biology |volume=4 |issue= |pages=44 |year=2004 |month=November |pmid=15535883 |pmc=533871 |doi=10.1186/1471-2148-4-44}}</ref> Aidha bakteria walishiriki katika geuko la pili kubwa, la akea na [[eukaryota]]. Hapo, eukaryota walitokana na bakteria wa kale na kuwa na uhusiano uliowafaidi wote huku seli za kwanza za eukaryota, ambazo huenda zilihusiana na akea.<ref>{{cite journal |author=Poole A, Penny D |title=Evaluating hypotheses for the origin of eukaryotes |journal=Bioessays |volume=29 |issue=1 |pages=74–84 |year=2007 |pmid=17187354 |doi=10.1002/bies.20516}}</ref><ref name="Dyall">{{cite journal |author=Dyall S, Brown M, Johnson P |title=Ancient invasions: from endosymbionts to organelles |url=https://archive.org/details/sim_science_2004-04-09_304_5668/page/252 |journal=Science |volume=304 |issue=5668 |pages=253&ndash;7 |year=2004 |pmid=15073369 |doi=10.1126/science.1094884}}</ref> Hii ilihusu kumezwa kwa seli za proto-eukaryota na alfa-protobakteria kwa manufaa ya wote na kuunda ama [[mitokondria]] au haidrojenisomi, ambazo bado zinapatikana kwenye eukaryota zote (wakati mwingine katika hali iliyo dhaifu sana, kwa mfano katika [[protozoa]] ya "amitokondrial" ya kale). Baadaye, baadhi ya eukaryota ambazo tayari zilikuwa na mitokondria pia zilimeza viumbe ambavyo vilikuwa kama cyanobakteri. Hii ilisababisha kuundwa kwa [[kloroplasti]] katika [[mwani]] na [[mimea]]. Aidha, kuna baadhi ya mwani ambayo ilichimbuka baadaye kutoka kwa matukio ya hali ya kutegemeana. Hapa, eukaryota zilimeza eukaryota ya mwani ambayo baadaye ilinawiri na hata kuwa plastidi ya "kizazi cha pili".<ref>{{cite journal |author=Lang B, Gray M, Burger G |title=Mitochondrial genome evolution and the origin of eukaryotes |journal=Annu Rev Genet |volume=33 |issue= |pages=351–97 |year= 1999|pmid=10690412 |doi=10.1146/annurev.genet.33.1.351}}</ref><ref>{{cite journal |author=McFadden G |title=Endosymbiosis and evolution of the plant cell |journal=Curr Opin Plant Biol |volume=2 |issue=6 |pages=513–9 |year=1999 |pmid=10607659 |doi=10.1016/S1369-5266(99)00025-4}}</ref> Hii inajulikana kama hali ya kutegemeana ya daraja la pili. ==Mofolojia== [[File:Prokaryote cell.svg|right|thumb|360px|Aina ya maumbo ya seli za bakteria na mpangilio wake.]] Bakteria huwa na maumbo na ukubwa tofautitofauti, unaoitwa [[mofolojia]]. Seli za bakteria ni karibu sudusi moja 1 / 10 ya seli za eukaryota na kwa kawaida huwa na [[urefu]] wa [[mikromita]] 0.5-5.0. Hata hivyo, spishi chache, kama vile ''Thiomargarita namibiensis'' na ''Epulopiscium fishelsoni'', huwa na urefu wa milimita nusu ya muda mrefu na zinaweza kuonekana kwa macho bila darubini.<ref>{{cite journal |author=Schulz H, Jorgensen B |title=Big bacteria |url=https://archive.org/details/sim_annual-review-of-microbiology_2001_55/page/105 |journal=Annu Rev Microbiol |volume=55 |issue=|pages=105&ndash;37 |year=2001|pmid=11544351 |doi=10.1146/annurev.micro.55.1.105}}</ref> Kati ya bakteria ambao ni wadogo ni wale wa jenasi ya ''Mykoplasma,'' ambao wana kipimo cha mikromita 0.3 tu, udogo wao unalingana na virusi vilivyo vikubwa zaidi.<ref>{{cite journal |author=Robertson J, Gomersall M, Gill P. |title=Mycoplasma hominis: growth, reproduction, and isolation of small viable cells |url=https://archive.org/details/sim_journal-of-bacteriology_1975-11_124_2/page/1007 |journal=J Bacteriol. |volume=124 |issue=2 |pages=1007&ndash;18 |year=1975 |pmid=1102522 |pmc=235991}}</ref> Baadhi ya bakteria wanaweza kuwa hata wadogo zaidi, lakini bakteria hao wadogo zaidi hawajatafitiwa vizuri.<ref name="Velimirov2001">{{cite journal | author = Velimirov, B. | year = 2001 | title = Nanobacteria, Ultramicrobacteria and Starvation Forms: A Search for the Smallest Metabolizing Bacterium | journal = Microbes and Environments | volume = 16 | issue = 2 | pages = 67–77 | url = http://www.jstage.jst.go.jp/article/jsme2/16/2/67/_pdf | accessdate = 2008-06-23 | doi = 10.1264/jsme2.2001.67 | archive-date = 2009-01-13 | archive-url = https://web.archive.org/web/20090113011403/http://www.jstage.jst.go.jp/article/jsme2/16/2/67/_pdf | dead-url = yes }}</ref> Spishi za bakteria nyingi huwa ama duara-dufu, waitwao koksi (umoja: kokusi, kutoka neno la Kigiriki ''κόκκος'' - ''kókkos,'' [[nafaka]], [[mbegu]]) au umbo la fimbo, waitwao bacilli (umoja: Bacillus, kutoka neno la [[Kilatini]] ''baculus'' [[Kilatini|Kilatini]], fimbo). Kurefuka huhusishwa na kuogelea.<ref>Dusenbery, David B.2009). Living at Micro Scale, pp.20-25. Harvard University Press, Cambridge, Mass ISBN 978-0-674-03116-6.</ref> Baadhi ya bakteria wenye umbo la fimbo, waitwao vibrio, huwa na mviringo kidogo au umbo la koma; na wengine, wanaweza kuwa na umbo la pia, waitwao spirilla, au kuzungushwa kwa pamoja, waitwao spirokiti. Idadi ndogo ya spishi wana umbo la [[pembenne]] au hata umbo la [[sanduku]].<ref>{{cite journal |author=Fritz I, Strömpl C, Abraham W |title=Phylogenetic relationships of the genera Stella, Labrys and Angulomicrobium within the 'Alphaproteobacteria' and description of Angulomicrobium amanitiforme sp. nov |url=http://ijs.sgmjournals.org/cgi/content/full/54/3/651 |journal=Int J Syst Evol Microbiol |volume=54 |issue=Pt 3 |pages=651–7 |year=2004 |pmid=15143003 |doi=10.1099/ijs.0.02746-0 |access-date=2015-05-07 |archive-date=2008-10-10 |archive-url=https://web.archive.org/web/20081010212929/http://ijs.sgmjournals.org/cgi/content/full/54/3/651 |dead-url=yes }}</ref> Hivi majuzi, bakteria waligunduliwa ndani ya [[sahani ya dunia]] ambao na kuwa na urefu kama wa fimbo na sehemu ya pembeni yenye umbo la [[nyota]]. Eneo lao kubwa ukilinganishwa na uwiano wa kiasi cha mofolojia hii linaweza kufaidi hawa bakteria katika mazingira yaliyo na [[madini]] machache.<ref>{{cite journal |author=Wanger Onstott Southam |title=Stars of the terrestrial deep subsurface: A novel `star-shaped' bacterial morphotype from a South African platinum mine |journal=Geobiology |volume=6 |issue=3 |pages=325–330 |year=2008 |doi=10.1111/j.1472-4669.2008.00163.x |pmid=18498531 |last1=Wanger |first1=G |last2=Onstott |first2=TC |last3=Southam |first3=G}}</ref> Maumbo haya tofauti ni kutokana na ukingo wa ukuta wa seli za bakteria na kuamua na bakteria na mfupa wa saitoplazimu, na ni muhimu kwa sababu unaweza kuathiri uwezo wa bakteria wa kupata virutubisho au madini, kujigandisha kwenye kingo, kuogelea kwa vitu viwevu na kujiepusha na [[Mnyama mla nyama|kuwindwa.]]<ref>{{cite journal |author=Cabeen M, Jacobs-Wagner C |title=Bacterial cell shape |journal=Nat Rev Microbiol |volume=3 |issue=8 |pages=601&ndash;10 |year=2005 |pmid=16012516 |doi=10.1038/nrmicro1205}}</ref><ref>{{cite journal |author=Young K |title=The selective value of bacterial shape |url=https://archive.org/details/sim_microbiology-and-molecular-biology-reviews_2006-09_70_3/page/660 |journal=Microbiol Mol Biol Rev |volume=70 |issue=3 |pages=660&ndash;703 |year=2006 |pmid=16959965 |doi=10.1128/MMBR.00001-06 |pmc=1594593}}</ref> Spishi nyingi za bakteria zinaishi kama seli moja tu, wengine huwa na ruwaza fulani ya muungano: ''Neisseria'' huunda diploidi ([[jozi]]), ''Streptococcus'' huunda minyororo, na ''Staphylococcus'' hujiunga kwenye kikundi cha "rundo la zabibu". Aidha bakteria zinaweza kurufushwa kuunda filamenti, kwa mfano Aktinobakteria. Mara nyingi bakteria za nyuzi huzungukwa na uo ambao una chembechembe nyingi za kibinafsi. Aina fulani, kama vile spishi za jenasi ya ''Nocardia,'' huweza hata kuunda filamenti za kushangaza zenye matagaa, zinazofanana na vimelea vya mycelia.<ref>{{cite journal |author=Douwes K, Schmalzbauer E, Linde H, Reisberger E, Fleischer K, Lehn N, Landthaler M, Vogt T |title=Branched filaments no fungus, ovoid bodies no bacteria: Two unusual cases of mycetoma |journal=J Am Acad Dermatol |volume=49 |issue=2 Suppl Case Reports |pages=S170&ndash;3 |year=2003 |pmid=12894113 |doi=10.1067/mjd.2003.302}}</ref> [[File:Relative scale.svg|thumb|310px|left|Aina ya maumbo ya prokaryoti ikilinganishwa na viumbe wengine.]] Mara nyingi bakteria hujiunganisha kwenye sehemu zingine ili kuunda mikusanyiko mikubwa iitwayo biofilamu au mikeka ya bakteria. Filamu hizi zinaweza kuwa kati ya mikromita chache kwa unene hadi [[nusu]] [[mita]] kwa [[kina]], na zinaweza kuwa na spishi nyingi za bakteria, [[protista]] na [[Archaea|akea.]] Bakteria wanaoishi katika biofilamu huwa na mpangilio mgumu wa seli na vipengele vya nje ya seli, na kuunda maumbo ya daraja la pili kama vile mikrokoloni, umbo ambalo huwa na njia nyingi kuwezesha upitishaji wa virutubisho.<ref>{{cite journal |author=Donlan R |title=Biofilms: microbial life on surfaces |journal=Emerg Infect Dis |volume=8 |issue=9 |pages=881–90 |year=2002 |pmid=12194761 |pmc=2732559}}</ref><ref>{{cite journal |author=Branda S, Vik S, Friedman L, Kolter R |title=Biofilms: the matrix revisited |url=https://archive.org/details/sim_trends-in-microbiology_2005-01_13_1/page/20 |journal=Trends Microbiol |volume=13 |issue=1 |pages=20–26 |year=2005 |pmid=15639628 |doi=10.1016/j.tim.2004.11.006}}</ref> Katika mazingira ya kawaida, kama vile udongo au mimea, bakteria wengi huunganishwa kwenye kingo katika bio-filamu.<ref name="Davey">{{cite journal |author=Davey M, O'toole G |title=Microbial biofilms: from ecology to molecular genetics |url=https://archive.org/details/sim_microbiology-and-molecular-biology-reviews_2000-12_64_4/page/847 |journal=Microbiol Mol Biol Rev |volume=64 |issue=4 |pages=847–67 |year=2000|pmid = 11104821 |doi=10.1128/MMBR.64.4.847-867.2000 |pmc=99016}}</ref> Bio-filamu ni muhimu pia katika [[uuguzi]], kwa sababu mara nyingi maumbo haya yanapatikana kwenye magonjwa mabaya ya kuambukizwa au katika maambukizi ya vifaa vya matibabu ambavyo vimewekwa mwilini, na bakteria wanaolindwa ndani ya bio-filamu ni vigumu sana kuwaua kuliko bakteria walio pweke.<ref>{{cite journal |author=Donlan RM, Costerton JW |title=Biofilms: survival mechanisms of clinically relevant microorganisms |url=https://archive.org/details/sim_clinical-microbiology-reviews_2002-04_15_2/page/167 |journal=Clin Microbiol Rev |volume=15 |issue=2 |pages=167–93 |year=2002 |pmid=11932229 |doi=10.1128/CMR.15.2.167-193.2002 |pmc=118068}}</ref> Wakati mwingine mabadiliko mengine makubwa ya kimofolojia yanaweza kutokea. Kwa mfano, wakinyimwa [[amino asidi]], miksoobakteria wanaweza kugundua seli ambazo zimewazingira, hali iitwayo hisi ya kikundi, hujumuika pamoja, na hukusanyika kuunda maumbo marefu ambayo yanaweza kufika mikromita 500 na yenye takriban seli za bakteria 100,000.<ref>{{cite journal |author=Shimkets L |title=Intercellular signaling during fruiting-body development of Myxococcus xanthus |url=https://archive.org/details/sim_annual-review-of-microbiology_1999_53/page/525 |journal=Annu Rev Microbiol |volume=53 |issue=|pages=525–49 | year =1999|pmid = 10547700 |doi=10.1146/annurev.micro.53.1.525}}</ref> Katika maumbo haya, bakteria hutekeleza majukumu tofauti: aina hii ya ushirikiano ni mfano rahisi wa ushirika wa seli nyingi. Kwa mfano, karibu seli moja kwa kila seli 10 huhamia sehemu ya juu ya maumbo haya na huwa katika hali ya utulivu iitwayo "myxospores", ambayo ina uwezo wa kustahimili [[ukavu]] na hali nyingine mbaya zaidi za mazingira, kinyume na ilivyo seli zingine.<ref name="autogenerated1">{{cite journal |author=Kaiser D |title=Signaling in myxobacteria |url=https://archive.org/details/sim_annual-review-of-microbiology_2004_58/page/75 |journal=Annu Rev Microbiol |volume=58 |issue=|pages=75–98 |year=2004|pmid=15487930 |doi=10.1146/annurev.micro.58.030603.123620}}</ref> ==Muundo wa seli == [[File:Average prokaryote cell- en.svg|thumb|280px|right|Muundo na sehemu ya kiini cha bakteria wa Gram chanya]] ===Miundo ya ndani ya seli=== Seli ya bakteria imezungukwa na utando wa [[lipidi]], au utando wa seli, ambao huifunika na pia kuikinga dhidi ya kushikilia virutubisho, [[protini]] na sehemu nyingine muhimu za [[saitoplazimu]] ndani ya seli. Kwa kuwa hizi seli ni prokaryota, bakteria mara nyingi huwa hazina [[oganeli]] kwenye utando katika saitoplazimu yao, kwa hivyo, huwa na sehemu chache zilizo kubwa ndani ya seli. Kwa sababu hiyo hawana [[kiini]], [[mitokondria]], [[kloroplast]] na oganeli nyingine ambazo zinapatikana katika seli za eukaryota, kama vile [[sehemu za Golgi]] na [[retikilamu]] ya endoplazimu.<ref name="Stryer">{{cite book | author = Berg JM, Tymoczko JL Stryer L | title = Molecular Cell Biology | url = https://archive.org/details/biochemistrysupp0000stry | edition = 5th | publisher = WH Freeman | year = 2002 | isbn = 0-7167-4955-6}}</ref> Wakati fulani bakteria walionekana kama mifuko tu ya saitoplazimu, lakini vitu kama vile mfupa-seli wa prokariyoti,<ref>{{cite journal |author=Gitai Z |title=The new bacterial cell biology: moving parts and subcellular architecture |url=https://archive.org/details/cell_2005-03-11_120_5/page/577 |journal=Cell |volume=120 |issue=5 |pages=577–86 |year=2005 |pmid=15766522 |doi=10.1016/j.cell.2005.02.026}}</ref><ref>{{cite journal |author=Shih YL, Rothfield L |title=The bacterial cytoskeleton |url=https://archive.org/details/sim_microbiology-and-molecular-biology-reviews_2006-09_70_3/page/729 |journal=Microbiology and Molecular Biology Reviews |volume=70 |issue=3 |pages=729–54 |year=2006 |month=September |pmid=16959967 |pmc=1594594 |doi=10.1128/MMBR.00017-06}}</ref> na ujanibishaji wa protini katika maeneo maalum ndani ya saitoplazimu <ref>{{cite journal |author=Gitai Z |title=The new bacterial cell biology: moving parts and subcellular architecture |url=https://archive.org/details/cell_2005-03-11_120_5/page/577 |journal=Cell |volume=120 |issue=5 |pages=577–86 |year=2005 |month=March |pmid=15766522 |doi=10.1016/j.cell.2005.02.026}}</ref> umedhihirisha viwango vya kuendelea. Vijisehemu hivi vya seli vimekuja kujulikana kama "maumbo ya hali ya juu ya bakteria".<ref>{{cite journal |author=Norris V, den Blaauwen T, Cabin-Flaman A, ''et al.'' |title=Functional taxonomy of bacterial hyperstructures |journal= Microbiology and Molecular Biology Reviews |volume=71 |issue=1 |pages=230–53 |year=2007 |month=March |pmid=17347523 |pmc=1847379 |doi=10.1128/MMBR.00035-06 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=17347523 |last12=Saier M |first12=Jr |last13=Skarstad |first13=K}}</ref> Vijisehemu vidogo kama vile [[kaboksisomu]]<ref>{{cite journal |author=Kerfeld CA, Sawaya MR, Tanaka S, ''et al.'' |title=Protein structures forming the shell of primitive bacterial organelles |url=https://archive.org/details/sim_science_2005-08-05_309_5736/page/936 |journal=Science (journal) |volume=309 |issue=5736 |pages=936–8 |year=2005 |month=August |pmid=16081736 |doi=10.1126/science.1113397}}</ref> vinadhihisha kiwango kingine cha mpangilio, ambavyo ni sehemu zilizo ndani ya bakteria ambazo zimezungukwa na [[ushanga|shanga]] za [[polihedra]] ya protini, badala ya utando wa lipidi.<ref name="Bobik2007">{{cite journal | author = Bobik, T. A. | title = Bacterial Microcompartments | year = 2007 | journal = Microbe | volume = 2 | pages = 25–31 | url = http://www.asm.org/ASM/files/ccLibraryFiles/Filename/000000002765/znw00107000025.pdf | publisher = Am Soc Microbiol | format = PDF | access-date = 2015-05-07 | archive-date = 2008-08-02 | archive-url = https://web.archive.org/web/20080802025916/http://www.asm.org/ASM/files/ccLibraryFiles/Filename/000000002765/znw00107000025.pdf | dead-url = yes }}</ref> "Oganeli hizi za polihedra" hujikusanya na kugawa [[umetaboli]] wa bakteria katika vyumba, kazi ambayo hutekelezwa na oganeli zinazopatikana kwenye utando kwenye eukaryota.<ref>{{cite journal |author=Yeates TO, Kerfeld CA, Heinhorst S, Cannon GC, Shively JM |title=Protein-based organelles in bacteria: carboxysomes and related microcompartments |journal=Nat. Rev. Microbiol. |volume=6 |pages=681–691 |year=2008 |month=August |pmid=18679172 |doi=10.1038/nrmicro1913 |issue=9}}</ref> Mifanyiko mingi ya [[Biokemia|kibiokemia]], kama vile kualisha nguvu, hutokana na tofauti za viwango vya chumvi kupitia kwa utando, sifa ambayo pia hupatikana katika [[betri]] ya. Kukosekana kwa jumla kwa utando wa ndani kwenye bakteria kunamaanisha kwamba mifanyiko kama vile [[usafiri]] wa [[elektroni]] hutokea kwenye utando baina ya saitoplazimu na nafasi kati ya periplazimu.<ref>{{cite journal |author=Harold FM |title=Conservation and transformation of energy by bacterial membranes |journal=Bacteriological Reviews |volume=36 |issue=2 |pages=172–230 |year=1972 |month=June |pmid=4261111 |pmc=408323 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=4261111}}</ref> Hata hivyo, katika bakteria wengi wanaotengeneza [[chakula]] kutoka kwa [[mwanga]] utando wa plazimu huwa umekunjwa sana na hujaza seli na safu ya utando wa kukusanya mwanga.<ref name="bryantfrigaard">{{cite journal |author=Bryant DA, Frigaard NU |year=2006 |title=Prokaryotic photosynthesis and phototrophy illuminated |journal=Trends Microbiol. |volume=14 |issue=11 |pages=488 |doi=10.1016/j.tim.2006.09.001 |pmid=16997562 |last1=Bryant |first1=DA |last2=Frigaard |first2=NU }}</ref> Utando huo wa kukusanya mwanga unaweza hata kuunda maumbo yaliyofunikwa na lipidi yaitwayo [[klorosomu]] katika bakteria za kijani za [[salfa]].<ref>{{cite journal |author=Psencík J, Ikonen TP, Laurinmäki P, ''et al.'' |title=Lamellar organization of pigments in chlorosomes, the light harvesting complexes of green photosynthetic bacteria |journal=Biophys. J. |volume=87 |issue=2 |pages=1165–72 |year=2004 |month=August |pmid=15298919 |pmc=1304455 |doi=10.1529/biophysj.104.040956 |url=http://www.biophysj.org/cgi/pmidlookup?view=long&pmid=15298919 |access-date=2015-05-07 |archive-date=2020-05-10 |archive-url=https://web.archive.org/web/20200510024136/https://www.cell.com/biophysj/cgi/pmidlookup?view=long&pmid=15298919 |dead-url=yes }}</ref> Protini zingine huleta virutubisho kupitia kwa utando wa seli, au kutoa molekiuli ambazo hazihitajiki kutoka kwa saitoplazimu. [[File:Carboxysome 3 images.png|thumb|left|450px|Karboksisomu ni protini-iliyoambatanishwa viungovya bakteria. Upande wa kushoto juu ni picha ya darubini ya elektroni ya karboksisomu katika Halothiobacillus neapolitanus , chini ni picha safi ya karboksisomu. Katika upande wa kulia ni mfano wa muundo wao. Viwango vya kupima ni 100 nm.]] Bakteria hawana kiini chenye utando, na wameundwa kutoka kwa jeni ya kromosomu moja ya mviringo iliyo katika saitoplazimu katika umbo lisilo na muundo maalum liitwalo nukleoidi.<ref>{{cite journal |author=Thanbichler M, Wang S, Shapiro L |title=The bacterial nucleoid: a highly organized and dynamic structure |journal=J Cell Biochem |volume=96 |issue=3 |pages=506–21 |year=2005 |pmid=15988757 |doi=10.1002/jcb.20519}}</ref> Kiini cha bakteria kina kromosomu yenye protini na RNA. Planktomaisiti zina upekee katika kukosekana kwa jumla kwa utando wa ndani katika bakteria, kwa sababu zina utando unaozunguka kiini chao na huwa na maumbo mengine ya seli yenye utando.<ref>{{cite journal |author=Fuerst J |title=Intracellular compartmentation in planctomycetes |url=https://archive.org/details/sim_annual-review-of-microbiology_2005_59/page/299 |journal=Annu Rev Microbiol |volume=59 |pages=299–328 |year=2005 |pmid=15910279 |doi=10.1146/annurev.micro.59.030804.121258}}</ref> Kama ilivyo kwa [[Kiumbehai|viumbe wote wenye]] uhai, bakteria huwa na ribosome kwa ajili ya kutengeneza protini, lakini maumbo ya ribosome wa bakteria ni tofauti ikilinganishwa na wa [[Eukaryota|yukariyoti]] na [[Archaea|Akea.]]<ref>{{cite journal |author=Poehlsgaard J, Douthwaite S |title=The bacterial ribosome as a target for antibiotics |journal=Nat Rev Microbiol |volume=3 |issue=11 |pages=870–81 |year=2005|pmid = 16261170 |doi=10.1038/nrmicro1265}}</ref> Baadhi ya bakteria hutengeneza chembechembe ndani ya seli za kuhifadhi virutubisho, kama vile glikojeni, <ref>{{cite journal |author=Yeo M, Chater K |title=The interplay of glycogen metabolism and differentiation provides an insight into the developmental biology of Streptomyces coelicolor |url=http://mic.sgmjournals.org/cgi/content/full/151/3/855?view=long&pmid=15758231 |journal=Microbiology |volume=151 |issue=Pt 3 |pages=855–61 |year=2005 |pmid=15758231 |doi=10.1099/mic.0.27428-0 |access-date=2015-05-07 |archive-date=2007-09-29 |archive-url=https://web.archive.org/web/20070929092242/http://mic.sgmjournals.org/cgi/content/full/151/3/855?view=long&pmid=15758231 |dead-url=yes }}</ref>polifosfeti, <ref>{{cite journal |author=Shiba T, Tsutsumi K, Ishige K, Noguchi T |title=Inorganic polyphosphate and polyphosphate kinase: their novel biological functions and applications |url=http://protein.bio.msu.ru/biokhimiya/contents/v65/full/65030375.html |journal=Biochemistry (Mosc) |volume=65 |issue=3 |pages=315–23 |year=2000 |pmid=10739474 |access-date=2015-05-07 |archive-date=2006-09-25 |archive-url=https://web.archive.org/web/20060925070012/http://protein.bio.msu.ru/biokhimiya/contents/v65/full/65030375.html |url-status=dead }}</ref>[[Sulfuri|salfa]] <ref>{{cite journal |author=Brune DC |title=Isolation and characterization of sulfur globule proteins from Chromatium vinosum and Thiocapsa roseopersicina |url=https://archive.org/details/sim_archives-of-microbiology_1995-06_163_6/page/391 |journal=Archives of Microbiology |volume=163 |issue=6 |pages=391–9 |year=1995 |month=June |pmid=7575095 |doi=10.1007/BF00272127}}</ref> au polihaidroksyalkanoeti.<ref>{{cite journal |author=Kadouri D, Jurkevitch E, Okon Y, Castro-Sowinski S |title=Ecological and agricultural significance of bacterial polyhydroxyalkanoates |url=https://archive.org/details/critical-reviews-in-microbiology_2005_31_2/page/55 |journal=Critical Reviews in Microbiology |volume=31 |issue=2 |pages=55–67 |year=2005 |pmid=15986831 |doi=10.1080/10408410590899228}}</ref> Chembechembe hizi huwezesha bakteria kuhifadhi misombo kwa ajili ya matumizi ya baadaye. Baadhi ya spishi za bakteria, kama vile zile za Sayanobacteria wa kifotosinthetiki, hutengeneza vilengelenge vya gesi vya ndani, ambavyo huvitumia kuwawezesha kuelea - na kuwaruhusu kuogolea juu na chini katika rusu za maji zenye mwanga na virutubisho tofauti.<ref>{{cite journal |author=Walsby AE |title=Gas vesicles |journal=Microbiological Reviews |volume=58 |issue=1 |pages=94–144 |year=1994 |month=March |pmid=8177173 |pmc=372955 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=8177173}}</ref> ===Miundo ya nje ya seli=== Karibu na nje ya utando wa seli kuna ukuta wa seli wa bakteria. kuta za seli za bakteria zimetengenezwa na peptidoglaikani (ambayo awali iliitwa murein), ambayo hutokana na mfululizo wa polisakaraidi zilizounganishwa na peptide isiyo ya kawaida yenye amino asidi ya D.<ref>{{cite journal |author=van Heijenoort J |title=Formation of the glycan chains in the synthesis of bacterial peptidoglycan | url=http://glycob.oxfordjournals.org/cgi/content/full/11/3/25R |journal=Glycobiology |volume=11 |issue=3 |pages=25R&ndash;36R |year=2001 |pmid=11320055 |doi=10.1093/glycob/11.3.25R}}</ref> Kuta za seli za bakteria hutofautiana na kuta za [[Mmea|mmea]] na [[Kuvu|kuvu]], ambao hutengenezwa kutokana na selulosi na chitini, mtawalia.<ref name="Koch">{{cite journal |author=Koch A |title=Bacterial wall as target for attack: past, present, and future research |url=http://cmr.asm.org/cgi/content/full/16/4/673?view=long&pmid=14557293 |journal=Clin Microbiol Rev |volume=16 |issue=4 |pages=673&ndash;87 |year=2003 |pmid=14557293 |doi=10.1128/CMR.16.4.673-687.2003 |pmc=207114 |access-date=2015-05-07 |archive-date=2008-09-28 |archive-url=https://web.archive.org/web/20080928093055/http://cmr.asm.org/cgi/content/full/16/4/673?view=long&pmid=14557293 |dead-url=yes }}</ref> Ukuta wa seli ya bakteria pia ni tofauti na ule wa Akea, ambao hauna peptidoglaikani. Ukuta wa seli ni muhimu katika maisha ya bakteria wengi, na antibiotiki ya penicillin anaweza kuua bakteria kwa kuzuia hatua moja katika matumizi ya peptidoglaikani.<ref name="Koch"></ref> Kuna aina mbili kuu za kuta za seli katika bakteria, ziitwazo Gramu-chanya na Gramu-hasi. Majina haya yanatokana na athari ya seli kwa waa la Gram,utafiti ambao ulitumiwa kwa muda mrefu katika kuainisha spishi za bakteria.<ref name="Gram">{{cite journal | last = Gram | first = HC | authorlink = Hans Christian Gram |year=1884 |title=Über die isolierte Färbung der Schizomyceten in Schnitt- und Trockenpräparaten |journal=Fortschr. Med. |volume=2 |pages=185&ndash;189 }}</ref> Bakteria za Gram-chanya zina ukuta wa seli mnene ambao una rusu nyingi za peptidoglaikani na asidi ya teikoiki. Kinyume na matarajio, bakteria wa Gramu-hasi wana ukuta mwembamba uliyo na rusu chache za peptidoglaikani iliyozungukwa na utando wa pili wa lipidi wenyelipopolisakaride na lipoprotini. Bakteria wengi wana ukuta wa seli wa Gramu-hasi, na Fimikuti tu na Aktinobakteria ambao(asilia walijulikana kama bakteria wa G + C ya chini na G + C ya juu Gramu-chanya, mtawalia) huwa na mpangilio wa Gramu-chanya mbadala.<ref>{{cite journal |author=Hugenholtz P |title=Exploring prokaryotic diversity in the genomic era |journal=Genome Biology |volume=3 |issue=2 |pages=REVIEWS0003 |year=2002 |pmid=11864374 |pmc=139013 |url=http://genomebiology.com/1465-6906/3/REVIEWS0003 |doi=10.1186/gb-2002-3-2-reviews0003 |access-date=2015-05-07 |archive-date=2020-03-15 |archive-url=https://web.archive.org/web/20200315111159/http://genomebiology.com/1465-6906/3/REVIEWS0003 |dead-url=yes }}</ref> Utofauti huu katika miundo unaweza kuleta tofauti katika kuathirika kwa antibiotiki, kwa mfano, vankomisin inaweza tu kuua bakteria wa Gram-chanya na hushindwa kuua pathojeni za Gram-hasi, kama vile ''Haemophilus influenzae'' au ''Pseudomonas aeruginosa.'' <ref>{{cite journal |author=Walsh F, Amyes S |title=Microbiology and drug resistance mechanisms of fully resistant pathogens |journal=Curr Opin Microbiol |volume=7 |issue=5 |pages=439–44 |year=2004 |pmid=15451497 |doi=10.1016/j.mib.2004.08.007}}</ref> Katika bakteria wengi rusu ya S ya molekiuli za protini zilizounganishwa pamoja hufunika nje ya ukuta wa seli.<ref>{{cite journal |author=Engelhardt H, Peters J |title=Structural research on surface layers: a focus on stability, surface layer homology domains, and surface layer-cell wall interactions |journal=J Struct Biol |volume=124 |issue=2&ndash;3 |pages=276–302 |year=1998|pmid = 10049812 |doi=10.1006/jsbi.1998.4070}}</ref> Rusu hii hukinga seli dhidi ya athari za kikemikali na zingine na inaweza kuzuia kuenea kwamakromolekiula. Rusu za S- zina kazi mbalimbali lakini ambazo hazieleweki vizuri, lakini inajulikana kwamba hufanya kazi kama sumu kali katika ''Campylobacter'' na zina [[Kimeng'enya|vimeng'enya]] katika ''stearothermophilus Bacillus.'' <ref>{{cite journal |author=Beveridge T, Pouwels P, Sára M, Kotiranta A, Lounatmaa K, Kari K, Kerosuo E, Haapasalo M, Egelseer E, Schocher I, Sleytr U, Morelli L, Callegari M, Nomellini J, Bingle W, Smit J, Leibovitz E, Lemaire M, Miras I, Salamitou S, Béguin P, Ohayon H, Gounon P, Matuschek M, Koval S |title=Functions of S-layers |journal=FEMS Microbiol Rev |volume=20 |issue=1&ndash;2 |pages=99&ndash;149 |year=1997 |pmid=9276929 |last12=Morelli |first12=L |last13=Callegari |first13=ML |last14=Nomellini |first14=JF |last15=Bingle |first15=WH |last16=Smit |first16=J |last17=Leibovitz |first17=E |last18=Lemaire |first18=M |last19=Miras |first19=I |last20=Salamitou |first20=S |last21=Béguin |first21=P |last22=Ohayon |first22=H |last23=Gounon |first23=P |last24=Matuschek |first24=M |last25=Koval |first25=SF}}</ref> [[File:EMpylori.jpg|thumb|250px|left|Mchoro wa elektroni za helikobakta pailori elektroni, unaoonyesha flajela nyingi kwenye seli]] Flajela ni maumbo magumu yenye protini, yana kipenyo cha takriban nanomita 20 [[Mita|Mita]] huwa na urefu wa hadi mikromita 20, ambazo hutumika kuwezesha usafiri wa ufanisi. Flajela huendeshwa kutokana na nguvu zinazozalishwa kupitia kwa ubadilishanaji wa Ionchini ya mwinamo wa elektrokemikali kupitia kwa utando wa seli.<ref>{{cite journal |author=Kojima S, Blair D |title=The bacterial flagellar motor: structure and function of a complex molecular machine |journal=Int Rev Cytol |volume=233 |issue=|pages=93&ndash;134 |year=2004|pmid=15037363 |doi=10.1016/S0074-7696(04)33003-2}}</ref> Fimbriae ni nyuzi nyororo za protini, zenye kipenyo cha nonimita 20-10 tu na urefu wa mikromita kadhaa. Huwa wamesambaa kwenye sehemu za sseli, na hufanana na nywele laini zinapoonwa kupitia kwa hadubini ya elektroni. Inaaminika kuwa Fimbriae huhusika katika kuunganisha vitu yabisi kwenye sehemu zingine au katika seli zingine na ni muhimu katika kutengeneza sumu kali ya pathojeni fulani za bakteria.<ref>{{cite journal |author=Beachey E |title=Bacterial adherence: adhesin-receptor interactions mediating the attachment of bacteria to mucosal surface |url=https://archive.org/details/sim_journal-of-infectious-diseases_1981-03_143_3/page/325 |journal=J Infect Dis |volume=143 |issue=3 |pages=325&ndash;45 |year=1981|pmid = 7014727}}</ref> Pili ''(kwa umoja'' pilus) ni viambatisho vya seli, kubwa kidogo kuliko fimbriae, ambavyo vinaweza kuhamisha vitu vya jenetiki baina ya seli za bakteria katika mchakato uitwao muungano (tazama jenetiki ya bakteria, hapa chini).<ref>{{cite journal |author=Silverman P |title=Towards a structural biology of bacterial conjugation |journal=Mol Microbiol |volume=23 |issue=3 |pages=423&ndash;9 |year=1997 |pmid=9044277 |doi=10.1046/j.1365-2958.1997.2411604.x}}</ref> Kapsuli au rusu za slimi zinazotengenezwa na bakteria wengi kuzingira seli zao, na hutofautiana kwa maumbo na miundo: kuanzia rusu ya slimu isiyo na mpangilio ya ya nje ya polima ya seli, na yenye muundo bainishi wa kapsuli au glaikokaliksi. Maumbo haya yanaweza kulinda seli dhidi ya kumezwa na seli za yukariyoti, kama vile makrofeji.<ref>{{cite journal |author=Stokes R, Norris-Jones R, Brooks D, Beveridge T, Doxsee D, Thorson L |title=The glycan-rich outer layer of the cell wall of Mycobacterium tuberculosis acts as an antiphagocytic capsule limiting the association of the bacterium with macrophages |url=http://iai.asm.org/cgi/content/full/72/10/5676?view=long&pmid=15385466 |journal=Infect Immun |volume=72 |issue=10 |pages=5676&ndash;86 |year=2004 |pmid=15385466 |doi=10.1128/IAI.72.10.5676-5686.2004 |pmc=517526 |access-date=2015-05-07 |archive-date=2008-09-29 |archive-url=https://web.archive.org/web/20080929082456/http://iai.asm.org/cgi/content/full/72/10/5676?view=long&pmid=15385466 |dead-url=yes }}</ref> Pia wanaweza kufanya kazi kama Antijeni na kushirikishwa katika utambuzi wa seli, kadhalika kuwezesha katika kuunganisha na na kutengenza bio-filamu.<ref>{{cite journal |author=Daffé M, Etienne G |title=The capsule of Mycobacterium tuberculosis and its implications for pathogenicity |journal=Tuber Lung Dis |volume=79 |issue=3 |pages=153&ndash;69 |year=1999 |pmid=10656114 |doi=10.1054/tuld.1998.0200}}</ref> Kuleta pamoja hii miundo au maumbo ya seli kunategemea mifumo ya utoaji wa ugiligili wa bakteria. Uhamisho wa protini kutoka kwa saitoplazimu hadi kwa periplazimu au katika mazingira yaliyo karibu na seli. Mifumo ya aina nyingi ya utoaji ugiligili inajulikana na mara nyingi miundo hii ni muhimu kwa ajili ya pathojeni za sumu kali, kwa hiyo hutafitiwa kwa kina.<ref>{{cite journal |author=Finlay BB, Falkow S |title=Common themes in microbial pathogenicity revisited |journal=Microbiology and Molecular Biology Reviews |volume=61 |issue=2 |pages=136–69 |year=1997 |month=June |pmid=9184008 |pmc=232605 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=9184008}}</ref> ===Endospora=== {{main|Endospora}} [[File:Gram Stain Anthrax.jpg|thumb|250px|right|Bacillus anthracis (yenye doa la zambarau) inyokua kwenye ugiligili wa uti wa mgongo]] Baadhi ya [[Jenasi|nasaba]] ya bakteria wa Gram-chanaya, kama vile Bacillus, Clostridium, Sporohalobacter, Anaerobacter na ''Heliobacterium,'' zinaweza kutengeneza maumbo yaliyotulia yenye uwezo kustahimili yaitwayo endospora.<ref>{{cite journal |author=Nicholson WL, Munakata N, Horneck G, Melosh HJ, Setlow P |title=Resistance of Bacillus endospores to extreme terrestrial and extraterrestrial environments |journal=Microbiology and Molecular Biology Reviews |volume=64 |issue=3 |pages=548–72 |year=2000 |month=September |pmid=10974126 |pmc=99004 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=10974126 |doi=10.1128/MMBR.64.3.548-572.2000}}</ref> Karibu katika visa vyote, endospora moja hutengenezwa na huu siyo mchakato wa uzazi, ingawa ''Anaerobacter'' wanaweza kutengeneza endospora kwenye seli moja.<ref>{{cite journal |author=Siunov A, Nikitin D, Suzina N, Dmitriev V, Kuzmin N, Duda V |title=Phylogenetic status of Anaerobacter polyendosporus, an anaerobic, polysporogenic bacterium |url=http://ijs.sgmjournals.org/cgi/reprint/49/3/1119.pdf |journal=Int J Syst Bacteriol |volume=49 Pt 3 |issue= |pages=1119&ndash;24 |year=1999 |pmid=10425769 |format=PDF |access-date=2015-05-07 |archive-date=2007-06-16 |archive-url=https://web.archive.org/web/20070616050314/http://ijs.sgmjournals.org/cgi/reprint/49/3/1119.pdf |dead-url=yes }}</ref> Endospora huwa na kitovu muhimu cha satoplazimu chenye [[ADN]] na ribosomu iliyozungukwa na rusu ya gamba na kulindwa na ngozi ngumu isiyopenyeka. Endospora haina umetaboli usiyoweza kuonekana nainaweza kustahimmili hali mbaya ya kimwili na kikemikali, kama vile viwango vya juu vya mwanga wa miale ya jua, mionzi ya gamma, sabuni za maji, vipukusi, joto, kuzizima, shinikizo na ukavu.<ref>{{cite journal |author=Nicholson W, Fajardo-Cavazos P, Rebeil R, Slieman T, Riesenman P, Law J, Xue Y |title=Bacterial endospores and their significance in stress resistance |url=https://archive.org/details/antonie-van-leeuwenhoek_2002_81_1-4/page/27 |journal=Antonie Van Leeuwenhoek |volume=81 |issue=1&ndash;4 |pages=27&ndash;32 |year=2002 |pmid=12448702 |doi=10.1023/A:1020561122764}}</ref> Katika hali hii iliyotulia, viumbe hawa wanaweza kusalia na uwezo wa kujitegemea kwa mamilioni ya miaka,<ref>{{cite journal |author=Vreeland R, Rosenzweig W, Powers D |title=Isolation of a 250 million-year-old halotolerant bacterium from a primary salt crystal |url=https://archive.org/details/sim_nature-uk_2000-10-19_407_6806/page/896 |journal=Nature |volume=407 |issue=6806 |pages=897&ndash;900 |year=2000 |pmid=11057666 |doi=10.1038/35038060}}</ref><ref>{{cite journal |author=Cano R, Borucki M |title=Revival and identification of bacterial spores in 25- to 40-million-year-old Dominican amber |url=https://archive.org/details/sim_science_1995-05-19_268_5213/page/n117 |journal=Science |volume=268 |issue=5213 |pages=1060&ndash;4 |year=1995 |pmid=7538699 |doi=10.1126/science.7538699}}</ref> na endospora huwezesha bakteria hata kushi kwenye ombwe tupu na mionzi ya anga.<ref>{{cite journal |author=Nicholson W, Schuerger A, Setlow P |title=The solar UV environment and bacterial spore UV resistance: considerations for Earth-to-Mars transport by natural processes and human spaceflight |journal=Mutat Res |volume=571 |issue=1&ndash;2 |pages=249&ndash;64 |year=2005|pmid = 15748651 |doi=10.1016/j.mrfmmm.2004.10.012}}</ref> Aidha, bakteria ambao hutengeneza endospora wanaweza kusababisha ugonjwa kwa mfano, unaweza kupata kimeta kwa kuvuta hewa yenye endospora za ''Bacillus'' ''anthracis,'' na uchafuzi wa vindnda vya ndani na endospora za '' Clostridium tetani'' husababisha pepopunda.<ref>{{cite journal |author=Hatheway CL |title=Toxigenic clostridia |journal=Clinical Microbiology Reviews |volume=3 |issue=1 |pages=66–98 |year=1990 |month=January |pmid=2404569 |pmc=358141 |url=http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=2404569 }}</ref> ==Umetaboli== Bakteria huonyesha aina mbalimbali za umetaboli.<ref>{{cite journal |author=Nealson K |title=Post-Viking microbiology: new approaches, new data, new insights |url=https://archive.org/details/sim_origins-of-life-and-evolution-of-biospheres_1999-01_29_1/page/73 |journal=Orig Life Evol Biosph |volume=29 |issue=1 |pages=73–93 |year=1999 |pmid=11536899 |doi=10.1023/A:1006515817767}}</ref> Sifa za kundi la bakteria kijadi zimetumika katika kuainisha jamii zao, lakini aghalabu sifa hizi hazioani na uainishaji wa kisasa wa jeni.<ref>{{cite journal |author=Xu J |title=Microbial ecology in the age of genomics and metagenomics: concepts, tools, and recent advances |journal=Mol Ecol |volume=15 |issue=7 |pages=1713–31 |year=2006|pmid = 16689892 |doi=10.1111/j.1365-294X.2006.02882.x}}</ref> Umetaboli wa bakteria huainishwa katika makundi ya lishe kwa misingi ya vigezo vitatu vikuu: aina ya nishati inayotumika katika kukua, chanzo cha [[Kaboni|kaboni]], na nyenzo za elektroni zinazotumika kwa ajili ya ukuaji. Kigezo kingine cha ziada cha vidubini vinavyopumua ni vinasa elektronivinavyotumika katika uzalishaji wa nguvu kwa kutumia oksijeni au bila oksijeni.<ref>{{cite journal |author=Zillig W |title=Comparative biochemistry of Archaea and Bacteria |journal=Curr Opin Genet Dev |volume=1 |issue=4 |pages=544–51 |year=1991 |pmid=1822288 |doi=10.1016/S0959-437X(05)80206-0}}</ref> {| class="wikitable" style="margin-left:auto;margin-right:auto" |+ Aina za lishe katika umetaboli wa bakteria |- !Aina ya lishe !Chanzo cha nguvu !Chanzo cha kaboni !Mifano |- | &nbsp;Fototrofu&nbsp; | align="center"|Mwanga wa jua | align="center"|&nbsp;Misombo ya kaboni (fotoheterotrofu) au uongezaji wa kaboni (fotoautotrofu) | &nbsp;Cyanobakteria, Bakteria wa kijani wa salfa, Klorofleksi, au bakteria wa zambarau &nbsp; |- | &nbsp;Lithotrofu | align="center"|Iso-Misombo | align="center"|&nbsp;Misombo ya kikaboni (lithoheterotrofu) au uongezaji wa kaboni (lithoautotrofu) | &nbsp;Thamodesalfobakteria, ''Hydrogenophilaceae,'' au Nitrospirae&nbsp; |- | &nbsp;Oganotrofi | align="center"|Misombo ya kaboni | align="center"|&nbsp;Misombo kaboni (kemoheterotrofi) au uongezaji wa kaboni (kemoautotrofi) &nbsp; | &nbsp;''Bacillus, Clostridium'' au ''Enterobacteriaceae'' &nbsp; |} Umetaboli wa kaboni katika bakteria huwa aidha pale ambapo misombo ya kaboni kiheterotrofiki, ambapo misombo kikaboni hutumiwa kama vyanzo vya kaboni, au kiototrofiki, kumaanisha kamba sseli ya kaboni hutokana na uongezaji wa [[Dioksidi kabonia|gesi ya kaboni yenye oksijeni]]. Bakteria za heterotrofiki ni pamoja na aina ya vimelea. Mfano mzuri wa bakteria za ototrofiki fototrofiki siyano-bakteria, bakteria za salfa ya kijani na baadhi wa bakteria za zambarau, lakini pia spishi nyingi za aina ya kemolithotrofiki, kama vile bakteria za kuongeza naitrojeni ama za kuongeza oksijeni katika salfa.<ref>{{cite journal |author=Hellingwerf K, Crielaard W, Hoff W, Matthijs H, Mur L, van Rotterdam B |title=Photobiology of bacteria |url=https://archive.org/details/sim_antonie-van-leeuwenhoek_1994_65_4/page/331 |journal=Antonie Van Leeuwenhoek |volume=65 |issue=4 |pages=331&ndash;47 |year=1994|pmid = 7832590 |doi=10.1007/BF00872217}}</ref> Umetaboli wa nishati ya bakteria ama huwa umejikita katika ototrofi, utumiaji wa mwanga kupitia kwa [[Usanisinuru|usanisinuru]], au kupitia kwa kemotrofi, utumiaji wa dutu za kemikali kuzalisha vyakula, ambayo mara nyingi hutengenzwa kwa gharama ya oksijeni au vipokea elektroni mbadala (mpumuo wa erobiki / anerobiki). [[File:Bluegreen algae.jpg|thumb|200px|right|Filamenti sinobakteria ya kuzalisha chakula kutoka kwa mwanga]] Hatimaye, bakteria zimegawanyika kama lithotrof ambazo hutumia vitoa elektroni vya isokaboni na oganotrofu ambazo hutumia misombo ya kikaboni kama vitoa elektroni. Vijiumbe vya kemotropiki hutumia vitoa elektroni husika katika kuhifadhi nguvu (kwa mpumuo wa aerobiki/uchachushaji wa anerobiki) na mifanyiko mingine ya biosinthetiki (kwa mfano, kuongezea gesi ya kaboni dioksidi), navyo viumbe vya fototropiki huzitumia tu kwa madhumuni ya biosinthetiki. Viumbe vipumuzi hutumia misombo ya kemikali kama kiini cha nishati kwa kuchukua elektroni kutoka kwa substreti ilopunguzwa na kuzihamisha hadi kwenye taminali ya kukubali elektroni katika mmenyuko wa aina ya redoksi. Mmenyuko huu husababisha nishati kutolewa inayoweza kutumika kwa kumeng'enya ATP na kuendesha umetaboli. Katika viumbe vya erobiki, [[Oksijeni|oksijeni]] hutumiwa kama kikubalio cha elektroni. Katika viumbe vya anaerobic misombo ya isokaboni nyingine kama vile, naitratisalfeti au kaboni dioksaidi hutumika kama vikubalio vya elektroni. Hii hupelekea michakato muhimu ya kiikoloji ya di-naitrifikashon kupunguza kwa salfeti na asetojenesis kwa mtiririko huo. Hali nyingine ya kimaisha ya kemotrofs katika hali ya kukosekana kwa vikubalio vya elektroni inayowezekana ni kuchachua (famenteshon), ambapo elektroni zilizochukuliwa kutoka sabstreti iliyo punguzwa huhamishiwa hadi kwenye substreti za kati zilizo oksidaiziwa kuzalisha bidhaa zilizo chachuka (mfano laktate, ethanol, [[Hidrojeni|hidrojeni]] na asidi ya butiriki). Kuchachuka kwa wezekana, kwa sababu kiwango cha nishati kilichomo kwenye sabstreti ni kikubwa kuliko kile cha mazao, na hii hufanya viumbe kusinthesise ATP na kufanyika kwa metaboli zao.<ref>{{cite journal |author=Zumft W |title=Cell biology and molecular basis of denitrification | url=http://mmbr.asm.org/cgi/reprint/61/4/533?view=long&pmid=9409151 |journal=Microbiol Mol Biol Rev |volume=61 |issue=4 |pages=533&ndash;616 |date=1 December 1997|pmid=9409151 |pmc=232623 }}</ref><ref>{{cite journal |author=Drake H, Daniel S, Küsel K, Matthies C, Kuhner C, Braus-Stromeyer S |title=Acetogenic bacteria: what are the in situ consequences of their diverse metabolic versatilities? |journal=Biofactors |volume=6 |issue=1 |pages=13&ndash;24 |year=1997 |pmid=9233536 |doi=10.1002/biof.5520060103}}</ref> Michakato hii ni muhimu pia katika baiolojia kwa mujibu wa uchafuzi wa mazingira, kwa mfano, bakteria za kupunguza salfeti huwajibika kwa kiasi kikubwa katika uzalishaji wa aina mbali mbali za sumu aina ya [[zebaki]] ([[methil-]] na [[daimethilzebaki]]) katika mazingira. Anaerobu zisizopumua hutumia uchachuaji kuzalisha nishati na nguvu wa kupunguza, kutengeneza bidhaa za metaboli (kama vile ethanol katika utengezaji wa pombe) kama bidhaa taka. Anaerobu aina ya Fakaltative zinanaweza kubadili kati ya kuchachua na ukomo kubalifu wa elektronitofauti kutegemeana na hali ya mazingira ambayo wao hupatikana. Bakteria aina ya lithotrofiki hutumia misombo isokaboni kama chanzo cha nishati. Isokaboni fadhili za elektroni za kawaida ni hidrojeni,kaboni monoksidi, [[Amonia|amonia]] (inayopelekea naitrifikashion), chuma na ayoni zingine za metali zilopungukiwa, na misombo kadhaa zilizopunguzwa za [[Sulfuri|sulfuri]]. Mara nyingi gesi ya methane inaweza kutumika na bakteria aina ya methanotrof kama kiini cha [[Elektroni|elektroni]] na chakula katika kunaboli kwa kaboni.<ref>{{cite journal |author=Dalton H |title=The Leeuwenhoek Lecture 2000 the natural and unnatural history of methane-oxidizing bacteria |url=http://www.journals.royalsoc.ac.uk/content/yl6umjthf30e4a59/ |journal=Philos Trans R Soc Lond B Biol Sci |volume=360 |issue=1458 |pages=1207&ndash;22 |year=2005 |pmid=16147517 |doi=10.1098/rstb.2005.1657 |pmc=1569495 |access-date=2015-05-07 |archive-date=2020-04-01 |archive-url=https://web.archive.org/web/20200401112813/http://www.journals.royalsoc.ac.uk/content/yl6umjthf30e4a59/ |dead-url=yes }}</ref> Katika aerobik fototrofi na kemolithotrofi, oksijeni hutumiwa kama kikomo kubalifu cha elektroni, na huku katika hali ya anaerobik, misombo isokaboni hutumika badala yake. Viumbe vingi aina ya Lithotrofiki ni ototrofiki, navyo viumbe aina ya oganatrofiki ni heterotrofiki. Mbali na kupachika kaboni dioksidi katika usanisinuru, baadhi ya bakteria pia hupachika gesi ya [[Nitrojeni|naitrojeni]] (upachikaji wa naitrojeni) kutumia enzaimu naitrojeni. Tabia hii muhimu inayoambatana na mazingira inaweza kupatikana katika bakteria wa metaboli karibu wa aina yote waliotajwa hapo mbeleni, lakini si kwa ujumlla.<ref>{{cite journal |author=Zehr J, Jenkins B, Short S, Steward G |title=Nitrogenase gene diversity and microbial community structure: a cross-system comparison |journal=Environ Microbiol |volume=5 |issue=7 |pages=539&ndash;54 |year=2003 |pmid=12823187 |doi=10.1046/j.1462-2920.2003.00451.x}}</ref> ==Ukuaji na Uzazi== [[File:Binary fission anim.gif|thumb|right|175px|Bakteria huongeza idadi kwa kujigawanya mara mbili]] Kinyume na viumbe vyenye seli mingi, kuongezeka kwa ukubwa wa bakteria (ukuaji wa seli) na uzalishi kwa ugawi wa seli zinahusishwa haswa na viumbe vyenye seli moja. Bakteria hukua hadi kiasi fulani na kisha kuzaa kupitia kwa urudufuwa fishoni ambayo ni aina ya uzazi usio wa kingono.<ref>{{cite journal |author=Koch A |title=Control of the bacterial cell cycle by cytoplasmic growth |url=https://archive.org/details/critical-reviews-in-microbiology_2002_28_1/page/61 |journal=Crit Rev Microbiol |volume=28 |issue=1 |pages=61&ndash;77 |year=2002 |pmid=12003041 |doi=10.1080/1040-840291046696}}</ref> Katika hali ya timilifu, bakteria zinaweza kukua na kugawanya sana kwa haraka, na idadi yao kufikia mara mbili kila baada ya dakika 9.8.<ref>{{cite journal |author=Eagon RG |title=Pseudomonas natriegens, a marine bacterium with a generation time of less than 10 minutes |journal=Journal of Bacteriology |volume=83 |issue=4 |pages=736–7 |year=1962 |month=April |pmid=13888946 |pmc=279347 |url=http://jb.asm.org/cgi/pmidlookup?view=long&pmid=13888946 }}</ref> Katika mgawanyiko wa seli, seli mbili zenye kufanana clone ni zinazozalishwa. Baadhi ya bakteria, wakati bado zinazalisha bila kutumia ngono, hutengeza miundo ya uzazi ili kusaidia kugawa seli mpya zilizoundwa. Mifano ni pamoja na kutengezwa kwa mwili wa malezi wa matunda na ''Myxobakteria'' na utengezaji wa hypha angani na ''Streptomyces'' au kuunganika. Budding huhusisha seli inayojumuisha kivimbe kinachojitenga na kisha kuutoa seli mpya. [[File:E.-coli-growth.gif|thumb|300px|Koloni ya Escherichia coli jinsi wanavyojigawanya na kuongezeka<ref> [205] </ref>.]] Katika maabara, bakteria hukuzwa kwa kutumia vyombo vya mango au viowevu. Vyombo vya ukuaji kama vile sahani ya agar hutumiwa kutenga aina moja tupu ya bakteria. Hata hivyo, ukuaji katika eneo/vyombo nyong'onyevu hutumika wakati kipimo cha ukuaji au kiasi kikubwa cha seli kinahitajika. Ukuaji katika vyombo vioewevu vilivyochochewa hufanyika kama vining'inio vya seli kwenye uoevu, na kufanya aina hizo rahisi kugawanyishwa na kuzihamisha, ingawa kutenga bakteria moja kutoka vyombo/eneo ya uoevu ni ngumu. Utumizi wa vyombo chagulizi (vyombo vilivyo ongezwa rutuba maalum au kupungukiwa nayo, au kuongezwa antibiotiki) inaweza kusaidia kubaini viumbe maalum.<ref name="Thomson">{{cite journal |author=Thomson R, Bertram H |title=Laboratory diagnosis of central nervous system infections |url=https://archive.org/details/sim_infectious-disease-clinics-of-north-america_2001-12_15_4/page/1047 |journal=Infectious Disease Clinics of North America |volume=15 |issue=4 |pages=1047–71 |year=2001 |pmid=11780267 |doi=10.1016/S0891-5520(05)70186-0}}</ref> Mbinu nyingi za maabara za kukuza bakteria hutumiakiasi kikubwa cha virutubisho kuzalisha kiasi kikubwa cha seli kwa bei nafuu na kwa haraka. Hata hivyo, katika mazingira ya asilia, rutuba ni adimu na kwa hivyo ina maana kuwa bakteria haziwezi kuendelea kuzaliana kwa muda usiojulikana. Kuadimika kwa virutubishi imesababisha mageuzi ya ukuaji wa mikakati mbalimbali (angalia r/K nadharia ya uteuzi). Baadhi ya viumbe vinaweza kukua kwa haraka sana wakati virutubisho vipatikanapo, kama vile ukuaji wa mwani (na sainobaktera) ambazo mara nyingi hutokea katika maziwa wakati wa msimu wa joto.<ref>{{cite journal |author=Paerl H, Fulton R, Moisander P, Dyble J |title=Harmful freshwater algal blooms, with an emphasis on cyanobacteria |journal=ScientificWorldJournal |volume=1 |issue=|pages=76&ndash;113 |year=2001|pmid=12805693 |doi=10.1100/tsw.2001.16}}</ref> Vijiumbe vingine hukabiliana na mazingira mbaya, kama vile uzalishaji wa antibiotiki nyingi na Streptomaises ili kuzuia ukuaji wa vijiumbe shindani.<ref>{{cite journal |author=Challis G, Hopwood D |title=Synergy and contingency as driving forces for the evolution of multiple secondary metabolite production by Streptomyces species |url=http://www.pnas.org/cgi/content/full/100/suppl_2/14555 |journal=Proc Natl Acad Sci USA |volume=100 Suppl 2 |issue= |pages=14555&ndash;61 |year=2003 |pmid=12970466 |doi=10.1073/pnas.1934677100 |pmc=304118 |access-date=2015-05-07 |archive-date=2008-07-25 |archive-url=https://web.archive.org/web/20080725001504/http://www.pnas.org/cgi/content/full/100/suppl_2/14555 |dead-url=yes }}</ref> Katika maumbile, viumbe vingi huishi katika jamii (mfano bio-filamu) ambayo inaweza kuruhusu kuongezeka kwa ugavi wa virutubisho na ulinzi kutoka mazingira finyu.<ref name="Davey"></ref> Mahusiano haya yananaweza kuwa muhimu kwa ukuaji wa viumbe fulani au kundi la viumbe (sintrofi).<ref>{{cite journal |author=Kooijman S, Auger P, Poggiale J, Kooi B |title=Quantitative steps in symbiogenesis and the evolution of homeostasis |url=https://archive.org/details/sim_biological-reviews_2003-08_78_3/page/435 |journal=Biol Rev Camb Philos Soc |volume=78 |issue=3 |pages=435&ndash;63 |year=2003 |pmid=14558592 |doi=10.1017/S1464793102006127}}</ref> Ukuaji wa bakteria hufuata awamu tatu. Wakati idadi ya bakteria huingia kwanza katika mazingira yenye idadi kubwa ya virutubisho inayoruhusu ukuaji, chembechembe hujiselehi na mazingira yao mapya. Awamu ya kwanza ya ukuaji wa uchumi ni awamu timu, ni kipindi cha kukua polepole wakati seli zinazoea kuishi katika mazingara yenye virutubishi vingi na kujitayarisha kwa ukuaji wa haraka. Awamu ya timu ina viwango vya juu vya mmeng'enyo wa vyakula, kwani protini muhimu kwa ukuaji wa haraka zinazalishwa.<ref>{{cite journal |author=Prats C, López D, Giró A, Ferrer J, Valls J |title=Individual-based modelling of bacterial cultures to study the microscopic causes of the lag phase |journal=J Theor Biol |volume=241 |issue=4 |pages=939&ndash;53 |year=2006|pmid = 16524598 |doi=10.1016/j.jtbi.2006.01.029}}</ref> Awamu ya pili ya ukuaji hujulikana kama awamu ya logarithimu (awamu ya logi ), pia inajulikana kama awamu kielelezo. Awamu hii ina ukuaji wakielel ezo wa haraka. Kiwango cha ukuaji cha seli katika awamu hii inajulikana kama ''kiwango cha ukuaji'' ''(k)'', na muda seli zinachukua kuongezeka mara mbili inajulikana kama ''muda wa kizazi'' ''(g''). Wakati wa awamu logi, virutubishi humetabolaiziwa kwa kasi sana hadi kirutubisho kimoja kuisha na kuwa kikwazo cha ukuaji. Awamu ya mwisho ya ukuaji ni ''awamu simamu'' na husababishwa na virutubisho vilivyomalizika. Seli hupunguza shughuli zao za metaboli na hujitosheleza na protini zisizo-muhimu kwenye chembechembe. Awamu simamu ni kipindi cha mpito kutoka ukuaji wa haraka kwa hali finyu ya na witikio na kuna ongezeko kwa uelekezi wa jeni zinazohusika katika kutengeneza ADN ,metaboli wa vito-oksidishaji na usafirishaji wa madini.<ref>{{cite journal |author=Hecker M, Völker U |title=General stress response of Bacillus subtilis and other bacteria |journal=Adv Microb Physiol |volume=44 |issue=|pages=35&ndash;91 |year=2001|pmid=11407115 |doi=10.1016/S0065-2911(01)44011-2}}</ref> ==Jenetikia== {{main|Jenomu}} Bakteria wengi huwa na kromosomu moja ya mviringo na ukubwa kutoka misingi jozi 160,000 katika bakteria ya endosimbiotik ''Candidatus Carsonella ruddii'',<ref>{{cite journal |author=Nakabachi A, Yamashita A, Toh H, Ishikawa H, Dunbar H, Moran N, Hattori M |title=The 160-kilobase genome of the bacterial endosymbiont Carsonella |url=https://archive.org/details/sim_science_2006-10-13_314_5797/page/266 |journal=Science |volume=314 |issue=5797 |pages=267 |year=2006 |pmid=17038615 |doi=10.1126/science.1134196}}</ref> hadi misingi jozi 12,200,000 katika bakteria zilizo na makao kwenye ''Sorangium cellulosum''.<ref>{{cite journal |author=Pradella S, Hans A, Spröer C, Reichenbach H, Gerth K, Beyer S |title=Characterisation, genome size and genetic manipulation of the myxobacterium Sorangium cellulosum So ce56 |url=https://archive.org/details/archives-of-microbiology_2002-12_178_6/page/484 |journal=Arch Microbiol |volume=178 |issue=6 |pages=484–92 |year=2002 |pmid=12420170 |doi=10.1007/s00203-002-0479-2}}</ref> Spirochaete za [[Jenasi|jenasi]] ''Borrelia'' ni mojawapo wa bakteria ya kipekee katika utaratibu huu, huku bakteria kama vile ''Borrelia burgdorferi'', inayosababisha ugonjwa wa lyme,ikiwa na kromosumu moja kwenye laini. Jeni katika jinomu za bakteria kawaida huwa kijikamba kimoja kiendelezi cha ADN na ingawa kuna aina mbalimbali za introni zinazopatikana kwenye bakteria, ni nadra ikilinganishwa na ukariotes.<ref>{{cite journal |author=Belfort M, Reaban ME, Coetzee T, Dalgaard JZ |title=Prokaryotic introns and inteins: a panoply of form and function |journal=J. Bacteriol. |volume=177 |issue=14 |pages=3897–903 |date=1 July 1995 |pmid=7608058 |url=http://jb.asm.org/cgi/pmidlookup?view=long&pmid=7608058 |pmc=177115 |access-date=2015-05-07 |archive-date=2020-05-30 |archive-url=https://web.archive.org/web/20200530142641/https://jb.asm.org/content/177/14/3897.long |dead-url=yes }}</ref> Bakteria pia zaweza kuwa na plasmids ambazo ni ADN ndogo zenye kromosumu za ziada zinazoweza kuwa na jeni zenye kupinga antibiotiki au virusi<ref>{{Rejea tovuti|title=Plasmid|url=https://www.genome.gov/genetics-glossary/Plasmid|work=Genome.gov|accessdate=2021-03-30|language=en}}</ref>. Bakteria, kama viumbe hukuzana bila ngono, hurithi nakala za jeni za kufanana za wazazi wao (yaani ni klonal). Hata hivyo, bakteria zote zaweza kubadilika na uteuzi juu ya mabadiliko ya maumbile nyenzo katika ADN yao inayosababishwa na kuja pamoja kwa maumbile au miuteshion. Miuteshions hutotokana na makosa yaliyotokana wakati ADN inapojiiga au kutokana na kujieka wazi kwa visababishaji vya tarasani. Viwango vya mabadiliko ya viinisaba hutofautiana sana kati ya aina tofauti ya bakteria na hata miongoni mwa kloni mbalimbali za bakteria aina moja.<ref>{{cite journal |author=Denamur E, Matic I |title=Evolution of mutation rates in bacteria |journal=Mol Microbiol |volume=60 |issue=4 |pages=820&ndash;7 |year=2006 |pmid=16677295 |doi=10.1111/j.1365-2958.2006.05150.x}}</ref> Mabadiliko ya kimaumbile katika jinomu za bakteria huja aidha kutokana na muteshion za nadra au "muteshion kutokana na hali finyu", ambapo jeni zinazohusika haswa katika michakato kadhaa za kudumisha ukuaji huongeza kiwango cha muteshion.<ref>{{cite journal |author=Wright B |title=Stress-directed adaptive mutations and evolution |journal=Mol Microbiol |volume=52 |issue=3 |pages=643&ndash;50 |year=2004 |pmid=15101972 |doi=10.1111/j.1365-2958.2004.04012.x}}</ref> Baadhi ya bakteria pia kuhamisha nyenzo za maumbile miongoni mwa seli. Hii inaweza kutokea kwa njia tatu kuu. Kwanza, bakteria inaweza kuchukua ADN za kutoka nje ya seli chembe kwenye mazingira yao, katika mchakato huitwao mabadiliko. Jeni pia zaweza kusafirishwa kwa wa transdakshion wakati wa mkungamanisho wa bakteriafej huingiza ADN za kigeni kwenye kromosomu. Njia ya tatu ya kuhamisha jeni ni kukonjugati kwa bakteria ambapo ADN huhamishwa kwa njia ya moja kwa moja baina ya chembechembe. Njia hii ya kupatikana kwa jeni kutoka bakteria zingine au mazingira inajulikana kama uhamisho wa mlalo wa jeni na inaweza kuwa ya kawaida katika hali ya kawaida.<ref>{{cite journal |author=Davison J |title=Genetic exchange between bacteria in the environment |url=https://archive.org/details/plasmid_1999-09_42_2/page/73 |journal=Plasmid |volume=42 |issue=2 |pages=73&ndash;91 |year=1999|pmid = 10489325 |doi=10.1006/plas.1999.1421}}</ref> Uhamisho wa jeni ni muhimu katika upinzani dhidi ya antibiotiki kwani huruhusu uhamisho wa haraka wa jeni pinzani kati miongoni mwa pathojeni.<ref>{{cite journal |author=Hastings P, Rosenberg S, Slack A |title=Antibiotic-induced lateral transfer of antibiotic resistance |url=https://archive.org/details/sim_trends-in-microbiology_2004-09_12_9/page/401 |journal=Trends Microbiol |volume=12 |issue=9 |pages=401&ndash;4 |year=2004 |pmid=15337159 |doi=10.1016/j.tim.2004.07.003}}</ref> ==Tabia== ===Uchozaji=== Bakteria mara kwa mara huwachilia kemikali kwenye mazingira yao ili kuyarekebisha iwafaavyo. Kemikali hizi mara nyingi huwa protini na mara nyingi hufanana na enzaimu kwa kusiaga aina fulani ya chakula katika mazingira. ===Bioluminesenz=== Bakteria chache huwa na mifumo ya kemikali ya kuzalisha mwangaza. Bakteri wa bioluminesenz mara nyingi hutokea katika bacteria wanaoishi katika muungano pamoja na samaki, na mwanga pengine husaidia kuvutia samaki au wanyama wengine wakubwa.<ref> Dusenbery, Daudi B. ((1996). Life at Small Scale. Scientific American Library. ISBN 0-7167-5060-0.</ref> - tazama Athari ya kibahari ya Milky. ===Uwepo wa seli nyingi=== Bakteria mara nyingi hufanya kazi kama totala ya seli mingi inayojulikana kama bio-filamus, zikibadilishana ishara za molekuli mbalimbali kwa mawasiliano baina ya chembechembe, na kushiriki katika shuguli zenye uratibu.<ref name="shapiro1">{{cite journal |author=Shapiro JA |title=Thinking about bacterial populations as multicellular organisms |journal=Annu. Rev. Microbiol. |volume=52 |issue= |pages=81–104 |year=1998 |pmid=9891794 |doi=10.1146/annurev.micro.52.1.81 |url=http://www.sci.uidaho.edu/newton/math501/Sp05/Shapiro.pdf |access-date=2015-05-07 |archive-date=2012-03-01 |archive-url=https://web.archive.org/web/20120301075327/http://www.sci.uidaho.edu/newton/math501/Sp05/Shapiro.pdf |dead-url=yes }}</ref><ref name="costerton1">{{cite journal |author=Costerton JW, Lewandowski Z, Caldwell DE, Korber DR, Lappin-Scott HM |title=Microbial biofilms |journal=Annu. Rev. Microbiol. |volume=49 |issue= |pages=711–45 |year=1995 |pmid=8561477 |doi=10.1146/annurev.mi.49.100195.003431 |url=http://www.ncbi.nlm.nih.gov/pubmed/8561477}}</ref> Faida ya jumuiya ya ushirikiano wa pamoja wa seli za bakteria ni pamoja na ugavi wa kazi baina ya seli, upatifu wa rasilimali ambazo kawaida seli moja haiwezi kufanikiwa kutimiza, kwa pamoja kulinda dhidi ya adui , na kulinda dhidi ya kufifia kwa idadi yao kwa kujibadili hadi kwenye chembechembe tofauti.<ref name="shapiro1"></ref> Kwa mfano, bakteria katika bio-filamus zaweza kuwa zimeongeza upinzani wake kwa ajenti wa bakteria mara zaidi ya 500 kuliko "bakteria" za kipekee za planktonik za aina hiyo.<ref name="costerton1"></ref> Aina moja ya mawasiliano baina ya seli kupitia ishara za molekuli inaitwa Kiwango hisi ambayo huumika kwa kusudi ya kutathmini uwepo wa msongamano wa idadi ya kutosha ili kujiingiza kwenye shughuli ambazo zitafanikiwa tu iwapo kuna idadi kubwa ya viumbe sawia vyenye kujishughulisha kwenye shughuli sawia, kama vile katika utoaji wa Enzaimu za utumbo au kutoa mwangaza. Kiwango hisi huruhusu bakteria kuratibu kujieleza kwa jeni, na kuziwezesha kuzalisha, kutoa na kubaini uwepo wa autoindusa au feromoni ambazo hujilimbikiza na ukuaji wa idadi ya chembechembe. <ref> http://www.ncbi.nlm.nih.gov/pubmed/11544353</ref> ===Usongaji=== Bakteria nyingi huenda kwa kutumia mbinu mbalimbali: flajela hutumika kwa kuogelea majini, utelezi na misuli ya bakteria huisongeza sakafuni, na mabadiliko ya ueleaji huruhusu mwendo wa wima.<ref name="Bardy">{{cite journal |author=Bardy S, Ng S, Jarrell K |title=Prokaryotic motility structures |url=http://mic.sgmjournals.org/cgi/content/full/149/2/295?view=long&pmid=12624192 |journal=Microbiology |volume=149 |issue=Pt 2 |pages=295&ndash;304 |year=2003 |pmid=12624192 |doi=10.1099/mic.0.25948-0 |access-date=2015-05-07 |archive-date=2007-09-14 |archive-url=https://web.archive.org/web/20070914013532/http://mic.sgmjournals.org/cgi/content/full/149/2/295?view=long&pmid=12624192 |dead-url=yes }}</ref> [[File:Flagellum base diagram-en.svg|thumb|right|350px|Flajelam ya Bakteria ya Gram-hasi. Viendesha msingi vya mzunguko wa kunasa na filamenti.]] Bakteria za kuogelea mara kadhaa husonga kiasi cha umbali wa miili yao mara 10 kwa sekunde na chache hata kwa kasi ya mara 100. Hii huwafanya angalau kuwa kasi kama samaki, kwa uzani fulani.<ref> Dusenbery, Daudi B. (2009). Living at Micro Scale, p. 136. Harvard University Press, Cambridge, Mass. ISBN 978-0-674-03116-6.</ref> Katika utumizi wa misuli kusogelea, bakteria hutumia Pili aina ya IV kama ndoano ya kushikilia, zikiirefusha zaidi, zikiishiliza na kisha kuirudisha kwa kutumia nguvu ya ajabu (>80[[Nyutoni|pN)]].<ref>{{cite journal |author=Merz A, So M, Sheetz M |title=Pilus retraction powers bacterial twitching motility |url=https://archive.org/details/sim_nature-uk_2000-09-07_407_6800/page/98 |journal=Nature |volume=407 |issue=6800 |pages=98–102 |year=2000 |pmid=10993081 |doi=10.1038/35024105}}</ref> Flajela ni miundo ya nusu-silinda iliyozungushwa na hufanya kazi kama propela kwa meli. Vitu vidogo kama bakteria hufanya kazi chini ya Nambari ya Reynold na mfumo wa silinda ni bora zaidi kuliko wa bapa, wa ki-kafi, mifumo muafaka kwa saizi ya binadamu.<ref> Dusenbery, David B. (2009). {. Living at Micro Scale, Chapter 13. Harvard University Press, Cambridge, Mass ISBN 978-0-674-03116-6.</ref> Spishi za aina za bakteria hutofautiana katika idadi na mpangilio wa flajela juu yazo; baadhi zina flajela moja (monotrikaos), zingine zina flajela kila upembe (amfitrikas), mrundiko wa flajela kwenye ubanze wa seli (lofotrikas), wakati zingine zina flajela zilizosambazwa kote kwenye seli (peritrikos). Flajela ya bakteria ndiyo iliyoeleweka kama kiungo cha usongezi katika kiumbe chochote na imetengezwa kwa takribani protini 20, na takriban protini 30 zingine zikihitajika kwa ajili ya udhibiti wake na mkutano. Flajela ni kiumbo kinachoendeshwa kwa mfumo wa kupokezana wa mota iliyoko chini na hutumia gradient ya elektrokemia kwenye utando kwa nguvu. Mota hii husukuma mwendo wa filamenti, ambayo hufanya kazi kama propela. Bakteria nyingi (kama vile ''E. coli)'' zina mbinu mbili tofauti za kujisongeza: kusonga mbele (kuogelea) na kutumbua. Kutumbua huziwezesha kujirekebisha na hufanya mwenendo zao kuwa tembezi baghala na mwenendo wa hali-tatu.(Tazama viungo vya nje chini kwa viungo zilizounganishwa na video.) Flajela wa kundi la kipekee la bakteria, spairochet, hupatikana kati ya utando mbili katika nafasi ya periplasmik. Wana mwili wa kipekee wa helikal ambao hufurukuta inaposonga.<ref name="Bardy"></ref> Bakteria songezi huvutiwa au hukataliwa kwa baadhi ya chochezi katia tabia iitwayo ''taksis'': na hizi hujumulisha kemotaksis, fototaksis na magnetotakis.<ref>{{cite journal |author=Lux R, Shi W |title=Chemotaxis-guided movements in bacteria |journal=Crit Rev Oral Biol Med |volume=15 |issue=4 |pages=207–20 |year=2004 |pmid=15284186 |doi=10.1177/154411130401500404}}</ref><ref>{{cite journal |author=Frankel R, Bazylinski D, Johnson M, Taylor B |title=Magneto-aerotaxis in marine coccoid bacteria |url=https://archive.org/details/sim_biophysical-journal_1997-08_73_2/page/994 |journal=Biophys J |volume=73 |issue=2 |pages=994&ndash;1000 |year=1997 |pmid=9251816 |doi=10.1016/S0006-3495(97)78132-3 |pmc=1180996}}</ref> Katika kundi moja pekee, myksobakteria, bakteria za kipekee hutembea pamoja kuunda mawimbi ya seli ambayo huunda vyombo vyenye matunda.<ref name="autogenerated1"></ref> Myksoobakteria husogelea tu kwenye sakafu kavu, tofauti na ''E. coli'' ambayo husogelea katika miundo kavu au oevu. ''Listeria'' na ''Shigella'' kadhaa husogelea ndani ya seli enyeji kwa kupenyeza saitoskeletoni, ambayo kawaida hutumika kwa kusafairisha viini ndani ya seli. Kwa kukuza upolimishaji wa actin kwenye banzi moja ya seli, zaweza kuunda aina ya mkia unaozisukuma kwenye saitoplasm ya seli enyeji.<ref>{{cite journal |author=Goldberg MB |title=Actin-based motility of intracellular microbial pathogens |url=https://archive.org/details/sim_microbiology-and-molecular-biology-reviews_2001-12_65_4/page/595 |journal=Microbiol Mol Biol Rev |volume=65 |issue=4 |pages=595–626 |year=2001 |pmid=11729265 |doi=10.1128/MMBR.65.4.595-626.2001 |pmc=99042 }}</ref> ==Uainisho na utambulisho== [[File:Streptococcus mutans Gram.jpg|right|thumb|200px|Mabadiliko ya Streptococcus inavyoonekana katika doa la Gram]] {{main|Uainishaji wa kisayansi}} Madhumuni ya uainishaji ni kuelezea spishi tofauti za bakteria kwa kuzitaja na kuwaweka viumbe msingi yanayofanana. Bakteria wanaweza kwa misingi ya umbo la kiini chao, umetaboli wa seli au kwa mujibu wa tofauti wa yaliyomo kwenye seli kama vile ADN, asidi za mafuta, rangi asili, antijeni s na kuinoni s.<ref name="Thomson"></ref> Ingawa skimu hizi ziliruhusu utambulisho na Uainishaji wa bakteria, haikubainika wazi kama tofauti hizi ziliwakilisha aina mbalimbali za spishi mbili tofauti ama aina ya spishi moja. uhakika huu umebadilisha kutokana na ukosefu wa miundo tofauti katika bakteria wengi, kama vile uhamisho jeni lateral kati ya aina unrelated. Kutokana na uhamisho wa jeni ya chini, baadhi ya bakteria wanaohusiana kwa karibu wanaweza kuwa umbo na umetaboli tofauti. Ili kuondokana na dukuduku hili, uainishaji wa bakteria wa kisasa husisitiza mpangilio wa molekiuli, kwa kutumia mbinu za kimaumbile kama vile guanine uwiano wa uamuzi wa sitosini uzalishaji wa genome-genome, pamoja na uratibishaji wa jeni ambazo hazijapitia ubadilishanaji mkubwa wa jeni za chini, kama vile jeni ya RNA.<ref>{{cite journal |author=Olsen GJ, Woese CR, Overbeek R |title=The winds of (evolutionary) change: breathing new life into microbiology |journal=Journal of Bacteriology |volume=176 |issue=1 |pages=1–6 |year=1994 |month=January |pmid=8282683 |pmc=205007 |url=http://jb.asm.org/cgi/pmidlookup?view=long&pmid=8282683}}</ref> Uainisho wa bakteria umetokana na Juzuu la Kimataifa kuhusu Mfumo Taaluma ya Bakteria,<ref>{{Rejea tovuti |url=http://ijs.sgmjournals.org/ |title=IJSEM - Home |accessdate=2015-05-07 |archivedate=2011-10-19 |archiveurl=https://web.archive.org/web/20111019160924/http://ijs.sgmjournals.org/ }}</ref> na Muongozo wa Bergey wa utaratibu Taaluma ya Bakteria.<ref>[279] ^ Bergey's Manual Trust</ref> Kamati ya Kimataifa juu ya Utaratibu Wa Bakteriolojia (ICSB) ndiyo hulinda kanuni za kimataifa za kuwapa majina makundi mbalimbali ya bakteria na kuwaweka katika viwango tofauti katika Kanuni ya Kimataifa ya majina ya Bakteria. Awali neno "bakteria" lilitumika kwa vijiumbe vyote vidogo, prokaryoti za seli moja. Hata hivyo, mifumo ya molekiuli ilionyesha maisha ya prokaryoti yakiwa na sehemu mbili tofauti ambazo awali ziliitwa ''Eubacteria'' na ''Archaebacteria,'' lakini ambayo kwa sasa inazoitwa ''Bakteria'' na ''[[Archaea|Akea]]'' ambayo ilitokana na mabadiliko ya kujitegemea kutoka mababu zao.</ref> Akea na yukaryoti hufanana sana kinyume na ilivyo na bakteria. Hii miundo miwili, pamoja na Yukarya, ndio msingi wa mfumo wa sehemu tatu ambayo kwa sasa ndiyo hutumika sana katika uainisho wa mikrobiolojia.<ref name="Gupta">{{cite journal |author=Gupta R |title=The natural evolutionary relationships among prokaryotes |url=https://archive.org/details/critical-reviews-in-microbiology_2000_26_2/page/111 |journal=Crit Rev Microbiol |volume=26 |issue=2 |pages=111–31 |year=2000 |pmid=10890353 |doi=10.1080/10408410091154219}}</ref> Hata hivyo, kutokana na kuanzishwa kwa hivi karibuni mifumo ya molekiuli na kuongezeka kwa kasi kwa idadi ya mfululizo wa genome waliopo,uainisho wa bakteria unaendelea kubadilika na kuwa eneo pana.<ref>{{cite journal |author=Doolittle RF |title=Evolutionary aspects of whole-genome biology |journal=Curr Opin Struct Biol |volume=15 |issue=3 |pages=248–253 |year=2005 |pmid=11837318 |doi=10.1016/j.sbi.2005.04.001}}</ref> Kwa mfano, wanabiolojia wachache wanadai kuwa Akea na Yukaryoti walitokana na mabadiliko chanya ya bakteria ya Gram.<ref name="Cavalier-Smith2002">{{cite journal |author=Cavalier-Smith T |title=The neomuran origin of archaebacteria, the negibacterial root of the universal tree and bacterial megaclassification |journal=Int J Syst Evol Microbiol |volume=52 |issue=Pt 1 |pages=7–76 |year=2002 |pmid=11837318}}</ref> Utambulisho wa bakteria katika maabara ni muhimu, hasa katika dawa, ambapo matibabu sahihi hutokana na spishi inayosababisha maambukizi. Kwa hiyo, haja ya kutambua visababisha magonjwa ya binadamu ilikuwa msukumo mkubwa katika maendeleo ya kuibua mbinu za kutambua bakteria. {{PhylomapA|size=400px|align=left|caption=[[Phylogenetic tree]] showing the diversity of bacteria, compared to other organisms.<ref>{{cite journal |author=Ciccarelli FD, Doerks T, von Mering C, Creevey CJ, Snel B, Bork P |title=Toward automatic reconstruction of a highly resolved tree of life |url=https://archive.org/details/sim_science_2006-03-03_311_5765/page/1282 |journal=Science |volume=311 |issue=5765 |pages=1283–7 |year=2006 |pmid=16513982 |doi=10.1126/science.1123061}}</ref> [[Eukaryote]]s are colored red, [[archaea]] green and bacteria blue.}} Waa la Gram, iliyoasisiwa mwaka 1884 na [[Hans Christian Gram]], inaweka bakteria katika makundi mbalimbali kwa msingi wa miundo ya kuta za seli zao.<ref name="Gram"></ref> Rusu nene za peptidoglaikoni "Gram-chanya" kuta za seli huwa na baka la zambarau ilihali ile nyembamba nyembamba "Gram-hasi" ukuta wa seli huonekana kuwa wa waridi. Kwa kuchanganya mofolojia na madoa ya Gram, bakteria wengi wanaweza kuainishwa kama waliyo kwenye kundi moja kati ya makundi manne (Gram-positive cocci, bacilli Gram-positive, cocci Gram-negative na bacilli Gram-negative bacilli). Baadhi ya viumbe hutambulika vizuri kwa kutumia mabaka kando na baka la Gram, hususan maikobakteria au ''Nokardia,'' ambao huonyesha kasi ya asidi wakati wako kwenye Ziehl-Neelsen au baka sawia na hilo.<ref>{{cite journal |author=Woods GL, Walker DH |title=Detection of infection or infectious agents by use of cytologic and histologic stains |journal=Clinical Microbiology Reviews |volume=9 |issue=3 |pages=382–404 |year=1996 |month=July |pmid=8809467 |pmc=172900 |url=http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=8809467 }}</ref> Baadhi ya viumbe wanaweza kutambuliwa kwa kuwalea katika mazingira na vifaa maalumu, au kwa mbinu nyingine, kama vile serolojia. Mbinu za mazingira maalumu zimebuniwa ili kukuza ukuaji na kutambua bakteria fulani, huku zikizuia ukuaji wa baadhi ya sampuli za bakteria. Mara nyingi mbinu hizi huwa zimeundwa kwa spishi maalumu, kwa mfano, sampuli ya sputum inaweza kushughulikwa ili kuonyesha ni vijiumbe gani husababishakichomi, ilihali sampuli za kinyesi hukuzwa katika mazingira maalumu kutambua vijiumbe ambao husababisha kuhara, huku ukidhibiti ukuaji wa vijiumbe visivyoleta magonjwa. Sampuli ambazo kwa kawaida huwa tasa, kama vile [[Damu|damu]], mkojo au maji ya mti wa mgongo, hukuzwa katika mazingira ambayo yanaweza kukuza vijiumbe vya kila nui.<ref name="Thomson"></ref><ref>{{cite journal |author=Weinstein M |title=Clinical importance of blood cultures |url=https://archive.org/details/sim_clinics-in-laboratory-medicine_1994-03_14_1/page/9 |journal=Clin Lab Med |volume=14 |issue=1 |pages=9&ndash;16 |year=1994|pmid = 8181237}}</ref> Mara tu kijiumbe kinachosababisha magonjwa kinapotengwa, kinaweza kuelezewa zaidi kupitia kwa umbo lake, ruwaza za ukuaji kama vile (ukuaji wa aerobiki au ukuaji, mifumo ya hemolisi) na matumizi ya mabaka. Kama ilivyo na uinisho wa bakteria, matumizi ya njia ya molekiuli katika utambulishio wa bakteria yanaendelea kuongezeka. Matibabu ya kutumia vifaa vya msingi wa ADN, kama vile mchakato wa mmenyeko wa polimerase, unazidi kuwa na umaarufu kutokana na umahususi na kasi yake, ikilinganishwa njia za ukuaji katika mazingira maalumu.<ref>{{cite journal |author=Louie M, Louie L, Simor AE |title=The role of DNA amplification technology in the diagnosis of infectious diseases |journal=CMAJ | url=http://www.cmaj.ca/cgi/content/full/163/3/301 |volume=163 |issue=3 |pages=301–309 |date=8 August 2000|pmid=10951731 |pmc=80298 }}</ref> Aidha, mbinu hizi huruhu uchunguzi na utambuzi wa seli zilizo hai lakini ambazo hazijakuzwa katika mazingira maalumu ambazo hazijigawanyi lakini zina umetaboli.<ref>{{cite journal |author=Oliver J |title=The viable but nonculturable state in bacteria |url=http://www.msk.or.kr/jsp/view_old_journalD.jsp?paperSeq=2134 |journal=J Microbiol |volume=43 Spec No |issue= |pages=93–100 |year=2005 |pmid=15765062 |access-date=2015-05-07 |archive-date=2013-04-04 |archive-url=https://web.archive.org/web/20130404021821/http://www.msk.or.kr/jsp/view_old_journalD.jsp?paperSeq=2134 |dead-url=yes }}</ref> Hata hivyo, kando na kutumia mbinu hizi zilizoboreshwa, idadi kamili ya spishi za bakteria haijulikani na haiwezi kukadiriwa na uhakika wowote. Kufuatia uainisho wa sasa, spishi za bakteria zinazojulikana ni chini ya 9,000 (ikiwa ni pamoja na cyanobacteria),<ref>ABRS - Numbers of living species in Australia and the World Report - Excutive Summary</ref> lakini majaribio ya kukisia viwango kamili vya baketeria mbalimbali vimekuwa kati ya 107 hadi 109 jumla ya spishi-na hata hayo makadirio haya mbalimbali yanaweza kuwa na viwango vingi vya kiasi mabalimbali.<ref>{{cite journal |author=Curtis TP, Sloan WT, Scannell JW |title=Estimating prokaryotic diversity and its limits |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=99 |issue=16 |pages=10494–9 |year=2002 |month=August |pmid=12097644 |pmc=124953 |doi=10.1073/pnas.142680199}}</ref><ref>{{cite journal |author=Schloss PD, Handelsman J |title=Status of the microbial census |url=https://archive.org/details/sim_microbiology-and-molecular-biology-reviews_2004-12_68_4/page/686 |journal=Microbiology and Molecular Biology Reviews |volume=68 |issue=4 |pages=686–91 |year=2004 |month=December |pmid=15590780 |pmc=539005 |doi=10.1128/MMBR.68.4.686-691.2004}}</ref> ==Mwingiliano na viumbe wengine== Licha ya ukawaida wao, bakteria wanaweza kuwa na muungano mkubwa na viumbe wengine. Uhusiano huu wa kutegemeana kugawanywa unaweza kugawanwa katika uhsiano wa ukupe, kutoshelezana na kunufaika. Kutokana na udogo wao, bakteria za komeshuali huwa na maumbo yasiyoeleweka na huishi kwa wanyama na mimea kama wanavyokua katika sehemu nyingine. Hata hivyo, ukuaji ukuaji wao unaweza kuongezwa kwa joto na jasho, na idadi kubwa ya viumbe hawa kwa binadamu ndiyo husababisha harufu ya mwili. ===Wawindaji=== Baadhi ya spishi za bakteria huua na hula vijiumbe vingine, viumbe hawa huitwa bakteria wawindaji.<ref>{{cite journal |author=Martin MO |title=Predatory prokaryotes: an emerging research opportunity |journal=Journal of Microbiology and Biotechnology |volume=4 |issue=5 |pages=467–77 |year=2002 |month=September |pmid=12432957}}</ref> Hawa ni pamoja na vijiumbe kama vile ''Myxococcus xanthus,'' ambao huunda kundi la seli ambazo huua na kumeng'enya bakteria yoyote wanayokutana nayo.<ref>{{cite journal |author=Velicer GJ, Stredwick KL |title=Experimental social evolution with Myxococcus xanthus |url=https://archive.org/details/antonie-van-leeuwenhoek_2002_81_1-4/page/155 |journal=Antonie Van Leeuwenhoek |volume=81 |issue=1-4 |pages=155–64 |year=2002 |month=August |pmid=12448714 |doi=10.1023/A:1020546130033}}</ref> Bakteria nyingine wawindaji ama hujiunganisha kwenye mawindo yao ili kuimeng'enya na kunyonya virutubisho, kama vile ''Vampirococcus,'' au huvamia seli nyingine na kuzaana ndani ya sehemu wazi ya seli, kama vile ''Daptobacter.''<ref>{{cite journal |author=Guerrero R, Pedros-Alio C, Esteve I, Mas J, Chase D, Margulis L |title=Predatory prokaryotes: predation and primary consumption evolved in bacteria |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=83 |issue= |pages=2138–42 |year=1986 |month=April |pmid=11542073 |pmc=323246 |doi= 10.1073/pnas.83.7.2138|url=http://www.pnas.org/cgi/pmidlookup?view=long&pmid=11542073}}</ref> Bakteria wawindaji zinadhaniwa kwamba zilitokana na saprophages ambao walikula mizoga, na kutokana na mazoea iliwawezesha kunasa na kuua vijiumbe wengine.<ref>{{cite journal |author=Velicer GJ, Mendes-Soares H |title=Bacterial predators |journal=Current Biology |volume=19 |issue=2 |pages=R55–R56 |year=2009 |month=January|doi=10.1016/j.cub.2008.10.043 |pmid=19174136 |last1=Velicer |first1=GJ |last2=Mendes-Soares |first2=H}}</ref> ===Wanaotegemeana=== Baadhi ya bakteria huwa na uhusia wakaribu na huunda makundi ambayo nimuhimu katika maisha yao. Mfano mmoja wauhusiano huu wa kutegemeana uitwao uhamisho wa haidrojeni hutokea kati ya makundi ya bakteria wa aerobiki na wale wa anaerobiki ambao hula asidi ya kaboni kama vile asidi biutiriki au asidi propioniki na huzalisha [[haidrojeni]], na methanogeni ya Akea ambayo hutumia haidrojeni.<ref>{{cite journal |author=Stams A, de Bok F, Plugge C, van Eekert M, Dolfing J, Schraa G |title=Exocellular electron transfer in anaerobic microbial communities |journal=Environ Microbiol |volume=8 |issue=3 |pages=371&ndash;82 |year=2006 |pmid=16478444 |doi=10.1111/j.1462-2920.2006.00989.x}}</ref> bakteria katika uhusiano huu hawawezi kutumia asidi ya kaboni kwa sababu mmenyeko hutoa haidrojeni ambayo hujilimbikiza katika mazingira yao. Ni uhusiano huu tu wa ndani na Akea wanaotumia haidrojeni ambao hudhibiti viwango vya haidrojeni kuwa chini ilikuruhusu bakteria kukua. Katika [[udongo]], vijiumbe wanaoishi kwenye raizosifia ya (a ukanda wa ozoni ambao ni pamoja na mizizi na udongo hunata kwenye mizizi baada ya kutikisa) hutekeleza jukumu la kuongeza nitrojeni kwa kuwageuza gesi ya nitrojeni kuwa misombo ya nitrojeni.<ref>{{cite journal |author=Barea J, Pozo M, Azcón R, Azcón-Aguilar C |title=Microbial co-operation in the rhizosphere |url=http://jxb.oxfordjournals.org/cgi/content/full/56/417/1761 |journal=J Exp Bot |volume=56 |issue=417 |pages=1761&ndash;78 |year=2005 |pmid=15911555 |doi=10.1093/jxb/eri197 |access-date=2015-05-07 |archive-date=2007-02-16 |archive-url=https://web.archive.org/web/20070216133241/http://jxb.oxfordjournals.org/cgi/content/full/56/417/1761 |dead-url=yes }}</ref> Hii husaidia kutooa aina ya haidrojeni ambayo inanyonyek kwa urahisi na mimea mingi, ambayo haiwezi kujiongezea oksijeni yenyewe. Bakteria wengine wengi hupatikana kama saimbioti katika binadamu na viumbe wengine. Kwa mfano, uwepo wa spishi za bakteria zaidi ya 1,000 katika utumbo wa binadamu unaweza kuchanga katika kinga ya utumbo mmeng'enyo wa vitamini kaama vile asidi ya foliki vitamini k na [[biotin]], kubadilisha [[protini ya maziwa]] na [[asidi laktik]] (Tazama ''[[Lactobacillus]]''), pamoja na uchachushaji wa kabohaidreti kubwa zisizomeng'enyeka.<ref>{{cite journal |author=O'Hara A, Shanahan F |title=The gut flora as a forgotten organ |journal=EMBO Rep |volume=7 |issue=7 |pages=688&ndash;93 |year=2006 |pmid=16819463 |doi=10.1038/sj.embor.7400731 |pmc=1500832}}</ref><ref>{{cite journal |author=Zoetendal E, Vaughan E, de Vos W |title=A microbial world within us |journal=Mol Microbiol |volume=59 |issue=6 |pages=1639&ndash;50 |year=2006 |pmid=16553872 |doi=10.1111/j.1365-2958.2006.05056.x}}</ref><ref>{{cite journal |author=Gorbach S |title=Lactic acid bacteria and human health |url=https://archive.org/details/sim_annals-of-medicine_1990-02_22_1/page/37 |journal=Ann Med |volume=22 |issue=1 |pages=37&ndash;41 |year=1990|pmid = 2109988 |doi=10.3109/07853899009147239}}</ref> Uwepo wa utumbo huu hudhibiti wa vimelea ambavyo husababisha magonjwa (kawaida kwa kutengwa kwa lazima) na bakteria hawa wa manufaa huuzwa kama chakula mbadala cha probiotiki.<ref>{{cite journal |author=Salminen S, Gueimonde M, Isolauri E |title=Probiotics that modify disease risk | url=http://jn.nutrition.org/cgi/content/full/135/5/1294 |journal=J Nutr |volume=135 |issue=5 |pages=1294&ndash;8 |date=1 May 2005|pmid=15867327 }}</ref> [[File:SalmonellaNIAID.jpg|thumb|250px|right|Picha inayoonyesha bakteriainayosababisha homa ya matumbo ikivamia seli za binadamu katika mazingira maalumu]] ===Vimelea vinavyosababisha magonjwa=== {{Main|Bakteria na maradhi}} Iwapo bakteria watakuwa na uhusiano wa kupe na viumbe wengine, huainishwa kama vimelea vya magonjwa. Bakteria wanaosababisha magonjwa ndiyo husababisha vifo vingi kwa binadamu na husababisha magonjwa ya kuambukizwa kama vile pepopunda, [[Homa ya matumbo|homa ya matumbo]], mkamba, [[Kaswende|kaswende]], [[Kipindupindu|kipindupindu]], magonjwa yanayotokana na chakula, ukoma na [[Kifua kikuu|kifua kikuu.]] Kimelea kinachojulikana kwa kusababisha magonjwa kinaweza kujulikana baada ya miaka mingi, kama ilivyokuwa kwa ''Helicobacter pylori '' na ugonjwa vidonda vya tumbo wa ''peptiki.'' Magonjwa ya bakteria ni muhimu pia katika [[kilimo]], huku bakteria wakisababisha madoa ya matawi, kukauka na kupukutika katika mimea, kadhalikaugonjwa wa Johne, ugonjwa wa maziwa, salmonella na kimeta katika wanyama wa kufugwa. Kila spishi ya pathojeni ina tabia ya mwingiliano na miili ya binadamu. Baadhi ya viumbe, kama vile ''Staphylococcus'' au ''Streptococcus,'' wanaweza kusababisha maambukizi ya ugonjwa wa ngozi, kichomi, [[ugonjwa wa uti wa mgongo]] na hata sepsis kupita kiasi, uvimbe wa mara kwa mara ambao huleta mshtuko, kunyong'onyea kwa mishipa ya damu na kifo.<ref>{{cite journal |author=Fish D |title=Optimal antimicrobial therapy for sepsis |journal=Am J Health Syst Pharm |volume=59 Suppl 1 |issue=|pages=S13&ndash;9 |year=2002|pmid=11885408}}</ref> Hata hivyo, viumbe hawa ni sehemu ya kawaida ya binadamu na mimea na huwa kwenye ngozi[[Pua| au pua]] bila kusababisha ugonjwa wowote. Viumbe vingine husababisha magonjwa kwa binadamu, kama vile Rickettsia, ambayo ni kimelea cha ndani ya seli ambayo huweza kukua na kuzaa kama iko ndani ya viumbe wengine. Spishi moja ya Rickettsia husababisha homaya matumbo, ilihali nyingine husababisha homa inayopatikana maeneo ya milima. ''Klamidia,'' kundi lingine la vimelea wa ndani, ina ina spishi ambazo zinaweza kusababisha kichomi, au maambukizi ya magonjwa ya njia ya mkojo na kuchangia katika magonjwa ya mishipa ya moyo.<ref>{{cite journal |author=Belland R, Ouellette S, Gieffers J, Byrne G |title=Chlamydia pneumoniae and atherosclerosis |journal=Cell Microbiol |volume=6 |issue=2 |pages=117&ndash;27 |year=2004|pmid = 14706098 |doi=10.1046/j.1462-5822.2003.00352.x}}</ref> Mwisho kabisa, baadhi ya spishi kama vile Pseudomonas aeruginosa, Burkholderia cenocepacia, na Mycobacterium avium ni ni pathojeni ambazo hutaka kutumia hali fulani ya binadamu walio na uhaba wa kinga ya magonjwa ama chanagarawe za s aitiki.<ref name="Saiman">{{cite journal |author=Saiman L |title=Microbiology of early CF lung disease |journal=Paediatric Respiratory Reviews |volume=5 Suppl A |issue= |pages=S367–9 |year=2004 |pmid=14980298}}</ref> [[File:Bacterial infections and involved species.png|thumb|left|380px|Muhtasari wa maambukiziya bakteria na spishi maalumu zinazohusika.]] Maambukizi ya bakteria yanaweza kutibiwa na [[antibaotiki]], ambazo huitwa antibakteriasida kama zinaweza kuua vimelea, au kusitisha ukuaji wa bakteria. Kuna antibaotiki za aina nyingi na kila kundi huzuia mchakato tofauti na ule wa pathojenikando na ule unaopatikana kwenye mazingira ilimo. Mfano wa jinsi bakteria wanavyotoa sumu kiuchaguzi ni kloramfebikoli na puromaisini, ambayo huzuia ribosomu ya bakteria, lakini si ribosomu ya yukaryoti ya umbo tofauti.<ref>{{cite journal |author=Yonath A, Bashan A |title=Ribosomal crystallography: initiation, peptide bond formation, and amino acid polymerization are hampered by antibiotics |url=https://archive.org/details/sim_annual-review-of-microbiology_2004_58/page/233 |journal=Annu Rev Microbiol |volume=58 |pages=233&ndash;51 |year=2004 |pmid=15487937 |doi=10.1146/annurev.micro.58.030603.123822}}</ref> Antibiotiki hutumiwa katika kutibu magonjwa ya binadamu na katika kilimo kikubwa kukuza ukuaji wa wanyama, ambapo zinaweza kuchangia katika ukuaji wa kasi ya uwezo wa kupigana na idadi ya bakteria.<ref>{{cite journal |author=Khachatourians GG |title=Agricultural use of antibiotics and the evolution and transfer of antibiotic-resistant bacteria |journal=CMAJ |volume=159 |issue=9 |pages=1129–36 |year=1998 |month=November |pmid=9835883 |pmc=1229782 |url=http://www.cmaj.ca/cgi/pmidlookup?view=reprint&pmid=9835883}}</ref> Maambukiziyanaweza kuzuiwa kwa kutumia maagizo ya antiseptiki kama vile kusafisha ngozi kabla ya kuitoboa kwa sindano au sirenji, na kwa utunzaji mzuri wa katheta za nyumbani. Vifaa vya upasuaji na vya meno pia husafishwa kuzuia kuchafuka kutokana na bakteria. Sabuni za kuosha kama vile blichi hutumiwa kuua bakteria au pathojeni zingine katika sehemu mablimbali ili kuzuia uchafu na uwezekano wa kuambukizwa ugonjwa. ===Maadui=== {{main|Bakteriofagi}} [[Bakteriofagi]] (pia fagi au vilabakteria) ni virusi vilivyo na uwezo wa kushambulia na kuua bakteria ili kuongeza idadi yao<ref>{{Rejea tovuti|title=understanding Bacteriophages in details|url=https://www.thephage.xyz/2021/02/understanding-bacteriophages-in-details.html|accessdate=2021-03-30|language=en|archivedate=2021-05-06|archiveurl=https://web.archive.org/web/20210506175516/https://www.thephage.xyz/2021/02/understanding-bacteriophages-in-details.html}}</ref>. Kuna spishi nyingi za bakteriofagi zinazoshambulia spishi zote za bakteria na [[arkea]] kwa kuingiza ADN au ARN ndani yao na kushirikisha utaratibu wa seli kutoa [[virioni]] mpya. Bakteria hupinga maambukizo ya fagi kupitia mfumo tata wa kijeni ambao huharibu ADN au ARN ya kigeni<ref>{{cite journal |author=Bickle TA, Krüger DH |title=Biology of DNA restriction |journal=Microbiol. Rev. |volume=57 |issue=2 |pages=434–50 |date=1 June 1993|pmid=8336674 |pmc=372918 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=8336674 }}</ref>. [[Jenomu]] ya bakteriofagi nyingi huunganishwa katika ile ya [[kimelewa]] na inaweza kukaa [[bwete]] kwa muda wa [[kizazi|vizazi]] vingi. Baadhi ya jeni za bakteriofagi zinaweza kuchangia [[sifajeni]] (fenotipi) ya vimelewa vyao. Kwa mfano, [[ukoo|koo]] fulani za ''[[Escherichia coli]]'' na za ''[[Clostridium botulinum]]'' zina [[sumu]] kwa sababu ya [[toksini]] zinazozalishwa na jeni za bakteriofagi, wakati koo bila jeni hizo hazina sumu. Jeni hizo hunakiliwa na bakteria pamoja na jeni zao binafsi, ambayo inawapatia uwezo wa kusababisha magonjwa<ref>{{cite journal |author=Brüssow H, Canchaya C, Hardt WD |title=Phages and the evolution of bacterial pathogens: from genomic rearrangements to lysogenic conversion |url=https://archive.org/details/sim_microbiology-and-molecular-biology-reviews_2004-09_68_3/page/560 |journal=Microbiology and Molecular Biology Reviews |volume=68 |issue=3 |pages=560–602 |year=2004 |month=September |pmid=15353570 |pmc=515249 |doi=10.1128/MMBR.68.3.560-602.2004}}</ref>. ==Umuhimu katika teknolojia na viwanda== {{main|Bakteria na uchumi}} Bakteria, hususan bakteria wa asidi ya laktiki kama vile ''Lactobacillus'' na ''Lactococcus,'' inapoongezwa chachu, wametumika kwa maelfu ya miaka katika maandalizi ya vyakula vya kuchachusha kama vile [[jibini]], sosi ya soya, [[divai]] na [[siki]].<ref>{{cite journal |author=Johnson M, Lucey J |title=Major technological advances and trends in cheese |url=https://archive.org/details/sim_journal-of-dairy-science_2006-04_89_4/page/1174 |journal=J Dairy Sci |volume=89 |issue=4 |pages=1174–8 |year=2006 |pmid=16537950 |doi=10.3168/jds.S0022-0302(06)72186-5}}</ref><ref>{{cite journal |author=Hagedorn S, Kaphammer B |title=Microbial biocatalysis in the generation of flavor and fragrance chemicals |url=https://archive.org/details/sim_annual-review-of-microbiology_1994_48/page/773 |journal=Annu. Rev. Microbiol. |volume=48 |issue= |pages=773–800 |year=1994 |pmid=7826026 |doi=10.1146/annurev.mi.48.100194.004013}}</ref> Uwezo wa bakteria kuharibu misombo mbalimbali ya kaboni ni muhimu na imetumika katika [[usindikaji]] wa taka na na ufuaji wa misombo ya kaboni kutoka kwa taka. Bakteria wenye uwezo wa kusaga haidrokaboni katika [[mafuta ya petroli]] mara nyingi hutumika kusafisha mafuta yanayovuja.<ref>{{cite journal |author=Cohen Y |title=Bioremediation of oil by marine microbial mats |journal=Int Microbiol |volume=5 |issue=4 |pages=189&ndash;93 |year=2002 |pmid=12497184 |doi=10.1007/s10123-002-0089-5}}</ref> Mbolea iliongezwa kwa baadhi ya fukwe katika Prince William Sound katika jaribio la kukuza ukuaji wa kawaida wa hawa bakteria baada ya kuvuja ambako kulileta hasara kwa mwaka 1989 ''Exxon Valdez''. Juhudi hizi zilifanikiwa katika fukwe ambazo hazikuwa zimefunikwa na rusu nene ya mafuta. Bakteria pia hutumika katika ufufuaji wa misombo ya kaboni kutoka taka za viwanda zenye sumu.<ref>{{cite journal |author=Neves LC, Miyamura TT, Moraes DA, Penna TC, Converti A |title=Biofiltration methods for the removal of phenolic residues |journal=Appl. Biochem. Biotechnol. |volume=129-132 |issue= |pages=130–52 |year=2006 |pmid=16915636 |doi=10.1385/ABAB:129:1:130}}</ref> Katika sekta ya viwanda vya kemikali, bakteria ni muhimu katika uzalishaji wa kemikali safi za enatiomeriki ambazo hutumika kama dawa au dawa za mimea.<ref>{{cite journal |author=Liese A, Filho M |title=Production of fine chemicals using biocatalysis |journal=Curr Opin Biotechnol |volume=10 |issue=6 |pages=595&ndash;603 |year=1999 |pmid=10600695 |doi=10.1016/S0958-1669(99)00040-3}}</ref> Bakteria pia zinaweza kutumika badala ya dawa za kuua wadudu katika kudhibiti wadudu kibiolojia. Kwa kawaida hii huhusisha '' Bacillus thuringiensis'' (pia huitwa BT), bakteria ya Gram-chanya inayopatikana katika udongo. Spishi ndogo za hii bakteria hutumika kama dawa maalumu ya kuua wadudu ya Lepidoptera inayojulikana kwa jina la madukani kama vile Dipel na Thuricide.<ref>{{cite journal |author=Aronson AI, Shai Y |title=Why Bacillus thuringiensis insecticidal toxins are so effective: unique features of their mode of action |journal=FEMS Microbiol. Lett. |volume=195 |issue=1 |pages=1–8 |year=2001 |pmid=11166987 |doi=10.1111/j.1574-6968.2001.tb10489.x}}</ref> Kwa sababu ya umaalumu wao, dawa hizi zinaaminika kuwa hazina madhara yoyote katika mazingira, bila atahri yoyote kwa binadamu wanyama, wadudu wa kufyonza na wadudu wengine wengi wenye manufaa kwa binadamu.<ref>{{cite journal |author=Bozsik A |title=Susceptibility of adult Coccinella septempunctata (Coleoptera: Coccinellidae) to insecticides with different modes of action |journal=Pest Manag Sci |volume=62 |issue=7 |pages=651–4 |year=2006 |pmid=16649191 |doi=10.1002/ps.1221}}</ref><ref>{{cite journal |author=Chattopadhyay A, Bhatnagar N, Bhatnagar R |title=Bacterial insecticidal toxins |url=https://archive.org/details/critical-reviews-in-microbiology_2004_30_1/page/33 |journal=Crit Rev Microbiol |volume=30 |issue=1 |pages=33–54 |year=2004 |pmid=15116762 |doi=10.1080/10408410490270712}}</ref> Kwa sababu ya uwezo wao kukua kwa haraka na urahisi ambao wanaweza kubadilishwa, bakteria hutumika pakubwa katika biolojia ya molekiuli {0,{/0} taaluma ya nasaba au [[jenetikia]] na [[biokemia]]. Kwa kubadilika katika maumbo ya ADN ya bakteria na kuchunguza umbo la nje linalotokea, wanasayansi wanaweza kujua dhima ya jeni, [[Kimeng'enya|vimeng'enya]] na njia za umetaboli katika bakteria, na kutumia ujuzi huu kwenye wanyama wakubwa.<ref>{{cite journal |author=Serres MH, Gopal S, Nahum LA, Liang P, Gaasterland T, Riley M |title=A functional update of the Escherichia coli K-12 genome |journal=Genome Biology |volume=2 |issue=9 |pages=RESEARCH0035 |year=2001 |pmid=11574054 |pmc=56896 |url=http://genomebiology.com/1465-6906/2/RESEARCH0035 |doi=10.1186/gb-2001-2-9-research0035 |access-date=2015-05-07 |archive-date=2020-03-15 |archive-url=https://web.archive.org/web/20200315111159/http://genomebiology.com/1465-6906/2/RESEARCH0035 |dead-url=yes }}</ref> Lengo la kulewa biokemi ya seli na hufikia kiwango chake tata katika usagaji wa wa iadi kubwa ya vimeng'enya na maelezo ya data ya jeni katika mtindo wa hisabati ya viumbe wote. Hali hii inaweza kufikiwa katika baadhi ya bakteria ambao wametafitiwa vizuri, wenye maumbo ya umetaboli wa ''Escherichia coli'' ambao kwa sasa wanazalishwa na kujaribiwa.<ref>{{cite journal |author=Almaas E, Kovács B, Vicsek T, Oltvai Z, Barabási A |title=Global organization of metabolic fluxes in the bacterium Escherichia coli |url=https://archive.org/details/sim_nature-uk_2004-02-26_427_6977/page/838 |journal=Nature |volume=427 |issue=6977 |pages=839–43 |year=2004 |pmid=14985762 |doi=10.1038/nature02289}}</ref><ref>{{cite journal |author=Reed JL, Vo TD, Schilling CH, Palsson BO |title=An expanded genome-scale model of Escherichia coli K-12 (iJR904 GSM/GPR) |journal=Genome Biol. |volume=4 |issue=9 |pages=R54 |year=2003 |pmid=12952533 |doi=10.1186/gb-2003-4-9-r54 |pmc=193654}}</ref> Uelewa wa umetaboli wa bakteria na jenetikia yake inawezesha matumizi ya bioteknolojia katika uhandisi wa bakteria kwa ajili ya uzalishaji wa protini ya matibabu, kama vile insulini, nyenzo za ukuaji, au kingamwili.<ref>{{cite journal |author=Walsh G |title=Therapeutic insulins and their large-scale manufacture |url=https://archive.org/details/applied-microbiology-and-biotechnology_2005-04_67_2/page/151 |journal=Appl Microbiol Biotechnol |volume=67 |issue=2 |pages=151&ndash;9 |year=2005 |pmid=15580495 |doi=10.1007/s00253-004-1809-x}}</ref><ref>{{cite journal |author=Graumann K, Premstaller A |title=Manufacturing of recombinant therapeutic proteins in microbial systems |journal=Biotechnol J |volume=1 |issue=2 |pages=164&ndash;86 |year=2006 |pmid=16892246 |doi=10.1002/biot.200500051}}</ref> ==Tazama Pia== *[[Bioteknolojia]] *[[Orodha ya makundi ya bakteria]] *[[Kidubini]] *[[Kanuni ya kimataifa ya majina ya bakteria]] ==Tanbihi== {{Reflist|2}} ==Marejeo== * {{cite book |author=Alcamo IE |title=Fundamentals of microbiology |url=https://archive.org/details/isbn_9790763710674 |publisher=Jones and Bartlett |location=Boston |year=2001 |pages= |isbn=0-7637-1067-9}} * {{cite book |author=Atlas RM |title=Principles of microbiology |url=https://archive.org/details/principlesofmicr0000atla_l1q7 |publisher=Mosby |location=St. Louis |year=1995 |pages= |isbn=0-8016-7790-4}} * {{cite book |author=Martinko JM, Madigan MT |title=Brock Biology of Microorganisms | edition = 11th |publisher=Prentice Hall |location=Englewood Cliffs, N.J |year=2005 |pages= |isbn=0-13-144329-1}} * {{cite book |author=Holt JC, Bergey DH |title=Bergey's manual of determinative bacteriology |edition = 9th |publisher=Williams & Wilkins |location=Baltimore |year=1994 |pages= |isbn=0-683-00603-7}} * {{cite journal | author=Hugenholtz P, Goebel BM, Pace NR | title=Impact of culture-independent studies on the emerging phylogenetic view of bacterial diversity | journal=J Bacteriol | date=15 September 1998 | pages=4765&ndash;74 | volume=180 | issue=18 | pmid=9733676 | url=http://jb.asm.org/cgi/content/full/180/18/4765?view=full&pmid=9733676 | pmc=107498 | access-date=2015-05-07 | archive-date=2008-09-14 | archive-url=https://web.archive.org/web/20080914121802/http://jb.asm.org/cgi/content/full/180/18/4765?view=full&pmid=9733676 | dead-url=yes }} * {{cite book |author=Funke BR, Tortora GJ, Case CL |title=Microbiology: an introduction |edition = 8th |publisher=Benjamin Cummings |location=San Francisco |year=2004 |pages= |isbn=0-8053-7614-3}} * {{cite book |author=Shively, Jessup M. |title=Complex Intracellular Structures in Prokaryotes (Microbiology Monographs) |publisher=Springer |location=Berlin |year=2006 |isbn=3-540-32524-7}} * {{cite journal | author=Witzany G, | title=Bio-Communication of Bacteria and their Evolutionary Roots in Natural Genome Editing Competences of Viruses | journal=Open Evol J | year=2008 | volume=2 |pages=44–54 | doi=10.2174/1874404400802010044}} ==Viungo vya nje== {{Wikispecies}} {{Sisterlinks}} * # MicrobeWiki, an extensive wiki about bacteria and viruses * [http://www.ncppb.com Bacteria which affect crops and other plants] * [http://www.dsmz.de/bactnom/bactname.htm Bacterial Nomenclature Up-To-Date from DSMZ] {{Wayback|url=http://www.dsmz.de/bactnom/bactname.htm |date=20070929083605 }} * Genera of the domain Bacteria - list of Prokaryotic names with Standing in Nomenclature * [http://www.sciencenews.org/pages/sn_arc99/4_17_99/fob5.htm The largest bacteria] {{Wayback|url=http://www.sciencenews.org/pages/sn_arc99/4_17_99/fob5.htm |date=20121211094146 }} * [http://tolweb.org/tree?group=Eubacteria&amp;contgroup=Life_on_Earth Tree of Life: Eubacteria] {{Wayback|url=http://tolweb.org/tree?group=Eubacteria&contgroup=Life_on_Earth |date=20141021015145 }} * Videos of bacteria swimming and tumbling, use of optical tweezers and other videos. * Planet of the Bacteria by Stephen Jay Gould * [http://www.textbookofbacteriology.net/ On-line text book on bacteriology] {{Wayback|url=http://www.textbookofbacteriology.net/ |date=20080913123627 }} * [http://www.blackwellpublishing.com/trun/artwork/Animations/Overview/overview.html Animated guide to bacterial cell structure.] * [http://www.newscientist.com/channel/life/dn14094-bacteria-make-major-evolutionary-shift-in-the-lab.html Bacteria Make Major Evolutionary Shift in the Lab] * Cell-Cell Communication in Bacteria on-line lecture by Bonnie Bassler, and TED: Discovering bacteria's amazing communication system * [http://esciencenews.com/articles/2009/02/19/online.collaboration.identifies.bacteria Online collaboration for bacterial taxonomy.] {{Wayback|url=http://esciencenews.com/articles/2009/02/19/online.collaboration.identifies.bacteria |date=20140415222312 }} * [http://www.smartymaps.com/map.php?s=prokaryote Parts of a bacterial cell] {{Wayback|url=http://www.smartymaps.com/map.php?s=prokaryote |date=20120305100006 }} * Bacterial Chemotaxis Interactive Simulator - A web-app that uses several simple algorithms to simulate bacterial chemotaxis. [[Jamii:Bakteria]] [[Jamii:Bakteriolojia]] [[Jamii:Mikrobiolojia]] qc5dmts32v0xnwckvu3xpgbt8sb64bd 0 16778 1578171 1536000 2026-07-02T23:28:47Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578171 wikitext text/x-wiki [[image:Saint Irenaeus.jpg|200px|thumb|Mt. Irenaeus, Askofu wa Lyon.]] '''Mtakatifu Ireneo''' (kwa [[Kigiriki]]: Εἰρηναῖος, ''Eirēnaios'' [[135]] hivi – [[202]] hivi) alikuwa [[askofu]] wa pili wa [[mji]] wa [[Lyon]], leo nchini [[Ufaransa]], aliyewajibika kueneza [[Ukristo]] katika eneo hilo lote. Zaidi ya hayo, alistawisha [[teolojia]] kwa kupinga [[uzushi]] hata kwa [[maandishi]] bora <ref>His best-known work is ''Adversus Haereses'', a refutation of [[gnosticism]], in particular that of [[Valentinus (Gnostic)|Valentinus]]. To counter the doctrines of the gnostic sects claiming [[Sofia (Gnosi)|secret wisdom]], he offered three pillars of [[imani sahihi|orthodoxy]]: the [[Biblia|scripture]]s, the [[Mapokeo ya Mitume|tradition]] handed down from the [[Mitume wa Yesu|apostles]], and the teaching of the apostles' [[mlolongo wa Kitume|successors]]. Intrinsic to his writing is that the surest source of Christian guidance is the Church of [[Upapa|Rome]], and he is the earliest surviving witness to regard all four of the now-[[kanuni ya Biblia|canonical]] [[Injili|gospel]]s as essential. Sehemu ndogo imetafsiriwa katika Masomo ya Breviari - Sikukuu za Bwana, za Bikira Maria na za Watakatifu - Ndanda Mission Press 1978, uk 210-212</ref> ya [[Kigiriki]], [[Lugha ya kwanza|lugha mama]] yake. Ni muhimu kwa juhudi zake za kupigania [[umoja wa Kanisa]] dhidi ya [[uzushi]], akisisitiza umuhimu wa [[mlolongo wa kitume]] wa maaskofu, akitoa kama mfano orodha ya wale wa [[Kanisa la Roma]] baada ya [[Mtume Petro]]. Alidai ma[[kanisa]] yalingane na imani ya Kanisa hilo. Hata hivyo alimsihi [[Papa Viktor I|Papa Vikta I]] asiwatenge na Kanisa Wakristo wa [[Asia Ndogo]] kwa sababu tu ya tofauti za [[Liturgia|kiliturujia]]<ref>[https://www.newadvent.org/fathers/250105.htm Book V Chapter 24, Section 1ff]</ref>. Katika maandishi yake alijitahidi sana kutetea [[imani]] ya [[Kanisa Katoliki]] inayotegemea [[mapokeo]] ya [[Mitume wa Yesu]]<ref>Irenaeus cited the New Testament approximately 1,000 times. About one third of his citations are made to Paul's letters. </ref> dhidi ya mafundisho ya [[Gnosis]] yaliyotegemea ujuzi ambao yeyote aliweza kudai kuwa nao akianzisha kikundi chake <ref>https://www.santiebeati.it/dettaglio/23500</ref>. Ni wa kwanza pia kushuhudia [[Injili]] [[nne]] kuwa [[Neno la Mungu]]. Ametambuliwa tangu kale kuwa [[mtakatifu]], hata kama [[mfiadini]]. [[Tarehe]] [[21 Januari]] [[2022]] [[Papa Fransisko]] alimuongezea [[sifa]] ya "[[mwalimu wa Kanisa]]" <ref>http://www.causesanti.va/it/notizie/notizie-2022/decreto-del-santo-padre-per-il-conferimento-del-titolo-di-dottor.html</ref> [[Sikukuu]] yake ni [[tarehe]] [[28 Juni]]<ref>[[Martyrologium Romanum]]</ref>. == Maisha == Ireneo<ref>The biographical information on him comes from his own testimony, handed down to us by Eusebius in his fifth book on Church History.</ref> alizaliwa yapata [[mwaka]] 135 akalelewa [[Kikristo]] katika [[mji]] wa [[Smirna]] (leo [[İzmir]] nchini [[Uturuki]]), akiwa [[mwanafunzi]] wa [[Polikarp Mtakatifu|Mt. Polikarpo]] aliyekuwa askofu wa mji huo baada ya kuwa mfuasi wa [[Mtume Yohane]]. Haijulikani ni lini alipohama [[Asia Ndogo]] kwenda [[Gallia]], lakini ndio wakati wa [[jumuia]] ya [[Ukristo|Wakristo]] wa Lyon kuanza kustawi. Huko, mwaka [[177]], Ireneo aliorodheshwa kati ya [[mapadri]]. Mwaka huohuo alitumwa kidogo [[Roma]] na [[barua]] ya [[kanisa]] lake kwa [[Papa Eleutero]], akinusurika hivyo kuuawa katika [[dhuluma]] ya [[Kaizari|kaisari]] [[Marcus Aurelius]] dhidi ya Wakristo iliyoua [[Wafiadini wa Lyon|walau waumini 48]], akiwemo askofu mkongwe [[Potinus wa Lyon|Potinus]]<ref>[https://www.newadvent.org/fathers/250105.htm Book V Chapter 4, Section 1]</ref>. Hapo Ireneo aliporudi aliteuliwa kuwa askofu akafanya [[bidii]] kubwa hadi mwaka 202-203 alipofariki, labda kwa kufia [[dini]]. ==Mchango wake== Ireneo alikuwa hasa mtu wa [[imani]] na [[mchungaji]] wa waamini. Kama mchungaji mwema, alikuwa na kipaji cha kuwianisha mambo mbalimali, [[utajiri]] wa mafundisho, na [[juhudi]] za [[umisionari|kimisionari]]. Kama [[mwandishi]], alilenga mawili: kutetea [[imani sahihi]] dhidi ya mashambulizi ya [[uzushi]], na kufafanua vizuri [[ukweli]] wa imani. Vitabu vyake vilivyotufikia - vitano kuhusu Kutambua na Kukanusha Maarifa ya Uongo na Uthibitisho wa Mafundisho ya Mitume (kinachoweza kuitwa [[katekisimu]] ya kwanza) - vinatimiza kikamilifu malengo hayo. Kifupi, Ireneo anaweza kutambulishwa kama [[shujaa]] wa mapigano dhidi ya aina mbalimbali za uzushi. [[Karne]] ya pili ya [[Kanisa Katoliki]] iliingia hatari ya kufuata [[Ujuzilio]], uzushi uliodai kwamba imani inayofundishwa ndani ya Kanisa ni kidokezo tu cha kuwafaa watu sahili mno wasioweza kuelewa mawazo ya juu; kumbe, wasomi walioelimishwa peke yao walidai kuelewa yaliyofichwa na kidokezo hicho, na kwa namna hiyo waliunda Ukristo maalumu kwa wachache bora. Ni rahisi kuelewa kwamba Ukristo huo wa wasomi ulizidi kugawanyika kwa kufuata mawazo tofautitofauti na mara nyingi ya ajabuajabu, ambayo hata hivyo yaliweza kuvutia wengi. Jambo lililounganisha [[Kundi|makundi]] yote ya Ujuzilio ni "dualism": kukana imani katika [[Umoja wa Mungu|Mungu pekee]], [[Mungu Baba|Baba]] wa wote, [[Muumba]] na [[Mwokozi]] wa [[binadamu]] na wa [[ulimwengu]] mzima. Ili kueleza uwepo wa mabaya [[dunia|duniani]], hao walisema kuna chanzo kingine kibaya, mbali na Mungu Mwema, nacho ndicho kilichosababisha [[mata]]. Ireneo, akiwa imara katika msimamo wa [[Biblia ya Kikristo|Biblia]] kuhusu [[uumbaji]], alikataa mafundisho hayo yenye mtazamo hasi kuhusu vitu vinavyoonekana, alisisitiza [[utakatifu]] wa mata na wa [[mwili]] sawa na ule wa [[roho]]. Kwake, [[heshima]] ya binadamu, mwili na roho, ina [[msingi]] imara katika uumbaji wa Kimungu, katika kuwa sura ya Kristo na katika [[kazi]] ya kudumu ya Roho Mtakatifu kwa ajili ya [[utakaso]]. Bila kuishia katika kukanusha uzushi, alijitokeza kama [[Mwanatheolojia|mwanateolojia]] wa kwanza wa Kanisa kwa kupanga [[ufafanuzi]] wa mafundisho ya imani na kuonyesha yanavyolingana yote sawasawa. Kiini cha [[teolojia]] yake ni suala la "[[kanuni]] ya imani" na uenezaji wake. Kwake kanuni hiyo ni [[Kanuni ya Imani ya Mitume|ile ya Mitume]], ambayo inatuwezesha kufafanua [[Injili]] na kuifafanua yenyewe kwa mwanga wa Injili. Kanuni hiyo, ikiwa kama [[muhtasari]] wa Injili, inatusaidia kuelewa maana yake na jinsi ya kusoma Injili yenyewe. Injili aliyoihubiri Ireneo ni ile aliyofundishwa na Polikarpo, ambayo tena ilitokana na Mtume Yohane, mwalimu wake. Hivyo mafundisho halisi si yale ambayo yanabuniwa na wasomi na kwenda mbali kukiko imani sahili ya Kanisa. Injili halisi ni ile inayotangazwa na maaskofu waliyoipokea kutoka wa [[Mitume wa Yesu]] kwa mlolongo usiokatika. Hao walifundisha hiyo imani sahili tu, ambayo ndiyo [[kina]] halisi cha [[ufunuo]] wa Mungu. Hivyo, hakuna mafundisho ya siri yaliyofichika ndani ya kanuni ya imani ya Kanisa lote. Hakuna Ukristo wa hali ya juu kwa ajili ya wasomi tu. Imani inayoungamwa na Kanisa hadharani ndiyo imani ya wote kabisa. Imani hiyo tu ni ya Kitume, imepokezwa na Mitume, yaani na Yesu na Mungu. Kwa kushika imani hiyo, iliyokabidhiwa rasmi na Mitume kwa [[Mlolongo wa Kitume|waandamizi]] wao, Wakristo wanatakiwa kuzingatia kinachosemwa na maaskofu wao na hasa kinachofundishwa na [[Kanisa la Roma]], lililo kuu na la kale sana, hivi kwamba ni la Kitume kwa namna ya pekee, likitokana na [[mtume Petro|Petro]] na [[Mtakatifu Paulo|Paulo]], [[nguzo]] za [[rika]] la Mitume. Makanisa yoye yanapaswa kukubaliana na Kanisa la Roma, yakitambua ndani yake [[kipimo]] cha [[Mapokeo ya Mitume]] kilicho halisi, imani pekee ya Kanisa lote. Kwa hoja hizo, zilizofupishwa sana humu, Ireneo alikataa toka mwanzo madai ya hao wajuzi. Kwanza kabisa, hao hawakuwa na ukweli wowote wa juu kuliko ule wa imani ya kawaida, kwa sababu waliochosema hakikuwa na asili kwa Mitume, bali kilibuniwa nao tu. Pili, ukweli na [[wokovu]] si [[mali]] ya wachache, bali viko tayari kwa wote kwa njia ya mahubiri ya waandamizi wa Mitume, hasa ya [[Papa|askofu wa Roma]]. Kwa namna ya pekee, akipinga tena [[tabia]] ya siri ya Ujuzilio na [[tawi|matawi]] yake mengi yaliyoshindana, Ireneo aliona umuhimu wa kufafanua vizuri Mapokeo ya Mitume namna tunayoweza kuifupisha katika mambo matatu. a) Mapokeo ya Mitume ni "ya hadhara", si ya binafsi wala ya siri. Ireneo hakutia shaka kwamba yaliyomo katika imani inayopokezwa na Kanisa ni yale yaliyokana na Mitume na Yesu, [[Mwana wa Mungu]]. Hakuna mafundisho zaidi ya hayo. Hivyo, kwa yeyote anayetamani kujua ukweli, inatosha kujua "Mapokeo yaliykabidhiwa na Mitume na imani iliyotangazwa kwa watu": mapokeo na imani ambavyo "vimetufikia kwa njia ya mlolongo wa maaskofu" (Adversus Haereses, 3, 3, 3-4). Kwa maana hiyo, mlolongo wa maaskofu na Mapokeo ya Mitume ni mamoja. b) Mapokeo ya Mitume yana "[[umoja]]". Kweli, wakati Ujuzilio uligawanyika katika makundi mengi, Mapokeo ya Kanisa yanadumisha umoja, kwa kushikilia kanuni ya imani au ya ukweli: kwa kuwa hiyo ni moja, inaunda umoja kati ya [[Taifa|mataifa]], [[Utamaduni|tamaduni]] na [[lugha]] mbalimbali. Kauli ya thamani sana ya Ireneo inayopatikana katika kitabu chake Adversus Haereses ni hii: "Kanisa, ingawa limetawanyika duniani kote... kwa kuwa limepokea [imani hiyo kutoka kwa Mitume]... linaitunza kwa makini kama kwamba lingeishi [[nyumba]] moja. Tena linasadiki mafundisho hayo kama kwamba lingekuwa na roho moja na [[moyo]] mmoja, nalo linayatangaza na kuyafundisha na kuyapokeza kwa ulinganifu kamili kama kwamba lingekuwa na [[kinywa]] kimoja. Kwa kuwa, ingawa lugha za ulimwengu ni tofauti, dhati ya mapokeo ni ileile moja tu. Kwa sababu Makanisa yaliyoanzishwa Ujerumani, wala yale yaliyoko Hispania, wala yale yaliyoko Gallia, wala yale yaliyoko Mashariki, wala yale yaliyoko Misri, wala yale yaliyoko Libya, wala yale yaliyoanzishwa katikati ya dunia hayasadiki wala kupokeza chochote tofauti" (1, 10, 1-2). Wakati huo - kwenye mwaka 200 - iliwezekana tayari kutambua katika Kanisa umataifa, [[katoliki|ukatoliki]] na uwezo wa ukweli wa kuunganisha mataifa tofauti sana katika umoja wa imani iliyofunuliwa na Kristo. c) Hatimaye, Mapokeo ya Mitume ni "ya Kiroho", akiongozwa na [[Roho Mtakatifu]] kwa kuwa hayapokezwi kadiri ya uwezo wa watu wenye elimu zaidi, bali kadiri ya Roho wa Mungu anayehakikisha uaminifu katika kueneza imani: hayo ndiyo "maisha" ya Kanisa, yanayolifanya daima kuwa na ujana na uhai, likizaa kwa [[karama]] nyingi. Kwa Ireneo, Kanisa na Roho Mtakatifu hawatenganiki: "Imani hiyo ambayo imepokezwa kwetu na Kanisa, na kwa hiyo tunaidumisha, na ambayo daima, kwa Roho wa Mungu, ikipata ujana upya kama kwamba ingekuwa amana ya thamani iliyotunzwa katika chombo bora, inasababisha chombo chenyewe kilicho nayo kuwa kipya pia.... Kwa sababu Kanisa lilipo, ndipo Roho wa Mungu alipo; na Roho wa Mungu alipo, ndipo Kanisa na aina zote za neema vilipo" (Adversus Haereses, 3, 24, 1). Ireneo hasimami kufafanua Mapokeo. Kwake hayo hayakatiki, hivyo hayaishii katika yale yaliyopita, bali yanaumuliwa kwa ndani na Roho Mtakatifu, anayeyafanya kuishi upya, anasababisha yafafanuliwe na kueleweka katika uhai wa Kanisa. Akishikilia mafundisho nyake, Kanisa linapaswa kupokeza imani kwa namna ambayo iweze kuonekana ilivyo: "ya hadhara", "yenye umoja" na "ya Kiroho". Kwa kuzingatia sifa hizo tatu, inawezekana kufanya upambanuzi wa kufaa wa uenezaji sahihi wa imani leo. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] *[[Mababu wa Kanisa]] *[[Walimu wa Kanisa]] ==Tanbihi== {{reflist}} ==Marejeo ya Kiswahili== * John Kabeya na wengine - Maisha ya Watakatifu – ed. T.M.P. Book Department – Tabora 1965, 1989, uk. 223 * Pd. Leandry Kimario, [[Wakapuchini|O.F.M.Cap.]] - Mfahamu Mtakatifu Somo Wako - Maisha ya Watakatifu wa Kila Siku pamoja na Watakatifu Wafransisko - Toleo la pili - Dar es Salaam 2021, uk. 188-189 * Maurice Soseleje, Kalendari yetu – Maisha ya Watakatifu – Toleo la pili – ed. Benedictine Publications Ndanda Peramiho – Peramiho 1986 – ISBN 9976-63-112-X, uk. 51 == Marejeo ya lugha nyingine== {{refbegin}} * {{cite CE1913|first=John P. |last=Arendzen|wstitle=Demiurge|volume=4}} * {{cite journal|last=Bandstra|first= Andrew J. |title=Paul and an Ancient Interpreter: A Comparison of the Teaching of Redemption in Paul and Irenaeus|url=https://archive.org/details/sim_calvin-theological-journal_1970-04_5_1/page/43|journal=Calvin Theological Journal|volume= 5 |date=1970|pages= 43–63}} * {{cite book|last=Blackwell|first=Ben C. |title=Christosis: Pauline Soteriology in Light of Deification in Irenaeus and Cyril of Alexandria|url=https://books.google.com/books?id=WDZxSq9nx4IC&pg=PR7|year=2011|publisher=Mohr Siebeck|isbn=978-3-16-151672-6}} *{{cite book|last=Brown|first=Raymond Edward |authorlink=Raymond Edward Brown|title=An Introduction to the New Testament|url=https://books.google.com/books?id=gk_uAAAAMAAJ&pg=PA14|year=1997|publisher=Doubleday|isbn=978-0-385-24767-2}} *{{cite journal |last=Bruce |first=F. F. |author-link=F. F. Bruce |orig-year=1963|date=1965 |title=Herod Antipas, Tetrarch of Galilee and Peraea |journal=Annual of Leeds University Oriental Society |volume=5}} *{{cite book|last=Carol|first=Juniper B. |title=Why Jesus Christ?: Thomistic, Scotistic and Conciliatory Perspectives|url=https://books.google.com/books?id=gRrkAAAAMAAJ|year=1986|publisher=Trinity Communications|isbn=978-0-937495-03-2}} *{{cite book|last1=Cross|first1=Frank Leslie |authorlink1=Frank Leslie Cross|last2=Livingstone|first2=Elizabeth A. |title=The Oxford Dictionary of the Christian Church|url=https://books.google.com/books?id=fUqcAQAAQBAJ&pg=PA852|year=2005|publisher=Oxford University Press|isbn=978-0-19-280290-3}} *{{cite book|first=Henry |last=Chadwick|title=The Early Church|url=https://archive.org/details/earlychurch0000chad_l1o5 |publisher=Penguin|date= 1993|edition=2nd}} *{{cite web|url=http://www.ntcanon.org/Irenaeus.shtml|title=The Development of the Canon of the New Testament – Irenaeus|website=ntcanon.org|access-date=24 November 2014|first=Glenn|last=Davis|date=2010}} *{{cite book|last=Durant|first=Will |authorlink=Will Durant|title=Caesar and Christ: A History of Roman Civilization and of Christianity from Their Beginnings to A.D. 325|url=https://books.google.com/books?id=89sruQAACAAJ|year=1972|publisher=Simon and Schuster|isbn=978-0-671-11500-5}} *{{Rejea kitabu|title=Lost Christianities|url=https://archive.org/details/lostchristianiti00ehrm_993/page/n140|url-access=limited|last=Ehrman|first=Bart D.|publisher=University Press|year=2005|isbn=978-0-19-518249-1|location=Oxford|author-link=Bart D. Ehrman}} *{{cite book|translator= Arthur Cushman McGiffert|series= Nicene and Post-Nicene Fathers, Second Series|volume= 1|editor1= Philip Schaff |editor2=Henry Wace|location=Buffalo, NY|publisher= Christian Literature Publishing Co.|date= 1890|author=Eusebius|author-link=Eusebius|url=https://www.newadvent.org/fathers/2501.htm|title=Church History}} *{{cite book|last=Farmer|first=David Hugh |title=The Oxford Dictionary of Saints|url=https://books.google.com/books?id=x0DQngEACAAJ|year=1997|publisher=Oxford University Press|isbn=978-0-19-280058-9}} *{{cite book|last=Grant|first=Robert McQueen |authorlink=Robert M. Grant (theologian)|title=The Formation of the New Testament|url=https://books.google.com/books?id=cerYAAAAMAAJ&pg=PA154|year=1965|publisher=Harper & Row}} *{{cite book|last=Grant|first=Robert M. |authorlink=Robert M. Grant (theologian)|title=Irenaeus of Lyons|url=https://books.google.com/books?id=Ox_jaDPt_0YC&pg=PA6|year=2006|publisher=Routledge|isbn=978-1-134-81518-0}} *{{cite book|author=Gregory Thaumaturgus|author-link=Gregory Thaumaturgus|translator= S.D.F. Salmond|series= Ante-Nicene Fathers|volume= 6|editor1= Alexander Roberts|editor2= James Donaldson|editor3= A. Cleveland Coxe|location=Buffalo, NY|publisher= Christian Literature Publishing Co.|date=1886|url=http://www.newadvent.org/fathers/0610.htm|title=On All the Saints}} *{{citation|author-link=Stephen L Harris|last=Harris|first=Stephen L.|title=Understanding the Bible|location=Palo Alto|publisher= Mayfield|date= 1985}} *{{cite book|last=Hartog|first=Paul A.|title=Orthodoxy and Heresy in Early Christian Contexts: Reconsidering the Bauer Thesis|url=https://books.google.com/books?id=sFanBgAAQBAJ&pg=PA199|year=2015|publisher=Wipf and Stock |isbn=978-1-61097-504-9}} * {{cite book|last=Hoh|first= J.|title=Die Lehre des hl. Irenäus uber das Neue Testament|publisher= Neutestamentliche Abhandlungen. vii. |location=Munster i. W. |date=1919}} * {{cite book|author=Irenaeus|url=http://newadvent.com/fathers/0103.htm |title=Against Heresies|via= [[New Advent]]|series=Ante-Nicene Fathers |volume=1|editor1= Alexander Roberts|editor2= James Donaldson|editor3= A. Cleveland Coze|translator= Alexander Roberts and William Rambaut|location=Buffalo, NY|publisher=Christian Literature Co.|date= 1885}} *{{cite book|author=Irenaeus|via=[[New Advent]]|title=Fragments from the Lost Writings of Irenæus|translator= Alexander Roberts|series=Ante-Nicene Fathers|volume= 1|editor1= Alexander Roberts|editor2= James Donaldson|editor3= A. Cleveland Coxe|location=Buffalo, NY|publisher= Christian Literature Publishing Co.|date= 1885a}} *{{cite book|url=http://www.ccel.org/ccel/irenaeus/demonstr.preaching_the_demonstration_of_the_apostolic_preaching.html |author=Irenaeus|title= Demonstration of Apostolic Preaching|date=1920|publisher=[[SPCK]]|translator=Armitage Robinson}} *{{cite book|editor=Dominic J. Unger |author=Irenaeus |translator=M.C. Steenberg |title=St Irenaeus of Lyons: Against the Heresies III|series= Ancient Christian Writers: The Works of the Fathers in Translation |location=New York|publisher= The Newman Press|date= 2012}} *{{cite book|editor-first=W. A. |editor-last=Jurgens|title=The Faith of the Early Fathers: A Source-book of Theological and Historical Passages from the Christian Writings of the Pre-Nicene and Nicene Eras|url=https://books.google.com/books?id=WTswAAAAYAAJ|year=1970|publisher=Liturgical Press|isbn=978-0-8146-1021-3}} *{{cite book| last= Klager|first= Andrew P. |chapter="Retaining and Reclaiming the Divine: Identification and the Recapitulation of Peace in St. Irenaeus of Lyons' Atonement Narrative|title=Stricken by God? Nonviolent Identification and the Victory of Christ|editor1= Brad Jersak |editor2=Michael Hardin|location=Grand Rapids|publisher= Eerdmans|date= 2007}} * {{cite journal|last=Litwa|first= M. David|title=The Wonderous Exchange: Irenaeus and Eastern Valentinians on the Soteriology of Interchange|url=https://archive.org/details/journal-of-early-christian-studies_fall-2014_22_3/page/311|journal=Journal of Early Christian Studies|volume= 22 |date=2014|issue= 3|pages= 311–340|doi=10.1353/earl.2014.0029|s2cid= 170888989}} *{{cite book|last=Most|first= William G.|title=The Holy Spirit and the Church|publisher=Notre Dame Institute Press|date= 1991}} *{{cite book|last1=McDonald|first1=Lee Martin |last2=Sanders|first2=James A. |title=The Canon Debate|url=https://books.google.com/books?id=kxW-AgAAQBAJ|year=2001|publisher=Baker|isbn=978-1-4412-4163-4}} * {{cite book|last=Nielsen|first= J.T. |title=Adam and Christ in the Theology of Irenaeus of Lyons: An Examination of the function of the Adam-Christ Typology in the Adversus Haereses of Ireaneus, against the Background of the Gnosticism of His Time|series=Van Gorcum's Theologische Bibliotheek|location= Asen, The Netherlands|publisher= Koninkliijke Van Gorcum 7 Comp. N.V.|date= 1968}} *{{cite book|last=Norris|first=Richard A |editor1=Frances Young|editor2= Lewis Ayres |editor3=Andrew Louth|title=The Cambridge History of Early Christian Literature|chapter-url=https://books.google.com/books?id=aepYpUVf9OkC&pg=PA47|year=2004|publisher=Cambridge University Press|isbn=978-0-521-46083-5|chapter=Irenaeus of Lyons}} *{{Rejea kitabu|title=The Gnostc Gospels|url=https://archive.org/details/gnosticgospels00page_0|last=Pagels|first=Elaine|publisher=Vintage Books|year=1979}} *{{cite book|last=Pagels|first= Elaine|title=Beyond Belief|publisher= Pan |date= 2005}} *{{cite book|last=Parvis|first=Paul|editor=Sara Parvis|editor2=Paul Foster|title=Irenaeus: Life, Scripture, Legacy|url=https://books.google.com/books?id=T5CrpwAACAAJ|year=2012|publisher=Fortress Press|location=Minneanpolis|isbn=978-0-8006-9796-9|chapter=Who was Irenaeus? An Introduction to the Man and His Work}} *{{cite CE1913|last1=Poncelet |first1=Albert |wstitle=St. Irenaeus |volume=8}} *{{cite book|last=Stark|first= Rodney|title=Cities of God|publisher= HarperCollins|date= 2007}} * Steenberg, Ireaneus M.C. "The Role of Mary as Co-Recapitulator in St. Irenaeus of Lyons." ''Vigilae Christianae'' 58 (2004):117–137. *{{cite book|first=Rev. J.|last= Tixeront|title=A Handbook of Patrology|url=http://www.earlychristianwritings.com/tixeront/section1-4.html#irenaeus|chapter= Section IV: The Opponents of Heresy in the Second Century|location= St. Louis, MO|publisher= B. Herder Book Co.|date= 1920}} *{{citation|first=Gustaf |last=Wingren|date=n.d.|title=Saint Irenaeus|encyclopedia=Encyclopædia Britannica|url=https://www.britannica.com/biography/Saint-Irenaeus}} {{refend}} ==Marejeo mengine== {{refbegin|2|indent=yes}} * Irenaeus, ''Proof of the Apostolic Preaching'', trans JP Smith, (ACW 16, 1952) * Irenaeus, ''Proof of the Apostolic Preaching'', trans John Behr (PPS, 1997) * Irenaeus, [http://www.newadvent.org/fathers/0103.htm ''Against Heresies''] {{Webarchive|url=https://web.archive.org/web/20160316114638/http://www.newadvent.org/fathers/0103.htm |date=16 March 2016 }}, trans. Alexander Roberts and William Rambaut, in ''Ante-Nicene Fathers'', vol. 1, ed. Alexander Roberts, James Donaldson, and A. Cleveland Coxe (Buffalo, NY: Christian Literature Co., 1885). * {{cite book|editor-last=Coxe|editor-first=Arthur Cleveland|url=https://archive.org/details/antenicenefathe05menzgoog|title=The Ante-Nicene Fathers|year=1885|publisher=The Christian Literature Company|location=Buffalo, NY|isbn=9780802880871}} * {{Rejea kitabu|last=Edwards|first=Mark|year=2009|title=Catholicity and Heresy in the Early Church|publisher=Ashgate|url=https://books.google.com/books?id=z9acTl-jAkAC|isbn=9780754662914}} * {{cite book |last=Eusebius|title=The Ecclesiastical History|year=1932|publisher=Putnam|location=New York|others=Kirsopp Lake and John E.L. Oulton, trans}} * {{cite book |last=Hägglund|first=Bengt|title=History of Theology|year=1968|publisher=Concordia Publishing|location=St. Louis|others=Gene J.Lund, trans}} * {{cite book |last=Minns|first=Denis|title=Irenaeus|url=https://archive.org/details/irenaeus0000minn|year=1994|publisher=Georgetown University Press|location=Washington, D.C.|isbn=0-87840-553-4}} * Payton Jr., James R. ''Irenaeus on the Christian Faith: A Condensation of 'Against Heresies'' (Cambridge, James Clarke and Co Ltd, 2012). * {{cite book |last=Quasten|first=J.|title=Patrology: The Beginnings of Patristic Literature|year=1960|publisher=Newman Press|location=Westminster, MD}} * {{cite book|last=Schaff|first=Philip|url=https://archive.org/details/historyofthechri009648mbp|title=History of the Christian Church: Ante-Nicene Christianity, A.D. 100–325|year=1980|publisher=Wm. Eerdmans|location=Grand Rapids, Mich|isbn=0-8028-8047-9}} * {{cite book |last=Tyson|first=Joseph B.|title=A Study of Early Christianity|url=https://archive.org/details/studyofearlychri0000tyso|year=1973|publisher=Macmillan|location=New York}} * {{cite book |last=Wolfson|first=Henry Austryn|title=The Philosophy of the Church Fathers: Faith, Trinity, Incarnation|url=https://archive.org/details/philosophyofchur0000harr|year=1970|publisher=Harvard University Press|location=Cambridge, MA}} {{refend}} ==Viungo vya nje== {{Sister project links|s=Author:Irenaeus|wikt=no|n=no|voy=no|v=no|b=no}} * [http://www.earlychristianwritings.com/irenaeus.html Early Christian Writings Irenaeus] * [http://www.newadvent.org/fathers/0134.htm Fragments from his lost works] * [http://www.newadvent.org/fathers/0103.htm Alexander Roberts and William Rambaut 1885 Ante-Nicene Fathers, Vol. 1. translation of Against Heresies] * [https://web.archive.org/web/20060925041929/http://www.ccel.org/fathers2/ANF-01/TOC.htm A nineteenth-century translation of Irenaeus's work] ** [http://www.ccel.org/ccel/irenaeus/demonstr.toc.html Demonstration of the Apostolic Preaching] ** [https://web.archive.org/web/20080520122853/http://www.ccel.org/fathers2/ANF-01/anf01-59.htm#P7011_1802900 Book II, ch. 22], where Irenaeus argues his unconventional views about the age of Jesus and the length of his ministry. * [http://www.earlychurch.org.uk/irenaeus.php EarlyChurch.org.uk] Extensive bibliography. * [https://www.vatican.va/content/benedict-xvi/en/audiences/2007/documents/hf_ben-xvi_aud_20070328.html [[Papa Benedikto XVI]] on St. Irenaeus] * [https://web.archive.org/web/20100207140719/http://www.revneal.org/Writings/evil.htm Gregory S. Neal: "The Nature of Evil and the Irenaean Theodicy" ''Grace Incarnate'' (1988)] * [https://www.pbs.org/wgbh/pages/frontline/shows/religion/story/emergence.html Critique of Irenaeus], [[Elaine H. Pagels]] * [http://www.catholicculture.org/news/features/index.cfm?recnum=43736 Critique of Pagel's article by Paul Mankowski] * [http://www.documentacatholicaomnia.eu/20_30_0130-0202-_Iraeneus.html Opera Omnia by Migne Patrologia Graeca with analytical indexes] * [http://www.bartleby.com/210/6/281.html "St. Irenæus, Bishop of Lyons, Martyr"], ''Butler's Lives of the Saints'' * [http://www.catholic.org/saints/saint.php?saint_id=291 "Catholic Online"] * [http://www.santiebeati.it/dettaglio/23500 "Santiebeati"] *{{YouTube|id=6hH4g-Thmg0|title=The First Theologians: Irenaeus and Tertullian }} a lecture by [[James L. Papandrea]] {{walimu wa Kanisa}} {{DEFAULTSORT:Ireneo wa Lyon}} [[Jamii:Waliozaliwa 135]] [[Jamii:Waliofariki 202]] [[Jamii:Maaskofu Wakatoliki]] [[Jamii:Wafiadini Wakristo]] [[Jamii:Watakatifu wa Uturuki]] [[Jamii:Watakatifu wa Ufaransa]] [[Jamii:Mababu wa Kanisa]] 4yw9jtm7vd5fs2sdr2te4gfq8q02ups 0 17872 1578100 1124955 2026-07-02T19:41:33Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578100 wikitext text/x-wiki [[Picha: 01_Luftbild_Frankfurt_oder_Slubice_09072011.jpg|thumbnail|right|280px|Frankfurt, Brandenburg]] [[Picha:Deutschland Lage von Brandenburg.svg|thumb|180px|Mahali pa Brandenburg katika Ujerumani]] [[Picha:Flag of Brandenburg.svg|thumb|bendera ya Brandenburg]] '''Brandenburg''' ni moja ya majimbo 16 ya kujitawala ya [[Ujerumani]] lenye wakazi milioni 2,6 kwenye eneo la 29 056&nbsp;km². Mji mkuu ni [[Potsdam]]. Waziri mkuu ni [[Matthias Platzeck]] wa chama cha [[SPD]] anayesimamia [[serikali ya mseto]]. == Jiografia == Brandenburg ni sehemu ya Ujerumani inayozunguka jimbo la mji mkuu wa [[Berlin]]; menginevyo imepakana na Poland upande wa mashriki na majimbo ya Kijerumani ya [[Mecklenburg-Pomerini]] (Mecklenburg-Vorpommern), [[Saksonia ya chini]] (Niedersachsen), [[Saksonia]] (Freistaat Sachsen) na [[Saksonia-Anhalt]] (Sachsen-Anhalt). Uso wa nchi ulifinyangwa na barafuto kubwa za [[Enzi ya Barafu]] zilizoacha hasa mchanga kwa umbo la safu za vilima vidogo ambavyo kwa jumla havizidi kimo cha mita 100 [[juu ya UB]]. Kwa hiyo sehemu kubwa ya mashamba haina rutba nzuri lakini kuna pia maeneo kadhaa yenye rutba. Kilimo kinategemea umwagiliaji na kuna maeneo mapana ya misitu. Mito mikubwa haipiti jimboni isipokuwa [[mto Havel]] lakini mito mikubwa ya [[Elbe]] na [[Oder]] ni mipaka ya Brandenburg. Kuna mihji minne mikubwa kidogo ambayo ni mji mkuu Potsdam uliopo mpakani wa Berlin halafu miji ya viwanda [[Brandenburg an der Havel]], [[Cottbus]] na [[Frankfurt (Oder)]] (ambayo ni tofauti na [[Frankfurt]] katika [[Hesse]]). == Historia == Eneo la jimbo lilikaliwa na makabila ya [[Waslavoni]] hadi mwaka 929 lilipovamiwa na Wajerumani. Baada ya kutekwa kabisa na makabaila Wajerumani Brandenburg ilikuwa dola la kujitegemea ndani ya [[Dola Takatifu la Kiroma]] tangu 1157. Watawala wapya walichukua walowezi Wajerumani na Waholanzi waliojenga vijiji na miji na wakazi kwa jumla walikuwa mchanganyiko wa Waslavoni na Wajerumani. Hadi leo kuna vijiji kadhaa vya Wasorbia wanaotumia lugha ya Kislavoni hata wakiwa Wajerumani kisiasa. Tangu 1415 nasaba ya [[Hohenzollern]] kutoka Ujerumani ya kusini ilipewa utemi wa Brandenburg. Nasaba hii iliendelea kutawala jimbo hadi 1918 na kuifanya dola kubwa kabisa katika Ujeruami na pia dola mihimu katika Ulaya. Mwaka 1618 watawala walirithi eneo la [[Prussia]] lililowahi kuwa dola la Wamisalaba. Baada ya uharibifu wa [[vita ya miaka 30]] utemi wa Brandenburg iliendelea kuwa sehemu ya Ujerumai iliyofaulu kujenga uchumi na jeshi lake na kupanusha eneo. Mwaka 1701 mtemi wa Brandenburg alijiwekea taji la kifalme akajiita mfalme wa [[Prussia]]. Hivyo Brandenburg iliendelea kuwa jimbo kubwa ndani ya ufalme wa Prussia. Prussia ilipoingia [[1871]] katika [[Dola la Ujerumani]] Brandenburg ilibaki kama mkoa mkubwa wa Prussia. Baada ya [[vita kuu ya pili ya dunia]] Prussia ilibomolewa 1945 na Brandenburg ilikuwa sehemu ya [[Jamhuri ya Kidemokrasia ya Kijerumani]] (JKK) iliyoshikamana upande wa [[Umoja wa Kisovyeti]]. Hapa eneo la Brandenburg iligawiwa mwaka 1952 wakati majimbo ya kale yaliondolewa katika JKK na ardhi yake iliingia chini ya mikoa mitatu. Baada ya maungano wa Ujerumani mwaka 1990 majimbo ya awali yalirudishwa kwenye eneo la JKK pamoja na Brandenburg. Tangu 1996 kuna mipango ya kuunganisha majimbo ya Brandenburg na Berlin lakini maungano haya yalisimamishwa mara ya kwanza katika kura ya wananchi isipokuwa mipango inaendelea. == Picha za Brandenburg == <gallery> Image:Katharinen Pauli Brandenburg.jpg|Mji wa Brandenburg a.d. Havel Image:Cottbus 07-2017 img23 Altmarkt.jpg|Kitovu cha Cottbus Image:2006-03 Frankfurt (Oder) 42.jpg|Makazi mapya ya Frankfurt (Oder) Image:Potsdam - Schloss Sanssouci.jpg|Jumba la kifalme cha Sancoussi mjini [[Potsdam]] Image:Preussnitz Rummel2 Steile Kieten.JPG|Brandenburg mashambani </gallery> == Tovuti za Nje == {{commons}} * [http://www.brandenburg.de Brandenburg - Official Website (also in English)] {{Wayback|url=http://www.brandenburg.de/ |date=20160305075149 }} {{Kigezo:Majimbo ya Ujerumani}} [[Jamii:Brandenburg|!]] [[Jamii:Majimbo ya Ujerumani]] osx3klri86ciq5rmvzlt52rwwq67op0 0 19123 1578069 1564481 2026-07-02T17:46:08Z InternetArchiveBot 41439 Add 8 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578069 wikitext text/x-wiki {{Infobox disease | Name = Kujiua | Image = Edouard Manet 059.jpg| Caption = ''Kujiua'' kadiri ya [[Édouard Manet]] [[1877]]–[[1881]] | ICD10 = {{ICD10|X|60||x|60}}–{{ICD10|X|84||x|60}} |ICD9 = {{ICD9|E950}} |MedlinePlus = 001554 | eMedicineSubj = article | eMedicineTopic = 288598 | MeshName = Suicide | MeshNumber = F01.145.126.980.875 }} <!-- Fasili na vipengele vya hatari --> '''Kujiua''' (kwa [[Kiingereza]] "suicide" kutoka [[neno]] la [[Kilatini]] ''suicidium'', lililotokana na ''sui caedere'', "kujiua") ni kitendo cha [[mtu]] kujisababishia [[kifo]] kwa makusudi ama kwa kufanya kitu kinachoharibu [[uhai]] wake au kwa kuacha yale yanayohitajika kuuendeleza kama [[kula]] au [[kunywa]]. Kuna sababu mbalimbali kwa nini watu wanajiua, kama vile *hali mbaya ya [[wasiwasi]], [[hofu]] au matatizo inayomsababisha kutaka kuepukana nayo mara moja<ref>https://www.dailysignal.com/2022/06/13/study-connects-jump-in-youth-suicide-with-transgender-treatments-lack-of-parental-consent/?inf_contact_key=52c5d855ea18910d25fdd65d9dc7222b4dfbc39d7283b2cb89d5189540b69330</ref> *[[ugonjwa wa akili]] *[[maumivu]] makali *kuona [[aibu]] kubwa pamoja na [[utamaduni]] kufundisha ni heri kufa kuliko kuishi na aibu *kujisikia kuwa na [[wajibu]] wa kumaliza [[maisha]] kwa [[heshima]] ya [[taifa]], [[dini]], [[ukoo]], [[familia]] au mengine. Mara nyingi, watu hujiua kufuatia hali ya [[kukata tamaa]] iliyosababishwa na [[tatizo la kiakili]] kama vile [[fadhaiko]], [[maradhi ya hisia mseto]], [[skizofrenia]], [[ulevi]] au matumizi ya [[dawa za kulevya]].<ref name=Hawton2009>{{cite journal |author=Hawton K, van Heeringen K |title=Suicide|url=https://archive.org/details/sim_the-lancet_april-18-24-2009_373_9672/page/1372 |journal=Lancet |volume=373 |issue=9672 |pages=1372–81 |year=2009 |month=April |pmid=19376453 |doi= 10.1016/S0140-6736(09)60372-X}}</ref> Vipengele vya dhiki kama vile [[matatizo ya kifedha]] au matatizo katika [[mahusiano ya kijamii]] huchangia sana. [[Juhudi]] za kuzuia kujiua hujumuisha kupunguza uwezekano wa kufikia [[bunduki]], kutibu [[magonjwa ya akili]], kuzuia matumizi mabaya ya [[dawa]] na kuboresha [[hali ya uchumi]]. <!--Mbinu na Uenezi--> [[Mbinu]] za kujiua ni nyingi na upendeleo hutegemea [[mazingira]] na utamaduni. <ref>[http://www.who.int/bulletin/volumes/86/9/07-043489.pdf Methods of suicide: international suicide patterns derived from the WHO mortality database]</ref>. Inayotumika zaidi hutofautiana katika nchi mbalimbali na huhusishwa kwa kiasi na mbinu zinazopatikana. Mara nyingi hujumuisha: [[kujinyonga]], [[kunywa sumu]] na kutumia bunduki. *Watu wa [[Marekani]] hupendelea kujipigia risasi (52[[%]] za wale waliojiua [[mwaka]] [[2005]]); inaonekana sababu kubwa ni ya kwamba kuna bunduki nyingi zinazopatikana kirahisi *[[Wajerumani]] hupendelea kujinyonga kwa [[kamba]] (50%), kujipigia risasi kunatokea mara chache ([[sheria]] kuhusu kumiliki bunduki ni kali) *Katika [[Ulaya ya Mashariki]] karibu wote wanaojiua hujinyonga kwa kamba *Kwenye nchi za [[wakulima]] wengi kama [[Asia]], [[Amerika Kusini]] na pia [[Ureno]] wengi hutumia [[sumu]] mbalimbali hasa za kuua [[wadudu]] *Katika nchi ndogo ambako watu huishi hasa [[Mji|mjini]] kama [[Hong Kong]] au [[Luxemburg]] kuna [[asilimia]] kubwa wanaoruka kutoka [[Jengo|majengo]] marefu. Kwa jumla [[wanaume]] hutumia zaidi mbinu kali kama [[silaha]] au kujinyonga, [[wanawake]] njia ambazo ni pole zaidi kama kunywa sumu au kujizamisha kwenye [[maji]]. [[Shirika la Afya Duniani]] linakadiria kwamba [[duniani]] kote kila baada ya [[sekunde]] 39 mtu mmoja anajiua, maana yake takriban watu 800,000 hadi [[milioni]] 1 hujiua kila mwaka. Kwa hiyo tendo la kujiua ni kati ya sababu muhimu za [[kifo]] cha watu, ni kisababishi kikuu cha 10 cha vifo vyote [[Ulimwengu|ulimwenguni]].<ref name=Hawton2009/><ref name=Var2012/> [[Idadi]] ya wanaume wanaojiua kwa jumla inazidi mara [[nne]] ile ya wanawake. [[Wazee]] hujiua kushinda [[vijana]]. <ref>[http://www.who.int/mental_health/prevention/suicide/suicide_rates_chart/en/index.html Taarifa ya [[WHO]]]</ref><ref>{{cite book|last=Meier|first=Marshall B. Clinard, Robert F.|title=Sociology of deviant behavior|year=2008|publisher=Wadsworth Cengage Learning|location=Belmont, CA|isbn=978-0-495-81167-1|page=169|url=http://books.google.co.uk/books?id=VB3OezIoI44C&pg=PA169|edition=14th ed.}}</ref> Pamoja na wale wanaofaulu, kila mwaka kuna majaribio kati ya milioni 10 hadi 20<ref>{{cite journal|author=Bertolote JM, Fleischmann A |title=Suicide and psychiatric diagnosis: a worldwide perspective |journal=World Psychiatry|volume=1 |issue=3 |pages=181–5 |year=2002 |month=October |pmid=16946849 |pmc=1489848 }}</ref>. Majaribio hayo mara nyingi huwa ya [[watoto]] na [[wanawake]]. [[Waganga]] wa kisasa huona kujiua kama tatizo la [[afya]] ya [[nafsi]]; mara nyingi watu wanaojaribu kujiua hawataki kufa bali kuepukana na matatizo na kama wangeona njia ya kuachana na tatizo wasingejiua. Hivyo majaribio ya kujiua inaweza kuwa ya kuwaonyesha watu wa mazingira ya kwamba kuna tatizo zito na kuomba msaada. Watu wanaorudia mara nyingi majaribio ya kujiua wanafaulu hatimaye kama hali yao haibadiliki. <!--Historia, jamii na utamaduni--> Katika mafundisho ya dini nyingi tendo la kujiua linatazamwa kama [[dhambi]] au kosa. [[Dini za Kiibrahimu]] zinachukulia kujiua kuwa dhambi kwa sababu ya [[imani]] juu ya [[utakatifu wa uhai]], [[heshima]] na [[thamani ya maisha]]. Katika [[Ulaya]] hadi [[karne ya 19]] watu waliojiua hawakuzikwa [[kaburi|makaburini]] pamoja na watu wengine lakini kando. Nchi mbalimbali zilikuwa na sheria dhidi ya wale waliojiua na jaribio lilitazamwa kama [[kosa la jinai]]. Ingawa kosa la kujiua au kujaribu kujiua lilichangia [[adhabu]] ya kisheria hapo awali katika [[mataifa ya magharibi]], kwa sasa haliadhibiwi. Kosa hili limesalia kuwa [[hatia]] katika mataifa mengi ya [[Kiislamu]]. Kuna pia [[jamii]] ambako hatua ile inaheshimiwa kama azimio la kila mtu. Katika utamaduni wa enzi za [[samurai]] nchini [[Japani]] kujiua kulitazamwa kama nafasi ya [[Ukabaila|mkabaila]] kujirudishia heshima yake kama ameshindwa au kuonekana na kosa kubwa. Hivyo [[seppuku]] iliheshimiwa kama mbinu ya kulipia kosa la kushindwa au njia ya utetezi. Katika utamaduni wa [[Uhindi]] [[mjane]] alisifiwa kama alijiua baada ya kifo cha [[mume]] wake hasa kwa kujichoma pamoja na [[maiti]] ya [[marehemu]]. [[Sati]] katika [[mazishi]] ya [[Kihindi]], ambayo sasa imeharamishwa, ilimhitaji [[mjane]] [[kujitoa kafara]] kwa kujichoma katika [[kimbwi]] cha [[mazishi]] ya [[Mume|mumewe]], kwa [[hiari]] au kwa kushinikizwa na [[familia]] na [[jamii]].<ref>{{cite web|url=http://www.bbc.co.uk/worldservice/learningenglish/news/words/general/020807_witn.shtml|title=Indian woman commits sati suicide |publisher=Bbc.co.uk |date=2002-08-07 |accessdate=2010-08-26}}</ref> Katika [[karne ya 20]] na [[Karne ya 21|21]], kujiua kwa mbinu ya [[kujitoa kafara]] kumetumika kama mbinu ya utetezi, na [[kamikaze]] na [[kujiua kwa bomu]] kama harakati za kijeshi au kigaidi.<ref>{{cite journal|last=Aggarwal|first=N|title=Rethinking suicide bombing.|journal=Crisis|year=2009|volume=30|issue=2|pages=94–7|pmid=19525169|doi=10.1027/0227-5910.30.2.94}}</ref> Hivyo katika [[vita]] vilivyopita [[askari]] walisifiwa kama waliamua kujiua kwa kutumia [[miili]] yao kama silaha dhidi ya adui. Mfano mashuhuri ni [[rubani|marubani]] wa [[kamikaze]] wa Japani waliojirusha pamoja na [[Ndege (uanahewa)|ndege]] zao dhidi ya [[meli]] za Marekani wakati wa [[vita kuu ya pili ya dunia]]. [[Wanamgambo]] wa [[Tamil Tiger]] nchini [[Sri Lanka]] walishambulia jeshi la [[serikali]] mara nyingi kwa [[Bomu|mabomu]] hai yaani askari waliobeba bomu na kujilipua karibu na maadui. Mbinu hiyohiyo inatumiwa pia katika dunia ya [[Kiislamu]] na wanamgambo na [[Ugaidi|magaidi]] mbalimbali, hasa katika nchi kama [[Palestina]], [[Irak]] au [[Afghanistan]]. Ilitumiwa pia na magaidi kutoka [[Checheniya]] dhidi ya [[Warusi]]. {{TOC limit|3}} ==Fasili== Kujiua ni kitendo cha "kujitoa uhai".<ref>{{cite book|title=Stedman's medical dictionary|url=https://archive.org/details/stedmansmedicald00sted_3|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-3390-8|edition=28th ed.}}</ref> Kujaribu kujiua ni kitendo cha kujidhuru kwa lengo la kujiangamiza, bila kufanikiwa kujiua.<ref name=Krug2002>{{cite book|last=Krug|first=Etienne|title=World Report on Violence and Health (Vol. 1)|year=2002|publisher=World Health Organization|location=Genève|isbn=978-92-4-154561-7|page=185|url=http://books.google.ca/books?id=db9OHpk-TksC&pg=PA185}}</ref> [[Usaidizi wa kujiua]] ni pale mtu anapomsaidia mwingine kujiua kwa njia isiyo ya moja kwa moja; kupitia [[ushauri]] au mbinu za kujiua.<ref name=Gullota2002>{{cite book|last=Gullota|first=edited by Thomas P.|title=The encyclopedia of primary prevention and health promotion|year=2002|publisher=Kluwer Academic/Plenum|location=New York|isbn=978-0-306-47296-1|page=1112|url=http://books.google.ca/books?id=Elx37xzO0bsC&pg=PA1112|coauthors=Bloom, Martin}}</ref> Hii ni tofauti na [[eutenasia]] ambapo mtu mwingine huhusika zaidi katika kusababisha kifo cha mwingine.<ref name=Gullota2002/> [[Mawazo ya kujiua]] ni kuwaza jinsi ya kujiangamiza.<ref name=Krug2002/> ==Vipengele vya hatari== [[File:Suicide cases from 16 American states (2008).png|thumb|upright=1.35|Hali zinazochangia kujiua katika majimbo 16 ya Marekani mwaka wa 2008.<ref>{{cite journal|last=Karch|first=DL|coauthors=Logan, J; Patel, N; Centers for Disease Control and Prevention, (CDC)|title=Surveillance for violent deaths—National Violent Death Reporting System, 16 states, 2008.|journal=Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002)|date=2011 Aug 26|volume=60|issue=10|pages=1–49|pmid=21866088}}</ref>]] Vipengele vinavyoathiri hatari ya kujiua hujumuisha [[ugonjwa wa akili]], [[matumizi mabaya ya dawa]], hali ya [[Saikolojia|kisaikolojia]], kiutamaduni, [[familia]] na vitengo vya kijamii na [[jenetikia]].<ref name=Hawton2012/> [[Ugonjwa wa akili]] na matumizi mabaya ya [[dawa]] mara nyingi hutokea kwa pamoja.<ref name=Drug2011/> Vipengele vingine vya hatari ni pamoja na jaribio la kujiua la hapo awali,<ref name=EB2011/> uwepo wa mbinu za kujiua, historia ya kujiua katika familia au uwepo wa [[jeraha kuu la ubongo]].<ref>{{cite journal|last=Simpson|first=G|coauthors=Tate, R|title=Suicidality in people surviving a traumatic brain injury: prevalence, risk factors and implications for clinical management.|journal=Brain injury : [BI]|date=2007 Dec|volume=21|issue=13–14|pages=1335–51|pmid=18066936|doi=10.1080/02699050701785542}}</ref> Kwa mfano, viwango vya kujiua vimetambulika kuwa vya juu katika familia zilizo na bunduki kuliko zisizo nazo.<ref name="Miller 393–408">{{cite journal|last=Miller|first=M|coauthors=Azrael, D; Barber, C|title=Suicide mortality in the United States: the importance of attending to method in understanding population-level disparities in the burden of suicide.|journal=Annual review of public health|date=2012 Apr|volume=33|pages=393–408|pmid=22224886|doi=10.1146/annurev-publhealth-031811-124636}}</ref> Vipengele vya kijamii na kiuchumi, kama vile [[ukosefu wa ajira]], [[umaskini]], [[kukosa makazi]] na [[ubaguzi]] vinaweza kusababisha fikira za kutaka kujiua.<ref>{{cite journal |author=Qin P, Agerbo E, Mortensen PB |title=Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981–1997 |url=https://archive.org/details/sim_american-journal-of-psychiatry_2003-04_160_4/page/765 |journal=Am J Psychiatry |volume=160 |issue=4 |pages=765–72|year=2003 |month=April |pmid=12668367 |doi=10.1176/appi.ajp.160.4.765}}</ref> Takriban 15-40% ya watu huacha [[ujumbe wa kujiua]].<ref>{{cite book|last=Gilliland|first=Richard K. James, Burl E.|title=Crisis intervention strategies|publisher=Brooks/Cole|location=Belmont, CA|isbn=978-1-111-18677-7|page=215|url=http://books.google.ca/books?id=E2sKf-sexZwC&pg=PA215|edition=7th ed.}}</ref> Jenetikia huonekana kuhusika kwa kati ya 38% na 55% ya mitindo ya kujiua.<ref name=Brent2008>{{cite journal|last=Brent|first=DA|coauthors=Melhem, N|title=Familial transmission of suicidal behavior.|url=https://archive.org/details/sim_psychiatric-clinics-of-north-america_2008-06_31_2/page/157|journal=The Psychiatric clinics of North America|date=2008 Jun|volume=31|issue=2|pages=157–77|pmid=18439442|doi=10.1016/j.psc.2008.02.001|pmc=2440417}}</ref> [[Wakongwe wa vita]] wana hatari zaidi ya kujiua kufuatia viwango vya juu vya [[magonjwa ya akili]] na matatizo ya kiafya yanayohusishwa na [[vita]].<ref name=Martyr2009>{{cite journal|last=Rozanov|first=V|coauthors=Carli, V|title=Suicide among war veterans.|journal=International journal of environmental research and public health|date=2012 Jul|volume=9|issue=7|pages=2504–19|pmid=22851956|doi=10.3390/ijerph9072504|pmc=3407917}}</ref> ===Matatizo ya akili=== [[Matatizo ya akili]] mara nyingi huwepo wakati wa kujiua, huku kadirio zikiwa kati ya 27%<ref name="University of Manchester Centre for Mental Health and Risk">{{cite web|last=University of Manchester Centre for Mental Health and Risk|title=The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness|url=http://www.medicine.manchester.ac.uk/cmhr/centreforsuicideprevention/nci/reports/annual_report_2012.pdf|accessdate=25 July 2012|archiveurl=https://web.archive.org/web/20130116021945/http://www.medicine.manchester.ac.uk/cmhr/centreforsuicideprevention/nci/reports/annual_report_2012.pdf|archivedate=2013-01-16|=https://web.archive.org/web/20130116021945/http://www.medicine.manchester.ac.uk/cmhr/centreforsuicideprevention/nci/reports/annual_report_2012.pdf}}</ref> hadi zaidi ya 90%.<ref name=EB2011/> Katika [[wagonjwa]] waliolazwa katika kitengo cha magonjwa ya akili, hatari yao ya kujiua kikamilifu katika [[maisha]] yao yote huwa takriban 8.6%<ref name=EB2011/> [[Nusu]] ya watu wote wanaofariki kutokana na kujiua wanaweza kuwa na tatizo kuu la fadhaiko; uwepo wa hali hii au mojawapo ya [[matatizo ya kihisia]], kama vile [[maradhi ya hisia mseto]] huongeza hatari ya kujiua kwa mara 20.<ref name=Che2012>{{cite book|last=Chehil|first=Stan Kutcher, Sonia|title=Suicide Risk Management A Manual for Health Professionals.|publisher=John Wiley & Sons|location=Chicester|isbn=978-1-119-95311-1|pages=30–33|year=2012|url=http://books.google.ca/books?id=fV8_1u0c7l0C&pg=PA31|edition=2nd ed.}}</ref> Hali nyingine zinazochangia kujiua ni pamoja na [[skizofrenia]] (14%), [[matatizo ya nafsi]] (14%),<ref>{{cite journal|last=Bertolote|first=JM|coauthors=Fleischmann, A; De Leo, D; Wasserman, D|title=Psychiatric diagnoses and suicide: revisiting the evidence.|journal=Crisis|year=2004|volume=25|issue=4|pages=147–55|pmid=15580849}}</ref> [[maradhi ya hisia mseto]],<ref name=Che2012/> na [[tatizo la dhiki baada ya kiwewe]].<ref name=EB2011/> Takriban 5% ya watu wenye [[skizofrenia]] hufa kutokana na kujiua.<ref name=Lancet09>{{vcite journal |author=[[Jim van Os|van Os J]], Kapur S |title=Schizophrenia |journal=Lancet |volume=374 |issue=9690 |pages=635–45 |year=2009 |month=August |pmid=19700006 |doi=10.1016/S0140-6736(09)60995-8 |url=http://xa.yimg.com/kq/groups/19525360/611943554/name/Schizophrenia+-+The+Lancet.pdf |accessdate=2013-11-28 |archivedate=2013-06-23 |archiveurl=https://web.archive.org/web/20130623065810/http://xa.yimg.com/kq/groups/19525360/611943554/name/Schizophrenia+-+The+Lancet.pdf }}</ref> [[Matatizo ya kula]] ni hali nyingine yenye hatari ya juu.<ref name=Tint2010/> Historia ya jaribio la awali la kujiua ni [[ishara]] kuu ya kujiua kikamilifu baadaye.<ref name=EB2011>{{cite journal|last=Chang|first=B|coauthors=Gitlin, D; Patel, R|title=The depressed patient and suicidal patient in the emergency department: evidence-based management and treatment strategies.|journal=Emergency medicine practice|date=2011 Sep|volume=13|issue=9|pages=1–23; quiz 23–4|pmid=22164363}}</ref> Takriban 20% ya visa vya kujiua hutanguliwa na jaribio la kujiua. 1% ya watu waliojaribu kujiua hufaulu kujiua katika mwaka mmoja<ref name=EB2011/>, na zaidi ya 5% hufaulu kujiua baada ya miaka 10&nbsp;.<ref name=Tint2010/> Ingawa vitendo vya kujidhuru havichukuliwi kama majaribio ya kujiua, kuwepo kwa mtindo wa kujidhuru huhusishwa na hatari zaidi ya kujiua.<ref>{{cite journal | pmid = 17606825 | doi=10.1001/archpedi.161.7.634 | volume=161 | issue=7 | title=The relationship between self-injurious behavior and suicide in a young adult population | year=2007 |month=July | author=Whitlock J, Knox KL | journal=Arch Pediatr Adolesc Med | pages=634–40}}</ref> Kwa takriban 80% ya visa vya kujiua kikamilifu, mwathiriwa huwa amemtembelea [[daktari]] katika [[mwaka]] huo kabla ya kujiua,<ref name=Pir1998/> ikijumuisha 45% ya visa katika [[Mwezi (wakati)|mwezi]] uliotangulia.<ref>{{cite journal|last=Luoma|first=JB|coauthors=Martin, CE; Pearson, JL|title=Contact with mental health and primary care providers before suicide: a review of the evidence.|url=https://archive.org/details/sim_american-journal-of-psychiatry_2002-06_159_6/page/909|journal=The American Journal of Psychiatry|date=2002 Jun|volume=159|issue=6|pages=909–16|pmid=12042175}}</ref> Takriban 25%-40% ya watu wanaojiua huwa wamepokea [[huduma]] ya afya ya kiakili katika mwaka uliotangulia. <ref name="University of Manchester Centre for Mental Health and Risk"/><ref name=Pir1998>{{cite journal|last=Pirkis|first=J|coauthors=Burgess, P|title=Suicide and recency of health care contacts. A systematic review.|journal=The British journal of psychiatry : the journal of mental science|date=1998 Dec|volume=173|pages=462–74|pmid=9926074}}</ref> ===Matumizi ya vileo=== [[File:The Drunkard's Progress 1846.jpg|thumb|upright=1.35|"Kuendelea kwa Mlevi", 1846 huonyesha jinsi ulevi unavyoweza kupelekea kujiua]] [[Kutumia vileo]] ni [[kipengele cha hatari]] cha pili kikuu kinachopelekea kujiua, baada ya [[mfadhaiko mkuu]] na [[maradhi ya nafsi mseto]].<ref>{{cite book|last=Perrotto|first=Jerome D. Levin, Joseph Culkin, Richard S.|title=Introduction to chemical dependency counseling|year=2001|publisher=Jason Aronson|location=Northvale, N.J.|isbn=978-0-7657-0289-0|pages=150–152|url=http://books.google.com/?id=felzn3Ntd-cC&pg=RA1-PA151}}</ref> Ulevi wa muda mrefu na [[Ulevi|ulevi wa muda mfupi]] huhusishwa na kujiua.<ref name=Drug2011/><ref name=Fadem2004/> Ikiwa hali hii itaambatana na masikitiko ya kibinafsi, kama vile [[Msiba|kufiwa]], hatari huongezeka zaidi.<ref name=Fadem2004>{{cite book|last=Fadem|first=Barbara|title=Behavioral science in medicine|year=2004|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-3669-5|page=217|url=http://books.google.ca/books?id=KB-g-oBfApsC&q=217}}</ref> Hali kadhalika, kutumia dawa za kulevya huhusishwa na matatizo ya afya ya kiakili.<ref name=Drug2011/> <!--Vitulizo (EtOH, benzodiazepines, opioids--> Watu wengi huwa wameathiriwa na [[kitulizo|dawa za kutuliza na kuwezesha usingizi]] (kama vile pombe au benzodiazepines) wakati wa kujiua <ref name=Youssef2008>{{cite journal |author=Youssef NA, Rich CL |title=Does acute treatment with sedatives/hypnotics for anxiety in depressed patients affect suicide risk? A literature review |journal=Ann Clin Psychiatry |volume=20 |issue=3|pages=157–69 |year=2008|pmid=18633742 |doi=10.1080/10401230802177698 |url=}}</ref>,huku ulevi ukiwepo katika 15%-61% ya visa.<ref name=Drug2011/> Nchi zilizo na viwango vya juu vya ulevi wa pombe na idadi kubwa ya baa pia huwa na viwango vya juu vya kujiua<ref name=ETOH2006/>. Uhusiano huu huhusishwa hasa na matumizi ya [[vinywaji vikali vilivyotoneshwa]] kuliko pombe kamili.<ref name=Drug2011/> Takriban 2.2-3.4% ya watu waliotibiwa kutokana na ulevi katika wakati fulani maishani mwao hufa kwa kujiua.<ref name=ETOH2006>{{cite journal|last=Sher|first=L|title=Alcohol consumption and suicide.|journal=QJM : monthly journal of the Association of Physicians|date=2006 Jan|volume=99|issue=1|pages=57–61|pmid=16287907|doi=10.1093/qjmed/hci146}}</ref> Walevi wanaojaribu kujiua kwa kawaida huwa wanaume wazee na ambao wamejaribu kujiua hapo awali.<ref name=Drug2011/>Kati ya 3% na 35% ya vifo vya watu wanaotumia heroini hutokana na kujiua (takriban mara 14 zaidi ya wale wasiotumia).<ref>{{cite journal |author=Darke S, Ross J |title=Suicide among heroin users: rates, risk factors and methods|journal=Addiction |volume=97 |issue=11 |pages=1383–94 |year=2002|month=November |pmid=12410779 |doi= 10.1046/j.1360-0443.2002.00214.x|url=http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0965-2140&date=2002&volume=97&issue=11&spage=1383}}</ref> <!--Vichangamshi--> Matumizi mabaya ya [[kokeini]] na [[methamphetamine]] huhusiana pakubwa na kujiua.<ref name=Drug2011/><ref>{{cite journal|last=Darke|first=S|coauthors=Kaye, S; McKetin, R; Duflou, J|title=Major physical and psychological harms of methamphetamine use.|journal=Drug and alcohol review|date=2008 May|volume=27|issue=3|pages=253–62|pmid=18368606|doi=10.1080/09595230801923702}}</ref> Katika watumizi wa kokeini, hatari huwa ya juu zaidi katika awamu ya kusitisha.<ref>{{cite book|last=Jr|first=Frank J. Ayd,|title=Lexicon of psychiatry, neurology, and the neurosciences|year=2000|publisher=Lippincott Williams & Wilkins|location=Philadelphia [u.a.]|isbn=978-0-7817-2468-5|page=256|url=http://books.google.ca/books?id=ea_QVG2BFy8C&q=256|edition=2nd ed.}}</ref> Waliotumia [[dawa za kuvuta]] pia huwa katika hatari, na takriban 20% yao hujaribu kujiua wakati fulani, huku zaidi ya 65% wakikusudia kujiua.<ref name=Drug2011/> Hata hivyo, [[bangi]] haitambuliki kuongeza hatari ikitumika pekee.<ref name=Drug2011/> [[Uvutaji tumbaku]] huhusishwa na hatari ya kujiua.<ref name=Hughes2008>{{cite journal|last=Hughes|first=JR|title=Smoking and suicide: a brief overview.|url=https://archive.org/details/sim_drug-and-alcohol-dependence_2008-12-01_98_3/page/n4|journal=Drug and alcohol dependence|date=2008 Dec 1|volume=98|issue=3|pages=169–78|pmid=18676099|doi=10.1016/j.drugalcdep.2008.06.003}}</ref> Kuna ushahidi mdogo kuhusu kuwepo kwa uhusiano huu; hata hivyo, imedhaniwa kuwa watu waliohatarishwa kwa [[moshi]] pia huhatarishwa kwa kujiua. Uvutaji husababisha matatizo ya afya yanayomfanya mtu kutaka kujiua. Pia, uvutaji huathiri [[kemia]] ya [[ubongo]] na kusababisha uwezekano wa kujiua.<ref name=Hughes2008/> ===Kubahatishia matatizo=== Kubahatishia matatizo huhusishwa na ongezeko la [[mawazo ya kujiua]] na majaribio ikilinganishwa na watu wa kawaida. <ref>{{cite book |first1=Stefano |last1=Pallanti |first2=Nicolò Baldini |last2=Rossi|first3=Eric |last3=Hollander |chapter=11. Pathological Gambling |editor1-first=Eric|editor1-last=Hollander |editor2-first=Dan J. | editor2-last=Stein |title=Clinical manual of impulse-control disorders |url=http://books.google.com/books?id=u2wVP8KJJtcC&pg=PA253 |year=2006|publisher=American Psychiatric Pub |isbn=978-1-58562-136-1 |page=253}}</ref> Kati ya 12% na 14% ya wabahatishi wa kipatholojia hujaribu kujiua.<ref name=Oliv2008/> Kiwango cha kujiua cha wake zao huwa mara tatu zaidi ya kile cha umma.<ref name=Oliv2008>{{cite journal|last=Oliveira|first=MP|coauthors=Silveira, DX; Silva, MT|title=[Pathological gambling and its consequences for public health].|journal=Revista de saude publica|date=2008 Jun|volume=42|issue=3|pages=542–9|pmid=18461253}}</ref> Vipengele vingine vinavyoongeza hatari kwa wanaobahatishia matatizo hujumuisha ugonjwa wa akili, ulevi wa pombe na dawa.<ref>{{cite journal|last=Hansen|first=M|coauthors=Rossow, I|title=[Gambling and suicidal behaviour].|journal=Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke|date=2008 Jan 17|volume=128|issue=2|pages=174–6|pmid=18202728}}</ref> ===Hali za kimatibabu=== Kuna uhusiano kati ya uwezekano wa kujiua na matatizo ya afya, ikijumuisha:<ref name=Tint2010/>[[maumivu ya muda mrefu]],<ref>{{cite journal|last=Manthorpe|first=J|coauthors=Iliffe, S|title=Suicide in later life: public health and practitioner perspectives.|url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_2010-12_25_12/page/1230|journal=International journal of geriatric psychiatry|date=2010 Dec|volume=25|issue=12|pages=1230–8|pmid=20104515|doi=10.1002/gps.2473}}</ref> [[jeraha la ubongo lenye kiwewe]],<ref>{{cite journal |author=Simpson GK, Tate RL |title=Preventing suicide after traumatic brain injury: implications for general practice |journal=Med. J. Aust. |volume=187|issue=4 |pages=229–32 |year=2007 |month=August|pmid=17708726|url=http://www.mja.com.au/public/issues/187_04_200807/sim11240_fm.html}}</ref> saratani,<ref name=Ang2012>{{cite journal|last=Anguiano|first=L|coauthors=Mayer, DK; Piven, ML; Rosenstein, D|title=A literature review of suicide in cancer patients.|journal=Cancer nursing|date=2012 Jul–Aug|volume=35|issue=4|pages=E14-26|pmid=21946906|doi=10.1097/NCC.0b013e31822fc76c}}</ref> watu wanaofanyiwa [[hemodialisi]], wenye [[VVU]], [[erithematosasi ya kitaratibu ya lupusi]] miongini mwa hali zingine.<ref name=Tint2010/> Utambuzi wa saratani huongeza hatari ya kujiua baadaye kwa takriban mara mbili.<ref name=Ang2012/> Ukithiri wa ongezeko la uwezekano wa kujiua ulijikita hata baada ya kurekebishwa kutokana na maradhi ya mfadhaiko na ulevi. Hatari katika watu wenye hali nyingi za kimatibabu huwa juu zaidi. Matatizo ya afya nchini Japan yanaorodheshwa kama sababu kuu ya kujiua.<ref>{{cite book|last=Yip|first=edited by Paul S.F.|title=Suicide in Asia : causes and prevention|url=https://archive.org/details/suicideinasiacau0000unse|year=2008|publisher=Hong Kong University Press|location=Hong Kong|isbn=9789622099432|page=[https://archive.org/details/suicideinasiacau0000unse/page/11 11]|pages=http://books.google.ca/books?id=HuHQbtlyM40C&pg=PA11}}</ref> Matatizo ya usingizi kama vile [[insomnia]]<ref>{{cite journal|last=Ribeiro|first=JD|coauthors=Pease, JL; Gutierrez, PM; Silva, C; Bernert, RA; Rudd, MD; Joiner TE, Jr|title=Sleep problems outperform depression and hopelessness as cross-sectional and longitudinal predictors of suicidal ideation and behavior in young adults in the military.|journal=Journal of Affective Disorders|date=2012 Feb|volume=136|issue=3|pages=743–50|pmid=22032872|doi=10.1016/j.jad.2011.09.049}}</ref> na [[apnea ya usingizi]] ni vipengele vya hatari vya mfadhaiko na kujiua. Wakati mwingine, masumbufu ya usingizi yanaweza kuwa vipengele vya hatari ya kujiua bila kutegemea mfadhaiko.<ref>{{cite journal|last=Bernert|first=RA|coauthors=Joiner TE, Jr; Cukrowicz, KC; Schmidt, NB; Krakow, B|title=Suicidality and sleep disturbances.|journal=Sleep|date=2005 Sep|volume=28|issue=9|pages=1135–41|pmid=16268383}}</ref> Hali nyingine za kimatibabu zinaweza kuwepo, huku zikiwa na dalili sawa na matatizo ya kihisia, ikiwa ni pamoja na:[[hipouthiroidi]], [[ugonjwa wa Alzheimer|Alzheimer]], [[kansa ya ubongo]], [[erithematosasi ya kitaratibu ya lupusi]] na madhara ya dawa (kama vile [[viziba beta]] na [[steroidi]]).<ref name=EB2011/> ===Hali za kimawazo na kijamii=== Baadhi ya hali za kimawazo na kijamii huongeza hatari ya kujiua, ikujumuisha: [[kukosa matumaini]], kupoteza furaha katika maisha, fadhaiko na wasiwasi.<ref name=Che2012/> Uwezo duni wa kusuluhisha matatizo, ukosefu wa uwezo aliokua nao mtu na udhibiti duni wa hisia pia unaweza kuchangia kujiua.<ref name=Che2012/><ref name=Joiner2005>{{cite journal|last=Joiner TE|first=Jr|coauthors=Brown, JS; Wingate, LR|title=The psychology and neurobiology of suicidal behavior.|url=https://archive.org/details/sim_annual-review-of-psychology_2005_56/page/287|journal=Annual review of psychology|year=2005|volume=56|pages=287–314|pmid=15709937|doi=10.1146/annurev.psych.56.091103.070320}}</ref>Katika watu wazima, wazo la kuwa mzigo kwa watu wengine ni kipengele kikuu.<ref name=Van2011>{{cite journal|last=Van Orden|first=K|coauthors=Conwell, Y|title=Suicides in late life.|journal=Current psychiatry reports|date=2011 Jun|volume=13|issue=3|pages=234–41|pmid=21369952|doi=10.1007/s11920-011-0193-3|pmc=3085020}}</ref><ref name=Van2011/> Dhiki za awali, kama vile kifo cha jamaa au rafiki, kupoteza kazi au kujitenga na jamii (kama vile kuishi pekee) huongeza hatari.<ref name=Che2012/> Watu ambao hawajawai kuoa pia wana hatari ya juu zaidi.<ref name=EB2011/> Kujihusisha na dini kunaweza kupunguza hatari ya kujiua.<ref name=Religion2009>{{cite journal|last=Koenig|first=HG|title=Research on religion, spirituality, and mental health: a review.|journal=Canadian journal of psychiatry. Revue canadienne de psychiatrie|date=2009 May|volume=54|issue=5|pages=283–91|pmid=19497160}}</ref> Hali hii imehusishwa na msimamo hasi wa dini dhidi ya kujiua, na uhusiano mkuu ulioko katika dini.<ref name=Religion2009/> [[Waislamu]], wakilingashwa na watu wa dini zingine, huwa na kiwango cha chini zaidi cha kujiua.<ref name=Islam2006>{{cite journal|last=Lester|first=D|title=Suicide and islam.|journal=Archives of suicide research : official journal of the International Academy for Suicide Research|year=2006|volume=10|issue=1|pages=77–97|pmid=16287698|doi=10.1080/13811110500318489}}</ref> Baadhi ya watu wanaweza kujiua ili kuepuka [[ukatili]] au [[ubaguzi]].<ref name=Cox2012>{{cite journal |last1= Cox |first1= William T. L. |last2= Abramson |first2= Lyn Y. |last3= Devine |first3= Patricia G. |last4= Hollon |first4= Steven D. |year= 2012 |title= Stereotypes, Prejudice, and Depression: The Integrated Perspective |journal= [[Perspectives on Psychological Science (journal)|Perspectives on Psychological Science]] |volume= 7 |issue= 5 |pages= 427–449 |publisher= |doi= 10.1177/1745691612455204 |url= http://pps.sagepub.com/content/7/5/427.abstract |accessdate= |archive-date= 2012-10-20 |archive-url= https://web.archive.org/web/20121020230619/http://pps.sagepub.com/content/7/5/427.abstract |dead-url= yes }}</ref> Historia ya [[dhuluma za kimapenzi]] dhidi ya watoto u<ref>{{cite journal|last=Wegman|first=HL|coauthors=Stetler, C|title=A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood.|url=https://archive.org/details/sim_psychosomatic-medicine_2009-10_71_8/page/805|journal=Psychosomatic Medicine|date=2009 Oct|volume=71|issue=8|pages=805–12|pmid=19779142|doi=10.1097/PSY.0b013e3181bb2b46}}</ref> na muda aliokaa mtu kwenye [[utunzaji wa walezi]] pia huwa vipengele vya hatari.<ref>{{cite journal|last=Oswald|first=SH|coauthors=Heil, K; Goldbeck, L|title=History of maltreatment and mental health problems in foster children: a review of the literature.|journal=Journal of pediatric psychology|date=2010 Jun|volume=35|issue=5|pages=462–72|pmid=20007747|doi=10.1093/jpepsy/jsp114}}</ref> Dhuluma za kimapenzi huaminika kuchangia hadi takriban 20% ya hatari ya kijumla.<ref name=Brent2008/> Maelezo ya [[saikolojia ya mageuko]] kuhusu kujiua ni kwamba kunaweza kuboresha [[uwezo wa kimalezi]]. Hii inaweza kutokea iwapo mtu anayejiua hawezi kupata watoto wengine na anaendelea kutumia raslimali za jamii kwa kuendelea kuishi. Pingamizi ni kuwa vifo vya watu waliobaleghe wenye afya mara nyingi haviongezi uwezo wa kimalezi. [[Utohozi]] katika mazingira tofauti na aliyozaliwa mtu unaweza kupelekea marekebisho mabaya katika mazingira anayoishi mtu kwa sasa.<ref name=Joiner2005/><ref>{{cite journal|last=Confer|first=Jaime C.|coauthors=Easton, Judith A.; Fleischman, Diana S.; Goetz, Cari D.; Lewis, David M. G.; Perilloux, Carin; Buss, David M.|title=Evolutionary psychology: Controversies, questions, prospects, and limitations.|url=https://archive.org/details/sim_american-psychologist_february-march-2010_65_2/page/110|journal=American Psychologist|date=1 January 2010|volume=65|issue=2|pages=110–126|doi=10.1037/a0018413|pmid=20141266}}</ref> Umaskini huhusishwa na hatari ya kujiua.<ref name=Stark2011>{{cite journal|last=Stark|first=CR|coauthors=Riordan, V; O'Connor, R|title=A conceptual model of suicide in rural areas.|journal=Rural and remote health|year=2011|volume=11|issue=2|page=1622|pmid=21702640}}</ref>Ongezeko la umaskini ukilinganishwa na watu walio karibu huongeza hatari ya kujiua.<ref>{{cite journal|last=Daly|first=Mary|title=Relative Status and Well-Being: Evidence from U.S. Suicide Deaths|journal=Federal Reserve Bank of San Francisco Working Paper Series|date=Sept 2012|url=http://www.frbsf.org/publications/economics/papers/2012/wp12-16bk.pdf|access-date=2013-11-28|archive-date=2012-10-19|archive-url=https://web.archive.org/web/20121019134902/http://www.frbsf.org/publications/economics/papers/2012/wp12-16bk.pdf|dead-url=yes}}</ref> Zaidi ya [[wakulima]] 200,000 nchini [[India]] wametekeleza kujiua kuanzia 1997 kwa sababu ya [[deni]].<ref>{{cite news|last=Lerner|first=George|title=Activist: Farmer suicides in India linked to debt, globalization|url=http://articles.cnn.com/2010-01-05/world/india.farmer.suicides_1_farmer-suicides-andhra-pradesh-vandana-shiva?_s=PM:WORLD|accessdate=13 February 2013|newspaper=CNN World|date=Jan 5,2010|archiveurl=https://web.archive.org/web/20130116020225/http://articles.cnn.com/2010-01-05/world/india.farmer.suicides_1_farmer-suicides-andhra-pradesh-vandana-shiva?_s=PM%3AWORLD|archivedate=2013-01-16}}</ref> Nchini [[China]], uwezo wa kujiua ni mara tatu zaidi katika maeneo ya mashambani kuliko mijini, kufuatia matatizo ya kifedha katika maeneo hayo.<ref>{{cite journal|last=Law|first=S|coauthors=Liu, P|title=Suicide in China: unique demographic patterns and relationship to depressive disorder.|journal=Current psychiatry reports|date=2008 Feb|volume=10|issue=1|pages=80–6|pmid=18269899}}</ref> ===Vyombo vya habari=== [[Vyombo vya habari]], ikiwa ni pamoja na [[mtandao]], huchangia pakubwa.<ref name=Hawton2012/> Jinsi vyombo hivi vinavyowasilisha kujiua inaweza kuwa na athari mbaya, huku habari zilizotiliwa mkazo, kusisitizwa na kurudiwa huku zikisifia matukio ya kujiua zikiwa na athari kuu zaidi.<ref name=Boh2012>{{cite journal|last=Bohanna|first=I|coauthors=Wang, X|title=Media guidelines for the responsible reporting of suicide: a review of effectiveness.|journal=Crisis|year=2012|volume=33|issue=4|pages=190–8|pmid=22713977|doi=10.1027/0227-5910/a000137}}</ref> Mbinu moja ya kujiua inapoangaziwa kwa kina, umaarufu wake unaweza kuongezeka kwenye umma.<ref name=Yip2012/> Kichochezi cha kusambaza hisia za kujiua au [[uigaji kujiua]] hujulikana kama [[athari ya Werther]] kutokana na [[mhusika]] mkuu katika [[kitabu]] cha [[Johann Wolfgang von Goethe]] ''[[The Sorrows of Young Werther]]'' aliyejiua.<ref name=Sia2012/>Hatari hii ni kubwa zaidi katika vijana wanaosifia [[kifo]].<ref>{{cite journal |author=Stack S |title=Suicide in the media: a quantitative review of studies based on non-fictional stories |url=https://archive.org/details/sim_suicide-life-threatening-behavior_2005-04_35_2/page/121 |journal=Suicide Life Threat Behav |volume=35 |issue=2 |pages=121–33|year=2005 |month=April |pmid=15843330 |doi=10.1521/suli.35.2.121.62877 }}</ref> Inaonekana kuwa, ingawa vyombo vya habari vina ushawishi mkubwa, ushawishi wa vyombo vya burudani ni wa kupotosha. Kinyume cha athari ya Werther ni ile inayoitwa athari ya Papageno, ambapo kuwasilisha habari kuhusu mbinu mwafaka za ukabilianaji kunaweza kupelekea matokeo bora ya kinga. Neno hili linatokana na mhusika katika [[tamthilia]] ya [[Wolfgang Amadeus Mozart] iitwayo ''[[The Magic Flute]]''. Mhusika huyu alitaka kujiua kwa kuogopa kumtopeza mpenzi wake hadi marafiki zake wakamshawishi asijiue. <ref name=Sia2012>{{cite journal|last=Sisask|first=M|coauthors=Värnik, A|title=Media roles in suicide prevention: a systematic review.|journal=International journal of environmental research and public health|date=2012 Jan|volume=9|issue=1|pages=123–38|pmid=22470283|doi=10.3390/ijerph9010123|pmc=3315075}}</ref> Hatari ya kujiua inaweza kupungua iwapo vyombo vya habari vitafuatilia miongozo inayofaa ya kuripoti.<ref name=Boh2012/> Inaweza kuwa vigumu kupata uwajibikaji wa wataalamu wa [[mawasiliano]], hasa katika muda mrefu wa usoni.<ref name=Boh2012/> ===Kujiua kirazini=== Kujiua ki[[razini]] ni kujiua baada ya kufanya uamuzi kwa [[akili timamu]], <ref name=Loue2008>{{cite book|last=Loue|first=Sana|title=Encyclopedia of aging and public health : with 19 tables|year=2008|publisher=Springer|location=New York, NY|isbn=978-0-387-33753-1|page=696|url=http://books.google.ca/books?id=rTMrB0AutLwC&pg=PA696}}</ref> ingawa baadhi ya watu husema kuwa kujiua hakuwezi kuwa jambo la [[busara]].<ref name=Loue2008/>Kitendo cha kujiua ili kuwanufaisha watu wengine hujulikana kama [[kujiua kiutu]].<ref name=Moody2010>{{cite book|last=Moody|first=Harry R.|title=Aging : concepts and controversies|year=2010|publisher=Pine Forge Press|location=Los Angeles|isbn=978-1-4129-6966-6|page=158|url=http://books.google.ca/books?id=qj8GS77QAgwC&pg=PA158|edition=6th ed.}}</ref> Mfano wa aina hii ni mzee akijiua ili kuwaachia watoto wake mali nyingi katika jamii.<ref name=Moody2010/> Katika baadhi ya tamaduni za [[Eskimo]], hatua ya kujiua kiutu imeonekana kama kitendo cha heshima, ujasiri au hekima.<ref name=Hales2012/> [[Shambulio la kujiua]] ni kitendo cha kisiasa ambapo mshambulizi huwavamia watu wengine akifahamu kuwa kitendo hicho kitapelekea kifo chake. <ref>{{cite book|last=editor|first=Tarek Sobh,|title=Innovations and advances in computer sciences and engineering|year=2010|publisher=Springer Verlag|location=Dordrecht|isbn=978-90-481-3658-2|page=503|url=http://books.google.ca/books?id=B-Zf1sQZapMC&pg=PA503|edition=Online-Ausg.}}</ref> Baadhi ya watu wanaojiua kwa bomu hufanya hivyo ili kupata umaarufu wa [[ufiadini]].<ref name=Martyr2009/> Mashambulizi ya [[Kamikaze]] yalitekelezwa kama wito mkuu au wajibu wa kimaadili.<ref name=Hales2012>{{cite book|last=Hales|first=edited by Robert I. Simon, Robert E.|title=The American Psychiatric Publishing textbook of suicide assessment and management|publisher=American Psychiatric Pub.|location=Washington, DC|isbn=978-1-58562-414-0|page=714|url=http://books.google.ca/books?id=H8tigTjBCRkC&pg=PA714|edition=2nd ed.}}</ref> [[Kujiua baada ya mauaji]] ni kitendo cha [[uuaji wa binadamu]] kinachofuatiwa punde na mtu aliyetekeleza mauaji hayo kujiua mwenyewe.<ref>{{cite journal|last=Eliason|first=S|title=Murder-suicide: a review of the recent literature.|url=https://archive.org/details/sim_journal-of-the-american-academy-of-psychiatry-and-the-law_2009_37_3/page/371|journal=The journal of the American Academy of Psychiatry and the Law|year=2009|volume=37|issue=3|pages=371–6|pmid=19767502}}</ref> [[Mauaji ya halaiki]] mara nyingi hutekelezwa chini ya [[ushawishi wa rika|ushawishi wa kijamii]] ambapo washirika humpa kiongozi mamlaka ya kuwafanyia atakavyo.<ref>{{cite book|last=Smith|first=William Kornblum in collaboration with Carolyn D.|title=Sociology in a changing world|publisher=Wadsworth Cengage Learning|location=Belmont, CA|isbn=978-1-111-30157-6|page=27|url=http://books.google.ca/books?id=DtKcG6qoY5AC&pg=PT51|edition=9e [9th ed].}}</ref> Mauaji ya watu wengi yanaweza kutekelezwa na hata watu wawili tu, maarufu kama [[mkataba wa kujiua]].<ref>{{cite book|last=Campbell|first=Robert Jean|title=Campbell's psychiatric dictionary|year=2004|publisher=Oxford University Press|location=Oxford|isbn=978-0-19-515221-0|page=636|url=http://books.google.ca/books?id=Vrlsos_O13UC&pg=PA636|edition=8th ed.}}</ref> Katika hali za kujaribu kuhalalisha, ambapo kuendelea kuishi kutapelekea mateso, watu wengi hutumia kujiua kama mbinu ya kuepuka. <ref>{{cite book|last=Veatch|first=ed. by Robert M.|title=Medical ethics|year=1997|publisher=Jones and Bartlett|location=Sudbury, Mass. [u.a.]|isbn=978-0-86720-974-7|page=292|url=http://books.google.ca/books?id=UCOT4sj-DwUC&pg=PA292|edition=2. ed.}}</ref> Baadhi ya wafungwa katika [[kambi za mkusanyiko]] waliripotiwa kujiua kimakusidi kwa kugusa ua za umeme.<ref>{{cite book|last=Gutman|first=Yisrael|title=Anatomy of the Auschwitz death camp|year=1998|publisher=Publ. in association with the United States Holocaust Memorial Museum, Washington, D.C. by Indiana University Press|location=Bloomington|isbn=978-0-253-20884-2|page=400|edition=1st pbk. ed.|coauthors=editors, Michael Berenbaum,}}</ref> ==Mbinu== [[File:SuicideCFR.png|thumb|upright=1.35|Uchunguzi vifo kwa kujiua nchini Marekani.<ref name="Miller 393–408"/>]] Mbinu maarufu ya kujiua hutofautiana katika nchi mbalimbali. Mbinu inayoongoza katika maeneo tofauti ni pamoja na [[kujia kwa kujinyonga|kunyonga]], [[kunywa sumu]] na kujiua kwa [[bunduki]].<ref>{{cite journal|author=Ajdacic-Gross V |title=Methods of suicide: international suicide patterns derived from the WHO mortality database |journal=Bull. World Health Organ.|volume=86 |issue=9 |pages=726–32 |year=2008|month=September |pmid=18797649 |pmc=2649482 |doi=10.2471/BLT.07.043489 |author-separator=,|author2=Weiss MG |author3=Ring M |display-authors=3 |last4=Hepp |first4=U |last5=Bopp |first5=M|last6=Gutzwiller |first6=F |last7=Rössler |first7=W}}</ref> Tofauti hizi zinaaminika kusababishwa na upatikanaji wa mbinu mbalimbali kulingana na kila eneo.<ref name=Yip2012/> Mapitio ya nchi 56 yalionyesha kuwa mbinu ya kujinyonga ilikuwa maarufu zaidi katika idadi kubwa ya nchi hizi, <ref>Ajdacic-Gross, Vladeta, ''et al''.{{PDFlink|[http://www.scielosp.org/pdf/bwho/v86n9/a17v86n9.pdf "Methods of suicide: international suicide patterns derived from the WHO mortality database"]|267&nbsp;KB}}. ''[[Bulletin of the World Health Organization]]'' '''86''' (9): 726–732. September 2008. Accessed 2 August 2011.[https://web.archive.org/web/20110920054902/http://www.scielosp.org/pdf/bwho/v86n9/a17v86n9.pdf Archived] 2 August 2011. See[http://www.who.int/bulletin/volumes/86/9/07-043489/en/index.html html version] {{Wayback|url=http://www.who.int/bulletin/volumes/86/9/07-043489/en/index.html |date=20131208175622 }}. The data can be seen here [http://www.who.int/bulletin/volumes/86/9/0042-9686_86_07-043489-table-T1.html] {{Wayback|url=http://www.who.int/bulletin/volumes/86/9/0042-9686_86_07-043489-table-T1.html |date=20110923003222 }}</ref> ikihasibia 53% ya visa vya kujiua kwa wanaume na 39% katika wanawake. <ref>{{cite book |editor1-first=Rory C.|editor1-last=O'Connor |editor2-first=Stephen |editor2-last=Platt |editor3-first=Jacki|editor3-last=Gordon |title=International Handbook of Suicide Prevention: Research, Policy and Practice|url=http://books.google.com/books?id=3fDGLWQtwFkC&pg=PA34 |date=1 June 2011 |publisher=John Wiley and Sons|isbn=978-1-119-99856-3|page=34}}</ref> Kote ulimwenguni, 30% ya visa vya kujiua hutokana na kunywa sumu. Visa vya kutumia mbinu hii, hata hivyo ni tofauti sana, kutoka 4% bara Uropa hadi zaidi ya 50% katika eneo la Pasifiki. <ref>{{cite journal |author=Gunnell D, Eddleston M, Phillips MR, Konradsen F |title=The global distribution of fatal pesticide self-poisoning: systematic review |journal=BMC Public Health |volume=7 |page=357 |year=2007 |pmid=18154668 |pmc=2262093|doi=10.1186/1471-2458-7-357}}</ref> Mbinu hii pia ni maarufu [[Marekani Kusini]] kwa sababu ya hali rahisi ya kupatikana kwa sumu za ukulima. <ref name=Yip2012/> Katika nchi nyingi, kuzidisha kipimo cha dawa husababisha takriban 60% ya visa vya kujiua miongoni mwa wanawake na 30% katika wanaume.<ref>{{cite book|last=Geddes|first=John|title=Psychiatry|publisher=Oxford University Press|location=Oxford|isbn=978-0-19-923396-0|page=62|url=http://books.google.ca/books?id=F4THKWvbAPEC&pg=PA62|edition=4th ed.|coauthors=Price, Jonathan; Gelder, Rebecca McKnight; with Michael; Mayou, Richard}}</ref> Idadi kubwa ya vifo hivi hutokea bila mpango, na hutokea katika kipindi kikali cha mashaka.<ref name=Yip2012/> Kiasi cha vifo hutofautiana na mbinu iliyotumika; bunduki: 80-90%, kuzama: 65-80%, kujinyonga: 60-85%, mivuke ya gari: 40-60%, kujirusha: 35-60%, [[kujiua kwa moshi wa makaa|kuchoma makaa]]: 40-50%, sumu ya kuua wadudu: 6-75%, kuzidisha kiasi cha dawa: 1.5-4%.<ref name=Yip2012/> Mbinu za kujiua zilizojaribiwa zaidi hutofautiana na mbinu kuu zaidi, huku kukiwa na 85% ya majaribio ya kuzidisha kiasi cha dawa katika mataifa yaliyostawi.<ref name=Tint2010/> Nchini Marekani, 57% ya visa vya kujiua vimehusisha kutumia bunduki, huku mbinu hii ikitumiwa zaidi na wanaume kuliko wanawake. <ref name=EB2011/> Mbinu iliyofuatia kwa umaarufu ni kujinyonga katika wanaume na kunywa sumu katika wanawake.<ref name=EB2011/> Mbinu hizi kwa pamoja zilichangia 40% ya visa vya kujiua nchini Marekani. <ref name=USStats2005>{{cite web|url=http://www.suicide.org/suicide-statistics.html |title=U.S. Suicide Statistics (2005) |accessdate=2008-03-24}}</ref> Nchini Uswisi, ambapo takriban kila mtu humiliki bunduki, idadi kubwa zaidi ya visa vya kujiua ni kwa kujinyonga. <ref>{{cite book|last=Eshun|first=edited by Sussie|title=Culture and mental health sociocultural influences, theory, and practice|year=2009|publisher=Wiley-Blackwell|location=Chichester, U.K.|isbn=9781444305814|page=301|url=http://books.google.ca/books?id=Y6uUDBBGqF4C&pg=PA301|coauthors=Gurung, Regan A.R.}}</ref> Visa vya kujiua ni maarufu nchini [[Hong kong]] na [[Singapore]] huku vikiwa 50% na 80% mtawalia. <ref name=Yip2012/> Nchini Uchina, mbinu kuu zaidi ni kunywa sumu. <ref name=WRVp196>{{cite book|last=Krug|first=Etienne|title=World Report on Violence and Health, Volume 1|year=2002|publisher=World Health Organization|location=Genève|isbn=9789241545617|page=196|pages=http://books.google.ca/books?id=db9OHpk-TksC&pg=PA196}}</ref> Nchini Japani, kujitoa matumbo, yaani [[seppuku]] au hara-kiri, bado hutokea, <ref name=WRVp196/>ingawa kujinyonga ndiyo njia kuu zaidi. <ref>{{cite book|last=(editor)|first=Diego de Leo|title=Suicide and euthanasia in older adults : a transcultural journey|url=https://archive.org/details/suicideeuthanasi0000unse|year=2001|publisher=Hogrefe & Huber|location=Toronto|isbn=9780889372511|page=[https://archive.org/details/suicideeuthanasi0000unse/page/121 121]}}</ref> ==Pathofisiolojia== Hakuna [[pathofisiolojia]] ya kujiua au mfadhaiko iliyo bayana, unganishi na ya kimsingi. <ref name=EB2011/> Hata hivyo, kujiua huaminika kutokana na mwingilianao wa vipengele vya kimtindo, kimazingira na kijamii na magonjwa ya akili. <ref name=Yip2012/> Viwango vya chini vya [[kipengele cha neurotrofiki zitokanazo na ubongo]] (KNZU) huhusishwa moja kwa moja na kujiua <ref>{{cite journal|last=Pjevac|first=M|coauthors=Pregelj, P|title=Neurobiology of suicidal behaviour.|journal=Psychiatria Danubina|date=2012 Oct|volume=24 Suppl 3|pages=S336-41|pmid=23114813}}</ref> na pasipo moja kwa moja jinsi vinavyochangia mfadhaiko mkuu, matatizo ya baada ya kiwewe, skizofrenia na [[matatizo ya ung’ang’anizi shurutishi]].<ref>{{cite journal|last=Sher|first=L|title=The role of brain-derived neurotrophic factor in the pathophysiology of adolescent suicidal behavior.|journal=International journal of adolescent medicine and health|year=2011|volume=23|issue=3|pages=181–5|pmid=22191181}}</ref> Uchunguzi wa [[Atopsi|Uchunguzi maiti]] umetambua viwango vya chini vya KNZU katika [[hipokampasi]] na [[koteksi ya mbele]] kwa watu walio au wasio na hali za ugonjwa wa akili. <ref>{{cite journal|last=Sher|first=L|title=Brain-derived neurotrophic factor and suicidal behavior.|journal=QJM : monthly journal of the Association of Physicians|date=2011 May|volume=104|issue=5|pages=455–8|pmid=21051476|doi=10.1093/qjmed/hcq207}}</ref> [[Serotonini]], ambayo ni [[niurotransmita]] ya ubongo, huanimika kuwa katika kiwango cha chini katika watu wanaojiua. Hii ni kwa kimsingi wa kupatikana kwa viwango vya juu vya [[kipokezi cha 5- HT2A]] vinavyopatikana baada ya kufa. <ref name=Dwi2012>{{cite book|last=Dwivedi|first=Yogesh|title=The neurobiological basis of suicide|year=2012|publisher=Taylor & Francis/CRC Press|location=Boca Raton, FL|isbn=978-1-4398-3881-5|page=166|url=http://books.google.ca/books?id=5hcOf_SM-U0C&pg=PA166}}</ref> Ushahidi mwingine ni pamoja na viwango vya chini vya [[asidi ya hidroksindoletisia-5]], zao linalopatikana baada ya serotonini kumeng’enywa, katika [[kiowevu cha uti wa mgongo]].<ref>{{cite book|last=Stein|first=edited by George|title=Seminars in general adult psychiatry|year=2007|publisher=Gaskell|location=London|isbn=978-1-904671-44-2|page=145|url=http://books.google.ca/books?id=6PGzHFuS1xkC&pg=PA145|edition=2. ed.|coauthors=Wilkinson, Greg}}</ref> Hata hivyo, ushahidi wa moja kwa moja ni mgumu kupata. <ref name=Dwi2012/> [[Epigenetikia]], somo la mabadiliko ya udhihirisho wa kijeni katika kuitikia vipengele vya kimazingira visivyobadilisha [[DNA]], pia inaaminika kuchangia katika kubaini hatari ya kujiua.<ref>{{cite journal|last=Autry|first=AE|coauthors=Monteggia, LM|title=Epigenetics in suicide and depression.|journal=Biological Psychiatry|date=2009 Nov 1|volume=66|issue=9|pages=812–3|pmid=19833253|doi=10.1016/j.biopsych.2009.08.033|pmc=2770810}}</ref> ==Kinga== [[File:suicidemessageggb01252006.JPG|thumb|Kama mpango wa kuzuia visa vya kujiua, picha hii inahamsisha kuhusu simu maalum kwenye [[Daraja la Golden Gate]] iliyounganishwa na [[simu ya dharura ya ushauri]].]] Kuzuia kujiua ni neno linalotumika kumaanisha juhudi za pamoja za kupunguza matukio ya kujiua kupitia hatua za kuzuia. Kupunguza ufikiaji mbinu fulani za kujiua, kama vile bunduki au sumu, hupunguza hatari hii. <ref name=Yip2012/><ref name=WHO2012/> Hatua nyingine ni pamoja na kupunguza ufikiaji makaa na kuweka vizuizi kwenye madaraja na reli za chini ya ardhi. <ref name=Yip2012/> Matibabu dhidi ya uraibu wa dawa za kulevya na pombe, mfadhaiko na majaribio ya kujiua pia yanaweza kuwa mwafaka. <ref name=WHO2012/> Baadhi ya wataalam wamependekeza ufikiaji pombe kama mkakati wa kuzuia (kama vile kupunguza idadi za baa.) <ref name=Drug2011>{{cite journal|last=Vijayakumar|first=L|coauthors=Kumar, MS; Vijayakumar, V|title=Substance use and suicide.|journal=Current opinion in psychiatry|date=2011 May|volume=24|issue=3|pages=197–202|pmid=21430536|doi=10.1097/YCO.0b013e3283459242}}</ref> Ingawa [[simu ya dharura ya ushauri]] hutumika sana, ushahidi uliopo ni mdogo wa kuunga mkono au kupinga ufanisi wake. <ref>{{cite journal|last=Sakinofsky|first=I|title=The current evidence base for the clinical care of suicidal patients: strengths and weaknesses|journal=Canadian Journal of Psychiatry|date=2007 Jun|volume=52|issue=6 Suppl 1|pages=7S–20S|pmid=17824349}}</ref><ref>{{cite web|title=Suicide|url=http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec5_1.html|work=The United States Surgeon General|accessdate=4 September 2011}}</ref> Katika vijana ambao awali wamekusudia kujiua, [[matibabu ya kubadilisha mawazo]] yametambulika kuboresha matokeo. <ref>{{cite journal|last=Robinson|first=J|coauthors=Hetrick, SE; Martin, C|title=Preventing suicide in young people: systematic review.|journal=The Australian and New Zealand journal of psychiatry|date=2011 Jan|volume=45|issue=1|pages=3–26|pmid=21174502|doi=10.3109/00048674.2010.511147}}</ref> [[Ukuaji wa uchumi]] unaweza kupunguza viwango vya visa vya kujiua kupitia uwezo wake wa kupunguza umaskini. <ref name=Stark2011/> Juhudi za kuongeza mahusiano ya kijamii, hasa katika wanaume wazee zinaweza kuwa mwafaka. <ref>{{cite journal|last=Fässberg|first=MM|coauthors=van Orden, KA; Duberstein, P; Erlangsen, A; Lapierre, S; Bodner, E; Canetto, SS; De Leo, D; Szanto, K; Waern, M|title=A systematic review of social factors and suicidal behavior in older adulthood.|journal=International journal of environmental research and public health|date=2012 Mar|volume=9|issue=3|pages=722–45|pmid=22690159|doi=10.3390/ijerph9030722|pmc=3367273}}</ref> ===Uchunguzi wa kimatibabu=== Takwimu zilizopo hazitoshi kuelezea matokeo ya uchunguzi wa kimatibabu kwa umma na viwango vya hatima vya viwango vya kujiua. <ref>{{cite journal|last=Williams|first=SB|coauthors=O'Connor, EA; Eder, M; Whitlock, EP|title=Screening for child and adolescent depression in primary care settings: a systematic evidence review for the US Preventive Services Task Force.|journal=Pediatrics|date=2009 Apr|volume=123|issue=4|pages=e716-35|pmid=19336361|doi=10.1542/peds.2008-2415}}</ref> Kwa kuwa kuna watu wengi wasio katika hatari ya kujiua wanaopata matokeo chanya kupitia mbinu hii, kuna wasiwasi kuwa uchunguzi unaweza kuongeza kwa kiasi kikubwa utumiaji wa raslimali za huduma ya afya. <ref>{{cite journal|last=Horowitz|first=LM|coauthors=Ballard, ED; Pao, M|title=Suicide screening in schools, primary care and emergency departments.|journal=Current Opinion in Pediatrics|date=2009 Oct|volume=21|issue=5|pages=620–7|pmid=19617829|doi=10.1097/MOP.0b013e3283307a89|pmc=2879582}}</ref> Hata hivyo, inapendekezwa kuwachunguza watu walio katika hatari kuu ya kujiua. <ref name=EB2011/> Kuuliza kuhusu uwezo wa kujiua hakuonekani kuongeza hatari hii.<ref name=EB2011/> ===Maradhi ya akili=== Katika watu walio na matatizo ya akili, aina kadhaa za matibabu zinaweza kupunguza hatari ya kujiua. Watu walio na hisia za kujiua wanaweza kulazwa katika kituo cha utunzaji wa kiakili, kwa hiari au bila hiari yao. <ref name=EB2011/> Kwa kawaida, vifaa anavyoweza kutumia mtu kujiumiza huondolewa. <ref name=Tint2010>{{cite book |author=Tintinalli, Judith E. |title=Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)) |publisher=McGraw-Hill Companies |location=New York |year=2010|pages=1940–1946|isbn=0-07-148480-9 |oclc= |doi= |accessdate=}}</ref> Baadhi ya madaktari huwaagiza wagonjwa kutia saini [[mkataba wa kuzuia kujiua]] ambapo wanaahidi kutojiumiza iwapo wataachiliwa. <ref name=EB2011/> Hata hivyo, ushahidi hauonyeshi matokeo mengi ya hatua hii. <ref name=EB2011/> Iwapo mtu yuko katika kiasi kidogo cha hatari, matibabu ya [[mgonjwa]] wa nje yanaweza kupangiwa. <ref name=Tint2010/> Kulazwa kwa muda mfupi hospitalini hakujatambulika kuwa na ufanisi zaidi ya utunzaji wa kijamii ili kunufaisha matokeo kwa wale walio na [[tatizo la nafsi hafifu]], ambao huwa na hisia za muda mrefu za kujiua. <ref>{{Rejea jarida|last=Paris|first=J|title=Is hospitalization useful for suicidal patients with borderline personality disorder?|url=https://archive.org/details/sim_journal-of-personality-disorders_2004-06_18_3/page/240|journal=Journal of personality disorders|date=June 2004|volume=18|issue=3|pages=240–7|pmid=15237044|doi=10.1521/pedi.18.3.240.35443}}</ref><ref>{{cite journal|last=Goodman|first=M|coauthors=Roiff, T; Oakes, AH; Paris, J|title=Suicidal risk and management in borderline personality disorder.|journal=Current psychiatry reports|date=2012 Feb|volume=14|issue=1|pages=79–85|pmid=22113831|doi=10.1007/s11920-011-0249-4}}</ref> Kuna ushahidi wa kutosha kuonyesha kuwa [[matibabu ya kisaikolojia]], hasa [[matibabu ya kitabia ya upembuzi]], hupunguza uwezo wa kujiua katika vijana baleghe <ref name=Can2010>{{cite journal|last=Canadian Agency for Drugs and Technologies in Health|first=(CADTH)|title=Dialectical behaviour therapy in adolescents for suicide prevention: systematic review of clinical-effectiveness.|journal=CADTH technology overviews|year=2010|volume=1|issue=1|pages=e0104|pmid=22977392|pmc=3411135}}</ref> pamoja na wale walio na [[tatizo la nafsi hafifu]].<ref>{{cite journal|last=Stoffers|first=JM|coauthors=Völlm, BA; Rücker, G; Timmer, A; Huband, N; Lieb, K|title=Psychological therapies for people with borderline personality disorder.|journal=Cochrane database of systematic reviews (Online)|date=2012 Aug 15|volume=8|pages=CD005652|pmid=22895952|doi=10.1002/14651858.CD005652.pub2}}</ref> Hata hivyo, ushahidi haujapata upungufu katika visa kamilifu vya kujiua. <ref name=Can2010/> Kuna utata kuhusu manufaa ya [[matibabu ya mfadhaiko]], ikilinganishwa na madhara yake. <ref name=Hawton2012/> Katika vijana, matibabu mapya zaidi, kama vile [[Kizuizi chaguzi cha uchukuzi wa serotonini|KCUS]] huaminiwa kuongeza hatari ya kujiua kutoka watu 25 hadi 40 kwa kila 1000. <ref>{{cite journal|last=Hetrick|first=SE|coauthors=McKenzie, JE; Cox, GR; Simmons, MB; Merry, SN|title=Newer generation antidepressants for depressive disorders in children and adolescents.|journal=Cochrane database of systematic reviews (Online)|date=2012 Nov 14|volume=11|pages=CD004851|pmid=23152227|doi=10.1002/14651858.CD004851.pub3}}</ref> Hata hivyo, katika watu wazee,matibabu haya yanawaweza kupunguza hatari ya kujiua.<ref name=EB2011/> [[Lithiamu]] huaminika kuwa mwafaka katika kupunguza hatari katika watu walio na maradhi ya hisia mseto na maradhi ya mfadhaiko mkuu hadi kufikia viwango sawa na watu wengine wa kawaida. <ref>{{cite journal|last=Baldessarini|first=RJ|coauthors=Tondo, L; Hennen, J|title=Lithium treatment and suicide risk in major affective disorders: update and new findings.|journal=The Journal of clinical psychiatry|year=2003|volume=64 Suppl 5|pages=44–52|pmid=12720484}}</ref><ref>{{cite journal|last=Cipriani|first=A|coauthors=Pretty, H; Hawton, K; Geddes, JR|title=Lithium in the prevention of suicidal behavior and all-cause mortality in patients with mood disorders: a systematic review of randomized trials.|url=https://archive.org/details/sim_american-journal-of-psychiatry_2005-10_162_10/page/1805|journal=The American Journal of Psychiatry|date=2005 Oct|volume=162|issue=10|pages=1805–19|pmid=16199826|doi=10.1176/appi.ajp.162.10.1805}}</ref> ==Uenezi== [[File:Self-inflicted injuries world map - Death - WHO2004.svg|thumb|left| Vifo kutokana na majeraha ya kujidhuru kwa kila watu 100,000&nbsp; mwaka wa 2004. <ref>{{cite web|url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=WHO Disease and injury country estimates |year=2009 |work=World Health Organization}}</ref> {{Multicol}} {{legend|#b3b3b3|unknown}} {{legend|#ffff65|<3}} {{legend|#fff200|3-6}} {{legend|#ffdc00|6-9}} {{legend|#ffc600|9-12}} {{legend|#ffb000|12-15}} {{legend|#ff9a00|15-18}} {{Multicol-break}} {{legend|#ff8400|18-21}} {{legend|#ff6e00|21-24}} {{legend|#ff5800|24-27}} {{legend|#ff4200|27-30}} {{legend|#ff2c00|30-33}} {{legend|#cb0000|>33}} {{Multicol-end}}]] Takriban 0.5% hadi 1.4% ya watu hufikia kifo kwa kujiua. <ref name=Var2012/><ref name=EB2011/> Kote ulimwenguni kufikia mwaka wa 2008/2009, kujiua ni kisababishi cha kumi kikuu <ref name=Hawton2009/>, huku takriban watu 800,000 hadi milioni moja wakifa kila mwaka, ikipelekea [[kima cha vifo]] cha watu 11.6 kwa kila 100,00 kwa mwaka. <ref name=Var2012/> Kima cha vifo kimeongezeka hadi 60% kutoka miaka ya 1960 hadi 2012, <ref name=WHO2012>{{cite web |title=Suicide prevention |publisher=World Health Organization|date=Aug 31,2012|work=WHO Sites: Mental Health|url=http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/|accessdate=2013-01-13}}</ref> huku ongezeko hili likitambulika hasa katika [[nchi zinazostawi|mataifa yanayostawi]].<ref name=Hawton2009/> Kwa kila kisa cha kujiua, kuna majaribio mengine 10 hadi 14 ya kujiua. <ref name=EB2011/> Viwango vya kujiua hutofautiana pakubwa kati ya nchi na wakati. <ref name=Var2012>{{cite journal|last=Värnik|first=P|title=Suicide in the world.|journal=International journal of environmental research and public health|date=2012 Mar|volume=9|issue=3|pages=760–71|pmid=22690161|doi=10.3390/ijerph9030760|pmc=3367275}}</ref> Takwimu kwa asilimia ya vifo mwaka wa 2008 zilikuwa: Afrika 0.5%, Kusini Mashariki mwa Asia 1.9%, Marekani 1.2 na Uropa 1.4%. <ref name=Var2012/> Viwango kwa kila watu 100,00 vilikuwa: Australia 8.6, Canada 11.1, Uchina 12.7, India 23.2, Uingereza 7.6, Marekani 11.4. <ref>{{cite web|title=Deaths estimates for 2008 by cause for WHO Member States|url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html|publisher=World Health Organization|accessdate=10 February 2013}}</ref> Kujiua kumerodheshwa katika nafasi ya 10 kama [[kifo|kisababishi cha kifo]] kinachoongoza nchini Marekani mwaka wa 2009, ikiwa ni takriban visa 36,000 kila mwaka. <ref>{{cite journal|last=Haney|first=EM|coauthors=O'Neil, ME; Carson, S; Low, A; Peterson, K; Denneson, LM; Oleksiewicz, C; Kansagara, D|title=Suicide Risk Factors and Risk Assessment Tools: A Systematic Review|date=2012 Mar|pmid=22574340}}</ref> Takriban watu 650,000 hupatikana katika idara ya dharura kila mwaka kutokana na majaribio ya kujiua. <ref name=EB2011/> Nchi za [[Lithuania]], Japani na Hangeria zina viwango vikubwa zaidi vya aina za kujiua. <ref name=Var2012/> Nchi zilizo na idadi kuu zaidi ya visa vya kujiua ni Uchina na India, zikihasibia zaidi ya nusu yaidadi yote <ref name=Var2012/> Nchini Uchina, kujiua ni kisababishi cha 5 kikuu cha kifo. <ref name=China2009/> ===Jinsia=== {{Double image|right|Suicide world map - 2009 Male.svg|200|Suicide world map - 2009 Female,2.svg|200|Suicide rate per 100,000 males (left) and female (right) (data from 1978–2008). {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|< 1}} {{legend|#fff200|1–5}} {{legend|#ffdc00|5–5.8}} {{Multicol-break}} {{legend|#ffc600|5.8–8.5}} {{legend|#ffb000|8.5–12}} {{legend|#ff9a00|12–19}} {{legend|#ff8400|19–22.5}} {{Multicol-break}} {{legend|#ff6e00|22.5–26}} {{legend|#ff5800|26–29.5}} {{legend|#ff4200|29.5–33}} {{legend|#ff2c00|33–36.5}} {{Multicol-break}} {{legend|#cb0000|>36.5}} {{Multicol-end}} ||}} Katika mataifa ya magharibi, wanaume hufa mara 3 hadi 4 zaidi kutokana na kujiua kuliko wanawake, ingawa wanawake hujaribu kujiua mara 4 zaidi. <ref name=Var2012/><ref name=EB2011/> Hali hii imesababishwa na wanaume kutumia mbinu kali zaidi za kujiua. <ref name=Sue2012>{{cite book|last=Sue|first=David Sue, Derald Wing Sue, Diane Sue, Stanley|title=Understanding abnormal behavior|publisher=Wadsworth/Cengage Learning|location=Belmont, CA|isbn=978-1-111-83459-3|page=255|url=http://books.google.ca/books?id=mTs--Kt-9a0C&pg=PA255|edition=Tenth ed., [student ed.]}}</ref> Tofauti hii inadhihirika zaidi katika watu wa umri wa zaidi ya miaka 65, huku visa vya kujiua kwa wanaume vikiwa zaidi ya vya wanawake kwa hadi mara 10. <ref name=Sue2012/> [[Uchina]] kuna mojawapo ya viwango vikuu zaidi vya kujiua kwa wanawake duniani, na ndiyo nchi pekee ambapo viwango vya kujiua kwa wanawake ni zaidi ya wanaume (uwiano wa 0.9). <ref name=Var2012/><ref name=China2009>{{cite journal|last=Weiyuan|first=C|title=Women and suicide in rural China.|url=https://archive.org/details/sim_world-health-organization-bulletin_2009-12_87_12/page/888|journal=Bulletin of the World Health Organization|date=2009 Dec|volume=87|issue=12|pages=888–9|pmid=20454475|doi=10.2471/BLT.09.011209|pmc=2789367}}</ref> Katika Mashariki mwa [[Mediteranea]], viwango vya kujiua ni karibu sawa baina ya wanaume na wanawake. <ref name=Var2012/> Katika wanawake, viwango vikubwa vya visa vya kujiua vinapatikana [[Korea Kusini]], ikiwa ni watu 22 kwa watu 100,000, huku kukiwa na viwango vya juu Asia ya Kusini Mashariki na Magharibi mwa Pasifiki kwa jumla.<ref name=Var2012/> Siku hizi linajitokeza pia suala la kujiua kwa [[msenge|wasenge]] <ref>https://www.heritage.org/gender/report/puberty-blockers-cross-sex-hormones-and-youth-suicide?inf_contact_key=86b22e8dd681576dcc0588920cc6f65d842e902fbefb79ab9abae13bfcb46658</ref> ===Umri=== Visa vingi vya kujiua katika nchi nyingi hutokea katika watu wa umri wa makamo<ref name=Pit2012>{{cite journal|last=Pitman|first=A|coauthors=Krysinska, K; Osborn, D; King, M|title=Suicide in young men.|url=https://archive.org/details/sim_the-lancet_june-23-29-2012_379_9834/page/2383|journal=Lancet|date=2012 Jun 23|volume=379|issue=9834|pages=2383–92|pmid=22726519|doi=10.1016/S0140-6736(12)60731-4}}</ref> au wazee.<ref name=Yip2012>{{cite journal|last=Yip|first=PS|coauthors=Caine, E; Yousuf, S; Chang, SS; Wu, KC; Chen, YY|title=Means restriction for suicide prevention.|url=https://archive.org/details/sim_the-lancet_june-23-29-2012_379_9834/page/2393|journal=Lancet|date=2012 Jun 23|volume=379|issue=9834|pages=2393–9|pmid=22726520|doi=10.1016/S0140-6736(12)60521-2}}</ref> Hata hivyo, idadi kamili ya visa vya kujiua ni vingi katika watu wa umri wa kati ya miaka 15 na 29, kwa sababu ya idadi ya watu iliyopo katika kikundi hiki.<ref name=Var2012/> Nchini Merikani, visa hivi hutokea kwa wingi katika [[wanaume wa asili ya kizungu|kizungu]], hasa wa umri wa zaidi ya miaka 80, ingawa watu wa umri wa chini hujaribu kujiua mara nyingi.<ref name=EB2011/> Kujiua ni kisababishi cha pili kikuu cha vifo katika umri wa [[kubaleghe|baleghe]]<ref name=Hawton2012>{{cite journal|last=Hawton|first=K|coauthors=Saunders, KE; O'Connor, RC|title=Self-harm and suicide in adolescents.|url=https://archive.org/details/sim_the-lancet_june-23-29-2012_379_9834/page/2373|journal=Lancet|date=2012 Jun 23|volume=379|issue=9834|pages=2373–82|pmid=22726518|doi=10.1016/S0140-6736(12)60322-5}}</ref> na katika wanaume wachanga ni cha pili baada ya vifo vya kiajali. <ref name=Pit2012/> Katika mataifa yaliyostawi, visa hivi ni visababishi vya 30% ya vifo vya wanaume wachanga.<ref name=Pit2012/> Katika mataifa yanayostawi, viwango vya visa hivi ni sawa, ingawa kwa ujumla huchangia idadi ndogo ya vifo vya kijumla kufuatia kiwango cha juu cha vifo kutokana na [[kiwewe (matibabu)|kiwewe]].<ref name=Pit2012/> Kinyume na sehemu zingine, vifo kufuatia kujiua katika Kusini Mashariki mwa Asia hutokea zaidi katika wanawake wachanga kuliko waliokomaa.<ref name=Var2012/> ==Historia== [[Image:106 Conrad Cichorius, Die Reliefs der Traianssäule, Tafel CVI.jpg|thumb|right|200px|Kujiua kwa Decebalus, kutoka katika [[Safu ya Trajan]].]] Katika [[Athene|Atheni ya Kale]], mtu aliyejiua bila idhini ya serikali alinyimwa haki ya kuzikwa kwa njia ya kawaida. Mtu huyu alizikwa peke yake, mpakani mwa jiji, bila kiashirio chochote cha kaburi lake.<ref>{{cite book|last=Szasz|first=Thomas|title=Fatal freedom : the ethics and politics of suicide|year=1999|publisher=Praeger|location=Westport, Conn.|isbn=978-0-275-96646-1|page=11|url=http://books.google.ca/books?id=5AqzlMdurkcC&pg=PA11}}</ref> Katika [[Ugiriki ya Kale]] na [[Roma ya Kale]], njia ya kujiua ilikubaliwa kama njia ya kuonyesha kushindwa vitani <ref name=Maris2000/>. Ingawa kujiua kulikubalika mwanzoni katika Roma ya kale, baadaye kuliharamishwa kama kosa dhidi ya serikali kwa sababu ya gharama za kiuchumi.<ref>{{cite book|last=Dickinson|first=Michael R. Leming, George E.|title=Understanding dying, death, and bereavement|publisher=Wadsworth Cengage Learning|location=Belmont, CA|isbn=978-0-495-81018-6|page=290|url=http://books.google.ca/books?id=L8ETDRsB8ZYC&pg=PA290|edition=7th ed.}}</ref> Amri ya uhalifu iliyotolewa na [[Louis XIV wa Ufaransa]] mwaka wa 1670 ilitoa adhabu kali zaidi: maiti ya mtu aliyejiua ilibururwa mitaani huku kichwa kikielekezwa chini, kisha kuninginishwa au kutupwa kenye biwi la takataka. Vile vile, mali yote ya mshukiwa ilichukuliwa.<ref>{{cite book|first=ed. by W.S.F. Pickering|title=Durkheim's Suicide : a century of research and debate|year=2000|publisher=Routledge|location=London [u.a.]|isbn=978-0-415-20582-5|page=69|url=http://books.google.ca/books?id=9KQO6dGY1cwC&pg=PA69|edition=1. publ.}}</ref><ref name=Maris540>{{cite book|last=Maris|first=Ronald|title=Comprehensive textbook of suicidology|year=2000|publisher=Guilford Press|location=New York [u.a.]|isbn=978-1-57230-541-0|page=540|url=http://books.google.ca/books?id=Zi-xoFAPnPMC&pg=PA540}}</ref>. Katika historia ya Ukristo, watu waliojaribu kujiua walikuwa [[kutengwa|wakitengwa]], huku waliokufa kufuatia kujiua wakizikwa nje ya eneo takatifu la makaburi.<ref name=McL2007/> Katika miaka ya mwishoni mwa karne ya 19 nchini Uingereza, jaribio la kujiua lilifananishwa na [[jaribio la kuua]] na adhabu yake ilikuwa kunyongwa.<ref name=McL2007/> Katika karne ya 19 barani Uropa, mtazamo wa kujiua ulibadilishwa kutoka mtazamo kuwa kulisababishwa na [[dhambi]], hadi kuwa kulisababiswa na [[wazimu]].<ref name=Maris540/>. ==Jamii na Utamaduni== ===Sheria=== [[File:Wakisashi-sepukku-p1000699.jpg|thumb|A ''[[tantō]]'' Kisu kilichotayarishwia ''[[seppuku]]''.]] Katika mataifa mengi ya Ulaya, kujiua hakuchukuliwi tena kama hatia,<ref>{{cite book|last=White|first=Tony|title=Working with suicidal individuals : a guide to providing understanding, assessment and support|year=2010|publisher=Jessica Kingsley Publishers|location=London|isbn=978-1-84905-115-6|page=12|url=http://books.google.ca/books?id=p_ZvK-DBYfIC&pg=PT12}}</ref> ingawa mtazamo huo ulikuwepo katika mataifa mengi ya Uropa kuanzia [[Enzi za Kati]] hadi angalau [[miaka ya 1800]].<ref>{{cite book|last=Paperno|first=Irina|title=Suicide as a cultural institution in Dostoevsky's Russia|year=1997|publisher=Cornell university press|location=Ithaca|isbn=978-0-8014-8425-4|page=60|url=http://books.google.ca/books?id=m3pqf8f-6bMC&pg=PA60}}</ref> Mataifa mengi ya Kiislamu huchukulia bado kujiua kama hatia.<ref name="Islam2006"/> Nchini [[Australia]], kujiua si hatia.<ref>{{cite book|last=al.]|first=David Lanham&nbsp;... [et|title=Criminal laws in Australia|year=2006|publisher=The Federation Press|location=Annandale, N.S.W.|isbn=978-1-86287-558-6|page=229|url=http://books.google.ca/books?id=D97doQ1iZx4C&pg=PA229}}</ref> Hata hivyo, ni hatia kumshauri, [[uchochezi|kumchochea]], au kumsadia na kumshawishi mtu kujaribu kujiua. Sheria inamruhusu kikamilifu mtu yeyote kutumia "kiwango chochote cha nguvu kama itakavyohitajika" ili kumzuia mwingine asijiue.<ref>{{cite book|last=Duffy|first=Michael Costa, Mark|title=Labor, prosperity and the nineties : beyond the bonsai economy|year=1991|publisher=Federation Press|location=Sydney|isbn=978-1-86287-060-4|page=315|url=http://books.google.ca/books?id=TqZqTHwvCH8C&pg=PA315|edition=2nd ed.}}</ref> Milki ya Kaskazini mwa Australia iliruhusu, kwa muda mfupi kutoka [[1996]] hadi [[1997]], kifo halali cha kusaidiwa na [[daktari]].<ref>{{cite book|last=Quill|first=Constance E. Putnam; foreword by Timothy E.|title=Hospice or hemlock? : searching for heroic compassion|year=2002|publisher=Praeger|location=Westport, Conn.|isbn=978-0-89789-921-5|page=143|url=http://books.google.ca/books?id=GmFwa3I7vqMC&pg=PA143}}</ref> Barani Uropa, hakuna taifa lolote linalochukulia kitendo au jaribio la kujiua kama hatia kwa sasa.<ref name=McL2007/> [[Uingereza]] na [[Wales]] ziliondoa sheria iliyoharamisha kujiua kupitia [[Sheria ya kijiua ya 1961]], nayo [[Jamhuri]] ya [[Ayalandi]] ikifuatia mwaka wa [[1993]]. <ref name=McL2007/> Neno "kutenda" lilitumika kurejelea uharamu wa kujiua. Hata hivyo, mashirika mengi yamekoma kulitumia kwa sababu ya mtazamo mbaya ya neno hili.<ref>Holt, Gerry.[http://www.bbc.co.uk/news/magazine-14374296 "When suicide was illegal"]. [[BBC News]] 3 August 2011. Accessed 11 August 2011.</ref><ref name=guardian_style>{{cite web|title=Guardian & Observer style guide|url=http://www.guardian.co.uk/styleguide/s|work=Guardian website|publisher=The Guardian|accessdate=29 November 2011}}</ref> Nchini India, kujiua ni hatia, na jamii ya mwathiriwa inaweza kushtakiwa.<ref>{{cite book|last=Srivastava|first=editors, Nitish Dogra, Sangeet|title=Climate change and disease dynamics in India|publisher=The Energy and Resources Institute|location=New Delhi|isbn=978-81-7993-412-8|page=256|url=http://books.google.ca/books?id=UGrUgX-nKTIC&pg=PA256}}</ref> Nchini Ujerumani, eutenasia ni haramu na mtu anayeshuhudia mwingine akijiua anaweza kuhukumiwa kwa kutotoa usaidizi wakati wa dharura.<ref>"German politician Roger Kusch helped elderly woman to die"[http://www.timesonline.co.uk/tol/news/world/europe/article4251894.ece Times Online] {{Wayback|url=http://www.timesonline.co.uk/tol/news/world/europe/article4251894.ece |date=20100601051855 }} July 2, 2008</ref> [[Uswisi]] hivi majuzi imepiga hatua katika kuruhusu [[usaidizi wa kujiua]] kwa watu walio na ugonjwa wa muda mrefu wa akili. [[Mahakama kuu]] ya [[Lausanne]], katika hukumu moja mwaka wa [[2006]], ilimpa mtu ambaye hakutajwa jina, mwenye tatizo la kiakili la muda mrefu idhini ya kujiua.<ref name=pmid17649899>{{cite journal|author=Appel, JM |title=A Suicide Right for the Mentally Ill? A Swiss Case Opens a New Debate|url=https://archive.org/details/sim_hastings-center-report_may-june-2007_37_3/page/n43 |journal=Hastings Center Report |volume=37 |issue=3 |pages=21–23 |year=2007 |pmid=17649899|doi=10.1353/hcr.2007.0035 |month=May }}</ref> Nchini Merikani, kujiua si hatia, ingawa watu wanaojaribu kujiua wanaweza kuadhibiwa.<ref name=McL2007>{{cite book|last=McLaughlin|first=Columba|title=Suicide-related behaviour understanding, caring and therapeutic responses|year=2007|publisher=John Wiley & Sons|location=Chichester, England|isbn=978-0-470-51241-8|page=24|url=http://books.google.ca/books?id=I2FJRbekdC8C&pg=PA24}}</ref> Kujiua kwa kusaidiwa na daktari ni halali katika [[jimbo]] la [[Oregon]]<ref>{{cite web|url=http://www.leg.state.or.us/ors/127.html|title=Chapter 127.800–995 The Oregon Death with Dignity Act|publisher=[[Oregon State Legislature]]|accessdate=2013-11-28|archiveurl=https://web.archive.org/web/20130916065501/http://www.leg.state.or.us/ors/127.html|archivedate=2013-09-16}}</ref> na Washington.<ref>{{cite news|title=Chapter 70.245 RCW, The Washington death with dignity act|url=http://apps.leg.wa.gov/RCW/default.aspx?cite=70.245|work=[[Washington State Legislature]]}}</ref> ===Dini=== [[File:A Hindoo Widow Burning Herself with the Corpse of her Husband.jpg|thumb|Mjane [[Mhindu]] akijichoma pamoja na maiti ya mumewe, miaka ya 1820.]] Katika [[madhehebu]] mengi ya [[Ukristo]] kujiua huchukuliwa kama [[dhambi]], kwa msingi wa [[maandishi]] ya [[wanateolojia]] wenye ushawishi mkuu kama vile [[Agostino wa Hippo]] na [[Thomas Aquinas]]. Hata hivyo, kujiua hakukuchuliwa kama dhambi katika [[kanuni za Justiniani]] za [[Milki ya Bizanti]], kwa mfano.<ref>{{cite web|author=Dr. Ronald Roth, D.Acu.|url=http://www.acu-cell.com/suicide.html|title=Suicide & Euthanasia – a Biblical Perspective|publisher=Acu-cell.com|accessdate=2009-05-06|archiveurl=https://web.archive.org/web/20090418073913/http://acu-cell.com/suicide.html|archivedate=2009-04-18|=https://web.archive.org/web/20090418073913/http://acu-cell.com/suicide.html}}</ref><ref>{{cite web|url=http://www.clas.ufl.edu/users/nholland/suicide.htm|title=Norman N. Holland, Literary Suicides: A Question of Style|publisher=Clas.ufl.edu|accessdate=2009-05-06|archivedate=2009-05-28|archiveurl=https://web.archive.org/web/20090528090133/http://www.clas.ufl.edu/users/nholland/suicide.htm}}</ref> Katika [[Kanisa Katoliki]], suala la kujiua liko kwenye msingi wa [[Amri Kumi|amri]] "Usiue" (iliyoidhinishwa na Yesu katika [[Agano Jipya]]; taz. [[Injili ya Mathayo|Math 19:18]]), pamoja na dhana kuwa [[uhai]] ni [[zawadi]] kutoka kwa Mungu, hivyo haufai kudhalilishwa au kuchezewa. Vile vile, kuua ni kinyume cha "amri asilia", hivyo huathiri mpango mkuu wa Mungu hapa duniani.<ref>{{cite web |url=http://www.scborromeo.org/ccc/p3s2c2a5.htm#2280 |title=Catechism of the Catholic Church – PART 3 SECTION 2 CHAPTER 2 ARTICLE 5 |publisher=Scborromeo.org |date=1941-06-01|accessdate=2009-05-06}}</ref> Hata hivyo, inaaminiwa kuwa ugonjwa wa akili au woga mkuu wa kuteseka hupunguza jukumu la mtu anayejiua.<ref>{{cite web |url=http://www.scborromeo.org/ccc/p3s2c2a5.htm#2282|title=Catechism of the Catholic Church – PART 3 SECTION 2 CHAPTER 2 ARTICLE 5 |publisher=Scborromeo.org|date=1941-06-01 |accessdate=2009-05-06}}</ref> Hoja pinzani ni pamoja na ifuatayo: kuwa [[Amri Kumi|Amri ya tano]] imefasiliwa kifasaha kama "usitekeleze mauaji", ambayo hailengi moja kwa moja mtu binafsi; yaani Mungu amempa uhuru kila binadamu kujichagulia; ya kuwa mtu akijiua hajavunja Sheria za Mungu, sawa na kuponya ugonjwa; na kuwa visa kadhaa vya watu waliojiua vimesimuliwa katika Biblia bila kuambatana na laana yoyote.<ref>{{cite web |url=http://www.religioustolerance.org/sui_bibl.htm |title=The Bible and Suicide |publisher=Religioustolerance.org |accessdate=2009-05-06 |archivedate=2014-07-15 |archiveurl=https://archive.today/20140715063310/http://www.religioustolerance.org/sui_bibl.htm }}</ref> Desturi za Kiyahudi huzingatia umuhimu wa kudhamini maisha yaliyopo, hivyo kujiua huchukuliwa kuwa sawa na mtu kujinyima wema wa Mungu duniani. Licha ya hayo, katika hali mbaya ambapo hakuna chaguo lingine ila kuuawa au kulazimishwa kuisaliti dini yao, Wayahudi walijiua binafsi au [[kujiua kwa umati]] (tazama [[Masada]], [[Mateso ya kwanza ya Wayahudi nchini Ufaransa]], na [[York Castle]], kwa mifano). Kwa ukumbusho wa tahadhari, kuna [[sala]] katika [[liturujia]] ya Kiyahudi ya "kisu kiwapo kooni" kwa watu wanaokufa "kulitukuza jina la Mungu "(tazama [[kifodini]]). Matendo haya yamepokewa kwa njia mbalimbali na watawala wa Kiyahudi, huku yakichukuliwa na baadhi ya watu kama mfano bora wa wafiadini mashujaa, huku wengine wakiyachukulia kama hatia kwa watu kujiua kwa kutazamia ufiadini.<ref>{{cite web |url=http://www.religionfacts.com/euthanasia/judaism.htm |title=Euthanasia and Judaism: Jewish Views of Euthanasia and Suicide |accessdate=2008-09-16 |publisher=ReligionFacts.com |archivedate=2006-05-06 |archiveurl=https://web.archive.org/web/20060506200930/http://www.religionfacts.com/euthanasia/judaism.htm }}</ref> [[Uislamu]] haukubali kujiua.<ref name="Islam2006"/> Katika [[Uhindu]] kwa jumla, kujiua hakukubaliwi, hivyo huchukuliwa kuwa dhambi sawa na kumuua mtu mwingine katika jamii ya kisasa ya Kihindu. [[Maandiko ya Kihindu]] yanasema kuwa mtu anayejiua huingia katika ulimwengu wa pepo, akitangatanga duniani hadi wakati ambapo angekufa iwapo hangejiua.<ref>Hindu Website. [http://www.hinduwebsite.com/hinduism/h_suicide.asp Hinduism and suicide]</ref> Hata hivyo, Uhindu hukubali [[haki ya kujiua]] kupitia njia isiyo na dhuluma ya kujinyima chakula hadi kufa, inayojulikana kama ''[[Prayopavesa]]''.<ref name="hindu">{{cite web |url=http://www.bbc.co.uk/religion/religions/hinduism/hinduethics/euthanasia.shtml|title= Hinduism –Euthanasia and Suicide|date= 2009-08-25|publisher= BBC}}</ref> Hata hivyo, Prayopavesa hukubalika tu kwa watu wasiokuwa na hamu au matarajio, wala majukumu maishani. [[Ujaini]] una desturi sawa na hii, iitwayo ''[[Santhara]]''. Desturi ya [[Sati]], au kujitoa kafara kwa wajane, ilikuwepo katika [[Karne za Kati]]. ===Falsafa=== Maswali mengi yameulizwa katika falsafa ya kujiua, ikiwa ni pamoja na fasili ya kujiua, ikiwa kujiua ni chaguo la busara au la, na kuruhusika kimaadili.<ref name="StanfordSuicide">{{cite web |url=http://plato.stanford.edu/entries/suicide/ |title=Suicide (Stanford Encyclopedia of Philosophy) |publisher=Plato.stanford.edu |accessdate=2009-05-06}}</ref> Mitazamo ya kifalsafa inayohusu kujiua kama jambo linaloweza kukubalika kimaadili hutofautiana kutoka upinzani, (kwa kuchukulia kujiua kama mwiko) hadi kuchukulia kujiua kama haki ya [[Kimungu]] ya mtu yeyote (hata mtoto mwenye afya njema) anayeamini kwamba amefikia, kwa busara na [[dhamiri]], uamuzi wa kukatisha maisha yake. Wapinzani wa kujiua ni pamoja na wanafalsafa Wakristo kama vile [[Agostino wa Hippo]] na [[Thomas Aquinas]],<ref name="StanfordSuicide" /> [[Immanuel Kant]]<ref>Kant, Immanuel. (1785) ''Kant: The Metaphysics of Morals'', M. Gregor (trans.), Cambridge: Cambridge University Press, 1996. ISBN 978-0-521-56673-5. p177.</ref> na, kwa njia moja [[John Stuart Mill]] – malengo ya Mill kuhusu umuhimu wa [[uhuru]] na [[kujitawala]] yalipelekea yeye kupinga chaguo ambazo zingemzuia mtu kufanya uamuzi wa kibinafsi katika siku za usoni.<ref>{{cite journal | author = Safranek John P | year = 1998 | title = Autonomy and Assisted Suicide: The Execution of Freedom | url =https://archive.org/details/sim_hastings-center-report_july-august-1998_28_4/page/n34| journal = The Hastings Center Report |volume = 28 | issue = 4| page = 33 }}</ref> Watu wengine huchukulia kujiua kama jambo halali la kujichagulia kibinafsi. Waafiki wa dhana hii husisitiza kuwa mtu yeyote hafai kushurutishwa kuteseka kinyume na mapenzi yake, hasa kutokana na hali kama vile ugonjwa usiotibika, ugonjwa wa akili na uzee usiokuwa na uwezekano wa kuimarika. Waafiki hawa hupinga imani ya kwamba, kila wakati, kujiua ni jambo lisilo la busara, badala yake wakihimiza kuwa linaweza kuwa chaguo halali la mwisho, kwa watu wanopitia maumivu makali au dhiki.<ref>Raymond Whiting: A natural right to die: twenty-three centuries of debate, pp. 13–17; Praeger (2001) ISBN 0-313-31474-8</ref> Dhana nyingine yenye msimamo mkali inahimiza kuwa watu wanapaswa kuruhusiwa wajichagulie kufa bila kuzingatia iwapo wanateseka au la. Waafiki mashuhuri wa [[dhana]] hii ni pamoja na mwanafalsafa [[Mskoti]] [[David Hume]]<ref name="StanfordSuicide" /> na Mmarekani mwana bayojilia na maadili [[Jacob M. Appel|Jacob Appel]].<ref name=pmid17649899 /><ref>[[Wesley J. Smith]], Death on Demand: The assisted-suicide movement sheds its fig leaf, ''The Weekly Standard'', June 5, 2007</ref> ===Utetezi=== [[Image:Alexandre-Gabriel Decamps - The Suicide - Walters 3742.jpg|thumb|Katika picha hii iliyochorwa na Alexandre-Gabriel Decamps, kisufugutu, bastola na daftari iliyolazwa sakafuni zinaashiria kwamba tukio hili la kutisha limetendeka; mchoraji amejiua.<ref>{{cite web|publisher= [[The Walters Art Museum]] |url=http://art.thewalters.org/detail/1589 |title= The Suicide}}</ref>]] Utetezi wa kujiua umetokea katika tamaduni nyingi. [[Jeshi la Japani]], katika Vita vya pili vya dunia, liliruhusu na kutukuza mashambulizi ya [[kamikaze]]. Haya yalikuwa mashambulizi ya kujiua yaliyotekelezwa na wanajeshi [[wanahewa]] wa Milki ya Japani dhidi ya vyombo vya majini vya Majeshi ya Muungano katika awamu za mwisho za uhamasisho wa Pasifiki wa Vita II vya Dunia. Jamii ya Japani kwa jumla imechukuliwa kama "inayoruhusu" kujiua<ref name="ozawa-desilva">{{cite journal|last=Ozawa-de Silva|first=C|title=Too lonely to die alone: internet suicide pacts and existential suffering in Japan.|url=https://archive.org/details/sim_culture-medicine-and-psychiatry_2008-12_32_4/page/516|journal=Culture, medicine and psychiatry|date=2008 Dec|volume=32|issue=4|pages=516–51|pmid=18800195|doi=10.1007/s11013-008-9108-0}}</ref>. Pekuzi mtandaoni kuhusu kijiua hutoa kurasa za mtandao ambazo huruhusu au kuwezesha majaribio ya kujiua kwa kiwango cha 10-30%.<!-- <ref name=Dur2011/> --> Kuna maoni kuwa kurasa kama hizo zinaweza kuchochea watu walio hatarini hadi wakajiua.<!-- <ref name=Dur2011/> -->Baadhi ya watu hutia [[mkataba wa kujiua]] mtandaoni, wakiwa na marafiki waliokuwa wakijuana mbeleni au waliopatana katika [[vyumba vya majadiliano]] au [[vikao vya mtandao|majojpo ya habari]].<!-- <ref name=Dur2011/> --> Hata hivyo, mtandao pia unaweza kusaidia kuzuia kujiua kupitia vikundi vya mahusiano kwa watu waliotengwa.<ref name=Dur2011>{{cite journal|last=Durkee|first=T|coauthors=Hadlaczky, G; Westerlund, M; Carli, V|title=Internet pathways in suicidality: a review of the evidence.|journal=International journal of environmental research and public health|date=2011 Oct|volume=8|issue=10|pages=3938–52|pmid=22073021|doi=10.3390/ijerph8103938|pmc=3210590}}</ref> ===Maeneo=== Baadhi ya maeneo yamekuwa maarufu kwa visa vingi vya majaribio ya kujiua.<ref name=Robinson2012/> Haya ni pamoja na [[Daraja la Golden Gate]], Jimbo la [[San Francisco]]; [[msitu wa Aokigahara]], Japani;<ref>{{cite book|last=Robinson|first=ed. by Peter|title=Research themes for tourism|year=2010|publisher=CABI|location=Oxfordshire [etc.]|isbn=978-1-84593-684-6|page=172|url=http://books.google.ca/books?id=219aFMSRPqgC&pg=PA172|coauthors=Heitmann, Sine; Dieke, Peter}}</ref> [[Beachy Head]], Uingereza;<ref name=Robinson2012>{{cite book|last=Robinson|first=edited by David Picard, Mike|title=Emotion in motion : tourism, affect and transformation|publisher=Ashgate|location=Farnham, Surrey|isbn=978-1-4094-2133-7|page=176|url=http://books.google.ca/books?id=PjuY_4Vy_UUC&pg=PT176}}</ref> na [[Bloor Street Viaduct]], jijini [[Toronto]].<ref name=Dennis2008>{{cite book|last=Dennis|first=Richard|title=Cities in modernity : representations and productions of metropolitan space, 1840 – 1930|year=2008|publisher=Cambridge Univ. Press|location=Cambridge [u.a.]|isbn=978-0-521-46841-1|page=20|url=http://books.google.ca/books?id=Gq9_uNNkmKUC&pg=PA20|edition=Repr.}}</ref> Kufikia mwaka wa 2010, Daraja la Golden Gate limekuwa na zaidi ya visa 1300 vya kujiua kwa kuruka tangu daraja hilo kujengwa mnamo [[1937]].<ref name=McDougall2010>{{cite book|last=McDougall|first=Tim|title=Helping children and young people who self-harm : an introduction to self-harming and suicidal behaviours for health professionals|year=2010|publisher=Routledge|location=Abingdon, Oxon|isbn=978-0-415-49913-2|page=23|url=http://books.google.ca/books?id=2VfP1-o0BgcC&pg=PA23|coauthors=Armstrong, Marie; Trainor, Gemma}}</ref> Maeneo mengi ambapo visa vingi vya kujiua hutokea yana vizuizi vilivyojengwa ili kuzuia visa hivi.<ref name=Bateson2008>{{cite book|last=Bateson|first=John|title=Building hope : leadership in the nonprofit world|year=2008|publisher=Praeger|location=Westport, Conn.|isbn=978-0-313-34851-8|page=180|url=http://books.google.ca/books?id=GUzq5qNegkYC&pg=PA180}}</ref> Maeneo haya ni pamoja na [[Luminous Veil]] jijini Toronto,<ref name=Dennis2008/>na vizuizi katika [[mnara wa Eiffel]] jijini Paris na [[Jengo la Empire State]] jijini New York.<ref name=Bateson2008/> Tangu mwaka wa 2001, kizuizi kinaendelea kujengwa katika daraja la Golden Gate <ref name=Miller2011>{{cite book|last=Miller|first=David|title=Child and Adolescent Suicidal Behavior: School-Based Prevention, Assessment, and Intervention|year=2011|isbn=978-1-60623-997-1|page=46|url=http://books.google.ca/books?id=bAHcIUDoVEoC&pg=PA46}}</ref> Vizuizi vimeonekana kuwa mwafaka sana. ==Spishi nyingine== Baadhi ya watu hudhani kuwa kujiua hakuwezi kutokea katika [[viumbehai]] wengine, kwa sababu kujiua huhitaji jaribio la hiari la kufa.<ref name=Maris2000>{{cite book|last=Maris|first=Ronald|title=Comprehensive textbook of suicidology|year=2000|publisher=Guilford Press|location=New York [u.a.]|isbn=978-1-57230-541-0|pages=97–103|url=http://books.google.ca/books?id=Zi-xoFAPnPMC&pg=PA97}}</ref> Mitindo inayohusishwa na kujiua imetambulika katika [[salmonela]] zinazojitahidi kushindana na [[bakteria]] kwa kuchochea [[mfumo wa kingamwili]] dhidi ya bakteria hizi.<ref>{{Rejea jarida|url=http://www.nytimes.com/2008/08/26/science/26obsalm.html?ref=science|title=In Salmonella Attack, Taking One for the Team|author=Chang, Kenneth|date=August 25, 2008|publisher=New York Times|postscript=<!--None-->}}</ref> Hatua za kujikinga kwa kujiua zimetambulika katika aina ya [[mchwa]] wa [[Brazil]], ''Forelius pusillus'', ambapo kikundi kidogo cha mchwa huacha [[usalama]] wa [[kiota]] kila [[usiku]], baada ya kufunga milango wakiwa nje. <ref>{{cite journal|title=Preemptive Defensive Self-Sacrifice by Ant Workers|url=http://www.cyf-kr.edu.pl/~rotofils/Tofilski_etal_2008.pdf|format=PDF|author=Tofilski,Adam; Couvillon, MJ;Evison, SEF; Helantera, H; Robinson, EJH; Ratnieks, FLW|year=2008|volume=172|pmid=18928332|issue=5|journal=The American Naturalist|doi=10.1086/591688|pages=E239–E243}}</ref> [[Afidi ya choroko]], anapotishwa na [[mbawakawa]], anaweza kujilipua na kutapakaa ili kuwakinga wengine, na hata wakati mwingine anaweza kuwaua mbawakawa hao.<ref>{{Rejea jarida|url=http://news.discovery.com/animals/animal-suicide-behavior.html|title=Animal Suicide Sheds Light on Human Behavior|author=Larry O'Hanlon|date=Mar 10, 2010|publisher=Discovery News|postscript=<!--None-->|journal=|access-date=2013-11-28|archive-date=2010-07-25|archive-url=https://web.archive.org/web/20100725200146/http://news.discovery.com/animals/animal-suicide-behavior.html|dead-url=yes}}</ref> Baadhi ya spishi za [[mchwa]] wana walinzi wanaojilipua hivyo kuwafunika adui zao na michozo inayoshikamanisha.<ref>{{Rejea jarida|url=http://www.bbc.co.uk/pressoffice/pressreleases/stories/2005/10_october/20/life_horrors.shtml|title=Life In The Undergrowth|publisher=BBC|postscript=<!--None-->|author1=<Please add first missing authors to populate metadata.>}}</ref><ref>{{Rejea jarida|title=Suicidal defensive behaviour by frontal gland dehiscence in Globitermes sulphureus Haviland soldiers (Isoptera)|first4=A.|last4=Peppuy|first3=V.|last3=Van Tuyen|volume=44|first2=A.|issue=3|journal=Insectes Sociaux|date=August, 1997|last2=Robert|page=289|doi=10.1007/s000400050049|url=http://www.springerlink.com/content/m727aywa4mdf04ln/|publisher=Birkhäuser Basel|author=Bordereau, C|postscript=<!--None-->|access-date=2013-11-28|archive-date=2020-04-18|archive-url=https://web.archive.org/web/20200418174725/http://www.springerlink.com/content/m727aywa4mdf04ln/|dead-url=yes|=https://web.archive.org/web/20200418174725/http://www.springerlink.com/content/m727aywa4mdf04ln/}}</ref> Kumekuwa na ripoti zisizotegemewa za [[mbwa]], [[farasi]] na [[pomboo]] wanaojiua, ingawa ushahidi uliopo ni mdogo na hauaminiki.<ref>{{Rejea jarida|title=Do Animals Commit Suicide? A Scientific Debate|date=Mar. 19, 2010|author=Nobel, Justin|publisher=Time|url=http://www.time.com/time/health/article/0,8599,1973486,00.html|postscript=<!--None-->|journal=|access-date=2013-11-28|archive-date=2013-08-17|archive-url=https://web.archive.org/web/20130817103106/http://www.time.com/time/health/article/0,8599,1973486,00.html|dead-url=yes|=https://web.archive.org/web/20130817103106/http://www.time.com/time/health/article/0,8599,1973486,00.html}}</ref> Kumekuwa na utafiti mdogo wa kisayansi kuhusu kujiua kwa wanyama.<ref>{{Rejea jarida|doi=10.1111/j.1749-6632.1997.tb52352.x|title=Suicide Research|first2=J. John|last2=Mann|url=http://www3.interscience.wiley.com/journal/120752899/abstract|author=Stoff, David|journal=Annals of the New York Academy of Sciences|publisher=Annals of the New York Academy of Sciences|volume=836|issue=Neurobiology of Suicide, The : From the Bench to the Clinic|year=1997|pages=1–11|postscript=<!--None-->|bibcode=1997NYASA.836....1S|access-date=2013-11-28|archive-date=2020-04-18|archive-url=https://web.archive.org/web/20200418174725/http://www3.interscience.wiley.com/journal/120752899/abstract|dead-url=yes|=https://web.archive.org/web/20200418174725/http://www3.interscience.wiley.com/journal/120752899/abstract}}</ref> ==Visa maarufu== Mfano wa kujiua kwa halaiki ni [[kujiua kwa kidini]] mwaka wa [[1978]] mjini [[Jonestown]], ambapo wanachama 918 wa [[Peoples Temple]], wa [[madhehebu]] ya Kimarekani, wakiongozwa naye [[Jim Jones]], walijiua kwa kunywa [[Flavor Aid]] ya [[zabibu]] iliyochanganywa na [[Sianidi ya potasiamu|sianidi]].<ref>Hall 1987, p.282</ref><ref name="tape">[http://jonestown.sdsu.edu/AboutJonestown/Tapes/Tapes/DeathTape/death.html "Jonestown Audiotape Primary Project."] {{Wayback|url=http://jonestown.sdsu.edu/AboutJonestown/Tapes/Tapes/DeathTape/death.html |date=20130518030445 }} ''Alternative Considerations of Jonestown and Peoples Temple''. San Diego State University.{{WebCite|url=http://www.webcitation.org/5vybbZjSY|date =2011-01-24}}</ref> Mwaka wa 1944, zaidi ya Wajapani 10,000 walijiua katika siku za mwisho za [[Vita vya Saipan]], baadhi yao wakiruka kutoka "Suicide Cliff" na "Banzai Cliff".<ref>John Toland, ''The Rising Sun: The Decline and Fall of the Japanese Empire 1936–1945'', Random House, 1970, p. 519</ref> Mgomo wa kususia chakula, nchini Ayalandi mwaka 1981, ulioongozwa na [[Bobby Sands]], ulisababisha vifo vya watu 10. Kisababishi cha vifo hivi kilirekodiwa na [[coroner]] kama "njaa ya kujitakia," badala ya kujiua. Kisababishi hiki kilibadilishwa na kuwa "njaa" kwenye vyeti vya kifo baada ya familia za waathiriwa kulalamika.<ref name=Philosophy59OKeeffe>[http://www.jstor.org/pss/3750951 Suicide and Self-Starvation], Terence M. O'Keeffe, [[Philosophy (journal)|''Philosophy'']], Vol. 59, No. 229 (Jul., 1984), pp. 349–363</ref> Katika Vita vya II vya Dunia [[Erwin Rommel]] aligunduliwa kufahamu mbeleni kuhusu [[Njama ya Julai 20]] kuhusu maisha ya Hitler, hivyo akatishwa kwa [[hukumu ya umma]], kuuawa na jeshi na pia familia yake kulipiziwa kisasi iwapo hatajua.<ref>{{cite book |last=Watson |first=Bruce|title=Exit Rommel: The Tunisian Campaign, 1942–43 |url=https://archive.org/details/exitrommeltunisi0000wats |publisher=Stackpole Books |year=2007|page=[https://archive.org/details/exitrommeltunisi0000wats/page/170 170]|isbn=978-0-8117-3381-6}}</ref> ==Tanbihi== {{marejeo}} [[Jamii:Magonjwa]] [[Jamii:Saikolojia]] [[Jamii:Maadili]] [[Category:Tiba]] [[Category:Sheria]] [[Category:Dini]] fo8duwbd3muj5tsqkv1hilbjc6nfmhk 0 21127 1578178 1575375 2026-07-03T00:06:36Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578178 wikitext text/x-wiki {{Infobox musical artist | Jina = Céline Dion | Img = Celine Dion 2018.jpg | Img_capt = Céline Dion, mnamo 2018. | Img_size = 250 | Landscape = | Background = solo_singer | Jina la kuzaliwa = Céline Marie Claudette Dion | Amezaliwa = {{birth date and age|1968|3|30|df=yes}}<br />[[Charlemagne, Quebec]], Kanada | Asili yake = [[Montreal]], [[Quebec]], Kanada | Ala = [[sauti]] | Aina = [[Pop]], [[Muziki wa rock|rock]] | Kazi yake = [[Mwimbaji]], [[mtunzi wa nyimbo]]<ref name=Brit>Britannica.com. ''[http://www.britannica.com/ebi/article-9311022 Céline Dion]''. Retrieved 13 Januari 2006.</ref> | Aina ya sauti = [[Soprano]]<ref name=SoundofCeline>[http://query.nytimes.com/gst/fullpage.html?res=9E07E6DD123AF931A35750C0A962958260 Review/Pop; The International Sound of Céline Dion]. ''[[:en:The New York Times|The New York Times]]''. 2 Machi 1994. Retrieved 17 Novemba 2008</ref> | Miaka ya kazi = 1980–2000, 2002-hadi leo | Studio = [[:en:550 Music|550]]/[[Epic Records|Epic]]/[[Sony Music Entertainment|Sony]] (1986–2004)<br />[[Epic Records|Epic]] (2004–2007)<br />[[Sony Music Entertainment]]/[[Columbia Records|Columbia]] (2007-hadi leo) | Tovuti = [http://www.celinedion.com www.celinedion.com] }} '''Céline Dion''' (amezaliwa [[Charlemagne]], [[Quebec]], [[Kanada]], [[30 Machi]] [[1968]]) ni [[mwimbaji]] na [[mtunzi wa nyimbo]] mashuhuri za [[pop]] kutoka nchini [[Kanada]]. ==Maisha== Yeye ni mdogo kwa kuzaliwa katika [[familia]] ya watoto [[kumi na nne]]. Alifikisha [[umri]] wa miaka 12, kaka yake alimpeleka kwa meneja wa urekodi aliyejulikana kwa jina la [[René Angélil]], ambaye baadaye akaja kumwoa na kumzalia mtoto. [[Image:Céline Dion 1986.jpg|left|thumb|upright|Dion alipokuwa na miaka 18]] Kwa msaada wake, alifanikiwa kutoa albamu yake ya kwanza mnamo mwaka wa 1981, ambazo alikuwa akiimba kwa [[Kifaransa]]. Alitoa albamu yake ya kwanza kwa lugha ya [[Kiingereza]] kunako mwaka wa 1990. Kwa sasa anaishi mjini [[Las Vegas]] ambapo alifanya maonyesho yake mengi sana. Mnamo mwaka wa 2007, aliimba katika onyesho moja akiwa na [[Elvis Presley]], ambalo liliandaliwa katika kompyuta ambazo kuna picha za maonyesho ya zamani yaliyofanywa na Elvis. Dhumuni la onyesho, lilikuwa likiandaliwa kwa ajili ya onyesho la TV la [[American Idol]]. Ameuza albamu babkubwa duniani kwa msanii wa kike, kitendo ambacho kimemfanya ashinde Tuzo za Muziki wa Dunia kunako mwaka wa 2004. Pia ameuza zaidi ya nakala milioni 7 za muziki kwa lugha ya Kifaransa. Amekuwa nyota maarufu kwa [[Ulaya]] kwa albamu yake ya ''[[Incognito]]'' ya mwaka wa 1987. Baada ya hapo, akafanya maonyesho kadhaa katika Ulaya kisha akaja kuwa maarufu zaidi. == Muziki == ===Albamu zake=== ====1980-1989==== {| class="wikitable plainrowheaders" style="text-align:center;" |- ! rowspan="2" style="width:15em;"| Jina ! rowspan="2" style="width:17em;"| Maelezo ! colspan="10"| Nafasi iliyoshika katika nchi tofauti ! rowspan="2" style="width:12em;"| Mauzo ! rowspan="2" style="width:12em;"| Matunukio |- style="font-size:smaller;" ! style="width:25px;"|Canada<br /><ref name="canadianpeaks"> Canadian Albums Chart peak positions: * For ''Unison'': {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1527&type=2&interval=24&PHPSESSID=dvgfubfgblsc92t61d929man50|title=Top Albums/CDs – Volume 53, No. 25, May 25, 1991|work=[[RPM (magazine)|RPM]]|date=25 May 1991|accessdate=16 August 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20160311104951/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1527&type=2&interval=24&PHPSESSID=dvgfubfgblsc92t61d929man50|archivedate=11 March 2016}} * For ''Dion chante Plamondon'' and ''À l'Olympia'': {{cite book|author=[[Nanda Lwin]]|title=Top 40 Hits: The Essential Chart Guide|publisher=Music Data Canada|year=1999|isbn= 1-896594-13-1}} * For ''Celine Dion'': {{cite web|url=https://books.google.com/books?id=jg8EAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|title=Hits of the World|work=[[Billboard (magazine)|Billboard]]|date=30 May 1992|accessdate=16 August 2014}} * For ''The Colour of My Love'': {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2346&type=2&interval=24&PHPSESSID=dvgfubfgblsc92t61d929man50|title=Top Albums/CDs – Volume 58, No. 24, December 25, 1993|work=RPM|date=25 November 1993|accessdate=16 August 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20150225150240/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2346&type=2&interval=24&PHPSESSID=dvgfubfgblsc92t61d929man50|archivedate=25 February 2015}} * For ''D'eux'': {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9229&type=2&interval=24&PHPSESSID=dvgfubfgblsc92t61d929man50|title=Top Albums/CDs – Volume 61, No. 19, June 12, 1995|work=RPM|date=12 June 1995|accessdate=16 August 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140809084358/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9229&type=2&interval=24&PHPSESSID=dvgfubfgblsc92t61d929man50|archivedate=9 August 2014}} * For ''Live à Paris'': {{cite web|url=https://books.google.com/books?id=ugkEAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|title=Hits of the World|work=Billboard|date=23 November 1996|accessdate=16 August 2014}} * For ''Taking Chances World Tour: The Concert'': {{cite web|title=Tour DVDs Take the Top 3 Spots!|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/news/tour-dvds-take-top-3-spots|archiveurl=https://web.archive.org/web/20140819085340/http://www.celinedion.com/ca/news/tour-dvds-take-top-3-spots|archivedate=19 August 2014|date=13 May 2010|accessdate=16 August 2014}} * For all the other albums: {{cite web|url=http://www.allmusic.com/artist/celine-dion-mn0000186185/awards|title=Celine Dion – Awards – Billboard Albums: Top Canadian Albums|publisher=[[AllMusic]]|accessdate=16 August 2014}}</ref> ! style="width:25px;"|Auustralia<br /><ref name="australianpeaks">Australian Albums Chart peak positions: * For ''Unison'': {{cite web |url=http://www.americanradiohistory.com/Archive-Billboard/90s/1992/Billboard-1992-10-10.pdf |title=Hits of the World |work=Billboard |page=47 |date=10 October 1992 |accessdate=9 May 2015 }} * For ''The Collector's Series, Volume One'': {{cite web |url=http://www.aria.com.au/issue566.PDF |title=Top 100 Albums – Week Commencing 25th December 2000 |publisher=[[Australian Recording Industry Association|ARIA]] |accessdate=16 August 2014 |deadurl=bot: unknown |archiveurl=https://pandora.nla.gov.au/pan/23790/20020221-0000/www.aria.com.au/issue566.PDF |archivedate=2002-02-21 |df= |url-status=live }} * For ''A New Day... Live in Las Vegas'': {{cite web |url=http://pandora.nla.gov.au/pan/23790/20040807-0000/ISSUE751.pdf |title=ARIA Top 100 Albums – Week Commencing 19th July 2004 |publisher=ARIA |accessdate=16 August 2014 |archive-date=2004-08-06 |archive-url=https://webarchive.nla.gov.au/awa/20040806140000/http://pandora.nla.gov.au/pan/23790/20040807-0000/issue751.pdf |url-status=dead }} * For ''Taking Chances World Tour: The Concert'': {{cite web |url=http://pandora.nla.gov.au/pan/23790/20100511-1124/Issue1054.pdf |title=ARIA Top 40 Music DVD – Week Commencing 10th May 2010 |publisher=ARIA |accessdate=16 August 2014 }} * For all the other albums: {{cite web |url=http://australian-charts.com/showitem.asp?interpret=C%E9line+Dion&titel=Celine+Dion&cat=a |title=Céline Dion in Australian Charts |publisher=Hung Medien |accessdate=16 August 2014 }}</ref> ! style="width:25px;"|Ubelgiji<br /><ref name="belgianpeaks"> Belgian Albums Chart peak positions: * For ''Incognito'', ''Unison'' and ''Gold Vol. 2'': {{cite book|author=Sam Jaspers|title=Ultratop 1995-2005|publisher=Book & Media Publishing|year=2006|isbn=90-5720-232-8}} * For ''The Colour of My Love'', ''The Collector's Series, Volume One'', ''One Heart'' and ''My Love: Essential Collection'': {{cite web|url=http://www.ultratop.be/nl/album/6f9/Celine-Dion-The-Colour-Of-My-Love|title=Céline Dion Charts: Albums – Ultratop|language=Dutch|publisher=[[Ultratop]] & Hung Medien|accessdate=16 August 2014}} * For all the other albums: {{cite web|url=http://www.ultratop.be/fr/album/28e9/Celine-Dion-A-l'Olympia|title=Céline Dion Classements: Albums – Ultratop|language=French|publisher=Ultratop & Hung Medien|accessdate=16 August 2014}}</ref> ! style="width:25px;"|Ufaransa<br /><ref name="frenchpeaks"> French Albums Chart peak positions: * For ''Des mots qui sonnent'', ''The Colour of My Love'', ''À l'Olympia'', ''D'eux'', ''Les premières chansons vol. 1'', ''Falling into You'', ''All the Way... A Decade of Song'', ''Tout en amour'', ''On ne change pas'', ''My Love: Essential Collection'', ''D'elles/D'eux'', ''Des mots qui sonnent/D'eux/S'il suffisait d'aimer/Au cœur du stade/1 fille & 4 types/D'elles'' and ''1 fille & 4 types/Sans attendre'': {{cite web |url=http://www.infodisc.fr/Album_D.php |title=Le Détail des Albums de chaque Artiste |language=French |publisher=InfoDisc |accessdate=16 August 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20140804194725/http://www.infodisc.fr/Album_D.php |archivedate=4 August 2014 }} * For ''La collection'': {{cite web |url=http://www.snepmusique.com/tops-semaine/top-albums-fusionnes/?ye=2013&we=48 |title=Le Top de la semaine : Top Albums |language=French |publisher=SNEP |date=23 December 2013 |accessdate=18 September 2016 }} * For ''Celine Dion Collection'': {{cite web |url=http://www.snepmusique.com/tops-semaine/top-albums-fusionnes/?ye=2016&we=25 |title=Le Top de la semaine : Top Albums |language=French |publisher=SNEP |date=17 June 2016 |accessdate=18 September 2016 }} * For ''On ne change pas/My Love: Essential Collection'', ''S'il suffisait d'aimer/Live à Paris'' and ''Loved Me Back to Life/A New Day Has Come'': {{cite web |url=http://lescharts.com/weekchart.asp?year=2016&date=20160910&cat=a |title=Album Top 100: 10/09/2016 |language=French |publisher=Hung Medien |date=17 June 2016 |accessdate=18 September 2016 }}<!-- 2CD albums are listed under the first album title --> * For all the other albums: {{cite web |url=http://lescharts.com/showitem.asp?interpret=C%E9line+Dion&titel=Live+%E0+Paris&cat=a |title=Céline Dion dans les charts français |language=French |publisher=Hung Medien |accessdate=16 August 2014 }}</ref> ! style="width:25px;"|Ujerumani<br /><ref name="germanpeaks">German Albums Chart peak positions: * For ''Taking Chances World Tour: The Concert'': {{cite web |url=http://www.media-control.de/dire-straits-preschen-vor.html |title=Dire Straits preschen vor |language=German |publisher=[[GfK Entertainment|Media Control]] |date=27 May 2010 |accessdate=17 August 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20100530055012/http://www.media-control.de/dire-straits-preschen-vor.html |archivedate=30 May 2010 }} * For all the other albums: {{cite web |url=http://www.musicline.de/de/chartverfolgung_summary/artist/Dion%2CCeline/?type=longplay |title=Céline Dion Longplay-Chartverfolgung |language=German |publisher=Phononet GmbH |accessdate=17 August 2014 |archive-url=https://web.archive.org/web/20120927061525/http://www.musicline.de/de/chartverfolgung_summary/artist/Dion,Celine/?type=longplay |archive-date=27 September 2012 |dead-url=yes |archiveurl=https://web.archive.org/web/20120927061525/http://www.musicline.de/de/chartverfolgung_summary/artist/Dion,Celine/?type=longplay |archivedate=2012-09-27 }}</ref> ! style="width:25px;"|Japan<br /><ref name="japanesepeaks">{{cite web|url=http://www.oricon.co.jp/prof/artist/98172/ranking/cd_album/|script-title=ja:セリーヌ・ディオンのアルバム売り上げランキング|language=Japanese|publisher=[[Oricon]]|accessdate=17 August 2014}}</ref> ! style="width:25px;"|Uholanzi<br /><ref name="dutchpeaks">{{cite web|url=http://dutchcharts.nl/showitem.asp?interpret=C%E9line+Dion&titel=The+Colour+Of+My+Love&cat=a|title=Céline Dion in Dutch Charts|language=Dutch|publisher=Hung Medien|accessdate=17 August 2014}}</ref> ! style="width:25px;"|Uswisi<br /><ref name="swisspeaks"> Swiss Albums Chart peak positions: * For ''Taking Chances World Tour: The Concert'': {{cite web|url=http://swisscharts.com/weekchart.asp?cat=d&date=20100523&year=2010|title=Swiss Charts: Music DVD Top 10|publisher=Hung Medien|accessdate=17 August 2014}} * For all the other albums: {{cite web|url=http://swisscharts.com/showitem.asp?interpret=C%E9line+Dion&titel=The+Colour+Of+My+Love&cat=a|title=Céline Dion Charts: Albums – Schweizer Hitparade|publisher=Hung Medien|accessdate=17 August 2014}}</ref> ! style="width:25px;"|Uingereza<br /><ref name="ukpeaks"> UK Albums Chart peak positions: * For ''For You'', ''Les premières années'', ''Au cœur du stade'' and ''Let's Talk About Love / Falling into You / A New Day Has Come'': {{cite web|url=http://zobbel.de/cluk/CLUK_D.HTM|title=Chart Log UK 1994–2010|publisher=Dipl.-Bibl.(FH)|accessdate=17 August 2014}} * For ''Sans attendre'': {{cite web|url=http://www.zobbel.de/cluk/121117cluk.txt|title=Chart: Cluck Update 17.11.2012 (wk45)|publisher=Dipl.-Bibl.(FH)|accessdate=17 August 2014}} * For all the other albums: {{cite web|url=http://www.officialcharts.com/artist/_/Celine%20Dion/|title=Celine Dion: Albums|publisher=[[Official Charts Company|OCS]]|accessdate=17 August 2014}}</ref> ! style="width:25px;"|Marekani<br /><ref name="uspeaks"> US Albums Chart peak positions: * For ''Taking Chances World Tour / The Concert'': {{cite web|author=Gary Trust|url=http://www.billboard.com/articles/columns/chart-beat/958175/chart-beat-thursday-fox-tvs-lee-glee|title=Chart Beat Thursday: Fox-TV's Lee & "Glee"|date=20 May 2010|accessdate=17 August 2014|work=Billboard}} * For all the other albums: {{cite web|url=http://www.allmusic.com/artist/celine-dion-mn0000186185/awards|title=Celine Dion – Awards – Billboard Albums: The Billboard 200|publisher=AllMusic|accessdate=17 August 2014}}</ref> |- ! scope="row"| ''La voix du bon Dieu'' | * Ilitoka: Novemba 6, 1981 * Lebo: Super Étoiles | — || — || — || — || — || — || — || — || — || — | * Canada: 100,000<ref>{{cite book|author=Georges-Hébert Germain|title=Céline: The Authorized Biography|publisher=Dundurn Press Limited|year=1998|isbn= 1-55002-318-7|url=https://books.google.com/?id=EvYnMhGsUWkC&printsec=frontcover#v=onepage&q=sold%20more%20than%20100%2C000%20copies&f=false|page=119}}</ref> | |- ! scope="row"| ''Céline Dion chante Noël'' | * Ilitoka: Disemba 4, 1981 * Lebo: Super Étoiles | — || — || — || — || — || — || — || — || — || — | | |- ! scope="row"| ''Tellement j'ai d'amour...'' | * Ilitoka: Septemb1 7, 1982 * Lebo: Saisons | || — || — || — || — || — || — || — || — || — | * Canada: 150,000<ref>{{cite book|author=Jean Beaunoyer|title=René Angelil: The Making of Céline Dion: The Unauthorized Biography|publisher=Dundurn Group|year=2004|isbn=1-55002-489-2|url=https://books.google.com/?id=EpOtS5GprskC&pg=PP1&lpg=PP1&dq=Rene+Angelil:+The+Making+of+C%C3%A9line+Dion:+The+Unauthorized+Biography#v=onepage&q=150%2C000%20copies&f=false|page=155}}</ref> | * Canada: Platinum<ref name="cria"/> |- ! scope="row"| ''Les chemins de ma maison'' | * Ilitoka: Septemba 7, 1983 * Lebo: Saisons | || — || — || — || — || — || — || — || — || — | * Canada: 100,000<ref>{{cite book|author=Georges-Hébert Germain|title=Céline: The Authorized Biography|publisher=Dundurn Press Limited|year=1998|isbn= 1-55002-318-7|url=https://books.google.com/?id=EvYnMhGsUWkC&printsec=frontcover#v=onepage&q=Les%20chemins%20de%20ma%20maison&f=false|page=143}}</ref> | * Canada: Gold<ref name="cria"/> |- ! scope="row"| ''Chants et contes de Noël'' | * Ilitoka: Disemba 3, 1983 * Lebo: Saisons | || — || — || — || — || — || — || — || — || — | | |- ! scope="row"| ''Mélanie'' | * Ilitoka: Agosti 22, 1984 * Lebo: TBS | || — || — || — || — || — || — || — || — || — | | * Canada: Gold<ref name="cria"/> |- ! scope="row"| ''C'est pour toi'' | * Ilitoka: Agosti 27, 1985 * Lebo: TBS | || — || — || — || — || — || — || — || — || — | | |- ! scope="row"| ''Incognito'' | * Ilitoka: Aprili 2, 1987 * Lebo: Columbia Records | || — || 65 || — || — || — || — || — || — || — | * 500,000<ref>''Incognito'' sales: * {{cite web|url=http://www.lemauricien.com/article/jean-alain-roussel-maestro-mauricien-qui-fait-chanter-monde|title=Jean Alain Roussel: Le Maestro mauricien qui a fait chanter le monde|work=[[Le Mauricien]]|date=18 October 2012|accessdate=17 August 2014|language=French|archive-date=2014-08-12|archive-url=https://web.archive.org/web/20140812205335/http://www.lemauricien.com/article/jean-alain-roussel-maestro-mauricien-qui-fait-chanter-monde|url-status=dead}} * {{cite web|author=Dany Bouchard|url=http://fr.canoe.ca/divertissement/musique/nouvelles/2007/05/18/4191982-jdm.html|title=Le parcours francophone d'une star mondiale|publisher=[[Canoe.ca]]|date=19 May 2007|accessdate=17 August 2014|language=French|archiveurl=https://web.archive.org/web/20140812202642/http://fr.canoe.ca/divertissement/musique/nouvelles/2007/05/18/4191982-jdm.html|archivedate=2014-08-12}}</ref> | * Canada: 2× Platinum<ref name="cria"/> |} ====1990-1999==== {| class="wikitable plainrowheaders" style="text-align:center;" |- ! rowspan="2" style="width:15em;"| Jina ! rowspan="2" style="width:17em;"| Maelezo ! colspan="10"| Nafasi iliyoshika katika nchi tofauti ! rowspan="2" style="width:12em;"| Mauzo ! rowspan="2" style="width:12em;"| Matunukio |- style="font-size:smaller;" ! style="width:25px;"|Canada<br /><ref name="canadianpeaks"/> ! style="width:25px;"|Australia<br /><ref name="australianpeaks"/> ! style="width:25px;"|Ubelgiji<br /><ref name="belgianpeaks"/> ! style="width:25px;"|Ufaransa<br /><ref name="frenchpeaks"/> ! style="width:25px;"|Ujerumani<br /><ref name="germanpeaks"/> ! style="width:25px;"|Japan<br /><ref name="japanesepeaks"/> ! style="width:25px;"|Uholanzi<br><ref name="dutchpeaks"/> ! style="width:25px;"|Uswisi<br /><ref name="swisspeaks"/> ! style="width:25px;"|Uingereza<br /><ref name="ukpeaks"/> ! style="width:25px;"|Marekani<br /><ref name="uspeaks"/> |- ! scope="row"| ''Unison'' | * Ilitolewa: Aprili 2, 1990 * Lebo: Columbia, Epic | 15 || 15 || 56 || — || — || — || — || — || 55 || 74 | * Duniani: 3,000,000<ref name="unison"/> * Ufaransa: 100,000<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=4600|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Marekani: 1,227,000<ref name="ussalesdec2010">{{cite web|author=Gary Trust|url=http://www.billboard.com/articles/columns/chart-beat/949407/ask-billboard-celine-dion-celebrates-chart-anniversary|title=Ask Billboard: Celine Dion Celebrates Chart Anniversary|date=10 December 2010|accessdate=17 August 2014|work=Billboard}}</ref> | * Canada: 7× Platinum<ref name="cria"/> * Ufaransa: Gold<ref name="snep"/> * Uingereza: Gold<ref name="bpi"/> * Marekani: Platinum<ref name="riaa"/> |- ! scope="row"| ''Dion chante Plamondon''<br />(''Des mots qui sonnent'') | * Ilitolewa: Novemba 4, 1991 * Lebo: Columbia, Epic | 57 || — || 17 || 4 || — || — || — || — || — || — | * Duniani: 2,000,000<ref>''Dion chante Plamondon'' worldwide sales: * {{cite web|author=Juan Rodriguez|url=http://www2.canada.com/montrealgazette/columnists/story.html?id=1ca9faa0-7fcf-4660-8fb8-c021ac114668|title=A soundtrack of Quebec history|work=[[The Gazette (Montreal)|The Gazette]]|date=25 November 2010|accessdate=17 August 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140714163926/http://www2.canada.com/montrealgazette/columnists/story.html?id=1ca9faa0-7fcf-4660-8fb8-c021ac114668|archivedate=14 July 2014}} * {{cite web|url=http://ici.radio-canada.ca/emissions/en_direct_de_l_univers/2010-2011/document.asp?idDoc=126021|title=Dans l'univers de Luc Plamondon / 4 décembre 2010|language=French|publisher=[[Canadian Broadcasting Corporation|Société Radio-Canada]]|accessdate=17 August 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140714143447/http://ici.radio-canada.ca/emissions/en_direct_de_l_univers/2010-2011/document.asp?idDoc=126021|archivedate=14 July 2014}}</ref> * Ufaransa: 660,000<ref>''Dion chante Plamondon'' French sales: * {{cite web|url=http://www.infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=350|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}} * {{cite web|url=http://canadianmusichalloffame.ca/inductees/luc-plamondon/|title=Luc Plamondon: 1999|publisher=Canadian Music Hall of Fame|accessdate=17 August 2014}} * {{cite web|url=http://www.thecanadianencyclopedia.ca/en/article/luc-plamondon-emc/|title=Luc Plamondon|work=[[The Canadian Encyclopedia]]|accessdate=17 August 2014|archive-date=2023-05-06|archive-url=https://web.archive.org/web/20230506000111/https://www.thecanadianencyclopedia.ca/en/article/luc-plamondon-emc|url-status=dead}}</ref> * Marekani: 275,000<ref name="huffington">{{cite web|author=Charles des Portes|title=Vidéos. Stromae en concert à New York : peut-il rejoindre le club très fermé des stars mondiales francophones?|work=[[The Huffington Post|Le Huffington Post]]|url=http://www.huffingtonpost.fr/2014/06/20/videos-stars-mondiales-francophones-stromae-tournee_n_5514129.html|language=French|date=20 June 2014|accessdate=17 August 2014}}</ref> | * Ubelgiji: Gold<ref name="bea"> Belgian certifications: * For ''Dion chante Plamondon'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=1995|accessdate=18 September 2018}} * For ''The Colour of My Love'', ''D'eux'' and ''Live à Paris'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=1996|accessdate=18 September 2018}} * For ''Falling into You'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=1997|accessdate=18 August 2014}} * For ''Let's Talk About Love'', ''S'il suffisait d'aimer'' and ''These Are Special Times'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=1998|accessdate=18 August 2014}} * For ''Au cœur du stade'', ''One Heart'' and ''1 fille & 4 types'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2003|accessdate=18 August 2014}} * For ''All the Way... A Decade of Song'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2000|accessdate=18 August 2014}} * For ''A New Day Has Come'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2002|accessdate=18 August 2014}} * For ''Miracle'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2004|accessdate=18 August 2014}} * For ''On ne change pas'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2006|accessdate=18 August 2014}} * For ''D'elles'' and ''Taking Chances'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2007|accessdate=18 August 2014}} * For ''My Love: Essential Collection'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2009|accessdate=18 August 2014}} * For ''Sans attendre'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2012|accessdate=18 August 2014}} * For ''Loved Me Back to Life'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2013|accessdate=18 August 2013}} * For ''Encore un soir'': {{cite certification|region=Belgium|type=album|artist=Celine Dion|certyear=2016|accessdate=18 August 2016}}</ref> * Canada: 2× Platinum<ref name="cria"/> * Ufaransa: 2× Platinum<ref name="snep"/> |- ! scope="row"| ''Celine Dion'' | * Ilitolewa: Machi 30, 1992 * Lebo: Columbia, Epic | 3 || 15 || — || — || — || 59 || — || — || 70 || 34 | * Duniani: 5,000,000<ref>{{cite web|author=David Ball|url=http://canadianmusichalloffame.ca/this-week-in-history-december-12-to-18/|title=This Week in History: December 12 to 18|publisher=Canadian Music Hall of Fame|accessdate=17 August 2014|archiveurl=https://web.archive.org/web/20140929172529/http://canadianmusichalloffame.ca/this-week-in-history-december-12-to-18/|archivedate=2014-09-29}}</ref> * Marekani: 2,400,000<ref name="SoundScanSales2016"/> | * Canada: Diamond<ref name="cria"/> * Australia: Gold<ref name="aria"> Australian certifications: * For ''Celine Dion'': {{cite book|author=[[David Kent (historian)|David Kent]]|title=Australian Chart Book 1970-1992|publisher=St Ives, N.S.W. : Australian Chart Book|location=Australia|year=1993|edition=|pages=|isbn=0-646-11917-6}} * For ''The Colour of My Love'': {{cite book|author=[[David Kent (historian)|David Kent]]|title=Australian Chart Book 1993-2005|publisher=Turramurra, N.S.W. : Australian Chart Book|location=Australia|year=2006|edition=|pages=|isbn=0-646-45889-2}} * For ''Falling into You'': {{cite certification|region=Australia|type=album|artist=Celine Dion|certyear=2011|accessdate=18 August 2014}} * For ''Let's Talk About Love'' and ''These Are Special Times'': {{cite certification|region=Australia|type=album|artist=Celine Dion|certyear=1998|accessdate=18 August 2014}} * For ''All the Way... A Decade of Song'': {{cite certification|region=Australia|type=album|artist=Celine Dion|certyear=1999|accessdate=18 August 2014}} * For ''A New Day Has Come'': {{cite certification|region=Australia|type=album|artist=Celine Dion|certyear=2002|accessdate=18 August 2014}} * For ''One Heart'': {{cite certification|region=Australia|type=album|artist=Celine Dion|certyear=2003|accessdate=18 August 2014}} * For ''Taking Chances'': {{cite certification|region=Australia|type=album|artist=Celine Dion|certyear=2008|accessdate=18 August 2014}}</ref> * [[Recording Industry Association of Japan|JPN]]: Gold<ref name="riaj"/> * Uingereza: Gold<ref name="bpi"/> * Marekani: 2× Platinum<ref name="riaa"/> |- ! scope="row"| ''The Colour of My Love'' | * Ilitolewa: Novemba 9, 1993 * Lebo: Columbia, Epic | 1 || 1 || 1 || 7 || 16 || 7 || 2 || 9 || 1 || 4 | * Duniani: 20,000,000<ref name="thecolourofmylove"/> * Canada: 1,500,000<ref>{{cite web|author=Chuck Taylor|url=https://books.google.com/books?id=ygkEAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|title=550's Celine Dion Takes Stardom to Next Level|work=Billboard|date=9 November 1996|accessdate=17 August 2014}}</ref> *Ufaransa: 352,600<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=1000|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Japan: 1,013,450<ref>''The Colour of My Love'' Japanese sales: * {{cite web|url=http://www.americanradiohistory.com/Archive-Billboard/90s/1996/BB-1996-01-06.pdf|title=Celine Dion, Epic Find Some Unusual Kompany|work=Billboard|date=6 January 1996|accessdate=13 May 2015|page=41}} * {{cite web|url=http://www.geocities.jp/object_ori/1995a.html|title=1995年 アルバム年間TOP100|publisher=Oricon|language=Japanese|accessdate=17 August 2014}} * {{cite web|url=http://www.geocities.jp/object_ori/1996a.html|title=1996年 アルバム年間TOP100|publisher=Oricon|language=Japanese|accessdate=17 August 2014}}</ref> * Uingereza: 1,816,915<ref name="ukbest">{{cite web|author=Bill Harris|title=Queen rules – in album sales|publisher=Jam!|url=http://jam.canoe.ca/Music/Artists/Q/Queen/2006/11/17/2391437.html|date=17 November 2006|accessdate=17 August 2014}}</ref> * Marekani: 4,600,000<ref name="SoundScanSales2016"/> | * Canada: Diamond<ref name="cria"/> * Australia: 8× Platinum<ref name="aria"/> * Ubelgiji: 2× Platinum<ref name="bea"/> * Ufaransa: Platinum<ref name="snep"/> * Ujerumani: Gold<ref name="bvmi">{{cite certification|region=Germany|artist=Celine Dion|type=album|accessdate=17 August 2014}}</ref> * Japan: 3× Platinum<ref name="riaj"/> * Uholanzi: 3× Platinum<ref name="nvpi">{{cite certification|region=Netherlands|type=album|artist=Celine Dion|accessdate=17 August 2014}}</ref> * Uswisi: Platinum<ref name="swisscerts">{{cite certification|region=Switzerland|artist=Dion|type=album|accessdate=17 August 2014}}</ref> * Uingereza: 5× Platinum<ref name="bpi"/> * Marekani: 6× Platinum<ref name="riaa"/> * EU: 4× Platinum<ref name="europeancerts"/> |- ! scope="row"| ''D'eux''<br />''(The French Album)'' | * Ilitolewa: Machi 27, 1995 * Lebo: Columbia, Epic | 29 || — || 1 || 1 || 69 ||50 || 1 || 1 || 7 || — | * Duniani: 10,000,000<ref name="deux"/> * Ufaransa: 4,500,000<ref name="10million"/><ref name="diamond">{{cite web|url=http://infodisc.fr/CDCertif_D.php |title=Les albums diamant |publisher=InfoDisc |accessdate=18 August 2014 |language=French |dead-url=yes |archiveurl=https://web.archive.org/web/20151208200508/http://infodisc.fr/CDCertif_D.php |archivedate=8 December 2015 }}</ref> * Uingereza: 250,000<ref>''D'eux'' UK sales: * {{cite web|author=Dany Bouchard|title=Céline Dion D'eux: Une nouvelle version "de luxe"|publisher=Canoe.ca|url=http://fr.canoe.ca/divertissement/musique/nouvelles/2009/11/26/11934231-jdm.html|date=26 November 2009|accessdate=18 August 2014|language=French|archiveurl=https://archive.today/20140812041943/http://fr.canoe.ca/divertissement/musique/nouvelles/2009/11/26/11934231-jdm.html|archivedate=2014-08-12}} * {{cite book|author=Jenna Glatzer|title=Céline Dion: For Keeps|url=https://archive.org/details/celinedionforkee0000glat|page=[https://archive.org/details/celinedionforkee0000glat/page/69 69]|publisher=Andrews McMeel Publishing|year=2005|isbn=0-7407-5559-5}}</ref> * Marekani: 300,000<ref name="huffington"/> | * Canada: 7× Platinum<ref name="cria"/> * Ubelgiji: 6× Platinum<ref name="bea"/> * Ufaransa: Diamond<ref name="snep"/> * Uholanzi: Platinum<ref name="nvpi"/> * Uswisi: 4× Platinum<ref name="swisscerts"/> * Uingereza: Gold<ref name="bpi"/> * EU: 8× Platinum<ref name="europeancerts"/> |- ! scope="row"| ''Falling into You'' | * Ilitoka: Machi 11, 1996 * Lebo: Columbia, Epic | 1 || 1 || 1 || 1 || 5 || 6 || 1 || 1 || 1 || 1 | * Duniani: 32,000,000<ref name="fallingintoyou"/> * Australia: 1,000,000<ref>{{cite web|url=https://books.google.com/books?hl=es&id=QQ0EAAAAMBAJ&q=dion#v=snippet&q=Falling%20Into%20You&f=false|title=Sony Australia, Dion Acknowledge Special Bond|date=16 May 1998|accessdate=18 August 2014|work=Billboard}}</ref> * Ufaransa: 1,172,500<ref name="diamond"/> * Marekani: 10,812,000<ref name="ussalesfeb2013"/> | * Canada: Diamond<ref name="cria"/> * Australia: 13× Platinum<ref name="aria"/> * Ubelgiji: 4× Platinum<ref name="bea"/> * Ufaransa: Diamond<ref name="snep"/> * Ujerumani: 5× Gold<ref name="bvmi"/> * Japan: 4× Platinum<ref name="riaj"/> * Uholanzi: 6× Platinum<ref name="nvpi"/> * Uswisi: 3× Platinum<ref name="swisscerts"/> * Uingereza: 7× Platinum<ref name="bpi"/> * Marekani: 11× Platinum<ref name="riaa"/> * EU: 9× Platinum<ref name="europeancerts"/> |- ! scope="row"| ''Let's Talk About Love'' | * Ilitolewa: Novemba 14, 1997 * Lebo: Columbia, Epic | 1 || 1 || 1 || 1 || 1 || 5 || 1 || 1 || 1 || 1 | * Duniani: 31,000,000<ref name="letstalkaboutlove"/> * Canada: 1,700,000<ref name="canadiansales1">{{cite web|author=Larry Leblanc|url=https://books.google.com/books?id=Mw0EAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|title=Seagram, Dion Led Canadian Biz|work=Billboard|date=26 December 1998|accessdate=19 August 2014}}</ref> * Ufaransa: 1,327,400<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=50|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Uingereza: 1,984,152<ref name="ukbest"/> * Marekani: 9,601,000<ref name="ussalesfeb2013"/> | * Canada: Diamond<ref name="cria"/> * Australia: 6× Platinum<ref name="aria"/> * Ubelgiji: 4× Platinum<ref name="bea"/> * Ufaransa: Diamond<ref name="snep"/> * Ujerumani: 3× Platinum<ref name="bvmi"/> * Japan: Million<ref name="riaj"/> * Uholanzi: 5× Platinum<ref name="nvpi"/> * Uswisi: 6× Platinum<ref name="swisscerts"/> * Uingereza: 6× Platinum<ref name="bpi"/> * Marekani: 10× Platinum<ref name="riaa"/> * EU: 10× Platinum<ref name="europeancerts"/> |- ! scope="row"| ''S'il suffisait d'aimer'' | * Ilitolewa: Septemba 7, 1998 * Lebo: Columbia, Epic | 1 || — || 1 || 1 || 11 || 37 || 4 || 1 || 17 || — | * Duniani: 4,000,000<ref>''S'il suffisait d'aimer'' worldwide sales: * {{cite web|url=http://www.rfimusique.com/musiqueen/articles/060/article_7167.asp|archiveurl=https://web.archive.org/web/20130928151128/http://www.rfimusique.com/musiqueen/articles/060/article_7167.asp|archivedate=28 September 2013|title=Céline Dion: The Recordbreaking Diva|author=Gilles Rio|publisher=Radio France Internationale|date=17 October 2003|accessdate=19 August 2014}} * {{cite web|author=Benjamin Jacquot|url=http://www.francebleu.fr/musique/celine-dion/celine-dion-et-goldman-20-ans-d-amitie-889726|title=Céline Dion et Jean-Jacques Goldman : 20 ans d'amitié|publisher=France Bleu|date=30 September 2013|accessdate=19 August 2014|language=French}}</ref> * Canada: 500,000<ref name="canadiansales1"/> * Ufaransa: 1,714,700<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=0|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Ujerumani: 120,000<ref name="rfi1">{{cite web|author=Gilles Rio|url=http://www.rfi.fr/musiquefr/articles/060/article_14085.asp|archiveurl=https://web.archive.org/web/20141223204606/http://www1.rfi.fr/musiquefr/articles/060/article_14085.asp|archivedate=23 December 2014|title=Les artistes Francophones s'exportent bien!|language=French|publisher=Radio France Internationale|date=9 December 1998|accessdate=19 August 2014}}</ref> * Japan: 41,000<ref name="rfi1"/> * Uingereza: 100,000<ref name="rfi1"/> * Marekani: 112,000<ref>{{cite web|author=Paul Grein |title=Week Ending Sept. 12, 2010: The Dulcet Tones Of Bruno Mars |publisher=Yahoo! |url=http://music.yahoo.com/blogs/chart-watch/week-ending-sept-12-2010-the-dulcet-tones-of-bruno-mars.html |date=15 September 2010 |accessdate=19 August 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20121002051223/http://music.yahoo.com/blogs/chart-watch/week-ending-sept-12-2010-the-dulcet-tones-of-bruno-mars.html |archivedate=2 October 2012 }}</ref> | * Canada: 4× Platinum<ref name="cria"/> * Ubelgiji: Platinum<ref name="bea"/> * Ufaransa: Diamond<ref name="snep"/> * Uholanzi: Gold<ref name="nvpi"/> * Uswisi: 2× Platinum<ref name="swisscerts"/> * Uingereza: Gold<ref name="bpi"/> * EU: 2× Platinum<ref name="europeancerts"/> |- ! scope="row"| ''These Are Special Times'' | * Ilitolewa: Oktoba 30, 1998 * Lebo: Columbia, Epic | 1 || 6 || 12 || 23 || 3 || 4 || 3 || 1 || 20 || 2 | * Duniani: 12,000,000<ref name="thesearespecialtimes2"/> * Ufaransa: 60,400<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=6550|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Japan: 500,000<ref>{{cite web|title=スペシャル・タイムス(Legacy Edition)|language=Japanese|publisher=[[Sony Music Entertainment Japan]]|url=http://www.sonymusic.co.jp/artist/CelineDion/discography/EICP-882|accessdate=19 August 2014}}</ref> * Marekani: 5,440,000<ref name="SoundScanSales2016updated"/> | * Canada: Diamond<ref name="cria"/> * Australia: Platinum<ref name="aria"/> * Ubelgiji: Platinum<ref name="bea"/> * Ujerumani: Gold<ref name="bvmi"/> * Japan: 2× Platinum<ref name="riaj"/> * Uholanzi: Gold<ref name="nvpi"/> * Uswisi: 2× Platinum<ref name="swisscerts"/> * Uingereza: Platinum<ref name="bpi"/> * Marekani: 5× Platinum<ref name="riaa"/> * EU: Platinum<ref name="europeancerts"/> |} ====2000-2009==== {| class="wikitable plainrowheaders" style="text-align:center;" |- ! rowspan="2" style="width:15em;"| Jina ! rowspan="2" style="width:17em;"| Maelezo ! colspan="10"| Nafasi iliyoshika katika nchi tofauti ! rowspan="2" style="width:12em;"| Mauzo ! rowspan="2" style="width:12em;"| Matunukio |- style="font-size:smaller;" ! style="width:25px;"|Canada<br /><ref name="canadianpeaks"/> ! style="width:25px;"|Australia<br /><ref name="australianpeaks"/> ! style="width:25px;"|Ubelgiji<br /><ref name="belgianpeaks"/> ! style="width:25px;"|Ufaransa<br /><ref name="frenchpeaks"/> ! style="width:25px;"|Ujerumani<br /><ref name="germanpeaks"/> ! style="width:25px;"|Japan<br /><ref name="japanesepeaks"/> ! style="width:25px;"|Uholanzi<br><ref name="dutchpeaks"/> ! style="width:25px;"|Uswisi<br /><ref name="swisspeaks"/> ! style="width:25px;"|Uingereza<br /><ref name="ukpeaks"/> ! style="width:25px;"|Marekani<br /><ref name="uspeaks"/> |- ! scope="row"| ''A New Day Has Come'' | * Ilitolewa: Machi 22, 2002 * Lebo: Columbia, Epic | 1 || 1 || 1 || 1 || 2 || 15 || 1 || 1 || 1 || 1 | * Duniani: 12,000,000<ref name="anewdayhascome"/> * Australia: 160,000<ref>{{cite web|url=http://www.sonybmg.com.au/cd/releaseDetails.do?catalogueNo=5108772000 |title=One Heart |publisher=[[Sony Music Australia]] |accessdate=19 August 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20050506132555/http://www.sonybmg.com.au/cd/releaseDetails.do?catalogueNo=5108772000 |archivedate=6 May 2005 }}</ref> * Ufaransa: 863,500<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=200|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Marekani: 3,307,000<ref name="ussalesdec2010"/> | * Canada: 6× Platinum<ref name="cria"/> * Australia: 2× Platinum<ref name="aria"/> * Ubelgiji: 2× Platinum<ref name="bea"/> * Ufaransa: 3× Platinum<ref name="snep"/> * Ujerumani: 3× Gold<ref name="bvmi"/> * Japan: Gold<ref name="riaj"/> * Uholanzi: Platinum<ref name="nvpi"/> * Uswisi: 3× Platinum<ref name="swisscerts"/> * Uingereza: Platinum<ref name="bpi"/> * Marekani: 3× Platinum<ref name="riaa"/> * EU: 3× Platinum<ref name="europeancerts"/> |- ! scope="row"| ''One Heart'' | * Ilitolewa: Machi 24, 2003 * Lebo: Columbia, Epic | 1 || 6 || 1 || 1 || 6 || 27 || 3 || 1 || 4 || 2 | * Duniani: 5,000,000<ref>{{cite web|url=http://www.rfimusique.com/musiqueen/articles/060/article_7167.asp|archiveurl=https://web.archive.org/web/20130928151128/http://www.rfimusique.com/musiqueen/articles/060/article_7167.asp|archivedate=28 September 2013|title=Céline Dion: The Recordbreaking Diva|author=Gilles Rio|publisher=Radio France Internationale|date=17 October 2003|accessdate=19 August 2014}}</ref> * Ufaransa: 270,900<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=1450|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Uingereza: 204,075<ref name="musicweek1">{{cite web|url=http://www.musicweek.com/story.asp?sectioncode=1&storycode=1032750&c=1|title=X Factor acts dominate charts|author=Ben Cardew|work=[[Music Week]]|date=31 December 2007|accessdate=19 August 2014}}</ref> * Marekani: 1,800,000<ref name="SoundScanSales2016"/> | * Canada: 3× Platinum<ref name="cria"/> * Australia: Platinum<ref name="aria"/> * Ubelgiji: Gold<ref name="bea"/> * Ufaransa: Platinum<ref name="snep"/> * Ujerumani: Gold<ref name="bvmi"/> * Uswisi: Platinum<ref name="swisscerts"/> * Uingereza: Gold<ref name="bpi"/> * Marekani: 2× Platinum<ref name="riaa"/> * EU: Platinum<ref name="europeancerts"/> |- ! scope="row"| ''1 fille & 4 types'' | * Ilitolewa: Oktoba 13, 2003 * Lebo: Columbia, Epic | 1 || — || 1 || 1 || 26 || — || 30 || 2 || — || — | * Canada: 100,000<ref>{{cite web|author=Maxime Demers|url=http://fr.canoe.ca/divertissement/musique/nouvelles/2003/12/31/1736244-jdm.html|title=Les Québécois ont acheté des disques de gens d'ici en 2003|publisher=Canoe.ca|date=31 December 2003|accessdate=19 August 2014|language=French|archivedate=2013-02-19|archiveurl=https://archive.today/20130219183218/http://fr.canoe.ca/divertissement/musique/nouvelles/2003/12/31/1736244-jdm.html}}</ref> * Ufaransa: 750,000<ref>{{cite web|url=http://www.francebleu.fr/musique/celine-dion/celine-dion-et-goldman-20-ans-d-amitie-889726|title=Céline Dion et Jean-Jacques Goldman : 20 ans d'amitié|author=Benjamin Jacquot|publisher=[[France Bleu]]|date=30 September 2013|accessdate=10 August 2014|language=French}}</ref> * Marekani: 26,000<ref name="frss">{{cite web|author=Paul Grein |title=Chart Watch Extra: Swift Joins An Elite Club |publisher=Yahoo! |url=http://new.music.yahoo.com/blogs/chart_watch/68870/chart-watch-extra-swift-joins-an-elite-club |date=3 November 2010 |accessdate=19 August 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20101107194009/http://new.music.yahoo.com/blogs/chart_watch/68870/chart-watch-extra-swift-joins-an-elite-club |archivedate=7 November 2010 }}</ref> | * Ubelgiji: Platinum<ref name="bea"/> * Ufaransa: 2× Platinum<ref name="snep"/> * Uswisi: Platinum<ref name="swisscerts"/> |- ! scope="row"| ''Miracle'' | * Ilitolewa: Oktoba 11, 2004 * Lebo: Columbia, Epic | 1 || 15 || 1 || 4 || 34 || 168 || 4 || 6 || 5 || 4 | * Ufaransa: 111,500<ref>{{cite web|url=http://infodisc.fr/Ventes_Alb_10Ans.php?debut=950|title=Les Albums les plus Vendus depuis le 1er Janvier 2000|language=French|publisher=InfoDisc|accessdate=19 August 2014|deadurl=unfit|archiveurl=https://web.archive.org/web/20160107002342/http://infodisc.fr/Ventes_Alb_10Ans.php?debut=950|archivedate=7 January 2016}}</ref> * Uingereza: 109,963<ref name="musicweek1"/> * Marekani: 944,000<ref name=paulgrein>{{cite web|url=http://new.music.yahoo.com/blogs/chart_watch/65334/chart-watch-extra-the-ageless-tina-turner |title=Chart Watch Extra: The Ageless Tina Turner |author=Paul Grein |date=3 September 2010 |accessdate=19 August 2014 |publisher=Yahoo! |deadurl=yes |archiveurl=https://web.archive.org/web/20100909113913/http://new.music.yahoo.com/blogs/chart_watch/65334/chart-watch-extra-the-ageless-tina-turner |archivedate=9 September 2010 }}</ref> | * Ubelgiji: Gold<ref name="bea"/> * Ufaransa: Gold<ref name="snep"/> * Uswisi: Gold<ref name="swisscerts"/> * Uingereza: Gold<ref name="bpi"/> * Marekani: Platinum<ref name="riaa"/> |- ! scope="row"| ''D'elles'' | * Ilitolewa: Mei 18, 2007 * Lebo: Columbia, Epic | 1 || — || 1 || 1 || 52 || — || 50 || 3 || — || — | * Ufaransa: 300,000<ref>{{cite web|url=http://www.chartsinfrance.net/Celine-Dion/news-70887.html|title=Série de l'été : la carrière de Céline Dion|author=Jonathan Hamard|publisher=[[PureMédias]]|date=12 September 2010|accessdate=12 September 2010|language=French}}</ref> | * Canada: 2× Platinum<ref name="cria"/> * Ubelgiji: Gold<ref name="bea"/> * Ufaransa: Platinum<ref name="snep"/> * Uswisi: Gold<ref name="swisscerts"/> |- ! scope="row"| ''Taking Chances'' | * Ilitolewa: Novemba 7, 2007 * Lebo: Columbia, Epic | 1 || 12 || 3 || 2 || 5 || 6 || 4 || 1 || 5 || 3 | * Duniani: 3,100,000<ref>{{cite web|url=http://www.ifpi.org/content/library/top-50-albums-2007.pdf |title=2007 – Top 50 Global Best Selling Albums |publisher=IFPI |accessdate=19 August 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20080411183036/http://www.ifpi.org/content/library/top-50-albums-2007.pdf |archivedate=11 April 2008 }}</ref> * Ufaransa: 150,000<ref>{{cite web|author=Jonathan Hamard|url=http://www.chartsinfrance.net/Celine-Dion/news-83636.html|title=Céline Dion : écoutez le titre "Unfinished Song", extrait de la B.O. de "Song for Marion" (màj)|publisher=PureMédias|date=2 March 2013|language=French|accessdate=19 August 2014}}</ref> * Uingereza: 392,998<ref>{{cite web|author=Alan Jones|url=http://www.musicweek.com/businessanalysis/read/official-charts-analysis-lady-gaga-hits-no-1-with-65k-sales/056769|archive-url=https://archive.today/20131118163848/http://www.musicweek.com/businessanalysis/read/official-charts-analysis-lady-gaga-hits-no-1-with-65k-sales/056769|dead-url=yes|archive-date=18 November 2013|title=Official Charts Analysis: Lady Gaga hits No.1 with 65k sales|work=[[Music Week]]|date=18 November 2013|accessdate=18 November 2013|archivedate=2013-11-18|archiveurl=https://archive.today/20131118163848/http://www.musicweek.com/businessanalysis/read/official-charts-analysis-lady-gaga-hits-no-1-with-65k-sales/056769}}</ref><!-- "(...)Her last new English language album was Taking Chances, which debuted and peaked six years ago this week at number five on sales of 55,592 copies, and has subsequently sold 392,998 copies.(...)" --> * Marekani: 1,100,000<ref name="SoundScanSales2016"/> | * Canada: 4× Platinum<ref name="cria"/> * Australia: Platinum<ref name="aria"/> * Ubelgiji: Gold<ref name="bea"/> * Ufaransa: Gold<ref name="snep"/> * Japan: Gold<ref name="riaj"/> * Uholanzi: Gold<ref name="nvpi"/> * Uswisi: Platinum<ref name="swisscerts"/> * Uingereza: Platinum<ref name="bpi"/> * Marekani: Platinum<ref name="riaa"/> |} ====2010-hadi leo==== {| class="wikitable plainrowheaders" style="text-align:center;" |- ! rowspan="2" style="width:15em;"| Jina ! rowspan="2" style="width:17em;"| Maelezo ! colspan="10"| Nafasi iliyofika katika nchi tofauti ! rowspan="2" style="width:12em;"| Mauzo ! rowspan="2" style="width:12em;"| Matunukio |- style="font-size:smaller;" ! style="width:25px;"|Canada<br /><ref name="canadianpeaks"/> ! style="width:25px;"|Australia<br /><ref name="australianpeaks"/> ! style="width:25px;"|Ubelgiji<br /><ref name="belgianpeaks"/> ! style="width:25px;"|Ufaransa<br /><ref name="frenchpeaks"/> ! style="width:25px;"|Ujerumani<br /><ref name="germanpeaks"/> ! style="width:25px;"|Japan<br /><ref name="japanesepeaks"/> ! style="width:25px;"|Uholanzi<br><ref name="dutchpeaks"/> ! style="width:25px;"|Uswisi<br /><ref name="swisspeaks"/> ! style="width:25px;"|Uingereza<br /><ref name="ukpeaks"/> ! style="width:25px;"|Marekani<br /><ref name="uspeaks"/> |- ! scope="row"| ''Sans attendre'' | * Ilitolewa: Novemba 2, 2012 * Lebo: Columbia | 1 || — || 1 || 1 || 44 || — || 20 || 2 || 158 || — | * Duniani: 1,500,000<ref>''Sans attendre'' worldwide sales: * {{cite web|author=Sandra Godin|title=Deux disques platine remis par Julie Snyder|work=[[Le Journal de Montréal]]|language=French|url=http://www.journaldemontreal.com/2013/11/14/deux-disques-platine-remis-par-julie-snyder|date=14 November 2013|accessdate=20 August 2014}} * {{cite web|author=Susan Harris|title=Celine Dion Divorce Rumors In Las Vegas|publisher=NewsOXY|url=http://www.newsoxy.com/entertainment/celine-dion-wedding-ring-146904.html|date=15 November 2013|accessdate=20 August 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140820184210/http://www.newsoxy.com/entertainment/celine-dion-wedding-ring-146904.html|archivedate=20 August 2014}} * {{cite web|author=Karen Enyeart|title=René Angélil & Celine Dion Split? Star Spotted Without Ring|publisher=eCanadaNow|url=http://www.ecanadanow.com/entertainment/2013/11/14/celine-dion-wedding-ring-photo-is-canadian-singers-marriage-on-the-rocks/|archiveurl=https://web.archive.org/web/20140820214733/http://www.ecanadanow.com/entertainment/2013/11/14/celine-dion-wedding-ring-photo-is-canadian-singers-marriage-on-the-rocks/|archivedate=20 August 2014|date=14 November 2013|accessdate=20 August 2014}}</ref> * Ufaransa: 800,000<ref>{{cite web|url=http://www.journaldequebec.com/2013/11/25/celine-dion-retrouve-ses-fans-parisiens|title=Céline Dion retrouve ses fans parisiens|author=Véronique Beaudet|work=Le Journal de Montréal|date=25 November 2013|accessdate=25 November 2013|language=French}}</ref> * Canada: 300,000<ref>{{cite web|author=Élizabeth Ménard|title=Céline Une chanson à la fois|work=Le Journal de Montréal|language=French|url=http://img4.hostingpics.net/pics/421574we03.jpg|date=24 July 2013|accessdate=19 August 2014|archive-url=https://web.archive.org/web/20131014041233/http://img4.hostingpics.net/pics/421574we03.jpg|archive-date=14 October 2013|dead-url=yes|archiveurl=https://web.archive.org/web/20131014041233/http://img4.hostingpics.net/pics/421574we03.jpg|archivedate=2013-10-14}}</ref> | * Canada: 3× Platinum<ref name="cria"/> * Ubelgiji: Platinum<ref name="bea"/> * Ufaransa: Diamond<ref name="snep"/> * Uswisi: Gold<ref name="swisscerts"/> |- ! scope="row"| ''Loved Me Back to Life'' | * Ilitolewa: Novemba 1, 2013 * Lebo: Columbia | 1 || 9 || 2 || 3 || 9 || 34 || 1 || 3 || 3 || 2 | * Duniani: 1,500,000<ref>{{cite web|author=Stacia Proefrock|url=http://www.billboard.com/artist/298857/celine-dion/biography|title=Celine Dion Biographys|work=[[Billboard (magazine)|Billboard]]|date=24 January 2014|accessdate=20 August 2014|archivedate=2015-07-14|archiveurl=https://web.archive.org/web/20150714202127/http://www.billboard.com/artist/298857/celine-dion/biography}}</ref> * Ufaransa: 218,600<ref>{{cite web|url=http://infodisc.fr/Ventes_Albums_Tout_Temps.php?debut=1900|title=Les Meilleures Ventes de CD / Albums "Tout Temps"|publisher=InfoDisc|language=French|accessdate=17 April 2016}}</ref> * Uingereza: 350,000<ref name="lmbtl">{{cite web|author=Julien Goncalves|title=Clip de "Incredible" : Céline Dion et Ne-Yo sur le toit du monde|language=French|publisher=PureMédias|url=http://www.chartsinfrance.net/Celine-Dion/news-92273.html|date=4 June 2014|accessdate=20 August 2014}}</ref> * Marekani: 300,000<ref name="lmbtl"/> | * Canada: 4× Platinum<ref name="cria"/> * Ubelgiji: Gold<ref name="bea"/> * Ufaransa: 2× Platinum<ref name="snep"/> * Uingereza: Platinum<ref name="bpi"/> * Uswisi: Gold<ref name="swisscerts"/> |- ! scope="row"| ''Encore un soir'' | * Ilitolewa: Agosti 26, 2016 * Lebo: Columbia | 1 || — || 1 || 1 || 16 || — || 7 || 1 || 88 || —{{efn|group=upper-alpha|''Encore un soir'' did not enter the [[Billboard 200|''Billboard'' 200]], but peaked at number 82 on the [[Billboard 200#Albums|Top Current Albums]] and number 96 on the [[Billboard 200#Albums|Top Album Sales]] chart.<ref>{{cite web|url=http://www.billboard.com/biz/search/charts?f[0]=is_bmdb_album_id%3A7497182&f[1]=itm_field_chart_id%3A1072&refine=1|title=Top Current Albums|work=Billboard|accessdate=7 September 2016|archivedate=2017-01-12|archiveurl=https://web.archive.org/web/20170112100830/http://www.billboard.com/biz/search/charts?f%5b0%5d=is_bmdb_album_id%3A7497182&f%5b1%5d=itm_field_chart_id%3A1072&refine=1}}</ref><ref>{{cite web|url=http://www.billboard.com/artist/298857/celine-dion/chart?page=1&f=2160|title=Top Album Sales|work=Billboard|accessdate=7 September 2016|archivedate=2018-11-22|archiveurl=https://web.archive.org/web/20181122181815/https://www.billboard.com/artist/298857/celine-dion/chart?page=1&f=2160}}</ref>}} | * Duniani: 1,500,000<ref>{{cite web|title=Céline Dion : Collaborations avec Adele, MHD, tracklist... On fait le point !|url=http://www.purepeople.com/article/celine-dion-collaborations-avec-adele-mhd-tracklist-on-fait-le-point_a255763/1|publisher=[[PureMédias]]|author=Thomas Montet|date=18 October 2017|accessdate=26 October 2017}}</ref> * Ufaransa: 800,000<ref>{{cite web|title=A Nice, Céline Dion rend un hommage bouleversant aux 86 victimes de l'attentat|author=Yohann Ruelle|publisher=Pure Charts|url=http://www.chartsinfrance.net/Celine-Dion/news-104698.html|date=21 July 2017|accessdate=21 July 2017|language=French}}</ref> | * Canada: 2× Platinum<ref name="euscerts">{{cite web|title=Encore un soir Hits #1!|publisher=celinedion.com|url=http://www.celinedion.com/news?n_id=346|date=7 September 2016|accessdate=7 September 2016}}</ref> * Ubelgiji: Platinum<ref name="bea"/> * Ufaransa: Diamond<ref name="diamond1">{{cite web|url=https://twitter.com/snep/status/798182980040593408|title=#ENCOREUNSOIR @celinedion sorti le 26 août est certifié ALBUM DIAMANT avec + de 500 000 ex (physique + téléchgt + streaming)|publisher=SNEP|date=14 November 2016|accessdate=14 November 2016}}</ref> * Uswusu: Platinum<ref name="swisscerts"/> |} === Single zake === {| class="wikitable plainrowheaders" style="text-align:center;" |- ! scope="col" rowspan="2" | Mwaka ! scope="col" rowspan="2" style="width:20em;" | Jina ! scope="col" colspan="12" | Nafasi ilitotokea katika nchi tofauti ! scope="col" rowspan="2" style="width:13em;" | Matunukio ! scope="col" rowspan="2" style="width:13em;" | Albamu |- ! scope="col" style="width:3em;font-size:90%;" |Canada<br /><ref name="ad1">Peak chart positions for singles in Canada: * All except listed below: {{cite book | author=[[Nanda Lwin]]| title=[[The Record (magazine)|Top 40 Hits: The Essential Chart Guide]] | publisher=Music Data Research | year=1999 | isbn=1-896594-13-1}}, {{cite web|url={{Allmusic|class=artist|id=celine-dion-p4099/charts-awards/billboard-singles|pure_url=yes}}|title=Celine Dion > Charts & Awards > Billboard Singles|publisher=[[AllMusic]]. [[Rovi|Macrovision]]|accessdate=1 November 2010}} and {{cite web |url=https://www.billboard.com/music/celine-dion/chart-history/canadian-hot-100 |title=Celine Dion Chart History: Canadian Hot 100 |work=Billboard |accessdate=19 March 2019 }} *"Can't Live with You, Can't Live Without You" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.6425&type=2&interval=24&PHPSESSID=2omscg8i3r01mpbe51mdqpklh4|title=Top Singles – Volume 50, No. 16, August 14, 1989|publisher=RPM|date=14 August 1989|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014120532/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.6425&type=2&interval=24&PHPSESSID=2omscg8i3r01mpbe51mdqpklh4|archivedate=14 October 2012}} *"(If There Was) Any Other Way" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7917&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 52, No. 4, June 09 1990|work=[[RPM (magazine)|RPM]]|date=9 June 1990|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014120751/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7917&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"The Last to Know" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1528&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 53, No. 25, May 25, 1991|publisher=RPM|date=25 May 1991|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014121159/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1528&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Have a Heart" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1624&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Top Singles – Volume 54, No. 15, September 14, 1991|publisher=RPM|date=14 September 1991|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014121242/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1624&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"If You Asked Me To" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2151&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 55, No. 23, June 06 1992|publisher=RPM|date=6 June 1992|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155502/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2151&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Nothing Broken But My Heart" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1910&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 56, No. 16, October 17, 1992|publisher=RPM|date=17 October 1992|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155554/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1910&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Love Can Move Mountains" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1839&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 57, No. 2, January 23, 1993|publisher=RPM|date=23 January 1993|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155725/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1839&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Water from the Moon" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1780&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 57, No. 17, May 08 1993|publisher=RPM|date=8 May 1993|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155813/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1780&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Did You Give Enough Love" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2207&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 58, No. 5, August 14, 1993|publisher=RPM|date=14 August 1993|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014160010/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2207&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"When I Fall in Love" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2263&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 58, No. 13, October 9, 1993|publisher=RPM|date=9 October 1993|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155917/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2263&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"The Power of Love" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2393&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 59, No. 5, February 21 1994|work=RPM|date=21 February 1994|accessdate=10 September 2014}} *"Misled" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2484&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 59, No. 18, May 23, 1994|publisher=RPM|date=23 May 1994|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014160430/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2484&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Think Twice" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2620&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 60, No. 12, October 10, 1994|publisher=RPM|date=10 October 1994|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014160502/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2620&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Only One Road" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2701&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 60, No. 23, January 09 1995|publisher=RPM|date=9 January 1995|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202453/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2701&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"To Love You More" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7850&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 65, No. 1, March 10, 1997|publisher=RPM|date=10 March 1997|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202530/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7850&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"(You Make Me Feel Like) A Natural Woman" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2913&type=2&interval=24&PHPSESSID=2omscg8i3r01mpbe51mdqpklh4|title=Top Singles – Volume 63, No. 4, March 11, 1996|publisher=RPM|date=11 March 1996|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202612/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2913&type=2&interval=24&PHPSESSID=2omscg8i3r01mpbe51mdqpklh4|archivedate=14 October 2012}} *"It's All Coming Back to Me Now" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9815&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 64, No. 11, November 04 1996|publisher=RPM|date=4 November 1996|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202704/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9815&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"All by Myself" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3210&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 65, No. 10, May 12, 1997|publisher=RPM|date=12 May 1997|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202748/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3210&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Tell Him" {{cite web|url={{Allmusic|class=artist|id=barbra-streisand-p3153/charts-awards/billboard-singles|pure_url=yes}}|title=Barbra Streisand > Charts & Awards > Billboard Singles|publisher=AllMusic. Macrovision|accessdate=1 November 2010}} *"My Heart Will Go On" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3476&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 66, No. 23, March 02 1998|publisher=RPM|date=2 March 1998|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202901/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3476&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"Immortality" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7907&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 67, No. 23, August 31, 1998|publisher=RPM|date=31 August 1998|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203327/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7907&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"I'm Your Angel" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7466&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|title=Top Singles – Volume 68, No. 14, January 25, 1999|publisher=RPM|date=25 January 1999|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203405/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7466&type=2&interval=24&PHPSESSID=a46dl095od0cosu0h4g49kv8g5|archivedate=14 October 2012}} *"That's the Way It Is" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9695&type=1&interval=24&PHPSESSID=vainn98scb905rrd6jhvrastm6|title=Top Singles – Volume 70, No. 12, January 24 2000|publisher=RPM|date=24 January 2000|accessdate=3 June 2015|deadurl=yes|archiveurl=https://web.archive.org/web/20161117065013/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9695&type=1&interval=24&PHPSESSID=vainn98scb905rrd6jhvrastm6|archivedate=17 November 2016}} *"Sous le vent" {{cite web|url={{Allmusic|class=artist|id=garou-p411486/charts-awards/billboard-singles|pure_url=yes}}|title=Garou > Charts & Awards > Billboard Singles|publisher=AllMusic. Macrovision|accessdate=1 November 2010}} *"A New Day Has Come" {{cite web |url=http://chartts.tripod.com/CA/CA0213.HTM |title=Canada (Top 10) |publisher=[[Nielsen SoundScan]] |accessdate=5 April 2009 |archive-date=2011-07-17 |archive-url=https://web.archive.org/web/20110717102720/http://chartts.tripod.com/CA/CA0213.HTM |url-status=dead }} *"The Prayer" (Live) {{cite web|url=http://acharts.us/canada_singles_top_100/2008/09|title=Canada Singles Top 100, March 01, 2008|work=αCharts.us|accessdate=5 April 2008}} *"Somebody Loves Somebody" {{cite web|url=http://www.billboard.com/biz/search/charts|title=Hot Canadian Digital Songs|accessdate=26 March 2015<!-- exact link: http://www.billboard.com/biz/search/charts?f[0]=is_bmdb_track_id%3A5790047&f[1]=itm_field_chart_id%3A1186&refine=1 -->|archivedate=2015-10-31|archiveurl=https://web.archive.org/web/20151031001207/http://www.billboard.com/biz/search/charts}} *"Voices That Care" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1528&type=2&interval=24&PHPSESSID=2omscg8i3r01mpbe51mdqpklh4|title=Top Singles – Volume 53, No. 25, May 25, 1991|publisher=RPM|date=25 May 1991|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121023075323/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1528&type=2&interval=24&PHPSESSID=2omscg8i3r01mpbe51mdqpklh4|archivedate=23 October 2012}} *"We Are the World 25 for Haiti" {{cite web|url=http://acharts.us/canada_singles_top_100/2010/09|title=Canada Singles Top 100, March 6, 2010|work=αCharts.us|accessdate=5 April 2009}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Canada AC<br /><ref name="ad2">Peak chart positions for singles on the Canadian Adult Contemporary Chart: * All except listed below: {{cite web |url=http://www.bdsradio.com/pdweb/pdweb.dll/login?GUID={5B9A8C32-7D8D-4ADC-B5EB-F5AD075BC376} |title=BDSradio National Airplay Charts |publisher=[[Nielsen N.V.|The Nielsen Company]] |accessdate=25 March 2010 }} and {{cite web|url=http://www.billboard.com/biz|title=Canada AC, Celine Dion|accessdate=23 March 2015}} *"Can't Live with You, Can't Live Without You" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.6436&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 50, No. 18, August 28, 1989|publisher=RPM|date=28 August 1989|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014120615/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.6436&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"(If There Was) Any Other Way" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7982&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 52, No. 4, June 09 1990|publisher=RPM|date=9 June 1990|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014120833/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7982&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Unison" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1295&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 52, No. 21, October 06 1990|publisher=RPM|date=6 October 1990|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014120942/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1295&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Where Does My Heart Beat Now" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1424&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 53, No. 9, February 02 1991|publisher=RPM|date=2 February 1991|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014121129/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1424&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"The Last to Know" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1517&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 53, No. 24, May 18, 1991|publisher=RPM|date=18 May 1991|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014121219/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1517&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Have a Heart" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1607&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 54, No. 13, August 31, 1991|publisher=RPM|date=31 August 1991|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155332/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1607&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Beauty and the Beast" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2037&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 55, No. 6, February 01 1992|publisher=RPM|date=1 February 1992|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155445/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2037&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"If You Asked Me To" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2166&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 55, No. 26, June 27, 1992|publisher=RPM|date=27 June 1992|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155515/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2166&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Nothing Broken But My Heart" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1932&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 56, No. 14, October 03 1992|publisher=RPM|date=3 October 1992|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155657/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1932&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Love Can Move Mountains" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1845&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 57, No. 3, January 30, 1993|publisher=RPM|date=30 January 1993|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155739/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.1845&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Water from the Moon" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.0973&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 57, No. 22, June 12, 1993|publisher=RPM|date=8 May 1993|accessdate=12 June 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155904/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.0973&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Did You Give Enough Love" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2189&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 58, No. 3, July 31, 1993|publisher=RPM|date=31 July 1993|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014160026/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2189&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"When I Fall in Love" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2253&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 58, No. 12, October 2, 1993|publisher=RPM|date=2 October 1993|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014155951/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2253&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"The Power of Love" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2323&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 59, No. 22, December 11, 1993|publisher=RPM|date=11 December 1993|accessdate=16 May 2010}} *"Misled" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2485&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 59, No. 19, May 30, 1994|publisher=RPM|date=30 May 1994|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014160451/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2485&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Think Twice" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2593&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 60, No. 9, September 19, 1994|publisher=RPM|date=19 September 1994|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014160516/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2593&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Only One Road" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2688&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 60, No. 22, December 19, 1994|publisher=RPM|date=19 December 1994|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202506/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2688&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"To Love You More" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9788&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 64, No. 21, January 27, 1997|publisher=RPM|date=27 January 1997|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202554/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9788&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"(You Make Me Feel Like) A Natural Woman" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2865&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 62, No. 24, January 29, 1996|publisher=RPM|date=29 January 1996|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202641/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2865&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Because You Loved Me" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2927&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 63, No. 7, April 01 1996|publisher=RPM|date=1 April 1996|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121021172419/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.2927&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=21 October 2012}} *"It's All Coming Back to Me Now" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9933&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 64, No. 6, September 23, 1996|publisher=RPM|date=23 September 1996|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202719/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.9933&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"All by Myself" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3191&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 65, No. 8, April 28, 1997|publisher=RPM|date=28 April 1997|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202813/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3191&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Tell Him" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3383&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 66, No. 11, November 17, 1997|publisher=RPM|date=17 November 1997|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014202844/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3383&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"My Heart Will Go On" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3433&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 66, No. 18, January 26, 1998|publisher=RPM|date=26 January 1998|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20110815053019/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3433&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=15 August 2011}} *"Immortality" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3657&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 67, No. 21, August 17, 1998|publisher=RPM|date=17 August 1998|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203342/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.3657&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Miles to Go (Before I Sleep)" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7022&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 68, No. 7, November 09 1998|publisher=RPM|date=9 November 1998|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203352/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7022&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"I'm Your Angel" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7024&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 68, No. 8, November 16, 1998|publisher=RPM|date=16 November 1998|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203420/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7024&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"The Prayer" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.8130&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 69, No. 4, May 17, 1999|publisher=RPM|date=17 May 1999|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203432/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.8130&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"That's the Way It Is" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7285&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 70, No. 5, November 22, 1999|publisher=RPM|date=22 November 1999|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203517/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7285&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"I Want You to Need Me" {{cite web|url=http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7295&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|title=Adult Contemporary – Volume 71, No. 6, June 12, 2000|publisher=RPM|date=12 June 2000|accessdate=16 May 2010|deadurl=yes|archiveurl=https://web.archive.org/web/20121014203631/http://www.collectionscanada.gc.ca/rpm/028020-119.01-e.php?brws_s=1&file_num=nlc008388.7295&type=2&interval=24&PHPSESSID=u3achcjsn764k581548u4f8gc3|archivedate=14 October 2012}} *"Le miracle" {{cite web|url=http://www.billboard.com/biz/search/charts|title=Canada AC|accessdate=26 March 2015<!-- exact link: http://www.billboard.com/biz/search/charts?f[0]=ss_chart_search_title%3A%22Le%20Miracle%22&f[1]=itm_field_chart_id%3A1237&refine=1 -->}} *"Qui peut vivre sans amour?" {{cite web|url=http://www.billboard.com/biz/search/charts|title=Canada AC|accessdate=26 March 2015<!-- exact link: http://www.billboard.com/biz/search/charts?f[0]=ss_chart_search_title%3A%22Qui%20Peut%20Vivre%20Sans%20Amour%22&f[1]=itm_field_chart_id%3A1237&refine=1 -->}} *"Loved Me Back to Life" {{cite web|url=http://www.billboard.com/artist/298857/Celine+Dion/chart?f=1237|title=''Billboard'' Chart History|accessdate=26 March 2015}} *"Incredible" {{cite web|url=http://www.billboard.com/biz/search/charts|title=Canada AC|accessdate=26 March 2015<!-- exact link: http://www.billboard.com/biz/search/charts?f[0]=ss_chart_search_title%3A%22Incredible%22&f[1]=itm_field_chart_id%3A1237&refine=1 -->}} *"L'hymne" {{cite web|url=http://www.billboard.com/biz/search/charts|title=Canada AC|accessdate=8 February 2016<!-- exact link: http://www.billboard.com/biz/search/charts?f[0]=ss_chart_search_title%3A%22L%27Hymne%22&f[1]=itm_field_chart_id%3A1237&refine=1 -->}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Australia<br /><ref name="ad3">Peak ([[ARIA Charts|ARIA Chart]]) positions for singles in Australia: *Top 50 peaks: {{cite web |url=http://australian-charts.com/showinterpret.asp?interpret=C%E9line+Dion |title=Céline Dion in Australian charts |publisher=australian-charts.com Hung Medien |accessdate=13 October 2015 }} *Top 100 peaks until December 2010: {{cite book|last=Ryan|first=Gavin|title=Australia's Music Charts 1988–2010|year=2011|publisher=Moonlight Publishing|location=Mt. Martha, VIC, Australia}} *"Where Does My Heart Beat Now" and "Taking Chances": {{cite journal |date=12 November 2007 |title=Issue 923 |journal=ARIA Report |issue=923 |page=3 |publisher=[[Australian Recording Industry Association|ARIA]] |url=http://pandora.nla.gov.au/pan/23790/20071120-0000/issue923.pdf |format=PDF, reprint |accessdate=3 July 2009 }} *"The Last to Know" and "Water from the Moon": {{cite web |url=http://i.imgur.com/1iEUqcX.jpg |title=Response from ARIA re: chart inquiry, received 14 November 2016 |publisher=Imgur.com |accessdate=17 March 2017 }} *"Nothing Broken but My Heart": {{cite web|url=https://i.imgur.com/MTv4MC1.gif|title=Response from ARIA re: chart inquiry, received 19 September 2017|publisher=Imgur.com|accessdate=19 September 2017}} *"Misled": {{cite web |url=http://i.imgur.com/0v4cNYv.jpg |title=The ARIA Australian Top 100 Singles Chart – Week Ending 24 Jul 1994 |publisher=Imgur.com (original document published by [[Australian Recording Industry Association|ARIA]]) |accessdate=9 March 2016 }} N.B. The HP column displays the highest peak reached. *"Next Plane Out": {{cite web |url=http://i.imgur.com/4M3kUBs.jpg |title=The ARIA Australian Top 100 Singles Chart – Week Ending 17 Dec 1995 |publisher=Imgur.com (original document published by ARIA) |accessdate=9 March 2016 }} *"One Heart": {{cite journal |date=28 July 2003 |title=Issue 701 |journal=ARIA Report |issue=701 |page=4 |publisher=ARIA |url=http://pandora.nla.gov.au/pan/23790/20030807-0000/Issue701.pdf |format=PDF, reprint |accessdate=3 July 2009 }} *"We Are the World 25 for Haiti": {{cite web |url=http://australian-charts.com/showitem.asp?interpret=Artists+For+Haiti&titel=We+Are+The+World+25&cat=s |title=Artists for Haiti in Australian charts |publisher=australian-charts.com Hung Medien |accessdate=9 September 2010 |deadurl=yes |archiveurl=https://web.archive.org/web/20120309034127/http://australian-charts.com/showitem.asp?interpret=Artists%20For%20Haiti&titel=We%20Are%20The%20World%2025&cat=s |archivedate=9 March 2012 }} *"Ashes": {{cite web|url=https://www.auspop.com.au/2018/5/aria-chart-watch-474/|title=ARIA Chart Watch #474|publisher=auspOp|date=26 May 2018|accessdate=26 May 2018|archivedate=2021-11-01|archiveurl=https://web.archive.org/web/20211101012722/https://www.auspop.com.au/2018/5/aria-chart-watch-474/}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Ubelgiji<br /><ref name="ad4">Peak chart positions for singles in Belgium: *All except listed below: {{cite web|url=http://www.ultratop.be/nl/song/ba9/Celine-Dion-Think-Twice |title=Ultratop 50 Singles (Flemish Chart) |work=Ultratop|accessdate=25 March 2010}} and {{cite web|url=http://www.ultratop.be/fr/showitem.asp?interpret=C%E9line+Dion&titel=Think+Twice&cat=s |title=Ultratop 50 Singles (Walloon Chart) |work=Ultratop|accessdate=25 March 2010}} *"The Reason", "Treat Her Like a Lady", "Live (For the One I Love)" and "I Want You to Need Me": {{cite book | author=Sam Jaspers| title=Ultratop 1995–2005 | publisher=Book & Media Publishing| year=2006 | isbn=90-5720-232-8}} *"We Are the World 25 for Haiti": {{cite web|url=http://www.ultratop.be/fr/showitem.asp?interpret=Artists+For+Haiti&titel=We+Are+The+World+25&cat=s |title=Artists for Haiti dans l'Ultratop Wallonie|publisher=Ultratop|language=French|accessdate=9 September 2010}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Ufaransa<br /><ref name="ad5">Peak chart positions for singles in France: *All except "D'amour ou d'amitié" and "J'irai où tu iras": {{cite web|url=http://lescharts.com/showitem.asp?interpret=C%E9line+Dion&titel=Ne+partez+pas+sans+moi&cat=s|title=Céline Dion dans les charts français|language=French|publisher=lescharts.com Hung Medien|accessdate=31 May 2008}} *"D'amour ou d'amitié": {{cite web|url=http://www.infodisc.fr/SongPts_80.php?debut=150|archiveurl=https://web.archive.org/web/20081118061623/http://www.infodisc.fr/SongPts_80.php?debut=150|archivedate=18 November 2008|title=Les chansons classées par points des années 80|publisher=InfoDisc|language=French|accessdate=9 November 2008}} *"J'irai où tu iras": {{cite web|url=http://www.chartsinfrance.net/charts/1901/singles.php,p4|title=Classement officiel des ventes de singles & titres en France du 28 décembre 2018 au 03 janvier 2019|publisher=[[PureMédias]]|language=French|accessdate=27 January 2019}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Ujerumani<br /><ref name="ad6">Peak chart positions for singles in Germany: *All except "Tell Him" and "I'm Your Angel": {{cite web|url=http://www.musicline.de/de/chartverfolgung_summary/artist/Dion%2CCeline/?type=single|title=Chartverfolgung / Dion, Celine / Single|language=German|publisher=musicline.de PhonoNet|accessdate=27 January 2008|archivedate=2012-04-12|archiveurl=https://web.archive.org/web/20120412043143/http://www.musicline.de/de/chartverfolgung_summary/artist/Dion,Celine/?type=single}} *"Tell Him": {{cite web|url=https://www.offiziellecharts.de/titel-details-3560|title=Barbra Streisand & Céline Dion, Tell Him|language=German|publisher=[[GfK Entertainment Charts]]|accessdate=19 October 2014}} *"I'm Your Angel": {{cite web|url=https://www.offiziellecharts.de/titel-details-3794|title=Céline Dion & R. Kelly, I'm Your Angel|language=German|publisher=GfK Entertainment Charts|accessdate=19 October 2014}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Japan<br /><ref name="jp1">Peak chart positions for singles in Japan: *All except listed below: {{cite web|url=http://www.oricon.co.jp/prof/98172/rank/single/|title=セリーヌ・ディオンのランキング|language=Japanese|publisher=[[Oricon]]|accessdate=24 March 2015}} *"Beauty and the Beast": {{cite web|url=http://www.oricon.co.jp/prof/475465/|title=セリーヌ・ディオン&ピーボ・ブライソンの作品|language=Japanese|publisher=Oricon|accessdate=24 March 2015}} *"To Love You More": {{cite web|url=http://www.oricon.co.jp/prof/98175/rank/single/|title=セリーヌ・ディオンwithクライズラー&カンパニーのランキング|language=Japanese|publisher=Oricon|accessdate=24 March 2015}} *"A World to Believe In": {{cite web|url=http://www.oricon.co.jp/prof/440511/rank/single/|title=伊藤由奈×セリーヌ・ディオンのランキング|language=Japanese|publisher=Oricon|accessdate=24 March 2015}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Uholanzi<br /><ref name="ad11">Peak chart positions for singles in the Netherlands: *All except listed below: {{cite web |url=http://www.top40.nl/top40-artiesten/celine-dion |title=Top 40-artiest: Celine Dion |language=Dutch |publisher=Stichting Nederlandse Top 40 |accessdate=19 October 2014 }} *"Ne partez pas sans moi", "When I Fall in Love", "Only One Road", "Je sais pas", "Falling into You", "All by Myself", "Je sais pas" (Live), "Call the Man", "Zora sourit", "Treat Her Like a Lady", "Live (for the One I Love)", "I Want You to Need Me", "Sous le vent", "I'm Alive", "I Drove All Night", "One Heart", "Tout l'or des hommes", "Taking Chances" and "Happy Xmas (War Is Over)": {{cite web |url=http://dutchcharts.nl/showitem.asp?interpret=C%E9line+Dion&titel=Ne+partez+pas+sans+moi&cat=s |title=Céline Dion – Ne partez pas sans moi (nummer) |language=Dutch |publisher=Hung Medien |accessdate=19 October 2014 }}</ref> ! scope="col" style="width:3em;font-size:90%;" |Uswisi<br /><ref name="ad7">{{cite web|url=http://swisscharts.com/showitem.asp?interpret=C%E9line+Dion&titel=Ne+partez+pas+sans+moi&cat=s|title=Singles – Schweizer Hitparade|publisher=swisscharts.com Hung Medien|accessdate=9 November 2008}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Uingereza<br /><ref name="ad8">Peak chart positions for singles in the United Kingdom: *All except listed below: {{cite web|url=http://www.officialcharts.com/artist/20048/CELINE-DION/ |title=Celine Dion – Singles|publisher=[[The Official Charts Company]]|accessdate=25 May 2009}} *"Eyes on Me" and "My Love": {{cite web| url=http://zobbel.de/cluk/CLUK_D.HTM| title=Chart Log UK 1994–2010: D| publisher=zobbel.de| accessdate=8 November 2008}} *"Sing": {{cite web| url=http://zobbel.de/cluk/CLUK_L.HTM| title=Chart Log UK 1994–2010: L| publisher=zobbel.de| accessdate=8 November 2008}} *"We Are the World 25 for Haiti": {{cite web|url=http://www.officialcharts.com/search/singles/WE%20ARE%20THE%20WORLD%2025%20FOR%20HAITI/|title=The Official Charts Company – We Are The World 25 For Haiti by Artists For Haiti |date=19 October 2014|publisher=The Official Charts Company}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Marekani<br /><ref name="ad9">Peak chart positions for singles in the United States: *All except listed below: {{cite web|url={{Allmusic|class=artist|id=celine-dion-p4099/charts-awards/billboard-singles|pure_url=yes}}|title=Celine Dion > Charts & Awards > Billboard Singles|publisher=AllMusic. Macrovision|accessdate=1 November 2010}} *"I'm Your Angel": {{cite web|url={{Allmusic|class=artist|id=r-kelly-p45175/charts-awards/billboard-singles|pure_url=yes}}|title=R. Kelly > Charts & Awards > Billboard Singles|publisher=AllMusic. Macrovision|accessdate=1 November 2010}} *"I'm Alive", "Have You Ever Been in Love", "Alone" and "Ashes": {{cite web|url=http://www.billboard.com/music/celine-dion/chart-history/bubbling-under-hot-100|title=Celine Dion Chart History: Bubbling Under Hot 100 Singles|work=Billboardaccessdate=15 May 2018}} *"Voices That Care": {{cite web|url=http://www.billboard.com/articles/columns/ask-billboard/268963/ask-billboard-n-sync-and-gulf-war-songs |title=Ask Billboard: 'N Sync and Gulf War Songs |date=10 April 2009|accessdate=10 April 2009|work=Billboard}} *"We Are the World 25 for Haiti": {{cite web|url=http://www.billboard.com/articles/news/959358/we-are-the-world-returns-to-the-upper-reaches-of-the-hot-100 |title='We Are The World' Returns to the Upper Reaches of the Hot 100|date=17 February 2010|accessdate=17 February 2010|work=Billboard}}</ref> ! scope="col" style="width:3em;font-size:90%;" |Marekani AC<br /><ref name="ad10">Peak chart positions for singles on the US Adult Contemporary Chart: *All except listed below: {{cite web|url={{Allmusic|class=artist|id=celine-dion-p4099/charts-awards/billboard-singles|pure_url=yes}}|title=Celine Dion > Charts & Awards > Billboard Singles|publisher=AllMusic. Macrovision|accessdate=1 November 2010}} *"(You Make Me Feel Like) A Natural Woman": {{cite web|url=http://www.americanradiohistory.com/Archive-Billboard/90s/1996/BB-1996-01-20.pdf|title=Hits of the World|work=Billboard|page=80|date=20 January 1996|accessdate=5 November 2015}} *"I'm Your Angel": {{cite web|url={{Allmusic|class=artist|id=r-kelly-p45175/charts-awards|pure_url=yes}}|title=R. Kelly > Charts & Awards > Billboard Singles|publisher=AllMusic. Macrovision|accessdate=1 November 2010}} *"I Believe in You": {{cite web|url=http://www.allmusic.com/artist/il-divo-mn0000071636/awards|title=Il Divo|accessdate=17 February 2010|publisher=AllMusic. Macrovision}} *"Voices That Care": {{cite web|url=http://www.allmusic.com/artist/david-foster-mn0000861757/awards|title=David Foster|accessdate=17 February 2010|publisher=AllMusic. Macrovision}} *"Sing": {{cite web|url=http://www.allmusic.com/artist/annie-lennox-mn0000585249/awards|title=Annie Lennox|accessdate=17 February 2010|publisher=AllMusic. Macrovision}} *"We Are the World 25 for Haiti": {{cite web|url={{Allmusic|class=album|id=hurricane-relief-come-together-now-r811104/charts-awards|pure_url=yes}} |title=Various Artists > Charts & Awards > Billboard Singles|publisher=AllMusic. Macrovision|accessdate=1 November 2010}}</ref> |- | rowspan=2 | 1981 ! scope="row" | "Ce n'était qu'un rêve" | | — | — | — | — | — | — | — | — | — | — | — | | rowspan=3 | ''La voix du bon Dieu'' |- ! scope="row" | "La voix du bon Dieu" | | — | — | — | — | — | — | — | — | — | — | — | |- | rowspan=3 | 1982 ! scope="row" | "L'amour viendra" | — | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Tellement j'ai d'amour pour toi" | | — | — | — | — | — | — | — | — | — | — | — | | rowspan=2 | ''Tellement j'ai d'amour...'' |- ! scope="row" | "D'amour ou d'amitié" | | — | — | — | 5 | — | — | — | — | — | — | — | * Canada: Gold<ref name="cria">{{cite web|url=https://musiccanada.com/gold-platinum/?fwp_gp_search=celine%20dion&fwp_gp_format=36|title=Gold/Platinum – Music Canada|publisher=[[Music Canada]]|accessdate=30 March 2015}}</ref> * Ufaransa: Gold<ref name="fr01">{{cite web |url=http://www.infodisc.fr/Single_Certif.php |title=Les Certifications depuis 1973 |publisher=InfoDisc |accessdate=24 March 2015 |language=French |deadurl=yes |archiveurl=https://web.archive.org/web/20071130030454/http://www.infodisc.fr/Single_Certif.php |archivedate=30 November 2007 |https://www.webcitation.org/697lSTfwO?url=http://www.infodisc.fr/Single_Certif.php |=https://www.webcitation.org/697lSTfwO?url=http://www.infodisc.fr/Single_Certif.php }}</ref> |- | rowspan=2 | 1983 ! scope="row" | "Mon ami m'a quittée" | | — | — | — | — | — | — | — | — | — | — | — | | ''Les chemins de ma maison'' |- ! scope="row" | "Un enfant" | — | — | — | — | — | — | — | — | — | — | — | — | | ''Chants et contes de Noël'' |- | rowspan=4 | 1984 ! scope="row" | "Ne me plaignez pas" | | — | — | — | — | — | — | — | — | — | — | — | | ''Les chemins de ma maison'' |- ! scope="row" | "Une colombe" | | — | — | — | — | — | — | — | — | — | — | — | * CAN: Gold<ref name="cria"/> | rowspan=3 | ''Mélanie'' |- ! scope="row" | "Mon rêve de toujours" | | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Un amour pour moi" | | — | — | — | — | — | — | — | — | — | — | — | |- | rowspan=4 | 1985 ! scope="row" | "C'est pour toi" | | — | — | — | — | — | — | — | — | — | — | — | | rowspan=2 | ''C'est pour toi'' |- ! scope="row" | "C'est pour vivre" | — | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Dans la main d'un magicien" / <br/>"Listen to the Magic Man" | — | — | — | — | — | — | — | — | — | — | — | — | | rowspan=2 | ''Opération beurre de pinottes'' / <br/>''The Peanut Butter Solution'' |- ! scope="row" | "La ballade de Michel" / <br/>"La ballade de Michel" | — | — | — | — | — | — | — | — | — | — | — | — | |- | rowspan=3 | 1986 ! scope="row" | "The Best of Celine Dion" | — | — | — | — | — | — | — | — | — | — | — | — | | rowspan="2" {{n/a|Non-album single}} |- ! scope="row" | "L'univers a besoin d'amour" | — | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Fais ce que tu voudras" | | — | — | — | — | — | — | — | — | — | — | — | | ''Les chansons en or'' |- | rowspan=4 | 1987 ! scope="row" | "Je ne veux pas" | — | — | — | — | — | — | — | — | — | — | — | — | | {{N/A|Non-album single}} |- ! scope="row" | "On traverse un miroir" | | — | — | — | — | — | — | — | — | — | — | — | | rowspan=4 | ''Incognito'' |- ! scope="row" | "Incognito" | | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Lolita (trop jeune pour aimer)" | | — | — | — | — | — | — | — | — | — | — | — | |- | rowspan=6 | 1988 ! scope="row" | "Comme un cœur froid" | | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "La religieuse" | — | — | — | — | — | — | — | — | — | — | — | — | | {{N/A|Non-album single}} |- ! scope="row" | "Ne partez pas sans moi" | | — | — | 12 | 36 | — | — | 42 | 11 | — | — | — | | ''The Best of Celine Dion'' |- ! scope="row" | "Délivre-moi" | | — | — | — | — | — | — | — | — | — | — | — | | rowspan=3 | ''Incognito'' |- ! scope="row" | "D'abord, c'est quoi l'amour" | | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Jours de fièvre" | — | — | — | — | — | — | — | — | — | — | — | — | |- | 1989 ! scope="row" | "Can't Live with You, Can't Live Without You"<br />{{small|(pamoja na [[Billy Newton-Davis]])}} | 41 | 12 | — | — | — | — | — | — | — | — | — | — | | ''Spellbound'' |- | rowspan=3 | 1990 ! scope="row" | "(If There Was) Any Other Way" | 23 | 12 | — | — | — | — | — | — | — | — | 35 | 8 | | rowspan=5 | ''Unison'' |- ! scope="row" | "Unison" | 38 | 7 | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Where Does My Heart Beat Now" | 6 | 1 | 62 | 23 | 20 | — | — | 24 | — | 72 | 4 | 2 | |- | rowspan=5 | 1991 ! scope="row" | "The Last to Know" | 16 | 7 | 134 | — | — | — | — | — | — | — | — | 22 | |- ! scope="row" | "Just Have a Heart" | 26 | 4 | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Des mots qui sonnent" | | — | — | — | — | — | — | — | — | — | — | — | | rowspan=2 | ''Dion chante Plamondon'' |- ! scope="row" | "L'amour existe encore" | | — | — | — | 31 | — | — | — | — | — | — | — | |- ! scope="row" | "Beauty and the Beast"<br />{{small|(pamoja na [[Peabo Bryson]])}} | 2 | 1 | 17 | 36 | — | — | 67 | 18 | — | 9 | 9 | 3 | * Japan: Platinum<ref>{{cite web|url=http://www.riaj.or.jp/issue/record/1997/199701.pdf|title=ビューティ・アンド・ザ・ビースト～美女と野獣 92.4.8 (SME)|publisher=[[Recording Industry Association of Japan|RIAJ]]|language=Japanese|accessdate=24 March 2015|archive-date=2013-11-02|archive-url=https://web.archive.org/web/20131102224637/http://www.riaj.or.jp/issue/record/1997/199701.pdf|url-status=dead}}</ref> * Marekani: Gold<ref name="riaa">{{cite web|url=https://www.riaa.com/gold-platinum/?tab_active=default-award&se=celine+dion|title=Gold & platinum searchable database |publisher=[[Recording Industry Association of America|RIAA]]|accessdate=11 June 2009}}</ref> | ''Celine Dion'' |- | rowspan=5 | 1992 ! scope="row" | "Je danse dans ma tête" | | — | — | — | — | — | — | — | — | — | — | — | | ''Dion chante Plamondon'' |- ! scope="row" | "If You Asked Me To" | 1 | 1 | 52 | — | — | — | — | 27 | — | 57 | 4 | 1 | | rowspan=2 | ''Celine Dion'' |- ! scope="row" | "Nothing Broken but My Heart" | 3 | 1 | 192 | — | — | — | — | — | — | — | 29 | 1 | |- ! scope="row" | "Quelqu'un que j'aime, quelqu'un qui m'aime" | | — | — | — | — | — | — | — | — | — | — | — | | ''Dion chante Plamondon'' |- ! scope="row" | "Love Can Move Mountains" | 2 | 1 | 54 | — | — | 61 | — | — | — | 46 | 36 | 8 | | rowspan=2 | ''Celine Dion'' |- | rowspan=5 | 1993 ! scope="row" | "Water from the Moon" | 7 | 3 | — | — | — | — | — | — | — | — | — | 11 | |- ! scope="row" | "Un garçon pas comme les autres (Ziggy)" | — | — | — | — | 2 | — | — | — | — | — | — | — | * Ufaransa: Gold<ref name="fr01"/> | ''Dion chante Plamondon'' |- ! scope="row" | "Did You Give Enough Love" | 17 | 23 | — | — | — | — | — | — | — | — | — | — | | ''Celine Dion'' |- ! scope="row" | "When I Fall in Love"<br />{{small|(pamoja na [[Clive Griffin]])}} | 21 | 2 | 93 | — | — | — | — | 37 | — | — | 23 | 6 | | rowspan=5 | ''The Colour of My Love'' |- ! scope="row" | "The Power of Love" | 1 | 1 | 1 | 5 | 3 | 57 | — | 18 | — | 4 | 1 | 1 | * Australia: Platinum<ref name="aria1">{{cite book|last=Ryan|first=Gavin|title=Australia's Music Charts 1988–2010|year=2011|publisher=Moonlight Publishing|location=Mt. Martha, VIC, Australia}}</ref> * Ufaransa: Silver<ref>{{cite web|url=http://www.disqueenfrance.com/fr/page-259165.xml?year=1994&type=6 |title=Certifications Singles Argent – année 1994 |language=French |publisher=[[Syndicat National de l'Édition Phonographique|SNEP]] |accessdate=24 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120303033010/http://www.disqueenfrance.com/fr/page-259165.xml?year=1994&type=6 |archivedate=3 March 2012 }}</ref> * Uingereza: Silver<ref name="bpi">{{cite web |url=http://www.bpi.co.uk/certified-awards.aspx |title=Certified Awards |publisher=[[British Phonographic Industry]] |accessdate=14 July 2017 |format=To access, enter the search parameter "Celine Dion" and select "Search by Keyword" |archivedate=2013-02-06 |archiveurl=https://www.webcitation.org/6EEYfYVwc?url=http://www.bpi.co.uk/certified-awards.aspx }}</ref> * Marekani: Platinum<ref name="riaa"/> |- | rowspan=4 | 1994 ! scope="row" | "Misled" | 4 | 2 | 55 | — | — | 83 | — | — | — | 15 | 23 | 15 | |- ! scope="row" | "Think Twice" | 13 | 3 | 2 | 1 | — | 19 | — | 1 | 6 | 1 | 95 | 21 | * Australia: Platinum<ref name="aria1"/> * Ubelgiji: Gold<ref name="belg95">{{cite web|url=https://www.ultratop.be/nl/goud-platina/1995/singles|title=Goud en Platina - Singles 1995|publisher=Ultratop|language=Dutch|accessdate=18 September 2018}}</ref> * Uingereza: Platinum<ref name="bpi"/> |- ! scope="row" | "Only One Road" | 15 | 1 | 23 | 17 | — | — | — | 40 | — | 8 | 93 | 27 | |- ! scope="row" | "Calling You" | — | — | — | — | 75 | — | — | — | — | — | — | — | | ''À l'Olympia'' |- | rowspan=5 | 1995 ! scope="row" | "Pour que tu m'aimes encore" | } | — | — | 1 | 1 | 39 | — | 3 | 17 | 7 | — | — | * Ubelgiji: Platinum<ref name="belg95"/> * Ufaransa: Platinum<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=1995&type=9 |title=Certifications Singles Platine – année 1995 |language=French |publisher=[[Syndicat National de l'Édition Phonographique|SNEP]] |accessdate=30 September 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20121011122437/http://www.snepmusique.com/fr/page-259165.xml?year=1995&type=9 |archivedate=11 October 2012 }}</ref> | rowspan=2 | ''[[D'eux]]'' |- ! scope="row" | "Je sais pas" | —{{efn|group=upper-alpha|"Je sais pas" peaked at number 1 in Quebec.<ref>{{cite web|url=http://www.qim.com/oeuvres/oeuvre.asp?oeuvreid=1326&albumid=107|title=Québec Info Musique: Céline Dion, Je sais pas|publisher=Québec Info Musique|accessdate=3 April 2015|language=French}}</ref>}} | — | — | 1 | 1 | — | — | 34 | — | — | — | — | * Ubelgiji: Gold<ref name="belg95"/> * Ufaransa: Silver<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=1995&type=6 |title=Certifications Singles Argent – année 1995 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120913021236/http://www.snepmusique.com/fr/page-259165.xml?year=1995&type=6 |archivedate=13 September 2012 }}</ref> |- ! scope="row" | "Next Plane Out" | — | — | 61 | — | — | — | — | — | — | — | — | — | | rowspan=2 | ''The Colour of My Love'' |- ! scope="row" | "To Love You More" | 9 | 1 | — | — | — | — | 1 | — | — | — | — | 1 | * Japan: Million<ref>{{cite web|url=http://www.riaj.or.jp/data/others/million_list/1995.html|script-title=ja:年度別ミリオンセラー一覧　1995年|trans-title=1995 million-seller list|language=Japanese|publisher=[[Recording Industry Association of Japan]]|accessdate=14 April 2012|archive-date=2013-11-03|archive-url=https://web.archive.org/web/20131103052144/http://www.riaj.or.jp/data/others/million_list/1995.html|url-status=dead}}</ref> |- ! scope="row" | "(You Make Me Feel Like) A Natural Woman" | 47 | 4 | — | — | — | — | — | — | — | — | — | 31 | | ''Falling into You'' |- | rowspan=9 | 1996 ! scope="row" | "Destin" | | — | — | — | — | — | — | — | — | — | — | — | | rowspan=2 | ''D'eux'' |- ! scope="row" | "Le ballet" | — | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Falling into You" | — | — | 12 | 11 | 11 | 71 | — | 18 | 19 | 10 | — | — | | rowspan=2 | ''Falling into You'' |- ! scope="row" | "Because You Loved Me" | 1 | 1 | 1 | 5 | 19 | 13 | — | 4 | 3 | 5 | 1 | 1 | * Australia: 2&times; Platinum<ref name="aria1"/> * Ujerumani: Gold<ref name="mediacontrol">{{cite certification|region=Germany|artist=Celine Dion|type=single|accessdate=31 December 2003}}</ref> * Uingereza: Platinum<ref name="bpi"/> * Marekani: Platinum<ref name="riaa"/> |- ! scope="row" | "J'irai où tu iras"<br />{{small|(pamoja na [[Jean-Jacques Goldman]])}} | | — | — | — | — | 181 | — | — | — | — | — | — | | ''D'eux'' |- ! scope="row" | "It's All Coming Back to Me Now" | 1 | 1 | 8 | 1 | 13 | 62 | — | 4 | — | 3 | 2 | 1 | * Australia: Gold<ref name="aria1"/> * Ubelgiji: Gold<ref>{{cite web|url=https://www.ultratop.be/nl/goud-platina/1996/singles|title=Goud en Platina - Singles 1996|publisher=Ultratop|language=Dutch|accessdate=18 September 2018}}</ref> * Uingereza: Gold<ref name="bpi"/> * Marekani: Platinum<ref name="riaa"/> | rowspan=3 | ''Falling into You'' |- ! scope="row" | "The Power of the Dream" | — | — | — | — | — | — | 30 | — | — | — | — | — | * Japan: Gold<ref>{{cite web|url=http://www.riaj.or.jp/issue/record/1997/199703.pdf |title=The Power of the Dream 96.8.21 (SME) |publisher=RIAJ |language=Japanese |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20140306111501/http://www.riaj.or.jp/issue/record/1997/199703.pdf |archivedate=6 March 2014 }}</ref> |- ! scope="row" | "All by Myself" | 7 | 1 | 38 | 7 | 5 | 55 | — | 20 | 36 | 6 | 4 | 1 | * Ufaransa: Silver<ref>{{cite web|url=http://www.disqueenfrance.com/fr/page-259165.xml?year=1996&type=6 |title=Certifications Singles Argent – année 1996 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120309184049/http://www.disqueenfrance.com/fr/page-259165.xml?year=1996&type=6 |archivedate=9 March 2012 }}</ref> * Uingereza: Silver<ref name="bpi"/> * Marekani: Gold<ref name="riaa"/> |- ! scope="row" | "Les derniers seront les premiers"<br />{{small|(pamoja na Jean-Jacques Goldman)}} | | — | — | — | — | — | — | — | — | — | — | — | | ''Live à Paris'' |- | rowspan=6 | 1997 ! scope="row" | "Call the Man" | — | — | — | 26 | — | — | — | 69 | — | 11 | — | — | | ''Falling into You'' |- ! scope="row" | "J'attendais" | — | — | — | 22 | 46 | — | — | — | — | — | — | — | | ''Live à Paris'' |- ! scope="row" | "Tell Him" <br />{{small|(pamoja na [[Barbra Streisand]])}} | 12 | 1 | 9 | 3 | 4 | 25 | — | 1 | 4 | 3 | — | 5 | * Australia: Gold<ref>{{cite web|url=http://aria.com.au/pages/aria-charts-accreditations-singles-1997.htm |title=ARIA charts – accreditations – 1997 Singles |publisher=ARIA |accessdate=30 November 2007 |deadurl=yes |archiveurl=https://web.archive.org/web/20090912150607/http://aria.com.au/pages/aria-charts-accreditations-singles-1997.htm |archivedate=12 September 2009 }}</ref> * Ubelgiji: Platinum<ref>{{cite web|url=http://www.ultratop.be/xls/Awards%201997.htm |title=Certifications awards 1997 |publisher=Ultratop|accessdate=27 March 2010}}</ref> * Ufaransa: Gold<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=1997&type=7 |title=Certifications Singles Or – année 1997 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120923124752/http://www.snepmusique.com/fr/page-259165.xml?year=1997&type=7 |archivedate=23 September 2012 }}</ref> * Uswisi: Gold<ref>{{cite web|url=http://swisscharts.com/awards.asp?year=1997 |title=Awards 1997 |publisher=[[Swiss Music Charts]] |accessdate=31 December 2007 |deadurl=yes |archiveurl=https://web.archive.org/web/20110613144052/http://swisscharts.com/awards.asp?year=1997 |archivedate=13 June 2011 }}</ref> * Uingereza: Gold<ref name="bpi"/> | rowspan=6 | ''Let's Talk About Love'' |- ! scope="row" | "Be the Man" | — | — | — | — | — | — | 24 | — | — | — | — | — | * Japan: Platinum<ref>{{cite web|url=http://www.riaj.or.jp/issue/record/1998/199801.pdf |title=Be the Man 97.11.13 (SME) |publisher=RIAJ |language=Japanese |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20140329071234/http://www.riaj.or.jp/issue/record/1998/199801.pdf |archivedate=29 March 2014 |df= }}</ref> |- ! scope="row" | "The Reason" | — | — | — | 59 | rowspan="2"| 1 | — | — | — | — | 11 | — | — | |- ! scope="row" | "My Heart Will Go On" | 1 | 1 | 1 | 1 | 1 | 34 | 1 | 1 | 1 | 1 | 1 | * Australia: 2&times; Platinum<ref name="aria98">{{cite web|url=http://aria.com.au/pages/aria-charts-accreditations-singles-1998.htm |title=ARIA charts – accreditations – 1998 singles |publisher=ARIA |accessdate=30 April 2008 |deadurl=yes |archiveurl=https://web.archive.org/web/20090912150715/http://aria.com.au/pages/aria-charts-accreditations-singles-1998.htm |archivedate=12 September 2009 }}</ref> * Ubelgiji: 2&times; Platinum<ref name="belgia">{{cite web|url=http://www.ultratop.be/xls/Awards%201998.htm |title=Certifications awards 1998 |publisher=Ultratop|accessdate=27 March 2010}}</ref> * Ufaransa: Diamond<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=1998&type=10 |title=Certifications Singles Diamant – année 1998 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120923124720/http://www.snepmusique.com/fr/page-259165.xml?year=1998&type=10 |archivedate=23 September 2012 }}</ref> * Ujerumani: 4&times; Platinum<ref name="mediacontrol"/> * Japan: 2&times; Platinum<ref>{{cite web|url=http://www.riaj.or.jp/issue/record/1999/199904.pdf |title=マイ・ハート・ウィル・ゴー・オン 1998.01.13 (SME) |publisher=RIAJ |language=Japanese |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20140123043927/http://www.riaj.or.jp/issue/record/1999/199904.pdf |archivedate=23 January 2014 }}</ref> * Uswisi: 2&times; Platinum<ref>{{cite web|url=http://swisscharts.com/awards.asp?year=1998 |title=Awards 1998 |publisher=Swiss Music Charts |accessdate=31 December 2008 |deadurl=yes |archiveurl=https://web.archive.org/web/20110716232621/http://www.swisscharts.com/awards.asp?year=1998 |archivedate=16 July 2011 }}</ref> * Uingereza: 2&times; Platinum<ref name="bpi"/> * Marekani: Gold<ref name="riaa"/> |- | rowspan=5 | 1998 ! scope="row" | "Immortality"<br />{{small|(pamoja na [[Bee Gees]])}} | 28 | 1 | 38 | 15 | 15 | 2 | — | 28 | 8 | 5 | — | — | * Ufaransa: Silver<ref name="snep98"> {{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=1998&type=6 |title=Certifications Singles Argent – année 1998 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120913021236/http://www.snepmusique.com/fr/page-259165.xml?year=1998&type=6 |archivedate=13 September 2012 }}</ref> * Ujerumani: Platinum<ref name="mediacontrol"/> * Uingereza: Silver<ref name="bpi"/> |- ! scope="row" | "Miles to Go (Before I Sleep)" | — | 17 | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Zora sourit" | | — | — | 12 | 20 | — | — | 67 | 25 | — | — | — | * Ubelgiji: Gold<ref name="belgia"/> * Ufaransa: Silver<ref name="snep98"/> | ''S'il suffisait d'aimer'' |- ! scope="row" | "I'm Your Angel"<br />{{small|(pamoja na [[R. Kelly]])}} | 11 | 1 | 31 | 26 | 97 | 14 | — | 8 | 7 | 3 | 1 | 1 | * Australia: Gold<ref name="aria98"/> * Uingereza: Silver<ref name="bpi"/> * Marekani: Platinum<ref name="riaa"/> | ''[[These Are Special Times]]'' |- ! scope="row" | "S'il suffisait d'aimer" | | — | — | 6 | 4 | — | — | — | — | — | — | — | * Ubelgiji: Gold<ref name="belgia1">{{cite web|url=http://www.ultratop.be/xls/Awards%201999.htm |title=Certifications awards 1999 |publisher=Ultratop|accessdate=27 March 2010}}</ref> * Ufaransa: Gold<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=1999&type=7 |title=Certifications Singles Or – année 1999 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120913021252/http://www.snepmusique.com/fr/page-259165.xml?year=1999&type=7 |archivedate=13 September 2012 }}</ref> | rowspan=2 | ''S'il suffisait d'aimer'' |- | rowspan=6 | 1999 ! scope="row" | "On ne change pas" | | — | — | 16 | 17 | — | — | — | — | — | — | — | |- ! scope="row" | "The Prayer"<br />{{small|(pamoja na [[Andrea Bocelli]])}} | — | 6 | — | — | — | — | — | — | — | — | — | 22 | | ''These Are Special Times'' |- ! scope="row" | "Treat Her Like a Lady"<br />{{small|(pamoja na [[Diana King]] na [[Brownstone (band)|Brownstone]])}} | — | — | — | 70 | — | 64 | — | 62 | — | 29 | — | — | | ''Let's Talk About Love'' |- ! scope="row" | "En attendant ses pas" | | — | — | — | — | — | — | — | — | — | — | — | | ''S'il suffisait d'aimer'' |- ! scope="row" | "Dans un autre monde" | | — | — | — | — | — | — | — | — | — | — | — | | ''Au cœur du stade'' |- ! scope="row" | "That's the Way It Is" | 5 | 1 | 14 | 7 | 6 | 8 | — | 7 | 5 | 12 | 6 | 1 | * Australia: Gold<ref>{{cite web|url=http://aria.com.au/pages/aria-charts-accreditations-singles-1999.htm |title=ARIA charts – accreditations – 1999 singles |publisher=ARIA|accessdate=31 December 2007}}</ref> * Ubelgiji: Gold<ref name="belgia1"/> * Ufaransa: Silver<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=2000&type=6 |title=Certifications Singles Argent – année 2000 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120923124705/http://www.snepmusique.com/fr/page-259165.xml?year=2000&type=6 |archivedate=23 September 2012 }}</ref> * Ujerumani: Gold<ref name="mediacontrol"/> | ''All the Way... A Decade of Song'' |- | rowspan=3 | 2000 ! scope="row" | "Live (for the One I Love)" | 23 | — | — | 47 | 63 | — | — | 89 | 82 | — | — | — | | rowspan=3 | ''All the Way... A Decade of Song'' |- ! scope="row" | "The First Time Ever I Saw Your Face" | — | — | — | — | — | — | — | — | — | 19 | — | — | |- ! scope="row" | "I Want You to Need Me" | 1 | 19 | — | 73 | — | — | — | 49 | 40 | — | — | 12 | |- | 2001 ! scope="row" |"Sous le vent"<br />{{small|(pamoja na [[Garou (singer)|Garou]])}} | 14 | — | — | 1 | 1 | — | — | 78 | 2 | — | — | — | * Ubelgiji: Platinum<ref>{{cite web|url=http://www.ultratop.be/fr/certifications.asp?year=2001 |title=Les disques d'or/de platine – singles – 2001 |publisher=Ultratop|language=French|accessdate=27 March 2010}}</ref> * Ufaransa: Diamond<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=2001&type=10 |title=Certifications Singles Diamant – année 2001 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120923124627/http://www.snepmusique.com/fr/page-259165.xml?year=2001&type=10 |archivedate=23 September 2012 }}</ref> * Uswisi: Platinum<ref>{{cite web|url=http://swisscharts.com/awards.asp?year=2002 |title=Awards 2002 |publisher=Swiss Music Charts |accessdate=31 December 2002 |deadurl=yes |archiveurl=https://web.archive.org/web/20110613140247/http://swisscharts.com/awards.asp?year=2002 |archivedate=13 June 2011 }}</ref> | ''[[Seul (album)|Seul]]'' |- | rowspan=4 | 2002 ! scope="row" | "A New Day Has Come" | 2 | 1 | 19 | 13 | 23 | 6 | — | 19 | 2 | 7 | 22 | 1 | * Australia: Gold<ref>{{cite web|url=http://aria.com.au/pages/aria-charts-accreditations-singles-2002.htm |title=ARIA charts – accreditations – 2002 singles |publisher=ARIA |accessdate=30 April 2002 |deadurl=yes |archiveurl=https://web.archive.org/web/20100829092953/http://aria.com.au/pages/aria-charts-accreditations-singles-2002.htm |archivedate=29 August 2010 }}</ref> * Uingereza: Silver<ref name="bpi"/> * Marekani: Gold<ref name="riaa"/> | rowspan=4 | ''A New Day Has Come'' |- ! scope="row" | "I'm Alive" | 21 | 1 | 30 | 2 | 7 | 4 | — | 7 | 7 | 17 | | 6 | * Ubelgiji: Platinum<ref>{{cite web|url=http://www.ultratop.be/fr/certifications.asp?year=2002 |title=Les disques d'or/de platine – singles – 2002 |publisher=Ultratop|language=French|accessdate=27 March 2010}}</ref> * Ufaransa: Gold<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=2002&type=7 |title=Certifications Singles Or – année 2002 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120923124553/http://www.snepmusique.com/fr/page-259165.xml?year=2002&type=7 |archivedate=23 September 2012 }}</ref> |- ! scope="row" | "Goodbye's (The Saddest Word)" | 67 | 11 | — | 36 | — | 56 | — | 37 | 35 | 38 | — | 27 | |- ! scope="row" | "At Last" | — | — | — | — | — | — | — | — | — | — | — | 16 | |- | rowspan=6 | 2003 ! scope="row" | "I Drove All Night" | 1 | 1 | 22 | 1 | 22 | 22 | — | 24 | 11 | rowspan="2"| 27 | 45 | 7 | * Australia: Gold<ref>{{cite web|url=http://aria.com.au/pages/aria-charts-accreditations-singles-2003.htm |title=ARIA charts – accreditations – 2003 singles |publisher=ARIA|accessdate=31 March 2003}}</ref> * Ubelgiji: Gold<ref>{{cite web|url=http://www.ultratop.be/fr/certifications.asp?year=2003 |title=Les disques d'or/de platine – singles – 2003 |publisher=Ultratop|language=French|accessdate=27 March 2010}}</ref> | rowspan=4 | ''One Heart'' |- ! scope="row" | "One Heart" | 59 | 13 | 75 | 37 | 63 | 56 | — | 78 | 36 | — | — | |- ! scope="row" | "Have You Ever Been in Love" | — | 3 | — | — | — | — | — | — | — | — | | 2 | |- ! scope="row" | "Stand by Your Side" | — | — | — | — | — | — | — | — | — | — | — | 17 | |- ! scope="row" | "Tout l'or des hommes" | 2 | — | — | 5 | 3 | 77 | — | 100 | 10 | — | — | — | * Ufaransa: Silver<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=2003&type=6 |title=Certifications Singles Argent – année 2003 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20121011122451/http://www.snepmusique.com/fr/page-259165.xml?year=2003&type=6 |archivedate=11 October 2012 }}</ref> | ''1 fille & 4 types'' |- ! scope="row" | "Faith" | — | 37 | — | — | — | — | — | — | — | — | — | — | | ''One Heart'' |- | rowspan=5 | 2004 ! scope="row" | "Et je t'aime encore" | — | — | — | 14 | 16 | — | — | — | 31 | — | — | — | | rowspan=2 | ''1 fille & 4 types'' |- ! scope="row" | "Contre nature" | — | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "You and I" | — | 1 | — | — | — | — | — | — | — | — | — | 16 | | ''A New Day... Live in Las Vegas'' |- ! scope="row" | "Beautiful Boy" | — | 32 | — | — | — | — | — | — | — | — | — | 18 | | rowspan=3 | ''Miracle'' |- ! scope="row" | "Je lui dirai"<ref name="belgianbook">{{cite book | author=Jaspers, Sam| title=Ultratop 1995–2005 | publisher=Book & Media Publishing| year=2006 | isbn=90-5720-232-8}}</ref> | — | — | — | — | — | — | — | — | — | — | — | — | |- | rowspan=2 | 2005 ! scope="row" | "In Some Small Way" | — | 14 | — | — | — | — | — | — | — | — | — | 28 | |- ! scope="row" | "Je ne vous oublie pas" | — | 23 | — | 4 | 2 | — | — | — | 21 | — | — | — | * Ufaransa: Silver<ref>{{cite web|url=http://www.snepmusique.com/fr/page-259165.xml?year=2005&type=6 |title=Certifications Singles Argent – année 2005 |language=French |publisher=SNEP |accessdate=26 March 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20120913021236/http://www.snepmusique.com/fr/page-259165.xml?year=2005&type=6 |archivedate=13 September 2012 }}</ref> | rowspan=3 | ''On ne change pas'' |- | rowspan=2 | 2006 ! scope="row" | "Tous les secrets" | — | 30 | — | 33 | 20 | — | — | — | 75 | — | — | — | |- ! scope="row" | "I Believe in You (Je crois en toi)"<br />{{small|(pamoja na [[Il Divo]])}} | — | — | — | — | 30 | — | — | — | 35 | — | — | 31 | |- | rowspan=4 | 2007 ! scope="row" | "Et s'il n'en restait qu'une (je serais celle-là)" | — | 28 | — | 4 | 1 | — | — | — | 34 | — | — | — | | rowspan=3 | ''D'elles'' |- ! scope="row" | "Immensité" | — | 30 | — | | — | — | — | — | — | — | — | — | |- ! scope="row" | "On s'est aimé à cause" | — | 23 | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Taking Chances" | 9 | 1 | 60 | 29 | 7 | 25 | — | 100 | 5 | 40 | 54 | 6 | * Canada: Gold<ref>{{cite web|url=https://musiccanada.com/gold-platinum/?fwp_gp_search=celine%20dion&fwp_gp_format=38|title=Gold/Platinum |publisher=Music Canada|accessdate=26 March 2015}}</ref> | rowspan=3 | ''Taking Chances'' |- | rowspan=5 | 2008 ! scope="row" | "Eyes on Me" | — | — | — | — | — | — | — | — | — | 113 | — | — | |- ! scope="row" | "A World to Believe In"<br />{{small|(pamoja na [[Yuna Ito]])}} | — | — | — | — | — | — | 8 | — | — | — | — | — | |- ! scope="row" | "The Prayer"<br />{{small|(pamoja na [[Josh Groban]])}} | 37 | — | — | — | — | — | — | — | — | — | 70 | — | | {{N/A|Non-album single}} |- ! scope="row" | "Alone" | 57 | 7 | — | — | — | — | — | — | — | 85 | | — | | ''Taking Chances'' |- ! scope="row" | "My Love" | 67 | 8 | — | | — | — | — | — | — | 129 | — | 15 | | ''My Love: Essential Collection'' |- | rowspan=2 | 2012 ! scope="row" | "Parler à mon père" | 53 | 29 | — | 11 | 8 | — | — | — | 25 | — | — | — | | rowspan=3 | ''Sans attendre'' |- ! scope="row" | "Le miracle" | — | 21 | — | 27 | 77 | — | — | — | — | — | — | — | |- | rowspan=3 | 2013 ! scope="row" | "Qui peut vivre sans amour?" | — | 41 | — | | — | — | — | — | — | — | — | — | |- ! scope="row" | "Loved Me Back to Life" | 26 | 39 | — | 25 | 32 | 38 | — | — | 25 | 14 | — | 24 | * Canada: Gold<ref>{{cite web|url=https://musiccanada.com/gold-platinum/?fwp_gp_search=Loved+Me+Back+to+Life%2520Celine+Dion|title=Gold/Platinum |publisher=Music Canada|accessdate=12 September 2016}}</ref> | rowspan=4 | ''Loved Me Back to Life'' |- ! scope="row" | "Break Away" | — | — | — | — | — | — | — | — | — | — | — | — | |- | rowspan=3 | 2014 ! scope="row" | "Incredible"<br />{{small|(pamoja na [[Ne-Yo]])}} | 44 | 24 | — | — | — | — | — | — | — | — | — | 25 | |- ! scope="row" | "Water and a Flame" | — | — | — | — | — | — | — | — | — | — | — | — | |- ! scope="row" | "Celle qui m'a tout appris" | — | — | — | | — | — | — | — | — | — | — | — | | ''Céline une seule fois / Live 2013'' |- | rowspan=5 | 2016 ! scope="row" | "The Show Must Go On"<br />{{small|(pamoja na [[Lindsey Stirling]])}} | 89 | — | — | | 23 | — | — | — | — | — | — | — | | {{N/A|Non-album single}} |- ! scope="row" | "Encore un soir" | 92 | 39 | — | 10 | 1 | — | — | — | 25 | — | — | — | * Ufaransa: Diamond<ref>{{cite web|url=http://www.snepmusique.com/les-disques-dor/?awards_cat=64&awards_awd=0&awards_year=0&awards_artist=dion&awards_title=encore+un+soir&awards_edit_distrib=&awards_sort=date_certif-desc&awards_nb=30&submitAdvanced=Rechercher|title=Les Certifications: Notre Base de Données|language=French|publisher=SNEP|accessdate=10 January 2018|archivedate=2018-06-13|archiveurl=https://web.archive.org/web/20180613041900/http://www.snepmusique.com/les-disques-dor/?awards_cat=64&awards_awd=0&awards_year=0&awards_artist=dion&awards_title=encore+un+soir&awards_edit_distrib=&awards_sort=date_certif-desc&awards_nb=30&submitAdvanced=Rechercher}}</ref> * Uswisi: Gold<ref>{{cite web|url=http://swisscharts.com/awards.asp?year=2017 |title=Awards 2017 |publisher=Swiss Music Charts |accessdate=18 May 2017}}</ref> | ''Encore un soir'' |- ! scope="row" | "Recovering" | | — | — | — | 50 | — | — | — | — | — | — | — | | {{N/A|Non-album single}} |- ! scope="row" | "L'étoile" | — | 35 | — | | 191 | — | — | — | — | — | — | — | | rowspan=4 | ''Encore un soir'' |- ! scope="row" | "Si c'était à refaire" | — | — | — | | 100 | — | — | — | — | — | — | — | |- | rowspan=2 | 2017 ! scope="row" | "Je nous veux" | — | 38 | — | — | 143 | — | — | — | — | — | — | — | |- ! scope="row" | "Les yeux au ciel" | — | 43 | — | — | 169 | — | — | — | — | — | — | — | |- | 2018 ! scope="row" | "Ashes" | 72 | 41 | 94 | | 15 | — | — | — | 65 | 86 | | 22 | | ''Deadpool 2'' |} ==Tuzo== ===American Music Awards=== [[Image:Celine Dion both walk of fame stars.jpg|thumb|right|Celine Dion kwenye ''Hollywood Walk of Fame'']] {{awards table}} |- |1995<ref>{{cite web|title=22nd American Music Awards|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1995/amas.htm|accessdate=8 January 2014}}</ref> |"The Power of Love" |American Music Award for Favorite Pop/Rock Song |Aliteuliwa |- |rowspan="2"|1997<ref>{{cite web|title=24th American Music Awards|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1997/amas.htm|accessdate=8 January 2014}}</ref> |rowspan="6"|Celine Dion |American Music Award for Favorite Pop/Rock Female Artist |Aliteuliwa |- |American Music Award for Favorite Adult Contemporary Artist |Aliteuliwa |- |rowspan="2"|1998<ref>{{cite web|title=25th American Music Awards|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1998/amas.htm|accessdate=8 January 2014}}</ref> |Favorite Pop/Rock Female Artist |{{won}} |- |Favorite Adult Contemporary Artist |Aliteuliwa |- |rowspan="4"|1999<ref>{{cite web|title=26th American Music Awards|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1999/amas.htm|accessdate=8 January 2014}}</ref> |Favorite Pop/Rock Female Artist |{{won}} |- |Favorite Adult Contemporary Artist |{{won}} |- |''Let's Talk About Love'' |American Music Award for Favorite Pop/Rock Album |Aliteuliwa |- |''Titanic: Music from the Motion Picture'' |American Music Award for Top Soundtrack |{{won}} |- |rowspan="2"|2001<ref>{{cite web|title=28th American Music Awards|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/2001/amas.htm|accessdate=8 January 2014}}</ref> |rowspan="6"|Celine Dion |Favorite Pop/Rock Female Artist |Aliteuliwa |- |Favorite Adult Contemporary Artist |{{won}} |- |rowspan="2"|2003<ref>{{cite web|title=30th American Music Awards|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/2003/amas.htm|accessdate=8 January 2014}}</ref> |Favorite Pop/Rock Female Artist |Aliteuliwa |- |Favorite Adult Contemporary Artist |{{won}} |- |rowspan="2"|2003<ref>{{cite web|title=31st American Music Awards|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/2003/amas2.htm|accessdate=8 January 2014}}</ref> |Favorite Pop/Rock Female Artist |Aliteuliwa |- |Favorite Adult Contemporary Artist |{{won}} |- {{end}} ===Amigo Awards=== {{awards table}} |- |1997<ref name="official"/> |rowspan="2"|Celine Dion |rowspan="2"|Best International Female Artist |{{won}} |- |1998<ref name="official"/> |{{won}} |- {{end}} ===Arion Music Awards=== {{awards table}} |- |2003<ref name="official"/> |''A New Day Has Come'' |Best Selling International Album |{{won}} |- {{end}} ===Bambi Awards=== {{awards table}} |- |1996<ref name="official"/> |rowspan="3"|Celine Dion |Top International Pop Star of the Year |{{won}} |- |1999<ref name="official"/> |Kwa mauzo ya kupita milioni 10 nchini Ujerumani, Austria na Uswisi |{{won}} |- |2012<ref name="official"/> | |{{won}} |- {{end}} ===Banff Television Foundation Awards=== {{awards table}} |- |2002<ref>{{cite web|title=Céline Among Famous Faces of Canadian TV|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/12524|date=21 June 2002|accessdate=4 February 2014|archiveurl=https://web.archive.org/web/20140222192053/http://www.celinedion.com/ca/node/12524|archivedate=2014-02-22}}</ref> |Celine Dion |''All-Time Famous Faces in Canadian Television'' |{{won}} |- {{end}} ===Best of Las Vegas Awards=== {{awards table}} |- |2003<ref name="official"/> |''A New Day...'' |''Best Overall Show'' |{{won}} |- |2004<ref name="official"/> |rowspan="5"|Celine Dion |Best Singer |{{won}} |- |2005<ref name="official"/> |rowspan="2"|''Best Headliner'' |{{won}} |- |2006<ref name="official"/> |{{won}} |- |rowspan="3"|2007<ref>{{cite web|title=Celine and A New Day... Win 'Best of Las Vegas' Awards!|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/64113|date=1 April 2007|accessdate=11 February 2014|archiveurl=https://web.archive.org/web/20140512213043/http://www.celinedion.com/ca/node/64113|archivedate=2014-05-12}}</ref> |''Best Singer'' |{{won}} |- |''Best All-Around Performer'' |{{won}} |- |''A New Day...'' |''Best Show Choreography'' |{{won}} |- |2008<ref>{{cite web|title=Celine Receives 'Best of Las Vegas 2008' Award!|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/75720|date=1 April 2008|accessdate=11 February 2014|archiveurl=https://web.archive.org/web/20140512212923/http://www.celinedion.com/ca/node/75720|archivedate=2014-05-12}}</ref> |Celine Dion |''Best Singer'' |{{won}} |- |2012<ref>{{cite web|title=Voted Best in '12: Overall Show|publisher=[[Stephens Media (newspapers)|Stephens Media]]|url=http://m.bestoflasvegas.com/propertyview.php?s=celine&pid=91bf802a61d177939d2e570c9be03c8c&bk=&lid=858641e51cf2336b732c1d7a2a9e8cc6&ret=default|accessdate=26 January 2014|archiveurl=https://web.archive.org/web/20140203062835/http://m.bestoflasvegas.com/propertyview.php?s=celine&pid=91bf802a61d177939d2e570c9be03c8c&bk=&lid=858641e51cf2336b732c1d7a2a9e8cc6&ret=default|archivedate=2014-02-03}}</ref> |rowspan="2"|''Celine'' |rowspan="2"|''Best Overall Show'' |{{won}} |- |2014<ref>{{cite web|title=Voted Best in '14: Overall Show|publisher=Stephens Media|url=http://m.bestoflasvegas.com/propertyview.php?s=celine&pid=91bf802a61d177939d2e570c9be03c8c&bk=&lid=858641e51cf2336b732c1d7a2a9e8cc6&ret=default|accessdate=31 March 2014|archiveurl=https://web.archive.org/web/20140203062835/http://m.bestoflasvegas.com/propertyview.php?s=celine&pid=91bf802a61d177939d2e570c9be03c8c&bk=&lid=858641e51cf2336b732c1d7a2a9e8cc6&ret=default|archivedate=2014-02-03}}</ref> |{{won}} |- |2016<ref>{{cite web|title=Best of Las Vegas 2016 Award Winners|publisher=bestoflasvegas.com|url=http://bestoflasvegas.com/winners-2016|accessdate=15 November 2016|deadurl=yes|archiveurl=https://web.archive.org/web/20161114035251/http://bestoflasvegas.com/winners-2016|archivedate=14 November 2016|=https://web.archive.org/web/20161114035251/http://bestoflasvegas.com/winners-2016}}</ref> |Celine Dion |''Best Singer'' |{{won}} |- {{end}} ===Best of Montreal Awards=== {{awards table}} |- |1997<ref>{{cite web|title=Most Desirable|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/596|date=30 May 1997|accessdate=8 February 2014|archiveurl=https://web.archive.org/web/20140222194655/http://www.celinedion.com/ca/node/596|archivedate=2014-02-22}}</ref> |Celine Dion |''Most Desirable Woman'' |Aliteuliwa |- {{end}} ===Billboard Latin Music Awards=== {{awards table}} |- |2002<ref name="official"/> |"My Heart Will Go On" |''First English-Language Song to Top'' |{{won}} |- {{end}} ===Billboard Music Awards=== {{awards table}} |- |rowspan="2"|1992<ref>{{cite web|title=1992 Billboard Music Awards|publisher=Timothy E. Ryan|work=[[The Baltimore Sun]]|url=http://articles.baltimoresun.com/1992-12-10/features/1992345145_1_garth-brooks-u2-billboard-200-albums|date=10 December 1992|accessdate=21 January 2014|archivedate=2014-12-02|archiveurl=https://web.archive.org/web/20141202152222/http://articles.baltimoresun.com/1992-12-10/features/1992345145_1_garth-brooks-u2-billboard-200-albums}}</ref> |Celine Dion |''Hot Adult Contemporary Artists'' |Aliteuliwa |- |"If You Asked Me To" |Hot Adult Contemporary Singles & Tracks |Aliteuliwa |- |rowspan="6"|1994<ref>{{cite web|title=Billboard 24 December 1994|work=[[Billboard (magazine)|Billboard]]|url=https://books.google.com/books?id=ZAgEAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|date=24 December 1994|accessdate=17 January 2014}}</ref> |rowspan="4"|Celine Dion |''Top Pop Artists - Female'' |Aliteuliwa |- |''Top Billboard 200 Album Artists - Female'' |Aliteuliwa |- |''Hot 100 Singles Artists - Female'' |Aliteuliwa |- |''Hot Adult Contemporary Artists'' |Aliteuliwa |- |rowspan="2"|"The Power of Love" |Hot 100 Singles |Aliteuliwa |- |''Hot Adult Contemporary Singles & Tracks'' |Aliteuliwa |- |rowspan="13"|1996<ref>{{cite web|title=1996 Billboard Music Awards|publisher=[[MetroLyrics]]|url=http://m.metrolyrics.com/1996-billboard-music-awards.html|accessdate=22 January 2014|archivedate=2014-02-02|archiveurl=https://web.archive.org/web/20140202154110/http://m.metrolyrics.com/1996-billboard-music-awards.html}}</ref> |rowspan="8"|Celine Dion |''Top Pop Artists'' |Aliteuliwa |- |Top Pop Artists - Female |Aliteuliwa |- |Top Billboard 200 Album Artists |Aliteuliwa |- |Top Billboard 200 Album Artists - Female |Aliteuliwa |- |Hot 100 Singles Artists |Aliteuliwa |- |Hot 100 Singles Artists - Female |Aliteuliwa |- |Hot Adult Contemporary Artists |Aliteuliwa |- |Hot Adult Top 40 Artists |Aliteuliwa |- |rowspan="4"|"[[Because You Loved Me]]" |Hot 100 Singles |Aliteuliwa |- |Hot 100 Singles Airplay |Aliteuliwa |- |Hot Adult Contemporary Singles & Tracks |Aliteuliwa |- |Hot Adult Top 40 Singles & Tracks |Aliteuliwa |- |''Falling into You'' |Top Billboard 200 Albums |Aliteuliwa |- |rowspan="6"|1997<ref>{{cite web|title=Billboard 24 December 1994|work=Billboard|url=https://books.google.com/books?id=0g0EAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|date=27 December 1997|accessdate=17 January 2014}}</ref> |rowspan="5"|Celine Dion |Top Pop Artists |Aliteuliwa |- |Top Pop Artists - Female |Aliteuliwa |- |Top Billboard 200 Album Artists |Aliteuliwa |- |Top Billboard 200 Album Artists - Female |Aliteuliwa |- |Hot Adult Contemporary Artists |Aliteuliwa |- |''Falling into You'' |Top Billboard 200 Albums |Aliteuliwa |- |rowspan="9"|1998<ref>{{cite web|title=Billboard 26 December 1998|work=Billboard|url=https://books.google.com/books?id=Mw0EAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|date=26 December 1998|accessdate=17 January 2014}}</ref> |rowspan="4"|Celine Dion |Top Pop Artists - Female |Aliteuliwa |- |Top Billboard 200 Album Artists |{{won}} |- |Top Billboard 200 Album Artists - Female |{{won}} |- |Hot Adult Contemporary Artists |{{won}} |- |rowspan="2"|"My Heart Will Go On" |Hot Adult Contemporary Singles & Tracks |Aliteuliwa |- |Hot Soundtrack Singles |{{won}} |- |''Let's Talk About Love'' |rowspan="2"|Top Billboard 200 Albums |Aliteuliwa |- |rowspan="2"|''Titanic: Music from the Motion Picture'' |{{won}} |- |Hot Soundtrack Albums |{{won}} |- |rowspan="2"|1999<ref>{{cite web|title=Billboard 25 December 1999|work=Billboard|url=https://books.google.com/books?id=9w0EAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|date=25 December 1999|accessdate=17 January 2014}}</ref> |Celine Dion |Top Billboard 200 Album Artists - Female |Aliteuliwa |- |"I'm Your Angel" |Hot 100 Singles Sales |Aliteuliwa |- |rowspan="2"|2000<ref>{{cite web|title=Billboard 30 December 2000|work=Billboard|url=https://books.google.com/books?id=ehEEAAAAMBAJ&printsec=frontcover&hl=pl&source=gbs_ge_summary_r&cad=0#v=onepage&q=dion&f=false|date=30 December 2000|accessdate=17 January 2014}}</ref> |rowspan="2"|Celine Dion |Top Pop Artists - Female |Aliteuliwa |- |Top Billboard 200 Artists - Female |Aliteuliwa |- |2016<ref>{{cite web|title=Celine Dion to Receive ICON Award & Perform at 2016 Billboard Music Awards|publisher=Billboard|url=http://www.billboard.com/articles/news/bbma/7356823/celine-dion-icon-award-perform-2016-billboard-music-awards|accessdate=4 May 2016}}</ref> |Celine Dion |Billboard Icon Award |{{won}} |- {{end}} ===Blockbuster Entertainment Awards=== {{awards table}} |- |rowspan="2"|1997<ref name="aw97">{{cite web|title=International Nominations For Celine|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/325|date=14 February 1997|accessdate=3 February 2014|archiveurl=https://web.archive.org/web/20140221080225/http://www.celinedion.com/ca/node/325|archivedate=2014-02-21}}</ref> |Celine Dion |Favorite Female Artist - Pop |Aliteuliwa |- |"Because You Loved Me" |rowspan="2"|Favourite Song from a Movie |Aliteuliwa |- |rowspan="2"|1999<ref>{{cite web|title=Blockbuster Entertainment Awards|publisher=[[Internet Movie Database|IMDb]]|url=https://www.imdb.com/event/ev0000104/1999|accessdate=29 January 2014}}</ref> |"My Heart Will Go On" |{{won}} |- |''Titanic: Music from the Motion Picture'' |Favorite Soundtrack{{ref|b|[b]}} |Aliteuliwa |- |2000<ref>{{cite web|title=Nominees Announced for 'Sixth Annual Blockbuster Entertainment Awards(R)' To Air in June on FOX|publisher=[[PR Newswire]]|url=http://www.prnewswire.com/news-releases/nominees-announced-for-sixth-annual-blockbuster-entertainment-awardsr-to-air-in-june-on-fox-72458137.html|accessdate=3 February 2014}}</ref> |rowspan="2"|Celine Dion |rowspan="2"|Favorite Female Artist - Pop |Aliteuliwa |- |2001<ref>{{cite web|title=7th Annual Blockbuster Entertainment Awards Nominees Announced|publisher=[[Google]]|url=https://groups.google.com/forum/#!topic/alt.fan.teen.idols/S2nGy7f3Mmg|accessdate=3 February 2014}}</ref> |Aliteuliwa |- {{end}} ===Bravo Otto Awards=== {{awards table}} |- |1998<ref>{{cite web|title=Bravo Otto - 1998!|work=[[Bravo (magazine)|Bravo]]|url=http://www.bravo.de/family/archiv/bravo-otto-1998|language=German|accessdate=16 February 2014|archiveurl=https://web.archive.org/web/20140221124250/http://www.bravo.de/family/archiv/bravo-otto-1998|archivedate=2014-02-21}}</ref> |Celine Dion |Gold Otto for Female Singer |{{won}} |- {{end}} ===Brit Awards=== {{awards table}} |- |1996<ref>{{cite web|title=1996|publisher=[[Brit Awards|BRIT Awards Ltd]]|url=http://www.brits.co.uk/history/shows/1996|accessdate=8 January 2014|archive-date=2010-02-25|archive-url=https://web.archive.org/web/20100225164347/http://www.brits.co.uk/history/shows/1996|url-status=dead}}</ref> |rowspan="3"|Celine Dion |rowspan="3"|Brit Award for International Female Solo Artist |Aliteuliwa |- |1997<ref>{{cite web|title=1997|publisher=BRIT Awards Ltd|url=http://www.brits.co.uk/history/shows/1997|accessdate=8 January 2014|archive-date=2011-11-12|archive-url=https://web.archive.org/web/20111112053839/http://www.brits.co.uk/history/shows/1997|url-status=dead}}</ref> |Aliteuliwa |- |1998<ref>{{cite web|title=1998|publisher=BRIT Awards Ltd|url=http://www.brits.co.uk/history/shows/1998|accessdate=8 January 2014|archive-date=2010-03-26|archive-url=https://web.archive.org/web/20100326191951/http://www.brits.co.uk/history/shows/1998|url-status=dead}}</ref> |Aliteuliwa |- |1999<ref>{{cite web|title=1999|publisher=BRIT Awards Ltd|url=http://www.brits.co.uk/history/shows/1999|accessdate=8 January 2014}}</ref> |''Titanic: Music from the Motion Picture'' |Best Soundtrack/Cast Recording{{ref|b|[b]}} |{{won}} |- {{end}} ===Canada's Walk of Fame=== {{awards table}} |- |1999<ref name="official"/> |Celine Dion |Inducted into Canada's Walk of Fame |{{won}} |- {{end}} ===Canadian Broadcast Hall of Fame=== {{awards table}} |- |1999<ref name="official"/><ref>{{cite web|title=Member of CAB Hall of Fame|publisher=The Canadian Communications Foundation|url=http://www.broadcasting-history.ca/index3.html?url=http%3A//www.broadcasting-history.ca/personalities/personalities.php%3Fid%3D206|accessdate=8 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20150402091432/http://www.broadcasting-history.ca/index3.html?url=http%3A%2F%2Fwww.broadcasting-history.ca%2Fpersonalities%2Fpersonalities.php%3Fid%3D206|archivedate=2 April 2015}}</ref> |Celine Dion |Inducted into Canadian Broadcast Hall of Fame |{{won}} |- {{end}} ===Canadian Radio Music Awards=== {{awards table}} |- |2005<ref>{{cite web|title=2005 Annual Canadian Radio Music Awards Nominations|publisher=One More Pill|url=http://www.onemorepill.com/article/%5Bfield_date_y%5D/2005_annual_canadian_radio_music_awards_nominations|accessdate=8 January 2014|archivedate=2009-01-06|archiveurl=https://web.archive.org/web/20090106072321/http://www.onemorepill.com/article/%5Bfield_date_y%5D/2005_annual_canadian_radio_music_awards_nominations}}</ref> |Celine Dion |Fans' Choice Award |Aliteuliwa |- {{end}} ===Canadian Broadcasting Corporation|CBC Music Awards=== {{awards table}} |- |2014<ref>{{cite web|title=2014 CBC Music Awards: the winners |publisher=[[Canadian Broadcasting Corporation]] |url=http://music.cbc.ca/#!/blogs/2014/12/2014-CBC-Music-Awards-the-winners |accessdate=9 December 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20160301002442/http://music.cbc.ca/ |archivedate=1 March 2016 |df= }}</ref> |Celine Dion |Artist of the Year Award |{{won}} |- {{end}} ===Chérie FM Stars=== {{awards table}} |- |2005<ref name="official"/> |rowspan="3"|Celine Dion |Honorary Award |{{won}} |- |rowspan="4"|2007<ref>{{cite web|title=Les Etoiles Chérie FM 2007|publisher=[[NRJ Group]]|url=http://www.nrjgroup.fr/commun/pdf/publi_1192464264_fr.pdf|accessdate=8 January 2014|archivedate=2008-11-16|archiveurl=https://web.archive.org/web/20081116083346/http://www.nrjgroup.fr/commun/pdf/publi_1192464264_fr.pdf}}</ref> |Honorary Award for the Entire Career |{{won}} |- |Female Artist of the Year |Aliteuliwa |- |''[[D'elles]]'' |Album of the Year |Aliteuliwa |- |"[[Et s'il n'en restait qu'une (je serais celle-là)]]" |French Song of the Year |Aliteuliwa |- {{end}} ===Chicago Film Critics Association Awards=== {{awards table}} |- |1998<ref name="titanic">{{cite web|title=Titanic Awards|publisher=anlimara.com|url=http://www.anlimara.com/dreampage/titanic/titanicawards.html|accessdate=16 February 2014|archiveurl=https://web.archive.org/web/20160528010500/http://www.anlimara.com/dreampage/titanic/titanicawards.html|archivedate=2016-05-28}}</ref> |''Titanic: Music from the Motion Picture'' |Chicago Film Critics Association Award for Best Original Score{{ref|b|[b]}} |{{won}} |- {{end}} ===Coca-Cola Full Blast Music Awards=== {{awards table}} |- |1997<ref name="official"/> |Celine Dion |Most Popular International Artist of 1996 |{{won}} |- {{end}} ===Commemorative Medallion of the 400th Anniversary of Quebec City=== {{awards table}} |- |2008<ref>{{cite web|title=Le médaillon commémoratif du 400e de la Ville de Québec|publisher=Numicanada|url=http://numicanada.com/jetons-medailles-articles.php?article=le-m%E9daillon-comm%E9moratif-du-400%3Csup%3Ee%3C/sup%3E-de-la-ville-de-qu%E9bec&id=256|language=French|accessdate=2 February 2014}}</ref> |Celine Dion |Commemorative Medallion of the 400th Anniversary of Quebec City |{{won}} |- {{end}} ===Music Canada|CRIA Special Awards=== {{awards table}} |- |1999<ref>{{cite web|title=Céline Trivia|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/10756|date=3 May 2002|accessdate=8 February 2014|archiveurl=https://web.archive.org/web/20140222195109/http://www.celinedion.com/ca/node/10756|archivedate=2014-02-22}}</ref><ref>{{cite web|title=This Day in Music|publisher= Billboard|url=http://www.billboard.com/articles/news/72832/this-day-in-music|language=French|accessdate=5 January 2003 }}</ref> |Celine Dion |Best Selling Canadian Recording Artist of the Century |{{won}} |- {{end}} ===Danish Music Awards=== {{awards table}} |- |1997<ref name="aw97"/> |rowspan="3"|Celine Dion |rowspan="3"|Best International Female Singer |Aliteuliwa |- |1998<ref>{{cite web|title=Award Highlights|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/1131|date=24 February 1998|accessdate=4 February 2014|archiveurl=https://web.archive.org/web/20150923224020/http://www.celinedion.com/ca/node/1131|archivedate=2015-09-23}}</ref> |Aliteuliwa |- |rowspan="2"|1999<ref>{{cite web|title=Dansk Grammy 1999 – samtlige nominerede|publisher=Dialog Design|url=http://tv-2.dk/grammy.html|language=Danish|accessdate=4 February 2014}}</ref> |Aliteuliwa |- |"[[My Heart Will Go On]]" |Best International Hit |Aliteuliwa |- {{end}} ===Dragon Awards=== {{awards table}} |- |2003<ref name="official"/> |rowspan="2"|Celine Dion |rowspan="2"|International Female Artist of the Year |{{won}} |- |2004<ref name="official"/> |{{won}} |- {{end}} ===Echo Awards=== {{awards table}} |- |1997<ref name="aw97"/> |rowspan="4"|Celine Dion |rowspan="4"|International Female Artist of the Year |Aliteuliwa |- |1998<ref name="echo">{{cite web|title=Echo Pop: Archiv |publisher=[[Echo (music award)|Echo]] |url=http://www.echopop.de/no_cache/pop-suche/ |language=German |accessdate=1 February 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20120217071025/http://www.echopop.de/no_cache/pop-suche/ |archivedate=17 February 2012 |df= }}</ref> |Aliteuliwa |- |1999<ref name="echo"/> |{{won}} |- |2003<ref name="echo"/> |Aliteuliwa |- {{end}} ===Edison Awards=== {{awards table}} |- |1995<ref>{{cite web|title=Platenbranche lanceert Edison-Publieksprijs|work=Nieuwsblad van het Noorden|url=http://www.dekrantvantoen.nl/vw/article.do?id=NVHN-19950811-AE0002008&vw=org&lm=edison%2CDVHN%2CAMB%2CBCH%2CBNH%2CBRU%2CDAM%2CDRC%2CEMS%2CFEA%2CFKC%2CFRC%2CFRI%2CGBS%2CGZB%2CHAH%2CHEC%2CHOH%2CHSK%2CHWB%2CJCH%2CKHN%2CKLA%2CKSK%2CKVF%2CKVH%2CMCK%2CMDW%2CMFH%2CMOH%2CNDC%2CNOF%2CNOK%2CNOL%2CNPD%2CNVHN%2CNVP%2CPEK%2CROJ%2CSBO%2CSNB%2CSSN%2CSSP%2CTAC%2CVEE%2CWEZ%2CWKL%2CWKW%2CZFH%2CZOH%2CLC|language=Dutch|date=11 August 1995|accessdate=3 February 2014}}</ref> |''The Colour of My Love'' |Best Album |Aliteuliwa |- |rowspan="2"|1998<ref name="official"/> |Celine Dion |Best International Female Singer |Aliteuliwa |- |"Tell Him" |Single of the Year |Aliteuliwa |- {{end}} ===Ella Awards=== {{awards table}} |- |2004<ref name="official"/><ref>{{cite web |url=http://www.singers.org/special-events/ |title=Ella Award Special Events |date=12 February 2011 |accessdate=10 May 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20150514064028/http://www.singers.org/special-events/ |archivedate=14 May 2015 |df= |=https://web.archive.org/web/20150514064028/http://www.singers.org/special-events/ }}</ref> |Celine Dion |For Contribution to Music and Humanitarian and Community Support |{{won}} |- {{end}} ===Eurovision Song Contest=== {{awards table}} |- |1988\ |"Ne partez pas sans moi" |First Prize |{{won}} |- {{end}} ===Félix Awards=== {{awards table}} |- |1982<ref>{{cite web|title=Gala de l'ADISQ - 1982|publisher=[[ADISQ]]|url=http://www.adisq.com/even-gala/archives/gala1982.html|accessdate=13 January 2014|archiveurl=https://web.archive.org/web/20131101075643/http://www.adisq.com/even-gala/archives/gala1982.html|archivedate=2013-11-01}}</ref> |rowspan="4"|Celine Dion |rowspan="2"|Newcomer of the Year |Aliteuliwa |- |rowspan="4"|1983<ref>{{cite web|title=Gala de l'ADISQ - 1983|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala1983.html|accessdate=13 January 2014|archiveurl=https://web.archive.org/web/20131101080246/http://www.adisq.com/even-gala/archives/gala1983.html|archivedate=2013-11-01}}</ref> |{{won}} |- |Artist of the Year Achieving the Most Success Outside Quebec |{{won}} |- |Female Vocalist of the Year |{{won}} |- |''Tellement j'ai d'amour...'' |Pop Album of the Year |{{won}} |- |rowspan="4"|1984<ref>{{cite web|title=Gala de l'ADISQ - 1984 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1984.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20160303171652/http://www.adisq.com/even-gala/archives/gala1984.html |archivedate=3 March 2016 |df= }}</ref> |rowspan="2"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |Aliteuliwa |- |Female Vocalist of the Year |{{won}} |- |rowspan="2"|''Les chemins de ma maison'' |Pop Album of the Year |Aliteuliwa |- |Best Selling Album of the Year |{{won}} |- |rowspan="10"|1985<ref>{{cite web|title=Gala de l'ADISQ - 1985 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1985.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20150926194550/http://www.adisq.com/even-gala/archives/gala1985.html |archivedate=26 September 2015 |df= }}</ref> |rowspan="2"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec - French Market |Aliteuliwa |- |Female Vocalist of the Year |{{won}} |- |rowspan="2"|"Une colombe" |Song of the Year |{{won}} |- |Best Selling Single of the Year |{{won}} |- |"Une colombe" - Paul Baillargeon |Arranger of the Year{{ref|d|[d]}} |Aliteuliwa |- |rowspan="3"|''Mélanie'' |Album of the Year |{{won}} |- |Pop Album of the Year |Aliteuliwa |- |Best Selling Album of the Year |{{won}} |- |Céline Dion en concert |Show of the Year - Music and Pop Songs |Aliteuliwa |- |Céline Dion en concert - Harvey Robitaille |Sound Engineer of the Year{{ref|e|[e]}} |{{won}} |- |1986<ref>{{cite web|title=Gala de l'ADISQ - 1986 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1986.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20131102051915/http://www.adisq.com/even-gala/archives/gala1986.html |archivedate=2 November 2013 |df= }}</ref> |''Opération beurre de pinottes'' |Kids Album of the Year |Aliteuliwa |- |rowspan="6"|1987<ref>{{cite web|title=Gala de l'ADISQ - 1987 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1987.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20160303130900/http://adisq.com/even-gala/archives/gala1987.html |archivedate=3 March 2016 |df= }}</ref> |Celine Dion |Female Vocalist of the Year |Aliteuliwa |- |"Fais ce que tu voudras" |Video of the Year |Aliteuliwa |- |rowspan="2"|"Incognito" - Jean-Alain Roussel |Producer of the Year{{ref|f|[f]}} |Aliteuliwa |- |Sound Engineer of the Year{{ref|g|[g]}} |Aliteuliwa |- |"Comme un cœur froid" - Jean-Alain Roussel |Arranger of the Year{{ref|d|[d]}} |{{won}} |- |''Incognito'' |Pop Album of the Year |Aliteuliwa |- |rowspan="8"|1988<ref>{{cite web|title=Gala de l'ADISQ - 1988 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1988.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20120604004606/http://www.adisq.com/even-gala/archives/gala1988.html |archivedate=4 June 2012 |df= }}</ref> |rowspan="2"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec - French Market |{{won}} |- |Female Vocalist of the Year |{{won}} |- |"Incognito" |Most Popular Song of the Year |{{won}} |- |rowspan="2"|[[Incognito tournée]] |Best Stage Performance of the Year |{{won}} |- |Show of the Year |Aliteuliwa |- |Incognito tournée - Jean Bissonnette |Stage Director of the Year{{ref|e|[e]}} |{{won}} |- |Incognito tournée - Pierre Labonté |Stage Designer of the Year{{ref|e|[e]}} |Aliteuliwa |- |Incognito tournée - Michel Murphy |Lighting Designer of the Year{{ref|e|[e]}} |Aliteuliwa |- |1990<ref>{{cite web|title=Gala de l'ADISQ - 1990 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1990.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20131102200845/http://www.adisq.com/even-gala/archives/gala1990.html |archivedate=2 November 2013 |df= }}</ref> |rowspan="3"|Celine Dion |Anglophone Artist of the Year |{{won}} |- |rowspan="4"|1991<ref>{{cite web|title=Gala de l'ADISQ - 1991|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala1991.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20131102201017/http://www.adisq.com/even-gala/archives/gala1991.html|archivedate=2 November 2013}}</ref> |Artist of the Year Achieving the Most Success Outside Quebec |Aliteuliwa |- |Artist of the Year Achieving the Most Success in a Language Other Than French |{{won}} |- |[[Unison Tour]] - René-Richard Cyr |Stage Director of the Year{{ref|e|[e]}} |{{won}} |- |Unison Tour - Yves Aucoin |Lighting Designer of the Year{{ref|e|[e]}} |Aliteuliwa |- |rowspan="5"|1992<ref>{{cite web|title=Gala de l'ADISQ - 1992 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1992.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20131103130044/http://www.adisq.com/even-gala/archives/gala1992.html |archivedate=3 November 2013 |df= }}</ref> |rowspan="3"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |Aliteuliwa |- |Artist of the Year Achieving the Most Success in a Language Other Than French |{{won}} |- |Female Vocalist of the Year |Aliteuliwa |- |rowspan="2"|''Dion chante Plamondon'' |Pop/Rock Album of the Year |Aliteuliwa |- |Best Selling Album of the Year |{{won}} |- |rowspan="4"|1993<ref>{{cite web|title=Gala de l'ADISQ - 1993 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1993.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20131103130042/http://www.adisq.com/even-gala/archives/gala1993.html |archivedate=3 November 2013 |df= }}</ref> |rowspan="3"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |{{won}} |- |Artist of the Year Achieving the Most Success in a Language Other Than French |{{won}} |- |Female Vocalist of the Year |Aliteuliwa |- |"Quelqu'un que j'aime, quelqu'un qui m'aime" |Most Popular Song of the Year |Aliteuliwa |- |rowspan="4"|1994<ref>{{cite web|title=Gala de l'ADISQ - 1994 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1994.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20131103173435/http://www.adisq.com/even-gala/archives/gala1994.html |archivedate=3 November 2013 |df= }}</ref> |rowspan="3"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |{{won}} |- |Artist of the Year Achieving the Most Success in a Language Other Than French |{{won}} |- |Female Vocalist of the Year |{{won}} |- |"L'amour existe encore" |Video of the Year |Aliteuliwa |- |rowspan="7"|1995<ref>{{cite web|title=Gala de l'ADISQ - 1995|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala1995.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20131103173009/http://www.adisq.com/even-gala/archives/gala1995.html|archivedate=3 November 2013}}</ref> |rowspan="3"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |{{won}} |- |Artist of the Year Achieving the Most Success in a Language Other Than French |Aliteuliwa |- |Female Vocalist of the Year |Aliteuliwa |- |rowspan="2"|"Pour que tu m'aimes encore" |Most Popular Song of the Year |{{won}} |- |Video of the Year |Aliteuliwa |- |rowspan="2"|''[[D'eux]]'' |Pop/Rock Album of the Year |{{won}} |- |Best Selling Album of the Year |Aliteuliwa |- |rowspan="8"|1996<ref>{{cite web|title=Gala de l'ADISQ - 1996|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala1996.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20141026004824/http://www.adisq.com/even-gala/archives/gala1996.html|archivedate=26 October 2014}}</ref> |rowspan="4"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |{{won}} |- |Artist of the Year Achieving the Most Success in a Language Other Than French |{{won}} |- |Female Vocalist of the Year |{{won}} |- |Special Award |{{won}} |- |rowspan="2"|"Je sais pas" |Most Popular Song of the Year |Aliteuliwa |- |Video of the Year |Aliteuliwa |- |''D'eux'' |Best Selling Album of the Year |{{won}} |- |[[D'eux Tour]] |Show of the Year - Performer |{{won}} |- |rowspan="7"|1997<ref>{{cite web|title=Gala de l'ADISQ - 1997 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1997.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20160303221137/http://www.adisq.com/even-gala/archives/gala1997.html |archivedate=3 March 2016 |df= }}</ref> |rowspan="3"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |{{won}} |- |Artist of the Year Achieving the Most Success in a Language Other Than French |{{won}} |- |Female Vocalist of the Year |{{won}} |- |rowspan="2"|"[[Les derniers seront les premiers]]" |Most Popular Song of the Year |Aliteuliwa |- |Video of the Year |Aliteuliwa |- |rowspan="2"|''[[Live à Paris]]'' |Pop/Rock Album of the Year |{{won}} |- |Best Selling Album of the Year |{{won}} |- |1998<ref>{{cite web|title=Gala de l'ADISQ - 1998|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala1998.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20131103232052/http://www.adisq.com/even-gala/archives/gala1998.html|archivedate=3 November 2013}}</ref> |rowspan="4"|Celine Dion |rowspan="2"|Artist of the Year Achieving the Most Success in a Language Other Than French |Aliteuliwa |- |1999<ref>{{cite web|title=Gala de l'ADISQ - 1999 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala1999.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20131103235845/http://www.adisq.com/even-gala/archives/gala1999.html |archivedate=3 November 2013 |df= }}</ref> |{{won}} |- |rowspan="3"|2000<ref>{{cite web|title=Gala de l'ADISQ - 2000|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala2000.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20131230232840/http://www.adisq.com/even-gala/archives/gala2000.html|archivedate=30 December 2013}}</ref> |Artist of the Year Achieving the Most Success Outside Quebec |Aliteuliwa |- |Female Vocalist of the Year |Aliteuliwa |- |''Let's Talk About Love World Tour'' |Show of the Year - Performer |Aliteuliwa |- |rowspan="4"|2002<ref>{{cite web|title=Gala de l'ADISQ - 2002|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala2002.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20131105181340/http://www.adisq.com/even-gala/archives/gala2002.html|archivedate=5 November 2013}}</ref> |Celine Dion |Artist of the Year Achieving the Most Success in a Language Other Than French |{{won}} |- |rowspan="2"|"Sous le vent" |Most Popular Song of the Year |Aliteuliwa |- |Video of the Year |Aliteuliwa |- |''La Fureur - Spécial Céline Dion'' |Television Show of the Year - Song{{ref|h|[h]}} |Aliteuliwa |- |2003<ref>{{cite web|title=Gala de l'ADISQ - 2003 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala2003.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20140113223038/http://www.adisq.com/even-gala/archives/gala2003.html |archivedate=13 January 2014 |df= }}</ref> |rowspan="2"|Celine Dion |Artist of the Year Achieving the Most Success in a Language Other Than French |Aliteuliwa |- |rowspan="3"|2004<ref>{{cite web|title=Gala de l'ADISQ - 2004|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala2004.html|accessdate=13 January 2014|archiveurl=https://web.archive.org/web/20131105181342/http://www.adisq.com/even-gala/archives/gala2004.html|archivedate=2013-11-05}}</ref> |Female Vocalist of the Year |Aliteuliwa |- |''1 fille & 4 types'' |Best Selling Album of the Year |Aliteuliwa |- |celinedion.com |Website of the Year{{ref|h|[h]}} |Aliteuliwa |- |rowspan="2"|2005<ref>{{cite web|title=Gala de l'ADISQ - 2005 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala2005.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20140113224835/http://www.adisq.com/even-gala/archives/gala2005.html |archivedate=13 January 2014 |df= }}</ref> |''A New Day... Live in Las Vegas'' |rowspan="2"|Anglophone Album of the Year |Aliteuliwa |- |''Miracle'' |Aliteuliwa |- |rowspan="2"|2006<ref>{{cite web|title=Gala de l'ADISQ - 2006|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala2006.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140110170707/http://www.adisq.com/even-gala/archives/gala2006.html|archivedate=10 January 2014}}</ref> |Celine Dion |Female Vocalist of the Year |Aliteuliwa |- |"Je ne vous oublie pas" |Most Popular Song of the Year |Aliteuliwa |- |2007<ref>{{cite web|title=Gala de l'ADISQ - 2007|publisher=ADISQ|url=http://www.adisq.com/even-gala/archives/gala2007.html|accessdate=13 January 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140113234321/http://www.adisq.com/even-gala/archives/gala2007.html|archivedate=13 January 2014}}</ref> |''Céline : 25 ans d'amour, 25 ans de télé'' |Television Show of the Year - Song{{ref|h|[h]}} |Aliteuliwa |- |2008<ref name="official"/> |rowspan="2"|Celine Dion |Honorary Award |{{won}} |- |rowspan="2"|2009<ref>{{cite web|title=Gala de l'ADISQ - 2009 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala2009.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20131109162835/http://www.adisq.com/even-gala/archives/gala2009.html |archivedate=9 November 2013 |df= }}</ref> |Artist of the Year Achieving the Most Success Outside Quebec |Aliteuliwa |- |''Céline sur les Plaines'' |DVD of the Year{{ref|h|[h]}} |{{won}} |- |rowspan="6"|2013<ref>{{cite web|title=Gala de l'ADISQ - 2013 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala2013.html |accessdate=13 January 2014 |deadurl=yes |archiveurl=https://web.archive.org/web/20140113225348/http://www.adisq.com/even-gala/archives/gala2013.html |archivedate=13 January 2014 |df= }}</ref> |rowspan="2"|Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |Aliteuliwa |- |Female Vocalist of the Year |Aliteuliwa |- |"Parler à mon père" |Most Popular Song of the Year |Aliteuliwa |- |rowspan="2"|''Sans attendre'' |Adult Contemporary Album of the Year |{{won}} |- |Best Selling Album of the Year |{{won}} |- |''Céline Dion... Sans attendre'' |Television Show of the Year - Music{{ref|h|[h]}} |Aliteuliwa |- |rowspan="3"|2014<ref>{{cite web|title=Gala de l'ADISQ - 2014 |publisher=ADISQ |url=http://www.adisq.com/even-gala/archives/gala2013.html |accessdate=7 June 2015 |deadurl=yes |archiveurl=https://web.archive.org/web/20140113225348/http://www.adisq.com/even-gala/archives/gala2013.html |archivedate=13 January 2014 |df= }}</ref> |Celine Dion |Artist of the Year Achieving the Most Success Outside Quebec |Aliteuliwa |- |''Loved Me Back to Life'' |Anglophone Album of the Year |Aliteuliwa |- |''Sans attendre Tour'' |Television Show of the Year - Music{{ref|h|[h]}} |Aliteuliwa |- |rowspan="4"|2017<ref>{{cite web|title=Gala de l'ADISQ - 2017|publisher=ADISQ|url=http://palmaresadisq.ca/fr/artiste/celine-dion/?ref=calendar#|accessdate=8 October 2017}}</ref> |Celine Dion |Female Vocalist of the Year |Aliteuliwa |- |rowspan="2"|''Encore un soir'' |Adult Contemporary Album of the Year |{{won}} |- |Best Selling Album of the Year |{{won}} |- |"Encore un soir" |Most Popular Song of the Year |Aliteuliwa {{end}} ===FiFi Awards=== {{awards table}} |- |2004<ref name="official"/> |Celine Dion Parfums |rowspan="2"|Women's Fragrance of the Year - Popular Appeal |{{won}} |- |rowspan="2"|2006<ref name="official"/> |rowspan="2"|Celine Dion Belong |Aliteuliwa |- |Women's Best Packaging of the Year - Popular Appeal |{{won}} |- |rowspan="2"|2007<ref name="official"/> |rowspan="2"|Fragrances Always Belong |Women's Fragrance of the Year - Popular Appeal |Aliteuliwa |- |Women's Best Packaging of the Year - Popular Appeal |Aliteuliwa |- |2008<ref name="official"/> |Celine Dion Parfums Enchanting |rowspan="2"|Women's Fragrance of the Year - Popular Appeal |Aliteuliwa |- |2009<ref name="official"/> |Celine Dion Parfums Sensational |Aliteuliwa |- {{end}} ===FM Select Diamond Award=== {{awards table}} |- |1997<ref name="official"/> |Celine Dion |Top Female International Artist |{{won}} |- {{end}} ===France Bleu Talent Awards=== {{awards table}} |- |2013<ref>{{cite web|title=Celine Receives A 'Talent d'Honneur France Bleu 2013' Award|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/news/celine-receives-%E2%80%98talent-d%E2%80%99honneur-france-bleu-2013%E2%80%99-award|date=26 December 2013|accessdate=28 January 2014|archiveurl=https://web.archive.org/web/20140201225802/http://www.celinedion.com/ca/news/celine-receives-%E2%80%98talent-d%E2%80%99honneur-france-bleu-2013%E2%80%99-award|archivedate=2014-02-01}}</ref> |Celine Dion |Honorary Award for the Long-Standing Career in France |{{won}} |- {{end}} ===Fryderyk Awards=== {{awards table}} |- |1998<ref>{{cite web|title=Nominees and Winners 1997|publisher=ZPAV|url=http://www.zpav.pl/fryderyk/nominowani/index.php?lang=2&year=1997|accessdate=29 January 2014}}</ref> |''Let's Talk About Love'' |Best Foreign Album |Aliteuliwa |- {{end}} ===Gémeaux Awards=== {{awards table}} |- |rowspan="6"|1988<ref>{{cite web|title=Canada's Awards Database: Céline Dion - Incognito|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line+Dion+-+Incognito&awyear=0&winonly=0&awards=3&rtype=2&curstep=4&submit.x=36&submit.y=5|language=French|accessdate=5 February 2014|archiveurl=https://web.archive.org/web/20140306213455/http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line+Dion+-+Incognito&awyear=0&winonly=0&awards=3&rtype=2&curstep=4&submit.x=36&submit.y=5|archivedate=2014-03-06}}</ref> |rowspan="6"|''Incognito'' |Best Cinematography: All Categories: Variety, Performing Arts or Humor{{ref|c|[c]}} |{{won}} |- |Best Lighting: Program or Series: All Categories{{ref|c|[c]}} |{{won}} |- |Best Direction: Program, Variety Series or Performing Arts{{ref|c|[c]}} |Aliteuliwa |- |Best Production Design: All Categories{{ref|c|[c]}} |Aliteuliwa |- |Best Costume Design: All Categories{{ref|c|[c]}} |Aliteuliwa |- |Best Makeup/Hair: All Categories{{ref|c|[c]}} |Aliteuliwa |- |rowspan="3"|1990<ref>{{cite web|title=Canada's Awards Database: Céline Dion - Unison|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line+Dion+-+Unison&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=28&submit.y=11|language=French|accessdate=6 February 2014|archiveurl=https://archive.today/20140206142437/http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line+Dion+-+Unison&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=28&submit.y=11|archivedate=2014-02-06}}</ref> |rowspan="3"|''Unison'' |Best Variety Special{{ref|c|[c]}} |{{won}} |- |Best Direction: Humor or Variety Special{{ref|c|[c]}} |Aliteuliwa |- |Best Editing: Variety, Humor, Performing Arts or Documentary Arts{{ref|c|[c]}} |Aliteuliwa |- |rowspan="5"|1992<ref>{{cite web|title=Canada's Awards Database: Dion, 1992|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=dion&awyear=1992&winonly=0&awards=0&rtype=2&curstep=4&submit.x=27&submit.y=11|language=French|accessdate=6 February 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140306213544/http://www2.academy.ca/hist/history.cfm?stitle=dion&awyear=1992&winonly=0&awards=0&rtype=2&curstep=4&submit.x=27&submit.y=11|archivedate=6 March 2014}}</ref> |rowspan="3"|''Céline Dion: 10 ans déjà'' |Best Variety Special{{ref|c|[c]}} |Aliteuliwa |- |Best Direction: Variety Series or Special{{ref|c|[c]}} |Aliteuliwa |- |Best Sound: All Categories: Variety, Humor, Performing Arts or Documentary Arts{{ref|c|[c]}} |Aliteuliwa |- |rowspan="2"|''Dion chante Plamondon'' |Best Variety Special{{ref|c|[c]}} |Aliteuliwa |- |Best Direction: Variety Series or Special{{ref|c|[c]}} |Aliteuliwa |- |1995<ref>{{cite web|title=Canada's Awards Database: Meilleur spécial de varieties, 1995|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?categid=300018&shownum=10&winonly=0&awards=3&rtype=5&curstep=4|language=French|accessdate=6 February 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140306213636/http://www2.academy.ca/hist/history.cfm?categid=300018&shownum=10&winonly=0&awards=3&rtype=5&curstep=4|archivedate=6 March 2014}}</ref> |''Céline Dion - D'eux'' |Best Variety Special{{ref|c|[c]}} |Aliteuliwa |- |rowspan="2"|1996<ref>{{cite web|title=Canada's Awards Database: Céline Dion - spécial d'enfer|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line+Dion+-+Sp%C3%A9cial+d%27Enfer&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=49&submit.y=5|language=French|accessdate=6 February 2014|archiveurl=https://archive.today/20140206145706/http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line+Dion+-+Sp%C3%A9cial+d'Enfer&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=49&submit.y=5|archivedate=2014-02-06}}</ref> |rowspan="2"|''Céline Dion - spécial d'enfer'' |Best Variety Special{{ref|c|[c]}} |Aliteuliwa |- |Best Animation: Series or Variety Special{{ref|c|[c]}} |Aliteuliwa |- |rowspan="6"|1998<ref>{{cite web|title=Canada's Awards Database: Céline, 1998|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line&awyear=1998&winonly=0&awards=0&rtype=2&curstep=4&submit.x=44&submit.y=7|language=French|accessdate=6 February 2014|archiveurl=https://web.archive.org/web/20140306213549/http://www2.academy.ca/hist/history.cfm?stitle=C%C3%A9line&awyear=1998&winonly=0&awards=0&rtype=2&curstep=4&submit.x=44&submit.y=7|archivedate=2014-03-06}}</ref> |rowspan="4"|''[[Let's Talk About Love|Let's Talk About Love avec Céline Dion]]'' |Best Variety Special{{ref|c|[c]}} |{{won}} |- |Best Direction: Variety Series or Special{{ref|c|[c]}} |{{won}} |- |Best Interview: All Categories{{ref|c|[c]}} |Aliteuliwa |- |Audience Award{{ref|c|[c]}} |Aliteuliwa |- |rowspan="2"|''[[Let's Talk About Love|Let's talk from Las Vegas, Céline]]'' |Best Variety Special{{ref|c|[c]}} |Aliteuliwa |- |Best Direction: Variety Series or Special{{ref|c|[c]}} |Aliteuliwa |- |rowspan="2"|1999<ref>{{cite web|title=Canada's Awards Database: Un an avec Céline|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=Un+an+avec+C%C3%A9line&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=49&submit.y=2|language=French|accessdate=7 February 2014|archiveurl=https://web.archive.org/web/20140306213628/http://www2.academy.ca/hist/history.cfm?stitle=Un+an+avec+C%C3%A9line&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=49&submit.y=2|archivedate=2014-03-06}}</ref> |rowspan="2"|''Let's Talk About Love'' |Best Variety{{ref|c|[c]}} |{{won}} |- |Best Direction: All Variety Categories{{ref|c|[c]}} |Aliteuliwa |- |rowspan="2"|2000<ref>{{cite web|title=Canada's Awards Database: La dernière de Céline|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=La+derni%C3%A8re+de+C%C3%A9line&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=48&submit.y=10|language=French|accessdate=7 February 2014|archiveurl=https://web.archive.org/web/20140306213623/http://www2.academy.ca/hist/history.cfm?stitle=La+derni%C3%A8re+de+C%C3%A9line&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=48&submit.y=10|archivedate=2014-03-06}}</ref> |rowspan="2"|''Let's Talk About Love World Tour'' |Best Variety{{ref|c|[c]}} |{{won}} |- |Best Direction: All Variety Categories{{ref|c|[c]}} |Aliteuliwa |- |rowspan="3"|2003<ref>{{cite web|title=Canada's Awards Database: La Petite Vie, 2003|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=La+Petite+vie&awyear=2003&winonly=0&awards=0&rtype=2&curstep=4&submit.x=52&submit.y=7|language=French|accessdate=7 February 2014|archiveurl=https://web.archive.org/web/20140306213630/http://www2.academy.ca/hist/history.cfm?stitle=La+Petite+vie&awyear=2003&winonly=0&awards=0&rtype=2&curstep=4&submit.x=52&submit.y=7|archivedate=2014-03-06}}</ref> |rowspan="3"|''[[La Petite Vie|La Petite Vie: Noël chez les pare]]'' |Best Performance: Humor |{{won}} |- |Best Comedy Series or Special{{ref|c|[c]}} |Aliteuliwa |- |Best Writing: Humor, Variety, Talk Show{{ref|c|[c]}} |Aliteuliwa |- {{end}} ===Gemini Awards=== {{awards table}} |- |1992<ref>{{cite web|title=Canada's Awards Database: Best Performance in a Variety Program or Series, 1992|publisher=[[Academy of Canadian Cinema & Television]]|url=http://www2.academy.ca/hist/history.cfm?categid=9512&shownum=6&winonly=0&awards=2&rtype=5&curstep=4|accessdate=5 February 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140306213502/http://www2.academy.ca/hist/history.cfm?categid=9512&shownum=6&winonly=0&awards=2&rtype=5&curstep=4|archivedate=6 March 2014}}</ref> |Celine Dion at the Juno Awards of 1991 |rowspan="3"|Best Performance in a Variety Program or Series |Aliteuliwa |- |1994<ref>{{cite web|title=Canada's Awards Database: Best Performance in a Variety Program or Series, 1994|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?categid=9512&shownum=8&winonly=0&awards=2&rtype=5&curstep=4|accessdate=5 February 2014|archiveurl=https://web.archive.org/web/20140306213457/http://www2.academy.ca/hist/history.cfm?categid=9512&shownum=8&winonly=0&awards=2&rtype=5&curstep=4|archivedate=2014-03-06}}</ref> |Celine Dion at the Juno Awards of 1993 |Aliteuliwa |- |1995<ref name="gemini">{{cite web|title=Canada's Awards Database: The Colour of My Love|publisher=Academy of Canadian Cinema & Television|url=http://www2.academy.ca/hist/history.cfm?stitle=The+Colour+of+My+Love&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=35&submit.y=12|accessdate=5 February 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140306213708/http://www2.academy.ca/hist/history.cfm?stitle=The+Colour+of+My+Love&awyear=0&winonly=0&awards=0&rtype=2&curstep=4&submit.x=35&submit.y=12|archivedate=6 March 2014}}</ref> |Celine Dion in ''The Colour of My Love Concert'' |Aliteuliwa |- {{end}} ===Governor General's Awards=== {{awards table}} |- |1992<ref name="official"/> |Celine Dion |Medal of Recognition for the Contribution to Canadian Culture |{{won}} |- {{end}} ===Grammy Awards=== {{awards table}} |- |rowspan="3"|1993<ref name="g1">{{cite web|title=35th Grammy Awards - 1993|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1993/grammys.htm|accessdate=11 January 2014}}</ref> |rowspan="2"|"[[Beauty and the Beast (Disney song)|Beauty and the Beast]]" |Grammy Award for Record of the Year |Aliteuliwa |- |Grammy Award for Best Pop Performance by a Duo or Group with Vocals |{{won}} |- |''Celine Dion'' |Grammy Award for Best Female Pop Vocal Performance |Aliteuliwa |- ||1994<ref name="g2">{{cite web|title=36th Grammy Awards - 1994|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1994/grammys.htm|accessdate=11 January 2014}}</ref> ||"When I Fall in Love" |Best Pop Performance by a Duo or Group with Vocal |Aliteuliwa |- |1995<ref>{{cite web|title=37th Grammy Awards - 1995|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1995/grammys.htm|accessdate=11 January 2014}}</ref> |"The Power of Love" |Best Female Pop Vocal Performance |Aliteuliwa |- |rowspan="4"|1997<ref name="g3">{{cite web|title=39th Grammy Awards - 1997|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1997/grammys.htm|accessdate=11 January 2014}}</ref> |rowspan="2"|"Because You Loved Me" |Record of the Year |Aliteuliwa |- |Best Female Pop Vocal Performance |Aliteuliwa |- |rowspan="2"|''Falling into You'' |Album of the Year |{{won}} |- |Grammy Award for Best Pop Vocal Album |{{won}} |- |1998<ref>{{cite web|title=39th Grammy Awards - 1998|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1998/grammys.htm|accessdate=12 January 2014}}</ref> |"Tell Him" |Grammy Award for Best Pop Collaboration with Vocals |Aliteuliwa |- |rowspan="4"|1999<ref name="g4">{{cite web|title=41st Grammy Awards - 1999|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/1999/grammys.htm|accessdate=12 January 2014}}</ref> |rowspan="2"|"My Heart Will Go On" |Record of the Year |{{won}} |- |Best Female Pop Vocal Performance |{{won}} |- |"I'm Your Angel" |Best Pop Collaboration with Vocals |Aliteuliwa |- |''Let's Talk About Love'' |Best Pop Album |Aliteuliwa |- |2000<ref>{{cite web|title=42nd Grammy Awards - 2000|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/2000/grammys.htm|accessdate=12 January 2014}}</ref> |"The Prayer" |rowspan="2"|Best Pop Collaboration with Vocals |Aliteuliwa |- |2001<ref>{{cite web|title=43rd Grammy Awards - 2001|publisher=Rock On The Net|url=http://www.rockonthenet.com/archive/2001/grammys.htm|accessdate=12 January 2014}}</ref> |"All the Way" |Aliteuliwa |- {{end}} ===Hungarian Music Awards=== {{awards table}} |- |1998<ref name="official"/> |''Let's Talk About Love'' |International Album of the Year |{{won}} |- {{end}} ===Hollywood Walk of Fame=== {{awards table}} |- |2004<ref name="official"/> |Celine Dion |Star on the Hollywood Walk of Fame |{{won}} |- {{end}} ===International Federation of the Phonographic Industry=== {{awards table}} |- |rowspan="2"|2003<ref>{{cite web|title=Céline Receives IFPI Award|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/23206|date=31 March 2003|accessdate=25 January 2014|archiveurl=https://web.archive.org/web/20140201215154/http://www.celinedion.com/ca/node/23206|archivedate=2014-02-01}}</ref> |rowspan="2"|Celine Dion |Special Award for Selling 50 Million Albums in Europe |{{won}} |- |Special Award for Selling 10 Million Copies of ''Let's Talk About Love'' in Europe |{{won}} |- {{end}} ===International Achievement in Arts Awards=== {{awards table}} |- |1997<ref name="official"/> |Celine Dion |Entertainer of the Year for Distinguished Achievement in Music |{{won}} |- {{end}} ===Irish Recorded Music Association=== {{awards table}} |- |1996<ref name="official"/> |''The Colour of My Love'' |rowspan="2"|Best International Female Artist Album |{{won}} |- |1997<ref name="official"/> |''Falling into You'' |{{won}} |- {{end}} ===Japan Record Awards=== {{awards table}} |- |1998<ref name="official"/> |"My Heart Will Go On" |Special Achievement Award |{{won}} |- {{end}} ===Kraków's Walk of Fame=== {{awards table}} |- |2008<ref name="official"/> |Celine Dion |Inducted into Kraków's Walk of Fame |{{won}} |- {{end}} ===Las Vegas Film Critics Society Awards=== {{awards table}} |- |1998<ref>{{cite web|title=Las Vegas Film Critics Society Awards|publisher=IMDb|url=https://www.imdb.com/event/ev0000392/1998-1|accessdate=22 February 2014}}</ref> |"My Heart Will Go On" |Best Song |{{won}} |- {{end}} ===Laval University's Honorary Doctorate in Music=== {{awards table}} |- |2008<ref name="official"/> |Celine Dion |In Recognition of the Personal and Professional Achievements |{{won}} |- {{end}} ===Legion of Honour=== {{awards table}} |- |2008 |Celine Dion |Knight of the Legion of Honour for Merits and Contributions to France |{{won}} |- {{end}} ===MTV Europe Music Awards=== {{awards table}} |- |1998<ref>{{cite web|title=Entertainment: All Saints top MTV nominations|publisher=[[BBC News]]|url=http://news.bbc.co.uk/2/hi/entertainment/184529.stm|date=1 October 1998|accessdate=10 January 2014}}</ref> |Celine Dion |MTV Europe Music Award for Best Female |Aliteuliwa |- {{end}} ===MuchMusic Video Awards=== {{awards table}} |- |1990<ref name="rockonthenet">{{cite web|title=Celine Dion: Timeline|publisher=Rock On The Net|url=http://www.rockonthenet.com/artists-d/celinedion_main.htm|accessdate=10 January 2014}}</ref> |"Can't Live with You, Can't Live Without You" |Best MOR Video |{{won}} |- |1992<ref name="rockonthenet"/> |"Je danse dans ma tête" |Best Adult Contemporary Video |{{won}} |- |1997<ref>{{cite web|title=The Choice Is Yours|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/717|date=30 July 1997|accessdate=8 February 2014|archiveurl=https://web.archive.org/web/20140222194542/http://www.celinedion.com/ca/node/717|archivedate=2014-02-22}}</ref> |Celine Dion |People's Choice: Favourite International Artist |Aliteuliwa |- |1998<ref name="rockonthenet"/> |"My Heart Will Go On" |Peoples Choice: Favourite Artist |{{won}} |- |1999<ref>{{cite web|title=MMVA Nominee|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/node/1494|date=1 September 1999|accessdate=4 February 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20140222191841/http://www.celinedion.com/ca/node/1494|archivedate=22 February 2014}}</ref> |"I'm Your Angel" |rowspan="5"|MuchMoreMusic Award |Aliteuliwa |- |2000<ref name="rockonthenet"/> |"That's the Way It Is" |Aliteuliwa |- |2002<ref>{{cite web|title=MuchMusic Video Awards: 12 nominacji Nickelback!|publisher=[[Interia.pl]]|url=http://muzyka.interia.pl/wiadomosci/news/muchmusic-video-awards-12-nominacji-nickelback,261201,44|language=Polish|date=15 May 2002|accessdate=10 January 2014|deadurl=yes|archiveurl=https://archive.today/20140110182039/http://muzyka.interia.pl/wiadomosci/news/muchmusic-video-awards-12-nominacji-nickelback,261201,44|archivedate=10 January 2014}}</ref> |"A New Day Has Come" |Aliteuliwa |- |2003<ref>{{cite web|title=2003 MuchMusic Video Awards Nominees|work=[[Billboard (magazine)|Billboard]]|url=http://www.billboard.com/articles/news/70812/2003-muchmusic-video-awards-nominees|date=30 May 2003|accessdate=10 January 2014}}</ref> |"I Drove All Night" |Aliteuliwa |- |[[2005 MuchMusic Video Awards|2005]]<ref>{{cite web|title=2005 MuchMusic Video Awards|publisher=MetroLyrics|url=http://m.metrolyrics.com/2005-muchmusic-video-awards.html|accessdate=10 January 2014|archivedate=2014-01-10|archiveurl=https://web.archive.org/web/20140110152057/http://m.metrolyrics.com/2005-muchmusic-video-awards.html}}</ref> |"You and I" |Aliteuliwa |- {{end}} ===World Music Awards=== {{awards table}} |- |1992<ref name="official"/> |rowspan="15"|Celine Dion |rowspan="2"|World's Best Selling Canadian Female Artist of the Year |{{won}} |- |1995<ref name="official"/> |{{won}} |- |1996<ref name="official"/> |World's Best Selling Canadian Artist of the Year |{{won}} |- |rowspan="3"|1997<ref name="official"/> |World's Best Selling Artist of the Year |{{won}} |- |World's Best Selling Pop Artist of the Year |{{won}} |- |rowspan="2"|World's Best Selling Canadian Artist of the Year |{{won}} |- |1998<ref name="official"/> |{{won}} |- |[[1999 World Music Awards|1999]]<ref name="official"/> |rowspan="2"|World's Best Selling Female Pop Artist of the Year |{{won}} |- |2000<ref name="official"/> |{{won}} |- |[[2004 World Music Awards|2004]]<ref name="official"/> |[[Chopard Diamond award|Diamond Award]] for Selling Over 100 Million Albums |{{won}} |- |[[2007 World Music Awards|2007]]<ref name="official"/> |[[World Music Awards#Legend Awards|Legend Award]] for Outstanding Contribution to the Music Industry |{{won}} |- |[[2008 World Music Awards|2008]]<ref name="official"/> |World's Best Selling Canadian Artist of the Year |{{won}} |- |rowspan="4"|2013<ref>{{cite web|title=Celine Nominated At The 2013 World Music Awards|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/news/celine-nominated-2013-world-music-awards|date=12 March 2013|accessdate=28 May 2014|deadurl=yes|archiveurl=https://web.archive.org/web/20130617030812/http://www.celinedion.com/ca/news/celine-nominated-2013-world-music-awards|archivedate=17 June 2013}}</ref> |World's Best Female Artist |Aliteuliwa |- |World's Best Live Act |Aliteuliwa |- |World's Best Entertainer of the Year |Aliteuliwa |- |rowspan="1"|''Sans attendre'' |World's Best Album |Aliteuliwa |- |rowspan="6"|[[2014 World Music Awards|2014]]<ref>{{cite web|title=Vote For Celine For the 2014 World Music Awards|publisher=Five Star Feeling Inc|url=http://www.celinedion.com/ca/news/vote-celine-2014-world-music-awards|date=22 May 2014|accessdate=28 May 2014|archiveurl=https://web.archive.org/web/20140529084610/http://www.celinedion.com/ca/news/vote-celine-2014-world-music-awards|archivedate=2014-05-29}}</ref> |rowspan="3"|Celine Dion |World's Best Female Artist |Aliteuliwa |- |World's Best Live Act |Aliteuliwa |- |World's Best Entertainer of the Year |Aliteuliwa |- |''Sans attendre'' |rowspan="2"|World's Best Album |Aliteuliwa |- |''Loved Me Back to Life'' |Aliteuliwa |- |"Incredible" |World's Best Song |Aliteuliwa |- {{end}} == Marejeo == {{Marejeo}} == Viungo vya Nje == {{Commons|Céline Dion}} * [http://www.celinedion.com CelineDion.com] – Official website, managed by Sony BMG Music Canada (English, French). * [http://www.celinetakingchances.com CelineTakingChances.com] {{Wayback|url=http://www.celinetakingchances.com/ |date=20090314153049 }} – Official UK website. * [http://www.youtube.com/user/CelineDionTV?ob=1 Céline Dion YouTube Channel] * [https://web.archive.org/web/20090719155542/http://www.billboard.com/bbcom/bio/index.jsp?JSESSIONID=Gd3v91yY0Zv2CLJLy0d5klgb2v1FgXnCspwqJ7vJj179TpKTt9B2!563335813&pid=4468 Celine Dion] at Billboard.com * {{IMDb name|id=0001144|name=Céline Dion}} {{Celine Dion}} {{BD|1968||Dion, Celine}} [[Jamii:muziki wa pop]] [[Jamii:Wanamuziki wa Kanada]] imewqu4ybr4etrjjljlgw3n2783ceda 0 22968 1578126 1398387 2026-07-02T21:12:52Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578126 wikitext text/x-wiki [[picha:Prevalence_of_Diabetes_by_Percent_of_Country_Population_(2014)_Gradient_Map.png|thumbnail|right|200px|Ueneaji wa kisukari mwaka 2014]] '''Kisukari''' au '''bolisukari''' ([[jina]] la kitaalamu: '''diabetes mellitus''') ni [[ugonjwa]] unaoonyesha viwango vikubwa vya [[glukosi]] katika [[damu]]. Sababu yake ni uhaba wa [[homoni]] ya [[insulini]] [[Mwili|mwilini]] au upungufu wa uwezo wa mwili wa kukubali insulini. [[Dalili]] za kisukari ni * [[Mkojo|kukojoa]] kupita kiasi cha kawaida * [[kiu]] kubwa * kuona vibaya na matatizo ya [[macho]] hadi kuwa [[kipofu]] * kuchoka haraka * [[kidonda|vidonda]] vinavyopoa polepole mno, hasa kwenye [[miguu]], hadi kupotewa na viungo [[Watu]] wachache huzaliwa na uhaba wa insulini. Walio wengi wana udhaifu fulani unaokuwa hatari kutokana na aina za [[vyakula]] na [[maisha]] ya kila [[siku]]. Kutumia [[sukari]] nyingi pamoja na [[mafuta]] mengi katika [[chakula]] na [[vinywaji]], kukosa [[mazoezi ya mwili]] (kwa watu wenye [[kazi]] [[ofisi|ofisini]]), kunywa [[pombe]] nyingi na kuvuta [[sigara]] huongeza hatari ya kushika kisukari kuanzia baada ya miaka ya [[ujana]]. Ugonjwa wa kisukari husababishwa na [[kongosho]] (kwa [[Kiingereza]] "pancreas") kutoweza kutoa kiwango cha insulini mwilini kinachofaa. Pia yaweza kuwa mwili haufanyi kama unavyotarajiwa kufanya insulini ikifika sehemu ile ya mwili. Kuna aina [[tatu]] za bolisukari: * Moja ni wakati kongosho imeshindwa kutengeneza insulini kiwango kizuri cha kudhibiti sukari mwilini * Aina ya pili ni wakati mwili unakataa kudhibiti sukari hata insulini ikitengenezwa na kongosho * Aina ya tatu ni bolisukari ambayo huathiri [[wanawake]] [[Ujauzito|wajawazito]] ambao hupata kwamba kiwango cha sukari miilini mwao kimekwenda juu hata kama hawana [[historia]] ya aina hii. [[Takwimu]] zadhihirisha kwamba [[mwaka]] [[2015]], watu [[milioni]] 415 duniani kote walikuwa na bolisukari<ref name=IDF2015>{{cite web |title=Update 2015 |url=http://www.diabetesatlas.org/|website=ID F|page=13|publisher=International Diabetes Federation |accessdate=21 March 2016 |deadurl=no |archiveurl=https://web.archive.org/web/20160322011630/http://www.diabetesatlas.org/ |archivedate=22 March 2016}}</ref>. [[Kisukari aina ya 2]], yaani miili yao ilikataa kudhibiti sukari hata baada ya kongosho kutoa insulini, ilichangia [[asilimia]] [[tisini]]<ref name=Will2011>{{cite book |title=Williams textbook of endocrinology |year=2011 |url=https://archive.org/details/williamstextbook00melm_993 |publisher=Elsevier/Saunders |isbn=978-1-4377-0324-5 |pages=[https://archive.org/details/williamstextbook00melm_993/page/n1365 1371]–1435 |edition=12th}}</ref><ref name=Shi2014>{{cite journal |last1=Shi |first1=Yuankai |last2=Hu |first2=Frank B |title=The global implications of diabetes and cancer |journal=The Lancet |date=7 June 2014 |volume=383 |issue=9933 |pages=1947–48|doi=10.1016/S0140-6736(14)60886-2 |pmid=24910221 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(14)60886-2}}</ref>. Hao ni asilimia 8.3 za watu wazima wote<ref name=Shi2014/>, wakiwemo wanaume na wanawake kwa uwiano sawa<ref name=Vos2012>{{cite journal |vauthors=Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V |title=Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. |url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2163 |journal=Lancet |volume=380 |issue=9859 |pages=2163–96 |date=15 December 2012 |pmid=23245607 |doi=10.1016/S0140-6736(12)61729-2 |display-authors=etal}}</ref>. Mwelekeo ni wa kuongezeka zaidi na zaidi.<ref name=IDF2014>{{cite web |title= Annual Report 2014 |url=http://www.idf.org/sites/default/files/IDF-2014-Annual-Report-final.pdf |website=IDF |publisher=International Diabetes Federation |accessdate= 13 July 2016 |deadurl= yes |archiveurl=https://web.archive.org/web/20161017171522/http://www.idf.org/sites/default/files/IDF-2014-Annual-Report-final.pdf |archivedate=17 October 2016}}</ref> Kisukari kinazidisha [[hatari ya kufa]] mapema walau mara mbili. Katika miaka [[2012]]-[[2015]], watu milioni 1.5 hadi 5.0 walifariki kila mwaka kutokana na kisukari.<ref name=IDF2015/> Hasara ya kiuchumi mwaka [[2014]] ilikadiriwa kuwa [[Dolar ya Marekani|dola]] [[bilioni]] 612.<ref name=IDF2013>{{cite book |title=IDF DIABETES ATLAS |year=2013 |publisher=International Diabetes Federation |isbn=2930229853 |edition=6th |page=7 |url=http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf |deadurl=yes |archiveurl=https://web.archive.org/web/20140609023846/http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf |archivedate=9 June 2014 |=https://web.archive.org/web/20140609023846/http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf }}</ref> [[File:Diabetes video.webm|thumb|upright=1.4|Maelezo ya kisukari kwa njia ya [[video]].]] == Kinga na tiba == Unapotaka kujikinga na bolisukari, inafaa ule [[lishe bora]], ufanye mazoezi, udhibiti [[uzani]] wako na usitumie sigara wala pombe. Walio na shida ya kisukari wafaa kudhibiti [[shinikizo la damu]] pamoja na kuangalia miguu yao vizuri. Kuna [[viatu]] maalumu za kuvalia kwa walio na bolisukari. Kwa walio na bolisukari aina ya kwanza, [[tiba]] ni kupokea [[sindano]] za insulini. Walio na aina ya pili ya bolisukari waweza kutibiwa kwa insulini au hata [[dawa]] nyingine. Wanawake walio na aina ya tatu ya bolisukari hupata kwamba bolisukari yao yaisha pindi tu wanapozaa. ==Tazama pia== *[[Kisukari aina ya 2]] ==Tanbihi== {{reflist}} == Viungo vya nje == * [http://www.who.int/diabetes/en/ World Health Organization Diabetes Programme] * [http://www.jdrf.org/ Juvenile Diabetes Research Foundation International] * [http://www.diabetes.org/home.jsp American Diabetes Association] {{Wayback|url=http://www.diabetes.org/home.jsp |date=20080327123601 }} * [http://www.diabetesforum.com Diabetes Forum] * [http://www.youngdiabetics.org Young Diabetic Community] {{Wayback|url=http://www.youngdiabetics.org/ |date=20201129045152 }} * [http://www.diabetes.ca/Section_Main/welcome.asp Canadian Diabetes Association] {{Wayback|url=http://www.diabetes.ca/Section_Main/welcome.asp |date=20060101024146 }} * [http://www.diabetesaustralia.com.au/home/index.htm Diabetes Australia] {{Wayback|url=http://www.diabetesaustralia.com.au/home/index.htm |date=20080905152347 }} * [http://www.diabetes.org.nz/ Diabetes New Zealand] * [http://www.diabetes.org.uk/ Diabetes UK] * [http://www.diabetesfriends.net/ DiabetesFriends.net - Social Networking for Diabetics] {{Wayback|url=http://www.diabetesfriends.net/ |date=20080723121549 }} * [http://www.diabetesforums.co.uk Diabetes Forum UK] {{Wayback|url=http://www.diabetesforums.co.uk/ |date=20080527175235 }} {{mbegu-tiba}} [[Jamii:Tiba]] [[Jamii:Magonjwa]] pnn4bffjevmex2gq0fc07hlq2xw9xmm 0 23631 1578067 1124456 2026-07-02T17:39:15Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578067 wikitext text/x-wiki [[Picha:Ensenada_Grande.jpg|thumbnail|right|200px|Isla Partida,Baja California]] [[Picha:Coat of arms of Baja California.svg|thumb|Nembo ya Sonora]] [[Picha:Mexico map, MX-BCN.svg|thumb|Mahali pa Baja California katika [[Mexiko]]]] '''Baja California''' ''(tamka ba-kha ka-li-for-ni-a, ''kwa maana Kalifornia ya Chini'')'' ni moja kati ya majimbo 31 ya [[Mexiko]] upande wa kaskazini-magharibi ya nchi. Jimbo lina wakazi wapatao 2,844,469 (2005) wanaokalia katika eneo la kilomita za mraba zipatazo 69,921. Mji mkuu ni [[Mexicali, Baja California|Mexicali]] na mji mkubwa ni [[Tijuana, Baja California|Tijuana]]. Iko kwenye pwani la [[Pasifiki]] na [[Ghuba ya California]] (au Bahari ya Cortez). Imepakana na [[Marekani]] (jimbo la [[Kalifornia]]), halafu majimbo ya Meksiko [[Sonora (jimbo)|Sonora]] na [[Baja California Sur]]. Gavana wa jimbo ni [[José Guadalupe Osuna Millán]]. Lugha rasmi ni [[Kihispania]]. == Miji Mikubwa == # [[Tijuana, Baja California|Tijuana]] (1,286,187) # [[Mexicali, Baja California|Mexicali]] (1,000,010) # [[Ensenada]] (460.075) # [[Tecate]] (91,034) [[Picha:Baja California Desert.jpg|thumb|200px|left|Pori ya Kati, Baja California]] == Viungo vya Nje == * {{es}} [http://www.bajacalifornia.gob.mx/ Estado de Baja California Sitio oficial] {{Wayback|url=http://www.bajacalifornia.gob.mx/ |date=19981212012739 }} {{mbegu-jio-Mexiko}} [[Jamii:Majimbo ya Mexiko]] [[Jamii:Baja California| ]] nmi7snwsdub85pcmbmrfp0xtvw39jqf 0 32708 1577959 1317996 2026-07-02T13:01:35Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577959 wikitext text/x-wiki {{Infobox settlement <!--See the Table at Infobox Settlement for all fields and descriptions of usage--> <!-- Basic info ----------------> |official_name = Juba |other_name = |native_name = <!-- for cities whose native name is not in English --> |nickname = |settlement_type = <!--For Town or Village (Leave blank for the default City)--> |motto = <!-- images and maps -----------> |image_skyline = Juba Sudan aerial view.jpg |imagesize = 300px |image_caption = Aerial view |image_flag = |flag_size = |image_seal = |seal_size = |image_shield = |shield_size = |image_blank_emblem = |blank_emblem_type = |blank_emblem_size = |image_map = |mapsize = |map_caption = |image_map1 = |mapsize1 = |map_caption1 = |image_dot_map = |dot_mapsize = |dot_map_caption = |dot_x = |dot_y = |pushpin_map = Sudan Kusini<!-- the name of a location map as per http://en.wikipedia.org/wiki/Template:Location_map --> |pushpin_label_position =top |pushpin_map_caption =Location in Sudan <!-- Location ------------------> |subdivision_type = Country |subdivision_name = [[Picha:Flag of South Sudan.svg|25px]] [[Sudan Kusini]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |subdivision_type3 = |subdivision_name3 = |subdivision_type4 = |subdivision_name4 = <!-- Politics -----------------> |government_footnotes = |government_type = |leader_title = |leader_name = |leader_title1 = <!-- for places with, say, both a mayor and a city manager --> |leader_name1 = |leader_title2 = |leader_name2 = |leader_title3 = |leader_name3 = |leader_title4 = |leader_name4 = |established_title = <!-- Settled --> |established_date = |established_title2 = <!-- Incorporated (town) --> |established_date2 = |established_title3 = <!-- Incorporated (city) --> |established_date3 = <!-- Area ---------------------> |area_magnitude = |unit_pref =Imperial <!--Enter: Imperial, if Imperial (metric) is desired--> |area_footnotes = |area_total_km2 = <!-- ALL fields dealing with a measurements are subject to automatic unit conversion--> |area_land_km2 = <!--See table @ Template:Infobox Settlement for details on automatic unit conversion--> |area_water_km2 = |area_total_sq_mi = |area_land_sq_mi = |area_water_sq_mi = |area_water_percent = |area_urban_km2 = |area_urban_sq_mi = |area_metro_km2 = |area_metro_sq_mi = |area_blank1_title = |area_blank1_km2 = |area_blank1_sq_mi = <!-- Population -----------------------> |population_as_of = 2017 |population_footnotes = |population_note = |population_total = 525,953 (est) |population_density_km2 = |population_density_sq_mi = |population_metro = |population_density_metro_km2 = |population_density_metro_sq_mi = |population_urban = |population_density_urban_km2 = |population_density_urban_sq_mi = |population_blank1_title =Ethnicities |population_blank1 = |population_blank2_title =Religions |population_blank2 = |population_density_blank1_km2 = |population_density_blank1_sq_mi = <!-- General information ---------------> |timezone = |utc_offset = |timezone_DST = |utc_offset_DST = |latd=4|latm=51|lats=0 |latNS=N |longd=31 |longm=36 |longs=0 |longEW=E |elevation_footnotes = <!--for references: use tags--> |elevation_m = |elevation_ft = <!-- Area/postal codes & others --------> |postal_code_type = <!-- enter ZIP code, Postcode, Post code, Postal code... --> |postal_code = |area_code = |blank_name = |blank_info = |blank1_name = |blank1_info = |website = |footnotes = }} [[Picha: Juba City.jpg|thumbnail|right|280px|Mji wa Juba, Sudan ]] '''Juba''' ni [[mji]] wa [[Sudan Kusini]] ambao ndio [[mji mkuu]] wa nchi hiyo na wa [[jimbo la Jubek]]. == Idadi ya watu == [[Idadi]] ya watu wake ilikuwa 525,953 mwaka wa 2017. Sensa ya Aprili / Mei 2008 matokeo yake yalikataliwa na [[serikali]] ya Kusini mwa Sudan. <ref>{{cite news|publisher=Sudan Tribune|title=South Sudan parliament throw outs census results|author=Isaac Vuni|date=8 Julai 2009|url=http://www.sudantribune.com/spip.php?article31746|accessdate=2009-12-03|archivedate=2014-07-12|archiveurl=https://web.archive.org/web/20140712230242/http://www.sudantribune.com/spip.php?article31746}}</ref> Juba ni mmojawapo wa miji inayokua haraka sana [[duniani]] na unaendelea kutokana na [[fedha]] za [[Mafuta ya petroli|mafuta]] na kuja kwa [[Jamhuri ya Watu wa China|Wachina]] kwa ajili ya [[kazi]] na [[maendeleo]]. Ukuaji wa idadi ya watu: {| class="wikitable" ! mwaka ! Idadi ya Watu |- | 1973 (sensa) | align="right"| 56.737 |- | 1983 (sensa) | align="right"| 83.787 |- | 1993 (sensa) | align="right"| 114.980 |- | 2005 (kadirio) | align="right"| 163.442 |- | 2017 (kadirio) | align="right"| 525,953} |} == Historia == Katika [[karne ya 19]], kituo cha [[biashara]] na [[dini]] kiitwacho [[Gondokoro]] kilikuwa jirani na Juba. Kilikuwa kituo cha [[kusini]] zaidi cha [[jeshi]] la [[Milki ya Osmani|Kituruki]] na kilikuwa na wanajeshi wachache sana, haswa waliokuwa wakiugua [[malaria]] na homa ya blackwater iliyokuwa imeenea kanda hii. Gondokoro ilikuwa pia kituo cha Baker, kwani hangeweza kwenda Kusini zaidi kuliko eneo hilo. Mwaka wa [[1922]], idadi ndogo ya [[Mfanyabiashara|wafanyabiashara]] wa [[Ugiriki|Kigiriki]] waliwasili katika eneo hilo na kuanzisha Juba, kando ya ufuo wa [[mto]] [[Nile Nyeupe|White Nile]]. Wagiriki ambao walikuwa na mahusiano bora na [[kabila]] la Juba ([[Wabari]]) walijenga kinachojulikana leo kama Business District. [[jengo|Majengo]] ambapo leo ni Buffalo Commercial Bank, Nile Commercial Bank, Paradise Hotel, Kinorwe Consul's House na hivyo wengine wengi, walijengwa na Wagiriki na walikuwa miundo ya kudumu tu mtu anaweza kupata mpaka mwanzoni mwa miaka ya 1940. Kutoka 1899-1956, Juba ilikuwa katika [[Sudan]] iliyosimamiwa kwa pamoja na [[Uingereza]] na [[Misri]]. [[Uingereza]] inatarajia kujiunga na sehemu ya kusini ya Sudan na [[Uganda]] walikuwa dashed mwaka 1947 kwa makubaliano ya Juba, pia inajulikana kama [[Mkutano wa Juba]], kuunganisha kaskazini na kusini mwa Sudan. Mwaka 1955, na uasi wa kusini mwa askari katika mji ulisababisha [[Vita vya wenyewe kwa wenyewe vya Sudan]] hadi 1972 na kuzuka tena baadaye hadi mwaka 2005 ilipotekwa na [[Sudan People's Liberation Army]] na kufanywa mji mkuu wa kudumu wa mikoa ya [[Kusini mwa Sudan]], ingawa mji mkuu wa mpito ulikuwa [[Rumbek]]. [[Picha:Sudan Juba Hotel 1936.jpg|thumb|left|Juba Hotel mwaka 1936.]] Baada ya ujio wa amani, [[Umoja wa Mataifa]] uliongeza uwepo Juba, [[Kusini mwa Sudan]] wakati ambapo shughuli nyingi zilikuwa zimesimamiwa kutoka [[Kenya]]. Chini ya uongozi wa [[Ofisi]] ya [[Umoja]] wa [[Mataifa ya Kuratibu Masuala ya Kibinadamu, Umoja wa Mataifa]] ilianzisha kambi ijulikanayo kama "OCHA Camp", ambalo lilikuwa kama msingi kwa mashirika mengi ya [[Umoja wa Mataifa]] na mashirika yasiyo ya kiserikali. [[Picha:Sudan Juba bridge.jpg|thumb|Daraja la Juba.]] [[Picha:Sudan Juba cattle on street.jpg|thumb|A'AM mitaani mwa Juba.]] == Miundombinu == Kabla ya vita vya wenyewe kwa wenyewe Juba ilikuwa pia kitovu cha usafiri, pamoja na kuunganisha barabara hiyo kwa [[Kenya]], [[Uganda]] na [[Jamhuri ya Kidemokrasia ya Kongo]]. Barabara na bandari zimekarabatiwa na Umoja wa Mataifa na serikali ya Sudan Kusini, lakini matengenezo kamili unatarajiwa kuchukua miaka mingi. [[Schweiziska Foundation Mine Action (FSD)]] kwenye 2003 ulianza kwa wazi barabara Juba kupelekea kutoka Uganda na Kenya, inatarajiwa kwamba barabara hizi utakuwa na demined upya kabisa katika mwendo wa 2006-2008. Barabara ya kwanza ambayo imeanza kuwa mpya ni barabara ya Uganda. Barabara hiyo ni muhimu hasa kama wakazi wengi waliokimbilia Uganda wakati wa vita. Barabara ni muhimu mno kwa mchakato wa amani nchini Sudan ili watu waweze kurudi majumbani mwao na kuishi maisha ya kawaida tena. Mwaka 2008 kulikuwa na barabara tatu za lami katika Juba . Moja kuu ni konkreta barabarani, kujengwa na [[Uingereza]] katika miaka ya 1950. Juba hutumika [[Juba Airport]] (JUB / HSSJ), uwanja wa ndege mmojawapo muhimu katika Afrika Mashariki. Mji huu ni eneo la [[Juba National University]] na United Nations Mission in Sudan (UNMIS) ina kiwanja kikubwa karibu na Juba Airport. [[Picha:Sudan Juba overview march 2006.jpg|thumb|Juba Machi 2006.]] ==Tazama pia== * [[Orodha ya miji ya Sudan Kusini]] ==Tanbihi== {{Marejeo}} == Marejeo == {{refbegin}} * Fisher, J. 2005, [http://news.bbc.co.uk/2/hi/africa/4461663.stm 'kwenda Kusini mwa Sudan mji',] ''BBC News,'' 20 Aprili. * Holt, K. 2007, [http://news.bbc.co.uk/2/hi/in_pictures/6228705.stm 'In pictures: Juba's mitaani Mapambano',] ''BBC News,'' 4 Januari. * [http://www.fallingrain.com/world/SU/28/Juba.html FallingRain Map - kimo = 550m] {{refend}} == Viungo vya nje == {{Commons category|Juba}} * [http://www.thejubapost.com The Juba Post] {{Wayback|url=http://www.thejubapost.com/ |date=20070531231318 }} {{Coord|4|51|N|31|36|E|region:SD_type:city|display=title}} [[Jamii:Miji ya Sudan Kusini]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Juba]] 041fmvvhq14mmnbecrx6stmc39wg4ge 1578003 1577959 2026-07-02T14:19:33Z Riccardo Riccioni 452 /* Viungo vya nje */ 1578003 wikitext text/x-wiki {{Infobox settlement <!--See the Table at Infobox Settlement for all fields and descriptions of usage--> <!-- Basic info ----------------> |official_name = Juba |other_name = |native_name = <!-- for cities whose native name is not in English --> |nickname = |settlement_type = <!--For Town or Village (Leave blank for the default City)--> |motto = <!-- images and maps -----------> |image_skyline = Juba Sudan aerial view.jpg |imagesize = 300px |image_caption = Aerial view |image_flag = |flag_size = |image_seal = |seal_size = |image_shield = |shield_size = |image_blank_emblem = |blank_emblem_type = |blank_emblem_size = |image_map = |mapsize = |map_caption = |image_map1 = |mapsize1 = |map_caption1 = |image_dot_map = |dot_mapsize = |dot_map_caption = |dot_x = |dot_y = |pushpin_map = Sudan Kusini<!-- the name of a location map as per http://en.wikipedia.org/wiki/Template:Location_map --> |pushpin_label_position =top |pushpin_map_caption =Location in Sudan <!-- Location ------------------> |subdivision_type = Country |subdivision_name = [[Picha:Flag of South Sudan.svg|25px]] [[Sudan Kusini]] |subdivision_type1 = |subdivision_name1 = |subdivision_type2 = |subdivision_name2 = |subdivision_type3 = |subdivision_name3 = |subdivision_type4 = |subdivision_name4 = <!-- Politics -----------------> |government_footnotes = |government_type = |leader_title = |leader_name = |leader_title1 = <!-- for places with, say, both a mayor and a city manager --> |leader_name1 = |leader_title2 = |leader_name2 = |leader_title3 = |leader_name3 = |leader_title4 = |leader_name4 = |established_title = <!-- Settled --> |established_date = |established_title2 = <!-- Incorporated (town) --> |established_date2 = |established_title3 = <!-- Incorporated (city) --> |established_date3 = <!-- Area ---------------------> |area_magnitude = |unit_pref =Imperial <!--Enter: Imperial, if Imperial (metric) is desired--> |area_footnotes = |area_total_km2 = <!-- ALL fields dealing with a measurements are subject to automatic unit conversion--> |area_land_km2 = <!--See table @ Template:Infobox Settlement for details on automatic unit conversion--> |area_water_km2 = |area_total_sq_mi = |area_land_sq_mi = |area_water_sq_mi = |area_water_percent = |area_urban_km2 = |area_urban_sq_mi = |area_metro_km2 = |area_metro_sq_mi = |area_blank1_title = |area_blank1_km2 = |area_blank1_sq_mi = <!-- Population -----------------------> |population_as_of = 2017 |population_footnotes = |population_note = |population_total = 525,953 (est) |population_density_km2 = |population_density_sq_mi = |population_metro = |population_density_metro_km2 = |population_density_metro_sq_mi = |population_urban = |population_density_urban_km2 = |population_density_urban_sq_mi = |population_blank1_title =Ethnicities |population_blank1 = |population_blank2_title =Religions |population_blank2 = |population_density_blank1_km2 = |population_density_blank1_sq_mi = <!-- General information ---------------> |timezone = |utc_offset = |timezone_DST = |utc_offset_DST = |latd=4|latm=51|lats=0 |latNS=N |longd=31 |longm=36 |longs=0 |longEW=E |elevation_footnotes = <!--for references: use tags--> |elevation_m = |elevation_ft = <!-- Area/postal codes & others --------> |postal_code_type = <!-- enter ZIP code, Postcode, Post code, Postal code... --> |postal_code = |area_code = |blank_name = |blank_info = |blank1_name = |blank1_info = |website = |footnotes = }} [[Picha: Juba City.jpg|thumbnail|right|280px|Mji wa Juba, Sudan ]] '''Juba''' ni [[mji]] wa [[Sudan Kusini]] ambao ndio [[mji mkuu]] wa nchi hiyo na wa [[jimbo la Jubek]]. == Idadi ya watu == [[Idadi]] ya watu wake ilikuwa 525,953 mwaka wa 2017. Sensa ya Aprili / Mei 2008 matokeo yake yalikataliwa na [[serikali]] ya Kusini mwa Sudan. <ref>{{cite news|publisher=Sudan Tribune|title=South Sudan parliament throw outs census results|author=Isaac Vuni|date=8 Julai 2009|url=http://www.sudantribune.com/spip.php?article31746|accessdate=2009-12-03|archivedate=2014-07-12|archiveurl=https://web.archive.org/web/20140712230242/http://www.sudantribune.com/spip.php?article31746}}</ref> Juba ni mmojawapo wa miji inayokua haraka sana [[duniani]] na unaendelea kutokana na [[fedha]] za [[Mafuta ya petroli|mafuta]] na kuja kwa [[Jamhuri ya Watu wa China|Wachina]] kwa ajili ya [[kazi]] na [[maendeleo]]. Ukuaji wa idadi ya watu: {| class="wikitable" ! mwaka ! Idadi ya Watu |- | 1973 (sensa) | align="right"| 56.737 |- | 1983 (sensa) | align="right"| 83.787 |- | 1993 (sensa) | align="right"| 114.980 |- | 2005 (kadirio) | align="right"| 163.442 |- | 2017 (kadirio) | align="right"| 525,953} |} == Historia == Katika [[karne ya 19]], kituo cha [[biashara]] na [[dini]] kiitwacho [[Gondokoro]] kilikuwa jirani na Juba. Kilikuwa kituo cha [[kusini]] zaidi cha [[jeshi]] la [[Milki ya Osmani|Kituruki]] na kilikuwa na wanajeshi wachache sana, haswa waliokuwa wakiugua [[malaria]] na homa ya blackwater iliyokuwa imeenea kanda hii. Gondokoro ilikuwa pia kituo cha Baker, kwani hangeweza kwenda Kusini zaidi kuliko eneo hilo. Mwaka wa [[1922]], idadi ndogo ya [[Mfanyabiashara|wafanyabiashara]] wa [[Ugiriki|Kigiriki]] waliwasili katika eneo hilo na kuanzisha Juba, kando ya ufuo wa [[mto]] [[Nile Nyeupe|White Nile]]. Wagiriki ambao walikuwa na mahusiano bora na [[kabila]] la Juba ([[Wabari]]) walijenga kinachojulikana leo kama Business District. [[jengo|Majengo]] ambapo leo ni Buffalo Commercial Bank, Nile Commercial Bank, Paradise Hotel, Kinorwe Consul's House na hivyo wengine wengi, walijengwa na Wagiriki na walikuwa miundo ya kudumu tu mtu anaweza kupata mpaka mwanzoni mwa miaka ya 1940. Kutoka 1899-1956, Juba ilikuwa katika [[Sudan]] iliyosimamiwa kwa pamoja na [[Uingereza]] na [[Misri]]. [[Uingereza]] inatarajia kujiunga na sehemu ya kusini ya Sudan na [[Uganda]] walikuwa dashed mwaka 1947 kwa makubaliano ya Juba, pia inajulikana kama [[Mkutano wa Juba]], kuunganisha kaskazini na kusini mwa Sudan. Mwaka 1955, na uasi wa kusini mwa askari katika mji ulisababisha [[Vita vya wenyewe kwa wenyewe vya Sudan]] hadi 1972 na kuzuka tena baadaye hadi mwaka 2005 ilipotekwa na [[Sudan People's Liberation Army]] na kufanywa mji mkuu wa kudumu wa mikoa ya [[Kusini mwa Sudan]], ingawa mji mkuu wa mpito ulikuwa [[Rumbek]]. [[Picha:Sudan Juba Hotel 1936.jpg|thumb|left|Juba Hotel mwaka 1936.]] Baada ya ujio wa amani, [[Umoja wa Mataifa]] uliongeza uwepo Juba, [[Kusini mwa Sudan]] wakati ambapo shughuli nyingi zilikuwa zimesimamiwa kutoka [[Kenya]]. Chini ya uongozi wa [[Ofisi]] ya [[Umoja]] wa [[Mataifa ya Kuratibu Masuala ya Kibinadamu, Umoja wa Mataifa]] ilianzisha kambi ijulikanayo kama "OCHA Camp", ambalo lilikuwa kama msingi kwa mashirika mengi ya [[Umoja wa Mataifa]] na mashirika yasiyo ya kiserikali. [[Picha:Sudan Juba bridge.jpg|thumb|Daraja la Juba.]] [[Picha:Sudan Juba cattle on street.jpg|thumb|A'AM mitaani mwa Juba.]] == Miundombinu == Kabla ya vita vya wenyewe kwa wenyewe Juba ilikuwa pia kitovu cha usafiri, pamoja na kuunganisha barabara hiyo kwa [[Kenya]], [[Uganda]] na [[Jamhuri ya Kidemokrasia ya Kongo]]. Barabara na bandari zimekarabatiwa na Umoja wa Mataifa na serikali ya Sudan Kusini, lakini matengenezo kamili unatarajiwa kuchukua miaka mingi. [[Schweiziska Foundation Mine Action (FSD)]] kwenye 2003 ulianza kwa wazi barabara Juba kupelekea kutoka Uganda na Kenya, inatarajiwa kwamba barabara hizi utakuwa na demined upya kabisa katika mwendo wa 2006-2008. Barabara ya kwanza ambayo imeanza kuwa mpya ni barabara ya Uganda. Barabara hiyo ni muhimu hasa kama wakazi wengi waliokimbilia Uganda wakati wa vita. Barabara ni muhimu mno kwa mchakato wa amani nchini Sudan ili watu waweze kurudi majumbani mwao na kuishi maisha ya kawaida tena. Mwaka 2008 kulikuwa na barabara tatu za lami katika Juba . Moja kuu ni konkreta barabarani, kujengwa na [[Uingereza]] katika miaka ya 1950. Juba hutumika [[Juba Airport]] (JUB / HSSJ), uwanja wa ndege mmojawapo muhimu katika Afrika Mashariki. Mji huu ni eneo la [[Juba National University]] na United Nations Mission in Sudan (UNMIS) ina kiwanja kikubwa karibu na Juba Airport. [[Picha:Sudan Juba overview march 2006.jpg|thumb|Juba Machi 2006.]] ==Tazama pia== * [[Orodha ya miji ya Sudan Kusini]] ==Tanbihi== {{Marejeo}} == Marejeo == {{refbegin}} * Fisher, J. 2005, [http://news.bbc.co.uk/2/hi/africa/4461663.stm 'kwenda Kusini mwa Sudan mji',] ''BBC News,'' 20 Aprili. * Holt, K. 2007, [http://news.bbc.co.uk/2/hi/in_pictures/6228705.stm 'In pictures: Juba's mitaani Mapambano',] ''BBC News,'' 4 Januari. * [http://www.fallingrain.com/world/SU/28/Juba.html FallingRain Map - kimo = 550m] {{refend}} == Viungo vya nje == {{Commons category|Juba}} * [http://www.thejubapost.com The Juba Post] {{Wayback|url=http://www.thejubapost.com/ |date=20070531231318 }} {{Coord|4|51|N|31|36|E|region:SD_type:city|display=title}} {{list of African capitals}} [[Jamii:Miji ya Sudan Kusini]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Juba]] mgw02jvb3a1cf6uakhl2ou9938mv7xo 14 32832 1577962 1244364 2026-07-02T13:03:21Z Riccardo Riccioni 452 1577962 wikitext text/x-wiki {{Commonscat|Maputo}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Msumbiji]] [[Jamii:mikoa ya Msumbiji|M]] mls25lzivt5cpuq420dbmc6ths15qt5 0 33676 1578122 1473041 2026-07-02T20:49:29Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578122 wikitext text/x-wiki {{History of Tanzania}} '''Isimila''' ni eneo la [[Historia|kihistoria]] lenye [[masalia]] ya [[Zama za Mawe|zana za Mawe]] za kutoka miaka milioni 1.5 iliyopita lililopo katika [[kijiji]] cha [[Ugwachanya]], [[kata]] ya [[Mseke]], [[Mkoa wa Iringa|mkoani Iringa]] nchini [[Tanzania]], [[kilomita]] 20 kutoka [[Iringa Mjini|Iringa mjini]] karibu na [[barabara]] kuu ya A 104 kuelekea [[Mbeya]]. Uchimbaji umeonyesha matumizi ya zana za mawe kwa shughuli za kila siku. [[Njia]] ya kuingia si rahisi kuikuta: ukitokea Iringa iko kabla ya kufikia [[Tanangozi]], upande wa kushoto. Eneo hili ni [[Vivutio vya Tanzania|kivutio kimojawapo]] kinachoupamba mkoa wa Iringa na eneo la utafiti muhimu kuhusu [[historia ya awali]] ya [[binadamu]]<ref>{{cite journal |last1=Wynn |first1=Thomas |title=Akili ya Hominidi wa Acheulean wa Baadaye |url=https://archive.org/details/sim_man-uk_1979-09_14_3/page/371 |journal=Man |date=Septemba 1979 |volume=14 |issue=3 |pages=371–391 |doi=10.2307/2801865 |jstor=2801865 }}</ref>. [[Bonde]] la Isimila lilikaliwa na [[watu]] tangu [[Zama_za_Mawe#Zama_za_mawe_ya_kale|Zama za Mawe za Kale]]. Ni katika eneo hilo ndipo [[zana]] za [[mawe]] za kale na [[nguzo]] za [[asili]] za Isimila zilipogunduliwa tangu [[mwaka]] [[1951]]. Zana hizo zinasadikiwa kuwa zilikuwepo tangu miaka 260,000 [[kabla ya Kristo]], [[umri]] uliopatikana kwa kupimwa [[mifupa]] ya kibinadamu iliyokutwa kati ya mawe yaliyochongwa kama zana<ref>F. Clark Howell et al.: Uranium-series Dating of Bone from the Isimila Prehistoric Site, Tanzania. In: Nature. Band 237, 1972, S. 51–52, doi:10.1038/237051a0, [https://www.nature.com/articles/237051a0 online hapa]</ref>. Miongoni mwa zana zilizopo katika [[Korongo (jiografia)|korongo]] la Isimila, ambalo lina mikondo miwili, ni pamoja na [[Mkuki|mikuki]] iliyotumika kwa ajili ya kujihami na pia mawe ya [[kombeo]] kwa ajili ya [[uwindaji]]. Korongo la pembeni lina [[mmomonyoko wa ardhi]] ulioacha nguzo za ajabu. Pia [[vifaa]] kama [[nyundo]] zilizokuwa zikitumika kwa ajili ya kutengenezea zana nyingine na [[shoka]] zilizotumika kwa [[kazi]] ya kuvunja mifupa, [[wembe|nyembe]] na [[Kisu|visu]]. Pia ndani ya eneo hili [[Fuvu|mafuvu]] na [[mifupa]] mingi vimeonekana; kati yake ilipatikana mifupa ambayo ilifanana na ya [[twiga]] wa hivi sasa, ila tofauti ni kwamba, mifupa hiyo iliashiria kuwa twiga hao walikuwa na [[shingo]] fupi, ambapo pia kulikuwa na aina tofauti ya [[viboko]]. ==Picha== <gallery> File:Isimila Stone age.jpg| Nguzo za asili, Isimila. File:Isimila Stone age 13.jpg File:Isimila Stone age 3.jpg File:Arch-tanzania-kmf.jpg|Mwongozaji wa watalii akiyatazama mawe katika bonde la Isimila </gallery> ==Tazama pia== * [[Maeneo ya Kihistoria ya Kitaifa ya Tanzania]] ==Marejeo== {{reflist}} ==Viungo vya nje== *[http://charaz.blogspot.com/2009/09/makumbusho-ya-zama-za-mawe-za-kale-za.html Zama za mawe za kale za Isimila] *[http://www.planetware.com/iringa/isimila-stone-age-site-tza-stza-isim.htm Isimila] {{Wayback|url=http://www.planetware.com/iringa/isimila-stone-age-site-tza-stza-isim.htm |date=20090530161118 }} *[https://www.lonelyplanet.com/tanzania/iringa/attractions/isimila-stone-age-site/a/poi-sig/1439900/1001344 Isimila Stone Age Site], tovuti ya Lonely Planet {{mbegu-jio-iringa}} [[Jamii:Historia ya Tanzania]] [[Jamii:Wilaya ya Iringa Vijijini]] [[Jamii:Utalii wa Tanzania]] [[Jamii:zama za Kale]] 7rhfn4wsm0a5450co4ujexb135457h1 0 33719 1578163 1549201 2026-07-02T22:53:59Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578163 wikitext text/x-wiki [[Picha:Tuberculosis-x-ray-1.jpg|thumbnail|right|200px|mapafu yanayoonyesha maambukizi ya Kifua kikuu]] {{Infobox disease |Name = Kifua Kikuu |Image = Tuberculosis-x-ray-1.jpg |Caption = kifua [[X-ray]] cha mtu mwenye kifua kikuu cha hatari. Mishale meupe inaonyesha maambukizi ya mapafu yote mawili. Mishale meusi inaonyesha matundu yaliyojitokeza. |DiseasesDB = 8515 |ICD10 = {{ICD10|A|15||a|15}}–{{ICD10|A|19||a|15}} |ICD9 = {{ICD9|010}}–{{ICD9|018}} |ICDO = |OMIM = 607948 |MedlinePlus = 000077 |MedlinePlus_mult = {{MedlinePlus2|000624}} |eMedicineSubj = med |eMedicineTopic = 2324 |eMedicine_mult = |MeshID = D014376 }} '''Kifua kikuu''' (kwa [[Kiingereza]] ''tuberculosis'', kifupi '''TB''') ni [[ugonjwa wa kuambukizwa]] ulio hatari. [[Ugonjwa]] huu husababishwa na aina mbalimbali za [[bakteria]] ambazo hujulikana kama ''[[Mycobacterium tuberculosis]]''.<ref name=Robbins>{{cite book |author=Kumar V, Abbas AK, Fausto N, Mitchell RN |year=2007 |title=Robbins Basic Pathology |edition=8th |publisher=Saunders Elsevier |pages=516–522 |isbn=978-1-4160-2973-1}}</ref> Kifua kikuu kwa kawaida kinaathiri [[mapafu]], lakini pia kinaweza kuathiri sehemu nyingine za [[mwili]]. Kifua kikuu husambazwa kutoka kwa [[mtu]] mmoja hadi mwingine kwa kupitia [[hewa]] wakati anapokohoa, kupiga chafya, au [[mate]] yake yakiwa hewani<ref name="AP">{{cite journal|author=Konstantinos A |year=2010|title=Testing for tuberculosis |journal=Australian Prescriber |volume= 33 |issue=1|pages=12–18 |url= http://www.australianprescriber.com/magazine/33/1/12/18/}}</ref> Maambukizi mengi hayana [[dalili]] wala hayaleti madhara. Lakini [[moja]] kati ya maambukizo kumi yasiyoleta madhara hatimaye huendelea na kuwa ugonjwa kamili. Kama kifua kikuu kisipotibiwa, kinaua zaidi ya 50[[%]] ya watu walioambukizwa. Dalili za kawaida za maambukizi ya kifua kikuu kinacholeta madhara ni [[kikohozi|kikohozi sugu]] na [[Hemoptysis|kukohoa damu]], [[Kohozi]], [[homa]], [[kutokwa na jasho usiku]], na [[kukonda]]. Maambukizi ya viungo vingine husababisha dalili mbalimbali. Njia ya kitaalamu ya utambuzi wa kifua kikuu kwa kutumia [[eksirei]] ya kuchunguza ugonjwa hujulikana kama eksirei ya kifua na pia wanatumia [[hadubini]] na kufanya uchunguzi wa [[vimelea maradhi]] vya [[majimaji]] ya mwilini. Uchunguzi wa kifua kikuu kisicholeta madhara hutumia kipimo kiitwacho [[Mantoux test|kipimo cha ngozi]] (TST) na vipimo vya damu. [[Matibabu ya kifua kikuu|tiba]] si rahisi na inabidi kupewa dawa nyingi za kinga mwili kwa kipindi kirefu. Mawasiliano ya kijamii pia yanapimwa na kutibiwa kama inavyotakiwa. [[Dawa zinazoshindwa kutibu magonjwa]] ni tatizo kubwa la maambukizi sugu mengi ya kifua kikuu]] (MDR-TB). Ili kuzuia kifua kikuu, ni lazima watu wapimwe ugonjwa na wapate [[chanjo]] ya [[Bacillus Calmette-Guérin|bacillus Calmette - Guérin]]. [[Wataalamu]] wanaamini kwamba [[theluthi]] moja ya [[idadi]] ya watu [[duniani]] waliambukizwa kifua kikuu,<ref name=WHO2012data>{{cite web|url=http://www.who.int/mediacentre/factsheets/fs104/en/index.html|title=Tuberculosis Fact sheet N°104|publisher=[[World Health Organization]]|date=November 2010|accessdate=26 July 2011}}</ref> na kila [[sekunde]] kuna mtu ambaye anaambukizwa <ref name= WHO2012data />. Mwaka [[2007]], kadri ya watu 13,700,000 duniani waliambukizwa kifua kikuu kinacholeta madhara sugu. Mwaka [[2010]], kadri ya milioni 8.8 ya watu waliambukizwa na milioni 1.5 ya watu walifariki baada ya kuambukizwa na kifua kikuu, na wagonjwa wengi wanapatikana katika [[nchi zinazoendelea]].<ref name=WHO2011>{{cite web|title=The sixteenth global report on tuberculosis|author=World Health Organization|url=http://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf|year=2011}}</ref> Idadi halisi ya wagonjwa wa kifua kikuu imekuwa ikipungua tangu mwaka [[2006]], na kesi mpya zimeshuka tangu mwaka [[2002]].<ref name=WHO2011/> Kifua kikuu si ugonjwa unaosambazwa sawasawa duniani kote. Kadri ya 80% ya watu katika nchi nyingi za [[Asia]] na [[Afrika]] waliofanyiwa kipimo cha ngozi walionekana wameambukizwa, lakini ni asilimia 5-10% tu ya wananchi wa [[Marekani]] ambao walionekana na ugonjwa huo.<ref name= Robbins/> Watu wengi waliopo katika [[nchi zilizoendelea]] wanaambukizwa kifua kikuu kwa sababu ya kutokuwa na kinga. Kwa kawaida, hawa watu wanaambukizwa kifua kikuu baada ya kuambukizwa na [[VVU]] na hatimaye wanapatwa na [[UKIMWI]].<ref name=Lancet11/> == Dalili na ishara == [[Picha:Tuberculosis symptoms.svg|thumb|Dalili kuu na ishara tofauti pamoja na hatua za kifua kikuu zinajulikana <ref>{{cite web|url=http://www.emedicinehealth.com/tuberculosis/page3_em.htm|title=Tuberculosis Symptoms|publisher=[[eMedicine]]Health|author=Schiffman G|date=15 January 2009}}</ref> Dalili nyingi huchanganyika na ishara zingine, ingawa kuna dalili zingine ambazo (ingawa sio lazima) ni za aina fulani ya kifua kikuu. Aina mbalimbali za kifua kikuu zinaweza kuwepo kwa pamoja.]] Kuna kadri ya 5-10% ya watu ambao hawana VVU ingawa wameambukizwa kifua kikuu na wanapatwa na madhara katika maisha yao.<ref name=Pet2005>{{Rejea kitabu|author=edited by Peter G. Gibson ; section editors, Michael Abramson ... ''et al.''|title=Evidence-based respiratory medicine|year=2005|publisher=Blackwell|location=Oxford|isbn=978-0-7279-1605-1|pages=321|url=http://books.google.ca/books?id=sDIKJ1s9wEQC&pg=PA321|edition=1. publ.}}</ref> Kwa upande mwingine, 30% ya watu ambao wameambukizwa VVU pamoja na kifua kikuu, huwa wanapatwa na madhara ya ugonjwa huo<ref name= Pet2005 /> Kifua kikuu kinaweza kuambukiza sehemu yoyote ya mwili, lakini kwa kawaida hutokea katika mapafu (na inajulikana kama kifua kikuu cha mapafu).<ref. name= ID10 /> TB Extrapulmonary ni kifua kikuu kinachotokea sehemu yoyote ya mwili yaani nje ya mapafu. Hicho kinaweza pia kuwepo pamoja na kifua kikuu cha mapafu <ref. Name= ID10 /> Ishara na dalili ni pamoja na [[homa]], [[baridi]], [[kutokwa na jasho usiku]], [[kupoteza hamu ya kula]], [[kukonda]], na [[uchovu (matibabu)|uchovu]].<ref Name= ID10 /> Kuna uwezekano mkubwa wa [[kujikunja kwa kucha pembeni]].<ref. Name= Pet2005 /> === Mapafu === Kifua kikuu kikiambukiza kinaathiri mapafu kwa 90% ya wagonjwa <ref name= Lancet11/> <ref>{{cite book|last=Behera|first=D.|title=Textbook of pulmonary medicine|year=2010|publisher=Jaypee Brothers Medical Pub.|location=New Delhi|isbn=978-81-8448-749-7|pages=457|url=http://books.google.ca/books?id=0TbJjd9eTp0C&pg=PA457|edition=2nd ed.}}</ref> Dalili zake huweza kuwa [[maumivu ya kifua]] na kikohozi cha muda mrefu chenye makohozi.<ref Name=Lancet11/> Kadri ya 25% ya watu hawana dalili yoyote (yaani, wao hawaonyeshi "dalili") <ref name= Lancet11/> Wakati mwingine, wagonjwa. [[Hemoptysis|wanakohoa damu]] kwa kiasi kidogo. Wakati mwingine, ugonjwa unaweza kusababisha [[mshipa wa mapafu]] imomonyoke, na kusababisha damu nyingi kuvuja hali hii inaitwa [[Rasmussen's aneurysm]].<ref name=ID10/> Kifua kikuu kinaweza kusababishwa na vimelea sugu na kusababisha makovu katika masikio ya juu ya mapafu.<ref Name=ID10/>. Mara nyingi ni mapafu ya juu yanayoathirika <ref name=ID10/> Sababu haijulikani vizuri <ref name=" Robbins "/> Labda mapafu ya juu yanaathirika zaidi kwa sababu yanapata hewa kwa njia bora <ref name=" Robbins "/> au kwa sababu ya ukaushaji mbaya wa [[limfu]].<ref Name= ID10 /> === Kifua kikuu katika sehemu nyingine ya mwili === Kadri ya 15-20% ya madhara yanayoletwa na ugonjwa yanaletwa na maambukizi yanayoenea nje ya viungo vya kupumua, na husababisha aina nyingine ya kifua kikuu.<ref>{{cite book|author=editor-in-chief SK Jindal|title=Textbook of pulmonary and critical care medicine|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-93-5025-073-0|pages=549|url=http://books.google.ca/books?id=EvGTw3wn-zEC&pg=PA549}}</ref> Kifua kikuu kinachotokea nje ya viungo vya kupumua kinaitwa "extrapulmonary tuberculosis".<ref name=Extra2005>{{cite journal|pmid=16300038|year=2005|author=Golden MP, Vikram HR|title=Extrapulmonary tuberculosis: an overview|url=https://archive.org/details/sim_american-family-physician_2005-11-01_72_9/page/n136|volume=72|issue=9|pages=1761–8|journal=American family physician}}</ref> Extrapulmonary TB hutokea zaidi kwa [[wagonjwa]] wenye upungufu wa kingamwili na watoto wadogo. ExtrapulmonaryTB hutokea kwa zaidi ya 50% ya wagonjwa wenye VVU <ref name=Extra2005/> Sehemu zinazoathiriwa na extrapulmonary TB ni pamoja na sehemu za nje ya mapafu [[pleura]] (au pleurisy tuberculous), [[mfumo wa neva]] (au kifua kikuu cha [[uti wa mgongo]]), na [[mfumo wa limfu]] (katika [[scrofula]] ya shingo).Extrapulmonary TB pia hutokea katika [mfumo wa [mkojo na sehemu za siri]] (au [[kifua kikuu cha sehemu za siri]]) katika mifupa na viungo (au [[Pott's disease]] wa mgongo), na maeneo mengine. Inapoenea katika mifupa, inajulikana kama "kifua kikuu cha mifupa",<ref>{{Rejea kitabu|author=[edited by] Vimlesh Seth, S.K. Kabra|title=Essentials of tuberculosis in children|year=2006|publisher=Jaypee Bros. Medical Publishers|location=New Delhi|isbn=978-81-8061-709-6|pages=249|url=http://books.google.ca/books?id=HkH0YbyBHDQC&pg=PA249|edition=3rd ed.}}</ref> ambayo ni aina ya [[maambukizi ya mifupa au osteomyelitis]] <ref name="Robbins"/> Aina hatari zaidi ya Extrapulmonary TB inaitwa TB ya "kueneza", inajulikana kama [[kifua kikuu]] inayoenea mwilini <ref name=ID10/> Asilimia 10% ya kifua kikuu kinachotokea nje ya viungo vya kupumua, husababisha kifua kikuu inayosamba mwilini. <ref name=Gho2008/> == Visababishi == === Mycobacteria === [[Picha: Mycobacterium tuberculosis.jpg|thumb|''[[Mycobacterium tuberculosis]]'']] Kisababishi kikubwa cha kifua kikuu ni '' [[Mycobacterium tuberculosis]]'', ni kiumbe kidogo kinachohitaji [[oksijeni]] na kisichotembea [[bacillus]]<ref name=ID10>{{cite book|author=[edited by] Gerald L. Mandell, John E. Bennett, Raphael Dolin|title=Mandell, Douglas, and Bennett's principles and practice of infectious diseases|year=2010|publisher=Churchill Livingstone/Elsevier|location=Philadelphia, PA|isbn=978-0-443-06839-3|pages=Chapter 250|edition=7th}}</ref> Sifa nyingi za pekee za kiumbe hiki zinaletwa na ongezeko kubwa la [[mafuta]] <ref>{{cite book |author=Southwick F |title=Infectious Diseases: A Clinical Short Course, 2nd ed. |publisher=McGraw-Hill Medical Publishing Division |date=10 December 2007 |pages=313–4 |chapter=Chapter 4: Pulmonary Infections |page=104 |url=http://pharma-books.blogspot.com/2009/01/infectious-disease-clinical-short.html |isbn=0-07-147722-5 |archiveurl=https://archive.today/20120713125232/http://pharma-books.blogspot.de/2009/01/infectious-disease-clinical-short.html |archivedate=2012-07-13 |access-date=2013-03-06 |dead-url=no }}</ref> Ina [[seli]] inayojigawa kila baada ya saa 16 hadi 20. Kiwango hiki si kikubwa ukilinganishwa na bakteria nyingine, ambazo kwa kawaida vinajigawa kwa muda usiopungua saa mmoja <ref>{{cite book|last=Jindal|first=editor-in-chief SK|title=Textbook of pulmonary and critical care medicine|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-93-5025-073-0|pages=525|url=http://books.google.ca/books?id=rAT1bdnDakAC&pg=PA525}}</ref> Mycobacteria wana [[muundo wa seli ya bakteria|utando wa nje]] utando wa mafuta <ref name=Niederweis2010>{{cite journal |author=Niederweis M, Danilchanka O, Huff J, Hoffmann C, Engelhardt H |title=Mycobacterial outer membranes: in search of proteins |journal=Trends in Microbiology |volume=18 |issue=3 |pages=109–16 |year=2010 |month=March |pmid=20060722 |pmc=2931330|doi=10.1016/j.tim.2009.12.005}}</ref> Kama jaribio la [[Gramu stain]] likifanywa, MTB haikolei sana rangi yaani "Gram-positive" haipatikani na rangi haionekani kwa sababu utando wake una mafuta mengi [[mafuta]] pamoja na asidi [[Mycolic acid]].<ref name=Madison_2001>{{cite journal |author=Madison B |title=Application of stains in clinical microbiology |journal=Biotech Histochem |volume=76 |issue=3 |pages=119–25 |year=2001 |pmid=11475314 |doi=10.1080/714028138}}</ref> MTB inaweza kuhimili kemikali [[dhaifu]] na hivi vimelea vinaweza kuishi katika [[kijimbegu au|sehemu kavu]] kwa wiki moja. Kwa kawaida, bakteria zinaweza kukua na kuishi tu ndani ya seli ya [[kiumbe (biolojia)|kiumbe]] viumbe, lakini'' M. tuberculosis' inaweza kukuzwa [[ndani in vitro|ya maabara]].<ref name=Parish_1999>{{cite journal |author=Parish T, Stoker N |title=Mycobacteria: bugs and bugbears (two steps forward and one step back) |journal=Molecular Biotechnology |volume=13 |issue=3 |pages=191–200 |year=1999| pmid=10934532 |doi = 10.1385/MB:13:3:191}}</ref> Kwa kutumia vipimo vya kimaabara vya kansa [[Histology|histological]] kwa kuweka madoa juu ya sampuli ya [[mate]] yaliyotoka kwenye [[makohozi]], wanasayansi wanaweza kutambua MTB chini ya makroskopi (nyepesi) ya kawaida. (Phlegm pia inaitwa "kohozi.") MTB huacha madoa hata baada ya kuchanganywa na asidi, na hivyo hujulikana kama [[Acid-fast bacillus]] (AFB)<ref name= Robbins/><ref name="Madison_2001"/> acid-fast bacillus. Kuna njia mbili zinazotumia vipimo vya asidi:. Kipimo kinachojulikana kama [[Ziehl - Neelsen stain]], kinageuza rangi ya vimelea AFB na kuwa vyekundu na vinaonekana wazi wazi dhidi ya sehemu ya bluu,<ref name=Stain2000>{{cite book |author= |title=Medical Laboratory Science: Theory and Practice|publisher=Tata McGraw-Hill |location=New Delhi |year=2000 |pages=473 |isbn=0-07-463223-X|url=http://books.google.ca/books?id=lciNs3VQPLoC&pg=PA473}}</ref> na [[auramine-rhodamine stain]] ambayo hufuatiwa na makroskopi yenye kuakisi mwanga.<ref>{{cite book|last=Piot|first=editors, Richard D. Semba, Martin W. Bloem; foreword by Peter|title=Nutrition and health in developing countries|year=2008|publisher=Humana Press|location=Totowa, NJ|isbn=978-1-934115-24-4|pages=291|url=http://books.google.ca/books?id=RhH6uSQy7a4C&pg=PA291|edition=2nd ed.}}</ref> Mchangamano wa “M. tuberculosis'' (MTBC) ni pamoja na bakteria nyingine nne zinazosababisha kifua kikuu {[[mycobacterium|mycobacteria]]: “[[Mycobacterium bovis|M. bovis]],” “[[Mycobacterium africanum|M. africanum]],” “[[Mycobacterium canetti|M. canetti]],” pamoja na “[[Mycobacterium microti|M. microti]].”<ref>{{cite journal|author=van Soolingen D |title=A novel pathogenic taxon of the Mycobacterium tuberculosis complex, Canetti: characterization of an exceptional isolate from Africa |journal=International Journal of Systematic Bacteriology |volume=47 |issue=4 |pages=1236–45 |year=1997 |pmid=9336935|doi=10.1099/00207713-47-4-1236 |author-separator=, |display-authors=1 |last2=Hoogenboezem |first2=T. |last3=De Haas|first3=P. E. W. |last4=Hermans |first4=P. W. M. |last5=Koedam |first5=M. A. |last6=Teppema |first6=K. S. |last7=Brennan|first7=P. J. |last8=Besra |first8=G. S. |last9=Portaels |first9=F.}}</ref> “M. africanum” haijasambaa sana, lakini ndio kisababishi kikubwa cha kifua kikuu katika maeneo ya Afrika <ref>{{cite journal |author=Niemann S |title=Mycobacterium africanum Subtype II Is Associated with Two Distinct Genotypes and Is a Major Cause of Human Tuberculosis in Kampala, Uganda|url=https://archive.org/details/sim_journal-of-clinical-microbiology_2002-09_40_9/page/3398 |journal=J. Clin. Microbiol. |volume=40 |issue=9 |pages=3398–405 |year=2002 |pmid=12202584 |pmc=130701|doi=10.1128/JCM.40.9.3398-3405.2002 |author-separator=, |display-authors=1 |last2=Rusch-Gerdes |first2=S. |last3=Joloba|first3=M. L. |last4=Whalen |first4=C. C. |last5=Guwatudde |first5=D. |last6=Ellner |first6=J. J. |last7=Eisenach|first7=K. |last8=Fumokong |first8=N. |last9=Johnson |first9=J. L.}}</ref><ref>{{cite journal |author=Niobe-Eyangoh SN|title=Genetic Biodiversity of Mycobacterium tuberculosis Complex Strains from Patients with Pulmonary Tuberculosis in Cameroon |url=https://archive.org/details/sim_journal-of-clinical-microbiology_2003-06_41_6/page/2547|journal=J. Clin. Microbiol. |volume=41 |issue=6 |pages=2547–53 |year=2003 |pmid=12791879 |pmc=156567|doi=10.1128/JCM.41.6.2547-2553.2003 |author-separator=, |display-authors=1 |last2=Kuaban |first2=C. |last3=Sorlin|first3=P. |last4=Cunin |first4=P. |last5=Thonnon |first5=J. |last6=Sola |first6=C. |last7=Rastogi |first7=N.|last8=Vincent |first8=V. |last9=Gutierrez |first9=M. C.}}</ref> “M. bovis” ndio ilikuwa ni kisababishi kikubwa cha kifua kikuu, lakini baada ya kuanza kutumia [[pasteurisation|maziwa yanayopashwa moto]] vimelea vya mycobacterium vimeweza kuondolewa na kupuguza matatizo ya kiafya katika nchi zinazoendelea.<ref name=Robbins/><ref>{{cite journal |author=Thoen C, Lobue P, de Kantor I |title=The importance of''Mycobacterium bovis'' as a zoonosis |journal=Vet. Microbiol.</ref> "M. Canetti " ni adimu sana na huonekana zaidi [[Eneo la Pembezoni mwa Afrika]], ingawa kuna wagonjwa wachache kati ya wahamiaji wanaotoka Afrika. <ref>{{cite book|last=Acton|first=Q. Ashton|title=Mycobacterium Infections: New Insights for the Healthcare Professional|year=2011|publisher=ScholarlyEditions|isbn=978-1-4649-0122-5|pages=1968|url=http://books.google.ca/books?id=g2iFfV6uEuAC&pg=PA1968}}</ref><ref>{{cite journal|last=Pfyffer|first=GE|coauthors=Auckenthaler, R, van Embden, JD, van Soolingen, D|title=Mycobacterium canettii, the smooth variant of M. tuberculosis, isolated from a Swiss patient exposed in Africa.|journal=Emerging infectious diseases|date=1998 Oct-Dec|volume=4|issue=4|pages=631-4|pmid=9866740}}</ref> "M. microti" pia ni adimu na inawaathiri zaidi watu wenye upungufu wa kingamwili, ingawa ugonjwa huu unaweza kuwa umeenea zaidi kuliko inavyofikiriwa<ref>{{cite journal|last=Panteix|first=G|coauthors=Gutierrez, MC, Boschiroli, ML, Rouviere, M, Plaidy, A, Pressac, D, Porcheret, H, Chyderiotis, G, Ponsada, M, Van Oortegem, K, Salloum, S, Cabuzel, S, Bañuls, AL, Van de Perre, P, Godreuil, S|title=Pulmonary tuberculosis due to Mycobacterium microti: a study of six recent cases in France.|journal=Journal of medical microbiology|date=2010 Aug|volume=59|issue=Pt 8|pages=984-9|pmid=20488936}}</ref> Mycobacteria zingine zinazojulikana ni pamoja na "[[Mycobacterium leprae|M. leprae]]," "[[Mycobacterium avium complex|M. avium]]," na "[[Mycobacterium kansasii|M. kansasii]]". Hizi aina mbili za mwisho zinajulikana kama "[[nontuberculous mycobacteria]] "(NTM). NTM hazisababishi kifua kikuu au [[ukoma]], lakini husababisha magonjwa ya mapafu yanayofanana na kifua kikuu <ref name=ALA_1997>{{cite journal |title=Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Medical Section of the American Lung Association |journal=Am J Respir Crit Care Med |volume=156 |issue=2 Pt 2 |pages=S1–25 |year=1997 |pmid = 9279284 |author=American Thoracic Society }}</ref> == Sababu za hatari == Idadi ya sababu za kufanya watu wahusike zaidi na maambukizi ya TB. Muhimu zaidi ni hatari ya kimataifa [[Virusi ya Ukimwi]] ; 13% ya kesi zote TB wameambukizwa na virusi.<ref name=WHO2011/> Hili ni tatizo hasa katika [[Afrika kusini mwa Sahara]] , ambapo viwango vya HIV ni kubwa.<ref>{{cite web author=WorldHealthOrganization|url=http://www.who.int/tb/publications/global_report/en/index.html|title=Global tuberculosis control–surveillance, planning, financing WHO Report 2006|accessdate=13 October 2006}}</ref><ref>{{cite journal|last=Chaisson|first=RE|coauthors=Martinson, NA|title=Tuberculosis in Africa--combating an HIV-driven crisis|journal=The New England Journal of Medicine|date=13 March 2008|volume=358|issue=11|pages=1089 92|pmid=18337598|doi=10.1056/NEJMp0800809}}</ref> Kifua Kikuu ni uhusiano wa karibu na wote msongamano na utapiamlo, na kuifanya moja ya magonjwa makuu ya [[umaskini]]. Wale walio katika hatari ya juu hivyo ni pamoja [[ugonjwa ya umaskini]].<ref name=Lancet11/> watu ambao hujidunga dawa za kulevya, wenyeji na wafanyakazi wa majengo ambapo watu wanaoishi katika mazingira magumu kukusanya (k.m. [[gereza|magereza]] na malazi makazi), jamii wasiojiweza kimatibabu na wasio na mtaji, ya hatari kwa makabila madogo, watoto katika mawasiliano ya karibu na hatari ya hali ya juu kwa jamii ya wagonjwa na watoa huduma ya afya ya kuwahudumia wateja.<ref name=Griffith_1996>{{citejournal |author=Griffith D, Kerr C|title=Tuberculosis: disease of the past, disease of the present |journal=J Perianesth Nurs |volume=11 |issue=4|pages=240–5 |year=1996|pmid = 8964016|doi = 10.1016/S1089-9472(96)80023-2}}</ref> uvimbe sugu ni sababu nyingine hatari ya ugonjwa. Kwa [[Silicosis]] kuongeza hatari kuhusu mara 30. <ref name=table3>{{cite journal |title=Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society |journal=MMWR Recomm Rep |volume=49 |issue=RR6|pages=151|year=200|month=June|pmid=10881762|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4906a1.htm#tab3|author1=ATS/CDC Statement Committee on Latent Tuberculosis Infection}}</ref> Wale ambao moshi [[sigara]]s kuwa karibu mara mbili ya hatari ya TB ya wasiovuta sigara.<ref>{{cite journal|last=van Zyl Smit|first=RN|coauthors=Pai, M, Yew, WW, Leung, CC, Zumla, A, Bateman, ED, Dheda, K|title=Global lung health: the colliding epidemics of tuberculosis, tobacco smoking, HIV and COPD.|journal=The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology|date=2010 Jan|volume=35|issue=1|pages=27-33|pmid=20044459|quote=These analyses indicate that smokers are almost twice as likely to be infected with TB and to progress to active disease (RR of ∼1.5 for latent TB infection (LTBI) and RR of ∼2.0 for TB disease). Smokers are also twice as likely to die from TB (RR of ∼2.0 for TB mortality), but data are difficult to interpret because of heterogeneity in the results across studies.}}</ref> Baadhi ya dawa hasa yanaweza pia kuongeza hatari ya kifua kikuu katika mataifa yaliyostawi, [[ulevi]] <ref name=Lancet11/> na [[Ugonjwa wa kisukari]] (kuongezeka maratatu ).<ref>{{cite journal|last=Restrepo|first=BI|title=Convergence of the tuberculosis and diabetes epidemics: renewal of old acquaintances journal=Clinical infectious diseases : an official publication of the Infectious Diseases Society of America|date=15 August 2007|volume=45|issue=4|pages=436–8|pmid=17638190|doi=10.1086/519939|pmc=2900315}}</ref> Baadhi ya dawa, kama vile [[corticosteroids]] na [[infliximab]] (an anti-αTNF monoclonal antibody) kuwa inazidi muhimu hatari, hasa katika [[nchi zilizoendelea]].<ref name=Lancet11/> Kuna pia, [[upungufu maumbile]] <ref>{{cite journal|last=Möller|first=M|coauthors=Hoal, EG|title=Current findings, challenges and novel approaches in human genetic susceptibility to tuberculosis|url=https://archive.org/details/sim_tuberculosis_2010-03_90_2/page/71|journal=Tuberculosis (Edinburgh, Scotland)|date=2010 Mar|volume=90|issue=2|pages=71–83|pmid=20206579|doi=10.1016/j.tube.2010.02.002}}</ref> kwa umuhimu ambayo kwa ujumla ni bado siowekwa wazi .<ref name=Lancet11/> == Mkakati == [[Picha:TB poster.jpg|thumb|Public health campaigns in the 1920s tried to halt the spread of TB.]] === Uenezi === Wakati watu walio na TB hukohoa mapafu, hupiga chafya, kuzungumza, kuimba, au kutema mate, wao hutoa viambukizi [[pekee|erosoli]] matone 0.5 na 5 [[µm]] katika [[kipenyo]]. kuchafya moja inaweza kutoa juu ya matone 40,000.<ref name=Cole_1998>{{cite journal author=Cole E, Cook C |title= Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies |journal=Am J Infect Control |volume=26 |issue=4 |pages=453–64 |year=1998|pmid=9721404|doi = 10.1016/S0196-6553(98)70046-X}}</ref> Kila moja ya matone haya wanaweza kuambukiza ugonjwa huo, tangu dozi ya kuambukiza ugonjwa wa kifua kikuu ni ya chini sana.<ref>{{cite journal |author=Nicas M, Nazaroff WW, Hubbard A |title=Toward understanding the risk of secondary airborne infection: emission of respirable pathogens |journal=J Occup Environ Hyg |volume=2 |issue=3 |pages=143–54 |year=2005|pmid=15764538|doi = 10.1080/15459620590918466}}</ref> Watu wenye TB kwa muda mrefu akiwa, mara kwa mara, au karibu na watu na TB ni hatari hasa juu ya kuambukizwa, na kiwango cha wastani 22% ya kuambukiza.<ref name=Ahmed_2011>{{cite journal |author=Ahmed N, Hasnain S |title=Molecular epidemiology of tuberculosis in India: Moving forward with a systems biology approach |url=https://archive.org/details/sim_tuberculosis_2011-09_91_5/page/407 |journal=Tuberculosis |volume=91|issue=5 |pages=407–3 |year=2011|pmid = 21514230|doi = 10.1016/j.tube.2011.03.006}}</ref> Mtu aliye na kifua kikuu hai, lakini hajatibiwa anaweza kuambukiza 10-15 (au zaidi) watu wengine kwa mwaka.<ref name="WHO2012data"/> Maambukizi lazima huwepo tu kutoka kwa watu wenye TB hai. Wale wenye maambukizi ya fiche hawadhaniwi kuambukiza. <ref name=Robbins/> uwezekano wa maambukizi kutoka kwa mtu mmoja hadi mwingine inategemea sababu kadhaa, ikiwa ni pamoja na idadi ya matone ya kuambukiza kufukuzwa na mwenezaji, ufanisi wa uingizaji hewa, muda wa mfiduo, [[ukali]] wa ''M. kifua kikuu'', kiwango cha kinga katika mtu ambaye hajaambukizwa na wengine.<ref name=CDCcourse>{{cite web|publisher=[[Centers for Disease Control and Prevention]] (CDC), Division of Tuberculosis Elimination|url=http://www.cdc.gov/tb/education/corecurr/pdf/corecurr_all.pdf|title=Core Curriculum on Tuberculosis: What the Clinician Should Know|pg=24|edition=5th|year=2011}}</ref> ili kupunguza maenezi ya mtu-kwa-mtu tenga watu wenye TB hai ("ya wazi") na kuweka kwenye regimenti dawa za kupambana na TB. Baada ya wiki mbili ya matibabu ya ufanisi, masomo na maambukizi [[kiuavijasumu cha upinzani|kutokana-upinzani]] maambukizi kwa ujumla hayazidi kuenea kwa wengine.<ref name="Ahmed_2011"/ mtu akiambukizwa yeye huchukua wiki 3 – 4 kabla ya kuanza kuambukiza wengine .<ref>{{cite web | url=http://www.mayoclinic.com/health/tuberculosis/DS00372/DSECTION=3|title=Causes of Tuberculosis|accessdate=19 October 2007|date=21 December 2006|publisher=[[Mayo Clinic]]}}</ref> === Pathojenesisi === Takribani 90% ya watu walioambukizwa ‘‘M. kifua kikuu'' na [[Dalili]], maambukizi ya TB (wakati mwingine huitwa LTBI). <ref name=Book90>{{cite book|last=Skolnik|first=Richard|title=Global health 101|year=2011|publisher=Jones & Bartlett Learning location=Burlington, MA|isbn=978-0-7637-9751-5|pages=253|url=http://books.google.ca/books?id=sBQRpj4uWmYC&pg=PA253|edition=2nd ed.}}</ref> na tu 10% maisha nafasi ya kuwa maambukizi fiche itakuwa maendeleo ya ugonjwa ya wazi, kazi ya kifua kikuu. <ref name=Arch2009> {{cite book|last=editors|first=Arch G. Mainous III, Claire Pomeroy,|title=Management of antimicrobials in infectious diseases : impact of antibiotic resistance. year=2009|publisher=Humana location=Totowa, N.J.|isbn=978-1-60327-238-4|pages=74|url=http://books.google.ca/books?id=hwVFAPLYznsC&pg=PA74|edition=2nd rev. ed.}}</ref> Katika wale wanaoishi na H.I.V, hatari ya kupatwa na TB hai inaongezeka hadi 10% karibu mwaka. <ref name=Arch2009/> Kama matibabu ya ufanisi hawakujaliwa, kiwango cha kifo kwa kesi kazi TB ni hadi 66%. <ref name=WHO2012data/> TB maambukizi huanza wakati mycobacteria [[Pulmonary alveolus pulmonary alveoli]], ambapo wao kuvamia na kuiga ndani [[endosomes]] ya alveolar [[macrophages]] tundu la mapafu.<ref name=Robbins/><ref name=Houben>{{cite journal |author=Houben E, Nguyen L, Pieters J | title=Interaction of pathogenic mycobacteria with the host immune system |journal=Curr Opin Microbiol | volume=9 | issue=1 | pages=76–85 | year=2006 | pmid=16406837 | doi=10.1016/j.mib.2005.12.014}}</ref> tovuti ya msingi ya maambukizi katika mapafu, unaojulikana kama "[[Lengo Ghon focus]]", ni kwa ujumla iko katika sehemu ama juu ya tundu ya chini, au sehemu ya chini ya [[pafu|tundu juu]].<ref name=Robbins/> Kifua kikuu cha mapafu pia huweza kutokea kupitia maambukizi kutoka mkondo wa damu, Hii inajulikana kama [[lengo Simon]]. A Simon focus na ni kawaida kupatikana katika kilele cha mapafu.<ref>{{cite book|last=Khan|title=Essence Of Paediatrics|year=2011|publisher=Elsevier India|isbn=978813122803|pages=401|url=http://books.google.ca/books?id=gERCc6KTxwoC&pg=PA401}}</ref> maambukizi haya ya hematogenous yanaweza pia kusambaza maambukizi kwa maeneo ya mbali zaidi, kama vile nodiya limfu ya pembeni, mafigo, ubongo na mifupa.<ref name=Robbins/><ref name=Herrmann_2005>{{cite journal |author=Herrmann J, Lagrange P |title=Dendritic cells and ''Mycobacterium tuberculosis'': which is the Trojan horse? |journal=Pathol Biol (Paris) |volume=53 |issue=1|pages=35–40 |year=2005|pmid = 15620608 |doi=10.1016/j.patbio.2004.01.004}}</ref> Maeneo yote ya mwili yanaweza kuathirika kwa ugonjwa huo, ingawa kwa sababu isiyojulikana ni mara chache tu huathiri [[moyo]], [[skeletal misuli]]s, [[kongosho]] , au [[tezi]].<ref>{{cite journal |author=Agarwal R, Malhotra P, Awasthi A, Kakkar N, Gupta D |pmc=1090580 |title=Tuberculous dilated cardiomyopathy: an under-recognized entity? |journal=BMCInfectDis |volume=5 |issue=1 |page=29 |year=2005|pmid=15857515 |doi=10.1186/1471-2334-5-29}}</ref> Kifua Kikuu huainishwa kama moja ya magonjwa [[granuloma]] ya inflamesheni tatizi. [[Macrophage]]s, [[T cell|T lymphocytes]], [[B cell|B lymphocytes]], na [[fibroblast]]s ni miongoni mwa seli zinazoungana kuunda limfu [[granuloma]]s. [[Lymphocytes]] na lymphocytes jirani macrophages kwa walioambukizwa. Granuloma huzuia usambazaji wa mycobacteria na hutoa mazingira ya mahali hapo kwa ajili ya mwingiliano wa seli ya mfumo wa kinga. Bakteria ndani ya granuloma inawezalala, kusababisha maambukizi ya fiche. Kipengele kingine cha granulomas ni maendeleo ya kifo isiyo ya kawaida katikati ([[necrosis]]) katika kituo cha [[Tubercle (anatomia)|tubercles]]. Kwa jicho uchi, hii ina umbo la jibini laini, nyeupe na inaitwa [[caseous]] [[necrosis]]. <ref name=Grosset> {{cite journal |author=Grosset J |title=Mycobacterium tuberculosis in the Extracellular Compartment: an Underestimated Adversary |url=https://archive.org/details/sim_antimicrobial-agents-and-chemotherapy_2003-03_47_3/page/833 |journal=Antimicrob Agents Chemother |volume=47|issue=3 |pages=833–6 |year=2003|pmid = 12604509|doi = 10.1128/AAC.47.3.833-836.2003 |pmc=149338}} </ref> Bakteria ya TB inaweza kuingia kwenye mfumo wa damu kutokana na eneo la tishu kuharibiwa. Zinaweza kuenea kwa mwili na kuanzisha maenezi ya ukimwi, tubercles zote huonekana vidogo, nyeupe katika tishu. <ref>{{cite book|last=Crowley|first=Leonard V.|title=An introduction to human disease : pathology and pathophysiology correlations|year=2010|publisher=Jones and Bartlett|location=Sudbury, Mass.|isbn=978-0-7637-6591-0|pages=374|url=http://books.google.ca/books?id=TEiuWP4z_QIC&pg=PA374|edition=8th ed.}}</ref>Aian hii kali ya ugonjwa wa TB hupatika kawaida zaidi kwa watoto wachanga na wale wanaoishi na VVU, inaitwa [[kifua kikuu military]] .<ref>{{cite book|last=Anthony|first=Harries|title=TB/HIV a Clinical Manual.|year=2005|publisher=World Health Organization|location=Geneva|isbn=978-924154638|pages=75|url=http://books.google.ca/books?id=8dfhwKaCSxkC&pg=PA75|edition=2nd }}</ref> Watu wenye TB hii huwa na kiwango cha juu cha vifo hata kwa matibabu (takriban 30%).<ref name=Gho2008>{{cite book|last=Ghosh|first=editors-in-chief, Thomas M. Habermann, Amit K.|title=Mayo Clinic internal medicine : concise textbook|year=2008|publisher=Mayo Clinic Scientific Press|location=Rochester,MN|isbn=9781420067491|pages=789|url=http://books.google.ca/books?id=YJtodBwNxokC&pg=PA789}}</ref><ref>{{citejournal|last=Jacob|first=JT|coauthors=Mehta, AK, Leonard, MK|title=Acute forms of tuberculosis in adults.|url=https://archive.org/details/sim_american-journal-of-medicine_2009-01_122_1/page/12|journal=The American journal of medicine|date=2009 Jan|volume=122|issue=1|pages=12-7|pmid=19114163}}</ref> Kwa watu wengi, maambukizi ya nta na hafifu. Uharibifu wa tishu na nekrisisi mara nyingi husawazishwa na [[adilifu]]. <ref name=Grosset/> Tishu zilizoathirika hubadilishwa kuwa kovu na matundu huujazwa kwa kisiesheni ya nekritiki. Wakati wa kuugua, baadhi ya mashimo hayo huungana na mapito ya hewa [[bronchi]] na nyenzo hii inaweza kutoka kwa kikohozi. Ni aina ya bakteria hai, na hivyo inaweza kueneza maambukizi. Tiba sahihi [[kiviujasumu]] inaua bakteria na inaruhusu uponyaji. Juu ya tiba, maeneo yaliyoathirika hatimaye kubadilishwa na tishu kovu. <ref name=Grosset/> == Uaguzi == [[Picha:TB in sputum.png|thumb|'' [[Mycobacterium tuberculosis]]'' ([[Ziehl-Neelsen stain|stained red]]) in [[sputum]]]] === Kifua Kikuu hai === Ni vigumu kuagua kifua kikuu kwa misingi ya ishara na dalili tu<ref name=DiagP2011>{{cite journal|last=Bento|first=J|coauthors=Silva, AS, Rodrigues, F, Duarte, R|title=[Diagnostic tools in tuberculosis].|journal=Acta medica portuguesa|date=2011 Jan-Feb|volume=24|issue=1|pages=145–54|pmid=21672452}}</ref>Ni vigumu pai kuagua ugonjwa huo kwa watu wenye shida ya kinga.<ref name=Clinic2009>{{cite journal|last=Escalante first=P|title=In the clinic. Tuberculosis. journal=Annals of internal medicine|date=2009 Jun 2|volume=150|issue=11|pages=ITC61-614; quiz ITV616|pmid=19487708}}</ref> hata hivyo watu wenye dalili za magonjwa ya mapafu [[walio na dalili]] au dalili za kudumu muda mrefu zaidi ya wiki mbili wanaweza kuwa na TB.<ref name=Clinic2009/> [[kifua X-ray]] na nyingi [[sputum utamadumi]] kwa [[bacilli asidi haraka]] ni kawaida sehemu ya tathmini ya awali.<ref name=Clinic2009/> Interferon-γ kutolewa assays na vipimo vya tuberculin ya ngozi hazisaidii katika nchi zinazoendelea.<ref>{{cite journal|last=Metcalfe first=JZ|coauthors=Everett, CK, Steinhart, KR, Cattamanchi, A, Huang, L, Hopewell, PC, Pai, M|title=Interferon-γ release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis.|journal=The Journal of infectious diseases|date=2011 Nov 15|volume=204 Suppl4|pages=S11209|pmid=21996694}}</ref><ref>{{citejournal|last=Sester|first=M|coauthors=Sotgiu, G, Lange, C, Giehl, C, Girardi, E, Migliori, GB, Bossink, A, Dheda, K, Diel, R, Dominguez, J, Lipman, M, Nemeth, J, Ravn, P, Winkler, S, Huitric, E, Sandgren, A, Manissero, D|title=Interferon-γ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis.|journal=The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology|date=2011 Jan|volume=37|issue=1|pages=100-11|pmid=20847080}}</ref>IGRAs mapungufu sawa katika wale wanaoishi na VVU.<ref>{{cite journal|last=Chen|first=J|coauthors=Zhang, R, Wang, J, Liu, L, Zheng, Y, Shen, Y, Qi, T, Lu, H|title=Interferon-gamma release assays for the diagnosis of active tuberculosis in HIV-infected patients: a systematic review and meta-analysis.|journal=PloS one|date=2011|volume=6|issue=11|pages=e26827|pmid=22069472}}</ref><ref>{{cite journal|last=Sester|first=M|coauthors=Sotgiu, G, Lange, C, Giehl, C, Girardi, E, Migliori, GB, Bossink, A, Dheda, K, Diel, R, Dominguez, J, Lipman, M, Nemeth, J, Ravn, P, Winkler, S, Huitric, E, Sandgren, A, Manissero, D|title=Interferon-γ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis.|journal=The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology|date=2011 Jan|volume=37|issue=1|pages=100-11|pmid=20847080}}</ref> Utambuzi yakinifu wa TB ni yaliyotolewa na kutambua “M. kifua KiKuu” katika sampuli ya kliniki (kwa mfano [[makohozi]], [[pus]], au [[tishu]] [[biopsy]]). Hata hivyo, ni vigumu kwa utamaduni mchakato huu viumbe polepole-kukua wanaweza kuchukua 2-6 wiki kwa ajili ya damu au utamaduni makohozi.<ref>{{cite book|last=Diseases|first=Special Programme for Research & Training in Tropical|title=Diagnostics for tuberculosis : global demand and market potential.|year=2006|publisher=World Health Organization on behalf of the Special Programme for Research and Training in Tropical Diseases|location=Geneva|isbn=978-9241563307|pages=36|url=http://books.google.ca/books?id=CFPpcCef4yQC&pg=PA36}}</ref> Hivyo, matibabu ni mara nyingi imeanza kabla ya tamaduni ni alithibitisha.<ref name=NICE2011/> [[Nucleic asidi amplification mithani]] na kupita [[Triphosphate deaminase]] huweza kuruhusu uchunguzi wa haraka wa TB.<ref name=DiagP2011/> Vipimo hivi, hata hivyo, si mara kwa mara ilipendekeza, kama wao mara chache kubadilisha jinsi mtu ni kutibiwa.<ref name=NICE2011/> Vipimo vya damu ili kuchunguza kingamwili si maalum au nyeti, hivyo haipendekezwi.<ref>{{cite journal|last=Steingart|first=KR|coauthors=Flores, LL, Dendukuri, N, Schiller, I, Laal, S, Ramsay, A, Hopewell, PC, Pai, M|title=Commercial serological tests for the diagnosis of active pulmonary and extrapulmonary tuberculosis: an updated systematic review and meta-analysis.|journal=PLoS medicine|date=2011 Aug|volume=8|issue=8|pages=e1001062|pmid=21857806|doi=10.1371/journal.pmed.1001062|pmc=3153457}}</ref> == Kifua kikuu kisichoonekana == [[Mantoux mithani |Mantoux tuberculin ngozi mithani mara nyingi hutumika kwa watu screen katika hatari kubwa ya TB.<ref name=Clinic2009/> Wale ambao wamekuwa awali chanjo wanaweza kuwa na uongo chanya mtihani matokeo.<ref name=Rothel_2005>{{cite journal author=Rothel J, Andersen P |title=Diagnosis of latent ''Mycobacterium tuberculosis'' infection: is the demise of the Mantoux test imminent?|journal=Expert Rev Anti Infect Ther |volume=3 |issue=6 |pages=981–93 |year=2005|pmid = 16307510|doi = 10.1586/14787210.3.6.981}}</ref>mtihani inaweza kuwa uongo hasi katika wale walio na [[sarcoidosis]], [[Hodgkin's lymphoma]], na [[utapiamlo]]. au wengi hasa, katika wale ambao kweli kufanya wana kifua kikuu hai.<ref name=Robbins/> [[Interferon assays katika vivuli mbalimbali ya njano lioenea, kuashiria juu ya watu 300 kwa kila 100,000, na kwa Marekani, Canada, Australia, na Ulaya ya kaskazini katika vivuli ya bluu kirefu, kuashiria kiwango cha maambukizi karibu 10 kwa kila watu 100,000. Asia ni njano lakini si hivyo kabisa mkali, kuashiria kiwango cha maambukizi ya kuzunguka 200 per mbalimbali 100,000. Amerika ya Kusini ni ya njano nyeusi. Mwaka 2007, kiwango cha maambukizi ya TB kwa watu 100,000 ilikuwa ya juu katika Afrika Kusini mwa Sahara, na pia alikuwa kiasi katika Asia.<ref>{{cite book|title=Global tuberculosis control: epidemiology, strategy, financing|author=World Health Organization|year=2009|isbn=978-92-4-156380-2|chapter=The Stop TB Strategy, case reports, treatment outcomes and estimates of TB burden|chapterurl=http://who.int/tb/publications/global_report/2009/annex_3/en/index.html|accessdate=14 November 2009|pages=187–300|archive-date=2009-11-19|archive-url=https://web.archive.org/web/20091119022738/http://www.who.int/tb/publications/global_report/2009/annex_3/en/index.html|dead-url=yes}}</ref> [[kutolewa gamma]] (IGRAs) juu ya sampuli ya damu, ni ilipendekeza kwa wale ambao ni chanya kwa mtihani Mantoux.<refname=NICE2011>{{NICE|117|Tuberculosis|2011}}</ref> IGRAs Haya si walioathirika na chanjo au zaidi [[mazingira mycobacteria]], hivyo wao kuzalisha wachache [[matokeo ya uongo]] na HIV. <ref>{{cite journal|author=Pai M, Zwerling A, Menzies D|title=Systematic Review: T-Cell–based Assays for the Diagnosis of Latent Tuberculosis Infection: An Update |journal=Ann. Intern. Med. |volume=149 |issue=3 |pages=1–9 |year=2008 |pmid=18593687 |pmc=2951987}} </ref> hivyo wao kuzalisha wachache matokeo ya uongo na HIV. Hata hivyo wao walioathirika na M. szulgai, M. marinum na M. kansasii.”<ref>{{cite book|last=Jindal|first=editor-in-chief SK|title=Textbook of pulmonary and critical care medicine|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-93-5025-073-0|pages=544|url=http://books.google.ca/books?id=rAT1bdnDakAC&pg=PA544}}</ref> IGRAs inaweza kuongeza usikivu wakati kutumika kwa kuongeza mtihani ngozi lakini inaweza kuwa chini zaidi kuliko mtihani nyeti ngozi wakati kutumika peke yake.<ref>{{cite journal|last=Amicosante|first=M|coauthors=Ciccozzi, M, Markova, R|title=Rational use of immunodiagnostic tools for tuberculosis infection: guidelines and cost effectiveness studies.|journal=The new microbiologica|date=2010Apr|volume=33|issue=2|pages=93107|pmid=205181}}</ref>. === Kuzuia === Kuzuia Kifua kikuu na kudhibiti juhudi kimsingi kunategemea chanjo ya watoto wachanga na kugundua matibabu sahihi ya matukio hai. <ref name=Lancet11/> [[Shirika la Afya Duniani]] (WHO) imepata baadhi ya mafanikio mazoezi kuboresha tiba, na kupungua kwa idadi ndogo ya kesi. <ref name=Lancet11/> == Chanjo == [[Chanjo]] tu sasa inapatikana kama ya 2011 ni [[bacillus Calmette-Guérin|bacillus Calmette&ndash; Guérin]] (BCG). Ambayo, wakati ni ufanisi dhidi ya ugonjwa kusambazwa katika utoto, unampa ulinzi dhidi ya kuambukizwa TB haiendani mapafu. <ref>{{cite journal|last=McShane|first=H|title=Tuberculosis vaccines: beyond bacille Calmette–Guérin|journal=Philosophical transactions of the Royal Society of London. Series B, Biological sciences|date=12 October 2011|volume=366|issue=1579|pages=27829|pmid=21893541|doi=10.1098/rstb.2011.0097|pmc=3146779}}</ref> Hata hivyo, ni wengi sana kutumika chanjo duniani kote, na zaidi ya 90% ya watoto wote kuwa [[chanjo]]. <ref name=Lancet11/>Hata hivyo, kinga ni kuvuta itapungua baada ya miaka kumi.<ref name=Lancet11/> Kama kifua kikuu ni kawaida katika zaidi ya Canada, Uingereza, na Marekani, BCG ni tu unasimamiwa na watu katika hatari ya juu. <ref>{{cite web|url=http://www.cdc.gov/tb/topic/vaccines/|title=Vaccine and Immunizations: TB Vaccine (BCG)|publisher =Centers for Disease Control and Prevention|year=2011|accessdate=26 July 2011}}</ref><ref name=UK06>{{cite journal|last=Teo|first=SS|coauthors=Shingadia, DV|title=Does BCG have a role in tuberculosis control and prevention in the United Kingdom?|url=https://archive.org/details/sim_archives-of-disease-in-childhood_2006-06_91_6/page/529|journal=Archives of Disease in Childhood|date=2006 Jun|volume=91|issue=6|pages=529–31|pmid=16714729|pmc= 2082765|doi=10.1136/adc.2005.085043 }}</ref> Sehemu ya hoja akisema dhidi ya matumizi ya chanjo ni kwamba inafanya [[ngozi tuberculin mtihani]] uongo chanya, na kwa hiyo, hakuna wa matumizi katika uchunguzi.<ref name=UK06/> idadi ya chanjo mpya ni sasa katika maendeleo<ref name=Lancet11/> === Afya ya Jamii === Shirika la Afya Duniani alitangaza TB "ya afya ya kimataifa dharura" katika 1993. <ref name=Lancet11/> na katika 2006, TB Stop Ushirikiano maendeleo [[Mpango wa Kimataifa Stop kifua kikuu]] kwamba lengo la kuokoa maisha ya milioni 14 kati ya uzinduzi wake na 2015.<ref>{{cite web|url=http://www.stoptb.org/global/plan/|title=The Global Plan to Stop TB|publisher=[[World Health Organization]]|year=2011|accessdate=13 June 2011|archive-date=2011-06-12|archive-url=https://web.archive.org/web/20110612030924/http://www.stoptb.org/global/plan/|url-status=dead}}</ref> idadi ya malengo ya wana kuweka si uwezekano wa kupatikana kwa 2015, hasa kutokana na ongezeko katika kifua kikuu HIV-kuhusishwa na kuibuka wa kifua kikuu sugu nyingi (MDR-TB).<ref name=Lancet11/> [[mfumo wa kifua kikuu] uainishaji maendeleo na [[Jamii ya Marekani Thoracic]] hutumiwa hasa katika mipango ya afya ya umma. .<ref>{{cite book|last=Warrell|first=ed. by D. J. Weatherall ... [4. + 5. ed.] ed. by David A.|title=Sections 1 - 10.|year=2005|publisher=Oxford Univ. Press|location=Oxford[u.a.]|isbn=9780198570141|pages=560|url=http://books.google.ca/books?id=EhjX517cGVsC&pg=PA560|edition=4.ed.,paperback.}}</ref> == Menejimenti == Tiba ya TB anatumia [[kiuvijasumu]] na kuua vimelea. Ufanisi kutibu TB ni vigumu, kutokana na muundo wa kawaida na cha kemikali katika ukuta mycobacterial kiini, ambayo inazuia kuingia ya madawa ya kulevya na hufanya kiuvijasumu wengi ufanisi. <ref>{{cite journal |author=Brennan PJ, Nikaido H |title=The envelope of mycobacteria|journal=Annu.Rev. Biochem. |volume=64 |pages=2963 |year=1995 |pmid=7574484|doi=10.1146/annurev.bi.64.070195.000333}}</ref> kiuvijasumu mbili ya kawaida kutumika ni [[isoniazid]] na [[rifampicin]], na matibabu yanaweza ziongezwe, kuchukua miezi kadhaa. <ref name=CDCcourse/> kutibu ya sioonekana TB kawaida inaajiri antibiotic moja, <ref name=Latent2011/> wakati kazi ugonjwa wa Kifua Kikuu ni bora kutibiwa na mchanganyiko wa kiuvijasumu kadhaa ili kupunguza hatari ya bakteria kuendeleza [[upinzani antibiotiki]]. <ref name=Lancet11/>. Watu wenye maambukizi ya latent pia kutibiwa kuwazuia inaendelea kwa ugonjwa kazi TB baadaye katika maisha.<ref name=Latent2011>{{cite journal|last=Menzies|first=D|coauthors=Al Jahdali, H, Al Otaibi, B|title=Recent developments in treatment of latent tuberculosis infection.|journal=The Indian journal of medical research|date=2011 Mar|volume=133|pages=257-66|pmid=21441678}}</ref> [[Moja kwa moja aliona tiba]], yaani kuwa na huduma ya afya mtoa kuangalia mtu kuchukua dawa zao, ni ilipendekeza na WHO katika jitihada za kupunguza idadi ya watu si ipasavyo kuchukua antibiotiki.<ref>{{cite book |author=Arch G., III Mainous |title=Management of Antimicrobials in Infectious Diseases: Impact of AntibioticResistance |publisher=HumanaPr |location= |year=2010 |pages=69 |isbn=1603272380 |oclc=|url=http://books.google.ca/books?id=hwVFAPLYznsC&pg=PA69}}</ref> ushahidi wa kuunga mkono kitendo hiki juu ya watu tu kutumia dawa zao kwa kujitegemea ni maskini. <ref>{{cite journal |author=Volmink J, Garner P |title=Directly observed therapy for treating tuberculosis |journal=CochraneDatabaseSystRev |volume= |issue=4 |pages=CD003343 |year=2007|pmid=17943789 |doi=10.1002/14651858.CD003343.pub3 |url=}}</ref> Mbinu ya kuwakumbusha watu kuhusu umuhimu wa tiba wala hata hivyo kuonekana ufanisi.<ref>{{cite journal|last=Liu|first=Q|coauthors=Abba, K; Alejandria, MM; Balanag, VM; Berba, RP; Lansang, MA|title=Reminder systems and late patient tracers in the diagnosis and management of tuberculosis.|journal=Cochrane database of systematicreviews(Online)|date=2008Oct8|issue=4|pages=CD006594|pmid=18843723}}</ref> === Mwanzo mpya === Matibabu ya kifua kikuu ilipendekeza mpya-mwanzo ya mapafu, kama wa 2010, ni miezi sita ya macho ya antibiotiki zenye rifampicin, isoniazidi, pyrazinamide na ethambutol kwa miezi miwili ya kwanza, na tu rifampicin na isoniazidi [[pyrazinamide]], na [[ethambutol]]. kwa miezi minne iliyopita. <ref name=Lancet11/> Ambapo upinzani isoniazidi ni ya juu, ethambutol inaweza kuongezwa kwa miezi minne iliyopita kama mbadala.<ref name=Lancet11/> === Matumizi ya kawaida ugonjwa === Kama kifua kikuu kurudia, kupima na kuamua ambayo antibiotiki ni nyeti ni muhimu kabla ya kuamua matibabu. <ref name=Lancet11/> Kama [[nyingi TB sugu]] (MDR-TB) ni wanaona, matibabu na antibiotiki angalau nne madhubuti kwa ajili ya miezi 18 hadi 24 ni ilipendekeza. <ref name=Lancet11/> === Upinzani na dawa === Upinzani Kanuni hutokea wakati mtu huwa wameambukizwa mnachuja sugu wa TB. Mtu aliye na TB kikamilifu wanahusika inaweza kuendeleza sekondari (alipewa) upinzani wakati wa tiba kwa sababu ya tiba za kutosha, si kuchukua regimen eda ipasavyo (ukosefu wa kufuata), au kwa kutumia chini quality dawa.<ref name=OBrien>{{cite journal |author=O'Brien R |title=Drug-resistant tuberculosis: etiology, management and prevention |journal=SeminRespir Infect |volume=9 |issue=2|pages=10412 |year=1994|pmid=7973169}}</ref> Sugu TB ni mbaya ya afya ya umma suala katika nchi nyingi zinazoendelea, kama tiba yake ni tena na inahitaji dawa ghali zaidi. MDR-TB hufafanuliwa kama upinzani kwa mbili ya ufanisi zaidi madawa ya TB ya mstari wa kwanza: rifampicin na isoniazidi. . [[Extensively drug-resistant tuberculosis|Sana sugu TB]] pia ni sugu kwa tatu au zaidi ya madarasa sita ya madawa ya mstari wa pili. .<ref name="MMWR2006">{{cite journal |title=Emergence of ''Mycobacterium tuberculosis'' with extensive resistance to second-line drugs—worldwide, 2000–2004 |journal=MMWR Morb Mortal Wkly Rep |volume=55 |issue=11 |pages=301–5 |year=2006|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5511a2.htm|pmid = 16557213 |author=Centers for Disease Control and Prevention (CDC)}}</ref> [[Totally drug-resistant tuberculosis|Kabisa sugu TB]], ambayo kwa mara ya kwanza aliona katika 2003 nchini Italia, lakini si sana taarifa mpaka 2012, ni sugu kwa madawa yote kwa sasa kutumika. <ref> {{cite web|title=Totally Resistant TB: Earliest Cases in Italy |url=http://www.wired.com/wiredscience/2012/01/tdrfirstitaly/|author=Maryn McKenna date=12 January 2012|accessdate=12 January 2012|publisher=[[Wired(magazine)|Wired]]}}</ref> == Ubashiri == Mwendelezo na maambukizi ya TB na ugonjwa wazi ya TB hutokea wakati bacilli kushinda ulinzi mfumo wa kinga na kuanza kuzidisha. Katika ugonjwa wa TB ya msingi (baadhi 1-5% ya kesi), hii hutokea mara baada ya maambukizi ya awali. [219] Hata hivyo, katika matukio mengi ya, [[Latent tuberculosis|maambukizi sioonekana]] hutokea na hakuna dalili za wazi. <ref name=Robbins/> Hizi bacilli kulala kuzalisha kifua kikuu kazi katika% 5-10 ya kesi hizi sioonekana, mara nyingi miaka mingi baada ya kuambukizwa. <ref name=Pet2005/> hatari ya kuongezeka kwa muathiriko immunosuppression, kama vile kuwa husababishwa na maambukizi ya VVU. Katika watu kuambukiza pamoja na M. kifua kikuu na VVU, hatari ya muathiriko inaongezeka hadi 10% kwa mwaka. <ref name=Robbins/> Mafunzo kutumia DNA ya alama ya kidole ya M. kifua kikuu Matatizo umeonyesha kuambukiza tena inachangia zaidi kikubwa kwa TB ya kawaida zaidi kuliko ilivyodhaniwa hapo awali,<ref>{{cite journal |doi=10.1016/S1473-3099(03)00607-8 |title=Recurrence in tuberculosis: relapse or reinfection? |year=2003 |author=Lambert M |journal=Lancet Infect Dis |volume=3 |page=282 |pmid=12726976 |issue=5|authorseparator=, |displayauthors=1 |last2=Hasker |first2=Epco |last3=Deun |first3=ArmandVan |last4=Roberfroid|first4=Dominique |last5=Boelaert |first5=Marleen |last6=Van Der Stuyft |first6=Patrick |pages=282–7}}</ref>na makadirio ili akaunti kwa zaidi ya 50% ya kesi ku hai tena katika maeneo ambapo TB ni ya kawaida.<ref>{{cite journal|last=Wang|first=JY|coauthors=Lee, LN, Lai, HC, Hsu, HL, Liaw, YS, Hsueh, PR, Yang, PC|title=Prediction of the tuberculosis reinfection proportion from the local incidence|url=https://archive.org/details/sim_journal-of-infectious-diseases_2007-07-15_196_2/page/281|journal=The Journal of infectious diseases|date=15 July 2007|volume=196|issue=2|pages=281–8|pmid=17570116|doi=10.1086/518898}}</ref> nafasi ya kifo kutokana na kesi ya kifua kikuu ni kuhusu 4% kama ya 2008, kutoka 8% mwaka 1995.<ref name=Lancet11/>. == Epidemolojia == [[Picha:Tuberculosis world map - DALY - WHO2004.svg|thumb|[[Age adjustment|Age-standardized]] death from tuberculosis per 100,000&nbsp;inhabitants in 2004.<ref>{{cite web|url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=WHO Disease and injury country estimates |year=2004 |work=World Health Organization |accessdate=11 November 2009}}</ref> {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<small>≤10</small>}} {{legend|#fff200|<small>≥10–25</small>}} {{legend|#ffdc00|<small>≥25–50</small>}} {{legend|#ffc600|<small>≥50–75</small>}} {{legend|#ffb000|<small>≥75–100</small>}} {{legend|#ff9a00|<small>≥100–250</small>}} {{Multicol-break}} {{legend|#ff8400|<small>≥250–500</small>}} {{legend|#ff6e00|<small>≥500–750</small>}} {{legend|#ff5800|<small>≥750–1000</small>}} {{legend|#ff4200|<small>≥1000–2000</small>}} {{legend|#ff2c00|<small>≥2000–3000</small>}} {{legend|#cb0000|<small>≥ 3000</small>}} {{Multicol-end}}]] Takribani theluthi moja ya idadi ya watu duniani imekuwa kuambukizwa na M. kifua kikuu, na maambukizi mapya ya kutokea kwa kiwango cha moja kwa pili kwa kiwango cha kimataifa. <ref name=WHO2012data/>Hata hivyo, wengi maambukizi na M. kifua kikuu wala kusababisha ugonjwa wa Kifua Kikuu, <ref name=CDC> {{cite web publisher= [[Centers for Disease Control]]|url=http://www.cdc.gov/tb/publications/factsheets/general/LTBIandActiveTB.htm|title=Fact Sheets: The Difference Between Latent TB Infection and Active TB Disease date=20 June 2011|accessdate=26 July 2011}}</ref> na 90-95% ya maambukizi ya kubaki bila dalili. <ref name=Book90/> Mwaka 2007, kulikuwa na wastani wa milioni 13.7 sugu kazi kesi. <ref name=WHO2009-Epidemiology/> Mwaka 2010, kulikuwa na milioni 8.8 mpya kesi ya TB kukutwa na vifo 1,450,000, zaidi ya haya yanayojitokeza katika [[Developing nation|nchi zinazoendelea]].<ref name=WHO2011/> Vifo hivi 1,450,000, kuhusu 0,350,000 kutokea katika wale wana ambukizwa pamoja na HIV. <ref name=WHO2011Control>{{cite web|title=GlobalTuberculosisControl2011|url=http://www.who.int/tb/publications/global_report/2011/gtbr11_full.pdf|work=WorldHealthOrganization|accessdate=15 April 2012|archivedate=2012-06-17|archiveurl=https://web.archive.org/web/20120617064025/http://www.who.int/tb/publications/global_report/2011/gtbr11_full.pdf}}</ref> Kifua Kikuu ni ya pili zaidi ya vifo kutokana na ugonjwa kuambukiza (baada ya wale kutokana na HIV / UKIMWI).<ref name=ID10/>idadi kamili ya kesi kifua kikuu ("maambukizi") imekuwa ikipungua tangu 2005, wakati mpya kesi ("[[Incidence (epidemiolojia )|matukio]]") zimeshuka tangu 2002.<ref name=WHO2011/>China imepata maendeleo makubwa hasa, pamoja na kupunguza takriban 80% katika kiwango cha TB wake vifo kati ya 1990 na 2010.<ref name=WHO2011Control/> Kifua Kikuu ni ya kawaida zaidi katika nchi zinazoendelea; kuhusu 80% ya idadi ya watu katika nchi nyingi za Asia na Afrika mtihani chanya katika vipimo tuberculin, wakati tu 5-10% ya mtihani Marekani idadi chanya.<ref name=Robbins/> Matumaini ya kudhibiti ugonjwa huo kabisa wamekuwa kasi unyevunyevu kwa sababu ya mambo kadhaa, ikiwa ni pamoja na ugumu wa kuendeleza chanjo ufanisi, ghali na muda mwingi uchunguzi wa mchakato, umuhimu wa miezi mingi ya matibabu, ongezeko la maambukizi ya virusi-kuhusishwa kifua kikuu , na kuibuka wa kesi sugu katika miaka ya 1980.<ref name=Lancet11/>[[Picha:TB incidence.png|thumb|left|Annual number of new reported TB cases. Data from [[World Health Organization|WHO]]. <ref> {{cite web|author=WorldHealthOrganization|url=http://www.who.int/tb/publications/global_report/2008/annex_3/en/index.html|title=WHO report 2008: Global tuberculosis control|accessdate=13 April 2009}}</ref>]] Katika 2007, nchi yenye kiwango cha juu zaidi ya makadirio ya matukio ya TB ilikuwa [[Swaziland]], na kesi 1,200 kwa kila watu 100,000. India ilikuwa kubwa jumla ya matukio, na wastani wa kesi 2.0 milioni mpya. <ref name=WHO2009-Epidemiology/> Katika nchi zilizoendelea, kifua kikuu ni. <ref name=WHO2009-Epidemiology/>chini ya kawaida na ni kupatikana hasa katika maeneo ya mijini. Viwango kila watu 100,000 katika maeneo mbalimbali ya dunia ambapo: Kimataifa 178, 332 Kusini, Amerika 36, Bahari ya Mashariki 173, Ulaya 63, Asia ya Kusini 278, na 139 Pacific Magharibi katika 2010 <ref name=WHO2011Control/> Nchini Canada na Australia, kifua kikuu ni mara nyingi zaidi ya kawaida kati ya [[Aboriginal peoples|Watu wa asili]],hasa katika maeneo ya kijijini.<ref>{{cite journal|last=FitzGerald|first=JM|coauthors=Wang,L,Elwood,RK|title=Tuberculosis: 13.Control of the disease among aboriginal people inCanada.|journal=CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne|date=2000 Feb 8|volume=162|issue=3|pages=351-5|pmid=10693593}}</ref><ref>{{cite book |author=Quah, Stella R.; Carrin, Guy; Buse, Kent; Kristian Heggenhougen |title=Health Systems Policy, Finance, andOrganization |publisher=AcademicPress |location=Boston |year=2009 |pages=424 |isbn=0123750873 |oclc= |url=http://books.google.ca/books?id=IEXUrc0tr1wC&pg=PA424}}</ref>Katika Marekani watu wa asili kuwa vifo vya mara tano zaidi kutoka TB.<ref>{{cite book |author= Anne-Emanuelle Birn |title= Textbook of International Health: Global Health in a Dynamic World |year=2009|pages=261 |isbn=9780199885213 |url=http://books.google.ca/books?id=2XBB4-eYGZIC&pg=PT261 |doi= |accessdate=}}</ref> matukio ya TB inatofautiana na umri Katika Afrika, kimsingi unaathiri vijana na watu wazima vijana. <ref>{{cite web|author=World Health Organization|url=http://www.who.int/tb/publications/global_report/2006/pdf/full_report_correctedversion.pdf|title=Global Tuberculosis Control Report, 2006 – Annex 1 Profiles of high-burden countries format=PDF accessdate=13 October 2006|archiveurl=https://web.archive.org/web/20060716135331/http://www.who.int/tb/publications/global_report/2006/pdf/full_report_correctedversion.pdf|archivedate=2006-07-16|accessdate=2013-03-06}}</ref>Hata hivyo, katika nchi ambapo matukio viwango zimepungua kasi ( kama vile Marekani), TB ni ugonjwa wa watu hasa wakubwa na kinga iliyoathirika. <ref name=Robbins/><ref>{{cite web|author=CentersforDiseaseControlandPrevention|url=http://www.cdc.gov/nchstp/tb/pubs/slidesets/surv/surv2005/default.htm|title=2005SurveillanceSlideSet|date=12September2006|accessdate=13October2006}}</ref>. == Historia == [[Picha:Mummy at British Museum.jpg|thumb|[[Maiti]] ya Misri katika [[Makumbusho ya Uingereza]] - kuoza kulikoathiriwa na kifua kikuu kumepatikana katika mifupa yake.]] Kifua kikuu kimekuwepo kwa [[binadamu]] tangu zamani sana.<ref name=Lancet11>{{cite journal|last=Lawn first=SD|coauthors=Zumla, AI|title=Tuberculosis journal=Lancet|date=2 July 2011|volume=378|issue=9785|pages=57–72|pmid=21420161|doi=10.1016/S0140-6736(10)62173-3}}</ref> Mwanzo zisizo na utata kutambua ya M. kifua kikuu inahusisha ushahidi wa ugonjwa huo katika mabaki ya bison tarehe na takriban 17,000 miaka iliyopita.<ref>{{cite journal |author=Rothschild BM |title=Mycobacterium tuberculosis complex DNA from an extinct bison dated 17,000 years before the present |journal=Clin. Infect. Dis. |volume=33 |issue=3 |pages=305–11 |year=2001 |month=August |pmid=11438894 |doi=10.1086/321886 |url=http://www.journals.uchicago.edu/cgi-bin/resolve?CID001531 |author-separator=, |author2=Martin LD |author3=Lev G |display-authors=3 |last4=Bercovier |first4=Helen |last5=Bar‐Gal |first5=Gila Kahila |last6=Greenblatt |first6=Charles |last7=Donoghue |first7=Helen |last8=Spigelman |first8=Mark |last9=Brittain |first9=David |archive-date=2019-03-25 |access-date=2013-03-06 |archive-url=https://web.archive.org/web/20190325085112/https://www.journals.uchicago.edu/cgi-bin/resolve?CID001531 |url-status=dead }}</ref> Hivyo, kama kifua kikuu asili katika mangombe, kisha kuhamishiwa kwa binadamu, au kama ni kuachana kutoka babu ya kawaida, sasa ni wazi. <ref>{{cite journal |author=Pearce-Duvet J |title=The origin of human pathogens: evaluating the role of agriculture and domestic animals in the evolution of human disease|url=https://archive.org/details/sim_biological-reviews_2006-08_81_3/page/369 |journal=Biol Rev Camb Philos Soc |volume=81 |issue=3 |pages=369–82 |year=2006|pmid = 16672105|doi=10.1017/S1464793106007020}}</ref> kulinganisha [[gene]]s ya M. kifua kikuu tata (MTBC) kwa binadamu kwa MTBC katika wanyama unaonyesha binadamu hakuwa kupata MTBC kutoka kwa wanyama wakati wa kufuga wanyama kama ilivyoaminika hapo nyuma. Wote Matatizo ya bakteria kifua kikuu kushiriki babu ya kawaida, ambayo ingeweza kuambukizwa binadamu kama mapema kama [[Mapinduzi Neolithiki]]. <ref>{{cite journal|last=Comas first=I coauthors=Gagneux, S|title=The past and future of tuberculosis research.|journal=PLoS pathogens date=2009 Oct|volume=5|issue=10|pages=e1000600|pmid=19855821}}</ref> Mabaki ya kiunzi kuonyesha prehistoric binadamu (4000 KK) [[Common Era|BC]] ) alikuwa TB. Na watafiti wamegundua kuoza enye umbo katika miiba ya [[Misri ya Egypt]] [[maiti|mummies]] kutoka BC 3000-2400.<ref>{{cite journal |author=Zink A, Sola C, Reischl U, Grabner W, Rastogi N, Wolf H, Nerlich A |title=Characterization of Mycobacterium tuberculosis Complex DNAs from Egyptian Mummies by Spoligotyping |url=https://archive.org/details/sim_journal-of-clinical-microbiology_2003-01_41_1/page/359 |journal=J Clin Microbiol |volume=41 |issue=1 |pages=359–67 |year=2003 |pmid=12517873|doi=10.1128/JCM.41.1.359-367.2003 |pmc=149558}}</ref> Phthisis ni neno la Kigiriki kwa ajili ya matumizi, mrefu zamani kwa ajili ya kifua kikuu cha mapafu; <ref>{{cite book|title=The Chambers Dictionary.|year=1998|publisher=Allied Chambers India Ltd.|location=New Delhi|isbn=978-81-86062-25-8|pages=352|url=http://books.google.ca/books?id=pz2ORay2HWoC&pg=RA1-PA352}}</ref> ] karibu 460 BC, [[Hippocrates]] kutambuliwa phthisis kama ugonjwa kuenea zaidi ya nyakati. Ilikuwa alisema kuhusisha homa na kukohoa ya damu, ambayo ilikuwa karibu daima mbaya. <ref>Hippocrates.[https://web.archive.org/web/20050211173218/http://classics.mit.edu/Hippocrates/aphorisms.mb.txt Aphorisms.] Accessed 7 October 2006.</ref> Masomo ya maumbile zinaonyesha TB alikuwepo katika [[Amerika]] kutoka BK mwaka 100. <ref>{{cite journal |author=Konomi N, Lebwohl E, Mowbray K, Tattersall I, Zhang D |title=Detection of Mycobacterial DNA in Andean Mummies |url=https://archive.org/details/sim_journal-of-clinical-microbiology_2002-12_40_12/page/4738 |journal=J Clin Microbiol |volume=40 |issue=12 |pages=4738–40 |year=2002 |pmid=12454182|doi=10.1128/JCM.40.12.4738-4740.2002 |pmc=154635}}</ref> Kabla ya [[Mapinduzi ya Viwanda]], ngano nyingi zinazohusiana na kifua kikuu [[vampire]]s. Wakati mmoja wa familia walikufa kutokana na hilo, wanachama wengine walioambukizwa bila kupoteza afya yao polepole. Watu waliamini hii kulitokana na mtu awali na TB kuondoa maji maisha kutoka kwa wanachama wengine wa familia.<ref name=sledzik>{{cite journal |last=Sledzik |first=Paul S. |coauthors=Nicholas Bellantoni |month=June |year=1994 |title=Bioarcheological and biocultural evidence for the New England vampire folk belief |journal=American Journal of Physical Anthropology |volume=94 |issue=2 |pages=269–274|doi=10.1002/ajpa.1330940210 |url=http://www.ceev.net/biocultural.pdf |format=PDF|pmid=8085617 |issn=0002-9483}}</ref> Ingawa aina ya mapafu kuhusishwa na [[tubercle (anatomia )|tubercles]] ilianzishwa kama patholojia na Dr Richard Morton katika 1689.<ref name="WhoNamedIt-Calmette">{{WhoNamedIt|doctor|2413|Léon Charles Albert Calmette}}</ref><ref name="MedHist1970-Trail">{{cite journal |author=Trail RR |title=Richard Morton (1637-1698) |journal=Med Hist |volume=14|issue=2 |pages=166–74 |year=1970 |month=April |pmid=4914685 |pmc=1034037 }}</ref> kutokana na aina ya dalili yake, TB ilikuwa si kutambuliwa kama ugonjwa mmoja hadi miaka ya 1820, na haikuitwa kifua kikuu mpaka 1839 na [[Johann Lukas Schönlein|J. L. Schönlein]].<ref>Zur Pathogenie der Impetigines. Auszug aus einer brieflichen Mitteilung an den Herausgeber. [Müller’s] ''Archiv für Anatomie, Physiologie und wissenschaftliche Medicin''. 1839, page 82.</ref> Katika miaka 1838-1845, Dk John Croghan, mmiliki wa of [[Pango Mammoth]] , kuletwa idadi ya watu wenye kifua kikuu katika pango kwa matumaini ya kutibu ugonjwa na joto mara kwa mara na usafi wa hewa pango; walikufa ndani ya mwaka. <ref>[http://edition.cnn.com/2004/TRAVEL/DESTINATIONS/02/26/mammoth.cave.ap/index.html Kentucky: Mammoth Cave long on history.] {{Wayback|url=http://edition.cnn.com/2004/TRAVEL/DESTINATIONS/02/26/mammoth.cave.ap/index.html |date=20060813140746 }} ''[[CNN]]''. 27 February 2004. Accessed 8 October 2006.</ref> Hermann Brehmer kufunguliwa kwanza TB [[sanatorium]] katika 1859 katika [[Sokołowsko|Sokołowsko, Poland]].<ref name =sanatoria>{{cite journal |author=McCarthy OR |title=The key to the sanatoria |journal=J R Soc Med |volume=94 |issue=8 |pages=413–7 |year=2001 |month=August |pmid=11461990 |pmc=1281640 |url=http://www.jrsm.org/cgi/pmidlookup?view=long&pmid=11461990 |access-date=2013-03-06 |archive-date=2012-08-03 |archive-url=https://archive.today/20120803180504/http://www.jrsm.org/cgi/pmidlookup?view=long&pmid=11461990 |url-status=dead }}</ref> [[Picha: RobertKoch.jpg|upright|thumb|left|Dr. Robert Koch aligundua tuberculosis bacilli.]] Kifua kikuu na kusababisha bacillus, ‘’Mycobacterium kifua kikuu ‘’, ilikuwa kutambuliwa na ilivyoelezwa kwenye Machi 24, 1882 na [[Robert Koch]]. Alipokea [[Tuzo ya Nobel katika in Fizilojia au dawa]] katika 1905 kwa ugunduzi huu. <ref>[[NobelFoundation]]. [http://nobelprize.org/nobel_prizes/medicine/laureates/1905/ The Nobel Prize in Physiology or Medicine 1905.]Accessed 7 October 2006. </ref> Koch hawakuamini bovin (ng'ombe) na kifua kikuu na magonjwa ya binadamu walikuwa sawa. Ambayo kuchelewa utambuzi wa maziwa aliyeambukizwa kama chanzo cha maambukizi. Baadaye, hatari ya maambukizi kutoka chanzo hili kasi kupunguzwa kwa uvumbuzi wa mchakato [[pasteurishaji]]. Koch alitangaza dondoo [[glycerine]] ya bacilli kinundu kama "dawa" ya kifua kikuu katika 1890, na kuiita 'tuberculin'. Wakati ilikuwa si ufanisi, baadaye mafanikio ilichukuliwa kama mtihani uchunguzi kwa ajili ya uwepo wa kifua kikuu mbele ya dalili. <ref>{{cite journal|author=Waddington K |title=To stamp out "So Terrible a Malady": bovine tuberculosis and tuberculin testing in Britain, 1890–1939 |url=https://archive.org/details/sim_medical-history_2004-01_48_1/page/29 |journal=Med Hist |volume=48 |issue=1 |pages=29–48 |year=2004 |month=January |pmid=14968644 |pmc=546294 }}</ref> [[Albert Calmette]] na [[Camille Guérin]] mafanikio ya kwanza ya kweli mafanikio katika utoaji wa chanjo dhidi ya kifua kikuu katika 1906. kwa kutumia mnachuja ya ngombe kufikika kifua kikuu. Ilikuwa inaitwa ([[Bacillus Calmette-Guérin|bacillus of Calmette and Guérin]]) (BCG). Chanjo ya BCG mara ya kwanza kutumika juu ya binadamu katika 1921 nchini [[Ufalansa]].<ref name=Bonah>{{cite journal |author=Bonah C|title=The 'experimental stable' of the BCG vaccine: safety, efficacy, proof, and standards, 1921–1933 |journal=Stud Hist Philos Biol Biomed Sci |volume=36 |issue=4 |pages=696–721 |year=2005 |pmid=16337557|doi=10.1016/j.shpsc.2005.09.003}}</ref> Lakini tu kupokea kukubalika kuenea katika [[United States|Marekani]], [[Uingereza]], and [[Ujerumani]] na baada ya Vita Kuu ya II. <ref name=Comstock>{{cite journal |author=Comstock G |title=The International Tuberculosis Campaign: a pioneering venture in mass vaccination and research |url=https://archive.org/details/sim_clinical-infectious-diseases_1994-09_19_3/page/528 |journal=Clin Infect Dis |volume=19 |issue=3 |pages=528–40 |year=1994|pmid=7811874|doi=10.1093/clinids/19.3.528}}</ref> Kifua Kikuu unasababishwa zaidi kuenea umma wasiwasi katika karne ya 19 na 20 mapema kama ugonjwa wa [[endemic (epidemiolojia )|ndwele]] maskini wa mijini. Katika 1815, moja katika vifo nne nchini Uingereza ni kutokana na "matumizi". By 1918, moja katika vifo sita katika Ufaransa alikuwa bado unasababishwa na TB. Baada ya kuamua ugonjwa huo kuenea katika miaka ya 1880, TB ilikuwa kuweka [[Katika orodha ya ugonjwa|liolazimu kujulishwa Ugonjwa]] katika Uingereza, kampeni walikuwa wameanza kuacha watu kutoka kutema katika maeneo ya umma, na maskini walioambukizwa walikuwa "moyo" kuingia [[sanatorium sanatoria]] ambayo inafanana magereza (sanatoria kwa ajili ya madarasa kati na juu inayotolewa huduma bora na matibabu ya mara kwa mara). <ref name =sanatoria/> Chochote faida ( kwa kusudi ) ya "hewa safi" na ajira katika sanatoria, hata chini ya hali bora, 50% ya wale waliokuwa wakiingia alikufa ndani ya miaka mitano (circa 1916).<ref name =sanatoria/> Katika Ulaya, viwango vya ugonjwa wa kifua kikuu ulianza kupanda katika miaka ya 1600 mapema kwa ngazi kilele katika miaka ya 1800, wakati unasababishwa karibu 25% ya vifo vyote.<ref>{{cite book|last=Bloom|first=editor, Barry R.|title=Tuberculosis : pathogenesis, protection, and control|year=1994|publisher=ASM Press|location=Washington, D.C.|isbn=978-1-55581-072-6}}</ref> Vifo vya kisha ilipungua karibu 90% kwa miaka ya 1950.<ref>{{cite book|last=Persson|first=Sheryl|title=Smallpox, Syphilis and Salvation: Medical Breakthroughs That Changed the World|year=2010|publisher=ReadHowYouWant.com|isbn=978-1-4587-6712-7|pages=141|url=http://books.google.ca/books?id=-W7ch1d6JOoC&pg=PA141}}</ref> Maboresho katika afya ya umma alianza kwa kiasi kikubwa kupunguza viwango vya ugonjwa wa kifua kikuu hata kabla ya kuwasili kwa [[streptomycin] na kiviujasumu nyingine. Ingawa ugonjwa alibakia tishio kubwa kwa afya ya umma ambao vile. Wakati [[Medical Research Council (UK)|Medical Council Utafiti]] iliundwa katika Uingereza katika 1913, lengo yake ya awali ilikuwa kifua kikuu utafiti. <ref>{{cite book|last=editor|first=Caroline Hannaway,|title=Biomedicine in the twentieth century: practices, policies, and politics|year=2008|publisher=IOS Press|location=Amsterdam|isbn=978-1-58603-832-8|pages=233|url=http://books.google.ca/books?id=o5HBxyg5APIC&pg=PA233}}</ref> Katika mwaka 1946, maendeleo ya[[streptomycin]] Kiviujasumu alifanya matibabu ya ufanisi na tiba ya TB ukweli. Kabla ya kuanzishwa kwa dawa hii, matibabu tu (isipokuwa sanatoria) alikuwa upasuaji kuingilia, ikiwa ni pamoja na "[[“mbinu pneumothorax”]], ambayo wanaohusika kuanguka uvimbe walioambukizwa na "kupumzika" ni na kuruhusu vidonda tuberculous kuponya. <ref>{{cite book|last=Shields|first=Thomas|title=General thoracic surgery|year=2009|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-7982-1|pages=792|url=http://books.google.ca/books?id=bVEEHmpU-1wC&pg=PA792|edition=7th ed.}}</ref> kuibuka wa MDR-TB ina tena ilianzisha upasuaji kama chaguo ndani ya kiwango kukubalika kwa ujumla wa huduma katika kutibu magonjwa ya TB. Hali kwa sasa hatua za upasuaji kuhusisha kuondolewa makijishimo ya patholojia ya kifua ("bullae") katika mapafu ya kupunguza idadi ya bakteria na kuongeza mfiduo wa bakteria iliyobaki kwa madawa katika mfumo wa damu, na hivyo ukipungua jumla bakteria mzigo na kuongeza ufanisi wa utaratibu ya tiba ya Kivuijasumu.<ref>{{cite journal |author=Lalloo UG, Naidoo R, Ambaram A |title=Recent advances in the medical and surgical treatment of multi-drug resistant tuberculosis |journal=Curr Opin Pulm Med |volume=12 |issue=3 |pages=179–85 |year=2006 |month=May |pmid=16582672 |doi=10.1097/01.mcp.0000219266.27439.52 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1070-5287&volume=12&issue=3&spage=179 |access-date=2013-03-06 |archive-date=2013-05-10 |archive-url=https://web.archive.org/web/20130510095840/http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1070-5287&volume=12&issue=3&spage=179 |dead-url=yes }}</ref> Matumaini ya TB kabisa kuondoa (''cf.'' [[smallpox]]), walikuwa kwa kimbilio baada ya kupanda ya Matatizo sugu katika miaka ya 1980. Liofufuka baadae ya kifua kikuu ilisababisha tamko la dharura ya afya ya kimataifa na Shirika la Afya Duniani mwaka 1993. <ref>{{cite web|title=Frequently asked questions about TB and HIV|url=http://www.who.int/tb/hiv/faq/en/index.html|work=World Health Organization|accessdate=15 April 2012|archiveurl=https://web.archive.org/web/20041225163604/http://www.who.int/tb/hiv/faq/en/index.html|archivedate=2004-12-25}}</ref> == Jamii na Ustaarabu == [[Shirika la Afya Duniani]] na [[Bill and Melinda Gates Foundation]] ni kutoa ruzuku mpya haraka-kaimu uchunguzi mtihani kwa ajili ya matumizi katika nchi chini na kipato cha kati.<ref name=Xpert2011>{{cite journal last=Lawn|first=SD|coauthors=Nicol, MP|title=Xpert® MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance.|journal=Future microbiology|date=2011 Sep|volume=6|issue=9|pages=1067-82|pmid=21958145}}</ref><ref>{{cite news|url=http://www.reuters.com/article/idUSTRE6B71RF20101208 |title=WHO says Cepheid rapid test will transform TB care|work= Reuters | date=8 December 2010}}</ref> Wengi raslimali maeneo kama ya 2011 bado tu kupata hadubini makohozi.<ref>{{cite journal last=Lienhardt|first=C|coauthors=Espinal, M, Pai, M, Maher, D, Raviglione, MC|title=What research is needed to stop TB? Introducing the TB Research Movement.|journal=PLoS medicine|date=2011 Nov|volume=8|issue=11|pages=e1001135|pmid=22140369|doi=10.1371/journal.pmed.1001135|pmc=3226454}}</ref> India ilikuwa ya juu jumla ya idadi ya wagonjwa wa TB duniani kote katika 2010, kwa sehemu kutokana na usimamizi mbovu ugonjwa ndani ya sekta binafsi ya afya. Mipango kama vile [[Programu ya Taifa ya Kifua Kikuu]] karatasi ya kufikiria tena ni kusaidia kupunguza viwango vya TB miongoni mwa watu wanaopata huduma ya afya ya umma.<ref name="Bhargava">{{cite journal |author=Anurag Bhargava, Lancelot Pinto, Madhukar Pai |title=Mismanagement of tuberculosis in India: Causes, consequences, and the way forward |journal=Hypothesis |volume=9 |issue=1 |pages=e7 |year=2011 |url=http://www.hypothesisjournal.com/?p=989 |access-date=2013-03-06 |archive-date=2020-01-12 |archive-url=https://web.archive.org/web/20200112192507/http://www.hypothesisjournal.com/?p=989 |dead-url=yes }}</ref><ref>{{cite journal last=Amdekar|first=Y|title=Changes in the management of tuberculosis.|journal=Indian journal of pediatrics|date=2009 Jul|volume=76|issue=7|pages=739-42|pmid=19693453}}</ref> == Utafiti == Chanjo ya BCG ina mapungufu, na utafiti wa kuendeleza chanjo ya TB mpya ni unaoendelea.<ref name=VacRes2011>{{cite journal last=Martín Montañés|first=C|coauthors=Gicquel, B|title=New tuberculosis vaccines. journal=Enfermedades infecciosas y microbiologia clinica|date=2011 Mar|volume=29 Suppl 1|pages=57–62|pmid=21420568|doi=10.1016/S0213-005X(11)70019-2}}</ref> idadi ya wagombea uwezekano ni sasa katika majaribio [[clinical trial|ya awamu ya I na II kliniki]] .<ref name=VacRes2011/> Mbili mbinu kuu ni kuwa kutumika kujaribu kuboresha ufanisi wa chanjo zinapatikana. Moja inahusisha mbinu kuongeza chanjo subunit kwa BCG, wakati mkakati mwingine ni kujaribu kujenga mpya na bora chanjo hai. <ref name=VacRes2011/> [[MVA85A]], mfano wa chanjo subunit, sasa katika majaribio nchini Afrika Kusini, ni msingi juu ya virusi vya vinasaba kufura ngozi.<ref name=Ibanga_2006>{{cite journal |author=Ibanga H, Brookes R, Hill P, Owiafe P, Fletcher H, Lienhardt C, Hill A, Adegbola R, McShane H |title=Early clinical trials with a new tuberculosis vaccine, MVA85A, in tuberculosis-endemic countries: issues in study design |journal=Lancet Infect Dis |volume=6 |issue=8|pages=522–8 |year=2006 |doi= 10.1016/S1473-3099(06)70552-7| pmid = 16870530}}</ref> Chanjo ni unaotarajiwa kuwa na jukumu muhimu katika matibabu ya wote fiche na ugonjwa hai.<ref>{{cite journal|author=Kaufmann SH|title=Future vaccination strategies against tuberculosis: Thinking outside the box|journal=Immunity|year=2010|volume=33|pages=567–77|pmid = 21029966|doi=10.1016/j.immuni.2010.09.015|issue=4}}</ref> Kuhamasisha ugunduzi zaidi, watafiti na watunga sera ni kukuza mpya mifano ya kiuchumi ya maendeleo ya chanjo, ikiwa ni pamoja na zawadi, motisha ya kodi, na [[ahadi mapema Soko]] .<ref>{{cite journal|author=Webber D, Kremer M|url=http://www.who.int/bulletin/archives/79(8)735.pdf |title=Stimulating Industrial R&D for Neglected Infectious Diseases: Economic Perspectives |journal=Bulletin of the World Health Organization|volume=79|issue=8|year=2001|pages=693–801}}</ref><ref>{{cite journal|author=Barder O, Kremer M, Williams H|url=http://www.bepress.com/ev/vol3/iss3/art1|title=Advance Market Commitments: A Policy to Stimulate Investment in Vaccines for Neglected Diseases|journal=The Economists' Voice|volume=3|year=2006|issue=3|doi=10.2202/1553-3832.1144|access-date=2013-03-06|archive-date=2006-11-05|archive-url=https://web.archive.org/web/20061105083659/http://www.bepress.com/ev/vol3/iss3/art1|dead-url=yes|=https://web.archive.org/web/20061105083659/http://www.bepress.com/ev/vol3/iss3/art1}}</ref> Idadi ya makundi, ikiwa ni pamoja na [[Ushirikiano Stop TB]] ,<ref>{{cite book|last=Economic|first=Department of|title=Achieving the global public health agenda : dialogues at the Economic and Social Council|year=2009|publisher=United Nations|location=New York|isbn=978-92-1-104596-3|pages=103|url=http://books.google.ca/books?id=VeF9dv74C4MC&pg=PA103|coauthors=Affairs, Social}}</ref> ] Afrika Kifua Initiative Chanjo, na the [[Aeras TB Duniani Foundation Chanjo]] , wanahusika na utafiti.<ref>{{cite book|last=Jong|first=[edited by] Jane N. Zuckerman, Elaine C.|title=Travelers' vaccines|year=2010|publisher=People's Medical Pub. House|location=Shelton, CT|isbn=978-1-60795-045-5|pages=319|url=http://books.google.ca/books?id=BKRpWFEy66wC&pg=PA319|edition=2nd ed.}}</ref> Kati ya hayo, Aeras TB Duniani Chanjo Foundation alipokea zawadi ya zaidi ya $ 280,000,000 (Marekani) kutoka kwa [[Bill na Melinda Gates Foundation]] kuendeleza na leseni ya chanjo dhidi ya kifua kikuu bora kwa ajili ya matumizi katika nchi mzigo mkubwa. == Katika wanyama == Mycobacteria kuambukiza wanyama mbalimbali, ikiwa ni pamoja na ndege, panya na wanyama watambaao. subspecies Mycobacterium kifua kikuu, ingawa, ni mara chache sasa katika wanyama wa porini. <ref>{{cite book|last=Wobeser|first=Gary A.|title=Essentials of disease in wild animals|year=2006|publisher=Blackwell Publ.|location=Ames, Iowa [u.a.]|isbn=978-0-8138-0589-4|pages=170|url=http://books.google.ca/books?id=JgyS6fxVasYC&pg=PA170|edition=1st ed.}}</ref> jitihada za kutokomeza kifua kikuu ng’ombe unasababishwa na “[[Bovis Mycobacterium]]” kutoka kwa ng'ombe na mifugo kulungu wa [[New Zealand]] imekuwa na mafanikio. Jitihada katika Uingereza wamekuwa chini ya mafanikio. == Tanbihi == {{marejeo}} [[Jamii:Maradhi ya kuambukiza]] ddha90oj35ntg7rigjwgw5s84f2rwy0 0 36299 1578055 1564482 2026-07-02T16:44:43Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578055 wikitext text/x-wiki {{Infobox disease | Name = Kaswende - Syphilis | Image = Treponema pallidum.jpg | Caption = Electron micrograph of ''Treponema pallidum'' | ICD10 = {{ICD10|A|50||a|50}}-{{ICD10|A|53||a|50}} | ICD9 = {{ICD9|090}}-{{ICD9|097}} | ICDO = | OMIM = | DiseasesDB = 29054 | MedlinePlus = 000861 | eMedicineSubj = med | eMedicineTopic = 2224 | eMedicine_mult = {{eMedicine2|emerg|563}} {{eMedicine2|derm|413}} | MeshID = D013587 | }} [[Image:Chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum 6803 lores.jpg|thumb|200px|Vipele vya awali vya kaswende katika [[uume]].]] [[Image:Secondary Syphilis on palms CDC 6809 lores.rsh.jpg|right| thumb|200px|Hatua ya pili ya kaswende inavyojitokeza mikononi.]] [[Image:Tertiary syphilis head.JPG|image|thumb|200px|Mfano wa kichwa cha mtu mwenye kaswende katika hatua ya tatu.]] '''Kaswende''' ([[ing.]] ''syphilis'') ni mojawapo kati ya [[maradhi ya zinaa]] ambayo inasababishwa na [[bakteria]] inayofahamika kama ''Treponema pallidum''. Katika hatua za mwanzo, vipele katika sehemu za uzazi huanza kujitokeza muda mfupi baada ya maambukizi ambavyo baadaye hupotea vyenyewe. Kama [[ugonjwa]] hautatibiwa, maambukizi huendelea kwa miaka, yakishambulia [[mifupa]], [[ubongo]] na [[moyo]] na kusababisha madhara mengine yanayotokana na matatizo katika [[mfumo wa fahamu]] kama vile [[homa ya uti wa mgongo]] na magonjwa ya [[moyo]] na [[kiharusi]]. Kaswende wakati wa ujauzito unaweza kuwa hatari kubwa kwa kiumbe tumboni, kama vile kusababisha kutoumbika vizuri (''deformity'') na [[kifo]]. Wanawake wengi wajawazito katika [[nchi zilizoendelea]] huchunguzwa kwa uwepo wa ugonjwa huu katika majuma ya kwanza ya [[mimba]] ili kutibu ugonjwa kabla kitoto hakijaathirika. Siku hizi kaswende inaweza kutibika kwa urahisi fulani kwa [[penicillin]]. ==Maelezo zaidi ya msingi== Kaswende inasababishwa na [[bakteria ya]] spirochete ''[[Treponema pallidum]]'' baadhi ya spishi ''pallidum''. Njia ya kawaida zaidi ya kuambukizwa ni kupitia [[ngono]]; hata hivyo, kaswende pia inaweza kuambukizwa kutoka kwa mama hadi kwa [[mimba]] wakati wa ujauzito au wakati wa kuzaliwa kwa mtoto, na kusababisha [[kuzaliwa na kaswende]]. Magonjwa mengine ya binadamu yanayohusiana ni''[[Treponema pallidum]]''bakteria inajumusiha [[buba]] (baadhi ya spishi ''pertenue''), [[Pinta (ugonjwa)|pinta]] (baadhi ya spishi ''carateum'') na [[bejel]] (baadhi ya spishi ''endemicum''). Dalili na ishara za kaswende hutofautiana kulingana na hatua iliyoko kati ya hatua nne. Hatua ni ya kwanza, ya pili, fiche, na ya mwisho. Hatua ya kwanza kawaida inajitokeza kimoja na [[shanka]] utokeaji wa kidonda kwa ngozi isiyowasha, ngumu, isiyokuwa na uchungu). Hatua ya pili ya kaswende hujitokeza na upele ambayo mara kwa mara inahusisha viganja vya mikono na nyayo za miguu. Hatua fiche ya kaswende hujitokeza na dalili kiasi au hata bila. Hatua ya mwisho ya kaswende hujitokeza na [[Guma (patholojia)|guma]], dalili zinazohusiana na mfumo wa neva, au zinazohusiana na moyo. Hata hivyo, kaswende imeitwa "mwiigaji mkuu" sababu mara nyingi hujitokeza kwa njia isiyo ya kawaida. Kwa kawaida kaswende hutambulika kwa [[kuchunguzwa na serolojia|uchunguzi wa damu]];hata hivyo, bakteria inaweza kuonekana kwa kutumia hadubini. Kaswende inaweza kutibiwa kwa njia inayofaa kwa kutumia [[antibiotiki]], haswa ndani ya misuli [[penisilini G]]. Hii inapendekezwa kwa watu walio na aleji ya penisilini, [[seftriaksoni]]. Inaaminika kwamba kufikia mwaka wa 1999 watu milioni 12 walikuwa wameambukizwa kaswende ulimwenguni na zaidi ya asilimia 90 ya hali hizi kutoka kwa [[nchi zinazoendelea]]. Hali za kaswende zilipungua kwa kasi baada ya penisilini kupatikana kwa urahisi katika miaka ya 1940, lakini viwango vya maambukizi vimeongezeka tangu mwaka 2000 katika nchi nyingi. Mara nyingi kaswende hupatikana pamoja na [[virusi vinavyosababisha UKIMWI]] (VVU). Hii imehusishwa na sehemu ya matendo ya ngono yasiyokuwa salama kati ya [[wanaume wanaofanya ngono na wanaume wengine]];Ongezeka la uasherati; ukahaba; na kupungua kwa matumizi ya kondomu.<ref>{{cite journal|last=Coffin|first=LS|coauthors=Newberry, A, Hagan, H, Cleland, CM, Des Jarlais, DC, Perlman, DC|title=Syphilis in Drug Users in Low and Middle Income Countries|journal=The International journal on drug policy|date=2010 Jan|volume=21|issue=1|pages=20–7|pmid=19361976|doi=10.1016/j.drugpo.2009.02.008|pmc=2790553}}</ref><ref>{{cite journal|last=Gao|first=L|coauthors=Zhang, L, Jin, Q|title=Meta-analysis: prevalence of HIV infection and syphilis among MSM in China|journal=Sexually transmitted infections|date=2009 Sep|volume=85|issue=5|pages=354–8|pmid=19351623|doi=10.1136/sti.2008.034702}}</ref><ref>{{cite journal|last=Karp|first=G|coauthors=Schlaeffer, F, Jotkowitz, A, Riesenberg, K|title=Syphilis and HIV co-infection|journal=European journal of internal medicine|date=2009 Jan|volume=20|issue=1|pages=9–13|pmid=19237085|doi=10.1016/j.ejim.2008.04.002}}</ref> {{TOC limit|3}} ==Dalili na ishara== Kaswende inaweza kuwa katika hatua moja kati ya hatua nne tofauti: ya kwanza, ya pili, fiche, na ya mwisho,<ref name=Kent08>{{cite journal |author=Kent ME, Romanelli F |title=Reexamining syphilis: an update on epidemiology, clinical manifestations, and management |journal=Ann Pharmacother |volume=42|issue=2 |pages=226–36 |year=2008 |month=February |pmid=18212261 |doi=10.1345/aph.1K086 |url=https://archive.org/details/sim_annals-of-pharmacotherapy_2008-02_42_2/page/226}}</ref> na pia inaweza kujitokeza [[wakati wa kuzaliwa]].<ref name=ST10/> ilirejelewa kama "mwiigaji mkuu" na [[Sir William Osler]] kutokana na njia mbalimbali inavyojitokeza<ref name=Kent08/><ref name=TUS00/> ===Hatua ya kwanza=== [[Image:Extragenital syphilitic chancre of the left index finger PHIL 4147 lores.jpg|thumb|200px|Vipele vya awali vya kaswende katika mkono.]] Hatua ya kwanza ya kaswende kawaida hupatikana kwa kuwasiliana kwa njia ya moja kwa moja kwa ngono na vidonda vilivyoambukizwa vya mtu mwingine.<ref name=RedBookSyphilis>{{cite book|author=Committee on Infectious Diseases |editor = Larry K. Pickering |title=Red book 2006 Report of the Committee on Infectious Diseases|url=https://archive.org/details/redbook0000larr |year=2006| pages=[https://archive.org/details/redbook0000larr/page/631 631]–44|publisher=American Academy of Pediatrics|location=Elk Grove Village, IL|isbn=9781581102079|edition=27th}}</ref>Takriban siku 3 hadi 90 baada ya kuathiriwa hapo awali ( wastani ya siku 21&nbsp;) kidonda kwa ngozi, iitwayo [[shanka]], hutokea mahali palipogusana.<ref name=Kent08/> Huu ni mfano hasa&nbsp;(Asilimia 40 ya wakati) kidonda kimoja, kigumu, kisichokuwa na uchungu, kisichowasha na sehemu yake ya chini iliyokuwa safi na mipaka mikali kati ya sentimita 0.3 na 3.0 kwa ukubwa .<ref name=Kent08/> Hata hivyo, kidonda, kinaweza kuonekana kuwa tofauti sana. <ref name=Pri2008>{{cite journal|last=Eccleston|first=K|coauthors=Collins, L, Higgins, SP|title=Primary syphilis|journal=International journal of STD & AIDS|date=2008 Mar|volume=19|issue=3|pages=145–51|pmid=18397550|doi=10.1258/ijsa.2007.007258}}</ref> Katika viwango, hugeuka kutoka[[macule]] hadi [[kipele]]na kisha kwa [[uyeyukaji (ugonjwa wa ngozi)#Hatua ya kwanza ya vidonda|uyeyukaji]] au [[Donda (ngozi)|donda]].<ref name=Pri2008/> Mara chache, kutakuwa na vidonda kadhaa. (~40%),<ref name=Kent08/> Hii pia ni ya kawaida mtu anapoambukizwa Virusi Vya Ukimwi<!-- Pri2008 --> Shanka yanaweza kuwa na uchungu au nyororo (30%),<!-- Pri2008 --> na zinaweza kutokea nje viungo vya uzazi (2–7%).<!-- Pri2008 --> Mahali pa kawaida zaidi pa chanikeri kwa wanawake ni [[kwa seviksi]](44%). Mahali pa kawaida zaidi kwa wanaume wanaovutiwa na jinsia tofauti ni [[Kwa uume]] (99%). Wakati mwingine shanka hutokea kwa tupu ya nyama au rektamu kwa[[wanaume wanaojishirikisha ngono na wanaume wengine]] (34%).<ref name=Pri2008/> [[Tenzi]] kuvimba mara kwa mara&nbsp;(80%)hutokea pahali palipo ambukizwa,<ref name=Kent08/> hutokea siku 7 hadi 10&nbsp;baada ya kutokea kwa shanka<ref name=Pri2008/> [[kidonda]] kinaweza kuendelea kutokea wiki watatu hadi sita bila matibabu<ref name=Kent08/> ===Hatua ya pili=== [[image:Syphilis second state 2.jpg|thumb|Nyekundu [[vipele]] na [[Uvimbe (daktari wa ngozi)#Hatua ya kwanza ya vidonda|vipele]] kuzidi mwilini kutokana na hatua ya pili ya kaswende]] Hatua ya pili ya kaswende hutokea takriban wiki nne hadi kumi baada ya hatua ya kwanza ya maambukizi.<ref name=Kent08/> hatua ya pili ya ugonjwa unaweza kujitokeza kwa njia nyingi tofauti, lakini kwa kawaida dalili sana sana huhusisha ngozi, [[membreni ute]], na [[tezi ya limfu]].<ref name=Sec2010/> kunaweza kuwa na upele mwekundu-waridi-isiyokuwa na mwasho kwa kiwiliwili pamoja na limbu (miguu na mikono), ikiwa ni pamoja na viganja na nyayo.<ref name=Kent08/><ref name=2darySyphilis>{{cite journal | author=Dylewski J, Duong M | title=The rash of secondary syphilis | url=https://archive.org/details/sim_canadian-medical-association-journal_2007-01-02_176_1/page/33 | journal=Canadian Medical Association Journal | date= 2 January 2007 |volume=176 | issue=1 | pages=33–5 | doi= 10.1503/cmaj.060665 | pmid=17200385 | pmc=1764588}}</ref> Vipele vinaweza kuwa [[makulopapula]] au [[usaha|yenye pustuli]].<!-- Kent08 --> inaweza kutengeneza chunjua kama vidonda iliyopana, nyeupe na sawa sawa inayojulikana kama [[kondiloma latum]] kwa [[membreni yenye ute]]s.<!-- Kent08 --> Vidonda hivi vyote vinamaambukizi na yanahifadhi bakteria.<!-- Kent08 --> Dalili zingine inaweza ni pamoja na [[homa]], [[uchungu wa koo]], [[hitilafu ya mwili]],[[kupunguza uzito]], [[kutokwa na nywele]], na [[maumivu ya kichwa]].<ref name=Kent08/> matokeo yasiyo kuwa ya kawaida ni pamoja na [[hepatitisi]], [[figo]] ugonjwa, [[athritisi]],[[periostitisi]], [[neuritsi ya kuona]], [[uveitisi]], na [[keratitisi ya interstitial]].<ref name=Kent08/><ref name=Eye07/> Kwa kawaida dalili kali uyeyuka baadaye kati ya wiki tatu hadi sita;<ref name=Eye07/> hata hivyo, katika hali iliyokaribia 25%, dalili ya hatua ya pili yanaweza kurudi. <!-- Sec2010 --> Watu wengi walio katika hatua ya pili ya kaswende (40–85% ya wanawake, 20–65% ya wanaume) hawatoi ripoti kuwa na shanka ya kiwango kilicho juu cha hatua ya kwanza ya kaswende.<ref name=Sec2010>{{cite journal|last=Mullooly|first=C|coauthors=Higgins, SP|title=Secondary syphilis: the classical triad of skin rash, mucosal ulceration and lymphadenopathy|journal=International journal of STD & AIDS|date=2010 Aug|volume=21|issue=8|pages=537–45|pmid=20975084|doi=10.1258/ijsa.2010.010243}}</ref> ===Hatua fiche=== Hatua fiche ya kaswende imefafanuliwa kama kuwa na [[serolojia|serologic]] utambuzi wa maambukizi bila dalili ya magonjwa.<ref name=RedBookSyphilis/> Imeelezwa zaidi kama ya hapo awali (chini ya mwaka wa 1&nbsp;mwaka mmoja baada ya hatua ya pili ya kaswende) katika Marekani<ref name=Eye07/> Uingerezani, masaa hizi huitwa miaka miwili ya hatua fiche ya kaswende ya mapema na iliyochelewa.<ref name=Pri2008/> Dalili ya hatua fiche ya kaswende ya mapema huweza kurudi tena.<!-- Eye07 --> Hatua fiche ya kaswende iliyochelewa huwa [[haina dalili za magonjwa]] (hayana dalili), na hatua fiche ya kaswende iliyochelewa haiambukizwi kwa urahisi kama hatua fiche ya kaswende ya mapema.<ref name=Eye07/> ===Hatua ya mwisho=== Hatua ya mwisho ya kaswende inaweza kutokea takriban miaka mitatu hadi 15 baada ya maambukizi ya kwanza, na inaweza kugawanywa kwa aina tatu tofauti: kaswende iliyosababishwa na guma (15%), iliyochelewa [[kaswende katika mfumo wa neva]] (6.5%), na kaswende inayoathiri moyo na mishipa ya damu (10%).<ref name=Kent08/><ref name=Eye07/> Bila matibabu, theluthi moja ya watu ambao wameambukizwa kaswende hupata hatua ya mwisho ya kaswende.<ref name=Eye07/> Watu walio na awamu ya mwisho ya kaswende hawawezi kuambukiza wengine.<ref name=Kent08/> Kaswende inayosababishwa na gum, pia inayoitwa [[mwanzo|hafifu]] kaswende, kwa kawaida hutokea moja kwa miaka&nbsp;46 baada ya maambukizi ya awali, kwa wastani wa miaka.15&nbsp; <!-- Kent08 --> Hatua hii ni sifa ya muundo sugu wa [[guma(patholojia)|guma]], ambayo ni uvimbe nyororo zinazofanana na vidonge vya inflamesheni vinavyoweza kuwa zinabadilika kulingana na ukubwa.<!-- Kent08 --> Kawaida huathiri ngozi, mifupa, na ini, lakini inaweza kutokea mahali popote.<ref name=Kent08/> [[Kaswende katika mfumo wa neva]] inamaanisha maambukizi inayohusisha [[mfumo mkuu wa neva]]. Unaweza kutokea mapema, ikiwa aidha isiyo kuwa na dalili ya ugonjwa au ya kusababisha kaswende [[meninjitisi]]; au inaweza kuchelewa, kama kaswende ya veni za tando za ubongo, [[paresi ya jumla]], au [[tabesi dorsalisi]], ambayo inahusu usawa wa mwili na uchungu mkali kwa limbu za chini.<!-- Kent08 --> Kaswende ya neva iliyochelewa huja kabisa baada ya miaka minne hadi 25 baada ya maambukizi ya hapo awali.<!-- Kent08 --> Kaswende ya veni za utando za ubongo hufanana hasa ikiwa haiwezi kuzuiliwa [[kifafa]], na paresi ya jumla hufanana hasa na [[dimenshia]] na [[tabtesi dorsalisi]].<ref name=Kent08/> Pia, kunaweza kuwa na [[Mboni za Agryll Robertson]] ambazo ni mboni ndogo kwa macho zinazofinyika mtu anapotazama vitu vilivyokaribu, lakini hayafinyiki zikiwa wazi kwa mwanga mkali. Kaswende ya moyo na mishipa kwa kawaida hutokea miaka 10 hadi30&nbsp;baada ya maambukizi ya awali.<!-- Kent08 --> Tatizo la kawaida kabisa ni ule wa [[kaswende ya kuvimba kwa aota]], ambayo inaweza kusababisha [[aneurisimi wa aota|aneurisimi]] kuundwa.<ref name=Kent08/> ===Ya kuzaliwa nayo=== [[Kaswende ya kuzaliwa nayo]] inaweza kutokea wakati wa mimba au wa kuzaa.<!-- Wood09 --> Theluthi-mbili ya watoto wazawa wanazaliwa bila dalili.<!-- Wood09 --> Dalili ambazo huendelea zaidi ya miaka michache ya kwanza ya maisha ni pamoja na: [[kunenepa nenepa kwa ini au wengu]] (70%), upele (70%), joto jingi mwilini (40%), kaswende ya neva (20%), na [[ugonjwa wa mapafu kuvimba]] (20%).<!-- Wood09 --> Ikiwa haita tibiwa, [[kaswende ya kuzaliwa ya baadae]] inaweza kutokea kwa 40 %, ikiwa ni pamoja na: [[pua lenye umbo la tandiko]]ulemavu, [[Higoumenakis sign]], [[saber shin]], au [[Clutton's joints]], miongoni mwa zingine.<ref name=Wood09/> ==Chanzo== ===Bakteriolojia=== [[Picha:Treponema pallidum 01.png|thumb|Histopatholojia ya ''Treponema pallidum'' spirosheti zinazotumia kifaa chembamba cha kutia waa cha kisasa]] ''Treponema pallidum'', kundi la spishi ''pallidum'' ni wa umbo la mzunguko, [[gramu-hasi]], bakteria inayosambaa kwa kasi.<ref name=Pri2008/><ref name=Music08/>Magonjwa mengine matatu ya binadamu husababishwa na zinazohusiana na ''Treponema pallidum'', ikiwa ni pamoja na [[buba]] (kundi la spishi ''pertenue''), [[Pinta (maradhi)|pinta]](kundi la spishi ''carateum''), na [[bejel]] (kundi la spishi ''endemicum'').<ref name=Kent08/> Tofauti na aina ya ''pallidum'' haya hayasababishi ugonjwa wa neva.<ref name=Wood09>{{cite journal |author=Woods CR|title=Congenital syphilis-persisting pestilence|journal=Pediatr. Ambukiza. Dis. J. |volume=28|issue=6 |pages=536–7 |year=2009 |month=June |pmid=19483520|doi=10.1097/INF.0b013e3181ac8a69 |url=}}</ref> Wanadamu tu ndio wanaojulikana kuwa na [[hifadhi asili]] kwa kundi la spishi ''pallidum''.<ref name=ST10/> Bakteria hii haiwezi kuishi bila kimelea.<!-- Pri2008 --> Hii ni kwa sababu ya jenomu yake ndogo (1.14&nbsp;[[Yuniti ya masi atomu|MDa]])na hivyo basi haitaweza kutengeneza virutubishi vikuu.<!-- Pri2008 --> Ina wakati mfupi wa kujiongeza zaidi ya saa&nbsp;30.<ref name=Pri2008/> ===Maambukizi=== Kaswende huambukizwa kimsingi kwa kupitia ngono [[ujauzito]] kutoka kwa mama hadi kwa [[fetasi]]; spirosheti huweza kupitia ukiwa mzima kwa membreni ya utetelezi au ngozi yenye haina kinga.<ref name=Kent08/><ref name=ST10>{{cite journal |author=Stamm LV |title=Global Challenge of Antibiotic-Resistant Treponema pallidum |journal=Antimicrob. Agents Chemother. |volume=54 |issue=2 |pages=583–9 |year=2010 |month=February |pmid=19805553 |pmc=2812177 |doi=10.1128/AAC.01095-09 |url=http://aac.asm.org/content/54/2/583.full.pdf |access-date=2013-11-28 |archive-date=2014-04-25 |archive-url=https://www.webcitation.org/6P5jOzkSb?url=http://aac.asm.org/content/54/2/583.full.pdf |dead-url=yes }}</ref> na hivyo husambazwa kwa[[kubusu]], pia mdomo kwa, uke, na tupu ya nyuma wakati wa ngono.<ref name=Kent08/> Takriban 30% hadi 60% kwa wale wako wazi kwa hatua ya kwanza au ya pili ya kaswende watapata ugonjwa huo.<ref name=Eye07>{{cite journal |author=Bhatti MT |title=Optic neuropathy from viruses and spirochetes |journal=Int Ophthalmol Clin |volume=47|issue=4 |pages=37–66, ix |year=2007 |pmid=18049280 |doi=10.1097/IIO.0b013e318157202d |url=https://archive.org/details/sim_international-ophthalmology-clinics_fall-2007_47_4/page/37}}</ref> Maambukizi ya kaswende imefananishwa na ukweli kwamba mtu ambaye amechanjwa na mshushio 57 pekee ana nafasi 50% ya kuambukizwa.<ref name=Pri2008/> Nyingi ya (60%) hali mpya Marekani hutokea kwa wanaume ambao hufanya ngono na wanaume wengine.<!-- Kent08 --> Kaswende inaweza kusambazwa kupitia [[vifaa vya damu]]. Hata hivyo, bidhaa za damu hupimwa kama kuna kaswende katika nchi nyingi, na hivyo hatari hupunguka.<!-- Kent08 --> Hatari ya maambukizi kutoka kwa [[kugawana sindano]] imeonekana kuwa ni chache.<ref name=Kent08/> Kaswende haiwezi kusambazwa kwa kupitia makalio ya choo, shughuli za kila siku, beseni ya maji moto, au kugawana vyombo vya kukulia au mavazi.<ref name="CDC Fact Sheet">{{cite web | title = Syphilis - CDC Fact Sheet | publisher = [[Centers for Disease Control and Prevention]] (CDC) | date = 16 September 2010 | url =http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm | accessdate = 2007-05-30 }}</ref> ==Utambuzi== [[Picha:Syphilis false shame and fear may destroy your future.png|thumb|Bango ya kupima kaswende, inaonyesha mwanamke na mwanaume wakiinamisha vichwa vyao kwa aibu (1936 hivi)]] Ni vigumu kutambua kaswende kwa kliniki mapema katika uwasilishaji wake.<ref name=Pri2008/> Uthibitisho wake hufanywa aidha kupitia [[kupima damu]] au moja kwa moja kukagua kwa kupitia [[uchunguzi kwa kutumia hadubini]].<!-- Kent08 --> Kwa kawaida vipimo vya damu hutumika, kwa sababu hutambulika kwa urahisi zaidi.<ref name=Kent08/> Vipimo vya kutambua ugonjwa haziwezi, hata hivyo, hutofautisha kati ya hatua ya ugonjwa.<ref name= Orgin10/> ===Kupima damu=== Kupimwa kwa damu hugawanywa katika [[Uchunguzi wa kaswende usiokuwa na treponemal |nontreponemal]] na vipimo vya treponemal .<ref name=Pri2008/> Vipimo vya Nontreponemal hutumika hapo awali, na ni pamoja na [[utafiti wa ugonjwa wa zinaa maabarani]] na [[vipimo vya]] Kuongeza ghafla tena kwa plasma. Hata hivyo, kwa vile vipimo hivi ni vya mara kwa mara[[Matokeo chanya#Kosa la kuandika I |matukio chanya]],uthibitisho inahitajika kwa kupima treponemal, kama vile [[treponemal pallidum particle agglutination]] au [[Uchunguzi wa ufonyzaji wa antibodi ya treponemal iliyo na mwangaza]] (FTA-Abs).<ref name=Kent08/> matukio chanya usiokuwa ya ukweli katika uchuguzi wa usio kuwa wa treponemal inaweza kutokea na maambukizi fulani ya virusi kama vile [[tetekuwanga]] na [[ukambi]], pia inaweza kutokea na [[limfoma]], [[kifua kikuu]], [[malaria]],[[uvimbemoyo]], [[ugonjwa wa kuungana kwa tishu]], na [[mimba]].<ref name=RedBookSyphilis/> Vipimo vya antibodi vya treponemal kawaida huwa chanya baada ya wiki mbili hadi tano ya maambukizi ya hapo awali.<ref name=Pri2008/> Kaswende ya neva hutambulika kwa kupata idadi ya juu ya [[lukosaiti]] (kuzidi[[limfositi]]) na kiwango cha juu cha protini [[viowevu vya ubongo na uti wa mgongo]] katika mazingira ya kaswende inayojulikana.<ref name=Kent08/><ref name=RedBookSyphilis/> ===Uchunguzi wa moja kwa moja=== [[Eneo la giza linalochunguzwa kwa kutumia hadubini|Eneo la giza linalochunguzwa kwa kutumia hadubini]] ya [[viowevu vya seramu]] kutoka shanka inaweza kutumika kwa kufanya utambuzi wa haraka.<!-- Pri2008 -->Hata hivyo, sio kawaida kupata vifaa au wakazi wenye ujuzi hospitalini, na vipimo hivi lazima vifanywe kati ya dakika &nbsp;10 ya kupata sampuli.<!-- Pri2008 --> [[kiwango cha hisi na udhihirishaji|Kiwango cha hisi]] kimeripotiwa kuwa takriban 80%, hivyo vipimo hivi vinaweza kutumika tu kuthibitisha utambuzi, lakini si kwa kuchuja moja nje.<!-- Pri2008 --> Vipimo vingine viwili vina weza kufanywa kwa sampuli iliyo toka kwa shanka ni [[antibodi ya mwangaza ya moja kwa moja]] na [[msururu wa athari za polima na vipimo vya|asidi ya kiini]] .<!-- Pri2008 --> antibodi ya floresini ya njia ya moja kwa moja [[antibodi]]zilizobandikwa na[[floresini]], ambayo inajishikilia kwa protini maalum za kaswende. Asidi ya kiini hutumia ufundisanifu, kama vile [[msururu wa athari za polima]], kutambua uwepo wa jeni maalum ya kaswende.<!-- Pri2008 --> Uchunguzi hizi sio shida kwa wakati kama makroskopu inayotumia giza, kwa sababu bakteria hahitajiki ili kufanya utambuzi.<ref name=Pri2008/> ==Udhibiti== Hakuna chanjo inayofaa kudhibiti. <ref name=ST10/> Kujiepusha na uhusiano kimwili na mtu aliyeambukizwa ni shahihi kwa kupunguza maambukizi ya kaswende, kama ilivyo kiasi kwa matumizi sahihi ya [[kondomu]], ambayo, hata hivyo, hayaondoi kabisa hatari.<ref>{{cite journal |author=Koss CA, Dunne EF, Warner L |title=A systematic review of epidemiologic studies assessing condom use and risk of syphilis |journal=Sex Transm Dis |volume=36 |issue=7 |pages=401–5 |year=2009 |month=July |pmid=19455075 |doi=10.1097/OLQ.0b013e3181a396eb|url=https://archive.org/details/sim_sexually-transmitted-diseases_2009-07_36_7/page/401}}</ref><ref name="CDC Fact Sheet" /> Hivyo, [[Vituo vya kudhibiti na kuzuia magonjwa]]vinapendekeza uhusiano wa muda-mrefu, kwa kushirikiana na mtu mmoja hajaambukizwa na kujiepusha na vitu kama [[vinywaji vinavyolewesha|pombe]] na dawa zingine ambazo huongeza hatari za kufanya ngono kiholela.<ref name="CDC Fact Sheet" /> Kaswende ya kuzaliwa nayo inaweza kuzuiwa kwa kuchunguzi mama mapema wakati wa ujauzito na kutibu wale ambao wameambukizwa.<ref name=Screening04>{{cite journal|last=Schmid|first=G|title=Economic and programmatic aspects of congenital syphilis prevention|journal=Bulletin of the World Health Organization|date=2004 Jun|volume=82|issue=6|pages=402–9|pmid=15356931|pmc=2622861}}</ref> [[Muungano wa Wahudumu wa kutoa udhibiti Merikani]] inapendekeza sana uchunguzi kwa wanawake wote wajawazito,<ref>{{cite journal|last=U.S. Preventive Services Task|first=Force|title=Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement|url=https://archive.org/details/sim_annals-of-internal-medicine_2009-05-19_150_10/page/n69|journal=Annals of internal medicine|date=2009 May 19|volume=150|issue=10|pages=705–9|pmid=19451577}}</ref> [[Shirika la Afya Duniani]] inapendekeza wanawake wote kupimwa mara ya kwanza wakitembelea kliniki(kabla ya kujifungua)na tena katika[[kipindi cha tatu cha ujauzito]].<ref name=Lancet11/> Iwapo vipimo vinaonyesha uwepo wa ungojwa,inapendekezwa washirika wa akina mama hawa pia watibiwe.<ref name=Lancet11>{{cite journal|last=Hawkes|first=S|coauthors=Matin, N, Broutet, N, Low, N|title=Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis|journal=The Lancet infectious diseases|date=2011 Jun 15|pmid=21683653|volume=11|issue=9|pages=684–91|doi=10.1016/S1473-3099(11)70104-9}}</ref>. Kaswende ya kuzaliwa nayo, hata hivyo, bado iko kawaida katika inch zinazoendelea, kwa kuwa wanawake wengi hawapati [[huduma ya kliniki ya wajauzito]] > kabisa, na wengine huduma ya kliniki ya wajawazito wanayopata haijumulishi uchunguzi wa kaswende.<ref name=Screening04/> Kaswende ya kuzaliwa nayo huaipatikani mara kwa mara katika nchi zilizoendelea, kwa sababu wale wanaoweza kupata kaswende (kupitia matumizi ya dawa, n.k) pia wako uwezo mdogo zaidi wa kupata huduma wakati wa ujauzito.<ref name=Screening04/> Hatua zingine za kuongezea upatikanaji wa kupimwa huonekana kuwa na ufanisi katika kupunguza viwango vya kaswende ya kuzaliwa nayo katika chini zilizo na mapato ya chini na ya kati.<ref name=Lancet11/> Kaswende ni [[ugonjwa inayohitaji kutolewa taarifa]] katika nchi nyingi, ikiwa ni pamoja na Canada,<ref>{{cite web|title=National Notifiable Diseases|url=http://dsol-smed.phac-aspc.gc.ca/dsol-smed/ndis/list-eng.php|publisher=Public Health Agency of Canada|date=2005-04-05|accessdate=2 August 2011|archivedate=2011-08-09|archiveurl=https://web.archive.org/web/20110809162040/http://dsol-smed.phac-aspc.gc.ca/dsol-smed/ndis/list-eng.php}}</ref> Umoja wa Ulaya,<ref>{{cite journal|last=Viñals-Iglesias|first=H|coauthors=Chimenos-Küstner, E|title=The reappearance of a forgotten disease in the oral cavity: syphilis|journal=Medicina oral, patologia oral y cirugia bucal|date=2009 Sep 1|volume=14|issue=9|pages=e416–20|pmid=19415060}}</ref> na Marikani.<ref>{{cite web|title=Table 6.5. Infectious Diseases Designated as Notifiable at the National Level-United States, 2009 [a]|url=http://www.unboundmedicine.com/redbook/ub/view/RedBook/187389/all/Table_6_5__Infectious_Diseases_Designated_as_Notifiable_at_the_National_Level_United_States__2009_%5Ba%5D|work=Red Book|accessdate=2 August 2011}}</ref> Hii inamaanisha kuwa wahuduma wa Afya wanatakiwa kutoa taarifa kwa[[wizara ya Afya]] ambayo itatoa [[taarifa kwa washirika]] hadi kwa washirika wa watu. <ref>{{cite book|title=Brunner & Suddarth's textbook of medical-surgical nursing.|year=2010|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781785891|pages=2144|edition=12th|url=http://books.google.com/books?id=SmtjSD1x688C&pg=PA2144}}</ref> Madaktari pia wanaweza kuhimiza wagonjwa kutumia washirika wao kupata huduma.<ref>{{cite journal|last=Hogben|first=M|title=Partner notification for sexually transmitted diseases|journal=Clinical infectious diseases: an official publication of the Infectious Diseases Society of America|date=2007 Apr 1|volume=44 Suppl 3|pages=S160–74|pmid=17342669|doi=10.1086/511429}}</ref> Kituo cha kudhibiti na kuzuia magonjwa kinapendekeza kwamba wanaume wanaoshiriki ngono na wanaume wengine lazima wapimwe angalau kila mwaka.<ref>{{cite web|title=Trends in Sexually Transmitted Diseases in the United States: 2009 National Data for Gonorrhea, Chlamydia and Syphilis|url=http://www.cdc.gov/std/stats09/tables/trends-table.htm|publisher=[[Centers for Disease Control and Prevention]] (CDC)|date=22 November 2010|accessdate=3 August 2011}}</ref> ==Matibabu== ===Maambukizi ya mapema=== Chaguo la kwanza kwa matibabu ya kaswende isiyo na tatizo bado tu ni dosi kimoja ya shindano kwa misuli[[Benzlipenisillini|penisilini G]] au dosi moja ya dawa ya kumeza[[azithromycin]].<ref>{{cite book|author = David N. Gilbert, Robert C. Moellering, George M. Eliopoulos, ''et al.''|title=The Sanford guide to antimicrobial therapy 2011|publisher=Antimicrobial Therapy |location=Sperryville, VA|isbn=9781930808652|pages=22| edition = 41st }}</ref><!-- ST10 -->[[Doksiklini]] na [[tetrasaiklini]] ni chaguo mbadala; hata hivyo, hazitumiki kwa akina mama wajawazito.<!-- ST10 --> [[Pingamizi kwa antibiotiki]]imetokezea kwa baadhi ya maajenti, ikiwa ni pamoja na [[makrolidi]], [[klindamisini]], na [[rifampini]].<ref name=ST10/> [[seftriaksoni]], sephalosporini-za tokeo la tatu [[antibiotiki]], zinaweza kufanya kazi kama penisilini kulingana na matibabu.<ref name=Kent08/> ===Maambukizi ya baadaye=== Kwa kaswende kwa sababu ya uingiaji duni wa penisilini G kwenye [[mfumo mkuu wa neva]], watu walioathiriwa wanashauriwa kupewa dosi kubwa za penisilini kwa mshipa kwa muda usiopungua siku 10 .<ref name=Kent08/><ref name=ST10/> Iwapo mtu ana aleji ya penisilini, seftriaksoni inaweza kutumiwa, au utoaji wa aleji ya penisilini unaweza kujaribiwa.<!-- Kent08 --> Zinaotokea baadaye zinaweza kutibiwa na shidano ya penisilini G kwa misuli mara moja-kwa wiki kwa muda wa wiki tatu.<!-- Kent08 --> Ikiwa mgonjwa ana aleji, doksikilini au tetrasaikilini zinaweza kutumiwa, lakini kwa muda mrefu.<!-- Kent08 -->Matibabu kwa wakati huu huzuia uendeleaji wa ugonjwa, lakini ina mabaadiliko madogo tu kwa madhara yenye tayari yametokea.<ref name=Kent08/> ===Athari ya Jarisch-Herxheimer=== Moja wapo ya athari inayoweza kutokana na matibabu ni [[athari aina ya Jarisch-Herxheimer]].<!-- Kent08 --> Mara nyingi inaanza ndani ya saa moja baada ya matibabu na hudumu kwa masaa 24, kukiwa na dalili za joto nyingi mwilini, maumivu kwa misuli, maumivu ya kichwa, na [[takikadia]].<ref name="Kent08"/> Inasababishwa na [[saitokini]] zinazotolewa na mfumo wa kinga kutokana na lipoprotini zinazotolewa wakati bakteria za kaswende zinazopasuka.<ref name=Radolf2006>{{cite book |author= Radolf, JD; Lukehart SA (editors)| year=2006 |title=Pathogenic ''Treponema'': Molekiuli na bayolojia ya chembechembe |url= https://archive.org/details/pathogenictrepon0000unse| publisher=Caister Academic Press | isbn= 1-904455-10-7}}</ref> ==Epidemiolojia== [[Image:Syphilis world map - DALY - WHO2004.svg|thumb|[[Age adjustment|Age-standardized]] death from syphilis per 100,000&nbsp;inhabitants in 2004<ref>{{cite web |url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=Disease and injury country estimates |year=2004 |publisher = [[World Health Organization]] (WHO) |accessdate=11 November 2009}}</ref> {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<35}} {{legend|#fff200|35-70}} {{legend|#ffdc00|70-105}} {{legend|#ffc600|105-140}} {{legend|#ffb000|140-175}} {{legend|#ff9a00|175-210}} {{Multicol-break}} {{legend|#ff8400|210-245}} {{legend|#ff6e00|245-280}} {{legend|#ff5800|280-315}} {{legend|#ff4200|315-350}} {{legend|#ff2c00|350-500}} {{legend|#cb0000|>500}} {{Multicol-end}}]] Inaaminiwa kuwa kaswende iliathiri watu milioni 12 mwaka wa 1999, 90% ya maambukizi yakiwa kwa [[nchi zinazoendelea]].<ref name=ST10/> Huathiri kati ya mimba 700,000 na milioni 1.6&nbsp; kwa mwaka, na kusababisha [[kuharibika kwa mimba bila hiari]]s, [[kuzaa mtoto aliyekufa]] na kuzaliwa na kaswende.<!-- Wood09 --> Katika[[sub-Saharan Africa]], kaswende huchangia takriban 20% ya [[vifo vya watoto wakati wa kuzaliwa]].<ref name=Wood09/> Viwango viko juu zaidi vikilinganishwa na [[wanaotumia dawa ya kulevya|wanaojidunga dawa kwa mshipa]], walio na maambukizi ya VVU, na wanaume wanaofanya ngono na wanaume wengine.<ref>{{cite journal|last=Coffin|first=LS|coauthors=Newberry, A, Hagan, H, Cleland, CM, Des Jarlais, DC, Perlman, DC|title=Syphilis in Drug Users in Low and Middle Income Countries|journal=The International journal on drug policy|date=2010 Jan|volume=21|issue=1|pages=20–7|pmid=19361976|doi=10.1016/j.drugpo.2009.02.008|pmc=2790553}}</ref><ref>{{cite journal|last=Gao|first=L|coauthors=Zhang, L, Jin, Q|title=Meta-analysis: prevalence of HIV infection and syphilis among MSM in China|journal=Sexually transmitted infections|date=2009 Sep|volume=85|issue=5|pages=354–8|pmid=19351623|doi=10.1136/sti.2008.034702}}</ref><ref>{{cite journal|last=Karp|first=G|coauthors=Schlaeffer, F, Jotkowitz, A, Riesenberg, K|title=Syphilis and HIV co-infection|journal=European journal of internal medicine|date=2009 Jan|volume=20|issue=1|pages=9–13|pmid=19237085|doi=10.1016/j.ejim.2008.04.002}}</ref> Nchini Marekani viwango vya kaswende mno mwaka wa 2007 vilikuwa mara sita zaidi kwa wanaume kuliko ya Wanawake, hata ingawa viwango hivi vilikuwa karibu sawa mwaka wa 1997.<ref>{{cite web|title=Trends in Reportable Sexually Transmitted Diseases in the United States, 2007|url=http://www.cdc.gov/std/stats07/trends.htm|publisher=[[Centers for Disease Control and Prevention]](CDC)|date=13 January 2009|accessdate=2 August 2011}}</ref> [[Wafrika Wamarika]] walichangia kwa takriban nusu ya walioambukizwa mwaka wa 2010.<ref>{{cite web|title=STD Trends in the United States: 2010 National Data for Gonorrhea, Chlamydia, and Syphilis|url=http://www.cdc.gov/std/stats10/tables/trends-table.htm|publisher=[[Centers for Disease Control and Prevention]] (CDC)|date=22 November 2010|accessdate=20 November 2011}}</ref> Kaswende ilikuwa ni kawaida nchini Ulaya wakati wa karne ya 18 na 19.<!-- Music08 --> -!>. Katika nchi zilizoendelea mwanzo wa karne ya 20, maambukizi yalipungua kwa haraka kwa sababu ya ongezeko la matumizi ya [[antibiotiki]], hadi miaka ya 1980 na 1990.<ref name=Music08/> Tangu mwaka wa 2000, viwango vya kaswende vimeongezeka nchini Marekani, Uingereza, Australia na Ulaya, hasa kati ya wanaume wanaofanya mapenzi na wanaume wengine.<ref name=ST10/> viwango vya kaswende miongoni mwa wanawake wa Marekani, hata hivyo,imebakia sawa wakati huu, na viwango kati ya wanawake Uingereza vimeongezeka, lakini katika kiwango cha chini kuliko kile cha wanaume.<ref name=AOP08>{{cite journal|last=Kent|first=ME|coauthors=Romanelli, F|title=Reexamining syphilis: an update on epidemiology, clinical manifestations, and management|url=https://archive.org/details/sim_annals-of-pharmacotherapy_2008-02_42_2/page/226|journal=The Annals of pharmacotherapy|date=2008 Feb|volume=42|issue=2|pages=226–36|pmid=18212261|doi=10.1345/aph.1K086}}</ref> Ongezeko kwa viwango miongoni mwa wapenzi wa jinsia tofauti ilitokea China na Urusi tangu miaka ya 1990.<ref name=ST10/> Hii imehusishwa na mazoea ya kufanya mapenzi bila kinga, kuwa na wapenzi wengi, ukahaba, na upunguvu wa matumizi ya kinga kama vile kondomu.<ref name=ST10/><ref>{{cite journal|last=Ficarra|first=G|coauthors=Carlos, R|title=Syphilis: The Renaissance of an Old Disease with Oral Implications|journal=Head and neck pathology|date=2009 Sep|volume=3|issue=3|pages=195–206|pmid=20596972|doi=10.1007/s12105-009-0127-0|pmc=2811633}}</ref><ref name=AOP08/> Bila kutibiwa, kaswende inasababisha vifo kwa 8% hadi 58%,kiwango kikubwa ikiwa kwa wanaume.<ref name=Kent08/> Dalili za kaswende zimepunguka kwa ukali katika karne ya 19 na 20&nbsp;,kwa sababu ya ueneaji na upatikanaji wa matibabu yanayofaa, na pia kupungua kwa[[ukali]] wa spirochaete.<ref name=Sec2010/> Ikitibiwa mapema, matatizo chache hutokea.<ref name=Pri2008/> Kaswende huongeza hatari ya maambukizi ya VVU kwa mara 2-5, na yale yanayoambatana ni ya kawaida (30-60% kwa baadhi ya vituo vya mijini).<ref name=Kent08/><ref name=ST10/> == Historia== [[Image:Rembrandt Harmensz. van Rijn 095.jpg|thumb|Portrait of [[Gerard de Lairesse]] na [[Rembrandt van Rijn]], ca. 1665–67, oil on canvas. De Lairesse,mwenyewe ni mchoraji na mwanasanaa, aliathiriwa na kaswende kutoka kuzaliwa iliyomwaribu uso wake na hatimaye ikasababisha upofu kwake<ref>''[[Metropolitan Museum of Art|The Metropolitan Museum of Art Bulletin]]'', Summer 2007, pp. 55–56.</ref>]] Mwanzo halisi wa kaswende haujulikani <ref name=Kent08/> Kuna nadharia tete mbili za kimsingi:. Moja inapendekeza kuwa kaswende ililetwa Ulaya na wafanyikazi wa meli kutoka [[Christopher Columbus]] safari kuelekea [[Marikani]], na nyingine inapendekeza kwamba kaswende ilikuwepo Ulaya hapo awali, lakini haikuwa imetambuliwa. <!-- Orgin10 --> nadharia hizi hujulikana kama nadharia "Columbian" na "kabla ya Columbian", mtawalio.<ref name=Orgin10>{{cite journal|last=Farhi|first=D|coauthors=Dupin, N|title=Origins of syphilis and management in the immunocompetent patient: facts and controversies|journal=Clinics in dermatology|date=2010 Sep-Oct|volume=28|issue=5|pages=533–8|pmid=20797514|doi=10.1016/j.clindermatol.2010.03.011}}</ref> Nadharia ya Columbia inathibitiswa na ushahidi uliopo.<ref>{{cite journal|last=Rothschild|first=BM|title=History of syphilis|url=https://archive.org/details/sim_clinical-infectious-diseases_2005-05-15_40_10/page/1454|journal=Clinical infectious diseases: an official publication of the Infectious Diseases Society of America|date=2005-05-15|volume=40|issue=10|pages=1454–63|pmid=15844068|doi=10.1086/429626}}</ref> Taarifa ya kwanza iliyoandikwa kuhusu mlipuko wa kaswende katika Ulaya iliyotokea katika mwaka wa 1494/1495 katika[[Naples|Naples, Italia]], wakati waliingiliwa na Ufaransa.<ref name=Music08>{{cite journal|last=Franzen|first=C|title=Syphilis in composers and musicians--Mozart, Beethoven, Paganini, Schubert, Schumann, Smetana|url=https://archive.org/details/european-journal-clinical-microbiology_2008-12_27_12/page/1151|journal=European Journal of Clinical Microbiology and Infectious Diseases |date=2008 Dec|volume=27|issue=12|pages=1151–7|pmid=18592279|doi=10.1007/s10096-008-0571-x}}</ref><ref name=Orgin10/> Kutokana na kuenezwa na kundi la wapiganaji wafaransa waliporudi, hapo awali ilijulikana kama "ugonjwa wa Kifaransa". Mwaka wa 1530, jina "kaswende" lilitumiwa kwanza na daktari Mwitaliano na mshairi [[GirolamoFracastoro]] kama kichwa cha[[Kilatini]] shairi lake kuelezea ongezeko la ugonjwa huo Italia.<ref> Nancy G. "Siraisi, Drugs and Diseases: New World Biology and Old World Learning," in Anthony Grafton, Nancy G. raisi, with April Shelton, eds., New World, Ancient Texts (Cambridge MA: Belknap Press/Harvard University Press, 1992), 159-94 </ref> Kaswende pia ilijulikana kihistoria kama "Poksi Kuu".<ref name=Old05>{{cite journal|last=Dayan|first=L|coauthors=Ooi, C|title=Syphilis treatment: old and new|journal=Expert opinion on pharmacotherapy|date=2005 Oct|volume=6|issue=13|pages=2271–80|pmid=16218887|doi=10.1517/14656566.6.13.2271}}</ref><ref name=Euro04>{{cite journal|last=Knell|first=RJ|title=Syphilis in renaissance Europe: rapid evolution of an introduced sexually transmitted disease?|journal=Proceedings. Biological sciences / the Royal Society|date=2004-05-07|volume=271 Suppl 4|pages=S174–6|pmid=15252975|doi=10.1098/rsbl.2003.0131|pmc=1810019|issue=Suppl 4|url=http://rspb.royalsocietypublishing.org/content/271/Suppl_4/S174.full.pdf|archive-date=2014-08-03|access-date=2013-11-28|archive-url=https://web.archive.org/web/20140803093827/http://rspb.royalsocietypublishing.org/content/271/Suppl_4/S174.full.pdf|url-status=dead}}</ref> Viumbe visababishi, ''Treponema pallidum'', vilitambuliwa kwa mara ya kwanza na [[Fritz Schaudinn]] na [[Erich Hoffmann]] mwaka wa 1905. <ref name=Music08/> matibabu yaliyofaa ya kwanza([[Salvarsan]]) yalitengezwa mwaka wa 1910 na [[Paul Ehrlich]], ambayo ilifuatiliwa na majaribio ya [[penisilini ]] na uthibitisho wa ufanisi wa dawa hiyo mwaka wa 1943 <ref name=Music08/><ref name=Old05/> Kabla ya kuwepo kwa matibabu yaliyofaa, [[mercury (elementi)|mercury]] na kwa kawaida utengaji ulitumika mara nyingi, pamoja na matibabu yaliyokuwa mara nyingi mbaya zaidi kuliko ugonjwa <ref name=Old05/> Watu wengi maarufu wa kihistoria, ikiwa ni pamoja na [[Franz Schubert]],[[Arthur Schopenhauer]], [[ÉdouardManet]]<ref name=Music08/> and [[Adolf Hitler]],<ref>{{cite news | url =http://news.bbc.co.uk/2/hi/health/2842819.stm | title = Hitler syphilis theory revived | publisher = BBC News | date = 12 March 2003}}</ref> waliaminika kuwa walikuwa na ugonjwa huo. ==Jamii na Utamaduni== ===Sanaa na Fasihi=== [[Picha:400Behandlung der Syphilis.jpg|thumb|The earliest known medical illustration of patients suffering from syphilis, Vienna, 1498]] Sanamu ya kwanza Ulaya iliyoonyesha kaswende ni ya[[Albrecht Dürer]] ''Mtu aliye kuwa na Kaswende'', sanamu ilioyo katwa kutoka kwa mti aliaminika kuonyeza [[Landsknecht]], mtu wa kutoka Ulaya kaskazini[[kufanya kwa lengo la pesa]].<ref>{{cite journal|last=Eisler|first=CT|title=Who is Dürer's "Syphilitic Man"?|url=https://archive.org/details/sim_perspectives-in-biology-and-medicine_winter-2009_52_1/page/48|journal=Perspectives in biology and medicine|date=2009 Winter|volume=52|issue=1|pages=48–60|pmid=19168944|doi=10.1353/pbm.0.0065}}</ref> kisasili cha''[[femme fatale]]'' au "Wanawake sumu" wa karne ya 19 inaaminika kuwa ilitokana na uharibifu wa kaswende, ikiwa na mifano maarufu katika maelezo pamoja na [[John Keats]]' [[La Belle Dame sans Merci]].<ref>{{cite book|last=Hughes|first=Robert|title=Things I didn't know : a memoir|url=https://archive.org/details/thingsididntknow00unse|year=2007|publisher=Vintage|location=New York|isbn=9780307385987|pages=[https://archive.org/details/thingsididntknow00unse/page/346 346]|edition=1st Vintage Book}}</ref><ref>{{cite book|last=Wilson|first=[ed]: Joanne Entwistle, Elizabeth|title=Body dressing|year=2005|publisher=Berg Publishers|location=Oxford|isbn=9781859734445|pages=205|edition=[Online-Ausg.]}}</ref> Msanii [[Jan van der Straet]] alichora mtu tajiri akipokea matibabu ya kaswende kwenye mti wa tropiki [[guaiacum]] hapo karibu mwaka wa 1580.<ref>{{cite book|last=Reid|first=Basil A.|title=Myths and realities of Caribbean history|year=2009|publisher=University of Alabama Press|location=Tuscaloosa|isbn=9780817355340|pages=113|url=http://books.google.com/books?id=KtT0_P-9xiAC&pg=PA113|edition=[Online-Ausg.]}}</ref> Kichwa cha kazi hiyo ni "Maandalizi na Matumizi ya Guayaco kwa Kutibu Kaswende".Kwa kuwa msanii alichagua kuweka picha hii kwa kazi zilizofuatana za kuadhimisha Dunia mpya inayoonyesha umuhimu wa matibabu ya kaswende, hata ingawa yasiofaa, ya kaswende ulivyokuwa kwa wasomi wa Ulaya wakati huo. Mchoro uliyokuwa na rangi nyingi na tondoti inaonyesha wafanyi kazi wanne wakiandaa mchanganyiko huo wakati daktari akiangalia, akiwa ameficha kitu nyuma wakati mgonjwa hasio bahatika anakunywa.<ref name="ALLPOSTERS">[http://www.allposters.com/-sp/Preparation-and-Use-of-Guayaco-for-Treating-Syphilis-Posters_i1587366_.htm"Preparation and Use of Guayaco for Treating Syphilis"] {{Wayback|url=http://www.allposters.com/-sp/Preparation-and-Use-of-Guayaco-for-Treating-Syphilis-Posters_i1587366_.htm |date=20110521060238 }}. Jan van der Straet. Retrieved 6 August 2007.</ref> ===Utafiti wa Tuskegee na Guatemala=== Moja ya hali iliyokuwa na sifa mbaya Merikani kuhusu [[maadili ya kimatibabu]] katika karne ya 20 ilikuwa [[Utafiti wa kaswende ya Tuskegee]].<ref>{{cite journal |author=Katz RV, Kegeles SS, Kressin NR, ''et al.''|title=The Tuskegee Legacy Project: Willingness of Minorities to Participate in Biomedical Research |journal=J Health Care Poor Underserved |volume=17 |issue=4 |pages=698–715|year=2006 |month=November |pmid=17242525|pmc=1780164 |doi=10.1353/hpu.2006.0126 |url=https://archive.org/details/sim_journal-of-health-care-for-the-poor-and-underserved_2006-11_17_4/page/698}}</ref> Utafiti ulifanywa [[Tuskegee, Alabama]], ilifadhiliwa na [[Huduma ya afya ya umma Marikani]] (PHS) ikisaidiana na [[Taasisi ya Tuskegee]].<ref name=CDCTime>{{cite web |url=http://www.cdc.gov/tuskegee/timeline.htm |title=U.S. Public Health Service Syphilis Study at Tuskegee | publisher = [[Centers for Disease Control and Prevention]] (CDC) | date = 15 June 2011 |accessdate=2010-07-07 }}</ref> Utafiti huu ulianza mwaka wa 1932, wakati kaswende ilikuwa tatizo sana na hakukuwa na matibabu yaliyofaa na salama.<ref name=TUS00>{{cite journal|last=White|first=RM|title=Unraveling the Tuskegee Study of Untreated Syphilis|journal=Archives of internal medicine|date=2000-03-13|volume=160|issue=5|pages=585–98|pmid=10724044|doi=10.1001/archinte.160.5.585}}</ref> Utafiti huo ulinuia kupima Maendeleo ya kaswende bila matibabu. Kufikia 1947, penisilini ilikuwa imekubaliwa kuwa ndio tiba sahihi kwa matibabu yaliofaa kwa kaswende na ilikuwa ikitumika sana kwa kutibu ugonjwa huo. <-! CDCTime ->Wakurugenzi wa utafiti huu, hata hivyo, waliendelea na utafiti na hawakuwapa washiriki matibabu na penisilini. <ref name=CDCTime/>hiiimejadiliwa, na baadhi yao wamegundua kwamba penisilini alipewa washirika wengi<ref. name="TUS00"/>Utafiti haukuisha hadi 1972.<ref name=CDCTime/> Majaribio ya kaswende pia yalifanywa katika[[Guatemala]] kutoka 1946 hadi 1948. Yalikuwa yamefadhiliwa na[[marikani]] [[|utafiti kwa binadamu|majaribio kwa binadamu]], yaliyofanywa wakati wa serikali ya [[Juan José Arévalo]] ikiwa na ushirikiano na baadhi ya wizara za afya na maafisa wa Guatemala. Madaktari waliambukiza askari, wafungwa, na [[wagonjwa wa akili]] na kaswende na magonjwa mengine[[magojnwa ya zinaa]], bila [[ridhaa]] ya washiriki, na kisha kuwatibi na [[antibiotiki]]. Mwezi wa Oktoba 2010, Marekani iliomba msamaha rasmi kwa Guatemala kwa kufanya majaribio haya.<ref>{{cite news |author= |coauthors= |title=U.S. apologizes for newly revealed syphilis experiments done in Guatemala|url=http://www.washingtonpost.com/wp-dyn/content/article/2010/10/01/AR2010100104457.html |quote=The United States revealed on Friday that the government conducted medical experiments in the 1940s in which doctors infected soldiers, prisoners and mental patients in Guatemala with syphilis and other sexually transmitted diseases.|work=[[The Washington Post]] |date=1 October 2010 |accessdate=1 October 2010}}</ref> {{clear}} ==Tanbihi== {{Reflist|colwidth=30em}} [[Jamii:Maradhi ya zinaa]] [[Jamii:Maradhi ya ngozi]] [[Jamii:magonjwa ya bakteria]] 3w4mte494j7o3wen0z68yxe91d2ssco 0 36355 1578134 1465521 2026-07-02T21:35:09Z InternetArchiveBot 41439 Rescuing 2 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578134 wikitext text/x-wiki [[Faili:Chantal Biya and Laura Bush, 2003.jpg|thumb|right|250px|Chantal Biya na Laura Bush baada ya kahawa katika White House, 21 Machi 2003.]] '''Chantal Biya''' (amezaliwa [[Dimako]], [[Mkoa wa Mashariki, Kamerun|Mkoa wa Mashariki]], [[1970]]) ni [[Mwanamke wa Kwanza]] wa [[Kamerun]], Alizaliwa na mtaalam wa kigeni wa [[Kifaransa]] Georges Vigouroux na mshindi wa tuzo la urembo la Miss [[Doumé]], Rosette Ndongo Mengolo. Chantal Biya ujanani aliishi [[Yaoundé]] <ref name="Morikang"> Morikang.</ref>. Aliolewa na Rais [[Paul Biya]] mnamo tarehe 23 Aprili 1994, baada ya mke wake wa kwanza, [[Jeanne-Irene Biya]], kuaga dunia mwakani 1992. Chantal Biya ameanzisha [[mashirika hisani]] kadhaa. Miongoni mwao ni [[African Synergy]], ambalo huendeleza mipango mbalimbali ya [[VVU]] / [[UKIMWI]], na [[Chantal Biya Foundation (Kifaransa]] ''Fondation Chantal Biya).'' Aliandaa [[Kongamano la First Ladies]] la kwanza mjini [[Yaoundé]] wakati wa kongamano la [[Umoja wa Afrika]]<ref> Ibrahim 17.</ref> la 1996 [[Jeunesse Active pour Chantal Biya]] ni sehemu ya [[Cameroon People Democratic Movement]] cha mumewe.<ref> Ngwane 17.</ref> Miongoni mwa wanawake wa Kamerun, Biya ni maarufu kwa sababu ya [[mitindo ya nywele]]. Staili yake ya kawaida inaitwa'' the banana,'' na hutumiwa kwa hafla rasmi. <ref> Nyamnjoh et al. 113.</ref> Biya ameeneza mitindo mingine; pamoja, inayojulikana kama'' the Chantal Biya.'' <ref> Nyamnjoh et al. 117.</ref> Pia anajulikana kwa sababu ya nguo zake. Baadhi ya wasanifu anaopenda zaidi wanajumuisha walio bora zaidi Ulaya kama vile Chanel au Dior. <ref> http://www.elmundo.es/yodona/albumes/2009/03/20/chantalbiya_style/index.html</ref> [[Grand Prix Chantal Biya]] ni [[mashindano wa baiskeli]] ya wataalam katika barabara ya [[UCI Afrika Tour.]] Mamake Chantal, Rosette Marie Mboutchouang, alichaguliwa Meya wa [[Bangou]] kufuatia uchaguzi wa manispaa mnamo Julai 2007. ==Tanbihi== {{Marejeo}} ==Marejeo== * Dorall, Charyl, ed. (2004). ''Kitabu cha Marejeo ya Mawaziri wa Jumuiya ya Madola cha 2003.'' Sekretarieti ya Jumuiya ya Madola. * F., M. (2 Agosti 2007). [http://www.quotidienmutations.info/mutations/aout/1186041292.php "Bangou - La mere de Chantal Biya élue maire".] {{Wayback|url=http://www.quotidienmutations.info/mutations/aout/1186041292.php |date=20120208060018 }} ''Le Quotidien Mutations.'' Accessed 7 Mei 2008. * Ibrahim, Jibrin (Oktoba 2003). [http://www.codesria.org/Links/Publications/monographs/Ibrahim.pdf "Mageuzi ya Kidemokrasia katika Afrika Magharibi".] {{Wayback|url=http://www.codesria.org/Links/Publications/monographs/Ibrahim.pdf |date=20090927155151 }} Baraza kwa ajili ya Maendeleo ya Utafiti wa Sayansi ya Jamii katika Afrika. * Morikang, Tche Irene (6 Mei 2008). [http://www.cameroon-tribune.net/article.php?lang=Fr&amp;oled=j06052008&amp;idart=10708&amp;olarch=j06052008 "Kutembelea tena Maisha ya Chantal Biya",] {{Wayback|url=http://www.cameroon-tribune.net/article.php?lang=Fr&oled=j06052008&idart=10708&olarch=j06052008 |date=20241127110133 }} ''[[Kamerun Tribune.]]'' Accessed 7 Mei 2008. * Ngwane, Mwalimu George (hakuna tarehe). [http://www.gngwane.com/files/cameroons_democratic_process.pdf "Mchakato wa Demokrasia nchini Kamerun: Vision 2020".] {{Wayback|url=http://www.gngwane.com/files/cameroons_democratic_process.pdf |date=20120205204115 }} gngwane.com. * Nyamnjoh, Francis B., Durham, Deborah, na Fokwang, Yuda D (Desemba 2002). [http://www.nyamnjoh.com/files/nyamnjoh_etal.pdf "Domestication of Hair and Modernised Consciousness in Cameroon: A Critique in the Context of Globalisation".] {{Wayback|url=http://www.nyamnjoh.com/files/nyamnjoh_etal.pdf |date=20060221205430 }} ''Utambulisho Utamaduni na Siasa,'' Vol. 3., Number 2, uk. 98-124. * [http://www.presidentielle2004.gov.cm/candidats.php?id_cand=10&amp;module=bio&amp;lang=en "Wasifu wa Paulo Biya".] {{Wayback|url=http://www.presidentielle2004.gov.cm/candidats.php?id_cand=10&module=bio&lang=en |date=20070930015344 }} Jamhuri ya Kamerun Uchaguzi 2004 tovuti ya uchaguzi wa kirais. Accessed 27 Oktoba 2006. ==Viungo vya nje== * [http://www.synergiesafricaines.org/partenaire_fr.php?idpt=5 Synergieffekter Africaines contre le SIDA et les Souffrances] {{Wayback|url=http://www.synergiesafricaines.org/partenaire_fr.php?idpt=5 |date=20110721061254 }} {{DEFAULTSORT:Biya, Chantal}} [[Category:Waliozaliwa 1970]] [[Category:Wanawake wa Kamerun]] [[Category:Watu walio hai]] 51ftrz3ykc717epcuay9jxz6uxnaac9 0 40508 1578089 1529946 2026-07-02T19:10:23Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578089 wikitext text/x-wiki [[Picha:Cristo crucificado.jpg|thumb|250px|[[Mchoro]] wa [[Diego Velázquez]], ''[[Yesu msulubiwa]]'', [[1631]], [[Jumba la Makumbusho|Makumbusho]] ya [[Prado]] ([[Madrid]], [[Hispania]]) unaonyesha anwani juu ya [[kichwa]] chake.]] [[Picha:SabinaCrucify.jpg|250px|right|thumb|[[Kigae]] cha msalaba - [[Basilika]] la [[Santa Sabina]] huko [[Roma]] ([[Italia]]).]] {{Yesu Kristo}} '''Msalaba wa Yesu''' ni [[msalaba]] ule ambao [[Yesu Kristo]] alisulubiwa juu yake hadi [[Mauti|kifo]] [[Kifo cha Yesu|chake]] kilichotokea huko [[Yerusalemu]] kwa [[amri]] ya [[Ponsyo Pilato]] [[siku]] ya [[Ijumaa Kuu|Ijumaa]], labda [[tarehe]] [[7 Aprili]] [[30]] [[BK]], la sivyo tarehe [[3 Aprili]] [[33]]<ref name=ChronosPaul >[[Paul L. Maier]] "The Date of the Nativity and Chronology of Jesus" in ''Chronos, kairos, Christos: nativity and chronological studies'' by Jerry Vardaman, Edwin M. Yamauchi 1989 {{ISBN|0-931464-50-1}} pp. 113–129</ref><ref name=Kostenberger140 >''The Cradle, the Cross, and the Crown: An Introduction to the New Testament'' by [[Andreas J. Köstenberger]], L. Scott Kellum 2009 {{ISBN|978-0-8054-4365-3}} p. 114</ref><ref name=Barnett19 >''Jesus & the Rise of Early Christianity: A History of New Testament Times'' by Paul Barnett 2002 {{ISBN|0-8308-2699-8}} pp. 19–21</ref>. Tukio hilo {{sfn|Eddy|Boyd|2007|page=172. "...if there is any fact of Jesus' life that has been established by a broad consensus, it is the fact of Jesus' crucifixion.}}, pamoja na [[ufufuko wa Yesu]] unaosadikiwa na [[Ukristo]] kutokea [[siku]] ya [[tatu]] ([[Jumapili]] ya [[Pasaka ya Kikristo|Pasaka]]), ndiyo [[kiini]] cha [[imani]] ya [[dini]] hiyo mpya iliyotokana na ile ya [[Uyahudi]]. Kwa Wakristo [[fumbo]] hilo la [[Pasaka]] ndilo [[kilele]] cha [[historia ya wokovu]] inayotangazwa na [[Biblia ya Kikristo]]<ref>Haight, Roger. "Jesus and Salvation: An Essay in Interpretation." Theological Studies, vol. 55, no. 2, 1994, pp. 227–250. [https://theologicalstudies.net/wp-content/uploads/2022/08/55.2.2.pdf] {{Webarchive|url=https://web.archive.org/web/20240217015756/https://theologicalstudies.net/wp-content/uploads/2022/08/55.2.2.pdf |date=February 17, 2024 }}</ref>. Fumbo hilo lilisababisha kazi nyingi za [[sanaa ya Kikristo]], hasa [[uchoraji]] na [[uchongaji]]. ==Historia== [[Adhabu]] hiyo kali ilianza kutumika huko [[Uajemi]] na kuenea hadi [[Dola la Roma]] ambalo liliitumia hasa katika maeneo ya pembeni na kwa [[watumwa]]. Kadiri ya [[Injili]] zote [[nne]], zinazoungwa mkono na [[maandishi]] mengine mbalimbali, Ponsyo Pilato, [[liwali]] wa [[Palestina]] ([[26]]-[[36]]<ref name="Lémonon 1981 29–32">{{cite book |last=Lémonon |first=J.P. |title=Pilate et le gouvernement de la Judée: textes et monuments, Études bibliques |publisher=Gabalda |location=Paris |year=1981 |pages=29–32}}</ref> ), aliamua [[Yesu]] aadhibiwe hivyo kulingana na shtaka la [[Kiongozi|viongozi]] wa [[Wayahudi]] waliodai kwamba mtuhumiwa huyo alijitangaza kuwa [[mfalme]] na kupinga [[mamlaka]] ya [[Kaisari]] wa [[Roma]], kwa wakati huo [[Tiberius]], ingawa Pilato alikuwa ametambua shtaka halikuwa la kweli, bali lilitokana na [[husuda]]<ref name=Kostenberger104 >''The Cradle, the Cross, and the Crown: An Introduction to the New Testament'' by [[Andreas J. Köstenberger]], L. Scott Kellum 2009 {{ISBN|978-0-8054-4365-3}} pp.&nbsp;104–108</ref><ref name="Evans, Craig A. 2001 page 316">{{Rejea kitabu|last1=Evans|first1=Craig A. |year=2001|title=Jesus and His Contemporaries: Comparative Studies|url=https://archive.org/details/jesushiscontempo0000evan|isbn=0-391-04118-5|page=[https://archive.org/details/jesushiscontempo0000evan/page/316 316]}}</ref><ref name="Wansbrough, Henry 2004 page 185">{{Rejea kitabu|last1=Wansbrough|first1=Henry |year=2004|title=Jesus and the Oral Gospel Tradition|url=https://archive.org/details/jesusoralgospelt0000unse|isbn=0-567-04090-9|page=[https://archive.org/details/jesusoralgospelt0000unse/page/184 185] |publisher=A&C Black }}</ref>. Kadiri ya [[Injili ya Yohane]], Pilato mwenyewe alisisitiza kwamba, katika [[maandishi]] yaliyotakiwa kuwajulisha [[watu]] sababu ya [[adhabu ya kifo]], iwekwe wazi kwamba Yesu aliuawa kama [[mfalme wa Wayahudi]], ingawa [[neno]] hilo lilichukiza viongozi wa [[taifa]]. Maneno ya ilani hiyo yaliandikwa katika [[lugha]] [[tatu]]: *[[Kilatini]]: Iesus Nazarenus Rex Iudeorum, [[kifupi]] [[INRI]], *[[Kigiriki]]: Ἰησοῦς ὁ Ναζωραῖος ὁ Bασιλεὺς τῶν Ἰουδαίω. Kutokana na [[herufi]] hizo, [[Wagiriki]] wanaandika INBI. *[[Kiebrania]]: ישוע הנוצרי ומלך היהודים. [[Herufi]] za kwanza za maneno hayo kwa Kiebrania ni יהוה, [[YHWH]], ndilo [[jina]] takatifu la [[Mungu]] katika [[Biblia ya Kiebrania]]. Yesu akiwa msalabani alisema maneno kadhaa. Kati ya hayo, ni maarufu [[maneno saba]] yaliyoripotiwa na Injili yakimuelekea [[Mungu Baba]], [[Bikira Maria]], [[Mtume Yohane]] na [[Dismas Mtakatifu|mhalifu aliyesulubiwa pamoja naye]]. ==Picha== <gallery widths="180" heights="180"> File:14th-century fresco of Jesus Christ bearing the cross, Visoki Dečani, Kosovo.jpg|''Kubeba Msalaba'' [[mchoro wa ukutani]], [[Decani monastery]], [[Kosovo]], karne ya 14 File:MCB icon3.jpg|[[Picha takatifu]] ya Yesu kusulubiwa, [[Athens]], [[Ugiriki]] File:Miguel Angel Crucifixion La Redonda Logrono Spain.jpg|''Kusulubiwa kwa Kristo'', mchoro wa [[Michelangelo]], 1540 File:De kruisiging.jpg|alt=Print of the Crucifixion, made at the end of the 16th century|[[Albrecht Dürer]], ''Die Kreuzigung'', iliyochapishwa karne ya 16<ref>{{Rejea tovuti|title=De Kruisiging|url=https://lib.ugent.be/viewer/archive.ugent.be:B4D16A3C-15CD-11E9-954B-23312282636C#?c=&m=&s=&cv=&xywh=-2876,-181,8131,3613|access-date=2020-09-28|website=lib.ugent.be|archive-date=October 17, 2020|archive-url=https://web.archive.org/web/20201017140700/https://lib.ugent.be/viewer/archive.ugent.be:B4D16A3C-15CD-11E9-954B-23312282636C#?c=&m=&s=&cv=&xywh=-2876,-181,8131,3613|url-status=live}}</ref> File:Paolo Veronese 010.jpg|''[[Kalivari]]'', mchoro wa [[Paolo Veronese]], karne ya 16 File:History of the Kings (f.38) the Crucifixion of Christ.jpg|[[Mchoro mdogo]] wa karne ya 14 au 15, [[Welisi]] File:ArchdiocesanShrineofSaint Annejf0133 12.JPG|Msalaba katika [[Taguig Church]], [[Ufilipino]] File:Jesus Tkors Ytterselo01.gif|Yesu msulubiwa, Ytterselö kyrka, [[Uswidi]], 1500 hivi File:Santíssimo Cristo 02.jpg|''[[Cristo de La Laguna]]'', 1510–14, [[San Cristóbal de La Laguna]], Hispania File:Crucifixion by G.Margkazinis (17th c.).jpg|''Kusulubiwa'', [[Georgios Markazinis]], 1647 File:Raffaello, pala baglioni, deposizione.jpg|''Kushushwa kutoka msalabani'', mchoro wa [[Raphael]], 1507 File:Peter Paul Rubens - Descent from the cross (1617).jpg|''Kushushwa kutoka msalabani'', mchoro wa [[Rubens]], 1616–17 </gallery> ==Tazama pia== * [[Kifo cha Yesu]] * [[Yesu kushushwa]] * [[Titulus Crucis]] ==Tanbihi== {{marejeo}} ==Vyanzo== {{refbegin}} <!-- B --> * {{cite book | last =Blomberg | first =Craig L. | year =2009 | title =Jesus and the Gospels: An Introduction and Survey | publisher =B&H Publishing | isbn =978-0-8054-4482-7}} <!-- C --> * {{cite book | last =Crossan | first =John Dominic | year =1995 | title =Jesus: A Revolutionary Biography | url =https://archive.org/details/jesusrevolutiona00cros_1 | publisher=HarperOne | isbn =0-06-061662-8}} <!-- D --> * {{cite book | last =Dunn | first =James D. G. | year =2003 | title =Jesus Remembered | url =https://archive.org/details/jesusremembered0000dunn | publisher =Wm. B. Eerdmans | isbn =0-8028-3931-2}} <!-- E --> * {{cite book | last1 =Eddy | first1 = Paul |last2=Boyd | first2 =Gregory | year =2007 | title =The Jesus Legend: A Case for the Historical Reliability of the Synoptic Jesus Tradition | publisher =Baker Academic | isbn =978-0-8010-3114-4}} * {{cite book | last =Ehrman | first =Bart D. | year =2008 | title =A Brief Introduction to the New Testament | url =https://archive.org/details/briefintroductio0000ehrm_x4c5 | publisher =Oxford University Press | isbn =978-0-19-536934-2}} <!-- L --> * {{cite book | last =Lüdemann | first =Gerd | year =1997 | title =The Unholy in Holy Scripture: The Dark Side of the Bible| publisher =Westminster John Knox Press | isbn =0-664-25739-9}} <!-- M --> * {{cite book | last = Meier | first =John P. | year =2006 | chapter =How do we decide what comes from Jesus | editor-last1 =Dunn | editor-first1 =James D. G. | editor-last2 =McKnight | editor-first2 =Scot | title =The Historical Jesus in Recent Research | url = https://archive.org/details/historicaljesusi0010unse | publisher =Eisenbrauns | isbn =1-57506-100-7}} <!-- T --> * {{cite book | last =Tuckett | first =Christopher M. | chapter = | editor-last =Bockmuehl | editor-first =Markus N. A. | year =2001 | title =The Cambridge Companion to Jesus | publisher =Cambridge University Press | isbn =0-521-79678-4}} <!-- V --> * {{cite book | last =Verhoeven | first =Paul | year =2010 | title =Jesus of Nazareth | url =https://archive.org/details/jesusofnazareth0000verh | publisher =Seven Stories Press | isbn =978-1-58322-905-7}} {{refend}} ==Marejeo mengine== * {{Rejea jarida| title = 'Doketismus' – eine Problemanzeige |periodical = Zeitschrift für Kirchengeschichte |last = Brox |first = Norbert |publisher =[[Kohlhammer Verlag]]|year = 1984 |volume = 95 |pages = 301–314 |issn = 0044-2925 }} * {{cite book |title=A Theology of the Cross: The Death of Jesus in the Pauline Letters |url=https://archive.org/details/theologyofcrossd0000cous |last=Cousar |first=Charles B. |year=1990 |publisher=Fortress Press |isbn=0-8006-1558-1 }} * {{cite journal |last=Dennis |first=John |year=2006 |title=Jesus' Death in John's Gospel: A Survey of Research from Bultmann to the Present with Special Reference to the Johannine Hyper-Texts |journal=[[Currents in Biblical Research]] |volume=4 |issue=3 |pages=331–363 |doi=10.1177/1476993X06064628 |s2cid=170326371 }} * {{cite book|title=The Symbols of the Church|last=Dilasser|first=Maurice|year=1999|publisher=Liturgical Press |isbn=978-0-8146-2538-5|url=https://archive.org/details/symbolsofchurch00dila}} * {{cite book |title=The Death of Jesus: Tradition and Interpretation in the Passion Narrative |url=https://archive.org/details/deathofjesustrad0000gree |last=Green |first=Joel B. |year=1988 |publisher=Mohr Siebeck |isbn=3-16-145349-2 }} * {{cite journal |last=Humphreys |first=Colin J. |date=December 1983 |title=Dating the Crucifixion |url=https://archive.org/details/sim_nature-uk_december-22-29-1983_306_5945/page/743 |journal=Nature |volume=306 |issue=5945 |pages=743–746 |doi=10.1038/306743a0 |author2=W. G. Waddington |bibcode=1983Natur.306..743H|s2cid=4360560 }} * {{cite book |title=Archaeology and the New Testament |last=McRay |first=John |year=1991 |publisher=Baker Books |isbn=0-8010-6267-5 }} * {{cite journal |last=Rosenblatt |first=Samuel |date=December 1956 |title=The Crucifixion of Jesus from the Standpoint of Pharisaic Law |url=https://archive.org/details/sim_journal-of-biblical-literature_1956-12_75_4/page/314 |journal=Journal of Biblical Literature |volume=75 |issue=4 |pages=315–321 |doi=10.2307/3261265 |publisher=The Society of Biblical Literature |jstor=3261265 }} * {{cite book |title=Crucifixion in Antiquity |url=https://archive.org/details/crucifixioninant0000samu |last=Samuelsson |first=Gunnar. |year=2011 |publisher=Mohr Siebeck |isbn=978-3-16-150694-9 }} * {{Rejea kitabu|chapter = The Gospel of Peter |title = New Testament Apocrypha: Gospels and related writings |last1 = Schneemelcher |first1 = Wilhelm |author-link = Wilhelm Schneemelcher |last2 = Maurer |first2 = Christian |editor1-last = Schneemelcher |editor1-first = Wilhelm |editor1-link = Wilhelm Schneemelcher |editor2-last = Wilson |editor2-first = McLachlan |publisher = Westminster John Knox Press |year = 1994 |orig-year = 1991 |volume = 1 |pages = 216–227 |isbn = 978-0-664-22721-0 |chapter-url = https://books.google.com/books?id=TDW0PeFSvGEC&pg=PA220 |access-date = April 25, 2012}} * {{cite book |title=The Crucifixion of Jesus |url=https://archive.org/details/crucifixionofjes0000sloy_l5n0 |last=Sloyan |first=Gerard S. |year=1995 |publisher=Fortress Press |isbn=0-8006-2886-1 }} {{Bikira Maria}} {{mbegu-Ukristo}} [[Jamii:Yesu Kristo]] [[Jamii:Injili]] [[Jamii:Teolojia]] [[Jamii:Rozari]] 1kz8u7a3e8ngixfk5e3l14pord4r9t4 14 41526 1577942 449082 2026-07-02T12:46:05Z Riccardo Riccioni 452 1577942 wikitext text/x-wiki [[Jamii:Miji ya Nigeria]] [[Jamii:Miji Mikuu Afrika]] 2792hmjt046565hktpcl9bvzmie9zah 14 41916 1577948 907404 2026-07-02T12:52:45Z Riccardo Riccioni 452 1577948 wikitext text/x-wiki {{commonscat}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Senegal]] [[Jamii:Senegal]] s5s2siktkdk4ialmm7cql5di93oipxg 14 43209 1577947 907151 2026-07-02T12:51:57Z Riccardo Riccioni 452 1577947 wikitext text/x-wiki {{Commonscat|Bloemfontein}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Afrika Kusini]] iy20z8czeu1sv6745vdv9b6dsqte5rw 14 43429 1577967 897129 2026-07-02T13:08:54Z Riccardo Riccioni 452 1577967 wikitext text/x-wiki {{Commonscat|Pretoria}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Gauteng]] [[Jamii:Miji ya Afrika Kusini]] [[Jamii:Afrika Kusini]] f6g7ufg7uijshiykojxp4is62f5rub8 14 43431 1577946 909319 2026-07-02T12:51:06Z Riccardo Riccioni 452 1577946 wikitext text/x-wiki {{Commonscat|Bamako}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Mali]] [[Jamii:Mali]] iny75ve8m4yb1igskrv6h75b4vl13va 0 44216 1578099 1513683 2026-07-02T19:41:14Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578099 wikitext text/x-wiki [[Picha:HerodtheGreat2.jpg|250 px|right|Herode Mkuu.]] [[Picha:Prise de Jérusalem par Hérode le Grand.jpg|250px|right|thumb|Herode akiteka [[Yerusalemu]].]] [[Picha:Jerusalem Modell BW 2.JPG|thumb|250px|right|[[Hekalu]] la [[Yerusalemu]].]] [[Picha:Magi Herod MNMA Cl23532.jpg|250 px|right|thumb|[[Mamajusi]] mbele ya Herode.]] [[Picha:Massacre of the Innocents - Maestà by Duccio - Museo dell'Opera del Duomo - Siena 2016.jpg|250px|thumb|right|[[Mchoro]] wa [[Duccio di Buoninsegna]] kuhusu ''Mauaji ya watoto wachanga'' yaliyoagizwa na Herode.]] '''Herode Mkuu''' ([[73 KK]] hivi - [[4 KK]]) ni [[jina]] la [[heshima]] linalotumika kumtajia [[mtu]] maarufu zaidi wa [[ukoo]] wa kifalme wa [[Yudea]] katika [[karne ya 1 KK]], yaani Herode (kwa [[Kiebrania]] הוֹרְדוֹס, ''Hordos'', kwa [[Kigiriki]]: Ἡρῴδης, ''Hērōdēs'').<ref>Richardson, Peter. ''Herod: King of the Jews and friend of the Romans'', (Continuum International Publishing Group, 1999) pp. xv–xx.</ref><ref>Knoblet, Jerry. ''Herod the Great'' (University Press of America, 2005), p. 179.</ref><ref>Rocca, Samuel. ''Herod's Judaea: a Mediterranean state in the classical world'' (Mohr Siebeck, 2008) p. 159.</ref><ref>[[Fergus Millar|Millar, Fergus]]; [[Emil Schürer|Schürer, Emil]]; [[Geza Vermes|Vermes, Geza]]. ''The History of the Jewish People in the Age of Jesus Christ'' (Continuum International Publishing Group, 1973) p. 327.</ref><ref>[[N. T. Wright|Wright, N. T.]] ''The New Testament and the People of God'' (SPCK, 1992), p. 172.</ref> Akiwa kwa [[asili]] mtu wa [[kabila]] la [[Waedomu]] upande wa [[baba]] na [[Myahudi]] upande wa [[mama]], alitawala Yudea yote chini ya [[himaya]] ya [[Dola la Roma]]. [[ukatili|Mkatili]] hasa, aliua hata [[mke]] wake mmojawapo na [[Mtoto|watoto]] watatu. Ingawa alifuata [[dini]] ya [[Uyahudi]] na kuanza kazi kubwa ya kupanua na kupamba [[hekalu la Yerusalemu]], alizingatia zaidi [[ustaarabu]] wa [[Kigiriki]] na kuendeleza [[Mji|miji]] [[Upagani|kipagani]]. Ni maarufu zaidi kutokana na [[taarifa]] za [[Injili ya Mathayo]] kuhusu jinsi alivyopokea kutoka kwa [[Mamajusi]] habari ya kuzaliwa kwa [[INRI|Mfalme wa Wayahudi]], [[Yesu]]. Kwa [[hofu]] yake aliposhindwa kumtambua [[mtoto]] huyo, aliagiza wauawe watoto wote [[Mwanaume|wa kiume]] chini ya [[umri]] wa miaka 2. {| class="wikitable" |+ '''Familia ya Herode Mkuu''' ! Mke ! Watoto |- | [[Doris]] | * [[Antipatro bin Herode]], alifariki 4 KK |- | [[Mariamne I]] | * [[Aleksanda bin Herode|Aleksanda]], alifariki [[7 KK]] * [[Aristobulo bin Herode|Aristobulo]], alifariki 7 KK * [[Salampsio]] * [[Kupro bin Herode|Cypro]] |- | [[Mariamne II]] | * [[Herode II]], alifariki [[6]] * [[Herode Filipo I|Herode Filipo]] |- | [[Malthake]] | * [[Arkelao]], mfalme mdogo wa [[Yudea]] * [[Herode Antipa]], mfalme mdogo wa [[Galilaya]] na [[Perea]] * [[Olimpia binti Herode|Olimpia]] |- | [[Kleopatra wa Yerusalemu]] | * [[Herode Filipo II]], mfalme mdogo wa [[Iturea]] na [[Trakoniti]] * Herode |- | [[Palade]] | * [[Fasaeli]] |- | [[Fedra]] | * [[Rosane]] |- | [[Elpide]] | * [[Salome II]] |} ==Tanbihi== {{reflist}} ==Marejeo== *{{cite journal|last=Brandon|first=S.&nbsp;G.&nbsp;F.|title=Herod the Great: Judaea's Most Able but Most Hated King|url=https://archive.org/details/sim_history-today_1962-04_12_4/page/234|journal=History Today|year=1962|volume=12|pages=234–242}} *{{cite book|last=Grant|first=Michael|authorlink=Michael Grant (author)|title=Herod the Great|url=https://archive.org/details/herodgreat00gran_0|year=1971|publisher=American Heritage Press|location=New York|isbn=0-07-024073-6}} * Günther, Linda-Marie (hg.) ''Herodes und Jerusalem'' (Stuttgart: Franz Steiner Verlag, 2009). * Günther, Linda-Marie (hg.) ''Herodes und Rom'' (Stuttgart: Franz Steiner Verlag, 2007). * Jacobson, David M. and Nikos Kokkinos (eds). ''Herod and Augustus: Papers Held at the Institute of Jewish Studies Conference, University College London, 21–23 June 2005'' (Leiden, Brill, 2009) (IJS Studies in Judaica, 6). * Knoblet, Jerry. ''Herod the Great''. Lanham, Maryland: University Press of America, 2005. * Kokkinos, Nikos. ''The Herodian Dynasty: Origins, Role in Society and Eclipse'' (Sheffield: Sheffield Academic,1998). *{{cite journal|last=Marshak|first=Adam Kolman|title=The Dated Coins of Herod the Great: Towards a New Chronology|url=https://archive.org/details/journal-for-the-study-of-judaism_2006_37_2/page/212|journal=Journal for the Study of Judaism|year=2006|volume=37|issue=2|pages=212–240|doi=10.1163/157006306776564700}} * Netzer, Ehud. ''The Architecture of Herod, the Great Builder'' (Tübingen: Mohr Siebeck, 2006). *{{cite book|last=Perowne|first=Stewart|authorlink=Stewart Perowne|title=The Life and Times of Herod the Great|year=1956|publisher=Abingdon Press|location=New York}} * Richardson, Peter. ''Herod the King of the Jews and Friend of the Romans'' (Edinburgh: 1999). *{{cite book|last=Roller|first=Duane W.|title=The Building Program of Herod the Great|url=https://archive.org/details/buildingprogramo0000roll|year=1998|publisher=University of California Press|location=Berkeley|isbn=978-0-520-91935-8}} *{{cite book|last=Sandmel|first=Samuel|title=Herod: Profile of a Tyrant|url=https://archive.org/details/herodprofileofty00sand|year=1967|publisher=Lippincott|location=Philadelphia}} * Schwentzel, Christian-Georges (2011). ''Hérode le Grand''. Paris: Pygmalion. * Witztum, Eliezer. ''King Herod: A Persecuted Persecutor. A Case Study in Psychohistory and Psychobiography'' (Berlin and New York, Walter de Gruyter, 2006). *{{cite journal|last=Zeitlin|authorlink=Solomon Zeitlin |first=Solomon|title=Herod: A Malevolent Maniac|journal=Jewish Quarterly Review|year=1963|volume=54|pages=1–27|doi=10.2307/1453457}} *{{Rejea kitabu|last=Zeitlin |first=Solomon |authorlink= |title=The Rise and Fall of the Judean State |publisher=The Jewish Publication Society |location=Philadelphia|year=1962–1978}} ==Viungo vya nje== * [http://www.imj.org.il/exhibitions/presentation/exhibit.asp?id=850 "Herod the Great: The King’s Final Journey"], The [[Israel Museum]], Jerusalem, February 13, 2013 – October 5, 2013. Curators: Dudi Mevorach and Silvia Rozenberg. * [http://jewishhistory.huji.ac.il/internetresources/historyresources/second_temple_and_talmudic_era.htm#Herod Herod and the Herodian Dynasty] {{Wayback|url=http://jewishhistory.huji.ac.il/internetresources/historyresources/second_temple_and_talmudic_era.htm#Herod |date=20160814122639 }} The Jewish History Resource Center - Project of the Dinur Center for Research in Jewish History, The [[Hebrew University of Jerusalem]] * [http://www.jewishencyclopedia.com/view.jsp?artid=630&letter=H "Herod I"] in the ''Jewish Encyclopedia''. {{Watawala wa Israeli ya Kale}} {{mbegu-mtu-Biblia}} [[Jamii:Waliozaliwa 73 KK]] [[Jamii:Waliofariki 4 KK]] [[Jamii:Watu wa Biblia]] [[Jamii:Wafalme wa Israeli]] [[Jamii:Yesu Kristo]] 6qw1oqtudinxf2oi3gpdvheau86ggdd 0 46071 1577997 1469452 2026-07-02T14:17:46Z Riccardo Riccioni 452 /* Tazama pia */ 1577997 wikitext text/x-wiki [[Picha:BI-Gitega.png|thumb|Mahali pa mji wa Gitega katika [[Burundi]]]] [[Picha:Gitega.JPG|thumb|Gitega]] '''Gitega''' ni [[mji mkuu]] wa [[mkoa wa Gitega]] na wa nchi ya [[Burundi]]. [[Idadi]] ya wakazi wake ni takriban 23.167 (2005). == Tazama pia == * [[Orodha ya miji ya Burundi]] ==Viungo vya nje== {{commonscat}} {{list of African capitals}} {{mbegu-jio-Burundi}} [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Burundi]] [[Jamii:Mkoa wa Gitega]] ljbufpx1t0s4g198a8e637c2i2wugda 0 55045 1578185 1528099 2026-07-03T01:50:43Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578185 wikitext text/x-wiki '''Utumizi mzuri wa dawa''' (pia: '''uzingativu''') katika [[taaluma]] ya [[uuguzi]], inaelezea kiwango ambacho [[mgonjwa]] huzingatia [[ushauri]] wa [[daktari]]. Kwa kawaida, humaanisha uzingativu katika matumizi ya [[dawa]], lakini pia ina maana ya matumizi ya vifaa vya matibabu kama vile stockings compression, utunzi wa [[jeraha sugu]], [[Mazoezi ya mwili|mazoezi ya binafsi]], au kuhudhuria ushauri au [[kozi]] nyingine za matibabu. [[Muuguzi]] na [[mgonjwa]] wote huathiri utumizi mzuri wa dawa, na uhusiano mwema baina ya daktari na mgonjwa huathiri pakubwa katika kuboresha utumizi bora wa dawa, ingawa [[gharama]] kubwa za dawa pia huchangia pakubwa. Kutozingatia utumizi bora wa dawa ni kikwazo kikubwa katika utoaji wa [[huduma]] bora ya [[afya]]. Makadirio ya [[Shirika la Afya Duniani]] yanaonyesha kwamba ni karibu 50[[%]] ya wagonjwa wanaougua [[magonjwa sugu]] wanaoishi katika [[nchi zilizoendelea]] hufuata mapendekezo ya matibabu. Haswa, viwango vya chini vya kuzingatia matibabu ya [[pumu]], [[kisukari]] na [[Shinikizo la damu]] huchangia kwa kiwango fulani gharama na mzigo wa kiuchumi wa hali hiyo. Makadirio ya viwango vya uzingativu yaweza kuwa juu katika maandiko ya utabibu, kwani kiwango cha uzingativu huwa juu katika uundaji wa majaribio ya kliniki lakini hushuka katika "ulimwengu wa halisi". <ref name="BandolierStatins2004"/> Vikwazo vikuu katika uzingativu wa dawa ni kama vile mfumo wa matibabu wa kisasa ulio na utaratibu, ukosefu wa "elimu ya afya" na ukosefu wa ufahamu wa faida za matibabu, matukio ya adhari za kando za dawa zisizojadiliwa, gharama ya madawa ya kuagizwa na daktari , na mawasiliano duni au ukosefu wa uaminifu baina ya mgonjwa na muuguzi au muhuduma wake wa afya. Juhudi za kuboresha utumiaji mzuri wa dawa zimelengwa katika kurahisisha ufungashaji dawa, kutoa kumbusho za dawa bora, kuboresha elimu ya wagonjwa,na kuweka vikwazo kwenye idadi ya dawa zinazoagizwa kwa wakati mmoja. ==Istilahi== Jumla ya nusu ya watu ambao mfumo wa utaratibu wa matibabu wameagiziwa,hawauzingatii ipasavyo. <ref name="WhoReport"/> Hadi hivi karibuni, ilijulikana kama "kutozingatia", ambayo wakati mwingine ilimaniisha kutofuata maagizo ya matibabu na ilitokana na tabia za kihuni au kupuuza maelekezo kwa makusudi. Leo, wataalamu wa afya hutumia kwa kawaida zaidi "uzingatifu wa mfumo ulio na utaratibu" kuliko "utumizi bora wa dawa", kwa sababu maneno haya hukisiwa kuwasilisha haswa sababu ambazo huwafanya wagonjwa hauri wa daktari.<ref name="Ngoh">{{cite journal |author=Ngoh LN |title=Health literacy: a barrier to pharmacist-patient communication and medication adherence |journal=J Am Pharm Assoc (2003) |volume=49 |issue=5 |pages=e132–46; quiz e147–9 |year=2009 |pmid=19748861 |doi=10.1331/JAPhA.2009.07075 }}</ref> Hata hivyo, istilahi kamili bado suala la mjadala. <ref>{{cite journal |doi=10.1056/NEJMra050100 |author=Osterberg L, Blaschke T |title=Adherence to Medication |url=https://archive.org/details/sim_new-england-journal-of-medicine_2005-08-04_353_5/page/487 |journal=[[N Engl J Med]] |year=2005 |volume=353 |issue=5 |pages=487–97 |pmid=16079372}}</ref> <ref>{{cite journal |author=Aronson JK |title=Compliance, concordance, adherence |journal=[[Br J Clin Pharmacol]] |year=2007 |volume=63 |issue=4 |pages=383–4 |pmid=17378797 |pmc=2203247 |doi=10.1111/j.1365-2125.2007.02893.x }}</ref> Katika baadhi ya matukio, upatano hutumika hasa kwa mgonjwa kuzingatia mfumo ulio na utaratibu wa matibabu ambao umeundwa kwa ushirikiano wake na daktari, na kuutofautisha na uaminifu, ambao ni mfumo ambao ni daktari pekee anayetoa utaratibu wa tiba.<ref>{{cite web |author=US NIH Office of Behavior and Social Sciences Research |url=http://obssr.od.nih.gov/pdf/Workshop_final_report.pdf |title=Framework for adherence research and translation: a blueprint for the next ten years |year=2008 |accessdate=2010-09-20 |archiveurl=https://web.archive.org/web/20100528015152/http://obssr.od.nih.gov/pdf/Workshop_final_report.pdf |archivedate=2010-05-28 }}</ref> Licha ya mjadala unaoendelea, uaminifu ndio neno linalopendelewa na [[Shirika la Afya Duniani]], Shirika la Wafamasia wa Marekani na Taasisi ya Utafiti na Mtandao wa Afya ya Marekani.<ref>{{cite web |author=Office of Behavior and Social Sciences Research |publisher=U.S. [[National Institutes of Health]] |title=Adherence Research Network |url=http://obssr.od.nih.gov/scientific_areas/health_behaviour/adherence/adherenceresearchnetwork.aspx |accessdate=12 Mei 2010 |archiveurl=https://web.archive.org/web/20100502064804/http://obssr.od.nih.gov/scientific_areas/health_behaviour/adherence/adherenceresearchnetwork.aspx |archivedate=2010-05-02 }}</ref> Upatano pia unahusu mpango wa [[Ufalme wa Muungano]] NHS wa kuhusisha mgonjwa katika mchakato wa kutibiwa ili kuboresha ukubalifu. <ref name="BMJ">{{cite journal |title=Not to be taken as directed - Putting concordance for taking medicines into practice |journal=[[BMJ]] |year=2003 |volume=326 |issue=7385 |pages=348–9 |date=15 Februari 2003 |author=Marinker and Shaw |doi=10.1136/bmj.326.7385.348}}</ref> Katika muktadha huu, mgonjwa anajulishwa hali yao na matibabu yaliyoko. Hushirikiana na timu ya matibabu katika uamuzi utakaochukuliwa na kuwajibika kwa kufuatilia na kuripoti kwa timu hiyo. Uzingativu wa matibabu ni huboreshwa kwa: * Kupendekeza matibabu ambayo ni bora katika muktadha ulioko * Kuchagua matibabu yaliyo na kiwango kidogo cha chini ya athari au matatizo machache kwa ajili ya matumizi ya muda mrefu * Kuagizia idadi ya chini ya dawa mbalimbali, kwa mfano, kuagizia dozi moja ya kiua vijasumu ambayo inatibu maambukizi mawili kwa wakati mmoja (ingawa kuhatarisha kuchangia ukuaji wa usugu wakiua vijasumu) * Kurahisisha mfumo ulio na utaratibu wa kipimo cha dawa kwa kuchagua dawa tofauti au kutumia kipimo cha dawa kinacho tolewa kwa uwendelevu na kuhitaji maandalizi na vipimo cha chini wakati wa siku <ref name="Bandolier117">{{cite journal |title=Dosing and compliance? |journal=[[Bandolier (journal)|Bandolier]] |volume=117 |date=Novemba 2003 |url=http://www.medicine.ox.ac.uk/bandolier/band117/b117-8.html |at=Figure 1 |access-date=2010-09-20 |archive-date=2012-12-24 |archive-url=https://archive.today/20121224190522/http://www.medicine.ox.ac.uk/bandolier/band117/b117-8.html |dead-url=yes }}</ref> * Kujadili athari zinazowezekana, na kama kuna umuhimu wa kuendelea kutumia dawa hizo bila kujali athari * Ushauri juu ya kupunguza au kukabiliana na madhara, kwa mfano, kama kuchukua dawa ukiwa na njaa au kama umeshiba. * Kujenga uaminifu ili wagonjwa wasiwe na hofu,aibu au hasira kama hawawezi kuchukua dawa pekee, na kuruhusu daktari kujaribu njia mbadala ya muhula bora == Athari za jamii == Makadirio ya utafiti wa Shirika la Afya Ulimwengu yaonyesha kuwa ni 50% tu ya wagonjwa wanaosumbuliwa na magonjwa sugu katika nchi zilizoendelea hufuata mapendekezo ya matibabu. <ref name="WhoReport"/> Hii inaweza kuathiri afya ya mgonjwa, na kuathiri jamii pana wakati inasababisha matatizo kutokana na magonjwa sugu, kusababisha maambukizi sugu, au bila kutibiwa, ugonjwa wa akili. Viwango vya utumiaji mzuri wa dawa wakati wa kisomo cha kufuatiliwa kwa karibu huwa kwa kawaida juu zaidi ikilinganishwa na hali halisia duniani. Kwa mfano, taarifa ya utafiti mmoja uliripoti 97% kufuata katika kiwango cha mwanzo wa matibabu na statins lakini 50% ya wagonjwa walikuwa bado wanafanya inavyotakikana baada ya miezi sita. <ref name="BandolierStatins2004">{{cite journal |title=Patient Compliance with statins |journal=[[Bandolier (journal)|Bandolier]] |url=http://medicine.ox.ac.uk/bandolier/booth/cardiac/patcomp.html |year=2004 |access-date=2010-09-20 |archive-date=2011-07-06 |archive-url=https://web.archive.org/web/20110706164817/http://www.medicine.ox.ac.uk/bandolier/booth/cardiac/patcomp.html |dead-url=yes }}</ref> == Masuala ya utumizi mzuri wa dawa == === Viwango vya kuagiza dawa kwa daktari === Ingawa mhuduma wa afya akikumbana na mgonjwa huweza kusababisha mgonjwa kuondoka na dawa kwa ajili ya ugonjwa, si wagonjwa wote watachukuwa dawa hiyo katika duka la dawa. Nchini Marekani, ni 20-30% ya maagizo ya dawa kutoka kwa daktari ambayo hujazwa katika duka la dawa. <ref>{{cite journal |author=Fischer MA, Stedman MR, Lii J, ''et al.'' |title=Primary medication non-adherence: analysis of 195,930 electronic prescriptions |journal=J Gen Intern Med |volume=25 |issue=4 |pages=284–90 |year=2010 |month=Aprili |pmid=20131023 |doi=10.1007/s11606-010-1253-9 |pmc=2842539 }}</ref> <ref> Norton M. (Reuters Health) ''Many patients may not fill their prescriptions'' (2010), [http://www.reuters.com/article/idUSTRE61G3QX20100217 ] Accessed 12 Mei 2010</ref> Kuna sababu nyingi zinazowafanya wagonjwa kutojaza maagizo ikiwa nipamoja na gharama ya dawa , mashaka haja ya dawa, au upendeleo kwa-huduma hatua binafsi kuliko dawa nyingine. Gharama ndio kizuizi kikuu kwa kufuata maagizo ya madawa. Utafiti wa kitaifa wa Marekani uliofanyiwa watu wazima ya 1,010 mwaka wa 2001 uligundua kuwa 22% walichagua kutojaza maagizo kwa sababu ya bei, ambayo ni sawa na kiwango cha jumla 20-30% ya maagizo ambayo huwa hayajazwi. <ref name="Harris"/> === Kumaliza tiba === Mara baada ya kuanza, wagonjwa mara si haba hawafuati mfumo wa matibabu kama ilivyoagizwa, na mara nyingi kumaliza kozi ya tiba. <ref name="APA"/> <ref name="Ngoh"/> Gharama na uelewaji mbaya wa maelekezo kwa ajili ya matibabu (inajulikana kama elimu ya afya '') ni vikwazo vikuu katika ukamilisho wa matibabu. Kama ilivyotajwa awali, Shirika la Afya Duniani (WHO) lina makadirio ya kwamba ni 50% tu ya watu ambao hukamilisha tiba ya ya muda mrefu kwa ajili ya matibabu ya muda mrefu illnesses as they were prescribed, which puts patient health at risk.<ref name="WhoReport"/> Aina mbalimbali ya mbinu zimependekezwa ili kusaidia wagonjwa kukamilisha ya matibabu kama walivyoagizwa. Mbinu hizi ni pamoja na miundo zinazosaidia kurahisisha kukumbuka mfumo wa matibabu na kipimo na pia maandiko mbalimbali kwa ajili ya kuongeza uelewano na subira ya maelekezo. Kwa mfano, dawa wakati mwingine hupakiwa na mifumo ya kukumbusha siku na / au muda wa wiki wa kuchukua dawa. Kwa lengo la kusaidia uzingativu wa dawa na wagonjwa, shirika lisilo na kibiashara ( '''Healthcare Compliance Packaging Council of Europe/HCPC-Europe )''' [http://www.hcpc-europe.org/cms/front_content.php?idcat=94 ] {{Wayback|url=http://www.hcpc-europe.org/cms/front_content.php?idcat=94 |date=20081019100628 }}[58] ilianzishwa kati ya wanasekta wa dawa, sekta ya upakiaji na wawakilishi, wa mashirika ya wagonjwa wa Ulaya. Maudhui ya HCPC-Ulaya ni kusaidia na kuelimisha sekta ya afya katika uboreshaji wa ufuataji wa matumizi ya dawa na wagojwa kupitia upakiaji mzuri. Aina mbalimbali ya upakiaji zimeendelezwa na ushirikiano huu ili kusaidia katika kufuata maagizo ya dawa. Kushindwa kukamilisha mfumo wa matibabu kama ilivyo agizwa ina athari mbaya ya afya duniani kote. <ref name="WhoReport"/> Mifano ya kiwango na matokeo ya kutozingatia mfumo wa matibabu kwa magonjwa kadha ni kama ifuatavyo: * Kutozingatia matumizi kwa Ugonjwa wa kisukari (98% katika Marekani) ni sababu kuu ya matatizo kuhusiana na ugonjwa wa kisukari yakiwa ni pamoja na uharibifu wa neva na kuharibika kwa figo. * Kutozingatia kwa Shinikizo la damu (93% nchini Marekani, 70% katika Uingereza) ni sababu kubwa ya mmambukizi ya ghafla ya moyo na kiharusi. * Kutozingatia kwa ugonjwa wa Pumu ni (28-70% duniani kote) huongeza hatari ya mashambulizi makali ya pumu yanayohitaji kulazwa hospaitalini. ==Marejeo== {{Marejeo|refs= <ref name=APA>{{Rejea tovuti |work=APA Highlights Newsletter |title=Enhancing Patient Adherence: Proceedings of the Pinnacle Roundtable Discussion |date=Oktoba 2004 |volume=7 |issue=4 |url=http://www.pharmacist.com/AM/Template.cfm?Section=Home2&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=11174 |accessdate=2021-12-29 |archivedate=2011-06-15 |archiveurl=https://web.archive.org/web/20110615092834/http://www.pharmacist.com/AM/Template.cfm?Section=Home2&TEMPLATE=%2FCM%2FContentDisplay.cfm&CONTENTID=11174 }}</ref> <ref name=Harris>{{Rejea habari |publisher=Harris Interactive |title=Out-of-pocket costs may be a substantial barrier to prescription drug compliance |url=http://www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2001Vol1_iss32.pdf |accessdate=12 Mei 2010 |archiveurl=https://web.archive.org/web/20100103211324/http://harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2001Vol1_iss32.pdf |archivedate=2010-01-03 }}</ref> <ref name=WhoReport>{{Rejea kitabu |author=World Health Organization |title=Adherence to Long-Term Therapies: Evidence for Action |publisher=World Health Organisation |location=Geneva |date=2003 |isbn=92-4-154599-2 |format=PDF |url=http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf}}</ref> }} ==Viungo vya nje== * [http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf Adherence to Long-Term Therapies], ripoti kutoka kwa [[Shirika la Afya Duniani]]. [[Jamii:Tiba]] [[Jamii:Madawa]] 359n0s77csa65lgy4cb1pe0jvoxg35r 0 55047 1578149 1465854 2026-07-02T22:11:58Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578149 wikitext text/x-wiki {{Taxobox | name = ''Poliovirus'' | image_caption = [[Transmission electron microscopy|TEM]] [[micrograph]] of poliovirus [[Virion#Structure|virions]]. | image = Polio.jpg | virus_group = iv | ordo = ''[[Picornavirales]]'' | familia = ''[[Picornaviridae]]'' | genus = ''[[Enterovirus]]'' | type_species = ''[[Human enterovirus C]]'' | subdivision_ranks = Species | subdivision = ''[[Human enterovirus C]]'' }} '''Virusi vya polio''', vikolezo visababishavyo [[ugonjwa]] wa [[polio]], ni [[virusi]] vya [[tumbo]] la [[binadamu]] na ni wanachama wa [[Familia (biolojia)|familia]] ya [[pikonaviridi]]. Vinaundwa na [[RNA]] aina ya [[jenomu]] na [[protini]] ya [[kapsidi]]. Jenomu ni single-Stranded na chanya-hisia RNA jenomu ambazo ni ndefu mara 7500 zaidi ya [[nukleotidi]]. [[Kipenyo]] cha virusi hivi ni kama mara 30 ya [[nanomita]] katika icosahedral symmetry. Kwa sababu ya ufupi wa jenomu na muundo wake rahisi inaundwa na RNA na haina kigamba kinachozingira protini hizi - Virusi vya polio ndivyo muhimu zaidi. Vilitengwa mara ya kwanza katika [[mwaka]] wa [[1909]] na [[Karl Landsteiner]] na [[Erwin Popper]]. <ref name="Paul_1971">{{cite book |author = Paul JR |title=A History of Poliomyelitis |url = https://archive.org/details/historyofpoliomy0000paul |publisher=Yale University Press |location=New Haven, Conn |year=1971 |isbn=0-300-01324-8 | series = (Yale studies in the history of science and medicine)}}</ref> Katika mwaka wa [[1981]], jenomu ya virusi vya polio ilichapishwa na [[timu]] mbili tofauti za [[watafiti]]: Vincent Racaniello na [[David Baltimore]] katika [[chuo]] cha [[MIT]] na [[Naomi Kitamura]] na wengine katika [[Chuo Kikuu cha Jimbo la New York]], Stony Brook. <ref name="Kitamura">{{cite journal |author=Kitamura N, Semler B, Rothberg P, ''et al.'' |title=Primary structure, gene organization and polypeptide expression of poliovirus RNA |url=https://archive.org/details/sim_nature-uk_1981-06-18_291_5816/page/n39 |journal=Nature |volume=291 |issue=5816 |pages=547–53 |year=1981 |pmid=6264310 |doi=10.1038/291547a0}}</ref> Ni kati ya virusi vyenye sifa zaidi, na vimekuwa muundo muhimu ili kuelewa [[biolojia]] ya virusi vya RNA. == Mzunguko wa maisha == [[File:Poliovirus life cycle.png|thumb|300px|right|Maisha ya seli mzunguko wa virusi ya polio huanzishwa kwa kufungwa kwa kipokezi cha uso wa kiini CD155. virioni huchukuliwa kupitia ulaji ndani wa chembe, na virusi ya RNA ni huru (2). Tafsiri ya RNA ya virusi hutokea na mfumo wa IRES-mediated (3). polyprotein ni zilizoandamana, hutoa virusi protini zilizokomaa (4). Hisia chanya RNA hutumika kama kigezo kwa ajili ya awali ya nyongeza ya hasi-strand, na huzalisha mbili-stranded replicative fomu (RF) RNA (5). Strand za RNA ambazo ni chanya nakala RNA ni huzalishwa kutoka strand moja hasi (6). Lasisi ya kiini kilichombukizwa matokeo ni kutolewa kwa virions za kuambukiza vizazi (9). <ref Name=DeJesus> [13] </ref>]] Virusi vya polio huambukiza seli za binadamu kwa kuungana na immunoglobulin kama kipokezi cha, CD155, (pia inajulikana kama '' kipokezi'' cha (PVR)) <ref name="Mendelsohn">{{cite journal |author=Mendelsohn Cl, Wimmer E, Racaniello VR|title=Cellular receptor for poliovirus: molecular cloning, nucleotide sequence, and expression of a new member of the immunoglobin superfamily |url=https://archive.org/details/cell_1989-03-10_56_5/page/855|journal=Cell |volume=56 |issue=5 |pages=855–865 |year=1989 |pmid = 2538245 |doi=10.1016/0092-8674(89)90690-9}}</ref> <ref name="He">{{cite journal |author=He Y, Mueller S, Chipman P, ''et al.'' |title=Complexes of poliovirus serotypes with their common cellular receptor, CD155 |url=http://jvi.asm.org/cgi/content/full/77/8/4827?view=long&pmid=12663789 |journal=J Virol |volume=77 |issue=8 |pages=4827–35 |year=2003 |pmid=12663789 |doi=10.1128/JVI.77.8.4827-4835.2003 |pmc=152153 |access-date=2010-09-20 |archive-date=2007-09-05 |archive-url=https://web.archive.org/web/20070905211036/http://jvi.asm.org/cgi/content/full/77/8/4827?view=long&pmid=12663789 |dead-url=yes }}</ref> juu ya uso wa kiini. Mwingiliano wa na CD155 inawezesha ukubalifu wa mabadiliko ya chembe za virusi kwa Malena kuwezesha virusi kuingia. <ref name="Gomez">{{cite journal |author=Gomez Yafal A, Kaplan G, Racaniello VR, Hogle, JM |title=Characterization of poliovirus conformational alteration mediated by soluble cell receptors |url=https://archive.org/details/virology_1993-11_197_1/page/501 |journal=Virology |volume=197 |issue=1 |pages=501–505 |year=1993 |pmid = 8212594 |doi=10.1006/viro.1993.1621}}</ref> ni mfumo wa matumizi sahihi kuingia katika kiini jeshi haikuwa imara haifahamiki. <ref name="Baron">{{cite book | title = Picornaviruses: The Enteroviruses: Polioviruses ''in:'' Baron's Medical Microbiology ''(Baron S ''et al.'', eds.)| edition = 4th | publisher = Univ of Texas Medical Branch | year = 1996 | url= http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.2862 | isbn = 0-9631172-1-1 | author = ed. by Samuel Baron }}</ref> utando wa seli, kuingia ya virusi nucleic asidi ilikuwa dhana ya kutokea moja ya njia mbili: via wa malezi ya pore katika utando Utegili njia ambayo RNA ni basi "hudungwa" ndani ya seli cytoplasm jeshi, au kwamba virusi ni kupelekwa kwa-mediated endocytosis receptor. <ref name="Mueller">{{cite journal |author=Mueller S, Wimmer E, Cello J |title=Poliovirus and poliomyelitis: a tale of guts, brains, and an accidental event |journal=Virus Res |volume=111 |issue=2 |pages=175–93 |year=2005 |pmid = 15885840 |doi=10.1016/j.virusres.2005.04.008}}</ref> Ushahidi kutoka majaribio ya hivi karibuni inasaidia dhanio la mwisho na kupendekeza kwamba virusi ya polio hugandana na CD155 na kupelekwa kupitia endocytosis. Mara baada ya chembe kuwekwa ndani, virusi ya RNA ni huru. <ref name="Brandenburg">{{cite journal |author=Brandenburg B, Lee LY, Lakadamyali M, Rust MJ, Zhuang X, Hogle JM, |title=Imaging poliovirus entry in live cells |doi= 10.1371/journal.pbio.0050183 |journal=PLOS Biology |volume=5 |issue=7 |pages=e183 |year=2007 |pmid = 17622193 |pmc=1914398}}</ref> Hata hivyo, mbinu zozote ambazo viini vya polio huingia seli ni fanisi sana; nakiambukizo kinaanzishwa ni juhudi kadiri 1% ya wakati huo. <ref name="Chan">Charles Chan na Roberto Neisa. [http://www.brown.edu/Courses/Bio_160/Projects2000/Polio/TableofContents.html "Polio"] {{Wayback|url=http://www.brown.edu/Courses/Bio_160/Projects2000/Polio/TableofContents.html |date=20070222133944 }} Brown University.</ref> Ni virusi vya RNA ambavyo ni chanya Stranded. Kwa hivyo jenomu iliyoambatanishwa katika chembe ya virusi inaweza kutumika kama mtume wa RNA na mara inatafsiriwa na seli jeshi. Viingiapo, virusi huchukua nyara nguvu za kimashine za kutafsiri za seli, na husababisha athari za kuzuia usanisi wa protini za seli kwa ajili ya virusi ya uzalishaji maalum protini. Tofauti na jeshi la kiini mRNAs, mwisho wa 5' ya RNA inachukua muda mrefu sana- zaidi ya 700 nukleotidi-na ni muundo sana. Ukanda huu wa virusi ya jenomu unaitwa kuingia ndani ya enoe kwa ribosomu tovuti (IRES) na anaongoza tafsiri ya virusi ya RNA. jeni kubadilika katika eneo hili huzuia uzalishaji wa virusi vyo protini. <ref name="Chen">{{cite journal |author=Chen CY, Sarnow P |title=Initiation of protein synthesis by the eukaryotic translational apparatus on circular RNAs |url=https://archive.org/details/sim_science_1995-04-21_268_5209/page/n79 |journal=Science |volume=268 |issue=5209 |pages=415–7 |year=1995 |pmid=7536344 |doi=10.1126/science.7536344}}</ref> <ref name="Pelletier">{{cite journal |author=Pelletier J, Sonenberg N |title=Internal initiation of translation of eukaryotic mRNA directed by a sequence derived from poliovirus RNA |url=https://archive.org/details/sim_nature-uk_1988-07-28_334_6180/page/320 |journal=Nature |volume=334 |issue=6180 |pages=320–325 |year=1988 |pmid = 2839775 |doi=10.1038/334320a0}}</ref> <ref name="Jang">{{cite journal |author=Jang SK, Kräusslich HG, Nicklin MJ, Duke GM, Palmenberg AC, Wimmer E |title=A segment of the 5' nontranslated region of encephalomyocarditis virus RNA directs internal entry of ribosomes during in vitro translation |journal=J. Virol. |volume=62 |issue=8 |pages=2636–43 |date=1 Agosti 1988 |pmid=2839690 |pmc=253694 |url=http://jvi.asm.org/cgi/pmidlookup?view=long&pmid=2839690 |access-date=2010-09-20 |archive-date=2019-09-16 |archive-url=https://web.archive.org/web/20190916023346/https://jvi.asm.org/content/62/8/2636.long |dead-url=yes }}</ref> Virusi vya polio vimetafsiriwa kama polipeptidi moja ndefu. Polypeptide hii basi auto-cleaved na proteases ndani ndani ya mtu 10 virusi protini ca, ikiwa ni pamoja na:</ref> <ref name="Chan"></ref> [[File:Poliovirus genome.png|thumb|right|300px|Muundo wa usomi-jenomu wa virusi ya polio wa aina 1]] * ''3D ^pol,'' na RNA tegemezi RNA kizidisha polima ambayo kazi yake ni kutoa nakala na kuongeza virusi ya RNA jenomu. * ''2A ^pro'' na ''3C ^pro / 3CD ^pro,'' protisi ambazo zinaungana na virusi ya polipeptidi . * ''VPg'' (3B), protini ndogo ambayo hufunga virusi ya RNA na ni muhimu kwa ajili ya usanisi wa virusi chanya na hasi strand RNA. * ''2BC, 2B, 2C, 3AB, 3A, 3B'' protini zilizochangamano zinahitajika kwa kuiga virusi. * ''VP0, VP1, VP2, VP3, VP4'' protini za virusi kapsidi. Mkusanyiko wa virusi vipya vya chembe, (yaani ya ufungaji wa jenomu vizazi katika kapsidi ambazo inaweza kuishi nje ya jeshi seli) hazifahamiki. <ref name="Mueller"></ref> Virusi ya polio vikikutana kikamilifu hutoka ndani mwa kiini cha kimelea kwa muda wa masaa 4 hadi 6 baada ya maambukizi kufundwa katika seli iliyokuzwa za binadamu. <ref name="Kew_2005">{{cite journal |author=Kew O, Sutter R, de Gourville E, Dowdle W, Pallansch M |title=Vaccine-derived polioviruses and the endgame strategy for global polio eradication |url=https://archive.org/details/sim_annual-review-of-microbiology_2005_59/page/587 |journal=Annu Rev Microbiol |volume=59 |issue= |pages=587–635 |year=2005 |pmid=16153180 |doi=10.1146/annurev.micro.58.030603.123625}}</ref> Utaratibu wa ambapo virusi hutoka katika kiini si wazi, lakini kila kiini kikifa kinaweza kutoa juu ya virioni za polio 10,000. <ref name="Kew_2005"></ref> == Asili na serotaipu == Muundo wa virusi vya polio ni sawa na enterovirusi wengine wa binadamu (coxsackievirus es na [[echovirus es), ikiwa ni pamoja na rhinovirus wa binadamu, ambazo pia hutumia molekuli imunoglobulini za kutambua na kuingia seli jeshi. Uchambuzi wa filojenetiki wa RNA na Mwandamano wa protini wa virusi wa polio unaonyesha kwamba virusi ya polio huweza tolewa ulipatikana kutoka kwa nguzo ya C coxsackie A virusi babu, zilizotokea kwa njia ya kubadilika kwa jeni ndani ya kapsidi. Tofauti katika virusi ya polio pengine kilitokea kwa ajili ya matokeo ya mabadiliko katika kipokezi cha seli kutoka kati mwa seli ya molekuli-1 (ICAM-1), ambayo hutumiwa na nguzo za C coxsackie A virusi, na CD155, na kusababisha mabadiliko katika pathogenicity, na kuruhusu virusi kuambukiza tishu za neva. Kuna serotaipu tatu za virusi ya polio, ''PV1, PV2,'' na ''PV3;'' kila na tofauti ndogo protinikapsidi. Protini Kapsidi hueleza seli kipokezi kwa umaalum na uwezo wa kinga wa virusi. ''PV1'' ni aina inayojulikana zaidi kwa kiasiri asili, hata hivyo aina zote tatu ni hatari zaidi kwa maambukizi sana. <ref name="Paul_1971"></ref> Virusi ya polio wa poli vinaweza kupatikana katika nchi takriban 10. PV1 imejanibisha sana katika nchi za India, Pakistan, Afghanistan, na Misri, lakini kufuatia kuzuka kwa poliomeyletis mwaka 2003-2004 bado ni kubwa katika Afrika Magharibi na Kati. Virusi ya polio mwitu vya aina 2 pengine vimemalizwa, lakini ilionekana mwisho katika Oktoba 1999 [[Uttar Pradesh]], India. PV3 mwaitu hupatikana katika maeneo ya nchi tano tu (Nigeria, Niger, Pakistan, India, na Sudan). <ref name="Kew_2005"></ref> Matatizo maalumu ya kila serotype hutumika kuandaa chanjo dhidi ya polio. Chanjo ya polio (IPV) iliyafanywa kuwa tuli hutayari kwa kufanya kuwa tuli formalini ya sumu kali na yakurejerea Matatizo, Mahoney au Brunenders (PV1), MEF-1/Lansing (PV2), na Saukett / Leon (PV3). Chanjo ya polio ya mdomo (OPV) ina straini zilizodhoofishwa (dhaifu) kati ya serotaipu tatu za virusi ya polio. Kupitisha virusi Matatizo katika seli ya epithalama ya figo ya nyani hutanguliza seli kubadilika kwingi katika virusi IRES, na huzuia (au hupunguza) uwezo wa virusi kuambukiza tishu neva. <ref name="Kew_2005"></ref><br> Hapo zamani virusi vya polio vilikuwa katika kundi la aina ya jenasi ya virusi tumbo katika ya familia pikonaviridi. Katika mwaka wa 2008 virusi ya polio viliondolewa kutoka jenasi ya virusi tumbo na serotaipu zile tatu kuajiliwa katika familia ya virusi ya tumbo wa Binadamu, katika jenasi ya virusi tumbo katika familia ya pikonaviridi. Spishi ya aina ya jenasi virusi ya tumbo ilipitishwa kutoka virusi ya polio hadi virusi wa tumbo wa Binadamu C. == Pathojenesisi == {{Main|Polio}} [[File:Polio EM PHIL 1875 lores.PNG|thumb|Elektroni mikrografu ya virusi ya polio.]] Kiamuzi msingi cha uambukizaji cha virusi wowote ni uwezo wake wa kuingia kiini na kuzalisha chembe ya ziada ya kuambukiza. Uwepo wa CD155 ni wazo kutambua wanyama na tishu ambazo zinaweza kuambukizwa kwa virusi ya polio. CD155 hupatikana (nje ya maabara) pekee kwa chembechembe za binadamu, jamii ya nyani ya juu, na nyani wa s. Kale Virusi ya polio hata hivyo husababisha magonjwa katika binadamu, na haina asili kuambukiza wengine aina yoyote (ingawa sokwe na nyani wa Dunia wazee wanaweza kuambukizwa). <ref>{{cite journal |author=Mueller S, Wimmer E |title=Recruitment of nectin-3 to cell-cell junctions through trans-heterophilic interaction with CD155, a vitronectin and poliovirus receptor that localizes to alpha(v)beta3 integrin-containing membrane microdomains |url=http://www.jbc.org/cgi/content/full/278/33/31251 |journal=J Biol Chem |volume=278 |issue=33 |pages=31251–60 |year=2003 |pmid=12759359 |doi=10.1074/jbc.M304166200 |access-date=2010-09-20 |archive-date=2009-03-18 |archive-url=https://web.archive.org/web/20090318012851/http://www.jbc.org/cgi/content/full/278/33/31251 |dead-url=yes }}</ref> Virusi vya polio ni virusi vya tumbo. Maambukizo hutokea kupitia njia ya kinyesi-njia ya mdomo ya, maana kuwa mtu hula virusi na huzalishana katikanjia ya mdomo. <ref name="Bodian_1965">{{cite book |author = Bodian D and Horstmann DH |title=Polioviruse |publisher=Lippincott |location=Philadelphia, Penn |year=1969 |pages=430–73}}</ref> Virusi humwaga katika kinyesi cha watu walioathirika. Katika 95% ya kesi ya msingi tu, muda mfupi mbele ya viremia (virusi mwilini mwako) hutokea, na maambukizi ni dalili tu. Katika 5% ya kesi, virusi huenea na huiga katika maeneo mengine kama vile mafuta, retikuloendothelia tishu kahawia, na misuli. Replicationi endelevu ya virusi inasababisha viremia sekondari na inaongoza kwa maendeleo ya dalili za mabadiliko madogo kama vile homa, kuumwa na kichwa na koo. <ref>{{cite journal |author=Sabin A |title=Pathogenesis of poliomyelitis; reappraisal in the light of new data |url=https://archive.org/details/sim_science_1956-06-29_123_3209/page/n5 |journal=Science |volume=123 |issue=3209 |pages=1151–7 |year=1956 |pmid=13337331 |doi=10.1126/science.123.3209.1151}}</ref> Polio ya kupooza hutokea katika chini ya 1% ya maambukizi ya virusi ya polio. Ugonjwa wa kupooza hutokea wakati virusi vinaingia mfumo mkuu wa neva (mifumo mingi) na replicates katika neuroni ya mwendo ndani ya uti wa mgongo, shina ubongo, au gamba ya mwenda, kusababisha uharibifu wa kuchagua neurons motor inayoongoza kwa muda au wa kudumu kupooza. Katika matukio machache, kupooza kwa polio kunaletwa na shinda za kupumua na kisha kifo. Katika kesi ya ugonjwa wa kupooza, maumivu ya misuli na mkazo wa mara kwa mara kabla ya kuanza kwa udhaifu na kupooza. Ulemavu huendelea kutoka siku hadi wiki kabla ya kupona. <ref> http://emedicine.medscape.com/article/306440-overview</ref> <ref> http://emedicine.medscape.com/article/967950-overview</ref> Kwa namna nyingi neva awamu ya kuambukizwa ni wazo kuwa ni ajali ya kawaida kutoka uambukizo wagastrointestinal. Mifumo ambazo virusi ya polio huingia CNS hazifahamiki. Maswali matatu yasiyo ya pande kipekee yamekuwa yakipendekezwa kueleza kuingia kwake. Nadharia zote zinahitaji viremia ya msingi. Dhanio ya kwanza anatabiri kwamba virioni hupita moja kwa moja kutoka damu katika mfumo wa neva na kuvuka kikwazo cha damu ya ubongo huru ya CD155. <ref>{{cite journal |author=Yang W, Terasaki T, Shiroki K, ''et al.''|title=Efficient delivery of circulating poliovirus to the central nervous system independently of poliovirus receptor |url=https://archive.org/details/virology_1997-03-17_229_2/page/421|journal=Virology |volume=229 |issue=2 |pages=421–8 |year=1997 |pmid=9126254 |doi=10.1006/viro.1997.8450}}</ref> Dhanio la pili unaonyesha kwamba virioni husafirishwa kutoka tishu pembeni ambazo zilizosafishwa katika damu ya viremia, kwa mfano tishu misuli, na uti wa kupitia na usafiri wa mkongo kurudi nyuma. dhanio la tatu ni kwamba virusi hupita katika mfumo kati wa neva na monositi zilizoambukizwa au maikrofaji. <ref name="DeJesus"></ref> Polio ni ugonjwa wa mfumo mkuu wa neva. Hata hivyo, CD155 inaaminika kuwa iko juu ya uso wa zaidi au seli zote za binadamu wote. Basi kipokezi hakijielezi ya kwamba virusi ya polio huambukiza tishu fulani. Hii inaonyesha kwamba tishu hugeuka na inaamuliwa baada ya kuambukizwa kwa seli. kazi ya karibuni imependekeza kuwa aina ya kwanza ya vikundi vyovyote vya glaikoprotini zinazotolewa na aina mbalimbali za seli mwitikio wa (hasa vile vya vikundi vyovyote vya glaikoprotini zinazotolewa na aina mbalimbali za selialpha na beta) ni jambo muhimu ambalo linafafanua aina ya seli inayoegemeza kuiga kwa virusi ya polio. <ref>{{cite journal |author=Ida-Hosonuma M, Iwasaki T, Yoshikawa T, ''et al.'' |title=The alpha/beta interferon response controls tissue tropism and pathogenicity of poliovirus |url=https://archive.org/details/sim_journal-of-virology_2005-04_79_7/page/4460 |journal=J. Virol. |volume=79 |issue=7 |pages=4460–9 |year=2005 |month=Aprili |pmid=15767446 |pmc=1061561 |doi=10.1128/JVI.79.7.4460-4469.2005 }}</ref> Katika panya kutoa CD155 (kwa njia ya uhandisi wa kimaumbile) lakini kukosa aina ya kwanza ya kipokezi vikundi vyovyote vya glaikoprotini zinazotolewa na aina mbalimbali za seli, virusi ya polio sio tu kuzalishana katika kupanua Répertoire ni ya aina ya tishu, lakini hawa panya pia wana uwezo wa kuambukizwa kwa mdomo na virusi hivi. <ref>{{cite journal |author=Ohka S, Igarashi H, Sakai M, Koike S, Nochi T, Kiyono A, Nomoto A |title=Esstablishment of a poliovirus oral infection system in human poliovirus receptor-expressing transgenic mice that are deficient in alpha/beta interferon receptor |url=https://archive.org/details/sim_journal-of-virology_2007-08_81_15/page/7902 |journal=J. Virol. |volume=81 |issue=15 |pages=7902–12 |year=2007 |pmid=17507470 |doi=10.1128/JVI.02675-06 |pmc=1951287}}</ref> == Mfumo wa kinga kuepusha == Virusi vya polio vinatumia njia mbili muhimu ili kuepukamfumo wa kinga. Kwanza, vina uwezo wa kuishi katika hali ya asidi kali sana iliyo katika ufereji wa utumbo , na kuruhusu virusi kuambukiza seli jeshi na kuenea katika mwili kupitia mfumo limfu. Pili, kwa sababu inaweza kuiga haraka sana, virusi hivi hulemea viungo jeshi kabla mwitikio wa kinga unaweza kuwa vyema. <ref name="Racaniello">{{cite journal |author=Racaniello V |title=One hundred years of poliovirus pathogenesis |journal=Virology |volume=344 |issue=1 |pages=9–16 |year=2006 |pmid=16364730 |doi=10.1016/j.virol.2005.09.015}}</ref> Watu ambao ni wazi kwa virusi ya polio, aidha kwa njia ya kuambukiza au kwa kinga ya chanjo ya polio, hupata kinga. Katika watu wenye kinga, zindiko dhidi ya virusi ya polio zipo katika [[findo na njia ya utumbo (hasa [[Iga zindiko) na wana uwezo wa kuzuia virusi ya polio kuiga; zindiko za IgG na IgM dhidi ya virusi ya polio wanaweza kuzuia kuenea kwa virusi katika neuroni ya mwendo wa mfumo mkuu wa neva. Maambukizi na serotype moja ya virusi ya polio haitoi kinga dhidi ya serotaipu zingine, hata hivyo mashambulizi ya pili ndani ya mtu binafsi huo ni nadra mno. == PVR transgenic kipanya == Ingawa binadamu ndio majeshi ya asili ya virusi vya polio inayojulikana, nyani wanaweza kuambukizwa kisayansi na wamekuwa wakitumika kujifunza virusi ya polio kwa muda mrefu. Katika 1990-1991, mfano wa mnyama mdogo wa polio ilianzishwa na maabara mbili. Panya walitengenezwa kueleza kipokezi cha binadamu hadi virusi ya polio (hPVR). Tofauti na panya kawaida, kipokezi vya virusi ya polio vilivyogeuzwa (TgPVR) panya huathirika kwa urahisivirusi ya polio vilivyodungwa ndani ya mshipa au ndani ya nyama, na wakati sindano ya moja kwa moja kwenye [[uti wa mgongo]] au ya ubongo. Inapoambukizwa, TgPVR panya huonyesha dalili za kupooza kwamba ambazo hufanana na zile za polio wa binadamu na nyani, na mfumo wa neva wa kati wa panya uliopooza histocytochemically sawa na wale wa binadamu na nyani. Mtindo huu wa panya wa maambukizi ya virusi ya polio vya binadamu una thibitisha kuwa chombo cha thawabu nyingi katika kuelewa baiolojia ya virusi ya polio na pathogenicity. <ref name="pmid11597452">{{cite journal |author=Ohka S, Nomoto A |title=Recent insights into poliovirus pathogenesis |url=https://archive.org/details/sim_trends-in-microbiology_2001-10_9_10/page/501 |journal=Trends Microbiol. |volume=9 |issue=10 |pages=501–6 |year=2001 |pmid=11597452 |doi=10.1016/S0966-842X(01)02200-4}}</ref> Aina tatu tofauti za panya TgPVR wamekuwa pia wakitafitiwa: <ref name="pmid7832641">{{cite journal |author=Koike S, Taya C, Aoki J, ''et al.'' |title=Characterization of three different transgenic mouse lines that carry human poliovirus receptor gene--influence of the transgene expression on pathogenesis |url=https://archive.org/details/sim_archives-of-virology_1994_139_3-4/page/351 |journal=Arch. Virol. |volume=139 |issue=3-4 |pages=351–63 |year=1994 |pmid=7832641|doi=10.1007/BF01310797}}</ref> * Katika panya TgPVR1 usimbaji wa transgene wa PVR wa binadamu mara uliingizwa kwenye kromosomu cha kipanya 4. Hizi panya hueleza ngazi ya juu ya transgene na unyeti juu ya virusi ya polio. Panya TgPVR1 wanaathirika kwa urahisi na virusi ya polio kupitia njia ya intraspinal, ndani ya ubongo, intramuscular, na ndani ya ubongo, lakini si kwa njia ya mdomo. * Panya TgPVR21 hupata binadamu PVR katika kromosomu13. Hawa panya hawaathiriwi kwa urahisi na maambukizi ya virusi ya polio kupitia njia ya ndani ya ubongo, huenda kwa sababu wao hukamua ngazi ya hPVR iliyopungua. Panya TgPVR21 wamekuwa wakionyesha kuwa wanahusika na maambukizi ya virusi ya polio kupitia chanjo ya ndani mwa pua, na inaweza kuwa na manufaa kama mtindo maambukizi ya mucosal. * Katika panya TgPVR5 transgene ya binadamu iko juu ya kromosomu 12. Hawa panya huonyesho ngazi ya chini ya kujieleza hPVR na haiathiriki kwa urahisi na maambukizi ya virusi ya polio. Hivi karibuni mfano wa panya TgPVR ulitengenezwa. Hawa "cPVR" panya hubeba hPVR cDNA, inayoendeshwa na kuadhiminiwa na a-actin β, na kuthibitika kuwa huathirika kwa urahisi na virusi ya polio kupitia, ndani ya misuli, na ndani ya mapua na ndani mwa ubongo. Pia, panya hawa wana uwezo wa kuendeleza aina ya balbu ya polio baada ya chanjo ya ndani ya pua. Maendeleo ya panya TgPVR imekuwa na madhara makubwa kwa uzalishaji wa chanjo ya virusi ya polio ya mdomo OPV) (. Hapo awali, ufuatiliaji wa usalama wa OPV ulikuwa ukifanywa kwa kutumia nyani, kwa sababu jamii ya nyani tu wanahusika na virusi hivi. Mwaka 1999 [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] kupitisha matumizi ya panya TgPVR kama njia mbadala ya kutathmini ufanisi wa chanjo dhidi ya virusi ya polio aina-3. Katika 2000 mtindo wa panya huo ulipitishwa kwa ajili ya vipimo ya chanjo dhidi ya aina-1 na aina 2 -. <ref name="pmid12764491">{{cite journal |author=Dragunsky E, Nomura T, Karpinski K, ''et al.'' |title=Transgenic mice as an alternative to monkeys for neurovirulence testing of live oral poliovirus vaccine: validation by a WHO collaborative study |url=http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862003000400006&lng=en&nrm=iso&tlng=en |journal=Bull. World Health Organ. |volume=81 |issue=4 |pages=251–60 |year=2003 |pmid=12764491 |pmc=2572431 |access-date=2010-09-20 |archive-date=2011-07-16 |archive-url=https://web.archive.org/web/20110716100306/http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862003000400006&lng=en&nrm=iso&tlng=en |url-status=dead }}</ref> == Kuhamisha nukliasi na tathmini == Katika 1981 Racaniello na Baltimore walitumia teknolojia ya DNA iliyoungana tena kuzalisha kuambukizi cha kwanza cha kuhamisha nuklasi ya wanyama ya virusi ya RNA, virusi ya polio. Usimbaji wa DNA wa jenomu RNA ya virusi ya polio ililetwa katika seli za kukuza viini za binadamu na maambukizo ya virusi ya polio yalitayarishwa. <ref>{{cite journal |author=Racaniello V, Baltimore D |title=Cloned poliovirus complemenatry DNA is infectious in mammalian cells |journal=Science |volume=214 |issue=453 |pages=916–9 |year=1981 |pmid=6272391 |doi=10.1126/science.6272391}}</ref> Uumbaji wa kloni ya kuambukiza iliendesha kuelewa kwa baiolojia ya virusi ya polio , na imekuwa ni teknolojia ya kiwango kutumika kujifunza virusi wengine wengi. Mwaka wa 2002 watafiti katika SUNY Stony Brook wamefanikiwa katika synthesizing virusi ya polio kutoka kanuni zake za kemikali, na kutengeneza virusi ya sintetiki vya kwanza duniani. <ref>{{cite journal |author=Cello J, Paul AV, Wimmer E |title=Chemical synthesis of poliovirus cDNA: generation of infectious virus in the absence of natural template |url=https://archive.org/details/sim_science_2002-08-09_297_5583/page/1016 |journal=Science |volume=297 |issue=5583 |pages=1016–8 |year=2002 |pmid=12114528 |doi=10.1126/science.1072266}}</ref> Wanasayansi kwanza waliongofu virusi ya polio na kuchapishwa kwa RNA mlolongo, 7,741 msingi kwa muda mrefu, hadi kwenye mlolongo DNA, kama DNA ilikuwa rahisi kwa kuunganisha. Vipande vifupi vya mlolongo huu wa DNA zilipatikana kwa njia ya barua na kuungana. Virusi jenomu kamilifu kisha zilizokusanywa na kampuni za usanisi wa jeni. Mchakato huu wote wenye maumivu makubwa ulichukua miaka miwili. Viweka alama kumi na tisa viliingizwa katika DNA iliyosanisiwa, na hivyo inaweza kuwa tofauti na virusi ya polio asili. Vienya vilitumika kubadili DNA nyuma hadi RNA, hali yake ya asili. Vienya vingine vilitumika kutafsiri RNA hadi polipeptidi, na kuzalisha chembe za virusi kamilifu. Virusi sanisi wapya hudungwa katika panya PVR aliyegeuzwa ili kuamua kama toleo sanisi alikuwa na uwezo wa kusababisha ugonjwa. Virusi vya sintetiki vilikuwa na uwezo wa kuiga, kuambukiza, na kusababisha ulemavu au kifo katika panya. Hata hivyo, toleo sanisi lilikuwa mara kati ya 1,000 na 10,000 chini katika kusababisha mauti kuliko virusi ya asili. <ref>{{cite journal |author=Couzin J |title=Virology. Active poliovirus baked from scratch |url=https://archive.org/details/sim_science_2002-07-12_297_5579/page/174 |journal=Science |volume=297 |issue=5579 |pages=174–5 |year=2002 |pmid=12114601 |doi=10.1126/science.297.5579.174b}}</ref> <br> == Marejeo (Kwa lugha ya Kingereza) == {{Marejeo|2}} == Viungo vya nje == * [http://talk.ictvonline.org/cfs-filesystemfile.ashx/__key/CommunityServer.Components.PostAttachments/00.00.00.12.31/ICTV_2D00_Master_2D00_Species_2D00_List_2D00_2009_5F00_v4.xls MWALIMU ICTV SPISHI ORODHA 2009 UGEUZI 4] {{Wayback|url=http://talk.ictvonline.org/cfs-filesystemfile.ashx/__key/CommunityServer.Components.PostAttachments/00.00.00.12.31/ICTV_2D00_Master_2D00_Species_2D00_List_2D00_2009_5F00_v4.xls |date=20200322170239 }} * [http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/00.052.0.01.001.htm Virusi ICTVdb Uainishaji 2006] * [http://www.picornaviridae.com/enterovirus/enterovirus.htm Nyumba ya Picornaviruses (toleo jipya la aina za, spishi, serotaipu, &amp; mabadiliko yaliopendekezwa)] {{Wayback|url=http://www.picornaviridae.com/enterovirus/enterovirus.htm |date=20101104143822 }} [[Category:Virusi]] m9xmml0sk0doqjzoccks0pdbfhjhb0r 0 55302 1578152 1369915 2026-07-02T22:18:55Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578152 wikitext text/x-wiki [[File:Pulmonaryedema09.JPG|thumb|Uvimbe wa mapafu wa ghafla. Kumbuka moyo ulozidishwa ukubwa, mgawanyo wa juu wa vascula(mduara), na mdogo wa pande zote za mtiririko wa damu kwenye membrini zilizoko kwenye mapafu (mshare).]] {moyo kushindwa kusambaza damu kwa ghafla{/0} (ADHF) ni sababu ya kawaida na kubwa ya kusababisha kushindwa kupumua kwa ghafla. ==visababishi== usugu wa kushindwa kwa uthabiti wa moyo unaweza kiulahisi kusababisha kushindwa kwa usambazaji wa damu. Hii kwa kawaida sana ni matokeo ya ugonjwa ulotokea karibuni (kama vile {)kichomi,{/0} uinifarakti wa maiokaridiali (mshtuko wa moyo), pumu, shinikizo la damu lisilozibitiwa, au mgonjwa kushindwa kudumisha udhibiti wa maji, chakula au dawa. <ref name="OPTIMIZE-HF">{{cite journal |author=Fonarow GC, Abraham WT, Albert NM, ''et al.'' |title=Factors Identified as Precipitating Hospital Admissions for Heart Failure and Clinical Outcomes: Findings From OPTIMIZE-HF |journal=Arch. Intern. Med. |volume=168 |issue=8 |pages=847–854 |year=2008 |month=Aprili |pmid=18443260 |doi=10.1001/archinte.168.8.847}}</ref> Sababu nyingine ambazo ni vizuri kutambuliwa na zinazochochea ni pamoja na upungufu wa damu na utoaji wa kiwango cha juu cha homoni za koromeo ambazo zinaleta maumivu ya ziada kwenye misuli ya moyo. Utumiaji mwingi wa vimiminika au ulaji wa chumvi, na dawa ambayo husababisha uwekaji wa maji kama vile NSAIDs na thiazolidinedione, pia inaweza kuchochea moyo kushindwa kusambaza damu . <ref>{{cite journal |author=Nieminen MS, Böhm M, Cowie MR, ''et al.'' |title=Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology |journal=Eur. Heart J. |volume=26 |issue=4 |pages=384–416 |year=2005 |month=Februari |pmid=15681577 |doi=10.1093/eurheartj/ehi044 |url=http://eurheartj.oxfordjournals.org/cgi/content/full/26/4/384}}</ref> uinifarakti wa maiokardia uliomkali unaweza kuchochea moyo kushindwa kusambaza damu kwa ghafla na itapelekea kuibuka kwa kurejea kwa mtiririko wa damu katika viungo na damu kushindwa kufunga, kupitisha damu bila kupitia korinari, au kipandikizi cha upenyo wa ariteri ya coronari. ==Tiba== katika moyo kushindwa kusambaza damu kwa ghafla, lengo la mara moja ni kuanzisha tena uingizaji damu wa kutosha na upelekaji wa oksijeni kwa viungo vyote vya mwisho. Hii inahusu kuhakikisha kwamba njia ya hewa, upumuaji, na mzunguko wa damu ni wa kutosha. ===Oksijeni=== oksijeni ya ziada inaweza kutumiwa iwapo kama hypoxemia yaani uwepo wa oksijeni kidogo kwenye moyo upo asasi inayoshuhurikia,Kushindwa kwa moyo ya Marekani, hata hivyo, imependekeza kuwa njia hiyo isitumiwe mara kwa mara. <ref name="HFS2006">{{cite journal |author=Heart Failure Society Of America |title=Evaluation and management of patients with acute decompensated heart failure |journal=J. Card. Fail. |volume=12 |issue=1 |pages=e86–e103 |year=2006 |month=Februari |pmid=16500576 |doi=10.1016/j.cardfail.2005.11.017 |url=http://www.guideline.gov/summary/summary.aspx?doc_id=9328 |access-date=2010-10-14 |archive-date=2008-11-04 |archive-url=https://web.archive.org/web/20081104053735/http://guideline.gov/summary/summary.aspx?doc_id=9328 |dead-url=yes |https://web.archive.org/web/20081104053735/http://guideline.gov/summary/summary.aspx?doc_id=9328 |=https://web.archive.org/web/20081104053735/http://guideline.gov/summary/summary.aspx?doc_id=9328 }}</ref> ===matibabu ya dawa=== Tiba ya awali ya moyo kushindwa kusambaza damu kwa kawaida inajumuisha baadhi ya muunganiko wa vipanuzi vya mishipa ya damu kama vile nitrogiliserine yaani dawa ya maji ya kuzibua mishipa ya damu, au dawa ya kuongeza mkojo kama vile furosemide, na upenyeshaji wa msukumo hasi usioonekana (NIPPV).o; Hata kama dalili ya kushindwa kwa [[Moyo]]haionekani kwa sasa, dawa inaweza kutumika kwa kutibu dalili ambazo zimezoeleka. Dawa hizo zinakazi ya kudhibiti dalili hizi ikiwa ni pamoja na kutibu matatizo mengine ya afya ambayo yanaweza kuwepo sasa. Yanaweza kufanya kazi ya kuboresha ubora wa maisha,kushusha chini kuendelea kwa kushindwa kwa moyo na kupunguza hatari ya matatizo mengine ambayo yanaweza kutokea kutokana na kushindwa kwa moyo. Ni muhimu sana kutumia madawa sahihi hasa kama yalivyoagizwa na daktari. Idadi kubwa ya dawa mbalimbali zinahitajika kwa ajili ya watu ambao wanapatwa na hali ya kushindwa kwa moyo. aina ya kawaida ya dawa ambazo zinaagizwa kwa wagonjwa wa kushindwa kwa moyo ni pamoja na dawa za kuzuia ACE, dawa za kupanua mishipa ya damu, dawa za kusaidia mwenendo wa moyo,dawa ya kuyeyusha damu, dawa ya kuvunja mpito wa kalisi, na dawa ya kupunguza kolesto. Kulingana na aina ya uharibifu ambao mgonjwa ameteseka nao na kusababisha msingi wa kushindwa kwa moyo, yeyote ya madaraja ya madawa hayo au mchanganyiko wake unaweza kutumika. Wagonjwa wenye matatizo ya moyo kusukuma damu watatumia mjumuisho wa dawa tofauti na zile wanazotumia wale ambao wanakabiliwa na matatizo ya moyo kujaa. Uwezekano wa hatari ya mwingiliano wa dawa unaweza kutokea wakati dawa tofauti zinapochanganywa pamoja na kufanyakazi dhidi ya kila mmoja. <ref>[6] ^ [http://www.americanheart.org/presenter.jhtml?identifier=118 Dawa za kawaida Zinazotumika kutibu Kushindwa kwa Moyo ] Ushirika wa Moyo Marekani. Iliyotolewa tena 2007/01/28.</ref> dawa zote zina madhara yake. Nyingi juu-ya-zinazotumika kama dawa zinaweza kusababisha hali ya kushindwa kwa moyo kuwa mbaya zaidi. ====Vitanuzi==== Nitreti kama vile nitrogiliserini mara nyingi hutumika kama sehemu ya matibabu ya awali kwa ajili ya ADHF. chaguo jingine ni nesiritidi, ingawa ni lazima tu kuchukuliwa kama matibabu ya kawaida yamekuwa hayana mafanikio au imeonekana kama ni ghali zaidi kuliko nitrogiliserini na haijawahi kuonesha kuwa na faida yoyote ya ziada. ====Dawa ya kuongeza mkojo ==== Kushindwa kwa moyo kwa kawaida kunahusishwa na hali ya ujazo mkubwa wa kupitiliza. Basi wale walio na ushahidi wa maji kuwa mengi wanatakiwa wapatiwe matibabu ya awali ya kitanzi cha kuzuia kuongezeka mkojo. Kutokana na kukosekana kwa dalili za kiwango cha chini cha msukumo wa damu ndani ya mishipa baruti kari mara nyingi hutumika pamoja na tiba ya kuongeza mkojo kuboresha dalili msongamano. <ref name="HFS2006"></ref> Hali ya ujazo inatakiwa iendelee kufanyiwa tathmini ya kutosha. Baadhi ya wagonjwa wa ugonjwa wa kushindwa kwa moyo wenye usugu wa dawa ya kuongeza mkojo wanaweza kuwa na ongezeko la mkojo zaidi. Katika matukio ya mtanuko wa moyo pale moyo unapopokea damu kushindwa kufanya kazi yake vizuri pasipo kusinyaa kwa moyo pale unapopeleka damu kwenye mishipa kushindwa kufanya kazi yake vizuri,kimiminika kikirejeshwa katika hali njema inaweza kwa kweli kuboresha mzunguko na kupunguza kiwango cha moyo, ambacho kitawezesha vyumba vya chini vya moyo kuwa na muda zaidi wa kujaza. Hata kama mgonjwa anajawa na maji mengi katikati ya seli za tishu, kimiminika kikilejeshwa katika hali njema inaweza kuwa njia ya kwanza ya matibabu kama mgonjwa ana msukumo mdogo wa damu. mgonjwa huweza kwa ukweli kutumia usambazaji uliopo wa ujazo kutokea ndani ya mishipa ya damu, ingawa endapo msukumo mdogo wa damu ni kutokana na mshtuko au ugonjwa wa moyo, maji ya ziada yanaweza kufanya hali kuwa mbaya. Endapo mgonjwa anamzunguko wa ujazo wa kutosha, lakini kuna mwendelezo wa ushahidi wa kutotosha uingizaji wakimiminika kwenye mwisho wa mishipa ya fahamu, athari ya msinyao wa misuli unaweza kuonekana. Katika hali fulani, kifaa cha kusaidia chumba cha moyo cha kushoto (LVAD) huwa ni lazima. Mara baada ya mgonjwa kutulia, tahadhari zinaweza kugeuka nakuwa kutibu uvimbe wa mapafu na kuboresha hewa. dawa ya kuchochea mkojo inayowekwa ndani ya mishipa kwa ujumla ni njia ya awali. Hata hivyo, wagonjwa walio kwenye matumizi ya muda mrefu ya mfumo wa dawa za kuongeza mkojo wanaweza kuwa wavumilivu, na lazima dozi kuendelea kuongezeka. Kama viwango vya juu vya dawa inayotumika kuchochea mkojo ni duni,njia ya kuingiza dawa kwa kutumia sindano ndani ya mishipa au kuendelea kuongeza dawa kupunguza majimaji ndani ya mishipa inaweza kuwa sahihi. kitanzi cha dawa ya kuongeza mkojo hizi huweza kuwa pamoja na dawa za kuongeza mkojo zinazochochea mtiririko mkubwa wa maji kama vile metolazone ya kumeza au klorothiazide ya kuweka kwenye mishipa kwa ajili ya athari ya dawa kwenye mishipa. maandalizi ya kuweka dawa ndani ya mishipa yanapendelewa zaidi kwa sababu ya nanma nyingi za kuchagua zinazotabirika. Wakati mgonjwa amezidiwa sana na maji, yanaweza kuendeleza uvimbe kwenye utumbo pia, ambao unaweza kuathiri ufyonzwaji wa dawa wa ndani. ===Matibabu mengine=== ;ACE inayozuia madhara ya kemikali na ARBs Ufanisi na usalama wa ACE inayozuia madhara ya kemikali na vivunjivu vya kithibiti vipokezi haraka katika ADHF haijawahi kuwa masomo lakini kinadharia zinadhuru. mtu anapaswa kuwa amedhibitiwa kabla ya tiba aidha ya haya makundi ya dawa kuanza. <ref>{{cite journal |author=Gheorghiade M, Zannad F, Sopko G, ''et al.'' |title=Acute heart failure syndromes: current state and framework for future research |journal=Circulation |volume=112 |issue=25 |pages=3958–68 |year=2005 |month=Desemba |pmid=16365214 |doi=10.1161/CIRCULATIONAHA.105.590091 |url=https://archive.org/details/sim_circulation_december-20-27-2005_112_25/page/n169}}</ref> ;vizuizi vya -B Vizuizi vya-B vikisimamishwa au vikipunguzwa kwa watu wenye shinikizo la chini la damu yaani BP. Hata hivyo muendelezo wa vizuizi vya-B kama shinikizo la damu ni la kutosha vinaweza kuwa sahihi. <ref>{{cite journal |author=Jondeau G, Neuder Y, Eicher JC, ''et al.'' |title=B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode |journal=Eur. Heart J. |volume=30 |issue=18 |pages=2186–92 |year=2009 |month=Septemba |pmid=19717851 |doi=10.1093/eurheartj/ehp323 |url=}}</ref> ;Mawakala wa kuathiri misuli kuathirika kwa misuli inatokea kama msukumo mdogo wa damu (BP <90) upo. ;dawa za usingizi Dawa za usingizi kijadi zinatumiwa katika matibabu ya uvimbe wa mapafu wa ghafla unaotokana na kushindwa kwa moyo kwa ghafla. Mapitio ya 2006 hata hivyo yalipata ushahidi kidogo kusaidia hili zoezi. <ref>{{cite web |url=http://www.bestbets.org/bets/bet.php?id=376 |title=BestBets: Does the application of opiates, during an attack of Acute Cardiogenic Pulmonary Oedma, reduce patients' mortality and morbidity? |format= |work= |accessdate=6 Desemba 2008 |archive-date=2010-06-16 |archive-url=https://web.archive.org/web/20100616155329/http://bestbets.org/bets/bet.php?id=376 |url-status=dead }}</ref> ===Uingizaji hewa=== Mwendelezo chanya wa msukumo wa njia za hewa unaweza kutumika kwa kutumia barakoa ya uso; hii imeonekana kuboresha dalili kwa haraka zaidi kuliko tiba ya oksijeni peke yake, <ref>{{cite journal |author=Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J |title=Noninvasive ventilation in acute cardiogenic pulmonary edema |url=https://archive.org/details/sim_new-england-journal-of-medicine_2008-07-10_359_2/page/n50 |journal=N. Engl. J. Med. |volume=359 |issue=2 |pages=142–51 |year=2008 |month=Julai |pmid=18614781|doi=10.1056/NEJMoa0707992}}</ref> na ina katika baadhi ya masomo imeonyeshwa kupunguza hatari ya kifo. <ref>{{cite journal |author=Masip J, Roque M, Sánchez B, Fernández R, Subirana M, Expósito JA |title=Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis |journal=JAMA |volume=294 |issue=24 |pages=3124–30 |year=2005 |month=Desemba |pmid=16380593 |doi=10.1001/jama.294.24.3124 |url=http://jama.ama-assn.org/cgi/content/full/294/24/3124}}</ref> <ref>{{cite journal |author=Peter JV, Moran JL, Phillips-Hughes J, Graham P, Bersten AD |title=Effect of non-invasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis |url=https://archive.org/details/sim_the-lancet_april-8-14-2006_367_9517/page/1155 |journal=Lancet |volume=367 |issue=9517 |pages=1155–63 |year=2006 |month=Aprili |pmid=16616558|doi=10.1016/S0140-6736(06)68506-1}}</ref> Hali mbaya yakushindwa kupumua inahitaji matibabu na kuweka neli ndani ya koo na uingizaji hewa kwa kutumia mitambo.{ === uchujaji wa hali ya juu === Uchujaji wa hali ya juu unaweza kutumika kuondoa maji maji kwa watu wenye ADHF yanayohusiana na kushindwa kwa figo. Mafunzo yamegundua kuwa huduma za afya zitapungua matumizi kwa siku ya tisini. <ref>{{cite journal |author=Costanzo MR, Guglin ME, Saltzberg MT, ''et al.'' |title=Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure |journal=J. Am. Coll. Cardiol. |volume=49 |issue=6 |pages=675–83 |year=2007 |month=Februari |pmid=17291932 |doi=10.1016/j.jacc.2006.07.073 |url=https://archive.org/details/sim_journal-of-the-american-college-of-cardiology_2007-02-13_49_6/page/n75}}</ref> ===Upasuaji=== Baadhi ya matukio itahitaji ushauri unaoibuka na upasuaji wa kifua na moyo. Kushindwa kwa moyo kutokana na urudishaji damu ukiwa wa ghafla unatakiwa upasuaji wa dharura uanaohusiana na vifo kwa wingi. Kushindwa kwa Moyo huweza kutokea baada ya kupasuka kwa aneurisimu ya chumba cha moyo[[]]. Hayo huweza kutengenezwa baada ya uinifarakti wa maiokaridiali,utakuwa umesababisha kizuizi cha damu inayoathiri moyo,kama mpasuko katika ukuta huru. Kama mpasuko uko kwenye septamu ya ndani ya chumba cha moyo, inaweza kuunda ulemavu wa septali ya chumba cha moyo. Sababu nyingine za kuzuia damu inayoathiri moyo pia zinahitaji kuingilia kati kwa kutumia upasuaji, ingawa matibabu ya haraka pembeni mwa kitanda yanaweza kutosha. Ni lazima pia kuamua kama mgonjwa alikuwa na historia ya ugonjwa wa moyo tangu kuzaliwa kwa jinsi mara kwa mara anavyopata matatizo ya kuathiriwa kwa ndani kwa umbo la moyo pamoja na tishu hai za bandia na sehemu zinazopitisha damu nje ya mfumo wake ili kuendeleza uharibifu, na hivyo kusababisha moyo kushindwa kusambaza damu kwa ghafla. Katika baadhi ya matukio, madaktari hupendekeza upasuaji kutibu tatizo la msingi linalo pelekea kushindwa kwa moyo. <ref>[22] ^ [http://www.mayoclinic.com/health/heart-failure/DS00061/DSECTION=treatments-and-drugs ]Matibabu na dawa kwa ajili ya Kushindwa kwa Moyo/1} Kliniki ya Mayo. Iliyotolewa tena 2007/01/28.</ref> Taratibu tofauti zinapatikana kulingana na kiwango cha ulazima na ni pamoja na upasuaji wa ariteri ya kolonali ili kurejesha mfumo wa damu kutengeneza valvu za moyo au uingizwaji, au upandikizwaji wa moyo. Wakati wa taratibu hizi, vifaa kama vile pampu za moyo, kiratibisha mapigo ya moyo, au mashine ya kustua moyo inaweza kupandwa. Matibabu ya maradhi ya moyo yanabadilika kwa kasi na hivyo Matibabu mapya kwa ajili ya matibabu ya kushindwa kwa moyo kwa ghafla matibabu yameanzishwa kuokoa maisha zaidi kutokana na mashambulizi hayo mkubwa. <ref>[23] ^ [http://www.acuteheart.com/ Kushindwa kwa Moyo kwa Ghafla Ufafanuzi Na Uratibu] Ilitolewa tena 2010/01/22</ref> '''upasuaji wa kurejesha njia ya damu''' unafanywa kwa kuondoa mshipa kutoka kwenye mkono, mguu, au kifua na kubadilisha mshipa ulokuwa umefungwa katika moyo. Hii inaruhusu damu kutiririka kwa uhuru zaidi kwa kupitia moyo. Kukarabati valvu ni pale valvu inayosababisha kushindwa kwa moyo inapofanyiwa matengenezo kwa kuondoa tishu zilizozidi ambazo zinasababisha msongamano mkubwa. Katika baadhi ya matukio, anuloplasiti inatakiwa kuchukua nafasi ya pete inayozunguka valvu. Kama ya marekebisho ya valvu hayawezekani,inabadilishwa na kuweka valvu ya bandia. Hatua ya mwisho ni moyo mbadala. Iwapo hali mbaya sana ya kushindwa kwa moyo inakuwepo na madawa au taratibu zingine za kutibu moyo si za ufanisi, moyo wenye ugonjwa unahitaji kubadilishwa. Utaratibu mwingine wa kawaida unaotumiwa kutibu wagonjwa wa kushindwa kwa moyo ni angioplasiti. Ni utaratibu unaotumika kuboresha dalili za ugonjwa wa ariteri za koronari (CAD), kupunguza uharibifu wa misuli ya moyo baada ya moyo kushambuliwa, na kupunguza hatari ya kifo kwa wagonjwa wengine. <ref>[24] ^ [http://www.nhlbi.nih.gov/health/dci/Diseases/Angioplasty/Angioplasty_WhatIs.html Angioplasti ya Coronari Ni Nini] Taifa na Taasisi ya Taifa ya Moyo Mapafu na Damu. Iliyotolewa tena 2007/01/28.</ref> utaratibu huu unafanywa kwa kuweka puto katika moyo ili kufungua ariteri ambayo imefungwa na atherosklerosisi yaani ugonjwa wa ariteri au ujenzi wa plaque juu ya kuta za ariteri. Wagonjwa ambao wanauzoefu wa kushindwa kwa moyo kwa sababu ya CAD au mashambulizi ya hivi karibuni ya moyo, wanaweza kufaidika kutoka utaratibu huu. '''kiratibisha mapigo ya moyo''' yaani pacemaker ni kifaa kidogo ambacho huwekwa ndani ya kifua au tumbo kusaidia kudhibiti mapigo ya moyo yasiyo sahihi. <ref>[25] ^ [http://www.nhlbi.nih.gov/health/dci/Diseases/pace/pace_whatis.html ]Angioplasti ya Coronari Ni Nini/1}Taasisi ya Taifa ya Moyo Mapafu na Damu. Iliyotolewa tena 2007/01/28.</ref> Vinafanya kazi kwa kupeleka mapigo ya umeme kwenda kwenye moyo kwa kuharakisha moyo kupiga kwa kiwango kitakachoonekana kuwa cha kawaida na zinatumika kutibu wagonjwa wa mapigo ya moyo kutokuwa mazuri yaani arrhythmias. Zinaweza kutumika kutibu moyo ambao uko kwenye kundi la tachikaridia ambao unapiga kwa haraka, au bradikaridia ambao unapiga polepole mno. ==Tazama Pia== <div class="references-medium"> * Ugonjwa wa mshtuko wa moyo * Utaratibu wa Dori * Urudiaji wa undaji wa ventriko * Kuzidiwa kwa kimiminika </div> ==Marejeo== {{Marejeo|2}} [[Category:Magonjwa ya moyo na mishipa]] 4nwusbjmmj91osl4l1abmt5cm8p7bn0 0 55350 1578215 1575451 2026-07-03T03:39:37Z InternetArchiveBot 41439 Add 4 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578215 wikitext text/x-wiki [[Picha:Prozac.jpg|thumb|right|Fluoxetine (Prozac), ni SSRI]] [[Picha:Venlafaxine-3D-balls.png|thumb|right|Venlafaxine, ni SNRI]] '''Dawamfadhaiko''' (''[[ing.]] antidepressant'') ni [[dawa]] za [[ugonjwa wa akili]] zinazotumika kupunguza mivurugo ya halihisi ya moyo, kama vile mfadhaiko mkubwa na ukataji tamaa na hali ya wasiwasi kama vile woga wa kuingiliana na watu. Dawa kama vile vizuia oksidesi vya monoamini (MAOIs), dawa dhidi ya mfadhaiko aina ya trisaikliki (TCAs), dawa dhidi ya mfadhaiko aina ya tetrasaikliki (TeCAs), vizuizi vya uchukuzi wa serotonini kinachochagua (SSRIs), na vizuizi vya uchukuzi wa serotonini-norepinefrini(SNRIs) ndizo zinazohusishwa kwa kawaida na neno hilo. Dawa hizo ni kati ya zile ambazo kwa kawaida huagizwa na wataalamu wa magonjwa ya akili na madaktari wengine, na ufanifu pamoja na athari zake ni mada ya tafiti nyingi na madai mengi yanayoshindana. Dawa nyingi husababisha athari za dawamfadhaiko, lakini vikwazo kuhusu matumizi yake yameleta utata unaosababishwa na kuzitumia kutibu maradhi mengine mbali na yale yaliyokusudiwa, licha ya madai kuwa yana ufanisi wa kiwango cha juu. Ufanifu wa dawamfadhaiko ya kisasa aina ya thaimoleptiki haijawahi kudhihirishwa kikamilifu kuwa ni bora zaidi ya ule wa kipozaungo hai, kulingana na tafiti mbili za shirika la Cochrane Collaboraton.<ref name="Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R 2008 252–60">{{cite journal |author=Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R |title=Selective publication of antidepressant trials and its influence on apparent efficacy |url=https://archive.org/details/sim_new-england-journal-of-medicine_2008-01-17_358_3/page/n74 |journal=N. Engl. J. Med. |volume=358 |issue=3 |pages=252–60 |year=2008 |month=Januari |pmid=18199864 |doi=10.1056/NEJMsa065779 }}</ref><ref name="ncbi.nlm.nih.gov"> Moncrieff J, Wessely S, Hardy R. (2004) [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&amp;DB=pubmed Vipozaungo hai dhidi ya dawamfadhaiko kwa mfadhaiko.] ''Cochrane Database Syst Rev'' (1): CD003012.</ref> Kwa maandishi yaliyochapishwa, tibamifadhaiko ilikuwa na mafanikio ya 94% katika kutibu mfadhaiko. <ref name="Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R 2008 252–60"/><ref name="ncbi.nlm.nih.gov"/> Kwa maandishi ambayo hayakuchapishwa, mafanikio yalikuwa ni chini ya 50%.<ref name="Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R 2008 252–60"/> Kwa ujumla, tafiti zote zilionyesha ufanisi<ref name="Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R 2008 252–60"/> wa 51% - pointi mbili tu zaidi kuliko ile ya kipozaungo. Hii iliongeza dhahiri ufanifi wa dawamfadhaiko tofauti kutoka 11% hadi 69% zaidi ya kipozaungo.<ref name="Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R 2008 252–60"/> Dawa ambayo huenda ikawa ni tofauti na ile ya mirtazepine- pinzani ya norepinefrini na serotonini, yenye athari zilizo kinyume na zile za SSRI na SNRIS - na venlafaksini, SNRI iliyo na usawa katika mfumo wa kemikali kwa kiwango kikubwa na tramadoli ya afyuni iliyonyumbuliwa. Afyuni zilitumika kutibu mfadhaiko wa kiwango cha juuu hadi mwishoni mwa miaka ya 1950. Ampfetamini zilitumika hadi katikati ya miaka ya 1960. Kuagiza afyuni au amfetamini kwa kutibu mfadhaiko ni jambo linaloleta utata kisheria. Utafiti kuhusu uwezo wa afyuni ya kunyumbuliwa wa kutibu mfadhaiko umefanywa mara chache tu katika kipindi cha miaka sitini iliyopita, ili hali amfetamini zimepata soko linalostawi kwa hali mbalimbali kama vile maradhi ya upungufu wa makini, nakolepsi, na [[unene wa kupindukia]] na zinaendelea kuchunguzwa kwa matumizi mengi. Afyuni na amfetamini zote husababisha mwitiko wa haraka sana wa matibabu. Huonyesha matokeo kwa muda usiopita masaa ishirini na manne hadi arobaini na manane; uwiano wa matibabu kwa afyuni na amfetamini ni mkubwa kuliko ule wa dawamfadhaiko aina ya trisaikliki. Katika baadhi ya tafiti hizi zenye vikwazo vikuu, buprenofini ya afyuni imeonyesha uwezo mkubwa wa kutibu mfadhaiko mkali ulio sugu kwa matibabu wa dawa yoyote inayojulikana katika utafiti mdogo ambao kwa ujumla ilitambuliwa na kuchapishwa mwaka wa 1995, lakini haijawahi kufwatiliwa kutokana na unyanyapaa wa kijamii unaohusishwa na afyuni pamoja na ile inayohusishwa na ugonjwa wa akili nchini Marekani.<ref> Bodkin JA. et al. (1995): "Buprenorphine treatment of refractory depression", Journal of Clinical Psychopharmacology 15:49-57. PMID 7714228</ref> Aina nyingi za dawamfadhaiko zinazofanana na asili huchelewa kuanza utekelezaji kwa (kati ya wiki 2-6) na kwa kawaida hutolewa kwa muda wa wakati wowote kati ya miezi hadi miaka. Licha ya jina hilo, dawamfadhaiko mara nyingi hutumika kwa njia ya ubishi, na katika muktadha wa upungufu wa ushahidi unaotegemea majaribio kusaidia dalili zao, matumizi ya dawa kutibu maradhi mengine bali na yale yaliyokusudiwa awali, kama vile hali ya wasiwasi, ugonjwa wa akili ambapo mtu huwa na kiwango cha juu cha tamaa au shauku, matatizo ya kula, maumivu sugu, na baadhi ya hali zinazotatiza urazini wa upatanisho wa homoni kama vile hedhi chungu. Zikiwa peke yao au pamoja na kinza msukosuko (kwa mfano Tegretoli au Depakote), dawa hizi zinaweza kutumika kutibu upungufu makini wa kupepesuka (ADHD) na matumizi mabaya ya dawa kwa kushughulikia mfadhaiko msingi. Pia, dawamfadhaiko zimetumika wakati mwingine kutibu kukoroma na vipandauso. Dawa zingine ambazo kwa kawaida haziitwi dawamfadhaiko, ikiwa ni pamoja na vizuia magonjwa ya akili vya vipimo vya chini <ref>{{cite journal |doi=10.4088/JCP.v64n0512 |author=Wheeler Vega JA, Mortimer AM, Tyson PJ |title=Conventional antipsychotic prescription in unipolar depression, I: an audit and recommendations for practice |journal=The Journal of Clinical Psychiatry |volume=64 |issue=5 |pages=568–74 |year=2003 |month=Mei |pmid=12755661 |url=http://www.psychiatrist.com/abstracts/abstracts.asp?abstract=200305/050311.htm |access-date=2010-10-18 |archive-date=2011-07-17 |archive-url=https://web.archive.org/web/20110717000127/http://www.psychiatrist.com/abstracts/abstracts.asp?abstract=200305/050311.htm |dead-url=yes }}</ref> na benzodiazepini, <ref>{{cite journal |author=Petty F, Trivedi MH, Fulton M, Rush AJ |title=Benzodiazepines as antidepressants: does GABA play a role in depression? |url=https://archive.org/details/sim_biological-psychiatry_1995-11-01_38_9/page/n13 |journal=Biological Psychiatry |volume=38 |issue=9 |pages=578–91 |year=1995 |month=Novemba |pmid=8573660 |doi=10.1016/0006-3223(95)00049-7}}</ref> zinaweza kutumika kwa kudhibiti mfadhaiko, ingawa benzodiazepini - pamoja na dawa zote zinazoitwa "dawamfadhaiko" - husababisha utegemezi wa mwili. Kuacha matibabu ya benzodiazepini (au SSRI) kwa ghafla kunaweza kusababisha dalili zisizopendeza za kuachishwa. Kizinduo cha mmea wa St John's Wort hutumika kwa kawaida kama dawamfadhaiko, ingawa imealamishwa kama kijalizo cha chakula katika nchi zingine. Neno ''dawamfadhaiko'' wakati mwingine hutumiwa kwa tiba (kwa mfano, matibabu ya kisaikolojia, tiba ya msukosuko ya umeme, tiba vitobo) au mchakato (kwa mfano kuvuruga usingizi, kuongezeka kwa kiwango cha mwanga, mazoezi ya mara kwa mara) yametambulika kama njia za kudhibiti mfadhaiko wa kimawazo. Vipozaungo tepetevu vinaweza kuleta athari kuu za dawamfadhaiko, kwa hivyo, ili kudhibitisha Dutu kama "dawamfadhaiko", katika utafiti wa kiafya wa kliniki ni muhimu kuonyesha ukuu wake ukilinganishwa na kipozaungo. <ref>" [http://healthlifeandstuff.com/2009/07/do-we-know-anything-about-antidepressants/ Je, dawamfadhaiko hufanya kazi kama ilivyoahidiwa?] {{Wayback|url=http://healthlifeandstuff.com/2009/07/do-we-know-anything-about-antidepressants/ |date=20100924095828 }}</ref> == Historia == [[Picha:Saint John's wort flowers.jpg|thumb|right|250px|St John's Wort]] Afyuni mbalimbali (kupitia kipokezi cha μ-cha afyuni na kipokezi cha k-cha afyuni) na ya amfetamini zilitumika mara nyingi kama dawamfadhaiko hadi miaka ya 1950, wakati zilipopoteza umaarufu wao kutokana na hali yao ya kulevya na madhara yake. <ref name="Weber 1988 255–66">{{cite journal|last=Weber|first=MM|year=1988|month=Julai|title=Current and Historical Concepts of Opiate Treatment in Psychiatric Disorders|journal=International Clinical Psychopharmacology|volume=3|issue=3|pages=255–66|publisher=Lippincott Williams & Wilkins |pmid=3153713 |url=http://journals.lww.com/intclinpsychopharm/Abstract/1988/07000/Current_and_Historical_Concepts_of_Opiate.7.aspx |doi=10.1097/00004850-198807000-00007 |accessdate=2009-05-28|last2=Emrich|first2=HM}}</ref> Dondoo kutoka kwenye mmea wa St John's Wort zimetumika kwa muda mrefu kama "dawa ya kuchangamsha neva" ili kupunguza mfadhaiko. <ref>{{cite journal|last=Czygan|first=FC|date=8 Mei 2003|title=Kulturgeschichte und Mystik des Johanniskrauts: Vom 2500 Jahre alten Apotropaikum zum aktuellen Antidepressivum|journal=Pharmazie in unserer Zeit|volume=32|issue=3|pages=184–190|publisher=WILEY-VCH Verlag|location=Weinheim|doi=10.1002/pauz.200390062|language=German|accessdate=2009-05-28|pmid=12784538}}</ref> === Isoniazidi na iproniazidi === Katika mwaka wa 1951, watu wawili kutoka Hospitali ya Sea View katika kisiwa cha Staten, Irving Selikoff na Edward Robitzek, walianza kufanya utafiti wa kiafya kwa vikolezo viwili vipya vya [[Kifua kikuu|kupambana na kifua kikuu]] kutoka Hoffman-LaRoche, isoniazidi na iproniazidi. Ni wagonjwa waliolemewa na ugonjwa pekee waliotibiwa hapo awali; hata hivyo, hali yao iliendelea kuwa bora kwa kasi kikubwa. Selikoff na Robitzek waligundua "mchangamsho mpole kwa ujumla...wagonjwa walionekana kuwa na nguvu mpya na kwa kweli, mara kwa mara jambo hili lilisababisha matatizo ya kinidhamu." Matumaini ya tiba ya kifua kikuu katika majaribio ya hospitali ya Sea View yalijadiliwa kwa msisimuko katika vyombo vikuu vya habari. Katika mwaka wa 1952, baada ya kujifunza kuhusu madhara ya uchochezi ya isoniazidi, mtaalamu wa saikolojia kutoka Cincinnati, Max Lurie, aliijaribu kuitumia kwa wagonjwa wake. Katika mwaka uliofuata, yeye na Harry Salzer waliripoti kuwa isoniazidi ilipunguza mfadhaiko katika theluthi mbili ya wagonjwa wao na wakaunda neno ''dawamfadhaiko'' kuelezea kitendo hiki. <ref name="isbn0-88048-397-0">{{cite book|last=Healy|first=D|editor=Weissman MM|title=The treatment of depression: bridging the 21st century|url=http://books.google.com/?id=LAmBVolIG5kC|accessdate=2009-05-28|year=2001|publisher=American Psychiatric Pub|isbn=978-0-88048-397-1|pages=10–11|chapter=The Antidepressant Drama|chapterurl=http://books.google.co.uk/books?id=LAmBVolIG5kC&printsec=frontcover#PPA7,M1}}</ref> Tukio sawa na hili lilifanyika Paris, ambako Jean Delay, mkuu wa taaluma ya tiba ya magonjwa ya akili katika hospitali ya Sainte-Anne, aligundua madhara ya isoniazidi kutoka kwa wenzake wa taaluma ya magonjwa ya mpumuo katika hospitali ya Cochin. Katika mwaka wa 1952, kabla ya Lurie na Salzer, Delay, pamoja na mkaazi Jean-Francois Buisson, alitoa taarifa kuhusu athari chanya ya isoniazidi kwa wagonjwa waliofadhaika. <ref name="Healy96"> " {{cite book|last=Healy|first=David|title=The psychopharmacologists : interviews|accessdate=2009-05-28|year=c1996|publisher=Chapman and Hall|location=London|isbn=978-1-86036-008-4|page=8}}</ref> Kwa sababu zisizohusiana na ufanisi wake, matumizi ya isoniazidi kama dawamfadhaiko hatimaye yalitolewa maanani na kubadilishwa na dawa yenye sumu zaidi ya iproniazid, <ref name="isbn0-88048-397-0"/> ingawa bado ni msingi wa matibabu ya kifua kikuu. Njia ya utendakazi ya dawamfadhaiko ya isoniazidi bado haieleweki vyema. Inakisiwa kwamba athari zake zinatokana na kuzuiliwa kwa oksidesi diamini, pamoja na uzuiaji dhaifu wa oksidesi ya monoamini A. <ref name="isbn1-86036-010-6">{{cite book |author=Healy, David |title=The Psychopharmacologists: Volume 2 |url=https://archive.org/details/psychopharmacolo0000heal |publisher=A Hodder Arnold Publication |year=1998 |pages=[https://archive.org/details/psychopharmacolo0000heal/page/132 132]–4 |isbn=978-1-86036-010-7 }}</ref> Dawa nyingine ya kifua kikuu iliyojaribiwa wakati huohuo na Selikoff na Robitzek, iproniazidi, ilionyesha athari kuu zaidi za "kichocheaakili", lakini ilikuwa na kiwango cha juu zaidi cha kusumisha. Baada ya chapisho kuhusu isoniazidi, majarida ya Jackson Smith, Gordon Kamman, George Crane, na Frank Ayd yalijitokeza, yakieleza namna mbalimbali ambavyo dawa ya iproniazid inaweza kutumika kutibu magonjwa ya akili. Zeller Ernst alitambua kuwa dawa ya iproniazidi ni kizuia oksidesi ya monoamini yenye nguvu. <ref name="pmid18004120">{{cite journal |author=López-Muñoz F, Alamo C, Juckel G, Assion HJ |title=Half a century of antidepressant drugs: on the clinical introduction of monoamine oxidase inhibitors, tricyclics, and tetracyclics. Part I: monoamine oxidase inhibitors |url=https://archive.org/details/sim_journal-of-clinical-psychopharmacology_2007-12_27_6/page/555 |journal=J Clin Psychopharmacol |volume=27 |issue=6 |pages=555–9 |year=2007 |pmid=18004120 |doi=10.1097/jcp.0b013e3181bb617 }}</ref> Hata hivyo, dawa ya iproniazidi ilibaki pembeni kiasi hadi pale ambapo Nathan Kline, mkuu wa utafiti katika hospitali ya Rock state mwenye ushaufu na ushawishi mkuubwa, alianza kuieneza katika vyombo vya habari vya uuguzi na vile maarufu kama "changamsho la akili". <ref name="pmid18004120"/> <ref>{{cite news|title=Psychic Energizer|url=http://www.time.com/time/magazine/article/0,9171,862555,00.html|date=15 Aprili 1957|publisher=Time Magazine|accessdate=2009-05-28|archivedate=2013-08-11|archiveurl=https://web.archive.org/web/20130811223331/http://www.time.com/time/magazine/article/0%2C9171%2C862555%2C00.html}}</ref> Roche ilitia juhudi za uuzaji wa iproniazid, ikiwa ni pamoja na ukuzaji wa matumizi yake kutibu maradhi mengine bali na yale yaliyokusudiwa awali kwa kutibu mfadhaiko. <ref name="pmid18004120"/> Mauzo yake yalikuwa kwa kiasi kikubwa katika miaka iliyofuata, hadi pale ambapo zilibatilishwa kutoka sokoni mwaka wa 1961 kutokana na matukio kadhaa ya uharibifu wa ini unaobababisha mauti. <ref name="pmid18004120"/> === Dawa ya Imipramini === Ugunduzi kwamba mchanganyiko wa duara tatu ("wenye duara tatu") uliokuwa na athari kubwa kama dawamfadhaiko iliundwa kwa mara ya kwanza mwaka wa 1957 na Roland Kuhn katika hospitali ya magonjwa ya akili nchini Uswisi. Kufikia wakati huo, vinyumbuliwa vya kimaliza kemikali za mzio vilitumiwa zaidi kutibu mshtuko wa upasuaji na baadaye kama niuroleptiki ya magonjwa ya akili. Ingawa katika mwaka wa 1955 risapini ilionyeshwa kuwa bora zaidi kuliko kipozaungo kwa kupunguza niuroleptiki za mfadhaiko (kwa maana iliyo wazi, "kushika neva" au "kukamata neva") zilikuwa zinaundwa kama vitulizo na vizuia magonjwa ya akili. Akijaribu kuboresha ufanisi wa klorpromazini, Kuhn, akishirikiana na kampuni ya madawa ya Geigy, aligundua kwamba mchanganyiko "G 22355" (uliotengenezwa na kuwekwa chini ya amri ya serikali dhidi ya uigaji wake nchini Marekani katika mwaka wa 1951 na Häfliger na Schinder) ilikuwa na athari ya manufaa kwa wagonjwa wa mfadhaiko unaofuatana na kudumaa kwa mwendo. Kuhn kwanza aliripoti matokeo yake kuhusu kile alichokiita "thaimoleptiki" (kwa maana iliyo wazi, "kukamata hisia," kinyume na niuroleptiki, "kukamata neva") katika miaka ya 1955-56. Hatua kwa hatua, yaliimarishwa, na kusababisha uuzaji na ununuzi wa dawa ya kwanza dhidi ya mfadhaiko aina ya trisaikliki, imipramini, ambayo punde ilifuatwa na vibadala. === Historia ya baadaye === Tiba hizi mpya za dawa ziligeuka kuwa dawa zinazoagizwa na daktari katika miaka ya 1950. Ilikadiriwa kuwa watu chini ya 50-100 kwa kila watu milioni moja waliugua kutokana na aina ya mfadhaiko ambao dawa hizi mpya zingetibu, na makampuni ya dawa hayakuwa na hamu. Mauzo katika miaka ya 1960 yaliendelea kuwa ya kiwango cha chini yakilinganishwa na dawa muhimu za kutuliza maumivu (nyuroleptiki / vizuia magonjwa ya akili) na dawa hafifu za kutuliza maumivu (kama vile benzodiazepini), ambazo ziliuzwa kwa matumizi mbalimbali. <ref name="3faces">{{cite journal |author=Healy D |title=The three faces of the antidepressants: a critical commentary on the clinical-economic context of diagnosis |journal=J. Nerv. Ment. Dis. |volume=187 |issue=3 |pages=174–80 |year=1999 |month=Machi |pmid=10086474 |doi=10.1097/00005053-199903000-00007 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0022-3018&volume=187&issue=3&spage=174 |access-date=2010-10-18 |archive-date=2012-01-11 |archive-url=https://web.archive.org/web/20120111120405/http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0022-3018&volume=187&issue=3&spage=174 |dead-url=yes }}</ref> Imipramine ilibaki kwa matumizi ya kawaida na dawa zingine nyingi zilivumbuliwa. Uwanja wa vizuizi vya MAO ulikimya kwa miaka mingi hadi miundo "inayoweza kupinduliwa" na zinazoathiri tu aina ndogo ya MAO-A ziliingizwa, ili kuepuka baadhi ya athari mbaya. <ref name="3faces"/> <ref>{{cite journal |author=Pletscher A |title=The discovery of antidepressants: a winding path |journal=Experientia |volume=47 |issue=1 |pages=4–8 |year=1991 |month=Januari |pmid=1999242 |doi= 10.1007/BF02041242|url=}}</ref> Kufikia miaka ya 1960, wataalamu wengi wa madawa walifikiri kuwa kazi muhimu ya matibabu ya trisaikliki ilikuwa ni kuzuia ufyonyaji mpya wa norepinefrini, lakini hatua kwa hatua ilidhihirika kwamba kitendo hiki kilihusishwa na athari za uchangamshaji na uchochezi wa misuli ya mwendo, ilhali baadhi ya michanganyiko ya dawamfadhaiko zilionekana kuwa na athari tofauti kupitia utendaji katika mifumo ya serotonini (hasa iliyopendekezwa katika mwaka wa 1969 na Carlsson na Lindqvist pamoja na Lapin na Oxenkrug). Watafiti walianza mchakato wa ubunifu wa madawa ya razini ili kutenga michanganyiko iliyozalishwa kutoka kwa kimaliza kemikali za mzio ambazo zingelenga mifumo hii kwa njia ya uteuzi. Mchanganyiko wa kwanza kama huu kulindwa na serikali dhidi ya uigaji ilikuwa zimelidini katika mwaka wa 1971, ili hali ya kwanza kuidhinishwa kwa matumizi ilikuwa indalpini. Fluoxetini iliidhinishwa kwa matumizi ya kibiashara na ya Shirika la Chakula na Dawa (Marekani) mwaka wa 1988, na ikawa SSRI ya kwanza kupata umaarufu. Fluoksetini ilitengenezwa na Eli Lilly katika miaka ya awali ya 1970 akiwa pamoja na Bryan Molloy, David Wong na wengine. <ref>{{cite journal |author=Domino EF |title=History of modern psychopharmacology: a personal view with an emphasis on antidepressants |journal=Psychosom Med |volume=61 |issue=5 |pages=591–8 |year=1999 |pmid=10511010 |doi= |url=http://www.psychosomaticmedicine.org/cgi/pmidlookup?view=long&pmid=10511010}}</ref> <ref>{{cite journal |author=Wong DT, Bymaster FP, Horng JS, Molloy BB |title=A new selective inhibitor for uptake of serotonin into synaptosomes of rat brain: 3-(p-trifluoromethylphenoxy). N-methyl-3-phenylpropylamine |journal=J. Pharmacol. Exp. Ther. |volume=193 |issue=3 |pages=804–11 |year=1975 |month=Juni |pmid=1151730 |doi= |url=http://jpet.aspetjournals.org/cgi/pmidlookup?view=long&pmid=1151730 |access-date=2010-10-18 |archive-date=2021-11-19 |archive-url=https://web.archive.org/web/20211119145719/https://jpet.aspetjournals.org/content/193/3/804.long |dead-url=yes }}</ref> Ingawa ilipoteza umaarufu wake katika nchi nyingi kupitia karne za 19 na 20, mmea St John's Wort iliendelea kuwa maarufu nchini [[Ujerumani]], ambapo dondoo za Haiparikamu hatimaye ziliidhinishwa, zikafungwa katika vifurushi na uagizwa na madaktari. Majaribio ya ufanisi kwa kiwango kidogo yalifanywa katika miaka ya 1970 na 1980, na yalitiliwa maanani zaidi katika miaka ya 1990 kufuatia uchambuzi wa matokeo ya tafiti kadhaa kati ya majaribio haya. <ref>{{cite journal |author=Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, Melchart D |title=St John's wort for depression--an overview and meta-analysis of randomised clinical trials |journal=BMJ |volume=313 |issue=7052 |pages=253–8 |year=1996 |month=Agosti |pmid=8704532 |pmc=2351679 |doi= |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=8704532}}</ref> Ilibaki kuwa dawa inayoweza kuuzwa bila maelekezo ya daktari (OTC) au ya kuongezea katika nchi nyingi na utafiti uliendelea ili kuchunguza athari zake za nyurotransmita na vijenzi kazi, hasa hyperforini <ref>{{cite journal |author=Müller WE |title=Current St John's wort research from mode of action to clinical efficacy |journal=Pharmacol. Res. |volume=47 |issue=2 |pages=101–9 |year=2003 |month=Februari |pmid=12543057 |doi= 10.1016/S1043-6618(02)00266-9|url=http://linkinghub.elsevier.com/retrieve/pii/S1043661802002669}}</ref> SSRI zilikuja kuwa maarufu kama "dawamfadhaiko mpya" pamoja na dawa nyingine mpya zaidi kama vile SNRI na NRI zilizokwa na athari mbalimbali teuzi, kama vile venlafaksini, duloksetini, nefazodoni na mitazapini. <ref>{{cite journal | last = Freeman | first = H | year = 1996 | url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VM1-3WJNNMF-TX&_coverDate=12%2F31%2F1996&_alid=513741720&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=6137&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=72e4e5cb18384ee1f4f599ed1080eda7 | title = Tolerability and safety of novel antidepressants | journal = European Psychiatry | volume = 11 | issue = supplement 4 | pages = 206 | doi = 10.1016/0924-9338(96)88597-X | access-date = 2010-10-18 | archive-date = 2008-12-06 | archive-url = https://web.archive.org/web/20081206232457/http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VM1-3WJNNMF-TX&_coverDate=12%2F31%2F1996&_alid=513741720&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=6137&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=72e4e5cb18384ee1f4f599ed1080eda7 | dead-url = yes }}</ref> == Aina za dawamfadhaiko == === Vizuizi chaguzi vya uchukuzi wa serotonini (SSRIs) === ''Vizuizi chaguzi vya uchukuzi wa serotonini'' (SSRIs) ni aina ya dawamfadhaiko zinazozingatiwa kama matibabu ya madawa ya kiwango cha kisasa. Yamkini chanzo kimoja cha mfadhaiko ni kiwango kisichotosha cha serotonini, kemikali inayotumika kwenye ubongo kuhamisha ishara kutoka niuroni moja hadi nyingine. Inaaminika kuwa SSRI hufanya kazi kwa kuzuia ufyonyaji upya wa serotonini (inayojulikana pia kama 5 haidroksitriptamini, au 5-HT) kupitia niuroni ya mwanya wa sinapati, na hivyo kudumisha viwango vya juu vya 5-HT katika sinepsi. Wataalamu wa kemia Klaus Schmiegel na Bryan Molloy wa Eli Lilly waligundua fluoksetini ya SSRI ya kwanza. Kategoria hii ya madawa ni pamoja na: *Sitalopramu (Celexa, Cipramili) *Eskitalopramu (Lexapro, Cipralex, Seroplex, Lexamili) *Fluoksetini (Prozak, Sarafemu, Symbyax) *Fluvoksamini (Luvox) *Paroksetini (Paxili, Aropax) *Satralini (Zoloft) Kwa kawaida, dawamfadhaiko hizi huwa na athari chache zaidi ikilinganishwa na zile za duara tatu au MAOI, ingawa athari kama kizunguzungu, kinywa kikavu, woga, wasiwasi, kukosa usingizi, kupungua kwa hamu ya chakula, kuongeza uzito kwa muda mrefu na kupunguka kwa uwezo kujamiiana huweza kutokea. Baadhi ya athari zinaweza kupungua kulingana na namna ambavyo mtu anazoea dawa, lakini huenda athari zingine zikaendelea. Ingawa ni salama kuliko kizazi cha kwanza cha dawamfadhaiko, SSRI huenda zisitibu wagonjwa wengi ikilinganishwa na kategoria za awali za dawamfadhaiko, {{Citation needed|date=Mei 2009}} na hivyo kupendekeza kuwa jukumu la norepinefrini katika matibabu ya mfadhaiko bado ni muhimu. Kazi ya watafiti wawili imeibua suala la uhusiano kati ya upungufu wa serotonini na dalili za mfadhaiko, ikibainisha kuwa utendakazi bora wa SSRI kama dawa ya matibabu pekee haithibitishi uhusiano huo. <ref>{{cite journal |author=Lacasse J, Leo J |title=Serotonin and depression: a disconnect between the advertisements and the scientific literature |journal=PLoS Med |volume=2 |issue=12 |pages=e392 |year=2005 |pmid=16268734 |doi=10.1371/journal.pmed.0020392 |pmc=1277931}} ''[http://medicine.plosjournals.org/perlserv/?request=get-document&amp;doi=10.1371/journal.pmed.0020392 Maelezo kamili] {{Wayback|url=http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0020392 |date=20090122081424 }}''</ref> Utafiti unaonyesha kuwa dawa hizi zinaweza kuingiliana na vipengele vya unukuzi vinavyojulikana kama "jeni za saa" <ref>{{cite journal |author=Uz T, Ahmed R, Akhisaroglu M, Kurtuncu M, Imbesi M, Dirim Arslan A, Manev H |title=Effect of fluoxetine and cocaine on the expression of clock genes in the mouse hippocampus and striatum |journal=Neuroscience |volume=134 |issue=4 |pages=1309–16 |year=2005 |pmid=15994025 |doi=10.1016/j.neuroscience.2005.05.003}}</ref>, zinazoweza kuchangia pakubwa kwa tabia ya uzoefu wa madawa ya kulevya (matumizi mabaya ya madawa), na huenda pia ikasababisha unene wa kupindukia. <ref>{{cite journal |author=Yuferov V, Butelman E, Kreek M |title=Biological clock: biological clocks may modulate drug addiction |journal=Eur J Hum Genet |volume=13 |issue=10 |pages=1101–3 |year=2005 |pmid=16094306 |doi=10.1038/sj.ejhg.5201483}}</ref> <ref> {{cite journal |author=Manev H, Uz T |title=Clock genes as a link between addiction and obesity |journal=Eur J Hum Genet |volume=14 |issue=1 |page=5 |year=2006 |pmid=16288309 |doi=10.1038/sj.ejhg.5201524}} ''[http://www.nature.com/ejhg/journal/v13/n10/full/5201483a.html Maelezo kamili]'' </ref> Majaribio yaliyodhibitiwa na yasiyo na utaratibu maalumu yaliyochapishwa katika Hifadhi za nyaraka za taaluma ya jumla ya tiba ya magonjwa ya akili yalionyesha kuwa hadi moja kati ya tatu ya athari za matibabu ya SSRI yanaweza kuonekana katika wiki ya kwanza. Athari hizi za awali pia zimeonyesha kuongeza upungufu kamili wa alama za HRSD kwa 50%. === Vizuizi vya ufyonyaji upya wa serotonini-norepinefrini (SNRIs) === ''Vizuizi vya ufyonyaji upya wa serotonini-norepinefrini'' (SNRIs) ni aina mpya ya dawamfadhaiko zinazofanya kazi na norepinefrini na 5-HT zote. Kwa kawaida dawa hizi zina athari sawa na SSRIs, ingawa zinaweza kusababisha athari zinazotokana na kutoendelea kuzitumia na jambo hili linaweza kulazimisha kupunguzwa polepole kwa kipimo cha dawa. Hizi ni pamoja na: *Desvenlafaksini (Pristiq) *Duloksetini (Cymbalta) *Milnasipramu (Ixel) *Venlafaksini (Effexor) === Dawamfadhaiko za norepinefrini na zinazotoa serotonini (NaSSAs) === Dawamfadhaiko za norepinefrini na zinazotoa serotonini (NaSSAs) zinaunda kategoria mpya zaidi ya dawamfadhaiko ambayo inaaminika inatenda kazi kwa kuongeza norepinefrini (noradrenalini) na uhamishaji wa serotonini kati ya niuroni kwa kuzuia vipokezi vya adrenaji vya mwanya wa sinapati alfa 2 na kwa wakati huo huo kuzuia vipokezi fulani vya serotonini. <ref> http://www.cnsforum.com/imagebank/item/Drug_nassa/default.aspx</ref> Athari ni pamoja kizunguzungu, kuongezeka kwa hamu ya chakula, na kuongezeka kwa uzito. <ref name="Stimmel">{{cite journal|last=Stimmel |first=GL|year=1997|month=Jan-Feb|title=Mirtazapine: an antidepressant with noradrenergic and specific serotonergic effects|url=https://archive.org/details/sim_pharmacotherapy_january-february-1997_17_1/page/10 |journal=Pharmacotherapy|volume=17|issue=1|pages=10–21|publisher=American College of Clinical Pharmacy|issn=0277-0008|pmid=9017762|accessdate=2009-05-28|last2=Dopheide|first2=JA|last3=Stahl|first3=SM}}</ref> Mifano ni pamoja na: *Mianserini (Tolvon) *Mirtazapini (Remeron, Avanza, Zispin) === Vizuizi vya ufyonyaji upya wa Norepinefrini (NRIs) === ''Vizuizi vya ufyonyaji upya wa Norepinefrini'' (NRIs) hutenda kazi kupitia norepinefrini (inayojulikana pia kama ''noradrenalini).'' NRIs zinadhaniwa kuwa na athari chanya hasa kwa umakini na motisha. Hivi ni pamoja na: *Atomoksetini (Strattera) *Mazindoli (Mazanor, Sanorex) *Reboksetini (Edronax) *Viloksazini (Vivalan) === Vizuizi vya ufyonyaji upya wa Norepinefrini na dopamini (NDRIs) === ''Vizuizi vya ufyonyaji upya wa Norepinefrini na dopamini'' huzuia na ufyonyaji upya wa dopamini na norepinefrini (noradrenalini). <ref>{{cite journal|last=Stahl|first=SM|year=2004|title=A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor|journal=Prim Care Companion J Clin Psychiatry|volume=6|issue=4|pages=159–166|publisher=Physicians Postgraduate Press|pmc=514842|accessdate=2009-05-28|doi=10.4088/PCC.v06n0403|pmid=15361919|last2=Pradko|first2=JF|last3=Haight|first3=BR|last4=Modell|first4=JG|last5=Rockett|first5=CB|last6=Learned-Coughlin|first6=S}}</ref> Hivi ni pamoja na: *Bupropioni (Wellbutrini, Zybani) === Vizidishi chaguzi vya ufyonyaji upya wa Serotonini (SSREs) === *Tianeptini (Stablon, Coaxil, Tatinol) === Viondoa vizuizi vya ufyonyaji upya wa Norepinefrini na dopamini (NDDIs) === Viondoa vizuizi vya ufyonyaji upya wa Norepinefrini na dopamini (NDDIs) hutenda kazi kwa kupingana na kipokezi cha serotonini cha 5-HT2C ambacho kwa kawaida huzuia kuondolewa kwa norepinefrini na dopamini, na hivyo kuendeleza mbubujiko wa nyurotransmita hizi. *Agomelatini (Valdoxan, Melitor, Thymanax) === Dawa dhidi ya mfadhaiko aina ya Trisaikliki (TCAs) === ''Dawa dhidi ya mfadhaiko aina ya Trisaikliki'' ni kategoria nzee zaidi ya dawa za dawamfadhaiko. Dawa za Trisaikliki huziba ufyonyaji upya wa nyurotransmita fulani kama vile norepinefrini (noradrenalini) na serotonini. Hazitumiki sana kutokana na uvumbuzi wa madawa salama zaidi na yenye uwezo zaidi wa kuchagua. Madhara ni pamoja na kuongezeka kwa kiwango cha upigaji [[Moyo|moyo]], kuzinzia, mdomo mkavu, uyabisi wa tumbo, uwekaji wa mkojo, kiwaa, kizunguzungu, kuchanganyikiwa, na utendakazi mbaya wa kingono. Kiwango cha sumu hutokea wakati takriban mara kumi ya kipimo cha kawaida cha dawa kinapofikiwa. Mara nyingi madawa haya husababisha mauti yakizidisha kiasi cha dawa kinachohitajika, na yanaweza kusababisha arithimia mbaya. Hata hivyo, dawa za dawamfadhaiko aina ya trisaikliki bado zinatumika kutokana na ufanisi wao, hasa katika matukio mabaya ya mfadhaiko mkuu. Hizi ni pamoja na: '''Dawamfadhaiko za kiwango cha juu aina ya trisaikliki amini''' *Amitriptailini (Elavil, Endep) *Klomipramini (Anafranili) *Doksepini (Adapini, Sinequani) *Imipramini (Tofranili) *Trimipramini (Surmontil) '''Dawamfadhaiko za kiwango cha kati aina ya trisaikliki amini''' *Desipramini (Norpramini) *Nortriptailini (Pamelor, Aventili, Noritreni) *Protriptailini (Vivactili) === Kizuizi cha oksidesi ya monoamini (MAOIs) === ''Vizuizi vya oksidesi ya monoamini'' (MAOIs) vinaweza kutumika ikiwa dawa zingine za dawamfadhaiko hazijafaulu kufanya kazi. MAOIs hufanya kazi za kuzuia kimeng'enya cha oksidesi ya monoamini inayovunja nyurotransmita dopamini, serotonini, na norepinefrini (noradrenalini). Kutokana na uwezekano wa mwingiliano unaoweza kusababisha kifo kati ya kategoria hii ya madawa na vyakula fulani (hasa vile vyenye tairamini), pamoja na baadhi ya madawa, MAOIs za zamani huagizwa mara chache zaidi siku hizi. Hata hivyo, Emsam,dawa yenye muundo wa kiraka wa selegilini inayopitia kwenye ngozi, ni tofauti. Kutokana na ukwepaji wake wa tumbo, ina uwezekano mdogo zaidi wa kusababisha matukio sawa na yale ya madawa mengine katika kikundi cha MAOIs. <ref name="Cascade01">{{cite journal |author=Cascade EF, Kalali AH |journal=Psychiatry 2007 |month=Juni |year=2007 |title=EMSAM: The First Year |url=http://www.psychiatrymmc.com/emsam-the-first-year/ |accessdate=2009-11-30 |archive-date=2010-02-28 |archive-url=https://web.archive.org/web/20100228220220/http://www.psychiatrymmc.com/emsam-the-first-year/ |dead-url=yes }}</ref> Madawa ya MAOIs yanaweza kuleta matokeo bora sawa na yale ya madawa dhidi ya dawamfadhaiko aina ya tricyclic, ingawa kwa ujumla hayatumiki sana kwa sababu yamerekodi matukio mengi zaidi ya athari hatari na kuathiriana. Kizazi kipya cha MAOIs kimeanzishwa; moklobemidi (Manerix), inayojulikana kama kizuizi kinachopindulika cha oksidesi ya monoamini A RIMA), na kinafanya kazi kwa kipindi kifupi zaidi na kwa njia ya kuchagua na haihitaji chakula maalum. Kikundi cha madawa ya MAOI ni pamoja na: *Aisokaboksazidi (Marplan) *Moklobemidi (Aurorix, Manerix) *Fenilzini (Nardili) *Selegilini (Eldepryl, Emsamu) *Tranilsaipromini (Parnati) === Dawa za Kukuza === Imetambulika kuwa baadhi ya dawa za mfadhaiko zinafanya kazi vizuri zaidi kwa wagonjwa wengine yakitumiwa pamoja na dawa zingine. Dawa kama hizo za "kukuza" ni pamoja na: *Buspironi (Buspar) *Gepironi (Ariza) *Nefazodoni (Serzoni) *Tandospironi (Sedieli) *Trazodoni (Desyreli) *Bupropioni (Wellbutrini / Zybani) ''Vitulizo na vipozo'', hasa vile vya benzodiazepini, huagizwa kwa kupunguza wasiwasi na kuleta usingizi. Kwa sababu ya hatari kubwa ya utegemezi, dawa hizi zinanuiwa kutumika kwa kipindi kifupi au mara chache pekee. Mara nyingi madawa huwa hayatumiki kwa utendakazi wao msingi, bali kwa ajili ya kutumia kile ambacho kwa kawaida ni athari yao. Fumarati ya Kwetiapini (Seroquel) imebuniwa kimsingi kwa kutibu skizofrenia na ugonjwa wa furaha-mfadhaiko, lakini mara kwa mara husababisha kusinzia kutokana na mshikamano wake na vipokezi vya histamini (H1 na H2); na hivyo inatumia madhara sawa na kidhibiti mzio wa hewa (Benadryl). ''Vizuia magonjwa ya akili'' kama vile risperidoni (Risperdal), olanzapini (Zyprexa), na kwetiapini (Seroqueli) yanaagizwa kama vidhibiti halihisi ya moyo na kwa kutibu wasiwasi. Matumizi yao kama vidhibiti halihisi ya moyo ni jambo la hivi karibuni, na limeibua utata kati ya wagonjwa wengine. Vizuia magonjwa ya akili, viwe ni vya kawaida au visokawaida vinaweza pia kuagizwa ili kukuza dawamfadhaiko, kuongeza ukolezi kwenye damu wa dawa nyingine, au kupunguza dalili za kichaa au za wazimu ambazo mara nyingi huandamana na mfadhaiko wa kimawazo. Hata hivyo, vinaweza kusababisha madhara makubwa, hasa vikichukuliwa kwa vipimo vya juu. Madhara ni pamoja na Kiwaa, mkazoghafla wa misuli, kutotulia, kutoweza kusongeza viungo kwenye dalili zinazoonekana polepole, na kuongezeka kwa uzito. Vichocheaakili wakati mwingine huongezwa kwenye utaratibu wa matibabu dhidi ya mfadhaiko ikiwa mgonjwa anaugua kutokana na anihedonia, na kulala kupindukia na/ au kula kupindukia pamoja na kiwango cha chini cha motisha. Dalili hizi ni za kawaida kwa mfadhaiko usio wa kawaida, na zinaweza kutatuliwa kwa kuongeza kipimo cha chini hadi wastani cha amfetamini (Adderall), methylphenidate (Ritalin) au modafinili (Provigil, Alertec), kwa kuwa kemikali hizi zinaweza kuongeza motisha na kuboresha maingiliano ya kijamii, na kuzuia hamu ya chakula na usingizi. Modafinili ni ya kipekee kutokana na athari zake kwa usingizi: inaongeza umakini na kupunguza kizunguzungu wakati mgonjwa yuko macho, lakini haizuii kulala kwa kawaida. Dawa hizi pia zinaweza kurejesha msukumo wa ngono, ingawa hii ni athari hasi na sio sababu ya kuagizwa kwa vichocheaakili. Hata hivyo, tahadhari ni lazima ichukuliwe vikitumika kwa watu fulani. Vichangamsha vimetambuliwa kuchokonoa vipindi vya wazimu kwa watu wanaougua maradhi ya hisia mseto. Usimamizi wa karibu unasisitizwa kwa walio na matatizo ya matumizi mabaya ya dawa. Wagonjwa wenye mhemuko unaobadilika kwa urahisi wanapaswa kujiepusha na vichangamsha kwa kuwa vinatibua kubadilika kwa halihisi ya moyo. ''Lithiamu'' bado ndiyo tiba ya kiwango kilichokubalika kutibu maradhi ya hisia mseto, na mara nyingi hutumika pamoja na madawa mengine, ikitegemea ikiwa kinachotibiwa ni wazimu au mfadhaiko. Madhara ya Lithiamu ambayo huenda yakajitokeza ni pamoja na kiu, kutetemeka,udhaifu, kichefuchefu na kuendesha. Baadhi ya kinza-msukosuko, kama vile kabamazefini (Tegretol), valiproati ya sodiamu (Epilim), na lamotrijini (Lamictal), pia hutumika kama vidhibiti halihisi ya moyo, hasa kwa kutibu maradhi ya hisia mseto. Lithiamu na lamotrijini zote pia zimechunguzwa na kutumika kwa kukuza dawa dhidi ya dawamfadhaiko katika matibabu ya mfadhaiko sugu ya hisia aina moja. == Mikondo ya uagizaji dawa == Nchini Uingereza matumizi ya dawamfadhaiko yameongezeka kwa 234% katika kipindi cha miaka 10 kufikia mwaka wa 2002. <ref>[74] ^ (Taasisi ya Kitaifa ya Ubora wa Matibabu, 2004)</ref> Nchini Marekani, ripoti huru iliyotolewa mwaka wa 2005 ilionyesha kuwa 11% ya wanawake na 5% ya wanaume wasioishi katika nyumba za utunzaji wa wenye mahitaji maalum (2002) hutumia dawamfadhaiko. <ref>[http://www.meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical%20Brief&amp;opt=2&amp;id=685 ] {{Wayback|url=http://www.meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical%20Brief&opt=2&id=685 |date=20250626193041 }} Stagnitti, M. (2005) Matumizi ya Dawamfadhaiko kati ya wananchi wa Marekani wasio katika vyumba vya ustawi wa jamii, 2002. Takwimu fupi # 77. Rockville, MD: Jopo la Matumizi ya pesa kwa Uuguzi, Shirika la Utafiti kuhusu Ubora wa Huduma za Afya.</ref> Uchunguzi uliofanywa mwaka wa 1998 uligundua kuwa 67% ya wagonjwa waliotambuliwa kuwa na mfadhaiko waliagiziwa dawamfadhaiko. <ref>{{cite journal |author=Sleath B, Shih YC |title=Sociological influences on antidepressant prescribing |url=https://archive.org/details/sim_social-science-medicine_2003-03_56_6/page/1335 |journal=Soc Sci Med |volume=56 |issue=6 |pages=1335–44 |year=2003 |month=Machi |pmid=12600369 |doi=10.1016/S0277-9536(02)00132-6 }}</ref> Utafiti uliofanywa mwaka wa 2007 ulionyesha kuwa 25% ya Wamarekani walitambulishwa kuwa na ugonjwa wa mfadhaiko zaidi ya idadi kamili iliyougua ugonjwa huo, hata bila kuzingatia matibabu yoyote.<ref>{{cite news|title=Depression could be overdiagnosed|url=http://www.heraldnet.com/article/20070403/NEWS02/704030755|agency=The Washington Post|publisher=HeraldNet|year=2007|month=Aprili|accessdate=2009-05-28}}</ref> Msingi wa matokeo haya yalikuwa ni utafiti wa kitaifa wa watu 8,098. Utafiti uliofanywa mwaka wa 2002 ulitambua kuwa karibu 3.5% ya watu wote nchini [[Ufaransa]] walikuwa wakiagiziwa dawamfadhaiko, ikilinganishwa na 1.7% mwaka wa 1992. Mara nyingi dawa hizi huagizwa bila kuzingatia amri wala miongozo <ref name="Ol">{{cite journal|last=Olié|first=JP|year=2002|month=Oktoba|title=Antidepressants consumption in the global population in France|journal=L'Encéphale|volume=28|issue=5 pt. 1|pages=411–7|publisher=Elsevier|pmid=12386542 |doi=ENC-10-2002-28-5-0013-7006-101019-ART4|accessdate=2009-05-29|language=French|doi_brokendate=2009-10-24|last2=Elomari|first2=F|last3=Spadone|first3=C|last4=Lépine|first4=JP}}</ref> Kati ya mwaka wa 1996 na 2004 katika [[British Kolumbia|British Columbia]], matumizi ya dawamfadhaiko yaliongezeka kutoka 3.4% hadi 7.2% ya wananchi. <ref>{{cite journal|last=Raymond|first=CB|year=2007|month=Januari|title=Antidepressant utilization in British Columbia from 1996 to 2004: increasing prevalence but not incidence|url=https://archive.org/details/sim_psychiatric-services_2007-01_58_1/page/79|journal=Psychiatric Services|volume=58|issue=1|pages=79–84|publisher=American Psychiatric Association|pmid=17215416|doi=10.1176/appi.ps.58.1.79|accessdate=2009-05-29|last2=Morgan|first2=SG|last3=Caetano|first3=PA}}</ref> Takwimu ya mwaka wa 1992 hadi 2001 kutoka [[Uholanzi]] ulionyesha ongezeko la kiwango cha maagizo ya SSRIs, na kuongezeka kwa muda wa matibabu. <ref>{{cite journal |author=Meijer W, Heerdink E, Leufkens H, Herings R, Egberts A, Nolen W |title=Incidence and determinants of long-term use of antidepressants |journal=Eur J Clin Pharmacol |volume=60 |issue=1 |pages=57–61 |year=2004 |pmid=14985889 |doi=10.1007/s00228-004-0726-3}}</ref> Utafiti unaonyesha kwamba matumizi ya dawamfadhaiko, hasa ya SSRIs, yameongezeka kwa haraka katika nchi nyingi zilizoendelea. Jambo hili linaendeshwa na kuongezeka kwa ufahamu kuhusu mfadhaiko pamoja na matangazo ya kibiashara kuhusu dawa mpya za dawamfadhaiko. <ref>{{cite journal |author=McManus P, Mant A, Mitchell PB, Montgomery WS, Marley J, Auland ME |title=Recent trends in the use of antidepressant drugs in Australia, 1990-1998 |url=https://archive.org/details/sim_medical-journal-of-australia_2000-11-06_173_9/page/n10 |journal=Med. J. Aust. |volume=173 |issue=9 |pages=458–61 |year=2000 |month=Novemba |pmid=11149300 }}</ref> Dawamfadhaiko pia zinazidi kutumiwa duniani kote kwa kutibu wagonjwa wasio na mfadhaiko na utafiti unaendelea kuonyesha uwezo wa sifa za dawamfadhaiko wa kubadili hali ya kinga mwilini, kutuliza maumivu, na kuzuia uvimbe. Uchaguzi wa aina fulai ya dawamfadhaiko unaripotiwa kufanyika kwa misingi isiyokuwa na ushahidi wa utafiti wa tofauti katika utendakazi, ili kuepuka athari fulani na kuzingatia magonjwa ambatani ya akili (yanayojitokeza kwa wakati mmoja), dalili maalumu ya ugonjwa na historia kabla ya matibabu. <ref>{{cite journal|last=Zimmerman|first=M|year=2004|month=Julai|title=Which factors influence psychiatrists' selection of antidepressants?|journal=American Journal of Psychiatry|volume=161|issue=7|pages=1285–9|publisher=American Psychiatric Association|pmid=15229063|url=http://ajp.psychiatryonline.org/cgi/content/full/161/7/1285|accessdate=2009-05-29|doi=10.1176/appi.ajp.161.7.1285|last2=Posternak|first2=M|last3=Friedman|first3=M|last4=Attiullah|first4=N|last5=Baymiller|first5=S|last6=Boland|first6=R|last7=Berlowitz|first7=S|last8=Rahman|first8=S|last9=Uy|first9=K|archive-date=2008-09-26|archive-url=https://web.archive.org/web/20080926121035/http://ajp.psychiatryonline.org/cgi/content/full/161/7/1285|url-status=dead}}</ref> Pia imeripotiwa kwamba, licha ya ushahidi babaishi unaoonyesha tofauti kubwa ya utendakazi kati ya dawamfadhaiko za awali na zile za karibuni zaidi, matabibu wanaona kuwa madawa mapya zaidi, ikiwa ni pamoja na SSRIs na SNRIs, yana ufanisi zaidi kuliko dawa za awali (dawa dhidi ya dawamfadhaiko aina ya trisaikliki na MAOIs). <ref>{{cite journal|last=Petersen|first=T|year=2002|month=Januari|title=A survey of prescribing practices in the treatment of depression|journal=Progress in Neuro-Psychopharmacology and Biological Psychiatry|volume=26|issue=1|pages=177–87|publisher=Elsevier|pmid=11853110|doi=10.1016/S0278-5846(01)00250-0 |accessdate=2009-05-29|last2=Dording|first2=C|last3=Neault|first3=NB|last4=Kornbluh|first4=R|last5=Alpert|first5=JE|last6=Nierenberg|first6=AA|last7=Rosenbaum|first7=JF|last8=Fava|first8=M}}</ref> Utafiti nchini Uingereza ulionyesha kwamba madaktari wa kiume walikuwa na uwezekano mkubwa zaidi wa kuagiza dawamfadhaiko kuliko madaktari wa kike. <ref>{{cite news|title=Male GPs depression pills 'bias' |url=http://news.bbc.co.uk/1/hi/health/4704053.stm|date=21 Julai 2005|publisher=BBC News|accessdate=2009-05-29}}</ref> Idadi ya dawamfadhaiko iliyoagizwa na NHS nchini Uingereza iliongezeka karibu mara dufu katika kipindi cha mwongo mmoja, kulingana na ripoti ya serikali katika mwaka wa 2010. Aidha idadi iliongezeka sana katika mwaka wa 2009 wakati maagizo milioni 39.1 yalitolewa ikilinganishwa na milioni 20.1 mwaka wa 1999. Pia, madaktari walitoa maagizo ya dawa milioni 3.18 zaidi mwaka wa 2009 kuliko mwaka wa 2008. Wizara za afya ziliamimi kuwa ongezeko hili kwa kiwango fulani lilitokana na kuzorota kwa uchumi. Hata hivyo, sababu nyingine ni pamoja na kuboreshwa kwa mchakato wa utambuzi wa magonjwa, na kupunguka kwa unyanyapaa kwa magonjwa ya akili, na dhiki zaidi iliyosababishwa na kuzorota kwa uchumi. Aidha, wasiwasi wa madaktari ni kuwa baadhi ya watu wanaoonyesha dalili kidogo zaidi za mfadhaiko wanaagiziwa dawa zisizohitajika kutokana na ukosefu wa chaguo zingine ikiwa ni pamoja na tiba kwa njia ya kuzungumza, kupata ushauri na tabia ya utambuzi wa tabia. Kipengele kimoja kingine ambacho huenda kinaongeza matumizi ya dawamfadhaiko ni kwamba dawa hizi sasa zinatumiwa kutibu magonjwa mengine ikiwa ni pamoja na wasiwasi wa kijamii na dhiki baada ya kiwewe. <ref>{{cite news|url=http://www.guardian.co.uk/society/2010/jun/11/antidepressant-prescriptions-rise-nhs-recession| title=Antidepressant Use Rises as Recession Feeds Wave of Worry|date=2010-06-11|accessdate= 2010-07-01 | location=London | work=The Guardian | first=Rowenna | last=Davis}}</ref> Matumizi ya dawamfadhaiko nchini Marekani yameongezeka mara dufu katika mwongo mmoja, kutoka mwaka wa 1996 hadi 2005. Dawamfadhaiko ziliagizwa kwa watu milioni 13 katika mwaka wa 1996 na kwa watu milioni 27 kufikia mwaka wa 2005. Katika mwaka wa 2008, zaidi ya maagizo milioni 164 yaliandikwa. Katika kipindi hiki, kulikuwa na uwezekano wa chini zaidi kwa wagonjwa kupitia matibabu ya kisaikolojia. <ref>{{cite news|url=http://www.reuters.com/article/idUSTRE5725E720090804| title=Antidepressant Use Doubles in U.S., Study Finds|date=2009-08-04|accessdate= 2010-07-01 | work=Reuters}}</ref> === Dawamfadhaiko zilizoagizwa zaidi === [[Picha:Escitalopram2DACS.svg|thumb|right|Fomula ya muundo wa eskitalopramu ya SSRI, katika hali yake ya msingi ya bure.]] Dawamfadhaiko zilizoagizwa zaidi katika soko la Marekani katika mwaka wa 2007 <ref>Idadi ya maagizo ilikadiriwa kama jumla ya maagizo kwa madawa yanayolingana ya mwigo na asilia kwa kutumia data kutoka kwa chati kwa majina ya madawa ya mwigo na asilidawa brand-generiska. {{cite web | title = Top 200 generic drugs by units in 2007. | work = Drug Topics, 18 Februari 2008 | url = http://drugtopics.modernmedicine.com/drugtopics/Top200Drugs/ArticleStandard/article/detail/491194 | accessdate = 2008-10-23 | archivedate = 2009-07-18 | archiveurl = https://web.archive.org/web/20090718184023/http://drugtopics.modernmedicine.com/drugtopics/Top200Drugs/ArticleStandard/article/detail/491194 }} {{cite web | title = Top 200 brand drugs by units in 2007. | work = Drug Topics, 18 Februari 2008 | url = http://drugtopics.modernmedicine.com/drugtopics/PharmacyFactsAndFigures/ArticleStandard/article/detail/491210 | accessdate = 2008-10-23 }}</ref> zilikuwa: {| class="wikitable sortable" border="1" |- ! Dawa ! Chapa ya dawa ! Kategoria ! Maagizo ya mwaka wa 2007 (kwa milioni) |- | Satralini | Zoloft | SSRI | 29.652 |- | Eskitalopramu | Lexapro | SSRI | 27.023 |- | Fluksetini | Prozac | SSRI | 22.266 |- | Bupropioni | Wellbutrin | NDRI | 20.184 |- | Paroksetini | Paxili | SSRI | 18.141 |- | Venlafaksini | Effexor | SNRI | 17.200 |- | Sitalopramu | Celexa | SSRI | 16.246 |- | Trazodoni | Desyrel | SARI | 15.473 |- | Amitriptailini | Elavil | TCA | 13.462 |- | Duloksetini | Cymbalta | SNRI | 12.551 |- | Mitazapini | Remeron | TCA | 5.129 |- | Nortriptailini | Pamelor | TCA | 3.105 |- | Imipramini | Tofranil | TCA | 1.524 |} Dawamfadhaiko zilizoagizwa zaidi nchini Ujerumani zinaripotiwa kuwa ni (minyopoo kolezi ya) hypericum perforatum (St John's Wort). <ref>{{cite book|last=Tyler|first=VE|editor=Janick J|title=Perspectives on New Crops and New Uses|url=http://www.hort.purdue.edu/newcrop/proceedings1999/|accessdate=2009-05-29|year=1999|publisher=ASHS Press|isbn=978-0-9615027-0-6|pages=528|chapter=Herbs Affecting the Central Nervous System|chapterurl=http://www.hort.purdue.edu/newcrop/proceedings1999/v4-442.html}}</ref> Nchini Uholanzi, paroksetini, inayouzwa kama Seroxat kati ya dawa zisizo asilia, ndiyo dawamfadhaiko inayoagizwa zaidi, ikifuatiwa na dawamfadhaiko aina ya trisaikliki inayoitwa amitriptailini, Sitalopramu na venlafaksini. <ref>{{cite web |url=http://www.gipdatabank.nl/index.asp?scherm=tabellenFrameSet&infoType=g&tabel=01-basis&item=N06AB |title=GIPdatabank |publisher=Gipdatabank.nl |date= |accessdate=2008-11-06 |archiveurl=https://web.archive.org/web/20081206123718/http://www.gipdatabank.nl/index.asp?scherm=tabellenFrameSet&infoType=g&tabel=01-basis&item=N06AB |archivedate=2008-12-06 |https://web.archive.org/web/20081206123718/http://www.gipdatabank.nl/index.asp?scherm=tabellenFrameSet&infoType=g&tabel=01-basis&item=N06AB |=https://web.archive.org/web/20081206123718/http://www.gipdatabank.nl/index.asp?scherm=tabellenFrameSet&infoType=g&tabel=01-basis&item=N06AB }}</ref> === Utaratibu wa utendakazi === Athari za matibabu za dawamfadhaiko zinaaminika kuwa zinasababishwa na madhara kwa nyurotransmita na upitishaji wa msukumo. Nadharia tete ya Monoamini ni nadharia ya bayolojia inayosema kuwa mfadhaiko unasababishwa na kiwango cha chini cha utendaji wa monoamini katika ubongo, kama vile dopamini, serotonini, na norepinefrini. Katika miaka ya 1950, vizuizi vya oksidesi ya monoamini (MAOIs) na madawa dhidi ya mfadhaiko aina ya tricyclic ziligunduliwa kimakosa kuwa na ufanisi katika matibabu ya mfadhaiko. Matokeo haya na ushahidi mwingine egemezi yalimfanya Joseph Schildkraut achapishe makala yake yanayoitwa "The Catecholamine Hypothesis of Affective Disorders" katika mwaka wa 1965. Schildkraut alihusisha viwango vya chini ya nyurotransmita na mfadhaiko. Utafiti kuhusu magonjwa mengine ya akili kama vile skizofrenia pia yalitambua kuwa kiwango cha chini cha shughuli za kifisiolojia za baadhi ya nyurotransmita zilihusishwa na matatizo hayo. Nadharia tete hii imelengwa sana katika utafiti wa ngazi za pathofisiolojia na kutibu magonjwa kwa utumia dawa kwa zaidi ya miaka 25. Vizuizi vya oksidesi ya monoamini (MAOIs) huzuia uvunjaji wa nyurotransmita za monoamini serotonini, norepinefrini, na dopamini kwa kuzuia [[kimeng'enya]] oksidesi ya monoamini, na hivyo kusababisha kuongezeka kwa ukolezi wa nyurotransmita hizi katika ubongo na kuongezeka kwa upitishaji wa msukumo. Dawamfadhaiko aina ya trisaikliki (TCAs) huzuia ufyonyaji upya wa nyurotransmita mbalimbali, ikiwa ni pamoja na serotonini norepinefrini, na kwa kiwango kidogo zaidi dopamini. Siku hizi dawamfadhaiko zinazotumiwa zaidi ni kizuizi cha uchukuzi wa serotonini kinachochagua (SSRIs), ambazo huzuia ufyonyaji upya wa serotonini (na hivyo kuongeza kiwango cha serotonini inayofanya kazi katika sinepsi ya ubongo). Dawamfadhaiko zingine zinaathiri ufyonyaji upya wa norepinefrini, au vipokezi vingine kwenye seli ya neva. Wakati MAOIs, TCAs na SSRIs zinaongeza viwango vya serotonini, zingine huzuia serotonini kushikana na vipokezi vya 5-HT _2A, na hivyo kupendekeza kuwa ni fikra sahili sana kusema kuwa serotonini ni homoni ya furaha. Kwa kweli, wakati dawamfadhaiko za awali hukusanyika kwenye mfumo wa damu na kiwango cha serotonini ikaongezeka, ni kawaida kwa mgonjwa kuhisi ni kama anazidiwa katika wiki za kwanza za matibabu. Mojawapo ya maelezo ya jambo hili ni kuwa vipokezi vya 5-HT_2A viligeuka kama ishara ya uloweshwaji (watu wanaotumia vipinzani vya 5-HT_2A mara nyingi huongeza uzito), na hivyo kumwambia mnyama aache kutafuta chakula, mwenzi, n.k., na aanze kutafuta wanyama wanaowawinda wanyama wengine. Katika hali ya hatari ni jambo la manufaa kwa mnyama kutohisi njaa hata kama anahitaji chakula. Mchangamsho wa vipokezi vya 5-HT_2A utawezesha jambo hili kufanyika. Lakini ikiwa ni tishio la kudumu, mnyama anahitaji kuanza kula na kujamiiana tena - na ukweli kuwa aliponea kifo inaonyesha kuwa tishio halikuwa la kiwango cha hatari kama mnyama huyo alihisi. Kwa hivyo idadi ya vipokezi vya 5-HT_2A hupungua kupitia mchakato unaojulikana kama urekebishaji kwa njia ya kupunguza na mnyama anarudia tabia yake ya kawaida. Hii inaashiria kwamba kuna njia mbili za kukabiliana na wasiwasi kwa binadamu na serotonergic: dawa za kuzuia kusisimua wa-HT _2A receptors 5 au kwa kuwasisimua kupita kiasi mpaka upungufu kupitia kuvumiliana. Kusisimua au kuzuia wa vipokezi tofauti juu ya kiini na huathiri maumbile usemi wake. Matokeo ya karibuni yameonyesha kuwa nyurojenesi, na hivyo, mabadiliko katika mofojenesi ya ubongo, hupatanisha athari za madawa ya dawamfadhaiko. <ref name="pmid16425236">{{cite journal |author=Warner-Schmidt JL, Duman RS |title=Hippocampal neurogenesis: opposing effects of stress and antidepressant treatment |journal=Hippocampus |volume=16 |issue=3 |pages=239–49 |year=2006 |pmid=16425236 |doi=10.1002/hipo.20156 |url=}}</ref> Nadharia tete nyingine ni kuwa huenda dawamfadhaiko zikawa na athari za muda mrefu kutokana na ukuzaji wa nyurojenesi katika hipokampasi, athari ambayo inapatikana kwa panya. <ref>{{cite journal|last=Malberg|first=JE|date=15 Desemba 200|title=Chronic antidepressant treatment increases neurogenesis in adult rat hippocampus|journal=Journal of Neuroscience|volume=20|issue=24|pages=9104–10|publisher=Society for Neuroscience|pmid=11124987|url=http://www.jneurosci.org/cgi/content/full/20/24/9104|accessdate=2009-05-29|author2=E|author3=N|author4=D}}</ref> <ref>{{cite journal|last=Manev|first=H|year=2001|month=Mei|title=Antidepressants alter cell proliferation in the adult brain in vivo and in neural cultures in vitro|journal=European Journal of Pharmacology|volume=411|issue=1-2|pages=67–70|publisher=Elsevier|pmid=11137860|doi=10.1016/S0014-2999(00)00904-3|accessdate=2009-05-29|last2=Uz|first2=T|last3=Smalheiser|first3=NR|last4=Manev|first4=R}}</ref> Utafiti wa wanyama wengine unaonyesha kuwa dawamfadhaiko zinaweza kuathiri ukamuaji wa jeni katika seli za ubongo, kwa kuathiri "jeni inayofinyanza protini zinazodhibiti mzunguko wa utendakazi wa mambo mbalimbali mwilini".<ref>{{cite journal|last=Uz|first=T|year=2005|title=Effect of fluoxetine and cocaine on the expression of clock genes in the mouse hippocampus and striatum|journal=Neuroscience|volume=134|issue=4|pages=1309–16|publisher=Elsevier|pmid=15994025|doi=10.1016/j.neuroscience.2005.05.003|accessdate=2009-05-29|last2=Ahmed|first2=R|last3=Akhisaroglu|first3=M|last4=Kurtuncu|first4=M|last5=Imbesi|first5=M|last6=Dirim Arslan|first6=A|last7=Manev|first7=H}}</ref> Utafiti mwingine unaonyesha kuwa kucheleweshwa kwa mwanzo wa athari zinazotokana na dawamfadhaiko kunaonyesha kuwepo kwa uwezo wa kubadilika kwa athari za dawamfadhaiko. Utafiti wa wanyama wagugunaji kila mara umeonyesha kuongezeka kwa kasi ya mfumo ya 3, 5-adenosini ya fosfeti moja wenye mzunguko (cAMP), ikisababishwa na aina tofauti za matibabu sugu lakini yasiyo kali ya dawamfadhaiko, ikiwa ni pamoja na serotonini na vizuizi vya ufyonyaji wa norepinefrini,vizuia oksidesi vya monoamini, dawa dhidi ya mfadhaiko aina ya tricyclic, lithiamu na matibabu ya mtukutiko meme. cAMP inasanisiwa kutoka kwa trifosfati 5-ya adenosini (ATP) na saiklesi ya adenilili na kufanyiwa umetaboli na mizunguko ya vivunja viungo vya fosfodi nyukleotidi (PDEs). <ref>{{cite journal|last=Zang|first=HT|date=12 Julai 2005|title=Interaction between the antidepressant-like behavioral effects of beta adrenergic agonists and the cyclic AMP PDE inhibitor rolipram in rats |url=https://archive.org/details/sim_psychopharmacology_2005-10_182_1/page/104|journal=Psychopharmacology|volume=182|issue=1|pages=104–115|publisher=Springer|location=Berlin|doi=10.1007/s00213-005-0055-y|pmid=16010541|accessdate=2009-05-28|last2=Huang|first2=Y|last3=Mishler|first3=K|last4=Roerig|first4=SC|last5=O'Donnell|first5=JM}}</ref> Takwimu pia zinaonyesha kwamba dawamfadhaiko zinaweza kurekebisha kunyumbuka kwa mfumo wa neva yakitumiwa kwa muda mrefu. <ref>{{cite journal|last=Carboni|first=L|year=2006|month=Oktoba|title=Proteomic analysis of rat hippocampus and frontal cortex after chronic treatment with fluoxetine or putative novel antidepressants: CRF1 and NK1 receptor antagonists|journal=European Neuropsychopharmacology|volume=16|issue=7|pages=521–537|publisher=Elsevier|doi=10.1016/j.euroneuro.2006.01.007|pmid=16517129|accessdate=2009-05-28|last2=Vighini|first2=M|last3=Piubelli|first3=C|last4=Castelletti|first4=L|last5=Milli|first5=A|last6=Domenici|first6=E}}</ref> Nadharia moja kuhusu chanzo cha mfadhaiko ni kwamba ina sifa ya utendaji wa kupita kiasi wa jira ya adrena ya hypothalamiki-tezi (jira ya HPA ) ambayo inafanana na mwitikio wa mfumo wa neva na mwili kwa dhiki. Hali hii ya jira za HPA zisizo za kawaida hushiriki katika kuendeleza ya dalili za mfadhaiko na dawamfadhaiko humtumika kudhibiti utendakazi wa jira ya HPA. <ref>Carmine M. Pariante kazi, Taasisi ya Taaluma ya tiba ya Psychiatry Mfalme wa Chuo cha London [http://www.neuroendo.org.uk/content/view/31/11/ unyogovu, stress och Adrenal axis ya.] {{Wayback|url=http://www.neuroendo.org.uk/content/view/31/11/ |date=20080706035853 }} Jamii ya Uingereza ya Niuroendokrinolojia, 2003.</ref> === Ulinganishaji === Dawamfadhaiko kadhaa zimelinganishwa hapa chini: <ref name="pmid9537821">{{cite journal | author = Tatsumi M, Groshan K, Blakely RD, Richelson E. | title = Pharmacological profile of antidepressants and related compounds at human monoamine transporters. | journal = Eur J Pharmacol. | volume = 340 | issue = 2-3 | pages = 249–258 | year = 1997 | pmid = 9537821 | doi = 10.1016/S0014-2999(97)01393-9 }}</ref> <ref name="pmid9400006">{{cite journal | author = Owens MJ, Morgan WN, Plott SJ, Nemeroff CB. | title = Neurotransmitter receptor and transporter binding profile of antidepressants and their metabolites. | journal = J Pharmacol Exp Ther. | volume = 283 | issue = 3 | pages = 1305–1322 | year = 1997 | pmid = 9400006 }}</ref> <ref name="pmid7855217">{{cite journal | author = Cusack B, Nelson A, Richelson E. | title = Binding of antidepressants to human brain receptors: focus on newer generation compounds. | url = https://archive.org/details/sim_psychopharmacology_1994-05_114_4/page/559 | journal = Psychopharmacology (Berl). | volume = 114 | issue = 4 | pages = 559–565 | year = 1994 | pmid = 7855217 | doi = 10.1007/BF02244985 }}</ref> <ref name="bookEssentials of clinical psychopharmacology">{{cite book | author = Alan F. Schatzberg, Charles B. | title = Essentials of clinical psychopharmacology | publisher = American Psychiatric Pub | year = 2006 | page = 7 | isbn = 1585622435, 9781585622436 }}</ref> <!-- table seems broken {| kategoria="sortable wikitable" | ''' Mchanganyiko ''' || '''[[Kisafirisha-Serotonini|SERT]]''' || '''[[Kisafirisha-Norepinefrini|NET]]''' || '''[[Kisafirisha-Dopamini|DAT]]''' || '''[[Kipokezi cha Histamine H1|H₁]]''' || '''[[Kipokezi cha asetilikolini ya Muskarini|M_1-5]]''' || '''[[Kipokezi cha andrenaji Alfa-1|α₁]]''' || '''[[Kipokezi cha andrenaji Alpha-2|α₂]]''' || '''[[5-HT1A|5-HT_1A]]''' || '''[[5-HT2|5-HT₂]]''' || '''[[Kipokezi cha D2|D₂]]''' |- | [[Agomelatini]] || ? | |? | |? | |? | |? | |? | |? | |? | | 270 | |? | - | [[Amitriptailini]] | | 4.3 | | 35 | | 3250 | | 0.95 | | 9.6 | | 24 | | 690 | | 450 | | 18 | | 1460 | - | [[Amoksapini]] | | 58 | | 16 | | 4310 | | 25 | | 1000 | | 50 | | 2600 | |? | |? | |? | - | [[Atomoksetini]] | | 8.9 | | 2.03 | | 1080 | | 5500 | | 2060 | | 3800 | | 8800 | | 10900 | | 940 | | 35,000 + | - | [[Bupropioni]] | | 45026 | | 1389 | | 2784 | | 11800 | | 35,000 + | | 4200 | | 35,000 + | | 35,000 + | | 35,000 + | | 35,000 + | - | Buspironi | |? | |? | |? | |? | |? | | 138 | |? | | 5.7 | | 174 | | 362 | - | Butriptailini | | 1360 | | 5100 | | 3940 | |? | |? | |? | |? | |? | |? | |? | - | Sitalopramu | | 1.16 | | 4070 | | 28100 | |? | |? | |? | |? | |? | |? | |? | - | Klomipramini | | 0.28 | | 38 | | 2190 | | 31 | | 37 | | 38 | | 3200 | |? | |? | |? | - | Desipramini | | 17.6 | | 0.83 | | 3190 | | 60 | | 66 | | 100 | | 5500 | | 6400 | | 350 | | 3500 | - | Dosulepini | | 8.6 | | 46 | | 5310 | |? | |? | |? | |? | |? | |? | |? | - | Doksepini | | 68 | | 29.5 | | 12100 | | 0.17 | | 23 | | 23.5 | | 1270 | | 276 | | 27 | | 360 | - | Duloksetini | | 0.8 | | 7.5 | | 240 | |? | |? | |? | |? | |? | |? | |? | - | Etoperidoni | | 890 | | 20000 | | 52000 | | 3100 | | 35,000 + | | 38 | | 570 | | 85 | | 36 | | 2300 | - | Femoksetini | | 11 | | | 760 | 2050 | | 4200 | | 184 | | 650 | | 1970 | | 2285 | | 130 | | 590 | - | Fluoksetini | | 0.81 | | 240 | | 3600 | | 5400 | | 590 | | 3800 | | 13900 | | 32400 | | 280 | | 12000 | - | Fluvoksamini | | 0.81 | | 240 | | 3600 | |? | |? | |? | |? | |? | |? | |? | - | Imipramini | | 1.4 | | 37 | | 8500 | | 37 | | 46 | | 32 | | 3100 | | 5800 | | 150 | | 620 | - | Lofepramini | | 70 | | 5.4 | | 18000 | | 360 | | 67 | | 100 | | 2700 | | 4600 | | 200 | | 2000 | - | Maprotilini | | 5800 | | 11.1 | | 1000 | | 2 | | 570 | | 90 | | 9400 | |? | |? | |? | - | | Mazindoli | 100 | | 1.4 | | 11 | |? | |? | |? | |? | |? | |? | |? | - | Mianserini | | 4000 | | 71 | | 9400 | |? | |? | |? | |? | |? | |? | |? | - | Milnasiprani | | 123 | | 200 | | 10,000 + | |? | |? | |? | |? | |? | |? | |? | - | Mirtazapini | | 1500 + | | ~ 1250 | | 1500 + | | 1 ~ | | ~ 1000 | | 500 ~ | | 100 ~ | | 1500 + | | 10 ~ | | 1,500 + | - | Nefazodoni | | 200 | | 360 | | 360 | | 24000 | | 11000 | | 48 | | 640 | | 80 | | 26 | | 910 | - | Nisoksetini | | 383 | | 5.1 | | 477 | |? | |? | |? | |? | |? | |? | |? | - | Nomifensini | | 1010 | | 15.6 | | 56 | |? | |? | |? | |? | |? | |? | |? | - | Nortriptailini | | 18 | | 4.37 | | 1140 | | 6.3 | | 37 | | 55 | | 2030 | | 294 | | 41 | | 2570 | - | Oksaprotilini | | 3900 | | 4.9 | | 4340 | |? | |? | |? | |? | |? | |? | |? | - | Paroksetini | | 0.13 | | 40 | | 490 | | 22000 | | 108 | | 4600 | | 17000 | | 35,000 + | | 19000 | | 32000 | - | Protriptailini | | 19.6 | | 1.41 | | 2100 | | 25 | | 25 | | 130 | | 6600 | |? | |? | |? | - | Reboksetini | | 720 | | 11 | | 10,000 + | |? | |? | |? | |? | |? | |? | |? | - | Satralini | | 0.29 | | 420 | | 25 | | 24000 | | 630 | | 380 | | 4100 | | 35,000 + | | 9900 | | 10700 | - | Trazodoni | | 160 | | 8500 | | 7400 | | 1100 | | 35,000 + | | 42 | | 320 | | 96 | | 25.0 | | 35,000 + | - | Trimipramini | | 149 | | 2450 | | 3780 | | 0.27 | | 58 | | 24 | | 680 | |? | |? | |? | - | Venlafaksini | | 82 | | 2480 | | 7647 | | 35,000 + | | 35,000 + | | 35,000 + | | 35,000 + | | 35,000 + | | 35,000 + | | 35,000 + | - | Viloksazini | | 17300 | | 155 | | 100,000 + | |? | |? | |? | |? | |? | |? | |? | - | Zimelidini | | 152 | | 9400 | | 11700 | |? | |? | |? | |? | |? | |? | |? |) --> Nambari zilizo hapo juu zimeandikwa kama nambari zisizobadilika za ulinganifu tenganishi. Unapaswa kukumbuka kuwa kidogo ni zaidi. SERT, NET, na DAT zinalingana na uwezo wa michanganyiko wa kuzuia ufyonyaji upya wa serotonini, norepinefrini, na dopamini, mtawalia. Hizo thamani zingine zinalingana na mvuto wao kwa vipokezi mbalimbali. === Kuzuia uvimbe na kuathiri kinga ya mwili === Utafiti wa karibuni unaonyesha kuwa michakato ya saikotini inayosababisha uvimbe hutendeka wakati wa mfadhaiko wa kimawazo, wazimu, na maradhi ya hisia mseto, na inawezekana kuwa dalili ya hali hizi hupunguzwa na athari za dawa ya dawamfadhaiko kwenye mfumo wa kinga. <ref>{{cite journal|last=O'Brien|first=SM|year=2006|month=Februari|title=Cytokine profiles in bipolar affective disorder: focus on acutely ill patients|journal=Journal of Affective Disorders|volume=90|issue=2-3|pages=263–7|publisher=Elsevier|pmid=16410025|doi=10.1016/j.jad.2005.11.015|accessdate=2009-05-29|last2=Scully|first2=P|last3=Scott|first3=LV|last4=Dinan|first4=TG}}</ref> <ref>{{cite journal|last=Obuchowicz|first=E|year=2005|month=Sep-OCt|title=Antidepressants and cytokines--clinical and experimental studies|journal=Neurol Neurochir Psychiatr Pol|volume=39|issue=5|pages=921–36|pmid=16358592|oclc=11190611|language=Polish|accessdate=2009-05-29|last2=Marcinowska|first2=A|last3=Herman|first3=ZS}}</ref> <ref>{{cite journal|last=Hong|first=C-J|year=2005|month=Novemba|title=Interleukin-6 Genetic Polymorphism and Chinese Major Depression|journal=Neuropsychobiology|volume=52|issue=4|pages=202–5|publisher=Karger AG|location=Basel|pmid=16244501|doi=10.1159/000089003|accessdate=2009-05-29|last2=Yu|first2=YW|last3=Chen|first3=TJ|last4=Tsai|first4=SJ}}</ref> <ref name="Elen">{{cite journal|last=Elenkov|first=IJ|year=2005|month=Septemba|title=Cytokine dysregulation, inflammation and well-being|journal=NeuroImmunoModulation|volume=12|issue=5|pages=225–69|publisher=Karger AG|location=Basel|pmid=16166805|doi=10.1159/000087104|accessdate=2009-05-29|last2=Iezzoni|first2=DG|last3=Daly|first3=A|last4=Harris|first4=AG|last5=Chrousos|first5=GP}}</ref> <ref>{{cite journal|last=Kubera|first=M|date=30 Aprili 2005|title=Effects of serotonin and serotonergic agonists and antagonists on the production of tumor necrosis factor alpha and interleukin-6|journal=Psychiatry Research|volume=134|issue=3|pages=251–8|publisher=Elsevier|pmid=15892984|doi=10.1016/j.psychres.2004.01.014|accessdate=2009-05-29|last2=Maes|first2=M|last3=Kenis|first3=G|last4=Kim|first4=YK|last5=Lasoń|first5=W}}</ref> Tafiti pia zimeonyesha kuwa utoaji wa kuselelea wa homoni za dhiki kutokana na ugonjwa, ikiwa ni pamoja na maambukizi ya viungo au dalili za kingamwilinafsi, unaweza kupunguza athari za nyurotransmita au vipokezi vingine katika ubongo kupitia njia zilizopatanishwa na seli zinazosababisha uvimbe, na hivyo kusababisha ya udibiti mbaya wa homoni za mfumo wa neva. <ref name="Elen" /> SSRIs, SNRIs na dawamfadhaiko{/3 aina ya {2}tricyclic zinazotenda kazi kwenye vipokezi vya serotonini, norepinefrini na dopamini vimetambuliwa kuwa dhahiri kuwa za kuathiri kinga ya mwili na kuzuia uvimbe dhidi ya michakato ya [[saitokini]], hasa kwa udhibiti wa [[Intaferoni ya gama]] (IFN-gamma) na [[Intaleukini-10]] (IL-10), pamoja na [[TNF-alfa]] na [[Intaleukini-6]] (IL-6). Imetambulika pia kuwa dawamfadhaiko huzuia kuongezeka kwa kasi ya mfumo wa TH1. <ref>{{cite journal|last=Diamond|first=M|year=2006|month=Oktoba|title=Antidepressants suppress production of the Th1 cytokine interferon-gamma, independent of monoamine transporter blockade|journal=European Neuropsychopharmacology|volume=16|issue=7|pages=481–90|publisher=Elsevier|pmid=16388933|doi=10.1016/j.euroneuro.2005.11.011|accessdate=2009-05-29|last2=Kelly|first2=JP|last3=Connor|first3=TJ}}</ref> <ref>{{cite journal|last=Kubera|first=M|year=2001|month=Aprili|title=Anti-Inflammatory effects of antidepressants through suppression of the interferon-gamma/interleukin-10 production ratio|journal=Journal of Clinical Psychopharmacology|volume=21|issue=2|pages=199–206|publisher=Lippincott Williams & Wilkins|pmid=11270917|doi=10.1097/00004714-200104000-00012|accessdate=2009-05-29|last2=Lin|first2=AH|last3=Kenis|first3=G|last4=Bosmans|first4=E|last5=Van Bockstaele|first5=D|last6=Maes|first6=M}}</ref> <ref>{{cite journal|last=Maes|first=M|year=2001|month=Januari|title=The immunoregulatory effects of antidepressants|url=https://archive.org/details/sim_human-psychopharmacology_2001-01_16_1/page/95|journal=Human Psychopharmacology: Clinical and Experimental|volume=16|issue=1|pages=95–103|publisher=John Wiley & Sons|pmid=12404604|doi=10.1002/hup.191|accessdate=2009-05-29}}</ref> <ref>{{cite journal|last=Maes|first=M|year=2005|month=Machi|title=The negative immunoregulatory effects of fluoxetine in relation to the cAMP-dependent PKA pathway|journal=International Immunopharmacology|volume=5|issue=3|pages=609–18|publisher=Elsevier|pmid=15683856|doi=10.1016/j.intimp.2004.11.008|accessdate=2009-05-29|last2=Kenis|first2=G|last3=Kubera|first3=M|last4=De Baets|first4=M|last5=Steinbusch|first5=H|last6=Bosmans|first6=E}}</ref> <ref>{{cite journal|last=Brustolim D|first=D|year=2006|month=Juni|title=A new chapter opens in anti-inflammatory treatments: the antidepressant bupropion lowers production of tumor necrosis factor-alpha and interferon-gamma in mice|journal=International Immunopharmacology|volume=6|issue=6|pages=903–7|publisher=Elsevier|pmid=16644475|doi=10.1016/j.intimp.2005.12.007|accessdate=2009-05-29|last2=Ribeiro-Dos-Santos|first2=R|last3=Kast|first3=RE|last4=Altschuler|first4=EL|last5=Soares|first5=MB}}</ref> Dawamfadhaiko, hasa TCAs na SNRIs (mchanganyiko wa SSRIna NRI), pia zimeonyesha tabia za kutuliza maumivu. <ref>{{cite journal|last=Moulin|first=DE|year=2007|month=Spring|title=Pharmacological management of chronic neuropathic pain - consensus statement and guidelines from the Canadian Pain Society|journal=Pain Research & Management|volume=12|issue=1|pages=13–21|publisher=Pulsus Group|pmid=17372630|pmc=2670721|accessdate=2009-05-29|last2=Clark|first2=AJ|last3=Gilron|first3=I|last4=Ware|first4=MA|last5=Watson|first5=CP|last6=Sessle|first6=BJ|last7=Coderre|first7=T|last8=Morley-Forster|first8=PK|last9=Stinson|first9=J}}</ref> <ref>{{cite journal|last=Jones|first=CK|year=2006|month=Desemba|title=Analgesic effects of serotonergic, noradrenergic or dual reuptake inhibitors in the carrageenan test in rats: Evidence for synergism between serotonergic and noradrenergic reuptake inhibition|journal=Neuropharmacology|volume=51|issue=7-8|pages=1172–1180|publisher=Elsevier|pmid=17045620|doi=10.1016/j.neuropharm.2006.08.005|accessdate=2009-05-29|last2=Eastwood|first2=BJ|last3=Need|first3=AB|last4=Shannon|first4=HE}}</ref> Tafiti hizi zinatoa kibali cha kuchunguza dawamfadhaiko kwa matumizi kwa magonjwa ya akili na yale yasiyo ya akili na kuwa huenda mkabala wa mwingiliano kati ya michakato ya kisaikolojia na mifumo ya neva na kinga utahitajika ili kufikia upeo wa kutibu magonjwa kwa dawa.<ref>{{cite journal|last=Kulmatycki|first=KM|year=2006|month=Oktoba|title=Drug disease interactions: role of inflammatory mediators in depression and variability in antidepressant drug response|journal=Journal of Pharmacy & Pharmaceutical Sciences|volume=9|issue=3|pages=292–306|publisher=Canadian Society for Pharmaceutical Sciences|pmid=17207413|url=http://www.ualberta.ca/~csps/JPPS9_3/Kulmatycki/Kul_Jam.htm|accessdate=2009-05-29|last2=Jamali|first2=F}}</ref> Huenda dawamfadhaiko za baadaye zitaundwa ili kulenga hasa mfumo wa kinga iwe kwa kuzuia utendaji wa saikotini zinazosababisha uvimbe au kwa kuongeza uzalishaji wa saikotini zinazozuia uvimbe. <ref>{{cite journal|last=O'Brien|first=SM|year=2004|month=Agosti|title=Cytokines: abnormalities in major depression and implications for pharmacological treatment|url=https://archive.org/details/sim_human-psychopharmacology_2004-08_19_6/page/397|journal=Human Psychopharmacology: Clinical and Experimental|volume=19|issue=6|pages=397–403|publisher=John Wiley & Sons|pmid=15303243|doi=10.1002/hup.609|accessdate=2009-05-29|last2=Scott|first2=LV|last3=Dinan|first3=TG}}</ref> == Ufanifu wa matibabu == Utafiti mwingi umefanywa ili kutathmini uwezekano wa athari za matibabu za dawamfadhaiko, iwe ni kupitia uchunguzi wa utendakazi katika hali ya majaribio (ikiwa ni pamoja na utafiti wa kiafya bila utaratibu maalumu) au kupitia uchunguzi wa ufanisi katika "hali halisi." ''Mwitikio'' unaofaa kwa dawa mara nyingi hufafanuliwa kama kupunguzwa kwa angalau 50% ya dalili zilizoripotiwa na mgonjwa binafsi au zinazoonekana, huku ''sehemu ya majibu'' ikifafanuliwa kama kupunguza angalau 25% ya dalili hizo. Neno ''kupungua'' linarejelea uondoaji wa kweli lakini usio bayana wa dalili za dawamfadhaiko, lakini wenye hatari ya ''kurudi'' kwa dalili au ''kuugua tena'' na ugonjwa wa mfadhaiko. Kupunguka kabisa au ''kupona'' kunaashiria kurudi kabisa kwa hali ya "kawaida" ya saikolojia ikiandamana na utendakazi kamili. === Ukaguzi wa tafiti === Ukaguzi wa tafiti za kimatibabu za hivi karibuni ni pamoja na: * Kulinganisha uhusiano wa utendakazi wa kategoria mbalimbali za dawamfadhaiko<ref>{{cite journal |author=Anderson IM |title=Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability |url=https://archive.org/details/sim_journal-of-affective-disorders_2000-04_58_1/page/19 |journal=J Affect Disord |volume=58 |issue=1 |pages=19–36 |year=2000 |month=Aprili |pmid=10760555 |doi=10.1016/S0165-0327(99)00092-0 }}</ref> katika mazingira tofauti <ref>MacGillivray, S., Arroll, B., Hatcher, S., Ogston, S., Reid, I., Sullivan, F., Williams, B., Crombie, I. (2003) [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=154760 Utendakazi na uvumilivu wa vizuizi vya uchukuzi wa serotonini vinavyochagua ikilinganishwa na dawa dhidi ya mfadhaiko aina ya tricyclic kwa mfadhaiko uliotibiwa katika unyogovu kutibiwa katika huduma: ukaguzi wa hatua kwa hatua na uchambuzi wa matokeo ya tafiti kadhaa] {{Webarchive|url=https://archive.today/20130801115652/http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=154760 |date=2013-08-01 }} ''BMJ.'' 10 Mei 326 (7397): 1014.</ref> na kwa aina mbalimbali za mfadhaiko<ref>{{cite journal |doi=10.4088/JCP.v62n0209 |author=Parker G, Roy K, Wilhelm K, Mitchell P |title=Assessing the comparative effectiveness of antidepressant therapies: a prospective clinical practice study |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2001-02_62_2/page/117 |journal=J Clin Psychiatry |volume=62 |issue=2 |pages=117–25 |year=2001 |month=Februari |pmid=11247097 |doi_brokendate=2010-08-28 }}</ref> * Utathmini wa dawamfadhaiko ikilinganishwa na "kipozaungo hai" <ref name="ncbi.nlm.nih.gov" /> * Utathmini wa aina mpya zaidi za ya kategoria ya MAOI <ref> Lotufo-Neto, F., Trivedi, M., &amp; Thase, M.E (1999) [http://www.nature.com/npp/journal/v20/n3/full/1395258a.html Uchambuzi wa matokeo ya tafiti kadhaa kuhusu ddI yanaweza kupunguzwa Inhibitors Aina ya Oxidase Monoamine A Moclobemide na Brofaromine kwa ajili ya matibabu ya unyogovu] ''Neuropsychopharmacology'' 20 226-247.10.1038</ref> * Uchambuzi wa matokeo ya majaribio kadhaa ya St John's Wort<ref>{{cite journal |author=Linde K, Mulrow CD, Berner M, Egger M |title=St John's wort for depression |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD000448 |year=2005 |pmid=15846605 |doi=10.1002/14651858.CD000448.pub2 }}</ref> yaliyochaguliwa bila utaratibu maalumu * Ukaguzi wa matumizi ya dawamfadhaiko kwa kutibu mfadhaiko kwa watoto<ref> Jureidini JN, CJ Doecke, Mansfield PR, Haby MM, Menkes DB, AL Tonkin. (2004) [http://www.bmj.com/cgi/content/full/328/7444/879?ijkey=4f893b9f91cb92fde9abb867c1dd21fb35b7b9d3&amp;keytype2=tf_ipsecsha Utendakazi na usalama wa dawamfadhaiko kwa watoto na vijana.] BMJ. 2004 10 Aprili, 328 (7444) :879-83.</ref> <ref> Lakhan SE, Hagger-Johnson G. [http://www.cpementalhealth.com/content/3/1/21 Matokeo ya maagizo ya vitatiza akili kwa vijana]. ''Mazoezi ya kimatibabu na Epidemolojia katika Uzima wa Akili'' 2007; 3 (21).</ref> *Ukaguzi wa majaribio yote kuhusu dawamfadhaiko yaliyowasilishwa kwa Usimamizi wa Vyakula na Dawa nchini Marekani (FDA) kutoka mwaka wa 1987 hadi 2004 umeonyesha kuwa karibu nusu ya majaribio hayo yalishindwa kuonyesha faida yoyote ikilinganishwa na kipozaungo. Matokeo yote ya majaribio yaliyofanikiwa ila moja yalichapishwa katika majarida ya kisayansi, huku karibu majaribio yote yaliyofeli ama hayakuchapishwa au yalitolewa kwa njia ya kuwapotosha watu kama matokeo chanya (ikilinganishwa na tathmini ya FDA ya data hiyo). Jambo hili lilitokea kwa kuwa ingawa uchunguzi unahitajika kabla ya kupata idhini ya kimatibabu, uchunguzi unaoonyesha matokeo mengi si lazima yachapishwe au (kama yakichapishwa) yapewe kipaumbele sawa. Kwa hivyo, ingawa vitabu vya utafiti vilionyesha kwamba asilimia 94 ya majaribio yalikuwa na matokeo mazuri, katika data halisi iliyowasilishwa kwa Usimamizi wa Vyakula na Dawa, ni asilimia 51 pekee iliyokuwa na matokeo mazuri. Upendeleo huu katika uchapishaji ulipandisha athari dhairi ya takwimu za kila dawamfadhaiko iliyochunguzwa kwa kati ya 11% na 69%. <ref name="Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R 2008 252–60" /> * Uchambuzi wa matokeo ya majaribio kadhaa uliofanywa na watafiti kutoka Uingereza, Marekani na Kanada na kuchapishwa mwaka wa 2008 ulitafiti majaribio ya madawa yaliyodhaminiwa na kampuni za dawa ili kutambua dawamfadhaiko sita kuu za kizazi kipya zilizoagizwa zaidi na kuwasilishwa kwa idhini ya FDA kati ya mwaka wa 1987 na 1999. Matokeo, kulingana na uchambuzi wa matokeo ya majaribio ya awali, yalionyesha kuwa tofauti katika utendakazi kati ya dawamfadhaiko na kipozaungo ulikuwa mdogo, lakini kuwa uliongezeka kutoka kiwango cha kutokuwa na tofauti hadi kiwango cha wastani cha mfadhaiko wa hadi tofauti ndogo kwa wagonjwa wenye mfadhaiko mkali. Tofauti hii ilifikia kigezo cha kawaida cha matibabu kwa wagonjwa waliokuwa upande wa juu wa kategoria ya walioathirika zaidi na mfadhaiko, kutokana na kupungua kwa utendakazi wa kipozaungo. <ref name="pmid18303940">{{cite journal |author=Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT |title=Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration |journal=PLoS Med. |volume=5 |issue=2 |pages=e45 |year=2008 |pmid=18303940 |doi=10.1371/journal.pmed.0050045 |pmc=2253608}}</ref> Utafiti ulienea katika vyombo vya habari katika baadhi ya nchi, lakini ulikosolewa na jamii ya wataalamu. <ref>[170] ^ K. Eisele, MD Je, dawamfadhaiko hufanya kazi? Ukaguzi wa mapitio. Tovuti ya Doctors Lounge. Inapatikana kwa: http://www.doctorslounge.com/index.php/articles/page/152 {{Wayback|url=http://www.doctorslounge.com/index.php/articles/page/152 |date=20100303180328 }}. Accessed 21 Septemba 2009.</ref> Eli Lilly na wenzake walijibu kwa kusisitiza kuwa utafiti haukuzingatia uchunguzi wa karibuni zaidi wa bidhaa yake, Prozac, na kuwa inajivunia tofauti iliyoletwa na Prozac kwa mamilioni ya watu. GlaxoSmithKline ilionya kuwa utafiti huu mmoja haupaswi kutumiwa kuwapa wasiwasi na kuwatisha wagonjwa. Wyeth alisema kuwa data hiyo ilitosha kwa FDA kuwapa idhini ya kutumia dawa hizo. <ref>Blue, L. (2008) [http://www.time.com/time/health/article/0,8599,1717306,00.html Dawamfadhaiko hazisaidii pakubwa] {{Wayback|url=http://www.time.com/time/health/article/0,8599,1717306,00.html |date=20110211013701 }} Time magazine, Jumanne 26 Februari</ref> Wataalamu wawili maarufu wa magonjwa ya akili/ wataalamu wa dawa, wenye uhusiano wa kifedha na kitaalamu na makampuni ya dawa, walisema kuwa majaribio ya muda mfupi hayafai katika kutathmini ufanisi, na kuwa yale ambayo hayajachapishwa ni duni zaidi. Pia walisema kuwa waandishi wa uchambuzi wa matokeo ya majaribio walitumia misingi ya kisaikolojia badala ya ile ya upimaji wa dawa, na kuwa vyombo vya habari na "vipengele vya jumuia ya kisayansi na tiba havijishughulishi na maswala kuhusu dawamfadhaiko" na kuwa vyombo vya habari havifahamu uzito wa ugonjwa wa mfadhaiko na badala yake vinawashutumu wanaougua kwa njia yenye misingi ya mitazamo ya kidini ya enzi za kati. <ref>{{cite journal |author=Nutt DJ, Malizia AL |title=Why does the world have such a 'down' on antidepressants? |journal=J. Psychopharmacol. (Oxford) |volume=22 |issue=3 |pages=223–6 |year=2008 |month=Mei |pmid=18541622 |doi=10.1177/0269881108091877 }}</ref> *Makala katika The Washington Post ya tarehe 7 Mei 2002 yenye kichwa "Against Depression, a Sugar Pill Is Hard to Beat" yalisema kuwa "Uchambuzi mpya umetambua kuwa katika nyingi ya majaribio yaliofanywa na makampuni ya dawa katika miongo ya hivi karibuni, vidonge vya sukari vimeleta matokeo bora yaliyo sawa na -au wakati mwingine bora zaidi ya- dawamfadhaiko. Makampuni yamepaswa kufanya majaribio kadhaa ili yaweze kupata mbili ambazo zinaonyesha matokeo mazuri, jambo ambalo ni hitaji la msingi kwa kupata idhini ya Usimamizi wa Vyakula na Dawa. Isitoshe, vidonge vya sukari, vipozaungo, kusababisha mabadiliko makubwa katika maeneo yaleyale ya ubongo yaliyoathirika na dawa, kulingana na utafiti iliochapishwa wiki iliyopita ... ya watengenezaji wa Prozac walipaswa kufanya majaribio matano ili kupata mawili chanya, na watengenezaji wa Paxil na Zoloft walipaswa hata kufanya majaribio mengi zaidi ... Leuchter alipolinganisha mabadiliko kwenye bongo za wagonjwa waliopewa vipozaungo, alishangaa kutambua kuwa wengi wao walikuwa na mabadiliko katika sehemu sawa za ubongo zinazodhaniwa kuwa hudhibiti vijisehemu muhimu vya hisia ... Baada ya jaribio hilo kuisha na wagonjwa waliopewa vipozaungo kufahamishwa, hali yao ilizorota mara kwa haraka. Imani ya watu kwa nguvu za dawamfadhaiko inaweza kueleza sababu za wagonjwa kufanya vizuri wakipewa vipozaungo... " <ref>[http://www.chelationtherapyonline.com/technical/p58.htm Dhidi ya Mfadhaiko, ni vigumu kushindana na kidonge cha sukari] {{Wayback|url=http://www.chelationtherapyonline.com/technical/p58.htm |date=20100925021110 }} , The Washington Post, 7 Mei 2002</ref> === Miongozo ya matibabu === Mwongozo wa mwaka wa 2000 wa Ushirikiano wa Marekani wa kuchunguza magonjwa ya akili wa kutibu wagonjwa wenye mfadhaiko mkuu<ref>{{cite web |url=http://www.guidelines.gov/summary/summary.aspx?doc_id=2605&nbr=1831 |title=Practice guideline for the treatment of patients with major depressive disorder |publisher=Guidelines.gov |date= |accessdate=2008-11-06 |archiveurl=https://web.archive.org/web/20081028165751/http://www.guidelines.gov/summary/summary.aspx?doc_id=2605&nbr=1831 |archivedate=2008-10-28 |https://web.archive.org/web/20081028165751/http://www.guidelines.gov/summary/summary.aspx?doc_id=2605&nbr=1831 |=https://web.archive.org/web/20081028165751/http://www.guidelines.gov/summary/summary.aspx?doc_id=2605&nbr=1831 }}</ref> unaonyesha kuwa ikipendelewa zaidi na mgonjwa, dawamfadhaiko inaweza kutolewa kama matibabu msingi ya awali kwa ugonjwa wa mfadhaiko mkuu wa kiwango cha chini; dawamfadhaiko inapaswa kutumika tu kwa viwango wastani hadi vikuu vya mfadhaiko isipokuwa kama matibabu ya mtukutiko meme yamepangwa; na mchanganyiko wa dawa za kuzuia magonjwa ya akili na dawamfadhaiko au ya ya mtukutiko meme zinafaa kutumika kwa kutibu mfadhaiko wa kichaa. Inasema kuwa utendakazi unaweza kulinganishwa kwa ujumla kati ya kategoria na ndani ya kategoria na kuwa uteuzi wa awali utategemea pakubwa msingi ya athari zinazotarajiwa kwa mgonjwa binafsi, mapendeleo ya mgonjwa, wingi na ubora wa data ya utafiti wa kiafya kuhusu dawa, na gharama yake. Miongozo ya mwaka wa 2004 wa Taasisi ya Taifa ya Ubora wa Matibabu nchini Uingereza (NICE) inaonyesha kuwa dawamfadhaiko hazipaswi kutumiwa kwa matibabu ya awali ya mfadhaiko wa kiwango cha chini, kwa kuwa uwiano kati ya hatari na manufaa ni wa chini; kwa ule wa mfadhaiko wa kiwango cha wastani hadi kali, dawa aina ya SSRI ina uwezekano mkuu zaidi wa kuvumiliwa kuliko ile ya tricyclic; na kuwa dawamfadhaiko za mfadhaiko mkuu zinafaa kujumuishwa na matibabu ya kisaikolojia kama vile Tiba ya Utambuzi wa Kitabia. <ref>{{cite web|url=http://www.nice.org.uk/guidance/CG23 |title=Depression |publisher=Nice.org.uk |date= |accessdate=2008-11-06}}</ref> === Upungufu wa ufanifu na mikakati === Kati ya 30% na 50% ya watu waliotibiwa na dawamfadhaiko maalumu hawaonyeshi mwitikio kwa dawa. <ref>{{cite journal |author=Baghai TC, Möller HJ, Rupprecht R |title=Recent progress in pharmacological and non-pharmacological treatment options of major depression |journal=Curr. Pharm. Des. |volume=12 |issue=4 |pages=503–15 |year=2006 |pmid=16472142 |doi=10.2174/138161206775474422 }}</ref> <ref name="SSRIswitch">{{cite journal |author=Ruhé HG, Huyser J, Swinkels JA, Schene AH |title=Switching antidepressants after a first selective serotonin reuptake inhibitor in major depressive disorder: a systematic review |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2006-12_67_12/page/1836 |journal=J Clin Psychiatry |volume=67 |issue=12 |pages=1836–55 |year=2006 |month=Desemba |pmid=17194261 |doi=10.4088/JCP.v67n1203 }}</ref> Hata pale ambapo kumekuwa na mwitikio mzuri, ni kawaida kupata kuwa mfadhaiko na utendakazi mbaya huendelea, na viwango vya kuugua tena ni vya juu kwa kati ya mara 3 hadi 6 zaidi katika matukio hayo. <ref>{{cite journal |author=Tranter R, O'Donovan C, Chandarana P, Kennedy S |title=Prevalence and outcome of partial remission in depression |journal=J Psychiatry Neurosci |volume=27 |issue=4 |pages=241–7 |year=2002 |month=Julai |pmid=12174733 |pmc=161658 }}</ref> Aidha, dawamfadhaiko huelekea kupoteza utendakazi katika kipindi cha matibabu. <ref>{{cite journal |author=Byrne SE, Rothschild AJ |title=Loss of antidepressant efficacy during maintenance therapy: possible mechanisms and treatments |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_1998-06_59_6/page/279 |journal=J Clin Psychiatry |volume=59 |issue=6 |pages=279–88 |year=1998 |month=Juni |pmid=9671339 }}</ref> Idadi kubwa ya mikakati hutumika katika matibabu ili kujaribu kushinda vikomo na tofauti hizi. <ref>{{cite journal |author=Mischoulon D, Nierenberg AA, Kizilbash L, Rosenbaum JF, Fava M |title=Strategies for managing depression refractory to selective serotonin reuptake inhibitor treatment: a survey of clinicians |url=https://archive.org/details/sim_canadian-journal-of-psychiatry_2000-06_45_5/page/476 |journal=Can J Psychiatry |volume=45 |issue=5 |pages=476–81 |year=2000 |month=Juni |pmid=10900529 }}</ref> ==== Ubadilishaji wa kubahatisha ==== Mwongozo wa mwaka wa 2000 wa Ushirikiano wa Marekani wa kuchunguza magonjwa ya akili unashauri kuwa pale ambapo hakuna mwitikio baada ya kati ya wiki sita na nane ya matibabu kwa kutumia dawamfadhaiko maalumu, unafaa kubadili dawa na utumie dawamfadhaiko nyingine katika kategoria hiyo, kisha baadaye utumie dawamfadhaiko kutoka kategoria tofauti. Ukaguzi wa matokeo ya majaribio ya hivi karibuni ulitambua tofauti kubwa katika matokeo ya tafiti za awali; kwa wagonjwa waliokosa kutibiwa na dawamfadhaiko aina ya SSRI, kati ya 12% na 86% walionyesha mwitikio kwa dawa mpya, huku kati ya 5% na 39% wakisimamisha matibabu kutokana na athari mbaya. Mgonjwa ambaye tayari amejaribu aina kadhaa za dawamfadhaiko ana uwezekano mdogo zaidi wa kunufaika kutokana na jaribio jipya la dawamfadhaiko. <ref name="SSRIswitch"/> ==== Ukuzaji na uambatanishaji ==== Kuhusu mwitikio wa kiasi, miongozo ya Ushirikiano wa Marekani kuhusu magonjwa ya akili inashauri kuongeza aina mbalimbali za vikolezo vya dawa kwenye dawamfadhaiko. Utafiti unaonyesha kuwa wagonjwa wengi hushindwa kufikia kiwango cha kupunguza tibamfadhiko, na mikakati ya kuongeza inayotimika katika matibabu ni pamoja na matumizi ya [[Lithi|lithiamu]] na kuongezwa kwa homoni ya kikoromeo, lakini hakuna misingi bora ya ushahidi kwa mbinu hizi au kwa mikakati mipya zaidi kama vile kutumia antagonisti za dopamini, steroidi za ngono, NRI, vikolezo maalum vya glukokotikoidi, au vizuiakifafa <ref name="augment">{{cite journal |author=DeBattista C, Lembke A |title=Update on augmentation of antidepressant response in resistant depression |journal=Curr Psychiatry Rep |volume=7 |issue=6 |pages=435–40 |year=2005 |month=Desemba |pmid=16318821 |doi=10.1007/s11920-005-0064-x }}</ref> Mkakati wa kuchanganya unahusisha kuongeza dawamfadhaiko moja au zaidi ya ziada, kwa kawaida kutoka kategoria tofauti ili kuleta athari mbalimbali kwenye mfumo wa neva. Ingawa hili linaweza kutumika katika matibabu, kuna ushahidi mdogo kuhusu uhusiano wa utendakazi au athari mbaya za mkakati huu. <ref>{{cite journal |author=Lam RW, Wan DD, Cohen NL, Kennedy SH |title=Combining antidepressants for treatment-resistant depression: a review |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2002-08_63_8/page/685 |journal=J Clin Psychiatry |volume=63 |issue=8 |pages=685–93 |year=2002 |month=Agosti |pmid=12197448 }}</ref> ==== Matumizi ya muda mrefu ==== Athari za matibabu ya dawamfadhaiko kwa kawaida hayaendelei kufanya kazi mara tu madawa yanapokomeshwa, na hivyo kusababisha kiwango cha juu cha kuugua tena. Uchambuzi wa karibuni wa matokeo ya majaribio 31 ya dawamfadhaiko yaliyodhibitiwa na vipozaungo, hasa yanayohusu utafiti uliofanywa kwa kipindi cha mwaka mmoja, yalionyesha 18% ya wagonjwa walioitikia dawamfadhaiko waliugua tena wakiwa wangali wanyatumia, ikilinganishwa na 41% ambao tiba zao zilibadilishwa na kupewa vipozaungo. <ref>{{cite journal |author=Geddes JR, Carney SM, Davies C |title=Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review |url=https://archive.org/details/sim_the-lancet_2003-02-22_361_9358/page/652 |journal=Lancet |volume=361 |issue=9358 |pages=653–61 |year=2003 |month=Februari |pmid=12606176 |doi=10.1016/S0140-6736(03)12599-8 }}</ref> Miongozo ya Ushirikiano wa Marekani kuhusu magonjwa ya akili inashauri kuendelezwa kwa matibabu ya dawamfadhaiko kwa kati ya miezi nne hadi sita kufuatia kumalizika kwa dalili. Kwa wagonjwa wenye historia ya matukio ya mfadhaiko, Miongozo ya Shirika la Uingereza la taaluma ya athari za dawa za magonjwa ya akili ya mwaka wa 2000 ya kutibu magonjwa ya mfadhaiko kwa kutumia dawamfadhaiko yanashauri mgonjwa aendelee kutumia dawamfadhaiko kwa angalau miezi sita na kwa muda wa hadi miaka mitano au milele. Iwapo mtu ataugua tena au la baada ya kuacha kutumia dawamfadhaiko haionekani kuhusiana na muda wa matibabu ya awali, hata hivyo, na kupotezwa polepole kwa faida za matibabu pia hutokea wakati huo huo. Mkakati unaohusisha kutibu magonjwa kwa dawa kwa kutibu magonjwa makali, ukifuatiwa na matibabu ya kisaikolojia katika awamu ya mabaki, yamependekezwa na tafiti fulani. <ref>{{cite journal |author=Fava GA, Park SK, Sonino N |title=Treatment of recurrent depression |journal=Expert Rev Neurother |volume=6 |issue=11 |pages=1735–40 |year=2006 |month=Novemba |pmid=17144786 |doi=10.1586/14737175.6.11.1735 }}</ref> <ref>{{cite journal |author=Petersen TJ |title=Enhancing the efficacy of antidepressants with psychotherapy |journal=J. Psychopharmacol. (Oxford) |volume=20 |issue=3 Suppl |pages=19–28 |year=2006 |month=Mei |pmid=16644768 |doi=10.1177/1359786806064314 }}</ref> === Kutofaulu kwa matibabu === Takriban 30% ya wagonjwa hupungukiwa na mfadhaiko baada ya kutumia dawa. <ref name="pmid16390886">{{cite journal |author=Trivedi MH, Rush AJ, Wisniewski SR |title=Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice |url=https://archive.org/details/sim_american-journal-of-psychiatry_2006-01_163_1/page/28 |journal=The American journal of psychiatry |volume=163 |issue=1 |pages=28–40 |year=2006 |pmid=16390886 |doi=10.1176/appi.ajp.163.1.28}}</ref> Kwa wagonjwa wasio na mwitikio wa kutosha, ama kuendelea kuongeza bupropioni (awali {{nowrap|200 mg}} ichukuliwe {{nowrap|100 mg}} kila siku na baadaye kuongezwa hadi jumla ya {{nowrap|400 mg}} kwa siku) au buspironi (hadi {{nowrap|60 mg}} kwa siku) ya kuongezwa kama dawa ya pili inaweza kusababisha kupunguka kwa karibu 30% ya wagonjwa, <ref name="pmid16554526">{{cite journal |author=Trivedi MH, Fava M, Wisniewski SR |title=Medication augmentation after the failure of SSRIs for depression |url=https://archive.org/details/sim_new-england-journal-of-medicine_2006-03-23_354_12/page/n55 |journal=N. Engl. J. Med. |volume=354 |issue=12 |pages=1243–52 |year=2006 |pmid=16554526 |doi=10.1056/NEJMoa052964}}</ref> huku kubadilisha madawa kunaweza kupunguza mfadhaiko kwa karibu 25% ya wagonjwa. <ref name="pmid16554525">{{cite journal |author=Rush AJ, Trivedi MH, Wisniewski SR |title=Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression |url=https://archive.org/details/sim_new-england-journal-of-medicine_2006-03-23_354_12/page/n43 |journal=N. Engl. J. Med. |volume=354 |issue=12 |pages=1231–42 |year=2006 |pmid=16554525 |doi=10.1056/NEJMoa052963}}</ref> ==== Kwa sababu ya mimba ==== Hakuna uhakika ikiwa mimba huchangia kutofaulu kwa dawa, kwa kuwa ripoti ya pekee hadi sasa imekumbwa na utata mwingi: Katika mwaka wa 2006, utafiti maarufu sana uliochapishwa katika jarida la ''Journal of the American Medical Association (JAMA)'' ulipinga dhana kuwa mabadiliko ya homoni wakati wa ujauzito huwalindwa mama wajawazito dhidi ya mfadhaiko, na kutambua kuwa kutoendelea na matibabu dhidi ya mfadhaiko wakati wa ujauzito husababisha zaidi kuugua tena. <ref>{{cite journal | last = Cohen, MD | first =Lee S. | title = Relapse of Major Depression During Pregnancy in Women Who Maintain or Discontinue Antidepressant Treatment | journal = Journal of the American Medical Association | volume =295 | issue = 5 | pages = 499–507 | publisher = American Medical Association | date= 1 Februari 2006 | url = http://jama.ama-assn.org/cgi/content/abstract/295/5/499 | accessdate = 2007-06-14 | doi = 10.1001/jama.295.5.499 | pmid = 16449615 | last2 = Altshuler | first2 = LL | last3 = Harlow | first3 = BL | last4 = Nonacs | first4 = R | last5 = Newport | first5 = DJ | last6 = Viguera | first6 = AC | last7 = Suri | first7 = R | last8 = Burt | first8 = VK | last9 = Hendrick | first9 = V}}</ref> Makala ya ''JAMA'' hayakufichua kuwa baadhi ya waandishi walikuwa na uhusiano wa kifedha na makampuni ya dawa yanayotengezeza dawamfadhaiko. ''JAMA'' baadaye ilichapisha makala rekebishi ili kubainisha uhusiano huo <ref>{{cite journal | title = Relapse of Major Depression During Pregnancy in Women Who Maintain or Discontinue Antidepressant Treatment—Correction | journal = JAMA | volume = 296 | issue = 2 | page = 170 | date = 12 Julai 2006 | url = http://jama.ama-assn.org/cgi/content/full/jama;296/2/170 | accessdate = 2007-06-14 | doi = 10.1001/jama.296.2.170 | archive-date = 2007-09-29 | archive-url = https://web.archive.org/web/20070929122051/http://jama.ama-assn.org/cgi/content/full/jama%3B296/2/170 | dead-url = yes }}</ref> na waandishi walisisitiza kuwa mahusiano hayo hayaathiri kwa vyovyote kazi yao ya utafiti. Daktari wa uzazi na afya ya mama na mtoto Adam Urato aliliambia jarida la ''Wall Street'' kuwa wagonjwa na wataalamu wa matibabu wanahitaji ushauri bila ushawishi wa viwanda. <ref>David Armstrong, "Mwingiliano wa Madawa: Mahusiano ya kifedha na Viwanda yanazingira utafiti mkuu kuhusu mfadhaiko kuhusu: Ikiwa ni salama kwa wanawake wajawazito kuendelea kutumia madawa - JAMA inawauliza Waandishi waeleze zaidi." Wall Street Journal. 11 Julai 2006 ( [http://www.post-gazette.com/pg/06192/705022-114.stm nakala] {{Wayback|url=http://www.post-gazette.com/pg/06192/705022-114.stm |date=20111125085721 }} iliyochapishwa kwenye post gazette.com-)</ref> == Dalili za kuacha matumizi == Dawa ya SSRI ikimomeshwa ghafla, inaweza kusababisha dalili za kuacha za kimwili na za kisaikolojia, jambo linalojulikana kama "Dalili za kuacha za SSRI" (Tamam & Ozpoyraz, 2002). Wakati uamuzi wa kuacha kutumia dawamfadhaiko unapofanywa, ni jambo la kawaida "kujiachisha" kwa kupunguza kipimo polepole kwa muda wa wiki kadhaa. Kesi nyingi za dalili za kuachishwa huendelea kwa kati ya wiki mmoja na nne. Uteuzi wa dawamfadhaiko na kipimo kinachofaa kwa tukio fulani na mtu fulani ni mchakato mrefu na wenye utata, unaohitaji maarifa ya mtaalamu. Baadhi ya dawamfadhaiko yanaweza kutibua mfadhaiko katika siku za awali, yanaweza kusababisha wasiwasi, au wanaweza kumfanya mgonjwa awe na fujo, dhiki au ahisi sana kujiua. Katika matukio chache, dawamfadhaiko inaweza kusababisha kubadilika kutoka mfadhaiko hadi wazimu au haipomania. == Athari == Dawamfadhaiko mara nyingi husababisha athari mbaya, na ugumu wa kuvumilia athari hizi ndiyo sababu kuu ya kutoendelea na dawa yenye ufanisi mkuu. Athari za SSRIs ni pamoja na: kichefuchefu, kuendesha, fadhaa, kuumwa na kichwa. Athari kwa ngono pia ni kawaida kwa SSRI, kama vile kupotea kwa hamu ya kufanya mapenzi, kushindwa kufikia mshindo na shida ya kusimika. Dalili za ugonjwa wa serotonini pia ni hali inayoleta wasiwasi inayohusishwa na matumizi ya SSRI. Usimamizi wa Vyakula na Dawa unahitaji SSRI zote ziweke onyo la Pakiti Nyeusi (Black Box), inayosema kuwa zinaongeza mara dufu kiwango cha kujiua (kutoka 2 kati ya 1000 hadi 4 kati ya 1000) kwa watoto na vijana. <ref>{{cite journal | last = Lenzer | first = Jeanne | title = Antidepressants double suicidality in children, says FDA | journal = BMJ | volume = 332 | page = 626 | year = 2006 | url = http://www.bmj.com/cgi/content/full/332/7542/626-c | doi = 10.1136/bmj.332.7542.626-c | accessdate = 2008-04-14}}</ref> Hatari iliyoongezeka kwa kutaka kujiua na tabia ya kujiua kati ya watu wazima chini ya umri wa miaka 25 ambayo yanaonekana kwa kuonekana kwa watoto na vijana. <ref> BMJ: [http://www.bmj.com/cgi/content/abstract/339/aug11_2/b2880?maxtoshow=&amp;HITS=10&amp;hits=10&amp;RESULTFORMAT=&amp;fulltext=suicide&amp;searchid=1&amp;FIRSTINDEX=0&amp;sortspec=date&amp;resourcetype=HWCIT Hatari ya kujiua katika majaribio ya kliniki ya dawamfadhaiko kwa watu wazima] . 11 Agosti 2009.</ref> Madhara ya TCAs (dawamfadhaiko aina ya trisaikliki): Athari zinazojitokeza sana ni pamoja na kinywa kikavu, kiwaa, kusinzia, kizunguzungu, kutetemeka, matatizo ya ngono, ugonjwa wa ngozi, na kupata uzito au hasara. Madhara ya MAOI (vizuizi vya oksidesi ya monoamini): Athari zisizo za kawaida za MAOIs kama fenilzini (Nardil) na tranilsaipromini (Parnate) ni pamoja na homa ya manjano, mshtuko wa moyo, [[Kiharusi|kiharusi]], na kifafa. Ugonjwa wa serotonini ni athari ya MAOIs ukiwekwa pamoja na madawa fulani. === Kujiua === Wagonjwa wa mfadhaiko ndio wenye hatari kubwa zaidi ya [[Jiua|kujiua]] mara tu baada ya kuanza kwa matibabu, kwa kuwa dawamfadhaiko zinaweza kupunguza dalili za mfadhaiko kama vile kudumaa kwa mwendo kunakohusishwa na michakato ya akili au ukosefu wa motisha kabla ya halihisi ya moyo kuanza kuwa bora. Ingawa jambo hili linaonekana kuwa kweli kinzani, uchunguzi unaonyesha kuwa uundaji wa mawazo ya kujiua ni kawaida wakati wa kuanza matibabu kwa dawamfadhaiko, na huenda likawa jambo la kawaida kwa wagonjwa wenye umri mdogo zaidi kama vile watoto walio karibu kubalehe na vijana. Watengenezaji wa madawa na madaktari mara nyingi huwapendekeza familia na wapendwa kufuatilia tabia ya mgonjwa mdogo kwa ishara zozote za mawazo ya kujiua au tabia, hasa katika kipindi cha wiki nane za kwanza za matibabu. Kabla ya onyo za pakiti nyeusi kwa madawa haya kutolewa na FDA na mashirika yaliyo sawa katika mataifa mengine, athari na kuzionya familia kuhusu hatari zilipuuzwa na kuchukuliwa kwa urahisi sana na watengenezaji wa madawa na wauguzi. Huenda jambo hili lilisababisha vifo kadhaa kupitia kujiua ingawa ushahidi wa moja kwa moja unaohusiana na matukio hayo hauna misingi dhabiti ya kisheria. Kuongezeka kwa taarifa kuhusu mawazo ya kujiua katika tafiti kadhaa kumevuta nadhari na kuibua uangalifu zaidi kuhusu namna ambavyo dawa hizi zinavyotumika. Watu wenye umri ulio chini ya miaka 24 wanaougua kutokana na mfadhaiko wanatahadharishwa kuwa matumizi ya dawamfadhaiko huenda yakaongeza hatari ya fikira na tabia ya kujiua. Maafisa wa afya ya ushirikisho walifungua [https://web.archive.org/web/20070930023930/http://www.ecanadanow.com/science/health/2006/12/13/fda-antidepressants-increase-suicidal-risk-for -young-adults/proposed changes] kwenye maandiko juu ya madawa ya dawamfadhaiko mnamo Desemba 2006 ili kuwaonya watu kuhusu hatari hii. FDA inasema kuwa Paxil inafaa kuepukwa kwa watoto na vijana na kuwa katika matukio ya matibabu ambapo watoto wanaugua kutokana na mfadhaiko, dawamfadhaiko inayopaswa kutumika ni Prozac. <ref>{{cite web|url=http://antidepressantseffects.com/depression/|title=Depression Antidepressants in Teenagers and Children|date=|accessdate=2010-07-01|archiveurl=https://web.archive.org/web/20130520234355/http://antidepressantseffects.com/depression/|archivedate=2013-05-20}}</ref> Tarehe 6 Septemba 2007, na Vituo vya Kdhibiti na Kuzuia Magonjwa viliripoti kuwa kiwango cha kujiua kati ya vijana nchini Marekani, (hasa wasichana, wenye umri wa kati ya miaka 10-24), kiliongezeka kwa 8% (mwaka wa 2003 hadi 2004), ongezeko kubwa zaidi katika muda wa miaka 15, <ref name="NYTimes"> [http://www.nytimes.com/2007/09/07/health/07suicide.html Visa vya kujiua vinaongezeka kati ya Vijana; Mjadala kuhusu dawamfadhaiko unaendelea] , Carey Benedict, New York Times, 7 Septemba 2007</ref> hadi kesi 4599 za kuiua kwa Waamerika wenye umri wa miaka 10 hadi 24 mwaka wa 2004, kutoka 4,232 mwaka wa 2003, hivyo kuifanya kiwango cha kujiua kiwe 7.32 kwa kila watu 100,000 wenye umri huo. Awali kiwango hicho kilikuwa kimeshuka hadi 6.78 kwa kila watu 100,000 katika mwaka wa 2003 kutoka 9.48 kwa kila watu 100,000 katika mwaka wa 1990. Baadhi ya wataalamu wa magonjwa ya akili wametambua kuwa ongezeko hili linatokana na kushuka kwa idadi ya maagizo ya dawamfadhaiko kama vile Prozac kwa vijana tangu mwaka wa 2003, na visa vingi zaidi vya mfadhaiko vimebaki bila kutibiwa. Katika utafiti wa Desemba 2006, jarida la The American Journal of Psychiatry lilisema kuwa kupungua kwa maagizo ya dawamfadhaiko kwa watoto kwa pointi chache tu za asilimia kulilingana na ongezeko la asilimia 14 ya waliojiua nchini Marekani; nchini [[Uholanzi]], kiwango cha kujiua kilipanda kwa 50% baada ya kupunguzwa kwa maagizo ya dawamfadhaiko. <ref>{{cite journal |author=Simon GE, Savarino J, Operskalski B, Wang PS |title=Suicide risk during antidepressant treatment |url=https://archive.org/details/sim_american-journal-of-psychiatry_2006-01_163_1/page/41 |journal=Am J Psychiatry |volume=163 |issue=1 |pages=41–7 |year=2006 |pmid=16390887 |doi=10.1176/appi.ajp.163.1.41}}</ref> Wahakiki kadhaa wa utafiti huu wanasema kuwa takwimu za kujiua za mwaka wa 2004 nchini Marekani zililinganishwa kwa njia sahili sana na mwaka uliopita, badala ya kuchunguza mabadiliko katika mwenendo kwa miaka kadhaa". <ref name="pmid18056248">{{cite journal |author=Jureidini J |title=The black box warning: decreased prescriptions and increased youth suicide? |url=https://archive.org/details/sim_american-journal-of-psychiatry_2007-12_164_12/page/1907 |journal=Am J Psychiatry |volume=164 |issue=12 |page=1907 |year=2007 |pmid=18056248 |doi=10.1176/appi.ajp.2007.07091463}}</ref> Shida ya jitihada kama hizo za kuamua mwelekeo kwa kutumia pointi mbili tu za data (miaka ya 2003 na 2004) zimedhihirishwa zaidi kutokana na ukweli kwamba, kwa mujibu wa data mpya ya uambukizaji na udhibiti wa magonjwa, kiwango cha kujiua katika mwaka wa 2005 kwa watoto na vijana kilipungua licha ya kuzidi kupungua kwa maagizo ya SSRI. "Ni hatari kufanya uamuzi kutokana na uchambuzi mdogo na finyu ya visa vichache vya mwaka hadi mwaka vya kupanda na kushuka kwa maagizo ya dawamfadhaiko na kujiua. Njia moja nzuri inayohusu uambukizaji na udhibiti wa magonjwa ni kuchunguza uhusiano kati ya mienendo katika matumizi ya dawa za akili na kujiua kwa muda katika maeneo mengi madogo ya kijiografia. Hadi pale ambapo matokeo ya kina ya uchambuzi yatakapofahamika, ni jambo la busara kuhairisha maoni kuhusu athari za onyo la FDA kwa afya ya umma". <ref name="pmid18056247">{{cite journal |author=Olfson M, Shaffer D |title=SSRI Prescriptions and the Rate of Suicide |url=https://archive.org/details/sim_american-journal-of-psychiatry_2007-12_164_12/page/1907 |journal=Am J Psychiatry |volume=164 |issue=12 |pages=1907–1908 |year=2007 |pmid=18056247 |doi=10.1176/appi.ajp.2007.07091467}}</ref> <ref name="titleN C H S - Health E Stats - Deaths: Preliminary Data for 2005">{{cite web |url=http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimdeaths05/prelimdeaths05.htm |title=N C H S - Health E Stats - Deaths: Preliminary Data for 2005 |accessdate=2007-12-12 |author=Kung HC, Hoyert DL, Xu J, Murphy SL |authorlink= |coauthors= |date= |work= |publisher=National Center for Health Statistics |pages= |language= |archiveurl= |archivedate= |quote=}}</ref> Chunguzi za kufuatilia zilizofanywa baadaye zimeunga mkono nadharia tete kuwa dawa za dawamfadhaiko hupunguza hatari ya kujiua. <ref>{{cite journal |author=Bridge JA, Iyengar S, Salary CB |title=Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials |url=https://archive.org/details/sim_jama_2007-04-18_297_15/page/n68 |journal=JAMA |volume=297 |issue=15 |pages=1683–96 |year=2007 |pmid=17440145 |doi=10.1001/jama.297.15.1683}}</ref> <ref>{{cite journal |author=Beasley CM, Ball SG, Nilsson ME |title=Fluoxetine and Adult Suicidality Revisited: An Updated Meta-Analysis Using Expanded Data Sources From Placebo-Controlled Trials |url=https://archive.org/details/sim_journal-of-clinical-psychopharmacology_2007-12_27_6/page/682 |journal=J Clin Psychopharmacol |volume=27 |issue=6 |pages=682–686 |year=2007 |pmid=18004137 |doi=10.1097/jcp.0b013e31815abf21 }}</ref> Hata hivyo, uamuzi kuwa kushuka kwa kiwango cha kujiua katika jamii kunatokana na dawa kuagizwa kwa dawamfadhaiko ni antidepressant haiwezi kuaminika kutokana na wingi wa vigeugeu vinavyofadhaisha. === Ngono === Matatizo ya ngono ni athari ya kawaida sana, hasa kwa dawa za SSRI. Athari zinazohusiana na ngono ni pamoja na matatizo na hamu ya ngono, kutovutiwa na ngono, na anogasmia (shida kupata mshindo). <ref>{{cite web |url=http://www.soc.ucsb.edu/sexinfo/question/antidepressants-and-anorgasmia |title=UCSB's SexInfo |publisher=Soc.ucsb.edu |date= |accessdate=2008-11-06 |archivedate=2009-05-20 |archiveurl=https://web.archive.org/web/20090520055421/http://www.soc.ucsb.edu/sexinfo/question/antidepressants-and-anorgasmia }}</ref> Ingawa zinaweza kupona, athari hizi za ngono zinaweza, katika visa vichache, kuendelea kwa miezi au miaka baada ya kuacha kabisa kutumia dawa. Hii inajulikana kama Utendakazi mbaya wa Kimapenzi baada ya matumizi ya SSRI. Utendakazi mbaya wa ngono uliosababishwa na SSRI huathiri 30% hadi 50% au zaidi ya watu wanaotumia dawa hizi kutibu mfadhaiko. Utaratibu wa kibiokemia unaosemekana kuwa wa kusababisha ni pamoja na kuongezeka kwa serotonini, hasa kunakoathiri vipokezi vya 5HT2 na 5HT3; kupungua kwa dopamini; kupungua kwa norepinefrini; uzuaji wa vipokezi vya kolinjeri na adrenaji alpha-1; kuzuiliwa kwa sinthetesi ya oksidi nitriki; na kupanda kwa viwango vya prolaktini. <ref>{{cite journal |author=Keltner NL, McAfee KM, Taylor CL |title=Mechanisms and treatments of SSRI-induced sexual dysfunction |url=https://archive.org/details/sim_perspectives-in-psychiatric-care_july-september-2002_38_3/page/111 |journal=Perspectives in Psychiatric Care |volume=38 |issue=3 |pages=111–6 |year=2002 |pmid=12385082 |doi=10.1111/j.1744-6163.2002.tb00665.x}}</ref> Bupropioni, kizuizi cha mara mbili (NE na DA) cha ufyonyaji upya, mara nyingi husababisha ongezeko la wastani la hamu ya kufanya mapenzi kutokana na kuongezeka kwa utendakazi wa dopamini. Athari hii pia hudhihirika kwa vizuizi vya ufyonyaji upya wa dopamini, vichangamsha CNS na agonisti za dopamini, na hutokana na kuongezeka kwa uzalishaji wa testosteroni (kutokana na kuzuiliwa kwa prolaktini) na usanisi wa oksidi nitriki. Mirtazapini (Remeron) imeripotiwa kuwa na athari chache zaidi, pengine kwa sababu inakinza vipokezi vya 5-HT2 na 5-HT3. Mitazapini, katika matukio fulani, inaweza kuondoa utendakazi mbaya wa ngono unaosababishwa na SSRI, ambayo pia kuna uwezekano kuwa unatokana na ukinzani wake na vipokezi vya 5-HT2 na 5-HT3<ref>{{cite journal |author=Ozmenler NK, Karlidere T, Bozkurt A |title=Mirtazapine augmentation in depressed patients with sexual dysfunction due to selective serotonin reuptake inhibitors |url=https://archive.org/details/sim_human-psychopharmacology_2008-06_23_4/page/321 |journal=Human Psychopharmacology |volume=23 |issue=4 |pages=321–6 |year=2008 |month=Juni |pmid=18278806 |doi=10.1002/hup.929}}</ref> Apomofini, nefazodoni na baruti kali zimeonyeshwa kuwa na uwezo wa kuondoa baadhi ya utendakazi mbaya wa ngono kupitia kuongezeka kwa utendakazi wa nitriki oksidi. MAOI zinaripotiwa kuwa na athari hasi chache zaidi kwa utendakazi wa ngono na hamu ya kufanya mapenzi, hasa moklobemidi kwa kiwango cha 1.9% ya matukio yote. Bethanekoli imeripotiwa kubadili utendakazi mbaya wa ngono unaosababishwa na MAOI kupitia sifa zake za agonisti za kolineji. <ref>{{cite journal |author=Gross MD |title=Reversal by bethanechol of sexual dysfunction caused by anticholinergic antidepressants |journal=The American Journal of Psychiatry |volume=139 |issue=9 |pages=1193–4 |year=1982 |month=Septemba |pmid=7114318 |doi= |url=http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=7114318}}</ref> === Mapenzi === Wanasaikolojia wengi wanaamini kuwamba dawamfadhaiko zinaathiri uwezo wa kupenda au kupokea upendo. Watumiaji wengi wa dawamfadhaiko pia wameripoti kuwa uwezo wao wa kupenda ulipunguzwa na dawamfadhaiko. Madawa ya dawamfadhaiko pia yanaweza kuzuia hisia za kimsingi za binadamu za upendo na mahaba. "Kuna sababu zinazofaa za kufikiri kuwa SSRI hupunguza uwezo wako wa kupenda na kubaki katika upendo," alisema Helen Fisher, mwana anthropolojia kutoka chuo kikuu cha Rutgers aliyeanzisha sayansi ya kisasa ya upendo. Dawamfadhaiko za SSRI hufanya kazi kwa kuongeza viwango vya mzunguko wa serotonini, nyurotransmita inayodhibiti halihisi ya moyo na pia inadhibiti tamaa. Madawa hayo pia hupunguza dopamini, nyurotransmita inayohusika katika michakato mbalimbali ya utambuzi na tabia, ikiwa ni pamoja na hamu na mwamsho. Utafiti mpya unaonyesha kuwa dopamini huenda pia ikawa na jukumu katika mahaba. Wakati wa kufanya mapenzi, mchanganyiko wa homoni hutolewa na unaonekana kuwa na majukumu muhimu katika kukuza uambatishaji wa kimapenzi ndani ya ubongo. Ukiondoa ngono, mapenzi ya kimahaba yanaweza kufifia. Lakini hii ni sehemu tu ya tatizo, anasema Fisher na mtaalamu wa saikolojia wa Chuo Kikuu cha Virginia James Thomson. Wakati wapenzi wanapopendana kwa dhati, kuonana tu kunasababisha kupanda kwa shughuli za ubongo zinazohusiana na dopamini. Wakiweza kuendelea kupendana, na hisia za awali ziweze kukua hadi ziwe mapenzi ya muda mrefu, kwa mvuto wa awali kukua hadi mapenzi ya muda mrefu, ruwaza za ubongo hubaki hai. Kupungua kwa viwango vya dopamini, hata hivyo, ni athari isiyoweza kuepukika ya SSRI. Ukipunguza dopamini, wanasema Fisher na Thomson, uwezekano wa upendo wenyewe ni utapunguka. <ref> http://www.wired.com/wiredscience/2009/02/antidepressants/</ref> Watu wapweke wanaotumia dawamfadhaiko huenda wakaona ugumu zaidi kukutana na watu, kwa kuwa mwitikio wao wa asili wa ngono umepunguka. Baadhi ya watafiti wanaamini kuwa hamu ilitengenezwa ili kuwasaidia watu kuchagua wenzi wanaowafaa kijenetiki. Cheche zinazowaka unapokutana na mtu kwa mara ya kwanza zinakuambia kitu: Huenda huyu ndiye mwenzi wako. Wakati ishara hizo hazijitokezi, uwezekano wako wa kupata mwenzi anayefaa hupungua. <ref> http://www.psychologytoday.com/articles/200704/sex-love-and-ssris</ref> Kuna tafiti kadhaa kuhusu athari za dawamfadhaiko kwa vipengele mbalimbali vya upendo zaidi ya ashiki na utendaji wa kingono. Lakini katika majaribio ya kuvutia, mwanasaikolojia mmoja wa Kanada, Maryanne Fisher (hana uhusiano na Helen), aliripoti ushahidi katika utafiti mdogo mwaka wa 2004 ya kile alichokiita "kukufisha ganzi uchumba" kwa wanawake wanaotumia dawamfadhaiko. Walipoulizwa wakague uvutivu wa nyuso za wanaume, wanawake wanaotumia madawa hayo walikagua wanaume hao vibaya zaidi, na walizipitia picha kwa haraka zaidi kuliko wanawake wasiotumia dawamfadhaiko. === Thaimoanesthesia === Wenye uhusiano wa karibu na madhara ya ngono ni dhana ya kukufisha hisia ganzi, au ganzi ya halihisi. Watumiaji wengi wa SSRI hulalamika kuhusu hali ya kutojali, ukosefu wa motisha, kuganda hisia, hisia ya kutengwa, na kutojihusisha na mazingira. Wanaweza kueleza jambo hili kama hisia ya "kutojali tena kuhusu kitu chochote." SSRI, SNRI, na TCA za kutoa serotonini zote zinaweza kusababisha tofauti hizi zinazobadilika, hasa vikiwa kwa viwango vya juu. <ref> http://www.ncbi.nlm.nih.gov/pubmed/9184611</ref> === Kipindi cha usingizi ambapo macho huzunguka kwa kasi === Madawa yote makuu ya dawamfadhaiko, isipokuwa trimipramini, mirtazapini na nefazodoni huzuia kipindi cha usingizi ambapo macho huzunguka kwa kasi, na imependekezwa kuwa utendakazi wa kiafya wa madawa haya unatokana kwa kiasi kikubwa na athari zao za kuzuia kipindi cha usingizi ambapo macho huzunguka kwa kasi. Kategoria tatu kuu za madawa ya dawamfadhaiko, vizuizi vya oksidesi ya monoamini (MAOIs), dawa dhidi ya mfadhaiko aina ya trisaikliki (TCAs) na vizuizi vya uchukuzi wa serotonini vinavyochagua (SSRIs), huzuia pakubwa kipindi cha usingizi ambapo macho huzunguka kwa kasi. <ref>{{cite journal |first=Robert P. |last=Vertes |year=2000 |title=The case against memory consolidation in REM sleep |url=https://archive.org/details/sim_behavioral-and-brain-sciences_2000-12_23_6/page/n82 |journal=Behavioral and Brain Sciences |volume=23 |issue=6 |pages=867–876 |doi=10.1017/S0140525X00004003 |pmid=11515146 |last2=Eastman |first2=KE}}</ref> Mirtazapini ama haina athari kwa kipindi cha usingizi ambapo macho huzunguka kwa kasi au huiongeza kwa kiwango kidogo. <ref>{{cite web |url=http://www.pslgroup.com/dg/2030e2.htm |title=ISP: Mirtazapine Regulates Stress Hormones, Improves Sleep In Depressed Patients |accessdate=2010-10-18 |archiveurl=https://web.archive.org/web/20120304235031/http://www.pslgroup.com/dg/2030e2.htm |archivedate=2012-03-04 }}</ref> Dawa za aina ya MAOI huzuia kipindi cha usingizi ambapo macho huzunguka kwa kasi karibu kabisa, huku dawa aina za TCA na SSRI zimetambuliwa kuwa zinazalisha mara moja (40-85%) na kwa kuendelezwa (30-50%) upungukaji wa kipindi cha usingizi ambapo macho huzunguka kwa kasi. Athari hii mara nyingi huongeza uchovu kwa wagonjwa wanaotumia vipimo vikubwa vya dawamfadhaiko kwa muda mrefu. Uchovu kama huo mara kwa mara unaweza kukatiza shughuli za mgonjwa za kila siku. Ukomeshaji wa ghafla wa MAOI unaweza kusababisha tukio la muda linalojulikana kama "kurudi tena kwa kipindi cha usingizi ambapo macho huzunguka kwa kasi" ambapo mgonjwa huota ndoto dhairi sana na jinamizi. === Kuongeza Uzito === Dawamfadhaiko nyingi huhusishwa na kuongeza uzito kwa kawaida katika kiwango cha {{Convert|5|–|25|kg|lb|abbr=on}} lakini mara chache kwenda juu hadi {{Convert|50|kg|lb|abbr=on}} . Chanzo maalum haijulikani, lakini dawamfadhaiko huhusishwa na kuongezeka kwa kutamani vitu, na kutokuwa na uwezo wa kuhisi kama umeshiba licha ya kuingiza kalori za kutosha, viwango vya chini vya nguvu na kuongezeka kwa usingizi wa mchana, ambao unaweza kusababisha kukula kupindukia na ukosefu wa hamu ya kufanya mazoezi, na kinywa kikavu, ambayo inaweza kusababisha unywaji wa vinywaji vyenye kalori nyingi. Sifa za kumaliza kemikali za mzio za dawamfadhaiko kadhaa za kategoria ya TCA na TeCA zimetambulika kuwa zinachangia na upande wa athari wa kuongezeka kwa hamu ya chakula na kuongeza uzito unaohusiana na kategoria hizi za madawa. Ulaji wa asusa za kabohaidreti zenye kiwango cha chini cha mafuta na protini na dhifa zenye kabohaidreti nyingi unaruhusu ubongo kuzalisha serotonini inayodhibiti hamu ya chakula na kusawazisha halihisi ya moyo. Kwa hivyo, kabohaidreti ikiliwa kama sehemu ya chakula bora, kwa mujibu wa athari zao kwa kiwango cha serotonini kwenye ubongo, zinaweza kusaidia kupoteza uzito katika muktadha wa kuongezeka uzito kutokana na dawamfadhaiko. <ref>{{cite book|last=Wurtman|first=JJ|coauthors=Marquis NF|title=The serotonin power diet : use your brain's natural chemistry to cut cravings, curb emotional overeating, and lose weight|accessdate=2009-05-29|year=c2006|publisher=Rodale|location=Emmaus, Penn|isbn=978-1-59486-346-2|pages=290}}</ref> == Ubishani == Tafiti kadhaa zimeibua shaka kuhusu ufanisi wa dawamfadhaiko. Utafiti uliofanywa mwaka wa 2002 ulionyesha kuwa tofauti kati ya dawamfadhaiko na vipozaungo ni mdogo sana. <ref>{{cite journal|last=Kirsch|first=I|year=2002|month=Julai|title=The emperor's new drugs: An analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration|journal=Prevention & Treatment|volume=5|issue=1|publisher=American Psychological Association|doi=10.1037/1522-3736.5.1.523a|accessdate=2009-05-29|last2=Moore|first2=Thomas J.|last3=Scoboria|first3=Alan|last4=Nicholls|first4=Sarah S.}}</ref> Kupitia ombi la Sheria ya uhuru wa kupata habari, wanasaikolojia wawili walipata tafiti 47 zilizotumiwa na FDA kuidhinisha dawamfadhaiko sita zilizoagizwa sana kati ya mwaka wa 1987 na mwaka wa 1999. Kwa ujumla, vidonge vya dawamfadhaiko vilitenda kazi vizuri zaidi kwa 18% kuliko vipozaungo, kitakwimu inayoleta tofauti kuu, lakini isiyo na maana kwa watu walio katika mazingira ya kliniki ", anasema Irving Kirsch, mwanasaikolojia wa Chuo Kikuu cha Connecticut. Yeye pamoja na mwandishi mwenzake Thomas Moore walitoa matokeo yao kuhusu "Kinga na Tiba", jarida la elektroniki la Shirika la Kisaikolojia la Marekani. <ref>{{cite news|url=http://www.usatoday.com/news/health/drugs/2002-07-08-antidepressants.htm |title= Study: Antidepressant barely better than placebo |publisher=Usatoday.com |date=2002-07-07&nbsp;-&nbsp;Updated&nbsp;11:47 PM&nbsp;ET |accessdate=2008-11-06}}</ref> Utafiti mwingine uliofanywa na wanasaikolojia wa Chuo Kikuu cha Pennsylvania, Chuo Kikuu cha Vanderbilt, Chuo Kikuu cha Colorado, na Chuo Kikuu cha New Mexico ulitambua kuwa ni vigumu kwa dawamfadhaiko kuwa na athari bora zaidi kuliko zile za vipozaungo katika visa vya mfadhaiko wa kiwango cha chini au wastani. Utafiti huo ulichapishwa katika jarida la Shirika la Marekani la Uuguzi. Utafiti huo ulilenga Paxili kutoka GlaxoSmithKline na imipramini. <ref>{{cite web|url=http://www.forbes.com/2010/01/05/antidepressant-paxil-placebo-business-healthcare-depression.html|title=Study Undermines Case for Antidepressants|date=|accessdate=2010-07-01|archiveurl=https://archive.today/20121208170044/http://www.forbes.com/2010/01/05/antidepressant-paxil-placebo-business-healthcare-depression.html|archivedate=2012-12-08}}</ref> Katika mwaka wa 2005, dawamfadhaiko ilikuwa ndio dawa iliyoagizwa zaidi nchini Marekani, na hivyo kusababisha mjadala zaidi kuhusu swala hilo. Baadhi ya madaktari wanaamini kuwa hii ni ishara nzuri kuwa watu hatimaye wanatafuta msaada kwa ajili ya matatizo yao. Wengine hawakubaliani, huku wakisema kuwa hii inaonyesha kwamba watu wanaendelea kutegemea dawamfadhaiko sana. <ref>{{cite news|url=http://www.cnn.com/2007/HEALTH/07/09/antidepressants/index.html |title=CDC: Antidepressants most prescribed drugs in U.S. |date= 2007-07-09|accessdate=2008-11-06 | work=CNN}}</ref> == Dawa == Mara nyingi watengenezaji wa dawa za SSRI wameficha habari kutoka kwa FDA na umma ili wachukulie kwa urahisi hatari na athari mbaya zinazohusishwa na SSRI. Hii ilisababisha ubishi dhidi ya watengenezaji wengi wa madawa ya kupambana na mfadhaiko ya SSRI katika visa vinavyohusiana na kujiua, kuachishwa kwa SSRI na kasoro kuzaliwa kwa watoto wachanga kutoka kwa mama wanaonyonyesha wanaotumia SSRI. Kwa moja kati ya kesi tatu pekee zilizowahi kufikishwa mahakamani kuhusu uwezekano kuwa SSRI huchangia kujiua, Eli Lilly na wenzake walishikwa wakiingilia mchakato wa kimahakama kwa kusikilizana na wakili wa mdai kutupa kesi hiyo, kwa sehemu kwa kutotoa ushahidi utakaowaletea hasara mbele ya mahakama. Kesi hiyo, inayojulikana kama Kesi ya Fentress ilihusisha mwanaume mmoja kutoka Kentucky, Joseph Wesbecker, kuhusu Prozac, aliyeenda mahali pake pa kazi na kuanza mashambulio kwa bunduki na kuwaua watu 8 (ikiwa ni pamoja na Fentress), na kuwajeruhi wengine 12 kabla ya kujiua mwenyewe kwa bastola. Juri ilitoa uamuzi wa 9-kwa-3 uliompendelea Lilly. Hakimu, mwishowe aliihamisha kesi hiyo hadi Mahakama Makuu ya Kentucky, iliyoamua kuwa "kulikuwa na ukosefu mkubwa wa uwazi kwa upande wa mahakama na huenda kulikuwa na udanganyifu, mwenendo ulioongozwa na imani mbaya, matumizi mabaya ya mchakato wa kimahakama na, pengine hata udanganyifu. "Hakimu baadaye alibatilisha uamuzi huo na badala yake, akasema kesi hiyo imefungwa. Thamani ya makubaliano ya mpango huo wa siri haujawahi kufichuliwa, lakini iliripotiwa kuwa ni "kubwa". <ref>[http://www.judicialaccountability.org/articles/hideandseek.htm ] {{Wayback|url=http://www.judicialaccountability.org/articles/hideandseek.htm |date=20100610031049 }} kutoka kwa Richard Zitrin &amp; Carol M. Langford. "Hide and Secrets in Louisville" kutoka "The Moral Compass of the American Lawyer". Vitabu vya Ballantine, 1999</ref> Tarehe 22 Desemba 2006, mahakama moja ya Marekani iliamua kuhusu Hoorman, na wenzake. dhidi ya SmithKline Beecham Corp. kuwa watu walionunua Paxil(R) au Paxil CR(TM) (paroksetini) kwa mtoto mdogo huenda wakastahiki kupata ruzuku chini ya maafikiano yaliyopendekezwa ya $ 63,800,000. Daawa lilishinda madai kuwa kampuni ya kutengeneza dawa za GlaxoSmithKline (GSK) ilikampenia uagizaji wa Paxil(R) au Paxil CR(TM) kwa watoto na vijana huku ikikatalia na kuficha habari muhimu kuhusu usalama na ufanisi wa dawa hizo kwa watoto. <ref>[http://www.ahrp.org/risks/SSRI0204/GSKpaxil/pg1.html ] {{Wayback|url=http://www.ahrp.org/risks/SSRI0204/GSKpaxil/pg1.html |date=20110614100740 }} Oktoba 1998 Kumbukumbu ya GSK: Mikakati ya ufichuzi</ref> Daawa hilo lilitokana na maandamano ya kutetea watumiaji dhidi ya GSK, watengenezaji wa Paroxetine. Tangu FDA iidhinishe paroxetine mwaka wa 1992, takriban raia 5,000 wa Marekani - na maelfu ya watu wengine duniani - wameishtaki GSK. Wengi wa watu hawa wanaona kuwa hawakuonywa inavyopaswa mapema kuhusu madhara ya dawa hii na sifa zake za utegemezi. Kulingana na [http://www.paxilprotest.com/ tovuti ya upingaji wa Paxil] {{Wayback|url=http://www.paxilprotest.com/ |date=20180307152504 }}, mamia ya daawa zaidi ziliwasilishwa dhidi ya GSK. Tovuti ya upingaji wa Paxil ilizinduliwa mnamo 8 Agosti 2005 ili kutoa taarifa kuhusu upingaji na habari juu ya Paxil ambayo awali haikupatikana kwa umma. Wiki tatu tu baada ya uzinduzi wake, tovuti hiyo ilitembelewa na zaidi ya watu robo milioni. Tovuti asili ya upingaji wa Paxil haipatikani tena. Inaeleweka kuwa hatua ya kuondoa tovuti hiyo kutoka kwenye mtandao ilichukuliwa kama sehemu ya makubaliano kuhusu usiri au 'amri ya kunyamazisha' ambayo mmiliki tovuti aliingilia kama sehemu ya maafikiano kwa hatua yake dhidi ya GlaxoSmithKline. (Hata hivyo, mnamo Machi 2007, tovuti ya Seroxat Secrets <ref>{{cite web|url=http://seroxatsecrets.wordpress.com/2007/03/03/the-paxil-protest-time-machine/ |title=The Paxil Protest time machine « seroxat secrets… |publisher=Seroxatsecrets.wordpress.com |date= |accessdate=2008-11-06}}</ref> iligundua kuwa nyaraka za tovuti ya upingaji wa Paxil<ref>{{cite web|url=http://paxilprotest.com/|archiveurl=https://web.archive.org/web/20060519170044/http://paxilprotest.com/|archivedate=2006-05-19|title=The Paxil Protest I Welcome<!-- Bot generated title -->|publisher=Web.archive.org|date=|accessdate=2008-11-06}}</ref> bado inapatikana kwenye mtandao kupitia Archive.org). Amri zakunyamazisha ni kawaida kwa kesi kama hizo na zinaweza kuhusisha hata hati ambazo washtakiwa wangependelea yaendeleaa kufichwa kwa umma. Hata hivyo, katika hali fulani, hati hizo zinaweza kutolewa kwa umma baadaye, kama zile zilizotolewa kwa umma na Peter Breggin mnamo Februari 2006. Toleo la habari kutoka kwa Dkt Breggin linaweza kuonekana hapa: <ref>{{cite web |url=http://www.breggin.com/courtfiling.pbreggin.2006.html |title=Suppressed Paxil Suicide Data Released |publisher=Breggin.com |date= |accessdate=2008-11-06 |archiveurl=https://web.archive.org/web/20081021042112/http://www.breggin.com/courtfiling.pbreggin.2006.html |archivedate=2008-10-21 }}</ref> Mnamo Januari 2007, kulingana na tovuti ya Seroxat Secrets, <ref>{{cite web|url=http://seroxatsecrets.wordpress.com |title=seroxat secrets… |publisher=Seroxatsecrets.wordpress.com |date= |accessdate=2008-11-06}}</ref> daawa ya kikundi cha kitaifa dhidi ya GlaxoSmithKline plc [[Ufalme wa Muungano|nchini Uingereza]], kwa niaba ya watu mia kadhaa ambao wanadai wamepata athari za kuachishwa baada ya kutumia dawa ya Seroxat, walichukua hatua ya karibu zaidi hadi Mahakama Kuu ya [[London]], na thibitisho kuwa fedha za umma zilirejeshwa kufuatia uamuzi wa Jopo la Rufaa kuhusu Maslahi ya Umma. Swala kuu kuhusiana na kitendo hiki linadai kuwa Seroxat ni dawa yenye kasoro kwa kuwa ina mwelekeo wa kusababisha mjibizo wa kuachishwa. Mawakili wa Hugh James wanathibitisha habari hii katika tovuti yao <ref>{{Rejea tovuti |url=http://www.hughjames.com/lifestyle/groupactions/seroxt.html |title=Nakala iliyohifadhiwa |accessdate=2007-02-22 |archiveurl=https://web.archive.org/web/20070222131722/http://www.hughjames.com/lifestyle/groupactions/seroxt.html |archivedate=2007-02-22 }}</ref> Tarehe 29 Januari 2007, shirika la BBC nchini Uingereza ilirushwa hewani filamu ya nne ionyeshayo hali halisi katika mfululizo wake unaoitwa 'Panorama' <ref>{{cite news|url=http://news.bbc.co.uk/1/hi/programmes/panorama/5346938.stm |title=BBC NEWS &#124; Programmes &#124; Panorama &#124; Seroxat update |publisher=News.bbc.co.uk |date=Last Updated: |accessdate=2008-11-06}}</ref> kuhusu dawa ya kulevya Seroxat ya. Kipindi hiki, kinachoitwa Siri za Majaribio ya Dawa, kinahusu majaribio matatu ya kiafya yaliyofanywa na GSK kwa watoto na vijana wenye mfadhaiko. == Marejeo == {{Reflist|2}} == Kusoma zaidi == * {{cite book |author=Healy, David |title=The antidepressant era |url=https://archive.org/details/antidepressanter00heal |publisher=Harvard University Press |location=Cambridge |year=1997 |isbn=0-674-03958-0 }} * {{cite book |author=Kramer, Peter D. |title=Listening to Prozac |url=https://archive.org/details/listeningtoproz000kram |publisher=Penguin Books |location=New York |year=1997 |isbn=0-14-026671-2 }} * {{cite book |author=Baumel, Syd |title=Natural Antidepressants |publisher=McGraw-Hill |location=New York |year=1999 |isbn=0-87983-900-7 }} * {{cite book |author=Stahl, Stephen M. |title=Psychopharmacology of Antidepressants |publisher=Informa Healthcare |year=1997 |isbn=1-85317-513-7 }} * {{cite journal |author=Pacher P, Kecskemeti V |title=Trends in the development of new antidepressants. Is there a light at the end of the tunnel? |journal=Curr. Med. Chem. |volume=11 |issue=7 |pages=925–43 |year=2004 |month=Aprili |pmid=15078174 |pmc=2495050 |doi=10.2174/0929867043455594 }} * {{cite journal |author=Pacher P, Kohegyi E, Kecskemeti V, Furst S |title=Current trends in the development of new antidepressants |journal=Curr. Med. Chem. |volume=8 |issue=2 |pages=89–100 |year=2001 |month=Februari |pmid=11172668 }} == Viungo vya nje == {{Commons category|Antidepressants}} {{Wiktionary|antidepressant}} * [http://www.nih.gov/news/pr/aug2003/nimh-07.htm Uumbaji wa Niuroni Mpya zilizo muhimu kwa Utendakazi wa Dawamfadhaiko kwenye Panya] {{Wayback|url=http://www.nih.gov/news/pr/aug2003/nimh-07.htm |date=20121010122000 }} * [http://cerhr.niehs.nih.gov/chemicals/fluoxetine/fluoxetine_final.pdf Jopo la Wataalamu la NIH kuhusu elimu juu ya asili na athari za sumu katika Prozac (Fluoxetine) kwa uzazi na kukua] {{Wayback|url=http://cerhr.niehs.nih.gov/chemicals/fluoxetine/fluoxetine_final.pdf |date=20090923193919 }} * [http://cerhr.niehs.nih.gov/chemicals/fluoxetine/fluoxetine_monograph.pdf Monografu ya NIH juu ya athari za Prozac (Fluoxetine) zinazoweza kujitokeza kwa uzazi na ukuaji wa binadamu] {{Wayback|url=http://cerhr.niehs.nih.gov/chemicals/fluoxetine/fluoxetine_monograph.pdf |date=20100527103308 }} * [http://www.psych.org/psych_pract/treatg/pg/MDD.watch.pdf Mwongozo wa Matibabu wa mwaka wa 1995 wa Ushirika wa Marekani wa Magonjwa ya Akili kwa ajili ya matibabu ya wagonjwa wenye ugonjwa wa Mfadhaiko mkuu] * [http://childadvocate.net/childpresentations/child_medication.htm Watoto na Madawa - wasilisho linalotumia mbinu nyingi] {{Wayback|url=http://childadvocate.net/childpresentations/child_medication.htm |date=20140810061955 }} * [http://www.bap.org.uk/consensus/antidepressant.pdf Shirika la Uingereza la Taaluma ya athari za dawa za magonjwa ya akili 2000 Miongozo inayozingatia ushahidi kwa kutibu magonjwa ya mfadhaiko kwa kutumia dawamfadhaiko] {{Wayback|url=http://www.bap.org.uk/consensus/antidepressant.pdf |date=20061012221324 }} * [http://biopsychiatry.com/index.html Mwongozo wa Madawa Mazuri: dawa mpya za kuboresha halihisi ya moyo na dawamfadhaiko] * [http://www.yoism.org/?q=node/234 Video ya Loren Mosher, MD] (Mkuu wa kwanza wa tafiti kuhusu Skizofrenia NIMH na mhariri mwanzilishi wa ''Bulletin dhiki)'' * [http://bmj.bmjjournals.com/cgi/content/full/330/7488/420 Joanna Moncrieff: Msingi wa ushahidi kuhusu dawamfadhaiko za awali ni dhaifu pia.] BMJ 2005;330:420 (19 Februari) * [http://www.healyprozac.com/Book/Introduction.pdf Utangulizi kwa ''Let Them Eat Prozac'' na David Healy] {{Wayback|url=http://www.healyprozac.com/Book/Introduction.pdf |date=20101226101007 }} * [http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/depression/antidepressants.aspx Ukurasa wenye habari kutoka Chuo cha Royal College of Psychiatrists] * Barry Yeoman, [http://www.barryyeoman.com/articles/courtroom.html Putting Science in the Dock, ] , The Nation * [http://ahp.yorku.ca/?p=60 Bibliografia kuhusu dawamfadhaiko katika historia ya saikolojia] * [http://www.rsc.org/Publishing/Journals/cb/Volume/2009/7/recognising_antidepressants.asp Ufahamu ya haraka] unaoonyesha jinsi mabadiliko madogo katika dawamfadhaiko yanaweza kubadilisha kwa kasi lengo lake katika ubongo. Kutoka kwa Royal Society of Chemistry * [http://www.ssristories.com/ Mkusanyiko wa habari 3100 na zaidi pamoja na makala kamili yanayopatikana, hasa kuhusu uhalifu, ambapo dawamfadhaiko zinatajwa.] {{Wayback|url=http://www.ssristories.com/ |date=20131212204756 }} * [http://news.bbc.co.uk/1/hi/health/8304782.stm Dawamfadhaiko hufanya kazi mara moja - Habari za BBC News] [[Jamii:madawa]] 1hoku0t8brpye4gs2kd9f6hkcojzne0 0 55351 1578188 1564502 2026-07-03T02:00:07Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578188 wikitext text/x-wiki {{tafsiri kompyuta}} {{Pp-move-indef}} {{Infobox disease | Name = Ulevi | Image = King Alcohol and his Prime Minister.jpg | Caption = "Mfalme Alkoholi na Waziri Mkuu wake", 1820 hivi | DiseasesDB = | ICD10 = {{ICD10|F|10||f|10}}.2 | ICD9 = {{ICD9|303}} | ICDO = | OMIM = | MedlinePlus = alcoholism | eMedicineSubj = | eMedicineTopic = 285913 | MeshID = D000437 }} '''Ulevi''' au '''uraibu wa pombe''' <ref>{{cite web |url=http://www.nlm.nih.gov/medlineplus/ency/article/000944.htm |title=Alcoholism |author=MedlinePlus |coauthors=National Library of Medicine |date=15 Januari 2009 |publisher=National Institute of Health }}</ref><ref>{{cite web |url=http://www.nih.gov/about/researchresultsforthepublic/AlcoholDependenceAlcoholism.pdf |title=Alcohol Dependence (Alcoholism) |author=Department of Health and Human Services |authorlink=Department of Health and Human Services |publisher=National Institutes of Health |format=PDF |accessdate=2010-10-18 |archivedate=2010-05-28 |archiveurl=https://web.archive.org/web/20100528081546/http://www.nih.gov//about/researchresultsforthepublic/AlcoholDependenceAlcoholism.pdf }}</ref> ni [[ulemavu]] unaotokana na unywaji [[pombe]] bila udhibiti licha ya madhara yake kwa [[afya]] ya mnywaji, mahusiano na hadhi yake machoni pa jamii. Kama matatizo mengine ya kiafya, ulevi ni mojawapo ya [[Ugonjwa|magonjwa]] yanayoweza kutibika.<ref>{{cite web |url=http://www.ama-assn.org/ama1/pub/upload/mm/388/alcoholism_treatable.pdf |title=DEFINITIONS |first= |last= |author=American Medical Association |authorlink=American Medical Association |publisher=AMA |location=USA |format=PDF |accessdate=2010-10-18 |archivedate=2010-03-04 |archiveurl=https://www.webcitation.org/5nyRluZTi?url=http://www.ama-assn.org/ama1/pub/upload/mm/388/alcoholism_treatable.pdf }}</ref> Neno "ulevi" hutumika kwa kawaida, lakini [[Shirika la Afya Duniani]] (WHO) limelifafanua kama "neno lililotumika kwa muda mrefu kwa maana tofautitofauti", na matumizi ya neno yalikataliwa na Kamati ya Wataalamu wake mwaka 1979 kama istilali ya kiafya, huku ikipendekeza "utegemezi pombe".<ref name="ladtpwho">{{cite web |url=http://www.who.int/substance_abuse/terminology/who_lexicon/en/ |title=Lexicon of alcohol and drug terms published by the World Health Organization |author=WHO |publisher=World Health Organisation }}</ref> Katika miktadha ya kitaalamu na kiutafiti, neno "ulevi" wakati mwingine hujumuisha utumiaji mbaya na utegemezi wa pombe.<ref>{{DorlandsDict|one/000002709|alcoholism}}</ref> na wakati mwingine kuchukuliwa kama kisawe cha utegemezi pombe. Hapana uhakika wa sababu za [[biolojia|kibiolojia]] zinazochangia ulevi, hata hivyo, hali hiyo yaweza kutokana na [[mazingira]] ya kijamii, [[mfadhaiko]] wa [[ubongo]],<ref name="Glavas">{{cite book | author = Glavas MM, Weinberg J| year = 2006 | chapter = Stress, Alcohol Consumption, and the Hypothalamic-Pituitary-Adrenal Axis | title = Nutrients, Stress, and Medical Disorders| editor = Yehuda S, Mostofsky DI| publisher = Humana Press | location = Totowa, NJ | isbn = 978-1-58829-432-6 | pages = 165–183}}</ref> tatizo la [[akili]], [[maumbile]], [[umri]], [[kabila]], na [[jinsia]].<ref name="Agarwal-Kozlowski-2000">{{Rejea jarida | last1 = Agarwal-Kozlowski | first1 = K. | last2 = Agarwal | first2 = DP. | title = [Genetic predisposition for alcoholism] | journal = Ther Umsch | volume = 57 | issue = 4 | pages = 179–84 | month = Apr | year = 2000 | pmid = 10804873 }}</ref><ref>{{Rejea jarida | last1 = Chen | first1 = CY. | last2 = Storr | first2 = CL. | last3 = Anthony | first3 = JC. | title = Early-onset drug use and risk for drug dependence problems. | url = https://archive.org/details/sim_addictive-behaviors_2009-03_34_3/page/319 | journal = Addict Behav | volume = 34 | issue = 3 | pages = 319–22 | month = Mar | year = 2009 | doi = 10.1016/j.addbeh.2008.10.021 | pmid = 19022584 | pmc = 2677076 }}</ref> Matumizi mabaya ya pombe kwa muda mrefu huleta mabadiliko ya kimwili katika ubongo kama vile uhimili na utegemezi. Mabadiliko ya [[kemia|kikemia]] katika ubongo hudumisha hali ya mlevi kushindwa kuacha pombe na huweza kusababisha dalili za mtegemea-pombe pale aachapo kunywa.<ref name="Hoffman-1996"></ref> Pombe huharibu takribani kila kiungo katika mwili, kwa sababu ya athari jumlishi ya [[sumu]] ya utegemezi pombe, mlevi hukumbwa na hatari nyingi za kimagonjwa na kiakili.<ref>{{cite book |editor1-first=Woody |editor1-last=Caan |editor2-first=Jackie de |editor2-last=Belleroche |title=Drink, Drugs and Dependence: From Science to Clinical Practice |url=http://books.google.com/?id=nPvbDUw4w5QC |edition=1st |date=11 Aprili 2002 |publisher=Routledge |isbn=978-0-415-27891-1 |pages=19–20}}</ref> ulevi una madhara makubwa ya kijamii kwa walevi na watu wanaohusika na maisha yao.<ref name="tcemh2006"></ref><ref name="abd2009"></ref> Ulevi ni athari inayodumu ya kuhimili na kutegemea matumizi ya pombe kupita kiasi; ukosefu wa kudhibiti ulevi, licha ya kufahamu madhara kwa afya, hudhihirisha kwamba mtu anaweza kuwa mlevi.<ref name="DSMIV"></ref> Uchunguzi kupitia hojaji ni njia ya kutambua mienendo ya unywaji hatari, ikiwemo utegemezi pombe.<ref name="Kahan-1996"></ref> Utoaji sumu ya pombe hufanywa ili kumwondoa mnywaji katika ulevi, kwa kawaida kwa dawa mbalimbali, kama vile benzodiazepini.<ref name="Blondell-2005"></ref> Utunzaji baada ya matibabu kama vile tiba ya kimakundi au katika vikundi vya kujisaidia binafsi, kwa kawaida huhitajika ili kudumisha ususiaji pombe.<ref name="Morgan-Lopez-2006"></ref><ref name="Soyka-2001"></ref> Mara nyingi, walevi pia ni wategemezi wa [[Mihadarati|mihadarati]] mingineyo, hasa benzodiazepini, ambayo inaweza kuhitaji matibabu ya ziada.<ref name="dolpdaa">{{cite journal |author=Johansson BA, Berglund M, Hanson M, Pöhlén C, Persson I |title=Dependence on legal [[psychotropic]] drugs among alcoholics |journal=Alcohol Alcohol. |volume=38 |issue=6 |pages=613–8 |year=2003 |pmid=14633651 |doi= 10.1093/alcalc/agg123|url=http://alcalc.oxfordjournals.org/cgi/reprint/38/6/613 |format=PDF |month= Novemba|issn=0735-0414}}</ref> [[Mwanamke]] mlevi huathirika zaidi kimwili, kihisia, na kiakili na ongezeko la unyanyapaa wa kijamii, kutokana na hali ya ulevi.<ref name="Blume Laura N., Nielson Nancy H., Riggs Joseph A., et all 1998 861–870"></ref><ref name="Walter H., Gutierrez K., Ramskogler K., Hertling I., Dvorak A., Lesch O.M., et al. 2003 253–268"></ref> Shirika la Afya Duniani linakadiria kuwa pana walevi milioni 140 duniani kote.<ref name="whoemcoypaa"></ref><ref name="whotmbcrtdhrai"></ref> ==Uainisho na istilahi== Utumiaji mbaya, utumiaji tatizi, utegemezi, na matumizi mazito hurejelea unywaji usiofaa wa pombe ambao unasababisha madhara ya kimwili, kijamii, au kimaadili.<ref name="the_american_heritage_dictionary_of_the_english_language_a12">{{Rejea kitabu | author = American Heritage Dictionaries | title = The American Heritage dictionary of the English language | url = http://books.google.com/?id=uPCFIQAACAAJ | date = 12 Aprili 2006 | publisher = Houghton Mifflin | location = Boston | edition = 4 |quote = To use wrongly or improperly; misuse: abuse alcohol | isbn = 978-0-618-70172-8 }}</ref> Matumizi ya wastani yanaelezwa na ''Mwongozo wa Lishe kwa Wamarekani'' kuwa yale yasiyozidi chupa mbili za vileo kwa siku kwa ajili ya wanaume na yasiyozidi chupa moja kwa siku kwa wanawake.<ref>{{cite web |url=http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm |title=Dietary Guidelines for Americans 2005 |year=2005 |publisher=health.gov |location=USA |accessdate=2010-10-18 |archiveurl=https://web.archive.org/web/20070701174135/http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm |archivedate=2007-07-01 |=https://web.archive.org/web/20070701174135/http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm }} malazi Mwongozo</ref> Katika mwaka 1960, Bill W. alisema: : Sisi kamwe hatujawahi kuuita ulevi ugonjwa kwa sababu, kwa mising ya kitaalamu, si namna ya ugonjwa. Kwa mfano, hakuna kitu kama ugonjwa wa moyo. Badala yake kuna aina tofauti ya kuugua moyo, au michanganyiko ya kuugua huko. Ni kitu kama hicho kwa ulevi. Ndiyo maana hatukutaka kuzua makosa na taaluma ya matibabu kwa kuchukulia taathira ya ulevi kuwa aina ya ugonjwa. Ndiyo maana sisi daima tukaiita kuugua, au maradhi - istilahi bora zaidi na salama muda sasa kwa ajili yetu kutumia.<ref name="McGovernWhite2003">{{cite book|author1=Thomas F. McGovern|author2=William L. White|title=Alcohol Problems in the United States: Twenty Years of Treatment Perspective|url=http://books.google.com/?id=3gRwmYohuooC&pg=PA7|accessdate=17 Aprili 2010|date=20 Mei 2003|publisher=Routledge|isbn=978-0-7890-2049-9|pages=7–}}</ref> Licha ya ukosefu wa hakika kuhusu neno hili, pamekuwa na majaribio ya kuelekeza jinsi neno "ulevi" linapaswa kufasiriwa wakati wowote.<ref>{{cite journal |author=Morse RM, Flavin DK |title=The definition of alcoholism. The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism |journal=JAMA : the journal of the American Medical Association |volume=268 |issue=8 |pages=1012–4 |year=1992 |month=Agosti |pmid=1501306 |doi=10.1001/jama.268.8.1012 |url=https://archive.org/details/sim_jama_1992-08-26_268_8/page/1012|issn=0098-7484 |format=}}</ref> [[File:1904 Claim of Alcoholism being Disease.jpg|thumb|150px|right|Tangazo la mwaka 1904 lililoeleza ulevi kama ugonjwa.]] Katika karne ya 19 na mapema karne ya 20, utegemezi pombe uliitwa dipsomania kabla ya kubadilishwa kuwa ulevi.<ref>{{Rejea kitabu | last1 = Tracy | first1 = Sarah J. | title = Alcoholism in America: from reconstruction to prohibition | url = http://books.google.com/?id=JkYyd4qmme0C&pg=PA31 | date = 25 Mei 2005 | publisher = Johns Hopkins University Press | location = Baltimore | isbn = 978-0-8018-8119-0 | pages = 31–52 }}</ref> Kihistoria, jina dipsomania lilibuniwa na daktari Mjerumani C W Hufeland mwaka 1819.<ref name="lexikon_psychiatrie_psychotherapie_medizinische_psychologie">{{Rejea kitabu | last1 = Peters | first1 = Uwe Henrik | title = Lexikon Psychiatrie, Psychotherapie, Medizinische Psychologie | date = 30 Aprili 2007 | publisher = Urban Fischer bei Elsev | isbn = 978-3-437-15061-6 }}</ref><ref>{{cite book | last = Valverde | first = Mariana | title = Diseases of the Will |page=48|url=http://books.google.com/?id=Kl5ugmvDgH0C&pg=PA48&lpg=PA48&dq=valentin+magnan+dipsomania | publisher = Cambridge University Press | location = Cambridge | year = 1998 | isbn = 978-0-521-64469-3 }}</ref> Neno "alcoholism" lilitumika mara ya kwanza mwaka wa 1849 na daktari Mswidi, Magnus Huss kuelezea madhara ya kitaratibu ya pombe.<ref>{{cite book|title=Alcoholismus chronicus, eller Chronisk alkoholssjukdom:|url=http://books.google.com/?id=wt6r2Zw8sCEC&pg=PR5|publisher=Stockholm und Leipzig|accessdate=19 Februari 2008|year=1852}}</ref> Chama cha Alcoholics Anonymous kinaeleza ulevi kama kuugua kunakohusu mzio wa kimwili<ref name="AABigBook">{{cite book | last = Anonymous | first = | authorlink = Alcoholics Anonymous | coauthors = The first 100 members of AA | title = Alcoholics Anonymous: the story of how many thousands of men and women have recovered from alcoholism | publisher = Alcoholics Anonymous World Services | date = 1939, 2001 | location = New York City | pages = xxxii, 575 p. | url = http://www.aa.org | doi = | id = | isbn = 1-893007-16-2 | nopp = true }}</ref>{{Rp|p.28}} na uzoefu wa kiakili.<ref name="AABigBook"></ref>{{Rp|p.23}}<ref>{{citeweb|title=The Big Book Self Test:|url=http://www.intoaction.us/SelfTest.html|publisher=intoaction.us|accessdate=19 Februari 2008}}</ref> Ufafanuzi wa "mzio" katika muktadha huu si sawa na unavyotumika katika utabibu wa kisasa.<ref>{{cite journal |author=Kay AB |title=Overview of 'allergy and allergic diseases: with a view to the future' |url=https://archive.org/details/sim_british-medical-bulletin_2000_56_4/page/n6 |journal=Br. Med. Bull. |volume=56 |issue=4 |pages=843–64 |year=2000 |pmid=11359624| doi = 10.1258/0007142001903481 |issn=0007-1420}}</ref> Daktari na mtalamu wa uzoefu wa dawa za kulevya William D. Silkworth MD anaandika kwa niaba ya AA kwamba "Walevi hukumbwa na tamaa (ya kimwili) "inayoshinda udhibiti wa akili".<ref name="AABigBook"></ref>{{Rp|XXVI}} Utafiti wa 1960 uliofanywa na E. Morton Jellinek unachukuliwa kuwa msingi wa nadharia ya kisasa ya ugonjwa wa ulevi.<ref>{{citeweb|title=OCTOBER 22 DEATHS|url=http://www.todayinsci.com/10/10_22.htm|publisher=todayinsci.com|accessdate=18 Februari 2008}}</ref> Ufafanuzi wa Jellinek uliwekea mipaka matumizi ya neno "ulevi" "kuwarejelea hasa walio na historia fulani asilia, lakini umerekibishwa mara nyingi tangu wakati huo. Chama cha Matabibu wa Marekani kwa sasa hutumia neno ulevi kurejelea hasa ugonjwa sugu wa msingi.<ref name="autogenerated1">{{cite web |url=http://www.ama-assn.org/ama1/pub/upload/mm/388/sci_drug_addiction.pdf |title=Science of Addiction |author=Nora Volkow |publisher=American Medical Association |format=PDF |accessdate=2010-10-18 |archivedate=2011-06-29 |archiveurl=https://web.archive.org/web/20110629022654/http://www.ama-assn.org/ama1/pub/upload/mm/388/sci_drug_addiction.pdf |=https://web.archive.org/web/20110629022654/http://www.ama-assn.org/ama1/pub/upload/mm/388/sci_drug_addiction.pdf }}</ref> Maoni ya wachache, hususan Herbert Fingarette na Stanton Peele, yanapinga kuwepo kwa ulevi kama ugonjwa. Wao hupendelea kutumia neno "unywaji mzito" wanapojadili athari hasi za matumizi ya pombe. ==Ishara na dalili== ===Dalili za matumizi mabaya ya pombe ya muda mrefu=== Ulevi hudhihirisha ongezeko la ustahimilivu na utegemezi kimwili katika pombe, na kuathiri uwezo wa mtu kudhibiti matumizi salama ya pombe. Dalili hizi ni huaminika kuchangia kushindwa kwa mlevi kuwa na uwezo wa kuacha kunywa.<ref name="Hoffman-1996">{{Rejea jarida | last1 = Hoffman | first1 = PL. | last2 = Tabakoff | first2 = B. | title = Alcohol dependence: a commentary on mechanisms. | url = https://archive.org/details/sim_alcohol-and-alcoholism_1996-07_31_4/page/333 | journal = Alcohol Alcohol | volume = 31 | issue = 4 | pages = 333–40 | month = Jul | year = 1996 | pmid = 8879279 }}</ref> Ulevi unaweza kuwa na madhara kwa afya ya akili, na kusababisha mvurugiko wa kiakili pamoja na ongezeko la hatari ya kujiua.<ref>{{cite journal |pmid=10476237 |year=1999 |month= Machi|last1=Dunn |first1=N |last2=Cook |title=Psychiatric aspects of alcohol misuse. |volume=60 |issue=3 |pages=169–72 |issn=1462-3935 |journal=Hospital medicine (London, England : 1998) |author2=Cook }}</ref><ref name="drug_abuse_prevention_a03">{{Rejea kitabu | last1 = Wilson | first1 = Richard | last2 = Kolander | first2 = Cheryl A. | title = Drug abuse prevention: a school and community partnership | year = 2003 | publisher = Jones and Bartlett | location = Sudbury, Mass. | url = http://books.google.com/?id=Cm1MfcBSucUC | isbn = 978-0-7637-1461-1 | pages = 40–45 }}</ref> ====Dalili za kimwili==== [[File:Possible long-term effects of ethanol.svg|thumb|351px|right|Baadhi ya madhara ya muda mrefu ya ethanol ambayo yanaweza kumkumba mtu. Zaidi ya hayo, pombe inaweza kuathiri mimba kwa wanawake wajawazito,]] Matumizi mabaya ya muda mrefu yanaweza kuzua dalili kadhaa katika mwili, zikiwa ni pamoja na sairosisi ya ini, ugonjwa wa kongosho, kifafa, polineuropathi, usahaulivu wa pombe, maradhi ya moyo, ukosefu wa lishe, na kutosisimka katika ngono. Madhara mengine ya kimwili ni pamoja na ongezeko la hatari ya ugonjwa wa mishipa ya moyo, [[kutofyonza lishe mwilini]], [[ugonjwa wa pombe unaoathiri ini]], na [[kansa]]. Uharibifu wa mfumo mkuu wa neva na mfumo wa neva za pembeni huweza kutokea pia.<ref>{{cite journal |author=Müller D, Koch RD, von Specht H, Völker W, Münch EM |title=[Neurophysiologic findings in chronic alcohol abuse] |language=German |journal=Psychiatr Neurol Med Psychol (Leipz) |volume=37 |issue=3 |pages=129–32 |year=1985 |month=Machi |pmid=2988001 }}</ref><ref>{{cite journal |author=Testino G |title=Alcoholic diseases in hepato-gastroenterology: a point of view |journal=Hepatogastroenterology |volume=55 |issue=82–83 |pages=371–7 |year=2008 |pmid=18613369 }}</ref> Wanawake hukabiliwa na matatizo ya muda mrefu ya utegemezi pombe haraka kuliko wanaume. Zaidi ya hayo, wanawake hufa kwa kiwango cha juu zaidi kutokana na ulevi.<ref name="Blume Laura N., Nielson Nancy H., Riggs Joseph A., et all 1998 861–870"></ref> Mifano ya matatizo ya muda mrefu ni pamoja na uharibifu wa ubongo, moyo, na ini <ref name="Walter H., Gutierrez K., Ramskogler K., Hertling I., Dvorak A., Lesch O.M., et al. 2003 253–268"></ref>, pia ongezeko la hatari ya saratani ya matiti. Zaidi ya hayo, unywaji mzito wa muda mrefu umegunduliwa kuwa na athari hasi katika uwezo wa kuzaa kwa wanawake. Hii husababisha mvurugiko wa uzazi kama vile kutozalisha vijiyai, kupunguka kwa kiwango cha molekuli ya ovari matatizo, au kukosa utaratibu wa hedhi, na kufunga uzazi mapema.<ref name="Blume Laura N., Nielson Nancy H., Riggs Joseph A., et all 1998 861–870"></ref> Ketoasidisi za pombe zinaweza kutokea kwa watu ambao hutumia pombe vibaya mara nyingi na walio na historia ya hivi majuzi ya ulevi kupindukia.<ref name="Mihai-">{{Rejea jarida | last1 = Mihai | first1 = B. | last2 = Lăcătuşu | first2 = C. | last3 = Graur | first3 = M. | title = [Alcoholic ketoacidosis] | journal = Rev Med Chir Soc Med Nat Iasi | volume = 112 | issue = 2 | pages = 321–6 | month = Aprili-Juni | year = 2008 | pmid = 19294998 }}</ref> ====Dalili za akili==== Matumizi mabaya ya muda mrefu wa pombe yanaweza kusababisha matatizo mbalimbali ya afya ya akili. Matatizo sugu ya ubongo si ya nadra, takribani asilimia 10 ya matukio yote ya shida za akili huhusiana na matumizi ya pombe, na hivyo kuifanya sababu kuu ya matatizo ya akili.<ref name="aamaibnc">{{cite web |url=http://www.eurekalert.org/pub_releases/2008-07/econ-ma070808.php |title=Alcoholism-associated molecular adaptations in brain neurocognitive circuits |accessdate=14 Februari 2009 |author=Professor Georgy Bakalkin |date=8 Julai 2008 |publisher=eurekalert.org |archive-date=2011-11-30 |archive-url=https://web.archive.org/web/20111130152434/http://www.eurekalert.org/pub_releases/2008-07/econ-ma070808.php |url-status=dead }}</ref> Matumizi ya pombe kupita kiasi husababisha uharibifu wa kazi za ubongo, na afya ya kisaikolojia inaweza kuathirika baada ya muda.<ref>{{cite journal |author=Oscar-Berman, Marlene|coauthors=Marinkovic, Ksenija|date=|year=2003 |title=Alcoholism and the brain: an overview|journal=Alcohol Res Health |volume=27 |issue=2 |pages=125–33 |pmid=15303622}}</ref> Mvurugiko wa akili ni jambo la kawaida kwa walevi, na hadi asilimia 25 hutatizika kwa mvurugiko sugu wa akili. Dalili ya tatizo la akili inayodhihirika zaidi ni wasiwasi na mfadhaiko. Dalili kwa kawaida huzidi mwanzoni mwa kuacha pombe, lakini hatimaye hupungua au kukoma baada ya mlevi kuacha pombe.<ref>{{cite journal |author=Wetterling T |journal=Eur Psychiatry |title=Psychopathology of alcoholics during withdrawal and early abstinence |year=2000 |month=Septemba |volume=15 |issue=8 |pages=483–8 |pmid=11175926 |doi=10.1016/S0924-9338(00)00519-8 |issn=0924-9338 |last2=Junghanns |first2=K }}</ref> Saikosi, kuchanganyikiwa, na dalili za ubongo zinaweza kusababishwa na matumizi mabaya ya pombe, ambayo yanaweza kudhanika kimakosa kuwa skizofrenia.<ref>{{cite journal |author=Schuckit MA |title=Alcoholism and other psychiatric disorders |journal=Hosp Community Psychiatry |volume=34 |issue=11 |pages=1022–7 |year=1983 |month=Novemba |pmid=6642446 |doi= |url= |issn=0022-1597}}</ref> Vurugu ya hofu inaweza kuendelea au kuzidi kutokana na matumizi mabaya ya moja kwa moja ya pombe kwa muda mrefu.<ref>{{cite journal |author=Cowley DS |journal=Am J Med |title=Alcohol abuse, substance abuse, and panic disorder |date= 24 Januari 1992 |volume=92 |issue=1A |pages=41S–48S |pmid=1346485 |doi=10.1016/0002-9343(92)90136-Y |issn=0002-9343 }}</ref><ref>{{cite journal |author=Cosci F |journal=J Clin Psychiatry |title=Alcohol use disorders and panic disorder: a review of the evidence of a direct relationship |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2007-06_68_6/page/n84 |year=2007 |month=Juni |volume=68 |issue=6 |pages=874–80 |pmid=17592911 |issn=0160-6689 |doi=10.4088/JCP.v68n0608 |last2=Schruers |first2=KR |last3=Abrams |first3=K |last4=Griez |first4=EJ }}</ref> Kutokea-kuwili kwa mvurugiko wa mfadhaiko na ulevi umeshugulikiiwa kwa mapana.<ref>{{cite journal |author=Grant BF, Harford TC |title=Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey |journal=Drug Alcohol Depend |volume=39 |issue=3 |pages=197–206 |year=1995 |month=Oktoba |pmid=8556968 |doi= 10.1016/0376-8716(95)01160-4|url=http://linkinghub.elsevier.com/retrieve/pii/0376871695011604 |issn=0376-8716}}</ref><ref>{{cite journal |author=Kandel DB, Huang FY, Davies M |title=Comorbidity between patterns of substance use dependence and psychiatric syndromes |journal=Drug Alcohol Depend |volume=64 |issue=2 |pages=233–41 |year=2001 |month=Oktoba |pmid=11543993 |doi= 10.1016/S0376-8716(01)00126-0|url=https://archive.org/details/sim_drug-and-alcohol-dependence_2001-10-01_64_2/page/232|issn=0376-8716}}</ref><ref>{{cite journal |author=Cornelius JR, Bukstein O, Salloum I, Clark D |title=Alcohol and psychiatric comorbidity |journal=Recent Dev Alcohol |volume=16 |issue= |pages=361–74 |year=2003 |pmid=12638646 |doi= 10.1007/0-306-47939-7_24|url= |issn=0738-422X |format=}}</ref> Miongoni mwa walio na hali ya komobidi; tofauti hubainishwa kwa kawaida kati ya mfadhaiko wa akili unaotokana na kuacha pombe ("Kutokana na vileweshaji"), na matukio ya msongangamano wa akili ya kimsingi na yasiyoondoshwa na kuacha ulevi(matukio "huru").<ref>{{cite journal |author=Schuckit MA, Tipp JE, Bergman M, Reich W, Hesselbrock VM, Smith TL |title=Comparison of induced and independent major depressive disorders in 2,945 alcoholics |journal=Am J Psychiatry |volume=154 |issue=7 |pages=948–57 |year=1997 |month=Julai |pmid=9210745 |doi= |url=http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=9210745 |issn=0002-953X}}</ref><ref>{{cite journal |author=Schuckit MA, Smith TL, Danko GP |title=A comparison of factors associated with substance-induced versus independent depressions |journal=J Stud Alcohol Drugs |volume=68 |issue=6 |pages=805–12 |year=2007 |month=Novemba |pmid=17960298 |doi= |url=https://archive.org/details/sim_journal-of-studies-on-alcohol-and-drugs_2007-11_68_6/page/805|issn=1937-1888}}</ref> Matumizi ya ziada ya dawa nyinginezo huweza kuzidisha hatari ya unyogovu. <ref>{{cite journal |author=Schuckit M |title=Alcoholic patients with secondary depression |journal=Am J Psychiatry |volume=140 |issue=6 |pages=711–4 |year=1983 |month=Juni |pmid=6846629 |doi= |url=http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=6846629 |issn=0002-953X}}</ref> Ugonjwa wa akili hutofautiana kutegemea jinsia. Wanawake walio na matatizo ya kutumia pombe mara nyingi huwa na utambuzi-andamizi wa matatizo ya akili ambayo hutokea kama msukumo mkubwa, wasiwasi, mvurugiko wa hofu, [[bulimia,-kiwewe]] cha baada ya tukio (PTSD), au mvurugo wa hali ya kitabia. Wanaume walio na matatizo ya kutumia pombe aghalabu zaidi hukumbwa na utambuzi-andamivu watabia ya kujienzi au kukosa mlahaka na watu , undumakuwili wa kitabia skizofrenia, matatizo ya msukumo au mvurugano wa hisia.<ref name="Karrol Brad R. 2002 337–356"></ref> Wanawake wanaolewa sana huwa na uwezekano mkubwa kuliko kawaida wa kuwa na historia ya mashambulizi ya kingono, udhalilishwaji na unyanyaswaji wa nyumbani ,<ref name="Karrol Brad R. 2002 337–356"></ref> ambayo yanaweza kusababisha matukio mengi ya kutatizika kiakili na utegemezi zaidi wa pombe. ====Athari za kijamii==== Matatizo ya kijamii kutokana na ulevi ni sugu, husababishwa na mabadiliko katika ubongo na kuleweshwa na pombe.<ref name="aamaibnc"></ref><ref name="Jessica Kingsley Publishers"></ref> Matumizi mabaya ya pombe huhusishwa na ongezeko la hatari ya kutenda makosa ya jinai, ikiwa ni pamoja na unyanyasaji wa watoto, ukatili wa nyumbani, ubakaji, uvunjaji na kushambuliaji.<ref name="drug_use_a_reference_handbook">{{Rejea kitabu | last1 = Isralowitz | first1 = Richard | title = Drug use: a reference handbook | url = http://books.google.com/?id=X0mxxfbIbp4C | year = 2004 | publisher = ABC-CLIO | location = Santa Barbara, Calif. | isbn = 978-1-57607-708-5 | pages = 122–123}}</ref> Ulevi huhusishwa na upotezaji ajira, <ref>{{Rejea kitabu | last1 = Langdana | first1 = Farrokh K. | title = Macroeconomic Policy: Demystifying Monetary and Fiscal Policy | url = http://books.google.com/?id=GCYWQn79JYwC | date = 27 Machi 2009 | publisher = Springer | edition = 2nd | isbn = 978-0-387-77665-1 | page = 81 }}</ref> ambayo huweza kusababisha matatizo ya kifedha. Kunywa wakati usiofaa, na matendo yanayosababishwa na kupungua kwa uwezo wa kuamua, kunaweza kusababisha matatizo ya kisheria, kama vile mashtaka ya mtu kuendesha gari akiwa mlevi <ref name="abd2009">{{Rejea kitabu | last1 = Gifford | first1 = Maria | title = Alcoholism (Biographies of Disease) | date = 22 Oktoba 2009 | publisher = Greenwood Press | url = http://books.google.com/?id=2OJV12astRUC | isbn = 978-0-313-35908-8 | pages = 89–91 }}</ref> au machafuko ya umma, au adhabu za kijamii kwa ukosefu wa nidhamu, na kuhukumiwa kwa uhalifu. Tabia ya mlevi na kutatizika akili inaweza kuwaathiri sana walio karibu nao na kusababisha kutengwa na familia na marafiki. kutengwa huku kunaweza kusababisha migogoro ya ndoa na kutalikiana, au kuchangia vurugu za nyumbani. Ulevi pia unaweza kusababisha kutelekezwa kwa watoto, na uharibifu wa kudumu wa ukuaji kihisia wa watoto wa mlevi.<ref name="tcemh2006">{{Rejea kitabu | last1 = Schadé | first1 = Johannes Petrus | title = The Complete Encyclopedia of Medicine and Health | date = Oktoba 2006 | publisher = Foreign Media Books | url = http://books.google.com/?id=j8DuEHxSCU4C | isbn = 978-1-60136-001-4 | pages = 132–133 }}</ref> ===Kuacha pombe=== Sawa na vileweshaji vya aina hii vyenye uwezo wa kudumaza-kupagaza, kama babitureti na benzodiazepini, kuacha utegemezi wa pombe kunaweza kuleta madhara kusipotekelezwa vyema.<ref name="Jessica Kingsley Publishers"></ref><ref>{{cite book |last1=Galanter |first1=Marc |last2=Kleber |first2=Herbert D. |title=The American Psychiatric Publishing Textbook of Substance Abuse Treatment |url=http://books.google.com/?id=6wdJgejlQzYC |edition=4th |date=1 Julai 2008 |publisher=American Psychiatric Publishing Inc |location=United States of America |isbn=978-1-58562-276-4 |page=58 |pages= |chapter= |chapterurl= }}</ref> Athari ya msingi ya pombe ni kuzidisha msisimko wa vihisishi vy aGABA _A, kuendeleza maudhiko ya mfumo mkuu wa neva. Kufutana na matumizi mazito ya pombe, vihisishi hivi hupoteza uwezo wa kuhisi na kupungua kwa idadi, na hivyo kusababisha uzoefu na utegemezi wa kimwili. Matumizi ya pombe yakisimamishwa ghafla mno, mfumo wa neva wa mtu hukumbwa na ukosefu wa udhibiti wa matukio ya kihisia. Hii inaweza kusababisha dalili kama vile wasiwasi, kutishika, kupagawa kudhania, mitetemo wa mwili na kuugua moyo.<ref name="Medical toxicology">{{cite book |last1=Dart |first1=Richard C. |title=Medical Toxicology |url=http://books.google.com/?id=qDf3AO8nILoC |edition=3rd |date=1 Desemba 2003 |publisher=Lippincott Williams & Wilkins |location=USA |isbn=978-0-7817-2845-4 |pages=139–140}}</ref><ref>{{cite journal |author=Idemudia SO, Bhadra S, Lal H |title=The pentylenetetrazol-like interoceptive stimulus produced by ethanol withdrawal is potentiated by bicuculline and picrotoxinin |journal=Neuropsychopharmacology |volume=2 |issue=2 |pages=115–22 |year=1989 |month=Juni |pmid=2742726 |doi= 10.1016/0893-133X(89)90014-6|url= |issn=0893-133X |format=}}</ref> Mifumo mingine ya kimawasiliano ya neva pia hushirikishwa, hasa dopamini na NMDA.<ref name="Hoffman-1996"></ref><ref>{{cite journal |pmid=17128954 |date= Oktoba 2006|author=Chastain, G |title=Alcohol, neurotransmitter systems, and behavior. |url=https://archive.org/details/sim_journal-of-general-psychology_2006-10_133_4/page/329 |volume=133 |issue=4 |pages=329–35 |issn=0022-1309 |journal=The Journal of general psychology |doi=10.3200/GENP.133.4.329-335 }}</ref> Dalili kali za kuacha pombe aghalabu hupungua baada ya wiki 1-3. Dalili zisizo kali (k.m. kukosa usingizi na wasiwasi, anhedonia) huendelea kama sehemu ya dalili za baada ya kuacha pombe, na hatimaye hupungua angalau baada ya mwaka au zaidi.<ref>{{cite journal |author=Martinotti G |journal=Subst Use Misuse |title=Alcohol protracted withdrawal syndrome: the role of anhedonia |year=2008 |volume=43 |issue=3–4 |pages=271–84 |pmid=18365930 |doi=10.1080/10826080701202429 |issn=1082-6084 |last2=Nicola |first2=MD |last3=Reina |first3=D |last4=Andreoli |first4=S |last5=Focà |first5=F |last6=Cunniff |first6=A |last7=Tonioni |first7=F |last8=Bria |first8=P |last9=Janiri |first9=L }}</ref><ref>{{cite journal | author = Stojek A | year = 1990 | month = Mei–Juni | title = [Correction of the symptoms of late substance withdrawal syndrome by intra-conjunctival administration of 5% homatropine solution (preliminary report)] | journal = Psychiatr Pol | volume = 24 | issue = 3 | pages = 195–201 | pmid = 2084727 | issn = 0033-2674 | url = | format = | last2 = Madejski | first2 = J | last3 = Dedelis | first3 = E | last4 = Janicki | first4 = K }}</ref><ref>{{cite journal | author =Le Bon O | year =2003 |month=Agosti | title =Double-blind, placebo-controlled study of the efficacy of trazodone in alcohol post-withdrawal syndrome: polysomnographic and clinical evaluations | journal =J Clin Psychopharmacol | volume =23 |issue=4 | pages =377–83 | pmid =12920414 | doi =10.1097/01.jcp.0000085411.08426.d3 | issn =0271-0749 | last2 =Murphy | first2 =JR | last3 =Staner | first3 =L | last4 =Hoffmann | first4 =G | last5 =Kormoss | first5 =N | last6 =Kentos | first6 =M | last7 =Dupont | first7 =P | last8 =Lion | first8 =K | last9 =Pelc | first9 =I }}</ref> Dalili za baada ya kuacha pombe huanza kupunguka jinsi mwili na mfumo mkuu wa neva hendelea kurejesha pombe udhibiti wa pombe na GABA kurejelea kazi kikawaida.<ref>{{ cite journal |pmid=14684873 |url=http://www.jneurosci.org/cgi/content/full/23/37/11711 |date=17 Desemba 2003 |title=Changes in GABA(A) receptor gene expression associated with selective alterations in receptor function and pharmacology after ethanol withdrawal |volume=23 |issue=37 |pages=11711–24 |issn=0270-6474 |journal=The Journal of neuroscience : the official journal of the Society for Neuroscience |author1=Sanna, E |author2=Mostallino, Mc |author3=Busonero, F |author4=Talani, G |author5=Tranquilli, S |author6=Mameli, M |author7=Spiga, S |author8=Follesa, P |author9=Biggio, G }}</ref><ref>{{cite journal |author=Idemudia SO, Bhadra S, Lal H |title=The pentylenetetrazol-like interoceptive stimulus produced by ethanol withdrawal is potentiated by bicuculline and picrotoxinin |journal=Neuropsychopharmacology |volume=2 |issue=2 |pages=115–22 |year=1989 |month=Juni |pmid=2742726 |doi= 10.1016/0893-133X(89)90014-6|url= |format=}}</ref> ==Sababu== Mchanganyiko changamano wa maumbile na mazingira huchangia kuendelea kwa ulevi.<ref name="Enoch-2006">{{Rejea jarida | last1 = Enoch | first1 = MA. | title = Genetic and environmental influences on the development of alcoholism: resilience vs. risk. | journal = Ann N Y Acad Sci | volume = 1094 | pages = 193–201 | month = Dec | year = 2006 | doi = 10.1196/annals.1376.019 | pmid = 17347351 }}</ref> Jeni zinazoathiri metaboli ya pombe pia huchangia hatari ya kutumbukia ulevini, na huweza kuonekana kutokana na historia ya familia ya ulevi.<ref>{{Rejea jarida | last1 = Bierut | first1 = LJ. | last2 = Schuckit | first2 = MA. | last3 = Hesselbrock | first3 = V. | last4 = Reich | first4 = T. | title = Co-occurring risk factors for alcohol dependence and habitual smoking. | journal = Alcohol Res Health | volume = 24 | issue = 4 | pages = 233–41 | year = 2000 | pmid = 15986718 }}</ref> Chapisho moja liligundua kwamba matumizi ya pombe tokea umri mdogo unaweza kuendeleza ukuaji wa jeni ambayo huongeza hatari ya utegemezi wa pombe.<ref>{{cite journal |doi=10.1111/j.1530-0277.2009.01044.x |pmc=2883563 |title=Evidence for an Interaction Between Age at First Drink and Genetic Influences on DSM-IV Alcohol Dependence Symptoms |pmid=19764935 |year=2009 |last1=Agrawal |first1=Arpana |last2=Sartor |first2=Carolyn E. |last3=Lynskey |first3=Michael T. |last4=Grant |first4=Julia D. |last5=Pergadia |first5=Michele L. |last6=Grucza |first6=Richard |last7=Bucholz |first7=Kathleen K. |last8=Nelson |first8=Elliot C. |last9=Madden |first9=Pamela A. F. |journal=Alcoholism: Clinical and Experimental Research |volume=33 |issue=12 |pages=2047 }}</ref> Watu walio na uwezekano / kimaumbile wa kutegemea ulevi pia huwa na uwezekano mkubwa wa kuanza kunywa katika umri mapema kuliko wastani.<ref name="eattrfad">{{cite web |url=http://www.medicalnewstoday.com/articles/164576.php |title=Early Age At First Drink May Modify Tween/Teen Risk For Alcohol Dependence |date=21 Septemba 2009 |publisher=Medical News Today |accessdate=2010-10-18 |archivedate=2010-02-13 |archiveurl=https://web.archive.org/web/20100213100208/http://www.medicalnewstoday.com/articles/164576.php |=https://web.archive.org/web/20100213100208/http://www.medicalnewstoday.com/articles/164576.php }}</ref> Kuanza unywaji pombe katika umri mdogo pia huhusishwa na ongezeko la hatari ya kuzidisha ulevi,<ref name="eattrfad"></ref>na takribani asilimia 40 ya walevi hunywa kupita kiasi kufikia umri wa kubaleghe. Haijaeleweka wazi kabisa iwapo uhusiano huu ndiyo kiini cha ulevi, na watafiti wengine hawakubaliana na mtazamo huu.<ref name="Schwandt-2010">{{Rejea jarida | doi = 10.1016/j.alcohol.2009.09.034 | last = Schwandt | first = M.L. |coauthors= S.G. Lindell, S. Chen, J.D. Higley, S.J. Suomi, M. Heilig, C.S. Barr| title =Alcohol response and consumption in adolescent rhesus macaques | url = https://archive.org/details/sim_alcohol_2010-02_44_1/page/67 | journal = Alcohol | volume = 44 | issue = 1 | pages = 67–80 | month = Feb | year = 2010 |pmc=2818103 | pmid= 20113875}}</ref> Kiwewe kikali cha utotoni pia huhusishwa na ongezeko la jumla katika hatari ya utegemezi wa dawa za kulevya.<ref name="Enoch-2006"></ref> Ukosefu wa usaidizi wa rika na familia huhusishwa na ongezeko la hatari ya kuendeleza ulevi.<ref name="Enoch-2006"></ref> Maumbile na ujana huhusishwa na ongezeko la athiri za madhara ya ya pombe kwa neva kutokana na matumizi ya pombe kupindukia. Kuzorota kwa gamba la ubongo kutokana na athari za ulevi kwa ubongo huongeza tabia ya kutotulia, ambayo yaweza kuchangia kukua, kudumu na usugu wa matatizo ya matumizi ya pombe. Kuna ushahidi kwamba kuacha pombe, husaidia kugeuza baadhi ya uharibifu ya pombe kwa mfumo mkuu wa neva .<ref name="Crews-2009">{{Rejea jarida | last1 = Crews | first1 = FT. | last2 = Boettiger | first2 = CA. | title = Impulsivity, frontal lobes and risk for addiction. | journal = Pharmacol Biochem Behav | volume = 93 | issue = 3 | pages = 237–47 | month = Sep | year = 2009 | doi = 10.1016/j.pbb.2009.04.018 | pmc = 2730661 | pmid = 19410598 }}</ref> ===Maumbile tofauti=== Tofauti za kimaumbile huwepo kati ya makundi mbalimbali ya kimbari nazo huchangia hatari ya kuanza utegemezi wa pombe. Kwa mfano, zipo tofauti kati ya Afrika Mashariki, Asia Mashariki na vikundi vya mbari za- Kihindi kuhusu jinsi ya uvunjaji kemikali za pombe. Hali hizi za kimaumbile huaminika, kwa kiasi, kueleza viwango tofauti vya utegemezi pombe miongoni mwa makundi ya kimbari.<ref name="Moore-2007">{{Rejea jarida | last1 = Moore | first1 = S. | last2 = Montane-Jaime | first2 = LK. | last3 = Carr | first3 = LG. | last4 = Ehlers | first4 = CL. | title = Variations in alcohol-metabolizing enzymes in people of East Indian and African descent from Trinidad and Tobago. | journal = Alcohol Res Health | volume = 30 | issue = 1 | pages = 28–30 | year = 2007 | pmid = 17718398 }}</ref><ref name="Eng-2007">{{Rejea jarida | last1 = Eng | first1 = MY. | last2 = Luczak | first2 = SE. | last3 = Wall | first3 = TL. | title = ALDH2, ADH1B, and ADH1C genotypes in Asians: a literature review. | journal = Alcohol Res Health | volume = 30 | issue = 1 | pages = 22–7 | year = 2007 | pmid = 17718397 }}</ref> Dehaidrojenesi ya pombe allele ADH1 B * 3 husababisha metaboliki ya haraka zaidi ya pombe. Allele ADH1 3 B * hupatikana tu kwa watu wa asili ya Afrika na baadhi ya makabila ya wenyeji asilia wa Marekani. Waafrika na Wamarekani asilia walio na allele huwa katika hatari ndogo ya kulemewa na ulevi.<ref name="Scott-2007">{{Rejea jarida | last1 = Scott | first1 = DM. | last2 = Taylor | first2 = RE. | title = Health-related effects of genetic variations of alcohol-metabolizing enzymes in African Americans. | journal = Alcohol Res Health | volume = 30 | issue = 1 | pages = 18–21 | year = 2007 | doi = | pmid = 17718396 }}</ref> Wenyeji asilia wa Marekani hata hivyo, huwa na kiwango cha juu sana cha ulevi kuliko wastani, sababu ya hali hii si wazi.<ref name="Ehlers-2007">{{Rejea jarida | last1 = Ehlers | first1 = CL. | title = Variations in ADH and ALDH in Southwest California Indians. | journal = Alcohol Res Health | volume = 30 | issue = 1 | pages = 14–7 | year = 2007 | pmid = 17718395 }}</ref> Hatari nyinginezo kutokana na mazingira ya kitamaduni kama vilekiwewe zimehusishwa na kiwango cha juu cha ulevi miongoni mwa Wamarekani Wenyeji ikilinganishwa na viwango vya ulevi miongoni mwa wazungu.<ref name="Szlemko-2006">{{Rejea jarida | doi = 10.3200/GENP.133.4.435-451 | last1 = Szlemko | first1 = WJ. | last2 = Wood | first2 = JW. | last3 = Thurman | first3 = PJ. | title = Native Americans and alcohol: past, present, and future. | url = https://archive.org/details/sim_journal-of-general-psychology_2006-10_133_4/page/435 | journal = J Gen Psychol | volume = 133 | issue = 4 | pages = 435–51 | month = Oct | year = 2006 | pmid = 17128961 }}</ref><ref name="Spillane-2007">{{Rejea jarida | last1 = Spillane | first1 = NS. | last2 = Smith | first2 = GT. | title = A theory of reservation-dwelling American Indian alcohol use risk. | url = https://archive.org/details/sim_psychological-bulletin_2007-05_133_3/page/395 | journal = Psychol Bull | volume = 133 | issue = 3 | pages = 395–418 | month = Mei | year = 2007 | doi = 10.1037/0033-2909.133.3.395 | pmid = 17469984 }}</ref> ==Pathofisiolojia== Athari za msingi za pombe ni kuongezeka kwa msisimuo wa vipohisishi vya GABA _A, kuendeleza unyongovu wa rmfumo mkuu wa neva. Kwa matumizi ya pombe kwa wingi, vihisishi hivyo hulemazwa na kupungua kwa idadi, na hivyo kusababisha uzoelevu na utegemezi wa kimwili.<ref name="Medical toxicology"></ref> Kiasi cha pombe ambacho kinaweza kuhimilika pamoja na athari zake hutofautiana kati ya jinsia. Kiasi sawa cha pombe kinaponywewa na wanaume na wanawake, kwa ujumla husababisha wanawake kuwa na viwango vilivyokolea vya pombe katika damu (BACs).<ref name="Karrol Brad R. 2002 337–356">{{cite journal |author=Karrol Brad R. |title=Women and alcohol use disorders: a review of important knowledge and its implications for social work practitioners |url=https://archive.org/details/sim_british-journal-of-social-work_2002-04_32_3/page/337 |journal=Journal of social work |volume=2 |issue=3 |pages=337–356 |year=2002 |doi=10.1177/146801730200200305 }}</ref> Hali hiyo inaweza kuhusishwa na sababu nyingi, ya msingi ikiwa kwamba wanawake wana maji machache mwilini kuliko wanaume, hivyo pombe hukolea zaidi katika mwili wa mwanamke. Pia kiasi kilekile cha pombe husababisha athari kubwa kwa wanawake kutokana na homoni tofauti zinazosisimuliwa ikilinganishwa na wanaume.<ref name="Walter H., Gutierrez K., Ramskogler K., Hertling I., Dvorak A., Lesch O.M., et al. 2003 253–268"></ref> ==Utambuzi== ===Vikwazo vya kijamii=== Mitazamo na imani za jamii vinaweza kusababisha vizuizi kwa utambuzi na tiba kwa utumiaji mbaya wa pombe. Hiki ni kikwazo zaidi kwa wanawake kuliko wanaume. Hofu ya unyanyapaa inaweza kusababisha wanawake kukana kuwa wanatatizika na ulevi, kujificha ili kunywa, na hata kunywa peke yao. Mazoea haya kwa upande wake, hupelekea familia, madaktari, na wengine kukosa uwezekano wa kushuku kuwa mwanamke wanayemjua ni mlevi kupindukia.<ref name="Blume Laura N., Nielson Nancy H., Riggs Joseph A., et all 1998 861–870">{{cite journal |author=Blume Laura N., Nielson Nancy H., Riggs Joseph A., ''et all'' |title=Alcoholism and alcohol abuse among women: report of the council on scientific affairs |journal=Journal of women's health |volume=7 |issue=7 |pages=861–870 |year=1998 |doi= 10.1089/jwh.1998.7.861|url=}}</ref> Kinyume na hivi, upungufu wa hofu ya unyanyapaa unaweza kusababisha watu wanaokabiliwa na matatizo ya kiafya kuonyesha ulevi wao hadharani, na kunywa katika vikundi. Mazoea haya, kwa upande wake, hupelekea familia, madaktari na wengine kuwa uwezekano wa kumshuku mtu wanayemjua.<ref name="Karrol Brad R. 2002 337–356"></ref> ===Uchunguzi=== Vifaa kadhaa vinaweza kutumika kugundua ukosefu wa udhibiti wa matumizi ya pombe. Vifaa hivi mara nyingi huwa ripoti na fomu za hojaji za mtu binafsi. Suala jingine la kawaida ni kipimo au ujumla wa ukali wa matumizi ya pombe.<ref name="Kahan-1996">{{Rejea jarida | last1 = Kahan | first1 = M. | title = Identifying and managing problem drinkers. | journal = Can Fam Physician | volume = 42 | issue = | pages = 661–71 | month = Apr | year = 1996 | doi = | pmid = 8653034 | pmc = 2146411 }}</ref> Hojaji za CAGE, zinazoitwa hivyo kufuatana na maswali yake manne, ni mfano unaoweza kutumika kwa kuchunguza wagonjwa kwa haraka katika ofisi ya daktari. {{Quotation|Two "yes" responses indicate that the respondent should be investigated further. The questionnaire asks the following questions: # Have you ever felt you needed to '''C'''ut down on your drinking? # Have people '''A'''nnoyed you by criticizing your drinking? # Have you ever felt '''G'''uilty about drinking? # Have you ever felt you needed a drink first thing in the morning ('''E'''ye-opener) to steady your nerves or to get rid of a hangover?<ref>{{cite journal |author=Ewing JA |title=Detecting alcoholism. The CAGE questionnaire |journal=JAMA : the journal of the American Medical Association |volume=252 |issue=14 |pages=1905–7 |year=1984 |month=Oktoba |pmid=6471323 |doi=10.1001/jama.252.14.1905 |url= |issn=0098-7484 |format= }}</ref><ref>{{cite web |url=http://www.whoguidemhpcuk.org/downloads/primary_care/11-1_CAGE_questionnaire.pdf |title=CAGE questionnaire – screen for alcohol misuse |format=PDF |accessdate=2010-10-18 |archivedate=2011-07-28 |archiveurl=https://web.archive.org/web/20110728175054/http://www.whoguidemhpcuk.org/downloads/primary_care/11-1_CAGE_questionnaire.pdf }}</ref>}} : Hojaji za CAGE zimedhihirisha ufanisi mkubwa katika kuchunguza matatizo kuhusiana na pombe, hata hivyo, huwa na pungufu zitumiwapo kwa watu wasio na matatizo sugu kuhusiana na pombe , wanawake wazungu na na wanafunzi wa chuo.<ref>{{Rejea jarida | last1 = Dhalla | first1 = S. | last2 = Kopec | first2 = JA. | title = The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies. | journal = Clin Invest Med | volume = 30 | issue = 1 | pages = 33–41 | year = 2007 | pmid = 17716538 }}</ref> Vipimo vingine wakati mwingine hutumika kwa uchunguzi wa utegemezi wa pombe, kama vile Hojaji ya Data ya Utegemezi wa Pombe, ambayo ni utambuzi changanuzi zaidi kuliko ile ya CAGE. Husaidia kutofautisha utambuzi kati ya utegemezi pombe na matumizi sugu ya pombe.<ref>{{cite web |url=http://www.emcdda.europa.eu/html.cfm/index3556EN.html |title=Alcohol Dependence Data Questionnaire (SADD) |author=Raistrick, D. |coauthors=Dunbar, G. Davidson, R. |year=1983 |publisher=European Monitoring Centre for Drugs and Drug Addiction |accessdate=2010-10-18 |archivedate=2016-07-21 |archiveurl=https://web.archive.org/web/20160721101929/http://www.emcdda.europa.eu/html.cfm/index3556EN.html |=https://web.archive.org/web/20160721101929/http://www.emcdda.europa.eu/html.cfm/index3556EN.html }}</ref> Kipimo cha Michigan Alcohol Screening Test (MAST) ni chombo cha uchunguzi wa ulevi itumiwayo kwingi na mahakama kuamua adhabu mwafaka kwa watu wapatikanao na makosa yanayohusiana na pombe,<ref>{{cite web |url=http://www.ncadd-sfv.org/symptoms/mast_test.html |title=Michigan Alcohol Screening Test |publisher=The National Council on Alcoholism and Drug Dependence |accessdate=2010-10-18 |archivedate=2006-09-06 |archiveurl=https://web.archive.org/web/20060906123532/http://www.ncadd-sfv.org/symptoms/mast_test.html }}</ref>ambapo uendeshaji gari baada ya kunywa ndilo la kawaida mno. Kipimo cha Utambuzi wa Matatizo ya Pombe (Audit),ambayo ni hojaji ya uchunguzi iliyovumbuliwa na [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]], ina upekee kwa kuwa imeidhinishwa katika nchi sita na hutumiwa kimataifa. Kama vile hojaji za CAGE, matumizi yake ni hutegemea maswali rahisi - kipimo cha juu hupelekea uchunguzi wa kina.<ref>{{cite web |url=http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf |title=The Alcohol Use Disorders Identification Test, Guidelines for Use in Primary Care |author=Thomas F. Babor |coauthors=John C. Higgins-Biddle, John B. Saunders, Maristela G. Monteiro |month=2001 |publisher=World Health Organization |format=PDF |accessdate=2010-10-18 |archivedate=2006-05-02 |archiveurl=https://web.archive.org/web/20060502132711/http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf }}</ref> Kipimo cha Paddington Alcohol Test (PAT) kiliundwa kuchunguzia matatizo kuhusiana na pombe miongoni mwa wale wanaohudhuria matibabu ya ajali na ya dharura s. Huwiana vyema na hojaji ya AUDIT lakini hutumiwa kwa kiwango cha moja kwa tano ya nyakati zote.<ref>{{cite journal|last=Smith|first=SG|title=Detection of alcohol misusing patients in accident and emergency departments: the Paddington alcohol test (PAT)|journal=Journal of Accident and Emergency Medicine|volume=13|issue=5|pages=308–312|publisher=British Association for Accident and Emergency Medicine|month=Septemba | year=1996|accessdate=19 Novemba 2006|pmid=8894853|doi=10.1093/alcalc/agh049|issn=1351-0622|pmc=1342761|last2=Touquet|first2=R|last3=Wright|first3=S|last4=Das Gupta|first4=N}}</ref> ===Upimaji Hali ya Kimaumbile=== Madaktari wa akili John I. Nurnberger, Jr, na Laura Jean Bierut wanadai kwamba ulevi hauna sababu moja mahususi-ikiwa ni pamoja na maumbile-lakini jeni huwa na jukumu muhimu "kwa kuathiri michakato ya ndani ya mwili na ubongo ambayo huingiliana na na tajriba ya mtu binafsi ya maisha na kusababisha kinga au kuugua ". Pia waliripoti kuwa chini ya dazeni-ya jeni zinazohusishwa na ulevi zimetambuliwa, lakini nyinginezo zaidi zangojea kugunduliwa.<ref name="Nurnberger"> Nurnberger, Jr, John I., na Bierut, Laura Jean. [http://www.sciam.com/article.cfm?chanID=sa006&amp;colID=1&amp;articleID=5C303E5F-E7F2-99DF-315ADC8A107AE976 "Kubaini Mahusiano: Ulevi na Jeni zetu."] ''Scientific American,'' Apr 2007, Vol. 296, Kua 4.</ref> Angalau upo uchunguzi mmoja wa kimaumbile wa allele ambao huhusiana na ulevi na dawa za kulevya.<ref>[205] ^ New York Daily News (William Sherman) [http://www.nydailynews.com/archives/news/2006/02/12/2006-02-12_test_targets_addiction_gene.html Jaribio Hulenga Jeni ya kulevya ] {{Wayback|url=http://www.nydailynews.com/archives/news/2006/02/12/2006-02-12_test_targets_addiction_gene.html |date=20200406113524 }}11 Februari 2006</ref> Vihisishi vya dopamini vya jeni huwa na tofauti bainifu zinazojulikana kama polimofi kama vile DRD2 TaqI. Wale walio na (aina hii ya )polimofimi ya A1 allele huwa na uzoefu wa kiwango kidogo lakini muhimu wa dawa za kulevya na vilewevu vya endofini-kutokana dawa kama pombe.<ref>{{cite journal |author=Berggren U, Fahlke C, Aronsson E |title=The taqI DRD2 A1 allele is associated with alcohol-dependence although its effect size is small |journal=Alcohol and alcoholism (Oxford, Oxfordshire) |volume=41 |issue=5 |pages=479–85 |year=2006 |pmid=16751215 |doi=10.1093/alcalc/agl043 |url=http://alcalc.oxfordjournals.org/cgi/content/full/41/5/479 |month= Septemba|issn=0735-0414 |format=Free full text}}</ref> Ingawa allele hii hupatikana zaidi katika walevi na watumiaji wa dawa za kulevya, yenyewe sio ishara tosha ya mazoea ya ulevi, na baadhi ya watafiti wanasema kuwa ushahidi wa DRD2 ni tofauti.<ref name="Nurnberger"></ref> ===Utambuzi wa DSM=== Utambuzi wa DSM-IV wa utegemezi pombe ni mojawapo ya mitazamo fafanuzi ya ulevi. Hii husaidia kukuza itifaki za kitafiti ambapo matokeo yanaweza kufananishwa na mengine. Kwa mujibu wa DSM-IV, ni utambuzi wa utegemezi pombe :<ref name="DSMIV">{{Rejea kitabu | title = Diagnostic and statistical manual of mental disorders: DSM-IV | url = http://books.google.com/?id=W-BGAAAAMAAJ | date = 31 Julai 1994 | publisher = American Psychiatric Association | location = Washington, DC | isbn = 978-0-89042-025-6 | pages = }}</ref> {{quote|...&nbsp;maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological [[sequela]]e.}} ===Mkojo na vipimo vya damu=== Pana majaribio ya kuaminika ya matumizi hakika ya pombe, mojawapo ya majaribio ya kawaida ni ya kiasi cha pombe katika damu (BAC).<ref>{{Rejea jarida | last1 = Jones | first1 = AW. | title = Urine as a biological specimen for forensic analysis of alcohol and variability in the urine-to-blood relationship. | url = https://archive.org/details/sim_toxicological-reviews_2006_25_1/page/15 | journal = Toxicol Rev | volume = 25 | issue = 1 | pages = 15–35 | year = 2006 | pmid = 16856767 | doi = 10.2165/00139709-200625010-00002 }}</ref> Majaribio haya hayatofautishi walevi na wasiolewa; hata hivyo, unywaji mzito wa muda mrefu una athari chache za kimwili zinazotambulika, ikiwa ni pamoja:<ref>{{Rejea jarida | last1 = Das | first1 = SK. | last2 = Dhanya | first2 = L. | last3 = Vasudevan | first3 = DM. | title = Biomarkers of alcoholism: an updated review. | journal = Scand J Clin Lab Invest | volume = 68 | issue = 2 | pages = 81–92 | year = 2008 | doi = 10.1080/00365510701532662 | pmid = 17852805 }}</ref> * Makrosaitosi (upanuzi MCV) * GGT iliyoinuka * Mwinuko wa wastani AST na Alt na AST: Alt uwiano wa 02:01 * Upungufu wa juu wa ayoni kutokana na kabohaidreti (CDT) Hata hivyo, hamna hata moja ya vipimo hivi vya damu vya kibiolojia iliyo bora kama hojaji za uchunguzi. ==Kuzuia== [[Shirika la Afya Duniani]], [[Umoja wa Ulaya]] na mashirika mengine ya kimaeneo, serikali za kitaifa na bunge vimeanzisha sera kuhusu pombe ili kupunguza madhara ya ulevi.<ref name="alchwho2010">{{cite web |url=http://www.who.int/topics/alcohol_drinking/en/ |title=Alcohol |author=World Health Organisation |year=2010 }}</ref><ref name="apitwhoer">{{cite web |url=http://www.euro.who.int/document/mediacentre/fs1005e.pdf |title=Alcohol policy in the WHO European Region: current status and the way forward |date=12 Septemba 2005 |publisher=World Health Organisation |format=PDF |accessdate=2010-10-18 |archivedate=2010-01-23 |archiveurl=https://web.archive.org/web/20100123105252/http://www.euro.who.int/document/mediacentre/fs1005e.pdf }}</ref> Kulenga wanaobalehe na vijana kunachukuliwa kama hatua muhimu ya kupunguza madhara ya utumizi mbaya wa pombe. Kuongeza umri ambapo dawa halali lewevu kama vile pombe zinaweza kununuliwa; kupiga marufuku au kuzuia matangazo ya pombe kumependekezwa kama njia za ziada za kupunguza madhara na utegemezi wa pombe. Ushahidi wa kuaminika, unaojikita katika kampeni za kuelimisha kupitia vyombo vya habari kuhusu madhara ya utumizi mbaya wa pombe, umependekezwa. Miongozo kwa wazazi kuzuia matumizi mabaya miongoni mwa waliobalehe, na kwa ajili ya kuwasaidia vijana wenye matatizo ya afya ya akili pia imependekezwa.<ref name="acdacpovfa">{{Rejea jarida | last1 = Crews | first1 = F. | last2 = He | first2 = J. | last3 = Hodge | first3 = C. | title = Adolescent cortical development: a critical period of vulnerability for addiction. | journal = Pharmacol Biochem Behav | volume = 86 | issue = 2 | pages = 189–99 | month = Feb | year = 2007 | doi = 10.1016/j.pbb.2006.12.001 | pmid = 17222895 }}</ref> ==Usimamizi== Matibabu ni ya aina mbalimbali kwa sababu pana mitazamo mbalimbali ya ulevi. Wale ambao huchukulia ulevi kama tatizo la kiafya au ugonjwa hupendekeza matibabu mbalimbali, kwa mfano, wale ambao hutazama hali hii kama moja uteuzi mojawapo ya kijamii. Matibabu mengi hulenga kuwasaidia watu kusitisha unywaji pombe, ikifuatiwa na mafunzo ya maisha na / au msaada wa kijamii ili kuwasaidia kujiepusha na kurejelea matumizi ya pombe. kwa vile ulevi huhusisha mambo kadhaa ambayo husababisha mtu kuendelea kunywa, lazima zote kushughulikiwa ili kuzuia kurejelea ulevi. Mfano wa aina hii ya matibabu ni kusafisha ulewevu ukifuatiwa na mchanganyiko wa matibabu saidizi, kuhudhuria vikundi vya kujisaidia kibinafsi, na taratibu endelevu ya kuyakabili. Jumuiya-tiba kwa ulevi kwa kawaida huunga mkono mtazamo wa kutoruhusu pombekamwe, hata hivyo, wapo baadhi ya watu ambao huendeleza mtazamo wa kupunguza madhara pia.<ref name="Gabbard"></ref> ===Usafishaji=== Usafishaji wa ulewevu au 'usafishaji' kwa walevi ni kuacha pombe ghafla na kupata kibadala cha dawa lewevu, kama vile benzodiazepini, zilizo na athari sawa katika uzuiaji athari za kuacha pombe. Watu wanaokumbwa na hatari hafifu hadi wastani ya dalili za kuacha pombe wanaweza kusaidiwa kusafisha pombe bila ya kulazwa. Watu wanaokumbwa na hatari ya dalili kali za kuacha pombe pamoja na walio na hali sugu ya komobidi, hutibiwa kwa jumla kama wagonjwa wa kulazwa. Usafishaji kwa kweli hautibu ulevi, na huhitaji kufuatiliwa na utaratibu mwafaka wa matibabu dhidi ya utegemezi wa pombe , ili kupunguza hatari ya kurejelea ulevi.<ref name="Blondell-2005">{{Rejea jarida | last1 = Blondell | first1 = RD. | title = Ambulatory detoxification of patients with alcohol dependence. | url = https://archive.org/details/sim_american-family-physician_2005-02-01_71_3/page/n104 | journal = Am Fam Physician | volume = 71 | issue = 3 | pages = 495–502 | month = Feb | year = 2005 | pmid = 15712624 }}</ref> ===Tiba ya vikundi na tiba-akili=== [[File:Alcoholics Anonymous Regional Service Center by David Shankbone.jpg|thumb|Kituo cha Kieneo cha huduma za Alcoholics Anonymous.]] Aina mbalimbali za tiba ya vikundi au tiba-akili zinaweza kutumika kushughulikia masuala ya kimsingi ya kisaikolojia ambayo huhusiana na utegemezi pombe, na pia kutoa ujuzi wa kuzuia kurejelea pombe. Mtazamo wa-kusaidina kimashauri kwa makundi ni njia moja ya inayotumika zaidi kuwasaidia walevi kudumisha hali ya kutolewa.<ref name="Morgan-Lopez-2006">{{Rejea jarida | last1 = Morgan-Lopez | first1 = AA. | last2 = Fals-Stewart | first2 = W. | title = Analytic complexities associated with group therapy in substance abuse treatment research: problems, recommendations, and future directions. | journal = Exp Clin Psychopharmacol | volume = 14 | issue = 2 | pages = 265–73 | month = Mei | year = 2006 | doi = 10.1037/1064-1297.14.2.265 | pmid = 16756430 }}</ref><ref name="Soyka-2001">{{Rejea jarida | last1 = Soyka | first1 = M. | last2 = Helten | first2 = C. | last3 = Scharfenberg | first3 = CO. | title = [Psychotherapy of alcohol addiction—principles and new findings of therapy research] | journal = Wien Med Wochenschr | volume = 151 | issue = 15–17 | pages = 380–8; discussion 389 | month = | year = 2001 | doi = | pmid = 11603209 }}</ref> Alcoholics Anonymous lilikuwa shirika mojawapo la kwanza kubuniwa ili kutoa ushauri usio wa kitaalamu wa kutegemeana, na ingali ndiyo kubwa. Mengine ni pamoja na LifeRing Secular Recovery, SMART Recovery, na Women For sobriety. ===Mgao na usawazisho=== Mgao na mipango ya usawazisho kama vile Mederation Management na DrinkWise hazipendekezi kuacha pombe kabisa. Ingawa walevi wengi hawawezi kuzuia unywaji wao kwa njia hii, baadhi yao hurudia unywaji wa wastani. Utafiti wa Taasisi ya Kitaifa ya Marekani ya Matumizi Mabaya ya Pombe (NIAAA)ya 2002 ulionyesha kuwa asilimia 17.7 ya watu waliotambuliwa kama wategemezi pombe mwaka mmoja kabla ya kurejelea-hatari hafifu ya kunywa. Kundi hili, hata hivyo, ilionyesha dalili chache za awali za utegemezi.<ref name="DAWSON2005">{{cite journal |title=Recovery from DSM-IV alcohol dependence: United States, 2001–2002 |url=http://pubs.niaaa.nih.gov/publications/arh29-2/131-142.htm |doi=10.1111/j.1360-0443.2004.00964.x |year=2005 |last1=Dawson |first1=Deborah A. |last2=Grant |first2=Bridget F. |last3=Stinson |first3=Frederick S. |last4=Chou |first4=Patricia S. |last5=Huang |first5=Boji |last6=Ruan |first6=W. Juni |journal=Addiction |volume=100 |pages=281 |pmid=15733237 |issue=3 |access-date=2010-10-18 |archive-date=2011-07-19 |archive-url=https://web.archive.org/web/20110719104620/http://pubs.niaaa.nih.gov/publications/arh29-2/131-142.htm |dead-url=yes }}</ref> Utafiti wa kufuatilia, kwa kutumia wahusika walioonekana kuwa katika hali ya kujirekebisha kutokana na pombe mnamo 2001-2002, ulichunguza kiwango chao cha kerejelea unywaji wa kutatiza 2004-2005. Utafiti uligndua kuwa kujitenga na pombe ndiyo iliyokuwa njia imara zaidi ya marerekebisho kwa walevi wanaorekebika.<ref name="DAWSON2007">{{cite journal |title=Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up |doi=10.1111/j.1530-0277.2007.00536.x |pmid=18034696 |year=2007 |last1=Dawson |first1=Deborah A. |last2=Goldstein |first2=Risë B. |last3=Grant |first3=Bridget F. |journal=Alcoholism: Clinical and Experimental Research |volume=31 |issue=12 |pages=2036}}</ref> Mfuatilio wa muda mrefu (miaka 60) wa makundi mawili ya wanaume walevi ilihitimisha kuwa "kurudia unywaji uliodhibitiwa hakuwezi kudumishwa kwa zaidi ya miaka kumi bila kurejelea ulevi au kuacha kabisa".<ref name="VAILLANT2003">{{cite journal |title=A 60-year follow-up of alcoholic men |url=https://archive.org/details/sim_british-journal-of-addiction_2003-08_98_8/page/1043 |pmid=12873238 |year=2003 |last1=Vaillant |first1=GE |volume=98 |issue=8 |pages=1043–51 |journal=Addiction (Abingdon, England)}}</ref> ===Dawa=== Aina tofauti za dawa zinaweza kupendekezwa kusaidia kutibu ulevi. '''Dawa zinazotumika kwa sasa''' * ''Antabuse'' (disulfiram) huzuia uondoaji wa asetaldehide, kemikali itokayo mwilini wakati wa kusagwa kwa ethanoli. Asetaldehidi yenyewe husababisha dalili nyingi za uchovu baada-ulevi kutokana na pombe. Athari jumla ni usumbufu mkubwa wakati pombe inaponywewa: uchovu mbaya ushikao kwa haraka na kudumu kwa muda mrefu. Hii humkatisha mlevi tamaa ya kunywa pombe na unywaji wa kiasi kikubwa wanapotumia dawa hii. Utafiti wa miaka 9 ya hivi karibuni uligundua kwamba ujumuishaji wa disulfiram kwa mpango pamoja na kemikali husika ya carbamide kwa mpangilio mpana wa tiba hupelekea kiwango cha asilimia 50 ya kuacha ya pombe.<ref name="Krampe-2006">{{cite journal |author=Krampe H, Stawicki S, Wagner T |title=Follow-up of 180 alcoholic patients for up to 7 years after outpatient treatment: impact of alcohol deterrents on outcome |journal=Alcoholism, clinical and experimental research |volume=30 |issue=1 |pages=86–95 |year=2006 |month=Januari |pmid=16433735 |doi=10.1111/j.1530-0277.2006.00013.x |url= |issn=0145-6008}}</ref> * ''Temposil'' (kalsiamu kabimidi) hufanya kazi kwa njia sawa na Antabuse; hata hivyo, ubora wake ni kuwa athari mbaya za mara kwa mara za disulfiram; kama vile sumu ya hepato na kizunguzungu, hazitokei kama vile kwa kabimidi kalsiamu.<ref name="Krampe-2006"></ref><ref>{{Rejea jarida | last1 = Ogborne | first1 = AC. | title = Identifying and treating patients with alcohol-related problems. | journal = CMAJ | volume = 162 | issue = 12 | pages = 1705–8 | month = Juni | year = 2000 | pmid = 10870503 | pmc = 1232509 }}</ref> * ''Naltrexone'' ni kemikali kinzani kwa vihisishi vya opioidi, ambayo huzuia kikamilifu madhara ya endofinina opiati. Naltrexone hutumika kupunguza utashi wa pombe na kuhimiza kuacha. Pombe husababisha mwili ya kutoa endofini ambayo nayo huamsha dopamini na kusisimua kuamsha pathways ya; kwa hivyo wakati naltrexone imo mwilini hupunguza madhara kutokana na unywaji pombe.<ref>{{Rejea jarida | last1 = Soyka | first1 = M. | last2 = Rösner | first2 = S. | title = Opioid antagonists for pharmacological treatment of alcohol dependence – a critical review. | journal = Curr Drug Abuse Rev | volume = 1 | issue = 3 | pages = 280–91 | month = Nov | year = 2008 | pmid = 19630726 }}</ref> Naltrexone pia hutumika katika njia ya kutibu ulevi iitwayo Sinclair, ambayo hutibu wagonjwa kupitia mchanganyiko wa Naltrexone na unywaji pombe.<ref>[243] ^ Hataza ya Marekani No. 4,882,335 (iliyotolewa 21 Novemba 1989), inapatikana kwa: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&amp;Sect2=HITOFF&amp;d=PALL&amp;p=1&amp;u {{Wayback|url=http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u |date=20210126205602 }} =% 2Fnetahtml% 2FPTO% 2Fsrchnum.htm &amp; r = 1 &amp; f = G &amp; l. &amp; OS = 50 &amp; s1 = 4882335.PN = PN/4882335 &amp; RS = PN/4882335</ref> * ''Campral'' (akamproseti) hudhibiti ya kemikali za ubongo ambazo hubadilishwa na utegemezi wa pombe kupitia matendo kinzani ya glutamati, kiungo wasilifu cha neuro ambacho ni sisimivu katika awamu ya kujitenga na ulevi.<ref>{{Rejea jarida | last1 = Mason | first1 = BJ. | last2 = Heyser | first2 = CJ. | title = The neurobiology, clinical efficacy and safety of acamprosate in the treatment of alcohol dependence. | journal = Expert Opin Drug Saf | volume = 9 | issue = 1 | pages = 177–88 | month = Jan | year = 2010 | doi = 10.1517/14740330903512943 | pmid = 20021295 }}</ref> '''Dawa za jaribio''' * ''Topamax'' (topirameti) ni kizalia katika sukari za kawaida zinazopatikana katika monosakaraidi D fruktosi-zimegundulika kuwa na uwezo wa kumsaidia mlevi kuacha au kupunguza kiasi cha pombe wanachokunywa. Ushahidi unaonyesha kuwa topirameti hukinza visisimuzi vya glutameti eksitatori, hufisha utoaji wa dopamini na kuzidisha utendaji wa asidi ya gamma-aminobutirik fifishi. Tathmini ya mwaka 2008 ya ufanisi wa topirameti aliafiki kuwa matokeo ya majaribio yaliyochapishwa ni ya kutia matumaini, hata hivyo, kufikia 2008, takwimu hazikutosha kusaidia kutumika kwa topirameti pamoja na ushauri mfupi wa kila wiki kama njia ya kimsingi dhidi ya utegemezi pombe.<ref>{{cite journal |author=Olmsted CL, Kockler DR |title=Topiramate for alcohol dependence |url=https://archive.org/details/sim_annals-of-pharmacotherapy_2008-10_42_10/page/1475 |journal=Ann Pharmacother |volume=42 |issue=10 |pages=1475–80 |year=2008 |month=Oktoba |pmid=18698008 |doi=10.1345/aph.1L157 |issn=1060-0280}}</ref> Tathmini ya 2010 iligundua kuwa topirameti inaweza kuwa na upevu kuliko njia nyinginezo zilizopo za kutibu unywaji pombe. Topirameti hupunguza kikamilifu tamaa ya pombe na ukali wa athari za kujitenga na unywaji mbali na kuboresha viwango vya hali ya maisha.<ref>{{Rejea jarida | last1 = Kenna | first1 = GA. | last2 = Lomastro | first2 = TL. | last3 = Schiesl | first3 = A. | last4 = Leggio | first4 = L. | last5 = Swift | first5 = RM. | title = Review of topiramate: an antiepileptic for the treatment of alcohol dependence. | journal = Curr Drug Abuse Rev | volume = 2 | issue = 2 | pages = 135–42 | month = Mei | year = 2009 | doi = | pmid = 19630744 }}</ref> '''Dawa zinazoweza kuvuruga matokeo''' * Benzodiazepini, licha ya kuwa muhimu katika utunzaji wa walioathirika vibaya na kuacha pombe, ikitumika kwa muda mrefu husababisha matokeo mabaya zaidi kwa mlevi. Walevi wanaotumia benzodiazepini sugu huwa na kiwango cha chini cha kufikia kuacha pombe kuliko wale wasiotumia benzodiazepini. Aina hii ya dawa aghalabu hupendekezwa kwa walevi katika kutibu ukosefu wa usingizi au kupunguza wasiwasi.<ref>{{cite book |editor1-first=S.J.E. |editor1-last=Lindsay |editor2-first=Graham E. |editor2-last=Powell |title=The Handbook of Clinical Adult Psychology |url=http://books.google.com/?id=a6A9AAAAIAAJ&pg=PA380 |edition=2nd |date=28 Julai 1998 |publisher=Routledge |isbn=978-0-415-07215-1 |page=402 |chapter= |chapterurl= }}</ref> Kuanzisha matumizi ya benzodiazepini au vitulizi-hiponozi kwa watu wanaotibiwa hupelekea kiwango cha juu cha urejeleaji ulevi huku mwandishi mmoja akieleza kuwa zaidi ya robo ya watu hurejelea ulevi baada ya kupewa vitulizi-hiponozi. Mara nyingi wagonjwa hufikiria kimakosa kwamba wamelevuka licha ya kuendelea kutumia benzodiazepini. Wale ambao ni watumiaji wa muda mrefu wa benzodiazepini hawafai kuondolewa kwa haraka, kwa vile wasiwasi kali na hofu zinaweza kuibuka, nazo ni hatari bainifu zinazoweza kusababisha kurejelea pombe. Kanuni za Taper za miezi 6-12 zimepatikana kuwa zenye mafanikio zaidi, kwani ina viwangi vya chini zaidi vya athari za kuacha ulevi.<ref>{{cite book |last1=Gitlow |first1=Stuart |title=Substance Use Disorders: A Practical Guide |url=http://books.google.com/?id=rbrSdWVerBUC |edition=2nd |date=1 Oktoba 2006 |publisher=Lippincott Williams and Wilkins |location=USA |isbn=978-0-7817-6998-3 |pages=52 and 103–121}}</ref><ref>{{cite journal |author=Kushner MG, Abrams K, Borchardt C |title=The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings |journal=Clin Psychol Rev |volume=20 |issue=2 |pages=149–71 |year=2000 |month=Machi |pmid=10721495 |doi= 10.1016/S0272-7358(99)00027-6|url=http://linkinghub.elsevier.com/retrieve/pii/S0272-7358(99)00027-6}}</ref> ===Uzoelevu wa ndumakuwili=== Walevi pia wanaweza kuhitaji matibabu kwa uzoelevu wa dawa nyinginezo za kulevya ubongo. Uzoelevu wa ndumakuwili ujulikanao zaidi wa utegemezi pombe ni utegemezi wa benzodiazepini huku tafiti zikionyesha asilimia 10-20 ya wategemezi wa pombe walikuwa na matatizo ya utegemezi au / na matatizo ya matumizi mabaya ya benzodiazepini. Benzodiazepines huongeza utashi wa pombe na kiasi cha pombe kinachnywewa na wanywaji-tatizi.<ref>{{cite journal |author=Poulos CX, Zack M |title=Low-dose diazepam primes motivation for alcohol and alcohol-related semantic networks in problem drinkers |journal=Behav Pharmacol |volume=15 |issue=7 |pages=503–12 |year=2004 |month=Novemba |pmid=15472572 |doi= 10.1097/00008877-200411000-00006|url= |issn=0955-8810}}</ref> Utegemevu wa benzodiazepini unahitaji kupunguzwa wa kitaratibu kwa vipimo ili kuepuka dalili za athari za kujiondoa katika benzodiazepini na madhara mengine ya kiafya . Utegemevu kwa vitulizi hiponozi kama vile zolpidemi na zopikloni pamoja na opiati na dawa za kulevya haramu ni kitu cha kawaida kwa walevi. Pombe yenyewe ni kitulizi-hiponozi na huweza kuhimiliana na vitulizi-hiponozi nyingine kama vile babitureti, benzodiazepini na zisizo benzodiazepini. Utegemezi na kujiondoa kwa vitulizi-hiponozi kunaweza kuonyesha dalili kali za kiafya, sawa na, kama kujiondoa katika pombe, pana hatari ya kichaa au kutwalika kiakili isiposimamiwa vizuri.<ref name="dolpdaa"></ref> ==Epidemolojia== [[File:Alcohol by Country.png|thumb|300px|right|Jumla ya rekodi za matumizi ya pombe kila mwaka kwa kila mwananchi (15 +), kwa lita ya pombe halisi.]] Madhara ya utumizi wa mihadarati ni tatizo kubwa la afya ya umma linalozikabili nchi nyingi. "Mihadarati inayotumika vibaya na wengi zaidi / inayotegemewa na wagonjwa wanaotafuta matibabu ni pombe".<ref name="Gabbard">{{Rejea kitabu | last1 = Gabbard | first1 = Glen O. | title = Treatments of psychiatric disorders | year = 2001 | publisher = American Psychiatric Press | location = Washington, DC | url = http://books.google.com/?id=hLVrAAAAMAAJ |edition=3| isbn = 978-0-88048-910-2 }}</ref> [[Ufalme wa Muungano|Nchini]] Uingereza, idadi ya 'wanywaji wategemezi' imlikadiriwa kuwa zaidi ya 2,800,000 mwaka 2001.<ref name="cosu">{{cite web |url=http://www.strategy.gov.uk/downloads/files/econ.pdf |title=Alcohol misuse: How much does it cost? |author= |authorlink= |coauthors= |date=Septemba 2003 |publisher=Cabinet Office Strategy Unit |format=PDF |accessdate=2010-10-18 |archiveurl=https://web.archive.org/web/20061102085849/http://www.strategy.gov.uk/downloads/files/econ.pdf |archivedate=2006-11-02 }}</ref> Takribani asilimia 12% ya watu wazima Marekani wamekuwa na tatizo la utegemezi pombe kwa wakati fulani katika maisha yao.<ref>{{cite journal |author=Hasin D et al. |title=Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States |journal=Archives of General Psychiatry |volume=64 |issue=7 |year=2007 |pages=830 |doi=10.1001/archpsyc.64.7.830 |pmid=17606817}}</ref> [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] linakadiria kuwa karibu watu 140,000,000 ulimwenguni wanakabiliwa na utegemezi wa pombe.<ref name="whoemcoypaa">{{cite web |url=http://www.who.int/director-general/speeches/2001/english/20010219_youngpeoplealcohol.en.html |title=WHO European Ministerial Conference on Young People and Alcohol |author=Dr Gro Harlem Brundtland |authorlink=Gro Harlem Brundtland |date=19 Februari 2001 |publisher=[[World Health Organisation]] }}</ref><ref name="whotmbcrtdhrai">{{cite web |url=http://www.who.int/mediacentre/news/releases/2003/pr6/en/index.html |title=WHO to meet beverage company representatives to discuss health-related alcohol issues |author=Ms Leanne Riley |date=31 Januari 2003 |publisher=[[World Health Organisation]] }}</ref> Nchini Marekani na Ulaya magharibi asilimia 10 hadi 20 ya wanaume na aslimia 5-10 ya wanawake kwa wakati mmoja katika maisha yao watafikia vigezo vya ulevi.<ref>{{cite web |url=http://www.britannica.com/EBchecked/topic/13448/alcoholism |title=alcoholism |year=2010 |publisher=Encyclopædia Britannica }}</ref> Miongoni mwa jamii za wataalamu wa kimatibabu na kisayansi, pana makubaliano mapana kuhusu ulevi kuwa hali ya ugonjwa. Kwa mfano, Chama cha Matabibu wa Marekani huchukulia pombe kama mihadarati na kuongeza kwamba " utegemevu wa dawa za kulevya ni ugonjwa sugu wa ubongo unaorejearejea ambao una sifa zinazojumuisha utashi wa juu wa kutumia dawa za kulevya licha ya madhara makubwa. Hutokana na maingiliano tata za udhaifu wa kibayolojia, mfichuo wa kimazingira, na sababu za ukuaji (kwa mfano, hatua ya ukomavu ubongo)."<ref name="autogenerated1"></ref> Ulevi una kiwango cha juu cha kutatiza minogni mwa wanaume, ingawa katika miongo ya hivi karibuni, idadi ya walevi wa kike imeongezeka.<ref name="Walter H., Gutierrez K., Ramskogler K., Hertling I., Dvorak A., Lesch O.M., et al. 2003 253–268">{{Rejea jarida | last1 = Walter | first1 = H. | last2 = Gutierrez | first2 = K. | last3 = Ramskogler | first3 = K. | last4 = Hertling | first4 = I. | last5 = Dvorak | first5 = A. | last6 = Lesch | first6 = OM. | title = Gender-specific differences in alcoholism: implications for treatment. | journal = Arch Womens Ment Health | volume = 6 | issue = 4 | pages = 253–8 | month = Nov | year = 2003 | doi = 10.1007/s00737-003-0014-8 | pmid = 14628177 }}</ref> Ushahidi wa kisasa unaonyesha kwamba asilimia 50-60 ya sababu za ulevi miongoni mwa wanaume na wanawake ni kutokana na jeni , kwa hivyo, asilimia 40-50 iliyobakia ni kutokana na sababu za mazingira.<ref>{{cite journal |author=Dick DM, Bierut LJ |title=The genetics of alcohol dependence |journal=Current psychiatry reports |volume=8 |issue=2 |pages=151–7 |year=2006 |month=Aprili |pmid=16539893 |doi= 10.1007/s11920-006-0015-1|url= |issn=1523-3812}}</ref> Walevi wengi huingilia ulevi wakati wa ujana au kabla utuzima.<ref name="Enoch-2006"></ref> ==Prognosi== Utafiti wa 2002 wa Taasisi ya Taifa ya Madhara ya Pombe na Ulevi uliochunguza kundi la watu wazima 4,422walioafiki vigezo vya utegemezi pombe na kugundua kwamba baada ya mwaka mmoja, baadhi yao waliafiki vigezo vya mwandishi vya-hatari ya kiwango cha chini, ingawa asilimia 25.5 ya kundi hili hawakupata tiba yoyote, kwa viwango vifuatavyo: asilimia 25 walionekana wangali wategemezi, asilimia 27.3 walikuwa katika hali ya kujaribu kujiondoa (baadhi ya dalili zikiendelea), asilimia 11.8 ya wanywaji wenye dalili (huzidisha hatari ya kurejelea) na asilimia 35.9 walipona kikamilifu - kutokana na asilimia 17.7 walio katika hatari ndogo na asilimia 18.2 ya wanaojiepusha.<ref name="NIAAA2002">{{cite web |url=http://www.nih.gov/news/pr/jan2005/niaaa-18.htm |title=2001–2002 Survey Finds That Many Recover From Alcoholism |author=The National Institute on Alcohol Abuse and Alcoholism |coauthors=U.S. Department of Health and Human Services, NIH News |date=18 Januari 2005 |publisher=National Institutes of Health |accessdate=2010-10-18 |archivedate=2006-08-18 |archiveurl=https://web.archive.org/web/20060818230335/http://www.nih.gov/news/pr/jan2005/niaaa-18.htm |=https://web.archive.org/web/20060818230335/http://www.nih.gov/news/pr/jan2005/niaaa-18.htm }}</ref> Kinyume na hayo, hata hivyo, matokeo ya mfuatilio wa muda mrefu (miaka 60) wa makundi mawili ya walevi na George Vaillant katika Chuo cha Matibabu cha Harvard alieleza kuwa "ni nadra kwa warejeleaji ulevi wa kudhibitiwa kudumu zaidi ya miaka kumi bila kurejelea au kufikia kuacha".<ref>{{cite journal | author=Vaillant GE | title= A 60-year follow-up of alcoholic men | url=https://archive.org/details/sim_british-journal-of-addiction_2003-08_98_8/page/1043 | journal=Addiction. | year=2003 | volume=98 |pages=1043–51 |pmid=12873238 | doi=10.1046/j.1360-0443.2003.00422.x | month= Agosti| issue=8 | issn=0965-2140}}</ref> Vaillant pia alibainisha kuwa "kurejelea-unywaji-wa kudhibitiwa, kama ilivyoripotiwa katika chunguzi za muda mfupi, mara kwa mara ni hazina za uhakika." Sababu ya kawaida zaidi ya vifo kwa walevi hutokana na matatizo ya mishipa ya moyo.<ref name="Zuskin-2006">{{Rejea jarida | last1 = Zuskin | first1 = E. | last2 = Jukić | first2 = V. | last3 = Lipozencić | first3 = J. | last4 = Matosić | first4 = A. | last5 = Mustajbegović | first5 = J. | last6 = Turcić | first6 = N. | last7 = Poplasen-Orlovac | first7 = D. | last8 = Bubas | first8 = M. | last9 = Prohić | first9 = A. | title = [Alcoholism—how it affects health and working capacity] | journal = Arh Hig Rada Toksikol | volume = 57 | issue = 4 | pages = 413–26 | month = Dec | year = 2006 | doi = | pmid = 17265681 }}</ref> Pana kiwango cha juu cha kujiua miongoni mwa walevi sugu, ambayo huongeza jinsi mnywaji anavyozidi kunywa. Hii huaminika kusababishwa na sababu kwamba pombe husababisha mvurugiko wa kemia za kimwili katika ubongo, na pia kutengwa kijamii. Kujiua pia ni jambo la kawaida sana miongoni mwa watumiaji pombe vijana, na asilimia 25 ya mauaji kwa vijana huhusiana na utumiaji pombe vibaya.<ref name="understanding_suicidal_behaviour_a02">{{Rejea kitabu | last1 = O'Connor | first1 = Rory | last2 = Sheehy | first2 = Noel | title = Understanding suicidal behaviour | url = http://books.google.com/?id=79hEYGdDA3oC | date = 29 Jan 2000 | publisher = BPS Books | location = Leicester | isbn = 978-1-85433-290-5 | pages = 33–37 }}</ref> Takribani asilimia 18 ya walevi hujiua,<ref name="drug_abuse_prevention_a03"></ref> na utafiti umegundua kwamba zaidi ya asilimia 50 ya visa vyote vya kujiua huhusiana na pombe au utegemezi wa dawa. Takwimu hii ni kubwa kwa vijana, wanaokunywa pombe au kutumia vibaya dawa nayo huchangia asilimia 70 ya visa vya kujiua<ref name="pmid1932152">{{cite journal |pmid=1932152 |year=1991 |last1=Miller |first1=NS |last2=Mahler |last3=Gold |title=Suicide risk associated with drug and alcohol dependence. |volume=10 |issue=3 |pages=49–61 |issn=1055-0887 |journal=Journal of addictive diseases |url=https://archive.org/details/sim_journal-of-addictive-diseases_1991_10_3/page/49|format= |doi=10.1300/J069v10n03_06 |author2=Mahler |author3=Gold }}</ref> ==Historia== Pombe ina historia ndefu ya kutumika kwake na matumizi mabaya katika historia ya binadamu iliyorekodiwa. Vyanzo vya Kibiblia, Wamisri na Wababeli vina rekodi za historia ya ulewaji na utegemezi wa pombe. Katika baadhi ya tamaduni za kale pombe ilichiwa na nyinginezo zikishutumu ulevi. Matumizi mabaya ya pombe kupita kiasi na ulevi yalitambuliwa kama visababishi vya matatizo, maelfu ya miaka iliyopita. Hata hivyo, ufafanuzi wa ulevi wa kuzoeleka kama ilivyojulikana nyakati hizo na athari zake mbaya hazikueleweka vyema kwa misingi ya kiafya hadi miaka ya 1700. Katika mwaka 1647 mtawa wa Kigiriki{{Who?|date=Juni 2010}} alikuwa wa kwanza kurekodi kwamba matumizi mabaya sugu ya pombe yalihusiana na sumu ya pombe kwa mfumo wa neva na mwili ambao ulisababisha matatizo mbalimbali ya kimatibabu kama vile,mishtuko ya moyo , kupooza na kutokwa damu kwa ndani. Katika mwaka 1920 madhara ya kutumia pombe vibaya na ulevi sugu yalisababisha kufikirika kwa utekelezwaji wa marufuku ya pombe yaliyoshindikana na hatimaye kuzingatiwa nchini Marekanui kwa muda ufupi. Mwaka 2005 gharama ya utegemezi pombe na matumizi mabaya ilikadiriwa kugharimu uchumi wa Marekani takriban dola bilioni 220 kwa mwaka, kuliko matatizo ya kansa na unenepaji.<ref name="soa2008">{{cite book |last1=Potter |first1= James V. |volume=2 |title=Substances of Abuse |url=http://books.google.com/?id=WU73eJAIDI4C&pg=PA1 |date=14 Januari 2008 |publisher=AFS Publishing Co |isbn=978-1-930327-46-7 |pages=1–13 }}</ref> ==Jamii na utamaduni== [[File:William Hogarth - Gin Lane.jpg|thumb|William Hogarth's Gin Lane, 1751]] Matatizo mbalimbali ya kiafya yanayohusiana na matumizi ya pombe kwa muda mrefu huchukuliwa kijumla kama yenye kudhuru jamii, kwa mfano fedha kutokana kupoteza masaa-ya kazi gharama za kimatibabu, na gharama za upeo wa pili za kimatibabu. Matumizi ya pombe ni sababu kubwa inayochangia majeraha ya kichwa, ajali za magari, mvurugano, na mashambulizi. Mbali na fedha, pia pana gharama kubwa za kijamii kwa mlevi, familia yake na marafiki.<ref name="Jessica Kingsley Publishers">{{cite book |last1=McCully |first1=Chris |title=Goodbye Mr. Wonderful. Alcohol, Addition and Early Recovery. |url=http://www.jkp.com/catalogue/book/9781843102656/contents |year=2004 |publisher=Jessica Kingsley Publishers |location=London |isbn=978-1-84310-265-6 |page= |pages= |chapter= |chapterurl= |author=Chris McCully. }}</ref> Kwa mfano, matumizi ya pombe yanaweza kusababisha dalili za ulevi kwa mimba ya mwanamke mja mzito,<ref>{{cite web |url=http://www.cdc.gov/ncbddd/fasd/documents/FAS_guidelines_accessible.pdf |title=Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis |author=Julie Louise Gerberding |coauthors=José Cordero, R. Louise Floyd |date=Mei 2005 |publisher=Centers for Disease Control and Prevention |location=USA |format=PDF }}</ref> ambayo ni hali haribifu na isiyotibika.<ref>{{Rejea kitabu | last1 = Streissguth | first1 = Ann Pytkowicz | title = Fetal alcohol syndrome: a guide for families and communities | date = 1 Septemba 1997 | publisher = Paul H Brookes Pub. |url=http://books.google.com/?id=kptHAAAAMAAJ | location = Baltimore, MD, USA | isbn = 978-1-55766-283-5 }}</ref> Makadirio ya gharama za kiuchumi ya matumizi mabaya ya pombe, yaliyokusanywa na Shirika la Afya Duniani; hufikia baina ya asilimia mmoja hadi sita ya Pato la Taifa.<ref>{{cite web | publisher=World Health Organization | url=http://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf | format=PDF | title=Global Status Report on Alcohol 2004 | accessdate=3 Januari 2007 }}</ref> Ukadiriaji mmoja wa Australia ulikisia kuwa gharama ya pombe kwa jamii hufikia asilimia 24 ya gharama zote za dawa za kulevya, na utafiti kama huo kule Canada ulihitimisha kuwa gharama ya pombe ilifikia asilimia 41.<ref>{{cite web | publisher=World Health Organization Global Alcohol Database | url=http://www.who.int/globalatlas/dataQuery/objectInterface.asp?objID=359&boCat=&p=null&lvl=0&catID=520700000000&level=2 | accessdate=3 Januari 2007 | title=Economic cost of alcohol consumption }}</ref> Utafiti mmoja uliafikia kuwa gharama ya aina zote za matumizi mabaya ya pombe ''nchini Uingereza '' katika 2001 ulikuwa bilioni £ 18.5-20.<ref name="cosu"></ref><ref>{{cite web | publisher=BBC | url=http://news.bbc.co.uk/1/hi/health/3122244.stm | title=Q&A: The costs of alcohol | date=19 Septemba 2003 }}</ref> Taasubi kuhusu walevi mara nyingi hupatikana katika tungo bunilizi na tamaduni maarufu. 'Mnywaji wa jijini' ni mhusika maarufu katika tamaduni maarufu za Kimagharibi. Taasubi za ulevi zinaweza kujikita kwa [[ubaguzi wa rangi]] au chuki dhidi ya wageni, kama vile kuwachukualia Waayalandikuwa walevi wakubwa.<ref>{{cite web | url=http://www.finfacts.ie/Private/bestprice/alcoholdrinkconsumptionpriceseurope.htm | title=World/Global Alcohol/Drink Consumption |year=2009 |publisher=Finfacts Ireland}}</ref> Tafiti za wanasaikolojia wa kijamii Stivers na Greeley hujaribu kukusanya rekodi ya visa vingi vya matumizi mabaya ya pombe miongoni mwa Waayalandi nchini Marekani.<ref>{{Rejea kitabu | last1 = Stivers | first1 = Richard | title = Hair of the dog: Irish drinking and its American stereotype | date = Mei 2000 | publisher = Continuum | location = New York |url=http://books.google.com/?id=MH3aAAAAMAAJ | isbn = 978-0-8264-1218-8 }}</ref> ==Marejeo== {{Marejeo|2}} ==Usomaji ziada== {{Refbegin}} * {{cite book |last=Galanter |first=Marc |editor= |title=Alcohol Problems in Adolescents and Young Adults: Epidemiology, Neurobiology, Prevention, Treatment |url=https://archive.org/details/recentdevelopmen17gala |edition= |year=2005 |publisher=Kluwer Academic/Plenum |location=New York, NY |isbn=0-306-48625-3 |oclc=133155628 56653179 57724687 71290784}} * {{cite book |last=Hedblom |first=Jack H. |editor= |title=Last Call: Alcoholism and Recovery |url=https://archive.org/details/lastcallalcoholi00hedb |edition= |year=2007 |publisher=[[Johns Hopkins University Press]] |location=Baltimore, MD |isbn=978-0-8018-8677-5 |oclc=237901552 77708730}} * Taasisi ya Taifa ya Matumizi Mabaya ya Pombe na Ulevi. " [http://pubs.niaaa.nih.gov/publications/Social/Module2Etiology&amp;NaturalHistory/Module2.html Chanzo na Historia Asilia ya Ulevi] {{Wayback|url=http://pubs.niaaa.nih.gov/publications/Social/Module2Etiology%26NaturalHistory/Module2.html |date=20181211133510 }} ". * {{cite book |last=O'Farrell |first=Timothy J. and William Fals-Stewart |editor= |title=Behavioral Couples Therapy for Alcoholism and Drug Abuse |url=https://archive.org/details/behavioralcouple0000ofar |edition= |year=2006 |publisher=Guilford Press |location=New York, NY |isbn=1-59385-324-6 |oclc=64336035}} * Pence, Gregory, "Kant kuhusu Iwapo Ulevi ni Ugonjwa," Sura ya 2, ''Elementi za Adili za Kibayolojia ,'' McGraw-Hill Books, 2007 ISBN 0-07-313277-2. * {{cite book |last=Plant |first=Martin A. and Moira Plant |title=Binge Britain: Alcohol and the National Response |url=https://archive.org/details/bingebritainalco0000plan |edition= |year=2006 |publisher=Oxford University Press |location=Oxford, UK; New York, NY |isbn=0-19-929940-4 |pages= |chapter= |chapterurl= |oclc=238809013 64554668 }} * {{cite book |last=Smart |first=Lesley |editor= |title=Alcohol and Human Health |url=https://archive.org/details/alcoholhumanheal0000unse |edition= |year=2007 |publisher=Oxford University Press |location=Oxford, UK |isbn=978-0-19-923735-7 |oclc=163616466}} * {{cite book |last=Sutton |first=Philip M. |editor=Michael L. Coulter, Stephen M. Krason, Richard S. Myers, and Joseph A. Varacalli |title=Encyclopedia of Catholic Social Thought, Social Science, and Social Policy |edition= |year=2007 |publisher=Scarecrow Press |location=Lanham, MD; Toronto, Canada; Plymouth, UK |isbn=978-0-8108-5906-7 |pages=22–24 |chapter=Alcoholism and Drug Abuse |chapterurl=}} * Thompson, Warren, MD, FACP. "[http://www.emedicine.com/med/topic98.htm Ulevi]. " Emedicine.com, 6 Juni 2007. Ilinakiliwa 2007/09/02. {{Refend}} ==Viungo vya nje== {{sisterlinks|wikt=alcoholism|b=no|q=Alcoholism|s=no|commons=Category:Alcoholism|n=no|v=no|species=no}} * [http://www.dmoz.org/Health/Addictions/Substance_Abuse/Alcohol/ Viungo vya DMOZ kuhusu matumizi mabaya ya pombe na vikundi vya kusaidia] {{Wayback|url=http://www.dmoz.org/Health/Addictions/Substance_Abuse/Alcohol/ |date=20100829173343 }} katika Mradi Wazi wa Kuelekeza [[Category:Vinywaji]] [[Category:Madawa ya Kulevya]] 63dqiyd3cv8mlew9meydq3ptwkvbdw4 0 55352 1578118 1564498 2026-07-02T20:36:09Z InternetArchiveBot 41439 Add 11 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578118 wikitext text/x-wiki '''Ugonjwa wa Alzheimer''' (pia hujulikana kama '''Udhaifu wa kiakili utokanao na uzee wa aina ya Alzeima''' au '''Alzeima''' tu) ni aina ya kawaida sana ya [[tatizo la kiakili]]. Huo [[ugonjwa]] usiotibika, wa kusawijika na unaoua, ulielezewa kwa mara ya kwanza na [[mtaalamu]] wa [[magonjwa ya akili]] na ya [[mfumo wa neva]] [[Alois Alzheimer]] katika [[mwaka]] wa [[1906]] ukapewa [[jina]] lake. Kwa jumla, huwa unatambuliwa kwa watu walio na [[umri]] wa zaidi ya miaka 65,<ref>{{cite journal |author=Brookmeyer R, Gray S, Kawas C |title=Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset |url=https://archive.org/details/sim_american-journal-of-public-health_1998-09_88_9/page/1337 |journal=Am J Public Health |volume=88 |issue=9 |pages=1337–42 |year=1998 |month=Septemba |pmid=9736873 |pmc=1509089 |doi=10.2105/AJPH.88.9.1337 }}</ref> ingawa kuna Alzeima ya nadra inayoanza mapema. Katika mwaka wa 2006, kulikuwa na wagonjwa [[milioni]] 26.6 kote [[duniani]]. Alzeima inakadiriwa itakuwa inaathiri mtu 1 kati ya watu 85 kote duniani kufikia mwaka wa 2050.<ref name="Brookmeyer2007"/> Ingawa [[chanzo]] cha ugonjwa wa Alzeima ni tofauti kwa kila mtu, kuna [[dalili]] kadhaa za kawaida.<ref name="alzheimers.org"> {{cite web | title=What is Alzheimer's disease? | url=http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=100 | publisher=Alzheimers.org.uk | year=2007 | month=Agosti | accessdate=2008-02-21 }}</ref> Dalili za mwanzo zinazoonekana mara nyingi hudhaniwa kimakosa kuwa matatizo 'yanayotokana na umri', au kuonyesha kuwa mtu anafadhaika.<ref name="pmid17222085">{{cite journal |author=Waldemar G, Dubois B, Emre M, ''et al.'' |title=Recommendations for the diagnosis and management of Alzheimer's disease and other disorders associated with dementia: EFNS guideline |journal=Eur J Neurol |volume=14 |issue=1 |pages=e1–26 |year=2007 |month=Januari |pmid=17222085 |doi=10.1111/j.1468-1331.2006.01605.x }}</ref> Katika hatua za mwanzo, dalili za kawaida zinazotambuliwa ni kukosa uwezo wa kupata kumbukumbu mpya, kama vile wa kukumbuka mambo yaliyofanyika hivi karibuni. Wakati Alzeima inakisiwa, utambuzi kwa kawaida huwa unathibitishwa na tathmini ya tabia na vipimo vya utambuzi wa mambo, mara nyingi zikifuatiwa na skani ya ubongo kama inapatikana.<ref name="alzres">{{cite web | title=Alzheimer's diagnosis of AD | url=http://www.alzheimers-research.org.uk/info/diagnosis/ | publisher=Alzheimer's Research Trust | accessdate=2008-02-29 | archivedate=2007-10-22 | archiveurl=https://web.archive.org/web/20071022154220/http://alzheimers-research.org.uk/info/diagnosis/ }}</ref> Ugonjwa unapoendelea, dalili huwa ni pamoja na kuchanganyikiwa, kukerwa na uchokozi, mabadiliko ya hali ya moyo, kutatizika kwa lugha, kupoteza kumbukumbu ya muda mrefu, na mgonjwa kujitenga sana kadiri hisia zake zinavyoendelea kupungua.<ref name="pmid17222085"/><ref name="pmid17823840"> {{cite journal |author=Tabert MH, Liu X, Doty RL, Serby M, Zamora D, Pelton GH, Marder K, Albers MW, Stern Y, Devanand DP |title=A 10-item smell identification scale related to risk for Alzheimer's disease |url=https://archive.org/details/sim_annals-of-neurology_2005-07_58_1/page/155 |journal=Ann. Neurol. |volume=58 |issue=1 |pages=155–160 |year=2005 |pmid=15984022 |doi=10.1002/ana.20533 }}</ref> Hatua kwa hatua, kazi za [[mwili]] hupotea, na hatimaye kusababisha [[kifo]].<ref name="nihstages">{{cite web | title=Understanding stages and symptoms of Alzheimer's disease | url=http://www.nia.nih.gov/Alzheimers/Publications/stages.htm | publisher=National Institute on Aging | date=2007-10-26 | accessdate=2008-02-21 | archiveurl=https://web.archive.org/web/20080516213955/http://www.nia.nih.gov/Alzheimers/Publications/stages.htm | archivedate=2008-05-16 }}</ref> Ni vigumu kubashiri hatima ya mgonjwa binafsi kwa vile muda wa ugonjwa unatofautiana. Alzeima hukua kwa kipindi kisichojulikana kabla ya kudhihirika kabisa, na inaweza kukua bila ya kutambuliwa kwa miaka mingi. Muda wa kuishi baada ya utambuzi ni takriban miaka saba.<ref name="pmid3776457">{{cite journal |author=Mölsä PK, Marttila RJ, Rinne UK |title=Survival and cause of death in Alzheimer's disease and multi-infarct dementia |journal=Acta Neurol Scand |volume=74 |issue=2 |pages=103–7 |year=1986 |month=Agosti |pmid=3776457 |accessdate=2008-08-04 |doi=10.1111/j.1600-0404.1986.tb04634.x }}</ref> Chini ya asilimia tatu ya wagonjwa huishi kwa zaidi ya miaka kumi na nne baada ya utambuzi.<ref name="pmid7793228">{{cite journal |author=Mölsä PK, Marttila RJ, Rinne UK |title=Long-term survival and predictors of mortality in Alzheimer's disease and multi-infarct dementia |journal=ActaNeurol Scand |volume=91 |issue=3 |pages=159–64 |year=1995 |month=Machi |pmid=7793228 }}</ref> Chanzo na kukua kwa Alzeima huwa havieleweki vizuri. Utafiti unaonyesha kuwa ugonjwa huu unahusiana na tando na mifungamano kwenye ubongo.<ref name="pmid15184601"/> Kwa sasa matibabu yanayotumika hupunguza dalili za ugonjwa lakini hakuna matibabu ya kuchelewesha au kusimamisha kuendelea kwa ugonjwa huu. Hadi mwaka wa 2012, zaidi ya majaribio 1000 ya kliniki yamefanywa kwa ajili ya kutambua tiba ya Alzeima, lakini haijulikani kama mojawapo ya mikakati iliyofanyiwa majaribio ya kusitisha ugonjwa huu itaonyesha matokeo yenye matumaini.<ref>{{cite web |url=http://www.clinicaltrials.gov/ct2/results?term=alzheimer |title= Alzheimer's Disease Clinical Trials |accessdate= 2008-08-18 |publisher= US National Institutes of Health }}</ref> Baadhi ya mienendo ya maisha ambayo haihusu upasuaji, imetajwa kwa ajili ya kuzuia ugonjwa wa Alzeima, lakini kuna ukosefu wa ushahidi wa kutosha wa uhusiano kati ya mapendekezo hayo na kupungua kwa kusawijika. Kusisimua akili, mazoezi, na lishe bora yanapendekezwa, kama njia za kujikinga na njia ya busara ya kudhibiti ugonjwa huo. <ref name="prevention1">{{cite web | title=Can Alzheimer's disease be prevented | url=http://www.nia.nih.gov/NR/rdonlyres/63B5A29C-F943-4DB7-91B4-0296772973F3/0/CanADbePrevented.pdf | format=pdf | publisher=National Institute on Aging | accessdate=2008-02-29 | date=2006-08-29 | archiveurl=https://web.archive.org/web/20061002125551/http://www.nia.nih.gov/NR/rdonlyres/63B5A29C-F943-4DB7-91B4-0296772973F3/0/CanADbePrevented.pdf | archivedate=2006-10-02 }}</ref> Kwa sababu Alzeima haiwezi kutibiwa na husababisha kusawijika, utunzaji wa wagonjwa ni muhimu. Wajibu mkuu wa mlezi mara nyingi kuchukuliwa na mke au jamaa wa karibu.<ref name="metlife.com">{{cite web | title= The MetLife study of Alzheimer's disease: The caregiving experience | month= Agosti | year= 2006 |archivedate=2008-06-25 | archiveurl=http://web.archive.org/web/20080625071754/http://www.metlife.com/WPSAssets/14050063731156260663V1FAlzheimerCaregivingExperience.pdf | publisher=MetLife Mature Market Institute | format=PDF | accessdate=2008-02-12 }}</ref> Ugonjwa wa Alzeima unajulikana kwa kuwatwika walezi wa wagonjwa mzigo mkubwa na mashinikizo yanaweza kuwa ya aina nyingi, yakiwemo ya kijamii, ya kisaikolojia, ya kimwili, na ya kiuchumi katika maisha ya mlezi huyo.<ref name="pmid17662119">{{cite journal |author=Thompson CA, Spilsbury K, Hall J, Birks Y, Barnes C, Adamson J |title=Systematic review of information and support interventions for caregivers of people with dementia |journal=BMC Geriatr |volume=7 |page=18 |year=2007 |pmid=17662119 |pmc=1951962 |doi=10.1186/1471-2318-7-18 }}</ref><ref name="pmid10489656">{{cite journal |author=Schneider J, Murray J, Banerjee S, Mann A |title=EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: I—Factors associated with carer burden |url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_1999-08_14_8/page/651 |journal=International Journal of Geriatric Psychiatry |volume=14 |issue=8 |pages=651–661 |year=1999 |month=Agosti |pmid=10489656 |doi=10.1002/(SICI)1099-1166(199908)14:8<651::AID-GPS992>3.0.CO;2-B |accessdate=2008-07-04 }}</ref><ref>{{cite journal |author=Murray J, Schneider J, Banerjee S, Mann A |title=EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: II—A qualitative analysis of the experience of caregiving |url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_1999-08_14_8/page/662 |journal=International Journal of Geriatric Psychiatry |volume=14 |issue=8 |pages=662–667 |year=1999 |month=Agosti |pmid=10489657 |doi=10.1002/(SICI)1099-1166(199908)14:8<662::AID-GPS993>3.0.CO;2-4 }}</ref> Katika nchi zilizoendelea, Alzeima ni mojawapo ya magonjwa yenye gharama kubwa sana kwa jamii.<ref name="pmid15685097">{{cite journal |author=Bonin-Guillaume S, Zekry D, Giacobini E, Gold G, Michel JP |title=Impact économique de la démence (English: The economical impact of dementia) |language=French |journal=Presse Med |issn=0755-4982 |volume=34 |issue=1 |pages=35–41 |year=2005 |month=Januari |pmid=15685097 }}</ref><ref name="pmid9543467">{{cite journal |author=Meek PD, McKeithan K, Schumock GT |title=Economic considerations in Alzheimer's disease |journal=Pharmacotherapy |volume=18 |issue=2 Pt 2 |pages=68–73; discussion 79–82 |year=1998 |pmid=9543467 }}</ref> == Sifa == Mkondo wa ugonjwa umegawanywa katika hatua nne, na mwelekeo wa kuendelea kuharibika kwa utambuzi na utendaji wa mambo. === Kabla ya Dementia === Dalili za kwanza mara nyingi uhusishwa kimakosa kama zinazotokana na kuzeeka au fadhaa.<ref name="pmid17222085"/> Upimwaji wa kina wa kinyurosaikolojia unaweza kufichua matatizo madogo madogo ya utambuzi wa mambo hadi miaka minane kabla ya mtu kutimiza vigezo vya kliniki kwa ajili ya utambuzi wa Alzeima.<ref name="pmid15324363">{{cite journal |author=Bäckman L, Jones S, Berger AK, Laukka EJ, Small BJ |title=Multiple cognitive deficits during the transition to Alzheimer's disease |url=https://archive.org/details/sim_journal-of-internal-medicine_2004-09_256_3/page/195 |journal=J Intern Med |volume=256 |issue=3 |pages=195–204 |year=2004 |month=Sep |pmid=15324363 |doi=10.1111/j.1365-2796.2004.01386.x }}</ref> Dalili hizi za mapema zinaweza kuathiri shughuli tata zaidi za maisha ya kila siku.<ref>{{cite journal |author= Nygård L |title=Instrumental activities of daily living: a stepping-stone towards Alzheimer's disease diagnosis in subjects with mild cognitive impairment? |journal=Acta Neurol Scand |volume=Suppl |issue=179 |pages=42–6 |year=2003 |month= |pmid=12603250 |doi= 10.1034/j.1600-0404.107.s179.8.x }}</ref> Upungufu unaoonekana kwa urahisi sana ni kupoteza kwa kumbukumbu ya mambo, ambayo hujitokeza kama ugumu wa kukumbuka mambo msingi yaliyosomwa hivi karibuni na kukosa uwezo wa kupata habari mpya.<ref name="pmid15324363"/><ref name="pmid12603249">{{cite journal |author=Arnáiz E, Almkvist O |title=Neuropsychological features of mild cognitive impairment and preclinical Alzheimer's disease |journal=Acta Neurol. Scand., Suppl. |volume=179 |pages=34–41 |year=2003 |pmid=12603249 |doi=10.1034/j.1600-0404.107.s179.7.x |accessdate=2008-06-12 }}</ref> Matatizo ya utambuzi na utendaji rasmi waumakinifu, [[Mipango|kupanga]], uwezo wa kubadilika kwa urahisi kutoka na mageuzi ya mambo, na kuwaza kidhahania, au kuharibika kwa kumbukumbu ya kisemantiki (kumbukumbu ya maana, na uhusiano wa dhana), yanaweza pia kuwa ni dalili ya hatua za kwanza za Alzeima.<ref name="pmid15324363"/> Kutojali kunaweza kuonekana katika hatua hii, na inaenaendelea kuwa dalili sugu yakinyurosaikologia katika mwenendo wa ugonjwa huu.<ref>{{cite journal |author=Landes AM, Sperry SD, Strauss ME, Geldmacher DS |title=Apathy in Alzheimer's disease |url=https://archive.org/details/sim_journal-of-the-american-geriatrics-society_2001-12_49_12/page/1700 |journal=J Am Geriatr Soc |volume=49 |issue=12 |pages=1700–7 |year=2001 |month=Dec |pmid=11844006 |doi=10.1046/j.1532-5415.2001.49282.x }}</ref> Hatua ya kabla ya kutambuliwa ya ugonjwa pia hujulikana kama uharibifu mdogo wa utambuzi wa mambo,<ref name="pmid12603249"/>lakini kama jina hili linalingana na hatua tofauti ya utambuzi au linatambua hatua ya kwanza ya Alzeima ni suala lenye mgogoro.<ref name="pmid17279076"> {{cite journal |author=Petersen RC |title=The current status of mild cognitive impairment—what do we tell our patients? |journal=Nat Clin Pract Neurol |volume=3 |issue=2 |pages=60–1 |year=2007 |month=Februari |pmid=17279076 |doi=10.1038/ncpneuro0402 }}</ref> === Kuanza kwa Dementia === Kwa watu walio na Alzeima ongezeko la kuharibika kwa uwezo wa kujifunza na kumbukumbu hatimaye hupelekea kufanywa kwa utambuzi dhihiri. Katika sehemu ndogo ya watu hawa, matatizo ya lugha, utendaji wa mambo, utambuzi (agnosia), au utekelezaji wa majukumu (apraksia) ni dhahiri zaidi kuliko matatizo ya kumbukumbu.<ref name="pmid10653284"> {{cite journal |author=Förstl H, Kurz A |title=Clinical features of Alzheimer's disease |journal=European Archives of Psychiatry and Clinical Neuroscience |volume=249 |issue=6 |pages=288–290 |year=1999 |pmid=10653284 |doi=10.1007/s004060050101 }}</ref> Alzeima haiathiri uwezo wote wa kumbukumbu kwa njia usawa. Kumbukumbu za kitambo za maisha ya mtu (kumbukumbu za matukio), mambo ya kujifunza (kumbukumbu za kisemantiki), na kumbukumbu isiyojitokeza wazi (kumbukumbu ya mwili kuhusu jinsi ya kufanya mambo, kama vile kutumia uma kula) huwa zinathirika na kiasi kidogo kuliko mambo mapya au kumbukumbu.<ref name="pmid1300219"> {{cite journal |author=Carlesimo GA, Oscar-Berman M |title=Memory deficits in Alzheimer's patients: a comprehensive review |url=https://archive.org/details/sim_neuropsychology-review_1992-06_3_2/page/n2 |journal=Neuropsychol Rev |volume=3 |issue=2 |pages=119–69 |year=1992 |month=Juni |pmid=1300219 |doi=10.1007/BF01108841 }}</ref><ref name="pmid8821346"> {{cite journal |author=Jelicic M, Bonebakker AE, Bonke B |title=Implicit memory performance of patients with Alzheimer's disease: a brief review |journal=International Psychogeriatrics |volume=7 |issue=3 |pages=385–392 |year=1995 |pmid=8821346 | doi = 10.1017/S1041610295002134 }}</ref> Matatizo ya lugha hasa huwa na sifa ya kupungua kwa msamiati na ufasaha wa maneno, husababisha kuharibika kwa jumla kwa lugha simulizi lugha ya kuandikwa.<ref name="pmid10653284"/><ref name="pmid1856925">{{cite journal |author=Taler V, Phillips NA |title=Language performance in Alzheimer's disease and mild cognitive impairment: a comparative review |journal= J Clin Exp Neuropsychol |volume=30 |issue=5 |pages=501–56 |year=2008 |month=Jul |pmid=1856925 |doi=10.1080/13803390701550128 }}</ref> Katika hatua hii, mtu aliye na Alzeima kwa kawaida huwa na uwezo wa kutosha wa kuwasilisha mawazo ya msingi.<ref name="pmid10653284"/><ref name="pmid1856925"/><ref name="pmid7967534">{{cite journal |author=Frank EM |title=Effect of Alzheimer's disease on communication function |url=https://archive.org/details/sim_journal-of-the-south-carolina-medical-association_1994-09_90_9/page/417 |journal=J S C Med Assoc |volume=90 |issue=9 |pages=417–23 |year=1994 |month=Septemba |pmid=7967534 }}</ref> Wakati anapotekeleza majukumu ya misuli kama vile kuandika, kuchora au kuvaa nguo, baadhi ya matatizo ya kudhibiti mwendo na kuratibu (apraksia) zinaweza kuwepo lakini kwa kawaida hazitambuliwi.<ref name="pmid10653284"/> Ugonjwa unavyoendelea, watu wenye Alzeima mara nyingi huendelea kufanya kazi nyingi kwa kujitegemea, lakini huhitaji msaada au usimamizi katika shughuli zinazohitaji uamuzi mkubwa.<ref name="pmid10653284"/> === Dementia ya Wastani === Kudhoofika kunavyoendelea hatimaye kunazuia kujitegemea, huku anayehusika akishindwa kufanya shughuli za kawaida za maisha ya kila siku.<ref name="pmid10653284"/> Matatizo ya maongezi huwa wazi kutokana na kutokuwa na uwezo wa kukumbuka msamiati, ambayo hupelekea matumizi ya mara kwa mara ya misamiati isiyo sawa (paraphasia). Ujuzi wa kusoma na kuandika pia huendelea kupotea.<ref name="pmid10653284"/><ref name="pmid7967534"/> Taratibu tata za shughuli zinazohusisha misuli huzidi hupoteza uwiano kadri wakati unavyopita na Alzeima inavyoendelea, hivyo hatari ya kuanguka huongezeka.<ref name="pmid10653284"/> Wakati wa awamu hii, matatizo ya kumbukumbu huwa mabaya, na mtu anaweza kushindwa kutambua jamaa wa karibu.<ref name="pmid10653284"/> Kumbukumbu ya muda mrefu, ambayo ilikuwa hapo awali haijaathiriwa, sasa hudhoofika.<ref name="pmid10653284"/> Mabadiliko ya kitabia na kinyurosaikayatri huenea zaidi. Mara nyingi haya hudhihirika katika kutangatanga, kuwashwa na kuathirika kwa maongezi, hali ambazo husababisha kilio, uvamizi usio na sababu au kukataa huduma za mtunzaji.<ref name="pmid10653284"/> Kuchanganyikiwa na njozi za usiku zinaweza pia kuonekana.<ref>{{cite journal |author=Volicer L, Harper DG, Manning BC, Goldstein R, Satlin A |title=Sundowning and circadian rhythms in Alzheimer's disease |journal=Am J Psychiatry |volume=158 |issue=5 |pages=704–11 |year=2001 |month=Mei |pmid=11329390 |url=http://ajp.psychiatryonline.org/cgi/content/full/158/5/704 |accessdate=2008-08-27 |doi=10.1176/appi.ajp.158.5.704 |archive-date=2011-06-11 |archive-url=https://web.archive.org/web/20110611235057/http://ajp.psychiatryonline.org/cgi/content/full/158/5/704 |url-status=dead }}</ref> Takriban 30% ya wagonjwa huwa na kutambua kusiko sahihi kwa mawazo yasiyo ya ukweli na dalili zingine za kudanganyika.<ref name="pmid10653284"/> Anayehusika pia hupoteza ufahamu wa mchakato wa ugonjwa wao na upungufu (anosognosia).<ref name="pmid10653284"/> Shida ya kutoweza kuzuia mkojo pia huanza.<ref name="pmid10653284"/> Dalili hizi huleta dhiki ya kimawazo kwa jamaa na watunzaji wake, mambo ambayo yaweza kupunguzwa kwa kumhamisha mgonjwa kutoka kwa huduma ya nyumbani hadi vituo vya huduma ya muda mrefu .<ref name="pmid10653284"/><ref name="pmid7806732">{{cite journal |author=Gold DP, Reis MF, Markiewicz D, Andres D |title=When home caregiving ends: a longitudinal study of outcomes for caregivers of relatives with dementia |url=https://archive.org/details/sim_journal-of-the-american-geriatrics-society_1995-01_43_1/page/10 |journal=J Am Geriatr Soc |volume=43 |issue=1 |pages=10–6 |year=1995 |month=Januari |pmid=7806732 }}</ref> === Dementia Pevu === Katika hatua hii ya mwisho ya Alzeima, mgonjwa hutegemea kabisa watunzaji.<ref name="pmid10653284"/> Lugha hupunguka hadi kwa maneno rahisi au hata neno moja, hatimaye kusababisha kupotea kabisa kwa uwezo wa maongezi.<ref name="pmid10653284"/><ref name="pmid7967534"/> Hata baada ya kupoteza uwezo wa maongezi ya lugha, wagonjwa wanaweza mara kwa mara kuelewa na kujibu ishara za kihisia.<ref name="pmid10653284"/> Ingawa uchokozi bado upo, hali ya kutojali iliyokithiri na uchovu ni matokeo ya kawaida zaidi.<ref name="pmid10653284"/> Wagonjwa hatimaye watashindwa kutenda hata mambo rahisi kabisa bila kusaidiwa.<ref name="pmid10653284"/> Mkusanyiko wa misuli na uwezo wa kuenda huzorota hadi pale ambapo wagonjwa hulazwa tu kitandani, na hupoteza uwezo wa kujilisha wenyewe.<ref name="pmid10653284"/> Alzeima ni ugonjwa usiotibika lakini sababu ya kifo aghalabu huwa ugonjwa mwingine kama vile vidonda vya shinikizo au nimonia, si Alzeima yenyewe.<ref name="pmid10653284"/> == Chanzo == Nadharia tete kadhaa zipo zinazojaribu kuelezea chanzo cha ugonjwa huu. Ile ya zamani, ambayo ni msingi wa matibabu ya madawa mengi ya kisasa ni nadharia tete ya kikolinajia ''<ref name="pmid10071091">{{cite journal |author=Francis PT, Palmer AM, Snape M, Wilcock GK |title=The cholinergic hypothesis of Alzheimer's disease: a review of progress |journal=J. Neurol. Neurosurg. Psychiatr. |volume=66 |issue=2 |pages=137–47 |year=1999 |month=Februari |pmid=10071091 |pmc=1736202 |doi= 10.1136/jnnp.66.2.137|url=https://archive.org/details/sim_journal-of-neurology-neurosurgery-and-psychiatry_1999-02_66_2/page/137}}</ref>ambayo inapendekeza kwamba Alzeima hunasababishwa na kupunguka kwa kutengezwa kwa kipeleki cha nyuro cha asetilikolini.'' Nadharia tete hii haijaungwa mkono sana, hasa kwa sababu madawa yanayonuiwa kutibu upungufu wa asetilikolini huwa si mazuri sana. Athari zingine za kikolinajia pia zimependekezwa, kwa mfano, kuanza kujikusanya kwa ukubwa wa amiloidi,<ref name="pmid15236795">{{cite journal |author=Shen ZX |title=Brain cholinesterases: II. The molecular and cellular basis of Alzheimer's disease |journal=Med Hypotheses |volume=63 |issue=2 |pages=308–21 |year=2004 |pmid=15236795 |doi=10.1016/j.mehy.2004.02.031 }}</ref>inayo sababisha uvimbe wa nyuro usio wa kawaida.<ref name="pmid12934968">{{cite journal |author=Wenk GL |title=Neuropathologic changes in Alzheimer's disease |journal=J Clin Psychiatry |volume=64 Suppl 9 |pages=7–10 |year=2003 |pmid=12934968 }}</ref> Katika mwaka wa 1991,''nadharia ya amiloidi'' ilidai kwamba amana za amiloidi beta (Aβ) ndiyo chanzo msingi cha ugonjwa huu.<ref name="pmid1763432">{{cite journal |author=Hardy J, Allsop D |title=Amyloid deposition as the central event in the aetiology of Alzheimer's disease |journal=Trends Pharmacol. Sci. |volume=12 |issue=10 |pages=383–88 |year=1991 |month=Oktoba |pmid=1763432 |doi=10.1016/0165-6147(91)90609-V }}</ref><ref name="pmid11801334">{{cite journal |author=Mudher A, Lovestone S |title=Alzheimer's disease-do tauists and baptists finally shake hands? |url=https://archive.org/details/sim_trends-in-neurosciences_2002-01_25_1/page/22 |journal=Trends Neurosci. |volume=25 |issue=1 |pages=22–26 |year=2002 |month=Januari |pmid=11801334 |doi=10.1016/S0166-2236(00)02031-2 }}</ref> Uungaji mkono wa madai haya unatokana na kuwepo kwa jeni ya amiloidi tangulizi ya protini beta (APP) juu ya kromosomu 21, pamoja na ukweli kwamba watu walio natrisomia 21 (Down Syndrome) ambao wana nakala ziada ya jeni karibu ulimwenguni kote hudhihirisha Alzeima wanapofikisha umri wa maika 40.<ref name="pmid16904243">{{cite journal |author=Nistor M, Don M, Parekh M, ''et al.'' |title=Alpha- and beta-secretase activity as a function of age and beta-amyloid in Down syndrome and normal brain |url=https://archive.org/details/sim_neurobiology-of-aging_2007-10_28_10/page/1493 |journal=Neurobiol Aging |volume=28 |issue=10 |pages=1493–1506 |year=2007 |month=Oktoba |pmid=16904243 |doi=10.1016/j.neurobiolaging.2006.06.023 |last12=Head |first12=E }}</ref><ref name="pmid15639317">{{cite journal |author=Lott IT, Head E |title=Alzheimer disease and Down syndrome: factors in pathogenesis |url=https://archive.org/details/sim_neurobiology-of-aging_2005-03_26_3/page/n112 |journal=Neurobiol Aging |volume=26 |issue=3 |pages=383–89 |year=2005 |month=Machi |pmid=15639317 |doi=10.1016/j.neurobiolaging.2004.08.005 }}</ref> APOE4 ndiyo hatari kubwa ya kimaumbile ya Alzeima, husababisha kuongezeka kwa mkusanyiko zaidi wa amiloidi katika ubongo kabla ya dalili za Alzeima kujitokeza. Hivyo basi, kujikusanya kwa Aβ hutokea kabla ya Alzeima ya kliniki.<ref name="pmid7566000">{{cite journal |author=Polvikoski T, Sulkava R, Haltia M, ''et al.'' |title=Apolipoprotein E, dementia, and cortical deposition of beta-amyloid protein |url=https://archive.org/details/sim_new-england-journal-of-medicine_the-new-england-journal-of-medicine_1995-11-09_333_19/page/1242 |journal=N Engl J Med |volume=333 |issue=19 |pages=1242–47 |year=1995 |month=Novemba |pmid=7566000 |doi=10.1056/NEJM199511093331902 }}</ref> Ushahidi zaidi unatokana na kupatikana kwamba panya wenye jeni geuzi iliyotokana na wanyama weingine ya jeni APP ya binadamu hukua na kusababisha utando wa amiloidi fibrila na ishara za ugonjwa wa akili kama Alzeima ulio na upungufu wa mafunzo ya kimahali. <ref>Panya wenye jeni za wanyama wengine: * {{cite journal |author=Games D, Adams D, Alessandrini R, ''et al.'' |title=Alzheimer-type neuropathology in transgenic mice overexpressing V717F beta-amyloid precursor protein |url=https://archive.org/details/sim_nature-uk_1995-02-09_373_6514/page/522 |journal=Nature |volume=373 |issue=6514 |pages=523–27 |year=1995 |month=Februari |pmid=7845465 |doi=10.1038/373523a0 }} * {{cite journal |author=Masliah E, Sisk A, Mallory M, Mucke L, Schenk D, Games D |title=Comparison of neurodegenerative pathology in transgenic mice overexpressing V717F beta-amyloid precursor protein and Alzheimer's disease |url=https://archive.org/details/sim_journal-of-neuroscience_1996-09-15_16_18/page/n244 |journal=J Neurosci |volume=16 |issue=18 |pages=5795–811 |year=1996 |month=Septemba |pmid=8795633 }} * {{cite journal |author=Hsiao K, Chapman P, Nilsen S, ''et al.'' |title=Correlative memory deficits, Abeta elevation, and amyloid plaques in transgenic mice |url=https://archive.org/details/sim_science_1996-10-04_274_5284/page/98 |journal=Science (journal) |volume=274 |issue=5284 |pages=99–102 |year=1996 |month=Oktoba |pmid=8810256 |doi=10.1126/science.274.5284.99 }} * {{cite journal |author=Lalonde R, Dumont M, Staufenbiel M, Sturchler-Pierrat C, Strazielle C. |title=Spatial learning, exploration, anxiety, and motor coordination in female APP23 transgenic mice with the Swedish mutation. |url=https://archive.org/details/sim_brain-research_2002-11-22_956_1/page/36 |journal=Brain Research (journal) |volume=956 |pages=36–44, year=2002 |pmid=12426044 |doi=10.1016/S0006-8993(02)03476-5 |year=2002 |issue=1 }} </ref> Majaribio ya chanjo yalionekana kuondoa utando wa amiloidi katika majaribio ya awali ya binadamu, lakini hayakuwa na athari yoyote muhimu kwa dementia. <ref name="pmid18640458">{{cite journal |author=Holmes C, Boche D, Wilkinson D, ''et al.'' |title=Long-term effects of Abeta42 immunisation in Alzheimer's disease: follow-up of a randomised, placebo-controlled phase I trial |url=https://archive.org/details/sim_the-lancet_july-19-25-2008_372_9634/page/216 |journal=Lancet |volume=372 |issue=9634 |pages=216–23 |year=2008 |month=Julai |pmid=18640458 |doi=10.1016/S0140-6736(08)61075-2 |last12=Nicoll |first12=JA }}</ref> Watafiti wamepelekewa kudhania kwamba oligoma zisizo za utando za Aβ (mkusanyiko wa monoma nyingi) ndio muundo wa kimsingi wa Aβ. Hizi oligoma za sumu, pia zinajulikana kama Seli-gandi Tawanyishi zitokanazo na Amiloidi (ADDLs), hujigandisha kwenye kipokezi cha nyuroni na kubadilisha muundo wa sinapsi, na hivyo basi kusitisha mawasiliano ya neva.<ref name="pmid17251419"> {{cite journal |author=Lacor PN,''et al.'' |title=Aß Oligomer-Induced Aberrations in Synapse Composition, Shape, and Density Provide a Molecular Basis for Loss of Connectivity in Alzheimer's Disease |url=https://archive.org/details/sim_journal-of-neuroscience_2007-01-24_27_4/page/796 |journal=Journal of Neuroscience |volume=27 |issue=4 |pages=796–807 |year=2007 |month=Januari |pmid=17251419 |doi=10.1523/JNEUROSCI.3501-06.2007 |last2=Buniel |first2=MC |last3=Furlow |first3=PW |last4=Clemente |first4=AS |last5=Velasco |first5=PT |last6=Wood |first6=M |last7=Viola |first7=KL |last8=Klein |first8=WL }}</ref> Mojawapo ya kipokezi cha Oligoma ya Aβ inaweza kuwaprotini aina ya Prioni, protini ambayo pia imehusishwa na ugonjwa wa kichaa cha ng'ombe na hali inayofanana kwenye binadamu, ugonjwa wa Creutzfeldt-Jakob, hivyo basi kuunganisha mfumo wa msingi wa matatizo haya ya kuzorota kwa nyuro na yale ya ugonjwa wa Alzeima.<ref name="pmid19242475"> {{cite journal |author=Lauren J, Gimbel D, ''et al.'' |title=Cellular prion protein mediates impairment of synaptic plasticity by amyloid-beta oligomers |journal=Nature |volume=457 |issue=7233 |pages=1128–32 |year=2009 |month=Februari |pmid=19242475 |doi=10.1038/nature07761 |pmc=2748841 }}</ref> Katika 2009, nadharia hii iliboreshwa,huku ikipendekeza kuwa aina ya karibu ya protini ya beta-amiloidi, na siyo lazima iwe beta-amiloidi yenyewe, inaweza kuwa ndiyo chanzo kikubwa cha ugonjwa huu. Nadharia hii inashikilia kwamba utaratibu unaohusiana na amiloidi inayopogoa viunganishi vya nyuro katika ubongo katika awamu ya haraka ya awali ya ukuaji wa maisha inaweza kusababishwa na mifumo inayohusiana na kuzeeka katika maisha ya baadaye na kusababisha kunyauka kwa neva kwa ugonjwa wa Alzeima.<ref name="Nikolaev">{{cite journal | first= Anatoly | last= Nikolaev | coauthors= Todd McLaughlin, Dennis O'Leary, Marc Tessier-Lavigne | date= 19 Februari 2009 | title= N-APP binds DR6 to cause axon pruning and neuron death via distinct caspases | url= https://archive.org/details/sim_nature-uk_2009-02-19_457_7232/page/981 | journal= Nature | volume= 457 | issue= 7232 | pages= 981–989 | issn= 0028-0836 | pmid= 19225519 | pmc= 2677572 | doi= 10.1038/nature07767 | accessdate= Mei 2009 }} </ref> N-APP, sehemu ya APP kutoka peptidi ya N ya mwisho-, ni karibu na beta-amiloidi na imepasuliwa kutoka kwa APP na mojawapo ya vimeng'enya. N-APP huchochea mkondo wa kujiharibu kwa kujiunganisha kwa kipokezi cha kinyuro kinachoitwa kipokezi cha kifo 6 (DR6, pia inajulikana kama TNFRSF21).<ref name="Nikolaev"/> DR6 huonekana sana katika maeneo ya ubongo wa binadamu walioathirika zaidi na Alzeima, hivyo inawezekana kwamba njia ya N-APP/DR6 yaweza kutekwa nyara katika ubongo unaozeeka ili kusababisha uharibifu. Katika mfumo huu, Beta-amiloidi hutekeleza jukumu la usaidizi, kwa kukomesha kazi kwa kubana utendakazi wa kisinapti. Utafiti uliofanywa katika mwaka wa 2004 ulipata kuwa utando za amiloidi haziwiani vyema na upotevu wa nyuro.<ref name="pmid15039236">{{cite journal |author=Schmitz C, Rutten BP, Pielen A, ''et al.'' |title=Hippocampal neuron loss exceeds amyloid plaque load in a transgenic mouse model of Alzheimer's disease |journal=Am J Pathol |volume=164 |issue=4 |pages=1495–1502 |year=2004 |month=Aprili |pmid=15039236 |pmc=1615337 |last12=Steinbusch |first12=HW |last13=Pradier |first13=L |last14=Bayer |first14=TA }}</ref> Uchunguzi huu unaunga mkono nadharia tete ya''tau,'' dhana kwamba matatizo ya protini ya tau huanzisha kuzuka kwa ugonjwa huu.<ref name="pmid11801334"/> Kulingana na mfumo huu, tau ya haipafosforilia huanza kushikana na nyuzi zingine za tau. Hatimaye, hutengeneza utando wa nyurofibirila ndani ya miili ya seli za neva.<ref name="pmid1669718">{{cite journal |author=Goedert M, Spillantini MG, Crowther RA |title=Tau proteins and neurofibrillary degeneration |journal=Brain Pathol |volume=1 |issue=4 |pages=279–86 |year=1991 |month=Julai |pmid=1669718 |doi=10.1111/j.1750-3639.1991.tb00671.x }}</ref> Wakati hili linapotokea, mishipa midogo zaidi husambaratika na kusababisha kuharibika kwa mfumo wa usafiri wa nyuro.<ref name="pmid15615638">{{cite journal |author=Iqbal K, Alonso Adel C, Chen S, ''et al.'' |title=Tau pathology in Alzheimer disease and other tauopathies |journal=Biochim Biophys Acta |volume=1739 |issue=2–3 |pages=198–210 |year=2005 |month=Januari |pmid=15615638 |doi=10.1016/j.bbadis.2004.09.008 |url= |last12=Grundke-Iqbal |first12=I }}</ref> Hii inaweza kusababisha kwanza kutofanya kazi kwa mawasiliano ya biokemikali kati ya nyuro na baadaye kifo cha seli.<ref name="pmid17127334">{{cite journal |author=Chun W, Johnson GV |title=The role of tau phosphorylation and cleavage in neuronal cell death |journal=Front Biosci |volume=12 |pages=733–56 |year=2007 |pmid=17127334 |doi=10.2741/2097 }}</ref> Malengelenge ya Hepisi simpuleksiya virusi vya aina 1 pia yamependekezwa kutekeleza jukumu sababishi katika kubeba aina shawishi za jeni ya apoE. <ref name="pmid18487848"> {{cite journal |author=Itzhaki RF, Wozniak MA |title=Herpes simplex virus type 1 in Alzheimer's disease: the enemy within |journal=J Alzheimers Dis |volume=13 |issue=4 |pages=393–405 |year=2008 |month=Mei |pmid=18487848 |doi= |issn=1387-2877 |url=http://iospress.metapress.com/openurl.asp?genre=article&issn=1387-2877&volume=13&issue=4&spage=393 }}</ref> Nadharia tete nyingine inasisitiza kwamba ugonjwa huu unaweza kuwa unasababishwa na kuvunjika kwa mayelinindani ya ubongo kunakotokana na umri. Kuvunjika huku kwa mayelini husababisha kusitishwa kwa usafiri wa kimkongo, na hivyo husababisha kupotezwa kwa nyuro ambazo huganda. Madini ya chuma yanayotolewa wakati wa kuvunjwa kwa mayelina hudaiwa kuwa husababisha uharibifu zaidi. Mifumo karabati wa uthabitishaji wa mayelini huchangia katika kukua kwa amana za protini kama vile-beta Amiloidi na tau.<ref>{{Cite pmid| 19775776}}</ref><ref>{{Cite pmid| 15665415}}</ref><ref>{{Cite pmid|18596894}}</ref> Fadhaa ya uoksidishaji ni sababu kubwa katika kutokea kwa ugonjwa huu./} Watu walio na Alzeima huonyesha kupoteza kwa 70% ya udhibiti wa seli za [[kurulusi]] ambazo hutoa norepinefrini (pamoja na wajibu wake wa uwasilishi wa nyuro) ambazo kwa kawaida huenea kutoka kwa “varicositi” kama za kusababishwa na mwili wenyewe kupiganan na uvimbe kwenye mazingira madogo yanayozunguka nyuro, seli za gliali, na mishipa ya damu kwenye neokoteksi na hipokampasi.<ref name="Heneka"> Heneka MT, Nadrigny F, Regen T, Martinez-Hernandez A, Dumitrescu-Ozimek L, Terwel D, Jardanhazi-Kurutz D, Walter J, Kirchhoff F, Hanisch UK, Kummer MP. (2010). [http://www.pnas.org.libproxy.ucl.ac.uk/content/107/13/6058.full.pdf Locus ceruleus hudhibiti patholojia ya Alzeima kwa kusimamia utendajikazi wa microglial kupitia norepinephrine.] Proc Natl Acad Sci Marekani A. 107:6058-6063 {{doi|10.1073/pnas.0909586107}} PMID 20,231,476</ref> Imeonyeshwa kuwa norepinefrini huchangamsha kipanya cha microglia na kuzuia Aβ- uzalishaji ulishawishiwa wa saitokini na fagosaitosisi zao za Aβ.<ref name="Heneka"/> Hii inaashiria kwamba kuzorota kwa ceruleusi ya mahali maalum yaweza kuwajibika kwa utuaji uliongezeka wa Aβ kwenye ubongo wa Alzeima.<ref name="Heneka"/> == Pathofiziolojia == [[Picha:Alzheimer dementia (3) presenile onset.jpg|thumb|Mfano wa Histopatholojia wa utando dhoofu unavyoonekana katika oteksi ya serebali ya mtu alye na ugonjwa wa mwanzo Alzeima kabla ya uzee. Kutiliwa fedha.]] === Patholojia ya Nyuro === Ugonjwa wa Alzeima una sifa ya kupotezwa kwa nyuro na sinepsi katika tabaka la juu la ubongo na baadhi ya ya maeneo madogo ya oteksi. Upotevu huu hupelekea kudhoofika kwa jumla kwa maeneo yaliyoathirika, ikiwa ni pamoja na kuzorota kwa ndewe ya wakati na ndewe ya parietali, na sehemu ya mbele ya koteksi na mzunguko wa "singulate".<ref name="pmid12934968"/> Utafiti unaotumia MRI na PET umetia kwenye kumbukumbu kupunguka kwa ukubwa maeneo maalum ya ubongo ya wagonjwa wanavyoendelea kutoka kwa kuharibika kwa umauzi wa kadiri hadi kwa ugonjwa wa Alzeima , na kwa kulinganisha na picha zinazofanana kutoka kwa watu wazima walio na uzeee na wenye afya.<ref>{{cite journal|author=Moan R|title=MRI software accurately IDs preclinical Alzheimer's disease|journal=Diagnostic Imaging|date=20 Julai 2009|url=http://www.diagnosticimaging.com/news/display/article/113619/1428344|access-date=2010-10-18|archive-date=2016-05-16|archive-url=http://arquivo.pt/wayback/20160516192841/http://www.diagnosticimaging.com/news/display/article/113619/1428344|dead-url=yes|=http://arquivo.pt/wayback/20160516192841/http://www.diagnosticimaging.com/news/display/article/113619/1428344}}</ref> Tando zote za amiloidi na utanda neurofibrila huonekana wazi wazi na microscopia katika akili ya wale walio na taabu ya Alzeima.<ref name="pmid15184601">{{cite journal |author=Tiraboschi P, Hansen LA, Thal LJ, Corey-Bloom J |title=The importance of neuritic plaques and tangles to the development and evolution of AD |url=https://archive.org/details/sim_neurology_2004-06-08_62_11/page/n140 |journal=Neurology |volume=62 |issue=11 |pages=1984–9 |year=2004 |month=Juni |pmid=15184601 }}</ref> Tando ni nene, hakunaamana zaidi za beta peptidi amiloidi na nyenzo [[Seli|za mkononi]] nje na kuzunguka nyuro. Mfungamano (mfungamano wa neurofibrila) ni mkusanyiko wa neli ndogo za protini za tau ambazo zimekuwa haipafosoforia na kujilimbikiza ndani ya seli zenyewe. Ingawa watu wengi zaidi hupata tando na mfungamano kama matokeo ya uzee, wagonjwa wa Alzeima huwa nazo kwa wingi katika sehemu maalum za ubongo kama vile tundu ya wakati.<ref name="pmid8038565">{{cite journal |author=Bouras C, Hof PR, Giannakopoulos P, Michel JP, Morrison JH |title=Regional distribution of neurofibrillary tangles and senile plaques in the cerebral cortex of elderly patients: a quantitative evaluation of a one-year autopsy population from a geriatric hospital |journal=Cereb. Cortex |volume=4 |issue=2 |pages=138–50 |year=1994 |pmid=8038565 |doi=10.1093/cercor/4.2.138 }}</ref> Mkusanyiko mkubwa wa protini (Miili ya Lewy) si adimu katika ubongo wa mgonjwa wa Alzeima.<ref name="pmid11816795">{{cite journal |author=Kotzbauer PT, Trojanowsk JQ, Lee VM |title=Lewy body pathology in Alzheimer's disease |journal=J Mol Neurosci |volume=17 |issue=2 |pages=225–32 |year=2001 |month=Oct |pmid=11816795 |doi=10.1385/JMN:17:2:225 }}</ref> === Biokemia === [[Picha:Amyloid-plaque formation-big.jpg|right|thumb|border|Vimeng'enya hufanyia kazi APP (protini tangulizi ya amiloidi) na kuikata katika vipande. Kipande cha amiloidi beta ni muhimu katika uundaji wa utando dhoofu katika Alzeima.]] Ugonjwa wa Alzeima umetambuliwa kama ugonjwa wa u kukunjwa vibaya kwa protini (proteopathia) , unaosababishwa na protini za A/beta na tau zilizojikunja vibaya ubongoni.<ref name="pmid14528050">{{cite journal |author=Hashimoto M, Rockenstein E, Crews L, Masliah E |title=Role of protein aggregation in mitochondrial dysfunction and neurodegeneration in Alzheimer's and Parkinson's diseases |journal=Neuromolecular Med. |volume=4 |issue=1–2 |pages=21–36 |year=2003 |pmid=14528050 |doi=10.1385/NMM:4:1-2:21 }}</ref> Utando umeundwa kwa peptidi ndogo, zenye urefu wa asidi ya amino 39-43 uitwao beta amiloidi-(pia huandikwa pia kama A-beta-au Aβ). Beta-amiloidi ni kipande kutoka protini kubwa iitwayo amiloidi tangulizi (APP), protini iliyotanda na hupenya kwa utando wa nyuroni. APP ni muhimu kwa ukuaji nyuroni, kuishi na-kujirekebisha baada ya majeraha.<ref name="pmid16822978">{{cite journal |author=Priller C, Bauer T, Mitteregger G, Krebs B, Kretzschmar HA, Herms J |title=Synapse formation and function is modulated by the amyloid precursor protein |url=https://archive.org/details/sim_journal-of-neuroscience_2006-07-05_26_27/page/n108 |journal=J. Neurosci. |volume=26 |issue=27 |pages=7212–21 |year=2006 |month=Julai |pmid=16822978 |doi=10.1523/JNEUROSCI.1450-06.2006 }}</ref><ref name="pmid12927332">{{cite journal |author=Turner PR, O'Connor K, Tate WP, Abraham WC |title=Roles of amyloid precursor protein and its fragments in regulating neural activity, plasticity and memory |url=https://archive.org/details/progress-in-neurobiology_2003-05_70_1/page/1 |journal=Prog. Neurobiol. |volume=70 |issue=1 |pages=1–32 |year=2003 |month=Mei |pmid=12927332 |doi=10.1016/S0301-0082(03)00089-3 }}</ref> Katika ugonjwa wa Alzeima, mchakato usiojulikana husababisha APP kugawanyika kwa vipande vidogo kupitia kimengenyakatika proteolisisi.<ref name="pmid15787600">{{cite journal |author=Hooper NM |title=Roles of proteolysis and lipid rafts in the processing of the amyloid precursor protein and prion protein |journal=Biochem. Soc. Trans. |volume=33 |issue=Pt 2 |pages=335–8 |year=2005 |month=Aprili |pmid=15787600 |doi=10.1042/BST0330335 }}</ref> Moja ya vipande hivi inazaa fibrili za amiloidi-beta, ambazo zinatengeza vibonge ambazo zinakusanyika nje ya nyuroni kwa wingi na kuunda vikundi ambavyo vinajulikana kama utando dhaifu.<ref name="pmid15184601"/><ref name="pmid15004691">{{cite journal |author=Ohnishi S, Takano K |title=Amyloid fibrils from the viewpoint of protein folding |url=https://archive.org/details/sim_cellular-and-molecular-life-sciences_2004-03_61_5/page/n3 |journal=Cell. Mol. Life Sci. |volume=61 |issue=5 |pages=511–24 |year=2004 |month=Machi |pmid=15004691 |doi=10.1007/s00018-003-3264-8 }}</ref> [[Picha:TANGLES HIGH.jpg|right|thumb|Katika ugonjwa wa Alzeima, mabadiliko katika protini ya tau yanapelekea kuharibika kwa mikrotubuli katika seli za ubongo.]] Alzeima pia hufikiriwa kuwa shida ya protini ya tau kutokana na kusanyikousio wa kawaida wa protini ya tau. Kila nyuroni ina mfupa wa ndani, mfumo wa ndani ambao kwa kiasi umeundwa kwa mifumo iitwayo mikrotubuli. Mikrotubuli hizi huwa kama alama, kuongoza virutubisho na molekuli kutoka katika mwili wa seli hadi mwisho wa mkongo na kurejea. Protini ya ''tau'' uhimarisha mikrotubuli wakati inapopata fosforasi, na kwa hiyo huitwa protini inayohusisha mikrotubuli. Katika Alzeima, tau bado hupitia mabadiliko ya kemikali, kuwa na fosfori nyingi, basi huanza kuunda jozi na nyuzi nyingine, na kuunda misokotano ya neurofibrila na kuharibu mfumo wa usafiri wa nyuroni.<ref name="pmid17604998">{{cite journal |author=Hernández F, Avila J |title=Tauopathies |url=https://archive.org/details/sim_cellular-and-molecular-life-sciences_2007-09_64_17/page/2219 |journal=Cell. Mol. Life Sci. |volume=64 |issue=17 |pages=2219–33 |year=2007 |month=Septemba |pmid=17604998 |doi=10.1007/s00018-007-7220-x }}</ref> === Utaratibu wa ugonjwa === Jinsi mvurugiko wa uzalishaji na mkusanyiko wa peptidi amiloidi beta husababisha kuongezeka kwa ugonjwa wa Alzeima haijulikani hasa.<ref name="pmid17622778">{{cite journal |author=Van Broeck B, Van Broeckhoven C, Kumar-Singh S |title=Current insights into molecular mechanisms of Alzheimer disease and their implications for therapeutic approaches |journal=Neurodegener Dis |volume=4 |issue=5 |pages=349–65 |year=2007 |pmid=17622778 |doi=10.1159/000105156 }}</ref> Nadharia tete ya amiloidi kijadi huashiria kuwa mkusanyiko wa peptidi amiloidi beta kama tukio kuu la kuchochea nyuroni kuzorota. Mkusanyiko wa fibrili za amiloidiambazo zinaaminika kuwa aina ya protini yenye sumu inayosababisha kuvuruga homiostasisi ya ayoni [[Kalisi|kalsiamu]] katika seli, husababisha chembe kufa (apoptosisi).<ref name="pmid2218531">{{cite journal |author=Yankner BA, Duffy LK, Kirschner DA |title=Neurotrophic and neurotoxic effects of amyloid beta protein: reversal by tachykinin neuropeptides |url=https://archive.org/details/sim_science_1990-10-12_250_4978/page/278 |journal=Science (journal) |volume=250 |issue=4978 |pages=279–82 |year=1990 |month=Oktoba |pmid=2218531 |doi=10.1126/science.2218531 }}</ref> Pia inajulikana kwamba Aβ huchagua kuendelea kukusanyika katika mitokondria katika seli za ubongo ulioathirika na Alzeima, na pia inazuia kazi fulani ya [[Kimeng'enya|kimengenya]] na matumizi ya glukosi na nyuroni.<ref name="pmid17424907">{{cite journal |author=Chen X, Yan SD |title=Mitochondrial Abeta: a potential cause of metabolic dysfunction in Alzheimer's disease |journal=IUBMB Life |volume=58 |issue=12 |pages=686–94 |year=2006 |month=Desemba |pmid=17424907 |doi=10.1080/15216540601047767}}</ref> Michakato mbalimbali yenye uvimbe na saitokini pia inaweza kuwa inahusika kwa kutokea kwa ugonjwa wa Alzeima. Kuvimba ni ishara ya jumla ya uharibifu wa tishu katika ugonjwa wowote, na huweza kuwa baada ya uharibifu wa tishu katika Alzeima au ishara ya jibu la kinga.<ref name="pmid15681814">{{cite journal |author=Greig NH, Mattson MP, Perry T, ''et al.'' |title=New therapeutic strategies and drug candidates for neurodegenerative diseases: p53 and TNF-alpha inhibitors, and GLP-1 receptor agonists |journal=Ann. N. Y. Acad. Sci. |volume=1035 |pages=290–315 |year=2004 |month=Desemba |pmid=15681814 |doi=10.1196/annals.1332.018 }}</ref> Tofauti katika ugawaji wa neurotrofiki na tofauti katika uelezaji wa vipokezi vyao kama vile vipengele vya neurotrofiki zinazotokana na ubongo(BDNF) zilivyoelezwa katika Alzeima.<ref>{{cite journal |author=Tapia-Arancibia L, Aliaga E, Silhol M, Arancibia S |title=New insights into brain BDNF function in normal aging and Alzheimer disease |journal=[[Brain Research Reviews]] |volume=59 |issue=1 |pages=201–20 |year=2008 |month=Nov |pmid=18708092 |doi=10.1016/j.brainresrev.2008.07.007 }}</ref><ref>{{cite journal |doi=10.1111/j.1601-183X.2007.00378.x |author=Schindowski K, Belarbi K, Buée L |title=Neurotrophic factors in Alzheimer's disease: role of axonal transport |journal= [[Genes, Brain and Behavior]] |volume=7 |issue=Suppl 1 |pages=43–56 |year=2008 |month=Feb |pmid=18184369 |pmc=2228393 }}</ref> === Jenetiki === Na idadi kubwa ya kesi za ugonjwa wa Alzeima ni za mtawanyiko, ina maana kuwa ugonjwa huu haurithiwi ingawa baadhi ya jeni zinaongeza hatari. Kwa upande mwingine, karibu 0.1% ya kesi ni aina ya ugonjwa unaosababishwa na urithi wa kifamilia kutoka jeni za mzazi mmoja, ambao kwa kawaida huanza kabla ya umri wa 65.<ref name="pmid16876668">{{cite journal |author=Blennow K, de Leon MJ, Zetterberg H |title=Alzheimer's disease |journal=Lancet |volume=368 |issue=9533 |pages=387–403 |year=2006 |month=Julai |pmid=16876668 |doi=10.1016/S0140-6736(06)69113-7 |url= }}</ref> Mara nyingi ugonjwa wa kifamilia wa Alzeima unaotokana na jeni za mzazi mmoja unaweza kuhusishwa na mabadiliko katika moja ya jeni tatu: protini tangulizi ya amiloidi (APP) na presenilini ya 1 na 2.<ref name="pmid18332245">{{cite journal |author=Waring SC, Rosenberg RN |title=Genome-wide association studies in Alzheimer disease |journal=Arch Neurol |volume=65 |issue=3 |pages=329–34 |year=2008 |month=Machi |pmid=18332245 |doi=10.1001/archneur.65.3.329 }}</ref> Mabadiliko mengi katika APP na jeni ya presenilini huchangia uzalishaji wa protini ndogo iitwayoAβ42, ambayo ni sehemu kuu ya utando dhaifu.<ref>{{cite journal |author=Selkoe DJ |title=Translating cell biology into therapeutic advances in Alzheimer's disease |journal=Nature |volume=399 |issue=6738 Suppl |pages=A23–31 |year=1999 |month=Juni |pmid=10392577 |doi=10.1038/19866 }}</ref> Baadhi ya mabadiliko hubadilisha tu uwiano wa kawaida kati ya Aβ42 na miundo mingine mikuu, kama vile Aβ40-bila kuongeza viwango vya Aβ42.<ref name="pmid8938131">{{cite journal |author=Borchelt DR, Thinakaran G, Eckman CB, ''et al.'' |title=Familial Alzheimer's disease-linked presenilin 1 variants elevate Aβ1-42/1-40 ratio in vitro and in vivo. |url=https://archive.org/details/neuron_1996-11_17_5/page/1005 |journal=Neuron |volume=17 |issue=5 |pages=1005–13 |year=1996 |month=Nov |pmid=8938131 |doi=10.1016/S0896-6273(00)80230-5 |last12=Wang |first12=R |last13=Seeger |first13=M |last14=Levey |first14=AI |last15=Gandy |first15=SE |last16=Copeland |first16=NG |last17=Jenkins |first17=NA |last18=Price |first18=DL |last19=Younkin |first19=SG |last20=Sisodia |first20=SS }}</ref><ref name="pmid17254019">{{cite journal |author=Shioi J, Georgakopoulos A, Mehta P, ''et al.'' |title=FAD mutants unable to increase neurotoxic Aβ 42 suggest that mutation effects on neurodegeneration may be independent of effects on Abeta. |journal=J Neurochem. |volume=101 |issue=3 |pages=674–81 |year=2007 |month=Mei |pmid=17254019 |doi=10.1111/j.1471-4159.2006.04391.x }}</ref> Hii inaashiria kwamba mabadiliko ya presenilini yanaweza kusababisha ugonjwa hata kama inapunguza kiwango cha Aβ zinazozalishwa na huweza kuashiria majukumu mengine ya presenilini au jukumu la mabadiliko katika kazi ya APP na / au vipande vyake vingine mbali na Aβ. Kesi zaidi za ugonjwa wa Alzeima hazionyeshi dalili za ugonjwa wa kurithi na hujulikana kama Alzeima ya mtawanyiko. Hata hivyo tofauti za kijenetiki zinaweza kuwa ishara ya hatari. Ishara ijulikanayo vyema zaidi ni urithi wa aleli ya ε4 apolipoprotini E (APOE).<ref name="pmid8446617">{{cite journal |author=Strittmatter WJ, Saunders AM, Schmechel D, ''et al.'' |title=Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease |journal=Proc. Natl. Acad. Sci. USA |volume=90 |issue=5 |pages=1977–81 |year=1993 |month=Machi |pmid=8446617 |pmc=46003 |doi=10.1073/pnas.90.5.1977 }}</ref><ref name="pmid16567625">{{cite journal |author=Mahley RW, Weisgraber KH, Huang Y |title=Apolipoprotein E4: a causative factor and therapeutic target in neuropathology, including Alzheimer's disease |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=103 |issue=15 |pages=5644–51 |year=2006 |month=Aprili |pmid=16567625 |pmc=1414631 |doi=10.1073/pnas.0600549103 |url= }}</ref> Kati ya 40 na 80% ya wagonjwa walio na Alzeima wanayo aleli ya apoE4.<ref name="pmid16567625"/> Aleli ya APOE4 huongeza hatari ya ugonjwa huo kwa mara tatu katika heterozigoti na kwa mara 15 katika homozigoti.<ref name="pmid16876668"/> Wanasayansi wa jenetiki wanakubaliana kwamba jeni nyingine nyingi pia huwa kama sababu za hatari au zina athari za kinga zinayoshawishi kuanza kwa kuchelewa ugonjwa wa Alzeima.<ref name="pmid18332245"/> Zaidi ya jeni 400 zimepimwa kuonyesha uhusiano na Alzeima ya mtawanyiko inayoanza kwa kuchelewa,<ref name="pmid18332245"/>nyingi bila matokeo.<ref name="pmid16876668"/> == Utambuzi wa Ugonjwa == [[Picha:PET Alzheimer.jpg|thumb|right|upright|Uchungzi wa PET wa ubongo wa mtu aliye na Alzeima huonyesha upungufu wa utendaji kazi katika tundu ya panja]] Ugonjwa wa Alzeima kwa kawaida hutambulika kama ugonjwa kutoka kwa historia ya mgonjwa, historia ya pamoja kutoka kwa jamaa, na uchunguzi wa kimatibabu, kutegemea na kuwepo kwa sifaza kinyurolojia na kinyurosaikolojia za neva na kukosekana kwa hali mbadala.<ref name="pmid17407994">{{cite journal |author=Mendez MF |title=The accurate diagnosis of early-onset dementia |journal=International Journal of Psychiatry Medicine |volume=36 |issue=4 |pages=401–412 |year=2006 |pmid=17407994 |doi=10.2190/Q6J4-R143-P630-KW41 }}</ref><ref name="pmid17018549">{{cite journal |author=Klafki HW, Staufenbiel M, Kornhuber J, Wiltfang J |title=Therapeutic approaches to Alzheimer's disease |url=https://archive.org/details/sim_brain_2006-11_129_11/page/2840 |journal=Brain |volume=129 |issue=Pt 11 |pages=2840–55 |year=2006 |month=Novemba |pmid=17018549 |doi=10.1093/brain/awl280 }}</ref> Matibabu ya mionzi ya hali ya juu na tomografia ya utendajikazi au mwangwi wa sumaku wa upigaji picha (MRI), na kwa upigaji picha wa kitomografia wa utendajikazi wa mwili(SPECT) au picha ya kompyuta ya miale ya gama (PET) zinaweza kutumika kusaidia kutenga magonjwa mengine ya ubongo au aina nyingine za magonjwa ya ubongo.<ref>{{cite web |url = http://www.nice.org.uk/nicemedia/pdf/CG042quickrefguide.pdf |format = PDF |title = Dementia: Quick reference guide |publisher = (UK) [[National Institute for Health and Clinical Excellence]] |location = London |month = Novemba |year = 2006 |isbn = 1-84629-312-X |accessdate = 2008-02-22 |archiveurl = https://web.archive.org/web/20080227161412/http://www.nice.org.uk/nicemedia/pdf/CG042quickrefguide.pdf |archivedate = 2008-02-27 }}</ref> Aidha, inaweza kutabiri kubadilika kutoka hatua za mwanzo (upungufu wa uwezo wa utambuzi) hadi kwa ugonjwa wa Alzeima.<ref>{{cite journal |author=Schroeter ML, Stein T, Maslowski N, Neumann J |title=Neural correlates of Alzheimer's disease and mild cognitive impairment – A meta-analysis including 1351 patients. |journal=NeuroImage |volume=47 |issue=4 |pages=1196–1206 |year=2009 |pmid=19463961 |pmc=2730171 |doi=10.1016/j.neuroimage.2009.05.037 }}</ref> Tathmini ya utendajikazi wa wasomi pamoja na kupima kumbukumbu kunaweza kusaidia zaidi kutathmini hali ya ugonjwa huo.<ref name="pmid17222085"/> Mashirika ya kimatibabu yameunda vigezo vya uchunguzi wa kimatibabu ili kurahisisha na kuwekeza viwango vya michakato ya wauguzi. Utambuzi huweza kuwa imara zaidi wakati wa uchunguzi wa mwili wakati sehemu za ubongo zinaweza kupatikana na kuchunguzwa kihistoria.<ref name="pmid6610841">{{cite journal |author=McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM |title=Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease |url=https://archive.org/details/sim_neurology_1984-07_34_7/page/939 |journal=Neurology |volume=34 |issue=7 |pages=939–44 |year=1984 |month=Julai |pmid=6610841 }}</ref> === Vigezo vya uchunguzi wa kiutambuzi === Taasisi ya Taifa ya Kinyurojia na matatizo ya kimawasiliano na kiharusi (NINCDS) na Ushirika wa ugonjwa wa Alzeima na magonjwa husika (ADRDA, sasa inajulikana kama [[Chama cha Alzeima)]] [[NINCDS-ADRDA]] iliunda vigezo vinavyotumika kwa kawaida katika utambuzi mnamo 1984,<ref name="pmid6610841"/> vilivyoboreshwa mnamo 2007.<ref name="pmid17616482">{{cite journal |author=Dubois B, Feldman HH, Jacova C, ''et al.'' |title=Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria |journal=Lancet Neurol |volume=6 |issue=8 |pages=734–46 |year=2007 |month=Agosti |pmid=17616482 |doi=10.1016/S1474-4422(07)70178-3 |last12=O'brien |first12=J |last13=Pasquier |first13=F |last14=Robert |first14=P |last15=Rossor |first15=M |last16=Salloway |first16=S |last17=Stern |first17=Y |last18=Visser |first18=PJ |last19=Scheltens |first19=P }}</ref> Vigezo hivi vinahitaji kuwa kuwepo kwa uharibifu wa utambuzi, na kukishukiwa kuwepo kwa shida ya akili, na kuthibitishwa na kupima saikolojia ya akili kwa uchunguzi wa kimatibabu wa uwezekano au uwepo wa Alzeima. Uthibitisho kutoka kwa uchunguzi wa kina wa ugonjwa ikiwa ni pamoja na uchunguzi wa kina wa tishu ya ubongo inahitajika kwa ajili ya kuthibitisha uchunguzi. Takwimu za kuaminika na uhalali zimeonyeshwa kati ya vigezo vya uchunguzi na uthibitisho wa uchunguzi wa historia na maendeleo ya ugonjwa huu.<ref name="pmid7986174">{{cite journal |author=Blacker D, Albert MS, Bassett SS, Go RC, Harrell LE, Folstein MF |title=Reliability and validity of NINCDS-ADRDA criteria for Alzheimer's disease. The National Institute of Mental Health Genetics Initiative |journal=Arch. Neurol. |volume=51 |issue=12 |pages=1198–204 |year=1994 |month=Desemba |pmid=7986174 }}</ref> Vitengo vinane vya utendaji kwa kawaida uharibiwa katika Alzeima- kumbukumbu, [[lugha]], ujuzi wa utambuzi, makini, uwezo wa kujenga, maelekezo, kutatua tatizo na uwezo wa utendaji. Vitengo hivi ni sawa na Vigezo vya Alzeima vya NINCDS-ADRDA kama vilivyoorodheshwa katika ''Uchunguzi na Takwimu za Mwongozo wa Magonjwa ya akili'' ''Diagnostic and Statistical Manual of Mental Disorders '' (DSM-IV-TR) iliyochapishwa na Chama cha Marekani cha Kiakili.<ref>{{cite book |last=American Psychiatric Association |title=Diagnostic and statistical manual of mental disorders: DSM-IV-TR |url=https://archive.org/details/diagnosticstatis00amer_2 |edition=4th Edition Text Revision |publisher=American Psychiatric Association |year=2000 |location=Washington, DC |isbn=0890420254 }}</ref><ref name="pmid8752526">{{cite journal |author=Ito N |title=[Clinical aspects of dementia] |language=Japanese |journal=Hokkaido Igaku Zasshi |volume=71 |issue=3 |pages=315–20 |year=1996 |month=Mei |pmid=8752526 }}</ref> === Vifaa vya Uchunguzi === [[Picha:InterlockingPentagons.svg|right|thumb|Uchunguzi wa vipimo wa saikolojia ya ubongo unaweza kusaidia katika uchunguzi wa Alzeima. Katika uchunguzi huo wagonjwa wanapaswa kunakili michoro sawa na ile inayoonyeshwa katika picha, kumbuka maneno, kusoma, na kuondoa nambari katika mfululizo.]] Uchunguzi wa kinyrosaikolojia kama vile uchunguzi wa kiasi wa hali ya akili(MMSE), hutumika sana kutathmini upungufu wa utambuzi unaohitajika kwa uchunguzi. Uchunguzi pana zaidi unahitajika kwa matokeo ya kuaminika zaidi, hasa katika hatua za mwanzo za ugonjwa huo.<ref name="pmid1512391">{{cite journal |author=Tombaugh TN, McIntyre NJ |title=The mini-mental state examination: a comprehensive review |journal=J Am Geriatr Soc |volume=40 |issue=9 |pages=922–35 |year=1992 |month=Septemba |pmid=1512391 }}</ref><ref name="pmid9987708">{{cite journal |author=Pasquier F |title=Early diagnosis of dementia: neuropsychology |url=https://archive.org/details/sim_journal-of-neurology_1999-01_246_1/page/n7 |journal=J. Neurol. |volume=246 |issue=1 |pages=6–15 |year=1999 |month=Januari |pmid=9987708 |doi=10.1007/s004150050299 }}</ref> Uchunguzi wa neva mwanzoni mwa Alzeima hutoa matokeo ya kawaida, ila kwa uharibifu dhahiri katika utambuzi, ambayo inaweza kosa kuwa tofauti na ile itokanayo na michakato mingine ya magonjwa, ikiwa ni pamoja na sababu nyingine ya shida ya akili. Uchunguzi zaidi kinyurojia ni muhimu katika kutofautisha utambuzi wa Alzeima na magonjwa mengine.<ref name="pmid17222085"/> Mahojiano na jamaa wa familia pia hutumika katika tathmini ya ugonjwa huo. Walezi wanaweza kusambaza taarifa muhimu kuhusu uwezo wa kuishi wa kila siku, na pia juu ya kupungua, baada ya muda, uwezo wa akili ya mtu kufanya kazi.<ref name="pmid16327345">{{cite journal |author=Harvey PD, Moriarty PJ, Kleinman L, ''et al.'' |title=The validation of a caregiver assessment of dementia: the Dementia Severity Scale |journal=Alzheimer Dis Assoc Disord |volume=19 |issue=4 |pages=186–94 |year=2005 |pmid=16327345 |doi=10.1097/01.wad.0000189034.43203.60 }}</ref> Mtizamo wa mlezi ni muhimu sana, kwani mtu aliye na Alzeima ni kawaida hajui upungufu wake mwenyewe.<ref name="pmid15738860">{{cite journal |author=Antoine C, Antoine P, Guermonprez P, Frigard B |title=[Awareness of deficits and anosognosia in Alzheimer's disease.] |language=French |journal=Encephale |volume=30 |issue=6 |pages=570–7 |year=2004 |pmid=15738860 |doi=10.1016/S0013-7006(04)95472-3 }}</ref> Mara nyingi, pia familia huwa na shida ya kutambua dalili za awali za dementia na wanaweza kukosa kutoa habari sahihi kwa daktari.<ref name="pmid16197855">{{cite journal |author=Cruz VT, Pais J, Teixeira A, Nunes B |title=[The initial symptoms of Alzheimer disease: caregiver perception] |language=Portuguese |journal=Acta Med Port |volume=17 |issue=6 |pages=435–44 |year=2004 |pmid=16197855 }}</ref> Dalili nyingine nzuri katika utambuzi wa ugonjwa ni ichunguzi wa maji ya serebali ya uti wa mgongo kwa uwepo wa amiloidi beta au protini ya tau,<ref name="pmid17612711">{{cite journal |author=Marksteiner J, Hinterhuber H, Humpel C |title=Cerebrospinal fluid biomarkers for diagnosis of Alzheimer's disease: beta-amyloid(1-42), tau, phospho-tau-181 and total protein |journal=Drugs Today |volume=43 |issue=6 |pages=423–31 |year=2007 |month=Juni |pmid=17612711 |doi=10.1358/dot.2007.43.6.1067341 }}</ref>yaani protini ya tau na protini ya tau iliyo na fosforasi _181P.<ref name="demeyer"/> Kutafuta protini hizo kwa kufyonza uti wa mgongo unaweza kutabiri kuanza kwa ugonjwa wa Alzeima na usahihi kwa kati ya 94% na 100%.<ref name="demeyer"/> Inapotumika na mbinu zilizopo za upigaji picha za ubongo, madaktari wanaweza kutambua wagonjwa wa kupoteza kumbukumbu ambao tayari wameanza kuugua ugonjwa huu.<ref name="demeyer">{{cite journal |author=De Meyer G, Shapiro F, Vanderstichele H, Vanmechelen E, Engelborghs S, De Deyn PP, Coart E, Hansson O, Minthon L, Zetterberg H, Blennow K, Shaw L, Trojanowski JQ |title=Diagnosis-Independent Alzheimer Disease Biomarker Signature in Cognitively Normal Elderly People |journal=Arch Neurol. |volume=67 |issue=8 |pages=949–56 |year=2010 |month=Agosti |pmid=20697045 |doi=10.1001/archneurol.2010.179 }}</ref> Uchunguzi wa maji ya uti wa mgongo unapatikana kwa kulipia, tofauti na teknolojia ya kisasa ya kupiga picha za akili.<ref>{{cite news |author=Kolata G |title=Spinal-Fluid Test Is Found to Predict Alzheimer's |url=http://www.nytimes.com/2010/08/10/health/research/10spinal.html |work=[[The New York Times]] |date=9 Agosti 2010 |accessdate=10 Agosti 2010 }}</ref> Ugonjwa wa Alzeima ulitambuliwa katika kila mmoja ya watu watatu ambao hawakuwa na dalili yoyote katika utafiti wa 2010, ina maana kuwa ugonjwa huanza kuota kabla ya dalili kutokea.<ref>{{cite news |author=Roan S |title=Tapping into an accurate diagnosis of Alzheimer's disease |url=http://www.latimes.com/health/boostershots/aging/la-heb-alzheimers-20100809,0,5683387.story |work=[[Los Angeles Times]] |date=9 Agosti 2010 |accessdate=10 Agosti 2010 }}</ref> Uchunguzi wa zaidi hutoa habari ya ziada juu ya sifa za ugonjwa au hutumika kuondhosha utambuzi wa ugonjwa mwingine. Kupima damu kunaweza kubaini sababu nyingine za shida ya akili mbali na Alzeima<ref name="pmid17222085"/> -sababu ambazo, katika kesi nadra, zinaweza kupinduliwa.<ref>{{cite journal |author=Clarfield AM |title=The decreasing prevalence of reversible dementias: an updated meta-analysis |journal=Arch. Intern. Med. |volume=163 |issue=18 |pages=2219–29 |year=2003 |month=Oktoba |pmid=14557220 |doi=10.1001/archinte.163.18.2219 }}</ref> Ni kawaida kufanya vipimo vya utendakazi wa kikoromeo, kutathmini B12, kuondosha kaswende, na matatizo ya metaboli (ikiwa ni pamoja na vipimo utendakazi wa figo, viwango vya elektrolaiti na ugonjwa wa kisukari), tathmini viwango vya metali nzito (mfano risasi, zebaki) na upungufu wa damu. (Angalia njia tofauti za utambuzi wa shida za akili). (Pia ni muhimu kwa kuondosha uwezekano wa mapayo). Vipimo vya kisaikolojia kwa unyogovu hutumiwa, kwani unyogovu unaweza unaweza kuwa sambamba na Alzeima (tz Unyogovu wa ugonjwa wa Alzeima), ni ishara ya mapema ya kuharibika kwa utambuzi,<ref>{{cite journal |author=Sun x, Steffens DC, Au R, ''et al.'' |title=Amyloid-Associated Depression: A Prodromal Depression of Alzheimer Disease? |journal=Arch Gen Psychiatry |volume=65 |issue=5 |pages=542–550|year=2008 |url=http://archpsyc.ama-assn.org/cgi/content/short/65/5/542 |doi=10.1001/archpsyc.65.5.542 |pmid=18458206 |last1=Sun |first1=X |last2=Steffens |first2=DC |last3=Au |first3=R |last4=Folstein |first4=M |last5=Summergrad |first5=P |last6=Yee |first6=J |last7=Rosenberg |first7=I |last8=Mwamburi |first8=DM |last9=Qiu |first9=WQ}}</ref> au hata sababu.<ref name="pmid9153154">{{cite journal |author=Geldmacher DS, Whitehouse PJ |title=Differential diagnosis of Alzheimer's disease |journal=Neurology |volume=48 |issue=5 Suppl 6 |pages=S2–9 |year=1997 |month=Mei |pmid=9153154 }}</ref><ref name="pmid17495754">{{cite journal |author=Potter GG, Steffens DC |title=Contribution of depression to cognitive impairment and dementia in older adults |journal=Neurologist |volume=13 |issue=3 |pages=105–17 |year=2007 |month=Mei |pmid=17495754 |doi=10.1097/01.nrl.0000252947.15389.a9 }}</ref> ==== Kupiga Picha za Utambuzi ==== Wakati inapopatikana kama chombo cha utambuzi, upigaji picha wa kitomografia wa utendakazi wa mwili (SPECT) na picha ya kompyuta ya miale ya gama (PET) upigaji picha za ubongo hutumika kuthibitisha utambuzi wa Alzeima kwa ushirikiano na tathmini ya uchunguzi wa hali ya akili.<ref name="pmid16785801">{{cite journal |author=Bonte FJ, Harris TS, Hynan LS, Bigio EH, White CL |title=Tc-99m HMPAO SPECT in the differential diagnosis of the dementias with histopathologic confirmation |url=https://archive.org/details/sim_clinical-nuclear-medicine_2006-07_31_7/page/376 |journal=Clin Nucl Med |volume=31 |issue=7 |pages=376–8 |year=2006 |month=Julai |pmid=16785801 |doi=10.1097/01.rlu.0000222736.81365.63 }}</ref> Kwa mtu ambaye tayari ana shida ya akili, SPECT inaonekana kuwa bora katika kutofautisha ugonjwa wa Alzeima na sababu zingine, ikilinganishwa na majaribio ya kawaida yanayotumia kupima akili na uchambuzi wa historia ya matibabu.<ref name="pmid15545324">{{cite journal |author=Dougall NJ, Bruggink S, Ebmeier KP |title=Systematic review of the diagnostic accuracy of 99mTc-HMPAO-SPECT in dementia |journal=Am J Geriatr Psychiatry |volume=12 |issue=6 |pages=554–70 |year=2004 |pmid=15545324 |doi=10.1176/appi.ajgp.12.6.554 }}</ref> Maendeleo yamepelekea kupendekezwa kwa vigezo vipya vya utambuzi.<ref name="pmid17222085"/><ref name="pmid17616482"/> Mbinu mpya inayojulikana kama PiB PET imeundwa kwa ajili kupiga picha moja kwa moja na kwa uwazi amana za amiloidi beta katika vivo kwa kutumia kinakili ambacho kinajishikilia kwa kipendeleo kwa amana ya A-beta. <ref> PiB PET: * {{cite journal |author=Kemppainen NM, Aalto S, Karrasch M, ''et al.'' |title=Cognitive reserve hypothesis: Pittsburgh Compound B and fluorodeoxyglucose positron emission tomography in relation to education in mild Alzheimer's disease |url=https://archive.org/details/sim_annals-of-neurology_2008-01_63_1/page/112 |journal=Ann. Neurol. |volume=63 |issue=1 |pages=112–8 |year=2008 |month=Januari |pmid=18023012 |doi=10.1002/ana.21212 }} * {{cite journal |author=Ikonomovic MD, Klunk WE, Abrahamson EE, ''et al.'' |title=Post-mortem correlates of in vivo PiB-PET amyloid imaging in a typical case of Alzheimer's disease |journal=Brain |volume=131 |issue=Pt 6 |pages=1630–45 |year=2008 |month=Juni |pmid=18339640 |pmc=2408940 |doi=10.1093/brain/awn016 |last12=Hope |first12=CE |last13=Isanski |first13=BA |last14=Hamilton |first14=RL |last15=Dekosky |first15=ST }} * {{cite journal |author=Jack CR, Lowe VJ, Senjem ML, ''et al.'' |title=11C PiB and structural MRI provide complementary information in imaging of Alzheimer's disease and amnestic mild cognitive impairment |journal=Brain |volume=131 |issue=Pt 3 |pages=665–80 |year=2008 |month=Machi |pmid=18263627 |doi=10.1093/brain/awm336 |pmc=2730157 }} </ref> Mchanganyiko wa PiB-PET unatumia uchunguzi wa PET kaboni-11. Utafiti wa karibuni unaonyesha kwamba PiB-PET ni sahihi 86% katika utabiri wa watu watakaoshikwa na ugonjwa wa Alzeima kati ya wale walio na viwango vya chini vya kupoteza uwezo wa utambuzi ndani ya miaka miwili, na usahihi wa 92% katika kuondoa uwezekano wa kushikwa na Alzeima. Mchanganyiko sawa wa uchunguzi wa PET wa uchunguzi wa dawa kwa miale ya redio uitwao(E) -4 - (2 - (6 - (2 - (2 - (2 - ^([18 F]-fluoroethoxy) ethoxy) ethoxy) pyridin-3-yl) vinyl)-N -methyl benzenamine, au ¹⁸ F AV-45, au florbetapir-florini-18, au tu florbetapir, ina radionuclide florini-18 ya kudumu, viliundwa hivi karibuni, na kufanyiwa majaribio kama chombo kinachoweza kutumika katika uchunguzi wa wagonjwa wa Alzeima.<ref>{{cite journal |journal=Q J Nucl Med Mol Imaging |date=2009 Aug |volume=53 |issue=4 |pages=387–93 |title=The use of the exploratory IND in the evaluation and development of ¹⁸F-PET radiopharmaceuticals for amyloid imaging in the brain: a review of one company's experience |author=Carpenter AP Jr, Pontecorvo MJ, Hefti FF, Skovronsky DM |pmid=19834448 }}</ref><ref>{{cite web |author=Leung K |url=http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=micad&part=AV-45-18F |title=(E)-4-(2-(6-(2-(2-(2-(¹⁸F-fluoroethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)-N-methyl benzenamine <nowiki>[[</nowiki>¹⁸F<nowiki>]AV-45]</nowiki> |work=Molecular Imaging and Contrast Agent Database |date=8 Aprili 2010 |accessdate=2010-06-24}}</ref><ref>{{cite news |author=[[Gina Kolata|Kolata G]] |url=http://www.nytimes.com/2010/06/24/health/research/24scans.html |title=Promise Seen for Detection of Alzheimer's |work=[[The New York Times]] |date=23 Juni 2010 |accessdate=23 Juni 2010 }}</ref><ref name="pmid20501908">{{cite journal |doi=10.2967/jnumed.109.069088 |journal=J Nucl Med |date=2010 Jun |volume=51 |issue=6 |pages=913–20 |title=In vivo imaging of amyloid deposition in Alzheimer disease using the radioligand 18F-AV-45 (flobetapir F 18) |url=https://archive.org/details/sim_journal-of-nuclear-medicine_2010-06_51_6/page/913 |author=Wong DF, Rosenberg PB, Zhou Y, Kumar A, Raymont V, Ravert HT, Dannals RF, Nandi A, Brasić JR, Ye W, Hilton J, Lyketsos C, Kung HF, Joshi AD, Skovronsky DM, Pontecorvo MJ |pmid=20501908 |laysummary=http://www.diagnosticimaging.com/news/display/article/113619/1598949 }}</ref> Florbetapir, kama PiB, hufungamana na amiloidi-beta, lakini kutokana na matumizi yake ya florini-18 ina maisha nusu ya dakika 110, kwa kulinganisha na maisha nusu ya kinyuklia ya PiB ya dakika 20. ''Et al Wong'' aligundua kwamba maisha marefu ya kinakili yalikiruhusu kujilimbikiza zaidi katika bongo za wagonjwa wa Alzeima, hasa katika sehemu zinazohusishwa na amana za amiloidi beta.<ref name="pmid20501908"/> Uchambuzi mmoja ulitabiri kwamba kuna uwezekano wa kutumika kwa kushirikiana na dalili nyengine badala ya kuwa mbadala.<ref name="pmid19847050">{{cite journal |author=Rabinovici GD, Jagust WJ |journal=Behav Neurol |year=2009 |volume=21 |issue=1 |pages=117–28 |title=Amyloid imaging in aging and dementia: testing the amyloid hypothesis in vivo |pmid=19847050 |pmc=2804478 |doi=10.3233/BEN-2009-0232 |doi_brokendate=2010-08-25 }}</ref> Kupima ukubwa waMRI unaweza kuchunguza mabadiliko katika ukubwa wa sehemu za ubongo. Upimaji wa maeneo hayo ambayo hudhoofika wakati wa ueneaji wa ugonjwa wa Alzeima inaonyesha ahadi nzuri kama kama kiashiria ya diagnostiksamarbetet. Inaweza kuja kuwa njia isiyo ghali ikilinganishwa na njia nyingine zinazofanyiwa uchunguzi kwa sasa.<ref name="pmid18445747">{{cite journal |author=O'Brien JT |title=Role of imaging techniques in the diagnosis of dementia |journal=Br J Radiol |date=2007 Dec |volume=80 |issue=Spec No 2 |pages=S71–7 |pmid=18445747 |doi=10.1259/bjr/33117326 }}</ref> Utafiti wa karibuni unaonyesha kwamba ngazi za metaboli za ubongo zinaweza kutumika kama viashiria vya baolojia vya ugonjwa wa Alzeima.<ref name="pmid 19501936">{{cite journal |author=Rupsingh R, Borrie M, Smith M, Wells JL, Bartha R |title=Reduced hippocampal glutamate in Alzheimer disease |journal=[[Neurobiol Aging]] |year=2009 |month=Juni |pmid=19501936 |doi=10.1016/j.neurobiolaging.2009.05.002 }}</ref> == Kuzuia == [[Picha:Honoré Daumier 032.jpg|right|thumb|Shughuli za kitaaluma kama vile kucheza chesi au kushirikiana kijamii kumehusishwa na upungufu wa hatari ya Alzeima katika utafiti wa kiepidemolojia, ingawa hakuna sababu shirikishi iliyopatikana.]] Kwa sasa, hakuna ushahidi dhabiti kuonyesha kuwa kuna njia yoyote yenye ufanisi katika kuzuia Alzeima. <ref>Mapendekezo ya Kuzuia hayajaungwa mkono: * {{cite journal |author=Kawas CH |title=Medications and diet: protective factors for AD? |journal=Alzheimer Dis Assoc Disord |volume=20 |issue=3 Suppl 2 |pages=S89–96 |year=2006 |pmid=16917203|doi=}} * {{cite journal |author=Luchsinger JA, Mayeux R |title=Dietary factors and Alzheimer's disease |journal=Lancet Neurol |volume=3 |issue=10 |pages=579–87 |year=2004 |pmid=15380154 |doi=10.1016/S1474-4422(04)00878-6}} * {{cite journal |author=Luchsinger JA, Noble JM, Scarmeas N |title=Diet and Alzheimer's disease |journal=Curr Neurol Neurosci Rep |volume=7 |issue=5 |pages=366–72 |year=2007 |pmid=17764625 |doi=10.1007/s11910-007-0057-8}} * {{cite press release |url=http://www.nih.gov/news/health/apr2010/od-28.htm |title=Independent Panel Finds Insufficient Evidence to Support Preventive Measures for Alzheimer's Disease |date=28 Aprili 2010 |publisher=[[National Institutes of Health]] |access-date=2010-10-18 |archivedate=2010-05-02 |archiveurl=https://web.archive.org/web/20100502034409/http://www.nih.gov/news/health/apr2010/od-28.htm }} * {{cite web |url=http://consensus.nih.gov/2010/alzstatement.htm |title=NIH State-of-the-Science Conference: Preventing Alzheimer's Disease and Cognitive Decline |date=26 Aprili–28, 2010 |author=Daviglus ML ''et al.'' |accessdate=2010-10-18 |archivedate=2010-05-03 |archiveurl=https://web.archive.org/web/20100503054126/http://consensus.nih.gov/2010/alzstatement.htm }}</ref> Uchunguzi wa ulimwengu wa kuzuia au kuchelewesha kuanza kwa Alzeima mara nyingi umetoa matokeo yasiyowiana. Hata hivyo, tafiti za epidemiolojia na mapendekezo katika uhusiano kati ya mambo fulani yanayoweza kubadilishwa, kama vile chakula, hatari ya moyo na mishipa, bidhaa za dawa, au shughuli za kitaaluma kati ya nyingine, na uwezekano wa wakazi wa kuugua Alzeima. Utafiti zaidi tu, ikiwa ni pamoja na majaribio ya kimatibabu, ndio utakaonyesha kama haya yanaweza kusaidia kuzuia Alzeima.<ref> {{cite journal |author=Szekely CA, Breitner JC, Zandi PP |title=Prevention of Alzheimer's disease |journal=Int Rev Psychiatry |volume=19 |issue=6 |pages=693–706 |year=2007 |pmid=18092245 |doi=10.1080/09540260701797944 }}</ref> Ingawa sababu za hatari za moyo na mishipa, kama vile haipakolesterolemia , shinikizo la damu ugonjwa wa kisukari, na uvutaji sigara, zinahusishwa na hatari kubwa zaidi na mwanzo na mkondo wa Alzeima,<ref name="pmid18299540">{{cite journal |author=Patterson C, Feightner JW, Garcia A, Hsiung GY, MacKnight C, Sadovnick AD |title=Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease |journal=CMAJ |volume=178 |issue=5 |pages=548–56 |year=2008 |month=Februari |pmid=18299540 |pmc=2244657 |doi=10.1503/cmaj.070796 }}</ref><ref name="pmid17483665">{{cite journal |author=Rosendorff C, Beeri MS, Silverman JM |title=Cardiovascular risk factors for Alzheimer's disease |journal=Am J Geriatr Cardiol |volume=16 |issue=3 |pages=143–9 |year=2007 |pmid=17483665 |doi=10.1111/j.1076-7460.2007.06696.x }}</ref>statini, ambayo ni madawa ya kupunguza kolestroli, hayajakuwa na ufanisi katika kuzuia au kuboresha mkondo wa ugonjwa huo.<ref name="pmid17927279">{{cite journal |author=Reiss AB, Wirkowski E |title=Role of HMG-CoA reductase inhibitors in neurological disorders: progress to date |journal=Drugs |volume=67 |issue=15 |pages=2111–20 |year=2007 |pmid=17927279|doi=10.2165/00003495-200767150-00001 }}</ref><ref name="pmid17877925">{{cite journal |author=Kuller LH |title=Statins and dementia |journal=Curr Atheroscler Rep |volume=9 |issue=2 |pages=154–61 |year=2007 |month=Agosti |pmid=17877925 |doi=10.1007/s11883-007-0012-9 }}</ref> Vipengele vya vyakula vya Mediterenia, ambayo ni pamoja na matunda na mboga, [[Mkate|mikate]], [[Nafaka|unga]] wa [[ngano]] na nyinginezo, mafuta, [[Samaki|samaki]], na mvinyo mwekundu, vyote kwa kibinafsi au kwa pamoja vinaweza kupunguza hatari au mkondo wa ugonjwa huo wa Alzeima.<ref name="pmid18088206">{{cite journal |author=Solfrizzi V, Capurso C, D'Introno A, ''et al.'' |title=Lifestyle-related factors in predementia and dementia syndromes |journal=Expert Rev Neurother |volume=8 |issue=1 |pages=133–58 |year=2008 |month=Januari |pmid=18088206 |doi=10.1586/14737175.8.1.133 |url= }}</ref> Athari yake ya manufaa kwa moyo na mishipa imependekezwa kama utaratibu wa utekelezaji.<ref name="pmid18088206"/> Kuna ushahidi mdogo kwamba kutumia pombe kwa wastani , hasa mvinyo mwekundu, kunahusiana na hatari ya chini ya Alzeima.<ref>{{cite journal |author=Panza F, Capurso C, D'Introno A, Colacicco AM, Frisardi V, Lorusso M, Santamato A, Seripa D, Pilotto A, Scafato E, Vendemiale G, Capurso A, Solfrizzi V. |title=Alcohol drinking, cognitive functions in older age, predementia, and dementia syndromes |journal=J Alzheimers Dis |volume=17 |issue=1 |pages=7–31 |date=Mei 2009 |pmid=19494429 |doi=10.3233/JAD-2009-1009 |last12=Capurso |first12=A |last13=Solfrizzi |first13=V |doi_brokendate=2010-08-25 }}</ref> Uchambuzi juu ya matumizi ya vitamini haujapata ushahidi wa kutosha wa umuhimu kupendekeza vitamini C,<ref name="pmid16227450">{{cite journal |author=Boothby LA, Doering PL |title=Vitamin C and vitamin E for Alzheimer's disease |journal=Ann Pharmacother |volume=39 |issue=12 |pages=2073–80 |year=2005 |month=Desemba |pmid=16227450 |doi=10.1345/aph.1E495 |url=https://archive.org/details/sim_annals-of-pharmacotherapy_2005-12_39_12/page/2073 }}</ref> E,<ref name="pmid16227450"/><ref>{{cite journal |author=Isaac MG, Quinn R, Tabet N |title=Vitamin E for Alzheimer's disease and mild cognitive impairment |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD002854 |year=2008 |pmid=18646084 |doi=10.1002/14651858.CD002854.pub2 |url= }}</ref> au asidi ya foliki na au bila vitamini B _12,<ref>{{cite journal |author=Malouf R, Grimley Evans J |title=Folic acid with or without vitamin B₁₂ for the prevention and treatment of healthy elderly and demented people |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD004514 |year=2008 |pmid=18843658 |doi=10.1002/14651858.CD004514.pub2 |url= }}</ref> kama kinga au tiba ya mawakala katika Alzeima. Kuzidisha vitamini E inahusishwa na hatari muhimu za kiafya.<ref name="pmid16227450"/> Majaribio ya kuchunguza asidi ya foliki B9 () na vitamini nyingine za B zilishindwa kuonyesha uhusiano wowote muhimu kwa kupungua kwa utambuzi.<ref>{{cite journal |title=Effect of folic acid, with or without other B vitamins, on cognitive decline: meta-analysis of randomized trials |url=https://archive.org/details/sim_american-journal-of-medicine_2010-06_123_6/page/522 |author=Wald DS, Kasturiratne A, Simmonds M |journal=[[The American Journal of Medicine]] |date=Juni 2010 |volume=123 |issue=6 |pages=522-527.e2 |doi=10.1016/j.amjmed.2010.01.017 |pii=S0002-9343(10)00131-2 }}</ref> Matumizi ya muda mrefu yamadawa yasiyo steroidi zenye mshawasho (NSAIDs) yamehusishwa na kupunguza uwezekano wa kuugua Alzeima.<ref name="pmid17612054">{{cite journal |author=Szekely CA, Town T, Zandi PP |title=NSAIDs for the chemoprevention of Alzheimer's disease |journal=Subcell Biochem |volume=42 |issue= |pages=229–48 |year=2007 |month= |pmid=17612054 |doi=10.1007/1-4020-5688-5_11 }}</ref> Masomo ya uchunguzi wa miili ya binadamu, katika mifano ya wanyama , au katika uchunguzi wa vitro pia uanongeza nguvu kwa dhana kwamba NSAID huweza kupunguza uvimbe kuhusiana na utando wa amiloidi.<ref name="pmid17612054"/> Hata hivyo uchunguzi wa majaribio ya matumizi yao kama matibabu ya kupunguza yameshindwa kuonyesha matokeo mazuri wakati hakuna majaribio ya kuzuia ambayo yamekamilika.<ref name="pmid17612054"/> Sakamini kutoka bizari manjano imeonyesha ufanisi kiasi katika kuzuia uharibifu wa ubongo kwa mifano ya panya kutokana na uwezo wake wa kuzuia uvimbe.<ref>{{cite journal |author=Ringman JM, Frautschy SA, Cole GM, Masterman DL, Cummings JL |title=A potential role of the curry spice curcumin in Alzheimer's disease |journal=Curr Alzheimer Res |issn=1567-2050 |volume=2 |issue=2 |pages=131–6 |year=2005 |month=Aprili |pmid=15974909 |pmc=1702408 |doi=10.2174/1567205053585882 }}</ref><ref>{{cite journal |author=Aggarwal BB, Harikumar KB |title=Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases |journal=Int J Biochem Cell Biol |volume=41 |issue=1 |pages=40–59 |year=2009 |month=Januari |pmid=18662800 |doi=10.1016/j.biocel.2008.06.010 |pmc=2637808 }}</ref> Tiba ya kubadilisha homoni, ingawa ilitumika awali, haidhaniwi tena kuzuia shida ya ubongo na kwa wakati mwingine inadhaniwa kuhusishwa nayo.<ref name="pmid19370593">{{cite journal |author=Farquhar C, Marjoribanks J, Lethaby A, Suckling JA, Lamberts Q |title=Long term hormone therapy for perimenopausal and postmenopausal women |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD004143 |date=15 Aprili 2009 |pmid=19370593 |doi=10.1002/14651858.CD004143.pub3 }}</ref><ref name="pmid19401958">{{cite journal |author=Barrett-Connor E, Laughlin GA |title=Endogenous and exogenous estrogen, cognitive function, and dementia in postmenopausal women: evidence from epidemiologic studies and clinical trials |journal=Semin Reprod Med |volume=27 |issue=3 |date=Mei 2009 |pages=275–82 |pmc=2701737 |doi=10.1055/s-0029-1216280 |pmid=19401958 |last1=Barrett-Connor |first1=E |last2=Laughlin |first2=GA }}</ref> Kuna ushahidi pinzani usioshawishi kwamba "ginkgo" ina athari yoyote chanya juu ya kuharibika kwa utambuzi na shida ya akili na utafiti wa hivi karibuni unaonyesha kwamba haina athari katika kupunguza kasi ya matukio ya Alzeima.<ref>{{cite journal |author=DeKosky ST, Williamson JD, Fitzpatrick AL ''et al.'' |title=Ginkgo biloba for Prevention of Dementia |journal=Journal of the American Medical Association |year=2008 |volume=300 |issue=19 |pages=2253–2262 |pmid=19017911 |doi=10.1001/jama.2008.683 |url=http://jama.ama-assn.org/cgi/content/full/300/19/2253 |accessdate=2008-11-18 |last12=Robbins |first12=JA |last13=Tracy |first13=RP |last14=Woolard |first14=NF |last15=Dunn |first15=L |last16=Snitz |first16=BE |last17=Nahin |first17=RL |last18=Furberg |first18=CD |last19=Ginkgo Evaluation Of Memory (Gem) Study |first19=Investigators |pmc=2823569 }}</ref> Utafiti wa miaka 21 uligundua kwamba wanywa kahawa vikombe 3-5 kwa siku katika makamo walikuwa na upungufu wa 65% katika hatari ya shida ya akili katika maisha ya uzeeni.<ref>{{cite journal |author=Eskelinen MH, Ngandu T, Tuomilehto J, Soininen H, Kivipelto M |title=Midlife coffee and tea drinking and the risk of late-life dementia: a population-based CAIDE study |journal=J Alzheimers Dis |volume=16 |issue=1 |pages=85–91 |year=2009 |month=Januari |pmid=19158424 |doi=10.3233/JAD-2009-0920 |doi_brokendate=2010-08-25 }}</ref> Watu wanaoshiriki katika shughuli za kitaaluma kama vile kusoma, kucheza michezo ya bodi, kukamilisha jedwali za maneno /, kucheza muziki wa ala, au kuhusiana mara kwa mara kijamii huonyesha kupungua kwa hatari ya ugonjwa wa Alzeima.<ref name="pmid16917199">{{cite pmid|16917199}}</ref> Hii inawiana na nadharia ya hifadhi ya utambuzi, ambayo inasema kwamba baadhi ya uzoefu wa maisha huleta ufanisi wa neva kufanya kazi zaidi kwa kumpa mtu hifadhi ya utambuzi na kuchelewesha kuanza kwa shida ya akili.<ref name="pmid16917199"/> Elimu huchelewesha mwanzo wa dalili za Alzeima, lakini haina uhusiano na kifo cha mapema baada ya utambuzi wa ugonjwa.<ref name="pmid19026089">{{cite journal |author=Paradise M, Cooper C, Livingston G |title=Systematic review of the effect of education on survival in Alzheimer's disease |url=https://archive.org/details/international-psychogeriatrics_2009-02_21_1/page/25 |journal=Int Psychogeriatr |volume=21 |issue=1 |pages=25–32 |year=2009 |month=Februari |pmid=19026089 |doi=10.1017/S1041610208008053 }}</ref> Mazoezi pia uhusishwa na kupunguza hatari ya Alzeima.<ref name="pmid19026089"/> Baadhi ya tafiti zimeonyesha ongezeko la hatari ya kupatwa na Alzeima kwa sababu ya mazingira hasa matumizi ya [[Metali|madini]], hasa[[Alumini|alumini]],<ref name="pmid17522444">{{cite journal |author=Shcherbatykh I, Carpenter DO |title=The role of metals in the etiology of Alzheimer's disease |journal=J Alzheimers Dis |volume=11 |issue=2 |pages=191–205 |year=2007 |month=Mei |pmid=17522444 }}</ref><ref>{{cite journal |author=Rondeau V, Commenges D, Jacqmin-Gadda H, Dartigues JF |title=Relation between aluminum concentrations in drinking water and Alzheimer's disease: an 8-year follow-up study |journal=Am J Epidemiol |volume=152 |issue=1 |pages=59–66 |year=2000 |month=Julai |pmid=10901330 |pmc=2215380 |doi=10.1093/aje/152.1.59 }}</ref> au kuingiliana na viyeyuko.<ref name="pmid7771442">{{cite journal |author=Kukull WA, Larson EB, Bowen JD, ''et al.'' |title=Solvent exposure as a risk factor for Alzheimer's disease: a case-control study |journal=Am J Epidemiol |volume=141 |issue=11 |pages=1059–71; discussion 1072–9 |year=1995 |month=Juni |pmid=7771442 }}</ref> Ubora wa baadhi ya tafiti hizi umekosolewa,<ref>{{cite journal |author=Santibáñez M, Bolumar F, García AM |title=Occupational risk factors in Alzheimer's disease: a review assessing the quality of published epidemiological studies |journal=Occupational and Environmental Medicine |volume=64 |issue=11 |pages=723–732 |year=2007 |pmid=17525096 |doi=10.1136/oem.2006.028209 }}</ref> na tafiti zingine zimekwisha pata kuwa hakuna uhusiano kati ya mazingira haya na kuugua Alzeima.<ref>{{cite journal |author=Seidler A, Geller P, Nienhaus A, ''et al.'' |title=Occupational exposure to low frequency magnetic fields and dementia: a case-control study |journal=Occup Environ Med |volume=64 |issue=2 |pages=108–14 |year=2007 |month=Februari |pmid=17043077 |doi=10.1136/oem.2005.024190 |pmc=2078432 }}</ref><ref name="pmid12222737">{{cite journal |author=Rondeau V |title=A review of epidemiologic studies on aluminum and silica in relation to Alzheimer's disease and associated disorders |journal=Rev Environ Health |volume=17 |issue=2 |pages=107–21 |year=2002 |pmid=12222737 }}</ref><ref name="pmid9115023">{{cite journal |author=Martyn CN, Coggon DN, Inskip H, Lacey RF, Young WF |title=Aluminum concentrations in drinking water and risk of Alzheimer's disease |journal=Epidemiology |volume=8 |issue=3 |pages=281–6 |year=1997 |month=Mei |pmid=9115023 |doi=10.1097/00001648-199705000-00009 }}</ref><ref name="pmid9861186">{{cite journal |author=Graves AB, Rosner D, Echeverria D, Mortimer JA, Larson EB |title=Occupational exposures to solvents and aluminium and estimated risk of Alzheimer's disease |journal=Occup Environ Med |volume=55 |issue=9 |pages=627–33 |year=1998 |month=Septemba |pmid=9861186 |pmc=1757634 |doi=10.1136/oem.55.9.627 }}</ref> Wakati baadhi ya uchunguzi unaonyesha kwamba marudio madogo sana ya maeneo ya sumakuumeme huweza kuongeza hatari ya ugonjwa wa Alzeima, wachunguzi walipata kwamba uchunguzi zaidi wa kiepidelemojia na uchunguzi wa maabara zaidi ya nadharia tete hili unahitajika.<ref>{{Cite document |title=Health Effects of Exposure to EMF |author=Scientific Committee on Emerging and Newly Identified Health Risks-SCENIHR|date=Januari 2009|publisher=Directorate General for Health&Consumers; European Commission |location=Brussels |pages=4–5 |url=http://ec.europa.eu/health/ph_risk/committees/04_scenihr/docs/scenihr_o_022.pdf |accessdate=2010-04-27 |postscript=<!--None-->}}</ref> Sigara ni kati ya sababu zenye hatari kubwa za Alzeima.<ref>{{cite journal |author=Cataldo JK, Prochaska JJ, Glantz SA |title=Cigarette smoking is a risk factor for Alzheimer's disease: an analysis controlling for tobacco industry affiliation |journal=J Alzheimers Dis |year=2010 |volume=19 |issue=2 |pages=465–80 |pmid= 20110594 |doi=10.3233/JAD-2010-1240 |doi_brokendate=2010-08-25 }}</ref> Utaratibu wa dalili za mifumo ya kinga ya ndani ni sababu za hatari za Alzeima inayaonza kuchelewa.<ref>{{cite journal|pmid=20160456}}</ref> == Udhibiti == Hakuna tiba ya ugonjwa wa Alzeima, matibabu yanayopatikana hutoa kiasi kidogo cha faida kwa kupunguza dalili lakini kimsingi huwa ya kupunguza athari. Matibabu ya sasa yanaweza kugawanywa katika dawa, kisaikolojia-kijamii na ulezi wa wagonjwa. === Dawa === [[Picha:Donepezil 1EVE.png‎|kulia | thumb | Pande Tatu mfano wa molekuli ya donepezili, ni kizuizi cha asetilkolinesterasi kinachotumika katika kutibu dalili za Alzeima.]] [[Picha:Memantine.svg|right|thumb|upright|Muundo Masi wa memantine, dawa iliyopitishwa kwa kutibu dalili za Alzeima iliyokomaa]] Dawa nne sasa zimeidhinishwa na mashirika ya udhibiti kama vile ya Shirika la Chakula na Matumizi ya Dawa la Marekani(FDA) na Shirika la Dawa la Ulaya (EMA) kutibu dalili za kiutambuzi za Alzeima: tatu kati ya hizi ni vizuizi vya kolinesterasi na nyingine ni memantini, ambacho ni kipokezi pimgamizi cha NMDA. Hakuna dawa iliyoonyesha dalili ya kuchelewesha au kusimamisha kuendelea kwa ugonjwa huu. Kupunguza kazi kwa nyuroni za kolineji ni kipengele maalumu kinachojulikana vizuri cha ugonjwa wa Alzeima.<ref name="pmid8534419">{{cite journal |author=Geula C, Mesulam MM |title=Cholinesterases and the pathology of Alzheimer disease |journal=[[Alzheimer Dis Assoc Disord]] |volume=9 Suppl 2 |pages=23–28 |year=1995 |pmid=8534419 }}</ref> Vizuizi vya Asetilkolinesterasi zinatumiwa kupunguza kasi ambayo asetikolini /1} (ACh) inavunjwa, na hivyo kuongeza kukoleza kwa ACh katika ubongo na kupambana na upotevu wa ACh ulionasababishwa na kufa kwa nyuroni za kolineji.<ref name="pmid11105732">{{cite journal |author=Stahl SM |title=The new cholinesterase inhibitors for Alzheimer's disease, Part 2: illustrating their mechanisms of action |journal=[[J Clin Psychiatry]] |volume=61 |issue=11 |pages=813–814 |year=2000 |pmid=11105732 }}</ref> {{as of | 2008}}Vizuizi vya kolinesterasi vilivyoidhinishwa kwa ajili ya udhibiti wa dalili za Alzeima ni [[donepesili]] (jina la kibiashara ni ''Arisepti),<ref>{{cite web |url=http://www.nlm.nih.gov/medlineplus/druginfo/meds/a697032.html |title=Donepezil |accessdate=2010-02-03 |date=2007-01-08 |publisher=[[US National Library of Medicine]] |work=[[Medline Plus]] }}</ref>galanitamini ''(Rasadine),'' <ref>{{cite web |url=http://www.nlm.nih.gov/medlineplus/druginfo/meds/a699058.html |title=Galantamine |accessdate=2010-02-03 |date=2007-01-08 |publisher=[[US National Library of Medicine]] |work=[[Medline Plus]] }}</ref> na [[rivasitigimini]] (huitwa ''Ekiloni'' <ref>{{cite web |url=http://www.nlm.nih.gov/medlineplus/druginfo/meds/a602009.html |title=Rivastigmine |accessdate=2010-02-03 |date=2007-01-08 |publisher=[[US National Library of Medicine]] |work=[[Medline Plus]] }}</ref> na ''Pachi ya Ekiloni'' <ref>{{cite web |url=http://www.nlm.nih.gov/medlineplus/druginfo/meds/a607078.html |title=Rivastigmine Transdermal |accessdate=2010-02-03 |date=2007-01-08 |publisher=[[US National Library of Medicine]] |work=[[Medline Plus]] }}</ref> ).'' Kuna ushahidi wa kufaa wa dawa hizi katika kutibu ugonjwa wa kadiri wa Alzeima,<ref name="pmid16437532">{{cite journal |author=Birks J |title=Cholinesterase inhibitors for Alzheimer's disease |journal=Cochrane Database Syst Rev |issue=1 |pages=CD005593 |year=2006 |pmid=16437532 |doi=10.1002/14651858.CD005593 |last2=Birks |first2=Jacqueline }}</ref><ref name="pmid19370562">{{cite journal |journal=[[Cochrane Database Syst Rev]] |date=2009 Apr 15 |issue=2 |at=CD001191 |title=Rivastigmine for Alzheimer's disease |author=Birks J, Grimley Evans J, Iakovidou V, Tsolaki M, Holt FE |pmid=19370562 }}</ref> na baadhi ya ushahidi wa matumizi yao katika hatua zilizoendelea. Donepesili tu ndiyo iliyopitishwa kwa ajili ya kutibu Dementia Alzeima ya kiwango cha juu. <ref name="pmid16437430">{{cite journal |author=Birks J, Harvey RJ |title=Donepezil for dementia due to Alzheimer's disease |journal=[[Cochrane Database Syst Rev]] |issue=1 |pages=CD001190 |date=2006 Jan 25 |pmid=16437430 |doi=10.1002/14651858.CD001190.pub2 }}</ref> Matumizi ya dawa hizi katika kuharibika kwa uamuzi wa mambo wa kadiri hakijaonyesha athari yoyote katika kuchelewesha kuanza kwa Alzeima.<ref name="pmid18044984">{{cite journal |author=Raschetti R, Albanese E, Vanacore N, Maggini M |title=Cholinesterase inhibitors in mild cognitive impairment: a systematic review of randomised trials |journal=[[PLoS Med]] |volume=4 |issue=11 |pages=e338 |year=2007 |pmid=18044984 |doi=10.1371/journal.pmed.0040338 |pmc=2082649 }}</ref> Athari za kawaida sana ni kichefuchefu na [[Kutapika|kutapika]], zote ambazo zinahusishwa na koligeni ya kupindukia. Madhara haya hutokea katika takriban 10-20% ya watumiaji na ukali wake ni wa chini hadi wastani. Athari za mkondo wa pili ambazo si za kawaida ni pamoja na kukakamaa misuli, kupungua kwa kiwangocha kupiga moyo (bradikadia), kupungua kwa hamu ya chakula na uzito, na ongezeko la uzalishaji wa asidi ya tumbo. <ref>Maelezo ya kutolewa kwa vizuizi vya astelikolinesterasi: * {{cite web |url=http://www.aricept.com/images/AriceptComboFullPINovember02006.pdf |form=pdf |title=Aricept Prescribing information |accessdate=2008-08-18 |format=PDF |publisher=Eisai and [[Pfizer]] |archiveurl=https://web.archive.org/web/20080910154231/http://www.aricept.com/images/AriceptComboFullPINovember02006.pdf |archivedate=2008-09-10 }} (chanzo msingi) * {{cite web |url=http://razadyneer.com/razadyneer/pages/pdf/razadyne_er.pdf |title=Razadyne ER U.S. Full Prescribing Information |accessdate=2008-02-19 |format=PDF |publisher=[[Ortho-McNeil Neurologics]] |archivedate=2008-05-28 |archiveurl=https://web.archive.org/web/20080528195504/http://razadyneer.com/razadyneer/pages/pdf/razadyne_er.pdf }} (chanzo msingi) * {{cite web |url=http://www.pharma.us.novartis.com/product/pi/pdf/exelonpatch.pdf |archiveurl=https://web.archive.org/web/20070728014715/http://www.pharma.us.novartis.com/product/pi/pdf/exelonpatch.pdf |archivedate=2007-07-28 |title=Exelon ER U.S. Prescribing Information |accessdate=2008-02-19 |format=PDF |publisher=[[Novartis Pharmaceuticals]] }} (chanzo msingi) * {{cite web |url=http://www.accessdata.fda.gov/drugsatfda_docs/label/2006/020823s016,021025s008lbl.pdf |archiveurl=https://web.archive.org/web/20070710074347/http://www.fda.gov/cder/foi/label/2006/020823s016,021025s008lbl.pdf |archivedate=2007-07-10 |title=Exelon U.S. Prescribing Information |date=Juni 2006 |accessdate=2009-07-30 |format=PDF |publisher=[[Novartis Pharmaceuticals]] }} ( chanzo msingi) * {{cite web |url=http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/ucm054180.pdf |format=PDF |title=Exelon Warning Letter |date=Agosti 2007 |accessdate=2009-07-30 |publisher=[[US Food and Drug Administration]] }}</ref> Glutamate ni kisisimuzi muhimu cha nyurotransmita ya mfumo wa neva, ingawa kuwepo kwa kiwango kingi katika ubongo kunaweza kusababisha kifo cha [[seli]] kupitia mchakato uitwao usisimuzi ambao unahusisha kusimuliwa sana kwa vipokezi vya glutamate. Usisimuzi hutokea sio tu kwa ugonjwa wa Alzeima, lakini pia katika magonjwa mengine ya neva kama vile ugonjwa wa Parkinson na uwingi-sklerosi.<ref name="pmid16424917">{{cite journal |author=Lipton SA |title=Paradigm shift in neuroprotection by NMDA receptor blockade: memantine and beyond |journal=[[Nat Rev Drug Discov]] |volume=5 |issue=2 |pages=160–170 |year=2006 |pmid=16424917 |doi=10.1038/nrd1958 }}</ref> Memanitine (jina la kibiashara ni ''Akatinoli, Axura, Ebixa'' / ''Abixa, Memox'' na ''Namenda),'' <ref>{{cite web |url=http://www.nlm.nih.gov/medlineplus/druginfo/meds/a604006.html |title=Memantine |accessdate=2010-02-03 |date=2004-01-04 |publisher= US National Library of Medicine (Medline) }}</ref> ni kizuizi kisicholeta ushindani cha kipokezi cha NMDA iliyoanza kutumika kama dawa ya kupigana nainfluenza. Hufanya kazi katika mfumo wa glutamaterigiki na kuzuia vipokezi vya NMDA na kuzuia kusisimuliwa zaidi kwao na glutamate.<ref name="pmid16424917"/> Memanatine imeonyeshwa kuwa kwa kiasi cha kadiri kuleta matokeo yanayokusudiwa katika matibabu ya ugonjwa wa Alzeima wa wastani hadi wa kiwango cha juu. Athari zake katika hatua za awali za Alzeima hazijulikani.<ref name="pmid15495043">{{cite journal |author=Areosa Sastre A, McShane R, Sherriff F |title=Memantine for dementia |journal=[[Cochrane Database Syst Rev]] |issue=4 |pages=CD003154 |year=2004 |pmid=15495043 |doi=10.1002/14651858.CD003154.pub2 }}</ref> Taarifa za matukio mabaya na memanitine si za kila mara na ni za kadiri, ikiwa ni pamoja na kuota, kuchanganyikiwa , kizunguzungu, kuumwa na kichwa na uchovu.<ref>[384] ^ {{cite web |url=http://www.frx.com/pi/namenda_pi.pdf |title=Namenda Prescribing Information |accessdate=2008-02-19 |format=PDF |publisher=[[Forest Pharmaceuticals]] }} (Asili ya msingi)</ref> Mchanganyiko wa memantine na donepesili imeonekana kuwa "yenye umuhimu kitwakimu lakini ufanisi mdogo wa kimatibabu".<ref name="pmid18316756">{{cite journal |author=Raina P, Santaguida P, Ismaila A, ''et al.'' |title=Effectiveness of cholinesterase inhibitors and memantine for treating dementia: evidence review for a clinical practice guideline |url=https://archive.org/details/sim_annals-of-internal-medicine_2008-03-04_148_5/page/n80 |journal=[[Annals of Internal Medicine]] |volume=148 |issue=5 |pages=379–397 |year=2008 |pmid=18316756 }}</ref> Dawa za kuzuia kichaa ni muhimu katika kupunguza kwa kadiri kwa uchokozi na kichaa katika ya wagonjwa wa Alzeima na matatizo ya kitabia, lakini zinahusishwa na athari mbaya sana, kama vile matukio ya damubongo, matatizo ya kutembea au kupungua kwa uamuzi wa mambo, ambazo haziruhusu matumizi yake ya kawaida. <ref> Matumizi ya dawa za kuzuia kichaa: * {{cite journal |author=Ballard C, Waite J |title=The effectiveness of atypical antipsychotics for the treatment of aggression and psychosis in Alzheimer's disease |journal=[[Cochrane Database Syst Rev]] |issue=1 |pages=CD003476 |year=2006 |pmid=16437455 |doi=10.1002/14651858.CD003476.pub2}} * {{cite journal |author=Ballard C, Lana MM, Theodoulou M, ''et al.'' |title=A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (The DART-AD trial) |journal=[[PLoS Med]] |volume=5 |issue=4 |pages=e76 |year=2008 |pmid=18384230 |doi=10.1371/journal.pmed.0050076 |pmc=2276521 }} * {{cite journal |author=Sink KM, Holden KF, Yaffe K |title=Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence |url=https://archive.org/details/sim_jama_2005-02-02_293_5/page/596 |journal=[[J Am Med Assoc]] |volume=293 |issue=5 |pages=596–608 |year=2005 |pmid=15687315 |doi=10.1001/jama.293.5.596 }} </ref><ref name="pmid19138567"> {{cite journal |author=Ballard C, Hanney ML, Theodoulou M, Douglas S, McShane R, Kossakowski K, Gill R, Juszczak E, Yu L-M, Jacoby R |title=The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial |journal=[[Lancet Neurology]] |date=9 Januari 2009 |pmid=19138567 |doi=10.1016/S1474-4422(08)70295-3 |laysummary=http://www.physorg.com/news150695213.html |volume=8 |page=151 |issue=2 }}</ref>Wakati zinapotumika kwa muda mrefu, zionyeshwa kuhusishwa na kuongezeka kwa vifo.<ref name="pmid19138567"/> === Hatua za Kisaikolojia na Kijamii === [[Picha:Snoezelruimte.JPG|thumb|upright|righ|Chumba kilichooundwa haswa kwa minajili ya tiba ya kuimarisha hisia , pia hujulikana kama snoezelen; kuingilia hisia kijamii na kwa kisaikolojia ili kuwasaidia watu wenye shida ya akili]] Hatua zakisaikolojia an kijamii zinatumiwa kama nyongeza ya matibabu ya dawa na kunaweza kuorodheshwa ndani mbinu zinazoegemea tabia, hisia, utambuzi au usisimuzi. Utafiti juu ya ufanifu wake hakupatikani na nadra ule unaozingatia kwa Alzeima, badala yake hulenga dementia kwa ujumla.<ref name="pracGuideAPA">{{cite web | url=http://www.psychiatryonline.com/pracGuide/loadGuidelinePdf.aspx?file=AlzPG101007 | format=PDF | title =Practice Guideline for the Treatment of Patients with Alzheimer's disease and Other Dementias | publisher =[[American Psychiatric Association]] | month=Oktoba | year=2007 | accessdate=2007-12-28 | doi=10.1176/appi.books.9780890423967.152139 }}</ref> Hatua za kitabia hujaribu kutambua na kupunguza chanzo na matokeo ya tabia zinazotatiza. Njia hii haijaonyesha mafanikio katika kuboresha utendaji kwa ujumla,<ref name="pmid16323385">{{cite journal |author=Bottino CM, Carvalho IA, Alvarez AM, ''et al.'' |title=Cognitive rehabilitation combined with drug treatment in Alzheimer's disease patients: a pilot study |journal=Clin Rehabil |volume=19 |issue=8 |pages=861–869 |year=2005 |pmid=16323385 |doi=10.1191/0269215505cr911oa }}</ref> lakini inaweza kusaidia kupunguza baadhi ya matatizo ya tabia fulani, kama vile kushindwa kudhibiti mkojo.<ref name="pmid11342679">{{cite journal |author=Doody RS, Stevens JC, Beck C, ''et al.'' |title=Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |url=https://archive.org/details/sim_neurology_2001-05-08_56_9/page/1154 |journal=Neurology |volume=56 |issue=9 |pages=1154–1166 |year=2001 |pmid=11342679 }}</ref> Kuna ukosefu wa twakimu bora kuhusu ufanisi wa mbinu hizi katika matatizo ya tabia mengine kama vile kuzurura.<ref name="pmid17253573">{{cite journal |author=Hermans DG, Htay UH, McShane R |title=Non-pharmacological interventions for wandering of people with dementia in the domestic setting |journal=Cochrane Database Syst Rev |issue=1 |pages=CD005994 |year=2007 |pmid=17253573 |doi=10.1002/14651858.CD005994.pub2 }}</ref><ref name="pmid17096455">{{cite journal |author=Robinson L, Hutchings D, Dickinson HO, ''et al.'' |title=Effectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia: a systematic review |url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_2007-01_22_1/page/9 |journal=Int J Geriatr Psychiatry |volume=22 |issue=1 |pages=9–22 |year=2007 |pmid=17096455 |doi=10.1002/gps.1643 }}</ref> Hatua zinazoegemea hisia zinahusu matibabu ya kukumbuka mambo ya zamani, matibabu ya uthibitishaji, matibabu ya kisaikolojia yanayounga mkono, kuunganishwa kwa hisi, pia hujulikana kama snoeseleni, na matibabu ya usimulizi wa sasa. Matibabu ya kisaikolojia yanyounga mkono yamepokea rasmi utafiti kidogo au usiokuwepo wa kisayansi, lakini baadhi ya madaktari huona kuwa yana manufaa katika kuwasaidia wagonjwa wenye uharibifu wa kadiri kuzoea maradhi yao.<ref name="pracGuideAPA"/> Matibabu ya kukumbuka mambo ya zamani (RT) yanahusu majadiliano ya mambo ya zamani na mtu mmoja au katika kikundi, mara nyingi kwa kutumia picha, vitu vya nyumbani, muziki na rekodi za sauti, au vitu vinavyofahamika vya zamani. Ingawa kuna uchache wa utafiti bora kuhusu ufanisi wa RT, inaweza kuwa ya manufaa kwa utambuzi wa mambo na hali ya hisia.<ref name="pmid15846613">{{cite journal |author=Woods B, Spector A, Jones C, Orrell M, Davies S |title=Reminiscence therapy for dementia |journal=Cochrane Database Syst Rev |issue=2 |pages=CD001120 |year=2005 |pmid=15846613 |doi=10.1002/14651858.CD001120.pub2 }}</ref> Matibabu ya uigaji mambo ya sasa (SPT) yana msingi wake katika nadharia za kushikamana na yanahusisha kucheza na kurekodi kwa sauti za jamaa wa karibu wa mtu huyo aliye na ugonjwa wa Alzeima. Kuna kiasi cha ushahidi unaoonyesha kwamba SPT yaweza kupunguza tabia zenye changamoto.<ref name="pmid19023729">{{cite journal |author=Zetteler J |title=Effectiveness of simulated presence therapy for individuals with dementia: a systematic review and meta-analysis |url=https://archive.org/details/aging-mental-health_2008-11_12_6/page/779 |journal=Aging Ment Health |volume=12 |issue=6 |pages=779–85 |year=2008 |month=Novemba |pmid=19023729 |doi=10.1080/13607860802380631 }}</ref> Hatimaye, matibabu ya uthibitishi ni msingi wake katika kukubali ukweli na ukweli wa kibinafsi wa maisha binafsi, wakati kuunganishwa kwa hisia nyingi kunatokana na mazoezi yenye lengo la kuchochea hisia. Kuna kiasi cha ushahidi kinachounga mkono manufaa ya matibabu haya.<ref name="pmid12917907">{{cite journal |author=Neal M, Briggs M |title=Validation therapy for dementia |journal=Cochrane Database Syst Rev |issue=3 |pages=CD001394 |year=2003 |pmid=12917907 |doi=10.1002/14651858.CD001394 }}</ref><ref name="pmid12519587">{{cite journal |author=Chung JC, Lai CK, Chung PM, French HP |title=Snoezelen for dementia |journal=Cochrane Database Syst Rev |issue=4 |pages=CD003152 |year=2002 |pmid=12519587 |doi=10.1002/14651858.CD003152 }}</ref> Lengo la matibabu yanayoegemea utambuzi, ambayo ni pamoja na mwelekeo wa ukweli na kufunzwa tena kwa utambuzi wa mambo, ni kupunguza nakisi ya utambuzi wa mambo. Mwelekeo wa ukweli unahusisha katika uwasilishaji wa taarifa juu ya muda, mahali au mtu ili kurahisisha kuelewa kwa mtu juu ya mazingira yake na sehemu yake ndani yake. Kwa upande mwingine kufunzwa tena utambuzi wa mambo hujaribu kuboresha uwezo wa utendaji ulioharibika kwa kusisimua uwezo wa akili. Hatua zote zimeonyesha baadhi ya matokeo yaliyotarajiwa ya kuboresha uwezo wa utambuzi,<ref name="pmid17636652">{{cite journal |author=Spector A, Orrell M, Davies S, Woods B |title=Withdrawn: Reality orientation for dementia |journal=Cochrane Database Syst Rev |issue=3 |pages=CD001119 |year=2000 |pmid=17636652 |doi=10.1002/14651858.CD001119.pub2 }}</ref><ref name="pmid12948999">{{cite journal |author=Spector A, Thorgrimsen L, Woods B, ''et al.'' |title=Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial |journal=Br J Psychiatry |volume=183 |pages=248–254 |year=2003 |pmid=12948999 |doi=10.1192/bjp.183.3.248 }}</ref>ingawa katika baadhi ya utafiti madhara haya yalikuwa ya muda mfupi na ya athari mbaya, kama vile kuudhika, pia yameripotiwa.<ref name="pracGuideAPA"/> Matibabu yanayoegemea usisimuzi ni pamoja na sanaa, muziki na matibabu ya chuki, mazoezi, na aina yoyote ya shughuli nyingine za burudani. Kusisimua kunasaidia kidogo katika kuboresha tabia, hisia, na, kwa kiasi cha chini utendakazi. Hata hivyo, muhimu kama athari hizi ni usaidizi mkuu kwa ajili ya matumizi ya matibabu ya kusisimua ni mabadiliko ya maisha ya mtu ya kawaida.<ref name="pracGuideAPA"/> === Matunzo === Kwa vile Alzeima haina tiba na hatua kwa hatua huwanya watu kutoweza kuchunga mahitaji yao wenyewe, utunzaji kimsingi ndiyo matibabu na lazima yathibitiwe kwa makini katika kipindi cha ugonjwa huu. Katika awamu za mapema na za wastani, mabadiliko ya mazingira ya kuishi na maisha yanaweza kuongeza usalama wa mgonjwa na kupunguza mzigo wa mlezi<ref name="pmid15860476">{{cite journal |author=Gitlin LN, Hauck WW, Dennis MP, Winter L |title=Maintenance of effects of the home environmental skill-building program for family caregivers and individuals with Alzheimer's disease and related disorders |url=https://archive.org/details/sim_journals-of-gerontology_2005-03_60a_3/page/368 |journal=J. Gerontol. A Biol. Sci. Med. Sci. |volume=60 |issue=3 |pages=368–74 |year=2005 |month=Machi |pmid=15860476 }}</ref> Mifano wa mabadiliko haya ni kama vile kuzingatia matendo yalirahisishwa ya kila siku, na kuweka kwa wa kufuli za usalama, na kuweka alama kwa vitu vya nyumbani ili kumtambulisha mtu mwenye ugonjwa au matumizi ya vitu vilivyobadilishwa vya maisha ya kila siku.<ref name="pracGuideAPA"/><ref>{{cite web |url=http://www.alz.org/Health/Treating/agitation.asp |title=Treating behavioral and psychiatric symptoms |year=2006 |accessdate=2006-09-25 |publisher=Alzheimer's Association |archivedate=2006-09-25 |archiveurl=https://web.archive.org/web/20060925112503/http://www.alz.org/Health/Treating/agitation.asp }}</ref><ref name="pmid15297089"> {{cite journal | author = Dunne TE, Neargarder SA, Cipolloni PB, Cronin-Golomb A | title = Visual contrast enhances food and liquid intake in advanced Alzheimer's disease | url = https://archive.org/details/sim_clinical-nutrition_2004-08_23_4/page/533 | journal = Clinical Nutrition | volume = 23 | issue = 4 | pages = 533–538 | year = 2004 | pmid = 15297089 | doi = 10.1016/j.clnu.2003.09.015 }}</ref> Mgonjwa anaweza pia kutoweza kujilisha mwenyewe, hivyo huhitaji chakula kikiwa katika vipande vidogo au kilichosagwa.<ref>{{cite book |author=Dudek, Susan G. |title=Nutrition essentials for nursing practice |publisher=Lippincott Williams & Wilkins |location=Hagerstown, Maryland |year=2007 |page=360 |isbn=0-7817-6651-6 |oclc= |doi= |url= http://books.google.com/?id=01zo6yf0IUEC&pg=PA360&dq=alzheimer%27s+chew |accessdate=2008-08-19 }}</ref> Wakati wa kumeza matatizo hutokea, na matumizi ya neli za kulisha zinaweza kuhutajika. Katika hali kama hizo, na ufanifu wa matibabu na maadili ya kuendelea kulisha ni muhimu kuzingatiwa na watunzaji na familia.<ref name="pmid16415742">{{cite journal |author=Dennehy C |title=Analysis of patients' rights: dementia and PEG insertion |journal=Br J Nurs |volume=15 |issue=1 |pages=18–20 |year=2006 |pmid=16415742 }}</ref><ref name="pmid16556924">{{cite journal |author=Chernoff R |title=Tube feeding patients with dementia |url=https://archive.org/details/sim_nutrition-in-clinical-practice_2006-04_21_2/page/142 |journal=Nutr Clin Pract |volume=21 |issue=2 |pages=142–6 |year=2006 |month=Aprili |pmid=16556924 |doi=10.1177/0115426506021002142 }}</ref> Matumizi ya vifaa vya kumfunga mgonjwa nadra huhitajika katika hatua yoyote ya ugonjwa huu, ingawa kuna wakati ambapo huwa muhimu ili kuzuia madhara kwa wagonjwa wa Alzeima au watunzaji wao.<ref name="pracGuideAPA"/> Ugonjwa unavyoendelea, masuala mbalimbali ya matibabu yanaweza kuonekana, kama vile maradhi ya mdomo na meno, vidonda vya mbano, utapiamlo, matatizo ya usafi, au matatizo ya upumuaji, ngozi, au [[Jicho|macho]]. Usimamizi wa makini unaweza kuzuia haya yote, na matibabu maalum yanahitajika wakati yanapotokea.<ref name="pmid10369823">{{cite journal |author=Gambassi G, Landi F, Lapane KL, Sgadari A, Mor V, Bernabei R |title=Predictors of mortality in patients with Alzheimer's disease living in nursing homes |url=https://archive.org/details/sim_journal-of-neurology-neurosurgery-and-psychiatry_1999-07_67_1/page/59 |journal=J. Neurol. Neurosurg. Psychiatr. |volume=67 |issue=1 |pages=59–65 |year=1999 |month=Julai |pmid=10369823 |pmc=1736445 |doi=10.1136/jnnp.67.1.59 }}</ref><ref> Masuala ya Matibabu: * {{cite journal |author=Head B |title=Palliative care for persons with dementia |journal=Home Healthc Nurse |volume=21 |issue=1 |pages=53–60; quiz 61 |year=2003 |month=Januari |pmid=12544465 |doi=10.1097/00004045-200301000-00012 }} * {{cite journal |author=Friedlander AH, Norman DC, Mahler ME, Norman KM, Yagiela JA |title=Alzheimer's disease: psychopathology, medical management and dental implications |journal=J Am Dent Assoc |volume=137 |issue=9 |pages=1240–51 |year=2006 |month=Septemba |pmid=16946428 }} * {{cite journal |author=Belmin J |title=Practical guidelines for the diagnosis and management of weight loss in Alzheimer's disease: a consensus from appropriateness ratings of a large expert panel |journal=J Nutr Health Aging |volume=11 |issue=1 |pages=33–7 |year=2007 |pmid=17315078 |author2=Expert Panel and Organisation Committee }} * {{cite journal |author=McCurry SM, Gibbons LE, Logsdon RG, Vitiello M, Teri L |title=Training caregivers to change the sleep hygiene practices of patients with dementia: the NITE-AD project |url=https://archive.org/details/sim_journal-of-the-american-geriatrics-society_2003-10_51_10/page/1455 |journal=J Am Geriatr Soc |volume=51 |issue=10 |pages=1455–60 |year=2003 |month=Oktoba |pmid=14511168 |doi=10.1046/j.1532-5415.2003.51466.x }} * {{cite journal |author=Perls TT, Herget M |title=Higher respiratory infection rates on an Alzheimer's special care unit and successful intervention |url=https://archive.org/details/sim_journal-of-the-american-geriatrics-society_1995-12_43_12/page/1341 |journal=J Am Geriatr Soc |volume=43 |issue=12 |pages=1341–4 |year=1995 |month=Desemba |pmid=7490383 }}</ref> Katika hatua ya mwisho ya ugonjwa huu, matibabu uhusisha kupunguza usumbufu hadi kifo.<ref name="pmid12854952">{{cite journal |author=Shega JW, Levin A, Hougham GW, ''et al.'' |title=Palliative Excellence in Alzheimer Care Efforts (PEACE): a program description |journal=J Palliat Med |volume=6 |issue=2 |pages=315–20 |year=2003 |month=Aprili |pmid=12854952 |doi=10.1089/109662103764978641 }}</ref> Utafiti mdogo wa hivi karibuni huko Marekani ulihitimisha kuwa wagonjwa ambao watunzaji wao walikuwa na uelewa mzuri wa matatizo na shida za kimatibabu za hatua ya mwisho ya dementia walikuwa na uwezekano wa chini wa kupata matibabu ya kutumia nguvu karibu na mwisho wa maisha. <ref>{{cite journal |author=Mitchell SL, Teno JM, Kiely DK, ''et al.'' |title=The clinical course of advanced dementia |url=https://archive.org/details/sim_new-england-journal-of-medicine_2009-10-15_361_16/page/1528 |journal=N Engl J Med |volume=361 |issue=16 |pages=1529–38 |year=2009 |month=Oct |pmid=19828530 |doi=10.1056/NEJMoa0902234 |pmc=2778850}}</ref> == Kutabiri Maendeleo yake == [[Picha:Alzheimer and other dementias world map - DALY - WHO2004.svg|thumb|Maisha yaliobadilishwa na Ulemavu-mwaka kwa Alzeima na shida ya akili nyingine kwa wakazi 100,000 katika 2004.[446][447][448][449][450][451][452][453][454][455][456][ 457][458]]] Hatua za kwanza za ugonjwa wa Alzeima ni ngumu kuzitambua. Utambuzi wa hakika huweza kufanyika mara tu uharibifu wa utambuzi huanza kuathiri shughuli za kila siku, ingawa mtu anaweza kuwa bado anaishi kivyake. Dalili huongezeka kutokana na shida ndogo ndogo za utambuzi, kuzidi kupoteza kumbukumbu katika hatua za kuzidi kuharibika kwa uwezo wa utambuzi, kuondoa uwezekano wowote wa kuishi ukiwa huru.<ref name="pmid10653284"/> Muda wa kuishi wa walio na ugonjwa huo hupungua.<ref name="pmid3776457"/><ref name="pmid8757016">{{cite journal |author=Bowen JD, Malter AD, Sheppard L, ''et al.'' |title=Predictors of mortality in patients diagnosed with probable Alzheimer's disease |url=https://archive.org/details/sim_neurology_1996-08_47_2/page/433 |journal=Neurology |volume=47 |issue=2 |pages=433–9 |year=1996 |month=Agosti |pmid=8757016 }}</ref><ref name="pmid12580712">{{cite journal |author=Dodge HH, Shen C, Pandav R, DeKosky ST, Ganguli M |title=Functional transitions and active life expectancy associated with Alzheimer disease |journal=Arch. Neurol. |volume=60 |issue=2 |pages=253–9 |year=2003 |month=Februari |pmid=12580712 |doi=10.1001/archneur.60.2.253 }}</ref> Kadiri ya muda wa kuishi baada ya kugunduliwa kwa ugonjwa ni takriban miaka saba.<ref name="pmid3776457"/> Chini ya 3% ya wagonjwa huishi zaidi ya miaka kumi na minne.<ref name="pmid7793228"/> Sifa za ugonjwa huu zinazohusishwa sana na kupunguka kwa maisha ni kuzidi kwa upungufu wa utambuzi, kupungua kwa kiwango cha utendaji kazi, historia ya kuanguka, na usumbufu katika uchunguzi wa kinyurolojia. Magonjwa mengine ya kisadfa kama vile matatizo ya moyo, [[Kisukari|ugonjwa wa kisukari]] au historia ya [[Utumiaji mbaya wa Pombe|ulevi]] pia uhusishwa na kupungua kwa maisha.<ref name="pmid8757016"/><ref name="pmid15068977">{{cite journal |author=Larson EB, Shadlen MF, Wang L, ''et al.'' |title=Survival after initial diagnosis of Alzheimer disease |url=https://archive.org/details/sim_annals-of-internal-medicine_2004-04-06_140_7/page/n52 |journal=Ann. Intern. Med. |volume=140 |issue=7 |pages=501–9 |year=2004 |month=Aprili |pmid=15068977 }}</ref><ref name="pmid7792352">{{cite journal |author=Jagger C, Clarke M, Stone A |title=Predictors of survival with Alzheimer's disease: a community-based study |url=https://archive.org/details/sim_psychological-medicine_1995-01_25_1/page/171 |journal=Psychol Med |volume=25 |issue=1 |pages=171–7 |year=1995 |month=Januari |pmid=7792352 |doi=10.1017/S0033291700028191 }}</ref> Iwapo ugonjwa utaanza mapema basi maisha huwa marefu zaidi, matarajio ya maisha ya walio wadogo kiumri hupungua sana hasa ikilinganishwa na jamii kwa jumla.<ref name="pmid12580712"/> Wagonjwa wanaume wana matarajio madogo zaidi ya kuishi ikilinganishwa na wanawake.<ref name="pmid7793228"/><ref name="pmid15883266">{{cite journal |author=Ganguli M, Dodge HH, Shen C, Pandav RS, DeKosky ST |title=Alzheimer disease and mortality: a 15-year epidemiological study |journal=Arch. Neurol. |volume=62 |issue=5 |pages=779–84 |year=2005 |month=Mei |pmid=15883266 |doi=10.1001/archneur.62.5.779 }}</ref> Ugonjwa ni [[Mauti|sababu]] ya kimsingi [[Mauti|ya kifo]] katika 70% ya kesi zote.<ref name="pmid3776457"/> Nimonia na kuishiwa na maji mwilini ni sababu kuu za vifo vya haraka, wakati saratani ni sababu ndogo ya kifo ikilinganishwa na jamii kwa jumla.<ref name="pmid3776457"/><ref name="pmid15883266"/> == Epidemiolojia == Hatua mbili kuu hutumiwa katika masomo ya epidemolojia: matukio na maenezi. Matukio ni idadi ya kesi mpya kwa idadi ya watu -na wakati kuna hatari ya kuambukiza (kwa kawaida idadi ya kesi mpya kwa watu na miaka elfu moja) matukio ya mwezi kwa kila wa elfu-); ilhali maenezi ni jumla ya idadi ya matukio ya ugonjwa kati ya watu wote katika wakati fulani. Kuhusu matukio, masomo ya kilongitudo {{/0} (masomo ambapo kundi la watu wasio na ugonjwa hufuatwa kwa muda) hutoa viwango kati ya miaka 10 na 15 kwa kila watu elfu 5-8 kwa Alzeima,<ref name="pmid17727890">{{cite journal |author=Bermejo-Pareja F, Benito-León J, Vega S, Medrano MJ, Román GC |title=Incidence and subtypes of dementia in three elderly populations of central Spain |journal=J. Neurol. Sci. |volume=264 |issue=1–2 |pages=63–72 |year=2008 |month=Januari |pmid=17727890 |doi=10.1016/j.jns.2007.07.021 }}</ref><ref name="pmid12028245">{{cite journal |author=Di Carlo A, Baldereschi M, Amaducci L, ''et al.'' |title=Incidence of dementia, Alzheimer's disease, and vascular dementia in Italy. The ILSA Study |url=https://archive.org/details/sim_journal-of-the-american-geriatrics-society_2002-01_50_1/page/41 |journal=J Am Geriatr Soc |volume=50 |issue=1 |pages=41–8 |year=2002 |month=Januari |pmid=12028245 |doi=10.1046/j.1532-5415.2002.50006.x |last12=Ilsa Working |first12=Group }}</ref> ambayo ina maana kwamba nusu ya kesi za shida ya akili kila mwaka ni za Alzeima. Kuongezeka kwa umri ni sababu ya kimsingi ya kuongezeka kwa hatari ya ugonjwa, na viwango vya matukio si sawa kwa rika zote: kila baada ya miaka mitano baada ya umri wa miaka 65, hatari ya kupata ugonjwa huongezeka takriban maradufu, kuongezeka kutoka 3 hadi 69 kwa kila miaka elfu ya mtu.<ref name="pmid17727890"/><ref name="pmid12028245"/> Pia kuna tofauti za kijinsia katika viwango vya matukio, wanawake huwa na hatari kubwa ya kuugua Alzeima hasa katika idadi ya watu wenye umri zaidi ya 85.<ref name="pmid12028245"/><ref>{{cite journal |author=Andersen K, Launer LJ, Dewey ME, ''et al.'' |title=Gender differences in the incidence of AD and vascular dementia: The EURODEM Studies. EURODEM Incidence Research Group |url=https://archive.org/details/sim_neurology_1999-12-10_53_9/page/1992 |journal=Neurology |volume=53 |issue=9 |pages=1992–7 |year=1999 |month=Desemba |pmid=10599770 |last12=Martinez-Lage |first12=JM |last13=Stijnen |first13=T |last14=Hofman |first14=A }}</ref> Maenezi ya Alzeima katika watu hutegemea mambo mbalimbali ikiwa ni pamoja na matukio na kuendelea kuishi. Kwa kuwa matukio ya Alzeima yanaongezeka na umri, ni muhimu kujumuisha umri wa watu walio na mvuto. Nchini Marekani, maambukizi ya Alzeima yalikadiriwa kuwa 1.6% mwaka 2000 kwa ujumla na katika umri 65-74, na kuongezeka kwa kiwango cha 19% katika kundi 75-84 na 42% katika kundi waliozidi miaka 84. <ref> 2000 Makadirio ya Marekani: * {{cite journal |author=Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA |title=Alzheimer disease in the US population: prevalence estimates using the 2000 census |journal=Arch. Neurol. |volume=60 |issue=8 |pages=1119–22 |year=2003 |month=Agosti |pmid=12925369 |doi=10.1001/archneur.60.8.1119 }} * {{cite web |title=Profiles of general demographic characteristics, 2000 census of population and housing, United States |year=2001 |publisher=U.S. Census Bureau |url=http://www.census.gov/prod/cen2000/dp1/2kh00.pdf |format=PDF |accessdate=2008-08-27 }} </ref> Uenezi katika sehemu zenye ustawi mdogo ni wa chini. [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Ulimwenguni]] lilikadiria kwamba mnamo mwaka 2005, 0.379% ya watu duniani kote walikuwa na shida ya akili, na kwamba kiwango cha maambukizi kitaongezeka kwa 0.441% katika 2015 na 0.556% katika 2030.<ref name="isbn9789241563369">{{cite book | last = World Health Organization | title = Neurological Disorders: Public Health Challenges | publisher = World Health Organization | year = 2006 | location = Switzerland | pages = 204–207 | url = http://www.who.int/mental_health/neurology/neurodiso/en/index.html | isbn = 978-92-4-156336-9 }}</ref> Tafiti zingine zimepata hitimisho sawa.<ref name="pmid16360788">{{cite journal |author=Ferri CP, Prince M, Brayne C, ''et al.'' |title=Global prevalence of dementia: a Delphi consensus study |journal=Lancet |volume=366 |issue=9503 |pages=2112–7 |year=2005 |month=Desemba |pmid=16360788 |pmc=2850264 |doi=10.1016/S0140-6736(05)67889-0 |url=http://www.sbgg.org.br/profissional/artigos/pdf/demencia_mundo.pdf |accessdate=2008-06-25 |format=PDF |last12=Mathers |first12=C |last13=Menezes |first13=PR |last14=Rimmer |first14=E |last15=Scazufca |first15=M |last16=Alzheimer's Disease |first16=International |archive-date=2008-06-25 |archive-url=https://web.archive.org/web/20080625071754/http://www.sbgg.org.br/profissional/artigos/pdf/demencia_mundo.pdf |dead-url= }}</ref> Utafiti mwingine ulikadiria kwamba mwaka 2006, 0.40% ya idadi ya watu duniani (kati ya % 0.17-0.89; idadi kamili {{Nowrap|26.6 million}}, kati ya {{Nowrap|11.4–59.4 million}} ) walikuwa wameathirika na Alzeima, na kwamba maenezi ya maambukizi yameongezeka mara tatu na idadi kamili ingekuwa mara nne kwa 2050. <ref name="Brookmeyer2007">2006 maambukizi ya makisio: * {{cite journal |author=Brookmeyer R, Johnson E, Ziegler-Graham K, MH Arrighi |title=Forecasting the global burden of Alzheimer's disease |journal=Alzheimer's and Dementia |volume=3 |issue=3 |pages=186–91 |year=2007 |month=Julai |doi=10.1016/j.jalz.2007.04.381 |url=http://works.bepress.com/cgi/viewcontent.cgi?article=1022&context=rbrookmeyer |accessdate=2008-06-18 |pmid=19595937 |last1=Brookmeyer |first1=R |last2=Johnson |first2=E |last3=Ziegler-Graham |first3=K |last4=Arrighi |first4=HM |archive-date=2008-12-07 |archive-url=https://web.archive.org/web/20081207025403/http://works.bepress.com/cgi/viewcontent.cgi?article=1022&context=rbrookmeyer |dead-url=yes }} * {{cite paper |url=http://un.org/esa/population/publications/wpp2006/WPP2006_Highlights_rev.pdf |format=PDF |accessdate=2008-08-27 |year=2007 |title=World population prospects: the 2006 revision, highlights |publisher=Population Division, Department of Economic and Social Affairs, United Nations |version=Working Paper No. ESA/P/WP.202 |journal= |archive-date=2008-08-19 |archive-url=https://web.archive.org/web/20080819191533/http://www.un.org/esa/population/publications/wpp2006/WPP2006_Highlights_rev.pdf |dead-url=yes |=https://web.archive.org/web/20080819191533/http://www.un.org/esa/population/publications/wpp2006/WPP2006_Highlights_rev.pdf }}</ref> == Historia == [[Picha:Auguste D aus Marktbreit.jpg|thumb|Alois mgonjwa wa Alzeima Auguste Deter katika 1902. Chake ndicho kisa cha kwanza kilichofafanuliwa kwa ugonjwa uliokuja kujulikana kama Alzeima.]] Wanafalsafa na madaktari wa [[Ugiriki ya Kale|Ugiriki]] na [[Roma wa Kale]] walihusisha kuzeeka na kuongezeka kwa dementia.<ref name="pmid9661992">{{cite journal |author=Berchtold NC, Cotman CW |title=Evolution in the conceptualization of dementia and Alzheimer's disease: Greco-Roman period to the 1960s |url=https://archive.org/details/sim_neurobiology-of-aging_may-june-1998_19_3/page/n6 |journal=Neurobiol. Aging |volume=19 |issue=3 |pages=173–89 |year=1998 |pmid=9661992 |doi=10.1016/S0197-4580(98)00052-9 }}</ref> Haikuwa hadi 1901 ndipo 0}mtaalamu wa saikolojia wa Kijerumani { Alois Alzheimer alipotambua kesi ya kwanza ya kile kilichochokuja kujulikana kama ugonjwa wa Alzeima katika mwanamke mwenye umri wa miaka 50 aliyemwita {1}Auguste D. Alzheimer alimfuata hadi alipokufa mnamo 1906, ambapo aliitangaza kesi hiyo hadharani kwa mara ya kwanza. <ref> Auguste D.: * {{ cite journal | author=Alzheimer Alois | title=Über eine eigenartige Erkrankung der Hirnrinde [About a peculiar disease of the cerebral cortex] | journal=Allgemeine Zeitschrift fur Psychiatrie und Psychisch-Gerichtlich Medizin | volume=64 | issue=1–2 | pages=146–148 | year=1907 | language={{de icon}} }} * {{cite journal |author=Alzheimer Alois |title=About a peculiar disease of the cerebral cortex. By Alois Alzheimer, 1907 (Translated by L. Jarvik and H. Greenson) |journal=Alzheimer Dis Assoc Disord |volume=1 |issue=1 |pages=3–8 |year=1987 |pmid=3331112 }} * {{cite book |author=Maurer Ulrike, Maurer Konrad |title=Alzheimer: the life of a physician and the career of a disease |url=https://archive.org/details/alzheimerlifeofp00maur |publisher=Columbia University Press |location=New York |year=2003 |page=[https://archive.org/details/alzheimerlifeofp00maur/page/270 270] |isbn=0-231-11896-1 |oclc= }} </ref> Katika kipindi cha miaka mitano iliyofuata, kesi sawa kumi na mmoja ziliripotiwa katika maandiko ya matibabu, na baadhi yao yakitumia jina la ugonjwa wa Alzeima kuutaja ugonjwa huo.<ref name="pmid9661992"/> Ugonjwa ulielezewa kama ugonjwa bainifu naye Emil Kraepelin baada ya kuzuia baadhi ya sifa za ugonjwa (upotovu na ndoto) na za kipatholojia (mabadiliko mkakamo wa ateri) zilizoko katika ripoti ya awali ya Auguste D.<ref>{{cite journal |author=Berrios G E |title=Alzheimer's disease: a conceptual history |journal=Int. J. Ger. Psychiatry |volume=5 |issue= |pages=355–365 |year=1990 |month= |pmid= |doi=10.1002/gps.930050603 }}</ref> Alijumuisha ''ugonjwa wa Alzeima,'' pia uiutwaodementiaya ''kabla ya udhoofu'' naye Kraepelin, kama aina ya ''shida ya akili ya udhoofu'' katika toleo la nane ya ''kitabu'' chake ''cha Saikayatria,'' kilichochapishwa mwaka 1910.<ref name="isbn1-4325-0833-4">{{cite book |author=Kraepelin Emil, Diefendorf A. Ross (translated by) |title=Clinical Psychiatry: A Textbook For Students And Physicians (Reprint) |url=https://archive.org/details/clinicalpsychiat0000emil |publisher=Kessinger Publishing |date=2007-01-17 |page=[https://archive.org/details/clinicalpsychiat0000emil/page/568 568] |isbn=1-4325-0833-4 |oclc= }}</ref> Kwa sehemu kubwa ya karne ya 20, utambuzi wa ugonjwa wa Alzeima ulikuwa miliki ya watu wenye umri kati ya 45 na 65 ambao walionyesha dalili za dementia. Istilahi hii ilipita baada ya 1977, wakati mkutano juu ya Alzeima ulihitimisha kuwa na dalili za kimatibabu na zakipatholojia za dementia za kudhoofika na kabla ya kudhoofika zilikuwa karibu sawa, ingawa waandishi pia waliongeza hawakuondoa uwezekano wa kuwa yalisababishwa na sababu tofauti.<ref name="isbn0-89004-225-X">{{cite book |author=Katzman Robert, Terry Robert D, Bick Katherine L (editors) |title=Alzheimer's disease: senile dementia and related disorders |url=https://archive.org/details/alzheimersdiseas0000work |publisher=Raven Press |location=New York |year=1978 |page=[https://archive.org/details/alzheimersdiseas0000work/page/594 595] |isbn=0-89004-225-X |oclc= }}</ref> Hii hatimaye ilipelekea utambuzi wa ''ugonjwa wa'' ''Alzeima'' bila kutegemea umri.<ref name="pmid9702682">{{cite journal |author=Boller F, Forbes MM |title=History of dementia and dementia in history: an overview |url=https://archive.org/details/sim_journal-of-the-neurological-sciences_1998-06-30_158_2/page/n9 |journal=J. Neurol. Sci. |volume=158 |issue=2 |pages=125–33 |year=1998 |month=Juni |pmid=9702682 |doi=10.1016/S0022-510X(98)00128-2 }}</ref> Jina '' dementia ya kudhoofika ya Alzeima '' (SDAT) lilitumika kwa muda kuelezea hali ya watu wa zaidi ya miaka 65, huku ugonjwa wa Alzeima ukitumika kuwaelezea wale waliokuwa na umri wa chini. Hatimaye, jina Alzeima lilichukuliwa rasmi katika utaratibu wa majina ya matibabu ya kuwaelezea watu wa umri wowote wenye sampuli sawa ya dalili mfano tabia, mkondo wa ugonjwa, na neuropatholojia.<ref name="pmid3531918">{{cite journal |author=Amaducci LA, Rocca WA, Schoenberg BS |title=Origin of the distinction between Alzheimer's disease and senile dementia: how history can clarify nosology |journal=Neurology |volume=36 |issue=11 |pages=1497–9 |year=1986 |month=Novemba |pmid=3531918 }}</ref> == Jamii na utamaduni == === Gharama za kijamii === Shida ya akili, na hasa ya ugonjwa wa Alzeima, inaweza kuwa kati ya magonjwa yenye gharama kubwa kwa jamii katika Ulaya na Marekani,<ref name="pmid15685097"/><ref name="pmid9543467"/> wakati gharama zao katika nchi nyingine kama vile [[Argentina|Ajentina]],<ref name="pmid16870037">{{cite journal |author=Allegri RF, Butman J, Arizaga RL, ''et al.'' |title=Economic impact of dementia in developing countries: an evaluation of costs of Alzheimer-type dementia in Argentina |url=https://archive.org/details/international-psychogeriatrics_2007-08_19_4/page/705 |journal=Int Psychogeriatr |volume=19 |issue=4 |pages=705–18 |year=2007 |month=Agosti |pmid=16870037 |doi=10.1017/S1041610206003784 }}</ref> au [[Korea Kusini]],<ref name="pmid16858741">{{cite journal |author=Suh GH, Knapp M, Kang CJ |title=The economic costs of dementia in Korea, 2002 |url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_2006-08_21_8/page/722 |journal=Int J Geriatr Psychiatry |volume=21 |issue=8 |pages=722–8 |year=2006 |month=Agosti |pmid=16858741 |doi=10.1002/gps.1552 }}</ref> pia inazidi kupanda. Gharama hizi pengine zitaongezeka sambamba na kuzeeka kwa jamii, na hivyo kuwa tatizo kuu katika kijamii. Gharama zinazohusiana na Alzeima ni pamoja na gharama za matibabu ya moja kwa moja kama vile huduma ya nyumba za uuguzi, gharama za moja kwa moja zisizo za matibabu kama vile katika huduma ya mchana ya nyumbani, gharama zisizo za moja kwa moja kama vile kupoteza uzalishaji wa mgonjwa na mtunzaji.<ref name="pmid9543467"/> Hesabu inatofautiana kati ya tafiti lakini gharama ya dementia duniani kote imekadiriwa karibu $ bilioni 160,<ref name="pmid16401889">{{cite journal |author=Wimo A, Jonsson L, Winblad B |title=An estimate of the worldwide prevalence and direct costs of dementia in 2003 |journal=Dement Geriatr Cogn Disord |volume=21 |issue=3 |pages=175–81 |year=2006 |pmid=16401889 |doi=10.1159/000090733 }}</ref>wakati gharama ya Alzeima nchini Marekani inaweza kuwa $ bilioni 100 kila mwaka.<ref name="pmid9543467"/> Asili kubwa zaidi ya gharama kwa jamii ni huduma ya muda mrefu kutoka kwa wataalamu wa huduma ya afya na hasa kuwekwa kwenye taasisi, ambazo zinahusiana na 2/3 ya jumla ya gharama kwa jamii.<ref name="pmid15685097"/> Gharama za maisha nyumbani pia ni za juu sana,<ref name="pmid15685097"/> hasa wakati gharama rasmi kwa familia zinapojumuishwa, kama vile ulezi, mapato yaliyopotezwa na mtunzaji.<ref name="pmid11445614">{{cite journal |author=Moore MJ, Zhu CW, Clipp EC |title=Informal costs of dementia care: estimates from the National Longitudinal Caregiver Study |journal=J Gerontol B Psychol Sci Soc Sci |volume=56 |issue=4 |pages=S219–28 |year=2001 |month=Julai |pmid=11445614 }}</ref> Gharama huongezeka na kuongezeka kwa dementia na kuwepo kwa shida za kitabia,<ref name="pmid16676288">{{cite journal |author=Jönsson L, Eriksdotter Jönhagen M, Kilander L, ''et al.'' |title=Determinants of costs of care for patients with Alzheimer's disease |url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_2006-05_21_5/page/449 |journal=Int J Geriatr Psychiatry |volume=21 |issue=5 |pages=449–59 |year=2006 |month=Mei |pmid=16676288 |doi=10.1002/gps.1489 }}</ref> na inahusiana na kuongezeka kwa muda unaohitajika wa utunzaji ya kimwili.<ref name="pmid11445614"/> Kwa hiyo tiba yoyote ambayo kwamba inapunguza kupotea kwa utambuzi, inayochelewesha kuwekwa kwenye taasisi au inayopunguza masaa ya mtunzaji yana faida za kiuchumi. Tathmini kiuchumi za matibabu ya sasa yameonyesha matokeo mazuri.<ref name="pmid9543467"/> === Mzigo wa utunzaji === Wajibu wa mtunzaji mkuu mara nyingi huchukuliwa na mke au jamaa wa karibu.<ref name="metlife.com"/> Ugonjwa wa Alzeima unajulikana kwa kuweka mzigo mkubwa juu ya walezi ambao ni pamoja na wa kisaikolojia, kimwili au hali ya kiuchumi.<ref name="pmid17662119"/><ref name="pmid10489656"/><ref name="pmid10489657">{{cite journal |author=Murray J, Schneider J, Banerjee S, Mann A |title=EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: II—A qualitative analysis of the experience of caregiving |url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_1999-08_14_8/page/662 |journal=Int J Geriatr Psychiatry |volume=14 |issue=8 |pages=662–7 |year=1999 |month=Agosti |pmid=10489657 |doi=10.1002/(SICI)1099-1166(199908)14:8<662::AID-GPS993>3.0.CO;2-4 }}</ref> Hudumaza nyumbani hupendelewa kwa kawaida na wagonjwa na familia.<ref name="pmid18044111">{{cite journal |author=Zhu CW, Sano M |title=Economic considerations in the management of Alzheimer's disease |journal=Clin Interv Aging |volume=1 |issue=2 |pages=143–54 |year=2006 |pmid=18044111 |doi=10.2147/ciia.2006.1.2.143 |pmc=2695165 }}</ref> Fursa hii pia huchelewesha au hupunguza haja ya huduma za kitaalamu zaidi na viwango vya gharama kubwa za matibabu.<ref name="pmid18044111"/><ref>{{cite journal |author=Gaugler JE, Kane RL, Kane RA, Newcomer R |title=Early community-based service utilization and its effects on institutionalization in dementia caregiving |url=https://archive.org/details/sim_gerontologist_2005-04_45_2/page/177 |journal=Gerontologist |volume=45 |issue=2 |pages=177–85 |year=2005 |month=Aprili |pmid=15799982 }}</ref> Hata hivyo, theluthi mbili ya wakazi wa nyumba ya uuguzi ni wagonjwa wa akili.<ref name="pracGuideAPA"/> Watunzaji wa dementia/0} wanaathiriwa na kiwango cha juu cha matatizo ya [[kiakili]] na kimwili.<ref name="pmid12480441">{{cite journal |author=Ritchie K, Lovestone S |title=The dementias |url=https://archive.org/details/sim_the-lancet_2002-11-30_360_9347/page/1758 |journal=Lancet |volume=360 |issue=9347 |pages=1759–66 |year=2002 |month=Novemba |pmid=12480441 |doi=10.1016/S0140-6736(02)11667-9 }}</ref> Mambo yanayohusiana na matatizo zaidi ya kisaikolojia ya watunzaji wa kimsingi ni pamoja na watunzaji na mtu aliyeathirika nyumbani, na mtunzaji kuwa mumewe au mkewe, tabia za mgonjwa kama vile huzuni, usumbufu wa kitabia, ndoto, matatizo ya kulala au matatizo ya kutembea na kutengwa kijamii.<ref name="pmid2241719">{{cite journal |author=Brodaty H, Hadzi-Pavlovic D |title=Psychosocial effects on carers of living with persons with dementia |journal=Aust N Z J Psychiatry |volume=24 |issue=3 |pages=351–61 |year=1990 |month=Septemba |pmid=2241719 |doi=10.3109/00048679009077702 }}</ref><ref name="pmid9646153">{{cite journal |author=Donaldson C, Tarrier N, Burns A |title=Determinants of carer stress in Alzheimer's disease |url=https://archive.org/details/sim_international-journal-of-geriatric-psychiatry_1998-04_13_4/page/248 |journal=Int J Geriatr Psychiatry |volume=13 |issue=4 |pages=248–56 |year=1998 |month=Aprili |pmid=9646153 |doi=10.1002/(SICI)1099-1166(199804)13:4<248::AID-GPS770>3.0.CO;2-0 }}</ref> Kuhusu matatizo ya kiuchumi, watunzaji wa familia mara nyingi huacha masaa ya kazi na kutumia kwa wastani masaa 47 kwa wiki kumshughulikia mtu aliye na Alzeima, wakati gharama za kuwatunza ziko juu. Gharama moja kwa moja na zisizo za moja kwa moja za kuhudumia wagonjwa wa Alzeima kwa kadri ni kati ya $ 18,000 na $ 77,500 kwa mwaka katika nchi ya Marekani, kulingana na utafiti. Matibabu ya tabia za utambuzi na mafundisho ya mikakati ya kukabiliana aitha mmoja mmoja au katika vikundi imeonyesha ufanisi katika kuboresha afya ya kisaikolojia ya walezi.<ref name="pmid17662119"/><ref name="pmid11511058">{{cite journal |author=Pusey H, Richards D |title=A systematic review of the effectiveness of psychosocial interventions for carers of people with dementia |url=https://archive.org/details/aging-mental-health_2001-05_5_2/page/107 |journal=Aging Ment Health |volume=5 |issue=2 |pages=107–19 |year=2001 |month=Mei |pmid=11511058 |doi=10.1080/13607860120038302 }}</ref> === Kesi zinazotambulika === [[Picha:President Ronald Reagan with Charlton Heston at a Meeting with The Presidential Task Force on The Arts and Humanities in Cabinet Room - DPLA - 47b9185ffd7680d8f23ce4d9fe269696.jpg|thumb|Charlton Heston na Ronald Reagan katika mkutano katika White House. Wote wawili baadaye walishikwa.]] Kwa kuwa ugonjwa wa Alzeima unapatikana sana, kuna watu wengi maarufu ambao wameathiriwa nao. Mifano maarufu ni pamoja Rais wa zamani wa Marekani [[Ronald Reagan]] na mwandishi wa Ayalandi Iris Murdoch, ambao wote walikuwa katika makala za kisayansi zikichunguza jinsi uwezo wao wa utambuzi ulivyoshushwa na ugonjwa huo.<ref name="pmid15574466">{{cite journal |author=Garrard P, Maloney LM, Hodges JR, Patterson K |title=[http://brain.oxfordjournals.org/cgi/content/full/128/2/250 The effects of very early Alzheimer's disease on the characteristics of writing by a renowned author] |url=https://archive.org/details/sim_brain_2005-02_128_2/page/250 |journal=Brain |volume=128 |issue=Pt 2 |pages=250–60 |year=2005 |month=Februari |pmid=15574466 |doi=10.1093/brain/awh341 }}</ref><ref name="pmid15461232">{{cite journal |author=Sherman FT |title=[http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=121676 Did President Reagan have mild cognitive impairment while in office? Living longer with Alzheimer's Disease] |journal=Geriatrics |volume=59 |issue=9 |pages=11, 15 |year=2004 |month=Septemba |pmid=15461232 }}</ref><ref name="pmid15788549">{{cite journal |author=Venneri A, Forbes-Mckay KE, Shanks MF |title=Impoverishment of spontaneous language and the prediction of Alzheimer's disease |journal=Brain |volume=128 |issue=Pt 4 |pages=E27 |year=2005 |month=Aprili |pmid=15788549 |doi=10.1093/brain/awh419 |url= }}</ref> Kesi nyingine ni pamoja na mwanakandanda mstaafu Ferenc Puskas,<ref>{{cite news | url=http://news.bbc.co.uk/sport1/hi/football/europe/6155766.stm |title=Hungary legend Puskas dies at 79 |publisher=BBC News |date=2006-11-17 |accessdate=2008-01-25}} </ref> na waliokuwa Maziri Wakuu Harold Wilson (Uingereza) na Adolfo Suárez [[Hispania|(Uhispania)]],<ref>{{cite web |url=http://www.number10.gov.uk/history-and-tour/prime-ministers-in-history/harold-wilson |title=Prime Ministers in History: Harold Wilson |publisher=10 Downing Street |location=London |accessdate=2008-08-18 |archiveurl=https://web.archive.org/web/20080825211328/http://www.number10.gov.uk/history-and-tour/prime-ministers-in-history/harold-wilson |archivedate=2008-08-25 }}</ref><ref>{{cite web |url=http://www.elpais.com/articulo/espana/padre/reconocio/Rey/noto/carino/elpepiesp/20080718elpepinac_11/Tes |title=Mi padre no reconoció al Rey pero notó el cariño |publisher=El País |location=Madrid |year=2008 |accessdate=2008-10-01 }}</ref> na mwigizaji Rita Hayworth,<ref>{{cite web |url=http://www.alz.org/galas/Rita/overview.asp |title=Chicago Rita Hayworth Gala |publisher=Alzheimer's Association |year=2007 |accessdate=2010-02-03 }} </ref> mwigizaji Charlton Heston,<ref>{{cite web |url=http://archives.cnn.com/2002/US/08/09/heston.illness/ |title=Charlton Heston has Alzheimer's symptoms |publisher=CNN |date=2002-08-09 |accessdate=2008-01-25 |archivedate=2008-02-01 |archiveurl=https://web.archive.org/web/20080201123928/http://archives.cnn.com/2002/US/08/09/heston.illness/ }}</ref> na mwandishi wa riwaya Terry Pratchett,<ref>{{cite news |url=http://www.guardian.co.uk/books/2007/dec/12/news.michellepauli1 |author=Pauli Michelle |title=Pratchett announces he has Alzheimer's |publisher=Guardian News and Media |date=2007-12-12 |accessdate=2008-08-18 | location=London}}</ref> na mshindi wa 2009 wa [[Tuzo ya Nobeli|Tuzo]] la [[Tuzo ya Nobeli|Nobel]] katika Fizikia Charles K. Kao.<ref>{{cite web |url=http://www.straitstimes.com/Breaking%2BNews/Asia/Story/STIStory_439665.html |title=Nobel Prize Winner has Alzheimer's |publisher=The Straits Times |date=2009-10-08 |accessdate=2009-10-09 }}</ref> Alzeima pia imeweza kuonyeshwa katika filamu kama vile: ''Iris'' (2001),<ref>{{cite web |url=http://www.imdb.com/title/tt0280778/ |title=Iris |date=2002-01-18 |publisher=IMDB |accessdate=2008-01-24}}</ref> iliyo na asili yake katika kumbukumbu zake John Bayley za mke wake Iris Murdoch,<ref>{{cite book |title=Iris: a memoir of Iris Murdoch |author=Bayley John |publisher=Abacus |location=London |year=2000 |isbn=9780349112152 |oclc=41960006 }}</ref> ''Daftari'' ya (2004),<ref>{{cite web |url=http://www.imdb.com/title/tt0332280/ |title=The notebook |publisher=IMDB |accessdate=2008-02-22}}</ref> iliyo na msingi wake katika riwaya ya jina kama hilo ya Nicholas Sparks ya 1996<ref>{{cite book |title=The notebook |url=https://archive.org/details/notebook00spar_1 |author=Sparks Nicholas |year=1996 |publisher=Thorndike Press |location=Thorndike, Maine |page=[https://archive.org/details/notebook00spar_1/page/268 268] |isbn=078620821X }} </ref> ''Muda wa kumbuka'' (2004); ''Thanmathra'' (2005),<ref>{{cite web |url=http://www.webindia123.com/movie/regional/thanmatra/index.htm |title=Thanmathra |publisher=Webindia123.com |accessdate=2008-01-24}} </ref> ''Kumbukumbu ya Kesho (Ashita no Kioku)'' (2006 ), <ref>{{cite web |url=http://www.imdb.com/title/tt0494640/ |title=Ashita no kioku |originallanguage={{jp icon}} |publisher=IMDB |accessdate=2008-01-24}}</ref> msingi wake ukiwa riwaya ya Ogiwara Hiroshi ya jina kama hilo, <ref>{{cite book |author=Ogiwara Hiroshi |year=2004 |title=Ashita no Kioku |url=https://archive.org/details/ashitanokioku0000ogiw |location=Tōkyō |publisher=Kōbunsha |isbn=9784334924461 |oclc=57352130 |language={{jp icon}} |isbn-status=Mei be invalid – please double check }}</ref> ''Mbali kutoka kwake'' (2006), msingi wake ukiwa ni hadithi fupi ya Alice Munro "Dubu alikuja juu ya mlima"."The Bear Came over the Mountain".<ref>{{cite book |title=[[Hateship, Friendship, Courtship, Loveship, Marriage|Hateship, Friendship, Courtship, Loveship, Marriage: Stories]] |author=Munro Alice |location=New York |publisher=A.A. Knopf |year=2001 |isbn=9780375413001 |oclc=46929223 |chapter-url=The bear came over the mountain}}</ref> Kumbukumbu juu ya ugonjwa Alzeima ni pamoja na ''Malcolm na Barbara: Hadithi ya Mapenzi'' (1999) na ''Malcolm na Barbara: Upendo wa Wasalaam'' (2007), zote zikiwashirikisha Malcolm Pointon. <ref>Malcolm na Barbara: * {{cite web |url=http://www.dfgdocs.com/Directory/Titles/700.aspx |title=Malcolm and Barbara: A love story |publisher=Dfgdocs |accessdate=2008-01-24 |archiveurl=https://web.archive.org/web/20080524213821/http://www.dfgdocs.com/Directory/Titles/700.aspx |archivedate=2008-05-24 |=https://web.archive.org/web/20080524213821/http://www.dfgdocs.com/Directory/Titles/700.aspx }} * {{cite web |url=http://www.bbc.co.uk/cambridgeshire/content/articles/2007/08/06/pointon_audio_feature.shtml |title=Malcolm and Barbara: A love story |publisher=BBC Cambridgeshire |accessdate=2008-03-02 }} * {{cite news |url=http://www.guardian.co.uk/media/2007/aug/07/broadcasting.itv |title=Alzheimer's film-maker to face ITV lawyers |publisher=Guardian Media |date=2007-08-07 |accessdate=2008-01-24 |location=London |first=John |last=Plunkett }}</ref> == Mkondo wa Utafiti == Mnamo 2008, usalama na ufanifu wa zaidi ya dawa za matibabu 400 ulifanyiwa uchunguzi katika utafiti wa kimatibabu ulimwenguni kote, na karibu nusu ya michanganyiko hiyo iko katika awamu ya ya III; majaribio ya hatua ya mwisho kabla ya kupitia kwa vyombo vya udhibiti viwango.<ref>{{cite web |url=http://www.clinicaltrials.gov/ct2/results?term=alzheimer |title= Clinical Trials. Found 459 studies with search of: alzheimer |accessdate= 2008-03-23 |publisher= US National Institutes of Health }}</ref> Eneo moja la utafiti wa kliniki limetilia makini katika kutibu sababu za kimsingi za ugonjwa. Kupunguza viwango vya Amiloidi beta ni lengo la kawaida la michanganyiko<ref> {{cite journal |author=Lashuel HA, Hartley DM, Balakhaneh D, Aggarwal A, Teichberg S, [[David J E Callaway|Callaway DJE]] |title=New class of inhibitors of [[Beta amyloid|amyloid-beta]] fibril formation. Implications for the mechanism of pathogenesis in Alzheimer's disease |url=http://www.jbc.org/cgi/content/abstract/277/45/42881 |journal=[[Journal of Biological Chemistry|J Biol Chem]] |year=2002 |volume=277 |pages=42881–42890 |pmid=12167652 |doi=10.1074/jbc.M206593200 |issue=45 }}</ref> (kama vile apomofini) inayofanyiwa uchunguzi. Tiba ya kuzuia au chanjo dhidi ya protini ya amiloidi ni moja matibabu yaliyo chini ya masomo ya kielelezo.<ref>{{cite journal |author=Dodel r, Neff F, Noelker C, Pul R, Du Y, Bacher M Oertel W. |title=Intravenous Immunoglobulins as a Treatment for Alzheimer's Disease: Rationale and Current Evidence |url=http://adisonline.com/drugs/Abstract/2010/70050/Intravenous_Immunoglobulins_as_a_Treatment_for.1.aspx |journal=Drugs |year=2010 |volume=70 |pages=513–528 |pmid=20329802 |doi=10.2165/11533070-000000000-00000 |issue=5 |access-date=2010-10-18 |archive-date=2011-09-17 |archive-url=https://web.archive.org/web/20110917191608/http://adisonline.com/drugs/Abstract/2010/70050/Intravenous_Immunoglobulins_as_a_Treatment_for.1.aspx |dead-url=yes |=https://web.archive.org/web/20110917191608/http://adisonline.com/drugs/Abstract/2010/70050/Intravenous_Immunoglobulins_as_a_Treatment_for.1.aspx }}</ref> Tofauti na chanjo ya kuzuia, tiba iliyodhaniwa itakuwa ikitumika kutibu watu ambao tayari wametambuliwa. Msingi wake ni dhana ya mafunzo kwa mfumo wa kinga ya kutambua, mashambulizi, na kurejesha nyuma utuaji wa amiloidi, hivyo Kubadili mwenendo wa ugonjwa huo.<ref>Kutoa Chanjo: * {{cite journal |author=Hawkes CA, McLaurin J |title=Immunotherapy as treatment for Alzheimer's disease |journal=Expert Rev Neurother |volume=7 |issue=11 |pages=1535–48 |year=2007 |month=Novemba |pmid=17997702 |doi=10.1586/14737175.7.11.1535 }} * {{cite journal |author=Solomon B |title=Clinical immunologic approaches for the treatment of Alzheimer's disease |journal=Expert Opin Investig Drugs |volume=16 |issue=6 |pages=819–28 |year=2007 |month=Juni |pmid=17501694 |doi=10.1517/13543784.16.6.819 }} * {{cite journal |author=Woodhouse A, Dickson TC, Vickers JC |title=Vaccination strategies for Alzheimer's disease: A new hope? |journal=Drugs Aging |volume=24 |issue=2 |pages=107–19 |year=2007 |pmid=17313199 |doi=10.2165/00002512-200724020-00003 }}</ref> Mfano wa chanjo hiyo iliyokuwa ikifanyiwa uchunguzi ni ACC-001,<ref>{{cite web |url=http://www.clinicaltrials.gov/ct/show/NCT00498602 |title = Study Evaluating ACC-001 in Mild to Moderate Alzheimers Disease Subjects |work = Clinical Trial |publisher =US National Institutes of Health |accessdate=2008-06-05 |date = 2008-03-11}}</ref><ref>{{cite web |url=http://clinicaltrials.gov/ct2/show/NCT00479557 |title=Study Evaluating Safety, Tolerability, and Immunogenicity of ACC-001 in Subjects With Alzheimer's Disease |publisher=US National Institutes of Health |accessdate=2008-06-05 }}</ref> ingawa majaribio yalisitishwa katika 2008.<ref>{{cite web |url=http://www.medpagetoday.com/MeetingCoverage/AAN/tb/9165 |title = Alzheimer's Disease Vaccine Trial Suspended on Safety Concern |publisher =Medpage Today |accessdate=2008-06-14 |date = 2008-04-18}}</ref> Kiungo kmwingine sawa na hiyo ni bapineuzumab, zindiko iliyoundwa ili kufanana na zindiko iliyo dhidi ya amiloidi inayopatikana kiasili mwilini.<ref>{{cite web |url=http://clinicaltrials.gov/ct2/show/NCT00574132 |title= Bapineuzumab in Patients With Mild to Moderate Alzheimer's Disease/ Apo_e4 non-carriers |work = Clinical Trial |accessdate=2008-03-23 |publisher= US National Institutes of Health |date= 2008-02-29 }}</ref> Njia nyingine ni wakala wa kukinga akili kama ,vile AL-108,<ref>{{cite web |url = http://clinicaltrials.gov/ct2/show/NCT00422981 |title = Safety, Tolerability and Efficacy Study to Evaluate Subjects With Mild Cognitive Impairment |work = Clinical Trial |accessdate=2008-03-23 |publisher= US National Institutes of Health |date = 2008-03-11 }}</ref> na viungo vya kuzuia mwingiliano wa protini na chuma, kama vile PBT2.<ref>{{cite web |url = http://clinicaltrials.gov/ct2/show/NCT00471211 |title = Study Evaluating the Safety, Tolerability and Efficacy of PBT2 in Patients With Early Alzheimer's Disease |work = Clinical Trial |accessdate=2008-03-23 |publisher= US National Institutes of Health |date = 2008-01-13 }}</ref> Kipokezi cha TNFα protini ya uyeunganishaji , etanercept imeonyesha matokeo ya kutia moyo.<ref name="pmid16926764">[629] ^utafiti wa Etanercept : ** {{cite journal |author=Tobinick E, Gross H, Weinberger A, Cohen H |title=TNF-alpha modulation for treatment of Alzheimer's disease: a 6-month pilot study |journal=MedGenMed |volume=8 |issue=2 |page=25 |year=2006 |pmid=16926764 |pmc=1785182 }} ** {{cite journal |author=Griffin WS |title=Perispinal etanercept: potential as an Alzheimer therapeutic |journal=J Neuroinflammation |volume=5 |page=3 |year=2008 |pmid=18186919 |pmc=2241592 |doi=10.1186/1742-2094-5-3 }} ** {{cite journal |author=Tobinick E |title=Perispinal etanercept for treatment of Alzheimer's disease |journal=Curr Alzheimer Res |volume=4 |issue=5 |pages=550–2 |year=2007 |month=Desemba |pmid=18220520 |doi=10.2174/156720507783018217 }}</ref> Katika 2008, majaribio mawili tofauti ya kimatibabu yalionyesha matokeo mazuri katika kubadilisha mwenendo wa ugonjwa wa Alzeima ya kiwango kidogo au cha kadri kwa kutumia methilithioniniamu kloridi (ijulikanayo kibiashara kama ''rember'' ), dawa izuiayo mrundiko wa tau, <ref>{{cite journal |title=Tau aggregation inhibitor (TAI) therapy with remberTM arrests disease progression in mild and moderate Alzheimer's disease over 50 weeks |author=Wischik Claude M, Bentham Peter, Wischik Damon J, Seng Kwang Meng |journal=Alzheimer's & Dementia |publisher=Alzheimer's Association |year=2008 |month=Julai |volume=4 |issue=4 |page=T167 |url=http://www.abstractsonline.com/viewer/viewAbstractPrintFriendly.asp?CKey={E7C717CF-8D73-41E0-8DB0-FA92205978CD}&SKey={68E04DB5-AB1C-4F7B-9511-DA3173F4F755}&MKey={CFC5F7C6-CB6A-40C4-BC87-B30C9E64B1CC}&AKey={50E1744A-0C52-45B2-BF85-2A798BF24E02} |accessdate=2008-07-30 |doi=10.1016/j.jalz.2008.05.438 }}</ref> <ref> {{cite journal |author=Harrington Charles, Rickard Janet E, Horsley David, ''et al.'' |title=Methylthioninium chloride (MTC) acts as a Tau aggregation inhibitor (TAI) in a cellular model and reverses Tau pathology in transgenic mouse models of Alzheimer's disease |journal=Alzheimer's & Dementia |publisher=Alzheimer's Association |year=2008 |month=Julai |pages=T120–T121 |doi=10.1016/j.jalz.2008.05.259 |volume=4 }}</ref> na dimebon, ni kimaliza kemikali za mzio.<ref name="pmid18640457">{{cite journal |author=Doody RS, Gavrilova SI, Sano M, ''et al.'' |title=Effect of dimebon on cognition, activities of daily living, behaviour, and global function in patients with mild-to-moderate Alzheimer's disease: a randomised, double-blind, placebo-controlled study |journal=Lancet |volume=372 |issue=9634 |pages=207–15 |year=2008 |month=Julai |pmid=18640457 |doi=10.1016/S0140-6736(08)61074-0 }}</ref> Awamu ya III ya mfululizo ya majaribio ya Dimebon ilishindwa kuonyesha athari chanya katika sehemu za mwisho za msingi na za upili.<ref> [http://www.alzforum.org/new/detail.asp?id=2387 Dimebon yavunja moyo katika majaribio ya Awamu ya 3]</ref> Uwezekano wa kwamba Alzeima inaweza kutibiwa na dawa kinzavirusi unatolewa na utafiti kuonyesha kuwa pamoja kwa malengelenge ya virusi vya vidonda mwilini na utando wa amiloidi.<ref>{{cite journal |author=Wozniak M, Mee A, Itzhaki R |title=Herpes simplex virus type 1 DNA is located within Alzheimer's disease amyloid plaques |journal=J Pathol |volume=217 |issue=1 |pages=131–138 |year=2008 |pmid=18973185 |doi=10.1002/path.2449}}</ref> Utafiti wa awali wa athari za tiba katika kurejesha kumbukumbu na uwezo wa kutambua umekuwa wa kutia moyo. Upungufu wa utafiti huu unaweza kushughulikiwa katika utafiti wa baadaye kwa uchambuzi wa kina zaidi.<ref>{{cite journal |pages=517–26 |last1=Newberg |first1=AB |issue=2 |last2=Wintering |first2=N |last3=Khalsa |first3=DS |last4=Roggenkamp |first4=H |last5=Waldman |first5=MR |author8=Newberg AB, Wintering N, Khalsa DS, Roggenkamp H, Waldman MR |volume=20 |title=Meditation effects on cognitive function and cerebral blood flow in subjects with memory loss: a preliminary study |year=2010 |journal=[[Journal of Alzheimer's Disease]] |url=http://www.j-alz.com/issues/20/vol20-2.html |pmid=20164557 |doi=10.3233/JAD-2010-1391 |doi_brokendate=2010-08-25 |archive-date=2010-10-07 |access-date=2010-10-18 |archive-url=https://web.archive.org/web/20101007041817/http://j-alz.com/issues/20/vol20-2.html |url-status=dead }} (Asili ya msingi)</ref> == Tanbihi == {{Marejeo|colwidth=30em}} == Marejeo == * {{cite book | title=Alzheimer's Disease: Unraveling the Mystery | url=http://www.nia.nih.gov/Alzheimers/Publications/UnravelingTheMystery | publisher=US Department of Health and Human Services, National Institute on Aging, NIH | year=2008 }} * {{cite book |url=http://www.nia.nih.gov/Alzheimers/Publications/ADPrevented/ |title=Can Alzheimer's Disease Be Prevented? |publisher=US Department of Health and Human Services, National Institute on Aging, NIH |year=2009 }} * {{cite book | title=Caring for a Person with Alzheimer's Disease: Your Easy-to-Use Guide from the National Institute on Aging | url=http://www.nia.nih.gov/Alzheimers/Publications/CaringAD/ | publisher=US Department of Health and Human Services, National Institute on Aging, NIH | year=2009 }} * {{cite journal |author=Cummings JL, Frank JC, Cherry D, Kohatsu ND, Kemp B, Hewett L, Mittman B |title=Guidelines for managing Alzheimer's disease: Part&nbsp;I. Assessment |journal=American Family Physician |volume=65 |issue=11 |pages=2263–2272 |year=2002 |pmid=12074525 |url=http://www.aafp.org/afp/20020601/2263.html }} * {{cite journal |author= Cummings JL, Frank JC, Cherry D, Kohatsu ND, Kemp B, Hewett L, Mittman B |title=Guidelines for managing Alzheimer's disease: Part&nbsp;II. Treatment |journal=American Family Physician |volume=65 |issue=12 |pages=2525–2534 |year=2002 |pmid=12086242 |url=http://www.aafp.org/afp/20020615/2525.html }} * {{cite web | title=Alzheimer's Behavior Management: Learn to manage common behavior problems | url=http://www.helpguide.org/elder/alzheimers_behavior_problems.htm | author=Russell D, Barston S, White M | publisher=helpguide.org | date=2007-12-19 | accessdate=2008-02-29 }} == Viungo vya nje == {{Commons category|Alzheimer's disease}} * '''''(en)''''' [http://www.nia.nih.gov/Alzheimers/ResearchInformation/ResearchCenters/ Vituo vya Ugonjwa wa Alzeima (AlzeimaCs)] {{Wayback|url=http://www.nia.nih.gov/Alzheimers/ResearchInformation/ResearchCenters/ |date=20100604070324 }} * '''''(en)''''' [http://www.nia.nih.gov/alzheimers Kituo cha Elimu na Malazi cha Ugojwa wa Alzeima (AlzeimaEAR) ] * '''''(en)''''' [http://www.alz.org/index.asp Chama cha Alzeima] {{Wayback|url=http://www.alz.org/index.asp |date=20120730181212 }} * '''''(en)''''' [http://memory.ucsf.edu/ Kituo cha Kuzeeka na Kumbukumbu UCSF] {{DEFAULTSORT:Alzeima}} [[Jamii:Maradhi ya ubongo]] [[Jamii:Maradhi ya uzee]] tfxp71x3bh70xy92jpzgyiy1l3k7u5d 0 55550 1578211 1564495 2026-07-03T03:17:15Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578211 wikitext text/x-wiki [[Picha:Medroxyprogesterone_acetate.svg|thumb|Depo-Provera]] [[Picha:Medroxyprogesterone_acetate_molecule_ball.png|thumb|Depo-Provera]] {{Infobox Birth control |name = Depo-Provera |image = |width = |caption = |bc_type = Hormonal |date_first_use = 1967 |rate_type = Failure |perfect_failure% = 0.3 |typical_failure% = 3 |duration_effect = 3 months<br>(12–14 weeks) |reversibility = 3–18 months |user_reminders = Maximum interval is just under 3 months |clinic_interval = 12 weeks |STD_protection_YesNo = no |periods_advantage = Usually no periods from 2nd injection |benefits = Especially good if poor pill compliance.<br>Reduced endometrial cancer risk. |periods_disadvantage = Especially in 1st injection may be frequent spotting |weight_gain_loss = +5-10 lbs average |risks = Reduced bone density, which may reverse after discontinuation |medical_notes = For those intending to start family, suggest switch 6 months prior to alternative method (eg [[Progestogen only pill|POP]]) allowing more reliable return fertility. }} '''Depot medroxyprogesterone acetate (DMPA)''' ni njia ya [[homoni]] ya kuzuia [[mimba]] iliyo na [[projesteroni]] pekee inayodumu kwa muda mrefu na huweza kuondolewa mwilini, ambayo hudungwa kila baada ya miezi 3. Ni mchanganyiko mzito wa sindano ya depoti ya pregnane 17α-hydroxyprogesteroni- iliyotolewa kwa progestini ya ''medroksiprogesteroni acetate.'' ==Bidhaa za biashara== ''Depo-subQ Provera 104,'' ambayo pia hutengenezwa na PFIZER, ni jina la kibiashara la mg 104 ya mchanganyiko mzito wa medroxyprogesterone acetate. Inajumuisha asilimia 69 ya homoni inayopatikana katika sindano ya Depo Provera asili. Inatumiwa kwa kudunga sindano chini ya ngozi, ambayo huweza kusababisha maumivu kidogo. Dawa hiyo lazima idungwe ndani ya paja au kwenye tumbo mara nne kwa mwaka na hutoa kinga ya haraka dhidi ya kupata mimba kuanzia wakati inapodungwa mara ya kwanza. Iliidhinishwa nchini Marekani na FDA kwa ajili ya matumizi ya kuzuia mimba mnamo 17 Desemba mwaka wa 2004, na kwa ajili ya kudhibiti maumivu yanayohusiana na endometriosisi4} tarehe 25 Machi mwaka wa 2005. ==Utaratibu wa utendakazi== Utaratibu wa utekelezaji wa dawa za kupanga uzazi zilizo na progosteroni pekee hutegemea shughuli za progestogeni na kipimo. Dozi ya juu ya dawa kukinga mimba mimba zilizo na progesteroni pekee kama vile sindano ya DMPA, huzuia kukua kwa unyweleo na kuzuia kukua kwa yai /1} kama mfumo wao msingi wa utendajikazi.<ref name="glasier">{{cite book |last=Glasier |first=Anna |editor=DeGroot, Leslie J.; Jameson, J. Larry (eds.) |title=Endocrinology |edition=5th |year=2006 |publisher=Elsevier Saunders |location=Philadelphia |isbn=0-7216-0376-9 |pages=2993–3003 |chapter=Contraception}}</ref><ref name="loose">{{cite book |author=Loose, Davis S.; Stancel, George M. |editor=Brunton, Laurence L.; Lazo, John S.; Parker, Keith L. (eds.) |year=2006 |chapter=Estrogens and Progestins |title=Goodman & Gilman's The Pharmacological Basis of Therapeutics |url=https://archive.org/details/goodmangilmansph2006good |edition=11th |pages=[https://archive.org/details/goodmangilmansph2006good/page/1541 1541]–1571 |location=New York |publisher=McGraw-Hill |isbn=0-07-142280-3}}</ref> Progestogeni hupunguza kupigapiga moyo mara kwa mara ya homoni inayotoa gonadotropini -(GnRH) inayotolewa na hipothalamasi, ambayo hupunguza kutolewa kwa [[homoni ya kusisimua kinyweleo (FSH) na [[homoni ya kulutenaizi]]]] (LH)inayotolewa na pituitari ya nje. Viwango vilivyoshuka vya FSH huzuia maendeleo ya kinyweleo, kuzuia kuongezeka kwa viwango vya estradioli. Majibu hasi ya progesteroni na ukosefu wa matokeo chanya ya estrogeni juu ya kutolewa kwa LH huzuia kuongezeka kwa LH. Udhibiti dhidi ya ukuaji wa kinyweleo na ukosefu wa kuongezeka kwa LH huzuia utoaji na ukuaji wa mbegu ya mwanamke.<ref name="hatcher">{{cite book |author=Hatcher, Robert A. |year=2004 |chapter=Depo-Provera Injections, Implants, and Progestin-Only Pills (Minipills) |editor=Hatcher, Robert A.; Trussell, James; Stewart, Felicia H.; Nelson, Anita L.; Cates Jr., Willard; Guest, Felicia; Kowal, Deborah |title=Contraceptive Technology |url=https://archive.org/details/isbn_9790966490229 |edition=18th rev. |pages=[https://archive.org/details/isbn_9790966490229/page/460 461]–494 |location=New York |publisher=Ardent Media |isbn=0-9664902-5-8}}</ref><ref name="speroff">{{cite book |author=Speroff, Leon; Darney, Philip D. |year=2005 |chapter=Injectable Contraception |title=A Clinical Guide for Contraception |edition=4th |pages=201–220 |location=Philadelphia |publisher=Lippincott Williams & Wilkins |isbn=0-7817-6488-2}}</ref> Kitendo cha sekondari cha utendakazi wa dawa za kukinga mimba zilizo na progestogeni ni kuzuia manii kupita kutokana na mabadiliko kwenye makamasi ya seviksi. Uzuiaji wa utendakazi wa yai la kike wakati wa matumizi ya DMPA husababisha endometriamu kuwa nyembamba na atropiki. Mabadiliko haya katika endometriamu yanaweza kinadharia, kuzuia uwezo wa kupata mimba. Hata hivyo, kwa vile DMPA ina ufanisi mkubwa katika kuzuia utoaji wa yai la kike na kupenya kwa manii, uwezekano wa kupata mimba ni mdogo zaidi. Hakuna data inayopatikana inayochangia kutopata kwa mimba kama mfumo wa utekelezaji wa DMPA. ==Ufanisi== Matokeo ya mwaka wa kwanza ya viwango vya kutofaulu kwa matumizi ya Depo- Provera kwa wanawake 8,183 katika majaribio saba mtawalia ya kliniki saba yalikuwa: 0%, 0%, 0.1%, 0.2%, 0.2%, 0.3%, na 0.7%, na kiwango cha wastani cha 0.3%.<ref name="trussell 2004a">{{cite book |author=Trussell, James |year=2004 |chapter=Contraceptive Efficacy |editor=Hatcher, Robert A.; Trussell, James; Stewart, Felicia H.; Nelson, Anita L.; Cates Jr., Willard; Guest, Felicia; Kowal, Deborah |title=Contraceptive Technology |edition=18th rev. |pages=773–845 |location=New York |publisher=Ardent Media |isbn=0-9664902-5-8}}</ref> Matokeo ya viwango vya kutofaulu kwa mwaka wa kwanza ya kipimo cha Pearl ya wanawake 2,042 waliotumia depo- subQ 104 katika majaribioa matatu ya kiliniki yalikuwa ni: 0%,0%, na 0%, na kipimo cha wastani cha 0%. Kiwango cha kutofaulu cha mwaka wa kwanza kwa wanawake 209 waliotumia Depo-Provera katika uchunguzi mmoja uliofuata kilikuwa ni: 2.6%.<ref name="fu 1999">{{cite journal |author=Fu H, Darroch JE, Haas T, Ranjit N |year=1999 |title=Contraceptive failure rates: new estimates from the 1995 National Survey of Family Growth |journal=Fam Plann Perspect |volume=31 |issue=2 |pages=56–63 |pmid=10224543 |url=http://www.guttmacher.org/pubs/journals/3105699.pdf |format=PDF|doi=10.2307/2991640 |jstor=2991640}}</ref><ref name="trussell 1999">{{cite journal |author=Trussell J, Vaughan B |year=1999 |title=Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth |journal=Fam Plann Perspect |volume=31 |issue=2 |pages=64–72,93 |pmid=10224544 |url=http://www.guttmacher.org/pubs/journals/3106499.pdf |format=PDF|doi=10.2307/2991641 |jstor=2991641}}</ref> * Uchunguzi wa kitaifa wa ukuaji wa familia wa (NSFG) wa mwaka wa 1995 - utafiti uliofuta ulijikita katika uwezo wa mwanamke kukumbuka katika mahojiano ya 90, kuhusu matumizi yake ya dawa za kukinga mimba mwezi baada ya mwezi katika kipindi cha miaka 4 hadi 5 iliyotangulia. ===Matumizi sahihi=== Kiwango cha matokeo cha matumizi sahihi cha Trussell cha kutofaulu kwa mwaka wa kwanza kwa Depo-Provera ni kipimo cha wastani cha kutofaulu katika majaribio saba ya kliniki: 0.3%.<ref name="trussell 2004a"></ref><ref name="trussell 2004b">{{cite journal |author=Trussell J |year=2004 |title=Contraceptive failure in the United States |url=https://archive.org/details/sim_contraception_2004-08_70_2/page/89 |journal=Contraception |volume=70 |issue=2 |pages=89–96 |pmid=15288211 |doi=10.1016/j.contraception.2004.03.009}}</ref> * imezingatiwa kama matumizi sahihi kwa sababu majaribio hayo yalipima usahihi wakati wa matumizi halisi ya Depo-Provera ** kufafanuliwa kama isiyo zaidi ya wiki 14 ama 15 baada ya sindano kudungwa (yaani, isipungue zaidi ya wiki 1 au 2 kabla haujadungwa sindano inayofuata) ===Matumizi ya kawaida=== Kabla ya mwaka wa 2004, kiwango cha Trusell cha kutofaulu cha matumizi ya kawaida cha Depo- Provera kilikuwa sawa na kile chake cha kutofaulu cha matumizi sahihi 0.3%.<ref>{{cite journal |author=Trussell J, Hatcher RA, Cates W Jr, Stewart FH, Kost K |year=1990 |title=A guide to interpreting contraceptive efficacy studies |journal=Obstet Gynecol |volume=76 |issue=3 Pt 2 |pages=558–67 |pmid=2199875}}</ref> * makadirio ya matumizi ya kawaida ya Depo- Provera kutofaulu mwaka wa kwanza ni 0.3% katika: ** '''' Teknolojia ya dawa kukinga mimba (Contraceptive Technology, 1994),toleo jipya la 16 (1994) ** '''' Teknolojia ya dawa za kukinga mimba (Contracepive Technology 1998)toleeo jipya la 17 (1998) *** yaliyozingatiwa na FDA mwaka wa 1998 kwa mathumuni ya usawazishaji wa sasa wa mwongozo wa kutaja dawa za kukinga mimba. Katika mwaka wa 2004, akitumia kiwango cha kutofaulu cha mwaka wa 1995 cha NSFG, Trussell aliongeza (kwa mara 10) kiwango chake cha kutofaulu cha matumizi ya kawaida ya Depo- Provera kutoka 0.3% hadi 3%.<ref name="trussell 2004a"></ref><ref name="trussell 2004b"></ref> * makadirio ya matumizi ya kawaida ya Depo-Provera kutofaulu mwaka wa kwanza ni 3% katika: ** ''Teknolojia ya dawa za kukinga mimba (Cotraceptive Technology),toleo jipya la 18 (2004)<ref name="trussell 2004a"></ref>'' ** ''Teknolojia ya dawa za kukinga mimba (Contraceptive Technology),toleo jipya la 19 (2007)<ref name="trussell 2007">{{cite book |author=Trussell, James |year=2007 |chapter=Contraceptive Efficacy |editor=Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates Jr., Willard; Stewart, Felicia H.; Kowal, Deborah |title=Contraceptive Technology |edition=19th rev. |location=New York |publisher=Ardent Media |url=http://www.contraceptivetechnology.com/table.html |accessdate=2007-06-21 |archive-date=2008-05-31 |archive-url=https://web.archive.org/web/20080531095926/http://www.contraceptivetechnology.com/table.html |dead-url=yes }}</ref>'' Trussell hakutumia viwango vya kutofaulu vya NSFG vya mwaka wa 1995 kwa dawa zingine mbili mpya zilizopatikana za muda mrefu za kukinga mimba zilizokuwa zimevumbiliwa, kibandiko cha Norplant (2.3%) na shaba ya T ya ParaGard 380A IUD (3.7%), ambazo zilikuwa (kama Depo -Provera) zenye amri ya kiwango cha juu kuliko katika majaribio ya kliniki. kwa vile Norplant na ParaGard haikubali wigo kwa makosa ya mtumizi, viwango vyao vya juu zaidi vya kutofaulu vya mwaka wa 1995 vya NSFG vilichangiwa na Trussell kwa kutoa habari zaidi wakati wa kupata mimba hivyo kuelekea kuzaa.<ref name="trussell 2004a"></ref><ref name="trussell 1999"></ref><ref name="trussell 2004b"></ref> ==Faida== Depo-Provera ina faida kadhaa:<ref name="hatcher"></ref><ref name="speroff"></ref><ref name="westhoff">{{cite journal |author=Westhoff C |year=2003 |title=Depot-medroxyprogesterone acetate injection (Depo-Provera): a highly effective contraceptive option with proven long-term safety |url=https://archive.org/details/sim_contraception_2003-08_68_2/page/n10 |journal=Contraception |volume=68 |issue=2 |pages=75–87 |pmid=12954518 |doi=10.1016/S0010-7824(03)00136-7}}</ref><ref name="mishell">{{cite book |author= Mishell Jr., Daniel R. |year=2004 |editor= Strauss, Jerome F. III; Barbieri, Robert L. (eds.) |title=Yen and Jaffe's Reproductive Endocrinology |url= https://archive.org/details/yenjaffesreprodu0000unse |edition=5th |publisher=Elsevier Saunders |location=Philadelphia |isbn=0-7216-9546-9 |pages=[https://archive.org/details/yenjaffesreprodu0000unse/page/899 899]–938 |chapter=Contraception}}</ref> * Ina ufanisi mkubwa katika kuzuia mimba. * Hudungwa kila baada ya wiki 12. kitendo cha pekee ni kuendeleza kupanga kufuatilia sindano zingine kila baada ya wiki kumi na mbili, na kuchunguza madhara yake kuhakikisha kwamba hauhitaji ushauri wa daktari. * Hakuna estrogeni Hakuna kuongezeka kwa hatari ya ugonjwa wa thrombosisi ya veni za ndani (DVT), na embolizimu ya mapafu (PE), ugonjw wa pigo ya mwoyo au maambukizi ya miyokadiali. * Mwingiliano mdogo na madawa (ikilinganishwa na dawa nyingine za kikinga mimba zenye homoni). * Inapunguza hatari ya saratani ya endometriali. Depo-Provera hupunguza hatari ya kansa ya endometriali kwa 80%.<ref name="Kaunitz">{{cite journal |author=Kaunitz AM |title=Current options for injectable contraception in the United States |url=https://archive.org/details/sim_seminars-in-reproductive-medicine_2001-12_19_4/page/331 |journal=Semin Reprod Med |year=2001 |volume=19 |issue=4 |pages=331–7 |pmid=11727175 |doi=10.1055/s-2001-18641}}</ref><ref name="BrJFP_Bigrigg1999">{{cite journal |author=Bigrigg A, Evans M, Gbolade B, Newton J, Pollard L, Szarewski A, Thomas C, Walling M |title=Depo Provera. Position paper on clinical use, effectiveness and side effects | journal = Br J Fam Plann | volume = 25 | issue = 2 |pages=69–76 |year=1999 | pmid = 10454658}}</ref><ref name="WHO DMPA EC">{{cite journal |author=WHO Collaborative Study of Neoplasia and Steroid Contraceptives |title=Depot-medroxyprogesterone acetate (DMPA) and risk of endometrial cancer |journal=Int J Cancer |year=1991 |volume=49 |issue=2 |pages=186–90 |pmid=1831802}}</ref> kupunguzwa kwa hatari ya kansa ya endometriali katika watumiaji wa Depo-Provera imedhaniwa kuwa ni kutokana na sababu mbili ambazo ni athari ya uhusiano wa moja kwa moja usiokuwa mzuri wa progestogeni kwa endometriumu na uhusiano usio wa moja kwa moja wa kupunguza viwango vya estrogeni kwa kupunguza ukuaji wa kinyweleo katika ovari.<ref name="Santen">{{cite book |author= Santen, Richard J. |editor=Strauss, Jerome F. III; Barbieri, Robert L. (eds.) |title=Yen and Jaffe's Reproductive Endocrinology |url= https://archive.org/details/yenjaffesreprodu0000unse |edition=5th |year=2004 |publisher=Elsevier Saunders |location=Philadelphia |isbn=0-7216-9546-9 |pages=[https://archive.org/details/yenjaffesreprodu0000unse/page/787 787]–809 |chapter=Endocrinology of Breast and Endometrial Cancer}}</ref> * Hupunguza hatari ya ugonjwa wa pungufu wa damu mwilini unaosababishwa na ukosefu wa madini ya chuma,ugonjwa wa kuwasha kwa mfupa wa nyonga (PID), mimba wa kubandikwa kwa kuta za uterasi , na uvimbe wa uterasi. * Hupunguza dalili za ugonjwa wa endometriosisi. * Hupunguza matukio ya kutukwa na damu mingi maumivu wakati wa kutoa yai, na vifuko vyenye maji vinavyofanya kazi katika ovari. * Hupunguza matukio ya mishtuko ya moyo katika wanawake walio na ugonjwa wa kifaduro. Zaidi ya hayo, tofauti na dawa nyingine za kukinga mimba zilizo na homoni, ufanisi wa utendakazi wa Depo-Provera hauathiriki na madawa ya yasiyo ya kifaduro yanayoshurutisha matukio cha kienizime. * Hupunguza matukio ya mabaya ya kiini mundu katika 0} wanawake wenye chembechembe za ugonjwa wa kiini mundu.<ref name="westhoff"></ref> Idara ya Afya Uingereza imechangia kikamilifu kukuzwa kwa matumizi ya dawa za kukinga mimba zenye kugeuzwa za kudumu kwa muda mrefu tangu mwaka wa 2008,hasa kwa vijana, kutokana na mwongoza bora wa Oktoba mwaka wa taasisi ya National Institute for Health and Clinical Excellence guidelines.<ref>{{cite web |title=CG30 Long-acting reversible contraception: quick reference guide |url=http://www.nice.org.uk/nicemedia/pdf/cg030quickrefguide.pdf |format=PDF |publisher=National Institute for Health and Clinical Excellence |accessdate=2009-06-19 |archiveurl=https://web.archive.org/web/20090920091647/http://www.nice.org.uk/nicemedia/pdf/cg030quickrefguide.pdf |archivedate=2009-09-20 |=https://web.archive.org/web/20090920091647/http://www.nice.org.uk/nicemedia/pdf/cg030quickrefguide.pdf }}</ref> Kutoa ushauri juu ya njia hizi za kuzuia mimba imewekwa kuwa katika {0 mfumo wa ubora na matokeo mwaka wa 2009 "matendo mema" kwa ajili ya afya ya kimsingi.{1/} ==Ujauzito na kunyonyesha== Depo Provera-inaweza kutumiwa na mama wanaonyonyesha. Kutokwa na damu nyingi inawezekana kama amepewa kipindi kinachofuata tu baada ya kuzaa na ni bora kuchelewa hadi wiki ya sita baada ya kuzaa. Inaweza kutumika katika siku tano kama hakuna kunyonyesha. utafiti ulionyesha "hakuna tofauti kubwa katika uzito wa kuzaliwa au matukio ya kasoro za kuzaliwa" na "hakuna ubadilishaji muhimu wa kinga mwili kwa magonjwa ya kuambukiza yanayosabibishwa na maziwa ya matiti yaliyo na DMPA", kikundi kidogo cha watoto ambao mama wao walianza kutumia Depo-Provera siku mbili baada ya kuzaa walikuwa na kiwango cha 75% juu cha kwenda kwa daktari kwa ajili ya magonjwa ya kuambukiza wakati wa mwaka wa kwanza wa maisha yao.<ref>{{cite journal |author=Dahlberg K |title=Some effects of depo-medroxyprogesterone acetate (DMPA): observations in the nursing infant and in the long-term user |url=https://archive.org/details/sim_international-journal-of-gynecology-obstetrics_1982-02_20_1/page/43 | journal = Int J Gynaecol Obstet | volume = 20 | issue = 1 |pages=43–8 |year=1982 | pmid = 6126406 | doi = 10.1016/0020-7292(82)90044-3}}</ref> Utafiti mkubwa wa muda mrefu na kufuatilia ulihitimisha kuwa "matumizi ya DMPA wakati wa ujauzito au kunyonyesha hayana athari kubwa kwa ukuaji wa muda mrefu na maendeleo ya watoto." Utafiti huu pia ulibainisha kuwa "watoto wenye mfiduo wa DMPA wakati wa ujauzito na kunyonyeshwa walikuwa na hatari ya uwezekano wa kupata urefu mdogo usio wa kawaida," lakini hiyo "baada ya marekebisho kwa sababu za kijamii na kiuchumi zinazosababishwa na kupunguka kwa mitindo mbalimbali, hakukuwa na kuongeza kwa hatari ya ukuaji wa utendaji miongoni mwa watoto ambao wamepapishwa kwa DMPA-. " Utafiti huo pia ulibainisha kuwa madhara ya mfiduo kwa DMPA wakati wa kubalehe yanahitaji utafiti zaidi, kwa hivyo watoto wachache wa umri wa miaka zaidi ya 10 walichunguzwa.<ref>{{cite journal |author=Pardthaisong T, Yenchit C, Gray R |title=The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation |url=https://archive.org/details/sim_contraception_1992-04_45_4/page/313 | journal = Contraception | volume = 45 | issue = 4 |pages=313–24 |year=1992 | pmid = 1387602 | doi = 10.1016/0010-7824(92)90053-V}}</ref> == Sababu za kutotumia == [[Shirika la Afya Duniani]] (WHO) ''Vigezo vya matumizi ya dawa za kukinga mimba'' na RCOG Kitivo cha kupanga Uzazi na Afya ya Uzazi (FFPRHC) '' Uingereza udaktari kriteria na vigezo vya matumizi ya dawa za kukinga mimba inaorodhesha zifauatazo kama hali pale ambapo matumizi ya Depo-Provera hayapendekezwi au hayapaswi kutumiwa kwa sababu ya hatari za kiafya zisizokublika au kwa sababu hatari haijaonyeshwa.<ref name="who mec">{{cite book |author=[[World Health Organization|WHO]] |year=2004 |chapter=Progestogen-only contraceptives |title=Medical Eligibility Criteria for Contraceptive Use |edition=3rd |location=Geneva |publisher=Reproductive Health and Research, WHO |isbn=92-4-156266-8 |chapterurl=http://www.who.int/reproductive-health/publications/mec/pocs.html}}</ref><ref name="ffprhc mec">{{cite web |author=[[Royal College of Obstetricians and Gynaecologists|FFPRHC]] |year=2006 |title=The UK Medical Eligibility Criteria for Contraceptive Use (2005/2006) |url=http://www.ffprhc.org.uk/admin/uploads/UKMEC200506.pdf |format=PDF |accessdate=2007-01-11 |archiveurl=https://web.archive.org/web/20090325034855/http://www.ffprhc.org.uk/admin/uploads/UKMEC200506.pdf |archivedate=2009-03-25 }}</ref> Hali ambazo hatari za kinadharia au zilizoshuhudiwa kwa kawaida huwa na manufaa zaidi kuliko matumizi ya Depo-Provera: * Hatari nyingi za ugonjwa wa mishipa ya ateri za moyo. * Hali ya sasa ya thrombosisi ya vena za ndani(DVT) au embolosi ya mapafu (PE) * Kuumwa kwa kichwa kwa uchungu sana na [[aura]] wakati wa matumizi ya Depo-Provera * Kabla ya tathmini isiyoeleweka ya uke kuvuja damu ambayo hushukiwa kuwa hali yenye hatari. * Historia ya Zamani ya kansa ya matiti na hakuna ushahidi wa sasa wa ugonjwa kwa muda wa miaka * Ugonjwa wa ini (hepatitisi ya virusi, sirosisisi kali ya kuoza, [[benigni]] au {4uvimbe wa ini wa kudhuru. * Hali ya wasiwasi ya athari za estrogeni ya kiwango cha juu na kupunguzwa kwa viwango vya HDL kinadharia kuongeza hatari ya majonjwa ya mishipa ya moyo: ** Presha na ugonjwa wa vaskula ** historia ya sasa na ya zamani ya }ugonjwa wa moyo iwa iskemiki ** Historia ya [[Kiharusi|ugonjwa wa pigo]] ** Ugonjwa wa kisukari kwa miaka 20 au mwenye neforopathi / retinopathi / neuropathi au ugonjwa wa mishipa} Hali ambazo zinawasilisha madhara ya kiafya yasiyokubalika kama depo provera ina tumika: * Hali ya sasa au ya hivi karibuni ya saratani ya matiti (uvimbe nyeti unaosisimuliwa na homoni) Hali ambazo matumizi ya Depo-Provera hayajaonyeshwa na ni lazima yasianzishwe: * Ujauzito == Hasara na madhara == ===Maonyo na tahadhari=== * Inachukua wiki mbili kuleta athari kama itachukuliwa baada ya siku za kwanza tano za mzunguko wa kipindi. Ufanisi mara moja kama inachukuliwa wakati wa siku tano za kwanza za mzunguko wa kipindi. * Haitoi kinga dhidi ya magonjwa ya [[Maradhi ya zinaa]] (STD). * Depo-Provera unaweza kuathiri uhedhi wa damu. Baada ya mwaka wa matumizi, 55% ya wanawake hupata amenorrhoea, baada ya miaka 2, kiwango huongezeka kwa 68%. Katika miezi ya kwanza ya matumizi "kutoka damu au madoadoa ya ya damu ambayo si ya kawaida na yasiyotabirika, au mara chache, au kutokwa na damu nyingi huendelea" iliripotiwa.<ref name="depo us patient info">{{cite web |author=[[Pfizer]] |month=Oktoba |year=2004 |title=Depo-Provera Contraceptive Injection, US patient labeling |url=http://www.pfizer.com/pfizer/download/ppi_depo_provera_contraceptive.pdf |format=PDF |accessdate=2007-02-21 |archivedate=2007-02-06 |archiveurl=https://web.archive.org/web/20070206044043/http://www.pfizer.com/pfizer/download/ppi_depo_provera_contraceptive.pdf |=https://web.archive.org/web/20070206044043/http://www.pfizer.com/pfizer/download/ppi_depo_provera_contraceptive.pdf }}</ref> * Kuchelewa kurudi kwa uzazi. kiwango wastani cha kurudi kwa uzazi ni miezi 9-10 baada ya kudungwa sindano mara ya mwisho. Kwa muda wa miezi 18 baada ya kudungwa sindano ya mwisho, uzazi ni sawa na ile ya watumiaji wa zamani wa njia nyingine za kukinga mimba.<ref name="hatcher"></ref><ref name="speroff"></ref> * Masomo ya muda mrefu ya watumiaji wa Depo-Provera yamegundua athari ndogo au hakuna hakuna kuongeza hatari ya saratani ya matiti kwa ujumla. Hata hivyo, idadi ya watu walioshiriki katika utafiti ilionyesha kuongezeka kwa hatari ya saratani ya matiti kidogo kwa watumiaji wa hivi karibuni (matumizi ya Depo katika miaka minne iliyopita) chini ya miaka 35, sawa na ile iliyoonekana kwa matumizi ya pamoja ya kunywa vidonge kama njia ya kukinga mimba.<ref name="depo us patient info"></ref> * Utafiti wa mimba isiyotarajiwa miongoni mwa wanawake ,askini wa Thailand ulipata kwamba watoto ambao walikuwa namfiduo ya Depo-Provera wakati wa ujauzito walikuwa na hatari kubwa ya uzito wa chini wa kuzaliwa na 80% nafasi ya zaidi-kuliko-kawaida kufa katika mwaka wa kwanza wa maisha.<ref>{{cite journal |author=|title=Exposure to DMPA in pregnancy may cause low birth weight | journal = Prog Hum Reprod Res | volume = | issue =23 |pages=2–3 | year=1992 | pmid = 12286194}}</ref> ==== Onyo muhimu ==== Ingawa kwa muda mrefu imekujulikana kuwa Depo-Provera husababisha upoteaji mifupa, hivi karibuni imegunduliwa kwamba athari za osteoporotiki ya sindano hukua zaidi kwa muda mrefu wakati Depo Provera inatumiwa kwa muda mrefu, inaweza kukaa kwa muda mrefu baada ya sindano kusimamishwa, au inaweza pia kutorudi katika hali ya awali. Kwa sababu hizi, tarehe 17 Novemba 2004 shirika la utawala la Marekani la Chakula na Dawa na PFIZER walikubaliana kuweka onyo muhimu juu ya label ya Provera.<ref name="FDA2004-Warning">{{cite web | author=FDA | authorlink = Food and Drug Administration |year=2004 | month =17 Novemba | url =http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01325.html | title =Black Box Warning Added Concerning Long-Term Use of Depo-Provera Contraceptive Injection | accessdate =2006-05-12}}</ref> Hata hivyo, [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] (WHO)linashauri kwamba matumizi ya Depo-Provera hayapaswi kukatazwa.<ref name="WHO2005">{{cite web | author=World Health Organization | authorlink =World Health Organization |year=2005 | month =Septemba | url =http://www.who.int/reproductive-health/family_planning/bone_health.html | title =Hormonal contraception and bone health | work =Family Planning | accessdate =2006-05-12}}</ref><ref name="Contraception2006-Curtis">{{cite journal | author=Curtis KM, Martins SL | title=Progestogen-only contraception and bone mineral density: a systematic review | url=https://archive.org/details/sim_contraception_2006-05_73_5/page/470 | journal=Contraception | year=2006 | pages=470–87 | volume=73 | issue=5 | pmid=16627031 | doi=10.1016/j.contraception.2005.12.010}}</ref> Haijulikani wazi iwapo kupoteza kwa uzitolinganifu wa mfupa unahusishwa na matumizi ya Depo-Provera unaweza kurudishwa katika hali ya kawaida, na kama ndivyo, kiasi gani hasa. Uchunguzi tatu umependekeza kuwa hasara ya mfupa yaweza kurekebishwa baada ya kukomesha matumizi ya Depo-Provera.<ref>{{cite journal |author=Cundy T, Cornish J, Evans M, Roberts H, Reid I |title=Recovery of bone density in women who stop using medroxyprogesterone acetate | journal = BMJ | volume = 308 | issue = 6923 |pages=247–8 |year=1994 | pmid = 8111260 |pmc=2539337}}</ref><ref name="Scholes2002">{{cite journal | author=Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM | title=Injectable hormone contraception and bone density: results from a prospective study | journal=Epidemiology | year=2002 | pages=581–7 | volume=13 | issue=5 | pmid=12192229 | doi=10.1097/00001648-200209000-00015}}</ref><ref name="Scholes2005">{{cite journal | author=Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM | title=Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception | journal=Arch Pediatr Adolesc Med | year=2005 | pages=139–44 | volume=159 | issue=2 | pmid=15699307 | doi=10.1001/archpedi.159.2.139}}</ref> Uchunguzi mwingine umependekeza kuwa athari za matumizi ya miaka ya mwakamke aliyeacha kuzaa hasa upoteaji wa uzitolinganifu wa mfupa ni ndogo,<ref>{{cite journal |author=Orr-Walker B, Evans M, Ames R, Clearwater J, Cundy T, Reid I |title=The effect of past use of the injectable contraceptive depot medroxyprogesterone acetate on bone mineral density in normal post-menopausal women |url=https://archive.org/details/sim_clinical-endocrinology_1998-11_49_5/page/615 | journal = Clin Endocrinol (Oxf) | volume = 49 | issue = 5 |pages=615–8 |year=1998 | pmid = 10197077 | doi = 10.1046/j.1365-2265.1998.00582.x}}</ref> labda kwa sababu watumiaji wa Depo hudhihirisha hasara ya chini ya mfupa katika miaka yao ikiwa wamemaliza kuzaa.<ref>{{cite journal |author=Cundy T, Cornish J, Roberts H, Reid I |title=Menopausal bone loss in long-term users of depot medroxyprogesterone acetate contraception |url=https://archive.org/details/sim_american-journal-of-obstetrics-and-gynecology_2002-05_186_5/page/978 | journal = Am J Obstet Gynecol | volume = 186 | issue = 5 |pages=978–83 |year=2002 | pmid = 12015524 | doi = 10.1067/mob.2002.122420}}</ref> Matumizi baada ya kilele cha molekuli wa mifupa huhusishwa na kuongeza kwa matokeo ya mifupa lakini hakuna upungufu katika wiani wa madini ya mifupa.<ref>{{cite journal |author=Walsh JS, Eastell R, Peel NF |title=Depot medroxyprogesterone acetate use after peak bone mass is associated with increased bone turnover but no decrease in bone mineral density |journal=Fertil. Steril. |volume= 93|issue= 3|pages= 697–701|year=2008 |month=Novemba |pmid=19013564 |doi=10.1016/j.fertnstert.2008.10.004 |url=}}</ref> Hata hivyo, kufikia mwaka wa 2006, hakuna utafiti ambao umechunguza hatari ya mifupa ya ndani moja kwa moja kwa wanawake ambao wamemaliza umri wa kuzaa ambao wametumia Depo-Provera, kwa hiyo, hatari haijulikani. PFIZER na FDA wamependekeza kwamba Depo-Provera isitumiwe kwa zaidi ya miaka miwili, isipokuwa kama hakuna njia mbadala ya kupanga uzazi, kutokana na wasiwasi juu ya kupoteza mifupa.<ref name="FDA2004-Warning"></ref> Hata hivyo, Kamati ya mwaka wa 2008 kuhusu pendekezo kutoka kwa Kamati ya Madaktari wa Ukunga na Magonjwa ya Wanawake ya Marekani (ACOG) walishauri watoa huduma ya afya kuhusu kupoteza kwa wiani wa madini madini wiani lazima au komesha kupewa au muendelezo wa depo Provera-zaidi ya miaka 2 ya kutumia.<ref name="pmid18757687">{{Cite pmid|18757687}}</ref> ===Madhara=== Katika majaribio makubwa ya kimatibabu ya Depo-Provera, madhara yenye athari sana yaliyoripotiwa mara nyingi (ambayo yanaweza au ikutoweza kuhusishwa na matumizi ya Depo-Provera) yalikuwa: kutokuwa na mpangilio mwafaka kuhusu hedhi (damu au kukosa hedhi kabisa- amenorrhea), maumivu au usumbufu wa tumbo , mabadiliko ya uzito, kuumwa na kichwa, asthenia (udhaifu au uchovu), na woga. Mengine, madahara yenye athari ndogo ambayo hayakuripotiwa mara kwa mara yameanishwa katika karatasi ya maelezo ya mtumizi na daktari habari kwa ajili ya Depo-Provera.<ref name="depo us patient info"></ref><ref name="depo us physician info">{{cite web |author=[[Pfizer]] |month=Novemba |year=2004 |title=Depo-Provera Contraceptive Injection, US physician information |url=http://www.pfizer.com/pfizer/download/uspi_depo_provera_contraceptive.pdf |format=PDF |accessdate=2007-02-21 |archivedate=2007-02-08 |archiveurl=https://web.archive.org/web/20070208112513/http://www.pfizer.com/pfizer/download/uspi_depo_provera_contraceptive.pdf }}</ref> ===Tafiti zinazohusiana=== * Utafiti wa wanawake 819 katika mji mmoja uligundua uhusiano baina ya matumizi ya Depo-Provera na matukio ya juu ya [[Klamidia]] na [[Kisonono|ugonjwa wa kisonono.]]<ref name="SexTransmDis2004-Morrison">{{cite journal | author=Morrison CS, Bright P, Wong EL, Kwok C, Yacobson I, Gaydos CA, Tucker HT, Blumenthal PD | title=Hormonal contraceptive use, cervical ectopy, and the acquisition of cervical infections | url=https://archive.org/details/sim_sexually-transmitted-diseases_2004-09_31_9/page/561 | journal=Sex Transm Dis | year=2004 | pages=561–7 | volume=31 | issue=9 | pmid=15480119 | doi=10.1097/01.olq.0000137904.56037.70}}</ref> Uchunguzi wa pili ulotazamiwa katika wanawake 948 nchini Kenya ulitambua matumizi ya Depo-Provera yalihusishwa na viwango vikubwa vya maambukizi klamadia, lakini viwango vya chini vya ugonjwa wa kuwasha wa mfupa wa kifandugu, ikilinganishwa na wanawake ambao hawatumii njia za kupanga wa uzazi.<ref>{{cite journal |author=Baeten J, Nyange P, Richardson B, Lavreys L, Chohan B, Martin H, Mandaliya K, Ndinya-Achola J, Bwayo J, Kreiss J |title=Hormonal contraception and risk of sexually transmitted disease acquisition: results from a prospective study |url=https://archive.org/details/sim_american-journal-of-obstetrics-and-gynecology_2001-08_185_2/page/380 | journal = Am J Obstet Gynecol | volume = 185 | issue = 2 |pages=380–5 |year=2001 | pmid = 11518896 | doi = 10.1067/mob.2001.115862}}</ref> * Masomo ya wanyama wenye familia ya wanyama ya medroxyprogesterone yamapendekeza inaweza kuongeza hatari ya maambukizi ya virusi vya simian (SIV), mfano wa HIV YA wanyama<ref>{{cite journal |author=Preston A. Marx, ''et al.'' |title=Progesterone implants enhance SIV vaginal transmission and early virus load | journal = Nature Medicine | volume = 2| issue =10 |pages=1084–9 | year=1996 | pmid = 8837605 | doi = 10.1038/nm1096-1084}}</ref><ref>{{cite journal|author=Trunova N et al.|title=Progestin-based contraceptive suppresses cellular immune responses in SHIV-infected rhesus macaques|journal=Virology|year=2006|volume=352|issue=1|page=169–77|pmid=16730772|pages=169|doi=10.1016/j.virol.2006.04.004}}</ref> Angalau uchunguzi mmoja katika binadamu umependekeza kiwango cha juu cha ongezeko la virusi vya ukimwi katika watumiaji wa Depo-Provera,<ref>{{cite journal |author=Martin H, Nyange P, Richardson B, Lavreys L, Mandaliya K, Jackson D, Ndinya-Achola J, Kreiss J |title=Hormonal contraception, sexually transmitted diseases, and risk of heterosexual transmission of human immunodeficiency virus type 1 |url=https://archive.org/details/sim_journal-of-infectious-diseases_1998-10_178_4/page/1053 | journal = J Infect Dis | volume = 178 | issue = 4 |pages=1053–9 |year=1998 | pmid = 9806034 | doi = 10.1086/515654}}</ref> huku idadi nyingine ya masomo imetambua kwamba hakuna uhusiano kama huu.<ref>{{cite journal |author=Bulterys M, Chao A, Habimana P, Dushimimana A, Nawrocki P, Saah A |title=Incident HIV-1 infection in a cohort of young women in Butare, Rwanda | journal = AIDS | volume = 8 | issue = 11 |pages=1585–91 |year=1994 | pmid = 7848595 | doi = 10.1097/00002030-199411000-00010}}</ref><ref>{{cite journal |author=Kiddugavu M, Makumbi F, Wawer M, Serwadda D, Sewankambo N, Wabwire-Mangen F, Lutalo T, Meehan M, Gray R |title=Hormonal contraceptive use and HIV-1 infection in a population-based cohort in Rakai, Uganda | journal = AIDS | volume = 17 | issue = 2 |pages=233–40 |year=2003 | pmid = 12545084 | doi = 10.1097/00002030-200301240-00014}}</ref><ref>{{cite journal |author=|title=Prospective study of hormonal contraception and women's risk of HIV infection in South Africa |url=https://archive.org/details/sim_international-journal-of-epidemiology_2007-02_36_1/page/166| journal = Int J Epidemiol | volume = 36| issue = 1|pages=166–74|year=2007| pmid = 17175547 |last1=Myer |first1=L |last2=Denny |first2=L |last3=Wright |first3=TC |last4=Kuhn |first4=L |doi=10.1093/ije/dyl251}}</ref> Idadi kubwa ya majaribio ya klinki yaliyotarajiwa kushughulikia swala hili la Depo-Provera na uwezekana wa kupata HIV yanaendelea sasa.<ref>{{cite journal |author=Morrison C, Richardson B, Celentano D, Chipato T, Mmiro F, Mugerwa R, [[Nancy Padian|Padian N]], Rugpao S, Salata R |title=Prospective clinical trials designed to assess the use of hormonal contraceptives and risk of HIV acquisition | journal = J Acquir Immune Defic Syndr | volume = 38 Suppl 1 | issue = |pages=S17–8 |year=2005| pmid = 15867602}}</ref> == Matumizi mengine == Depo Provera- pia hutumiwa na wahalifu wa kingono wa kiume kama aina ya kutoa mapumbu ya kemikali kwani ina athari ya kubwa kabisa kupunguza ari ya miongoni mwa wanaume.<ref>{{cite web | url = http://archive.salon.com/health/feature/2000/03/01/castration/ | title = The chemical knife | accessdate = 2009-01-22 | archiveurl = https://web.archive.org/web/20090107134347/http://archive.salon.com/health/feature/2000/03/01/castration/ | archivedate = 2009-01-07 | = https://web.archive.org/web/20090107134347/http://archive.salon.com/health/feature/2000/03/01/castration/ }}</ref> ==Utata juu ya idhini ya Depo-Provera nchini Marekani== Kulikuwa kwa muda mrefu, historia ya utata kuhusu idhini ya Depo-Provera na shirika tawala la Chakula na Dawa Marekani. Mtengenezaji asilia, Upjohn, aliandika mara kadhaa ili kupata idhini. Kamati ya ushauri ya FDA kwa umoja ilipendekeza kupitishwa katika 1973, 1975 na 1992, kama walivyofanya wafanyikazi wenye taaluma ya udaktari wa FDA, lakini FDA iliendelea kukataa kutoa kibali. Hatimaye, tarehe 29 Oktoba 1992,FDA ilipitisha Depo-Provera, ambayo ilikuwa kwisha tumiwa na wanawake zaidi ya milioni 30 tangu mwaka wa 1969 iliidhinishawa na ilikuwa natumiwa na karibu ya milioni 9 karibu katika nchi zaidi ya 90, ikiwa ni pamoja na [[Ufalme wa Muungano]], [[Ufaransa]], [[Ujerumani]], [[Uswisi]], [[Uthai]], [[New Zealand]] na [[Indonesia]].<ref>{{cite journal |author=Leary, Warren E. |month=30 Oktoba, |year=1992 |title=U.S. Approves Injectable Drug As Birth Control |journal=[[The New York Times]] |url=http://query.nytimes.com/gst/fullpage.html?sec=health&res=9E0CE1DD123BF933A05753C1A964958260 |pmid=11646958 | pages=A.1}}</ref> Sehemu za utata zilijumuisha: * wanyama waliopimwa kwa kasinogeni Depo-Provera ilisababisha uvimbe wa saratani ya matiti katika mbwa. Wakosoaji wa utafiti huo walidai kuwa mbwa huhisi zaidi kwa progestoroni ya kuumbwa au bandia, na kwamba vipimo vilikuwa juu sana kwa kupewa kwa binadamu. FDA ilisema kuwa kila dutu zenye kasinogeni kwa binadamu ni zenye kasinogeni kwa wanyama pia, na kama kitu si chenye kasinogeni haijiandikisha kama kasinojeni kwa viwango vya juu. Viwango vya Depo-Provera ambayo vilisababishwa uvimbe vya mbaya kwenye sehemu za kunyonyesha katika mbwa vilikuwa sawa kufikia mara 25kiwango cha kawaida cha awamu ya luteali kiwango cha progesteroni kwa ajili ya mbwa. (Ambayo ni kiwango cha chini zaidi kuliko kiwango cha chunu cha mimba cha projesteroni kwa ajili ya mbwa, na ni aina maalum.)[http://www.inchem.org/documents/iarc/suppl7/progestins.html ]<br>Depo-Provera inasababishwa saratani ya endometriali katika nyani -2 ya tumbili 12 walifanyiwa majaribio,kisa cha kwanza cha kanza ya endometriali kilikuwa katika aina ya nyani inayojulkana kama nyani aina ya Rhesus<ref name="MM_Goodman1985">{{Rejea jarida | author=Amy Goodman | title=The Case Against Depo-Provera - Problems in the U.S | journal=Multinational Monitor | year=1985 | month=Februari/Machi | volume=Volume 6 | issue=Numbers 2 & 3 | url=http://www.multinationalmonitor.org/hyper/issues/1985/02/problems-us.html | archive-date=2006-10-03 | access-date=2010-11-06 | archive-url=https://web.archive.org/web/20061003000448/http://www.multinationalmonitor.org/hyper/issues/1985/02/problems-us.html | url-status=dead }}</ref> Hata hivyo, utafiti uliofuata umeonyesha kwamba katika binadamu, Depo-Provera kweli ''hupunguza'' hatari ya kansa ya endometriali kwa karibu 80%.<ref name="Kaunitz"></ref><ref name="BrJFP_Bigrigg1999"></ref><ref name="WHO DMPA EC"></ref><br>Akizungumza katika kulinganisha suala kuhusu masomo ya wanyama ya kasinogeni kwa madawa, mwanachama wa Ofisi ya FDA idara ya alitoa ushahidi katika shirika la Depo, "...data ya wanyama kuhusu dawa hii inatia wasiwasi mno kuliko dawa nyingine yoyote tunajua kupewa kwa watu wenye afya nzuri. " * Saratani ya seviksi katika uchunguzi wa Upjohn /na NCI. Saratani ya seviksi ikana kuongezeka zaidi juu kama 9- katika utafiti wa binadamu wa kwanza ilirekodiwa na mtengenezaji na Taasisi ya Kitaifa ya Saratani <ref>{{cite journal |author=|title=Controversy over Depo-Provera | journal = Wash Drug Device Lett | volume = 9 | issue = 1 |pages=2 |year=1977 | pmid = 12335988}}</ref> Hata hivyo, tafiti mbalimbali kubwa iliyofuata umeonyesha kuwa matumizi ya Depo-Provera haingezi hatari ya kansa ya kizazi.<ref>{{cite journal |author=Thomas D, Ye Z, Ray R |title=Cervical carcinoma in situ and use of depot-medroxyprogesterone acetate (DMPA). WHO Collaborative Study of Neoplasia and Steroid Contraceptives |url=https://archive.org/details/sim_contraception_1995-01_51_1/page/25 | journal = Contraception | volume = 51 | issue = 1 |pages=25–31 |year=1995 | pmid = 7750280 | doi = 10.1016/0010-7824(94)00007-J}}</ref><ref>{{cite journal |author=The Who Collaborative Study Of Neop,|title=Depot-medroxyprogesterone acetate (DMPA) and risk of invasive squamous cell cervical cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives |url=https://archive.org/details/sim_contraception_1992-04_45_4/page/299| journal = Contraception | volume = 45 | issue = 4 |pages=299–312 |year=1992 | pmid = 1387601 | doi = 10.1016/0010-7824(92)90052-U}}</ref><ref>{{cite journal |author=Thomas D, Ray R |title=Depot-medroxyprogesterone acetate (DMPA) and risk of invasive adenocarcinomas and adenosquamous carcinomas of the uterine cervix. WHO Collaborative Study of Neoplasia and Steroid Contraceptives |url=https://archive.org/details/sim_contraception_1995-11_52_5/page/307 | journal = Contraception | volume = 52 | issue = 5 |pages=307–12 |year=1995 | pmid = 8585888 | doi = 10.1016/0010-7824(95)00215-V}}</ref><ref>{{cite journal |author=Shapiro S, Rosenberg L, Hoffman M, Kelly J, Cooper D, Carrara H, Denny L, du Toit G, Allan B, Stander I, Williamson A |title=Risk of invasive cancer of the cervix in relation to the use of injectable progestogen contraceptives and combined estrogen/progestogen oral contraceptives (South Africa) | journal = Cancer Causes Control | volume = 14 | issue = 5 |pages=485–95 |year=2003 | pmid = 12946044 | doi = 10.1023/A:1024910808307}}</ref><ref>{{cite journal |author=Kaunitz A |title=Depot medroxyprogesterone acetate contraception and the risk of breast and gynecologic cancer | journal = J Reprod Med | volume = 41 | issue = 5 Suppl |pages=419–27 |year=1996 | pmid = 8725705}}</ref> * Kutumia nguvu na ukosefu wa kibali cha kutoa habari. Kupima matumizi / ya Depo yalishughulikiwa kwa wanawake pekee katika nchi zinazoendelea na wanawake maskini nchini Marekani,<ref name="albion">{{cite web|author=Karen Hawkins, Jeff Elliott|title=Seeking Approval|publisher=Albion Monitor|date=1996-05-05|accessdate=2006-11-20|url=http://www.monitor.net/monitor/controlled/bc-depohearing.html|archiveurl=https://web.archive.org/web/20151121180041/http://www.monitor.net/monitor/controlled/bc-depohearing.html|archivedate=2015-11-21|=https://web.archive.org/web/20151121180041/http://www.monitor.net/monitor/controlled/bc-depohearing.html}}</ref> iliibua maswali makubwa juu ya kutumia nguvu na ukosefu wa kukubali habari, hasa kwa kwa wale ambao hawajui hawajui kusoma na kuandika<ref>{{cite journal |author=|title=Sterilization of minors leads to controversy | journal = JOICFP Rev | volume = 2 | issue = 4 |pages=77–8 |year=1973 | pmid = 12257656}}</ref> na kwa wale wenye changamoto za kiakili, ambao waliripoti kuwa walipewa Depo kwa muda mrefu kwa sababu ya "usafi wa hedhi"", licha ya ukweli kwamba hawakuwa washiriki tendi katika ngono.<ref>{{cite journal |author=Egan T, Siegert R, Fairley N |title=Use of hormonal contraceptives in an institutional setting: reasons for use, consent and safety in women with psychiatric and intellectual disabilities | journal = N Z Med J | volume = 106 | issue = 961 |pages=338–41 |year=1993 | pmid = 8341476}}</ref> * Uchunguzi wa Atlanta / Grady. Upjohn alichunguza athari ya Depo kwa miaka kumi na moja huko Atlanta, hasa kwa wanawake wenye asili ya Kiafrika waliokuwa wakipata msaada wa umma, lakini hakuweka rekodi zozote za ufuatilizi zilizohitajika na FDA. hatimaye Wachunguzi ambao walitembelea eneo hilo walibainisha kuwa tafiti zikosa mpangilio. "Waligundua kwamba ukusanyaji wa data ulikuwa na dosari, fomu za kukubali na itifaki hazikuwepo vilevile isitoshe kwa vale wanawake ambao walikubali kuchunguzwa hawakuelezwa athari zinazoweza kutokea. Wanawake ambao hali zao aya zilionyesha kwamba matumizi ya Depo yangehatarisha afya zao walidungwa sindano hii. wanawake kadhaa katika uchunguzi huo walifariki, wengine kutokana na saratani lakini wengine kutokana na sababu zingine kama vile kujinyonga kutoka na unyogovu. Zaidi ya nusu ya wanawake elfu 13 katika uchunguzi hawkuweza kufuatiliwa kutokana na uwekaji rekodi dhaifu." Hivyo, hakuna data katika uchunguzi huu iliyoweza kutumika. * Tahakiki ya Shirika la Afya Duniani WHO. Katika mwaka wa 1992, shirika la WHO liliwasilisha tahakiki za Depo katika nchi nne zinazoendelea kwa FDA. Shirika la Kitaifa la Afya ya Wanawake pamoja na mashirika mengine ya wanwake yalitoa ushahidi katika mkutano huo kwamba Shirika la WHO halikuwa na uyakini, Kwani tayari lilikuwa limesambaza Depo-Provera katika nchi zinazoendelea. Depo ilipitishwa kwa matumizi Marekani sababu ikiwa ni kutokana na tahakiki ya Shirika la WHO ambalo liliwasilisha ushahidi wa awali kutoka nchi kama vile Thailandi, ushahidi ambayo FDA ilidhamiria kwamba haukutosheleza na haukuwa umepangangwa kwa ajili ya tathmini ya hatari kansa ya saa katika mkutano huo wa awali.Taasisi ya Alan Guttmacher inadhania kwamba kuidhinisha kwa Marekani kwa Depo kunaweza kuongeza kupatikana na kukubalika kwake katika nchini zinazoendelea.[http://www.monitor.net/monitor/controlled/bc-depohearing.html ] {{Wayback|url=http://www.monitor.net/monitor/controlled/bc-depohearing.html |date=20151121180041 }}<ref>{{cite journal |author=Singh S |title=Adolescent knowledge and use of injectable contraceptives in developing countries |url=https://archive.org/details/sim_journal-of-adolescent-health_1995-05_16_5/page/396 | journal = J Adolesc Health | volume = 16 | issue = 5 |pages=396–404 |year=1995 | pmid = 7662691 | doi = 10.1016/S1054-139X(94)00060-R}}</ref> ===Matokeo ya baadaye=== * Mnamo Mwaka wa 1995, makundi kadhaa ya afya ya wanawake yaliomba FDA kusimamisha kwa muda matumizi ya Depo-Provera, na kuanzisha fomu zilizosawazishwa za kuomba idhini ya uchunguzi. * Mmoja kwa vijana watano wenye asili ya Kiafrika wanaotumia njia za kupanga uzazi Marekani wanatumia Depo-Provera, kiwango cha juu cha matumizi kuliko vijana wenye asili ya kizungu. Mwanaharakati mmoja, Dorothy Roberts, anadai kuwa sababu ni kwamba vijana wenye asili ya Kiafrika wanalengwa kwa namna isiyo sawa kwa njia zisizo salama za kupanga uzazi. ==Mgogoro nje ya Marekani== * Katika mwaka wa 1994, wakati Depo iliidhinishwa huko India, Gazeti la India la Economic and Political Weekly liliripoti kwamba "FDA hatimaye iliidhinisha Depo Provera kutokana na wasiwasi wa idadi ya juu ya watu katika mataifa yanayoendelea na kutotaka kwa serikali za nchi zinazoendelea kutoa leseni kwa dawa ambayo haijakubalika katika nchi ilipotengenezewa." <ref>{{cite journal|title=Contraceptives. Case for public enquiry|url=https://archive.org/details/economic-political-weekly_1994-04-09_29_15/page/825|journal=Economic and Political Weekly|year=1994|volume=29|issue=15|id=Popline database document number 096527|pages=825–6}}</ref> Baadhi ya wanasayansi na wa makundi ya wanawake huko India yanaendelea kupinga matumizi ya Depo-Provera. Mnamo mwaka wa 2002, Depo iliondolewa katika itifaki ya dawa za kupanga uzazi kule India. * Muungano wa Kanada kuhusu Depo-Provera, yaani muungano wa wataalamu wa afya ya wanawake na makundi ya utetezi, yalipinga kuidhinishwa kwa matumizi ya Depo-Provera nchini humo. Tangu kuidhinishwa kwa Depo nchini Kanada mwaka wa 1997, kesi ya dola milioni$700 ilipelekwa kortini dhidi PFIZER na watumiaji wa Depo ambao walanza kuwa na ugonjwa wa mifupa kuwa nyepesi na kuvunjika kwa urahisi osteoporosisi. PFIZER ilijibu kwamba alikuwa imetimiza matakwa yake kwa kufichua na kueleza athari za matumizi ya Depo-Provera na Jamii ya Wauguzi wa Canada. ==Marejeo == * {{Marejeo|colwidth=30em}} ==Viungo vya nje== * [http://www.depoprovera.com Tovuti rasmi ya PFIZER ] {{Wayback|url=http://www.depoprovera.com/ |date=20120307131939 }} * [http://www.fhi.org/en/topics/injectables Utafiti juu ya njia za kupanga uzazi za kudungwa sindano] - Shirika la kimataifa la Afya ya Familia Family Health International kweli maelezo kuhusu kudungwa sindano ikiwemo Depo-Provera. [[Category:uzazi]] [[Category:Madawa]] id6gmj6lg2pqhxojc5t41rr6k8wip0g 0 55553 1578165 1564471 2026-07-02T23:01:24Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578165 wikitext text/x-wiki {{tafsiri kompyuta}} '''Utegemezi wa dawa za kulevya''' unafafanuliwa kama ifuatavyo: : :: ''"Wakati mtu anaposhiriki katika matumizi ya [[pombe]] au [[dawa]] nyinginezo, licha ya matatizo yanayohusiana na matumizi ya [[kileo]] hicho, utegemezi wa kileo unaweza kuaguliwa.'' ''Matumizi ya kimazoea na ya kila mara huweza kusababisha [[uraibu]] athari za dawa na [[dalili]] za kuacha wakati matumizi yanapopunguzwa au kukomeshwa.'' ''Haya, pamoja na matumizi mabaya ya vileo hujumuishwa kama matatizo ya utumiaji bidhaa za kulevya..."'' <ref name="DSM4">{{Rejea tovuti |url=http://www.behavenet.com/capsules/disorders/subdep.htm |title=DSM-IV & DSM-IV-TR: Utegemezi wa Vilewevu |accessdate=2010-11-06 |archivedate=2011-09-27 |archiveurl=https://web.archive.org/web/20110927024534/http://www.behavenet.com/capsules/disorders/subdep.htm }}</ref> Utegemezi wa dawa za kulevya unaweza kutambuliwa kwa utegemezi wa kimwili, ushahidi wa kuzoea au kuacha, au bila utegemezi wa kimwili. Dhana ya utegemeaji wa dawa za kulevya ina fafanuzi nyingi tofauti. Baadhi ya waandishi hutoa maana sawa kwa dawa za kulevya na utegemeaji wa vileo, wengine kwa mfano hutoa ufafanuzi finyu kwa dawa za kulevya ambao hutenga dawa zisizo na ushahidi wa kuzoeleka au dalili za kuacha. ==Ufafanuzi== Utegemezi wa dawa za kulevya ni hali ya kuugua au isiyo ya kawaida ambayo hutokana na matumizi ya dawa ya mara kwa mara. Tatizo la dawa za kulevya linahusisha uendelezaji matumizi sugu ya dawa hadi kufikia tabia ya kutafuta dawa za kulevya, kuwa katika hatari ya kurejelea matumizi na upungufu wa uwezo wa kukabiliana na visisimuaji vya kuridhisha kwa kawaida. Mwongozo wa Utambuzi na Takwimu ya Matatizo ya Akili (DSM-IV) imebainisha hatua tatu za utegemezi wa dawa za kulevya: kujihusisha/kutarajia, unywaji/ulevi, na kuacha/athari mbaya. Sifa za hatua hizi hudhihirika mtawalia, kila mahali, kwa utashi wa mara kwa mara na ujihusishaji na kutafuta vileo; matumizi zaidi ya vileo kuliko inavyohitajika kufikia madhara ya kulevya, na kufikia uraibu, dalili za kujiondoa na upungufu wa motisha kwa shughuli za kawaida za kimaisha.<ref name="Koob and Kreek">{{cite journal |author=Boob G, Kreek MJ |title=Stress, dysregulation of drug reward pathways, and the transition to drug dependence |url=https://archive.org/details/sim_american-journal-of-psychiatry_2007-08_164_8/page/1149 |journal=Am J Psychiatry |volume=164 |issue=8 |pages=1149–59 |year=2007 |pmid=17671276 |doi=10.1176/appi.ajp.2007.05030503 |pmc=2837343}}</ref> Kulingana na ufafanuzi wa Shirika la Marekani la Tiba za Ulevi, utegemezi wa dawa za kulevya hutofautianana utegemeaji wa dawana uzoevu wa dawa za kulevya.<ref name="painmed">[http://www.painmed.org/pdf/definition.pdf 2001 "Fafanuzi kuhusiana na Matumizi ya Opioidi kwa Kutibu ya Maumivu,"] {{Wayback|url=http://www.painmed.org/pdf/definition.pdf |date=20100601093354 }} , Chuo cha Marekani cha Tiba ya Maumivu, Chama cha Maumivu cha Marekani, na Chama cha Marekani cha Dawa za Kulevya</ref> Ni jambo la kawaida kabisa kati ya [[wanasayansi]] na [[waandishi]] wengine, kuruhusu dhana ya matumizi ya dawa za kulevya kujumuisha watu ambao si watumiaji dawa za kulevya, kulingana na ufafanuzi wa Shirika la Marekani la Tiba za Ulevi. Neno utegemezi wa dawa za kulevya hatimaye hutumika kama kategoria ambayo inaweza kujumuisha wale watu ambao, chini ya DSM-IV, wanaweza kutambuliwa kama wategemezi wa vileo au watumiaji wa vileo hivi vibaya. (Tazama pia DSM-IV codes) ''Istilahi matumizi mabaya'' na ''uraibu wa dawa za kulevya'' zimeweza kufafanuliwa tena na tena kwa miaka mingi. Kamati ya Wataalamu wa Shirika la Afya Duniani ya 1957 [[Shirika la Afya Duniani]] (WHO) kuhusu dawa zinazosababisha utegemeaji wa kulevya walifafanua-utegemezi kwa vileo na uzoevu kama sehemu ya matumizi mabaya ya dawa za kulevya: <blockquote>''Matumizi ya dawa za kulevya'' ''ni hali ya ulevi wa muda au wa kila mara unaotokana na matumizi ya mara kwa mara ya dawa (asili au sanisi).'' ''Sifa zake ni pamoja na: (i) utashi mkubwa au uhitaji (wa kimazoea) wa kuendelea kutumia dawa ya kulevya na kuitafuta kwa njia yoyote ile; (ii) tabia ya kuongeza kiwango, (iii) utegemeaji wa kiakili (kisaikolojia) na wa kimwili kwa jumla kwa athari za dawa za kulevya, na (iv) athiri mbaya kwa mtu binafsi na kwa jamii.'' </blockquote> <blockquote>''Uraibu wa dawa (tabia) ni hali inayosababishwa na matumizi ya mara kwa mara ya dawa za kulevya.'' ''Sifa zake ni pamoja na (i) utashi (lakini siyo ya kimazoea) wa kuendelea kutumia dawa za kulevya kwa minajili ya kuhisi ustawi wa kihali ambayo huibushwa; (ii) tabia ya kuongeza kiwango kidogo au kutoongeza , (iii) kiasi fulani cha utegemeaji wa kiakili kwa athari za dawa za kulevya, lakini bila ya utegemezi wa kimwili na hivyo ni wa dalili za kuacha [kujiondoa], na (iv) madhara mabaya, iwapo yapo, hasa kwa mtu binafsi.'' </blockquote> Mwaka wa 1964, kamati mpya ya WHO iligundua kuwa fafanuzi hizi ni duni, na kupendekeza matumizi ya istilahi ya jumla ya "utegemezi wa dawa za kulevya": <blockquote>''Ufafanuzi wa neno kulevya ulipata ukubalifu, lakini utata katika matumizi ya istilahi matumizi ya dawa za kulevya na uzoevu na matumizi mabaya uliendelea.'' ''Aidha, orodha ya dawa za zilizotumika vibaya iliongezeka kiidadi na kwa wingi.'' ''Utata huu umezidi kubainika wazi na jitihada mbalimbali zimefanywa kutafuta istilahi inayoweza kutumika kwa ujumla kuelezea matumizi mabaya ya dawa za kulevya.'' ''Dhana ya msingi katika yote mawili inaonekana kuwa utegemezi, ama wa kiakili au wa kimwili.'' ''Kwa hivyo, matumizi ya neno 'utegemezi wa dawa , yanayojumuisha awamu ya kimpito huihusisha na aina mahususi ya dawa ili kutofautisha aina moja ya dawa ya kulevya na nyingine, yalipewa uzingativu wa makini sana.'' ''Kamati ya wataalamu inapendekeza matumizi ya neno 'utegemeaji wa dawa' badala ya 'matumizi ya dawa za kulevya' na 'uzoevu wa dawa za kulevya'.'' </blockquote> Kamati hiyo haikufafanua kikamilifu utegemezi, bali aliendelea kwa kubainisha tofauti kati ya utegemezi wa kimwili na wa kisaikolojia ("kiakili"). Ilieleza kuwa matumizi mabaya ya dawa za kulevya ilikuwa ''"hali ya utegemezi wa kiakili au utegemezi wa kimwili, au yote mawili, kwa dawa za kulevya, ambayo hudhihirika kwa mtu kufuatana na matumizi ya dawa hiyo kwa vipindi vifupi au vinavyodumu kwa muda."'' Utegemezi wa kiakili ulifafanuliwa kama hali ambapo ''"pana hisia za kuridhika na msisimko wa kiakili ambao huhitaji matumizi ya dawa ili kuibusha raha au kuepusha usumbufu" kwa muda mfupi au muda mrefu"'' na dawa zote za kulevya zilisemekana kuwa na uwezo wa kuibusha hali hii: <blockquote>''Ni nadra sana kupata hali ambapo kitu chochote kinachoingizwa mwilini kitashindwa kuwasababisha baadhi ya watu kuathirika kwa msisimko wa kuridhika au kufurahia, kwa namna inayowashawishi kuendeleza matumizi yake hadi kufikia kiwango cha matumizi mabaya - yaani, kutumia kupita kiasi au kutumia zaidi ya invyohitajika kimatibabu.'' </blockquote> Fafanuzi za miaka ya 1957 na 1964 za matumizi ya dawa za kulevya, utegemezi na utumiaji mbaya zimeendelea kudumu hadi sasa katika vitabu vya kitabibu. Inafaa kukumbukwa kuwa Mwongozo Utambuzi wa Takwimu (DSM-IV-TR) kwa sasa (2006) unatoa vigezo maalum vya kufafanulia matumizi mabaya na utegemezi. (DSM-IV-TR) hutumia istilahi utegemezi wa vileo badala ya ''matumizi ya vileo,'' ambao ni uigaji mbaya wa mkondo wa matumizi mabaya ya vileo, unaosababisha kuathirika vibaya kiafya au dhiki, kama ionekanavyo kwa vigezo vitatu (au zaidi) vilivyopendekezwa , kuanzia wakati wowote katika kipindi kimoja cha miezi 12. Ufafanuzi huu pia huweza kutumika kwa dawa za kulevya zenye ishara ndogo au zisizoonekana za kimwili baada ya kuacha, kwa mfano, bangi. Mwaka 2001, Chuo cha Marekani cha Dawa za Maumivu, Shirika la Maumivu Marekani na Shirika la Marekani la Dawa za kulevya, kwa pamoja zilitoa "Fafanuzi Zilizohusiana na Matumizi ya Opioidi kwa kutibu maumivu", ambayo ilibainisha zifuatazo masharti yafuatayo: <ref name="painmed"></ref> <blockquote>''Matumizi ya vileo'' ''kimsingi, ni ugonjwa sugu, wa kinyurobiolojia, kutokana na sababu za jeni, kisaikolojia na hali za kimazingira zinazochangia ukuaji na kudhihirika kwake.'' ''Ina sifa za tabia ambazo ni pamoja na mojawapo au zaidi ya hizi: kuvurugika kwa udhibiti wa matumizi ya dawa, matumizi ya kuzoea, kuendelea kutumia licha ya madhara ya kutumia, na utashi mkubwa.'' </blockquote> <blockquote>''Utegemezi wa kimwili ni hali ya kujizoesha ambayo hudhihirishwa na dalili maalum za kuacha ambazo zinaweza kusababishwa na kuacha kighafla, kupunguza kiwango kwa kasi, upungufu wa kiwango cha dawa ya kulevya katika damu na/au utumiaji wa dawa kinzani.'' </blockquote> <blockquote>''Uzoevu ni hali ya mwili kujizoesha na dawa ya kulevya: kiasi kikubwa zaidi cha dawa ya kulevya zinahitajika jinsi muda unavyozidi ili kufikia matokeo kama ya awali jinsi mwili "anavyozoea kutumia" na kujizoesha matumizi hayo.'' </blockquote> <blockquote>''Utegemezi bandia wa dawa za kulevya'' ''ni istilahi ambayo imetumika kuelezea tabia za wagonjwa ambazo zinaweza kutokea wakati maumivu hayatibiwi vya kutosha.'' ''Wagonjwa walio na maumivu yasiyopunguzika wanaweza kulenga kupata dawa, "kwa muda fulani," ama wanaweza kuonekana vinginevyo kama 'wanaotafuta dawa' kwa njia isiyofaa." '' ''Hata tabia kama vile matumizi haramu ya dawa za kulevya na udanganyifu zinaweza kutokea katika juhudi za mgonjwa kupata nafuu.'' ''Utegemezi bandia wa dawa za kulevya unaweza kutofautishwa kutoka kwa utegemezi wa kweli kwa kuwa tabia hutoweka wakati maumivu yametibiwa kikamilifu.'' </blockquote> Mwongozo wa Utambuzi na Takwimu za Matatizo ya Akili, '''DSM-IV-TR''' haitumii kamwe neno ''utegemezi wa dawa za kulevya''. Badala yake ina sehemu kuhusu utegemeaji wa vileo <blockquote>''"Wakati mtu hushikilia matumizi ya pombe au dawa nyingine licha ya matatizo yanayohusiana na matumizi yake, utegemezi wa kileo inaweza kubainika.'' ''Matumizi ya kimazoea na matumizi ya mara kwa mara yanaweza kusababisha uzoelevu kwa athari za dawa ya kulevya na dalili za kuathithirika wakati matumizi yake yanapopunguzwa au kukomeshwa.'' ''Hii, pamoja na mabaya ya kileo huchukuliwa kama Matatizo ya Matumizi mabaya..."'' <ref name="DSM4"></ref></blockquote> Ufafanzi wa ''Utegemezi wa dawa za kulevya'' uliopendekezwa na Profesa Nils Bejerot: <blockquote>''"Hisia kwamivu (mtazamo) inayopatikana kwa kujifunza, ambayo hudhihirika wakati mwingine au daima kupitia tabia za kimaksudi, za kudhanika kwa mienendo na misukumo ya nguvu za asili, zinzzolenga uridhikaji maalum au kujiepusha na usumbufu fulani maalum".'' <ref name="NIDA">[8] ^ [http://www.nida.nih.gov/pdf/monographs/30.pdf Nils Bejerot katika Nadharia za Matumizi mabaya ya Dawa za kulevya, Baaadhi ya mitazamo ya kisasa] {{Wayback|url=http://www.nida.nih.gov/pdf/monographs/30.pdf |date=20090509100018 }} , ukurasa wa 246-255, NIDA, 1980</ref>'''' </blockquote> ==Visababishi== Dawa zinazojulikana kusababisha utegemezi wa dawa za kulevya ni pamoja na dawa haramu na zinazotokana na cheti cha daktari au dawa zinazonunuliwa rejareja, kulingana na ufafanuzi wa Shirika la Dawa za Tiba za Ulevi la Marekani. * Vichochezi (vya utegemezi wa kiakili, wa wastani hadi ulio sugu, kuacha ni hali ya kisaikolojia na matatizo ya akili/kisaikosomati): ** Amfeetamini na methamfetamini ** [[Kokain|Kokeni]] ** [[Nikotini]] * Vitulizi na hiponoti (utegemezi wa kiakili wa dawa za kulevya, zenye uhafifu hadi zilizo kali, na utegemezi wa kimwili kwa dawa za kulevya, athari kali za kujiondoa kighafla zinaweza kudhuru): ** Pombe ** Dawa za usingizi ** Benzodiazepini, hasa flunitrazepamu, triazolami, temazepamu, na nimetazepamu ** Methakualoni na kuhusiana kuinazolinoni vitulizi- hiponoti * Opiati na analjesi ya opioidi (utegemezi wa kiakili kwa dawa za kulevya, hafifu hadi zenye ukali wastani; kujiondoa kwa ghafla hakuongezi uwezekano wa kupata madhara mabaya): ** Mofini na kodini, analjesi mbili zinazotoke kwa asli kikawaida ** Opiates za sandarusi-kiasi, kama vile [[heroini]] (diasetilmofini), oksikodoni, buprenofini, na hidromofoni ** Opioidi za sandarusi kamili kama vile fentanili, meperidini / pethidini na methadoni Dawa za kulevya pia hujumuisha idadi kubwa ya vileo ambavyo kwa sasa vinaonekana kutokuwa na thamani ya kimatibabu na hazipatikani rejareja ama kwa cheti cha daktari. Nadharia nyingi za dawa za kulevya zipo, baadhi ya zile kuu ni ya hali za kimaumbile, nadharia ya utabibu wa kibinafsi, na ya sababu za zinazohusisha maendeleo ya kijamii/kiuchumi.Kwa muda mrefu imethibitishwa kuwa sababu za jeni pamoja na sababu za kijamii na kisaikolojia huchangia utegemezi wa dawa za kulevya. Nadharia ya kawaida inayofungamana na hizi ni ya tiba-ya-kibinafsi. Tafiti za pidemioloji zinaisi kuwa sababu za jeni huchangia asilimia 40-60% ya hali zinazozidisha hatari ya kuingilia ulevi. viwango kama hiyo vya urithi kwa aina nyingine za dawa za kulevya zimethibitishwa katika tafiti nyinginezo (Kendler, 1994). Katika mwaka 1964 Knestler aliibua haipothesia kuwa jeni au kikundi cha jeni zinaweza kuchangia uwezekano wa kuingilia utegemeaji wa vileo kwa njia kadhaa. Kwa mfano, viwango vya protini vya kawaida vinapobadilishwa kutokana na sababu za kimazingira kunaweza basi kugeuza muundo au utendaji wa sakiti maalum za ubongo wakati wa kukua. Sakiti hizi za ubongo zilizogeuzwa zinaweza kubadilisha uwezekano wa mtu binafsi kuanzisha uzoefu wa matumizi ya dawa ya kulevya. Kwa kuchangia nadharia tete hii, tafiti za wanyama zimeonyesha kwamba sababu za kimazingira kama vile msongo znaweza kuathiri aina ya jeni ya mnyama.<ref> Kendler, KS, et al., (1994). A twin family Study of alcoholism in women. Katika: Am J. Psychiatry 151, (pp707-715)</ref> ===Uwezekano wa utegemezi dawa za kulevya === Uwezekano wa kutegemea dawa za kulevya hutofautiana kutoka kileo hadi kingine na kutoka mtu hadi mwingine. Kipimo, awamu, nishati-dawa ya aina fulani ya kileo, njia ya matumizi na ya kati ni mambo muhimu katika kuendeleza matumizi ya dawa za kulevya. Makala katika jarida la ''The Lancet'' ililinganisha madhara na utegemezi wa dawa 20 za kulevya, kwa kutumia vipimo vya 0-3 kupimia ulevi wa kimwili, uraibu wa kisaikolojia na uridhishaji ili kupata kipimo wastani cha ulewaji. Kafeni haikujumuishwa katika utafiti huu. Baadhi ya matokeo yanaweza kuonekana katika chati iliyopo chini.<ref> Nutt, King, Saulsbury, &amp; Blakemore (2007). Development of arational scale to asses the harm of drugs of potential misuse. ''Lancet, 369,'' 1047-1053.</ref> {| class="wikitable sortable" |- ! Dawa ! Wastani ! Raha ! Utegemezi wa kisaikolojia ! Utegemezi wa kimwili |- | Heroini | 3.00 | 3.0 | 3.0 | 3.0 |- | Kokeni | 2.39 | 3.0 | 2.8 | 1.3 |- | Tumbaku | 2.21 | 2.3 | 2.6 | 1.8 |- | Vitulizi | 2.01 | 2.0 | 2.2 | 1.8 |- | Pombe | 1.93 | 2.3 | 2.6 | 1.8 |- | Benzodiazepini | 1.83 | 1.7 | 2.1 | 1.8 |- | Amfetamini | 1.67 | 2.0 | 1.9 | 1.1 |- | Bangi | 1.51 | 1.9 | 1.7 | 0.8 |- | LSD | 1.23 | 2.2 | 1.1 | 0.3 |- | Kisisimuo (Ecstasy) | 1.13 | 1.5 | 1.2 | 0.7 |} ===Nadharia tete ya tiba-ya-mtu binafsi=== Inavyoelezwa na watathmini wa kisaikoloji na watafiti wa kibayolojia,wote wanakisia kwamba baadhi ya watu hutumia vibaya dawa za kulevya katika jaribio la kufidia hali zao za pekee na zisizoeleweka za akili.<ref> Khantzian, E.J. (1985). The Self-medication hypothesis of addictive disorders: Focus on heroin and coccaine. In: Am. L. Psychiatry 142: (pp 1259-1264). </ref>Nadharia wa tiba-ya-kibinafsi ina historia ya muda mrefu. Freud kwa mara ya kwanza aliibua dhana hii katika mwaka wa 1884, alipobainisha uwezo wa kokeni wa kukinzana na hisia za huzuni. Msongo umetambulika kwa muda mrefu kama sababu kubwa inayochangia utashi wa kutumia dawa za kulevya na kurejelea matumizi na hivyo basi huchangia nadharia ya tiba-ya-kibinafsi. Kulingana na nadharia hii, jinsi mtu atumiavyo dawa fulani huwa si kiajali, bali ni kwa uteuzi kulingana na athari zake za kimatibabu katika kupunguza dalili za mfaidhaiko au hisia zisizohitajika. Utafiti umeonyesha kwamba watu ambao huponea majanga hukabiliwa na matatizo yanayohusiana na msongo kama vile kiwewe cha baada ya tukio (PTSD) na hali ya unyongovu. Watu ambao hupatwa na kiwewe kikubwa katika maisha wanaweza kingilia hali ya kujitibu kibinafsi kwa dawa na madawa ya kulevya au pombe ya kukabiliana na dalili za kiwewe baada ya tukio (PTSD) na unyogovu.<ref> Vlahov, D., et al. (2002). Increased use of cigarettes, alcohol and marijuana among Manhattan, New York, residents after the September 11 terrorist attacks. American Journal of Epidemologia 155 (11): 988-996, (2002).</ref> ===Maendeleo ya kijamii=== Maendeleo ya kijamii na sababu za kurekebisha mambo pia ina jukumu katika matumizi mabaya ya dawa za kulevya na utegemeaji wa dawa za kulevya. Wazo la mtazamo wa maendeleo, kama ilivyotajwa na Thornberry 1987, ni kuwa mkondo wa maisha ya mtu ni hatua ambapo hali katika maisha hubadilika, mambo muhimu hutimizwa na kukosa kutimizwa na majukumu mapya ya kijamii hubuniwa na ya awali kuachwa. Pia pana kanuni zinazojulikana na kukubalika sana kuhusu wakati ambapo matukio ya maendeleo yanastahili kutokea katika maisha ya mtu. Tafiti kuhusu sababu za kijamii zinazosiana na matumizi ya dawa za kulevya zimelenga zaidi aidha vijana waliobaleghe au vijana wanaoingia utu uzima, lakini la kushangaza ni kuwa kiasi kikubwa cha watumiaji kokeni huenda wasianze kuitumia hadi katikati ya miaka ya utu uzima. Wengi wa watu huingilia majukumu ya kijamii ya kiutu uzima kwa wakati unaotazamiwa. Hata hivyo, baadhi ya watu huingilia majukumu haya mapema au baadaye kuliko wenzao wa umri sawa. Mtazamo wa maendeleo hukisia kwamba hayai yatasababisha marekebisho yasiyoridhisha kikamilifu na huenda matokeo mabaya kama vile matumizi ya dawa za kulevya na utegemezi wa pombe<ref>[13] ^ Neugarten &amp; Datan, (1973), Elder, (1975). Katika: Journal of health and Social Behaviours 37 (uk.75-91) The efects of role socialization on the initiation of cocaine use: An event history analysis from adolescence into adulthood. Burton, R., (1996).</ref> ==Pathofisiolojia== Watafiti wamefanya chunguzi mbalimbali kwa kutumia wanyama kama mfano wa kazi amilifu za ubongo wa binadamu ili kufafanua michakato ya kimsingi ya dawa za kulevya katika ubongo. Mada hii ya kushangaza inashirikisha maeneo kadhaa za ubongo na mabadiliko ya sinapsi au mageuko ya neva, ambayo hutokea katika maeneo hayo. ===Athari kali=== Matumizi sugu (au burudishi) ya dawa nyingi zenye kusisimua kisaikolojia husababisha utolewaji na athari za muda mrefu za dopamini na serotonini ndani ya mfumo mzima wa sakiti ya uridhikaji. Aina mbalimbali za dawa huzua athari hizi kwa njia tofauti. Dopamini (DA) inaonekana kuwa na athari kubwa na utendakazi wake umebainika. Dopamini (DA) huunganika kwa vipokezi vya D1 na kuchochea dalili ya msisimuo ndani ya seli) protini kinase (PKA) fosforilati ya cAMP-tegemezi ya kujibia protini (CREB) inayounganisha elementi, kiunukuzi, ambayo huzua unukuzi wa jeni kadhaa ikiwemo C-Fos.<ref name="Kalivas and Volkow">{{cite journal |author=Kalivas PW, Volkow ND |title=The neural basis of addiction: a pathology of motivation and choice |url=https://archive.org/details/sim_american-journal-of-psychiatry_2005-08_162_8/page/n41 |journal=Am J Psychiatry |volume=162 |issue=8 |pages=1403–13 |year=2005 |pmid=16055761 |doi=10.1176/appi.ajp.162.8.1403}}</ref> ===Sakiti za kuzawadia=== Baada ya kuchunguza misingi ya kibayolojia ya utegemezi wa dawa za kulevya, sharti mtu kwanza aelewe njia ambazo dawa huathiri na jinsi dawa za kulevya zinavyoweza kubadilisha njia hizi. Uridhikaji wa sakiti,ambayo pia hujulikana kama mfumo mesolimbi, hubainisha mwingiliano wa maeneo kadhaa ya ubongo. * Eneo la ventrali tegmentali (VTA) hujumuisha neuroni za dopamineji ambayo hujibia glutamati. Seli hizi kujibu wakati stimuli dalili ya tuzo ni sasa. VTA husaidia kujifunza na mwendelezo wa uhamasishaji na hutoa dopamini (DA) katika sehemu ya mbele ya ubongo.<ref name="Jones and Bonci">{{cite journal |author=Jones S, Bonci A |title=Synaptic plasticity and drug addiction |journal=Curr Opin Pharmacol |volume=5 |issue=1 |pages=20–5 |year=2005 |pmid=15661621 |doi=10.1016/j.coph.2004.08.011}}</ref> Neuroni hizi pia huelekeza na kutoa DA kuelekea akubeni za kiini<ref name="Eisch and Harburg">{{cite journal |author=Eisch AJ, Harburg GC |title=Opiates, psychostimulants, and adult hippocampal neurogenesis: Insights for addiction and stem cell biology |journal=Hippocampus |volume=16 |issue=3 |pages=271–86 |year=2006 |pmid=16411230 |doi=10.1002/hipo.20161}}</ref> kwa njia ya mesolimbi. Karibu dawa zote zinazosababisha ulewevu wa dawa za kulevya huongeza utolewaji wa dopamine katika njia ya mesolimbi,<ref name="Rang">{{cite book |author=Rang, H. P. |title=Pharmacology |url=https://archive.org/details/isbn_9788181479174 |publisher=Churchill Livingstone |location=Edinburgh |year=2003 |pages=[https://archive.org/details/isbn_9788181479174/page/596 596] |isbn=0-443-07145-4}}</ref> kwa kuongeza madhara yao maalum. * Akumbeni za kiini(NAc) hushirikisha hasa neuroni zinazochomoza-kwenye uti (MSNs), ambazo ni neuroni za GABA .<ref name="Kourrich">{{cite journal |author=Kourrich S, Rothwell PE, Klug JR, Thomas MJ |title=Cocaine experience controls bidirectional synaptic plasticity in the nucleus accumbens |url=https://archive.org/details/sim_journal-of-neuroscience_2007-07-25_27_30/page/n49 |journal=J. Neurosci. |volume=27 |issue=30 |pages=7921–8 |year=2007 |pmid=17652583 |doi=10.1523/JNEUROSCI.1859-07.2007}}</ref> NAcc huhusishwa na uibushaji na kusababisha tabia zoelevu na kujihusisha na ongezeko la uhusivu wa dawa za kulevya jinsi utegemezi unavyoendelea.<ref name="Jones and Bonci"></ref> * Sehemu tangulizi mbeleya gamba la nje mwa ubongo, hasa singulati ya mbele na kotisi ya mbele mwa jicho ,<ref name="Kalivas and Volkow"></ref> ni muhimu kwa muungano wa habari ambazo huchangia kuamua iwapo tabia itaibushwa. Inaonekana kuwa ndiyo eneo ambapo motisha huanzia na sifa za vichochezi huamuliwa.<ref name="Floresco">{{cite journal |author=Floresco SB, Ghods-Sharifi S |title=Amygdala-prefrontal cortical circuitry regulates effort-based decision making |journal=Cereb. Cortex |volume=17 |issue=2 |pages=251–60 |year=2007 |pmid=16495432 |doi=10.1093/cercor/bhj143}}</ref> * Amigdala za kimsingi zinazotangulia huchomoza ndani ya NAcc na hudhaniwa kuwa muhimu kwa motisha pia.<ref name="Floresco"></ref> * Ushahidi zaidi hulenga jukumu la hipokampu katika utegemezi wa dawa za kulevya kwa sababu ya umuhimu wake katika kujifunza na kumbukumbu. Mengi ya ushahidi huu hutokana na uchunguzi unaochezesha seli katika hipokampu kwa kubadili viwango vya dopamini katika NAcc na viwango vya kurusha vya seli skumivu-dopamini VTA.<ref name="Eisch and Harburg"></ref> ===Wajibu wa dopamini=== Karibu dawa zote za kulevya hulenga mfumo wa uridhikaji wa ubongo moja kwa moja au kinyumenyume, kwa kufurika sakiti za dopamini.<ref name="addict">{{cite web|url=http://www.drugabuse.gov/infofacts/understand.html|title=Understanding Drug Abuse and Addiction|accessdate=2010-11-06|archivedate=2011-08-23|archiveurl=https://www.webcitation.org/619xCtWsE?url=http://www.drugabuse.gov/infofacts/understand.html}}</ref> Jinsi mtu anavyondelea kusisimua "sakiti za uridhikaji", ubongo hujizoesha kwa viwango vinavyoongezeka vya dopamini kwa kuzalisha homoni chache au kwa kupunguza idadi ya vipokezi katika sakiti za uridhifu. Matokeo yake, ni kuwa athari za kemikali kwa sakiti za uridhifu hupunguzwa, na hivyo kupunguza uwezo wa mtumiaji dawa kufurahia mambo ambayo awali yalimletea uridhifu.<ref name="addict"></ref> Upungufu huu huwalazimisha waliozoea dopamini kuongeza matumizi ya dawa za kulevya ili kujaribu kurejesha viwango vyao vya homoni za "kuhisi vyema" katika hali za kawaida-an athari inayojulikana kama uzoeaji. Ukuaji wa uzoeaji dopamini unaweza hatimaye kusababisha mabadiliko makubwa katika neuroni na sakiti za ubongo na uwezo kuibua uwezekano wa kudhuru afya ya muda mrefu ya afya ya ubongo.<ref>{{cite web|url=http://www.abovetheinfluence.com/facts/science-behind-addiction.aspx#|title=The Science Behind Drug Use and Addiction|accessdate=2010-11-06|archivedate=2011-08-22|archiveurl=https://www.webcitation.org/618O5GxBH?url=http://www.abovetheinfluence.com/facts/sciencebehindaddiction}}</ref> Dawa za kisasa za kukabili matatizo ya akili hutengenezwa ili kuzuia kazi ya dopamine. Kwa bahati mbaya, uzuiaji huu unaweza pia kusababisha kudidimia hadi kufikia hali ya huzuni na kuzidisha tabia kutegemea zaidi dawa.<ref>{{cite web|url=http://www.iscid.org/encyclopedia/Dopamine|title=Dopamine|accessdate=2010-11-06|archiveurl=https://www.webcitation.org/619xDUYIy?url=http://www.iscid.org/encyclopedia/Dopamine|archivedate=2011-08-23}}</ref> ===Mwitikio wa mfadhaiko=== Kwa kuongezea sakiti za uridhifu, nadharia-tete zinakisia kuwa msongo ni sababu inayochangia utegemeaji wa dawa za kulevya. Koob na Kreek wametoa nadhari-tete kwamba wakati wa matumizi ya dawa, sababu zinazoibusha kotikotropini (CRF) huamsha uhusiano wa hipothalami-pituitari-Adrena (HPA) na mifumo mingine ya msongo katika amigdala iliyoongezeka ya. Uibushwaji huu huathiri wa hali ya mhemko usioelekezwa inayohusiana na dawa za kulevya. Wamegundua kwamba jinsi matumizi ya dawa huongezeka, ndivyo vile vile CRF vile katika kiowevu katika uti wa binadamu (CSF). Katika mifano ya panya, na matumizi tofauti ya vikinzani vya CRF na vipokezi vya CRF vyote vilipunguza matumizi ya kibinafsi ya dawa za utafiti. Tafiti nyinginezo katika tathmini hii zilionyesha kutodhbitika katika homoni nyingine zinazohusika na mshikamano wa HPA, ikiwa ni pamoja enkefalini ambayo ni opioidi peptidiya nje mwa ngozi ambayo huzuia maumivu. Pia inaonekana kwamba mfumo wa opioidi μ-pokevu, ambayo enkephalini hushikamana nayo, ina athari katika mfumo wa mridhiko na inaweza kudhibiti mdhihiriko wa homoni za msongo.<ref name="Koob and Kreek"></ref> ===Tabia=== Kuelewa jinsi [[Tabia|kujifunza na tabia]] kufanya kazi katika sakiti ya mridhiko wa inaweza kusaidia kuelewa mwenendo wa dawa za kulevya. Utegemezi wa dawa za kulevya hudhihirika kwa utafutaji dawa kwa nguvu ambapo mtumiaji mara nyingi hutaka na hutafuta dawa ya kulevya, licha ya kuelewa madhara yake hatari.<ref name="Koob and Kreek"></ref><ref name="Kalivas and Volkow"></ref> Dawa za kulevya huzalisha uridhifu, ambayo ni hisia ya kusisimua inayosababishwa na viwango kolezi vya DA katika neuroni ya ufa wa sinapti katika ubongo. Tabia za kuzoeleka huonekana katika watumiaji wa dawa za kulevya sawa na katrika panya wa maabara, panya, na tumbili, zinaweza kuhusisha vitendo na tabia, katika hii wakitafuta dawa, kwa ajili ya mridhiko, ambayo ni athari ya dawa hii.<ref name="Jones and Bonci"></ref> Ushahidi unaonyesha kwamba tabia hii ina uwezekano mkubwa sana kuwa matokeo ya mabadiliko ya sinapti ambayo yametokea kutokana na matumizi ya dawa za kulevya ya mara kwa mara.<ref name="Koob and Kreek"></ref><ref name="Kalivas and Volkow"></ref><ref name="Jones and Bonci"></ref> Tabia ya kutafuta dawa za kulevya husababishwa na glutamateji zinazochomoza kutoka koteksi ya mbele hadi NAc. Wazo hili linaungwa mkono na data kutoka kwa majaribio yanayoonyesha kuwa tabia ya kutafuta dawa inaweza kuzuiwa kufuatana na uzuiaji wa vipokezi glutamati ya AMPA na kutolewa kwa glutamati katika NAc.<ref name="Kalivas and Volkow"></ref> ===Alostasisi=== Alostasisi ni mchakato wa kufikia udhabiti kwa mabadiliko katika tabia na pia umbo la mwili. Jinsi mtu anavyoendelea na matumizi ya dawa za kulevya, yeye huonekana kuingia katika hali ya alostati ambayo hufafanuliwa kama kubadilika kutoka kiwango cha kawaida cha mabadiliko ambayo hudumu katika kwa muda mrefu. Utegemezi wa dawa za kulevya unaweza kusababisha uharibifu kwa ubongo na mwili jinsi viumbe wanavyoingia katika hali ya kuugua, madhara yanayotokana na uharibifu unajulikana kama ujazo wa alostati. Udhibiti wa alostasisi hatimaye hutoweka hatua kwa hatua jinsi uridhikaji kutokakana na dawa za kulevya na uwezo wa kuondosha hali ya kukata tamaa kwa matumizi ya dawa za kulevya huanza pia kupungua. Mzigo unaosababishwa na alostati huibua hali ya unyongovu wa mara kwa mara ikilinganishwa na mabadiliko ya kawaida ya alostati. Kinachosukuma upungufu huu ni msukumo wa watumiaji wa kutumia dawa kabla ya ubongo na mwili kurudia viwango vya awali vya alostati, na hivyo kuzua hali ya dhiki ya kila mara. Kwa hivyo, uwepo wa hali za kufadhaisha za kimazingira unaweza kusukumiza tabia ya kutafuta dawa za kulevya.<ref name="Koob and Kreek"></ref> ===Neuroplastisi=== Neuroplastisi ndio mfumo wa udhanifu unaochangia kujifunza na kumbukumbu. Inahusu mabadiliko ya kimwili katika sinapsi baina ya neuroni mbili za kuwasiliana, ongezeko la sifa za jeni kujitokeza , mageuzo ya ishara za seli na kuzalishwa kwa sinapsi mpya kati ya neuroni za kuwasiliana. Wakati dawa za kulevya zipo katika mfumo, huonekana kuteka nyara mifanyiko hiyo katika mfumo wa uridhikaji hiyo motisha hulengwa kwa utoaji wa dawa za kulevya kuliko uridhikaji wa asili.<ref name="Jones and Bonci"></ref> Kufuatana na historia ya matumizi ya dawa ya kulevya, sinapsi zinazosisimuliwa katika akumbeni za kiini (NAc) hukumbwa na aina mbili za ubadilikaji wa neva: potensheni ya muda mrefu (LTP) na unyongovu wa muda mrefu (LTD). Wakitumia panya kama mfano, Kourrich na wenzake walionyesha kwamba matumizi sugu ya kokeni huongeza nguvu za synapsi katika NAc baada ya kipindi cha kujiondoa cha siku 10-14, ilhali sinapsi zenye nguvu hazijitokezi kwa kipindi cha saa 24 baada ya matumizi ya mara kwa mara ya kokeni. Kipimo kimoja cha kokeni hakikusababisha sifa zozote za sinapsi zenye nguvu. Wakati panya walio na uzoevu wa dawa ya walipopewa changamoto kwa kipimo kimoja cha kokeni, unyogovu wa sinapti ulitokea. Kwa hiyo, inaonekana historia ya matumizi ya kokeni pamoja na athari za uondoaji huathiri mwelekeo wa kugeuza umbo la glutamati katika NAc. <ref name="Kourrich"></ref> Mara mtu ageukapo kutoka matumizi hadi utegemezi wa dawa za kulevya, tabia yake hulenga kikamilifu katika utafutaji wa dawa, hata ingawa watumiaji huripoti kuwa wao huhisi msisimuo usio mkali kama ilivyokuwa wakati mmoja. Licha ya athari mbalimbali za dawa za kulevya wakati zinapotumika sana, njia inayopelekea utegemezi wa dawa za kulevya ni sawa. Swala lingine la dawa za kulevya linahusu upungufu wa kujibia msisimuo kwa mambo ya kawaida ya kibiolojia, kama vile chakula ngono na mahusiano ya kijamii. Kwa njia ya picha za bongo za wagonjwa wanaojitegemeza kwa kokeni, wanasayansi wameweza kupata taswira ya ongezeko la shughuli za usagaji katika singuleti ya mbele na koteksi ya mbele mwa jicho (maeneo ya yanayotngulia koteksi ya mbele ) katika bongo za watu hawa. Michakato ya maeneo hayo ya bongo za watu hawa wanaotegemea dawa za kulevya hushirikishwa katika motisha kali zaidi za kupata dawa badala ya kutafuta uridhifu wa kiasili mbali na upungufu wa uwezo wa kushinda utashi huu. Picha za bongo pia zimeonyesha kuwa wategemeaji kokeni-huwa na ulegevu kiutendaji katika koteksi zao za mbele wakilinganishwa na wasiotumia dawa za kulevya, wanapokumbana na misisimuo inayohusiana na mridhiko wa asili. Mpito kutoka matumizi ya dawa za kulevya kwa matumizi ya kuburudika hadi utegemezi hutokea kwa hatua za taratibu na hutokana na athari za dawa, kulingana na uteuzi wake, wa mabadiliko ya neva zinazopatikana katika sakiti za mridhiko. Wakati wa matukio kabla ya kutegemea ulevi, utashi huzalishwa na kutolewa kwa dopamini (DA) katika koteksi ya mbele. Jinsi mtu anavyobadilika kutoka matumizi ha utegemeaji wa dawa za kulevya, kutolewa kwa DA katika NAc huwa haihitaji kuzalisha utashi bali utolewaji wa DA hupunguka wakati ongezeko la shughuli za usagaji katika koteksi za mbele mwa jicho huchangia utashi. Wakati huu mtu anaweza kuhisi dalili za unyogovu iwapo kokeni haitumiki.<ref> AJ Giannini. Drug abuse and depression: Catecholamine depletion suggested as biological tie between cocaine withdrawal and depression. National Instiyute of Drug Abuse Notes. 2 (2) 5, 1987.</ref> Kabla ya mtu kuanza kutegemea dawa za kulevya na kuonyesha tabia za kutafuta dawa za kulevya, pana kipindi cha muda ambapo mkondo wa neuroplastisi unaweza kugeuzwa. Utegemezi dawa za kulevya hufanyika wakati tabia ya kutafuta dawa inapobainika na uwezekano wa kurejelea matumizi kuendelea, licha kujiondoa kwa muda mrefu, hizi sifa hizi za kitabia ni matokeo ya mabadiliko ya neuroplasti ambayo ni huletwa na matumizi ya mara kwa mara na hudumu kwa kiasi .<ref name="Kalivas and Volkow"></ref> Utaratibu unaosababisha athari za molekuli ya dawa ya juu ubadilishaji umbo wa sinapti bado haieleweki vilivyo. Hata hivyo, neuroplastisi katika glutamati zinazochomoza inaonekana kuwa muhimu ya matumizi ya mara kwa mara ya dawa za kulevya. Aina hii ya ubadilishaji umbo wa sinapti huwa na matokeo yanayosababisha LTP, ambayo huzipa nguvu mahusiano kati ya neva mbili, mwanzo wa haya hutokea haraka na matokeo yake ni ya mara kwa mara. Mbali na neva za glutamati, neva za dopamini zilizo katika VTA hukabiliana na glutamati na huweza kushirikishwa mapema zaidi wakati wa kujizoesha kwa neva kufuatia matumizi ya mara kwa mara ya dawa za kulevya. Kama ilivyoonyeshwa na Kourrich na wenzake, historia ya matumizi ya dawa za kulevya na wakati wa kujiondoa kutoka matumizi ya mwisho inaonekana kuwa na umuhimu katika kuelekeza mabadiliko ya umbo la neva za mfumo wa kuzawadia.<ref name="Jones and Bonci"></ref> Suala la ukuaji wa neva ambalo pia linaweza kuwa na jukumu muhimu katika mabadiliko ya umbo la neva kutokana na dawa za kulevya-ni kuwepo kwa molekuli-elekezi za aksoni kama vile semaforini na efrin. Baada ya matibabu ya kokeni ya mara nyingi ,mabadiliko yaliyodhihirika(ongezeko au upungufu hutegemea aina ya molekuli) ya msimbo wa mRNA kwa molekuli-elekezi ya aksoni yalitokea katika panya. Haya yanaweza kuchangia mabadiliko katika tabia za sakiti za mridhiko wa utegemevu kwa dawa za kulevya.<ref name="Bahi and Dreyer">{{cite journal |author=Bahi A, Dreyer JL |title=Cocaine-induced expression changes of axon guidance molecules in the adult rat brain |journal=Mol. Cell. Neurosci. |volume=28 |issue=2 |pages=275–91 |year=2005 |pmid=15691709 |doi=10.1016/j.mcn.2004.09.011}}</ref> ===Nyurojenesi=== Utegemezi wa dawa za kulevya pia huzua suala la athari zinazodhuru ukuaji wa neuroni mpya kwa watu wazima. Eisch na Harburg walizua dhana tatu mpya walizoiga kutoka tafiti mbalimbali za hivi karibuni kuhusiana na dawa za kulevya. Kwanza, chimbuko la neva hupungua kutokana na matumizi ya mara kwa mara ya dawa za kulevya. Orodha ya tafitia inaonyesha kuwa matumizi ya muda mrefu ya opiati, visisimuzi vya kisaikolojia, nikotini, na pombe hupunguza chimbuko la neva katika panya. Pili, upungufu huu katika chimbuko la neva huonekana kutotegemea mshikamano unaoelekezwa na HPA. Sababu nyingine za kimazingira mbali na matumizi ya dawa za kulevya kama vile umri, msongo na mazoezi, pia zinaweza kuwa na athari kwa chimbuko la neva kwa kudhibiti mshikamano wa Adrenal-hipothalami-pituitari(HPA). Ushahidi unaozidi kujitokeza unaonyesha hili kwa sababu 3: kipimo kidogo cha opiati na visisimuzi vya kisakolojia hukoleza korikosteroni katika seramu lakini bila ya athari kwa chimbuko la neva, ingawa chimbuko la neva iliyopunguka ni sawa kati ya watumiaji dawa za kulevya kibinafsi ama waliolazimishwa kumeza. Msisimuo wa mshikamano wa HPA, ni mkubwa katika watumiaji dawa wa kibinafsi na hata baada ya kuzuiliwa kwa ongezeko la kotikosteroni zitokanazo na opiati, upungufu wa chimbuko la neva ulitokea. Haya, bila shaka, yanahitaji kuchunguzwa zaidi. Mwisho, dawa zinazolevya huonekana kuathiri tu mpenyezo katika ukanda wa sabgranula (SGZ),badala ya maeneo mengine yanayohusiana na chimbuko la neva. Tafiti za matumizi ya dawa za kulevya na chimbuko la neva huenda zikawa na athari kwa bayolojia ya seli .<ref name="Eisch and Harburg"></ref> ===Uzoevu wa kisaikolojia wa dawa === Mfumo wa mridhiko kwa kiasi huchangia sehemu ya saikolojia ya uzoevu wa dawa za kulevya. Protini ya CREB, sababu yaunukuzi unaosisimuliwa na adeosini monophosfaeti kwa vipindi (cAMP) mara baada ya kufikia upeo wa juu, huchochea jeni zinazozalisha protini kama vile dinofini, ambayo hukatiza utoaji dopamini na kukatiza pia sakiti ya mridhiko kwa muda. Kwa watumiaji sugu wa dawa za kulevya, msisimuo endelevu wa CREB hivyo basi husababisha vipimo vikubwa kutumika ili kuibua athari sawa. Zaidi ya hayo humwacha mtumiaji na hisia za kukata tamaa kwa ujumla na kutoridhika na huwezi kupata mridhiko kutokana na shughuli ambazo alizifurahia awali, mara nyingi ikipelekea kurudia matumizi ya dawa ya kulevya kwa "raha" ya ziada.<ref> AJ Giannini, RQ Quinones , DM Martin. Role of beta-endorphin and cAMP in addiction and mania. Society for Neuroscience Abstracts. 15:149, 1998.</ref> Mfumo sawa, unaoathiri pia na dopamini, lakini unaotegemea kigezo tofauti cha unukuzi, CEBPB, pia imependekezwa. Katika hali hii kutolewa kwa dopamini kwenye neva za akumbeni za kiini kunaweza kuchochea kuongezeka kwa usanisi wa kileo P ambacho, kwa upande wake, kitaongeza usanisi wa dopamini katika VTA. Athari ya matokeo haya chanya huonekanaa kulemewa na matumizi ya mara kwa mara ya vileo.<ref name="pmid16771829">{{cite journal | author = Kovács KA, Steinmann M, Magistretti PJ, Halfon O, Cardinaux JR| title = C/EBPbeta couples dopamine signalling to substance P precursor gene expression in striatal neurones | journal = Journal of Neurochemistry | volume = 98 | issue = 5 | pages = 1390–9 | year = 2006 | month = Septemba | pmid = 16771829 | doi = 10.1111/j.1471-4159.2006.03957.x | url = }}</ref> ===Uhisivu=== Uhamasishaji ni kuongezeka kwa usikivu wa athari za dawa ya kulevya baada ya kuitumia kwa muda mrefu. Protini za delta FosB na kidhibiti cha protini-G inayoashiria 9-2 (RGS9 -2) hudhaniwa kuhusika: Kigezo cha unukuzi kinachojulikana kama delta FosB, hudhianiwa kuchochea jeni ambazo hukabiliana na athari za CREB, kwa kweli hungeza uhisivu wa mtumiaji wa athari za vileo. Delta FosB huongezeka polepole jinsi utumiaji dawa za kulevya unavyoongezeka na husalia katika hali ya utendakazi kwa wiki kadhaa baada ya matumizi ya mwisho-muda mrefu baada ya athari za CREB kufifia. Hisia za hali ya juu ambazo husababika hudhaniwa kuchangia utashi mkubwa wa dawa za kulevya, na mara nyingi huchochewa hata na vitu vya pembeni vinavyoashiria dawa za kulevya, kama vile tabia zinazohusiana na dawa au kuona vifaa vya dawa. Pana ushahidi kwamba FosB delta hata husababisha mabadiliko ya miundo ndani ya akumbeni za kiini , ambazo huaminika kusaidia kuendeleza utashi wa dawa, na pia inaweza kuchangia matukio mengi ya kurejelea matumizi ya dawa za kulevya miongoni mwa watumiaji waliotibiwa.<ref name="pmid11572966">{{cite journal |author=Nestler EJ, Barrot M, Self DW |title=DeltaFosB: a sustained molecular switch for addiction |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=98 |issue=20 |pages=11042–6 |year=2001 |month=Septemba |pmid=11572966 |pmc=58680 |doi=10.1073/pnas.191352698}}</ref><ref name="pmid14746512">{{cite journal |author=Chao J, Nestler EJ |title=Molecular neurobiology of drug addiction |journal=Annual Review of Medicine |volume=55 |pages=113–32 |year=2004 |pmid=14746512 |doi=10.1146/annurev.med.55.091902.103730}}</ref><ref name="pmid18552739">{{cite journal |author=Nestler EJ |title=The neurobiology of cocaine addiction |journal=Science & Practice Perspectives / a Publication of the National Institute on Drug Abuse, National Institutes of Health |volume=3 |issue=1 |pages=4–10 |year=2005 |month=Desemba |pmid=18552739}}</ref><ref name="pmid18184321">{{cite journal |author=Conversi D, Bonito-Oliva A, Orsini C, Colelli V, Cabib S |title=DeltaFosB accumulation in ventro-medial caudate underlies the induction but not the expression of behavioral sensitization by both repeated amphetamine and stress |journal=The European Journal of Neuroscience |volume=27 |issue=1 |pages=191–201 |year=2008 |month=Januari |pmid=18184321 |doi=10.1111/j.1460-9568.2007.06003.x}}</ref><ref name="pmid18293355">{{cite journal |author=Perrotti LI, Weaver RR, Robison B, Renthal W, Maze I, Yazdani S, Elmore RG, Knapp DJ, Selley DE, Martin BR, Sim-Selley L, Bachtell RK, Self DW, Nestler EJ |title=Distinct patterns of DeltaFosB induction in brain by drugs of abuse |journal= Synapse (New York, N.Y.) |volume=62 |issue=5 |pages=358–69 |year=2008 |month=Mei |pmid=18293355 |pmc=2667282 |doi=10.1002/syn.20500}}</ref><ref name="pmid18445218">{{cite journal |author=Nikulina EM, Arrillaga-Romany I, Miczek KA, Hammer RP |title=Long-lasting alteration in mesocorticolimbic structures after repeated social defeat stress in rats: time course of mu-opioid receptor mRNA and FosB/DeltaFosB immunoreactivity |journal=The European Journal of Neuroscience |volume=27 |issue=9 |pages=2272–84 |year=2008 |month=Mei |pmid=18445218 |pmc=2442756 |doi=10.1111/j.1460-9568.2008.06176.x}}</ref><ref name="pmid18842886">{{cite journal |author=Wallace DL, Vialou V, Rios L, Carle-Florence TL, Chakravarty S, Kumar A, Graham DL, Green TA, Kirk A, Iñiguez SD, Perrotti LI, Barrot M, DiLeone RJ, Nestler EJ, Bolaños-Guzmán CA |title=The influence of DeltaFosB in the nucleus accumbens on natural reward-related behavior |journal=The Journal of Neuroscience : the Official Journal of the Society for Neuroscience |volume=28 |issue=41 |pages=10272–7 |year=2008 |month=Oktoba |pmid= 18842886 |pmc=2653197 |doi=10.1523/JNEUROSCI.1531-08.2008}}</ref><ref name="pmid18640924">{{cite journal |author=Nestler EJ |title=Review. Transcriptional mechanisms of addiction: role of DeltaFosB |journal=Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences |volume=363 |issue=1507 |pages=3245–55 |year=2008 |month=Oktoba |pmid=18640924 |doi=10.1098/rstb.2008.0067 |pmc=2607320}}</ref><ref name="pmid19041372">{{cite journal |author=Ulery-Reynolds PG, Castillo MA, Vialou V, Russo SJ, Nestler EJ |title= Phosphorylation of DeltaFosB mediates its stability in vivo |journal=Neuroscience |volume=158 |issue=2 |pages=369–72 |year=2009 |month=Januari |pmid=19041372 |doi= 10.1016/j.neuroscience.2008.10.059 |pmc=2734485}}</ref><ref name="pmid19202072">{{cite journal |author=Kim Y, Teylan MA, Baron M, Sands A, Nairn AC, Greengard P |title= Methylphenidate-induced dendritic spine formation and DeltaFosB expression in nucleus accumbens |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=106 |issue=8 |pages=2915–20 |year=2009 |month=Februari |pmid=19202072 |doi=10.1073/pnas.0813179106 |pmc=2650365}}</ref><ref name="pmid19403004">{{cite journal |author=Chen JC, Chen PC, Chiang YC |title=Molecular mechanisms of psychostimulant addiction |journal=Chang Gung Medical Journal |volume=32 |issue=2 |pages=148–54 |year=2009 |pmid=19403004}}</ref><ref name="pmid19465087">{{cite journal |author=Teegarden SL, Scott AN, Bale TL |title=Early life exposure to a high fat diet promotes long-term changes in dietary preferences and central reward signaling |journal=Neuroscience |volume=162|issue=4|pages=924–32|year=2009 |month=Mei |pmid=19465087 |doi=10.1016/j.neuroscience.2009.05.029 |pmc=2723193}}</ref><ref name="pmid19523044">{{cite journal |author=Watanabe H, Henriksson R, Ohnishi YN, Ohnishi YH, Harper C, Sheedy D, Garrick T, Nyberg F, Nestler EJ, Bakalkin G, Yakovleva T |title=FOSB proteins in the orbitofrontal and dorsolateral prefrontal cortices of human alcoholics |journal=Addiction Biology |volume=14 |issue=3 |pages=294–7 |year=2009 |month=Julai |pmid=19523044 |doi=10.1111/j.1369-1600.2009.00155.x |pmc=2828493}}</ref> Kidhibiti cha protini-G ashiria 9-2 (RGS9-2) kimeangaziwa zaidi katika tafiti za wanyama katika miaka ya hivi majuzi. Wanyama wasio na RGS9-2 huonekana kuwa na hisia iliyoongezeka za uhisivu wa vipokezi vya agonisti za dopamini kama vile kokeni na amfetamini, kudhihirika zaidi kwa RGS9-2husababisha ukosefu wa mwitikio kwa agonisti hizi. RGS9 2- huaminika kwa kuzidisha kasi ya kutotenda kwa vipokezi D2 vya protini G- kwa kuongeza kasi ya hidrolisisi ya GTP ya kisehemu cha G alpha ambacho hufikisha ishara ndani ya seli.<ref name="pmid15632124">{{cite journal |author=Garzón J, Rodríguez-Muñoz M, López-Fando A, Sánchez-Blázquez P |title=Activation of mu-opioid receptors transfers control of Galpha subunits to the regulator of G-protein signaling RGS9-2: role in receptor desensitization |url=https://archive.org/details/sim_journal-of-biological-chemistry_2005-03-11_280_10/page/n338 |journal=The Journal of Biological Chemistry |volume=280 |issue=10 |pages=8951–60 |year=2005 |month= Machi |pmid=15632124 |doi=10.1074/jbc.M407005200}}</ref><ref name="pmid15728856">{{cite journal |author=Kovoor A, Seyffarth P, Ebert J, Barghshoon S, Chen CK, Schwarz S, Axelrod JD, Cheyette BN, Simon MI, Lester HA, Schwarz J |title=D2 dopamine receptors colocalize regulator of G-protein signaling 9-2 (RGS9-2) via the RGS9 DEP domain, and RGS9 knock-out mice develop dyskinesias associated with dopamine pathways |url=https://archive.org/details/sim_journal-of-neuroscience_2005-02-23_25_8/page/n292 |journal=The Journal of Neuroscience |volume=25 |issue=8 |pages=2157–65 |year=2005 |month=Februari |pmid=15728856 |doi= 10.1523/JNEUROSCI.2840-04.2005}}</ref><ref name="pmid15829256">{{cite journal |author=Garzón J, Rodríguez-Muñoz M, Sánchez-Blázquez P |title=Morphine alters the selective association between mu-opioid receptors and specific RGS proteins in mouse periaqueductal gray matter |journal=Neuropharmacology |volume=48 |issue=6 |pages=853–68 |year=2005 |month=Mei |pmid= 15829256 |doi=10.1016/j.neuropharm.2005.01.004}}</ref><ref name="pmid16510730">{{cite journal |author=Bouhamdan M, Yan HD, Yan XH, Bannon MJ, Andrade R |title=Brain-specific regulator of G-protein signaling 9-2 selectively interacts with alpha-actinin-2 to regulate calcium-dependent inactivation of NMDA receptors |url=https://archive.org/details/sim_journal-of-neuroscience_2006-03-01_26_9/page/2522 |journal=The Journal of Neuroscience : the Official Journal of the Society for Neuroscience |volume=26 |issue=9 |pages=2522–30 |year=2006 |month=Machi |pmid=16510730 |doi=10.1523/JNEUROSCI.4083-05.2006}}</ref><ref name="pmid17493623">{{cite journal |author=Silverman JL, Koenig JI |title=Evidence for the involvement of ERbeta and RGS9-2 in 17-beta estradiol enhancement of amphetamine-induced place preference behavior |journal=Hormones and Behavior |volume=52 |issue=2 |pages=146–55 |year=2007 |month=Agosti |pmid=17493623 |pmc=2096711 |doi=10.1016/j.yhbeh.2007.03.017}}</ref><ref name="pmid17880927">{{cite journal |author=Hooks SB, Martemyanov K, Zachariou V |title=A role of RGS proteins in drug addiction |journal=Biochemical Pharmacology |volume=75 |issue=1 |pages=76–84 |year=2008 |month=Januari |pmid=17880927 |doi=10.1016/j.bcp.2007.07.045}}</ref><ref name="pmid19098104">{{cite journal |author=Martemyanov KA, Krispel CM, Lishko PV, Burns ME, Arshavsky VY |title=Functional comparison of RGS9 splice isoforms in a living cell |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=105 |issue=52 |pages=20988–93 |year=2008 |month=Desemba |pmid=19098104 |pmc=2634932 |doi=10.1073/pnas.0808941106}}</ref><ref name="pmid19211160">{{cite journal |author= Traynor JR, Terzi D, Caldarone BJ, Zachariou V |title=RGS9-2: probing an intracellular modulator of behavior as a drug target |journal=Trends in Pharmacological Sciences |volume=30 |issue=3 |pages=105–11 |year=2009 |month=Machi |pmid=19211160 |doi=10.1016/j.tips.2008.11.006}}</ref> ===Utaratibu wa athari kwa mtu binafsi === Taratibu za kimsingi ambayo vileo tofauti huibusha mfumo wa uridhifu ni kama ilivyoelezwa hapo juu, lakini hutofautiana kidogo baina ya makundi ya dawa za kulevya.<ref>{{cite journal |author=Miller NS, Giannini AJ |title=The disease model of addiction: a biopsychiatrist's view |journal=J Psychoactive Drugs |volume=22 |issue=1 |pages=83–5 |year=1990 |pmid=2324867}}</ref> ;Vifadhaishi Vichochezi-vya-mfadhaiko kama vile pombe, vitulizi, na benzodiazepini hutenda kazi kwa kuongeza mshikamano wa vipokezi vya GABA kwa ligandi yake; GABA. Mihadarati kama vile Mofini na [[heroini]] hufanya kazi kwa kuiga endofin - kemikali zinazozalishwa na mwili kwa kawaida ambazo huwa na athari sawa na ya dopamini-au kwa kulemaza neva ambazo kwa kawaida huzuia kutolewa kwa dopamini katika mfumo wa uridhifu. Hivi vileo (wakati mwingine huitwa "vitelekezi") kwa kawaida huwezesha utulivu na upungufu wa maumivu. ;Vichocheo Vichocheokama vile amfetamini [[Nikotini|nikotini]], na [[Kokain|kokeni]] huongeza ishara zinazoibusha dopamini katika mfumo wa uridhifu ama kwa kuchoche kutolewa kwake moja moja kwa au kwa kuzuia kufyonzwa kwake (tazama "Reuptake"). Vileo hivi (wakati mwingine huitwa "viinua-hisia") kwa kawaida husababisha ongezeko la umakinifu na nguvu. Nazo husababisha hisia nzuri mwilini na furaha tele, inayojulikana kama mwinuko-hisia. Punde mwinuko-hisia unapoyoyomea, mtumiaji dawa anaweza kuhisi huzuni. Hii huwafanya kutaka kipimo kingine cha dawa ya kulevya, na inaweza kuzidisha utegemezi kwa dawa ya kulevya. ==Utaratibu wa Kimatibabu== Utegemezi wa dawa za kulevya ni ugonjwa sugu lakini unaotibika. Hubainika kwa utashi wa kimazoea wa dawa za kulevya, utafutaji dawa, na matumizi ambayo huendelezwa hata licha ya madhara yake makubwa. Kwa watu wengi, matumizi ya dawa za kulevya hugeuka sugu, na kurejelea matumizi huwezekana hata baada ya muda mrefu wa kuacha. Kama ugonjwa sugu, unaorejearejea, kulevya kunaweza kuhitaji matibabu endelevu ili kuongeza vipindi baina ya urejeleaji na upunguzaji athari yake. Kupitia kwa matibabu yanayoambatana na mahitaji ya mtu binafsi, watu wanaotegemea dawa za kulevya wanaweza kupona na kuishi maisha bora. Lengo kuu la matibabu ya kulevya ni kumwezesha mtu binafsi kufikia kuacha ambako kutadumu, lakini malengo ya muda mfupi ni kupunguza matumizi mabaya ya kileo, kuboresha uwezo wa kutenda kazi wa mgonjwa na kupunguza matatizo ya kimatibabu na kijamii ya utumiaji mbaya na utegemeaji wa dawa za kulevya. Sawa na watu wenye ugonjwa wa kisukari au ugonjwa wa moyo, watu wanaotibiwa kwa utegemeaji wa dawa za kulevya huhitaji mabadiliko ya tabia ili kuzingatia maisha yanayolenga afya bora zaidi.<ref>[http://www.nida.nih.gov/Infofacts/treatmeth.html Mikabala ya Matibabu kwa Utegemezi wa Dawa za kulevya] {{Wayback|url=http://www.nida.nih.gov/Infofacts/treatmeth.html |date=20101017085347 }}, Taasisi ya Taifa ya Dawa za Kulevya</ref> Matibabu ya utegemeaji wa dawa za kulevya hutofautiana sana kulingana na aina ya dawa husika, kiasi cha dawa kilichotumika,muda wa utegemeaji wa dawa ya kulevya, matatizo ya kiafya na mahitaji ya kijamii ya mtu binafsi. Uamuzi wa aina bora zaidi ya mpango wa matibabu kwa mtu anayetegemea dawa za kulevya hutegemea vigezo kadhaa kama vile: tabia, dawa za kulevya anazopendelea mtumiaji, dhana za kiimani au kidini, ugonjwa wa akili au kimwili, na upatikanaji na gharama ya mpango. Mawazo mengi tofauti huenea kuhusu kinachochukuliwa kama matokeo ya "kufanikiwa" kupona kutoka kwa utegemeaji wa dawa za kulevya. Inakubalika sana kuwa kuacha matumizi ya kileo ni matokeo ya mafanikio. Hata hivyo, kufikia hali ya kuacha sio rahisi kufikia kwa kawaida. Mipango ambayo husisitiza unywaji uliodhibitiwa huwepo kwa wategemezi wa pombe. Tiba ya kubadili opiati imekuwa njia inayokubalika ya matibabu ya utegemeaji wa opioidi kwa miaka mingi. Matibabu na mitazamo kuhusu utegemeaji kwa vileo hutofautiana sana kati ya nchi mbalimbali. Huko Marekani na nchi zinazoendelea, lengo la matibabu kwa utegemezi wa dawa za kulevya kwa ujumla ni kusidia kuacha dawa zote za kulevya. Licha ya kuwa halisi, mpango huu kwa hakika sio rahisi kutimiza. Nchi nyinginezo, hasa za Ulaya, zinaonelea kuwa malengo ya matibabu ya utegemezi wa dawa za kulevya ni mpana zaidi, kwani malengo ya matibabu hujumuisha upunguzaji matumizi kwa kiasi kwamba matumizi ya dawa za kulevya yasiweze tena kuhitilafiana na shughuli za kawaida kama vile kazi na majukumu ya familia, kumgeuza mtumiaji kutoka njia hatari zaidi za kutumia dawa za kulevya kama vile kudunga kwa sindano hadi kwa njia salama kama vile kumeza kwa mdomo, kupunguza uhalifu unaotekelezwa na watumiaji wa dawa za kulevya na matibabu ya hali nyinginezo za komobidi kama vile [[Ukimwi|UKIMWI]], hepatiti na matatizo ya afya ya akili Matokeo ya aina hii yanaweza kupatikana bila kuondoa kabisa matumizi ya dawa. Mipango ya matibabu ya dawa za kulevya kule Ulaya mara nyingi huripoti matokeo mazuri zaidi kuliko ile ya Marekani kwa sababu vigezo vya kupima mafanikio imejikita katika utendaji kuliko misingi ya kuacha.<ref name="Ball and van de Wijngaart">{{cite journal |author=Ball JC, van de Wijngaart GF |title=A Dutch addict's view of methadone maintenance—an American and a Dutch appraisal |url=https://archive.org/details/sim_british-journal-of-addiction_1994-07_89_7/page/799 |journal=[[Addiction (journal)|Addiction]] |volume=89 |issue=7 |pages=799–802; discussion 803–14 |year=1994 |pmid=8081178 |doi=10.1111/j.1360-0443.1994.tb00974.x}}</ref><ref name="Reynolds">{{cite journal |author=Reynolds M, Mezey G, Chapman M, Wheeler M, Drummond C, Baldacchino A |title=Co-morbid post-traumatic stress disorder in a substance misusing clinical population |url=https://archive.org/details/sim_drug-and-alcohol-dependence_2005-03-07_77_3/page/n48 |journal=Drug Alcohol Depend |volume=77 |issue=3 |pages=251–8 |year=2005 |pmid=15734225 |doi=10.1016/j.drugalcdep.2004.08.017}}</ref><ref name="Moggi">{{cite journal |author=Moggi F, Giovanoli A, Strik W, Moos BS, Moos RH |title=Substance use disorder treatment programs in Switzerland and the USA: Program characteristics and 1-year outcomes |url=https://archive.org/details/sim_drug-and-alcohol-dependence_2007-01-05_86_1/page/n78 |journal=Drug Alcohol Depend |volume=86 |issue=1 |pages=75–83 |year=2007 |pmid=16782286 |doi=10.1016/j.drugalcdep.2006.05.017}}</ref> Waungaji mkono mipango inayolenga kuacha kabisa matumizi ya dawa za kulevya kwa jumla hushikilia kwamba kuwezesha matumizi zaidi ya dawa humaanisha tu muda mrefu wa matumizi ya dawa na ongezeko la hatari na matatizo ya kulevya.<ref name="Nils Bejerot"> Nils Bejerot: Swedish epidemic in an internationa perspective, 1988</ref> ===Makazi=== Matibabu kwa matumizi ya dawa za kulevya katika makazi yanaweza kugawanywa katika aina mbili pana: mipango ya hatua 12 au Jumuiya za Kimatibabu. Mipango ya hatua 12 huwa na faida ya kuja na mtandao usaidizi wa kijamii, ingawa baadhi hawaridhishwi na uzingatiaji maswala ya kiimani. Nchini Uingereza matibabu ya dawa za kulevya kwa ujumla inaelekea mkondo wa mkabala jumuishi zaidi huku vituo vya marekebisho vikipendekeza aina tofauti za mikabala. Mipango hii mingine inaweza kutumia Tiba za mikabala ya Mawazo-Tabia kama vile kupona SMART, ambayo hutazama uhusiano kati ya mawazo hisia na tabia, huku wakitambua kwamba mabadiliko yoyote katika mojawapo ya haya yanaweza kuathiri mengine yote. CBT huchukulia utegemezi dawa za kulevya zaidi kama tabia kuliko ugonjwa na hatimaye pia hutibika, au tuseme, husahaulika. Mipango ya CBT kutambua kuwa kwa baadhi ya watu matumizi yaliyodhibitiwa yanaweza kutekelezeka kihalisi zaidi.<ref>{{cite journal |author=Giannini AJ |title=Alexithymia, affective disorders and substance abuse: possible cross-relationships |journal=Psychol Rep |volume=78 |issue=3 Pt 2 |pages=1389–90 |year=1996 |month=Juni |pmid=8816054}}</ref> Njia mojawapo kati ya nyinginezo za kutibiwa ni ile ya mpango wa tiba ya hatua 12, ambapo mifano yake maarufu ni kama vile Alcoholics Anonymous, Narcotics Anonymous, Drug Addicts Anonymous <ref> [http://www.drugaddictsanonymous.org.uk/ DAA / Uingereza]</ref> na Pills Anonymous. Zinajulikana na kutumiwa kwa aina tofauti za utegemezi ulevi na mtu anayetegemea ulevi na familia ya mtu kama huyo. Urekebishwaji kutokana na matumizi mabaya ya vileo (au vituo vya "marekebisho") mara nyingi huwa ni wa mpango wa tiba ya makazi kwa walioathirika mno ili kumtenga mgonjwa na dawa za kulevya na mwingiliano na watumiaji wengine na walanguzi. Kliniki za kutolazwa kwa kawaida hutoa ushauri wa mtu binafsi na ushauri wa vikundi. Mara kwa mara na daktari au mtaalamu wa akili anaweza kusaidia katika kubainisha dawa na madhara ya dawa za kulevya. Dawa zinaweza kusaidia pakubwa dhidi ya wasiwasi, ukosefu wa usingizi na pia kutibu matatizo ya akili yasiyo wazi (taz. Nadharia tete ya tiba-ya-kibinafsi, Khantzian 1997) kama vile (kiwewe cha manic-), na inaweza kusaidia kupunguza au kuondosha dalili za kuacha matumizi wakati mtu anapojiondoa kutoka dawa zinazoweza kutegemeza kimwili. Baadhi ya mifano hutumia benzodiazepini kwa kusafisha athari za pombe, ambayo huzuia deliriamu tremensi na matatizo, kwa kutumia taper ya polepole ya benzodiazepini au taper ya {2fenobabitali,{/2} wakati mwingine ikijumuisha vidonge vinavyokabiliana na kifafa kama vile gabapentini, pregabalini, au valproati, kwa ajili ya kujiondoa kutoka vitulizi/babitureti au benzodiazepini, kwa kutumia dawa za kulevya kama vile baklofeni kupunguza utashi na msukumo wa kurejelea miongoni mwa watumiaji wa dawa ya kulevya yoyote ile, huwa hasa na ufanisi katika watumiaji vichochezi, na wanywaji pombe (ambapo ina ufanisi unaokaribiana na wa benzodiazepini katika kuzuia matatizo); kwa kutumia klonidini, a benzodiazepini, na loperamidi kwa kusafisha opioidi kwa watumiaji wa mara ya kwanza au wale ambao wanajaribu kupata afueni ya kutotumia kabisa dawa za kulevya (90% ya watumiaji wa opioid hurejelea matumizi sugu ya dawa za kulevya katika miezi 8 na / au ni "wagonjwa wanaorejelea matumizi mara nyingi"), au kubadilisha opioidi ambayo inahitilafiana na au kudhuru maisha ya mtumiaji kama vile[[heroini]] inayopatikana kwa haramu, Dilaudidi, au oksikodoni pamoja na opioidi ambayo inaweza kutumika kihalali, hupunguza au kumaliza utashi wa dawa za kulevya, na isiyozua mwinukio-hisia, kama vile methadoni au buprenofini - tiba ya kubadili opioidi - ambayo ni kiwango cha dhahabu cha matibabu ya utegemezi wa opioidi katika nchi zilizoendelea, inayopunguza hatari na gharama kwa mtumiaji na jamii kwa ufanisi zaidi kuliko njia za matibabu (kwa utegemezi wa opioidi), na huonyesha mafanikio bora ya muda mfupi na ya muda mrefu kwa mtumiaji, iliyo na urefu mkubwa, hatari ndogo wa kudhurika, ubora wa juu zaidi wa maisha na hatari ya chini zaidi ya kurejelea matumizi na / au masuala ya kisheria ikiwa ni pamoja na kukamatwa na kufungiwa. Katika utafiti wa [http://www.drugrehabs.ca/Sitemap.html watoa huduma za matibabu] {{Wayback|url=http://www.drugrehabs.ca/Sitemap.html |date=20101118223153 }} kutoka taasisi tatu tofauti (Chama cha Taifa cha Washauri wa maswala ya Ulevi na Dawa za Kulevya, Mifumo Razini ya Kimatibabu na Chama cha Wanasaikolojia wa Tabia za Utegemezi) iliyopima majibu ya watoa huduma kuhusu Upimifu wa Imani za Kiroho (kipimo cha imani kwa vigezo vinne vya AA vya kiroho vinavyotambuliwa na Ernest Kurtz),matokeo yalionekana kueleza 41% ya utofautiano katika majibu ya watoa huduma kuhusu Kipimo cha Imani Utegemeaji wa Vilewevu (kipimaji kinachokadiria uzingativu wa kielelezo cha ugonjwa au kielelezo cha hiari-huru wa dawa za kulevya).<ref name="SCHALER1997">{{cite journal |last=Schaler |first=Jeffrey Alfred |title=Addiction Beliefs of Treatment Providers: Factors Explaining Variance |journal=Addiction Research & Theory |volume=4 |issue=4 |year=1997 |pages=367–384 |doi=10.3109/16066359709002970 |issn=1476-7392}}</ref> ===Dawa zinazokabiliana na kulevya=== Aina nyingine za matibabu ni pamoja na dawa badalia kama vile methadoni, suboksoni / subuteksi ambazo kwa pamoja za kuigwa zinajulikana kama buprenofini, zote hutumika kama dawa mbadala kwa zile haramu za opiati .<ref>{{cite journal |author=Johnson RE, Chutuape MA, Strain EC, Walsh SL, Stitzer ML, Bigelow GE |title=A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence |url=https://archive.org/details/sim_new-england-journal-of-medicine_2000-11-02_343_18/page/1290 |journal=N. Engl. J. Med. |volume=343 |issue=18 |pages=1290–7 |year=2000 |pmid=11058673|doi=10.1056/NEJM200011023431802}}</ref><ref>{{cite journal |author=Connock M, Juarez-Garcia A, Jowett S, et al. |title=Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation |journal= Health Technol Assess |volume=11 |issue=9 |pages=1–171, iii–iv |year=2007 |pmid=17313907}}</ref> Ingawa dawa zenyewe pia zinaweza kuwa tegemezi, lengo la kudumisha opiati ni kutoa vipimo vilivyosimamiwa kimatibabu, kiwango thabiti cha matumizi ya opioidi fulani ili kutoa kiasi cha udhibiti dhiti ya maumivu na utashi. Hii hutoa nafasi kwa mtegemezi dawa za kulevya kufanya kazi kikawaida na kupunguza madhara hasi yanayohusiana na kupata vipimo toshelezi vya vileo vilivyodhibitiwa kiharamu kwa kupunguza utashi wa opioidi na dalili za kujionda. Mradi kipimo kinachokubalika kimeshatimizwa, matibabu huingia katika awamu ya kutunzwa au kupunguka. Nchini Marekani, tiba badalia ya opiati husimamiwa kikamilifu katika kliniki za methadoni na chini ya sheria ya DATA 2000. Katika baadhi ya nchi, dawa nyingine zinazotokana na opioidi kama vile asetati levomethadili,<ref>{{cite journal |author=Marsch LA, Stephens MA, Mudric T, Strain EC, Bigelow GE, Johnson RE |title=Predictors of outcome in LAAM, buprenorphine, and methadone treatment for opioid dependence |journal=Exp Clin Psychopharmacol |volume=13 |issue=4 |pages=293–302 |year=2005 |pmid=16366759 |doi=10.1037/1064-1297.13.4.293}}</ref> dihaidrokodeini,<ref>{{cite journal |author=Robertson JR, Raab GM, Bruce M, McKenzie JS, Storkey HR, Salter A |title=Addressing the efficacy of dihydrocodeine versus methadone as an alternative maintenance treatment for opiate dependence: A randomized controlled trial |url=https://archive.org/details/sim_british-journal-of-addiction_2006-12_101_12/page/1752 |journal=[[Addiction (journal)|Addiction]] |volume=101 |issue=12 |pages=1752–9 |year=2006 |pmid=17156174 |doi=10.1111/j.1360-0443.2006.01603.x}}</ref> dihaidroetofini<ref>{{cite journal |author=Qin Bo-Yi |title=Advances in dihydroetorphine: From analgesia to detoxification |journal=Drug Development Research|volume=39|issue=2 |pages=131–134 |year=1998 |doi= 10.1002/(SICI)1098-2299(199610)39:2<131::AID-DDR3>3.0.CO;2-Q}} [http://www3.interscience.wiley.com/cgi-bin/abstract/67067/ABSTRACT?CRETRY=1&amp;SRETRY=0 Link] {{Webarchive|url=https://archive.today/20121210055522/http://www3.interscience.wiley.com/cgi-bin/abstract/67067/ABSTRACT?CRETRY=1&SRETRY=0 |date=2012-12-10 }}</ref> na hata [[heroini]]<ref name="Metrebian1">{{cite journal |author=Metrebian N, Shanahan W, Wells B, Stimson GV |title=Feasibility of prescribing injectable heroin and methadone to opiate-dependent drug users: associated health gains and harm reductions |url=https://archive.org/details/sim_medical-journal-of-australia_1998-06-15_168_12/page/596 |journal=Med. J. Aust. |volume=168 |issue=12 |pages=596–600 |year=1998 |pmid=9673620}}</ref><ref name="Metrebian2">{{cite journal |author=Metrebian N, Mott J, Carnwath Z, Carnwath T, Stimson GV, Sell L |title=Pathways into receiving a prescription for diamorphine (heroin) for the treatment of opiate dependence in the United kingdom |journal=Eur Addict Res |volume=13 |issue=3 |pages=144–7 |year=2007 |pmid=17570910 |doi=10.1159/000101550}}</ref> hutumika kama dawa mbadala badala ya dawa zinazolanguliwa za opiati , huku dawa tofauti zikitumika kulingana na mahitaji ya mgonjwa binafsi. Baklofeni imeonekana kufanikiwa katika kupunguza utashi wa dawa nyingi za kulevya - vichochezi, ethanoli, na opioidi - na pia hupunguza dalili halisi za kujiondoa katika matumizi ya ethanoli. wagonjwa wengi wamesema kwamba wao "huhisi badiliko dhidi ya pombe" au "huhisi badiliko dhidi ya kokeni" mara moja baada ya kuanza tiba ya baklofeni.<ref>{{cite journal |author=Kenna GA, Nielsen DM, Mello P, Schiesl A, Swift RM |title=Pharmacotherapy of dual substance abuse and dependence |journal=CNS Drugs |volume=21 |issue=3 |pages=213–37 |year=2007 |pmid=17338593 |doi= 10.2165/00023210-200721030-00003}}</ref> Inawezekana kwamba mojawapo ya tiba bora zaidi, ambayo ingali kueleweka kikamilifu, mbinu ya matibabu ya utegemeaji wa opioidi - ambao ndio utegemeaji mgumu zaidi kutibu (na kupata nafuu kutoka nayo), ikiwa na uwezekano wa kurejelea wa kiwango kinachokaribia 60% kwa wiki nne na 97% katika kipindi cha miezi kumi na miwili ikiwa hawapo katika tiba ya utunzaji na mu-opioidi agonisti<ref>{{cite journal |author=Kenna GA, Nielsen DM, Mello P, Schiesl A, Swift RM |title=Pharmacotherapy of dual substance abuse and dependence |journal=CNS Drugs |volume=21 |issue=3 |pages=213–37 |year=2007 |pmid=17338593 |doi= 10.2165/00023210-200721030-00003}}</ref> - itakuwa kuchanganya kidonge kinachodumisha opioidi, kama vile methadoni au buprenorphini, ya kuzuia dalili za kujiondoa katika matumizi, na baklofeni ya kupunguza utashi na hamu ya kutumia, kwa watu ambao hujipata wangali wanatumia au wangali na utashi huku wakiwa katika tiba ya methadoni au tunzo ya buprenofini. Dawa mbadala kwa aina nyingine za utegemezi wa dawa za kulevya, kihistoria hazijakuwa na mafanikio kama ule wa tiba mbadala ya opioidi, ingawa kiasi fulani cha mafanikio kimeonekana katika matumizi ya dawa kama vile dektroamfetaminiya kutibu utegemezi wa visisimuo vya kulevya,<ref>{{cite journal |author=Mattick RP, Darke S |title=Drug replacement treatments: is amphetamine substitution a horse of a different colour? |journal=Drug Alcohol Rev |volume=14 |issue=4 |pages=389–94 |year=1995 |pmid=16203339 |doi=10.1080/09595239500185531}}</ref><ref>{{cite journal |author=White R |title=Dexamphetamine substitution in the treatment of amphetamine abuse: an initial investigation |url=https://archive.org/details/sim_british-journal-of-addiction_2000-02_95_2/page/229 |journal=[[Addiction (journal)|Addiction]] |volume=95 |issue=2 |pages=229–38 |year=2000 |pmid=10723851 |doi=10.1046/j.1360-0443.2000.9522299.x}}</ref> na klomethiazoli inayotibu utegemezi wa pombe.<ref>{{cite journal |author=Majumdar SK |title= Chlormethiazole: current status in the treatment of the acute ethanol withdrawal syndrome |url=https://archive.org/details/sim_drug-and-alcohol-dependence_1991-05_27_3/page/201 |journal=Drug Alcohol Depend |volume=27 |issue=3 |pages=201–7 |year=1991 |pmid=1884662 |doi=10.1016/0376-8716(91)90001-F}}</ref> Bromokriptini na desipramini zimeripotiwa kuwa na ufanisi katika matibabu ya kokeni na sio kwa matibabu ya utegemeaji wa amfetamini.<ref>{{cite journal |author=Giannini AJ, Billett W |title=Bromocriptine-desipramine protocol in treatment of cocaine addiction |journal=J Clin Pharmacol |volume=27 |issue=8 |pages=549–54 |year=1987 |month=Agosti |pmid=3308977}}</ref> Matibabu mengine ya dawa za utegemeaji wa pombe ni pamoja na dawa ya kama vile naltreksoni, disulfiramu, akamprosati na topiramati,<ref>{{cite journal |author=Soyka M, Roesner S |title=New pharmacological approaches for the treatment of alcoholism |journal=Expert Opin Pharmacother |volume=7 |issue=17 |pages=2341–53 |year=2006 |pmid=17109610 |doi= 10.1517/14656566.7.17.2341}}</ref><ref>{{cite journal |author=Pettinati HM, Rabinowitz AR |title=Choosing the right medication for the treatment of alcoholism |journal=Curr Psychiatry Rep |volume=8 |issue=5 |pages=383–8 |year=2006 |pmid=16968619|doi=10.1007/s11920-006-0040-0}}</ref> badala ya kubadili kwa pombe, dawa hizi hulenga kupunguza hamu ya kunywa, angalau kwa kupunguza utashi moja kwa moja kama katika akamprosati na topiramati, au kwa kuzalisha athari zisizopendeza wakati pombe inapotumiwa, sawa na ilivyo kwa disulfiramu. Dawa hizi zinaweza kuwa na ufanisi iwapo matibabu yataduishwa, lakini kufuata ratiba kunaweza kuwa suala la kutatiza kwani wagonjwa wa ulevi mara nyingi husahau kumeza dawa zao, ama huacha kutumia kwa sababu ya madhara mengi.<ref>{{cite journal |author=Bouza C, Angeles M, Magro A, Muñoz A, Amate JM |title=Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review |url=https://archive.org/details/sim_british-journal-of-addiction_2004-07_99_7/page/811 |journal=[[Addiction (journal)|Addiction]] |volume=99 |issue=7 |pages=811–28 |year=2004 |pmid=15200577 |doi=10.1111/j.1360-0443.2004.00763.x}}</ref><ref>{{cite journal |author=Williams SH |title=Medications for treating alcohol dependence |url=https://archive.org/details/sim_american-family-physician_2005-11-01_72_9/page/n150 |journal=Am Fam Physician |volume=72 |issue=9 |pages=1775–80 |year=2005 |pmid=16300039}}</ref> Dawa za ziada zinazotumika kwa glutamati ya mawasiliano katika neva kama vile modafinili, lamotrijini, gabapentini na memantini pia zimependekezwa kutumika kutibu utegemeaji wa pombe na dawa nyinginezo.<ref>{{cite journal |author=Gass JT, Olive MF |title=Glutamatergic substrates of drug addiction and alcoholism |journal=Biochem. Pharmacol. |volume=75 |issue=1 |pages=218–65 |year=2008 |pmid=17706608 |doi=10.1016/j.bcp.2007.06.039 |pmc=2239014}}</ref> Vipingiti vya opioidi kama vile naltreksoni na nalmefeni pia vinatumiwa kwa mafanikio katika matibabu ya utegemezi wa pombe,<ref>{{cite journal |author=Srisurapanont M, Jarusuraisin N |title=Opioid antagonists for alcohol dependence |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD001867 |year=2005 |pmid=15674887 |doi= 10.1002/14651858.CD001867.pub2}}</ref><ref>{{cite journal |author=Karhuvaara S, Simojoki K, Virta A, et al. |title=Targeted nalmefene with simple medical management in the treatment of heavy drinkers: a randomized double-blind placebo-controlled multicenter study |journal=Alcohol. Clin. Exp. Res. |volume=31 |issue=7 |pages=1179–87 |year=2007 |pmid=17451401 |doi=10.1111/j.1530-0277.2007.00401.x}}</ref> ambayo mara nyingi huwa changamoto kutibu. Wengine pia wamejaribu kutumia dawa hizi kwa tiba ya kuwatunza watumiaji wa awali wa opiati na kupata mafanikio madogo. Haziwezi kuanzishwa hadi mgonjwa aweze kuacha matumizi kwa kipindi kipana cha muda - haina uwezekano kwa watumiaji ambao hawapo katika tunzo kamili au tunzo kiasi ya agonisti ya mu-opioidi - au zitazua dalili kali za kujiondoa katika matumizi ya opioidi. Hakuna utafiti ambao umezionyesha kuwa na ufanisi katika matibabu ya kuzuia kurejelea matumizi ya dawa za kulevya. Hazizuii tamaa na huzuia endofini na enkefalini, viwasilishi-neva viwili vya asili ambavyo hudhibiti hisia za mtu za hali bora kiafya. Mtegemezi anastahili kusitisha matumizi ya dawa za kulevya kwa masaa kumi tu ili kuendelea kuitumia tena.<ref>{{cite journal |author=Comer SD, Sullivan MA, Hulse GK |title=Sustained-release naltrexone: novel treatment for opioid dependence |journal=Expert Opin Investig Drugs |volume=16 |issue=8 |pages=1285–94 |year=2007 |pmid=17685876 |doi=10.1517/13543784.16.8.1285}}</ref> Matibabu ya utegemezi wavichochezi inaweza kuwa ngumu, na mara kwa mara dawa badala mara nyingi huwa hazifanyi kazi, ingawa dawa mpya kama vile nokaini, vanokserini na modafinili zinaweza kuwa bora zaidi katika hali hili, pamoja na GABA _B agonisti baklofeni.<ref>{{cite journal |author=Ling W, Rawson R, Shoptaw S, Ling W |title=Management of methamphetamine abuse and dependence |journal=Curr Psychiatry Rep |volume=8 |issue=5 |pages=345–54 |year=2006 |pmid=16968614 |doi=10.1007/s11920-006-0035-x}}</ref><ref>{{cite journal |author=Preti A |title=New developments in the pharmacotherapy of cocaine abuse |journal=Addict Biol |volume=12 |issue=2 |pages=133–51 |year=2007 |pmid=17508985 |doi= 10.1111/j.1369-1600.2007.00061.x}}</ref> Mkakati mwingine ambao ulionyesha mafanikio ya kimajaribio hivi karibuni ni uliotumia mchanganyiko wa flumazenili pingiti vya benzodiazepini pamoja na haidrosizini na gabapentini kwa matibabu ya utegemeaji wa methamfetamini.<ref>{{cite journal |author=Urschel HC, Hanselka LL, Gromov I, White L, Baron M |title= Open-label study of a proprietary treatment program targeting type A gamma-aminobutyric acid receptor dysregulation in methamphetamine dependence |url=https://archive.org/details/sim_mayo-clinic-proceedings_2007-10_82_10/page/1170 |journal=Mayo Clin. Proc. |volume=82 |issue=10 |pages=1170–8 |year=2007 |pmid=17908523 |doi=10.4065/82.10.1170}}</ref> Sehemu nyingine ambapo matibabu ya dawa za kulevya imetumika sana ni katika kutibu utegemeaji wa [[nikotini]]. Dawa mbalimbali zimetumika kwa kusudi hili kama vile bupropioni, mekamilamini na vareniklini iliyovumbuliwa hivi karibuni zaidi. Vipingiti vya kanaboinoidi rimonabanti pia vimejaribiwa kwa matibabu ya utegemezi wa nikotini lakini bado haijakubalika sana kwa kusudi hili.<ref>{{cite journal |author=Garwood CL, Potts LA |title=Emerging pharmacotherapies for smoking cessation |url=https://archive.org/details/sim_american-journal-of-health-system-pharmacy_2007-08-15_64_16/page/n34 |journal=Am J Health Syst Pharm |volume= 64 |issue=16 |pages=1693–8 |year=2007 |pmid=17687057 |doi=10.2146/ajhp060427}}</ref><ref>{{cite journal |author=Frishman WH |title=Smoking cessation pharmacotherapy—nicotine and non-nicotine preparations |journal=Prev Cardiol |volume=10 |issue=2 Suppl 1 |pages=10–22 |year=2007 |pmid=17396063|doi=10.1111/j.1520-037X.2007.05963.x}}</ref><ref>{{cite journal |author=Siu EC, Tyndale RF |title=Non-nicotinic therapies for smoking cessation |url=https://archive.org/details/sim_annual-review-of-pharmacology-and-toxicology_2007_47/page/541 |journal=Annu. Rev. Pharmacol. Toxicol. |volume=47 |pages=541–64 |year=2007 |pmid=17209799 |doi= 10.1146/annurev.pharmtox.47.120505.105354}}</ref> Ibogeni ni halusinojeni (saikotomimetri) - dawa isiyo halali ambayo baadhi ya huzua fikra-njozi kwamba ambayo makundi fulani hudai kuwa hupinga utegemeaji wa dawa za kulevya na kupunguza au kuondoa dalili za kujiondoa katika matumizi, hasa zinazohusiana na opioidi.<ref name="ibogaine">{{cite journal |author=K.R. Alper, H.S. Lotsof, G.M. Frenken, D.J. Luciano, J. Bastiaans |year=1999 |title=Treatment of Acute Opioid Withdrawal with Ibogaine |journal=The American Journal on Addictions |volume=8 |issue=3 |pages=234–242 |url=http://www.ibogaine.desk.nl/p234_s.pdf |accessdate=2009-06-16 |pmid=10506904 |doi=10.1080/105504999305848 |archive-date=2006-09-12 |archive-url=https://web.archive.org/web/20060912201401/http://www.ibogaine.desk.nl/p234_s.pdf |dead-url=yes }}</ref> Utaratibu wake wa utekelezaji haujulikani, lakini pana uwezekano kuwa unahusishwa na mpingano wa nAchR α3ß4. Katika jaribio moja lililofanywa kwa kutumia wanyama, ilibainika kupunguza matumizi ya kokeni kwa mtu binafsi.<ref>{{cite journal| author=S.L.T. Cappendijk, M.R. Dzoljic| title=Inhibitory effects of ibogaine on cocaine self-administration in rats| url=https://archive.org/details/sim_european-journal-pharmacology_1993-09-14_241_2-3/page/261| journal=European Journal of Pharmacology| volume=241| issue=2-3| pages=261–265| year=1993 |doi=10.1016/0014-2999(93)90212-Z| pmid=8243561}}</ref> Jaribio lingine ambalo halikudhibitiwa lilionyesha ilipunguza mtetemo usiozuilika kwa kiasi kidogo hadi wastani wakati wa kujitoa katika matumizi ya mofini katika panya.<ref>{{cite journal| author=S.D. Glick, K. Rossman, N.C. Rao, I.M. Maisonneuve and J.N. Carlson |title=Effects of ibogaine on acute signs of morphine withdrawal in rats: Independence from tremor | url=https://archive.org/details/sim_neuropharmacology_1992-05_31_5/page/497 |journal=Neuropharmacology |volume=31 |issue=5 |pages=497–500 |year=1992 |doi=10.1016/0028-3908(92)90089-8| pmid=1528400}}</ref> Matokeo haya hayawezi kutumika kwa binadamu kwa uhakika wowote. Utafiti hutatizwa na sababu kwamba ibogaini si halali katika nchi zote zilizoendelea na ni kileo cha Kiwango I nchini Marekani. Hakuna majaribio yaliyodhibitiwa ya binadamu yamewahi kufanywa. Sintheti analojia isokamilifu ya ibojeni, 18-methoksikoronaridini ilitengenezwa, katika jaribio la kupunguza sumu (ibogeni ina sumu zinazodhuru sana moyo, na vifo vingi vimeripotiwa kutokana na matumizi yake; kwa sababu ya matumizi haramu na ya siri, ni vigumu kujua kiwango cha sumu kilivyo) na madhara saikotomimetri ya dawa ya kulevya . ===Utaratibu wa tabia=== Utaratibu wa tabia huchuliwa kuwa muhimu katika kuwasaidia wale wanaotegemea ulevi kufikia kiwango cha kuacha. Kutokana na maandishi ya uchangnuzi tekelezi wa tabia na yale ya saikolojia ya tabia, taratibu nyingi zilizojikita kwa misingi inayothibitika zimejitokeza (1) tiba kwa tabia kindoa; (2) mkabala wa kuimarisha jamii kuimarisha mfumo; (3) tiba ya kutambua dalili , na (4) mikakati ya usimamizi dharura.<ref>{{cite journal | last = O'Donohue| first = W| authorlink = | coauthors = K.E. Ferguson| title = Evidence-Based Practice in Psychology and Behavior Analysis| journal = The Behavior Analyst Today| volume = 7| issue = 3| pages = 335–350| publisher = Joseph D. Cautilli| location = | year = 2006| url = http://www.baojournal.com| format = accessdate = 2008-03-24}}</ref><ref>{{cite journal | last = Chambless et al.| first = D.L.| authorlink = | coauthors = | title = An update on empirically validated therapies| journal = Clinical Psychology| volume = 49| issue = | pages = 5–14| publisher = American Psychological Association| location = | year = 1998| url = www.apa.org/divisions/div12/est/newrpt.pdf|format=PDF| doi = | id = | accessdate = 2008-03-24}}</ref> Aidha, mwandishi huyo alipendekeza kwamba mafunzo ya ujuzi wa maswala ya kijamii yanayohusiana na matibabu ya wagonjwa wa utegemezi pombe waliolazwa pengine ina ufanisi zaidi. Kuimarisha jamii ina data kuhusu ubora na utekelezaji.<ref>Dutcher, LW, Anderson, R., Moore, M., Luna-Anderson, C., Meyers, RJ, Delaney, Harold D., na Smith, Je (2009). Community Reinforcement and Family Training (CRAFT): An Efectiveness Study. ''Journal of Behavior Analysis of Sports , Health Fitness and Behavioral Medicine, 2 (1),'' [http://baojournal.com/Health%20Journal/JBAHSFM-2-1.pdf ] {{Wayback|url=http://baojournal.com/Health%20Journal/JBAHSFM-2-1.pdf |date=20101229132307 }}</ref> Aidha, matibabu ya tabia kama vile kuimarisha jamii na mafunzo ya familia (CRAFT) yamesaidia familia kuwaingiza wapendwa katika matibabu.<ref> Meyers, RJ, Smith, Je &amp; Lash, DN (2005): A Program fro Engaging Treatment-refusing Substance Abusers into treatment: CRAFT ''IJBCT., 1 (2),'' Page 90 -100 [http://www.baojournal.com Bao]</ref><ref> Smith, Je, Milford, JL na Meyers, RJ (2004). CRA na CRAFT: Behavioral Approaches to Treating Sustance-Abusing Individuals ''The Behavior Analyst Today , 5). (4,'' 391-403 [http://www.baojournal.com link Bao] </ref> ===Matibabu mbadala === Matibabu mbadala kama vile [[akiupancha]], hutumiwa na matibabu mengine kupunguza dalili za utegemezi wa dawa kulevya. Katika mwaka wa 1997, Chama cha Watabibu cha Marekani(AMA) kilikubali taarifa ifuatayo kama sera, baada ya ripoti kuhusu ya baadhi ya tiba mbadala ikiwemo akiupancha: <blockquote>Pana ushahidi mdogo unaoweza kuthibitisha usalama au ubora wa tiba nyingi mbadala. Nyingi ya habari zinazojulikana sasa kuhusu tiba hizi zinabainisha kuwa nyingi ya tiba hizi hazijaonekana kuwa na ufanisi bora. Zinaweka wazi kwamba nyingi si dhahiri kuwa na ufanisi. Tafiti zilizopangwa vyema na kusimamiwa kikamilifu zinastahili kutekelezwa ili kutathmini ubora wa tiba mbadala.</blockquote> Akiupancha imeonekana kutokuwa na ubora kuliko matibabu yaliyodhibitiwa katika kutibu utegemezi wa opiati.<ref>{{cite journal |author=Jordan JB |title=Acupuncture treatment for opiate addiction: a systematic review |url=https://archive.org/details/sim_journal-of-substance-abuse-treatment_2006-06_30_4/page/309 |journal=J Subst Abuse Treat |volume=30 |issue=4 |pages=309–14 |year=2006 |pmid=16716845 |doi=10.1016/j.jsat.2006.02.005}}</ref> Akiupancha, akiupresha, tiba ya leza na msisimuo wa stima hazina ufanisi unaoonekana kwa kuacha sigara.<ref>{{cite journal |author=White AR, Rampes H, Campbell JL |title=Acupuncture and related interventions for smoking cessation |journal=Cochrane Database Syst Rev |issue=1 |pages=CD000009 |year=2006 |pmid=16437420 |doi= 10.1002/14651858.CD000009.pub2}}</ref> ==Epidemiolojia== [[File:Drug use disorders world map - DALY - WHO2002.svg|thumb|Ulemavu-kubadilishwa maisha mwaka kwa matatizo ya matumizi ya madawa ya kulevya kwa wakazi 100,000 katika 2002 [187] [188] [189] [190] [191] [192] [193] [. 194] [195] [196] [197] [198 ] [199] ]] Aina za kawaida mno za utegemezi kwa dawa za kulevya ni kwa vileo halali /zinazokubalika kisheria kama vile: * [[Nikotini]] katika hali ya [[tumbaku]], hasa sigara * Pombe * Kafeni ==Historia== Tukio la utegemezi kwa dawa za kulevya imekuwepo kwa kiwango fulani katika kumbukumbu zilizonakiliwa za [[historia]] (angalia [[Afyuni|"Afyuni").]] Mazoea ya kisasa ya [[kilimo]], kuboresha upatikanaji wa dawa, uimarikaji wa [[Biokemia]] na mapendekezo ya matumizi ya dawa unaofanywa na wataalamu wa kimatabibu zimezidisha tatizo hili kwa kiasi kikubwa katika karne ya 20. Kuboresha njia bora za kibiolojia za utengenezaji wa vidonge na kuanzishwa misombo sintheti, kama vile methamphetamini pia ni sababu zinazochangia utegemezi wa dawa za kulevya.<ref> DCA Hillman. The Chemical Muse. New York City. St Martin's Press. 2008</ref><ref> MA Rinella. Pharmakon: Plato,Drug Culture and Identity in Ancient Athens. Lanham, Maryland. Lexington Books. 2010</ref> ==Jamii na utamaduni== ===Utungaji Sheria=== Kwa kutegemea mamlaka, dawa za kulevya zinaweza tu kuwa halali kama ni sehemu ya utafiti uliodhaminiwa na serikali na sio halali kwa madhumuni mengine yoyote, sio halali kuuza na sio halali hata kumiliki tu. Nchi nyingi zina sheria ambazo huleta dawa mbalimbali na-vidonge vifananavyo na dawa za kulevya chini ya udhibiti wa mifumo ya leseni. Kwa kawaida sheria hii hushughulikia aina fulani au zote za opiati, amfetamini, canabinoidi, kokeni, vitulizi, halusinojeni na aina nyingi za dawa sintheti za kisasa zaidi. uzalishaji usio halali, usambazaji au umuliki ni kosa la jinai. Hata hivyo,kwa kawaida, uainishaji wa dawa za kulevya chini ya sheria hiyo haihusiani tu na utegemeaji wa dawa. Vilewevu vinavyogusiwa mara nyingi huwa na uwezo tofauti wa utegemeaji. Baadhi huwa na uwezo kusababisha utegemeaji wa kimwili ilhali nyingine ni nadra kusababisha aina yoyote ya utegemezi wa kimazoea. Aidha, chini ya sheria hasa kuhusu dawa za kulevya, pombe, kafeni na [[nikotini]] kwa kawaida hazijumuishwi. Ingawa sheria hii inaweza kukubalika kwa misingi ya kimaadili au ya afya ya umma, inaweza kufanya kulevya au utegemezi suala kubwa zaidi kwa mtu binafsi: upatikanaji wa kutegemeka wa dawa huwa vigumu kupata na kila mtu huwa katika hatari ya kuitumia kiharamu na pia kukabiliwa na adhabu za kisheria . Haijabainika wazi iwapo sheria dhidi ya dawa za kulevya hufanya chochote kupunguza matumizi na utegemezi. Katika maeneo ambapo dawa tegemezi ni haramu, kwa ujumla zinapatikana kupitia walanguzi wa dawa za kulevya, wasio na vibali ambao mara nyingi huhusika na uhalifu wa kupangwa. Hata ingawa gharama ya kuzalisha vidonge vingi haramu vya kutegemeza ni mdogo sana, uharamisho wao pamoja na haja ya mtumiaji humpa muuzaji fursa ya kuweka bei ya juu, mara nyingi mamia maradufu ya gharama za uzalishaji. Matokeo yake, ni kuwa mtegemezi dawa ya kulevya wakati mwingine hugeukia uhalifu ili kuendeleza tabia zao. ==Tazama pia== * [[Sera ya dawa za kulevya]] * [[Uraibu]] * [[Utegemezi wa kimwili]] * [[Vitu vya hatari katika ujauzito]] * [[Tiba ya binafsi]] * [[Utumizi mbaya Wa vileo]] ==Marejeo== {{Marejeo|colwidth=30em}} [[Category:Afya]] [[Category:Madawa ya Kulevya]] asxtw6zz1s1jafx1mn2ybrfn6kdge2i 0 55724 1578225 1527925 2026-07-03T04:10:42Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578225 wikitext text/x-wiki {{DiseaseDisorder infobox | Name = Alopecia | Image = Bald head.jpg | Caption = Mwanamume anayezidi kupatwa na upara | DiseasesDB = 14765 | ICD10 = {{ICD10|L|65|9}} | ICD9 = {{ICD9|704.0}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D000505 }} '''Upara''' (kwa [[Kiingereza]] ''baldness'') ni hali ya kutokuwa na [[unywele|nywele]] au ukosefu wa nywele mahali ambapo mara nyingi hukua, hasa [[Kichwa|kichwani]]. Aina ya upara ya kawaida zaidi ni upungufu wa nywele unaowatokea hatua kwa hatua [[binadamu]] [[wanaume]] na [[Viumbehai|viumbehai]] wengine na ambayo huitwa "mkondo wa upara wa kiume". Kiasi na mikondo ya upara vinaweza kutofautiana sana, baina ya mikondo ya kiume na ya kike ya alopeshia (androgenic alopecia au alopecia androgenetica), alopecia areata, ambayo huhusisha upotevu wa baadhi ya nywele kichwani na alopecia totalis, ambayo huhusisha upotevu wa nywele zote kichwani, hadi aina iliyokithiri zaidi ambayo ni universalis alopecia, inayohusisha kupoteza nywele zote kichwani na mwilini. == Asili ya jina la kimataifa == [[Istilahi]] ''alopeshia'' hutokana na [[neno]] la [[Kigiriki]] αλώπηξ, ''alópex'', inayomaanisha [[mbweha]]. Asili ya matumizi hayo ni kuwa [[mnyama]] huyu huvua [[unyoya|manyoya]] yake mara mbili kwa [[mwaka]]. ==Dalili== Ishara ya upara ni ukosefu wa nywele juu ya kichwa cha mtu. <gallery> File:Back of man's head.jpg|Mgongo wa mwanamume aliye na mkondo wa upara wa kiume File:Craigventer2.jpg|J. Craig Venter, ambaye mlolongo wake kamili wa [[DNA]] umechapishwa, kuonyesha mkondo wa upara wa kiume File:David Suchet.jpg|[[Mwigizaji]] wa [[Uingereza]] [[David Suchet]] ana upara mkubwa File:Michael Jordan.jpg|Baadhi ya watu walio na upara wa visehemu huamua kunyoa nywele zote </gallery> == Sababu == '''Matukio''' ya '''upara wa kiolezo''' hutofautiana miongoni mwa idadi kubwa ya watu kwa misingi ya [[maumbile]] ya [[jeni]]; sababu za [[mazingira|kimazingira]] hazionekani kuathiri sana aina hii ya upara. [[Utafiti]] mmoja mkubwa uliofanywa katika Maryborough, [[Victoria]], [[Australia]] ulionyesha kuwa kiwango cha ya upotezaji nywele za mbeleni mwa kichwa-katikati hulingana na ongezeko la [[umri]] na huathiri 73.5% ya wanaume na 57% ya [[wanawake]] wenye umri wa miaka 80 na zaidi. Kwa mujibu wa [[tovuti]] ya Medem Medical Library, upara wa kiume huathiri takribani wanaume [[milioni]] 4 nchini [[Marekani]]. Takriban [[asilimia]] 25 ya wanaume huanza kupata upara tokea umri wa miaka 20, [[theluthi]] mbili huanza kupata upara kuanzia miaka 60. Uwezekano wa kupata jeni ya upara ni 4 kwa 7. Mkondo wa wanaume hudhihirisha upungufu wa nywele kutoka pande za [[paji la kichwa]] unaojulikana kama "upeo wa nywele unaopungua". Upungufu wa upeo wa nywele huonekana katika wanaume waliozidi miaka 20 lakini unaweza kuonekana mapema, mwishoni mwa umri wa [[ujana]] pia. Sehemu ndogo ya upara inaweza kujitokeza sehemu ya juu (vertex). Sababu za aina hii ya upara (uitwao ''androjenetic alopecia)'' ni [[DHT]], [[homoni]] yenye msukumo wa nguvu za [[ngono]], ukuaji wa nywele za mwilini na usoni, ambayo huweza kuathiri vibaya [[tezi kibofu]] pamoja na nywele za kichwani.<ref>{{cite journal |author=Rebora A |title=Pathogenesis of androgenetic alopecia |url=https://archive.org/details/sim_american-academy-of-dermatology-journal_2004-05_50_5/page/777 |journal=J Am Acad Dermatol |volume=50 |issue=5 |pages=777–9 |year=2004 |pmid=15097964 |doi=10.1016/j.jaad.2003.11.073}}</ref> Bado haijafahamika kikamilifu namna ambayo DHT hutekeleza jambo hili. Kwenye [[ngozi]] za vichwa zinazoathirika na jeni hii, DHT huzua mchakato wa ukondefu wa nywele. Kupitia mchakato wa ukondefu wa nywele, [[upana]] wa [[mzizi]] wa nywele huendelea kupungua kitaratibu hadi nywele kwenye ngozi ya kichwa kufanana na [[unyoya|manyoya]] hafifu au "sufi za pichi" au hata kutoweka kabisa. Mwanzo wa kupoteza nywele wakati mwingine huanza mapema mwishoni mwa [[ubalehe]] na hasa husababishwa na jeni. Upara wa mkondo wa kiume huainishwa katika kipimo cha Hamilton Norwood I-VII. Iliaminika awali kuwa upara ulirithiwa kutoka kwa [[babu]] wa [[ukoo]] wa [[mama]]. Ingawa pana misingi ya imani hii, [[wazazi]] wote huchangia uwezekano wa [[vizalia]] wao kupoteza nywele. Pana uwezekano mkubwa zaidi wa kurithi upara iwapo mchanganyiko wa jeni zinazosheheni kwa nguvu kutoka wazazi wote zina hali hiyo. Kuna aina nyingine nyingi za upara: * Alopeshia ya mvuto hupatikana kwa kawaida kwa watu wenye nywele ndefu zifungwazo kwa nyuma au mistari ambao huvuta nywele zao kwa nguvu nyingi. * Trikotilomania ni upoteaji wa nywele unaosababishwa na uvutaji au ukunjaji shurutishi wa nywele. Hutokea zaidi kwa [[watoto]] kuliko [[watu wazima]]. Katika hali hii, nywele hazitoweki kichwani, bali hukatika. Nywele zinapokatika karibu na ngozi ya kichwa husababisha nywele fupi zenye umbo la "[[alama ya mshangao]]." * [[Kiwewe]] kama vile cha [[kemotherapia]], kujifungua, [[upasuaji]] mkubwa, [[sumu]] na mfadhaiko kali kinaweza kusababisha upotevu wa nywele unaojulikana kama effluviamu ya telojeni.<ref>{{cite journal |author=Nnoruka E, Nnoruka N |title=Hair loss: is there a relationship with hair care practices in Nigeria? |journal=Int J Dermatol |volume=44 |issue=Suppl 1 |pages=13–7 |year=2005 |month= Oktoba|pmid=16187950 |doi=10.1111/j.1365-4632.2005.02801.x}}</ref> Mzizi wa nywele katika awamu ya kukua huathirika na kemotherapia wakati [[matibabu]] hayo hulenga kutenganisha [[seli]] za [[saratani]]. Kwa hiyo, karibu asilimia 90 ya nywele hudondoka punde tu baada ya kemotherapia kuanza.<ref>{{cite web|url=http://americanhairloss.org/women_hair_loss/causes_of_hair_loss.asp|title=Anagen Effluvium|date=|accessdate=2010-06-29|archive-date=2010-06-16|archive-url=https://web.archive.org/web/20100616025307/http://americanhairloss.org/women_hair_loss/causes_of_hair_loss.asp|dead-url=yes}}</ref> * Kupoteza nywele kunakotia shaka aghalabu hufuatia kujifungua pasipo kusababisha athari upara halisi. Katika hali hii, nywele kwa hakika hunawiri wakati wa [[mimba]] kutokana na ongezeko la [[estrojeni]] mwilini. Baada ya mtoto kuzaliwa, viwango vya estrojeni hushuka hadi viwango vya kawaida vya kabla-ya-mimba, nayo mizizi ya ziada ya nywele hudondoka. Hali kama hiyo hutokea kwa wanawake wanaotumia [[dawa]] ya kuchochea ushikaji-mimba ya clomiphene. * Upungufu wa [[chuma]] ni sababu ya kawaida ya ukondefu wa nywele, ingawa upara halisi si kawaida kuonekana. * [[Mnururisho]] unaoangazwa ngozini mwa kichwa, kama wakati wa [[rediotherapia]], hutumika kwa minajili ya kutibu baadhi ya saratani humo, nao huweza kusababisha upara katika maeneo yaliyoathirika. * Baadhi ya [[maambukizi]] [[Kuvu|ya maikoti]] yanaweza kusababisha upotevu mkubwa wa nywele.<ref>{{cite journal | author = Pappas P, Kauffman C, Perfect J, Johnson P, McKinsey D, Bamberger D, Hamill R, Sharkey P, Chapman S, Sobel J | title = Alopecia associated with fluconazole therapy. | url = https://archive.org/details/sim_annals-of-internal-medicine_1995-09-01_123_5/page/354 | journal = Ann Intern Med | volume = 123 | issue = 5 | pages = 354–7 | year = 1995 | pmid = 7625624}}</ref> * Alopeshia areata ni mvurugiko wa [[mfumo wa kingamwili]] ambao pia hujulikana kama "upara wa doa" na ambao unaweza kusababisha kupotea kwa nywele kuanzia eneo moja tu ''(Alopecia areata monolocularis)'' hadi katika mwili mzima ''(Alopecia areata univesalis).'' * Upotevu wa nywele wa eneo moja au uliotawanyika huweza pia kutokea katika alopeshia sikatrishia (lupus erithematosu, licheni plano pilari, folliculitis dekalvansi, sentrifugi sikatrishia alopeshia ya kati, alopeshia fibrosi ya mbele baada ya kukoma uzazi, nk). Uvimbe na michipuko ngozini pia husababisha upara wa eneo moja (neva ya sebashia, seli ya msingi ya kasinoma, seli ya juu ya karsinoma). * [[Hipothairoidi]] inaweza kusababisha kupotea kwa nywele za mbele kwa kawaida, na huhushwa hasa na ukondefu wa thuluthi ya nje ya [[kope]] za [[macho]] ([[kaswende]] pia inaweza kusababisha upotevu wa thuluthi ya nje ya kope za macho) * [[Hipathairoidi]] pia inaweza kusababisha kupotea kwa nywele, ambayo kwa njia sawa na siyo tu mbele. * Kupoteza nywele kwa muda kunaweza kutokea katika maeneo ambapo uvimbe wa ngozi umekuwepo kwa muda; kwa kawaida tokea [[muda]] wa [[wiki]] moja hadi wiki kadhaa. * Alopeshia ya pembetatu ya muda mrefu - Upotevu wa nywele ulio na [[umbo]] la [[pembetatu]] au [[duaradufu]] kwa baadhi ya nyakati, katika eneo la kandokando ya kichwa ambayo hutokea hasa kwa watoto wadogo. Eneo lililoathirika hasa huwa na mizizi kondefu ya nywele au mizizi hiyo hutoweka kabisa, lakini halipanuki. Sababu zake hazijulikani na ingawa ni hali ya kudumu, haina madhara mengine yoyote kwa walioathirika.<ref>{{cite web|url=http://www.keratin.com/af/af005.shtml|title=Congenital triangular alopecia|date=|accessdate=2010-06-29|archivedate=2011-07-13|archiveurl=https://web.archive.org/web/20110713144349/http://www.keratin.com/af/af005.shtml}}</ref> === Nadharia tete za mageuko ya kimaumbile === Hakuna makubaliano kuhusu maelezo ya mageuzi ya mkondo wa upara wa kiume. Madai ya kwamba mkondo wa upara wa kiume (MPB) hunuiwa kuwasilisha [[ujumbe]] wa kijamii unaungwa [[mkono]] na [[ukweli]] kwamba msambao wa vihisivu androjeni kwenye ngozi ya kichwani hutofautiana baina ya wanaume na wanawake, aidha waume na wake wazee walio na viwango vya juu vya [[androjeni]] mara nyingi hudhihirisha ukondefu wa nywele uliotawanyika, kinyume na ilivyo katika mkondo wa upara wa kiume. [[Nadharia]] moja, iliyotolewa na Muscarella na Cunningham,<ref name="Muscarella">{{cite journal | author = Muscarella, F. & Cunningham, M.R.| title = The evolutionary significance and social perception of male pattern baldness and facial hair. | journal = Ethology and Sociobiology | volume = 17 | issue = 2 | pages = 99–117 | year = 1996 | doi = 10.1016/0162-3095(95)00130-1}}</ref> inaeleza kuwa upara ulijitokeza miongoni mwa wanaume kufuatia uteuzi wa [[jinsia]] kama ishara pevu ya [[uzee]] na [[ukomavu]] wa kijamii, ambapo uchokozi na tabia za kujihatarisha huongezeka. Hii ilitoa [[taswira]] ya mwanamume aliyefikia hali iliyoimarika kijamii lakini aliyepungukiwa na uwezo wa kimwili wa kupata washirika wa kujamiiana na kukuza watoto hadi utu uzima. Katika utafiti wa Muscarella na Cunningham<ref name="Muscarella"></ref> , wanaume na wanawake walitazama [[wanamitindo]] 6 wa kiume waliokuwa na viwango tofauti vya nywele usoni (walio na [[ndevu]] na [[sharubu|masharubu]] au bila) na nywele kichwani (kichwa kilichojaa nywele, zinazopungua na upara). Washiriki walitathmini kila mafungu kwa kutumia [[vivumishi]] 32 vilivyohusiana na mitazamo ya jamii. Wanaume waliokuwa na upara ama waliokuwa na nywele usoni au nywele zinazopungua walichukuliwa kuwa wenye umri mkubwa zaidi kuliko wale ambao waliokuwa wamenyolewa kabisa au waliokuwa na nywele nyingi kichwani. Ndevu na kichwa kilochojaa nywele zilionekana kama hali ya [[ujasiri]] zaidi na kutokomaa kijamii, nao upara ukahusishwa na ukomavu zaidi kijamii. Hariri ya maoni ya kijamii kuhusu mikondo ya upara wa kiume umetolewa na Henss (2001).<ref name="Henss">{{cite journal | author = Henss, R. | title = Social perceptions of male pattern baldness. A review | journal = Dermatology and Psychosomatics | volume = 2 | issue = 1 | pages = 63–71 | year = 2001 | doi =10.1159/000049641 }}</ref> Nadharia tete nyingine za mageuko ya kimaumbile ni pamoja na miunganiko baina ya jeni kwa sifa bainishi zenye manufaa zisizohusiana na nywele wala utofauti wa jeni. === Upara usio wa binadamu === Upara si tu ni sifa bainishi ya binadamu. Viumbe wengine wa jamii ya [[nyani]], kama vile [[masokwe]], [[makakiu]] wenye mikia minene, na uakari wa [[Amerika ya Kusini]] hudhihirisha ukondefu taratibu wa nywele kichwani baada ya kubalehe. Makakiu wazima wenye mikia minene, kwa kweli, hutumika mara nyingi [[maabara|maabarani]] katika kutafiti matibabu yasaidiayo ukuaji wa nywele. Watangulizi mbalimbali wa [[tai]] wa [[Ulimwengu wa Kale]] na [[Ulimwengu Mpya]] waligeuka kwa kipindi cha wakati na kupata upara kichwani, iliyozuia manyoya kushika vipande vya [[nyama]] zilizooza kutoka mlo wa tai, na kusaidia pia kupunguza [[joto]].<ref>{{cite journal | author=Stanley Rice | title=On the Problem of Apparent Evil in the Natural World | journal=Perspectives on Science and Christian Faith | volume=39 | month=Septemba | year=1987 | pages=150–157 | url=http://www.asa3.org/ASA/PSCF/1987/PSCF9-87Rice.html}}</ref> === Jenetikia === Utafiti mwingi ulifanywa kuhusu maumbile ya jeni zinazohusiana na mkondo wa upara wa kiume, au ''androgenetic alopecia'' (AGA). Utafiti unaonyesha kwamba kwa kiasi kikubwa, uwezekano wa kupatwa na upara wa mapema wa kiume hutokana na jeni za [[chembeuzi X]]. Jeni nyingine zisizohusiana na ngono pia hushirikishwa. Watafiti wa [[Ujerumani]] wanataja [[jeni pokezi]] ya androjeni kama kiungo muhimu zaidi cha upara.<ref>Hillmer AM, Hanneken S, Maumbile tofauti ya jeni pokezi ya Androjeni katika binadamu ndiyo sababu kuu ya kawaida ya kuanza mapema kwa Androjeneti Alopeshia (AGA). Idara ya Genomi, Maisha na Kituo cha Ubongo, Chuo Kikuu cha Bonn, Bonn, Ujerumani.</ref> Wanahitimisha kwamba aina fulani ya jeni pokezi ya androjeni huhitajika kwa ukuaji wa AGA. Mwaka huohuo matokeo ya utafiti huu yalithibitishwa na watafiti wengine.<ref>Levy-Nissenbaum E, Bar-Natan M, Thibitisho la uhusiano baina ya mkondo wa Upara wa kiume na jeni pokezi ya androjeni, Taasisi ya Gartner Danek ya Jenetiki ya Binadamu, Kituo cha Matibabu cha Sheba , Tel Hashomer, Israeli</ref> Jeni hii ni dhaifu, kwa hivyo mwanamke huhitaji [[kromosomu]] mbili za X zenye kasoro ili kuonyesha alopeshia ya mkondo sawa na wa kiume. Kwa vile androjeni na mahusiano yake na kipokezi cha androjeni ndiyo sababu za AGA inaonekana jambo la kimantiki kuchukulia kuwa jeni hisivu ya androjeni ina jukumu muhimu katika ukuaji wake. Utafiti mwingine wa mwaka [[2007]] ulipendekeza kuwa jeni nyingine katika kromosomu X, iliyo karibu na jeni pokezi ya androjeni, ilikuwa na jukumu muhimu katika mkondo wa upara wa kiume. Walipata kuwa eneo la Xq11-q 12 katika kromosomu X- lilihusiana pakubwa na AGA katika wanaume. Walisisitiza kuwa EDA2R ndiyo jeni inyohusiana zaidi na AGA. Utafiti huu umeigwa katika angalau tafiti tatu huru zifuatazo. Jeni nyinginezo zinazohusika na upotevu wa nywele zimegunduliwa. Mojawapo ikiwa jeni ya kromosomu 3. Jeni huwa iko katika 3q26.<ref>Hillmer AM, Flaquer A, Utafiti wa AGA wa Ushikamano wa Ukaguzi wa Jenomu-pana na ujenzi-ramani unadhihirisha lokaso ya kromosomu 3q26. Idara ya Jenomu, Kituo cha Maisha na Ubongo, Chuo Kikuu cha Bonn, D-53127 Bonn, Ujerumani.</ref> Jeni hii pia huchangia katika aina ya upara unaohusishwa na ulemavu wa akili. Jeni hii ni dhaifu. Jeni nyingine ambayo inaweza kushiriki katika upotevu wa nywele ni P2RY5. Jeni hii inahusika na muundo wa nywele. Baadhi zinaweza kusababisha upara wakati wa kuzaliwa ilhali aina nyinginezo husababisha "nywele za sufu".<ref> Petukhova L, Sousa EC Jr, Martinez-Mir A, Vitebsky A, Dos Santos LG, Shapiro L, Haynes C, Gordon D, Shimomura Y, Christiano AM. Uchambuzi wa uhusiano wa jenomu-pana kuhusu haipotrikosisi hafifu ya autosomal unabainisha mabadiliko makubwa ya P2RY5. Jenomu. 2008 Novemba, 92 (5) :273-8. Epub 2008 13 Septemba. PubMed PMID: 18692127.</ref> Utafiti wa hivi karibuni ulithibitisha jeni pokezi X zinazohusiana na androjeni kuwa za muhimu zaidi. Huku jeni katika kromosomu 20 ikiwa ya pili kwa umuhimu wa kuchangia hali hiyo (snpedia) === Upotezaji nywele kwa wanawake === Ingawa upara si kawaida sana katika wanawake kama ilivyo kwa wanaume, athari za kisaikolojia za kupoteza nywele huwa kubwa zaidi. Kwa kawaida ukanda wa nywele za mbele hudumu ilhali uwingi wa nywele hupungua katika maeneo yote kichwani. Hapo awali iliaminika kuwa ilisababishwa na testosteroni sawa na katika upara wa kiume, lakini wanawake wengi ambao kupoteza nywele huwa na viwango vya kawaida vya testosteroni. Hata hivyo, upotezaji nywele kwa mwanamke umekuwa tatizo linaloendelea, ambalo kwa mujibu wa Akademia ya Marekani ya Matibabu ya ngozi, huathiri karibu wanawake 30,000,000nchini [[Marekani]]. Ingawa upotezaji nywele kwa wanawake kwa kawaida hutokea baada ya umri wa miaka 50 au hata baadaye, isipoambatana na matukio kama ujauzito, maradhi sugu, ya mlo, na mfadhaiko kati ya nyinginezo, kwa sasa inatokea miaka ya mapema na huku ripoti zikionyesha kuwa hutokea hata wanawake wachanga kama wa miaka 15 au 16.<ref>{{cite web|url=http://www.webmd.com/skin-problems-and-treatments/hair-loss/features/women-hair-loss-causes| title=Women and Hair Loss: The Causes|date=|accessdate= 2010-06-29}}</ref> Sababu za upotevu wa nywele mingoni mwa wanawake zinaweza kutofautiana na zinazoathiri wanaume. Kuhusiana na alopeshia androjeni, upotevu wa nywele za wanawake hutokea kulingana na athari za homoni za androjeni (testosteroni, androsteinedioni, na dihaidrotestosteroni (DHT)). Homoni hizi za kiume, kwa kawaida hutokea kwa kiasi kidogo kwa wanawake. Hata hivyo, kulingana na Ted Daly, MD, tabibu wa ngozi kutoka Kituo cha Matibabu cha Chuo Kikuu cha [[Long Island]], alopeshia androjeni sio sababu kuu ya kupotea kwa nywele kwa wanawake na wataalamu wa ngozi kwa sasa hupendelea kuita hali hii mkondo wa upotevu wa nywele kwa wanawake badala ya kutumia neno androjeni alopeshia. Anaongeza kuwa mkondo wa kike ni wa mtawanyiko na hudhihirika katika eneo lote la juu ya kichwa na waweza kuathiri wanawake wakati wowote.<ref>{{cite web|url=http://www.webmd.com/skin-problems-and-treatments/hair-loss/features/women-hair-loss-causes?page=2| title=Female, Male Balding Not the Same Pattern|date=|accessdate= 2010-06-29}}</ref> Wakati mwingine pia mchakato wa homoni huweza kusababisha upotevu wa nywele kwa mwanamke. Baadhi ya mifano ni: uja uzito, kufikia kutoweza kuzaa, uwepo wa uvimbe wa ovari, dawa za kudhibiti upataji mimba na kiwango juu cha androjeni, dalili za vimbe nyingi za ovari. Pia matatizo ya tezi, anemia, ugonjwa sugu na baadhi ya dawa husababisha upotevu wa nywele kwa mwanamke .<ref>{{cite web|url=http://americanhairloss.org/women_hair_loss/causes_of_hair_loss.asp|title=Andogenetic Alopecia|date=|accessdate=2010-06-29|archive-date=2010-06-16|archive-url=https://web.archive.org/web/20100616025307/http://americanhairloss.org/women_hair_loss/causes_of_hair_loss.asp|dead-url=yes}}</ref> == Utunzaji == === Athari za kisaikolojia === Alopeshia kutokana na kemotherapi ya saratani imeripotiwa kusababisha mabadiliko katika dhana-nafsia na taswira ya mwili. Taswira ya mwili hairejelei hali ya awali baada ya kuota upya kwa nywele kwa idadi kubwa ya wagonjwa. Katika hali kama hizo, wagonjwa hutatizika kuonyesha hisia zao (alexithymia) na hutaka zaidi kujiepusha na migogoro ya familia. Tiba ya familia inaweza kusaidia familia kukabiliana na matatizo ya kisaikolojia yakijitokeza.<ref>{{cite journal | author=Poot F | title=[Psychological consequences of chronic hair diseases] | journal=Rev Med Brux | volume=25 | issue=4 | pages=A286–8 | year=2004 | pmid=15516058}}</ref> Matatizo ya kisaikolojia kutokana na upara, yakiwepo, kwa kawaida hushamiri zaidi mwanzoni mwa dalili.<ref>{{cite journal | author=Passchier J, Erdman J, Hammiche F, Erdman R | title=Androgenetic alopecia: stress of discovery. | journal=Psychol Rep | volume=98 | issue=1 | pages=226–8 | year=2006 | pmid=16673981 | doi=10.2466/PR0.98.1.226-228}}</ref> Baadhi ya wanaume wenye upara huonea fahari upara wao, wakihisi unasaba na [[Karama|watu maarufu wenye haiba]] walio na upara kama vile [[Yul Brynner]], [[Bruce Willis]], [[Vin Diesel]], [[Sean Connery]], [[Jason Statham]], Patrick Stewart, Ben Kingsley, "Stone Cold Steve Austin, [[Tupac Shakur]], Michael Chiklis , Telly Savalas, na Jeffrey Eugenides. Larry David hasa hutumia upara wake kama njia ya ucheshi-nafsia katika vipindi vyake vya televisheni vya Seinfeld and Curb Your Enthusiasm. Katika miaka ya hivi karibuni, upara ,umekuwa si tatizo kubwa kutokana na ongezeko la mtindo wa kudumisha nywele fupi sana, au hata kunyoa nywele kabisa, miongoni mwa wanaume katika nchi za magharibi. Kwa mfano, Patrick Stewart alitajwa kama "Mume wa Kuvutia zaidi kwenye TV" kwa jukumu lake la haiba kama Kapteni Jean-Luc Picard. Makampuni mengi yamefanikiwa kibiashara kwa kuuza [[bidhaa]] ambazo hugeuza hali ya upara, kwa ukuzaji nywele upya, upandikizaji nywele kwa upasuaji au kuuza vibandiko vya nywele. === Kuzuia na kugeuza upotevu wa nywele === Matibabu ya aina mbalimbali za alopeshia huwa na mafanikio madogo. Baadhi ya waliopoteza nywele hutumia matibabu yaliyothibitika kiafya kama vile finasteridi, dutasteridi na mchanganyiko wa minoksidili inayotumiwa katika jaribio la kuzuia upotevu zaidi ya nywele na kuikuza upya. Kama kanuni ya jumla, ni rahisi kudumisha nywele zilizosalia kuliko kukuza upya, hata hivyo, matibabu yaliyotajwa yanaweza kuzuia kupotea kwa nywele kutokana na Androjeni alopeshia , na kuna teknolojia mpya katika upasuaji wa kujirembesha wa kupandikiza na mifumo ya uwekaji nywele ambayo huenda yasitambulike kabisa. Nchini Marekani pana tiba aina mbili za dawa, ambazo zimeidhinishwa naShirika la Usimamizi wa Chakula na Dawa la Marekani (FDA) ikiwemo bidhaa moja iliyokubaliwa na FDA kwa matibabu ya alopeshia androgeni, inayojulikana pia kama mkondo wa kupoteza nywele wa kiume au wa kike. Matibabu mawili yaliyoidhinishwa na FDA ni finasteridi (inayotangazwa kama propeshia kwa kutibu upotevu wa nywele) na minoksidili. Uchunguzi unaonyesha kupungua kwa testosteroni bure pamoja na kuongezeka kwa nguvu kutokana na mafunzo(yasiyobainika)ya utaratibu wa nguvu. ==== Kupunguza mfadhaiko ==== Kupunguza mfadhaiko kunaweza kusaidia kupunguza kasi ya upotevu wa nywele. ==== Vizuiakinga-mwili ==== Vizuiakinga-mwili vinavyotumiwa kichwani zimeonyeshwa kugeuza kwa muda alopeshia areata, ingawa madhara ya baadhi ya dawa hizi husababisha maswala kuzushwa kuhusu dawa hizi.<ref>{{cite journal |author=Joly P |title=The use of methotrexate alone or in combination with low doses of oral corticosteroids in the treatment of alopecia totalis or universalis |url=https://archive.org/details/sim_american-academy-of-dermatology-journal_2006-10_55_4/page/632 |journal=J Am Acad Dermatol. |volume=55 |issue=4 |pages=632–6 |year=2006 |month= Oktoba|pmid=17010743 |doi=10.1016/j.jaad.2005.09.010 }}</ref><ref>{{cite journal |author=Freyschmidt-Paul P, Ziegler A, McElwee KJ, ''et al.'' |title=Treatment of alopecia areata in C3H/HeJ mice with the topical immunosuppressant FK506 (Tacrolimus) |journal=Eur J Dermatol |volume=11 |issue=5 |pages=405–9 |year=2001 |pmid=11525945 |url=http://www.john-libbey-eurotext.fr/medline.md?issn=1167-1122&vol=11&iss=5&page=405}}</ref> === Kuficha potevu wa nywele === ==== Kichwa ==== Njia moja ya kuficha upotevu wa nywele ni mtindo wa kuchana "kufunika", ambapo nywele zilizosalia hutengenezwa kwa mkao wa kufidia eneo la upara. Hii aghalabu huwa suluhisho la muda, na hufidia tu iwapo eneo lililipoteza nywele ni ndogo. Jinsi upotevu wa nywele huongezeka , kuchana "kufunika" hauweza tena kutegemewa. Wakati hali hii hufikia hatua ya juhudi kubwa na manufaa madogo-inaweza kumfanya mtu kukejeliwa au kudharauliwa. Njia nyingine ni ya kuvaa kofia au kibandiko cha nywele- wigi au nywele za bandia. Wigi ni safu ya nywele bandia au halisi ambazo kwa kawaida hutengezwa kwa mitindo inayofanana na nywele za kawaida. Mara nyingi nywele hizi ni bandia. Wigi hutofautiana sana katika ubora na gharama. Nchini Marekani, wigi bora zaidi-ni zile zinazofanana na nywele halisi-hugharimu hadi kumi ya maelfu ya dola. Mashirika pia hukusanya 'michango ya nywele asili za watu binafsi ili kutengenezea wigi kwa wagonjwa wachanga wa saratani yaambao wamepoteza nywele zao kutokana na kemotherapia au matibabu mengine ya kansa mbali na aina yoyote ya upotevu wa nywele. Ikumbukwe kuwa idadi kadhaa ya vibandiko maarurufu mbadala vipo kama vile Nanogen (Uropa) na Toppik (Marekani) nazo ni maarufu sana kama vipodozi visivyo vya wigi ambavyo huchangia unyuzi-embamba wa elektrostati kwa nywele za mtu binafsi. ==== Nyusi ==== Ingawa si kawaida kama vile upotevu wa nywele kichwani, kemotherapia, kutosawazika kwa homoni, aina za alopeshia, na sababu nyinginezo zinaweza pia kusababisha upotevu wa nywele katika nyusi. Nyusi bandia hupatikana kufidia nyusi zisizokuwepo au kufunika nyusi zenye mianya. Uchoraji mdogo sana wa kuchanja pia huwezekana. === Kukubali upara === Badala ya kuficha upotevu wa nywele, mtu anaweza kuikubali hali hiyo. Kichwa kilichonyolewa huotesha vishina kwa namna na kiwango sawa na unyoaji wa nywele za usoni. Umma kwa jumla umeweza kukubali unyoaji wa kichwa pia, lakini upara wa wanawake bado haujakubalika sana kijamii. == Jamii na utamaduni == Pana visasili vingi kuhusiana na sababu za upara na ulingano wazo na nguvu za kiumeza mtu, uwerevu wake, kabila, kazi, tabaka la kijamii, utajiri n.k. Ingawa kutia shaka kunatarajiwa kutokana na ukosefu wa ithibati za kisayansi, baadhi ya visasili hivi vina kiwango cha ukweli wa kimsingi . * "Unarithi upara kutoka kwa baba ya mama yako." ** Hapo awali, upara wa mapema wa aina ya androjeni ilidhaniwa kuhusiana na hali-ngono zilizolizoshamiri katika wanaume na kwa kufifia hali-ngono katika wanawake. ** Utafiti unaonyesha kwamba jeni kwa vipokezi androjeni, ambayo ni muhimu katika kuamua uwezekano wa kupoteza nywele, ipo kwenye kromosomu X na hivyo daima hurithiwa kutoka upande wa mama.<ref>{{cite journal | author = Hillmer A, Hanneken S, Ritzmann S, Becker T, Freudenberg J, Brockschmidt F, Flaquer A, Freudenberg-Hua Y, Jamra R, Metzen C, Heyn U, Schweiger N, Betz R, Blaumeiser B, Hampe J, Schreiber S, Schulze T, Hennies H, Schumacher J, Propping P, Ruzicka T, Cichon S, Wienker T, Kruse R, Nothen M | title = Genetic variation in the human androgen receptor gene is the major determinant of common early-onset androgenetic alopecia. | url = https://archive.org/details/sim_american-journal-of-human-genetics_2005-07_77_1/page/140 | journal = Am J Hum Genet | volume = 77 | issue = 1 | pages = 140–8 | year = 2005 | pmid = 15902657 | doi = 10.1086/431425 | pmc = 1226186}}</ref> Pana uwezekano wa 50% kwamba mtu huwa na kromosomu X sawa na babuye wa kuukeni. Kwa vile wanawake wana kromosomu X mbili, wao huwa na nakala mbili za jeni pokezi ya androjeni ilhali wanaume wana moja tu. Hata hivyo, utafiti pia unaonyesha kuwa mtu aliye na baba mwenye upara pia ana nafasi kubwa sana ya kukumbwa na upotevu wa nywele.<ref>{{cite journal | author = Chumlea W, Rhodes T, Girman C, Johnson-Levonas A, Lilly F, Wu R, Guo S | title = Family history and risk of hair loss. | journal = Dermatology | volume = 209 | issue = 1 | pages = 33–9 | year = 2004 | pmid = 15237265 | doi = 10.1159/000078584}}</ref> * "Shughuli za ubongo au matatizo ya kisaikolojia yanaweza kusababisha upara." ** Wazo hili linaweza kutokana na sababu kuwa kolesteroli hushirikishwa katika mchakato wa neurojenesi na pia vifaa vya mkisingi ambavyo mwili hutumia kuunda DHT. Licha ya kwamba wazo kuwa watu wenye upara ni werevu zaidi huenda halina mashiko katika ulimwengu wa kisasa, katika ulimwengu wa kale kama mtu aliyekuwa na upara, iliwezekana kwamba alikuwa na kiasi cha kutosha cha mafuta katika mlo wake. Kwa hiyo, ukuaji wa akili yake labda haukudumaa kwa utapiamlo katika miaka yake muhimu ya awali, alikuwa na uwezekano mkubwa wa kuwa tajiri, na pia kuwa alipata elimu ya kimsingi. Hata hivyo, maisha ya kulazadamu na uwerevu katika ulimwengu wa kisasa, hauwezi kuhusishwa mno na hali ya ulaji mafuta unaoambatanishwa na tabaka la kiuchumi katika nchi za kisasa zilizoendelea. Uwezekano mwingine ni kwamba kwa baadhi ya watu,wakati wa kujamiana hali yao kijamii iliyoyokana na uwerevu, huweza kufidiana na upungufu wa mvutio unaoletwa na upotevu wa nywele na hivyo kuzalisha watoto wa kiume ambao hukabiliwa na hali zote mbili za uwerevu au upotevu nywele. Hata hivyo, kwa mujibu wa hali bora ya kijami na kiuchumi na hivyo uwezo zaidi wa kugharamia matibabu ya upotevu wa nywele , katika miaka ya hivi karibuni uwezekano wa kudai uhusiano baina ya uwerevu na upotevu halisi wa nywele ni mdogo. Bila shaka, mbali na sababu hizi zote za kisayansi, upara unaweza tu kuhusishwa na uwerevu au hekima kwa sababu watu hupata upara jinsi umri unavyokua na tajriba kuzidi, huku watu wenye uwerevu mdogo wakifa wangali wachanga. ** Testosteroni nyingi hudhihirisha uhusiano chanya na uwezo wa mbinu-nyingi na uwezo usio wa kawaida. Testosteroni nyingi ina uhusiano hasi na ufasaha wa kimaongezi wa mtu. Testosteroni katika mate pia ina uhusiano chanya na uwingi-mbinu katika ufanisi wa mitihani, pamoja na, uhuru wa kitaalamu. DHT na uwiano wa DHT/testosteroni nyingi una uhusiano chanya na ufasaha wa kimaongezi na uhusiano hasi na kiwango cha uwezo usio wa kawaida na uwingi-mbinu. <ref>{{cite journal | author = Christiansen K | title = Sex hormone-related variations of cognitive performance in !Kung San hunter-gatherers of Namibia. | journal = Neuropsychobiology | volume = 27 | issue = 2 | pages = 97–107 | year = 1993 | pmid = 8515835 | doi = 10.1159/000118961}}</ref> * "Upara husababishwa na mfadhaiko wa hisia, usinyifu wa kingono n.k" ** Msongo wa hisia umeonekana kuharakisha upara kwa watu wenye jeni za zinazoweza kuzua upara.<ref>{{cite journal | author = Schmidt J | title = Hormonal basis of male and female androgenic alopecia: clinical relevance. | journal = Skin Pharmacol | volume = 7 | issue = 1-2 | pages = 61–6 | year = 1994 | pmid = 8003325 | doi = 10.1159/000211275}}</ref> ** Msongo kutokana na kutolala vya kutosha miongoni mwa makurutu wa kijeshi ulipunguza kiwango cha testosteroni, lakini haujabanika kuathiri SHBG.<ref>{{cite journal | author = Remes K, Kuoppasalmi K, Adlercreutz H | title = Effect of physical exercise and sleep deprivation on plasma androgen levels: modifying effect of physical fitness. | journal = Int J Sports Med | volume = 6 | issue = 3 | pages = 131–5 | year = 1985 | pmid = 4040893 | doi = 10.1055/s-2008-1025825}}</ref> Hivyo, mfadhaiko kutokana na kutolala vya kutosha kwa wanaume wenye afya hauna uwezekano wa kuzidisha DHT, ambayo husababisha mkondo wa upara wa kiume. Si wazi iwapo inaweza kusababisha upotevu wa nywele kwa njia nyingine ile. * "Wanaume wenye upara wana uwezo zaidi 'wa kiume' au kujamiiana kuliko wengine." ** Kiwango cha testosteroni huria huhusiana kwa dhati na utashi wa ngono na pia viwango vya DHT, lakini mradi testosteroni huria hukaribia kutokuwepo haijabainika wazi jinsi inavyoathiri uwezo wa kiume. Wanaume wenye androjeni alopeshia wana uwezekano mkubwa kimsingi wa kuwa na androgeni huria. Hata hivyo, uwezo wa kingono hutokana na sababu nyingi, na sifa za androjeni sio tu ya pekee inayoamua hali ya upara. Zaidi ya hayo, kwa kuwa upotevu wa nywele ni endelevu na testosteroni huria hupungua kulingana na umri, ukanda wa nywele kichwani unaweza zaidi kuwa dalili ya siku zao za nyuma kuliko ya / sasa.<ref>{{cite journal | author = Toone B, Wheeler M, Nanjee M, Fenwick P, Grant R | title = Sex hormones, sexual activity and plasma anticonvulsant levels in male epileptics. | url = https://archive.org/details/sim_journal-of-neurology-neurosurgery-and-psychiatry_1983-09_46_9/page/824 | journal = J Neurol Neurosurg Psychiatry | volume = 46 | issue = 9 | pages = 824–6 | year = 1983 | pmid = 6413659 | doi = 10.1136/jnnp.46.9.824 | pmc = 1027564}}</ref><ref>{{cite journal | author = Davidson J, Kwan M, Greenleaf W | title = Hormonal replacement and sexuality in men. | journal = Clin Endocrinol Metab | volume = 11 | issue = 3 | pages = 599–623 | year = 1982 | pmid = 6814798 | doi = 10.1016/S0300-595X(82)80003-0}}</ref> * "Kumwaga shahawa mara kwa mara husababisha upara" ** Pana imani nyingi potovu kuhusu kinachoweza kusaidia kuzuia upoteaji wa nywele, mojawapo ikiwa kwamba umwagaji shahawa wa mara kwa mara unaweza kuathiri MPB. Kulingana na idadi ya nyakati, inaweza kuongeza au kupunguza plazma ya testosteroni.<ref>Exton MS, Krüger TH, Bursch N, ''et al.'', Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence, World J Urol, volume 19, issue 5, pages 377–382, Novemba 2001</ref> * "Mtu asimamapo kwa kichwa huepusha upara" * "Kofia zinazokaza kichwani husababisha upara." ** Ingawa hii inaweza kuwa imani potovu, kofia husababisha kukatika kwa nywele na, kwa kiwango kidogo, kupasuka mwisho kwa nywele. Kwa kuwa kofia hazioshwi mara kwa mara kama nguo nyingine, znaweza pia kusababisha uchafu kichwani na uwezekano uchafuzi wa Pitirosporamu ovali kwa wanaume walio na ngozi ambazo kwa kawaida zina mafuta. Baadhi ya magonjwa ya kichwani, yakiachwa bila kutibiwa, yanaweza kusababisha upotevu wa nywele. == Utafiti == Utafiti unaangazia uhusiano kati ya upotevu wa nywele na masuala mengine ya [[afya]]. Ingawa pamekuwepo uvumi juu ya uhusiano kati ya kuanza mapema kwa-androjeni alopeshia na [[maradhi ya moyo]], upitiaji upya wa makala kuanzia 1954-1999 haikupata uhusiano wa kudumu kati ya upara na [[ugonjwa]] wa [[mishipa ya moyo]]. Wataalamu wa ngozi walioendesha shughuli hiyo walipendekeza utafiti zaidi unahitajika. Sababu za kimazingira zinachunguzwa upya. Utafiti wa mwaka 2007 ulionyesha kuwa uvutaji sigara unaweza kuwa sababu inayohusishwa na upotevu wa nywele kutokana na uzee miongoni mwa wanaume wa Kiesia. Utafiti huu uliozingatia maswala ya umri na historia ya familia, ulipa takwimu kubwa ya uhusiano chanya kati ya androjeni alopeshia kali au wastani na uvutaji sigara.<ref>[http://www.eurekalert.org/pub_releases/2007-11/jaaj-amw111507.php Wanaume wa Kiasia wanaovuta sigara wanaweza kuwa k ongezeko kubwa la hatari ya kupoteza nywele] {{Wayback|url=http://www.eurekalert.org/pub_releases/2007-11/jaaj-amw111507.php |date=20140530052250 }}<br>{{cite journal |author=Su LH, Chen TH |title=Association of androgenetic alopecia with smoking and its prevalence among Asian men: a community-based survey |journal=Arch Dermatol |volume=143 |issue=11 |pages=1401–6 |year=2007 |month= Novemba|pmid=18025364 |doi=10.1001/archderm.143.11.1401 }}</ref> Katika Mei 2007, watafiti katika Chuo Kikuu cha Pennsylvania walivumbua njia mpya ya kisayansi ambayo huenda ikatibu upara kwa seli shina. Bidhaa hii inaweza kuwa sokoni katika muda wa miaka mitatu ijayo.<ref> [http://www.uphs.upenn.edu/news/News_Releases/may07/hair-follicle-regeneration.html ]</ref><ref>{{Rejea tovuti |url=http://video.msn.com/?mkt=en-us&brand=msnbc&vid=3b251041-8028-403d-a6fc-e749264afc01 |title=Nakala iliyohifadhiwa |accessdate=2021-01-17 |archiveurl=https://web.archive.org/web/20081219094737/http://video.msn.com/?mkt=en-us&brand=msnbc&vid=3b251041-8028-403d-a6fc-e749264afc01 |archivedate=2008-12-19 |https://web.archive.org/web/20081219094737/http://video.msn.com/?mkt=en-us&brand=msnbc&vid=3b251041-8028-403d-a6fc-e749264afc01 |=https://web.archive.org/web/20081219094737/http://video.msn.com/?mkt=en-us&brand=msnbc&vid=3b251041-8028-403d-a6fc-e749264afc01 }}</ref> Watafiti waligundua kwamba ukuaji wa shina mpya zinazoweza kuotesha nywele uliweza kusisimuliwa katika panya kwa kuharibu ngozi zao.<ref>{{cite news | first=Jessica | last=Berman | coauthors= | authorlink= | title=Scientists Grow New Hair in Mice | date=17 Mei 2007 | publisher=Voice of America | url=http://voanews.com/english/archive/2007-05/2007-05-17-voa63.cfm | work=VOA News | pages= | accessdate=5 Januari 2009 | language= | archiveurl=https://web.archive.org/web/20081216113806/http://voanews.com/english/archive/2007-05/2007-05-17-voa63.cfm | archivedate=2008-12-16 }}</ref> Februari 2008 watafiti katika Chuo Kikuu cha Bonn walitangaza kugundua msingi wa kijentiki wa aina mbili tofauti ya ipotevu wa nywele uliorithiwa, hivyo basi wakafungua njia pana ya matibabu ya upara. Ukweli kwamba kipokezi mahususi kilikuwa na wajibu maalum katika ukuaji wa nywele haukujulikana awali kwa wanasayansi na kutikana na maarifa haya mapya, tafiti zinazolenga kugundua jeni zaidi za aina hii huenda ikachangia ongezeko la tiba kwa aina tofauti za upotezavu wa nywele.<ref>{{Rejea tovuti |url=http://www.breitbart.com/article.php?id=080224183501.59dd4jek&show_article=1 |title=Nakala iliyohifadhiwa |accessdate=2022-01-04 |archivedate=2008-06-24 |archiveurl=https://web.archive.org/web/20080624005735/http://www.breitbart.com/article.php?id=080224183501.59dd4jek&show_article=1 }}</ref><ref> [http://www.msnbc.msn.com/id/23334554 ]</ref> Utafiti wa miezi minane katika Taasisi ya Sayansi ya Dawa katika Chuo Kikuu cha Sayansi ya Malaysia ulionyesha virutubisho vya kila siku vilivyodhihirishwa vya tokotrienoli(vitamini E) tata inaweza kuongeza ukuaji wa nywele kwa watu wenye mkondo wa upara wa kiume kwa asilimia 42.<ref> [http://www.nutraingredients-usa.com/Research/Vitamin-E-may-reverse-male-pattern-baldness-Study ]</ref> Mnamo Mei 2009, watafiti kule [[Japani|Ujapani]] walitambua jeni, SOX21, inayoonekana kuwa ndiyo yenye wajibu wa upotevu wa nywele kwa watu.<ref>{{Rejea tovuti |url=http://uk.reuters.com/article/scienceNews/idUKTRE54O4D020090525 |title=Nakala iliyohifadhiwa |accessdate=2010-11-30 |archive-date=2009-05-30 |archive-url=https://web.archive.org/web/20090530231632/http://uk.reuters.com/article/scienceNews/idUKTRE54O4D020090525 |url-status=dead }}</ref> == Marejeo == {{columns-list|2| {{Marejeo}} }} == Marejeo ya ziada == {{Wikisource1911Enc}} * Cyclopaedia, London: Ephraim Chambers, 1728. * Rossi S (: mha.) (2004). ''Kitabu-elekevu cha Madawa cha Australia 2004.'' Adelaide: Kitabu-elekevu cha Madawa cha Australia. ISBN 0-9578521-4-2 * {{cite journal |author=Stárka L, Cermáková I, Dusková M, Hill M, Dolezal M, Polácek V |title=Hormonal profile of men with premature balding. |journal=Exp Clin Endocrinol Diabetes |volume=112 |issue=1 |pages=24–8 |year=2004 |pmid=14758568 |doi=10.1055/s-2004-815723}} == Viungo vya nje == {{Wiktionary}} * [http://www.webmd.com/skin-problems-and-treatments/hair-loss/news/20061109/inherited-hair-loss-may-be-upped-by-gene-glitch Utafiti wa jeni ya LIPH] * [http://news.bbc.co.uk/2/hi/health/6661849.stm Utafiti wa jeni ya WNT] [[Category:Ngozi]] [[Category:Kichwa]] [[Category:Magonjwa]] dbzc8tsc7tz610tb2jmktuiddjxdoxc 0 55725 1578081 1509334 2026-07-02T18:48:27Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578081 wikitext text/x-wiki {{tafsiri kompyuta}} [[Picha:AminoAcidball.svg|thumbnail|200px|Mfumo wa jumla wa asidi amino alfa.]] [[Picha:Molecular_structures_of_the_21_proteinogenic_amino_acids.svg|thumb|right|upright=2.0|alt=Table of Amino Acids.|Asidi amino zinazopatikana katika yukaryoti, ambazo zimepangwa kulingana na 'pKa za minyororo yao ya upande na chaji katika pH 7.4 ya kimwili]] '''Asidi amino''' ni [[molekyuli]] zilizo na kikundi cha amaini, kikundi cha asidi ya kaboksili na mnyororo wa upande ambao unatofautiana katika asidi amino mbalimbali. Molekyuli hizi zina vipengele muhimu vya [[kaboni]], [[hidrojeni]], [[oksijeni]] na [[nitrojeni]]. Molekyuli hizi ni muhimu sana hasa katika [[biokemia]], ambapo neno hili kwa kawaida huashiria asidi amino alfa zilizo na [[fomula]] ya jumla H₂NCHRCOOH, ambapo R ni kibadala cha kiogani.<ref> Prolini inakinzana na fomula hii ya ujumla. Inakosa kundi la NH ₂ kwa sababu ya mzunguko wa mnyororo wa upande na kujulikana kama imino asidi; huwa chini ya kikundi cha muundo wa asidi amino maalum.</ref> Katika asidi amino alfa, kikundi cha amino kimeunganishwa na atomu ya [[kaboni]] kinachopakana na kikundi cha kaboksili (kaboni ya α), lakini kumbuka kwamba aina nyingine za asidi amino huwepo wakati kikundi cha amino kimeunganishwa kwa atomu nyingine ya kaboni (kwa mfano, katika asidi za amino za gama kama vile asidi amino butireti ya gama atomu ya kaboni ambapo kikundi cha amino hujiunga hujitenga kutoka kwa kikundi cha kaboksili na atomu zingine mbili). Amino asisi za alfa zinatofautiana katika upande ambao mnyororo (kikundi R) unapounganishwa na kaboni yao ya alfa na hizi zinaweza kutofautiana kwa ukubwa kutoka kwa atomu moja tu [[hidrojeni]] katika glaisini au kikundi cha methili katika alanini, hadi kwa kundi kubwa la heterosaikliki katika triptofani. Asidi amino ni muhimu kwa [[uhai]], na huwa na majukumu mengi katika [[umetaboli]]. Kazi muhimu hasa ni kutumika kama miundo msingi ya ujenzi wa [[protini]], ambayo ni minyororo tu ya asidi amino. Kila protini hufafanuliwa kikemikali kwa mpangilio wa mabaki ya asidi amino, muundo msingi na hii, kwa upande wake, huamua muundo wao wa sekondari (kwa mfano sifa zilizoelezewa vizuri kama vile helisi alfa au [[karatasi beta za mkunjo]]), mfumo wa tatu (umbo la protini binafsi, kwa mfano umbo la tufe kama katika [[kimeng'enya]] au kama safu katika kolajeni) au muundo wa nne (sura jumla ya changamano ya protini iwapo monoma zimepangwa kwa pamoja, kama katika mchangamo wahimoglobini, ambayo inajumuisha monoma nne ambazo zimeshikiliwa pamoja na vifungo vya hidrojeni ambavyo vina uwezo wa kuja pamoja wakati moja au zaidi yazo inapoifunga molekuli nyingine kwa mfano [[oksijeni]] ). Kama vile herufi za alfabeti zinaweza kuwekwa pamoja na kuunda orodha isyo na mwisho ya maneno, asidi amino inaweza kuunganishwa pamoja kwa utaratibu tofauti na kuunda aina nyingi ya protini.<ref name="NIGMS">{{cite web | url = http://publications.nigms.nih.gov/structlife/chapter1.html | title = The Structures of Life | publisher = National Institute of General Medical Sciences | accessdate = 2008-05-20 | archivedate = 2014-06-07 | archiveurl = https://web.archive.org/web/20140607084902/http://publications.nigms.nih.gov/structlife/chapter1.html }}</ref> Asidi amino ni muhimu pia katika molekuli nyingine nyingi za bayolojia , kwa mfano huwa na majukumu muhimu katika vimeng'enya mwenza kama vile S adenosilmethionini. Kutokana na majukumu yao muhimu katika biokemi, asidi amino ni muhimu sana katika [[lishe]] na ni kawaida kutumiwa katika teknolojia ya chakula na viwanda. Kwa mfano, monosodiamu glutamati ni kiimarisha ladha cha kawaida ambacho hupatia vyakula ladha iitwayo ''umami.'' Pia hutumika katika sekta ya viwanda ambapo matumizi ni pamoja na uzalishaji wa plastiki bayochungulika, [[madawa ya kulevya]] na vichocheo vya chirali. == Historia == Asidi amino za kwanza ziligunduliwa mapema miaka ya 1800. Katika 1806, na wanakemia wa Kifaransa Louis-Nicolas Vauquelin na Pierre Jean Robiquet waliutenga mchanganyiko katika asparaga ambayo ilipatikana kuwa asparagini, na kuwa asidi amino ya kwanza kugunduliwa.<ref>{{cite journal |title=The discovery of a new plant principle in Asparagus sativus |author=Vauquelin LN, Robiquet PJ |journal=Annales de Chimie |year=1806 |volume=57 |pages=88–93}}</ref><ref name="Anfinsen">{{cite book |title=Advances in Protein Chemistry |url=https://archive.org/details/advancesinprotei26anfi |author=Anfinsen CB, Edsall JT, Richards FM |date=1972 |pages=[https://archive.org/details/advancesinprotei26anfi/page/99 99], 103 |publisher=Academic Press |location=New York |isbn=978-0-12-034226-6}}</ref> Asidi amino nyingine iliyogunduliwa mapema karne ya 19 ilikuwa sistini, katika 1810,<ref>{{cite journal |title=On cystic oxide, a new species of urinary calculus |author=Wollaston WH |journal=Philosophical Transactions of the Royal Society of London |year=1810 |volume=100 |pages=223–30 |doi=10.1098/rstl.1810.0015}}</ref> ingawa monoma yake, sisteini, ilikuja kugunduliwa miaka mingi baadaye, katika 1884.<ref name="Anfinsen"/><ref>{{cite journal |title=Über cystin und cystein |author=Baumann E |journal=Z Physiol Chemie |year=1884 |volume=8 |pages=299}}</ref> Leucine Glycine na pia ziligunduliwa katika wakati huu, katika 1820.<ref>{{cite journal |title=Sur la conversion des matières animales en nouvelles substances par le moyen de l'acide sulfurique |author=Braconnot HM |journal=Ann Chim Phys Ser 2 |year=1820 |volume=13 |pages=113–25}}</ref> Matumizi ya neno "amino acid" katika lugha ya Kiingereza ni kutoka [[1898]]<ref>{{cite web | url = http://www.etymonline.com/index.php?term=amino | publisher = www.etymonline.com | title = etymonline.com entry for ''amino'' | accessdate = 2010-07-19 | archivedate = 2012-10-20 | archiveurl = https://web.archive.org/web/20121020154535/http://www.etymonline.com/index.php?term=amino }}</ref>. == Muundo jumla == [[Picha:Lysine fisher struct num.png|thumb|right|Lysine with the carbon atoms in the side chain labeled|Alt = Lisini ina atomi dioksidi sita. Atomi ya kati ya dioksidi iliyounganishwa na makundi ya amino na kaboksili na imelezewa kwa ishara alfa. Atomi nne za dioksidi katika mlolongo wake wa laini wa upande umepewa majina kutoka beta (karibu na dioksidi ya kati), gama, delta, hadi kwa dioksidi Epsilon mwisho wa mnyororo na mbali kutoka dioksidi ya kati.]] Katika muundo ulioonyeshwa katika sehemu ya juu ya ukurasa, '''R''' inawakilisha upande wa mnyororo maalum kwa kila asidi amino. Atomu [[Kaboni|ya kaboni]] karibu na kikundi cha kabonili inaitwa α-kaboni na asidi amino na mnyororo upande bonded na dioksidi hii inajulikana kama ''asidi amino alpha.'' Hii ndio miundo inayopatikana sana katika maumbile. Katika asidi amino ya alfa, kaboni-α ni atomu ya kaboni chirali , isipokuwa ile ya glaisini.<ref name="Creighton">{{cite book |last=Creighton |first=Thomas H. |title=Proteins: structures and molecular properties |url=https://archive.org/details/proteinsstructur0000crei |publisher=W. H. Freeman |location=San Francisco |year=1993 |chapter=Chapter 1 |isbn=978-0-7167-7030-5 |pages=}}</ref> Katika asidi amino ambazo zina mnyororo wa kaboni iliyoshikana na kaboni-α (kama vile laisini, imeonyesha kulia) kaboni zimepewa majina yafuatavyo α, β, γ; δ, na kadhalika.<ref>{{cite web | url = http://www.chem.qmul.ac.uk/iupac/AminoAcid/AA1n2.html | title = Nomenclature and Symbolism for Amino Acids and Peptides | publisher = IUPAC-IUB Joint Commission on Biochemical Nomenclature | year = 1983 | accessdate = 2008-11-17}}</ref> Katika asidi amino fulani, kikundi cha amino kimeshikana na β au γ-kaboni, na hizi kwa hiyo zinajulikana kama asidi amino za ''beta'' au ''gamma .'' Asidi amino ni kwa kawaida zimegawanishwa kwa asili mnyororo yao ya upande katika makundi manne. Mnyororo wa upande unaweza kufanya asidi amino iwe asidi dhaifu au besi dhaifu, na iwe hidrofili kama mnyororo wa upande ni ncha au hidrofobi kama si ncha.<ref name="Creighton"/> Mifumo ya kemikali ishirini na mbili za asidi amino za kawaida, pamoja na sifa zao za kemikali, zimeelezewa zaidi katika makala ya asidi amino za proteinojeniki. Maneno ya "asidi amino yenye matawi" au BCAA yanahusu asidi amino yenye minyororo upande alifatiki usio kwenye laini , hizi ni liusini, isolusini, na valini. Prolini ni asidi amino ya proteinojeniki tu ambayo kundi lake la kando limeungana na kikundi cha amino-α, hivyo, pia ni asidi amino ya proteinojeniki ambayo ina amino ya pili katika nafasi hii.<ref name="Creighton"/> Kemikali, proline basi ni asidi imino kwani inakosa kikundi cha amino ya msingi,<ref>{{Cite journal | doi = 10.1021/ja01414a033 | volume = 48 | issue = 3 | pages = 751–753 | last = Jodidi | first = S. L. | title = The Formol Titration of Certain Amino Acids | journal = Journal of the American Chemical Society | accessdate = 2009-08-20 | date = 1926-03-01 }}</ref> ingawa bado inaorodhwashwa kama asidi amino utaratibu wa majina wa sasa, <ref>{{cite book |editor1-first=Claude |editor1-last=Liebecq |title=Biochemical Nomenclature and Related Documents |url=https://archive.org/details/biochemicalnomen0000unse |edition=2nd |publisher=Portland Press |year=1992 |pages=[https://archive.org/details/biochemicalnomen0000unse/page/39 39]–69 |isbn=978-1-85578-005-7}}</ref> na pia inaweza kuitwa "asidi amino alfa yenye alikali-N".<ref>{{cite book |first=Anthony D. |last=Smith |title=Oxford dictionary of biochemistry and molecular biology |url=https://archive.org/details/oxforddictionary0000unse_e9s4 |publisher=Oxford University Press |location=Oxford |year=1997 |pages=[https://archive.org/details/oxforddictionary0000unse_e9s4/page/535 535] |isbn=978-0-19-854768-6 |oclc=37616711}}</ref> [[Picha:D+L-Alanine.gif|thumb|left|alt=Animation of two mirror image molecules rotating around a central axis. |Isoma mbili za kuonekana za alanini, D-Alanini na L-Alanini]] === Waisoma === Kwa asidi amino-α za kawaida, zote ila glaisini zinaweza kuwepo kwa aidha ya isoma zionekanazo mbili, ziitwazo asidi amino <small>L</small> au <small>D</small> , ambazo ni zinafanana kama shilingi kwa ya pili ''(tazama pia Chirality).'' Wakati asidi <small>L-amino</small> zinawakilisha asidi amino zote zinazopatikana kwa [[protini]] ya wakati wa tafsiri ya ribosomu, asidi amino <small>D</small> ni protini ambazo hupatikana katika baadhi ya protini zilizotayarishwa na vimeng'enya wakati baada ya kutafsiriwa kimuundo baada ya kutafsiriwa na kuchukuliwa na hadi kwa endoplasmu retikulamu kama katika viumbe wa baharini wa kipekee kama vile konokono koni.<ref>{{cite journal |author=Pisarewicz K, Mora D, Pflueger FC, Fields GB, Marí F |title=Polypeptide chains containing D-gamma-hydroxyvaline |journal=Journal of the American Chemical Society |volume=127 |issue=17 |pages=6207–15 |year=2005 |month=Mei |pmid=15853325 |doi=10.1021/ja050088m}}</ref> Pia ni sehemu nyingi za ukuta wa seli wa peptidoglikani za [[Bakteria|bakteria.]]<ref>{{cite journal |author=van Heijenoort J |title=Formation of the glycan chains in the synthesis of bacterial peptidoglycan |journal=Glycobiology |volume=11 |issue=3 |pages=25R–36R |year=2001 |month=Machi |pmid=11320055 |doi=10.1093/glycob/11.3.25R}}</ref> na <small>serini-D</small> huweza kutendakazi kama nyurotransmita katika ubongo.<ref>{{cite journal |author=Wolosker H, Dumin E, Balan L, Foltyn VN |title=D-amino acids in the brain: D-serine in neurotransmission and neurodegeneration |journal=The FEBS Journal |volume=275 |issue=14 |pages=3514–26 |year=2008 |month=Julai |pmid=18564180 |doi=10.1111/j.1742-4658.2008.06515.x}}</ref> Mpangilio wa <small>L</small> na <small>D</small> kwa muundo wa asidi amino hairejelei jinsi asidi inavyoonekana, bali kwa kuzunguka kwa macho kwa aisoma ya gliseralidehidi ambayo asidi amino ambayo inaweza kinadharia kutengezwa kutoka kwayo<small>(gliseraldehidi-D</small> ni deksitrorotari, <small>L</small> - glyceraldehidi ni levorotari). Vinginevyo, viashiria vya ''(S)'' na ''R)'' ''(hutumiwa'' kuonyesha stereokemia kamili. Takriban asidi amino zote katika protini ni ''(S)'' katika kaboni α, huku sistini ikiwa ''(R)'' na glisini siyo chirali.<ref>{{cite web | last = Hatem | first = Salama Mohamed Ali | year = 2006 | url = http://geb.uni-giessen.de/geb/volltexte/2006/3038/index.html | title = Gas chromatographic determination of Amino Acid Enantiomers in tobacco and bottled wines | publisher = University of Giessen | accessdate = 2008-11-17}}</ref> Sistini si ya kawaida kwani ina chembe ya [[sulfuri]] katika nafasi ya kwanza katika mnyororo wake wa upande, ambayo ina uzani mkubwa wa [[Uzani atomia|atomia]] kuliko makundi yaliyoshikana na kaboni α katika asidi nyingine, hivyo ''(R)'' badala ya ''(S ).'' === Zwiterioni === Asidi amino inaamaini naasidi ya kaboksili vikundi vya kazi na kwa hiyo wote ni [[asidi]] na besi wakati huo huo.<ref name="Creighton"/> Katika baadhi ya [[Thamani pH|pH]] inayojulikana kama ncha ya isoelektriki na asidi kwa ujumla haina chaji, kwa vile idadi ya vikundi vya amonia vilivyo na protoni (chaji chanya) na vikundi vya kaboksili zisizo na protoni(bila chaji chanya) ni sawa.<ref>{{cite book |title=Food Chemistry |edition=3rd |author=Fennema OR |year=1996 |pages=327–8 |publisher=CRC Press |isbn=0-8247-9691-8}}</ref> Asidi amino zote zina ncha tofauti za ki-isoelektriki. Ayoni zinazozalishwa katika ncha ya isoelektriki huwa na chaji chanya na chaji hasi na hujulikana kama ''zwitterioni,'' ambayo huja kutoka neno la Kijerumani ''Zwitter'' maana "huntha" au "mchanganyiko".<ref>{{cite book |author=Simmons, William J.; Gerhard Meisenberg |title=Principles of medical biochemistry |url=https://archive.org/details/principlesofmedi0000meis |publisher=Mosby Elsevier |location= |year=2006 |pages= |isbn=0-323-02942-6 |oclc= |page=[https://archive.org/details/principlesofmedi0000meis/page/19 19]}}</ref> Asidi amino inaweza kupatikana kama zwiterioni katika mango na ufumbuzi kama vile maji, lakini si katika awamu ya gesi.<ref>{{cite journal |author=Remko M, Rode BM |title=Effect of metal ions (Li+, Na+, K+, Mg2+, Ca2+, Ni2+, Cu2+, and Zn2+) and water coordination on the structure of glycine and zwitterionic glycine |journal=The journal of physical chemistry. A |volume=110 |issue=5 |pages=1960–7 |year=2006 |month=Februari |pmid=16451030 |doi=10.1021/jp054119b}}</ref> Zwiterioni huwa na umumunyifu mdogo katika ncha yake ya kielektriki na asidi amino na inawezakutengwa kwa kutumia kutuama kutoka kwa maji kwa kubadilisha PH yake hadi kwa ncha yake hasa ya elektriki. == Matukio na kazi katika bayokemia == [[Picha:Protein primary structure.svg|thumb|300px|right|alt=A protein depicted as a long unbranched string of linked circles each representing amino acids. One circle is magnified, to show the general structure of an amino acid. This is a simplified model of the repeating structure of protein, illustrating how amino acids are joined together in these molecules. | Polipeptidi ni mnyororo ambao hauna matawi ya asidi amino.]] === Asidi amino za kawaida === Asidi amino ni viungo msingi vya kutengeneza protini. Hujiunga pamoja na kuunda minyororo mifupi ya polima ziitwazo peptidi au minyororo mirefu iitwayo aidha polipeptidi au [[protini]]. Polima hizi ni zenye matawi na za mistari, na kila asidi amino ndani ya mnyororo imeshikana na asidi amino mbili jirani. Mchakato wa kutengeneza protini huitwa ''tafsiri'' na unahusu kuongezwa hatua kwa hatua kwa aidha asidi amino kwa mnyororo unaokuwa wa protini na ribozaimu iitwayo ribosomu.<ref>{{cite journal |author=Rodnina MV, Beringer M, Wintermeyer W |title=How ribosomes make peptide bonds |url=https://archive.org/details/sim_trends-in-biochemical-sciences_2007-01_32_1/page/20 |journal=Trends in Biochemical Sciences |volume=32 |issue=1 |pages=20–6 |year=2007 |month=Januari |pmid=17157507 |doi=10.1016/j.tibs.2006.11.007}}</ref> Utaratibu ambao asidi amino zinaongezwa nao unasomwa kutoka kwa programu ya maumbile kutoka kwa programu ya jeni ya mRNA, ambayo ni nakala ya RNA ya jeni ya moja ya kiumbe. Asidi amino ishirini na mbili kiasili zimejumuishwa katika polipeptidi na huitwa proteinojeniki au asidi amino za kawaida.<ref name="Creighton"/> Kati ya hizi 22 ishirini, ishirini zimejumuishwa moja kwa moja na kanuni kuu ya maumbile. Zilizosalia mbili, selenosistini na pirolisini, hujumuishwa katika protini kwa utaratibu kusanisi wa kipekee. Selenosistini hujumuishwa wakati mRNA inapokuwa ikitafsiriwa ikiwa na kipengele SECIS, ambayo husababisha kodoni ya UGA kuweka Selenosistini badala ya kodoni ya kusimama.<ref>{{cite journal |author=Driscoll DM, Copeland PR |title=Mechanism and regulation of selenoprotein synthesis |url=https://archive.org/details/sim_annual-review-of-nutrition_2003_23/page/17 |journal=Annual Review of Nutrition |volume=23 |issue= |pages=17–40 |year=2003 |pmid=12524431 |doi=10.1146/annurev.nutr.23.011702.073318}}</ref> Pirolisini hutumiwa na baadhi methanojeni [[Archaea|echea]] katika vimeng'enya vinavyotumika kuzalisha methani. Imewekwa kwa kanuni pamoja na kodoni ya UAG, ambayo kwa kawaida huwa ni kodoni ya kusimama katika viumbe wengine.<ref>{{cite journal |author=Krzycki JA |title=The direct genetic encoding of pyrrolysine |journal=Current Opinion in Microbiology |volume=8 |issue=6 |pages=706–12 |year=2005 |month=Desemba |pmid=16256420 |doi=10.1016/j.mib.2005.10.009}}</ref> [[Picha:L-selenocysteine-2D-skeletal.png|thumb|left|alt=The structure of selenocysteine, this differs from the lead image by having the R group (the side chain) replaced by a carbon atom with two hydrogen and a selenium attached.|Asidi amino selenosisteini]] === Asidi amino zisizo za kawaida === Mbali na asidi amino za msingi ishirini na mbili, kuna idadi kubwa ya "asidi amino zisizo za kawaida". Hizi asidi amino zisizo za kawaida zinazopatikana kwa protini huundwa kwa mabadiliko baada ya kutafsiriwa, ambayo ni kubadilishwa baada ya tafsiri katika protini ya awali. Mabadiliko haya mara nyingi ni muhimu kwa ajili ya utendajikazi au udhibiti wa protini, kwa mfano, ukabsilishaji wa glutamati unaruhusu kushikilia vizuri kwa kashoni za kalsiamu,<ref>{{cite journal |author=Vermeer C |title=Gamma-carboxyglutamate-containing proteins and the vitamin K-dependent carboxylase |journal=The Biochemical Journal |volume=266 |issue=3 |pages=625–36 |year=1990 |month=Machi |pmid=2183788 |pmc=1131186}}</ref> na hidroksilesheni ya prolini ni muhimu kwa ajili ya kudumisha tishu zilizoshikana.<ref>{{cite journal |author=Bhattacharjee A, Bansal M |title=Collagen structure: the Madras triple helix and the current scenario |journal=IUBMB Life |volume=57 |issue=3 |pages=161–72 |year=2005 |month=Machi |pmid=16036578 |doi=10.1080/15216540500090710}}</ref> Mfano mwingine ni uundaji wa hipusini katika kuanzishwa kwa kipengele tafsiri cha EIF5A, kwa kubadilishwa kwa mabaki ya laisini.<ref>{{cite journal |author=Park MH |title=The post-translational synthesis of a polyamine-derived amino acid, hypusine, in the eukaryotic translation initiation factor 5A (eIF5A) |journal=Journal of Biochemistry |volume=139 |issue=2 |pages=161–9 |year=2006 |month=Februari |pmid=16452303 |pmc=2494880 |doi=10.1093/jb/mvj034}}</ref> Mabadiliko kama hayo yanaweza pia kuamua ujanibishaji wa protini, kwa mfano, nyongeza ya makundi marefu ya kukwepamaji kunaweza kusababisha protini kujifunga kwa utando wa fosfolidi.<ref>{{cite journal |author=Blenis J, Resh MD |title=Subcellular localization specified by protein acylation and phosphorylation |url=https://archive.org/details/current-opinion-in-cell-biology_1993_5_6/page/984 |journal=Current Opinion in Cell Biology |volume=5 |issue=6 |pages=984–9 |year=1993 |month=Desemba |pmid=8129952 |doi=10.1016/0955-0674(93)90081-Z}}</ref> [[Picha:Beta alanine comparison.png|thumb|250px|right|alt=Comparison of the structures of alanine and beta alanine. In alanine the side chain is a methyl group, in beta alanine the side chain contains a methylene group connected to an amino group and the alpha carbon lacks an amino group. The two amino acids therefore have the same formulae but different structures.| β-alanini na isoma yake α-alanini]] Mifano ya asidi amino zisizo za kawaida na hazipatikani kwa protini ni pamoja na [[lanthionini,asidi-aminoisobutiri 2]] , dehidroalanini na nyurotransmita asidi ya gama-aminobutiriki. Asidi amino zisizo za kawaida mara nyingi hutokea baina ya njia za metaboli kwa asidi amino za kawaida- kwa mfano orinithini na sitrulini hutokea katika mzunguko wa urea, sehemu ya ukataboli wa asidi amino (angalia hapo chini).<ref>{{cite journal |author=Curis E, Nicolis I, Moinard C, ''et al.'' |title=Almost all about citrulline in mammals |journal=Amino Acids |volume=29 |issue=3 |pages=177–205 |year=2005 |month=Novemba |pmid=16082501 |doi=10.1007/s00726-005-0235-4}}</ref> Tofauti ya nadra kwa kutawala kwa asidi amino α katika biolojia ni asidi amino β beta alanini (asidi aminopropanu 3), ambayo hutumiwa na mimea na vidubini katika uundaji wa asidi pantotheni (vitamini B _5), sehemu ya kimeng'enya pacha A.<ref>{{cite journal |author=Coxon KM, Chakauya E, Ottenhof HH, ''et al.'' |title=Pantothenate biosynthesis in higher plants |journal=Biochemical Society Transactions |volume=33 |issue=Pt 4 |pages=743–6 |year=2005 |month=Agosti |pmid=16042590 |doi=10.1042/BST0330743}}</ref> === Katika lishe ya binadamu === Baada ya kupelekwa katika mwili wa binadamu kutoka kwa chakula, aina 22 za asidi amino hutumiwa kutengeza protini na bayomolekuli nyingine au huoksidishwa na kuwa urea na kaboni dioksidi kama chanzo cha nishati.<ref>{{cite journal |author=Sakami W, Harrington H |title=Amino acid metabolism |journal=Annual Review of Biochemistry |volume=32 |issue= |pages=355–98 |year=1963 |pmid=14144484 |doi=10.1146/annurev.bi.32.070163.002035}}</ref> Njia ya uoksidishaji huanza na kuondolewa kwa kikundi cha amino na transaminasi, kundi la amino basi huongezwa katika mzunguko wa urea. Bidhaa nyingine za transamidesheni ni asidi keto ambayo inaingia mzunguko wa asidi sitriki.<ref>{{cite journal |author=Brosnan JT |title=Glutamate, at the interface between amino acid and carbohydrate metabolism |journal=The Journal of Nutrition |volume=130 |issue=4S Suppl |pages=988S–90S |year=2000 |month=Aprili |pmid=10736367 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=10736367}}</ref> Asidi amino Glukojeniki pia inaweza kugeuzwa kuwa glukosi, kupitia glukoneojenesi.<ref>{{cite journal |author=Young VR, Ajami AM |title=Glutamine: the emperor or his clothes? |journal=The Journal of Nutrition |volume=131 |issue=9 Suppl |pages=2449S–59S; discussion 2486S–7S |year=2001 |month=Septemba |pmid=11533293 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=11533293}}</ref> Pirolisini bainishi iko kwa vijiumbe maradhi kadhaa, na kiumbe kimoja tu kina Pyl na Sec. Kati ya asidi amino ishirini na mbili, nane huitwa asidi amino muhimu kwa sababu mwili wa binadamu hauwezi kuzitengeza kutoka [[Kampaundi|misombo]] mingine katika ngazi inayohitajika kwa ajili ya ukuaji wa kawaida, hivyo ni lazima zipatikane kutoka kwa vyakula.<ref>{{cite journal |author=Young VR |title=Adult amino acid requirements: the case for a major revision in current recommendations |journal=The Journal of Nutrition |volume=124 |issue=8 Suppl |pages=1517S–1523S |year=1994 |month=Agosti |pmid=8064412 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=8064412}}</ref> Hata hivyo, hali ni ya kuchanganya kwani sistini, taurini, tirosini, histidini na arginini ni asidi amino muhimu kiasi kwa watoto, kwa sababu njia za metaboli za kutengeza asidi amino hizi hazijaumbika kikamilifu.<ref>{{cite journal |author=Imura K, Okada A |title=Amino acid metabolism in pediatric patients |url=https://archive.org/details/sim_nutrition_1998-01_14_1/page/143 |journal=Nutrition |volume=14 |issue=1 |pages=143–8 |year=1998 |month=Januari |pmid=9437700 |doi=10.1016/S0899-9007(97)00230-X}}</ref><ref>{{cite journal |author=Lourenço R, Camilo ME |title=Taurine: a conditionally essential amino acid in humans? An overview in health and disease |journal=Nutrición Hospitalaria |volume=17 |issue=6 |pages=262–70 |year=2002 |pmid=12514918}}</ref> Kiasi kinachohitajika pia hutegemea umri na afya ya mtu binafsi, hivyo ni vigumu kutoa taarifa ya jumla kuhusu mahitaji ya malazi ya baadhi ya asidi amino. {| class="wikitable" ! Muhimu ! Zisizo Muhimu |- | Isoleusini | Alanini |- | Leusini | Asparajini |- | Lisini | Asidi Aspariti |- | Methionini | Sisteini * |- | fenilalanini | Asidi Glutamiki |- | Threonini | Glutamini * |- | Triptofani | Glisini * |- | Valini | Prolini * |- | | Selenosistini * |- | | Serini * |- | | Tirosini * |- | | Arginini * |- | | Histidini * |- | | Ornithini * |- | | Taurini * |} (*) Muhimu katika kesi fulani tu.<ref>{{cite journal |author=Fürst P, Stehle P |title=What are the essential elements needed for the determination of amino acid requirements in humans? |journal=The Journal of Nutrition |volume=134 |issue=6 Suppl |pages=1558S–1565S |year=2004 |month=Juni |pmid=15173430 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=15173430}}</ref><ref>{{cite journal |author=Reeds PJ |title=Dispensable and indispensable amino acids for humans |journal=The Journal of Nutrition |volume=130 |issue=7 |pages=1835S–40S |year=2000 |month=Julai |pmid=10867060 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=10867060}}</ref> === Kazi zisizo za protini === Kwa binadamu, asidi amino zisizo protini pia zina majukumu muhimu kama viungo vya kati vya metaboli, kama vile katika biosanisi ya nyeurotransmita ya asidi gama aminobutiriki. Asidi amino nyingi hutumiwa katika usanisi wa molekuli nyingine, kwa mfano: * Triptofani ni mtangulizi wa nyeurotransmita serotonini.<ref>{{cite journal |author=Savelieva KV, Zhao S, Pogorelov VM, ''et al.'' |title=Genetic disruption of both tryptophan hydroxylase genes dramatically reduces serotonin and affects behavior in models sensitive to antidepressants |journal=PloS ONE |volume=3 |issue=10 |pages=e3301 |year=2008 |pmid=18923670 |pmc=2565062 |doi=10.1371/journal.pone.0003301}}</ref> * Glisini ni mtangulizi wa porifirini kama vile heme.<ref>{{cite journal |title=The biological utilization of glycine for the synthesis of the protoporphyrin of hemoglobin |author=Shemin D, Rittenberg D |journal=Journal of Biological Chemistry |date=1 Desemba 1946 |volume=166 |issue=2 |page=621 |url=http://www.jbc.org/cgi/reprint/166/2/621 |pages=621–5 |pmid=20276176}}</ref> * Arginini ni mtangulizi wa oksidi nitriki.<ref>{{cite journal |author=Tejero J, Biswas A, Wang ZQ, ''et al.'' |title=Stabilization and characterization of a heme-oxy reaction intermediate in inducible nitric-oxide synthase |journal=The Journal of Biological Chemistry |volume=283 |issue=48 |pages=33498–507 |year=2008 |month=Novemba |pmid=18815130 |pmc=2586280 |doi=10.1074/jbc.M806122200}}</ref> * Ornithini na S-adenosilmethionini ni tangulizi kwa poliamini.<ref>{{cite journal |author=Rodríguez-Caso C, Montañez R, Cascante M, Sánchez-Jiménez F, Medina MA |title=Mathematical modeling of polyamine metabolism in mammals |url=https://archive.org/details/sim_journal-of-biological-chemistry_2006-08-04_281_31/page/n236 |journal=The Journal of Biological Chemistry |volume=281 |issue=31 |pages=21799–812 |year=2006 |month=Agosti |pmid=16709566 |doi=10.1074/jbc.M602756200}}</ref> * Aspartate, glisini na glutamini ni tangulizi kwa nukleotidi.<ref>{{cite book |author=Stryer, Lubert; Berg, Jeremy Mark; Tymoczko, John L. |title=Biochemistry |publisher=W.H. Freeman |location=San Francisco |year=2002 |pages=693–8 |isbn=0-7167-4684-0}}</ref> * Fenilalanini ni mtangulizi wa Fenipropanoidi mbalimbali ambayo ni muhimu katika metaboli ya mimea. Hata hivyo, si kazi zote za asidi amino nyingi zisizo za kawaida zinajulikana, kwa mfano taurini ni asidi amino kubwa katika misuli na tishu ya ubongo, lakini ingawa kazi nyingi zimependekezwa, wajibu wake hasa katika mwili bado haujatambuliwa.<ref name="Brosnan"/> Baadhi ya asidi amino zisizo za kawaida hutumika katika mimea kama kinga dhidi ya wanyama walao mimea.<ref name="Hylin1969">{{Cite journal |last=Hylin |first=John W. |year=1969 |title=Toxic peptides and amino acids in foods and feeds |journal=Journal of Agricultural and Food Chemistry |volume=17 |issue=3 |pages=492–6 |doi=10.1021/jf60163a003}}</ref> Kwa mfano kanavanini ni mfano wa argininiambayo hupatikana katika mimea ya jamii ya [[Jamii kunde|kunde]],<ref name="Turner1967">{{Cite journal |last1=Turner |first1=B. L. |last2=Harborne |first2=J. B. |year=1967 |title=Distribution of canavanine in the plant kingdom |url=https://archive.org/details/sim_phytochemistry_1967_6/page/863 |journal=Phytochemistry |volume=6 |pages=863–66 |doi=10.1016/S0031-9422(00)86033-1}}</ref> na kwa kiasi kikubwa hasa katika ''Kanavalia gladiata'' (maharage upanga ).<ref>{{cite journal |author=Ekanayake S, Skog K, Asp NG |title=Canavanine content in sword beans (Canavalia gladiata): analysis and effect of processing |journal=Food and Chemical Toxicology |volume=45 |issue=5 |pages=797–803 |year=2007 |month=Mei |pmid=17187914 |doi=10.1016/j.fct.2006.10.030}}</ref> Hii asidi amino hulinda mimea kutoka waporaji kama vile [[wadudu]] na inaweza kusababisha ugonjwa kwa watu kama aina fulani ya kunde ni kuliwa bila ya usindikaji.<ref>{{cite journal |author=Rosenthal GA |title=L-Canavanine: a higher plant insecticidal allelochemical |journal=Amino Acids |volume=21 |issue=3 |pages=319–30 |year=2001 |pmid=11764412 |doi=10.1007/s007260170017}}</ref> Asidi amino isiyo protini mimosini hupatikana katika aina nyingine ya kunde, hasa ''Leucaena leucocephala.'' Mchanganyiko huu ni mfano wa tairosini na inaweza kuwa sumu kwa wanyama wanaolishwa na mimea hiyo. == Matumizi katika teknolojia == Asidi amino hutumika kwa njia nyingi tofauti viwandani lakini matumizi yao makuu ni kama viziada vyachakula cha mifugo. Hii ni muhimu kwani sehemu kuu ya vyakula hivi, kama vile [[Soya|soya]], aidha ina viwango vya chini au hukosa baadhi ya asidi amino muhimu: lisini, methionini, threonini, na triptofani ni muhimu katika uzalishaji wa vyakula hivi.<ref name="Leuchtenberger2005">{{cite journal |author=Leuchtenberger W, Huthmacher K, Drauz K |title=Biotechnological production of amino acids and derivatives: current status and prospects |journal=Applied Microbiology and Biotechnology |volume=69 |issue=1 |pages=1–8 |year=2005 |month=Novemba |pmid=16195792 |doi=10.1007/s00253-005-0155-y}}</ref> Sekta ya chakula pia ni mtumizi mkubwa wa asidi amino, hasa asidi glutamiki, ambayo hutumiwa kama kiongeza ladha,<ref name="Garattini">{{cite journal |author=Garattini S |title=Glutamic acid, twenty years later |journal=The Journal of Nutrition |volume=130 |issue=4S Suppl |pages=901S–9S |year=2000 |month=Aprili |pmid=10736350 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=10736350}}</ref> na Aspartami (aspartili-fanilalanini-1-methili esta) kama kiongeza tamu bandia cha kalori kidogo.<ref>{{cite journal |author=Stegink LD |title=The aspartame story: a model for the clinical testing of a food additive |journal=The American Journal of Clinical Nutrition |volume=46 |issue=1 Suppl |pages=204–15 |year=1987 |month=Julai |pmid=3300262 |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=3300262}}</ref> Uzalishaji uliosalia wa asidi amino hutumika katika usanisi wa madawa na vipodozi.<ref name="Leuchtenberger2005"/> {| class="wikitable" style="margin-left:auto;margin-right:auto" !Minyambuliko ya asidi Amino !Matumizi ya Dawa |- | align="center"|5-HTP (5-hidroksitriptofani) | align="center"|Majaribio ya matibabu ya unyogovu.<ref>{{cite journal |author=Turner EH, Loftis JM, Blackwell AD |title=Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan |journal=Pharmacology & Therapeutics |volume=109 |issue=3 |pages=325–38 |year=2006 |month=Machi |pmid=16023217 |doi=10.1016/j.pharmthera.2005.06.004}}</ref> |- | align="center"|L-dopa (L-dihidroksifenilalanini) | align="center"|Matibabu kwa Pakinsoni.<ref>{{cite journal |author=Kostrzewa RM, Nowak P, Kostrzewa JP, Kostrzewa RA, Brus R |title=Peculiarities of L: -DOPA treatment of Parkinson's disease |journal=Amino Acids |volume=28 |issue=2 |pages=157–64 |year=2005 |month=Machi |pmid=15750845 |doi=10.1007/s00726-005-0162-4}}</ref> |- | align="center"|Eflornithini | align="center"|Dawa inayozuia dekaboksilasi ya ornithini na hutumiwa katika matibabu ya ugonjwa<ref>{{cite journal |author=Heby O, Persson L, Rentala M |title=Targeting the polyamine biosynthetic enzymes: a promising approach to therapy of African sleeping sickness, Chagas' disease, and leishmaniasis |journal=Amino Acids |volume=33 |issue=2 |pages=359–66 |year=2007 |month=Agosti |pmid=17610127 |doi=10.1007/s00726-007-0537-9}}</ref> wa [[kulala]]. |- |} === Maumbile jeni yaliyopanuliwa === Tangu mwaka wa 2001, asidi amino 40 zisizo za kiasili zimeongezwa kwa protini kwa kujenga kodoni ya kipekee (kubadilisha) na uhamisho unaombatana wa jozi ya RNA: aminoacyl - tRNA-sinthetesi jozi kwa usimbaji wa mwili na kemikali tofauti na tabia ya kibayolojia ili kutumika kama chombo cha kuchunguza mfumo wa protini na kazi au kutengeneza mkusanyiko wa protini zilzoimarishwa.<ref name="pmid16260173">{{cite journal | author = Xie J, Schultz PG | title = Adding amino acids to the genetic repertoire | journal = Curr Opin Chem Biol | volume = 9 | issue = 6 | pages = 548–54 | year = 2005 | month = Desemba | pmid = 16260173 | doi = 10.1016/j.cbpa.2005.10.011 | url = | issn = }}</ref><ref name="pmid19318213">{{cite journal | author = Wang Q, Parrish AR, Wang L | title = Expanding the genetic code for biological studies | journal = Chem. Biol. | volume = 16 | issue = 3 | pages = 323–36 | year = 2009 | month = Machi | pmid = 19318213 | doi = 10.1016/j.chembiol.2009.03.001 | url = | issn = | pmc = 2696486 }}</ref> === Miundo msingi ya kemikali === Asidi amino ni muhimu kama viambajengo vya gharama ya chini. Misombo hii inatumika katika bwawa la chirali husaidia kujenga miundo mbinu yenye molekuli zenye [[chirali]].<ref name="Hanessian1993">{{Cite journal |last=Hanessian |first=S. |year=1993 |title=Reflections on the total synthesis of natural products: Art, craft, logic, and the chiron approach |journal=Pure and Applied Chemistry |volume=65 |pages=1189–204 |doi=10.1351/pac199365061189}}</ref> Asidi amino zimechunguzwa kama kitangulizi cha kichocheo chirali, kwa mfano kwa mrundikano wa atomu zisopacha katika hidrojenesheni, ingawa hakuna matumizi yaliyomo kwa sasa.<ref name="Blaser1992">{{Cite journal |last=Blaser |first=Hans Ulrich |year=1992 |title=The chiral pool as a source of enantioselective catalysts and auxiliaries |journal=Chemical Reviews |volume=92 |issue=5 |pages=935–52 |doi=10.1021/cr00013a009}}</ref> === Plastiki zinazoweza kuvundishwa === Asidi amino zinaundwa kama sehemu ya polima nyingi zinazoweza kuvundishwa. Vifaa na maombi kama zisizo na madhara ya ufungaji wa mazingira na madawa katika utoaji wa madawa na ujenzi wa uwekaji wa viungo bandia. Polima hizi ni pamoja na polipeptidi poliamidi, poliesta, polisulfuri na polietheni amabzo zina asidi asidi amino kama sehemu ya minyororo yao kuu au imeshikana kama minyororo ya upande. Mabadiliko haya hugeuza maumbile ya polima hizi pamoja na mrundikano wao wa atomu.<ref name="Sanda1999">{{Cite journal |last1=Sanda |first1=Fumio |last2=Endo |first2=Takeshi |year=1999 |title=Feature Article Syntheses and functions of polymers based on amino acids |journal=Macromolecular Chemistry and Physics |volume=200 |pages=2651–61 |doi=10.1002/(SICI)1521-3935(19991201)200:12<2651::AID-MACP2651>3.0.CO;2-P}}</ref> Mfano mzuri wa nyenzo hizi ni poliaspartati, polima ambayo inaweza kuyeyuka kwa maji na pia inaweza kuvundishwa na bakteria na inaweza kutumika katika utengezaji wa nepi za kutupwa na kilimo.<ref name="Gross2002">{{Cite journal | last1 = Gross | first1 = R. A. | last2 = Kalra | first2 = B. | year = 2002 | title = Biodegradable Polymers for the Environment | journal = Science | volume = 297 | issue = 5582 | pages = 803–807 | doi = 10.1126/science.297.5582.803 | url = http://www.sciencemag.org/cgi/content/abstract/297/5582/803 | pmid = 12161646}}</ref> Kutokana na umumunyifu wake na uwezo wa kushikana na molekuli zaidi ya moja za metali, poliaspartati pia hutumika kama ajenti inayoweza kuvundishwa na ya kuzuia ubambuzi.<ref>{{cite book |title= Commercial poly(aspartic acid) and Its Uses |last = Low | first = K. C. | coauthors = Wheeler, A. P.; Koskan, L. P. |series= Advances in Chemistry Series |volume= 248 |publisher= [[American Chemical Society]] |location= Washington, D.C. |year= 1996}}</ref><ref name="Thombre2005">{{Cite journal | last1 = Thombre | first1 = S.M. | last2 = Sarwade | first2 = B.D. | year = 2005 | title = Synthesis and Biodegradability of Polyaspartic Acid: A Critical Review | journal = Journal of Macromolecular Science, Part A | volume = 42 | issue = 9 | pages = 1299–1315 | url = http://www.informaworld.com/index/718581646.pdf | doi = 10.1080/10601320500189604}}</ref> Aidha, asidi amino ya kunukia tirosini inaundwa kama iweze kuwa badala ya kwa fenoli zenye sumu kama vile bisfenoli A katika utengenezaji wa polikaboni.<ref name="Bourke2003">{{Cite journal | last1 = Bourke | first1 = S. L. | last2 = Kohn | first2 = J. | year = 2003 | title = Polymers derived from the amino acid l-tyrosine: polycarbonates, polyarylates and copolymers with poly(ethylene glycol) | journal = Advanced Drug Delivery Reviews | volume = 55 | issue = 4 | pages = 447–466 | doi = 10.1016/S0169-409X(03)00038-3 | url = http://linkinghub.elsevier.com/retrieve/pii/S0169409X03000383 | pmid = 12706045}}</ref> == Miitikio == Kwa kuwa asidi amino ina kikundi cha msingi cha kaboksili na amino, hizi kemikali zinaweza kuwa na athari zinazohusiana na makundi hayo. Hizi ni pamoja na kuongeza nukleofiliki, kutengeza kiunganishi cha amaidi na kutengezwa kwa imini kwa kikundi cha amaini na uundaji wa esterasi, uundaji wa kiunganishi cha amaidi na udikaboksishaji kwa kikundi cha asidi ya kaboksili.<ref>{{cite book |author=Elmore, Donald Trevor; Barrett, G. C. |title=Amino acids and peptides |publisher=Cambridge University Press |location=Cambridge, UK |year=1998 |pages=48–60 |isbn=0-521-46827-2}}</ref> Minyororo mingi ya upande ya asidi amino inaweza pia kuwa na miitikio ya kemikali.<ref>{{cite journal |author=Gutteridge A, Thornton JM |title=Understanding nature's catalytic toolkit |url=https://archive.org/details/sim_trends-in-biochemical-sciences_2005-11_30_11/page/622 |journal=Trends in Biochemical Sciences |volume=30 |issue=11 |pages=622–9 |year=2005 |month=Novemba |pmid=16214343 |doi=10.1016/j.tibs.2005.09.006}}</ref> Aina ya hizi athari huamuliwa na kwa makundi haya kwenye minyororo ya upande na kwa hivyo ni tofauti kati ya aina mbalimbali za asidi amino. [[Picha:Strecker Amino Acid Synthesis Scheme.png|thumb|400px|left|The Strecker amino acid synthesis|Alt = kwa hatua katika mmenyuko, angalia maandishi.]] === Usanisi wa kemikali === Mbinu kadhaa zipo za kusanisi asidi amino. Moja ya mbinu kongwe, huanza na kuongezwa kwa bromidikatika kaboni-α ya asidi ya kaboksili. Kubadilisha niuklofili na [[amonia]] nayo hubadilisha alkili bromidi kuwa asidi amino.<ref>{{cite book |last=McMurry |first=John |title=Organic chemistry |url=https://archive.org/details/organicchemistry0000mcmu_t5f0 |publisher=Brooks/Cole |location=Pacific Grove, CA, USA |year=1996 |page=[https://archive.org/details/organicchemistry0000mcmu_t5f0/page/1064 1064] |isbn=0-534-23832-7}}</ref> Vinginevyo, usanisi wa asidi amino Strecker unahusisha matibabu ya alidehaidi na potasiamu sianidi na amonia, hii hutoa amino nitrili α kama cha kati. Hidrolisisi ya nitrili katika asidi hutoa asidi amino α.<ref>{{cite journal |first1=Adolph |last1=Strecker |authorlink1=Adolph Strecker |title=Ueber die künstliche Bildung der Milchsäure und einen neuen, dem Glycocoll homologen Körper |journal=Justus Liebigs Annalen der Chemie |year=1850 |volume=75 |issue=1 |doi=10.1002/jlac.18500750103 |pages=27–45}}</ref> Kutumia amonia au chumvi za amonia katika mmenyuko huu inatoa asidi amino ambazo hazikubadilishana, wakati kubadilisha amini za msingi na upili kutatoa asidi amino zilizobadilishwa.<ref>{{cite journal |first1=Adolph |last1=Strecker |authorlink1=Adolph Strecker |title=Ueber einen neuen aus Aldehyd - Ammoniak und Blausäure entstehenden Körper |journal=Justus Liebigs Annalen der Chemie |year=1854 |volume=91 |issue=3 |doi=10.1002/jlac.18540910309 |pages=349–51}}</ref> Kadhalika, kutumia ketoni, badala ya aldehidi, inatoa α, asidi amino α zilizobadilishwa.<ref>{{cite journal |author=Masumoto S, Usuda H, Suzuki M, Kanai M, Shibasaki M |title=Catalytic enantioselective Strecker reaction of ketoimines |journal=Journal of the American Chemical Society |volume=125 |issue=19 |pages=5634–5 |year=2003 |month=Mei |pmid=12733893 |doi=10.1021/ja034980}}</ref> Usanisi wa awali unatoa mchanganyiko rasimu wa asidi amino α kama mavuno, lakini taratibu kadhaa mbadala kwa kutumia mbinu saidizi zisopacha <ref>{{cite journal |last=Davis |first=F. A. |journal=[[Tetrahedron Letters]] |year=1994 |volume=35 |page=9351}}</ref> au vichocheo visopacha <ref>{{cite journal |first1=Haruro |last1=Ishitani |first2=Susumu |last2=Komiyama |first3=Yoshiki |last3=Hasegawa |first4=Shū |last4=Kobayashi |title=Catalytic Asymmetric Strecker Synthesis. Preparation of Enantiomerically Pure α-Amino Acid Derivatives from Aldimines and Tributyltin Cyanide or Achiral Aldehydes, Amines, and Hydrogen Cyanide Using a Chiral Zirconium Catalyst |journal= Journal of the American Chemical Society |year=2000 |volume=122 |issue=5 |pages=762–6 |doi=10.1021/ja9935207}}</ref><ref>{{cite journal |first1=Jinkun |last1=Huang |first2=E. J. |last2=Corey |title=A New Chiral Catalyst for the Enantioselective Strecker Synthesis of α-Amino Acids |journal=Orgic Letters |year=2004 |volume=62 |issue=6 |pages=5027–9 |doi=10.1021/ol047698w |pmid=15606127}}</ref>vimeundwa.<ref>{{cite journal |first1=Rudolf O. |last1=Duthaler |journal=Tetrahedron |year=1994 |volume=50 |issue=6 |pages=1539–1650 |doi=10.1016/S0040-4020(01)80840-1 |title=Recent developments in the stereoselective synthesis of α-aminoacids|url=https://archive.org/details/sim_tetrahedron_1994-02-07_50_6/page/n11 }}</ref> Kwa sasa njia inayotumika sana ni usanisi kwa kutumia mashine iliyo na nguzo imara (km shanga za polistirini), kwa kutumia makundi ya kulinda la (kwa mfano, t-Boc) na Fmoc na vikundi viamilishaji (mfano DCC na DIC). === Kuundwa kwa kiunganishi cha Peptidi === [[Picha:Peptidformationball.svg|thumbnail|right|400px|The condensation of two amino acids to form a peptide bond|Alt = asidi amino mbili zimeonyeshwa karibu na kila mmoja. Moja hupoteza hidrojeni na oksijeni kutoka kwa kundi lake la kaboksili (COOH) na nyingine hupoteza hidrojeni kutoka kwa kundi lake la amino (NH2). Mmenyuko huu hutoa molekuli ya maji (h2o) na asidi amino mbili zilizounganishwa na kiunganishi peptidi (-CO-NH-). Asidi amino mbili zilizojiunga huitwa dipeptidi.]] Kwa kuwa vikundi vyote viwili vya asidi ya kaboksili na amaini vya asidi amino vinaweza kuathiriwa na kuunda viunganishi vya amaidi, molekuli moja ya asidi amino inaweza kuathiriwa na nyingine na kujiunga nayo na kuunda muungano wa amaidi. Huu upolimishaji wa asidi amino ni ndio unaounda protini. Huu mtonesho wa kutonesha unazaa kiunganishi cha peptidi na molekuli ya maji. Katika seli, mwitikio huu hautokei moja kwa moja, badala yake asidi amino kwanza huchochewa kwa kufungiliwa kwa molekuli hamishi yaRNA kupitia kwa kiunganishi cha esta. Hii aminoasili tRNA huzalishwa katika mwitikio unaotegemea ATP unaofanywa na asidi amino tRNA sanisifu.<ref>{{cite journal |author=Ibba M, Söll D |title=The renaissance of aminoacyl-tRNA synthesis |journal=EMBO Reports |volume=2 |issue=5 |pages=382–7 |year=2001 |month=Mei |pmid=11375928 |pmc=1083889 |doi=10.1093/embo-reports/kve095 |doi_brokendate=2010-02-18 |url=http://www.nature.com/embor/journal/v2/n5/full/embor420.html}}</ref> Aminoasili-tRNA hii huwa tena ni sabstreti ya ribosomu, ambayo huchochea ya mashambulizi ya kundi la amino la kurefusha mnyororo wa protini kwa kiunganishi cha esta.<ref>{{cite journal |author=Lengyel P, Söll D |title=Mechanism of protein biosynthesis |journal=Bacteriological Reviews |volume=33 |issue=2 |pages=264–301 |year=1969 |month=Juni |pmid=4896351 |pmc=378322 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=4896351}}</ref> Kutokana na utaratibu huu, protini zote zinazotengezwa na ribosomu husanisiwa kuanzia kituo chao cha N na kusonga kuelekea kituo chao cha C. Hata hivyo, si viunganishi vyote hutengenezwa kwa njia hii. Katika kesi chache, peptidi husanisiwa na vimeng'enya maalum. Kwa mfano, glutathioni tripeptidi ni sehemu muhimu ya ulinzi wa seli dhidi ya dhiki ya uoksidishaji. Peptidi huundwa kutoka katika asidi amino huru kwa hatua mbili.<ref>{{cite journal |author=Wu G, Fang YZ, Yang S, Lupton JR, Turner ND |title=Glutathione metabolism and its implications for health |journal=The Journal of Nutrition |volume=134 |issue=3 |pages=489–92 |year=2004 |month=Machi |pmid=14988435 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=14988435}}</ref> Katika hatua ya kwanza gamma-glutamilisistini sinthetesi hutonesha sistini na asidi ya glutamiki kupitia kwa kiunganishi cha peptidi kilichoundwa kati ya mnyororo wa upande wa kaboksili wa glutameti(kaboni ya gama ya mnyororo huu) na kundi la amino la sistini. Dipeptidi hii basi hutoneshwa na glisini na sinthetesi glutathioni kuunda glutathioni.<ref>{{cite journal |author=Meister A |title=Glutathione metabolism and its selective modification |journal=The Journal of Biological Chemistry |volume=263 |issue=33 |pages=17205–8 |year=1988 |month=Novemba |pmid=3053703 |url=http://www.jbc.org/cgi/pmidlookup?view=long&pmid=3053703 |access-date=2010-11-30 |archive-date=2020-06-10 |archive-url=https://web.archive.org/web/20200610200802/https://www.jbc.org/content/263/33/17205.long |dead-url=yes }}</ref> Katika kemia, peptidi husanisiwa kupitia m mbalimbali. Moja kati ya sanisi za peptidi za awamu-mango zinazotumika sana, ambayo inatumia vitu vinavyotokana na oksime ya kunukia ya asidi amino kama vipande vilivyooamilishwa. Hizi huongezwa kwa mlolongo unaokua kwenye mnyororo wa peptidi, ambayo imeshikanishwa na utomvu imara.<ref>{{cite journal |first1=Louis A. |last1=Carpino |year=1992 |title=1-Hydroxy-7-azabenzotriazole. An efficient peptide coupling additive |journal=Journal of the American Chemical Society |volume=115 |pages=4397–8 |doi=10.1021/ja00063a082 |issue=10}}</ref> Uwezo wa kusanisi idadi kubwa ya peptidi tofauti kwa kubadilisha aina tofauti na utaratibu wa asidi amino (kutumia kemia ya kuunganisha) imefanya usanisi wa peptidi kuwa muhimu katika kujenga maktaba ya peptidi kwa matumizi ya ugunduzi wa madawa kwa njia ya uchunguzi hali ya juu.<ref>{{cite journal |author=Marasco D, Perretta G, Sabatella M, Ruvo M |title=Past and future perspectives of synthetic peptide libraries |journal=Current Protein & Peptide Science |volume=9 |issue=5 |pages=447–67 |year=2008 |month=Oktoba |pmid=18855697 |doi=10.2174/138920308785915209}}</ref> === Biosanisi na ukataboli === Katika mimea, nitrojeni kwanza hulishizwa kwenda kwa misombo ya kikaboni katika mfumo wa glutemeti, hutengenezwa kutoka kwa alfa-ketoglutareti na amonia katika mitokondria. Ili kuunda asidi amino nyingine, mmea hutumia transaminasi kusongesha kikundi cha amino kwenda kwa asidi alfa-keto kaboksili nyingine. Kwa mfano, aminotransferasi aspartati hubadilisha glutameti na oksaloasetati kuwa alfa-ketoglutareti na asparteti.<ref>{{cite book |author=Jones, Russell Celyn; Buchanan, Bob B.; Gruissem, Wilhelm |title=Biochemistry & molecular biology of plants |publisher=American Society of Plant Physiologists |location=Rockville, Md |year=2000 |pages=371–2 |isbn=0-943088-39-9}}</ref> Viumbe wengine hutumia transaminasi kwa usanisi wa asidi amino pia. Transaminasi pia hushiriki katika kuvunja asidi amino. Udhalilishaji wa asidi amino mara nyingi unahusisha kusongesha kundi lake la amino kwenda kwa alfa-ketoglutareti na kutengeneza glutameti. Katika wanyama wenye uti wa mgongo wengi, kikundi cha amino kisha huondolewa kwa njia ya mzunguko wa urea na kisha kuondolewa mwlilini kwa fomu ya urea. Hata hivyo, uharibifu wa asidi amino unaweza kutoa asidi mkojo au amonia badala yake. Kwa mfano, kiondoa-oksijeni serini hubadilisha serini kuwa piruvati na amonia.<ref>{{cite book |author=Stryer, Lubert; Berg, Jeremy Mark; Tymoczko, John L. |title=Biochemistry |publisher=W.H. Freeman |location=San Francisco |year=2002 |pages=639–49 |isbn=0-7167-4684-0}}</ref> Asidi amino zisizo za kawaida hutengenezwa kwa kubadilishwa kwa asidi amino za kawaida. Kwa mfano, homosisteini hutengezwa kwa kusongeshwa njia ya sulfuri kwa njia ya kutolewa kwa methili kutoka kwa methionini kupitia kwa kimetaboli kati S-adenosili methionini,<ref name="Brosnan">{{cite journal |author=Brosnan JT, Brosnan ME |title=The sulfur-containing amino acids: an overview |journal=The Journal of Nutrition |volume=136 |issue=6 Suppl |pages=1636S–1640S |year=2006 |month=Juni |pmid=16702333 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=16702333}}</ref> wakati hidroksiprolini hutengezwa na kubadilishwa kwa [[proline]] baada ya kutafsiriwa ya <ref>{{cite journal |author=Kivirikko KI, Pihlajaniemi T |title=Collagen hydroxylases and the protein disulfide isomerase subunit of prolyl 4-hydroxylases |journal=Advances in Enzymology and Related Areas of Molecular Biology |volume=72 |issue= |pages=325–98 |year=1998 |pmid=9559057}}</ref> Vidubini na mimea inaweza kusanisi asidi amino nyingi zisizo za kawaida. Kwa mfano, baadhi ya vijiumbe maradhi hutengeza asidi amino sobutiriki-2 na lanthionini, ambayo imetokana na sulfidi ya alanini. Asidi amino hizi zote mbili zinapatikana katika lantibiotiki peptidi kama vile alamethisini.<ref>{{cite journal |author=Whitmore L, Wallace BA |title=Analysis of peptaibol sequence composition: implications for in vivo synthesis and channel formation |journal=European Biophysics Journal |volume=33 |issue=3 |pages=233–7 |year=2004 |month=Mei |pmid=14534753 |doi=10.1007/s00249-003-0348-1}}</ref> Ilihali katika mimea, asidi amino saiklopropani-1-kaboksili ni asidi ndogo iliyobadilishwa ya asidi amino ya mzunguko, ambayo ni muhimu katika uzalishaji homoni kati ya mmea ya ethilini.<ref>{{cite journal |author=Alexander L, Grierson D |title=Ethylene biosynthesis and action in tomato: a model for climacteric fruit ripening |url=https://archive.org/details/sim_journal-of-experimental-botany_2002-10_53_377/page/2039 |journal=Journal of Experimental Botany |volume=53 |issue=377 |pages=2039–55 |year=2002 |month=Oktoba |pmid=12324528 |doi=10.1093/jxb/erf072}}</ref> == Sifa za kemikali za asidi amino == Asidi amino 20 zinazopatikana kiasili zinaweza kugawanywa katika makundi mbalimbali kulingana na sifa zao. Sababu muhimu ni chaji, kiwango cha kupenda maji au kukwepa maji, ukubwa na vikundi vya kazi <ref name="Creighton"/> . Hizi sifa ni muhimu kwa mfumo wa protini mwingiliano wa protini na protini. Protini mumunyifu kwa maji zinaelekea kuwa na mabaki yao ya kukwepamaji (Leu, Ile, Val, Phe na Trp) kuzikwa katikati ya protini, ilhali minyororo ya kupendamaji hufunuliwa kwa kiyeyusho cha majimaji. Utando wa muhimu wa protini mara nyingi huwa na pete za asidi amino za kukwepamaji iliyoonyeshwa wazi ambazo huzitia nanga katika rusu mbili ya lipidi ya. Katika sehemu ya kesi kati ya njia mbili tofauti sana, baadhi ya tando za protini za pembeni huwa na kiraka cha asidi amino za kukwepamaji juu ya uso wao ambacho hushikilia kwa utando. Vile vile, protini ambazo hufaa kushikilia kwa molekuli zenye chaji chanya huwa na asidi amino zenye chaji hasi kwenye nyuso zao kama vile glutameti na aspartati, wakati protini zinazofaa kushikilia kwa molekuli zenye chaji hasi huwa na nyuso zenye minyororo chaji chanya kama vile lisini na ajinini. Kuna mizani tofauti ya kukwepamaji ya mabaki ya asidi amino.<ref>{{cite journal |first1=Dan W. |last1=Urry |title=The change in Gibbs free energy for hydrophobic association: Derivation and evaluation by means of inverse temperature transitions |url=https://archive.org/details/sim_chemical-physics-letters_2004-11-21_399_1-3/page/177 |journal=Chemical Physics Letters |volume=399 |issue=1–3 |pages=177–83 |year=2004 |doi=10.1016/S0009-2614(04)01565-9}}</ref> Baadhi ya asidi amino huwa na sifa za kipekee kama vile seistini, ambayo huweza kutengeneza kiunganishi chenye kugawanyika cha sulfudi na mabaki mengine ya seistini, prolini ambayo inaunda mzunguko kwa uti wa mgongo wa polipeptidi, na glisini ambayo ni rahisi kubadilika zaidi kuliko asidi amino nyingine. Protini nyingi hupitia mabadliko mengi ya muundo baada ya kutafsiriwa, wakati makundi ya ziada ya kemikali yanaposhikanishwa na asidi amino katika protini. Baadhi ya mabadiliko yanaweza kuzalisha lipoprotini za kukwepamaji,<ref>{{cite journal |author=Magee T, Seabra MC |title=Fatty acylation and prenylation of proteins: what's hot in fat |journal=Current Opinion in Cell Biology |volume=17 |issue=2 |pages=190–6 |year=2005 |month=Aprili |pmid=15780596 |doi=10.1016/j.ceb.2005.02.003}}</ref> au glikoprotini za kupendamaji.<ref>{{cite journal |author=Pilobello KT, Mahal LK |title=Deciphering the glycocode: the complexity and analytical challenge of glycomics |journal=Current Opinion in Chemical Biology |volume=11 |issue=3 |pages=300–5 |year=2007 |month=Juni |pmid=17500024 |doi=10.1016/j.cbpa.2007.05.002}}</ref> Mabadiliko ya aina hii yaruhusu kulenga kunakoweza kurejeshwa kwa protini kwa utando. Kwa mfano, kuongezwa na kuondolewa kwa asidi yenye mafuta ya asidi ya kiganja kwa mabaki ya seistini katika protini fulani za kuashiria husababisha protini kujiambatanisha na kisha kujitenga kutoka katika utando wa seli.<ref>{{cite journal |author=Smotrys JE, Linder ME |title=Palmitoylation of intracellular signaling proteins: regulation and function |url=https://archive.org/details/sim_annual-review-of-biochemistry_2004_73/page/559 |journal=Annual Review of Biochemistry |volume=73 |issue= |pages=559–87 |year=2004 |pmid=15189153 |doi=10.1146/annurev.biochem.73.011303.073954}}</ref> === Orodha ya vifupisho na sifa za asidi amino za kawaida === {| class="wikitable sortable" ! Asidi amino ! 3-Herufi<ref name="Hausman"/> ! Herufi-1<ref name="Hausman"/> ! Mnyororo wa upande:Upola <ref name="Hausman">{{cite book |author=Hausman, Robert E.; Cooper, Geoffrey M. |title=The cell: a molecular approach |publisher=ASM Press |location=Washington, D.C |year=2004 |page=51 |isbn=0-87893-214-3}}</ref> ! Chaji ya Mnyororo wa upande (pH 7.4)<ref name="Hausman"/> ! Kielelezo cha Hidropatiki<ref>{{cite journal |author=Kyte J, Doolittle RF |title=A simple method for displaying the hydropathic character of a protein |url=https://archive.org/details/journal-of-molecular-biology_1982-05-05_157_1/page/105 |journal=Journal of Molecular Biology |volume=157 |issue=1 |pages=105–32 |year=1982 |month=Mei |pmid=7108955 |doi=10.1016/0022-2836(82)90515-0}}</ref> ! Λ Uwezo wa Kufyonza _juu(nm)<ref name="Freifelder"/> ! ε katikaλ _juu (X10 ^-3 M^-1cm^-1)<ref name="Freifelder">{{cite book | title=Physical Biochemistry| edition=2nd| author = Freifelder, D.| publisher=W. H. Freeman and Company| isbn=0-7167-1315-2 | year=1983}}{{pn}}</ref> |- align="center" | Alanini | Ala | A. | iso pola | sio na sifa zinazobainika | 1.8 | | |- align="center" | Arginini | Arg | R | pola | chanya | -4.5 | | |- align="center" | Asparagini | Asn | N | pola | sio na sifa zinazobainika | -3.5 | | |- align="center" | Asidi Aspartiki | ASP | D | pola | hasi | -3.5 | | |- align="center" | Sisteini | Cys | C | iso pola | sio na sifa zinazobainika | 2.5 | 250 | 0.3 |- align="center" | Asidi ya glutamiki | Glu | E | pola | hasi | -3.5 | | |- align="center" | Glutamini | Gln | Q | pola | sio na sifa zinazobainika | -3.5 | | |- align="center" | Glisini | Gly | G | iso pola | sio na sifa zinazobainika | -0.4 | | |- align="center" | Histidini | His | H | pola | chanya (10%) zisizobainika (90%) | -3.2 | 211 | 5.9 | | |- align="center" | Isoleusini | Ile | I | iso pola | sio na sifa zinazobainika | 4.5 | | |- align="center" | Leusini | Leu | L | iso pola | sio na sifa zinazobainika | 3.8 | | |- align="center" | Lisini | Lys | K | pola | chanya | -3.9 | | |- align="center" | Methionini | Met | M | iso pola | sio na sifa zinazobainika | 1.9 | | |- align="center" | Fenilalanini | Phe | F | Iso pola | sio na sifa zinazobainika | 2.8 | 257, 206, 188 | 0.2, 9.3, 60.0 | | - align="center" | Prolini Pro | P | iso pola sio na sifa zinazobainika | -1.6 | | - align="center" | Serini Ser | S pola sio na sifa zinazobainika | -0.8 | | - align="center" | Threonini | Thr | T pola sio na sifa zinazobainika | -0.7 | | - align="center" | Triptofani | Trp W | iso pola sio na sifa zinazobainika | -0.9 | 280, 219 | 5.6, 47.0 | | - align="center" | Tirosini | Tyr | Y pola sio na sifa zinazobainika | −1.3 | 274, 222, 193 | 1.4, 8.0, 48.0 | | - align="center" | Valini | Val | V | iso pola sio na sifa zinazobainika | 4.2 | | |) |} Zaidi ya hayo, kuna asidi amino mbili za ziada ambazo zinajumuishwa kwa kutotilia manaani kodoni za kuacha: {| class="wikitable" ! asidi amino ya 21 na 22 ! Herufi-3 ! Herufi-1 |- align="center" | Selenosisteini | Sec | U |- align="center" | Pirolisini | Pyl | O |} Mbali na mfumo maalum za asidi amino, vishikilia sehemu hutumika katika kesi ambapo uchambuzi wa kemikali au wa chembechembe za peptidi au wa protini hauwezi kuamua kikamilifu utambulisho wa mabaki. {| class="wikitable" ! Asidi amino zenye utata ! Herufi-3 ! Herufi-1 |- align="center" | Asparagini au asidi aspartiki | Asx | B |- align="center" | Glutamini au asidi glutamiki | Glx | Z |- align="center" | Leusini au Isoleusini | Xle | J |- align="center" | Isoelezewa au asidi amino isojulikana | Xaa | X |} '''Unk''' wakati mwingine hutumiwa badala ya '''Xaa,''' lakini si kawaida. Zaidi ya hayo, nyingi zisizo za kawa asidi amino kuwa na mfumo maalum. Kwa mfano, dawa kadhaa za peptidi, kama vile Bortezomibi au MG132 ni zimesanisiwa kibandia na uhifadhi vikundi vyao vya kulinda, ambavyo vina mfumo maalum. Bortezomibi ni Pyz-Phe-boroLeu na MG132 ni Z-Leu-Leu-Leu-al. Zaidi ya hayo, ili kusaidia katika uchambuzi wa mfumo wa protini, mifano ya kuunganisha kwa asidi amino inapatikana. Hizi ni pamoja na fotoleusini '''(pLeu)''' na fotomethionini '''(pMet).''' <ref>{{cite journal |author=Suchanek M, Radzikowska A, Thiele C |title=Photo-leucine and photo-methionine allow identification of protein-protein interactions in living cells |journal=Nature Methods |volume=2 |issue=4 |pages=261–7 |year=2005 |month=Aprili |pmid=15782218 |doi=10.1038/nmeth752}}</ref> == Tanbihi == {{Marejeo|colwidth=30em}} == Marejeo == * Doolittle, RF (1989) Vitu visivyohitajika katika Utaratibu wa protini. Katika ''utabiri wa Muundo wa protini na Kanuni za kuwiana kwa protini'' (Fasman, G.D ed) Plenum Press, New York, uk 599-623. * David L. Nelson na Michael M. Cox, ''Kanuni za Biokemia chake Lehninger ,'' toleo la 3, 2000, Worth Publishers, ISBN 1-57259-153-6 * Meierhenrich, UJ: ''Asidi amino na kutokuwa pacha kwa maisha,'' Springer-Verlag, Berlin, New York, 2008. ISBN 978-3-540-76885-2 * Morelli, Robert J. "Mafunzo ya kufyonzwa kwa asidi amino kutoka utumbo mdogo. " San Francisco: Morelli, 1952. == Viungo vya nje == * [http://www.aminoacidsguide.com/ Muhtasari wa asidi amino] sifa za kimaumbile-kemia , miundo ya 3D, nk * [http://www.unc.edu/~bzafer/aminoacids/ Orodha ya asidi amino za kawaida] {{Wayback|url=http://www.unc.edu/~bzafer/aminoacids/ |date=20101110124343 }} Orodha ya undani ya PDF ya asidi amino za kawaida (ikiwa ni pamoja na picha za 3D) * [http://www.chem.qmul.ac.uk/iupac/AminoAcid/ Mfano kwa majina na picha ya asidi amino na Peptidi] IUPAC-IUB Tume ya Pamoja ya majina ya Bayokeia (JCBN) * [http://micro.magnet.fsu.edu/aminoacids/index.html Maelezo ya Masi: Ukusanyaji wa Asidi Amino] - Ina taarifa za kina na picha za darubini za asidi amino. * [http://www.russell.embl.de/aas/ Sifa za Asidi amino] {{Wayback|url=http://www.russell.embl.de/aas/ |date=20070927001521 }} - Sifa za asidi amino (chombo kinachowalenga wanasayansi wa jeni za molekuli wanaojaribu kuelewa maana ya mabadiliko) * [http://www.organic-chemistry.org/synthesis/C1C/nitrogen/alpha-amino-acids2.shtm Usanisi wa asidi amino na minyambuliko yao] * [http://www.mathiasbader.de/studium/biology/index.php?lng=en Jifunze juu ya asidi amino proteinojeniki 20 kwa mtandao] {{Wayback|url=http://www.mathiasbader.de/studium/biology/index.php?lng=en |date=20101029232236 }} * [http://www.biology.arizona.edu/biochemistry/problem_sets/aa/Dayhoff.html Asili ya mfumo wa herufi moja ya asidi ya amino] * [http://www2.iq.usp.br/docente/gutz/Curtipot_.html PH ya mchanganyiko wa Asidi amino, kuchanganya kwa kemikali na hesabu ya ncha ya isoelektriki ] {{Wayback|url=http://www2.iq.usp.br/docente/gutz/Curtipot_.html |date=20190126143238 }} {{DEFAULTSORT:Asidi amino}} [[Jamii:Kemia]] buitu0c7cozkmvfk7bwkf0wogdxq4kq 0 55727 1578162 1527689 2026-07-02T22:49:36Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578162 wikitext text/x-wiki {{About|bongo za kila aina ya wanyama, hata binadamu|maelezo kuhusu ubongo wa binadamu|Ubongo wa binadamu|}} [[Picha:Chimp Brain in a jar.jpg|thumb|250px|alt=A brain floating in a liquid-filled glass jar. Yellowing of the handwritten labels on the jar give the object an antique appearance.|Ubongo wa sokwe.]] [[Picha:Brain Anatomy.png|alt=|thumb|250x250px|Ubongo wa binadamu.]] [[Picha:Brain-anatomy.jpg|thumb|Mgawanyo wa ubongo.]] '''Ubongo''' ndio kiini cha [[mfumo wa neva]] katika [[wanyama]] wote wenye [[ugwemgongo]], na wengi wa wanyama wasio na ugwemgongo.<ref name="Shepard"> Shepherd, ''Neurobiology'' </ref> Baadhi ya wanyama wasiositawi, kama vile [[konyeza]] na kiti cha [[pweza]], wana mfumo wa [[neva]] uliogatuliwa bila ubongo, huku [[tipwatipwa]] wa [[bahari]] wakikosa mfumo wa neva kabisa. Katika wanyama wenye ugwemgongo, ubongo umo katika [[kichwa]] ukilindwa na [[mifupa]] ya [[fuvu]] na ukiwa karibu na viungo vya [[hisia]] za msingi yaani kuona, kusikia, kugusa, [[ladha]] na [[harufu]]. Ubongo unaweza kuwa changamani sana. [[Gamba la ubongo]] wa [[binadamu]] lina takribani [[neuroni]] [[bilioni]] 15-33, labda zaidi, kutegemea [[jinsia]] na [[umri]],<ref> Pelvig et al., 2008</ref> zilizounganishwa na takribani miunganiko ya [[sinapsi]] 10,000 kila mmoja. Kila milimita ya kizio cha ukubwa wa gamba la ubongo lina takribani sinapsi bilioni moja.<ref> AlonsoNanclares et al., 2008</ref> Neuroni hizi huwasiliana na nyingine kwa njia ya fumwele ndefu za protoplazimu ziitwazo akzoni, ambazo hubeba mifuatano ya mipigo ya vichocheo vitwavyo matendo tarajiwa kuelekea sehemu mbali za ubongo au mwili na kulenga seli maalumu itakazovipokea. Ubongo hudhibiti mifumo mingine ya viungo vingine vya mwili, iwe kwa kusisimua [[misuli]] au kwa kusababisha kutolewa kwa kemikali kama vile [[homoni]] ambayo ni homoni ya [[pituitari]]. Udhibiti huu kutoka mahali moja unaruhusu majibu ya haraka na yaliyoratibiwa kwa mabadiliko katika mazingira. Baadhi ya mwitikio wa kimsingi inawezekana bila ubongo: hata viumbe walio na chembe moja wanaweza kufasiri yaliyo katika mazingira na kutenda kulingana na mabadiliko hayo.<ref> Gehring, 2005</ref> Tipwatipwa wa bahari, wasio na mfumo mkuu wa neva, wanaweza kujikunyata na hata kusonga kwa namana iliyotibiwa.<ref> Nickel, 2002</ref> Katika wauti, uti wa mgongo wenyewe una viungo vya neva vinavyoweza kuanzisha tendohiaria pamoja na kuelekeza mifumo rahisi ya kusonga kama vile kuogelea au kutembea.<ref> Grillner &amp; Wallén, 2002</ref> Hata hivyo, udhibiti changamani wa tabia kwa msingi ya mchango wa hisia tete unahitaji uwezo-unganishaji wa ubongo wa kati. Licha ya maendeleo ya kasi ya sayansi, mengi kuhusu jinsi ubongo unavyofanya kazi bado ni siri. Majukumu ya neva na sinapsi zikiwa pekee sasa inaeleweka kwa undani makubwa, lakini jinsi yanavyoshirikiana katika majumuia ya maelfu au mamilioni imekuwa vigumu sana fumbua. Mbinu za uchunguzi kama vile unakili wa EEG na upigaji picha ubongo unaofanya kazi umetuambia kwamba utendaji wa ubongo unatendeka kwa utaratibu sana, huku kunakili kitengo kimoja kukiweza kufichua shughuli za neva moja, jinsi chembe moja inavyo inavyochangia michakato changamani haijulikani.<ref> Sejnowski, ''23 Problems in Systems Neuroscience'' </ref> == Muundo Hadubini == Ubongo ndio umbile la kibayolojia changamani zaidi inayojulikana,<ref> Shepherd, ''Neurobiology,'' uk. 3</ref> na kulinganisha bongo za spishi mbalimbali kwa msingi wa jinsi zinavyoonekana aghalabu ni vigumu. Hata hivyo, kuna kanuni za kawaida ya muundo wa ubongo zinazotumika kote katika spishi mbalimbali. Hizi huwekwa wazi hasa kwa njia tatu. Mbinu ya mageuko inamaanisha kulinganisha miundo ua bongo za spishi mbalimbali, na kwa kutumia kanuni kwamba mionekano inayopatikana katika matawi yote ambayo alipokelewa kutoka kwa muundo fulani wa kale na kwamba pengine ilikuwa katika watangulizi. Mbinu ya ukuaji ina maananisha kuchunguza jinsi umbo la ubongo unavyobadiliko ya wakati wa ukuaji kutoka kipindi cha kiinitete hadi utu uzima. Mbinu ya kijenetiki ina maanisha kuchunguza jeni zinazopatikana katika maeneo mbalimbali ya ubongo miongoni mwa spishi anuwai. Kila mbinu hukamilisha nyingine na huchangia hayo mengine mawili. === Wenzipacha === [[Picha:Bilaterian-plan.svg|thumb|right|alt=A rod-shaped body contains a digestive system running from the mouth at one end to the anus at the other. Alongside the digestive system is a nerve cord with a brain at the end, near to the mouth. |Mfumo wa neva wa mnyama mwenye uenzipacha, katika mfumo wa kamba ya neva na vivimbe vya vipingili, na "ubongo" ukiwa mbele]] Isipokuwa aina chache za tipwatipwa na konyeza wasiostawi, wanyama wote wenye uhai wana wenzipacha, kumaanisha wanyama walio na maumbo ya miili iliyo linganifu (yaani, pande za kushoto na kulia ni karibu taswira akisi ya kila moja).<ref name="Urbilateria"/> Wenzipacha wote wanadhaniwa kuwa walitokana na mhenga mmoja aliyeishi mapema katika kipindi cha Kambria, miaka milioni 550-600 iliyopita.<ref name="Urbilateria"> Balavoine &amp; Adoutte, 2003</ref> Mhenga huyo alikuwa na umbo neli la mnyoo sahili mwenye mwili uliokuwa na mikato, katika kiwango cha kidhahania, umbo hilo kama la mnyoo unaendelea kujitokeza katika mwili na mfumo wa neva wa wanyama wenzipacha wa kisasa, ikiwa ni pamoja na binadamu.<ref> Schmidt-Rhaesa, ''Evolution of Organ Systems,'' uk. 110</ref> Umbo la kimsingi la mwili enzipacha ni neli iliyo na kijishimo wazi cha utumbu kinachotoka mdomoni hadi kwenye mkundu, na ukano wa neva ulio na uvimbe (''ganglioni'') kwa kila sehemu ya mwili, huku kukiwa na ganglioni mahsusi kubwa mbele, iitwayo ''ubongo''. === wasouti === [[Picha:Drosophila melanogaster - side (aka).jpg|thumb|right|alt=A fly resting on a reflective surface. A large, red eye faces the camera. The body appears transparent, apart from black pigment at the end of its abdomen. |Drosofila]] Kwa wasouti (k.m, wadudu, konokono, minyoo, n.k) sehemu za ubongo hutofautiana sana na muundo wa wauti hivi kwamba ni vigumu kufanya ulinganishi wowote wa maana isipokuwa kwa misingi ya jenetiki. Makundi mawili ya wasouti hasa yana bongo changamani: [[Arithropodi|athropoda]] ([[Wadudu|wadudu]], krasteshia, [[Arakinida|araknida]], na wengine), na sefalopoda ( pweza, ngisi, na moluska )wengine kama hao.<ref name="butler"> Butler, 2000</ref> Ubongo wa athropoda na sefalopoda huchimbuka kutoka katika kano mbili sambamba za neva zinazosambaa kote katika mwili wa mnyama. Athropoda wana ubongo mmoja kuu ulio na tabaka tatu na ''ndewe za macho'' kubwa nyuma ya kila [[jicho]] kwa uchakataji maono.<ref name="butler"/> Sefalopoda wana bongo kubwa zaidi kati ya wasouti wote. Ubongo wa pweza hasa umesitawi sana, unalinganika kwa uchangamano na ubongo wa baadhi ya wauti. Kuna <span class="goog-gtc-fnr-highlight">wasouti</span> wachache sana ambao bongo zao zimetafitiwa kwa makini. Babaje mkubwa wa bahari wa ''Aplisia'' alichaguliwa na mshinda wa Tuzo Nobel mwanafiziolojia Eric Kandel, kwa sababu ya usahili na upatikanaji wa mfumo wake wa neva, kama mfano wa kutafiti chembe kama msingi wa kujifunza na kumbukumbu, na ukafanyiwa mamia ya majaribio.<ref> Kandel, ''In Search of Memory'' </ref> Bongo za wasouti zilizotafitiwa kwa undani zaidi, hata hivyo, ni za nzi-tunda ''Drosofila'' na minyoo wadogo sana ''Caenorhabditis elegans (C. elegans).'' Kwa sababu ya aina nyingi ya mbinu za kutafiti jenetiki zao, nzi-tunda wamekuwa watafitiwa asili katika majukumu ya kutafiti jeni na ukuaji wa ubongo.<ref> Flybrain web site</ref> Inashangaza kuwa, vipengele vingi vya nyurojenetiki ya ''Drosofila'' yametambuliwa kuwa muhimu kwa binadamu. Jeni za kwanza za majira ya kibayolojoa, kwa mfano, yalitambuliwa kwa kuchunguza ''Drosofila'' zilizobadilika zilioonyesha kuvurugwa kwa mpangilio wa shughuli za kila siku.<ref> Konopka &amp; Benzer, 1971</ref> Uchunguzi katika jinomu za wauti uligundua jozi linganifu za jeni, zilizopatikana kutekeleza majukumu sawa katika majira ya kibayolojia ya panya-na hiyo kwa uhakika wa kiwango kikubwa katika majira ya kibayolojia ya binadamu pia.<ref> Shin et al., 1985</ref> Sawa na ''Drosofila,'' mnyoo nematoda ''C. elegans'' umechunguzwa kwa kiasi kikubwa kwa sababu ya umuhimu wake katika jenetiki.<ref> WormBook mtandao</ref> Mapema miaka ya 1970, Sydney Brenner aliuchagua kama mfano elekezi kwa kuchunguzia jinsi jeni hudhibiti ukuaji. Moja ya faida za kufanya kazi na mnyoo huu ni kwamba mpangilio wa mwili wake ni wa kawaida: mfumo wa neva wenye umbo huntha una neuroni 302 kamili, neuroni kila mara huwa katika sehemu sawa, na hufanya miungano yakufanana ya sinapsi katika kila mnyoo.<ref> Hobert, ''WormBook'' </ref> Katika mradi wa kishujaa, kikosi cha Brenner kilimpasua mnyoo kuwa maelfu ya sehemu nyembamba zaidi na kupiga picha kila sehemu ya chini ya hadubini meme, kisha kwa kutazama akalinganisha fumwele kutoka sehemu moja na sehemu nyingi, ili kuonyesha kila neuroni na sinapsi katika mwili mzima.<ref> White et al,. 1986</ref> Hakuna kinachokaribia ngazi hii ya utondoti kuhusu viumbe wengine wowote, na ujumbe huo umetumika kuwezesha tafiti kadhaa ambayo haingewezekana bila utafiti huo. === wauti === [[Picha:Shark brain.png|thumb|right|alt=A T-shaped object is made up of the cord at the bottom which feeds into a lower central mass. This is topped by a larger central mass with an arm extending from either side. |Ubongo wa papa]] Bongo za wauti zimeundwa kwa tishu laini sana, ikiwa na na texture ambao imelinganishwa na Jell-O.<ref>[21] ^ ''Principles of neural science,'' Sur. 17</ref> Tishu ya ubongo hai ni ya rangi waridi kwa nje na nyeupe kwa wingi ndani, huku kukia na mabadiliko utofauti mdogo wa rangi. Bongo za wauti zimezungukwa kwa mfumo wa tandu za tishu unganishi ziitwazo meninji zinazo tofautisha fuvu na ubongo.<ref name="CarpenterCh1"> ''Carpenter's Human Neuroanatomy,'' Sur. 1</ref> Kifuniko hiki chenye safu tatu kinajumuisha (kutoka nje) dura mama ("mama mgumu"), mama araknoida ("mama mwembamba"), na mama pia ("mama laini "). Araknoida na pia zimeshikana kimaumbo na hivyo huchukuliwa kuwa safu moja, ya pia-araknoida. Chini ya araknoida kuna nafasi ya araknoida ndogo ambayo ina ugiligili wa ubongo na uti wa mgongo (CSF), ambayo huzunguka katika nafasi nyembamba kati ya chembechembe na penyu ziitwazo ventrikali, jukumu lake ni kurutubisha, kukimu, na kulinda tishu za ubongo. Mishipa ya damu huingia mfumo mkuu wa neva kupitia nafasi isiyo na mishipa juu ya mama pia. Chembe katika kuta za mishipa ya damu zimeshikana kwa nguvu sana, na hivyo kuunda mpaka wa damu na ubongo ambayo huilinda ubongo dhidi ya sumu inayoweza kuingia kupitia damu. wauti wa kwanza walionekana zaidi ya miaka milioni 500 iliyopita (mmi ), katika kipindi cha Kambri, na huenda walifanana kwa kiasi fulani na umbo la kisasa la samaki balika (hagfish).<ref> Shu et al., 2003</ref> Papa walionekana takribani miaka milioni 450 iliyopita, amfibia yapata miaka milioni 400 iliyopita, reptilia yapata miaka milioni 350 iliyopita, na mamalia yapata miaka milioni 200 iliyopita. Hakuna spishi ya kisasa inayoweza kuelezewa kuwa "isiyositawi" zaidi ikilinganishwa na nyingine, kwa kuwa zote zina historia ndefu ya mageuko, lakini bongo za samaki balika wa kisasa, mikunga, papa, amfibia, reptilia na mamalia huonyesha tofauti katika ukubwa na uchangamani ambayo kwa kiasi fulani hufuata utaratibu wa mageuko.<ref> Striedter, ''Principles of Brain Evolution'' </ref> Bongo hizo zote zina mkusanyiko sawa wa vipengele muhimu vya kianatomia, lakini nyingi hazijakamilika katika balika, ambapo katika mamalia sehemu za kwanza kabisa zimesitawika na kupanuka sana. Bongo zote za wauti huwa na umbo moja la kimsingi, ambayo inaweza kuelewekwa kwa urahisi zaidi kwa kuchunguza jinsi zilivyokua.<ref> ''Principles of Neural Science,'' uk. 1019</ref> Dalili ya kwanza ya mfumo wa neva hujitokeza kama utepe mwembamba wa tishu unaoonekana katika mgongo wa kiinitete. Utepe huo hunenepa na kisha kujikunja kuunda neli tupu. Upande wa mbele wa neli hiyo hukua kuwa ubongo. Katika muumdo wake wa kwanza, ubongo huonekana kama vivimbe vitatu, ambayo hatimaye huwa ubongombele, ubongokati, na ubongonyuma. Katika aina nyingi za wauti sehemu hizi tatu hubakia sawa kwa ukubwa katika mnyama mzima, lakini katika mamalia ubongombele hukua kubwa zaidi kuliko sehemu nyingine, na ubongokati mdogo kabisa. Uhusiano kati ya ukubwa wa ubongo, ukubwa wa mwili na vipengee vingine vya kubadilika vimetafitiwa miongoni mwa aina mbalimbali za wauti. Ukubwa wa ubongo huongezeka na ongezeko la ukubwa wa mwili lakini si kwa uwiano. Ikifanyiwa wastani katika aina zote za mamalia, inafuata sheria ya kipeo, ikiwa na kipeo cha takribani 0.75.<ref> Armstrong, 1983</ref> Fomyula hii inatumika katika bongo wastani ya mamalia lakini kila jamii hujitofautisha kutokana nayo, kuonyesha tabia zao changamno.<ref> Jerison, ''Evolution ya Brain and Intelligence'' </ref> Kwa mfano, jamii ya nyani ina bongo zilizo mara 5-10 kubwa zaidi ya jinsi fomyula inavyotabiri. Wanyama wa kuwinda aghalabu huwa na bongo kubwa. Wakati ubongo wa mamalia unapoongezeka kwa ukubwa, si sehemu zote zinazoongezeka kwa kiwango sawa. Kadri ubongo wa spishi unavyokuwa mkubwa, ndivyo gamba la ubongo linavyokuwa na jukumu kubwa.<ref name="Finlay"> Finlay et al., 2001</ref> ==== Sehemu za ubongo wa wauti ==== Wana-anatomia wa neva kawaida huchukulia ubongo kuwa na sehemu sita kuu: gamba-nje la ubongo (vizio vya ubongo), gamba-ndani la ubongo (thelamasi na haipothelamasi), gamba-kati la ubongo (ubongokati), ubongonyuma, ponsi, na medula oblongata.<ref> Principles of Neural Science, Sur. 17</ref> Kila moja ya sehemu hizi vilevile zina muundo changamani ndani. Baadhi ya sehemu, kama vile gamba na ubongonyuma, huwa na safu, zilizokunjwa au zilizoviringishwa kutoshea katika nafasi iliyopo. Sehemu zingine huwa na mikusanyiko ya viini vingi vidogo. Ikiwa utofautishaji wa kina ungefanywa kwa msingi wa muundo wa neva, kemia, na miunganiko, maelfu ya maeneo tofauti yanaweza kutambuliwa ndani ya ubongo wa wauti. Baadhi ya matawi ya mageuzi ya wauti yameleta mabadiliko makubwa katika sura za ubongo, hasa katika ubongombele. Ubongo wa papa unaonyesha sehemu za kimsingi katika njia ya moja kwa moja, lakini katika samaki wenye mifupa (wengi wa kisana ni wa aina hii), ubongombele "umepiduliwa", kama soksi imepinduliwa ndani nje. Katika ndege, pia kuna mabadiliko makubwa katika umbo.<ref> Northcutt, 2008</ref> Moja ya miundo mikuu katika ubongombele wa nedege, kigongo cha ventrikali ya nyuma, kwa muda mrefu kilidhaniwa kulingana na ganglia ya msingi kwa wanyama, lakini sasa inadhaniwa kulingana na zaidi na gamba la nje.<ref> Reiner et al,. 2005</ref> [[Picha:Vertebrate-brain-regions.png|thumb|left|alt=Corresponding regions of human and shark brain are shown. The shark brain is splayed out, while the human brain is more compact. The shark brain starts with the medulla, which is surrounded by various structures, and ends with the telencephalon. The cross-section of the human brain shows the medulla at the bottom surrounded by the same structures, with the telencephalon thickly coating the top of the brain. |Sehemu kuu kianatomia za ubongo wa wauti]] Sehemu kadhaa za ubongo zimehifadhiwa maumbo zao katika aina zote za wauti, kutoka kwa balika hadi kwa binadamu.<ref name="Shepard"/> Hii ni orodha ya baadhi ya sehemu muhimu, pamoja na maelezo mafupi sana ya kazi zao jinsi inavyoeleweka sasa (lakini kumbuka kuwa kazi za nyingi yazo bado zina utata kwa kiasi fulani): * Medula, pamoja na uti wa mgongo, ina viini vingi vodogo vinavyohusika katika aina nyingi za hisia na usogevu wa misuli.<ref> ''Principles of Neural Science'' Sur. 44, 45</ref> * Haipothelamasi ni eneo dogo katika shina la ubongombele, ambao uchangamani na umuhimu wake haulingani na ukubwa wake. Inajumuisha viini vingi vidogo, kila mmoja ikiwa na viunganisha tofauti na nyurokemia tofauti. Haipothelamasi ndio kituo kuu cha kudhibiti mzunguko wa usingizi/kuamka, udhibiti wa kula na kunywa, udhibiti wa kutolewa kwa homoni, na majukumu mengine mengi muhimu ya kibayolojia.<ref> Swaab et al., ''The Hypothalamus Binadamu'' </ref> * Sawa na haipothelamasi, thelamasi ni mkusanyiko wa viini vilivyo na kazi mbalimbali. Baadhi yavyo vinahusika katika kupitisha habari kutoka na kuelekea vizio vya ubongo. Vingine vinashiriki katika kutia motisha. Eneo lilo chini ya thelamasi (zona insarta) inaonekana kuwa na mifumo ya kuzalisha utendaji wa aina mbalimbali za tabia "kamilishi", ikiwa ni pamoja na kula, kunywa, kunya, na kujamiiana.<ref> Jones, ''The Thalamus'' </ref> * Ubongonyuma unadhibiti utendaji wa mifumo mingine ya ubongo ili kuzifanya sahihi zaidi. Kuondolewa kwa ubongonyuma hakumzuii mnyama kufanya kitu chochote hasa, lakini hufanya matendo kuchelewa na isiyo elekevu. Usahihi huu si wa kuzaliwa, bali ni wa kujifunza kwa majaribio na makosa. Kujifunza jinsi ya kuendesha baiskeli ni mfano wa aina ya unyumbufu wa neva unaoweza kufanyika kwa kiasi kikubwa ndani ya ubongonyuma.<ref name="refprinciples"> ''Principles of Neural Science'' Sur. 42</ref> * Tektama, mara nyingi huitwa "ganda la uonaji", unaruhusu vitendo kuelekezwa katika meneo hewani. Katika mamalia inaitwa "kolikyulasi kuu", na kazi yake iliyotafitiwa sana ni kuelekeza mielekeo ya macho. Pia anaongoza mielekeo ya kufikia vitu pia. Hupoke vichangamshi vikuu vya kuonekana, pia hupokea vichangamshi kutoka katika hisi nyigine ambayo ni muhimu katika kuongoza vitendo, kama vile vichangamshi vya kusikia katika bundi, vichangamshi kutoka katika viungo vya kutambua joto katika nyoka, n.k katika baadhi ya samaki, kama vile mkunga, ndio sehemu kubwa ya ubongo.<ref> Saitoh et al., 2007</ref> * Paliamu ni safu ya dutu kijivu unao kaa juu ya ubongombele. Katika reptilia na mamalia inaitwa gamba. Paliamu hushiriki katika kazi mbalimbali, ikiwa ni pamoja na unusaji na kumbukumbu ya anga. Katika mamalia, inapo anza kutawala ubongo, hujumuisha majukumu kutoka katika maeneo yaliyo chini ya gamba la ubongo.<ref> Puelles, 2001</ref> * Hipokampasi, kwa hakika, inapatikana kwa mamalia tu. Hata hivyo, sehemu ambapo inatoka, paliamu ya kati, ipo katika wauti wote. Kuna ushahidi kwamba sehemu hii ya ubongo hushiriki katika kumbukumbu za masuala yasiyoshikika na uongozaji katika samaki, ndege, reptilia, na mamalia.<ref> Salas et al., 2003</ref> * Ganglia ya chini ni kundi la viungo vinayoshikana katika ubongombele, ambavyo uelewa wetu kuvihusu umeongezeka pakubwa sana zaidi katika miaka michache iliyopita. Jukumu la msingi ganglia ya chini inaonekana kuwa uteuzi wa vitendo. Ganglia ya chini hutuma onyo zuizi kwa sehemu zote za ubongo zinazoweza kuanzisha utendaji, na katika hali ya nzuri inaweza kuzuia tendo lenyewe, hivyi kwamba mifumo ya kuanzisha utendaji viweze kushughulikia majukumu mengine. Utuzaji na adhabu hutekeleza zaidi athari zao muhimu katika neva ndani ganglia ya chini.<ref> Grillner et al., 2005</ref> * Kivimbe cha unusaji ni kiungo maalum kinachochakata hisia kutoka katika hisi za unusaji, na kuelekeza matokeo yake katka sehemu ya paliamu inayohusika na hisi harufu. Ni sehemu kubwa ya ubongo katika wauti wengi, lakini imepunguzwa sana katika jamii ya nyani.<ref> Northcutt, 1981</ref> === Mamalia === Gamba la ubongondio ni sehemu ya ubongo inayotofautisha tofauti kati ya mamalia na wauti wengine, jamii ya nyani kutoka kwa wanyama wengine, na binadamu na wanyama wengine wa jamii ya nyani. Ubongonyuma na ubongokati wa mamalia kijumla huwa sawa na yale ya wauti wengine, lakini tofauti kubwa hutokea katika ubongombele, ambao haujakuwa kwa ukubwa tu, bali pia umebadilika katika umbo.<ref> Barton &amp; Harvey, 2000</ref> Miongoni mwa wauti wasio mamalia , sehemu ya juu ya ubongonyuma imefunikwa kwa safu zisizo tete kwa ulinganisho ziitwazo paliamu.<ref> Aboitiz et al., 2003</ref> Katika mamalia, paliamu hugeuka na kuwa katika muundo moja changamani wa safu 6 iitwaye gamba-jipya au ''gamba-sawa.'' Katika jamii ya nyani, gamba-jipya imekuwa kubwa sana, hasa sehemu iitwayo ndewe ya mbele. Kwa binadamu, upanukaji huu wa ndewe ya mbele hukithiri, na sehemu nyingine za gamba pia huwa kubwa kabisa na changamani. Haipokampasi ya mamalia pia ina muundo tofauti. Kwa bahati mbaya, historia ya mabadiliko ya sehemu hizi katika mamalia, hasa gamba lenye safu sita, ni vigumu kufuatilia.<ref> Aboitiz, 2004</ref> Hii kwa kiasi kikubwa ni kutokana na tatizo la kukosa kiungo. Wahenga wa mamalia, waitwao sinapsidi, waligawanyika kutoka kwa wahenga wa wanyama watambaao na ndege wa kisasa yapata miaka milioni 350 iliyopita. Hata hivyo, mgawanyiko wa hivi karibuni ulio na mabadiliko dhahiri miongoni mwa mamalia ulikuwa mgawanyiko kati ya monotrimata (kinyamadege na ekidna), wambeleko (panya opusu, kangaruu, n.k) na wanyamakondo (wengi mamalia wanaoishi), ambayo ilifanyika takribani miaka milioni 120 iliyopita. Bongo za monotrimata na wambeleko ni tofauti na zile za wanyamakondo kwa namna fulani, lakini zina gamba na haipokampasi zenye umbo la kimamali. Kwa hivyo, maumbo haya lazima yaligeuka kati ya miaka milioni 350 na 120 iliyopita, kipindi ambacho hakijaacha ushahidi wowote ila visukuku ambavyo havihifadi tishu laini kama ubongo. === Jamaa ya nyani === Bongo za binadamu na jamaa wengine wa nyani huwa na miundo sawa na bongo za mamalia wengine, lakini ni kubwa ikilinganishwa na ukubwa wa mwili.<ref name="Finlay"/> Wingi wa ukubwa huu hutokana na upaukaji mkubwa wa gamba, ukilenga hasa katika maeneo yanayohudumia kuona na mawazo ya awali.<ref> Calvin, ''How Brains Think'' </ref> Mtandao wa mchakato wa kuona katika jamaa ya nyani ni chanagamano sana, ikijumuisha angalau maeneo 30 yanayoweza kutofautika, ikiwa na miunganiko ya mitandao ya kuajabia. Haya yote yakichukuliwa pamoja, uchakataji wa hisi za kuona hutumia zaidi ya nusu ya gamba-jipya ya wanyama jamaa ya nyani.<ref name="Sereno1995"> "Zaidi ya nusu ya gamba-jipya katika wanyama wajamii ya nyani wasio wanadamu huchukuliwa na maeneo ya kuona. Angalau zaidi ya maeneo 25 ya kuona zaidi ya gamba la msingi la kuona (V1) zimetambuliwa kwa mchanganyiko wa uchoraji ramani kwa vijielekrodi, vitafutio sindano, rangi za kihistolojia, na utafiti akisi (1). "tazama: {{cite journal | doi = 10.1126/science.7754376 | last1 = Sereno |first1 = MI | last2 = Dale | first2 = AM | last3 = Reppas | first3 = AM | last4 = Kwong | first4 = KK | last5 = Belliveau | first5 = JW | last6 = Brady | first6 = TJ | last7 = Rosen | first7 = BR | last8 = Tootell |first8 = RBH | year = 1995 | title = Borders of multiple visual areas in human revealed by functional magnetic resonance imaging | journal = Science | publisher = AAAS | volume = 268 | issue = 5212 | pages = 889–893 | url = http://www.cogsci.ucsd.edu/~sereno/papers/HumanRetin95.pdf | pmid = 7754376}} na marejeo yaliyomo humo</ref> Sehemu nyingine ya ubongo ambayo imekuwa kubwa zaidi ni gamba-mbele ya ubongombele, ambayo kazi ni vigumu kueleza kwa maneno machache, lakini inayohusika na upangaji, kumbukumbu inayotumika, motisha, tahadhari, na udhibiti utendaji. == Muundo hadubini == [[Picha:Neuron with oligodendrocyte and myelin sheath.svg|thumb|right|250 px|alt=At the top, an irregular roundish blue object is labeled "Oligodendrocyte", with a darker blue center labeled "Nucleus". Below it is a long red tubular object terminating at the right in a group of branches. From the oligodendrocyte extend a series of blue wrappings around the red tube; these wrappings are labeled "Myelin Sheath" while the red spaces between each of them are labeled "Node of Ranvier". At the bottom, an insert shows one myelin sheath enlarged and partly cut open to show how the blue sheath consists of concentric layers. In the insert, the red tubular object is labeled "Axon", with thin yellow stripes running lengthwise inside the axon labeled "Microfilament" and a slightly thicker orange stripe labeled "Microtubule".|Olijodendrosaiti ni daraja la chembe za glia zinazounda miyelini inayozunguka akzoni ya neuroni.]] Ubongo unajumuisha aina mbili kuu za chembechembe: neuroni na glia.<ref> ''Principles of '' Neural Science uk. 20</ref> Aina hizi mbili kijumla ni nyingi katika ubongo, ingawa chembe glia zinazidi neuroni kwa uwiano wa 4 kwa 1 katika gamba la ubongo.<ref> Azevedo ''et al.,'' 2009</ref> Glia huwa katika aina mbalimbali, ambazo hufanya kazi kadhaa muhimu, ikiwa ni pamoja na kuhimili mwili, kudhibiti metaboli kudhibiti halijoto, na uongozaji wa kukua. Kipengee kinachofanya neuroni kuwa muhimu sana ni kwamba, tofauti na glia, zina uwezo wa kutuma vichocheo kwa nyingine zilizo hatua ya mbali.<ref> Principles of Neural Science, uk. 21</ref> Glia hutuma vichocheo hizi kwa njia ya akzoni, fumwele nyembamba ya protoplazimu inayotoka katika mwili wa chembe na kuelekea, kwa kawaida ikiwa na matawi kadhaa, maeneo mengine, wakati mwingine ya karibu na wakati mwingine katika sehemu mbali ya ubongo au mwili. Umbali ambao akzoni inaweza kwenda ni ya kustaajabisha: kwa mfano, ikiwa chembechembe yenye umbo haram za gamba-jipya zikikuzwa ili mwili wa chembe hiyo iwe sawa kwa ukubwa na binadamu, akzoni yake, ikikuzwa kwa kiwango sawa, inaweza kuwa kebo yenye sentimita kadhaa katika kipenyo wenye urefu wa zaidi ya kilomita. Akzoni hizi husambaza vichacheo katika umbo la mipigo ya kemikali-meme aitwaye vtendo tarajiwa, vinayodumu muda usiozidi kipande kimoja cha mmoja juu ya sehemu moja ya sekunde na kusafiri katika akzon katika kasi ya kati ya mita 1-100 kwa sekunde. Baadhi neuroni huzua vitendo tarajiwa kila wakati, katika viwango vya 10-100 kwa kiala sekunde, kwa kawaida katika mifumo isiyotabirika na isiyo ya kudumu; neuroni nyingine huwa tulivu wakati mwingi, lakini mara chache kwa ghafla huzua vitendo tarajiwa ya uwezo. [[Picha:Pyramidal hippocampal neuron 40x.jpg|thumb|left|250 px|alt=A triangular black cell is seen against a gray background, with long, highly branched, black processes extending out from it in multiple directions.|Aghalabu neuroni huwa na mitandao ya dendraiti, ambayo hupokea miunganiko ya sinapsi. Inavyoonekana hapa ni pichahadubini ya neuroni ya lenye umbo haram kutoka haipokampasi ya binadamu, iliyopakwa rangi kwa mtindo wa Golgi.]] Akzoni huelekeza vichocheo kwa neuroni nyingine, au kwa chembe nyingine zisizo za neuroni, kwa njia ya makutano maalumu yaitwayo sinapsi.<ref> Principles of Neural Science Sur. 10</ref> Akzoni moja inaweza kuwa na mikutano ya sinapsi elfu kadhaa. Wakati kitendo tarajiwa, kinachosafiri kupitia akzoni, kinapofika katika sinapsi, kinasababisha kutolewa kwa kemikali itwayo niurotransmita. Niurotransmita hujifungamanisha katika molekyuli pokezi iliyo katika utando wa chembe inayolengwa. Baadhi ya neuroni pokeza ni ''sisimuzi,'' kumaanisha kwamba zinaongeza kiwango cha vitendo tarajiwa katika chembe inayolengwa; vipokezi vingine ni ''zuizi,'' kumaanisha kwamba vinapunguza viwango vya vitendo tarajiwa, vingine vina athari changamano ya udhibiti. Kwa kweli akzoni huchukua nafasi kubwa katika ubongo.<ref> ''Principles of Neural Science'' Sur. 2</ref> Mara nyingi makundi makubwa hukusanyika pamoja katika kile ni kinachoitwaye ''viungo fumwele vya neva.'' Akzoni nyingi zimefunikwa katika vifuniko vyenye maki nene ya mafuta iitwayo miyelini, ambazo huchangia kuongeza kasi ya msukumo kwa vitendo tarajiwa. Miyelin ni nyeupe, hivyo sehemu za ubongo zilizojazwa kwa fumwele za neva huonekana kama ''dutu'' ''nyeupe,'' tofauti na ''dutu ya kijivu'' vinazoonyesha maeneo yaliyo na idadi kubwa ya miili ya chembe za neuroni. Urefu wa jumla wa akzoni iliyo na miyelini katika ubongo wa mwanadamu mzima wastani ni zaidi ya {{convert|100000|km}}.<ref name="Marner"> Marner ''et al.,'' 2003</ref> == Ukuaji == [[Picha:EmbryonicBrain.svg|thumb|right|alt=The nervous system is shown as a rod with protrusions along its length. The spinal cord at the bottom connects to the hindbrain which widens out before narrowing again. This is connected to the midbrain, which again bulges, and which finally connects to the forebrain which has two large protrusions. |Mchoro huu inaonyesha vijisehemu vikuu vya ubongo kiinitete cha mwauti. Sehemu hizi baadaye zinatajitofauti kuwa ubongombele, ubongokati na ubongonyuma.]] ubongo haukui tu, bali hustawi kwa njia changamani inayofuata mipangilio ya hatua.<ref name="PurvesLichtmanCh1">[58] ^ ''Principles of Neural Development,'' Sur. 1</ref> Neuroni nyingi hutengenezwa katika kanda maalum zilizo na chembe tete, na kisha kuhamia kupitia tishu ili kufikia yanapohitajika.<ref> ''Principles of Neural Development,'' Sur. 4</ref> Katika gamba, kwa mfano, hatua ya kwanza ya ustawi ni kuundwa kwa "dungu" na kundi maalum la chembe za glia, ziitwazo glia ya miali, ambazo huelekeza fumwele kiwima katika gamba. Neuroni mpya za gamba hutengenezwa chini ya gamba, na kisha "hupanda" kupitia fumwele-miali mpaka zifike katika safu ambamo zinafaa kukaa katika utu uzima. Katika wauti, hatua za kwanza za ustawi wa neuroni ni sawa kwa spishi zote.<ref name="PurvesLichtmanCh1"/> Kadri kiini tete kinavyobadilika kutoka kibonge mviringo cha chembechembe na kuwa na umbo kama la mnyoo, utepe mwembamba wa ngozi ya nje unaoenea katikati ya mgongo inasababishwa kuwa bamba la neuroni, mtangulizi wa mfumo wa neva. Bamba la neuroni hujikunja na kuunda mfuo wa neuroni, na kisha mikunjo inayofunika mfuo huungana na kufunika neli ya neuroni, mkanda wazi wa chembe ulio na ventrikali uliojaa umajimaji katikakati. Katika ncha ya mbele, ventrikali na mkanda hufura kuunda vilengelenge vitatu ambavyo ndivyo mwanzo wa ubongombele, ubongokati, na ubongonyuma.<ref name="PurvesLichtmanCh1"/> Katika hatua nyingine, ubongombele hugawanyika katika vilengelenge viwili viitwavyo ubongomwisho (ambayo ina gamba la ubongo, ganglia ya msingi, na viungo vinavyohusiana navyo) na diencephalon (ambayo ina thalamasi na haipothalamasi). Karibu wakati huo huo, ubongokando hugawanyika kuwa ubongometeni (ambayo ina ubongonyuma na ponsi) na ubongomyeleni (ambayo ina medula oblongata). Kila moja ya maeneo haya yana sehemu za usambaaji ambapo chembe za neuroni na glia huzalishwa; chembechembe zinazopatikana kisha huhama, wakati mwingine kuelekea mbali sana, kufikia sehemu zao ya mwisho. Mara tu neuroni inapofika mahali pake, inaanza kueneza dendraiti na akzoni kuelekea eneo linaloizingira.<ref>[62] ^ ''Principles of Neural Development,'' Sur. 5, 7</ref> Kwa sababu kawaida akzoni huenea mbali sana kutoka katika mwili wa chembe na huhitaji kuungana na viungo maalum, hua zinakua kwa njia changamani. Ncha ya akzoni inayokua huwa na kibonge cha protoplazimu iitwayo "sonobari ya ukuaji", iliyofungwa kwa vipokezi vya kemikali. Vipokezi hivi huhisi mazingira ya karibu, na kusababisha sonobari ya ukuaji kuvutiwa au kukataliwa na viungo mbalimbali vya chembe, na hivyo kuvutwa kuelekea upande mmoja maalum katika kila njia yake. Matokeo ya makakati huu wa utafutaji njia ni kwamba sonobari ya ukuaji hujipenyeza kupitia ubongo mpaka ifikie mahali pake pa mwisho, ambapo viashiria vingine vya kikemikali huifanya kuanza kukuza sinapsi. Kwa kuzingatia ubongo mzima, maelfu kadhaa ya jeni huzalisha protini zinazoathiri utafutaji wa njia kwa akzoni. Mtandao wa sinapsi ambayo hatimaye hujitokeza huathiriwa kwa kiwango tu na jeni. Katika maeneo mengi ya ubongo, akzoni huanza kwa "kukua kupita kiasi", na kisha "kupunguzwa" kwa utaratibu unaotegemea shughuli za kiniuro.<ref> ''Principles of Neural Development,'' Sur. 12</ref> Kwa mfano, katika kuelekeza kutoka machoni hadi ubongokati, , mfumo ulio miongoni mwa watu wazima una ramani sahihi sana, unaounganisha kila sehemu katika uso wa retina na sehemu husika katika safu ya ubongokati. Katika hatua za kwanza za ukuaji, kila akzoni kutoka retina huelekezwa katika eneo jirani la kijumla katika ubongokati na viashiria kemikali, lakini hupinduka sana na kugusana kwa awali na rundo pana la neuroni za ubongokati. Kabla ya kuzaliwa, retina huwa na taratibu maalum zinazoifanya kuzalisha mawimbi ya shughuli zinazotokea kwa wakati moja na kisha kujiendeleza polepole kote katika safu ya retina.<ref name="Wong"> Wong, 1999</ref> Mawimbi haya ni muhimu kwa sababu husababisha neuroni jirani kufanya kazi kwa wakati mmoja: yaani, zinazalisha mifumo ya shughuli za niuro zilizo na taarifa kuhusu mpangilio wa kieneo wa niuro. Taarifa hii hutumika katika ubongo kati kwa utaratibu ambao husababisha sinapsi kulegea, na hatimaye kutoweka, ikiwa shughuli katika akzoni haifuatiwa na shughuli katika chembe iliyo lengwa. Matokeo ya utaratibu huu changamani ni uonishaji kitaratibu na imarishaji wa ramani, ili hatimaye kuiacha katika hali yake halisi ya utu uzima. Vitu sawa na hivyo hufanyika katika maeneo mengine ya ubongo: matriki awali ya sinapsi huzalishwa kutokana na mwongozo wa kikemikali unaoamuliwa kijenetiki, lakini baadaye hatua kwa hatua huboreshwa kwa utaratibu unaotegemea utendaji, kwa kiwango inayotegemea mabadiliko ya kindani, kwa kiwango fulani michango ya nje ya kihisia. Katika hali zingine, kwa mfumo katika mifumo ya retina-ubongokati, mipangilio ya matukio hutegemea taratibu zinazotokea tu katika bongo zinazostawi, na yamkini huwepo kwa madhumuni ya kuongoza ustawi pekee.<ref name="Wong"/> Katika binadamu na mamali wengine wengi, neuroni mpya hutengenezwa mara nyingi kabla ya kuzaliwa, na ubongo wa mtoto mchanga kwa hakika huwa na neuroni zaidi kuliko ya ubongo wa watu wazima.<ref> ''Principles of Neural Development,'' Sur. 6</ref> Hata hivyo, kuna maeneo machache ambapo neuroni mpya huendelea mwezi kuzalishwa katika maisha yote. Maeneo mawili ambapo hili limejidhihirisha kikamilifu ni katika ya kilenge cha kunusa, ambacho kinahusika katika hisia za harufu, na jairasi yenye menomeno ya hipokampasi, ambapo kuna ushahidi kwamba neuroni mpya hutekeleza jukumu katika kuhifadhi kumbukumbu mpya zinazopatika. Kando na hali hizi tofauti, hata hivyo, idadi ya neuroni iliyopo mapema utotoni, ndio hiyo hiyo inayopatikana katika maisha yote. Chembe za glia ni tofauti, kama na aina nyingi za chembe mwilini, hizi huzalishwa katika kipindi chote cha maisha. Ingawa mkusanyiko wa neuroni huwa kwa kiwango kikubwa zipo za ktosha kufikia wakati wa kuzaliwa, miunganiko ya akzoni huendelea kukua kwa muda mrefu baadaye. Katika binadamu, ukuaji kamili wa neva hukamiliki wakati wa kubaleghe.<ref> Paus et al., 2001</ref> Kumekuwa na majadala wa muda mrefu kuhusu ikiwa ubora wa akili, hulka na uwerevu kwa kiwango kikubwa huhusishwa na urathi au malezi; mjadala wa maumbile dhidi ya malezi.<ref> Ridley, ''Nature vs Nurture'' </ref> Huu si suala falsafa tu: una umuhimu mkubwa wa kuvitendo kwa wazazi na waalimu. Ingawa maelezo mengi hayajakamilishwa, wanaelimu neva wanaonyesha waziwazi kwamba sababu zote mbili ni muhimu. Jeni huamua hali ya kijumla ya ubongo, na jeni huamua jinsi ubongo unavyoitikia uzoefu. Uzoefu, hata hivyo, unahitajika kuboresha matriksi ya miunganiko ya sinapsi. Wakati mwingine huwa kwa suala la kuwepo au kutokuwepo kwa uzoefu katika vipindi muhimu vya ukuaji.<ref> Wiesel, 1982</ref> Wakati mwingine, wingi na ubora wa uzoefu unaweza kuwa muhimu zaidi; kwa mfano, kuna ushahidi mkubwa kuwa wanyama waliokua katika mazingira mazuri huwa na magamba manene, kuonyesha idadi kubwa ya miungano ya sinapsi, kuliko wanyama ambao viwango vyao vya kusisimka ni mdogo.<ref> van Praag et al., 2000</ref> == Majukumu == Kwa mtazamo wa kiviumbe, kazi ya msingi ya ubongo ni kudhibiti utendaji wa mnyama.<ref> Carew, ''Behavioral Neurobiology,'' Sur. 1</ref> Ili kufanya hivyo, huwa inachuja taarifa muhimu za kutosha kutoka katika viungo vya hisi ili kuboresha vitendo. Vichocheo vya hisia vinaweza kuamsha majibu ya papo kwa papo kwa mfano wakati mfumo wa kunusa wa kulungu unaponusa harufu ya mbwa mwitu; pia zinaweza kudhibiti tendo linaloendelea kwa mfano katika athari ya mzunguko wa mwanga-giza kwa tabia ya kulala na kuamka kwa viumbe, au taarifa zao zinaweza kuhifadhiwa kwa madhumuni ya umuhimu baadaye. Ubongo husimamia kazi zake changamani kwa kuanzisha mifumo ya utendaji, ambazo zinaweza kuanishwa katika njia nne: kimaubile, kikemikali, na kiutendakazi. === Mifumo tendakazi === Njia rahisi zaidi ya kuainisha sehemu za ubongo ni kuzingatia maumbile, lakini pia kuna njia kadhaa kuianisha zaidi kutegemea utendakazi. Moja wa njia muhimu zaidi kati ya hizo ni kutegemea kemikali za nyurotransmita zinazotumiwa na neuroni kuwasiliana na kila moja. Nyingine ni katika namna eneo ubongo huchangia uchakataji ujume: maeneo ya hisia huleta taarifa ubongoni na kurekebisha umumbo lake; vichochezi vya matendo ya mwili hutuma ujumbe nje ya ubongo ili kudhibiti misuli na tezi, mifumo sisimuzi hudhibiti utendaji wa ubongo kulingana na muda wa siku na mambo mengine. ==== Mifumo ya nyurotramsita ==== Isipokuwa katika hali chache, kila neuroni katika ubongo huendelea kutoa kemikali za niurohamishi, isiyobadilika au mchanganyiko wa niurohamishi, katika miunganiko yoyote ya sinapsi inayofanya na neuroni nyingine, kanuni hii inajulikana kama kanuni ya Dale.<ref> ''Principles of Neural Science,'' Sur. 15</ref> Kwa hivyo, niuron anaweza kuainishwa kutegemea niurohamisho iinayotoa. Niurohamishi mbili zinazoomekana mara nyingi zaidi ni glutamati, ambayo aghalabu huwa sisimuzi, na sidi ya gama-aminobutri (GABA), ambayo aghalabu huwa pingamizi. Neuroni zinazotumia transmita hizi zinaweza kupatikana katika karibu kila sehemu ya ubongo, zikibuni asilimia kubwa ya mkusanyiko wa sinapsi za ubongo.<ref> McGeer and McGeer, ''Basic Neurochemistry,'' uk. 311-332.</ref> Hata hivyo, idadi kubwa ya madawa yanayoathiri ubongo huelekeza athari zao kwa kubadili mfumo wa niurohamishi zisizohusiana moja kwa moja na glutamati au uhamishaji wa GABA.<ref> Cooper et al., ''Biochemical Basis of Neuropharmacology'' </ref> Madawa kama vile kafeini, nikotini, heroini, kokeini, Prozac, Thorazine, ''n.k,'' huathiri neiurohamishi nyingine. Nyingi ya transmita hizi hutoka katika neuroni ambazo zinakaa katika sehemu fulani ya ubongo. Serotonini, kwa mfano- lengo la msingi la madawa ya kulevya ya kinza huzuni na viamsha hamu-huja kimahsusi kutoka eneo dogo la shina la ubongo iitwayo kiini Rafe. Norepainifrini, ambayo hushiriki katika usisimuzi, hutoka kimahsusi kutoka eneo dogo karibu liitwalo lokasi serulesi. Histamini, kama niurohamishi, hutoka katika sehemu ndogo ya hypothelamasi iitwayo kiini tubaromamilari (histamini pia ina kazi zisizo za mfumo kuu wa neva, lakini kjukumu la niurohamishi ndio sababu kwa kinzahisatami kuwa na athari za kutuliza). Niurohamishi nyingine kama vile asetilkolini na dopamini huwa na vyanzo mbalimbali katika ubongo, lakini hazijasambazwa kwa wingi kama glutamati na GABA. ==== Mifumo ya hisi ==== Moja ya majukumu ya kimsingi ya ubongo ni kudondoa ujumbe muhimu kutoka katika viungo vya hisia.<ref> ''Principles of Neural Science'' Sur. 21</ref> Hata katika ubongo wa binadamu, mifumo ya hisi huwa nyingi zaidi ya hisi tano za kawaida zinazojulikana za maono, sauti, ladha, mguso, na harufu: bongo zetu hupokea taarifa kuhusu joto, usawa, mkao wa miguu na mikono, na vijenzi kemikali vya mfumo wa damu, kati ya mambo mengine. Hali hizi zote hutambuliwa na viungo maalum vya hisi vinavyoelekeza vichoche ndani ya ubongo. Katika wanyama wengine, milango zaidi ya hisi vinaweza kuwepo, kama vile hisi ya miale ya joto isiyoonekana miongoni mwa wanyama wanaoishi shimoni kama nyoka, au "hisi za kawaida" zinaweza kutumika katika njia isiyo ya kawaida, kama jinsi usikiaji unavyotumiwa na katika popo ''sona''. Haya hapa kanuni chache zinazotumika katika mifumo nyingi ya hisi, ikitumia mfumo sikizi katika mifano maalum. Kila mfumo wa hisi huanza kwa chembechembe mahsusi za "vipokea hisia". Hizi ni neuroni, lakini tofauti na neuroni nyingi, hazijadhibitiwa na mchango wa sinapsi kutoka katika neuroni nyingine: badala yake zinaamilishwa na vipokezi vilivyofungamana na zinazohisi baadhi ya hisi za mguso, kama vile mwanga, joto, au mikazo ya kimwili. Akzoni za chembe pokezi-hisia husafiri katika utiwa mgomgo au ubongo. Kwa hisia ya kusikia, vipokezi viko katika sikio la ndani, katika konokono la sikio, na huamilishwa na mtikiso.<ref name="hearing">[78] ^ ''Principles of Neural Science,'' Sur. 21, 30</ref> Kwa hisi nyingi, kuna " kiini cha msingi" au seti ya viini, vilivyo katika shina la ubongo, zinazokusanya vichocheo kutoka katika chembe pokezi. Katika hisia sikizi, hizi ni viini vya konokono la sikio.<ref name="hearing"/> Mara nyingi, kuna maeneo ya mengine yaliyo chini ya ubongo ambayo hudondoa habari maalum ya aina fulani. Kwa hisi ya kusikia, eneo bora la unusaji na eneo hafifu ya kalikulusi hushiriki katika kulinganisha vichocheo kutoka katika masikio mawili kudondoa kuhusu ujumbe kuhusu mwelekeo wa chanzo cha sauti, miongoni mwa kazi nyingine.<ref name="hearing"/> Kila mfumo wa hisi pia ina sehemu maalum ya thelamasi iliyotengwa kwayo, ambayo huhudumu kama kiunganishi na gamba la ubongo. Katika hisi ya kusikiliza, hii ni kiini kati chenye umbo la goti.<ref name="hearing"/> Kwa kila mfumo wa hisi, kuna eneo "msingi" la gamba la ubongo linalopokea ujumbe moja kwa moja kutoka eneo la thelamasi linalopokea na kutuma ujumbe. Katika mfumo wa kusikia, huu ni gamba msingi la usikizi, ulio katika sehemu ya juu ya ndewe la ubongo.<ref name="hearing"/> Kawaida pia huwa kuna seti ya maeneo ya gemba yenye hisi za "ngazi ya juu", zinazochanganua ujumbe wa hisi zinazoingai kwa njia maalum. Kwa mfumo wa usikiaji, kuna maeneo ambayo huchambua ubora wa sauti, mahadhi, na mielekeo ya mabadiliko kwa muda, miongoni mwa sifa nyingine.<ref name="hearing"/> Mwisho, kuna maeneo ya ''hali nyingi'' yanayochanganya jumbe kutoka hisi mbalimbali, kwa mfano kusikia na kuona. Katika hatua hii, vichocheo huwa vimefikia sehemu za ubongo zinazoweza kuelezeka vizuri kuwa ''jumuishi'' wala si ''hisishi '' hasa.<ref name="hearing"/> Kanuni hizi zote zina ukiushi. Kwa mfano, hisi ya mguso (ambayo kwa kweli ni mkusanyiko wa angalau nusu dazeni ya hisi tendi mbalimbali), kichocheo cha hisi kinachoingia humalizika hasa katika uti wa mgongo, katika neuroni ambazo kisha huzielekeza katika shina la ubongo.<ref> ''Principles of Neural Science'' Sur. 23</ref> Kwa hisi ya harufu, hakuna mawasiliano katika thelamasi; badala yake kichocheo huenda moja kwa moja kutoka eneo msingi la ubongo-kibonge cha kunusa-hadi kwenye gamba.<ref> ''Principles of Neural Science'' Sur. 32</ref> ==== Mifumo ya mwendo ==== Mifumo ya mwendo ni maeneo ya ubongo ambayo kwa njia moja au nyingine yanahusika moja kwa moja katika kuanzisha mienendo ya mwili, yaani, katika amilisha misuli. Isipokuwa misuli inayodhibiti macho, misuli yote inayofanya kihiari<ref> Angalia misuli</ref>katika mwili imeunganishwa moja kwa moja na neva za mwendo katika uti wa mgongo, ambayo ndiyo njia ya mwisho ya pamoja kwa mfumo wa kuzalisha uendaji.<ref>[89] ^ ''Principles of Neural Science'' Sur. 34</ref> Neva za uti wa mgongo zinadhibitiwa na saketi za neva asili za uti wa mgongo, na kwa michango inayoteremka kutoka ubongoni. Sakati asili za uti wa mgongo hutekeleza majukumu mengi ya tendohiari na pia huwa na mifumo ya kuanzisha miendo kama vile kutembea au kuogelea.<ref>''Principles of Neural Science,'' Sur. 36, 37</ref> Miunganiko inayoshuka kutokana ubongoni hufanikisha udhibiti changamano zaidi . Ubongo una baadhi ya maeneo ambayo huwasiliana moja kwa moja na uti wamgongo.<ref> ''Principles of Neural Science'' Sur. 33</ref> Katika ngazi ya chini kabisa ni maeneo ya mienendo katika medula na ponsi. Katika ngazi za juu ni maeneo ya ubongokati, kama vile viini vyekundu, ambayo inawajibikia kuratibu usogezaji mikono na miguu. Katika ngazi ya juu zaidi ambayo ni gamba msingi la mwendo, utepe wa tishu ulioupande wa nyuma wa ndewe la mbele ya ubongo. Gamba msingi la mwendo hituma ujumbe katika ameneo chini ya gamba yanayohusika na mwendo, lakini pia hutuma jumbe kubwa moja kwa moja katika uti wa mgongo, kupitia kinachojulikana kama njia piramidi. Uelekezaji huu wa moja kwa moja kati ya gamba na uti wa mgongo huruhusu udhibiti sahihi wa hiari wa miendo. Maeneo mengine ya "upili" ya ubongo yanayohusiana na mwendo hayawasiliani moja kwa moja na uti wa mgongo, na badala yake hugusa maeneo ya mwendo katika gamba au maeneo ya msingi chini ya gamba. Miongoni mwa maeneo muhimu ya upili ni gamba linaloshughulikia mwendo, ganglia ya msingi, na ubongonyuma: * Gamba-awali ya mwendo (ambayo kwa kweli ni maeneo kubwa changamani) inakaribiana na gamba msingi la mwendo, na kuielekeza. Huku vitengo vya gamba msingi ya mwendo hulingana na sehemu maalum ya mwili, vitengo vya gamba-awali ya mwendo mara nyingi hushirikishwa katika usogezwaji wa sehemu nyingi za mwili kwa wakati moja.<ref> ''Principles of Neural Science'' Sur. 38</ref> * Ganglia ya msingi ni mkusanyiko wa viungo vya chini ya ubongembele zinazoelekeza katika maeneo mengine yanayohusiana na mwendo.<ref> ''Principles of Neural Science'' Sur. 43</ref> Kazi zao imekuwa vigumu kuelewa, lakini mmoja ya nadharia maarufu ya sasa ni kuwa yanatekeleza jukumu muhimu uteuzi wa utendaji.<ref> Gurney et al., 2004</ref> Mara nyingi, huwa zinazuia vitendo kwa kutumamara k wa mara vichochezi vizuizi kwa mifumo ya kuzalisha mwendo, lakini katika hali nzuri, huwa zinatoa vizuizi hivyo na kuruhusu maeneo yaliyolengwa kudhibiti tabia. * Ubongonyuma una muundo tofauti sana na upo katika sehemu ya nyuma ya ubongo.<ref name="refprinciples"/> Haidhibiti au kuanzisha tabia, bali huzalisha vichocheo rekebishi kufanya miendo iwe sahihi zaidi. Watu walio na bongonyuma zilizo haribika hawapoozi kwa njia yoyote, bali miili yao huwa na miendo isiyokuwa na uhakika na isiyo ratibika. Pamoja na hayo yote hapo juu, ubongo na uti wa mgongo zina mitandao pana ya kudhibiti mfumo wa neva wa kujiendesha, ambayo hufanya kazi kwa kunyunyiza homoni na kwa kurekebisha " misuli laini" ya tumbo.<ref> ''Principles of Neural Science'' Sur. 49</ref> Mfumo wa neva wa kujiendesha huathiri mipigo ya moyo, mmeng'enyo;, kiwango cha kupumua, kutoa mate, jasho; kukojoa, na hisia za ngono japo majukumu yake mengi hayako chini ya udhibiti wa hiari moja kwa moja. ==== Mifumo ya kusisimua ==== Labda kipengele cha wazi zaidi cha tabia ya mnyama yoyote yule ni mzunguko wa kila siku kati ya kulala na kuamka. Usisimuaji na utahadhari pia huongozwa kwa kiwango sahishi zaidi cha muda, ingawa, kwa mtandao mkubwa wa maeneo ya ubongo.<ref name="Principles45"> ''Principles of Neural Science'' Sur. 45</ref> Sehemu muhimu ya mifumo ya kusisimua ni kiini suprakiasmatiki (SCN), sehemu ndogo ya haipothelamasi iliyo juu ya sehemu ambapo neva ya kuona kutoka macho mawili inapopitia.<ref> Antle &amp; Silver, 2005</ref> SCN ina majira kuu ya kibayolojia ya mwili. Neuroni hapa huonyesha kupanda na kushuka kwa viwango vya shughuli katika kipindi cha saa 24, mipigo ya moyo: mabadiliko katika shughuli hizi yanaendeshwa na mabadiliko ya kiurari katika maelezo kwa mkusanyiko wa ''jeni za saa". SCN huendelea kupima saa hata ikikatwa kutoka ubongoni na kuwekwa katika bakuli lililo na myeyusho wa madini fuvutende, hata hivyo kwa kawaida huwa inapokea ujumbe kutoka katika neva ya kuona, kupitia njia ya retinohaipothelamiki (RHT), ambayo huruhusu mzunguko wa kila siku wa mwanga-giza kunakiliwa katika saa hiyo. SCN huwasiliana na seti ya maeneo katika haipothelamasi, na shina la ubongo, na ubongokati zinazohusika katika utekelezaji wa mzunguko usingizi- na kuamka. Kiungo muhimu katika mfumo huo ni kile kinachoitwa muundo menomeno, kundi la neva zilizosambazwa kwa usawa kote katika shina la ubongochini.<ref name="Principles45"/> Neva menomeno hutuma vichocheo kwa thelamasi, ambayo kwa upande wake hutuma vichocheo vya ngazi ya kudhibiti kwa kila sehemu ya gamba la ubongo. Kuharibika kwa muundo menomeno kunaweza kusababisha hali ya kudumu ya kukosa fahamu. Usingizi huhusisha mabadiliko makubwa katika utendakazi wa ubongo.<ref> ''Principles of Neural Science'' Sur. 47</ref> Hadi miaka 1950 iliaminika kijumla kwamba ubongo kimsingi huacha kufanya kazi wakati wa kulala<ref> Kleitman, 1938</ref>, lakini hii sasa inajulikana kuwa si kweli: shughuli huendelea lakini mwelekeo huwa tofauti sana. Kwa hakika, kuna aina mbili ya usingizi, ''usingizi REM'' (ulio na ndoto) na usingizi ''NREM'' (usio-REM, kwa kawaida bila ndoto), ambao hujirudia katika mifumo tofauti kidogo katika kipindi chote cha kulala. Aina tatu tofauti za mwelekeo mpana wa shughuli za ubongo zinaweza kupimika: REM, NREM nyepesi na NREM nzito. Wakati wa usingizi mzito wa NREM, ambao pia hujulikana kama usingizi wenye wimbi pole, shughuli katika gamba huchukua mfumo wa mawimbi makubwa yenye urari, ambapo katika hali ya kuamka huwa na kelele na bila urari. Viwango vya niurohamishi norepainefrini na serotonini hupungua wakati wa usingizi wenye wimbi pole, hupungua hadi kukaribia sufuri wakati wa usingizi wa REM; viwango vya asetilikolini huonyesha mfumo ulio kinyume na huu. === Utumiaji nishati kwa ubongo === [[Picha:PET-image.jpg|thumb|right|alt=A flat oval object is surrounded by blue. The object is largely green-yellow, but contains a dark red patch at one end and a number of blue patches. |Taswira ya PET ya ubongo wa binadamu ikionyesha matumizi ya nishati]] Ingawa ubongo wa binadamu unawakilisha 2% tu ya uzito wa mwili, unapokea 15% cha kinachozalishwa na moyo, 20% ya jumla ya matumizi ya oksijeni mwilini, na 25% ya jumla ya matumizi ya glukosi mwilini.<ref> Clark &amp; Sokoloff, 1999</ref> Haja ya kupunguza uzito wa mwili ili, kwa mfano, kuweza kuruka, imesababisha uamuzi wa kupunguza ukubwa wa ubongo katika spishi fulani, kama vile popo.<ref> Safi et al., 2005</ref> Ubongo sanasana hutumia glukosi kupata nguvu, na kuinyima glukosi, kama inavyoweza kutokea katika haipoglukemia, unaweza kusababisha kupoteza fahamu. Matumizi ya nishati katika ubongo haubadiliki sana katika muda, lakini maeneo ya gamba yanayofanya kazi hutumia nishati zaidi kuliko maeneo yasiyoshughulika: ukweli huu ndio msingi wa mbinu za upigaji picha akisi wa ubongo kama vile PET na fMRI.<ref> Raichle &amp; Gusnard, 2002</ref> Hizi ni mbinu za matibabu nyuklia ya upigaji picha zinazotoa picha zenye pande olwa tatu kwa shughuli za kimetaboli. {{Clear}} == Ubongo na akili == Kuelewa uhusiano kati ya ubongo na akili ni changamoto inayotatiza kifalsafa na kisayansi.<ref> Churchland, ''Neurophilosophy'' </ref> Ushahidi wa kisayansi wa moja kwa moja kwamba kuna uhusiano kati ya kiungo ubongo na akili ni kiwango cha athari kinachojidhihirisha baada ya ubongo kubadilishwa, kama vile maumivi ya ubongo yanayosababisha kiwewe na matumizi ya madawa yanayoathiri ubongo.<ref> Boake na Diller, 2005</ref> Tatizo la uhusiano wa akili-mwili ni moja kati masuala ya ndani ya historia ya [[falsafa]],<ref> ''Neurophilosophy,'' Sur. 7</ref> inayotuliza kufikiria ikiwa ubongo na akili ni kitu kimoja, kinachotofautiana kidogo, au kinachohusiana kwa njia fulani isiyojulikana. Kuna mitazamo mitatu mikubwa tatu kuhusu jibu hili: uwili, uyakinifu, na udhanifu. Uwili unashikilia kwamba akili inajisimami kivyake bila kutegemea ubongo,<ref> Hart, 1996</ref> uyakinifu unashikilia kwamba matukio ya akili yanafanana na matukio la neva<ref name="DicPhil"> Lacey, 1996</ref> na udhanifu unashikilia kwamba matukio ya akili tu ndio zipo.<ref name="DicPhil"/> Pamoja na maswali ya kifalsafa, uhusiano kati ya akili na ubongo unahusisha idadi kubwa ya maswali ya kisayansi, ikiwa ni pamoja na uelewa wa uhusiano kati ya shughuli za kiakili na shughuli ubongo, taratibu kamili ambazo kwazo dawa huathiri ufahamu, na mahusiano ya neva kwa dhamira. Katika kipindi kingi cha historia wanafalsafa waliliona jambo la kutofikirika kwamba ufahamu unaweza kutekelezwa na kitu dutu ye umbile kama vile tishu ya ubongo (yaani neuroni na sinapsi).<ref> ''Neurophilosophy,'' Sur. 6</ref> Wanafalsafa kama vile Patricia Churchland wanadai kuwa mwingiliano wa akili na dawa ni dalili ya uhusiano wa karibu sana kati ya ubongo na akili, si kwamba hivi viwili ni kitu kimoja.<ref> ''Neurophilosophy,'' Sur. 8</ref> Descartes, aliyewazia sana kuhusu uhusiano wa ubongo-akili, aliweza kuelezea matendohiari na tabia nyingine sahili katika mtazamo wa kimekaniki, ingawa hakuamini kuwa mawazo tata, na hasa lugha, inaweza kuelezwa kwa rejelea za umbo la ubongo pekee.<ref> Descartes, ''Description of the human body'' </ref> == Utafiti == Fani ya taaluma ya elimuneva inajumuisha mbinu zote zinazotafuta kuelewa ubongo na mifumo nyinginezo za neva. [[Elimunafsia]] hutaka kuelewa akili na tabia, na nyurorojia ni fani ya matibabu inayotibu magonjwa ya mfumo wa neva. Ubongo pia ni kiungo muhimu sana kinachotafitiwa na tiba-akili, tawi la matibabu inayofanya kazi ya kutafiti, kuzuia na kutibu magonjwa ya akili.<ref> Storrow, ''Outline of Clinical Psychiatry'' </ref> Sayansi ya ufahamu hutaka kuunganisha elimuneva na elimunafsia pamoja na fani nyingine zinazojuhusisha na ubongo, kama vile sayansi ya tarakilishi (akili ya kuundwa na mwanadamu na mashamba sawa) na [[falsafa]]. Mbinu kongwe kabisa ya kuutafiti ubongo ni kianatomial, na hadi katikati ya karne ya 20, sehemu kubwa ya maendeleo katika elimuneva ilitokana na kutengenezwa kwa rangi bora na hadibuni bora -mwana elimuveva Floyd Bloomni maarufu kwa kutania kuwa "ufanisi katika utafiti wa ubongo unategemea zaidi rangi."<ref> ''Neuroscience: Exploring the Brain,'' Sur. 2</ref> Wana-anatomia wa elimuneva hutafiti muundo wa ubongo kwa kiwango pamoja na muundo wake wa kimaikroskopu wa neuroni na vijenzi vyao, hasa sinapsi. Pamoja na zana nyingine, wao hutumia rangi nyingi sana zinazodhihirisha muundo wa neva, kemia, na miunganisho. Katika miaka ya hivi karibuni, ukuaji katika mbinu za elimu kingamaradhi inayotumia rangi imeruhusiwa kutiwa rangi kwa neuroni zinazoonyesha aina fulani maalum ya jeni. Pia, ''uchunguzi amilifu wa neva'' unatumia mbinu za upigaji picha wa kimatibabu kuhusisha tofauti katika muundo wa ubongo wa binadamu na tofauti katika ufahamu au tabia. Wanafiziolojia hutafiti vipengee vya kemikali, famakolojia, na mienendo ya meme ya ubongo: zana zao za msingi ni dawa na vifaa vya kunakili. Maelfu nyingi ya dawa za zilizoundwa kimajaribio huathiri mfumo wa neva, baadhi ya njia ya juu mahsusi sana. Kurekodi shughuli za ubongo unaweza kufanywa kwa kutumia elektrodi, ikiwa imeshikiliwa kwenye fuvu kama katika uchunguzi wa EEG, au uliodungwa ndani ya bongo za wanyama kwa ajili ya kurekodi nje ya chembe, ambayo inaweza kuchunguza uwezekano wa utendaji unaotokana na kila niurni kibifansi.<ref> Dowling, ''Neurons and Networks,'' kurasa za 15-24</ref> Kwa sababu ubongo hauna vipokezi vya maumivu, inawezekana kutumia mbinu hizi kunakili kutoka katika wanyama walio macho huku wanaendelea na tabia zao kama kawaida bila kuwasababishia kuwasumbua. Mbinu sawa na hiyo zimetumika mara nyingine kuchunguza utendakazi wa ubongo katika wagonjwa binadamu wanaougua na kifafa isoyokamili, katika matukio ambapo kulikuwa na haja ya kimatibabu kuiweka elektrodi ili kubaini eneo la ubongo ulioathirika na kifafa s.<ref> Wyllie et al., ''Treatment of Epilepsy,'' Sur. 77</ref> Pia inawezekana kuchunguza utendaji wa ubongo bila kutumia mbinu za kuingilia binadamu kwa mibu amilifu za kupiga picha kama vile MRI uwanda huu umepanuka sana katika kipindi cha miongo miwili iliyopita. Njia tofauti ya kubaini kazi ya ubongo ni kuchunguza madhara ya kuharibu maeneo maalum ya ubongo. Inagawa umelindwa kwa fuvu na utando ukizungukwa na ugiligili wa ubongo na uti wa mgongo, nakutengwa na mfumo wa damu kwa kizuizi cha kati ya ubongo na damu, ulaini wa ubongo unaufanya kuwa rahisi kuvamiwa na magonjwa mbalimbali na aina tofauti za maumivu. Kwa binadamu, athari za kupooza na aina nyingine ya uharibifu wa ubongo zimekuwa chanzo muhimu cha habari kuhusu majukumu ya ubongo.<ref> Fundamentals of Human Neuropsychology, Sur. 1</ref> Kwa sababu hakuna uwezo wa kudhibiti hali ya uharibifu kimajaribio, hata hivyo, habari hii aghalabu huwa vigumu kufafanua. Katika tafiti zinazowahusisha wanyama, kwa kawaida panya, inawezekana kutumia elektrodi au kudunga kemikali katika mahali maalum ili kuleta uharibifu kwa mfumo unaohitajika na kisha kuchunguza matokeo ya tabia. Nyurosayansi ya kitarakilishi inajumuisha njia mbili: kwanza, matumizi ya tarakilishi kuuchunguza ubongo, pili, utafiti wa jinsi ubongo hutarakilisha.<ref name="Abbott"> Abbott &amp; Dayan, ''Theoretical Neuroscience'' </ref> Kwa upande mmoja, inawezekana kuandika programu ya tarakilishi kuigiza kazi ya kundi la neva kwa kutumia mifumo ya milinganyo yanayoeleza shunguli zao kielektrokemikali; miigizo kama hiyo hujulikana kama ''mitandao ya neuroni amilifu kibayalojia.'' Kwa upande mwingine, inawezekana kuchunguza algorithimi ili kukokotoa neva kwa uigizaji, au kuchanganua kihesisabati, utendakazi wa '' vitengo'' vilivyosahilishwa vilivyo na baadhi ya sifa za neuroni lakini vimetoa nyingi ya uchangamani wao wa kibayolojia. Majukumu ya ukokotooaji wa ubongo huchunguzwa na wanaelimuneva na wanasayansi wa tarakilishi. Miaka ya hivi karibuni imeshuhudia utumizi wa kwanza wa mbinu za uhandisi wa kijenetiki kutafitia ubongo.<ref> Tonegawa et al., 2003</ref> Utafiti mwingi kwa kawaida hufanywa kwa panya, kwa sababu zana za kiufundi zimeimarika zaidi kwa spishi hawa zaidi ya wengine wowote. Sasa inawezekana kwa urahisi wa kiwango cha haja "kuchambua" au kugeuza aina mbalimbali za jeni, na kisha kuchunguza athari katika utendakazi wa ubongo. Mbinu changamani zaidi pia zina anza kutumika: kwa mfano, kutumia mbinu ya uchanganyishaji upya wa Cre-Lox inawezekana kusisimua au kituliza jeni katika sehemu maalumu ya ubongo, kwa wakati maalumu. == Historia == Maoni ya awali yaligawanyika ikiwa makao makuu ya nafsi yako katika ubongo au moyo. Kwa upande mmoja, ilikuwa vigumu kutoona ukweli kwamba ufahamu unahisiwa kuwa katika kichwa, na kwamba kupigwa kwa kishindo kikubwa katika kichwa kunaweza kusababisha kupoteza fahamu kwa urahisi zaidi kuliko kupigwa kifuani, na kwamba kichwa kutikisa kichwa husababisha kizunguzungu. Kwa upande mwingine, uchunguzi wa juujuu wa ubongo unadhihirisha kiungo ajizi, ukilinganishwa na moyo ambao hupigapiga kila wakati. Kukoma kwa mpigo wa moyo unamaanisha kifo; hisia kali huleta mabadiliko katika mpigo wa moyo, na mara nyingi hisia za huzuni husababisha hisia ya maumivu katika sehemu za moyo ("maumivu ya moyo"). Aristotle alipendelea moyo, na kudhania kwamba kazi ya ubongo ilikuwa tu kupoesha damu. Democritus, mvumbuzi wa nadharia ya atomiki ya dutu, alipendelea nafsi yenye sehemu tatu, akili ikiwa katika kichwa, hisia katika moyo, na tamaa katika sehemu karibu na ini.<ref> Finger, ''Origins of Neuroscience,'' uk. 14</ref> Haipokrates, "baba wa matibabu" , alikuwa aliupendelea ubongo kabisa. Katika ''On the Sacred Disease,'' maelezo yake kuhusu kifafa, aliandika: <blockquote> <p>Wanadamu wanapaswa kujua kwamba furaha, nderemo, kicheko na michezo, masikitiko, utegemezi, na maombolezo hayatoki kwingine ila tu katika ubongo. ... Na kwa kiungo hicho hicho tunakuwa wendawazimu na kupagawa, na woga na hofu kubwa hutuandama, wakati mwingine mchana na wakati mwingine usiku, na ndoto na wasiwasi isiyotarajiwa, na majukumu yasiyo mazuri, na kutojua hali za kisasa, kutoaminika, na kutokuwa na ujuzi. Mambo haya yote tunayavumilia kutoka kwenye ubongo, wakati hauna afya ...</p></blockquote> <p>- [[Hippokrates|Hippocrates]], ''On the Sacred Disease'' <ref> Hippokrates, ''On the Sacred Disease'' </ref></p> Daktari maarufu wa Roma Galen pia alitetea umuhimu wa ubongo, na akatunga dhahania kwa kina kuhusu jinsi inavyo weza kufanya kazi. Hata baada ya madaktari na wanafalsafa kukubaliwa kuhusu ukuu wa ubongo, haidhuru, dhana ya moyo kuwa makao makuu ya ufahamu uliendelea kudumu katika nahau maarufu, kama vile "kujitolea kwa moyo".<ref> ''Encyclopedia of Word and Phrase Origins'' </ref> Galen alifanya kazi kubwa ya kueleza uhusiano wa kianotomi baina ya ubongo, neva na misuli, na kuonyesha kwamba misuli yote katika mwili imeshikana na ubongo kwa njia ya mtandao wa matawi ya neva. Alidai kwamba neva huamsha misuli moja kwa moja, kwa kubeba dutu ya ajabu aliyoita ''pneumata psychikon,'' ambayo kwa kawaida hutafsiriwa kuwa "mazimwi ya wanyama". Mawazo yake yalijulikana pakubwa wakati wa Zama ya Kati, lakini mafanikio mengi zaidi hayakuja hadi katika kipindi cha Mvuvumko, wakati utafiti wa kina wa kianatomia uliporejea, pamoja na makadirio ya kinadharia ya Descartes na wafuasi wake. Descartes, kama Galen, aliwazia mfumo wa neva katika msingi wa kihadroliki. Aliamini kwamba kazi kubwa za kiutambuzi- hasa lugha- hufanywa na viungo visiyoonekana ''res cogitans '' lakini kwamba nyingi ya tabia za binadamu na wanyama zinaweza kuelezeka kwa mambo yanayoshikika. Hatua ya kwanza kuelekea uelewa wa kisasawa kazi wa neva, hata hivyo, ulitokana na uchunguzi wa Luigi Galvani, aliyegundua kwamba wimbi la umeme tuli ukielekezwa katika neva iliyo wazi ya chura aliyekufa inaweza kusababisha mguu wake kujikunja. [[Picha:PurkinjeCell.jpg|thumb|right|200px|alt=A drawing on yellowing paper with an archiving stamp in the corner. A spidery tree branch structure connects to the top of a mass. A few narrow processes follow away from the bottom of the mass. |Mchora wa Santiago Ramon y Cajal wa aina mbili za neuroni kutoka katika ubongonyuma wa njiwa zilizopakwa kwa Golgi]] Kila uelewa mpana umefuatia moja kwa moja au kidogo kutoka kwa uundwaji wa mbinu mpya ya uchunguzi. Hadi miaka ya mapema ya karne ya 20, maendeleo muhimu zaidi yalitokana na rangi mipya.<ref> Bloom, 1972, uk. 211 </ref> Muhimu hasa ulikuwa uvumbuzi wa rangi Golgi, ambayo (ikitumika kiusahihi) hupaka sehemu ndogo tu, na kwa usahihi bila kubagua, baadhi ya neuroni, huzipaka kikamilifu, ikiwa ni pamoja na mwili wa chembe, dendraiti, na akzoni. Bila rangi kama hiyo, tishu ya ubongo chini ya hadubini huonekana kama mshikamano wa fumwele ya protoplazimu isiyopenyeka, ambayo ni vigumu kubaini muundo wowote. Katika mikono ya [[Camillo Golgi]], na hasa kwa mwana-antomia wa neva wa Kihispania Santiago Ramon y Cajal, rangi hiyo mpya ilifichua mamia ya aina tofauti za neuroni, kila mmoja ikiwa na muundo wa kipekee wa dendriti na mtindo wa mwunganisho. Katika karne ya 20, maendeleo katika uwanda wa elektroniki yaliwezesha uchunguzi wa sifa za kielektroniki za chembe za neva, kilele kilikuwa kazi za Alan Hodgkin, [[Andrew Huxley]], na wengi kuhusu bayofizikia ya tendo tarajiwa, na kazi ya [[Bernard Katz]] na wengine kuhusu uelektrokemia wa sinapsi.<ref> Piccolino, 2002</ref> Chunguzi za awali zilitumia maandalizi maalum, kama vile mfumo wa "mwitikio wa kutorika haraka" wa ngisi, ambayo inahusisha akzoni kubwa wewe unene kama kaa la penseli, na sinapsi kubwa inayoungana na akzoni hii. Maboresho thabiti katika elekrodi na vifaameme viliwezesha umadhubuti wa hali ya juu. Chunguzi hizi zilichangia picha ya kianatomia wa ubongo kukiwa na mtazamo kuwa ubongo ni kiungo kinachobadilika. Akiangazia uelewa mpya, mnamo 1942 [[Charles Sherrington]] alielezea kufanya kazi kwa ubongo katika hatua kwa maelezo ya kushangaza: <blockquote> <p>Sehemu kuu ya juu ya umbo, kwamba sehemu ambapo ni nadra mwanga imewahi kumulika au kugusa, sasa inakuwa sasa kitengo cha uangavu unaorindima kwa urari kukiwa idadi kubwa ya vimulimuli vinavyosafiri hapa na huko. ... Ni kana kwamba Kilimia ilianza kwa namna fulani ya kucheza kwanulimwengu. Kwa haraka kichwa kizima kinakuwa na maliwazo ambapo mamilioni ya vipisha uzi vinashona mtindo usioonekana, kila mara mtindo wenye maana ingawa si wa kudumu; na mwingiliano mtulivu wa vijimiundo.</p> <p>-Sherrington, 1942, ''Man on his Nature'' <ref>[131] ^ Sherrington, ''Man on his Nature'' </ref></p> </blockquote> Miaka ya 1990 ilijulikana katika Marekani kuwa "Muongo wa Ubongo" ili kuadhimisha maendeleo yaliyopigwa katika utafiti wa ubongo, na ili kuendeleza ufadhili kwa ajili ya tafiti kama hizo.<ref>{{cite web|url=http://www.loc.gov/loc/brain/proclaim.html|title= Project on the Decade of the Brain|accessdate=2009-09-30|last=Bush|first=George H.W.|year=1990|month= Julai}}</ref><ref>{{Rejea jarida|url=http://www.sciencemag.org/cgi/content/summary/284/5415/739|first1=Edward G.|last1=Jones|authorlink1=Edward G. Jones|first2=Lorne M.|last2=Mendell|title=Assessing the Decade of the Brain|journal=Science|doi=10.1126/science.284.5415.739|date=30 Aprili 1999|volume=284|issue=5415|page=739|accessdate=2010-04-05|publisher=[[American Association for the Advancement of Science]]}}</ref> == Maelezo == {{Marejeo|colwidth=20em}} == Marejeo == {{Refbegin|2}} * <cite id="refAbbott">{{cite book | last = Abbott | first = LF | title = Theoretical Neuroscience: Computational and Mathematical Modeling of Neural Systems | publisher = MIT Press | year = 2001 | url = http://books.google.com/?id=hrZYAAAACAAJ | isbn = 9780262541855 | coauthors = Dayan P }}</cite> * <cite id="refAboitiz">{{cite journal | last = Aboitiz | first = F | title = The evolutionary origin of the mammalian isocortex: Towards an integrated developmental and functional approach | journal = Behav Brain Sci | year = 2003 | volume = 26 | pages = 535–52 | url = http://www.bbsonline.org/Preprints/Aboitiz/Referees/ | pmid = 15179935 | doi = 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Connors, Michael A. Paradiso | title = Neuroscience | publisher = Lippincott Williams & Wilkins | location = Philadelphia, Pennsylvania | year = 2006 | isbn = 9780781760034 | oclc = 62509134}} * {{cite book | last = Blackmore | first = Susan M. | title = Conversations on Consciousness | url = https://archive.org/details/conversationsonc0000blac | year = 2006 | publisher = Oxford University Press | location = Oxford; New York | isbn = 9780195179583 | oclc = 62555307}} * {{cite book | last = Buzsaki | first = Gyorgy | title = Rhythms of the Brain | year = 2006 | publisher = Oxford University Press | location = Oxford; New York | isbn = 9780195301069 | oclc = 63279497}} * {{cite book | last = Calvin | first = William H. | title = The River That Flows Uphill: A Journey from the Big Bang to the Big Brain | year = 2001 | publisher = Iuniverse.com | location = Lincoln, Nebraska | isbn = 9780595167005 | oclc = 48962546 }} * {{cite book | last = Della Sala | first = Sergio | title = Mind myths: Exploring popular assumptions about the mind and brain | url = https://archive.org/details/mindmythsexplori0000unse | publisher = J. Wiley & Sons | location = Chichester England; New York | year = 1999 | isbn = 0471983039 | oclc = 39700332}} * {{cite book | last = Restak | first = Richard | title = The Secret Life of the Brain | url = https://archive.org/details/secretlifeofbrai0000rest | publisher = Joseph Henry Press | location = Washington, DC | year = 2001 | isbn = 9780309074353 | oclc = 47863192}} * {{cite book | last = Shepherd | first = Gordon M. | title = The Synaptic Organization of the Brain | url = https://archive.org/details/synapticorganiza0000unse_d1q8_5thed | publisher = Oxford University Press | location = Oxford; New York | year = 2004 | edition = Fifth | isbn = 9780195159561 | oclc = 51769076}} Yameandikwa kwa ajili ya watoto wa zaidi ya miaka 8: * {{cite book | last = Simon | first = Seymour | title = The Brain | publisher = Morrow Junior | location = New York | year = 2000 | isbn = 9780688170608 | oclc = 35686089 }} == Viungo vya nje == {{Commons category|Brain}} * [http://www.sfn.org The Society for Neuroscience] * [http://www.ibro.org IBRO (Brain Research International Organization)] * [http://www.stanford.edu/group/hopes/basics/braintut/ab0.html The HOPES Brain Tutorial] {{Wayback|url=http://www.stanford.edu/group/hopes/basics/braintut/ab0.html |date=20090325101705 }} at [http://hopes.stanford.edu/ hopes.stanford.edu] {{Wayback|url=http://hopes.stanford.edu/ |date=20200827144014 }} * [http://brainmuseum.org/ Comparative Mammalian Brain Collection] * [http://www.sciencedaily.com/news/mind_brain/ Brain Research News from ScienceDaily] * [http://braininfo.rprc.washington.edu BrainInfo for Neuroanatomy] * [http://faculty.washington.edu/chudler/neurok.html Neuroscience for kids] * [http://www.brainmaps.org/ BrainMaps.org] {{Wayback|url=http://www.brainmaps.org/ |date=20200402002218 }} , atlasi yenye mwingiliano na yenye umadhubuti wa juu wa kidititali wa ubongo ulioundwa kwa msururu wa picha zilochunguliwa za bongo za wanyama wa jamii ya nyani wa wasio wa jamii ya nyani * [http://thebrain.mcgill.ca The Brain from Top to Bottom] * [[v:Topic:Neuroscience|The Department of Neuroscience]] at [[v:|Wikiversity]] * [http://www.pbs.org/wnet/brain/history/index.html The Secret Life of the Brain :] History of the Brain from PBS * [http://www9.biostr.washington.edu/cgi-bin/DA/PageMaster?atlas:Neuroanatomy+ffpathIndex:Splash%5EPage+2 University of Washington ] {{Wayback|url=http://www9.biostr.washington.edu/cgi-bin/DA/PageMaster?atlas:Neuroanatomy+ffpathIndex:Splash%5EPage+2 |date=20180704152239 }} 3D animations of brain regions - click through from "Click for copyright" * [http://www.youtube.com/watch?v=yZZrhkGbhgw.com 7 circuits of the Brain] * [http://ccdb.ucsd.edu/sand/main?stype=lite&amp;keyword=brain&amp;event=display&amp;Submit=Go&amp;start=1 Cell Centered Database] [[Jamii:Ubongo]] [[Jamii:Neva]] [[Jamii:Anatomia]] [[Jamii:Kichwa]] c0ukzxwv1o5gmn0hw03rtmshyhih4ec 0 55734 1578170 1564503 2026-07-02T23:27:47Z InternetArchiveBot 41439 Add 5 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578170 wikitext text/x-wiki {{Italic title}} {{Taxobox | color = lightgrey | status = | image = E. coli Bacteria (7316101966).jpg | image_width = 250px | domain = [[Bacteria]] | phylum = [[Proteobacteria]] | classis = [[Gammaproteobacteria]] | ordo = [[Enterobacteriaceae|Enterobacteriales]] | familia = [[Enterobacteriaceae]] | genus = ''[[Escherichia]]'' | species = '''''E. coli''''' | binomial = ''Escherichia coli'' | binomial_authority = ([[Walter Migula|Migula]] 1895)<br>[[Castellani]] and [[Chalmers]] 1919 | synonyms = ''Bacillus coli communis'' <small>[[Theodor Escherich|Escherich]] 1885</small> }} '''''Escherichia coli''''' (ilipewa jina la Theodor Escherich; kwa kawaida hufupisha kama '''''E. coli''''', tamka: ɛʃɘˈrɪɣiɑ ˈkoʊli) ni bakteria ya Gramu hasi yenye umbo la fimbo ambayo kwa kawaida hupatikana katika utumbo wa chini wa viumbe wenye damu moto (endothamu). Aina nyingi za''E.'' ''koli'' si hatari, lakini nyingine, kama vile serotaipu [[Escherichia coli O157:H7|O157: H7]], zinaweza kusababisha madhara makubwa ya sumu ya chakula katika [[Binadamu|binadamu]], na mara kwa mara husababisha bidhaa kurejeshwa kwa watengenezaji.<ref name="CDC">{{cite web | title=''Escherichia coli'' O157:H7| work=CDC Division of Bacterial and Mycotic Diseases | url=http://www.cdc.gov/ncidod/dbmd/diseaseinfo/escherichiacoli_g.htm | accessdate=2007-01-25}}</ref><ref name="Vogt">{{cite journal |author=Vogt RL, Dippold L |title=''Escherichia coli O157:H7'' outbreak associated with consumption of ground beef, June-July 2002 |journal=Public Health Rep |volume=120 |issue=2 |pages=174–8 |year=2005 |pmid=15842119 |pmc=1497708 }}</ref> Zile zisizo hatari ni sehemu ya kawaida ya viumbe vya utumbo, na zinaweza kufaidi wenyeji kwa kuzalisha vitamini K_2,<ref name="Bentley">{{cite journal |author=Bentley R, Meganathan R |title=Biosynthesis of vitamin K (menaquinone) in bacteria |journal=Microbiol. Rev. |volume=46 |issue=3 |pages=241–80 |date=1 Septemba 1982|pmid=6127606 |pmc=281544 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=6127606 }}</ref> na kwa kuzuia kuanzishwa kwa bakteria ya kusababisha magonjwa ndani ya utumbo.<ref name="Hudault">{{cite journal |author=Hudault S, Guignot J, Servin AL |title=''Escherichia coli'' strains colonising the gastrointestinal tract protect germfree mice against ''Salmonella typhimurium'' infection |url=https://archive.org/details/sim_gut_2001-07_49_1/page/47 |journal=Gut |volume=49 |issue=1 |pages=47–55 |year=2001 |month=Julai |pmid=11413110 |pmc=1728375 |doi=10.1136/gut.49.1.47 }}</ref><ref name="Reid">{{cite journal |author=Reid G, Howard J, Gan BS |title=Can bacterial interference prevent infection? |url=https://archive.org/details/sim_trends-in-microbiology_2001-09_9_9/page/424 |journal=Trends Microbiol. |volume=9 |issue=9 |pages=424–8 |year=2001 |month=Septemba |pmid=11553454 |doi=10.1016/S0966-842X(01)02132-1 }}</ref> ''E. koli'' hazikai tu kwenye utumbo, na uwezo wao wa kuishi kwa muda mfupi nje ya mwili inazifanya viumbe viashiria halisi kupima sampuli za mazingira kwa ukolezi wa kinyesi.<ref name="Feng_2002"></ref><ref name="Thompson">{{cite news |first=Andrea |last=Thompson |title=E. coli Thrives in Beach Sands |url=http://www.livescience.com/health/070604_beach_ecoli.html |work= |publisher=Live Science |date=2007-06-04 |accessdate=2007-12-03 }}</ref> Bakteria hii inaweza kukuzwa kwa urahisi na jeni yake ni rahisi na inaweza kufanywa kwa urahisi au kurudiwa kwa kupitia mchakato wa metajeni, na kuifanya moja ya viumbe vya prokarioti ambavyo mifano yao imetafitiwa sana, na aina muhimu katika teknolojia ya mimea na mikrobiolojia. ''E. koli'' iligunduliwa na daktari wa watoto na mtafiti wa bakteria Mjerumani Theodor Escherich katika 1885,<ref name="Feng_2002">{{cite web | author=Feng P, Weagant S, Grant, M | title=Enumeration of ''Escherichia coli'' and the Coliform Bacteria | work=Bacteriological Analytical Manual (8th ed.) | publisher=FDA/Center for Food Safety & Applied Nutrition | date=2002-09-01 | url=http://www.cfsan.fda.gov/~ebam/bam-4.html | accessdate=2007-01-25 | archiveurl=https://web.archive.org/web/20090519200935/http://www.cfsan.fda.gov/~ebam/bam-4.html | archivedate=2009-05-19 }}</ref> na kwa sasa imeainishwa kama sehemu ya familia ya Enterobacteriaceae ya gamma proteobacteria[[.]]<ref>{{cite web |url=http://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?mode=Tree&id=561&lvl=3&lin=f&keep=1&srchmode=1&unlock |title=''Escherichia'' |accessdate=2007-11-30 |last= |first= |coauthors= |date= |work=Taxonomy Browser |publisher=NCBI}}</ref> == Aina == [[File:Life cycle of Escherichia coli.png|thumb|right|Mfano wa mfululizo wa mpasuko jozi katika E. koli]] Aina ya ''E. koli'' ni kikundi kidogo ndani ya jamii hiyo ambacho kina sifa za kipekee ambazo zinaitofautisha kutokana aina nyingine za ''E.'' ''koli.'' Tofauti hizi mara nyingi huweza kuonekana tu katika ngazi ya Masi, hata hivyo, zinaweza kuleta mabadiliko katika fiziolojia au maisha ya bakteria hii. Kwa mfano, aina inaweza kupata uwezo kusababisha magonjwa, uwezo wa matumizi ya chanzo cha kipekee cha kaboni , uwezo wa kupambana na shubaka fulani ya kimazingira au uwezo wa kupinga mawakala wa kumaliza mikrobu. Aina mbalimbali za ''E. koli'' mara nyingi hutegemea kimelea, na kuifanya rahisi kujua chanzo cha Ukolezi wa kinyesi katika sampuli ya mazingira.<ref name="Feng_2002"></ref><ref name="Thompson"></ref> Kwa mfano, kujua aina ya ''E.'' ''koli'' iliopo katika sampuli ya maji inaruhusu kufanya uamuzi kuhusu asili ya ukolezi kama umetoka kutoka kwa binadamu, [[mamalia]] mwingine au [[Ndege (mnyama)|ndege.]] Aina mpya za ''E. koli'' hufuka kwa njia ya mchakato wa asili wa kibiolojia na kupitia mabadiliko ya jeni na kupitia uhamisho wa upande<ref> Lawrence, JG na Ochman, H. (1998) Akiolojia ya Masi ya ''jenomu'' ya ''Esicherichia koli'' Proc. Natl. Acad. Sci. USA 95:9413-9417 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC21352/?tool=pubmed PMC21352]</ref>. Baadhi ya aina huendeleza sifa ambazo zinaweza kudhuru mnyama kimelea. Aina hizi zenye madhara kawaida husababisha wimbi la kuhara ambayo ni kero katika watu wazima na mara nyingi ni hatari kwa afya ya watoto katika nchi zinazoendelea duniani. <ref name="Nataro">{{cite journal |author=Nataro JP, Kaper JB |title=Diarrheagenic Escherichia coli |url=https://archive.org/details/sim_clinical-microbiology-reviews_1998-01_11_1/page/142 |journal=Clin. Microbiol. Rev. |volume=11 |issue=1 |pages=142–201 |year=1998 |month=Januari |pmid=9457432 |pmc=121379}}</ref> Aina hatari zaidi, kama vile [[Escherichia coli O157:H7|O157: H7]] husababisha ugonjwa mkubwa ugonjwa au kifo kwa wazee, wachanga sana au wenye kinga dhoofu.<ref name="Hudault"/><ref name="Nataro"></ref> == Biolojia na biokemia == ''E. koli'' ni Gramu-hasi, enerobu zinazozalisha ATP na zisizozalisha vijimbegu. Seli kwa kawaida huwa na umbo la fimbo na zina ukubwa wa karibu 2 [[Mikromita]]2 (μm) na kipenyo cha 0.5 μm , kwa kiasi cha kiini cha 0.6-0.7 μm ^3.<ref>{{cite journal |author=Kubitschek HE |title=Cell volume increase in Escherichia coli after shifts to richer media |journal=J. Bacteriol. |volume=172 |issue=1 |pages=94–101 |date=1 Januari 1990|pmid=2403552 |pmc=208405 |url=http://jb.asm.org/cgi/pmidlookup?view=long&pmid=2403552 }}</ref> Inaweza kuishi kwa aina mbalimbali ya nyenzo. ''E. koli'' inatumia kugandisha mchanganyiko-asidi katika hali anaerobiki, inayozalisha lakteti, susineti, ethanoli, asetati na [[Dioksidi kabonia|kaboni dioksidi.]] Kwa vile njia nyingi katika kugandisha asidi-mchanganyiko huzalisha gesi ya [[Hidrojeni|hidrojeni]], hizi njia uhitaji viwango vya hidrojeni kuwa chini, kama ilivyo wakati ''E. koli'' inapoishi pamoja naviumbe vinavyotumnia hidrojeni kama vile methanojeni au bakteria zinazopunguza salfeti.<ref>{{cite book | title=Brock Biology of microorganisms| author=Madigan MT, Martinko JM| year=2006| publisher=Pearson| isbn=0-13-196893-9| edition=11th}}</ref> Ukuaji wa juu wa ''E. koli'' hutokea katika kiwango cha joto cha 37 ° C (98.6 ° F) lakini aina nyingine za maabara zinaweza kuongezeka kwa joto la juu ya 49 ° C (120.2 ° F).<ref>{{cite journal |author=Fotadar U, Zaveloff P, Terracio L |title=Growth of Escherichia coli at elevated temperatures |journal=J. Basic Microbiol. |volume=45 |issue=5 |pages=403–4 |year=2005 |pmid=16187264 | doi = 10.1002/jobm.200410542 }}</ref> Ukuaji inaweza kuendeshwa na kupumua anaerobiki au aerobiki, kwa kutumia aina kubwa ya jozi redoksi, ikiwa ni pamoja na uoksidisha wa asidi piruvati, asidi fomi, [[hidrojeni]] na asidi amino, na kupunguza nyenzo kama vile [[Oksijeni|oksijeni]], nitrati, dimethili salfoksidi na trimethilamini oksidi-N.<ref name="Ingledew">{{cite journal |author=Ingledew WJ, Poole RK |title=The respiratory chains of Escherichia coli |journal=Microbiol. Rev. |volume=48 |issue=3 |pages=222&ndash;71 |year=1984 |pmid=6387427 |pmc=373010}}</ref> Aina ambazo zina flajela zinaweza kuogelea na ni sogezi. flajela zina utaratibu wa viungo vya pembeni.<ref>[36] ^ Darnton NC, Turner L, Rojevsky S, Berg HC, Kuhusu msongonyo katika Esicherichia koli ya kuogelea. J Bacteriol. 2007 Machi, 189 (5) :1756-64. Epub 2006 22 Desemba.</ref> ''E. koli'' na bacteria zinazohusiana humiliki uwezo wa kuhamisha [[DNA]] kupitia bakteria za muungano, uhamisho wa DNA kutoka kwa seli ya bakteria hadi nyingine au mabadiliko, ambayo inaruhusu nyenzo za kijenetiki kueneza kiupande kwa jamii iliyopo. Utaratibu huu ulisababisha kuenea kwa mwandiko wa jeni wa sumu shiga kutoka ''Shigella'' hadi [[E. coli O157:H7]] , inayoenezwa kwa kilabakteria.<ref>{{cite journal |author=Brüssow H, Canchaya C, Hardt WD |title=Phages and the evolution of bacterial pathogens: from genomic rearrangements to lysogenic conversion |journal=Microbiol. Mol. Biol. Rev. |volume=68 |issue=3 |pagesteuhqw89-ty389q=560–602 |year=2004 |month=Septemba |pmid=15353570 |pmc=515249 |doi=10.1128/MMBR.68.3.560-602.2004 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=15353570 |pages=560–602}}</ref> == Wajibu kama mikrobiota ya kawaida == ''E. koli'' kwa kawaida humiliki njia ya utumbo wa mtoto mchanga ndani ya masaa 40 baada ya kuzaliwa, huwasili kwa chakula au maji au kupitia kwa watu wanaombeba mtoto. Katika utumbo, hushikamana na kamasi ya utumbo mkubwa. Ni enerobu ya msingi ya kutengeneza ATP katika njia ya utumbo <ref name="Todar"></ref>wa binadamu. (Enerobu za kuzalisha ATP ni viumbe ambavyo vinaweza kukua katika uwepo au bila uwepo wa oksijeni.) Bora tu bakteria zisipate vipengele vya kijenetiki vya kusababisha madhara, hizo hazisababishi madhara.<ref name="Evans"></ref> === Matumizi ya kimatibabu ya ''E. ''koli'' '' isiyosababisha magonjwa === Aina ya ''Esicherichia koli'' ya Nissle 1917 pia ijulikanayo kama Mutaflor hutumika kama hamira katika dawa, hasa kwa ajili ya kutibu magonjwa mbalimbali ya njia ya utumbo, <ref>{{Rejea jarida | last1 = Grozdanov | first1 = L | last2 = Raasch | first2 = C | last3 = Schulze | first3 = J | last4 = Sonnenborn | first4 = U | last5 = Gottschalk | first5 = G | last6 = Hacker | first6 = J | last7 = Dobrindt | first7 = U | title = Analysis of the genome structure of the nonpathogenic probiotic Escherichia coli strain Nissle 1917. | journal = J Bacteriol | volume = 186 | issue = 16 | pages = 5432–41 | month= Agosti| year = 2004 | doi = 10.1128/JB.186.16.5432-5441.2004 | pmid = 15292145 | author2 = Raasch | author3 = Schulze | author4 = Sonnenborn | author5 = Gottschalk | author6 = Hacker | author7 = Dobrindt | pmc = 490877 }}</ref> ikiwa ni pamoja na ugonjwa wa uvimbe wa tumbo.<ref>{{Rejea jarida | last1 = Kamada | first1 = N | last2 = Inoue | first2 = N | last3 = Hisamatsu | first3 = T | last4 = Okamoto | first4 = S | last5 = Matsuoka | first5 = K | last6 = Sato | first6 = T | last7 = Chinen | first7 = H | last8 = Hong | first8 = KS | last9 = Yamada | first9 = T | title = Nonpathogenic Escherichia coli strain Nissle1917 prevents murine acute and chronic colitis. | journal = Inflamm Bowel Dis | volume = 11 | issue = 5 | pages = 455–63 | month = Mei | year = 2005 | doi = 10.1097/01.MIB.0000158158.55955.de| pmid = 15867585 | author2 = Inoue | author3 = Hisamatsu | author4 = Okamoto | author5 = Matsuoka | author6 = Sato | author7 = Chinen | author8 = Hong | author9 = Yamada }}</ref> == Wajibu katika ugonjwa == Aina zenye madhara za ''E. koli'' zinaweza kusababisha gastroenteritisi, maambukizi ya njia ya mkojo, na [[Meningitis|ugonjwa wa uvimbe wa tando za uti wa mgongo na ubongo]] katika mwezi wa kwanza wa utotoni. Katika kesi adimu, aina zenye madhara husababisha ugonjwa wa haemoliti uremiki (HUS), peritonitisi, mastitisi, septikemia na kichomi cha Gramu-hasi.<ref name="Todar"></ref> === Maambukizi ya Utumbo === [[File:E coli at 10000x, original.jpg|thumb|right|250px|Mikrografu ya kielektroni ya joto la chini ya nguzo za bakteria za E. koli, akasifiwa mara 10,000. Bakteria moja ni silinda ya mviringo.]] Baadhi ya aina za ''E. koli,'' kama vile [[Escherichia coli O157:H7|O157: H7]], O121 na [[Escherichia coli O104:H21|O104: H21]], huzalisha sumu zinazoweza kuwa hatari. Sumu ya chakula inayotokana na ''E. koli'' husababishwa na kula mboga amabzo hazikuoshwa au nyama ambayo haikupikwa vizuri. O157: H7 pia ina sifa mbaya ya kusababisha athari kubwa na hata kusababisha matatizo yenye kutishia maisha kama vile ugonjwa wa hemoliti-uremiki (HUS). Aina hii inahusishwa na mkurupuko wa 2006 wa ''E. coli'' huko [[Marekani]] kutokana na mchicha mbichi. Ukali wa ugonjwa unatofautiana mno, hivyo unaweza kuwa mbaya, hasa kwa watoto wadogo, wazee au walio na upungufu wa kinga, lakini ni mara nyingi si kali. Awali, njia zisizozingatia usafi katika kuandaa nyama nchini Uskoti kuliwaua watu saba mwaka 1996 kutokana na sumu ya ''E. koli'' , na kuacha mamia zaidi wakiwa wameambukizwa. ''E. koli'' inaweza kuhifadhi enterotoksini zisizoathiriwa na joto na zinazoathiriwa na joto. Hiyo ya mwisho, huitwa LT, ina sehemu moja A na tano za B zilizopangwa katika holotoksini moja, na ni sawa sana katika umbo na utendajikazi na sumu ya [[Kipindupindu|kipindupindu.]] Sehemu za B husaidia katika kushikilia na kuingia kwa sumu ndani ya seli za matumbo ya kimelea, wakati sehemu ya A hupasuliwa na kuzuia seli kufonyonza maji, na kusababisha kuhara. LT ni huzalishwa na njia ya uzalisha ya Aina ya 2.<ref>{{cite journal |author=Tauschek M, Gorrell R, Robins-Browne RM, |title=Identification of a protein secretory pathway for the secretion of heat-labile enterotoxin by an enterotoxigenic strain of Escherichia coli | journal=PNAS | volume=99 |pages=7066–71 | url=http://www.pnas.org/cgi/content/abstract/99/10/7066 | pmid = 12011463 | doi = 10.1073/pnas.092152899 }}</ref> Iwapo bakteria za ''E. koli'' zitatoka kwenye njia ya utumbo kupitia utoboaji (kwa mfano kutoka kwa kidonda, na kiambatanisho kilichopasuka, au kutokana na makosa ya upasuaji a) na kuingia katika tumbo, kawaida husababisha peritonitisi ambayo inaweza kuwa hatari isipotibiwa haraka. Hata hivyo, ''E. koli'' ni nyeti sana kwa Antibiotiki kama vile streptomisini au gentamisini. Hii inaweza kubadilika kwani, kama ilivyobainishwa awali, ''E. koli'' hupata upinzani kwa dawa haraka.<ref name="SciDaily_2001">{{cite web | title=Gene Sequence Of Deadly E. Coli Reveals Surprisingly Dynamic Genome | publisher=Science Daily | url=http://www.sciencedaily.com/releases/2001/01/010125082330.htm | date=2001-01-25 | accessdate=2007-02-08}}</ref> Utafiti wa karibuni unaonyesha kwamba matibabu ya antibiotiki hayaboreshi matokeo ya ugonjwa huo, na yanaweza kuongeza pakubwa uwezekano wa kuugua ugonjwa wa haemolitiki uraemiki.<ref>{{cite journal |author=Wong CS, Jelacic S, Habeeb RL, et al. |title= The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections.| journal=N Engl J Med | volume=342 | issue=26 |pages=1930–6| pmid =10874060| date=29 Juni 2000}}</ref> Mukosa ya matumbo inayohusishwa na ''E. koli'' huonekana kwa idadi iliongezeka katika uvimbe wa tumbo ugonjwa, na ugonjwa wa Crohn na colitis ya vidonda.<ref name="Rolhion">{{cite journal |author=Rolhion N, Darfeuille-Michaud A |title=Adherent-invasive Escherichia coli in inflammatory bowel disease |journal=Inflamm. Bowel Dis. |volume=13 |issue=10 |pages=1277–83 |year=2007 |pmid=17476674 |doi=10.1002/ibd.20176}}</ref> Aina za kuingilia za ''E. koli'' huwepo kwa idadi kubwa katika tishu zilizovimba, na idadi ya bakteria katika sehemu zilizofura zinawiana na ukali wa kuvimba tumbo.<ref name="Baumgart">{{cite journal |author=Baumgart M, Dogan B, Rishniw M, ''et al.'' |title=Culture independent analysis of ileal mucosa reveals a selective increase in invasive Escherichia coli of novel phylogeny relative to depletion of Clostridiales in Crohn's disease involving the ileum |journal=ISME J |volume=1 |issue=5 |pages=403–18 |year=2007 |pmid=18043660 |doi=10.1038/ismej.2007.52}}</ref> ====Sifa hatari==== ''E. koli'' za matumbo (EC) huanishwa kwa misingi ya sifa za majimaji ya damu na tabia za uhatari.<ref name="Todar">{{cite web |url=http://www.textbookofbacteriology.net/e.coli.html |title=Pathogenic ''E. coli'' |accessdate=2007-11-30 |last=Todar |first=K. |coauthors= |date= |work=Online Textbook of Bacteriology |publisher=University of Wisconsin–Madison Department of Bacteriology |archive-date=2018-07-29 |archive-url=https://web.archive.org/web/20180729144111/http://www.textbookofbacteriology.net/e.coli.html |url-status=dead }}</ref> Virotaipu ni pamoja na: {| class="wikitable" |- ! Jina ! Vimelea ! Maelezo |- | ''E. koli'' '''Enterotoksijeniki ''' (ETEC) | chanzo cha kuhara (bila homa) kwa binadamu, nguruwe, kondoo, mbuzi, ng'ombe, mbwa, farasi | ETEC hutumia vinato vya fimbriali (vichomozi kutoka eneo la kiini cha bakteria ) kufunga seli za enterosaiti katika utumbo mdogo. ETEC unaweza kuzalisha enterotoksini mbili zenye [[Protini|protini:]]aina za ETEC haziingilii, na hazitoki kwenye lumeni ya matumbo. ETEC ni sababu ya bakteria inayoongoza ya kuhara kwa watoto katika nchi zinazoendelea duniani, na pia ni chanzo kikuu cha kuharisha kwa msafiri. Kila mwaka, ETEC husababisha milioni 200 kesi zaidi ya kuhara na vifo 380,000, wengi wao wakiwa watoto katika nchi zinazoendelea. <ref>[http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index4.html Shirika la Afya Duniani.] {{Wayback|url=http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index4.html |date=20120515142857 }}[http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index4.html Enterotoksijeniki ''Esicherichia koli'' (ETEC).] {{Wayback|url=http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index4.html |date=20120515142857 }}</ref> * protini kubwa kwa hizi mbili, ''' enterotoksini ya LT,''' ni sawa na sumu ya kipindupindu kimuundo na utendajikazi. |- | ''E. koli'' '''Enteropathojeniki ''' (EPEC) | Sababu ya kuhara kwa binadamu, sungura, mbwa, paka na farasi | Kama ETEC, EPEC pia husababisha kuhara, lakini utaratibu wa Masi wa ukoloni na etiolojia ni tofauti. EPEC hukosa fimbriae, na sumu ya ST na LT, lakini hutumia kinatisha kinachojulikana kama intimini kufunga seli za matumbo. Virotaipu hii ina mpangilio wa vipengele hatari ambazo ni sawa na zile zinazopatikana katika ''Shigela,'' na zinazweza kuwa na sumu shiga. Kunata kwa mukosa ya matumbo husababisha ya kupangwa tena kwa aktini katika seli kimelea, inayosababisha kulemaa sana. Seli za EPEC huvamia kwa kiasi (yaani hizo huingia katika seli kimelea) na kusababisha athari ya uvimbe Mabadiliko katika muundo wa msingi wa seli za matumbo kutokana na "kunatisha na kufutilia mbali" kunaweza kuwa sababu kuu ya kuhara kwa wale walioathiriwa na EPEC. |- | ''E. koli'' '''Vamizi ''' (EIEC) | hupatikana tu kwa binadamu | maambukizi ya EIEC husababisha ugonjwa unaofanana na Shigelosisi, na kuhara sana na homa kali. |- | ''E. koli'' ya '''Kuharisha damu ''' (EHEC) | hupatikana kwa binadamu, mifugo, na mbuzi | Mwanachama maarufu sana kwa virotaipu hii ni aina ya [[O157:H7]] , ambayo husababisha kuhara damu na haina homa. EHEC inaweza kusababisha ugonjwa hemolaiti-uremiki na kufeli ghafla kwa figo. Inatumia fimbriae ya kibakteria kwa kunata (pilusi ya kawaida ya E. koli , ECP), <ref>{{cite journal |last=Rendón |first=M. A. |authorlink= |coauthors=''et al.'' |year=2007 |title=Commensal and pathogenic ''Escherichia coli'' use a common pilus adherence factor for epithelial cell colonization |journal=[[Proceedings of the National Academy of Sciences|PNAS]] |volume=104 |issue=25 |pages=10637–42 |doi=10.1073/pnas.0704104104 |url=https://archive.org/details/sim_proceedings-of-the-national-academy-of-sciences-usa_2007-06-19_104_25/page/10637|accessdate= |quote= |pmid=17563352 |pmc=1890562 }}</ref> huvamia kwa kiasi na ina sumu ya shiga ambayo inaweza kusababisha uvimbe wenye uchungu mwingi. |- | '''''E. koli'' Ya kukusanya ''' (EAEC) | hupatikana tu kwa binadamu | Imeitwa hivyo kwa sababu ina fimbriae ambazo hukusanya seli za tishu, EAEC hunata kwenye mukosa ya matumbo na kusababisha kuhara majimaji bila homa. EAEC si vamizi. Hizo huzalisha hemolaisini na enterotoksini ya ST sawa na ile ya ETEC. |} ==== Epidemolojia ya maambukizi ya utumbo ==== Kusambaa kwa ''E.'' ''koli'' inayosababisha magonjwa mara nyingi hutokea kwa kinyesi kuingia mdomoni.<ref name="Evans">{{cite web |url=http://www.gsbs.utmb.edu/microbook/ch025.htm |title=Escherichia Coli |accessdate=2007-12-02 |last=Evans Jr. |first=Doyle J. |coauthors=Dolores G. Evans |date= |work=Medical Microbiology, 4th edition |publisher=The University of Texas Medical Branch at Galveston |archive-date=2007-11-02 |archive-url=https://web.archive.org/web/20071102062813/http://www.gsbs.utmb.edu/microbook/ch025.htm |url-status=dead }}</ref><ref name="haccp">{{cite web |url=http://www.cfsan.fda.gov/~dms/hret2-a3.html |title=Retail Establishments; Annex 3 - Hazard Analysis |accessdate=2007-12-02 |last= |first= |coauthors= |month=Aprili |year=2006 |work=Managing Food Safety: A Manual for the Voluntary Use of HACCP Principles for Operators of Food Service and Retail Establishments |publisher=U.S. Department of Health and Human Services Food and Drug Administration Center for Food Safety and Applied Nutrition |archiveurl=https://web.archive.org/web/20070607221204/http://www.cfsan.fda.gov/~dms/hret2-a3.html |archivedate=2007-06-07 }}</ref><ref>{{cite journal |last=Gehlbach |first=S.H. |coauthors=J.N. MacCormack, B.M. Drake, W.V. Thompson |year=1973 |month=Aprili |title=Spread of disease by fecal-oral route in day nurseries |journal=Health Service Reports |volume=88 |issue=4 |pages=320–322 |pmid=4574421 |url= |quote= |pmc=1616047 }}</ref> Njia za kawaida za kusambaa ni pamoja na: maandalizi ya chakula yasiyozingatia usafi,<ref name="haccp"></ref>Ukolezi wa shamba kutokana na kuwekwa mbolea,<ref name="spinach">{{cite news |author=Sabin Russell |coauthors= |title=Spinach E. coli linked to cattle; Manure on pasture had same strain as bacteria in outbreak |url=http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2006/10/13/MNG71LOT711.DTL |publisher=San Francisco Chronicle |id= |date= 13 Oktoba 2006 |accessdate=2007-12-02 }}</ref> umwagiliaji maji wa mazao kwa maji taka kutoka bafu au jikoni yaliyosibikwa au maji taka yenye kinyesi, nguruwe mwitu katika nchi za kilimo,<ref name="DeGregori">{{cite web |author=Thomas R. DeGregori |date=2007-08-17 |url=http://www.cgfi.org/cgficommentary/maddening-media-misinformation-on-biotech-and-industrial-agriculture-part-5-of-5 |title=CGFI: Maddening Media Misinformation on Biotech and Industrial Agriculture |accessdate=2007-12-08 |format= |work= |archiveurl=https://web.archive.org/web/20071013030645/http://www.cgfi.org/cgficommentary/maddening-media-misinformation-on-biotech-and-industrial-agriculture-part-5-of-5 |archivedate=2007-10-13 }}</ref> au matumizi ya moja kwa moja ya maji-taka yaliyosibikwa.<ref>{{cite journal |last=Chalmers |first=R.M. |coauthors=H. Aird, F.J. Bolton |year=2000 |title=Waterborne ''Escherichia coli'' O157 |journal=Society for Applied Microbiology Symposium Series |volume= |issue=29 |pages=124S–132S |pmid=10880187}}</ref> Ng'ombe wa maziwa na nyama ni hifadhi ya msingi ya ''E. koli'' O157: H7,<ref name="bach"></ref> na wanaweza kuibeba bila dalili na kuimwaga katika vinyesi vyao. Bidhaa za chakula zinazohusiana na kuzuka kwa ''E. koli'' ni pamoja na nyama mbichi,<ref>{{cite book |last=Institute of Medicine of the National Academies |first= |authorlink= |coauthors= |editor= |others= |title=''Escherichia coli'' O157:H7 in Ground Beef: Review of a Draft Risk Assessment |url=http://www.nap.edu/catalog.php?record_id=10528 |edition= |series= |year=2002 |publisher=The National Academies Press |location=Washington, D.C. |isbn=0-309-08627-2 |pages= |chapter= |chapterurl= |quote= |author=Committee on the Review of the USDA E. coli O157:H7 Farm-to-Table Process Risk Assessment, Board on Health Promotion and Disease Prevention Food and Nutrition Board, Institute of Medicine of the National Academies. }}</ref> mbegu ghafi zinazootesha au mchicha,<ref name="spinach"></ref> maziwa ghafi, juisi ambayo haijaondolewa vijidudu, siagi ambayo haijaondolewa vijidudu na vyakula vilivyosibikwa na wafanyakazi wa chakula kupitia njia ya kinyesi na mdomo.<ref name="haccp"></ref> Kwa mujibu wa Tawala za Marekani za Chakula na Dawa ,mzunguko wa njia ya kinyesi na mdomo wa usambazaji unaweza kukatizwa kwa kupika vyakula vizuri, kuzuia kusabikiwa, kuanzisha vikwazo kama vile glavu za mipira kwa wafanyakazi wa vyakula, kuanzisha sera za huduma ya afya ili wafanyakazi wa sekta ya chakula kutafuta matibabu wakati wao ni wagonjwa, kuondoa vijidudu kwa maziwa au juisi na mahitaji halisi ya kuosha mkono.<ref name="haccp"></ref> ''E. koli zinazozalisha sumu ya '' Shiga (STEC), hasa serotaipu O157: H7, pia husambazwa na nzi,<ref>{{cite journal |author=Szalanski A, Owens C, McKay T, Steelman C |title=Detection of ''Campylobacter'' and ''Escherichia coli'' O157:H7 from filth flies by polymerase chain reaction |journal=Med Vet Entomol |volume=18 |issue=3 |pages=241–6 |year=2004 |url=http://doi.org/10.1111/j.0269-283X.2004.00502.x | pmid = 15347391 | doi = 10.1111/j.0269-283X.2004.00502.x }}</ref><ref>{{cite journal |author=Sela S, Nestel D, Pinto R, Nemny-Lavy E, Bar-Joseph M |title=Mediterranean fruit fly as a potential vector of bacterial pathogens |url=https://archive.org/details/sim_applied-and-environmental-microbiology_2005-07_71_7/page/4052 |journal=Appl Environ Microbiol |volume=71 |issue=7 |pages=4052–6 |year=2005 |pmid = 16000820 | doi = 10.1128/AEM.71.7.4052-4056.2005 }}</ref><ref>{{cite journal |author=Alam M, Zurek L |title=Association of ''Escherichia coli'' O157:H7 with houseflies on a cattle farm |url=https://archive.org/details/sim_applied-and-environmental-microbiology_2004-12_70_12/page/7578 |journal=Appl Environ Microbiol |volume=70 |issue=12 |pages=7578–80 |year=2004 |pmid=15574966 | doi = 10.1128/AEM.70.12.7578-7580.2004 }}</ref> na pia kugusana moja kwa moja na wanyama wa shambani,<ref>{{cite journal |last=Rahn |first=K. |coauthors=S.A. Renwick, R.P. Johnson, J.B. Wilson, R.C. Clarke, D. Alves, S.A. McEwen, H. Lior, J. Spika |title=Follow-up study of verocytotoxigenic Escherichia coli infection in dairy farm families |url=https://archive.org/details/sim_journal-of-infectious-diseases_1998-04_177_4/page/1139 |journal=Journal of Infectious Disease |volume=177 |issue=4 |pages=1139–1140 |year=1998 |month=Aprili |pmid=9535003 |doi=10.1086/517394}}</ref><ref>{{cite journal |last=Trevena |first=W.B. |coauthors=G.A Willshaw, T. Cheasty, G. Domingue, C. Wray |title=Transmission of Vero cytotoxin producing ''Escherichia coli'' O157 infection from farm animals to humans in Cornwall and west Devon |journal=Community Disease and Public Health |volume=2 |issue=4 |pages=263–268 |year=1999 |month=Desemba |pmid=10598383}}</ref> kuwagusa wanyama wa pori waliofugwa,<ref>{{cite journal |last=Heuvelink |first=A.E. |coauthors=C. van Heerwaarden, J.T. Zwartkruis-Nahuis, R. van Oosterom, K. Edink, Y.T. van Duynhoven and E. de Boer |title=''Escherichia coli'' O157 infection associated with a petting zoo |url=https://archive.org/details/sim_epidemiology-and-infection_2002-10_129_2/page/n62 |journal=Epidemiology and Infection |volume=129 |issue=2 |pages=295–302 |year=2002 |month=Oktoba |pmid=12403105 | doi = 10.1017/S095026880200732X }}</ref> na chembechembe zinazopeperuka hewani zinazopatikana katika mazingira ya ufugaji wanyama.<ref>{{cite journal |last=Varma |first=J.K. |coauthors=K.D. Greene, M.E. Reller, S.M. DeLong, J. Trottier, S.F. Nowicki, M. DiOrio, E.M. Koch, T.L. Bannerman, S.T. York, M.A. Lambert-Fair, J.G. Wells, P.S. Mead |title=An outbreak of ''Escherichia coli'' O157 infection following exposure to a contaminated building |url=https://archive.org/details/sim_jama_2003-11-26_290_20/page/n82 |journal=JAMA |volume=290 |issue=20 |pages=2709–2712 |year=2003 |month=26 Novemba |pmid=14645313 | doi = 10.1001/jama.290.20.2709 }}</ref> === Maambukizi ya njia ya mkojo === [[File:E choli Gram.JPG|thumb|200px|Bakteria ya E. koli, viumbe wenye gramu-hasi wanaopatikana kwa wingi sana katika utumbo <ref> [100] </ref>.]] ''E. koli'' ya Uropathojeniki (UPEC) huwa chanzo cha takriban 90% ya maambukizi ya njia ya mkojo (UTI) kuonekanako katika watu wenye maumbile ya kawaida.<ref name="Todar"></ref> Katika ''maambukizi yanayoongezeka,'' bakteria ya kinyesi hutawala yurethra na kuenea kwenda juu kwa njia ya mkojo na kibofu cha mkojo na vilevile mafigo (kusababisha athari ya kuvimba kwa mafigo na fupanyonga lake),<ref>{{cite journal |author=Nicolle LE |title=Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis |url=https://archive.org/details/sim_urologic-clinics-of-north-america_2008-02_35_1/page/n14 |journal=Urol. Clin. North Am. |volume=35 |issue=1 |pages=1–12, v |year=2008 |month=Februari |pmid=18061019 |doi=10.1016/j.ucl.2007.09.004}}</ref> au tezi kibofu katika wanaume. Kwa sababu wanawake wana yurethra fupi kuliko wanaume, wao wana uwezekano mara 14 zaidi kuugua kutokana na kupanda kwa UTI.<ref name="Todar"></ref> Uropathojeniki za ''E. koli'' hutumia fimbriae P (kuvimba kwa mafigo na fupanyonga lake inayohusiana na pili) ili [[wikt:bind|kufunga]] seli za endotheli za njia ya mkojo na kutawala kibofu cha mkojo. [[wikt:adhesin|Vinata]] hivi hufunga D-galaktosi-D-galaktosi [[wiktionary:moiety|ya kundi tendakazi la molekuli]] kwenye kundi P la antijeni ya damu ya erythrosaiti na seli uroepitheli.<ref name="Todar"></ref> Takriban 1% ya binadamu hawana hukosa vipokezi hivi, na uwepo au ukosefu wake huamua uwezekano wa mtu kuathiriwa na ''E.'' ''koli'' ya njia ya mkojo. Uropathojeniki za ''E. koli'' huzalisha hemolaisini za alpha na beta, hiyo husababisha lisisi ya seli za njia ya mkojo. UPEC inaweza kuepuka kinga ya ndani ya mwili (kwa mfano mfumo wa kusaidia) kwa kuvamia mwavuli wa juu juu wa seli na kuunda jamii ya bakteria ndani ya seli(IBC s).<ref>{{cite journal |author=Justice S, Hunstad D, Seed P, Hultgren S |title=Filamentation by Escherichia coli subverts innate defenses during urinary tract infection |url=https://archive.org/details/sim_proceedings-of-the-national-academy-of-sciences-usa_2006-12-26_103_52/page/19884 |journal=Proc Natl Acad Sci U S A |volume=103 |issue=52 |pages=19884–9 |year=2006 |pmid=17172451 | doi = 10.1073/pnas.0606329104 }}</ref> Hizo pia zina uwezo wa kuunda antijeni K, polisakaraidi zenye umbo la kapsuli ambazo huchangia ukuaji wa viumbe vinavyokuwa vimeshikamana. ''E. koli'' zinazozalisha viumbe vinavyokuwa vimeshikamana ni kinzani kwa vipengele vya kinga na tiba ya [[Antibaotiki|antibiotiki]] na mara nyingi huwa chanzo cha maambukizi sugu ya njia ya mkojo.<ref>{{cite journal |author=Ehrlich G, Hu F, Shen K, Stoodley P, Post J |title=Bacterial plurality as a general mechanism driving persistence in chronic infections |journal=Clin Orthop Relat Res |volume= |issue=437 |pages=20–4 |year=2005 |month=Agosti |pmid=16056021 |pmc=1351326 | doi = 10.1073/pnas.0606329104 }}</ref> Maambukizi ya ''E.'' ''koli'' yanayozalisha antijeni-K kwa kawaida hupatikana katika sehemu ya juu ya njia ya mkojo.<ref name="Todar"></ref> ''Maambukizi yanayoshuka,'' ingawa kwa kiasi ni nadra, hutokea wakati seli za ''E. koli'' huingia katika viungo vya juu vya njia ya mkojo ([[Figo|figo]], kibofu cha mkojo au ureta) kutoka mkondo wa damu. ===Ugonjwa wa uvimbe wa tando za uti wa mgongo na ubongo wa utotoni=== Huzalishwa na serotaipu ya ''Esicherichia koli'' ambayo ina antijeni ya kikapsuli iitwayo K1. Ukoloni wa matumbo ya mtoto mchanga kwa mashina haya, ambayo yako katika uke wa mama, husababisha bakteriemia, ambayo inapelekea kwa [[Meningitis|ugonjwa uvimbe wa tando za uti wa mgongo na ubongo.]] Na kwa sababu ya kukosekana kwa kingamwili ya IgM kutoka kwa mama (hizi hazivuki kondo kwa sababu FcRn husimamia uhamisho wa IgG), pamoja na kuwa mwili hutambua antijeni K1 kama yake, kwa kuwa inafanana na serebali ya glikopeptidi, hii husababisha ugonjwa mkali wa uvimbe wa tando za uti wa mgongo na ubongo katika watoto wachanga. == Uaguzi wa kimaabara == Katika sampuli za kinyesi masomo ya hadumini huonyesha fimbo za Gramu hasi, bila mpango maalum wa seli. Kisha, aidha agari MacConkey au agari EMB (au zote) inachanjwa kwa kinyesi. Katika agari MacConkey, makoloni nyekundu ya kina huzalishwa kwa kiumbe kina laktosi, na kuchachishwa kwa sukari hii husababisha [[Thamani pH|pH]] ya chombo kushuka, na hivyo kusababisha chombo kuwa giza. Ukuaji katika agari Levini EMB hutoa koloni nyeusi na mngaro wa kimetali wa rangi ya nyeusi-kijani. Huu niutambuzi wa ''E. koli.'' Kiumbe pia kina laisini, na hukua kwa TSI iliyopinda kwa mtazamo wa (A / A / g + / H ₂S-). Pia, IMViC ni + + - kwa ''E. koli,'' kama ni 2}indoli yake chanya (pete nyekundu) na methili nyekundu chanya (nyekundu angavu), lakini VP hasi (hakuna mabadiliko-haina rangi) na sitreti hasi (rangi ya kijani-hakuna mabadiliko). Vipimo vya uzalishaji wa sumu viaweza kutumia seli za mamalia katika tishu, ambazo huuawa haraka kwa sumu shiga. Ingawa inaathirika kwa urahisi sana na ni maalum sana, utaratibu huu ni wa polepole na wa gharama kubwa. Utambuzi wa kawaida umefanyika kwa kukuza viini kwa chombo cha sobitoli cha MacConkey kisha kutumia antiserumu ya kuandika. Hata hivyo, mipira ya kuchanganua kiasi cha dutu na baadhi antiserumu za kuandika umeonyesha athari za kuvuka na koloni zisizo za E koli O157. Aidha, si aina zote za E. coli O157 zinazohusiana na HUS ni vichachishaji vya sobitoli. Baraza la Jimbo na Wanaepidemiolojia wa Wamaeneo walipendekeza kwamba maabara ya kliniki angalau yapime vinyesi vyote vyenye damu kwa uwepo wa pathojeni hii. Chama cha Marekani cha Msingi wa Magonjwa ya Njia ya Tumbo(AGAF) kilipendekeza katika Julai 1994 kuwa sampuli zote za kinyesi zipimwe mara kwa mara kwa uwepo wa E. koli O157: H7.{{Citation needed|date=Novemba 2008}} Inapendekezwa kwamba Tabibu awasiliane na idara ya hali ya afya zao au na Kituo cha Kudhibiti Ugonjwa na Kuzuia kuamua sampuli ambazo ni lazima zipimwe na kama matokeo yanafaa kuripotiwa. Njia nyingine za kuchunguza ''E.'' ''koli'' O157 kwenye kinyesi ni pamoja na vipimo vya ELISA, koloni ya vipimo vya kupima protini, masomo ya moja kwa moja ya hadumini ya imunofloresensi ya vichungi, pamoja na mbinu za kutenga viumbe maalum kwa kutumia shanga za kisumaku.<ref>{{cite journal |author=De Boer E, Heuvelink AE |title=Methods for the detection and isolation of Shiga toxin-producing Escherichia coli |journal=Symp Ser Soc Appl Microbiol |volume= |issue=29 |pages=133S–143S |year=2000 |pmid=10880188}}</ref> Changanuzi hizi zimekusudiwa kama chombo kuruhusu uchunguzi wa haraka kwa ajili ya kupima uwepo wa ''E. koli'' O157 bila ya kukuza viini kwanza kwa sampuli hiyo ya kinyesi. == Tiba ya Antibiotiki na upinzani == {{Main|Antibiotic resistance}} Maambukizi ya bakteria kwa kawaida hutibiwa kwa [[Antibaotiki|antibiotiki]] Hata hivyo kiwango cha kuathiriwa na antibiotiki cha aina mbalimbali za ''E. koli'' kinatofautiana sana. Kama viumbe vya Gramu-hasi, ''E. koli'' ni stahimilivu kwa antibiotiki nyingi ambazo hufanyakazi dhidi ya Gramu-chanya. Antibiotiki ambazo zinaweza kutumika kutibu maambukizi ya ''E.'' ''koli'' ni pamoja na amoksilini pamoja na penisilini nyingine zilizosanisiwa nusu, sefalosporini nyingi, kabapenemi, aztreonami, trimethoprim-sulfamethoksazoli, ciprofloksasini, nitrofurantoini na aminoglaikosidi. Kustahimili Antibiotiki ni tatizo linalokua. Baadhi ya hii inatokana na kutumika sana kwa antibiotiki na binadamu, lakini baadhi yake pengine ni kutokana na matumizi ya antibiotiki kama viendelezi ukuaji wa chakula cha wanyama.<ref name="Johnson_2006">{{cite journal |author=Johnson J, Kuskowski M, Menard M, Gajewski A, Xercavins M, Garau J |title=Similarity between human and chicken Escherichia coli isolates in relation to ciprofloxacin resistance status |journal=J Infect Dis |volume=194 |issue=1 |pages=71–8 |year=2006 |url=http://www.journals.uchicago.edu/JID/journal/issues/v194n1/35787/35787.html | pmid=16741884 | doi = 10.1086/504921 }}</ref> Utafiti uliochapishwa katika jarida la ''Sayansi'' katika Agosti 2007 ulipata kuwa kiwango cha mabadiliko katika ''E. koli'' ni "juu ya mara 10 ^-5 kwa kila jenomu kwa kizazi, ambayo ni mara 1000 zaidi ya makadirio ya awali," matokeo ambayo yanaweza kuwa na maana kwa ajili ya utafiti na uthibiti wa ustahimilivu kwa antibiotiki wa bakteria.<ref>{{cite web | url=http://www.sciencemag.org/cgi/content/abstract/317/5839/813?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=isabel+gordo&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT|title= Adaptive Mutations in Bacteria: High Rate and Small Effects|publisher=Science Magazine|date=10 Agosti 2007|accessdate=10 Septemba 2007}}</ref> ''E. koli'' inayostahimili Antibiotiki pia inaweza kupitisha jeni zinazosababisha ustahimilivu kwa antibiotiki kwenda kwa aina nyingine ya bakteria, kama vile ''Stafilokokasi aureasi,'' kupitia mchakato uitwao uhamisho wa upande wa jeni . ''E. koli'' mara nyingi hubeba plasmidi zinazostahimili madawa mengi na uzihamisha kwa urahisi iwapo ina shinikizo kwenda kwa aina nyingine. Hakika, ''E. koli'' ni mwanachama wa mara kwa mara wa jamii ya viumbe ambapo aina nyingi za bakteria huishi kwa karibu karibu. Mchanganyiko huu wa aina unaruhusu aina za ''E.'' ''koli'' ambazo zimefunikwa na pili ili kukubali na kuhamisha plasmidi kutoka na kwenda kwa bakteria zingine. Hivyo ''E. koli'' na enterobakteria nyingine ni hifadhi muhimu ya ustahimilivu wa antibiotiki unaoweza kuhamishwa.<ref>{{cite journal |author=Salyers AA, Gupta A, Wang Y |title=Human intestinal bacteria as reservoirs for antibiotic resistance genes |url=https://archive.org/details/sim_trends-in-microbiology_2004-09_12_9/page/412 |journal=Trends Microbiol. |volume=12 |issue=9 |pages=412–6 |year=2004 |pmid=15337162 | doi = 10.1016/j.tim.2004.07.004 }}</ref> === Aina ya laktamisi beta === Ustahimilivu kwa antibiotiki laktamu beta umekuwa tatizo hasa katika miongo ya hivi karibuni, kama aina ya bakteria ambazo huzalisha laktamasi beta zimekuwa za kawaida zaidi.<ref>{{cite journal |author=Paterson DL, Bonomo RA |title=Extended-spectrum beta-lactamases: a clinical update |journal=Clin. Microbiol. Rev. |volume=18 |issue=4 |pages=657–86 |year=2005 |pmid=16223952 |pmc=1265908 |doi=10.1128/CMR.18.4.657-686.2005 }}</ref> Vimeng'enya hivi vya laktamsi beta hufanya penisilini sefalosporini nyingi, kuwa tiba isiyofanya kazi. Laktamasi beta za wigo uliopanuliwa zinazozalisha ''E. koli'' ni stahimilivu sana kwa aina nyingi ya antibiotiki na maambukizi ya aina hizi ni magumu kutibu. Katika matukio mengi, mbili tu ya antibiotiki simulizi na kiasi kidogo sana cha antibiotiki za ndani ya mishipa bado zina ufanisi. Katika 2009, jeni iitwayo New Delhi metallo-beta-lactamasi (kwa kifupi NDM-1) ambayo inatoa ustahimilivu kwa antibiotiki kabapenemu ya ndani ya mifupa, ziligunduliwa katika [[Uhindi|India]] na [[Pakistan]] katika bakteria za ''E. koli'' . Kuongezeka kwa wasiwasi kuhusu maambukizi ya aina hii ya "bakteria hatari" [[Ufalme wa Muungano|nchini]] Uingereza kumesababisha wito wa ufuatiliaji zaidi na mkakati wa Uingereza nzima wa kukabiliana na maambukizi na vifo.<ref>{{cite web |title= HPA Press Statement: Infections caused by ESBL-producing E. coli |url= http://www.hpa.org.uk/hpa/news/articles/press_releases/2007/070924_esbl.htm |accessdate= 2010-11-30 |archiveurl= https://web.archive.org/web/20110717232443/http://www.hpa.org.uk/hpa/news/articles/press_releases/2007/070924_esbl.htm |archivedate= 2011-07-17 }}</ref> Vipimo vya uwezekano wa kuathiriwa vinafaa kuongoza tiba katika magonjwa yote ambayo viumbe vinaweza kutengwa kwa ajili ya kukuza viini. == Tiba ya feji == Tiba ya bakteriafeji virusi ambavyo hasa vinalenga baketria ya kipathojeni imekuwa ikiendelezwa kwa zaidi ya miaka 80 iliyopita, hasa katika [[Umoja wa Kisovyeti|Urusi]] ya zamani, ambapo ilitumika kuzuia kuhara kulikosababishwa na ''E. koli.'' <ref>{{cite web|url=http://www.iitd.pan.wroc.pl/phages/phages.html|title=Therapeutic use of bacteriophages in bacterial infections|publisher=Polish Academy of Sciences|accessdate=2010-11-30|archiveurl=https://web.archive.org/web/20060208092017/http://www.iitd.pan.wroc.pl/phages/phages.html|archivedate=2006-02-08}}</ref> Hivi sasa, tiba ya kilabakteria kwa binadamu inapatikana tu katika Kituo cha Tiba ya kilabakteria katika Jamhuri ya Jeojia na [[Polandi]].<ref>{{cite web|url=http://www.phagetherapycenter.com/pii/PatientServlet?command=static_conditions&language=0|title=Medical conditions treated with phage therapy|publisher=Phage Therapy Center}}</ref> Hata hivyo, tarehe 2 Januari 2007, shirika la Marekani la FDA lilitoa kibali kwa Omnilytics kutumia Tiba yake ya kilabakteria ya kuua''E.'' ''koli'' O157: H7 katika ukungu, kinyunyizio au safisha ya wanyama hai watakaochinjwa kwa ajili ya matumizi ya binadamu.<ref>{{cite web|url=http://home.businesswire.com/portal/site/google/index.jsp?ndmViewId=news_view&newsId=20070102005459&newsLang=en|title=OmniLytics Announces USDA/FSIS Approval for Bacteriophage Treatment of ''E. coli'' O157:H7 on Livestock|publisher=OmniLytics|accessdate=2010-11-30|archiveurl=https://web.archive.org/web/20070930035711/http://home.businesswire.com/portal/site/google/index.jsp?ndmViewId=news_view&newsId=20070102005459&newsLang=en|archivedate=2007-09-30}}</ref> Bakteriafeji T4 ni feji iliyotafitiwa sana kwa malengo ya kuambukiza E. koli. == Chanjo == Watafiti wamefanya juhudi kuendeleza chanjo yenye usalama, na ufanisi wa kupunguza matukio ya maambukizi duniani kote ya ''E. koli'' .<ref name="Girard_2006">{{cite journal |author=Girard M, Steele D, Chaignat C, Kieny M |title=A review of vaccine research and development: human enteric infections |journal=Vaccine |volume=24 |issue=15 |pages=2732–50 |year=2006 |pmid=16483695 | doi = 10.1016/j.vaccine.2005.10.014 }}</ref> Katika Machi 2006, chanjo iliyosababisha jibu la kinga dhidi ya ''E. koli'' O157: H7 O-maalum polisakaraidi ilo unganishwa tena kwa eksotoksini ''Pseudomonas aeruginosa'' (O157-rEPA) iliripotiwa kuwa salama kwa watoto wa umri wa miaka miwili hadi mitano. Kazi ya awali ilikuwa tayari imeonyesha kuwa ni salama kwa watu wazima.<ref name="Ahmed_2006">{{cite journal |author=Ahmed A, Li J, Shiloach Y, Robbins J, Szu S |title=Safety and immunogenicity of ''Escherichia coli'' O157 O-specific polysaccharide conjugate vaccine in 2-5-year-old children |url=https://archive.org/details/sim_journal-of-infectious-diseases_2006-02-15_193_4/page/n48 |journal=J Infect Dis |volume=193 |issue=4 |pages=515–21 |year=2006 |pmid=16425130 | doi = 10.1086/499821 }}</ref> Awamu ya III ya majaribio ya kimatibabu ya kuthibitisha ufanisi kwa kiwango kikubwa wa matibabu imepangwa.<ref name="Ahmed_2006"></ref> Katika 2006 Afya ya Wanyama ya Fort Dodge (Wyeth) ilianzisha chanjo madhubuti ya virusi visoukali ili kudhibiti aisakulitisi na peritonitisi katika kuku. Chanjo hii ni chanjo nasaba isosumu ambayo imethibitisha kinga dhidi ya O78 na aina zisizoweza kupigwa chapa .<ref name="Watt poultry.com_2008">{{Rejea tovuti |url=http://www.wattpoultry.com/PoultryInternational/Article.aspx?id=22434%2F |title=Nakala iliyohifadhiwa |accessdate=2021-01-16 |archiveurl=https://web.archive.org/web/20090108174255/http://www.wattpoultry.com/PoultryInternational/Article.aspx?id=22434%2F |archivedate=2009-01-08 }}</ref> Katika Januari 2007 kampuni ya Kanada Madawa, Bioniche ilitangaza kuwa imetengeneza chanjo ya mifugo ambayo inapunguza idadi ya O157: H7 inayomwaga katika mbolea kwa mara 1000, hadi karibu bakteria pathojeni 1000 kwa kila gramu ya mbolea.<ref name="Pearson_2007">{{cite journal |author=Pearson H |title=The dark side of ''E. coli'' |url=https://archive.org/details/sim_nature-uk_2007-01-04_445_7123/page/n22 |journal=Nature |volume=445 |issue=7123 |pages=8–9 |year=2007 |pmid=17203031 | doi = 10.1038/445008a}}</ref><ref name="CanadaAM_2007">{{cite web | title=New cattle vaccine controls ''E. coli'' infections | work=Canada AM | url=http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070111/ecoli_vaccine_cattle_070111/20070111?hub=CanadaAM | date=2007-01-11 | accessdate=2007-02-08 | archivedate=2007-01-13 | archiveurl=https://web.archive.org/web/20070113092506/http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070111/ecoli_vaccine_cattle_070111/20070111?hub=CanadaAM | =https://web.archive.org/web/20070113092506/http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070111/ecoli_vaccine_cattle_070111/20070111?hub=CanadaAM }} {{Wayback|url=http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070111/ecoli_vaccine_cattle_070111/20070111?hub=CanadaAM |date=20070113092506 }}</ref><ref name="BionichePR_2007">{{cite press release | title = Canadian Research Collaboration Produces World's First Food Safety Vaccine: Against ''E. coli'' O157:H7 | publisher = Bioniche Life Sciences Inc. | date = 2007-01-10 | url = http://www.cnxmarketlink.com/en/releases/archive/January2007/10/c4698.html | accessdate = 2007-02-08 | archivedate = 2007-10-11 | archiveurl = https://web.archive.org/web/20071011103738/http://cnxmarketlink.com/en/releases/archive/January2007/10/c4698.html | deadurl = yes }}</ref> Katika Aprili 2009 mtafiti wa Chuo Kikuu cha Jimbo la Michigan alitangaza kwamba ameanzisha chanjo inayofanya kazi kwa aina ya ''E. koli.'' Mahdi Saeed, profesa wa Epidemolojia na maradhi ya kuambukiza katika vyuo vya MSU vya Tiba Wanyama na Dawa za Binadamu, ametuma maombi kwa ajili ya hataza kwa ugunduzi wake na amefanya mawasiliano na makampuni ya dawa kwa ajili ya uzalishaji wa kibiashara.<ref> http://www.physorg.com/news158951048.html</ref> == Wajibu katika bioteknolojia == Kwa sababu ya historia yake ndefu ya utamaduni wa maabara na urahisi wa kushughulikiwa, ''E. koli'' pia ina jukumu muhimu katika uhandisi wa kibiolojia wa kisasa na mikrobiolojia ya kiviwanda.<ref name="lee1996">{{cite journal |author=Lee SY |title=High cell-density culture of Escherichia coli |url=https://archive.org/details/trends-in-biotechnology_1996-03_14_3/page/98 |journal=Trends Biotechnol. |volume=14 |issue=3 |pages=98–105 |year=1996 |pmid=8867291 |doi=10.1016/0167-7799(96)80930-9}}</ref> Kazi ya Stanley Cohen Norman na Herbert Boyer katika ''E. koli,'' kwa kutumia plasmidi na vimeng'enya vya kuzuia kuunda DNA inayoshikana tena, ikawa msingi wa bioteknolojia.<ref name="birth">{{cite journal |author=Russo E |title=The birth of biotechnology |journal=Nature |volume=421 |issue=6921 |pages=456–7 |year=2003 |month=Januari |pmid=12540923 |doi=10.1038/nj6921-456a |url=http://www.nature.com/nature/journal/v421/n6921/full/nj6921-456a.html}}</ref> Hufikiriwa kuwa kimelea chenye uwezo mkubwa sana kwa ajili ya uzalishaji wa [[protini]] heterologu,<ref name="Cornelis"></ref> watafiti wanaweza kujumuisha jeni katika vijiumbe maradhi kwa kutumia plasmidi, kuruhusu uzalishaji kwa wingi wa protini katika mchakato uchachishaji wa kiviwanda. Mifumo ya maumbile pia imeendelezwa ambayo inaruhusu uzalishaji wa protini inayoweza kuunganishwa tena kwa kutumia ''E. koli.'' Moja ya matumizi muhimu ya kwanza ya teknolojia ya DNA inayoweza kuungana tena ilikuwa kughilibiwa kwa ''E. koli'' kuzalisha insulini binadamu.<ref>{{cite web |url=http://www.littletree.com.au/dna.htm |title=Recombinant DNA Technology in the Synthesis of Human Insulin |accessdate=2007-11-30 |last=Tof |first=Ilanit |coauthors= |year=1994 |work= |publisher=Little Tree Pty. Ltd.}}</ref> ''E. koli'' zilizobadilishwa zimetumika katika maendelezo ya chanjo, kutumia viumbe kurejesha mazingira ya awali, na uzalishaji wa[[Kimeng'enya| vimeng'enya]] visivyoweza kusonga.<ref name="Cornelis">{{cite journal |author=Cornelis P |title=Expressing genes in different Escherichia coli compartments |journal=Curr. Opin. Biotechnol. |volume=11 |issue=5 |pages=450–4 |year=2000 |pmid=11024362 |doi=10.1016/S0958-1669(00)00131-2}}</ref> Hata hivyo,''E. koli'' haiwezi, kutumika kuzalisha baadhi ya protini tata kubwa zaidi, ambazo zina bondi za disulfidi nyingi na, hasa, thiol zisizopacha, au protini zinazohitaji pia kubadilishwa baada ya kutafsiriwa kimuundo kwa ajili ya utendajikazi.<ref name="lee1996"></ref> Tafiti pia zinafanywa katika kuweka programu katika ''E. koli'' ili labda iweze kutatua matatizo ya hisabati magumu kama vile tatizo la njia la Hamilton. == Ubora wa Mazingira == Bakteria za ''E. koli'' kwa kawaida zimekuwa zikipatikana katika maji ya burudani na uwepo wao hutumika kuashiria uwepo wa kuhasibika kwa kinyesi kwa hivi karibuni, lakini uwepo wa ''E. koli'' inaweza kosa kuwa dalili ya kinyesi cha binadamu. ''E. koli'' ni mkadhania katika wanyama wote wasioathiriwa na joto: ndege na mamalia. Bakteria ya ''E. koli'' pia zimepatikana katika [http://www.d.umn.edu/~rhicks/lab/Hansen%20et%20al%202008%20JGLR%2034.pdf samaki] na kasa. [http://pubs.acs.org/doi/pdf/10.1021/es0623156?cookieSet=1 Mchanga] na [http://www.d.umn.edu/~rhicks/lab/Ishii%20et%20al%202006%20AEM%2072.pdf udongo] pia huifadhi bakteria ya ''E.'' ''koli'' na baadhi ya aina za ''E. koli'' ambazo [http://www.d.umn.edu/~rhicks/lab/Ksoll%20et%20al%202007%20AEM%2073.pdf asilishwa] . Baadhi ya maeneo ya kijiografia yanaweza kusaidia aina za kipekee za ''E. koli'' na kinyume, baadhi aina za ''E.'' ''koli'' zina asili tofauti[http://www.d.umn.edu/~rhicks/lab/Hansen%20et%20al%202009%20AEM%2075(6).pdf ]. == Viumbe Mifano == ''E. koli'' mara nyingi hutumika kama viumbe mfano katika masomo ya mikrobiolojia. Aina zilizokuzwa (km ''E. koli'' K12) zinaishi vizuri katika mazingira ya maabara, na, tofauti na aina zisizokuzwa, zimepoteza uwezo wao wa kustawi katika utumbo. Aina nyingi za maabara hupoteza uwezo wao wa kuunda muungano wa seli tofauti.<ref>{{cite journal |author=Fux CA, Shirtliff M, Stoodley P, Costerton JW |title=Can laboratory reference strains mirror "real-world" pathogenesis? |url=https://archive.org/details/sim_trends-in-microbiology_2005-02_13_2/page/58 |journal=Trends Microbiol. |volume=13 |issue=2 |pages=58–63 |year=2005 |pmid=15680764 |doi=10.1016/j.tim.2004.11.001}}</ref><ref>{{cite journal |author=Vidal O, Longin R, Prigent-Combaret C, Dorel C, Hooreman M, Lejeune P |title=Isolation of an Escherichia coli K-12 mutant strain able to form biofilms on inert surfaces: involvement of a new ompR allele that increases curli expression |url=https://archive.org/details/sim_journal-of-bacteriology_1998-05_180_9/page/2442 |journal=J. Bacteriol. |volume=180 |issue=9 |pages=2442–9 |year=1998 |pmid=9573197 |doi= |pmc=107187}}</ref> Maumbile haya hulinda aina zisizokuzwa kutokana na kingamwili na mashambulizi mengine ya kemikali, lakini uhitaji matumizi makubwa ya nishati na rasilimali. Katika 1946, [[Joshua Lederberg]] na Edward Tatum kwanza walielezea jambo lililojulikana kama kuunganisha bakteria kwa kutumia bakteria ya ''E. koli'' kama mfano,<ref>[164] ^ {{cite journal |last=Lederberg |first=Joshua |coauthors=E.L. Tatum |year=1946 |month=19 Oktoba |title=Gene recombination in E. coli |journal=Nature |volume=158 |issue= |pages=558 |id= |url=http://profiles.nlm.nih.gov/BB/G/A/S/Z/_/bbgasz.pdf |doi=10.1038/158558a0|format=PDF}} Chanzo: [http://profiles.nlm.nih.gov/BB/G/A/S/Z/ Maktaba ya Kitaifa ya Tiba - Machapisho ya Joshua Lederberg ]</ref> na inabakia kuwa mfano wa msingi wa kutafiti muungano.{{Citation needed|date=Desemba 2007}} ''E. koli'' ilikuwa ni sehemu muhimu ya majaribio ya kwanza ya kuelewa jenetiki za kilabakteria,<ref>{{cite web |url=http://www.cshl.edu/History/phagecourse.html |title=The Phage Course - Origins |accessdate=2007-12-03 |last= |first= |coauthors= |year=2006 |work= |publisher=Cold Spring Harbor Laboratory |archiveurl=https://web.archive.org/web/20020720094306/http://www.cshl.edu/History/phagecourse.html |archivedate=2002-07-20 }}</ref> na watafiti mapema, kama vile Seymour Benzer, alitumia ''E. koli'' na kilabakteria ya T4 kuelewa topografia ya muundo wa jeni.<ref>{{cite journal |last=Benzer |first=Seymour |coauthors= |year=1961 |month=Machi |title=On the topography of the genetic fine structure |journal=PNAS |volume=47 |issue=3 |pages=403–15 |pmc=221592 |doi=10.1073/pnas.47.3.403 }}</ref> Kabla ya utafiti wa Benzer, haikuwa inayojulikana kama jeni ilikuwa na utaratibu kimstari, au kama ulikuwa na muundo wa kimatawi. ''E. koli'' ilikuwa moja ya viumbe vya kwanza kuwa na jenomu iliyotaratibiwa; jenomu kamili ya ''E.'' ''koli'' K12 ilichapishwa na ''Sayansi'' katika 1997.<ref>{{cite journal |authors=Frederick R. Blattner, Guy Plunkett III, Craig Bloch, Nicole Perna, Valerie Burland, Monica Riley, Julio Collado-Vides, Jeremy Glasner, Christopher Rode, George Mayhew, Jason Gregor, Nelson Davis, Heather Kirkpatrick, Michael Goeden, Debra Rose, Bob Mau, Ying Shao|year=1997 |month=5 Septemba |title=The complete genome sequence of Escherichia coli K-12|journal=Science |volume=277 |issue=5331 |pages=1453–1462 |pmc=9278503 |doi=10.1126/science.277.5331.1453}}</ref> Majaribio ya muda mrefu ya mabadiliko kwa kutumia ''E. koli,'' yalianzishwa na Richard Lenski mwaka 1988, yameruhusu kushuhudiwa moja kwa moja kwa mabadiliko makubwa katika maabara.<ref>[172] ^ [http://www.newscientist.com/channel/life/dn14094-bacteria-make-major-evolutionary-shift-in-the-lab.html Bakteria zafanya mabadiliko makubwa katika maabara] ''Mwanasayansi Mpya'' </ref> Katika jaribio hili, moja ya idadi ya ''E. koli'' bila kutarajia ilitoa uwezo wa kumetaboli siterati kwa kutumia oksijeni. Uwezo huu ni nadra sana katika ''E. koli.'' Kwa kuwa kukosa uwezo na kukua kukiwepo oksijeni kwa kawaida hutumika kama njia ya kutofautisha ''E. koli'' kutokana nyingine, zinazohusiana kwa karibu sana kibakteria kama vile ''Salmonella,'' uvumbuzi huu unaweza kuashiria tukio la kipekee kuonekana katika maabara. Kwa kuchanganya nanoteknolojia na ikolojia ya kimazingira Mandhari ya mazingira magumu yanaweza kutolewa na maaelezo katika skeli ya nano.<ref>{{cite journal|author= Keymer J.E., P. Galajda, C. Muldoon R., and R. Austin|year=2006 |month=Novemba |title=Bacterial metapopulations in nanofabricated landscapes|url= https://archive.org/details/sim_proceedings-of-the-national-academy-of-sciences-usa_2006-11-14_103_46/page/17290|journal=PNAS |volume=103 |issue=46 |pages= 17290–295 |pmc= |doi=10.1073/pnas.0607971103 }}</ref> Kwa mazingira sanisi kama haya majaribio ya mabadiliko kwa kutumia ''E. koli'' yamefanywa ili kutafiti biofizikia ya kukabiliana na hali katika kisiwa cha biojiografia kwenye . == Tazama Pia == * [[Escherichia coli O157:H7]] * Majaribio ya mageuzi ya muda mrefu ya ''E. koli'' * Kanuni za Kimataifa za majina ya Bakteria * Mfumo wa T4 ''rII'' * uchambuzi wa bakteria ya maji * Bakteria kolifomu * Kudhibiti ukolezi * Sumu ya chakula * Kolifomu ya kinyesi * uzalishaji wa gesi kutoka glukosi na E. koli [http://www.tgw1916.net/movies2.html maonyesho ya video] {{Wayback|url=http://www.tgw1916.net/movies2.html |date=20121124075912 }} == Marejeo == {{Marejeo|2}} == Sehemu nyingine == {{wikispecies}} {{Commons category|Escherichia coli}} ;Jumla * [http://redpoll.pharmacy.ualberta.ca/CCDB/cgi-bin/STAT_NEW.cgi Takwimu za ''E. koli'' ] {{Wayback|url=http://redpoll.pharmacy.ualberta.ca/CCDB/cgi-bin/STAT_NEW.cgi |date=20060717052111 }} * [http://www.fda.gov/oc/opacom/hottopics/spinach.html Mchicha na kuzuka kwa ''E. koli'' - Marekani FDA] * [http://www.cdc.gov/foodborne/ecolispinach/ ''E. koli'' kuzuka Kutokana na Mchicha bichi - Marekani CDC] * [http://www.micron.ac.uk/organisms/eco.html Utafiti wa sasa kuhusu ''Escherichia coli'' katika Norwich Research Park] * [http://www.microbeid.com/Media/mac_img.html Picha ya E. koli katika Agari ya MacConkey ] {{Wayback|url=http://www.microbeid.com/Media/mac_img.html |date=20100528080703 }} ;Hifadhidata * [http://www.ecosal.org/ EcoSal] rasilimali ya mtandao ambayo daima inafanywa kulingana na uchapishaji wa jadi wa ASM Press ''Esicherichia koli'' ''na Salmonella: seli na Masi ya Biolojia'' * [http://www.genome.wisc.edu/sequencing/upec.htm Uropathojeniki Esicherichia koli (UPEC)] * [http://www.casper.organ.su.se/ECODAB/ ECODAB] muundo wa O-Antigeni ambayo inaunda msingi ya Uainishaji wa seroloji wa ''E. koli'' *[http://2dbase.techfak.uni-bielefeld.de/cgi-bin/2d/2d.cgi 2DBase] {{Wayback|url=http://2dbase.techfak.uni-bielefeld.de/cgi-bin/2d/2d.cgi |date=20110511112533 }} 2D-PAGE hifadhidata ya Esicherichia koli Chuo Kikuu cha Bielefeld - Fermentation Engineering Group (AGFT) *[http://biobases.ibch.poznan.pl/5SData/ Hifadhidata ya 5S rRNA] Habari juu ya Utaratibu wa nukleotidi ya rRNAs 5S na jeni zao *[http://aclame.ulb.ac.be/ ACLAME] {{Wayback|url=http://aclame.ulb.ac.be/ |date=20110706132209 }} Ainisho ya Vipengele vya maumbile yanayohamahama *[http://arep.med.harvard.edu/ecoli_matrices/ AlignACE] Makalibu ambayo hutafuta maeneo ya ziada ya kujishikilia katika mlolongo wa jenomu ya E. koli *[http://www.ebi.ac.uk/microarray-as/ae/ ArrayExpress] Hifadhidata ya majaribio ya jenomu zinazofanya kazi *[Https: / / asap.ahabs.wisc.edu / ASAP / home.php ASAP] habari kamili ya jenomu kuhusu bakteria kadhaa enteriki kwa vidokezo vya jamii *[http://www.compsysbio.org/bacteriome/ Bacteriome] {{Wayback|url=http://www.compsysbio.org/bacteriome/ |date=20101126112431 }} Sehemu za kunatisha za DNA ya ''E. koli'' iliyotumika kwa Jenomu kamilifu ya ''E.'' ''koli K-12 '' *[http://biogps.gnf.org/#goto=welcome BioGPS] {{Wayback|url=http://biogps.gnf.org/#goto=welcome |date=20091230141946 }} kitovu cha jeni *[http://www.brenda-enzymes.info/ Brenda] Mfumo wa habari kaili juu ya vimeng'enya *[http://sgen.bri.nrc.ca/brimsg/bsgi.html BSGI] {{Wayback|url=http://sgen.bri.nrc.ca/brimsg/bsgi.html |date=20110706190822 }} uanzilishi wa muundo wa jenomu ya bakteria *[http://www.cathdb.info/ CATH]Ainisho ya Muundo wa protini *[http://www.cbs.dtu.dk/services/GenomeAtlas/ CBS Kitabu cha ramani ya Jenomu ] {{Webarchive|url=http://arquivo.pt/wayback/20160516135600/http://www.cbs.dtu.dk/services/GenomeAtlas |date=2016-05-16 }} *[http://www.ncbi.nlm.nih.gov/Structure/cdd/cdd.shtml CDD] Hifadhidata ya hifadhi ya miliki *[http://cibex.nig.ac.jp/index.jsp CIBEX] {{Wayback|url=http://cibex.nig.ac.jp/index.jsp |date=20100302194313 }} Kituo cha Hifadhidata ya Habari ya Biolojia ya Kujieleza kwa Jeni *[http://www.ncbi.nlm.nih.gov/COG/old/ COGS] *[http://cgsc.biology.yale.edu/index.php Kituo cha Hifadhi ya Maumbile ya Koli] {{Wayback|url=http://cgsc.biology.yale.edu/index.php |date=20100311130121 }} Aina na habari za maumbile ya ''E. koli'' K-12 *[http://xbase.bham.ac.uk/colibase/ coliBASE] {{Wayback|url=http://xbase.bham.ac.uk/colibase/ |date=20090620110902 }} *[http://ecolihub.org EcoliHub] {{Wayback|url=http://ecolihub.org/ |date=20101201013920 }} - unaofadhiliwa na NIH na rasilimali ya kina ya takwimu za ''E. koli'' K-12 na kilabakteria yake, plasmidi, na vipengele vya maumbile yanayobadilikabadilika *[http://ecoliwiki.net EcoliWiki] {{Wayback|url=http://ecoliwiki.net/ |date=20080828091310 }} ni sehemu ya jamii ya vidokezo ya [http://www.ecolihub.org EcoliHub] {{Wayback|url=http://www.ecolihub.org/ |date=20101201013920 }} {{Model Organisms}} {{Gram-negative proteobacterial diseases}} {{DEFAULTSORT:Escherichia Coli}} [[Category:bakteria]] 45xxpmfj3ygmyuoav3f4jlmi7s60syv 0 55745 1578088 1527735 2026-07-02T19:09:55Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578088 wikitext text/x-wiki '''Ufahamu wa uwezo wa kushika mimba''' (kwa [[Kiingereza]] "Fertility Awareness", kifupi FA) ni elimu inayohusu mbinu zinazotumika kutambua wakati [[mwanamke]] anapoweza kushika [[mimba]] na asipoweza kushika mimba katika mzunguko wa [[hedhi]]. Mbinu hizo zinaweza kutumika ili [[Uzazi wa mpango|kuzuia mimba]] isiyotarajiwa huku ikisaidia pia uwezekano wa kupata mimba iliyotarajiwa. Kadhalika hutumika kama njia ya kusimamia [[afya ya uzazi]] wa mwanamke. Mbinu kadhaa za kubaini siku ambazo mwanamke hawezi kupata mimba zinajulikana tangu zamani, lakini ujuzi wa ki[[sayansi]] uliopatikana katika [[karne ya 20]] umeongeza sana idadi na usahihi wa mbinu hizo. Kutoka mwaka [[1930]] hadi [[1980]], [[utafiti]] na ukuzaji wa uelewa huo wa masuala ya [[uzazi]] ulifanywa hasa na wataalamu wanaohusika na [[Kanisa Katoliki]] kwa lengo la kusaidia kupanga uzazi watu wa [[ndoa]] wanaokataa mbinu za [[teknolojia]] kwa msingi wa [[maadili]] au kwa kuzingatia ma[[dhara]] yake. Kimsingi, njia ya kwanza iliyo rasmi ya kuhesabu kalenda iliundwa mnamo mwaka 1930 na [[John Smulders]], daktari Mkatoliki kutoka [[Uholanzi]]. Kwa kiasi kikubwa mashirika yanayotafuta na kueneza ufahamu wa uwezo wa kushika mimba yanaendelea kuongozwa na Wakatoliki, lakini baadhi ya mashirika ya kawaida sasa yapo. Mbinu za ufahamu wa uwezo wa kushika mimba hutegemea uchunguzi wa mabadiliko ya ishara za msingi yanayoashiria uwezekano wa kutunga mimba (kama vile [[joto la mwili]], [[ute wa uke]], na [[mkao wa seviksi]]) kwa kufuatilia mzunguko wote wa hedhi na hivyo kubaini wakati ambapo inawezekana kushika mimba. Ishara nyingine pia zinaweza kuzingatiwa: hizo ni pamoja na ulaini wa ma[[titi]] na [[uchungu]] wakati [[kijiyai]] kinapoachiliwa, uchunguzi wa [[mkojo]] kwa vifaa vya kubashiri udondoshwaji wa vijiyai, na uchunguzi wa ki[[hadubini]] wa [[ute]] au [[ugiligili]] wa [[seviksi]] (yaani mlango wa kizazi). Isitoshe, ipo njia ya kufuatilia uwezo wa kushika mimba kwa [[tarakilishi]]. ==Istilahi== Mbinu zinazotegemea dalili zinafuatilia moja au zaidi kati ya ishara tatu za msingi za kuweza kutunga mimba - joto la msingi la mwili, ute wa uke na mkao wa seviksi.<ref name="tcoyf">{{cite book | first=Toni | last=Weschler | year=2002 | title=Taking Charge of Your Fertility | url=https://archive.org/details/takingchargeofyo00toni | pages=[https://archive.org/details/takingchargeofyo00toni/page/52 52] | edition=Revised | publisher=HarperCollins | location=New York | isbn=0-06-093764-5 }}</ref> Mbinu zinazotegemea ute wa uke tu ni pamoja na [[Mbinu ya Billings]] ya Kutambua Kijiyai Kuachiliwa, [http://www.familynfp.com The Ovulation Method] {{Wayback|url=http://www.familynfp.com/ |date=20180528084727 }}, [[Mbinu ya Creighton]], na [[Mbinu ya Siku Mbili]]. Mbinu za dalili ya joto la mwili hujumuisha pia uchunguzi wa joto la msingi la mwili (basal body temperature = BBT), ute wa uke, na wakati mwingine mkao wa seviksi. [[Mbinu zinazotegemea kalenda]] hufuatilia mzunguko wa hedhi ya mwanamke na kwa kuzingatia urefu wa mzunguko wake kutambua anapoweza kupata mimba. Mbinu maarufu zaidi kati ya hizo ni [[Mbinu ya Siku Sanifu]]. [[Mbinu ya Urari-Kalenda]] pia huhesabiwa njia ya kutegemea kalenda, ingawa haijafafanuliwa vizuri na ina maana nyingi tofauti kwa watu tofauti. Mbinu hizo za kupanga uzazi zinaweza kuitwa Mbinu za Uzazi Zinazotegemea Ufahamu (wa uwezo wa kuzaa), <ref name="who">{{Rejea jarida |title=Medical Eligibility Criteria for Contraceptive Use:Fertility awareness-based methods | version = Fourth edition |publisher=World Health Organization |year=2010 |url=http://www.who.int/reproductivehealth/publications/family_planning/9789241563888/en/index.html |accessdate=2012-12-11 }}</ref> Jina "Mbinu ya Uelewa wa Uzazi" (kwa Kiingereza Fertility Awareness Method = FAM) linatumika hasa kwa mfumo uliofundishwa na [[Toni Weschler]]. Jina "Mbinu Asili ya Uzazi wa Mpango" (kwa Kiingereza natural family planning = NFP) wakati mwingine hutumiwa kutaja mbinu yoyote inayotegemea Ufahamu wa Uzazi. Hata hivyo, msamiati huo ni mahsusi kuhusu mbinu zile zinazokubaliwa na Kanisa Katoliki: mbali ya uwezekano wa kutopata mimba wakati wa kunyonyesha (kwa Kiingereza Lactational amenorrhea method = LAM), ni kutofanya tendo la ndoa siku ambapo kuna uwezekano wa kupata mimba. Hapo mbinu za FA zinaweza kutumika ili kutambua nyakati hizo zinazoweza kuleta mimba. Wanawake ambao wananyonyesha na wanapenda kukwepa mimba wanaweza kutegemea kukatizwa kwa hedhi wakati wa kunyonyesha. Hiyo ni tofauti na ufahamu wa uzazi, lakini kwa sababu haihusishi vifaa wala kemikali, mara nyingi hutajwa pamoja na FA kama njia asili ya uzazi wa mpango. ==Historia== ===Ukuaji wa mbinu zinazotegemea kalenda=== Haijulikani kwa hakika lini iligunduliwa kwa mara ya kwanza kuwa wanawake wana vipindi vya kutunga mimba na visivyo vya kutunga mimba vinavyoweza kutabirika. Mwaka [[388]] [[Agostino wa Hippo]] aliandika kuhusu kuepuka mara kwa mara tendo la ndoa ili kuzuia mimba akiwalaumu [[Wamani]] kwa kutumia njia hiyo ili kubaki bila watoto.<ref name="augustine">{{cite book |last=Saint |first=Bishop of Hippo Augustine | authorlink = | coauthors = Philip Schaff (Editor) |title=A Select Library of the Nicene and Post-Nicene Fathers of the Christian Church, Volume IV |publisher=WM. B. Eerdmans Publishing Co. |year=1887 |location=Grand Rapids, MI |pages=[http://www.ccel.org/ccel/schaff/npnf104.iv.v.xx.html ''On the Morals of the Manichæans'', Chapter 18] }}</ref> Kitabu fulani kinasema kuacha ngono kwa muda kulipendekezwa na "watu wachache wasio wa dini tangu katikati ya karne ya 19",<ref name="wife">{{cite book | first=Marilyn | last=Yalom | year=2001 | title=A History of the Wife | url=https://archive.org/details/historyofwife2001yalo | edition=First | publisher=HarperCollins | location=New York | isbn=0-06-019338-7 |pages=[https://archive.org/details/historyofwife2001yalo/page/297 297]–8, 307}}</ref> lakini katika [[karne ya 20]] ushawishi mkuu uliohamasisha mbinu za ufahamu wa uwezo wa kushika mimba ulitoka katika Kanisa Katoliki. Mwaka [[1905]] [[Theodoor Hendrik van de Velde]], [[mwanajinakolojia]] wa [[Uholanzi]], alionyesha kuwa wanawake hutoa kijiyai mara moja tu kila mzunguko wa hedhi.<ref>{{cite web | title=A Brief History of Fertility Charting | work=FertilityFriend.com | url=http://www.fertilityfriend.com/Faqs/A_brief_history_of_fertility_charting.html | accessdate=2006-06-18}}</ref> [[Miaka ya 1920]] [[Kyusaku Ogino]], mwanajinakolojia wa [[Ujapani]], na [[Hermann Knaus]], kutoka [[Austria]], wakifanya kazi bila ushirikiano waligundua kwamba kijiyai hutokea siku kumi na nne hivi kabla ya kipindi cha hedhi kinachofuata.<ref name="singer">{{cite book | first=Katie | last=Singer | year=2004 | title=The Garden of Fertility | publisher=Avery, a member of Penguin Group (USA) | location=New York | isbn=1-58333-182-4 |pages=226–7}}</ref> Ogino alitumia uvumbuzi wake kutengeneza hesabu ya kuwasaidia wanawake wasiopata mimba kwa kufanya tendo la ndoa kwa wakati mwafaka kupata mimba. Mwaka [[1930]] [[John Smulders]], daktari Mkatoliki kutoka Uholanzi, alitumia uvumbuzi huo kuunda mbinu ya kuepuka mimba. Smulders alichapisha kazi yake chini ya Chama cha Matabibu Wakatoliki wa Uholanzi, na hiyo ilikuwa mbinu sanifu ya kwanza ya kuepuka mimba kwa kuacha kujamiiana kwa kipindi fulani - mbinu ya kalenda.<ref name="singer"></ref> ===Uanzilishi wa mbinu za dalili za joto na ute wa mlango wa uzazi=== Katika miaka ya 1930, [[Wilhelm Hillebrand]], [[padri]] Mkatoliki nchini [[Ujerumani]], alitunga mbinu ya kuzuia mimba kwa kutegemea joto la msingi la mwili.<ref name="puzzle">{{cite journal |last=Hays |first=Charlotte |title=Solving the Puzzle of Natural Family Planning |journal=Holy Spirit Interactive |url=http://www.holyspiritinteractive.net/features/prolife/article_05.asp |accessdate=2012-02-15 |archive-date=2017-12-12 |archive-url=https://web.archive.org/web/20171212031741/http://www.holyspiritinteractive.net/features/prolife/article_05.asp |dead-url=yes }}</ref> Mbinu hiyo ya joto ilionekana kuwa na ufanisi mkubwa zaidi katika kuwasaidia wanawake kuzuia mimba kuliko mbinu ya kutegemea kalenda. Katika miongo michache iliyofuata, mbinu hizo mbili zikawa zinatumika sana miongoni mwa wanawake Wakatoliki. Hotuba mbili zilizotolewa na [[Papa Pius XII]] mwaka [[1951]] zilitoa kibali cha hali ya juu kutoka Kanisa Katoliki kwa mbinu hizo kutumiwa na [[mume]] na [[mke]] waliohitaji kuzuia mimba.<ref name="wife"></ref><ref>[18] ^ ''Moral Questions Affecting Married Life:'' [http://www.ewtn.com/library/PAPALDOC/P511029.HTM Addresses given October 29, 1951 to the Italian Catholic Union of midwives] {{Wayback|url=http://www.ewtn.com/library/PAPALDOC/P511029.HTM |date=20101206084012 }} 26 Novemba 1951 to the National Congress of the Family Front and the Association of Large Families, National Catholic Welfare Conference, Washington, DC.</ref> Mwanzo mwa [[miaka ya 1950]], [[John Billings]] aligundua uhusiano kati ya ute wa mlango wa uzazi na uwezekano wa kutunga mimba alipokuwa akifanya kazi katika Shirika Katoliki la Ustawi wa Jamii mjini [[Melbourne]], [[Australia]]. Billings na madaktari wengine kadhaa, akiwemo mke wake [[Evelyn Billings|Evelyn]], walifanyia utafiti ishara hiyo kwa miaka kadhaa, na kufikia mwishoni mwa [[miaka ya 1960]] walikuwa wamefanya majaribio ya kitabibu na kuanzisha vituo vya kufundishia mbinu yao duniani kote.<ref>{{cite journal |last=Billings |first=John |authorlink=John Billings |title=THE QUEST&nbsp;— leading to the discovery of the Billings Ovulation Method |journal=Bulletin of Ovulation Method Research and Reference Centre of Australia |volume=29 |issue=1 |pages=18–28 |month=Machi |year=2002 |url=http://www.woomb.org/omrrca/bulletin/vol29/no1/thequest.shtml |accessdate=2007-03-18 |archive-date=2007-02-19 |archive-url=https://web.archive.org/web/20070219081722/http://www.woomb.org/omrrca/bulletin/vol29/no1/thequest.shtml |dead-url=yes }}</ref> ===Mashirika ya kwanza ya ufundishaji mbinu zilizozingatia dalili=== Japo awali akina Billings walifundisha pamoja mbinu za dalili ya joto na ya ute wa uke, walipata shida katika kufundisha ishara ya joto kwa idadi kubwa ya watu wasiojua kusoma na kuandika katika [[nchi zinazoendelea]]. Hivyo katika [[miaka ya 1970]] walibadilisha mbinu ili kutegemea ute tu.<ref name="puzzle"></ref> Taasisi ya kimataifa iliyoanzishwa na Billings sasa inajulikana kama "Shirika la Kimataifa la Mbinu ya Kudondosha Kijiyai ya Billings" (kwa Kiingereza World Organization Ovulation Method Billings = WOOMB). Shirika la kwanza kufundisha mbinu ya dalili za joto lilianzishwa mwaka [[1971]]. [[John na Sheila Kippley]], [[walei]] Wakatoliki, walijiunga na [[Konald Prem]] katika kufundisha mbinu iliyotegemea dalili zote tatu: joto, ute na mkao wa mlango wa uzazi. Taasisi yao sasa inaitwa "Shirika la Kimataifa la Wanandoa kwa Wanandoa" (kwa Kiingereza "Couple to Couple League International").<ref name="puzzle"></ref> [[Muongo]] uliofuata ulishuhudia kuanzishwa kwa mashirika mengine ya Kikatoliki ambayo sasa ni makubwa - "Familia ya Amerika" (kwa Kiingereza "Family of the Americas") iliyoundwa mwaka [[1977]] na kufundisha mbinu ya Billings,<ref>{{cite web |title=About us |work=Family of the Americas |year=2006 |url=http://www.familyplanning.net/main.php?parent_id=1&id_area=1 |accessdate=2007-03-18 |archivedate=2007-02-13 |archiveurl=https://web.archive.org/web/20070213070450/http://www.familyplanning.net/main.php?parent_id=1&id_area=1 }}</ref> halafu "Taasisi ya [[Papa Paulo VI]]" ([[1985]]), inayofundisha mbinu mpya ya ute pekee iitwayo Creighton Model.<ref>{{cite web |title=About the Institute |work=Pope Paul VI Institute |year=2006 |url=http://www.popepaulvi.com/about2.html |accessdate=2012-02-21 |archiveurl=https://web.archive.org/web/20120312012943/http://www.popepaulvi.com/about2.html |archivedate=2012-03-12 }}</ref> Hadi [[miaka ya 1980]], habari kuhusu ufahamu wa uwezo wa kushika mimba ulipatikana tu kutoka vyanzo vya Kikatoliki.<ref> Singer (2004), p.xxiii</ref> Shirika la kwanza lisilo la kidini la kutolea mafundisho hayo ya uzazi lilikuwa Kituo cha Uelewa wa Uzazi cha New York, lililoanzishwa mwaka [[1981]].<ref>{{cite web |title=About us |work=Fertility Awareness Center |year=2006 |url=http://www.fertaware.com/ |accessdate=2007-03-18 }}</ref> [[Toni Weschler]] alianza kufundisha mwaka [[1982]] na kuchapisha kitabu kilichouzwa sana cha ''Taking Charge of Your Fertility '' mwaka [[1995]].<ref> Weschler (2002)</ref> "Justisse" ilianzishwa mwaka [[1987]] huko [[Edmonton]], [[Kanada]].<ref>{{cite web |title=About Us |work=Justisse |year=2002 |url=http://www.justisse.ca/new/aboutUs.asp |accessdate=2007-03-18 |archiveurl=https://web.archive.org/web/20061116202933/http://www.justisse.ca/new/aboutUs.asp |archivedate=2006-11-16 }}</ref> Mashirika hayo yote yasiyo ya kidini yanafundisha mbinu ya dalili za joto. Ingawa mashirika ya Kikatoliki yanayoeneza uelewa wa uzazi ni makubwa sana kuliko hayo ya [[wanaharakati]] yasiyo ya kidini, walimu wasiotegemea dini wamezidi kuongezeka katika [[miaka ya 1990]] na [[milenia mpya]]. ===Maendeleo ya sasa=== Ustawi wa mbinu za ufahamu wa uwezo wa kushika mimba unaendelea. Mwishoni mwa miaka ya 1990, "Taasisi ya [[Afya ya Uzazi]]" katika [[Chuo Kikuu cha Georgetown]] ilianzisha mbinu mbili mpya.<ref>{{cite journal |author=Arévalo M, Jennings V, Sinai I |title=Efficacy of a new method of family planning: the Standard Days Method. |journal=Contraception |volume=65 |issue=5 |pages=333–8 |year=2002 |pmid=12057784 |url=http://pdf.dec.org/pdf_docs/PNACQ416.pdf |doi=10.1016/S0010-7824(02)00288-3 |format=PDF |access-date=2010-11-30 |archive-date=2019-09-07 |archive-url=https://web.archive.org/web/20190907012126/http://pdf.dec.org/pdf_docs/PNACQ416.pdf |dead-url=yes }}</ref><ref>{{cite journal |author=Jennings V, Sinai I |title=Further analysis of the theoretical effectiveness of the TwoDay method of family planning |url=https://archive.org/details/sim_contraception_2001-09_64_3/page/149 |journal=Contraception |volume=64 |issue=3 |pages=149–53 |year=2001 |pmid=11704093 | doi = 10.1016/S0010-7824(01)00251-7}}</ref> Mbinu ya Siku Mbili, inayotegemea ute tu, na [[CycleBeads]], ambayo inafuata mbinu ya Siku Sanifu na ina pia toleo la kieletroniki, iCycleBeads), zimeundwa ili kuwa na ufanisi na urahisi mkubwa zaidi katika kufundisha, kujifunza, na kutumia. ==Ishara za uwezo wa kushika mimba== Mizunguko mingi ya hedhi huwa na siku kadhaa za mwanzo ambapo mimba haiwezi kupatikana (muda wa kutoshika mimba kabla ya kudondosha kijiyai), halafu siku ambazo mimba inaweza kutungika, na kisha siku kadhaa tu kabla ya hedhi ambazo mimba haiwezi kutungika ( muda wa kutoshika mimba baada ya kijiyai kudondoshwa). Siku ya kwanza ya kuvuja damu inahesabiwa kuwa siku ya kwanza ya mzunguko wa hedhi. Mbinu mbalimbali za kufahamu uwezo wa kushika mimba huhesabu kwa njia tofauti kidogo kipindi ambapo kuna uwezekano wa kupata mimba, yaani hutumia ishara za msingi za uwezekano huo, historia ya mzunguko, au zote mbili. ===Ishara za msingi za kuweza kupata mimba=== Ishara tatu za msingi za uwezekano wa kushika mimba ni ''joto msingi la mwili'', ''ute wa uke'' na ''mkao wa seviksi.'' Mwanamke anayetumia dalili hizo ili kujua uwezo wake wa kupata mimba anachagua kutumia ishara moja, mbili, au zote tatu pamoja. Wanawake wengi hung'amua pia ishara nyingine za ziada kulingana na mzunguko wa hedhi, kama vile maumivu na uzito tumboni, maumivu mgongoni, ulaini wa matiti na maumivu ya kudondosha kijiyai. ===Joto la msingi la mwili=== '''Joto la msingi la mwili''' ni joto la mwili wa mtu linalopimwa wakati wa kwanza anapoamka asubuhi (au baada ya usingizi wa muda mrefu zaidi katika siku). Miongoni mwa wanawake, kudondoshwa kijiyai husababisha joto kupanda kwa 0.3°C hadi 0.9° C (0.5°F hadi 1.6°F) na kubakia hivyo kipindi chote hadi wakati wa hedhi ijayo. Mabadiliko hayo ya joto yanaweza kutumika kubaini mwanzo wa kipindi cha kutoweza kutungika mimba kabla ya kudodosha kijiyai. ===Ute wa uke=== [[File:cervical mucus1.jpg|thumb|125px|Ute wa uke]] Kuonekana kwa '''ute wa uke''' na [[mwasho]] wake ni ishara zinazoelezwa kwa kawaida pamoja kama njia za kubaini ishara hiyohiyo. Ute wa uke huzalishwa na seviksi, ambayo huunganisha [[mji wa mimba]] na [[mfereji wa uke]]. Ute wa uke wenye uwezo wa kushika mimba hukuza maisha ya manii kwa kupunguza [[uasidi]] wa uke, na husaidia kuongoza manii kupitia seviksi na kuelekea ndani ya mji wa mimba. Uzalishaji wa ute wa uke wenye uwezo wa kupata mimba husababishwa na [[homoni]] ileile ([[istrojeni]]) ambayo huandaa mwili wa mwanamke kwa [[udondoshwaji wa kijiyai]]. Kwa kuangalia ute wa uke wake, na kuzingatia hisia pindi unapopita ukeni, mwanamke anaweza kubaini wakati mwili wake unapojiandaa kudondosha kijiyai, na wakati ambapo udondoshwaji wa kijiyai umepita. Kijiyai kikidondoshwa, uzalishwaji wa istrojeni hupungua na [[projesteroni]] huanza kuongezeka. Kupanda kwa kiwango cha projesteroni husababisha mabadiliko maalumu katika wingi na hali ya ute wa uke.<ref>{{cite web | author=James B. Brown | title=Physiology of Ovulation | year=2005 | work=Ovarian Activity and Fertility and the Billings Ovulation Method | url=http://www.woomb.org/bom/science/physiology.html | publisher=Ovulation Method Research and Reference Centre of Australia | accessdate=2010-11-30 | archiveurl=https://web.archive.org/web/20051224031839/http://www.woomb.org/bom/science/physiology.html | archivedate=2005-12-24 }}</ref> ===Mkao wa seviksi=== Seviksi hubadilisha mkao kutokana na homoni zilezile zinazosababisha ute wa uke kutolewa na kukauka. Wakati mwanamke yuko katika awamu ya kutoshika mimba katika mzunguko wa hedhi, seviksi hushuka chini katika mfereji wa uke, ikiguswa huwa ngumu (kama [[ncha]] ya [[pua]] ya mtu), na [[upenyu]] (mlango wa seviksi) unakuwa mdogo ukilinganishwa na wakati mwingine, au umefungika. Kadiri mwanamke anavyozidi kuwa na uwezo wa kushika mimba ndivyo seviksi inavyopanda juu katika mfereji wa uke, inakuwa laini ikiguswa (kama [[mdomo]] wa mtu), na upenyu unakuwa wazi zaidi. Baada ya kudondoshwa kwa kijiyai, seviksi itarejea mkao wake wa wakati usio wa kushika mimba. ===Historia ya mzunguko=== Mbinu zinazotegemea kalenda hubainisha uwezekano wa kutopata mimba kabla na baada ya kudondosha kijiyai kulingana na historia ya mzunguko. Zinapotumika vizuri kuzuia mimba, mbinu hizo si madhubuti kama mbinu zinazotegemea dalili, hata hivyo umadhubuti wake unalingana na mbinu zuizi kama vile [[kiwambo]] na [[kizibo cha seviksi]]. Mbinu za kuepuka mimba zinazotegemea ute wa uke na joto la mwili kubainisha uwezo wa kutunga mimba baada ya kijiyai kudondoshwa, hushindikana mara chache sana zinapotumika vizuri.<ref>Kippley (2003), uk.121-134, 376-381</ref> Hata hivyo, mbinu hizo huwa na upungufu fulani katika kubaini uwezo wa kutotunga mimba kabla ya kudondosha kijiyai. Rekodi ya joto la mwili pekee haitoi mwongozo kuhusu uwezekano wa mimba kutungwa au kutotungwa kabla ya kijiyai kudondoshwa. Kubaini uwezekano wa kutoshika mimba kabla ya tukio hilo kunaweza kufanywa kwa kuchunguza ute wa uke; hata hivyo, njia hii inafanikiwa kwa kiwango cha chini kuliko ule unaoshuhudiwa katika kipindi baada ya kudondosha kijiyai.<ref>Kippley (2003), uk.114</ref> Kutegemea uchunguzi wa ute pekee pia ina maana kwamba [[tendo la ndoa]] haliruhusiwi wakati wa hedhi, kwa sababu ute wowote hautakuwa dhahiri.<ref>{{cite book |author=Evelyn, Dr. Billings, Ann Westinore, |title=The Billings Method: Controlling Fertility Without Drugs or Devices |publisher=Life Cycle Books |location=Toronto |year=1998 |pages=47 |isbn=0-919225-17-9 }}</ref> Matumizi ya sheria fulani za kalenda katika kutambua urefu wa kipindi cha kutoweza kutunga mimba kabla ya kijiyai kudondoshwa huruhusu siku chache za ngono mwanzoni mwa mzunguko wa hedhi huku kukiwa na kiwango cha chini sana cha uwezekano wa kupata mimba.<ref name="calendar">Kippley (2003), uk.108-113</ref> Kwa kutumia mbinu ya ute pekee, kuna uwezekano wa kukosea kwa kudhani ni hedhi damu inapotoka katikati ya mzunguko wa hedhi au wakati ambapo kijiyai halikudondoshwa. Kuweka [[chati]] sahihi ya joto la msingi la mwili huwezesha utambuzi wa hedhi, wakati ambapo sheria za kalenda kuhusu kipindi kabla ya kudondosha kijiyai zinaweza kutumiwa kwa usahihi.<ref>Kippley (2003), uk.101 sidebar na Weschler (2002), uk.125</ref> Katika mbinu za joto pekee, sheria ya kalenda inaweza kutegemewa pale tu kutambua uwezekano wa kutoshika mimba kabla ya kudondosha kijiyai. Katika mbinu za joto na ishara, sheria ya kalenda huthibitishwa na rekodi za ute: uchunguzi wa ute wa uke unaoashiria uwezo wa kupata mimba unapewa kipaumbele kuliko mbinu yoyote ya kalenda ya kubainisha uwezo wa kushika mimba.<ref name="calendar"></ref> Sheria za kalenda zinaweza kuweka idadi mahsusi ya siku, ikibainisha kwamba (kulingana na urefu wa mizunguzo iliyopita ya hedhi ya mhusika) siku tatu hadi sita za kwanza katika kila mzunguko wa hedhi huchukuliwa kuwa hazina uwezo wa kupata mimba.<ref>Kippley (2003), uk.108-109 na Weschler (2002), uk.125-126</ref> Au, sheria ya kalenda inaweza kuhitaji hesabu, kwa mfano lazima iwe kwamba urefu wa kipindi kisicholeta uzazi kabla ya kudondosha kijiyai ni sawa na urefu wa mzunguko mfupi zaidi wa mwanamke huyo ukiondoa siku ishirini na moja.<ref>Kippley (2003), uk.110-111</ref> Badala ya kutegemea urefu wa mzunguko, sheria ya kalenda inaweza kuhakikishwa kutokana na siku ya mzunguko ambapo mwanamke ameshuhudia badiliko la joto la mwili. Mfumo mmoja unasema urefu wa kipindi cha kutoweza kutunga mimba kabla ya kudondosha kijiyai unalingana na siku ya kwanza ambapo mwanamke alishuhudia kupanda joto la mwili ondoa siku saba.<ref>Kippley (2003), uk.112-113</ref> ===Mbinu nyingine=== Vifaa vya kubashiri udondoshwaji wa kijiyai (kwa Kiingereza Ovulation predictor kits = OPKs) vinaweza kutambua udondoshwaji unaokaribia kutokea kwa kutegemea wingi wa homoni ya kuandaa ukuta wa chupa ya kizazi (kwa Kiingereza "lutenizing hormone" = LH) katika mkojo wa mwanamke. Kwa kawaida ubashiri wa kufana wa undondoshwaji huo hufuatiwa na udondoshwaji ndani ya saa 12-36. Uchunguzi wa mate kwa hadubini, ukifanyika kwa usahihi, unaweza kugundua vijidutu maalum katika mate ambavyo hutangulia udondoshwaji wa kijiyai. Vijidutu hivyo kwa kawaida huonekana siku tatu kabla ya udondoshwaji na kuendelea mpaka udondoshwaji utokee. Katika kipindi hiki, vijidutu hivyo hutokea katika ute wa uke pamoja na mate. Vichunguza uzazi vya kieletroniki vinapatikana kwa majina mbalimbali ya ki[[biashara]]. Vichunguzi hivyo vinaweza kutumia mifumo ya Joto la Msingi la Mwili pekee, au kuchambua vitepe vya kupimia mkojo, au kufuatilia dalili mchanganyiko au kuchunguza ukinzani umeme wa mate na ugiligili wa uke, au kwa pamoja baadhi ya mambo hayo mbalimbali . ==Manufaa na mapungufu== Ufahamu wa uwezo wa kushika mimba una kiwango fulani cha sifa bainifu: * Ufahamu wa uwezo wa kushika mimba unaweza kutumika kudhibiti afya ya uzazi. Mabadiliko katika mzunguko wa hedhi yanaweza kumtahadharisha mtumiaji kuhusu kujitokeza kwa matatizo ya kiginakolojia. Ufahamu wa uwezo wa kushika mimba pia unaweza kutumika kusaidia katika kuagua matatizo yanayojulikana ya kijinakolojia kama vile kutoweza kushika mimba. * Ufahamu wa uwezo wa kushika mimba ni uwanda mpana: unaweza kutumika kuzuia mimba au kusaidia katika kutunga mimba. * Ufahamu wa uwezo wa kushika mimba unaweza kutumiwa na wanawake wote katika kipindi chote cha uzazi, bila kujali ikiwa anakaribia kumaliza kuzaa, ananyonyesha, au anapata mzunguko wa hedhi usio wa kawaida kwa sababu zingine. * Matumizi ya ufahamu wa uwezo wa kushika mimba unaweza kutoa ufahamu kuhusu jinsi mwili wa mwanamke unavyofanya kazi, na unaweza kuwaruhusu wanawake kuwa na udhibiti mkubwa wa uzazi wao wenyewe. * Aina fulani ya mbinu za ufahamu wa uwezo wa kushika mimba zinazotegemea dalili ya uzazi zinahitaji uchunguzi au kugusa ute wa uke, matendo ambayo baadhi ya wanawake hawafurahii. Baadhi ya wahudumu wanapendelea kutumia neno "majimaji ya seviksi" badala ya ute wa uke, katika juhudi ya kuwafanya wanawake kama hao kuhisi huru kidogo. * Baadhi ya dawa, kama vile ya kupunguza kupaliwa mapafuni, yanaweza kubadili ute ya kizazi. Kwa wanawake wanaotumia dawa hizi, ishara ya ute huenda isionyeshe kisahihi uwezo wa kutunga mimba .<ref name="ffh">{{cite web | year =2004 | url =http://www.fertilityfriend.com/HelpCenter/FFBook/ff_fertility_signs.html | title =How to Observe and Record Your Fertility Signs | work =Fertility Friend Handbook | publisher =Tamtris Web Services | accessdate =2005-06-15 | archivedate =2005-05-28 | archiveurl =https://web.archive.org/web/20050528235842/http://www.fertilityfriend.com/HelpCenter/FFBook/ff_fertility_signs.html }}</ref> * Baadhi ya mbinu zinazotegemea dalili huhitaji ufuatiliaji wa joto la kimsingi ya mwili. Kwa sababu usingizi usiokuwa na utaratibu unaweza kuvuruga usahihi wa joto la kimsingi la mwili, wafanyakazi wa kubadilisha zamu na walio na watoto wadogo sana, kwa mfano, huenda wasiweze kutumia mbinu hizo.<ref name="ffh"></ref> ==Kama njia ya kupanga uzazi== Kwa kufanya tendo kamili la ndoa siku zile tu ambapo katika mzunguko wa hedhi mimba haiwezi kutungwa, maharusi wanaweza kuzuia mimba isipatikane. Wakati ambapo katika mzunguko wa hedhi mimba inaweza kutungwa, wanaweza wakaacha ngono ili kuwa na hakika ya kutoitunga. Wengine siku hizo wanatumia mbinu mbadala za kuzuia mimba ingawa pengine hazifai kwa sababu mbalimbali. <ref name="FABM">{{cite journal|last1=Manhart|first1=MD|last2=Daune|first2=M|last3=Lind|first3=A|last4=Sinai|first4=I|last5=Golden-Tevald|first5=J|title=Fertility awareness-based methods of family planning: A review of effectiveness for avoiding pregnancy using SORT.|journal=Osteopathic Family Physician |volume=5 |issue=1 |pages=2–8 |date=January–February 2013|url=http://www.sciencedirect.com/science/article/pii/S1877573X12001542|doi=10.1016/j.osfp.2012.09.002}}</ref> Kinyume chake maharusi wanaweza kulenga uzazi kwa hakika zaidi wakifanya tendo la ndoa kwa kutumia vizuri siku zinazouwezesha. ===Manufaa=== * Katika kutumia ufahamu wa uwezo wa kushika mimba hakuna madhara yanayotokana na teknolojia inayotumiwa na mbinu nyingine. Kwa jumla hakuna madhara yoyote ya utumiaji, isipokuwa yanayoweza kutokea kwa kuingiza vidole ndani ya uke ili kuchunguza seviksi (kama inavyopendekezwa na baadhi ya mbinu). * Ufahamu wa uwezo wa kushika mimba unaweza ukatumika pamoja na vifaa vya kuzuia mimba ili kuendelea kujamiiana katika kipindi ambapo kuna uwezekano wa kupata mimba. Tofauti na utumiaji wa vifaa hivyo bila ufahamu wa uwezo wa kushika mimba, ufahamu huo unawezesha kutumia vizuiamimba siku chache tu, na hivyo kupunguza madhara yanayoletwa navyo. * Ufahamu wa uwezo wa kushika mimba hauna gharama au ni nafuu sana. Watumiaji wanaweza wakahitaji kununua chati, kalenda, [[kipimajoto]], au tarakilishi, au pengine kumlipa [[mkufunzi]]. Kwa vyovyote gharama ni ya chini ikilinganishwa na mbinu nyingine. * Tofauti na mbinu nyingine mbalimbali ambazo zina athari za muda mrefu, ufahamu wa uwezo wa kushika mimba unawezesha kubadili mara moja kutoka uamuzi wa kuzuia mimba hadi ule wa kuilenga. ===Mapungufu=== * Wasipotumia vifaa vya kizuia mimba katika kipindi ambapo mimba inaweza kutungwa, wanandoa wanalazimika waache ngono. Ila kupunguza uwezekano wa kupata mimba uwe chini ya 1% kwa mwaka, katika kila mzunguko kuna takriban siku 13 ambapo lazima waache ngono.<ref name="german study">{{cite journal |author=Frank-Herrmann P, Heil J, Gnoth C, ''et al.'' |title=The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple's sexual behaviour during the fertile time: a prospective longitudinal study |url=https://archive.org/details/sim_human-reproduction_2007-05_22_5/page/1310 |journal=Hum. Reprod. |volume=22 |issue=5 |pages=1310–9 |year=2007 |pmid=17314078 |doi=10.1093/humrep/dem003}}</ref> Kwa wanawake wenye mzunguko unaobadilikabadilika sana - kama ilivyo kawaida wakati wa kunyonyesha, karibu na hedhi kwisha kabisa, au kwa wenye magonjwa ya homoni (kama vile Polycystic ovary syndrome = PCOS) kuacha kujamiiana au kutumia vizuizi kunaweza kuhitajika miezi mfululizo. Wengi hawana [[motisha]] au [[nidhamu]] ya kutosha wafanye hivyo kwa muda mrefu. Wanaposhindwa kufuata masharti, ni rahisi kupata mimba isiyopangwa. * Ufahamu wa uwezo wa kushika mimba haukingi dhidi ya [[maradhi ya zinaa]].<ref name="uihc">{{cite web | year =2012 | url =http://brown.edu/Student_Services/Health_Services/Health_Education/sexual_health/safer_sex_and_contraceptives/fertility_awareness_method.php#3 | title =Fertility Awareness Method | work =Brown University Health Education Website | publisher =Brown University | accessdate =2012-12-11 | archive-date =2016-01-08 | archive-url =https://web.archive.org/web/20160108171131/http://brown.edu/Student_Services/Health_Services/Health_Education/sexual_health/safer_sex_and_contraceptives/fertility_awareness_method.php#3 | url-status =dead }}</ref>Ndiyo maana inafaa zaidi kati ya watu ambao ni waaminifu wao kwa wao, kama watu wa ndoa. ===Ufanisi=== Ufanisi wa ufahamu ya uzazi, kama ulivyo kwa mbinu nyingi za [[uzazi wa mpango]], unaweza kutathminiwa kwa njia mbili zifuatazo. Kwa kawaida mfumo wa Pearl Index hutumika kukokotoa viwango vya ufanisi, lakini baadhi ya tafiti hutumia majedwali ya mapunguzo.<ref>{{cite book | first=John | last=Kippley | coauthors=Sheila Kippley | year=1996 | title=The Art of Natural Family Planning | url=https://archive.org/details/artofnaturalfami0000kipp | edition=4th addition | publisher=The Couple to Couple League | location=Cincinnati, OH | isbn=0-926412-13-2 | pages=[https://archive.org/details/artofnaturalfami0000kipp/page/141 141] }}</ref>Kwa kawaida viwango hupimwa katika mwaka wa kwanza wa matumizi.<ref name="hatcher">{{cite book | first=RA | last=Hatcher | coauthors=Trussel J, Stewart F, et al. | year=2000 | title=Contraceptive Technology | edition=18th | publisher=Ardent Media | location=New York | isbn=0-9664902-6-6 | url=http://www.contraceptivetechnology.com/table.html | access-date=2010-11-30 | archive-date=2008-05-31 | archive-url=https://web.archive.org/web/20080531095926/http://www.contraceptivetechnology.com/table.html | dead-url=yes }}</ref> Viwango vya ''matumizi kamili'' ni kwa wale tu wanaofuata sheria zote, wakitambua kwa usahihi kipindi ambapo kuna uwezekano wa kutunga mimba, na wanaacha ngono isiyo na kinga siku walizotambua kuna uwezekano wa kuitunga. Viwango vya ''matumizi halisi'' au ''matumizi ya kawaida'' ni kwa wale wote wanaotegemea ufahamu wa uwezo wa kushika mimba ili kuizuia, wakiwa ni pamoja na wasioweza kutimiza vigezo vya "matumizi kamili". Kiwango cha kufeli kwa ufahamu wa uwezo wa kushika mimba hutofautiana pakubwa kulingana na mbinu iliyotumika kubaini uwezekano wa kupata mimba, njia ya mafundisho, na idadi ya wanaotafitiwa. Baadhi ya tafiti zimekuta viwango halisi vya kufeli vya 25% kwa mwaka au zaidi.<ref>{{cite journal | author=Wade ME, McCarthy P, Braunstein GD, et al. | title= A randomized prospective study of the use-effectiveness of two methods of natural family planning | url=https://archive.org/details/sim_american-journal-of-obstetrics-and-gynecology_1981-10-15_141_4/page/n43 | journal=American journal of obstetrics and gynecology | month=Oktoba | year=1981 | volume=141 | issue=4 | pages=368–376 | pmid=7025639 }}</ref><ref>{{cite journal | author=Medina JE, Cifuentes A, Abernathy JR, et al. | title= Comparative evaluation of two methods of natural family planning in Colombia | url=https://archive.org/details/sim_american-journal-of-obstetrics-and-gynecology_1980-12-15_138_8/page/n57 | journal=American journal of obstetrics and gynecology | month=Desemba | year=1980 | volume=138 | issue=8 | pages=1142–1147 | pmid=7446621 }}</ref><ref>{{cite journal | author=Marshall J | title= Cervical-mucus and basal body-temperature method of regulating births: field trial | url=https://archive.org/details/sim_the-lancet_1976-08-07_2_7980/page/n14 | journal=Lancet | month=Agosti | year=1976 | volume=2 | issue=7980 | pages=282–283 | pmid=59854 | doi=10.1016/S0140-6736(76)90732-7 }}</ref> Angalau utafiti mmoja umepata kiwango cha kufeli cha chini ya 1% kwa mwaka kukiwa na mafundisho endelevu na mapitio ya kila mwezi,<ref name="billings"></ref> na tafiti kadhaa zimegundua viwango vya kufeli halisi vya 2-3% kwa mwaka.<ref name="german study" /><ref>{{cite journal | author=Frank-Herrmann P, Freundl G, Baur S, et al. | title= Effectiveness and acceptability of the sympto-thermal method of natural family planning in Germany | journal=American journal of obstetrics and gynecology | month=Desemba | year=1991 | volume=165 | issue=6 Pt 2 | pages=2052–2054 | pmid=1755469 }}</ref><ref>{{cite conference | author=Clubb EM, Pyper CM, Knight J | title=A pilot study on teaching natural family planning (NFP) in general practice | booktitle=Proceedings of the Conference at Georgetown University, Washington, DC | year=1991 | url=http://www.fertilityuk.org/nfps822.html | access-date=2010-11-30 | archivedate=2007-03-23 | archiveurl=https://web.archive.org/web/20070323160200/http://www.fertilityuk.org/nfps822.html }}</ref><ref>{{cite journal | author=Frank-Herrmann P, Freundl G, Gnoth C, et al. | title= Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study | url=https://archive.org/details/sim_advances-in-contraception_june-september-1997_13_2-3/page/179 | journal=Advances in Contraception | date=Juni-Septemba 1997 | volume=13 | issue=2-3 | pages=179–189 | pmid=9288336 | doi= 10.1023/A:1006551921219 }}</ref> Inapotumika kwa usahihi, na kuandamana na mafundisho endelevu ya mara kwa mara, baadhi ya tafiti zimeonyesha kuwa mbinu fulani za ufahamu wa uwezo wa kushika mimba huwa na 99% za ufanisi,<ref name="billings">[http://www.woomb.org/omrrca/bulletin/vol27/no4/chinaEvaluation.html Evaluation of the Effectiveness of a Natural Fertility Regulation Programme in China] {{Wayback|url=http://www.woomb.org/omrrca/bulletin/vol27/no4/chinaEvaluation.html |date=20070427204752 }}: Shao-Zhen Qian, et al. Reproduction and Contraception (English edition), in press 2000.</ref><ref>{{Rejea jarida | last1 = Ecochard | first1 = R. | last2 = Pinguet | first2 = F. | last3 = Ecochard | first3 = I. | last4 = De Gouvello | first4 = R. | last5 = Guy | first5 = M. | last6 = Huy | first6 = F. | year = 1998 | title = Analysis of natural family planning failures. In 7007 cycles of use | url = | journal = Fertilite Contraception Sexualite | volume = 26 | issue = 4| pages = 291–6 |pmid = 9622963}}</ref><ref name="creighton2">{{Rejea jarida | last1 = Hilgers | first1 = T.W. | last2 = Stanford | first2 = J.B. | year = 1998 | title = Creighton Model NaProEducation Technology for avoiding pregnancy. Use effectiveness | url = | journal = Journal of Reproductive Medicine | volume = 43 | issue = 6| pages = 495–502 | pmid = 9653695 }}</ref><ref name="creighton">{{Rejea jarida | doi = 10.1001/archfami.8.5.391 | last1 = Howard | first1 = M.P. | last2 = Stanford | first2 = J.B. | year = 1999 | title = Pregnancy probabilities during use of the Creighton Model Fertility Care System | url = | journal = Archives of Family Medicine | volume = 8 | issue = 5| pages = 391–402 | pmid = 10500511 }}</ref> Kitabu ''Teknolojia ya Uzazi'' kinaripoti hivi:<ref name="conttech"> James Trussell et al. (2000) "Contraceptive effectiveness rates", ''Contraceptive Technology'' - 18 Edition, New York: Ardent Media. On-press.</ref> * Mbinu za baada ya kudondosha kijiyai (yaani kuacha ngono kuanzia wakati wa hedhi mpaka baada ya kudondoshwa) inafeli kwa 1% kwa mwaka. * Mbinu ya dalili na joto la mwili inafeli kwa 2% kwa mwaka. * Mbinu ya ute wa uke pekee inafeli kwa 3% kwa mwaka. * Mbinu ya urari wa kalenda inafeli kwa 9% kwa mwaka. * Mbinu ya Siku Wastani inafeli kwa 5% kwa mwaka. ===Sababu za ufanisi mdogo katika matumizi ya kawaida=== Sababu kadhaa zinachangia kufanya ufanisi wa matumizi ya kawaida uwe wa chini kuliko ule wa matumizi kamili: * watumiaji kutotii kwa makusudi maelezo (kushiriki ngono bila kinga siku ambapo wanajua mimba inaweza kutungwa): ndiyo sababu ya kawaida zaidi<ref name="german study"></ref><ref name="creighton"></ref> * makosa ya watoa maelezo ya jinsi ya kutumia mbinu (mkufunzi kutoa taarifa isiyo sahihi au isiyo kamili) * makosa ya mtumiaji (kutoelewa sheria, kutunza kumbukumbu vibaya) ==Kama njia ya kupata mimba== Ufahamu wa uwezo wa kushika mimba unaweza kutumika pia kwa lengo la kupata mimba kwa urahisi zaidi. ===Kupanga wakati wa kujamiiana=== Utafiti uliofanywa na Barrett na Marshall umeonyesha kuwa vitendo vya ngono visivyopangwa huwa na uwezekano wa 24% kutungisha mimba katika mzunguko wa hedhi. Utafiti huo pia uligundua kuwa ngono inayolenga wakati maalumu kulingana na ufahamu unaotokana na mbinu ya joto la msingi la mwili pekee huongeza viwango vya mimba hadi 31% -68%.<!-- I couldn't find this study in a PubMed search, but it is mentioned in the Hilgers study --> Utafiti wa mbinu ya ute wa uke umegundua viwango vya mimba vya 67%-81% katika mzunguko wa kwanza ikiwa kujamiiana kutatokea katika Siku ya Kilele cha ishara za ute.<ref>{{cite journal |author=Ryder R |title="Natural family planning": effective birth control supported by the Catholic Church | journal = BMJ | volume = 307 | issue = 6906 |pages=723–6 |year=1993 | pmid = 8401097 |doi=10.1136/bmj.307.6906.723 |pmc=1678728}}</ref><!-- This isn't actually the study that found 67%, but it describes the "WHO study in Australia, India, Ireland, the Philippines, and El Salvador" that did. Hoping someone will find the correct ref and fix this.--><ref>{{cite journal |author=Hilgers T, Daly K, Prebil A, Hilgers S |title=Cumulative pregnancy rates in patients with apparently normal fertility and fertility-focused intercourse | journal = J Reprod Med | volume = 37 | issue = 10 |pages=864–6 |year=1992 | month=Oktoba | pmid = 1479570}}</ref> Kwa sababu ya viwango vya juu vya mimba kutoka mapema sana (25% za mimba hupotea katika wiki sita za kwanza tangu hedhi ya mwisho ya mwanamke), mbinu zinazotumika kuchunguza uwepo wa mimba zinaweza kusababisha upendeleo katika viwango vya utungaji mimba. Mbinu tofauti na hizo zinaweza kuonyesha viwango vya chini kwa sababu tu huwa zinakosa kugundua mimba zilizotoka mapema. Utafiti mmoja nchini China kati ya wanaoshiriki ngono bila mpangilio ili kutungisha mimba ulitumia mbinu bora za kugundua mimba, ikapata kiwango cha 40% cha kutungwa mimba kwa kila mzunguko katika kipindi cha utafiti cha miezi 12.<ref>{{cite journal |author=Wang X, Chen C, Wang L, Chen D, Guang W, French J |title=Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study | journal = Fertil Steril | volume = 79 | issue = 3 |pages=577–84 |year=2003 | pmid = 12620443 | doi = 10.1016/S0015-0282(02)04694-0}}</ref> ===Uchunguzi wa tatizo=== Mizunguko ya kawaida ya hedhi wakati mwingine huchukuliwa kuwa ushahidi kwamba mwanamke anadondosha vijiyai kawaida, na mizunguko isiyo ya kawaida kuwa ushahidi kuwa udondoshaji wa kijiyai si wa kawaida.<ref>{{Rejea jarida |contribution=Infertility fact sheet |publisher=womenshealth.gov, U.S. Department of Health and Human Services, Office on Women's Health |url=http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm#f |accessdate=2012-12-11 |title=Nakala iliyohifadhiwa |journal= |archive-date=2012-11-02 |archive-url=https://web.archive.org/web/20121102032112/http://womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm#f |dead-url=yes }}. ''"Some signs that a woman is not ovulating normally include irregular or absent menstrual periods."''<br> {{Rejea jarida | contribution = Female Infertility | title = Adult Health Advisor | year = 2012 | contribution-url = http://www.ihacares.com/index.cfm/HealthAdvisors/AdultHealthAdvisor/crs-aha-aha_obg_female.infertility/ | access-date = 2014-08-22 | archive-date = 2010-12-29 | archive-url = https://web.archive.org/web/20101229161028/http://www.ihacares.com/index.cfm/HealthAdvisors/AdultHealthAdvisor/crs-aha-aha_obg_female.infertility/ | dead-url = yes }}. ''"A woman who is not ovulating normally may have irregular or missed menstrual periods."''<br> {{Rejea jarida | contribution = Is Clomid Right For You? | title = JustMommies.com | year = 2007 | contribution-url = http://www.justmommies.com/articles/clomid-and-ovulation.shtml | access-date = 2014-08-22 | archive-date = 2023-11-30 | archive-url = https://web.archive.org/web/20231130203350/https://www.justmommies.com/articles/clomid-and-ovulation.shtml | url-status = dead }}. ''"If you have an irregular cycle there is a good chance you are not ovulating normally."''</ref> Hata hivyo, wanawake wengi ambao mizunguko yao si ya kawaida hudondosha vijiyai kama kawaida, na baadhi ya wenye mizunguko ya kawaida kwa kweli hawadondoshi vijiyai au wana matatizo katika utayarishaji wa ukuta wa chupa cha uzazi. Hasa rekodi za joto la msingi la mwili, lakini pia rekodi za ute wa uke na mkao wake, zinaweza kutumika kwa usahihi kung'amua ikiwa mwanamke anadondosha kijiyai, na kama urefu wa kipindi cha baada ya kudondosha kijiyai cha mzunguko wa hedhi unatosha kwa ujauzito. Ute wa uke unaoweza kutunga mimba ni muhimu katika kujenga mazingira ambayo yanaruhusu manii kupiti mlango wa uzazi na katika [[viriba vya falopu]] ambako husubiri kudondoshwa kwa kijiyai.<ref>{{cite web |last=Ellington |first=Joanna |title=Sperm Transport to the Fallopian Tubes |work=Frequently Asked Questions with Dr. E |publisher=INGfertility Inc |year=2004 |url=http://www.preseed.com/FAQs/FAQ3.php#Sperm_Leaking_Out_After_Intercourse-_Lessons_in_Sperm_Transport_Through_the_Cervix_ |accessdate=2008-04-27 |archivedate=2008-08-28 |archiveurl=https://web.archive.org/web/20080828025800/http://www.preseed.com/FAQs/FAQ3.php#Sperm_Leaking_Out_After_Intercourse-_Lessons_in_Sperm_Transport_Through_the_Cervix_ }}</ref> Chati za uwezo wa kupata mimba zinaweza kusaidia kugundua ute hasimu kwa mimba kutungwa, ambao ni sababu ya kawaida ya kutopata mimba. Ikiwa hali hii itagunduliwa, baadhi wanapendekeza matumizi ya [[guaifenesini]] katika siku chache kabla ya udondoshwaji wa kijiyai ili kupunguza uzito wa ute.<ref>Weschler (2002), uk. 173.</ref> ===Upimaji mimba na umri wa ujauzito=== [[Vipimo vya ujauzito]] si sahihi mpaka wiki 1-2 baada ya kudondoshwa kijiyai. Kujua tarehe inayokisiwa ambayo kijiyai kitadondoka kunaweza kukamzuia mwanamke asipate matokeo yasiyo sahihi kutokana na upimaji wa mapema mno. Pia, siku 18 mfululizo za joto la juu zinamaanisha mwanamke ni mjamzito karibu bila shaka.<ref>Weschler (2002), uk.316</ref> Makadirio ya tarehe ya kudondosha kijiyai kutokana na chati za uwezo wa kuzaa ni njia sahihi zaidi ya kukadiria umri wa ujauzito kuliko mbinu za jadi za kupima mimba au mbinu ya kuchunguza hedhi ya mwisho katika utaratibu wa kufuatilia hedhi.<ref>Weschler (2002), uk.3-4 ,155-156, Insert p.7</ref> ==Kama njia ya kupanga jinsia ya mimba== Ufahamu wa uwezo wa kushika mimba unaweza kutumika pia kwa lengo la kupata mimba ya jinsia inayotamaniwa zaidi.<ref>{{cite book |author= Ursula Birgitta Schnell OSB |authorlink= Ursula Birgitta Schnell OSB |title=Uimarishaji wa Familia - Mpango wa uzazi kwa njia ya asili Billings Ovulation Method |publisher=Benedictine Publication Ndanda-Peramiho |location=Ndanda, Tanzania |year=2011 |isbn=9976-63-132-4 |edition=15th }}</ref> Maharusi wanaweza kuchagua mtoto wa kiume au wa kike kwa 85% ya hakika wakifanya tendo la ndoa kwa kupanga kulingana na ute wa uke kuwa wa kuvutika na kuteleza au siyo. Ni kwamba jinsia ya mimba inategemea tu kromosomu za mbegu za baba ambazo ni nusunusu: X kwa kuzaa watoto wa kike na Y kwa kuzaa watoto wa kiume. Mbegu zenye kromosomu X ni dhaifu kidogo nazo huogelea polepole, lakini zinaishi muda mrefu. Kumbe zenye kromosomu Y zina nguvu zaidi na kuogelea upesi, lakini hufa upesi. ===Ili kupata mtoto wa kiume=== Kwa kuzingatia tabia hizo mbili tofauti, maharusi wakitaka mtoto wa kiume wanatakiwa kufanya tendo la ndoa siku ya kwanza baada ya kilele (kujisikia kuteleza) na kuendelea kwa miandamo 6 ya hedhi. Kama mwanamke hajapata mimba baada ya miandamo 6, waanze kuonana siku ya kilele na siku inayofuata. Kama mwanamke amekosa siku ya kilele, yaani kama utelezi wa ute unaendelea siku inayofuata, waonane tena siku inayofuata. Kwa njia hiyo mbegu zenye kromosomu Y tu zitafikia kijiyai kilichochopoka, kwa sababu mbegu zenye kromosomu X zinaogelea polepole tu. ===Ili kupata mtoto wa kike=== Kinyume chake, wakitaka mtoto wa kike wanatakiwa kufanya tendo la ndoa siku ya kwanza ya ute wa uzazi. Halafu wapumzike mpaka siku ya nne baada ya kilele. Waendelee hivyo kwa miandamo michache. Kama mwanamke hajapata mimba baada ya miezi michache, wafanye tendo la ndoa siku ya kwanza na ya pili ya ute wa uzazi halafu wapumzike mpaka siku ya nne baada ya kilele. Waendelee hivyo kwa miandamo michache. Kama mwanamke hajapata mimba baada ya miezi michache, wafanye tendo la ndoa pia siku ya tatu ya ute wa uzazi halafu wapumzike mpaka siku ya nne baada ya kilele. Waendelee hivyo kwa miandamo michache. Kwa njia hiyo mbegu zenye kromosomu Y zitakufa kabla ya kuweza kuungana na kijiyai, na hivyo zitabaki zenye kromosomu X kuwa na nafasi hiyo. Siku nzuri ya kupata mtoto wa kike ni kufanya tendo la ndoa siku mbili kabla ya kilele. ==Tazama pia== *[[Uzazi wa mpango]] *[[Uzazi wa mpango kwa njia asilia]] ==Marejeo== {{Reflist|colwidth=30em}} ==Marejeo mengine== ===Kwa [[Kiswahili]]=== * {{cite book |author= Ursula Birgitta Schnell OSB |authorlink= Ursula Birgitta Schnell OSB |title=Uimarishaji wa Familia - Mpango wa uzazi kwa njia ya asili Billings Ovulation Method |publisher=Benedictine Publication Ndanda-Peramiho |location=Ndanda, Tanzania |year=2011 |isbn=9976-63-132-4 |edition=15th }} ===Kwa [[Kiingereza]]=== * {{cite book |author=Toni Weschler |authorlink=Toni Weschler |title=Taking Charge of Your Fertility |url=https://archive.org/details/takingchargeofy000wesc |publisher=Collins |location=New York |year=2006 |isbn=0-06-088190-9 |edition=10th Anniversary}} * {{cite book |author=John F. Kippley and Sheila K. Kippley |title=The Art of Natural Family Planning |url=https://archive.org/details/artofnaturalfami0000kipp |publisher=Couple to Couple League International |location=Cincinnati, OH |year=1996 |isbn=0-926412-13-2 |edition=Fourth}} * {{cite book |author= Léonie McSweeney |title= Love & Life, Billings Method of Natural Family Planning |publisher= African Universities Press |location=Ibadan, Nigeria |year=2006 |isbn=978-148-092-0 |edition=Ninth}} [[Jamii:Biolojia]] [[Jamii:Jinsia]] [[Category:Uzazi]] [[Jamii:Uzazi wa mpango]] d1pn4zktdm7d9qzug3n9i0hftvklh1z 0 55746 1578157 1395103 2026-07-02T22:41:37Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578157 wikitext text/x-wiki '''Kiwango-hisi cha gluteni''' (GS) kinajumuisha hali mbalimbali za kiafya ambapo [[gluteni]] ina athari mbaya. Kwa watu wenye [[Ugonjwa|maradhi]] ya utumbo unaoathiri gluteni, kuondolewa kwa gluteni kwa ujumla husababisha kurejeshwa kwa usanifu wa vidole<ref name="pmid4426981">{{cite journal | author = Thompson H | title = Necropsy studies on adult coeliac disease | url = https://archive.org/details/sim_journal-of-clinical-pathology_1974-09_27_9/page/710 | journal = J. Clin. Pathol. | volume = 27 | issue = 9 | pages = 710–21 | year = 1974 | pmid = 4426981 | doi =10.1136/jcp.27.9.710 | pmc = 475446 }}</ref> au uzito wa chini zaidi wa limfosaiti kwenye utumbo.<ref name="pmid6693043">{{cite journal | author = Corazza GR, Frazzoni M, Gasbarrini G | title = Jejunal intraepithelial lymphocytes in celiac disease: are they increased or decreased? | journal = Gut | volume = 25 | issue = 2 | pages = 158–62 | year = 1984 | pmid = 6693043 | doi =10.1136/gut.25.2.158 | pmc = 1432248 }}</ref> Katika baadhi ya viwango vya hisi, kustawi kwa hali ya neva kunaweza kudhihirika, lakini matokeo ya kiafya huenda yasiwe wazi.<ref name="pmid12351994">{{cite journal | author = Wills AJ, Unsworth DJ | title = The neurology of gluten sensitivity: separating the wheat from the chaff | journal = Curr. Opin. Neurol. | volume = 15 | issue = 5 | pages = 519–23 | year = 2002 | pmid = 12351994 | doi =10.1097/00019052-200210000-00001 }}</ref><ref name="pmid1908173">{{cite journal | author = Ventura A, Bouquet F, Sartorelli C, Barbi E, Torre G, Tommasini G | title = Coeliac disease, folic acid deficiency and epilepsy with cerebral calcifications | url = https://archive.org/details/sim_acta-paediatrica_1991-05_80_5/page/559 | journal = Acta paediatrica Scandinavica | volume = 80 | issue = 5 | pages = 559–62 | year = 1991 | pmid = 1908173 | doi =10.1111/j.1651-2227.1991.tb11906.x }}</ref> GS pia inaweza kuathiri kemia ya damu,<ref name="pmid8675082">{{cite journal | author = Valdimarsson T, Löfman O, Toss G, Ström M | title = Reversal of osteopenia with diet in adult coeliac disease | url = https://archive.org/details/sim_gut_1996-03_38_3/page/322 | journal = Gut | volume = 38 | issue = 3 | pages = 322–7 | year = 1996 | pmid = 8675082 | doi =10.1136/gut.38.3.322 | pmc = 1383058 }}</ref> uwezo wa kutibu baadhi ya magonjwa kingamwilinafsi,<ref name="pmid773406">{{cite journal | author = Heading RC, Paterson WD, McClelland DB, Barnetson RS, Murray MS | title = Clinical response of dermatitis herpetiformis skin lesions to a gluten-free diet | journal = Br. J. Dermatol. | volume = 94 | issue = 5 | pages = 509–14 | year = 1976 | pmid = 773406 | doi =10.1111/j.1365-2133.1976.tb05138.x }}</ref> na / au kuboresha bila kutibiwa kwa hali za kingamwilinafsi.<ref name="pmid16458087">{{cite journal | author = Volta U, De Giorgio R, Granito A, ''et al.'' | title = Anti-ganglioside antibodies in coeliac disease with neurological disorders | journal = Digestive and liver disease: official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver | volume = 38 | issue = 3 | pages = 183–7 | year = 2006 | pmid = 16458087 | doi = 10.1016/j.dld.2005.11.013}}</ref><ref name="pmid12087007">{{cite journal | author = Amin R, Murphy N, Edge J, Ahmed ML, Acerini CL, Dunger DB | title = A longitudinal study of the effects of a gluten-free diet on glycemic control and weight gain in subjects with type 1 diabetes and celiac disease | url = https://archive.org/details/sim_diabetes-care_2002-07_25_7/page/1117 | journal = Diabetes Care | volume = 25 | issue = 7 | pages = 1117–22 | year = 2002 | pmid = 12087007 | doi =10.2337/diacare.25.7.1117 }}</ref><ref name="pmid11910339">{{cite journal | author = Kaukinen K, Halme L, Collin P, ''et al.'' | title = Celiac disease in patients with severe liver disease: gluten-free diet may reverse hepatic failure | url = https://archive.org/details/sim_gastroenterology_2002-04_122_4/page/881 | journal = Gastroenterology | volume = 122 | issue = 4 | pages = 881–8 | year = 2002 | pmid = 11910339 | doi =10.1053/gast.2002.32416 }}</ref> Gluteni imeundwa kwa [[protini]] za kuhifadhi na zinazonata zinazopatikana katika [[Ngano|ngano.]] Ugonjwa wa enteropathia unaoathiri gluteni '''(GSE)''' unaweza kujitokeza kwa viwango mbalimbali kutoka uvimbe mdogo wa mukosa wa chango hadi ugonjwa mkali wa siliaki. Istilahi unyeti wa gluteni inatumika wakati ambapo utambuzi unaokisiwa wa GSE ulio na misingi katika hali kama vile chunusi sugu yenye mwasho. Hata hivyo, GS inaweza kutumika katika hali ya utata wakati ambapo hali zingine zinawezekana. Kwa mfano, mzio wa ngano kwa gluteni unaweza kusababisha anafilaksisi huku zingine huenda zikawa ni vigumu kutambua kutokana na baadhi ya sifa fichifu za kuvimba za protini za ngano. Istilahi 'unyeti wa gluteni' hutumika kwa kawaida wakati ambapo upimaji kwa ajili ya utambuzi haujafanywa kutokana na mlo usio na gluteni unaoliwa kwa muda mrefu na / au ukataaji wa changamoto ya gluten kabla ya bayopsi. Uteuzi wa jina la unyeti wa gluteni huenda usifae katika matukio yote, kwa kuwa mizio ya ngano mara nyingi huelekezwa kwa albumini au globulini za ngano, au mtu anaweza kuathirika kirahisi na protini ambazo kwa kawaida hupatikana kwenye bidhaa za ngano (k.m. amilesi ya ukungu au hamira ya mkate). Kwa hiyo, vigezo vya utambuzi vinapendelewa zaidi. Uhusiano kati ya gluteni na viwango mbalimbali vya hisi ni tata. Kwa ugonjwa wa enteropathia ya gluteni, uathirikaji wa kiini T unapatikana tu katika spishi/ glutelini za prolamini ndani ya kabila, la majani la ''Triticeae'' na hasa α-gliadini ya ngano.<ref name="pmid16634791">{{cite journal | author = Srinivasan U, Jones E, Carolan J, Feighery C | title = Immunohistochemical analysis of coeliac mucosa following ingestion of oats | journal = Clin. Exp. Immunol. | volume = 144 | issue = 2 | pages = 197–203 | year = 2006 | pmid = 16634791 | doi = 10.1111/j.1365-2249.2006.03052.x | pmc = 1809658}}</ref><ref name="pmid674547">{{cite journal | author = Anand BS, Piris J, Truelove SC | title = The role of various cereals in coeliac disease | journal = Q. J. Med. | volume = 47 | issue = 185 | pages = 101–110 | year = 1978 | pmid = 674547 | doi = }}</ref> Kwa idadi ndogo ya GSE, mwitiko wa kuvimba unaweza kuhusisha pia [[Oti|shayiri]].<ref name="pmid17376046">{{cite journal | author = Silano M, Dessì M, De Vincenzi M, Cornell H | title = In vitro tests indicate that certain varieties of oats may be harmful to patients with coeliac disease | journal = J. Gastroenterol. Hepatol. | volume = 22 | issue = 4 | pages = 528–31 | year = 2007 | pmid = 17376046 | doi = 10.1111/j.1440-1746.2006.04512.x}}</ref> Mzio wa gluteni unaweza kuhusisha aina mbalimbali za taksa au unaweza kuwa maalum kwa aina maalum za protini za ngano na mzio unaweza kuhusisha shayiri. [[File:Gluten Sources.png|thumb|350px|right|Aina 4 mbalimbali za miundo ya kibiashara ya Tritikea cultivars. Kwa mzunguko wa akrabu kutoka juu: unga wa ngano wa gluteni, Spelti ya Ulaya, mbegu ya bali, rai zilizovingirishwa]] Kiwango-hisi cha gluteni kinapaswa kuwa na sababu iliyofafanuliwa, ingawa si wazi daima katika upimaji wa kwanza, watu walioathirika wanafaa hatimaye kuwekwa katika kategoria ya mzio wa GSE au ngano. Ni nadra kupata kuwa kiwango-hisi cha gluteni ina asili isiyojulikana. Kiwango-hisi cha gluteni chenye asili isiyojulikana '''(IGS)''' hujitokeza "kwa hiari au kutokana na sababu isiyoeleweka au isiyojulikana" na inaweza kuhusisha nyuropathia, miopathia, ya ngozi, au hali ya matumbo isiyo ya kawaida. Kingamwili dhidi ya gliadini ndizo viungo msingi kati ya gluteni na hisi ya ugonjwa wenye asili isiyojulikana ''ambapo enteropathia au mzio hazihusiki kiwazi.'' <ref name="pmid12566288">{{cite journal | author = Hadjivassiliou M, Grünewald R, Sharrack B, ''et al.'' | title = Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics | url = https://archive.org/details/sim_brain_2003-03_126_3/page/685 | journal = Brain | volume = 126 | issue = Pt 3 | pages = 685–91 | year = 2003 | pmid = 12566288 | doi =10.1093/brain/awg050 }}</ref> Aina hii ya hisi ya gluteni ina utata kwa sasa. ==Dalili== Hisi ya gluteni ni mkusanyiko wa magonjwa ambapo prolamini na glutelini za ngano ndizo vipengele vya hisi. Kwa hivyo, dalili zinategemea patholojia maalum. Katika matukio mengi, hisi ya gluteni haionyeshi dalili au dalili mara nyingi hujitokeza wakati wa kufuatilia matukio ya magonjwa mengine yenye asili isiyojulikana (k.m. nyuropathia ya pembeni, ugonjwa wa kingamwilinafsi) na masharti haya mengine yanaweza kutofautiana sana (ugonjwa wa siliaki umeitwa 'kiigaji kikubwa', tazama ugonjwa wa siliaki - ishara na dalili). Katika tukio la majibu ya mzio, dalili huweza kuonekana kama uvimbe ngozi lakini pia zinaweza kujitokeza kama matatizo ya kupumua wakati wa mazoezi. Katika hali zote mbili, dalili za matatizo ya utumbo huweza kutokea. Katika hali ya hisi ya gluteni yenye asili isiyojulikana, dalili zote zinazojulikana zina uhusiano na mfumo wa neva. ==Etiolojia == Hisi inaweza kuanza katika awamu yoyote ya maisha, na dalili za ugonjwa zinaweza kuonekana miaka mingi baada ya ugonjwa kuanza. Wakati ambapo enteropathia inajitokeza mapema utotoni, ugonjwa wenye dalili ni dhahiri kwa haraka zaidi. Uchunguzi wa jeriatriki nchini [[Ufini|Finland]] ulionyesha kwamba matukio ya ugonjwa yalikuwa juu zaidi kuliko idadi ya watu kwa jumla. Ugonjwa wa mzio unaweza kuongezeka au kupunguka kulingana na umri. Hata hivyo, ushahidi fulani unaashiria kuwa kuongeza au matumizi ya kila siku ya vipengele vya kuzuia uvimbe na visivyo vya steroidi (aspirini, ibuprofeni) kama sababu zinazoongeza hatari ya kupata urtikaria au anafilaksi, na kipimo cha hisi kinaweza kuhusisha kiwango cha chini cha tiba ya aspirin yanayotumika kutibu maradhi ya moyo. Ugonjwa wenye asili isiyojulikana mara nyingi hujitokeza uzeeni. Ugonjwa wa enteropathia unaoathiri gluteni hutokana na sababu za kijenetiki na kimazingira. Bali na kuhusika kwa isofomu fulani za HLA-DQ (antijeni zinazotoa protini kwa mwili wa binadamu) na protini kadhaa za ngano, hakuna uwazi kuhusu kuhusishwa kwa jeni zingine au sababu zingine za kimazingira (tazama vivumishi vya hatari). Sababu thabiti za kimaumbile kama inavyodhihirika katika GSE havijadhihirika katika mzio wa gluteni, na katika hisi ya gluteni wenye asili isiyojulikana, mahusiano ya HLA-DQ ni dhaifu. ==Chanzo cha kiwango-hisi cha gluteni== {| style="margin-left:2em;border:1px #ccffdd solid;background:#ebffef" align="right" |- | {| style="text-align:left;margin-left:0em;background:#ebffef" |- align="center" | <div style="font-size:medium;line-height:120%">'''Hali za kimsingi''' </div> |- | '''Utumbo wa kawaida''' |- | width="350px"|[[File:Normal Villus Illustration.png|thumb|right|Mchoro wa mpaka wa utando brashi wa vili za chango]] Protini za ngano huingiliana na mfumo wa kinga kupitia kifo kilichopangwa na kusimamiwa cha seli za DQ2 (apoptosisi) ya matumbo kwa watu wenye hisi. Utafiti mpya umetambua kuwa matumbo ya siliaki huenda yakawa ni yenye kuvutika kwa hisi pale ambapo kuna ukosefu wa vipengele vya kijenetiki vya HLA. <br> |- | '''Namna ambavyo protini za vyakula hufikia damu''' |- | width="350px"| [[File:Protein digestion.PNG|thumb|left|Hatima ya protini zinazoweza kumeng'enywa katika chango]] Katika matumbo ya kawaida, protini humeng'enywa na kuwa peptidi kupitia pepsini (tumbo), traipsini na kaimotripsini (inayotokana na kongosho na kuamilishwa kwenye tumbo). Peptidi humeng'enywa zaidi wakati zinapoingia kwenye vili, ambapo peptidesi zinazopakana nayo huvunja protini na kuunda asidi ya amino. Katika sehemu kubwa ya utumbo, ni vimumunyishwaji vidogo, kwa mfano maji, vinavyoweza kupenyeza miungano midogo. Hata hivyo, baadhi ya sehemu za peptidi za utumbo zenye ukubwa wa hadi daltoni 500 (mabaki manne ya asidi ya amino kwa yanaweza kupenyeza). <br> |- | '''Utumbo yenye kiwango cha juu cha hisi kwa gluteni''' |- | width="350px"| [[File:Gluten digestion.PNG|thumb|right|hatima ya gluteni katika ugonjwa wa siliaki au EIA]] Ushahidi unaongezeka unaoonyesha kwamba utumbo wenye kiwango cha juu cha hisi kwa gluteni hutofautiana na utumbo wa kawaida. Baadhi ya peptidi za gluteni zinaweza kupenyeza eneo lililo nyuma ya seli zinazofunika chango. "33mer" ya gliadini α-2 kina ukubwa zaidi ya kiwango kikubwa kabisa kinachokubalika na kizuizi kinachoizingira seli, mianya midogo. Peptidi za gliadini za omega-5 zimepatikana katika mkondo wa damu wa watu wenye anafilaksisi inayosababishwa na mazoezi, na kusaidiwa na salisaileti. Na "25mer" ya asili ina uwezo wa kufikia seli za mononuklea katika siliaki ya utumbo, lakini katika utumbo wa kawaida huvunjwa na peptidesi za mipakamswaki. Huenda ikawa ni kiwango cha chini cha shughuli za peptidesi ndicho kinaeleza kuwepo kwa peptidesi hizi nyuma ya utando wa mipakamswaki. Hivi karibuni, ilitambuliwa kuwa peptidi ya giadini α-9 ilikuwa na uwezo wa kushikanisha kipokezi cha "CXCR3", na hivyo kuongeza uzalishaji wa zonulini na kudhoofisha mianya midogo. Jambo hili linaweza kueleza namna ambavyo, kwa ujumla, peptidi kubwa zinaweza kuingia kwenye utumbo nyeti wa gluteni.<br> |} |} ===''Tritikea'' na uwezekano wa jukumu la mageuko chaguzi katika gluteni nyeti=== Sehemu za mimea zinazotoa matunda zina jeni pamoja na akiba ya madini zinazoruhusu miche kukua. Kiwango cha juu cha virutubisho huwa ni kivutio kwa wanyama walanyama na walamajani. Kwa nyasi zinazotoa mbegu kwa muda mfupi kila mwaka kuna haja ya kulinda mbegu wakati wa upevukaji kutokana na wadudu au wanyama, ambayo yanaweza kuweka mbegu kwa matumizi ya mwaka mzima. Katika ngano, alfa-gliadini ni protini za kuhifadhi mbegu, na pia ni kizuizi cha shughuli za alfa-amilesi za wanyama wengine, hasa wadudu.<ref name="pmid16628930">{{cite journal |author=Bandani AR |title=Effect of plant a-amylase inhibitors on sunn pest, Eurygaster integriceps Puton (Hemiptera: Scutelleridae), alpha-amylase activity |journal=Commun. Agric. Appl. Biol. Sci. |volume=70 |issue=4 |pages=869–73 |year=2005 |pmid=16628930 |doi= |url=}}</ref> Pia inajulikana kwamba gliadini ya ngano huleta ugonjwa wa utumbo ukilishwa kwa wanyama wadogo wagugunaji.<ref name="pmid12500003">{{cite journal |author=Stepánková R, Kofronová O, Tucková L, Kozáková H, Cebra JJ, Tlaskalová- Hogenová H |title=Experimentally induced gluten enteropathy and protective effect of epidermal growth factor in artificially fed neonatal rats |journal=J. Pediatr. Gastroenterol. Nutr. |volume=36 |issue=1 |pages=96–104 |year=2003 |month=Januari |pmid=12500003 |doi=10.1097/00005176-200301000-00018 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0277-2116&volume=36&issue=1&spage=96 |access-date=2010-11-30 |archive-date=2012-04-28 |archive-url=https://web.archive.org/web/20120428192625/http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0277-2116&volume=36&issue=1&spage=96 |dead-url=yes }}</ref> Uchapishaji wa hivi karibuni unaibua swali 'je, ni salama kwa mtu yeyote kuula ngano?'.<ref name="pmid17519496">{{cite journal | author = Bernardo D, Garrote JA, Fernández-Salazar L, Riestra S, Arranz E | title = Is gliadin really safe for non-coeliac individuals? Production of interleukin 15 in biopsy culture from non-coeliac individuals challenged with gliadin peptides | url = https://archive.org/details/sim_gut_2007-06_56_6/page/889 | journal = Gut | volume = 56 | issue = 6 | pages = 889–90 | year = 2007 | pmid = 17519496 | doi = 10.1136/gut.2006.118265 | pmc = 1954879}}</ref> Kwa kina, patholojia katika wadudu au wanyama wagugunaji wanaolishwa na binadamu haionyeshi chanzo cha ugonjwa katika binadamu, lakini la kuvutia ni kwamba madhara ya kitoksikolojia ya ngano yenye uwezo wa kusababisha patholojia katika binadamu yanaendelea kutambuliwa. Tokeo moja muhimu ya tafiti hizi ni kwamba huenda kuna unyeti wa ujumla wa gluteni ambao huwa yamefichika chini ya maonyesho mbalimbali ya kipatholojia, kama vile ugonjwa wa siliaki, urtikaria na unyeti wenye asili isiyojulikana. Kupanda kwa kiwango-hisi cha gluteni (hasa kwa watu wazima) unaweza kuonyesha mwingiliano wa vipengele vingi. Kikundi cha watu wanaozeeka, hatari za kijenetiki zinazohusiana na uigaji wa tamaduni wa kimagharibi, kiawango cha ziada cha kalori katika mlo, kemikali za kuhamasisha (kwa mfano, MSG, NSAID), na kuongeza kemikali zinazoongeza mzio kwenye vyakula (kwa mfano uondoaji amino kutoka kwenye gluteni kwa kutumia vimeng'enya) vinaweza kufanya kazi kwa kushirikiana na vikolezo vya asili vinavyozuia katika vyakula na kuvuka kizingiti kati ya hali ya kawaida na patholojia. [[File:Gliadin-immuno-innate.png|thumb|left|Mchoro wa alfa gliadini 2 unaoonyesha maeneo mawili yaliyo sugu kiproteolitiki, Juu inaonyesha maeneo 6 ya seli T katika 33mer, na chini inaonyesha peptidi asili za kinga na maeneo mawili ya ushikanishaji ya CXCR3]] ===Usumishaji wa gluteni=== Ongezeko la idadi tafiti kuhusu gliadini linaonyesha kuwa gluteni ina athari ya moja kwa moja na kubadilisha seli za chango. Tafiti mbili tofauti zimeonyesha kwamba gliadini tofauti zinaweza kuongeza upenyezaji wa seli za epithelimu (seli za nje kabisa za vidole) na kuruhusu protini za chakula kuingia. Utafiti mmoja ulichunguza athari za gliadini za ω-5, sababu ya msingi ya anafilaksisi inayosababishwa na mazoezi / aspirini, na ukatambua upenyezaji ulioongezeka wa seli za utumbo unaosababishwa na gliadini hii na albumini nyingine ya ngano.<ref name="pmid17477542">{{cite journal |author=Bodinier M, Legoux MA, Pineau F, ''et al.'' |title=Intestinal translocation capabilities of wheat allergens using the Caco-2 cell line |journal=J. Agric. Food Chem. |volume=55 |issue=11 |pages=4576–83 |year=2007 |month=Mei |pmid=17477542 |doi=10.1021/jf070187e |url=}}</ref> Mkondo mwingine wa utafiti unaonyesha kuwa gliadini huunganisha kipokezi cha [[wikt:chemoattractant|kuvutia kemikali]] na kuongeza kipengele kinachoharibu mianya midogo.<ref name="pmid16456012">{{cite journal |author=Thomas KE, Sapone A, Fasano A, Vogel SN |title=Gliadin stimulation of murine macrophage inflammatory gene expression and intestinal permeability are MyD88-dependent: role of the innate immune response in Celiac disease |journal=J. Immunol. |volume=176 |issue=4 |pages=2512–21 |year=2006 |month=Februari |pmid=16456012 |doi= |url=http://www.jimmunol.org/cgi/pmidlookup?view=long&pmid=16456012}}</ref> Mianya hii huzuia kuvuja kwenye seli zinazozingira chango, vinavyosababisha mvujo wa protini za chakula kuingia ndani ya mwili.<ref name="pmid18485912">{{cite journal |author=Lammers KM, Lu R, Brownley J, ''et al.'' |title=Gliadin Induces an Increase in Intestinal Permeability and Zonulin Release by Binding to the Chemokine Receptor CXCR3 |journal=Gastroenterology |volume= 135|issue= 1|pages= 194–204.e3|year=2008 |month=Machi |pmid=18485912 |doi=10.1053/j.gastro.2008.03.023 |url=https://archive.org/details/sim_gastroenterology_2008-07_135_1/page/194|pmc=2653457}}</ref> Sumu hizi za gluteni ambazo si sehemu ya majibu ya mfumo wa kinga wa kuzoea unaweza kuwa ndio uhusiano kati ya ngano na kiwango cha hisi cha gluten, na wakati mwingine ugonjwa wa kisukari wa aina ya kwanza. ===Kemia ya mfumo wa kinga wa gluteni=== Gluteni za ''Tritikea'' ni vipengele muhimu katika maradhi kadhaa zinazosababisha uvimbe. Kemia ya mfumo wa kinga inaweza kugawa katika majibu ya asili (usisimuaji wa moja kwa moja wa mfumo wa kinga), daraja ya pili la upatanisho (HLA DQ), daraja ya kwanza ya usisimuaji uliopatanishwa wa seli zinazoua, na kutambua zindiko. Majibu kwa [[protini]] za gluteni na meneo yenye polipeptidi hutofautiana kulingana na aina ya hisi ya gluteni. Majibu pia hutegemea maumbile ya kijenetiki ya jeni za antijeni za lukosaiti ya binadamu. Katika enteropathia, kuna angalau aina 3 za utambuzi, kinga ya asili (aina ya utayarishaji wa kinga za seli), HLA-DQ na kutambua zindiko za gliadini na transglutaminesi.<ref name="pmid16766754">{{cite journal |author=van Heel DA, West J |title=Recent advances in coeliac disease |journal=Gut |volume=55 |issue=7 |pages=1037–46 |year=2006 |month=Julai |pmid=16766754 |doi=10.1136/gut.2005.075119 |url=https://archive.org/details/sim_gut_2006-07_55_7/page/1037|pmc=1856316}}</ref> Mifuatano mitatu kuu inayoleta mmenyuko imetambuliwa.<ref> http://www.livescience.com/health/celiac-disease-gluten-peptides-100721.html</ref><ref name="pmid20650871">{{cite journal |author = Tye-Din JA, Stewart JA, Dromey JA, Beissbarth T, van Heel DA, Tatham A, Henderson K, Mannering SI, Gianfrani C, Jewell DP, Hill AV, McCluskey J, Rossjohn J, Anderson RP |title = Comprehensive, quantitative mapping of T cell epitopes in gluten in celiac disease.|journal=Sci Transl Med |volume = 2 |issue = 41 |pages = 41ra51 |year = 2010 |pmid = 20650871|doi=10.1126/scitranslmed.3001012}}</ref> Kwa magonjwa yenye asili isiyojulikana, ni utambuaji wa zindiko kwa gliadini pekee ndio umetatuliwa. Katika mzio wa ngano, inaonekana kuwa kuna vipengele vya asili na njia za majibu zinapatanishwa IgE dhidi ya gliadini na protini zingine za ngano.<ref name="pmid18036646">{{cite journal |author=Bittner C, Grassau B, Frenzel K, Baur X |title=Identification of wheat gliadins as an allergen family related to baker's asthma |journal=J. Allergy Clin. Immunol. |volume=121 |issue=3 |pages=744–9 |year=2008 |month=Machi |pmid=18036646 |doi=10.1016/j.jaci.2007.09.051 |url=https://archive.org/details/sim_journal-of-allergy-and-clinical-immunology_2008-03_121_3/page/744}}</ref><ref name="pmid18186814">{{cite journal |author=Matsuo H, Dahlström J, Tanaka A, ''et al.'' |title=Sensitivity and specificity of recombinant omega-5 gliadin-specific IgE measurement for the diagnosis of wheat-dependent exercise-induced anaphylaxis |journal=Allergy |volume=63 |issue=2 |pages=233–6 |year=2008 |month=Februari |pmid=18186814 |doi=10.1111/j.1398-9995.2007.01504.x |url= |doi_brokendate=2010-01-01}}</ref><ref name="pmid17655322">{{cite journal |author=Akagawa M, Handoyo T, Ishii T, Kumazawa S, Morita N, Suyama K |title=Proteomic analysis of wheat flour allergens |journal=J. Agric. Food Chem. |volume=55 |issue=17 |pages=6863–70 |year=2007 |month=Agosti |pmid=17655322 |doi=10.1021/jf070843a |url=}}</ref> ==Kutenganisha aina za kiwango-hisi cha gluteni== Ni nadra sana kwa hisi ya gluteni kujitokeza bila sababu. Kwa ujumla, kiwango cha hisi kinaweza kugawanywa kati ya enteropathia ya unyeti wa gluteni na mzio wa ngano. Kwa kuwa watu wenye GSE wanaweza pia kuwa na mzio wa ngano, kupatikana kwa mzio wa ngano hakuondoi uwezekano wa enteropathia. Watu wanaoshukiwa kuwa na enteropathia ya kiwango cha juu cha hisi cha gluteni wanaweza kupimwa kwa kingamwili zinazopambana na transglutaminesi ikifuatiwa na bayopsi ya mbuti, ambayo huthibitisha au kupigana na ugonjwa hai wa siliaki.<ref name="pmid17383983">{{cite journal |author=Hopper AD, Cross SS, Hurlstone DP, ''et al.'' |title=Pre-endoscopy serological testing for coeliac disease: evaluation of a clinical decision tool |journal=BMJ |volume=334 |issue=7596 |pages=729 |year=2007 |month=Aprili |pmid=17383983 |pmc=1847864 |doi=10.1136/bmj.39133.668681.BE |url=}}</ref> Utafiti unaopendekeza jambo hili, hata hivyo, una idadi kadhaa ya watu wenye ATA/wasio na bayopsi, na jambo hili linaweza kuwa limesababishwa na uvimbe kwenye viungo au tishu au patholojia isiyo na dalili za kliniki.<ref name="pmid18058655">{{cite journal |author=Hopper AD, Cross SS, Sanders DS |title=Patchy villous atrophy in adult patients with suspected gluten-sensitive enteropathy: is a multiple duodenal biopsy strategy appropriate? |journal=Endoscopy |volume=40 |issue=3 |pages=219–24 |year=2008 |month=Machi |pmid=18058655 |doi=10.1055/s-2007-995361 |url=}}</ref><ref name="pmid16036509">{{cite journal |author=Kaukinen K, Peräaho M, Collin P, ''et al.'' |title=Small-bowel mucosal transglutaminase 2-specific IgA deposits in coeliac disease without villous atrophy: a prospective and randomized clinical study |journal=Scand. J. Gastroenterol. |volume=40 |issue=5 |pages=564–72 |year=2005 |month=Mei |pmid=16036509 |doi=10.1080/00365520510023422 |url=https://archive.org/details/sim_scandinavian-journal-of-gastroenterology_2005-05_40_5/page/564}}</ref> Utafiti mmoja wa sasa umependekeza kwa sampuli za bayopsi zilizo distali na mbuti ili kuepuka hatari ya bandia hasi. Kuondoa uwezekano wa GSE kunaweza kufanywa kwa ujumla kwa kuongeza uanishaji wa HLA-DQ, ambapo DQ2 na DQ8 zinapatikana katika enteropathia kwa 98% ya matukio kati ya watu wenye asili ya Kihindi-Kizungu, DQ7.5 ya 1.6% iliyobakia na 0.4% ambayo haikupatikana kwa yoyote kati ya hizi 3. Bila ATA au uchanya wa HLA-DQ2 / 8, GSE ina uwezekano mdogo sana wa kuwa ndio chanzo cha unyeti. Katika matukio yote mawili, mbinu zingine za utambuaji, kama vile kupima mzio zinapatikana. <ref name="pmid11063153">{{cite journal |author=Kaukinen K, Turjanmaa K, Mäki M, ''et al.'' |title=Intolerance to cereals is not specific for coeliac disease |journal=Scand. J. Gastroenterol. |volume=35 |issue=9 |pages=942–6 |year=2000 |month=Septemba |pmid=11063153 |doi= 10.1080/003655200750022995|url=https://archive.org/details/sim_scandinavian-journal-of-gastroenterology_2000-09_35_9/page/942}}</ref> Mara nadra unyeti wa gluteni unaweza kuwa na asili isiyojulikana, uwezekano kuwa protini za ngano huchangia kwa magonjwa mengine, katika matukio hayo DQ1 inaweza kuhusishwa na unyeti, lakini kwa matatizo ya neva, lishe lisilo na gluteni halijaonyeshwa kuwa na athari chanya kwa matokeo ya wagonjwa kama ilivyo katika enteropathia au mzio. == Enteropathia unaoathiri kiwango-hisi cha gluteni == [[File:Coeliac Disease.png|left|thumb|300px|Mchoro wa Uainishaji wa Marsh wa patholojia ya juu ya jejuni katika ugonjwa wa siliaki]] Ugonjwa wa siliaki ni unyeti wa gluteni uliofafanuliwa kirasmi na ugonjwa wa chunusi sugu yenye mwasho uliongezewa katika ufafanuzi unaopanuka wa unyeti wa gluteni. Utambuaji wa "kiwango cha dhahabu" cha ugonjwa wa siliaki kama vile uvombe wa viungo au tishu unaotambvuliwa katika bayopsi za mbuti. Hata hivyo, kwa sasa inatambulika kuwa uvimbe wa tishu ya epitheliali ya chango unatangulia atrofia. Katika awamu ya kwanza ya ugonjwa huo, gluteni hutoa kitambua limfu ya T ya haidroliseti za gluteni (polipeptidi za gluteni) na peptidi za gluteni ambazo huungana na transglutaminesi (tTG) ya tishu za mamalia. Mwingiliano wa pili huleta matokeo katika uzalishaji wa "kingamwili" binafsi kwa tTG. Hii inaongeza limfu ndani ya epithelia ya chango (Marsh daraja la 1 na 2) na changamano za zindiko za tTG huonekana kama mashapo. Hii huendelea na kuwa ugonjwa wa siliaki (Marsh daraja la 3 na 4). Chanzo kuu cha mlisho cha GSE sio gluteni ya ngano pekee. 'Gluteni' kutoka kwa kila aina ya mimea yote inayolika ya ''Tritikea'' zinaweza kusababisha GSE kati ya watu walio na uwezekano wa kuambukizwa (taz: Kemia ya kinga ya gluteni). {{Main|Coeliac disease|l1=Coeliac disease (CD)}} {| class="wikitable" align="right" |+ Marudio ya fenotaipu katika ugonjwa wa Siliaki, Wamarekani wa kawaida, uwiano wa uwezekano wa kuambukizwa ugonjwa | | colspan="5"| Ainahaplo za DQ-Ugonjwa wa siliaki |- | 2.5 | 2.2 | 7.5 | 8.0 | Zingine |- | '''2.5''' | 34 | 22 | 4.0 | 2.0 | 22 |- | '''2.2''' | | 1.1 | 4.0 | 1.1 | 2.9 |- | '''7.5''' | | | 0.3 | 0.0 | 1.3 |- | '''8.1''' | | | | 2.9 | 2.0 |- | '''nyingine''' | | | | | 0.4 |- | | colspan="5"| haplotaipu za DQ -Idadi ya kawaida |- | 2.5 | 2.2 | 7.5 | 8.1 | Zingine |- | '''2.5''' | 1.7 | 2.9 | 2.9 | 1.8 | 15.1 |- | '''2.2''' | | 1.2 | 2.4% | 1.6 | 12.8 |- | '''7.5''' | | | 1.2 | 1.5 | 1.3 |- | '''8.1''' | | | | 0.5 | 8.0 |- | '''nyingine''' | | | | | 33.4 |- | | colspan="5"| Uwiano wa uwezekano wa kuambukizwa ugonjwa |- | 2.5 | 2.2 | 7.5 | 8.1 | Zingine |- align="center" | '''2.5''' | 20:01 ¹ | 8:01 ² | 1.4:1 ⁶ | 1.1:1 | 1.5:1 ⁵ |- align="center" | '''2.2''' | | 1:1.1 | 1.6:1 ⁴ | 1:1.3 | 1:05 |- align="center" | '''7.5''' | | | 1:04 | 0 | 1:10 |- align="center" | '''8.1''' | | | | 6:01 ³ | 1:04 |- align="center" | '''nyingine''' | | | | | 1:100 |} Kuna idadi kubwa ya magonjwa yanayotokana na GSE ambayo yanaweza kutokea kabla ya kustawi kwa ugonjwa wa siliaki na huenda ikawa na na inaweza kuwa na majibu ya gluteni. Ingawa kiwango cha uvimbe wa viungo na tishu katika baadhi ya matukio ya GSE huenda yasifikie kiwango cha kutambulika cha ugonjwa wa siliaki, kupanda kwa kiwango cha kinga kwenye seli kuna uwezo wa kusababisha matatizo yanayohusiana mara kwa mara na ugonjwa wa siliaki. Hali za baadaye za GSE ni vigezo muhimu vya utambuaji wa kiwango-hisi cha gluteni wakati ambapo huenda kukawa hakuna matatizo yoyote dhahiri ya chango. Kujitokeza kwa GSE mara nyingi hutokana na utambuzi wa awali wa hali ya baadaye ambayo katika upimaji wa kufuatilia (upimaji wa ATA, upimaji wa AGA, Uainishaji wa HLA-DQ, na / au bayopsi) hutambua hali ya msingi. Hali za baadaye zinazohusishwa na GSE huwa na mwegemeo wa kufanya kujitokeza baadaye kwa ugonjwa wa Siliaki kuwa jambo linalofuata utaratibu. == Unyeti wa gluteni wenye asili isiyojulikana == Magonjwa '''yenye asili isiyojulikana''' yanapendekezwa kama upanuzi wa unyeti wa gluteni. Asili ya magonjwa haya huwa hayajulikani. Miaka mia moja iliyopita, kabla ya gluteni kutambuliwa kuwa chanzo cha ugonjwa wa siliaki, ugonjwa wa siliaki kati ya watu wazima uliitwa steatoria ya watu wazima wenye asili isiyojulikana, ugonjwa wa sprue wa hari, na majina mengine mengi. Mjadala kuhusu kategoria hii ndogo unatokana na hali ambapo utambulishaji wa daraja zote za GSE na mzio hazitumii mtazamo mmoja. Matukio zaidi ya awali ya GSE huwa hayatambuliki, hasa kabla ya mwaka wa 2005. Inaonekana kuwa kuna idadi ndogo ya watu wasio na unyeti wa gluten ya GSE wasioonyesha yoyote kati ya mizio ya gluteni lakini wana kiwango cha juu kuwa nyanyuliwa kinza-gliadini IgA au IgG. Dalili za kawaida ni niuropathia za pembeni na ataksia ya ubongo. Ndani ya seti ya GSE, matokeo haya yanaweza kuelezwa kupitia ukalisishaji wa mipito ya ubongo na ukosefu wa vitamini. Ndani ya makundi yaliyobakia ya 'DQ2 na bila DQ8'. Kwa kuwa kundi hili la GS lina asili lisilojulikana, jukumu la mzio, dutu zingine zenye hisi (km aspirini), au vipengele vingine katika IGS pia bado hazijatatuliwa. '''Ugonjwa wa kimya.''' Ikitegemea upimaji, kati ya 3% na 15% ya watu wa kawaida wana kingamwili dhidi ya gliadin (AGA). Utafiti unaotumia kingamwili dhidi ya gliadini (AGA) umeonyesha kwamba kati ya watu ambao hawajatambuliwa kuwa na ugonjwa au watu wenye AGA ambao hawajatibiwa wana hatari zaidi ya kupata saratani za limfu na uwezekano wa chini zaid wa kupata magonjwa mengine yanayohusishwa na utajiri.<ref name="pmid17206762">{{cite journal | author = Anderson LA, McMillan SA, Watson RG, ''et al.'' | title = Malignancy and mortality in a population-based cohort of patients with coeliac disease or "gluten sensitivity" | journal = World J. Gastroenterol. | volume = 13 | issue = 1 | pages = 146–51 | year = 2007 | pmid = 17206762 | doi = }}</ref> Hata hivyo haijulikani ni asilimia ngapi walio katika awamu ya kwanza ya GSE. ===Niuropathia === ===Hali nyingine === Kingamwili za gliadin ya α zimeongezeka kwa kiasi kikubwa kati ya watu wasiougua ugonjwa wa siliaki lakini wana vidonda vya mdomo.<ref name="pmid1753350">{{cite journal | author = O'Farrelly C, O'Mahony C, Graeme-Cook F, Feighery C, McCartan BE, Weir DG | title = Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy | journal = J. Oral Pathol. Med. | volume = 20 | issue = 10 | pages = 476–8 | year = 1991 | pmid = 1753350 | doi =10.1111/j.1600-0714.1991.tb00407.x }}</ref> Kingamwili dhidi ya kingamwili za gliadin α hupatikana mara nyingi katika ugonjwa wa siliaki (CD), na kwa kiwango kidogo zaidi katika matukio [[wikt:subclinical|yasiyo na dalili za kliniki]], lakini pia hupatikana kati ya makundi madogo yasiyo na ugonjwa huo. Marejeo ya 1991 yanatokana na kipindi ambapo upimaji wa CD isiyo na dalili za kliniki ulikuwa haujastawi ipasavyo. Kati ya watu wenye ugonjwa bandia wa ubambuaji, 25% walionyesha kuongezeka kwa viwango vya kinza-gliadini IgA.<ref name="pmid7656149">{{cite journal | author = Ringvold A, Overgaard RG | title = Increased IgA antibodies to gluten and gliadin in serum of persons with ocular pseudo-exfoliation | journal = Acta ophthalmologica Scandinavica | volume = 73 | issue = 2 | pages = 171–2 | year = 1995 | pmid = 7656149 | doi =10.1111/j.1600-0420.1995.tb00662.x }}</ref> Robo ya watu wenye ugonjwa wa Sjögren walikuwa majibu kwa gluteni, kati ya 5 waliokuwa na mwitikio chanya kwa gluteni, ni mmoja tu angeweza kudhibitishwa kama CD na mwingine alikuwa uwezekano wa kuwa na GSE, watatu waliosalia wanaonekana kuwa na kiwango cha juu cha hisi cha gluteni. Wote walikuwa na HLA-DQ2 na / au DQ8.<ref name="pmid17613926">{{cite journal | author = Lidén M, Kristjánsson G, Valtýsdóttir S, Hällgren R | title = Gluten sensitivity in patients with primary Sjögren's syndrome | url = https://archive.org/details/sim_scandinavian-journal-of-gastroenterology_2007-08_42_8/page/962 | journal = Scand. J. Gastroenterol. | volume = 42 | issue = 8 | pages = 962–7 | year = 2007 | pmid = 17613926 | doi = 10.1080/00365520701195345}}</ref> Matibabu ya kutibu dalili za ugonjwa wa Crohns (CrD) kupitia mlo wa kubagua ulionyesha kuwa vyakula kuu zaidi zilizosababisha dalili vilikuwa no ngano na maziwa.<ref name="pmid6526690">{{cite journal | author = Workman EM, Alun Jones V, Wilson AJ, Hunter JO | title = Diet in the management of Crohn's disease | journal = Human nutrition. Applied nutrition | volume = 38 | issue = 6 | pages = 469–73 | year = 1984 | pmid = 6526690 | doi = }}</ref> Uchunguzi wa baadaye ulionyesha mwitiko mdogo wa kupatanishwa wa IgE, isipokuwa wa maziwa,<ref name="pmid2321808">{{cite journal | author = Frieri M, Claus M, Boris M, Zitt M, Scalise D, Harris N | title = Preliminary investigation on humoral and cellular immune responses to selected food proteins in patients with Crohn's disease | journal = Annals of allergy | volume = 64 | issue = 4 | pages = 345–51 | year = 1990 | pmid = 2321808 | doi = }}</ref> huku utafiti mwingine ukionyesha ukosefu wa uhusiano muhimu wa IgE dhidi ya chakula.<ref name="pmid9430498">{{cite journal | author = Huber A, Genser D, Spitzauer S, Scheiner O, Jensen-Jarolim E | title = IgE/anti-IgE immune complexes in sera from patients with Crohn's disease do not contain food-specific IgE | journal = Int. Arch. Allergy Immunol. | volume = 115 | issue = 1 | pages = 67–72 | year = 1998 | pmid = 9430498 | doi =10.1159/000023832 }}</ref> Ugonjwa wa Crohn (CrD) unaweza kuwa na uhusiano na ngano usiotegemea gluteni. CrD inaonekana kuhusishwa na kiwanngo cha juu cha kingamwili dhidi ya chachu mwiliini (ASCA - antijeni za chachu hupatikana kwenye mkate na bidhaa zingine zinazotokana na nafaka) na watu walioathirika hawana protini za lektini zinazounganisha na hivyo basi manini kwenye chachu, kingamwili zinazoziunganisha na huongeza kolitisi inayosababisha uvimbe. Jambo la kufadhaisha kuhusu utafiti huu ni kujitokeza kwa waalamishaji wengi wa enteropathia ya unyeti wa gluteni, na mtu anapaswa kujiuliza namna ambavyo hali hizi zipo ikiwa uchunguzi wa makini wa GSE bado haujafanywa. == Viwango mbalimbali vya hisi vyenye uhusiano na mzio wa gluteni == '''Ni kwa nini [[mzio]] wa gluteni unapaswa kutibiwa kama unyeti?''' katika miaka 10 iliyopita, imedhihirika ya kuwa mzio kwa dutu fulani hazijitokezi kwa njia zinazoweza kutabirika. Mfano mmoja wazi wa jambo hili ulihusisha anafilaksisi na pumu. WDEIA (Anafilaksisi unaotegemea Ngano na kusababihwa na mazoezi) sasa inaaminika kuwa inatokana na gluteni iliyomezwa na kufikia mfumo wa damu. Njia hii kwa sasa inaaminika kuwa ndicho chanzo cha aina fulani za ukurutu. Tafiti za karibuni kuhusu vizio zinaonyesha kuwa zinamiliki uwezo wa kupita kizuizi cha matumbo/damu. Kati ya hizi mbili, iliyo hai zaidi ni gliadini ω-5 ambayo ni sehemu ya gluteni iliyo kizio dhabiti na husababisha WD_EIA. Upimaji wa mzio hueda usitambue mizio yote kwa gluteni kwa kuwa vizio ambavyo havijagawanywa 'vimefichwa' kutokana na upimaji huo, na vipimo vinavyopatikana vya hivi karibuni haviwezi kutambua vizio hivi vipya. Hatimaye, mizio kwa kawaida huhusisha IgE, lakini baadhi ya tafiti zinaonyesha kuwa kuna kategoria kadhaa za majibu, kwa mfano IgG1, IgG2, IgG4 ambazo zinahusishwa na IgE.<ref name="pmid1693911">{{cite journal | author = Pfeil T, Schwabl U, Ulmer WT, König W | title = Western blot analysis of water-soluble wheat flour (Triticum vulgaris) allergens | journal = Int. Arch. Allergy Appl. Immunol. | volume = 91 | issue = 3 | pages = 224–31 | year = 1990 | pmid = 1693911 | doi =10.1159/000235121 }}</ref> Mzio wa gluteni unaweza kuwa ni chanzo cha baadhi ya unyeti wa gluten wenye asili isiyojulikana na mzio wa gluteni unaweza kuwa matokeo ya pili ya enteropathia ya unyeti wa gluteni. == Ulinganishaji wa pathofisiolojia == <div align="center"> {| class="wikitable" style="text-align: left; font-size:90%" |+ Ulinganishaji wa aina tofauti za | hisi ya gluteni -! ! | Enteropathia ya unyeti wa gluteni !! | | Mzio wa ngano! | Niuropathia ya unyeti wa gluteni wenye asili isiyojulikana | - | Dalili za kawaida | | stiatoria (kiwango cha juu cha mafuta kwenye kinyesi), utapiamlo, kuhara, kutostahimili laktosi, mzio kwa chakula | | ukurutu, pumu | | ataksia, niuropathia za pembeni | - | Malengo ya msingi ya tishu | | epithelia ya chango | | (ngozi ya nje) ngozi ya ndani, vikoromeo, matumbo | | CNS, neva za pembeni | - | Patholojia zisizo za kawaida | | wengine magonjwa mengine ya kingamwilinafsi,uyabisi sugu wa tumbo, niuropathia, kansa (ya limfu) | | ugonjwa wa baridi yabisi, vipandauso, anafilaksisi (ya mazoezi au inayosababishwa na aspirini) | | zisizojulikana | - | Malengo ya pili (ya kawaida) | | damu (Kemia), utumbo, mfumo wa neva, antijeni za kiotomatiki | | tishu unganifu, CNS, za utomvu | | | - | Isotipu ya Imunoglubulini | | IgA, IgG | | IgE, <small>IgG, IgA</small> | | IgG, <small>IgA</small> | - | Utambuaji wa kingamwili | | gliadini α / β, y (AGA), transglutaminesi (ATA) | | albumini, globulini, prolamini(gliadini-ω) (AGA), glutelini (LMW) (AGA) | | gliadini α / β | - | Mahusiano HLA | DQ2.5 |, DQ8, DQ2.2 / DQ7.5 | | zisizofahamika | | DQ2, DQ8?, DQ1? | - | Kinga ya seli | | Viini T, Esinofili, Monositi | | seli za masti, Esinofili | | zisizofahamika | - | Majibu ya asili | | (gliadini α) kinga, kuongezeka kwa upenyezaji | | (gliadini ω-5) - kuongezeka kwa upenyezaji | | zisizofahamika | - | Historia na marejeo | | Ugonjwa wa siliaki, Hali za GSEA | | Mzio wa ngano | | Niuropathia za IGS |)</div><small>Vidokezo kuhusu jedwali. </small><small>Vipengele vya niuropathia vyenye asili isiyojulikana vinadhani kwamba vikundi vyote vya GSE vimeondolewa, na kuwa kuna unyeti wa gluteni, lakini hakuna uwezekano wa kukuwa kwa GSE. </small><small>Kingamwili dhidi ya gliadini zinahusisha isotipu zoe za imunoglobulini na isofomu zote za gliadini. </small><small>Kiini T, Kiini kinachoua, na vitambuaji vingine vya gluteni vimejumishwa katika imunokemia ya gluten.</small> |} ==Vyanzo vya gluteni== {| style="margin-left:2em;border:1px #ccffdd solid;background:#ebffef" align="right" |- | {| style="text-align:left;margin-left:0em;background:#ebffef" |- align="center" | <div style="font-size:medium;line-height:120%">'''Siasa za dutu zisizo na gluteni na shayiri''' </div> |- | '''Miongozo ya sasa''' |- | width="350px"|Kutokana na hali ilivyo, kiwago cha sasa cha kimataifa kuhusu maelezo ya dutu "zisizo na gluteni", kilichoandikwa mwaka wa 1981 na kukubaliwa juu ya mwaka wa 1983<ref>[82] ^ p.47, MRADI WA PAMOJA WA FAO / WHO WA VIWANGO VYA CHAKULA TUME YA CODEX ALIMENTARIUS Kikao cha 15 cha Roma, 4-15 Julai 1983 TAARIFA YA KIKAO CHA 13 CHA [http://www.codexalimentarius.net/download/report/241/al83_26e.pdf KAMATI YA CODEX KUHUSU VYAKULA KWA MATUMIZI MAALUM YA LISHE] {{Wayback|url=http://www.codexalimentarius.net/download/report/241/al83_26e.pdf |date=20110604193235 }} Bonn-Bad Godesberg, 20-24 Septemba 1982</ref> kulingana na Codex Alimentarius (CA), inasema:<blockquote>''Kwa madhumuni ya kiwango hiki, gluteni inafafanuliwa kama protini ambazo, kwa kawaida hupatikana katika ngano, tritikali, aina tofauti za shayiri ambazo watu wengine hawawezi kustahimili.'' <ref>[83] ^ ''"Codex standard kwa" GLUTEN-za vyakula ", [http://www.codexalimentarius.net/download/standards/291/CXS_118e.pdf Codex Stan 118-19811] {{Wayback|url=http://www.codexalimentarius.net/download/standards/291/CXS_118e.pdf |date=20111221074901 }} .'' Codex ''alimentaris, Shirika la Chakula na Kilimo la Umoja wa Mataifa''</ref></blockquote>Mwongozo wa huduma ya Lishe la Shirika la Marekani la Chakula ''umetoa msimamo ufuatao kuhusu utumiaji wa shayiri katika hali ya matibabu inayohitaji chakula kisicho na gluteni:'' <blockquote>'''' </blockquote>'''' Hata hivyo, shayiri zinazopatikana sokoni nchini Marekani huenda zimeongezewa kiasi fulani cha ngano au shayiri. Kwa sababu hiyo, ikiwa umetambuliwa kuwa una ugonjwa wa siliaki, haupaswi kukula. Mara tu utumbo wako unapopona, unaweza kujadiliana na mtaalamu wako wa chakula a daktari yako kuhusu matumizi ya shayiri.''<ref name="ADA_Oats"></ref> Hii inaonyesha haja ya kuwepo kwa kiwango tofauti cha uhalisi kwa watu walio na unyeti wa gluten.'' <br>'''' |- | '''Viwango vipya vinavyojitokeza''' |- | width="350px"| ''Codex Alimentarius'' inarekebishwa na kiwango kilichorekebishwa kitawasilishwa katika mkutano wa Tume ya Codex Alimentarius mwishoni mwa Juni 2008.<ref>[85] ^ "TUME LA CODEX ALIMENTARIUS - Kikao cha Thelathini na moja - Geneva, Uswisi, 30 Juni - 5 Julai 2008". Kutoka ukurasa wa juu. Kamati kuhusu lishe na vyakula kwa Matumizi Maalum ya mlo. MRADI WA PAMOJA WA FAO / WHO KUHUSU KIWANGO CHA CHAKULA TUME LA CODEX ALIMENTARIUS. Kikao cha thelathini na moja Geneva, Uswisi, 30 Juni-4 Julai 2008, Tume ya Codex Alimentarius [http://www.codexalimentarius.net/download/report/687/al08_26e.pdf TAARIFA YA MKUTANO wa 29 WA KAMATI KUHUSU LISHE NA VYAKULA KWA MATUMIZI MAALUM KATIKA MLO] {{Wayback|url=http://www.codexalimentarius.net/download/report/687/al08_26e.pdf |date=20110511134650 }}</ref> Kiwango kinachopendekezwa kinaweka kimomo kwa kiasi cha dutu kinachoongezwa kwa bidhaa fulani kitakachoifanya bidhaa hiyo kuhihitimu kuitwa bidhaa isiyo na gluteni <blockquote>''Vyakula visivyao na gluteni ni vyakula vya ugunga a) vinavyojumuisha au vilivyoundwa kwa kiungo moja au zaidi ambazo hazina ngano (yaani, kila aina ya spishi ya Tritikamu, kama vile ngano ya durumu, spelti na kamuti), shayiri ¹ au aina tofauti zilizochnganywa, na kiwango cha gluteni kisichozidi miligramu 20 / kilogramu kwa jumla, kulingana na chakula kama inavyouzwa au kusambazwa kwa mtumiaji, na / au b) ikijumuisha kiungo moja au zaidi kutoka kwa ngano (yaani, aina zote za Tritikamu kama vile durumu, ngano, spelti na kamuti), shayiri ¹ au aina zilizochanganywa, na ambazo zimepitia mchakato wa kuondoa gluteni, na kiwango cha gluteni hakizidishi miligramu 20 / kilogramu kwa jumla, kulingana na chakula ilivyouzwa au kusambazwa kwa mtumiaji.'' <ref name="CAC_GF">[86] ^ ''"Rasimu ya kiwango kilichorekebishwa cha Vyakula kwa matumizi ya lishe maalum kwa Watu wasio na uastahimilivu Gluteni (kwa Hatua ya 8)".'' ukurasa 50-51. Kamati ya Lishe na vyakula kwa Matumizi Maalum ya lishe. MRADI WA PAMOJA WA FAO / WHO WA VIWANGO VYA CHAKULA TUME YA CODEX ALIMENTARIUS KIKAO CHA thelathini na moja Geneva, Uswisi, 30 Juni-4 Julai 2008, Tume ya Codex Alimentarius [http://www.codexalimentarius.net/download/report/687/al08_26e.pdf TAARIFA YA MKUTANO WA 29 WA KAMATI YA CODEX KUHUSU LISHE NA VYAKULA KWA MATUMIZI MAALUM KATIKA MLO] {{Wayback|url=http://www.codexalimentarius.net/download/report/687/al08_26e.pdf |date=20110511134650 }}</ref></blockquote><blockquote>^''1'' Kamati ilikubali kubainisha kuwa posho za shayiri ambazo hazijachanganywa na ngano, au aina zingine za shayiri katika vyakula vilivyojumuishwa chini ya kiwango hiki vinaweza kubainishwa katika ngazi ya kitaifa.''"<ref name="CAC_GF"></ref>'' </blockquote>Kwa kutambua faida ya shayiri zima katika chakula kishicho na gluteni, Shirika la Siliaki la Kanada lilijitolea kuhakikisha kuwa shayiri na bidhaa za shayiri zinatimiza viwango vya vyakula visivyo na gluteni vilivyowekwa na Shirika la Ukaguzi wa Chakula na Afya la Kanada:<blockquote>Kwa kushirikiana na Shirika la Afya la Kanada, Shirika la Kilimo na vyakula vinavyopandwa la Kanada na Shirika la Ukaguzi wa Chakula la Kanada, limeorodhesha mambo yanayohitajika kwa upanzi, uchakataji, na upimaji wa uhalisi na ualamishaji wa shayiri ''halisi.<ref name="pmid17948135">{{cite journal |author=Rashid M, Butzner D, Burrows V, ''et al.'' |title=Consumption of pure oats by individuals with celiac disease: a position statement by the Canadian Celiac Association |journal=Can. J. Gastroenterol. |volume=21 |issue=10 |pages=649–51 |year=2007 |month=Oktoba |pmid=17948135 |doi= |url= |pmc=2658132}}</ref>'' </blockquote> |} Kutokana na mtazamo wa unyeti wa gluteni hakuna ufafanuzi wowote mmoja wa gluteni unaoeleza kikamilifu aina zote za gluteni ambazo zina uwezekano wa kusababisha magonjwa. Kwa mizio ya ngano, kunaweza kuwa na spishi nyingi ambazo huenda zikazindua mizio katika protini sawa. Protini za omega-gliadini zina protini sawa na zile zinazopatikana kwa kiwango cha juu katika shayiri, lakini mzio wa omega-gliadini hauwezi kutabiri mzio wa ukosefu wa ustahimilivu kwa shayari.<ref name="pmid6154431">{{cite journal | author = Baldo BA, Krilis S, Wrigley CW | title = Hypersensitivity to inhaled flour allergens. Comparison between cereals | journal = Allergy | volume = 35 | issue = 1 | pages = 45–56 | year = 1980 | pmid = 6154431 | doi =10.1111/j.1398-9995.1980.tb01716.x }}</ref> Mtu anaweza kuwa na mzio kwa ngano, lakini asiwe na mzio kwa shayari.<ref name="pmid16025333">{{cite journal | author = Karatay S, Erdem T, Kiziltunc A, ''et al.'' | title = General or personal diet: the individualized model for diet challenges in patients with rheumatoid arthritis | journal = Rheumatol. Int. | volume = 26 | issue = 6 | pages = 556–60 | year = 2006 | pmid = 16025333 | doi = 10.1007/s00296-005-0018-y}}</ref> Glutelini hazijaainishwa katika taksonomia pana. Katika unyeti wa gluteni wenye asili isiyojulikana, kingamwili zinazohusianan na ugonjwa ni kingamwili dhidi ya gliadini. Haijulikani ikiwa kingamwili hizi zinaweza kusababisha magonjwa au ni viashiria tu vya gliadini inayozunguka mwilini. Kwa enteropathia ya unyeti wa gluten, gliadini na protini za umbo sawa kutoka kwa shayiri huleta ugonjwa. Epitopi za kiini T zinaohusishwa na ugonjwa zimepatikana katika jeni za protini za kunata katika aina zote za spishi zilizoorodheshwa ndani ya kabila la ''Tritikea'' .<ref name="Kupper">{{cite journal | author = Kupper C | title = Dietary guidelines and implementation for celiac disease | journal = Gastroenterology | volume = 128 | issue = 4 Suppl 1 | pages = S121–7 | year = 2005 | pmid=15825119 | doi = 10.1053/j.gastro.2005.02.024}}</ref> Pia, kwa kuwa shayiri ina uhusiano wa mbali na ngano, lakini inabeba epitopi, inaweza kudhaniwa kuwa mimea yote ya kategoria ya ''Tritikea'' inapaswa kuwa na seli za T zenye uwezo wa kuendeleza ugonjwa (tazama pia Jenetiki ya Tritikea). Ingawa mara nyingi haieezwi katika baadhi ya viwango, gluteni za ugonjwa zinazopatikana katika ngano pia hupatikana katika Spelti na Kamuti (zote ni aina za ngano), Tritikale (aina ndogo ya mchangnyiko wa Tritikea). [[File:Haverkorrels Avena sativa.jpg|left|thumb|Nafaka za shayiri katika katika maganda yao]] ===Mabishano kuhusu shayari=== [[Oti|Shayari]] ni spishi katika kabila la majani la ''Avenea,'' ambalo liko katika jamii ndogo ya Pooidea pamoja na Tritikea (iliyo na ngano, shayari na jenera zingine nyingi). Shayiri ndizo spishi zenye uhusiano wa karibu zaidi sana na nafaka za ''Tritikea'' . Shayiri ziaweza kuwa na protini zinazosababisha ugonjwa na ambazo huendeleza ugonjwa wa unyeti wa gluteni. Vinginevyo, mbegu za shayiri huonekana kufanana na mbegu za ngano na shayiri na uchanganyikaji kati ya nafaka hizi ni mgumu kutatua. ====Asili ya ubishi==== Baada ya [[Vita Kuu ya Pili ya Dunia|Vita Kuu vya II vya Dunia]], ngano ilituhumiwa kuwa ndiyo chanzo chz ugonjwa wa siliaki, na gluteni kutoka kwa ngano ilitambuliwa baadaye kama mojawapo ya sababu. Wakati huo, bayopsi ya mbuti-kiwango cha sasa cha "dhahabu" katika utambuzi-ilikuwa bado haijatengenezwa,<ref name="pmid13571252">{{cite journal |author=SMITH RB, SPRINZ H, CROSBY WH, SULLIVAN BH |title=Peroral small bowel mucosal biopsy |journal=Am. J. Med. |volume=25 |issue=3 |pages=391–4 |year=1958 |month=Septemba |pmid=13571252 |doi= 10.1016/0002-9343(58)90077-9|url=http://linkinghub.elsevier.com/retrieve/pii/0002-9343(58)90077-9}}</ref> na vipimo vya ugonjwa visivyo vya vilitumika. Katika tafiti mbili, watoto watatu walipewa gramu 75 hadi 150 ya shayiri kwa siku na dalili zilijitokeza. Katika tafiti tatu zilizofanywa kwa wakati mmoja, watoto 10 na watu wawili wazima waliruhusiwa kula gramu 28 hadi 60 ya shayiri na hakuna dalili zozote zilizojitokeza.<ref name="pmid17327936">{{cite journal |author=Garsed K, Scott BB |title=Can oats be taken in a gluten-free diet? A systematic review |journal=Scand. J. Gastroenterol. |volume=42 |issue=2 |pages=171–8 |year=2007 |month=Februari |pmid=17327936 |doi=10.1080/00365520600863944 |url=https://archive.org/details/sim_scandinavian-journal-of-gastroenterology_2007-02_42_2/page/171}}</ref> Kwa kuwa ngano, bali na wakati mwingine rai ni dutu ambazo kwa kawaida huongezwa katika shayiri,<ref name="ADA_Oats">[101] ^ Shirika la Lishe la Marekani. Mwongozo wa huduma za lishe: Ugonjwa wa siliaki. Inapatikana: http://www.nutritioncaremanual.org. Ilifikiwa 15 Desemba 2004.</ref><ref name="pmid15525734">{{cite journal |author=Thompson T |title=Gluten contamination of commercial oat products in the United States |journal=N. Engl. J. Med. |volume=351 |issue=19 |pages=2021–2 |year=2004 |month=Novemba |pmid=15525734 |doi=10.1056/NEJM200411043511924 |url=https://archive.org/details/sim_new-england-journal-of-medicine_2004-11-04_351_19/page/n153}}</ref> hadi pale ambapojambo hili lilichunguzwa, shayiri iliaminika kuwa ni sumu kwa siliaki. ====Matokeo ya sasa==== Ingawa tatizo la ukolezi limejulikana kwa miaka kadhaa, utafiti uliochapishwa mnamo Juni 2008 ilionyesha kuwa kati ya vyanzo 109 vya shayiri vilivyochinguzwa, 85 vilikuwa na viwango visivyokubalika vya gluteni kutoka kwa ngano, bali au rai.<ref name="pmid18467914">{{cite journal |author=Hernando A, Mujico JR, Mena MC, Lombardía M, Méndez E |title=Measurement of wheat gluten and barley hordeins in contaminated oats from Europe, the United States and Canada by Sandwich R5 ELISA |journal=Eur J Gastroenterol Hepatol |volume=20 |issue=6 |pages=545–54 |year=2008 |month=Juni |pmid=18467914 |doi=10.1097/MEG.0b013e3282f46597 |url=}}</ref> Shayiri zilizochafuliwa na ''tritikea'' katika utafiti zilitoka nchi nyingi na hivyo kuonyesha kwamba vyanzo vingi vya shayiri havikubaliki kwa GS kulingana na ukolezi. ===Viwango vinavyostahimilika vya gluteni=== Kwa muhtasari wa maendeleo ya hivi karibuni, shayiri inaweza kustahimilika katika lishe lisilo na gluteni, lakini bidhaa za shayiri zinafaa kudhibitiwa kutokana na ukolezi wa gluteni inayotokana na ''Tritikea'' na 20 PPM (miligramu 20 kwa kilo). Marekani ina uhuru wa kukataa kiwango cha lebo ya GF kwa bidhaa za shayiri, kama imeidhinishwa (tazama Siasa za Kutokuwa kwa gluteni na shayiri). ===Upimaji wa kutokuwa kwa gluteni=== ELISA mpya yenye unyeti kwa bali iitwayo sandwichi changanuzi ya R5 haitambui gluteni katika yoyote kati ya aina 25 asili za shayiri, lakini inatambua bali, ngano na rai.<ref name="pmid18467914"></ref> Shughuli za kilimo zinazozingatia magonjwa, upimaji wa kingamwili na upimaji maaalum wa kijenetiki unaozingatia spishi zina uwezo wa kuzalisha shayiri asili.<ref name="pmid18467914"></ref> Nchini Marekani, chapa 3 za humo nchini za GF zinapatikana na chapa moja iliyotoka Ayalandi 'anadai' kutengenezwa kwa 99.95% ya shayiri pekee.<ref name="GFO_C/I_P">[109] ^ [http://www.glutenfreeoats.com/cleaning.aspx ''Mchakato wa Usafishaji / Ukaguzi'' Shayiri zisizo na gluteni] {{Wayback|url=http://www.glutenfreeoats.com/cleaning.aspx |date=20101123010043 }}</ref><ref>[110] ^ ''"Je, bidhaa za Shayiri za McCann hazina gluteni"?.'' URL: [http://www.mccanns.ie/faq.html FAQ - Maswali ya mara kwa mara] {{Wayback|url=http://www.mccanns.ie/faq.html |date=20100702152825 }}</ref> Chapa mbili nchini Marekani hutumia upimaji wa kingamwili wa R5 na unadai kuwa na kiwango fafanuzi cha gluteni kilicho chini ya 20 PPM.<ref name="GFO_C/I_P"></ref><ref>[112] ^ [http://www.bobsredmill.com/catalog/index.php?action=showdetails&amp;product_ID=680 ''Shayiri zilizozunhgushwa zisizo na gluteni'' Vyakula vya kiasili vya Bob's Red Mill] {{Wayback|url=http://www.bobsredmill.com/catalog/index.php?action=showdetails&product_ID=680 |date=20210125034051 }}</ref> ===Mlo=== '''Shayiri zisizo na gluteni katika mlo usio na gluteni.''' Shayiri zisizo na gluteni zinaweza kwa chanzo muhimu cha thamani cha unyuzi, vitamini B, chuma, zinki na wanga changamano.<ref name="pmid12844381">{{cite journal |author=Størsrud S, Hulthén LR, Lenner RA |title=Beneficial effects of oats in the gluten-free diet of adults with special reference to nutrient status, symptoms and subjective experiences |journal=Br. J. Nutr. |volume=90 |issue=1 |pages=101–7 |year=2003 |month=Julai |pmid=12844381 |doi= 10.1079/BJN2003872|url=https://archive.org/details/sim_british-journal-of-nutrition_2003-07_90_1/page/101}}</ref> Tafiti za karibuni zinaonyesha kuwa watu wenye unyeti wa gluteni wanaokula chakula kishicho na gluteni mara nyingi hupata kiwango kikubwa cha stachi (wanga), kiasi kidogo cha unyuzi na vitamini B. Kwa sasa miongozo mingi haijumuishi shayiri katika mlo usio na gluteni. Igawa kuna uwezekano kuwa jambo hili litabadilika, shayiri hazipendekezwi kablay ya kupita kwa mwaka mmoja baada ya utambuzi kutokana na hatari ya enteropathia ya unyeti kwa shayiri (ASE), kutaka kujenga misingi ya kiafya na utata wa swala la ukolezi. Ulaji wa shayiri wakati kingamwili dhidi ya gliadini ziko unaongeza kingamwili dhidi ya avenini, na unaweza kukuza ASE. Bayopsi ya mbuti unaweza kupendekezwa baada ya kuanzishwa kwa ulaji wa shayiri. Fenotaipu ya DQ ya watu wote 3 wenye ASE waliochunguzwa ulionyesha hadi hapo kuwa hadi sasa unahitajika homozaigoti za DQ2 zina hatari ya kupata ASE. Ni bora zaidi ikiwa wagonjwa wa siliaki waliotoka kutambuliwa wangetafuta msaada kutoka kwa mtaalamu wa vyakula. Hata hivyo, miongozo inapatikana pia kwa ajili ya kuanzishwa kwa shayiri safi, ambazo hazijachanganywa katika mlo usio na gluteni.<ref>{{cite web | title=Guidelines for Consumption of Pure and Uncontaminated Oats by Individuals with Celiac Disease | last=Rashid | first=Mohsin | date=2007-06-08 | url=http://www.celiac.ca/Articles/PABoatsguidelines2007June.html | publisher=Professional Advisory Board of Canadian Celiac Association | accessdate=2008-08-14 | archiveurl=https://web.archive.org/web/20080417232410/http://www.celiac.ca/Articles/PABoatsguidelines2007June.html | archivedate=2008-04-17 }}</ref> == Marejeo == {{Marejeo|2}} [[Category:Magonjwa]] [[Category:Chakula]] 3b0n8xu6nyp6g01lq4v1zu1sz5h518k 0 55750 1578060 1576061 2026-07-02T17:18:41Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578060 wikitext text/x-wiki [[File:Alcohol use disorders world map - DALY - WHO2004.svg|thumb|Ulemavu-ulibadilisha maisha kwa waliotatizika na matumizi ya pombe kwa kila wakaazi 100,000 mwaka wa 2004 [0] [1] [2] [3] [4] [5] [6] [. 7] [8] [9] [10] [11 ] [12]]] [[File:Alcohol by Country.png|thumb|200px|Jumla ya rekodi ya matumizi ya pombe kwa kila mwananchi (15 +), kwa lita za pombe halisi <ref> Ripoti ya Kilimwengu ya Hali ya Pombe ya 2004 </ref>]] [[File:Possible long-term effects of ethanol.svg|thumb|300px|right|La muhimu zaidi katika madhara yanayoweza kutokea kufuatana matumizi ya muda mrefu ya ethanoli. Zaidi ya hayo, katika wanawake wajawazito,husababisha dalili za ulevi wa kijusi.]] '''Athari za muda mrefu za pombe''' hutapakaa baina ya uwezekano wa faida za kiafya kwa watumiaji wa viwango vya chini vya pombe hadi madhara makubwa katika hali ya [[Utumiaji mbaya wa vileo|matumizi mabaya ya pombe]] kwa muda mrefu. Viwango vya juu vya matumizi ya pombe huhusiana na ongezeko la hatari ya kuendeleza ulevi, ugonjwa wa moyo, kutofyonza vyakula, ugonjwa sugu wa kongosho, ugonjwa wa ini kutokana na pombe, na [[kansa]]. Uharibifu kwa mfumo mkuu wa neva na mfumo wa neva za pembeni unaweza kusababishwa matumizi kila mara ya pombe.<ref>{{cite journal |author=Müller D, Koch RD, von Specht H, Völker W, Münch EM |title=[Neurophysiologic findings in chronic alcohol abuse] |language=German |journal=Psychiatr Neurol Med Psychol (Leipz) |volume=37 |issue=3 |pages=129–32 |year=1985 |month=Machi |pmid=2988001 |doi= |url=}}</ref><ref>{{cite journal |author=Testino G |title=Alcoholic diseases in hepato-gastroenterology: a point of view |journal=Hepatogastroenterology |volume=55 |issue=82-83 |pages=371–7 |year=2008 |pmid=18613369 |doi= |url=}}</ref> Matumizi ya pombe kupita kiasi kwa muda mrefu yanaweza kuharibu takribani kila kiungo na mfumo katika mwili.<ref>{{cite book |editor1-first=Woody |editor1-last=Caan |editor2-first=Jackie de |editor2-last=Belleroche |title=Drink, Drugs and Dependence: From Science to Clinical Practice |url=http://books.google.com/?id=nPvbDUw4w5QC |edition=1st |date=11 Aprili 2002 |publisher=Routledge |isbn=978-0415278911 |pages=19–20}}</ref> Ubongo unaokua wa kijana aliyebaleghe huwa hasa katika hatari kubwa ya kudhurika na sumu ya pombe.<ref>{{Cite journal | last1 = Mellon | first1 = RD. | last2 = Simone | first2 = AF. | last3 = Rappaport | first3 = BA. | title = Use of anesthetic agents in neonates and young children. | url = http://www.anesthesia-analgesia.org/cgi/content/full/104/3/509 | journal = Anesth Analg | volume = 104 | issue = 3 | pages = 509–20 | month = Mar | year = 2007 | doi = 10.1213/01.ane.0000255729.96438.b0 | pmid = 17312200 }}</ref> Kihistoria, madaktari wametetea pombe kwa faida zake za kiafya na hivi karibuni kwa ajili ya uwezo wake wa kulinda watumiaji dhidi ya ugonjwa wa moyo. Kuna ushahidi wa faida kwa mishipa ya moyo inayotokana na kutumia kinywaji 1- 2 kwa siku, hata hivyo, faida za kiafya kutokana na unywaji pombe kwa wastani ni swala lenye utata. Shauku zimetolewa kuwa sawa na ilivyo katika sekta ya dawa, wadau wa sekta ya pombe piawamehusika katika kutilia chumvi faida za kiafya za pombe. Pombe inapaswa kuonekana kama dawa ya burudani yenye uwezo mkubwa wa kusababisha athari mbaya kwa afya na hipependekezwi kwa-ulinzi wa moyo badala ya mbinu nyinginezo za salama na zilizothibitika za jadi kama vile [[lishe]] bora mazoezi na [[tiba]] za dawa.<ref name="Sellman-2009">{{Cite journal | last1 = Sellman | first1 = D. | last2 = Connor | first2 = J. | last3 = Robinson | first3 = G. | last4 = Jackson | first4 = R. | title = Alcohol cardio-protection has been talked up. | journal = N Z Med J | volume = 122 | issue = 1303 | pages = 97–101 | year = 2009 | pmid = 19851424 }}</ref><ref>{{Cite journal | last1 = Sinkiewicz | first1 = W. | last2 = Weglarz | first2 = M. | title = [Alcohol and wine and cardiovascular diseases in epidemiologic studies] | journal = Przegl Lek | volume = 66 | issue = 5 | pages = 233–8 | month = | year = 2009 | doi = | pmid = 19739580 }}</ref> Baadhi ya wataalamu wanadai kuwa faida za matumizi ya pombe ya wastani zinaweza kupitwa na ongezeko la hatari ikiwa ni pamoja na majeraha, vurugu, uharibifu wa mimba, aina fulani za [[saratani]], ugonjwa wa kongosho na presha.<ref name="Andréasson-"></ref> Kwa vile faida bainifu za kiafya za matumizi ya pombe ya wastani ni ndogo kwa watu walio katika hatari ndogo ya kupata [[Ugonjwa|maradhi]] ya moyo, wataalamu wengine wanatahadharisha itumike kwatahadhari kwa sababu ya uwezekano kwamba kupendekeza matumizi wastani ya pombe kunaweza kusababisha ongezeko la hatari ya matumizi mabaya ya pombe, hasa miongoni mwa vijana.<ref>{{Cite web |url=http://pubs.niaaa.nih.gov/publications/arh24-1/05-11.pdf |title=Nakala iliyohifadhiwa |accessdate=2010-11-30 |archivedate=2020-11-11 |archiveurl=https://web.archive.org/web/20201111230707/https://pubs.niaaa.nih.gov/publications/arh24-1/05-11.pdf }}</ref> Manufaa haya ya matumizi wastani ya pombe yanapitwa na hatari za matumizi ya pombe wastani.<ref name="Andréasson-"></ref> ==Tafiti za kisayansi== ===Historia=== Madhara mabaya ya matumizi ya pombe kwa muda mrefu kupita kiasi ni sawa na yale yanaoonekana katika vitulizi-hipnoti vingine (mbali na sumu kwa viungo ambayo hutatiza zaidi katika pombe). Athari za kujiondoakatika pombe na utegemezi hukaribia sana kufanana.<ref>{{cite book |last1=Gitlow |first1=Stuart |title=Substance Use Disorders: A Practical Guide |url=http://books.google.com/?id=rbrSdWVerBUC |edition=2nd |date=1 Oktoba 2006 |publisher=Lippincott Williams and Wilkins |location=USA |isbn=978-0781769983 |pages=101–103}}</ref> Pombe cha kiwango wastani ina athari chanya na hasi kwa afya. Athari hasi ni pamoja na ongezeka la hatari ya magonjwa ya ini, sarataniya orofarinji, kansa ya umio na [[ugonjwa wa kongosho.]] Kinyume na hayo, unywaji wastani wa pombe unaweza kuwa na athiri za faida kwa gastriti na kolelithiasi.<ref>{{cite journal |author=Taylor B, Rehm J, Gmel G |title=Moderate alcohol consumption and the gastrointestinal tract |journal=Dig Dis |volume=23 |issue=3-4 |pages=170–6 |year=2005 |pmid=16508280 |doi=10.1159/000090163 |url=http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=DDI20050233_4170}}</ref> Matumizi sugu na mabaya ya pombe huwa na athari kubwa kwa afya ya mwili na akili. Unywaji sugu wa pombe kupita kiasi au utegemezi pombe, unaweza kusababisha uharibifu mpana viungo mbalimbali vya nevaza ubongo,mfumo wa neva ama ugonjwa wa mishipa ya moyo, maradhi ya ini, na neoplasmsi isiyopona. Matatizo ya akili ambayo huhusishwa na ulevi ni pamoja na mfadhaiko mkubwa, disthimia, mania, hipomania, tatizo la hofu fobia , tatizo la wasiwasi wa kijumla, tatizo la tabia za mtu, skizofrenia, [[kujiua]], upunufu wa mfumo wa utendakazi mwilini (km kazi za kumbukumbu, hisia, kazi za uamuzi, uwezo wa kuona,mwendo na uwiano) na uharibifu wa ubongo. utegemezi wa pombe ni huhusishwa na shinikizo la damu, ugonjwa wa moyo na kiharusi cha iskemi, kansa ya mfumo wa upumuaji, mbali pia na saratani ya mfumo wa mlo, ini, kifua na ovari. Unywaji kupita kiasi huhusishwa na ugonjwa wa ini, kama vile sairosi.<ref>{{cite journal |author=Cargiulo T |title=Understanding the health impact of alcohol dependence |journal=Am J Health Syst Pharm |volume=64 |issue=5 Suppl 3 |pages=S5–11 |year=2007 |month=Machi |pmid=17322182 |doi=10.2146/ajhp060647 |url=}}</ref> Utafiti zimelenga wanaume na wanawake, vikundi vya umri mbalimbali na watu wa makundi mengi ya kijamii. Machapisho kwa sasa yanafikia jumla ya mamia huku tafiti zikiweza kuonyesha uwiano uliopo kati ya matumizi wastani ya pombe na afya ambayo labda yanaweza kuwa yalitokana na athari za manufaa ya maingiliano ya kijamii ambayo mara nyingi huambatana na matumizi ya pombe. Baadhi ya njia mahususi ambapo pombe huweza kuathiri afya ya mishipa ya moyo zimetafitiwa.<ref>{{cite journal |author=Vliegenthart R, Oei HH, van den Elzen AP, ''et al.'' |title=Alcohol consumption and coronary calcification in a general population |journal=Arch. Intern. Med. |volume=164 |issue=21 |pages=2355–60 |year=2004 |month=Novemba |pmid=15557415 |doi=10.1001/archinte.164.21.2355 }}<br> {{cite journal |author=Koppes LL, Twisk JW, Snel J, Van Mechelen W, Kemper HC |title=Blood cholesterol levels of 32-year-old alcohol consumers are better than of nonconsumers |journal=Pharmacol Biochem Behav. |volume=66 |issue=1 |pages=163–7 |year=2000 |month=Mei |pmid=10837856 |url=http://linkinghub.elsevier.com/retrieve/pii/S0091-3057(00)00195-7 |doi=10.1016/S0091-3057(00)00195-7}}<br> {{cite journal |author=Albert MA, Glynn RJ, Ridker PM |title=Alcohol consumption and plasma concentration of C-reactive protein |journal=Circulation |volume=107 |issue=3 |pages=443–7 |year=2003 |month=Januari |pmid=12551869 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=12551869 |doi=10.1161/01.CIR.0000045669.16499.EC}}<br> {{cite journal |author=Baer DJ, Judd JT, Clevidence BA, ''et al.'' |title=Moderate alcohol consumption lowers risk factors for cardiovascular disease in postmenopausal women fed a controlled diet |journal=Am J Clin Nutr. |volume=75 |issue=3 |pages=593–9 |date=1 Machi 2002|pmid=11864868 |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=11864868 }}<br> {{cite journal |author=Catena C, Novello M, Dotto L, De Marchi S, Sechi LA |title=Serum lipoprotein(a) concentrations and alcohol consumption in hypertension: possible relevance for cardiovascular damage |journal=J. Hypertens. |volume=21 |issue=2 |pages=281–8 |year=2003 |month=Februari |pmid=12569257 |doi=10.1097/01.hjh.0000052436.12292.26 |doi_brokendate=2009-01-13 }}</ref> ===Mtazamo wa kisasa=== Utafiti fulani katika baadhi ya nchi umedai kuwa vifo vinavyosababishwa na sababu zozote zile vinaweza kufikia viwango vya baina ya 16 hadi 28% kwa uchache miongoni mwa wanywaji wa wastani (vinywaji 1-2 kwa siku) ikilinganishwa na ile miongoni mwa wanaojiepusha na unywaji kabisa.<ref>{{cite journal |author=Boffetta P, Garfinkel L |title=Alcohol drinking and mortality among men enrolled in an American Cancer Society prospective study |journal=Epidemiology |volume=1 |issue=5 |pages=342–8 |year=1990 |month=Septemba |pmid=2078609 |doi=10.1097/00001648-199009000-00003}}</ref><ref>{{cite journal |author=Coate D |title=Moderate drinking and coronary heart disease mortality: evidence from NHANES I and the NHANES I Follow-up |journal=Am J Public Health |volume=83 |issue=6 |pages=888–90 |year=1993 |month=Juni |pmid=8498629 |pmc=1694739 |url=http://www.ajph.org/cgi/pmidlookup?view=long&pmid=8498629 |doi=10.2105/AJPH.83.6.888}}</ref><ref>{{cite journal |author=Fuchs CS, Stampfer MJ, Colditz GA, ''et al.'' |title=Alcohol consumption and mortality among women |journal=N Engl J Med. |volume=332 |issue=19 |pages=1245–50 |year=1995 |month=Mei |pmid=7708067 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=7708067&promo=ONFLNS19 |doi=10.1056/NEJM199505113321901}}</ref><ref>{{cite journal |author=Klatsky AL, Friedman GD, Siegelaub AB |title=Alcohol and mortality. A ten-year Kaiser-Permanente experience |url=https://archive.org/details/sim_annals-of-internal-medicine_1981-08_95_2/page/139 |journal=Ann Intern Med. |volume=95 |issue=2 |pages=139–45 |year=1981 |month=Agosti |pmid=7258861 }}</ref> Mmwandishi wa habari Roni Caryn Rabin wa New York Times anasema kwamba takwimu za utafiti huu zina makosa.<ref name="NYT"> Roni Caryn Rabin, "Pombe" ni Nzuri Kwako? Baadhi ya Wanasayansi Wanashuku, ''"New York Times,'' 16 Juni 2009, uk. D6 [http://query.nytimes.com/gst/fullpage.html?res=9D05EFD81F3BF935A25755C0A96F9C8B63 web version]</ref> ====Upeo wa kiasi kinachopendekezwa==== Nchi mbalimbali hupendekeza kiasi tofauti cha upeo wa kunywewa. Kwa nchi nyingi kiasi cha upeo kwa wanaume ni 210g-140g kwa wiki. Kwa wanawake, kiasi ni 84g-140g kwa wiki. Nchi nyingi hupendekeza kutumiwa kwa pombe kabisa wakati ujauzito ama kunyonyesha. ==Vifo vinavyohusiana na pombe== Matumizi ya pombe kupita kiasi ni mojawapo ya sababu zinazoweza kuzuilikaambayo husababisha vifo vingi kote duniani.<ref>{{cite journal |author=Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ |title=Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data |journal=Lancet |volume=367 |issue=9524 |pages=1747–57 |year=2006 |month=Mei |pmid=16731270 |doi=10.1016/S0140-6736(06)68770-9 |url=https://archive.org/details/sim_the-lancet_may-27-june-2-2006_367_9524/page/1747}}</ref> Utafiti mmoja unahusisha pombe na kila kifo 1 katika 25 kote duniani na kwamba 5% ya miaka wanayoishi watu na ulemavu hutokana na matumizi ya pombe.<ref> BBC [http://news.bbc.co.uk/1/hi/health/8118475.stm Uhusiano wa pombe na moja katika vifo 25]</ref><ref> Jürgen Rehm, Colin Mathers, Svetlana Popova, Montarat Thavorncharoensap, Yot Teerawattananon, Jayadeep Patra [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60746-7/abstract Mzigo wa Kilimwengu wa magonjwa na maumivu na gharama za kiuchumi zinatokana na matumizi ya pombe na kutumia matatizo ya utumiaji pombe] ''The Lancet,'' Juzuu 373, Toleo 9682, Kurasa 2223 - 2233, 27 Juni 2009 doi: 10.1016/S0140-6736 (09) 60746-7</ref> Nchi hukusanya takwimu kuhusu wanaofariki kwa ajili ya pombe. Huku baadhi ya takwimu zikihusiana na athari za muda mfupi kama vile ajali, nyingi huhusiana na athari za muda mrefu wa kutumia pombe. === Urusi === "Matumizi ya pombe kupita kiasi nchini Urusi, hasa kmiongoni mwa wanaume, katika miaka ya hivi karibuni imesababisha zaidi ya nusu ya vifo katika umri wa miaka 15-54.<ref> IARC [http://www.iarc.fr/en/media-centre/iarcnews/2009/IARCLancet270709.pdf Pombe husababisha zaidi ya nusu ya vifo vyote vya mapema katika watu wazima nchini Urusi]</ref> ===Uingereza=== Vifo vinavyohusiana na pombe nchini Uingereza ni huainishwa kwa kutumia Uainisho wa Kimataifa wa Magonjwa, Toleo la Kumi (ICD-10).<ref name="NSO">[55] ^ [http://www.statistics.gov.uk/statbase/Product.asp?vlnk=14496 Vifo vinavyohusiana na pombe nchini Uingereza] na viungo vinginevyo</ref> ICD-10 hujumuisha: * Matatizo ya akili na tabia kutokana na matumizi ya pombe - ICD-10 F10 * Kuzorota kwa mfumo wa neva kutokana na pombe - ICD-10 G31.2 * Polineuropathi ya pombe - ICD-10 G62.1 * Kadiomiopathi ya pombe - ICD-10 I42.6 * Gastriti ya Pombe - ICD-10 K29.2 * Ugonjwa wa ini wa pombe - ICD-10 K70 * Hepatitis sugu , isiyoainishwa mahali kwingine kokote - ICD-10 K73 * Fibrosi na sairosi ya ini - ICD-10 K74 (bila kujumuisha K74.5 K74.3-Sairosi ya biliari) * Ugonjwa sugu wa kongosho kutokana na pombe - ICD-10 K86.0 * Sumu itumikayo kiajali kutokana na mkumbano na pombe - ICD-10 X45 * Sumu itumikayo na mtu binafsi kimaksudi kutokana na mkumbano na pombe - ICD-10 X65 * Sumu kutokana matumizi na kukumbana na pombe, bila kusudi wazi - Y15 ICD-10 Mashirika ya takwimu ya Uingereza yanaripoti kwamba "Kulikuwa na vifo 8,724 vinavyouhusiana na pombe katika mwaka 2007, chini zaidi kuliko 2006, lakini zaidi ya mara mbili ya 4,144 iliyorekodiwa katika mwaka 1991. Kiwango cha vifo kuhusiana na pombe kilikuwa 13.3 ya watu kwa kila watu 100,000 mwaka 2007, ikilinganishwa na idadi ya watu 100,000 6.9 kwa mwaka 1991."<ref> [http://www.statistics.gov.uk/cci/nugget.asp?id=1091 Vifo vya Pombe : Viwango vyalia nchini Uingereza]</ref> Nchini Skotlandi, NHS inakisio kwamba katika mwaka 2003 kifi cha kia mtu mmoja katika 20 waliofariki inaweza kuhusishwa na pombe.<ref> BBC [http://news.bbc.co.uk/1/hi/scotland/8126129.stm Pombe huua mmoja katika Waskoti 20'] 30 Juni 2009</ref> Utafiti wa 2009 uligundua kuwa watu 9,000 hufa kutokana na magonjwa yanayohusiana na pombe kila mwaka, mara tatu ya idadi ya miaka 25 ya hapo awali. ===Marekani=== Kituo cha Udhibiti na Uzuiaji Magonjwa kinaripoti kuwa, "Kutoka 2001-2005, kulikuwa na takribani vifo 79,000 kila mwaka zinazotokana na matumizi ya pombe kupita kiasi. Kwa hakika, matumizi ya pombe kupita kiasi ni ya 3 katika sababu zinazoambatana na mitindo ya kimaisha kwa kusababisha vifo kwa watu nchini Marekani kila mwaka".<ref> Vituo vya Kudhibiti na Kuzuia Magonjwa [http://www.cdc.gov/alcohol/ Pombe na Afya ya umma]</ref> Utafiti mmoja wa 1993 ulikadiria vifo vya waliofariki Marekani kupitia pombe kuwa 100,000. <ref> J. Michael McGinnis, William H. Foege [http://jama.ama-assn.org/cgi/reprint/270/18/2207?ijkey=f6b2a35ebda67d08b66074771b6a6000007c3770 Sababu Halisi za Vifo nchini Marekani] ''JAMA'' 1993, 270 (18) :2207-2212.</ref> === Vifo kwa ujumla === Utafiti uliotazamiwa wa miaka 23 wa madaktari wa kiume 12,000 Waingereza [[Ufalme wa Muungano]]wenye umri wa miaka 48-78, waligundua kuwa vifo kwa jumla vilikuwa vya chini sana kwa makundi yaliyokunywa chini ya "vipimo" 2 (Vipimo vya Uingereza = 8 g) kwa siku zaidi ya ilivyokuwa katika makundi ya wasiokunywa pombe. Zaidi ya vipimo 2 kwa siku ilihusishwa na ongezeko la hatari ya vifo. Pombe iliwakilishwa 5% ya vifo katika sampuli ya madaktari.<ref>{{cite journal |author=Doll R, Peto R, Boreham J, Sutherland I |title=Mortality in relation to alcohol consumption: a prospective study among male British doctors |journal=Int J Epidemiol |volume=34 |issue=1 |pages=199–204 |year=2005 |month=Februari |pmid=15647313 |doi=10.1093/ije/dyh369 |url=http://ije.oxfordjournals.org/cgi/content/full/34/1/199}}</ref> ==Mfumo wa mishipa ya moyo == Uchambuzi-mpevu wa tafiti 34 uligundua upungufu wa hatari ya vifo kutokana na ugonjwa wa moyo kwa wanaume ambao hutumia vinywaji 2-4 kwa siku na wanawake ambao hutumia 1-2 kwa siku.<ref name="Di Castelnuovo-">{{Cite journal | last1 = Di Castelnuovo | first1 = A. | last2 = Costanzo | first2 = S. | last3 = Bagnardi | first3 = V. | last4 = Donati | first4 = MB. | last5 = Iacoviello | first5 = L. | last6 = de Gaetano | first6 = G. | title = Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. | url = http://archinte.ama-assn.org/cgi/content/full/166/22/2437 | journal = Arch Intern Med | volume = 166 | issue = 22 | pages = 2437-45 | month = Desemba | year = 2006 | doi = 10.1001/archinte.166.22.2437 | PMID = 17159008 }}</ref> Uchambuzi-mpevu wa jaribio usioratibiwa uligundua kwamba matumizi ya pombe kwa kiasi cha wastani hupunguza kiwango cha seramu ya fibrinojeni, protini ambayo husaidia mchakato wa kugandisha na kukuza viwango vya ongezeko la ukuajib wa aina ya plasminojeni ya tishu,kimeng'enya ambayo husaidia kuyeyusha mgandamano.<ref>{{Cite journal | last1 = Rimm | first1 = EB. | last2 = Williams | first2 = P. | last3 = Fosher | first3 = K. | last4 = Criqui | first4 = M. | last5 = Stampfer | first5 = MJ. | title = Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. | journal = BMJ | volume = 319 | issue = 7224 | pages = 1523-8 | month = Dec | year = 1999 | PMID = 10591709 }}</ref> Kiwango cha seramu ya protini C-tendaji(CRP)ya kuvimba na kiashiria cha hatari ya CHD, ni cha chini kwa watu ambao hunywa kiasi wastani kuliko wale wasiokunywa pombe kabisa; hivyo basi inaonyesha kuwa matumizi ya pombe kwa kiasi cha wastani inaweza kuwa na athari zinazozuia kuvimba.<ref name="Albert-2003">{{Cite journal | last1 = Albert | first1 = MA. | last2 = Glynn | first2 = RJ. | last3 = Ridker | first3 = PM. | title = Alcohol consumption and plasma concentration of C-reactive protein. | url = https://archive.org/details/sim_circulation_2003-01-28_107_3/page/442 | journal = Circulation | volume = 107 | issue = 3 | pages = 443-7 | month = Jan | year = 2003 | doi = | PMID = 12551869 }}</ref><ref name="Stewart-">{{Cite journal | last1 = Stewart | first1 = SH. | last2 = Mainous | first2 = AG. | last3 = Gilbert | first3 = G. | title = Relation between alcohol consumption and C-reactive protein levels in the adult US population. | url = http://www.jabfm.org/cgi/reprint/15/6/437.pdf | format = PDF | journal = J Am Board Fam Pract | volume = 15 | issue = 6 | pages = 437-42 | month = | year = | doi = | PMID = 12463288 }}</ref><ref name="Imhof-2001">{{Cite journal | last1 = Imhof | first1 = A. | last2 = Froehlich | first2 = M. | last3 = Brenner | first3 = H. | last4 = Boeing | first4 = H. | last5 = Pepys | first5 = MB. | last6 = Koenig | first6 = W. | title = Effect of alcohol consumption on systemic markers of inflammation. | url = https://archive.org/details/sim_the-lancet_2001-03-10_357_9258/page/762 | journal = Lancet | volume = 357 | issue = 9258 | pages = 763-7 | month = Mar | year = 2001 | doi = 10.1016/S0140-6736(00)04170-2 | PMID = 11253971 }}</ref> Mbali na matokeo yake kwa akili, pombe ina athari dhidi ya mgandamano, yenye matokeo sawa na warfarini.<ref name="Mennen">{{cite journal |author=Mennen LI, Balkau B, Vol S, Cacès E, Eschwège E |title=Fibrinogen: a possible link between alcohol consumption and cardiovascular disease? DESIR Study Group |journal=Arterioscler Thromb Vasc Biol. |volume=19 |issue=4 |pages=887–92 |date=1 Aprili 1999 |pmid=10195914 |url=http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=10195914 |access-date=2010-11-30 |archive-date=2013-01-12 |archive-url=https://archive.today/20130112121432/http://atvb.ahajournals.org/cgi/pmidlookup?view=long&pmid=10195914 |dead-url=yes }}</ref><ref>{{cite journal |author=Paassilta M, Kervinen K, Rantala AO, ''et al.'' |title=Social alcohol consumption and low Lp(a) lipoprotein concentrations in middle aged Finnish men: population based study |journal=BMJ |volume=316 |issue=7131 |pages=594–5 |date=14 Februari 1998|pmid=9518912 |pmc=28464 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=9518912 }}</ref> Zaidi ya hayo, ugonjwa wa moyo ni wa kiasi cha chini kwa wanywao kwa wastani kuliko watumiaji chai.<ref>{{cite journal |author=Lacoste L, Hung J, Lam JY |title=Acute and delayed antithrombotic effects of alcohol in humans |journal=Am J Cardiol. |volume=87 |issue=1 |pages=82–5 |year=2001 |month=Januari |pmid=11137839 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(00)01277-7 |doi=10.1016/S0002-9149(00)01277-7}}<br>{{cite journal |author=Pahor M, Guralnik JM, Havlik RJ, ''et al.'' |title=Alcohol consumption and risk of deep venous thrombosis and pulmonary embolism in older persons |url=https://archive.org/details/sim_journal-of-the-american-geriatrics-society_1996-09_44_9/page/1030 |journal=J Am Geriatr Soc |volume=44 |issue=9 |pages=1030–7 |year=1996 |month=Septemba |pmid=8790226 }}<br>Ridker, P., ''et al.'' Unywaji pombe wastani unaweza kupunguza hatari ya mshtuko wa moyo. American Medical Association press release , 22 Septemba 1994<br>{{cite book |author=Ridker, P. |chapter=The Pathogenesis of Atherosclerosis and Acute Thrombosis |editor=Manson, JoAnn E. |title=Prevention of myocardial infarction |url=https://archive.org/details/preventionofmyoc0000unse |publisher=Oxford University Press |location=Oxford [Oxfordshire] |year=1996 |pages= |isbn=0-19-508582-5 }}</ref> Licha ya ushahidi wa kiepidemiolojia, baadhi ya watu wanakosoa wazo la kupendekeza pombe kuwa na faida za kiafya. Daktari katika Shirika la Afya Duniani alisema kuwa kupendekeza matumizi ya pombe wastani kwa faida za kiafya ni "ya ujinga na hatari."< ref>{{cite journal |author=Naimi TS, Brown DW, Brewer RD, ''et al.'' |title=Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults |journal=Am J Prev Med |volume=28 |issue=4 |pages=369–73 |year=2005 |month=Mei |pmid=15831343 |doi=10.1016/j.amepre.2005.01.011 |url=https://archive.org/details/sim_american-journal-of-preventive-medicine_2005-05_28_4/page/369}}</ref> Kumekuwa hakuna majaribio yaliyoratibiwa na kudhibitiwa kuonyesha faida za pombe kwa moyo. Kutokana na hatari ya kutumia vibaya, utegemezi, athari mbaya, pombe haifai kamwe kupendekezwa kwa faida za moyo. Badala yake, chakula bora, mazoezi na kama inapohitajika matumizi ya dawa ndizo tiba zinazopendekezwa kwa kutunza moyo.<ref name="Vogel-2002">{{Cite journal | last1 = Vogel | first1 = RA. | title = Alcohol, heart disease, and mortality: a review. | journal = Rev Cardiovasc Med | volume = 3 | issue = 1 | pages = 7–13 | year = 2002 | pmid = 12439349 }}</ref> Imesemwa kuwa faida za kiafya za pombe ni swala la kujadiliwa na huenda lilitiliwa chumvi na wadau wa sekta ya pombe. Pombe inafaa kuchukuliwa kama dawa-lewevu ya burudani ambayo ina uwezo wa kuzua athari kali na mbaya kwa afya na haipaswi kutangazwa kwa utunzaji wa moyo.<ref name="Sellman-2009"></ref> ===Ugonjwa wa pembeni wa mishipa (PAD)=== "Matumizi wastani ya pombe inaonekana kupunguza hatari ya PAD katika wanaume walio na afya".<ref>{{cite journal |author=Camargo CA, Stampfer MJ, Glynn RJ, ''et al.'' |title=Prospective study of moderate alcohol consumption and risk of peripheral arterial disease in US male physicians |journal=Circulation |volume=95 |issue=3 |pages=577–80 |date=4 Februari 1997 |pmid=9024142 |url=http://www.circ.ahajournals.org/cgi/content/full/95/3/577 |access-date=2010-11-30 |archive-date=2011-02-12 |archive-url=https://web.archive.org/web/20110212015931/http://www.circ.ahajournals.org/cgi/content/full/95/3/577 |dead-url=yes }}</ref> "Katika utafiti huu mkubwa uliohusu raia, matumizi wastani ya pombe yalionyesha uhusiano wa kupungua kuhusiana na ugonjwa wa pembeni wa mishipa miongoni mwa wanawake, waliplinganishwa na wanaume. Mkolezo wa mabaki kutokana na sigara huenda uliweza kuwa kuathiri matokeo. Miongoni mwa wasiovuta sigara, uhusiano wa kinyume ulionekana kati ya matumizi ya pombe na ugonjwa wa pembeni wa mishipa katika wanaume na wanawake."<ref>{{cite journal |author=Vliegenthart R, Geleijnse JM, Hofman A, ''et al.'' |title=Alcohol consumption and risk of peripheral arterial disease: the Rotterdam study |journal=Am J Epidemiol. |volume=155 |issue=4 |pages=332–8 |year=2002 |month=Februari |pmid=11836197 |url=http://aje.oxfordjournals.org/cgi/content/full/155/4/332 |doi=10.1093/aje/155.4.332}}</ref><ref>{{cite journal |author=Mingardi R, Avogaro A, Noventa F, ''et al.'' |title=Alcohol intake is associated with a lower prevalence of peripheral vascular disease in non-insulin dependent diabetic women |journal=Nutrition Metabolism and Cardiovascular Disease |volume=7 |issue=4 |pages=301–8 |year=1997}}</ref> ===Uzibifu wa muda (IC)=== Utafiti uligundua kwamba matumizi wastani ya pombe yalikuwa na athari ya kinga dhidi ya uzibifu wa muda. Hatari ya chini zidi ilionekana katika wanaume waliotumia na vinywaji 1 hadi 2 kwa siku na kwa wanawake ambao wanaotumia kinywaji nusu hadi 1 kwa siku.<ref>{{cite journal |author=Djoussé L, Levy D, Murabito JM, Cupples LA, Ellison RC |title=Alcohol consumption and risk of intermittent claudication in the Framingham Heart Study |journal=Circulation |volume=102 |issue=25 |pages=3092–7 |date=19 Desemba 2000|pmid=11120700 |url=http://circ.ahajournals.org/cgi/content/full/102/25/3092 }}</ref> ===Mshtuko wa moyo na kiharusi=== Unywaji pombe wa kiasi cha wastani umeonekana kuwasaidia wale ambao wamekumbwa na mshtuko wa moyo kuendelea kuishi.<ref>{{cite journal |author=Muntwyler J, Hennekens CH, Buring JE, Gaziano JM |title=Mortality and light to moderate alcohol consumption after myocardial infarction |url=https://archive.org/details/sim_the-lancet_1998-12-12_352_9144/page/1882 |journal=Lancet |volume=352 |issue=9144 |pages=1882–5 |year=1998 |month=Desemba |pmid=9863785 |doi=10.1016/S0140-6736(98)06351-X }}<br>{{cite journal |author=Mukamal KJ, Maclure M, Muller JE, Sherwood JB, Mittleman MA |title=Prior alcohol consumption and mortality following acute myocardial infarction |journal=JAMA |volume=285 |issue=15 |pages=1965–70 |year=2001 |month=Aprili |pmid=11308432 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=11308432 |doi=10.1001/jama.285.15.1965}}</ref><ref>[100] ^ [http://www.newswise.com/articles/view/506828/ Pombe husaidia kupunguza uharibifu baada ya mshtuko wa moyo]</ref> Hata hivyo, matumizi ya pombe kupita kiasi husababisha ongezeko la hatari ya kupata ugonjwa wa moyo.<ref>{{cite journal |author=Djoussé L, Gaziano JM |title=Alcohol consumption and heart failure: a systematic review |journal=Curr Atheroscler Rep |volume=10 |issue=2 |pages=117–20 |year=2008 |month=Aprili |pmid=18417065 |doi= 10.1007/s11883-008-0017-z|url= |pmc=2365733}}</ref> Durusu ya maandishi iligundua kuwa unywaji pombe kwa kiasi nusu ulitoa kiwango bora zidi cha ulinzi kwa moyo. Hata hivyo, walibainisha kuwa kwa sasa hapajakuwa na majaribio yaliyoratibiwa kuthibitisha ushahidi ambao unaonyesha jukumu la vipimo vidogo vya pombe kukinga kwa dhidi ya mshtuko wa moyo.<ref>{{cite journal |author=Kloner RA, Rezkalla SH |title=To drink or not to drink? That is the question |journal=Circulation |volume=116 |issue=11 |pages=1306–17 |year=2007 |month=Septemba |pmid=17846344 |doi=10.1161/CIRCULATIONAHA.106.678375 |url=http://circ.ahajournals.org/cgi/content/full/116/11/1306}}</ref> Hata hivyo, matumizi wastani ya pombe huhusishwa na shinikizo la damu.<ref name="Andréasson-"></ref> Pana ongezeko la hatari ya kwa hipatrigliseridemia, kadiomiopathi presha,, na [[kiharusi]] iwapo vinywaji 3 au zaidi vya pombe vitatumiwa kwa siku.<ref>{{cite journal |author=Saremi A, Arora R |title=The cardiovascular implications of alcohol and red wine |journal=Am J Ther |volume=15 |issue=3 |pages=265–77 |year=2008 |pmid=18496264 |doi=10.1097/MJT.0b013e3180a5e61a |url=}}</ref> Ikilinganishwa na kuacha pombe, unywaji wa kiasi wastani huhusishwa na ongezeko la hatari ya [[Kiharusi|kiharusi.]] Unywaji wa kiasi cha chini hauna faida yeyote kwa kuzuia kiharusi.<ref>{{cite news| url=http://news.bbc.co.uk/1/hi/health/377381.stm | work=BBC News | title=Alcohol benefits debunked | date=25 Juni 1999 | accessdate=11 Mei 2010}}</ref> ===Kadiomiopathi=== Kiasi kikubwa cha pombe kinaweza kusababisha kadiomiopathiya pombe, inayojulikana kama " dalili za moyo wa likizo." Kadiomiopathi ya pombe hujitokeza kwa namna ambayo kimatibabu ya hufanana na kadiomiopathi iliyopanuka idiopathi, inayoshirikisha hipartrofi ya misuli ya moyo ambayo inaweza kusababisha aina fulani ya arithmia ya moyo. Tofauti hizi zisizo za kawaida za umeme, zinazowakilisha katika EKG, mara nyingi hutofautiana kwa hali, lakini huwa kutoka mabadiliko mbalimbali ya vipindi vya muda vya PR, QRS, au QT hadi vipindi na matukio paroxsysmal ya tachycardia ventricular. Pathofisiolojia (sababu za kuugua mwilini) ya kadiomiopathi ya pombe haijatambuliwa kikamilifu, lakini baadhi ya nadharia huelezea kuhusu ongezeko la utoaji wa epinefrini na norepinefrini, ongezeko la utendaji, au ongezeko la kiwango cha asidi huria za mafuta zisizo na plazma ya kama taratibu inayowezekana.<ref>{{EMedicine|med|1024|Holiday Heart Syndrome}}</ref> ===Magonjwa ya damu=== Walevi wanaweza kuwa na upungufu wa damu kutokana na sababu kadhaa,<ref>{{cite journal |author=Savage D, Lindenbaum J |title=Anemia in alcoholics |journal=Medicine (Baltimore) |volume=65 |issue=5 |pages=322–38 |year=1986 |pmid=3747828 |doi=}}</ref> pia wanaweza kupata thrombositopenia kutokana na athari ya sumu ya megakariositi, au kutokana na hipespleni. ==Mfumo wa neva== Matumizi ya pombe sugu ya kiasi kikubwa cha pombe huvuruga ukuaji wa ubongo, na kusababisha ubongo kunywea, shida ya akili, utegemezi wa kimwili, kuongezeka kwa matatizo ya neva za akili na matatizo na usumbufu wa utambuzi licha ya kuvuruga kemia ya ubongo. Hata hivyo baadhi ya tafiti zimeonyesha kwamba unywaji pombe cha kiwango wastani unaweza kupunguza hatari ya shida ya akili ikiwa ni pamoja na ugonjwa Alzeima, ingawa pana tafiti ambazo zilipata matokeo kinyume. Kwa sasa kutokana na miundo duni ya mbinu za utafiti, maandishi sio toshelezi kuhusu iwapo unywaji wastani wa pombe huongeza au hupunguza hatari ya shida ya akili.<ref>{{cite journal |author=Panza F, Capurso C, D'Introno A, ''et al.'' |title=Vascular risk factors, alcohol intake, and cognitive decline |journal=J Nutr Health Aging |volume=12 |issue=6 |pages=376–81 |year=2008 |pmid=18548174 |doi= 10.1007/BF02982669|url=}}</ref> Ushahidi kuhusu athari za kinga ya matumizi wastani ya pombe kwa upungufu wa utambuzi katika misingi inayohusiana na umri imependekezwa na utafiti fulani, hata hivyo, utafiti mwingine haukupata athari za kinga kutokana na matumizi ya pombe kwa wastani.<ref name="Panza-2009">{{Cite journal | last1 = Panza | first1 = F. | last2 = Capurso | first2 = C. | last3 = D'Introno | first3 = A. | last4 = Colacicco | first4 = AM. | last5 = Frisardi | first5 = V. | last6 = Lorusso | first6 = M. | last7 = Santamato | first7 = A. | last8 = Seripa | first8 = D. | last9 = Pilotto | first9 = A. | title = Alcohol drinking, cognitive functions in older age, predementia, and dementia syndromes. | journal = J Alzheimers Dis | volume = 17 | issue = 1 | pages = 7-31 | month = Mei | year = 2009 | doi = 10.3233/JAD-2009-1009 | PMID = 19494429 }}</ref> Baadhi ya ushahidi unaonyesha kuwa matumizi ya kiwango cha pombe cha chini hadi wastani unaweza kuharakisha kupunguka kwa kiasi cha ubongo. 0/} ===Kiharusi=== Utafiti wa 2003 uliofanywa na Johns Hopkins ulihusisha matumizi wastani ya pombe na kunywea kwa ubongo nao haukuona upungufu wowote wa hatari ya kiharusi miongoni mwa wanywao kwa wastani.<ref> [http://www.sciencedaily.com/releases/2003/12/031205052952.htm Matumizi ya Pombe Wastani Huhusishwa na Kunywea kwa Ubongo]</ref> ===Ukuaji wa ubongo=== Matumizi ya kiasi kikubwa cha pombe kwa kipindi cha muda unaweza kutatiza ukuaji wa ubongo wa kawaida binadamu.<ref>{{cite journal |author=White AM, Bae JG, Truesdale MC, Ahmad S, Wilson WA, Swartzwelder HS |title=Chronic-intermittent ethanol exposure during adolescence prevents normal developmental changes in sensitivity to ethanol-induced motor impairments |journal=[[Alcohol. Clin. Exp. Res.]] |volume=26 |issue=7 |pages=960–8 |year=2002 |month=Julai |pmid=12170104 |doi=10.1111/j.1530-0277.2002.tb02628.x }}</ref><ref>{{cite journal |author=Tapert SF, Brown GG, Kindermann SS, Cheung EH, Frank LR, Brown SA |title=fMRI measurement of brain dysfunction in alcohol-dependent young women |journal=[[Alcohol. Clin. Exp. Res.]] |volume=25 |issue=2 |pages=236–45 |year=2001 |month=Februari |pmid=11236838 |doi=10.1111/j.1530-0277.2001.tb02204.x |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0145-6008&date=2001&volume=25&issue=2&spage=236 |access-date=2010-11-30 |archive-date=2019-12-08 |archive-url=https://web.archive.org/web/20191208071401/http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0145-6008&date=2001&volume=25&issue=2&spage=236 |dead-url=yes |=https://web.archive.org/web/20191208071401/http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0145-6008&date=2001&volume=25&issue=2&spage=236 }}</ref> Upungufu katika kukumbuka taarifa za kimazungumzo na zisizozungumzwa na katika utendaji wa kuona zilidhihirika kwa vijana walio na historia ya unywaji katika miaka ya mapema na katikati ya ubaleghe.<ref>{{cite journal |author=Squeglia LM, Jacobus J, Tapert SF |title=The influence of substance use on adolescent brain development |journal=Clin EEG Neurosci |volume=40 |issue=1 |pages=31–8 |year=2009 |month=Januari |pmid=19278130 |doi= |url= |pmc=2827693}}</ref><ref>{{cite journal |author=Brown SA, Tapert SF, Granholm E, Delis DC |title=Neurocognitive functioning of adolescents: effects of protracted alcohol use |journal=[[Alcohol Clin Exp Res]]. |volume=24 |issue=2 |pages=164–71 |year=2000 |month=Februari |pmid=10698367 |doi=10.1111/j.1530-0277.2000.tb04586.x |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0145-6008&date=2000&volume=24&issue=2&spage=164 |access-date=2010-11-30 |archive-date=2019-12-08 |archive-url=https://web.archive.org/web/20191208071407/http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0145-6008&date=2000&volume=24&issue=2&spage=164 |dead-url=yes |=https://web.archive.org/web/20191208071407/http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0145-6008&date=2000&volume=24&issue=2&spage=164 }}</ref> Wakati wa ubalehe hatua muhimu za ukuaji wa neva hutokea. Unywaji wa kilevi, ambayo ni kawaida miongoni mwa vijana huhitilatiana na hatua hii muhimu ya ukuaji.<ref>{{Cite journal | last1 = Crews | first1 = F. | last2 = He | first2 = J. | last3 = Hodge | first3 = C. | title = Adolescent cortical development: a critical period of vulnerability for addiction. | url = https://archive.org/details/sim_pharmacology-biochemistry-and-behavior_2007-02_86_2/page/n6 | journal = Pharmacol Biochem Behav | volume = 86 | issue = 2 | pages = 189–99 | month = Feb | year = 2007 | doi = 10.1016/j.pbb.2006.12.001 | pmid = 17222895 }}</ref> Matumizi mazito ya pombe huzuia ukuaji wa seli mpya za ubongo.<ref>[131] ^ Chama cha Marekani cha Kuendeleza ya Sayansi ya [http://www.eurekalert.org/pub_releases/2004-11/uonc-nbc110504.php seli Mpya za ubongo hukua wakati wa kuacha pombe,utafiti wa UNC unaonyesha]</ref> Takribani nusu ya walevi sugu wanaweza kuwa na miopathi.<ref>{{cite journal |author=Urbano-Marquez A, Estruch R, Navarro-Lopez F, Grau JM, Mont L, Rubin E |title=The effects of alcoholism on skeletal and cardiac muscle |url=https://archive.org/details/sim_new-england-journal-of-medicine_1989-02-16_320_7/page/409 |journal=[[N. Engl. J. Med.]] |volume=320 |issue=7 |pages=409–15 |year=1989 |pmid=2913506 |doi=10.1056/NEJM198902163200701}}</ref> Vikundi vya misuli inayokaribiana ndiyo hasa huathirika. Asilimia ishirini na tano ya walevi wanaweza kuwa na neuropathi ya pembeni, ikiwa ni pamoja na zilizo huru.<ref>{{cite journal |author=Monforte R, Estruch R, Valls-Solé J, Nicolás J, Villalta J, Urbano-Marquez A |title=Autonomic and peripheral neuropathies in patients with chronic alcoholism. A dose-related toxic effect of alcohol |journal=[[Arch. Neurol.]] |volume=52 |issue=1 |pages=45–51 |year=1995 |pmid=7826275 }}</ref> ===Utambuzi na shida ya akili=== Unywaji wa pombe kupita kiasi huhusishwa na mvurugiko wa kumbukumbu unaoweza kuwepo. Uwezo huu wa utambuzi uliovurugika husababisha ongezeko la kushindwa kutimiza kazi inayonuiwa katika siku zijazo, kwa mfano, kusahau kufunga mlango au kutuma barua kwa wakati unaotakikana. Jinsi kiasi cha pombe na muda wa kutumika unavyoongezeka ndivyo ukali wa madhara huongezeka kwa viungo.<ref name="Heffernan-2008">{{Cite journal | last1 = Heffernan | first1 = TM. | title = The impact of excessive alcohol use on prospective memory: a brief review. | journal = Curr Drug Abuse Rev | volume = 1 | issue = 1 | pages = 36–41 | month = Jan | year = 2008 | pmid = 19630703 }}</ref> Kiungo mojawapo kinachohisi sana madhara ya sumu ya matumizi ya pombe kwa muda mrefu ni ubongo. Nchini Ufaransa takribani 20% ya wanaolzwa katika vituo vya afya ya akili huhusiana na kuvurugika kwa utambuzi kutokana na ulevi, hasa shida za akili kuhusiana na pombe. Unywaji pombe sugu kupita kiasi pia huhusishwa na upungufu mkubwa wa utambuzi na matatizo mbalimbali ya neva za akili. Wazee ndio huhisi sana mwathiriko wa sumu ya madhara ya pombe kwenye ubongo.<ref>{{cite journal |author=Pierucci-Lagha A, Derouesné C |title=[Alcoholism and aging. 2. Alcoholic dementia or alcoholic cognitive impairment?] |language=French |journal=Psychol Neuropsychiatr Vieil |volume=1 |issue=4 |pages=237–49 |year=2003 |month=Desemba |pmid=15683959 |doi= |url=}}</ref> Pana baadhi ya ushahidi usio mkamilifu kuwa kiasi kidogo cha pombe kinachotumiwa katika katika miaka ya mapema ya maisha ya utu uzima huw a na kinga ya ni maisha ya baadaye dhidi ya kupungua kwa utambuzi na shida ya akili.<ref>{{cite journal |author=Peters R, Peters J, Warner J, Beckett N, Bulpitt C |title=Alcohol, dementia and cognitive decline in the elderly: a systematic review |journal=Age Ageing |volume=37 |issue=5 |pages=505–12 |year=2008 |month=Septemba |pmid=18487267 |doi=10.1093/ageing/afn095 |url=http://ageing.oxfordjournals.org/cgi/content/full/37/5/505}}</ref> Hata hivyo, utafiti fulani ulihitimisha kuwa, "Matokeo yetu yanaonyesha kwamba, licha ya mapendekezo yaliyopita, matumizi ya kiasi wastani cha pombe hayawezi kuwalinda watu wazee dhidi ya kupungua kwa utambuzi wao".<ref>[142] ^ Claudia Cooper, Paul Bebbington, Howard Meltzer, Rachel Jenkins, Traolach Brugha, James Lindesay na Gill Livingston [http://jnnp.bmj.com/cgi/content/abstract/jnnp.2008.163964v1 Alcohol in moderation, premorbid cognition intelligence and Cognition In Older Adults: results from the Psyciatric Morbity Survey ]''J Neurol Neurosurg Psychiatry'' doi: 10.1136 / jnnp.2008.163964</ref> Asetaldehidi hutolewa na ini ini wakati wa kusagwa kwa ethanoli. Watu walio na upungufu wa jeni ambayo hutumika kubadilisha asetaldehidi baadaye kuwa asidi asetiki (hali inayobainika zaidi kwa watu wa asili ya Asia ya Mashariki) wanaweza kuwa katika hatari kubwa ya kupataugonjwa wa Alzeima. "Matokeo haya yanaonyesha kwamba upungufu wa ALDH2 ni kigezo cha hatari kwa LOAD [-kujitokeza kwa ugonjwa Alzeima katika miaka ya baadaye ] ..." Dalili za Wernicke-Korsakoff ni dhihirisho la upungufu wathiamini, kwa kawaida kama athari ya kiwango cha pili cha matumizi mabaya ya pombe.<ref>{{cite journal |author=Martin PR, Singleton CK, Hiller-Sturmhöfel S |title=The role of thiamine deficiency in alcoholic brain disease |journal=Alcohol Res Health |volume=27 |issue=2 |pages=134–42 |year=2003 |pmid=15303623 }}</ref> Dalili hizi ni dhihirisho la pamoja la matatizo mawili ya mwanzoni , Saikosi ya Korsakoff na uvimbaji ubongo (enselopathia) wa Wernicke, yaliyotajwa kuambatana na majina ya Dkt. Sergei Korsakoff na Dkt. Carl Wernicke. Uvimbe wa ubongo wa Wernicke ni dhihirisho kubwa wa dalili na hubainika kwa hali ya kuchanganyikiwa wakati ambapo dalili kuu za saikosi ya Korsakoff ni amnesia na mvurugiko wa utendaji.<ref>{{cite journal |author=Butters N |title=The Wernicke-Korsakoff syndrome: a review of psychological, neuropathological and etiological factors |journal=Curr Alcohol |volume=8 |pages=205–32 |year=1981 |pmid=6806017 |doi= |url= }}</ref> ===Mitetemo Isiyoepukika=== Mitetemo isiyoepukika inaweza kuondolewa kwa muda mfupi kufikia kwa hadi thuluthi mbili ya wagonjwa kwa kunywa kiasi kidogo cha pombe.<ref> {{cite journal |author=Bain PG, Findley LJ, Thompson PD, ''et al.'' |title=A study of hereditary essential tremor |journal=Brain |volume=117 |issue=(Pt 4) |pages=805–24 |year=1994 |month=Agosti |pmid=7922467 |doi=10.1093/brain/117.4.805 |url=http://brain.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=7922467}}<br> {{cite journal |author=Lou JS, Jankovic J |title=Essential tremor: clinical correlates in 350 patients |journal=Neurology |volume=41 |issue=2 (Pt 1) |pages=234–8 |year=1991 |month=Februari |pmid=1992367 }}<br> {{cite journal |doi=10.1002/mds.870131316 |author=Wasielewski PG, Burns JM, Koller WC |title=Pharmacologic treatment of tremor |journal=Mov Disord. |volume=13 |issue=Suppl 3 |pages=90–100 |year=1998 |pmid=9827602 }}<br> {{cite journal |author=Boecker H, Wills AJ, Ceballos-Baumann A, ''et al.'' |title=The effect of ethanol on alcohol-responsive essential tremor: a positron emission tomography study |url=https://archive.org/details/sim_annals-of-neurology_1996-05_39_5/page/650 |journal=Ann. Neurol. |volume=39 |issue=5 |pages=650–8 |year=1996 |month=Mei |pmid=8619551 |doi=10.1002/ana.410390515 }}<br> {{cite journal |author= |title=Setting a steady course for benign essential tremor |journal=Johns Hopkins Med Lett Health After 50 |volume=11 |issue=10 |pages=3 |year=1999 |month=Desemba |pmid=10586714 }}</ref> ===Usingizi=== Matumizi sugu ya pombe katika kuleta usingizi yanaweza kusababisha ukosefu wa usingizi. Kutembea mara kwa mara katika hatua za usingizi, huku kukiwa na kuamkaamka kutokana na maumivu ya kichwa na diaforesi. Kusitisha matumizi mabaya sugu ya pombe pia kunaweza kusababisha usumbufu makubwa wa usingizi kwa ndoto nyingi. Matumizi mabaya sugu ya pombe huhusishwa na NREM hatua ya kulala ya 3 na 4 pamoja na ukandamizaji usingizi wa REM na kugawanyika kwa usingizi wa REM. Wakati wa kujiondoa katika ulevi, usingizi wa REM kwa kawaida hukolezwa kama sehemu ya athari ya kujibia.<ref name="sleep_medicine_a04">{{Cite book | last1 = Lee-chiong | first1 = Teofilo | title = Sleep Medicine: Essentials and Review | date = 24 Aprili 2008 | publisher = Oxford University Press, USA | url = http://books.google.com/?id=s1F_DEbRNMcC&pg=PT105 | isbn = 0-19-530659-7 | page = 105 }}</ref> ===Athari za afya ya akili=== Viwango vya juu ya vya mfadhaiko mkubwa hutokea kwa wanywaji pombe kwa wingi na wale ambao hutumia pombe vibaya. Utata hapo awali umehusu swala la iwapo wale waliotumia pombe vibaya na kupatwa na tatizo la mfadhaiko mkubwa walikuwa wakijitibu kibinafsi(ambayo inaweza kuwa kweli katika baadhi ya matukio), lakini utafiti wa hivi karibuni sasa umehitimisha kuwa unywaji sugu wa pombe kupita kiasi nayo yenyewe huweza moja kwa moja kusababisha ukuaji wa tatizo la mfadhaiko mkubwa katika idadi kubwa ya watumiaji wa pombe vibaya. Matumizi mabaya ya pombe inahuhusishwa na idadi kadhaa ya matatizo ya afya ya akili na viwango vya juu sana vya walevi [[kujiua.]]<ref>{{cite journal |author=Chignon JM, Cortes MJ, Martin P, Chabannes JP |title=[Attempted suicide and alcohol dependence: results of an epidemiologic survey] |language=French |journal=Encephale |volume=24 |issue=4 |pages=347–54 |year=1998 |pmid=9809240 |doi= |url=}}</ref> Utafiti wa watu waliolazwa hospitalini kwa ajili ya majaribio ya kujiua uligundua kwamba wale ambao walikuwa walevi walikuwa mara 75 zaidi ya wale ambao wangefanikiwa kujiua kuliko wasiotimia pombe ambao walijaribu kujiua.<ref>{{Cite book | last1 = Ayd | first1 = Frank J. | title = Lexicon of psychiatry, neurology, and the neurosciences | url = http://books.google.com/?id=ea_QVG2BFy8C | date = 31 Mei 2000 | publisher = Lippincott-Williams Wilkins | location = Philadelphia | isbn = 978-0-7817-2468-5 | page = 349 }}</ref> Katika idadi jumla ya wanywaji pombe, ongezeko la hatari ya kujiua ikilinganishwa na umma yote kijumla ni mara 5-20 zaidi. Karibu asilimia 15 ya walevi hujiua. Matumizi mabaya ya dawa nyingine pia huhusishwa na ongezeko la hatari ya kujiua. Takribani asilimia 33 ya visa vya kujiua kwa walio chini ya miaka 35 ni kutokana na pombe au dutu matumizi mabaya ya vilewevu vingine.<ref>{{Cite book | last1 = Appleby | first1 = Louis | last2 = Duffy | first2 = David | last3 = Ryan | first3 = Tony | date = 25 Aug 2004 | title = New Approaches to Preventing Suicide: A Manual For Practitioners | url= http://books.google.com/?id=d6Kw9GaJdzEC | publisher = Jessica Kingsley Publishers | isbn = 978-1-84310-221-2 | pages = 31–32 }}</ref> Tafiti zimeonyesha kwamba utegemezi wa pombe unahusiana moja kwa moja na tamaa na mwasho.<ref>{{cite journal |author=Jasova D, Bob P, Fedor-Freybergh P |title=Alcohol craving, limbic irritability, and stress |journal=Med Sci Monit. |volume=13 |issue=12 |pages=CR543–7 |year=2007 |month=Desemba |pmid=18049433 |doi= |url=http://www.medscimonit.com/fulltxt.php?ICID=563763 |issn= |accessdate=2008-05-13}}</ref> Utafiti mwingine umeonyesha kuwa matumizi ya pombe ni kigezo muhimu cha kumwelekeza mtu katika tabia zisizoambatana na maadili ya jamii kwa watoto.<ref name="antisocial">{{cite journal |author=Young R, Sweeting H, West P |title=A longitudinal study of alcohol use and antisocial behaviour in young people |journal=Alcohol Alcohol. |volume=43 |issue=2 |pages=204–14 |year=2008 |pmid=17977868 |doi=10.1093/alcalc/agm147 |url=http://alcalc.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=17977868|accessdate=2008-05-13 |pmc=2367698}}</ref> Unyogovu, wasiwasi na hofu ni matatizo ya kawaida yaliyoripotiwa na watu wanaotegemea pombe. Ulevi huhusishwa na upungukaji wa kutenda katika mifanyiko ya ubongo ambayo huwajibikia mchakato wa kihisia (kwa ''mfano'' amigdala na hipokampusi).<ref>{{cite journal |author=Marinkovic K|coauthors=Oscar-Berman M, Urban T, O'Reilly CE, Howard JA, Sawyer K, Harris GJ|date=|year=2009 |month= Novemba|title=Alcoholism and dampened temporal limbic activation to emotional faces|journal=Alcohol Clin Exp Res |volume=33 |issue=11 |pages=1880–92 |pmid=19673745 |doi=10.1111/j.1530-0277.2009.01026.x}}</ref> Ushahidi kwamba matatizo ya afya ya akili mara nyingi hutokana na matumizi mabaya ya pombe kuvuruga kemikali za neva za ubongo hudihirika kupitia kuimarika au upotevu wa dalili ambako hutokea baada ya muda mrefu bila kutumia pombe, ingawa matatizo yanaweza kuwa kuzidi katika kipindi cha awali baada ya kujionda katika pombe na kupona.<ref>{{cite journal |author=Wetterling T |coauthors=Junghanns K |date=|year=2000 |month= Desemba|title=Psychopathology of alcoholics during withdrawal and early abstinence|journal=Eur Psychiatry |volume=15 |issue=8 |pages=483–8 |pmid=11175926 |doi=10.1016/S0924-9338(00)00519-8}}</ref><ref>{{cite journal|author=Cowley DS |year=1992 |month= Januari|date=24 |title=Alcohol abuse, substance abuse, and panic disorder|journal=Am J Med |volume=92 |issue=1A |pages=41S–8S |pmid=1346485 |doi=10.1016/0002-9343(92)90136-Y}}</ref><ref>{{cite journal |author=Cosci F |coauthors=Schruers KR, Abrams K, Griez EJ |date=|year=2007 |month= Juni|title=Alcohol use disorders and panic disorder: a review of the evidence of a direct relationship|url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2007-06_68_6/page/n84 |journal=J Clin Psychiatry |volume=68 |issue=6 |pages=874–80 |pmid=17592911 |doi=10.4088/JCP.v68n0608}}</ref> Tatizo la akili (saikosi) ni matokeo ya kiwango cha pili ya hali nyingi zinazohusiana na pombe ikiwa ni pamoja na madhara makali ya sumu na kujitoa baada ya matumizi ya muda mrefu.<ref name="emedicine">{{EMedicine|med|3113|Alcohol-Related Psychosis}}</ref> Matumizi mabaya ya pombe kwa muda mrefu yanaweza kusababisha dalili za namna ya tatizo la akili kuibuka, zaidi ya ilivyo na dawa nyingine za matumizi mabaya. Matumizi mabaya ya pombe yameonyeshwa kusababisha ongezeko la 800% ya hatari ya tatizo la akili(saikosi) kwa wanaume, na ongezeko la 300% la hatari ya tatizo la sikosi kwa wanawake,ambazo hazihusiani na matatizo ya akili kabla ya yaliyopo kwa sasa. Hii ni kubwa zaidi kuliko ongezeko la hatari ya ugonjwa wa akili unaonekana kutokana na bangi ambayo hufanya matumizi mabaya ya pombe kuwa chanzo kikubwa sana cha matatizo ya akili.<ref>{{cite journal |author=Tien AY, Anthony JC |title=Epidemiological analysis of alcohol and drug use as risk factors for psychotic experiences |journal=J. Nerv. Ment. Dis. |volume=178 |issue=8 |pages=473–80 |year=1990 |month=Agosti |pmid=2380692 |doi= |url=}}</ref> Maono-njozi kwa wingina / au ya udanganyifu wa akili ni kawaida sasa wakati mgonjwa amelewa au kujiondoa kutoka ulevi kwa siku za karibuni.<ref name="emedicine"></ref> Ingawa pombe husaidia awali kupunguza dalili za fobia au hofu za kijamii, matumizi mabaya ya pombe kwa muda mrefu yanaweza kuzidisha dalili za fobia ya kijamii na kusababisha dalili za fobia ya kijamii hasa wakati wa kujiondoa katika pombe. Athari hii si ya kipekee kwa pombe lakini inaweza pia kutokea kwa matumizi ya muda mrefu wa dawa za kulevya ambazo zina mfumo sawa wa utendaji wa pombe kama vile benzodiazepini ambazo ni wakati mwingine hupendekezwa kama vitulizi kwa watu walio na matatizo ya pombe.<ref>{{cite journal |author=Terra MB, Figueira I, Barros HM |title=Impact of alcohol intoxication and withdrawal syndrome on social phobia and panic disorder in alcoholic inpatients |journal=Rev Hosp Clin Fac Med Sao Paulo |volume=59 |issue=4 |pages=187–92 |year=2004 |month=Agosti |pmid=15361983 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812004000400006&lng=en&nrm=iso&tlng=en |doi=10.1590/S0041-87812004000400006 }}</ref> Takriban nusu ya wagonjwa wanaohudhuria huduma za afya ya akili kwa hali ikiwa ni pamoja na ugonjwa wa wasiwasi kama vile tatizo la hofu au fobia ya kijamii ni matokeo ya pombe au utegemezi wa benzodiazepini. Ilibainishwa kwamba kila mtu ana kiwango cha uhisivu wake binafsi kwa matumizi ya pombe au dawa za hipnotiki-tulizi hivyo basi kitu ambacho mtu mmoja anaweza kuvumilia bila ya kuathirika kiafya, mgonjwa mwingine anaweza kutatizika sana kiafya na kwamba hata unywaji wastani unaweza kusababisha dalili za wasiwasi unaojibia na matatizo ya kulala. Mtu ambaye anatatizika na madhara ya sumu ya pombe hawezi kufaidika na aina nyingine za tiba au dawa kwa vile hazizisulihishi dalili za kimsingi.<ref>{{cite journal |author=Cohen SI |title=Alcohol and benzodiazepines generate anxiety, panic and phobias |journal=J R Soc Med |volume=88 |issue=2 |pages=73–7 |year=1995 |month=Februari |pmid=7769598 |pmc=1295099 }}</ref> ==Mfumo wa mmeng'enyo wa chakula na ongezeko la uzani== Athari za pombe kwa ongezeko la uzani ni swala tata:<ref>{{cite journal |author=Cordain L, Bryan ED, Melby CL, Smith MJ |title=Influence of moderate daily wine consumption on body weight regulation and metabolism in healthy free-living males |journal=J Am Coll Nutr |volume=16 |issue=2 |pages=134–9 |date=1 Aprili 1997 |pmid=9100213 |url=http://intl.jacn.org/cgi/content/abstract/16/2/134 |access-date=2010-11-30 |archive-date=2009-05-01 |archive-url=https://web.archive.org/web/20090501191524/http://intl.jacn.org/cgi/content/abstract/16/2/134 |dead-url=yes }}</ref> huku tafiti nyingine zikishindwa kugundua upungufu <ref>{{cite journal |author=Arif AA, Rohrer JE |title=Patterns of alcohol drinking and its association with obesity: data from the Third National Health and Nutrition Examination Survey, 1988-1994 |journal=BMC Public Health |volume=5 |pages=126 |year=2005 |pmid=16329757 |pmc=1318457 |doi=10.1186/1471-2458-5-126 |url=http://www.biomedcentral.com/1471-2458/5/126}}</ref> nyingine zimegundua pombe kuwa na athari kwa ongezeko la uzani. Matumizi ya pombe kwa muda mrefu huongeza hatari ya gastriti sugu (kuvimba tumbo),<ref>{{cite journal |author=[[National Institute on Alcohol Abuse and Alcoholism]] (NIAAA) |title=Health risks and benefits of alcohol consumption |journal=Alcohol Res Health |volume=24 |issue=1 |pages=5–11 |year=2000 |pmid=11199274 |url=http://pubs.niaaa.nih.gov/publications/arh24-1/05-11.pdf |access-date=2010-11-30 |archive-date=2020-11-11 |archive-url=https://web.archive.org/web/20201111230707/https://pubs.niaaa.nih.gov/publications/arh24-1/05-11.pdf |dead-url=yes }}</ref><ref name="bode1">{{cite journal |author=Bode C, Bode JC |title=Alcohol's role in gastrointestinal tract disorders |journal=Alcohol Health Res World |volume=21 |issue=1 |pages=76–83 |year=1997 |pmid=15706765 |url=https://webapps.ou.edu/alcohol/docs/12EtohGastroinstestinalTractDisorders76.pdf |access-date=2010-11-30 |archive-date=2015-09-10 |archive-url=https://web.archive.org/web/20150910174805/https://webapps.ou.edu/alcohol/docs/12EtohGastroinstestinalTractDisorders76.pdf |dead-url=yes }}</ref> ni sababu mojawapo ya sairosi, hepatiti, na wa kongosho katika hali zake zote, sugu na kali. ===Dalili za Metaboli=== Utafiti ulihitimisha kuwa, "Matumizi madogo hadi wastani ya pombe huhusishwa na tatizo la upungufu wa dalili za metaboli , pamoja na athari nzuri kwa mafuta, mzingo wa kiuno, na mfungo wa insulini. Uhusiano huu alibainika zaidi miongoni mwa wazungu na miongoni mwa wanywaji wa bia na mvinyo."<ref>{{cite journal |author=Freiberg MS, Cabral HJ, Heeren TC, Vasan RS, Curtis Ellison R |title=Alcohol consumption and the prevalence of the Metabolic Syndrome in the US.: a cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey |journal=Diabetes Care |volume=27 |issue=12 |pages=2954–9 |year=2004 |month=Desemba |pmid=15562213 |url=http://care.diabetesjournals.org/cgi/content/full/27/12/2954 |doi=10.2337/diacare.27.12.2954}}</ref> "Uwiano usio wa kawaida wa dalili za metaboli na vipengele vyake vilionyesha kuongeza kwa matumizi ya pombe.<ref>{{cite journal |author=Yoon YS, Oh SW, Baik HW, Park HS, Kim WY |title=Alcohol consumption and the metabolic syndrome in Korean adults: the 1998 Korean National Health and Nutrition Examination Survey |journal=Am J Clin Nutr'''. |volume=80 |issue=1 |pages=217–24 |date=1 Julai 2004|pmid=15213051 |url=http://www.ajcn.org/cgi/content/full/80/1/217 }}</ref>'''''' ===Athari kwa Kibofu nyongo === Utafiti umegundua kwamba unywaji pombe hupunguza hatari ya kupatwa na vijiwe vya nyongo. Ikilinganishwa na ilivyo kwa watu wanaojiepusha na pombe, hatari jumla kutokana na ugonjwa wa vijiwe vya nyongo, kudhibiti umri, jinsia, elimu sigara, na uwiano wa ukubwa-mwili na uzani , ni 0.83 kwa wanywao mara chache na wanywao mara nyingi kwa kiasi wastani (<25 ml ya ethanoli kwa siku), 0.67 kwa wanywao kiasi cha kati ( 25-50 ml kwa siku), na 0.58 kwa wanywao kwa wingi. Uhusiano huu wa kinyume ulionyesha uthabiti katika safu za umri, jinsia na mwili uwiano wa ukubwa-mwili na uzani."<ref>{{cite journal |author=La Vecchia C, Decarli A, Ferraroni M, Negri E |title=Alcohol drinking and prevalence of self-reported gallstone disease in the 1983 Italian National Health Survey |url=https://archive.org/details/sim_journal-of-clinical-epidemiology_1994-05_47_5/page/533 |journal=Epidemiology |volume=5 |issue=5 |pages=533–6 |year=1994 |month=Septemba |pmid=7986868 }}</ref> Idadi ya nyakati za unywaji pia inaonekana kuwa sababu inayochangia. "Ongezeka la idadi ya nyakati za matumizi ya pombe pia ilihusishwa na ya upungufu wa hatari. Kwa kuunganisha taarifa za wingi wa kiasi cha pombe na idadi ya nyakati za unywaji pombe, mkondo wa matumizi ya pombe uliodhihirisha unywaji wa mara kwa mara (siku 5-7 kwa wiki) wa kiasi chochote cha pombe ulihusishwa na upungufu wa hatari ya kuugua ikilinganishwa na wasiotumia pombe. Kinyume na hayo, unywaji pombe wa mara kwa mara (siku 1-2 kwa wiki) haukuonyesha uhusiano wowote na hatari ya kuugua." Matumizi ya pombe hayahusiani na ugonjwa wa vijiwe vya nyongo.<ref>{{cite journal |author=Sahi T, Paffenbarger RS, Hsieh CC, Lee IM |title=Body mass index, cigarette smoking, and other characteristics as predictors of self-reported, physician-diagnosed gallbladder disease in male college alumni |journal=Am J Epidemiol. |volume=147 |issue=7 |pages=644–51 |date=1 Aprili 1998|pmid=9554603 |url=http://aje.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=9554603 }}</ref> Hata hivyo utafiti mmoja ulipendekeza kuwa wanywaji pombe ambao huchukua vitamini C (asidi ya askorbi) inaweza kupunguza hatari ya ugonjwa wa vijiwe vya nyongo.<ref>{{cite journal |author=Simon JA, Grady D, Snabes MC, Fong J, Hunninghake DB |title=Ascorbic acid supplement use and the prevalence of gallbladder disease. Heart & Estrogen-Progestin Replacement Study (HERS) Research Group |journal=J Clin Epidemiol |volume=51 |issue=3 |pages=257–65 |year=1998 |month=Machi |pmid=9495691 |url=http://linkinghub.elsevier.com/retrieve/pii/S0895435697802806 |doi=10.1016/S0895-4356(97)80280-6}}</ref> ===Ugonjwa wa ini=== Ugonjwa wa ini kutokana na pombe ni tatizo kubwa kwa afya ya umma. Kwa mfano nchini Marekani hadi kufikia watu milioni mbili wana matatizo yanayohusiana na ugonjwa wa ini. Matumizi mabaya ya pombe kwa muda mrefu yanaweza kusababisha mafuta ya ini, sirosi na hepatiti ya pombe. Njia za matibabu ni chache na hatua mojawapo muhimu zaidi inayojumuisha ni kusitisha matumizi ya pombe. Katika matukio ya ugonjwa mkali wa ini, njia ya pekee ya matibabu inaweza kuwa kupandikiza ini kwa wagonjwa walioacha pombe. Utafiti kubainisha ufanisi viziua-TNF. Baadhi ya dawa za nyongeza, kwa mfano, mbaruti za maziwa na silimarini, zinaonekana kuwa faida fulani.<ref>{{cite journal |author=Barve A, Khan R, Marsano L, Ravindra KV, McClain C |title=Treatment of alcoholic liver disease |journal=Ann Hepatol |volume=7 |issue=1 |pages=5–15 |year=2008 |pmid=18376362 |doi= |url=}}</ref><ref>{{cite journal |author=Fehér J, Lengyel G |title=[Silymarin in the treatment of chronic liver diseases: past and future] |language=Hungarian |journal=Orv Hetil |volume=149 |issue=51 |pages=2413–8 |year=2008 |month=Desemba |pmid=19073452 |doi=10.1556/OH.2008.28519 |url=http://www.akademiai.com/openurl.asp?genre=article&doi=10.1556/OH.2008.28519}}</ref> Pombe ni sababu inayoongoza katika kusababisha [[kansa ya ini]] katika nchi za Magharibi, huchangia 32-45% ya saratani ya hepati. Hadi watu nusu milioni nchini Marekani hupata matatizo ya kansa ya ini [[Kansa ya ini|inayohusiana]]na<ref>{{cite journal |author=Voigt MD |title=Alcohol in hepatocellular cancer |journal=Clin Liver Dis |volume=9 |issue=1 |pages=151–69 |year=2005 |month=Februari |pmid=15763234 |doi=10.1016/j.cld.2004.10.003 |url=http://journals.elsevierhealth.com/retrieve/pii/S1089-3261(04)00115-1}}</ref>pombe <ref>{{cite journal |author=Morgan TR, Mandayam S, Jamal MM |title=Alcohol and hepatocellular carcinoma |journal=Gastroenterology |volume=127 |issue=5 Suppl 1 |pages=S87–96 |year=2004 |month=Novemba |pmid=15508108 |doi= 10.1053/j.gastro.2004.09.020|url=http://linkinghub.elsevier.com/retrieve/pii/S0016508504015999}}</ref> Matumizi ya pombe wastani pia huongeza hatari ya ugonjwa wa ini.<ref name="Andréasson-"></ref> ===Ugonjwa wa kongosho=== Matumizi mabaya ya pombe ni sababu inayoongoza ya ugonjwa kali wa kongosho na ugonjwa wa kongosho wa muda mrefu.<ref>{{cite journal |author=Frossard JL, Steer ML, Pastor CM |title=Acute pancreatitis |journal=Lancet |volume=371 |issue=9607 |pages=143–52 |year=2008 |month=Januari |pmid=18191686 |doi=10.1016/S0140-6736(08)60107-5 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)60107-5}}</ref><ref>{{cite journal |author=Bachmann K, Mann O, Izbicki JR, Strate T |title=Chronic pancreatitis--a surgeons' view |journal=Med. Sci. Monit. |volume=14 |issue=11 |pages=RA198–205 |year=2008 |month=Novemba |pmid=18971885 |doi= |url=}}</ref> Unwaji pombe sugu wa kupindukia unaweza kusababisha uharibifu wa kongosho unaopelekea maumivu makali ya muda mrefu ambayo yanaweza kuendeleo na kuwa kansa ya kongosho.<ref>{{cite journal |author=Nair RJ, Lawler L, Miller MR |title=Chronic pancreatitis |journal=Am Fam Physician |volume=76 |issue=11 |pages=1679–88 |year=2007 |month=Desemba |pmid=18092710 |doi= |url=https://archive.org/details/sim_american-family-physician_2007-12-01_76_11/page/1678}}</ref> Kongosho sugu mara nyingi husababisha matatizo ya ufyonzaji wa chakula tumboni na ugonjwa wa kisukari. ==Mifumo mingine== ===Ugonjwa wa mapafu kutokana na pombe=== Utumiaji sugu wa pombe hutatiza kazi nyingi muhimu za seli katika mapafu. Hitilafu za seli hizi huzidisha uwezekano wa kuongezeka kwa kupata matatizo makubwa kutokana na ugonjwa wa mapafu. Tafiti za hivi karibuni zinabainisha vifo vinavyohusiana na ugonjwa wa ini kutokana na pombe zikilinganishwa na vya ugonjwa wa ini kutokana na pombe. Watumiaji pombe wako katika hatari kubwa ya kupatwa na dalili mbaya za dhiki za upumuaji (ARDS) na hupatwa na kiwango cha juu cha vifo kutokana na ARDS ikilinganishwa na wasiokunywa pombe. ===Vijiwe vya figo === Utafiti unaonyesha kuwa unywaji pombe unahusiana na upungufu wa hatari ya kupatwa na vijiwe vya figo. Utafiti mmoja ulihitimisha kuwa, "Kwa vile bia ilionekana kukinga dhidi ya vijiwe vya figo,athari za kimwili za vilewevu mbali na ethanoli, hasa zile za hopsi, lazima pia kuchunguzwa".<ref>{{cite journal |author=Hirvonen T, Pietinen P, Virtanen M, Albanes D, Virtamo J |title=Nutrient intake and use of beverages and the risk of kidney stones among male smokers |journal=Am J Epidemiol. |volume=150 |issue=2 |pages=187–94 |date=15 Julai 1999|pmid=10412964 |url=http://aje.oxfordjournals.org/cgi/reprint/150/2/187 }}</ref> "... Matumizi ya kahawa, pombe na virutubisho vya vitamini C vihusiana kwa kinyume na vijiwe".<ref>{{cite journal |author=Soucie JM, Coates RJ, McClellan W, Austin H, Thun M |title=Relation between geographic variability in kidney stones prevalence and risk factors for stones |journal=Am J Epidemiol. |volume=143 |issue=5 |pages=487–95 |date=1 Machi 1996|pmid=8610664 |url=http://aje.oxfordjournals.org/cgi/reprint/143/5/487 }}</ref> "Baada ya mpatano wa kimwili na matayarisho kwa ajili ya unywaji wa vinywaji vingine, hatari ya ukuaji wa vijiwe ulipungua kwa kiasi kifuatacho kwa kila 240-ml (8-oz) iliyonywewa kwa siku: 10% kwa kahawa yenye kafeni ; 10% kwa kahawa isiyo na kafeni, 14 % kwa chai, 21% kwa bia, na mvinyo, 39% ".<ref>{{cite journal |author=Curhan GC, Willett WC, Rimm EB, Spiegelman D, Stampfer MJ |title=Prospective study of beverage use and the risk of kidney stones |journal=Am J Epidemiol. |volume=143 |issue=3 |pages=240–7 |date=1 Februari 1996|pmid=8561157 |url=http://aje.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=8561157 }}</ref> "... ukuaji wa vijiwe ulipungua kwa kiasi kifuatazo kwa kila 240-ml (8-oz) iliyotunywewa kila siku: 10% a kahawa yenye kafeni, 9% kwa kahawa isiyo na kafeni, 8% ya chai, na 59% kwa divai." (Cl data iliyotolewa kutoka nukuu mbili za mwisho.).<ref>{{cite journal |author=Curhan GC, Willett WC, Speizer FE, Stampfer MJ |title=Beverage use and risk for kidney stones in women |journal=Ann Intern Med. |volume=128 |issue=7 |pages=534–40 |date=1 Aprili 1998|pmid=9518397 |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=9518397 |doi=10.1059/0003-4819-128-7-199804010-00003 |doi_brokendate=2010-03-16 }}</ref> ===Hitilafu katika ngono === Unywaji pombe kupindukia wa muda mrefu unaweza kusababisha uharibifu kwa mfumo mkuu wa neva na mfumo wa neva za pembeni na kupelekea kupoteza tamaa ya ngono na kutosisimka kwa wanaume hususani unywaji wa pombe kali bila kula chakula na matunda Pia mboga mboga na kutokufanya mazoezi .<ref>{{cite journal |author=Taniguchi N, Kaneko S |title=[Alcoholic effect on male sexual function] |language=Japanese |journal=Nippon Rinsho |volume=55 |issue=11 |pages=3040–4 |year=1997 |month=Novemba |pmid=9396310 |doi= |url=}}</ref> ===Utofautiano wa homoni=== Unywaji pombe kupita kiasi unaweza kusababisha mchakato wa hiperoestrojeni.<ref>{{Cite journal | last1 = Fentiman | first1 = IS. | last2 = Fourquet | first2 = A. | last3 = Hortobagyi | first3 = GN. | title = Male breast cancer. | url = https://archive.org/details/sim_the-lancet_february-18-24-2006_367_9510/page/595 | journal = Lancet | volume = 367 | issue = 9510 | pages = 595–604 | month = Feb | year = 2006 | doi = 10.1016/S0140-6736(06)68226-3 | pmid = 16488803 }}</ref> Imekisiwa kwamba vinywaji vilivyo pombe vinaweza kudhibiti misombo ya estrojeni. Kwa wanaume, viwango vikubwa vya estrojeni vinaweza kusababisha kushindwa kwa kazi za makende na ukuaji wa hulka ya uke ikiwa ni pamoja na ukuaji wa matiti ya kiume zinazoitwa jainekomastia.<ref>{{Cite journal | last1 = Gavaler | first1 = JS. | title = Alcoholic beverages as a source of estrogens. | journal = Alcohol Health Res World | volume = 22 | issue = 3 | pages = 220–7 | month = | year = 1998 | pmid = 15706799 }}</ref><ref name="Weiss-2005">{{Cite journal | last1 = Weiss | first1 = JR. | last2 = Moysich | first2 = KB. | last3 = Swede | first3 = H. | title = Epidemiology of male breast cancer. | journal = Cancer Epidemiol Biomarkers Prev | volume = 14 | issue = 1 | pages = 20–6 | month = Jan | year = 2005 | url = http://cebp.aacrjournals.org/content/14/1/20.long | pmid = 15668471 }}</ref> Kwa wanawake, viwango juu vya estrojeni kutokana na unywaji pombe kupindukia vimehusishwa na ongezeko la hatari ya kansa ya matiti.<ref name="Weiss-2005"></ref><ref>{{Cite journal | last1 = Boffetta | first1 = P. | last2 = Hashibe | first2 = M. | title = Alcohol and cancer. | journal = Lancet Oncol | volume = 7 | issue = 2 | pages = 149–56 | month = Feb | year = 2006 | doi = 10.1016/S1470-2045(06)70577-0 | pmid = 16455479 }}</ref> ===Ugonjwa wa kisukari melitusi=== Wanywaji pombe wa wastani wanaweza kuwa katika hatari ndogo ya kupata kisukari kuliko wasiokunywa. Kwa upande mwingine, ulevi wa pombe na matumizi ya pombe kwa kiasi cha kikubwa huweza kuzidisha hatari ya aina 2 za ugonjwa wa kisukari kwa wanawake."<ref>{{cite journal |author=Carlsson S, Hammar N, Grill V, Kaprio J |title=Alcohol consumption and the incidence of type 2 diabetes: a 20-year follow-up of the Finnish twin cohort study |journal=Diabetes Care |volume=26 |issue=10 |pages=2785–90 |year=2003 |month=Oktoba |pmid=14514580 |url=http://care.diabetesjournals.org/cgi/content/full/26/10/2785 |doi=10.2337/diacare.26.10.2785}}</ref> Matumizi ya pombe huimarisha uhisivu wa insulini.<ref>[245] ^ J Hong1, RR Smith, AE Harvey na NP Núñez [http://www.nature.com/ijo/journal/v33/n2/abs/ijo2008266a.html Matumizi ya pombe hukuza uhisivu wa insulini bila ya kuathiri viwango vya mafuta ya mwili] ''International Journal of Obesity'' (2009) 33, 197-203; doi: 10.1038/ijo.2008.266</ref> ===Ugonjwa wa maumivu ya viungo=== Matumizi ya kila mara ya pombe huhusishwa na ongezeko la hatari ya maumivu ya viungo kutokana na jongo.<ref>{{cite journal |author=Star VL, Hochberg MC |title=Prevention and management of gout |journal=Drugs |volume=45 |issue=2 |pages=212–22 |year=1993 |month=Februari |pmid=7681372 |doi= 10.2165/00003495-199345020-00004|url=}}</ref><ref>{{cite journal |author=Eggebeen AT |title=Gout: an update |journal=Am Fam Physician |volume=76 |issue=6 |pages=801–8 |year=2007 |month=Septemba |pmid=17910294 |doi= |url=https://archive.org/details/sim_american-family-physician_2007-09-15_76_6/page/800}}</ref> Matumizi ya pombe huhusishwa na upungufu wa hatari ya maumivu ya viungo.<ref>{{Cite web |url=http://arc.org.uk/arthinfo/patpubs/6033/6033.asp |title=Nakala iliyohifadhiwa |accessdate=2010-11-30 |archiveurl=https://web.archive.org/web/20100224073218/http://www.arc.org.uk/arthinfo/patpubs/6033/6033.asp |archivedate=2010-02-24 }}</ref><ref>{{cite journal |author=Myllykangas-Luosujärvi R, Aho K, Kautiainen H, Hakala M |title=Reduced incidence of alcohol related deaths in subjects with rheumatoid arthritis |journal=Ann Rheum Dis. |volume=59 |issue=1 |pages=75–6 |year=2000 |month=Januari |pmid=10627433 |pmc=1752983 |url=http://ard.bmj.com/cgi/pmidlookup?view=long&pmid=10627433 |doi=10.1136/ard.59.1.75}}</ref><ref>{{cite journal |author=Nagata C, Fujita S, Iwata H, ''et al.'' |title=Systemic lupus erythematosus: a case-control epidemiologic study in Japan |url=https://archive.org/details/sim_international-journal-of-dermatology_1995-05_34_5/page/333 |journal=Int J Dermatol. |volume=34 |issue=5 |pages=333–7 |year=1995 |month=Mei |pmid=7607794 |doi=10.1111/j.1365-4362.1995.tb03614.x }}</ref><ref>{{cite journal |author=Aho K, Heliövaara M |title=Alcohol, androgens and arthritis |url=https://archive.org/details/sim_annals-of-the-rheumatic-diseases_1993-12_52_12/page/897 |journal=Ann Rheum Dis. |volume=52 |issue=12 |pages=897 |year=1993 |month=Desemba |pmid=8311545 |pmc=1005228 |doi=10.1136/ard.52.12.897-b }}</ref><ref>{{cite journal |author=Hardy CJ, Palmer BP, Muir KR, Sutton AJ, Powell RJ |title=Smoking history, alcohol consumption, and systemic lupus erythematosus: a case-control study |journal=Ann Rheum Dis. |volume=57 |issue=8 |pages=451–5 |year=1998 |month=Agosti |pmid=9797548 |pmc=1752721 |url=http://ard.bmj.com/cgi/content/abstract/57/8/451 |doi=10.1136/ard.57.8.451}}</ref> Tafiti mbili za hivi karibuni zinaripoti kwamba jinsi pombe zaidi inavyotumiwa, ndivyo hatari ya kupatwa na maumivu ya viungo hupungua. Miongoni mwa watu wanaokuunywa mara kwa mara, robo moja ya wanaokunywa zaidi walikuwa na kiwango cha hadi 50% cha chini cha uwezekano wa kupata ugonjwa wakilinganishwa na nusu ambao hunywa kidogo.<ref>{{cite journal |author=Källberg H, Jacobsen S, Bengtsson C, ''et al.'' |title=Alcohol consumption is associated with decreased risk of rheumatoid arthritis; Results from two Scandinavian case-control studies |journal=Ann Rheum Dis. |year=2008 |month=Julai |pmid=18535114 |doi=10.1136/ard.2007.086314 |volume=68 |pages=222 |issue=2 }}</ref> Watafiti walibainisha kuwa matumizi ya pombe wastani pia hupunguza hatari ya matukio mengine ya kutatiza kama vile ugonjwa mishipa ya moyo. Baadhi ya michakato ya kibayolojia ambapo kwayo ethanoli hupunguza hatari ya maumivu ya viungo na kuzuia uharibifu wa upotevu wa madini ya uzito wa fupa (BMD), ambayo ni sehemu ya mchakato wa maradhi.<ref>{{cite journal |author=Jonsson IM, Verdrengh M, Brisslert M, ''et al.'' |title=Ethanol prevents development of destructive arthritis |journal=Proc Natl Acad Sci USA. |volume=104 |issue=1 |pages=258–63 |year=2007 |month=Januari |pmid=17185416 |pmc=1765445 |doi=10.1073/pnas.0608620104 }}</ref> Utafiti ulihitimisha kuwa, "Pombe ama hulinda dhidi ya RAmaumivu ya viungo au, watu walio na RA husitisha unywaji wao baada ya kudhihirika kwa RA".<ref>{{cite journal |author=Myllykangas-Luosujärvi R, Aho K, Kautiainen H, Hakala M |title=Reduced incidence of alcohol related deaths in subjects with rheumatoid arthritis |journal=Ann Rheum Dis. |volume=59 |issue=1 |pages=75–6 |year=2000 |month=Januari |pmid=10627433 |pmc=1752983 |url=http://ard.bmj.com/cgi/content/abstract/59/1/75 |doi=10.1136/ard.59.1.75}}</ref> Utafiti mwingine uligundua kuwa, "Wanawake waliopitisha miaka ya kuzaa ambao kwa wastani hutumia zaidi ya vinywaji 14 vya pombe kwa wiki walikuwa na upungufu wa hatari ya maumivu ya viungo ..."<ref>{{cite journal |author=Voigt LF, Koepsell TD, Nelson JL, Dugowson CE, Daling JR |title=Smoking, obesity, alcohol consumption, and the risk of rheumatoid arthritis |url=https://archive.org/details/sim_journal-of-clinical-epidemiology_1994-05_47_5/page/525 |journal=Epidemiology |volume=5 |issue=5 |pages=525–32 |year=1994 |month=Septemba |pmid=7986867 }}</ref> ===Osteoporosi=== Matumizi wastani ya pombe huhusishwa na uzito wamadini ya mfupa kwa wanawake waliopitisha umri wa kujifungua. "...Matumizi ya pombe yalipunguza sana ya uwezekano wa [osteoporosis]."<ref>{{cite journal |author=Siris ES, Miller PD, Barrett-Connor E, ''et al.'' |title=Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment |journal=JAMA |volume=286 |issue=22 |pages=2815–22 |year=2001 |month=Desemba |pmid=11735756 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=11735756 |doi=10.1001/jama.286.22.2815}}</ref> "Unywaji wa pombe wastani ulihusishwa na BMD katika wanawake wazee waliopita miaka ya kujifungua".<ref>{{cite journal |author=Rapuri PB, Gallagher JC, Balhorn KE, Ryschon KL |title=Alcohol intake and bone metabolism in elderly women |journal=Am J Clin Nutr. |volume=72 |issue=5 |pages=1206–13 |date=1 Novemba 2000 |pmid=11063451 |url=http://intl.ajcn.org/cgi/content/abstract/72/5/1206 |access-date=2010-11-30 |archive-date=2012-05-27 |archive-url=https://archive.today/20120527081459/http://intl.ajcn.org/cgi/content/abstract/72/5/1206 |dead-url=yes }}</ref> "Unywa wa kijamii huhusishwa na uzito wa juu wa madini ya mfupa katika wanaume na wanawake [juu] 45".<ref>{{cite journal |author=Holbrook TL, Barrett-Connor E |title=A prospective study of alcohol consumption and bone mineral density |journal=BMJ |volume=306 |issue=6891 |pages=1506–9 |year=1993 |month=Juni |pmid=8518677 |pmc=1677960 |doi=10.1136/bmj.306.6891.1506 }}</ref> Hata hivyo,matumizi mabaya ya pombe ni huhusishwa na upungufu wa mfupa.<ref name="Ronis-2007">{{Cite journal | last1 = Ronis | first1 = MJ. | last2 = Wands | first2 = JR. | last3 = Badger | first3 = TM. | last4 = de la Monte | first4 = SM. | last5 = Lang | first5 = CH. | last6 = Calissendorff | first6 = J. | title = Alcohol-induced disruption of endocrine signaling. | journal = Alcohol Clin Exp Res | volume = 31 | issue = 8 | pages = 1269–85 | month = Aug | year = 2007 | doi = 10.1111/j.1530-0277.2007.00436.x | pmid = 17559547 }}</ref><ref name="Peer-">{{Cite journal | last1 = Peer | first1 = KS. | last2 = Newsham | first2 = KR. | title = A case study on osteoporosis in a male athlete: looking beyond the usual suspects. | journal = Orthop Nurs | volume = 24 | issue = 3 | pages = 193–9; quiz 200–1 | month = | year = 2005| doi = | pmid = 15928528 }}</ref> ===Ngozi=== Matumizi mabaya ya pombe kupita kiasi ni huhusishwa na matatizo mbalimbali ya ngozi ikiwa ni pamoja naurtikaria, pofiria tarda kutanea, kuhisi joto na kujaa, stigmata ya ngozi ya saiirosi, soriasisi, pruritusi, ugonjwa wa seborei ya ngozi na rosasea.<ref>{{cite journal |author=Kostović K, Lipozencić J |title=Skin diseases in alcoholics |journal=Acta Dermatovenerol Croat |volume=12 |issue=3 |pages=181–90 |year=2004 |pmid=15369644 |doi= |url=}}</ref> Utafiti wa 2010 ulihitimisha, "unywaji bia usio mwepesi huhusishwa na hatari ya kuongezeka kwa uwezekano wa kupata soriasisi kwa wanawake. Vinywaji vingine vya kulevya havikuongeza hatari ya soriasis katika katika utafiti huu."<ref>[279] ^ Abrar A. Qureshi, Patrick L. Dominguez, Hyon K. Choi, Jiali Han, Gary Curhan [http://archderm.ama-assn.org/cgi/content/full/archdermatol.2010.204 Unywaji pombe na Hatari ya Soriasisi katika Wanawake Marekani:Tafiti linalotazamiwa] {{Wayback|url=http://archderm.ama-assn.org/cgi/content/full/archdermatol.2010.204 |date=20100820111906 }} ''Arch Dermatology'' doi: 10.1001/archdermatol.2010.204</ref> ==Mfumo wa kinga, bakteria Ukolezi, maambukizi ya virusi na kansa== ===Maambukizi ya bakteria=== Kuna athari za kinga ya matumizi ya pombe dhidi ya maambukizi makali ya ''H pylori'' <ref>{{cite journal |author=Brenner H, Rothenbacher D, Bode G, Adler G |title=Relation of smoking and alcohol and coffee consumption to active ''Helicobacter pylori'' infection: cross sectional study |journal=BMJ |volume=315 |issue=7121 |pages=1489–92 |date=6 Desemba 1997|pmid=9420488 |pmc=2127930 |url=http://bmj.bmjjournals.com/cgi/content/full/315/7121/1489 }}</ref> Kinyume na hayo, unywaji pombe (unapolinganisha wale ambao hunywa> 30 gm ya pombe kila siku kwa wasiokunywa) haihusiani na hatari kubwa ya vidonda vya duodena.<ref>{{cite journal |author=Aldoori WH, Giovannucci EL, Stampfer MJ, Rimm EB, Wing AL, Willett WC |title=A prospective study of alcohol, smoking, caffeine, and the risk of duodenal ulcer in men |journal=Epidemiology |volume=8 |issue=4 |pages=420–4 |year=1997 |month=Julai |pmid=9209857 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1044-3983&volume=8&issue=4&spage=420 |doi=10.1097/00001648-199707000-00012}}</ref> Matumizi ya pombe kupita kiasi ya pombe unaoonekana katika walevi hujulikana kama kigezo hatari cha nyumonia. ===Homa ya mafua=== Utafiti kuhusu homa ya mafua ulipata kuwa "Idadi kubwa ya vinynywaji vya pombe (hadi vitatu au vinne kwa siku) vilihusishwa na upungufu wa hatari ya kupata homa ya mafua kwa sababu ya kunywa kulihusishwa na ulipunguaji wa magonjwa baada ya kuugua. Hata hivyo, faida za kunywa zilitokeza tu miongoni mwa wasiovuta sigara... Ingawa matumizi ya pombe hayakuchangia hatari ya ugonjwa ya kimwili kwa wavutaji, matumizi wastani ya pombe yalihusishwa na upunguaji wa hatari kwa wasiovuta sigara."<ref>{{cite journal |author=Cohen S, Tyrrell DA, Russell MA, Jarvis MJ, Smith AP |title=Smoking, alcohol consumption, and susceptibility to the common cold |journal=Am J Public Health |volume=83 |issue=9 |pages=1277–83 |year=1993 |month=Septemba |pmid=8363004 |pmc=1694990 |url=http://www.ajph.org/cgi/reprint/83/9/1277 |doi=10.2105/AJPH.83.9.1277}}</ref> Utafiti mwingine ulihitimisha kuwa, "Matokeo yanaonyesha kwamba unywaji divai, hasa divai nyekundu unaweza kuwa na athari ya kinga dhidi ya hioma ya mafua. Bia, vileo vikali na pombe jumla hazionekani kuathiri matukio ya homa ya mafua."<ref>{{cite journal |author=Takkouche B, Regueira-Méndez C, García-Closas R, Figueiras A, Gestal-Otero JJ, Hernán MA |title=Intake of wine, beer, and spirits and the risk of clinical common cold |journal=Am J Epidemiol. |volume=155 |issue=9 |pages=853–8 |year=2002 |month=Mei |pmid=11978590 |url=http://aje.oxfordjournals.org/cgi/content/full/155/9/853 |doi=10.1093/aje/155.9.853}}</ref> ===Kansa=== Shirika la Kimataifa la Taasisi ya Utafiti wa Saratani (Centre International de Recherche sur le Saratani) la [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]]liliainisha pombe kama kasinojeni la Kundi ya 1. Tathmini yake inasema, "Kuna ushahidi wa kutosha kwa hali ya kasinojeni ya vinywaji wa vileo kwa binadamu .... Vinywaji vya pombe vina kasinojeni kwa binadamu (Kundi la 1)."<ref> IARC Monografu ya Tathmini za Hatari za Kasinojeni kwa Binadamu: Juzuu 44 ''[http://monographs.iarc.fr/ENG/Monographs/vol44/volume44.pdf Unywaji Pombe : Muhtasari wa taarifa iliyoripotiwa na Tathmini]'' </ref> Idara ya Marekani &amp; Huduma za Kibinadamu 'Mpango wa Afya ya Taifa uliotaja pombe kama ''kasinojeni inajulikana '' mwaka wa 2000.<ref> National Toxicology Program [http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s007alco.pdf Matumizi ya vinywaji vilewevu: Yanajulikana kuwa kasinojeni kwa binadamu] wa Iliotajwa kwanza katika ''Ripoti ya Tisa Kuhusu Kasinojeni '' (2000) (PDF)</ref> Utafiti mmoja uliamua kwamba "3.6% ya matukio yote ya kansa duniani yanahusiana na kunywa pombe ambayo husababisha 3.5% ya vifo vyote vya kansa ".<ref>{{Cite web |url=http://www.oncolink.com/resources/article.cfm?c=3&s=8&ss=23&id=13383&month=08&year=2006 |title=Mzigo mkubwa wa kansa zinazohusiana na pombe |accessdate=2024-01-20 |archivedate=2008-05-04 |archiveurl=https://web.archive.org/web/20080504161019/http://www.oncolink.com/resources/article.cfm?c=3&s=8&ss=23&id=13383&month=08&year=2006 }}</ref> Ripoti ya jopo la Wakfu wa Utafiti wa Saratani Duniani iitwayo ''Chakula, Lishe, Shughuli za kimwili na Kuzuia Saratani: Mtazamo wa Kilimwengu'' wapata ushahidi wa "kushawishi" kwamba kunywa pombe huongeza hatari aina za saratani zifuatazo: kinywa na koo, umio, kolorektamu (wanaume), kifua (kabla na baada ya umri wa kujifungua).<ref name="WCRF">WCRF [http://www.dietandcancerreport.org/downloads/Second_Expert_Report.pdf Chakula, Lishe, Shughuli za kimwili na ya Kuzuia Saratani: Mtazamo wa Kilimwengu] {{Wayback|url=http://www.dietandcancerreport.org/downloads/Second_Expert_Report.pdf |date=20090325235446 }}</ref> Ukolezi mkubwa wa asetalidehidi, ambayo huzalika wakati mwili unavunja ethanoli, unaweza kuharibu DNA katika seli zilizo na afya. Taasisi ya Taifa ya Matumizi mabaya ya Pombe na Ulevi zimeonyesha kwamba asetalidehidi hushikamana na poliaminesi ambayo ni misombo inayotokea kwa kawaida nayo ni muhimu kwa ukuaji wa seli - kuibusha aina ya msingi wa DNA hatari inayoitwa Cr-Pdg adduct.<ref> ''Makala ya '' New Scientist [http://www.newscientist.com/channel/health/mg18725125.600.html "Uhusiano wa pombe na kansa umeelezezwa"]</ref> Hata viwango vya wastani vya matumizi ya pombe huhusishwa na ongezeko la hatari ya aina fulani za kansa.<ref name="Andréasson-"></ref> ==Athari za pombe kwa kijusi == Dalili za ulevi wa kijusi au FAS ni tatizo la kudumu kutokana na pungufu za kuzaliwa ambazo hutokea katika kizazi cha wanawake ambao hunywa pombe wakati wa ujauzito. Unywaji pombe kupindukia au wakati wa hatua za awali za ukuaji wa kijusi imehusishwa kikamilifu na FAS, matumizi wastani ya pombe huhusishwa na uharibifu wa kijusi. <ref name="Andréasson-">{{Cite journal | last1 = Andréasson | first1 = S. | last2 = Allebeck | first2 = P. | title = [Alcohol as medication is no good. More risks than benefits according to a survey of current knowledge] | journal = Lakartidningen | volume = 102 | issue = 9 | pages = 632–7 | date = 28 Februari - 6 Machi 2005 | pmid = 15804034 }}</ref> Pombe huvuka kizuizi cha plasenta na inaweza kudidimiza ukuaji wa kijusi au uzito, kuzua stigmata za pekee usoni , kuharibuneva na miundo ya ubongo, na kusababisha matatizo mengine ya kimwili, kiakili au kitabia. .<ref>{{cite journal |author=Ulleland CN |title=The offspring of alcoholic mothers |journal=Ann. N. Y. Acad. Sci. |volume=197 |issue= |pages=167–9 |year=1972 |month=Mei |pmid=4504588 |doi=10.1111/j.1749-6632.1972.tb28142.x }}</ref> Kijusi kuonjeshwa pombe ndiyo sababu inayoongoza kwa kusababisha ulemavu wa akili katika nchi za Kimagharibi.<ref>{{cite journal |author=Abel EL, Sokol RJ |title=Incidence of foetal alcohol syndrome and economic impact of FAS-related anomalies |journal=Drug Alcohol Depend |volume=19 |issue=1 |pages=51–70 |year=1987 |month=Januari |pmid=3545731 |url=http://linkinghub.elsevier.com/retrieve/pii/0376-8716(87)90087-1 |doi=10.1016/0376-8716(87)90087-1 }}</ref> Matumizi ya pombe wakati wa ujauzito huhusishwa na insulini ya ubongo na ukinzani wa sababu za ukuaji wa vipengele sawa na insulini.<ref name="Ronis-2007"></ref> ==Marejeo== {{Marejeo|2}} ==Viungo vya nje== * [http://www.bu.edu/act/alcoholandhealth/index.html Pombe na Afya: Ushahidi wa Kisasa. ] {{Wayback|url=http://www.bu.edu/act/alcoholandhealth/index.html |date=20070427093736 }}[http://www.bu.edu/act/alcoholandhealth/index.html Chuo Kikuu cha Boston / Jarida la Taasisi ya Taifa ya Matumizi Mabaya ya Pombe na Ulevi] {{Wayback|url=http://www.bu.edu/act/alcoholandhealth/index.html |date=20070427093736 }} * [http://ec.europa.eu/health-eu/my_lifestyle/alcohol/index_en.htm Health EU Portal] Pombe na Afya katika EU * [http://www.drinking.nhs.uk/index.html Pombe inaohusiana na shinikizo la damu, saratani, na mshtuko wa moyo] {{Wayback|url=http://www.drinking.nhs.uk/index.html |date=20101201180308 }} (NHS) [[Category:Vinywaji]] [[Jamii:afya]] sirsbolko4euh91yh9nftg34hk5kwvq 0 55756 1578190 1527774 2026-07-03T02:09:25Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578190 wikitext text/x-wiki {{Infobox Disease | Name = Acute kidney injury | Image = Kidney – acute cortical necrosis.jpg | Caption = Pathologic kidney specimen showing marked pallor of the cortex, contrasting to the darker areas of surviving medullary tissue. The patient died with acute kidney injury. | DiseasesDB = 11263 | ICD10 = {{ICD10|N|17||n|17}} | ICD9 = {{ICD9|584}} | ICDO = | OMIM = | MedlinePlus = 000501 | eMedicineSubj = med | eMedicineTopic = 1595 | MeshID = D007675 | }} '''Ugonjwa wa jeraha baya la figo (Aki), ''' ambao awali ulijulikana kama '''kushindwa kwa figo (ARF),''' <ref name="aki-vs-arf">{{cite journal |author=Webb S, Dobb G |title=ARF, ATN or AKI? It's now acute kidney injury |journal=Anaesthesia and Intensive Care |volume=35 |issue=6 |pages=843–4 |year=2007 |month=Desemba |pmid=18084974 |doi= |url=}}</ref> ni kupungua kwa haraka katika utendakazi wa figo. Kuna vitu vingi vinavyousababisha ikiwemo kupungua kwa kiasi cha damu, athari za sumu, na kuongezeka kwa tezi. AKI hutibiwa kwa misingi ya historia ya afya, kama vile kupungua kwa kiwango cha mkojo, na matokeo ya ukaguzi wa maabara, kama vile kuongezeka kwa ya mkojodamu ya naitrojeni na kreatini. AKI inaweza kusababisha matatizo kadhaa kutegemea ukali wake, , ikiwa ni pamoja na asidi ya kutumia chakula, viwango vya juu vya potasiamu, mabadiliko ya usawa wa maji mwilini, na madhara ya mfumo wa viungo vingine. Miongoni mwa njia za kudhibiti hali hii ni kama vile ubadilishaji wa figo, pamoja na kutibu ugonjwa msingi. ==Epidemolojia== Wagonjwa wengi wanaolazwa hospitalini huwa na ugonjwa wa figo kujeruhiwa vibaya. Ugonjwa huu huathiri baadhi ya asilimia 3-7% ya wagonjwa waliolazwa katika hospitali na takriban asilimia 25-30% ya wagonjwa katika kitengo wodi wa wagonjwa mahututi.<ref name="isbn1-4160-3110-3">{{cite book |author= |title=Brenner and Rector's The Kidney |publisher=Saunders |location=Philadelphia |year=2007 |pages= |isbn=1-4160-3110-3 |oclc= |doi= |accessdate=}}</ref> ==Chanzo chake== {| class="wikitable" style="float:right;text-align:center" |+ Matokeo ya utafiti wa maabara ya AKI ! Aina ! U _Osm ! U _Na ! Fe _Na ! BUN / Cr |- | Kabla ya figo | > 500 | 10 | <1% | > 20 |- | Asilia | <350 | > 20 | > 2% | <15 |- | Baada ya figo | <350 | [51] | 4. | > 15 |} Kwa kawaida sababu nyingi zinazoleta kuathirika kwa figo vibayazinaainishwa kama zile za ''kabla ya figo, asilia,'' na ''baada ya figo.'' ===Kabla ya figo=== ''Sababu za'' kabla ya figo zinazoleta AKI ni zile zinazopunguza kutembea kwa damu vizuri kwenye figo. Hizi ni pamoja na sababu zinazofuatana, kama vile kiwango cha chini cha damu, kiwango cha chini cha shinikizo la damu, na moyo kushindwa, hali kadhalika mabadiliko ya ndani ya mishipa ya kusambaza damu kwa figo. Sababu za mwisho ni zile za ufinyu wa mishipa ya , ambayo ni mshipa unaosambaza damu kwa figo kuwa mwembamba mahitaji ya figo, na mvilio wa mshipa wa figo, ambayo ni kuganda kwa damu kwenye mshipa wa figo ambao hutoa damu kwenye figo. Mvilio wa mishipa ya figo hatimaye hutatiza utendakazi, unyogovu wa GFR, au hali zote mbili. Hali hii hupunguza uwezo wa moyo kusukuma damu au magonjwa ya mishipa ya damu kusababisha upungufu wa upiliziaji wa figo zote mbili. ===Asilia=== Vyanzo vya uharibifu wa figo yenyewe ni huwa ni vya ''kiasilia.'' AKi asilia inaweza kutokana na uharibifu wa glomeruli, mirija ya figo, au mwanya. Sababu za kawaida za glomerulomefriti, ugonjwa mbaya wa nekrosi ya mirija (ATN), na nefriti kali ya matumbo (AIN), kwa usanjari huo. ===Baada ya figo=== ''AKI'' ya baada ya figo hutokana na kuziba kwa njia ya mkojo. Hii inaweza kutokana na kumea kwa nyama kwenye njia ya mkojo, ya mkojo, kuziba kwa katheta changarawe za kibofu, kansa ya figo au kibofu. Ni muhimu kuchanganua picha ya kibofu au kuepuka kutuacha mkojo kwa muda mrefu. Picha tiba za figo zitaonyesha kama ugonjwa wa haidronefrosis kama upo. Uchanganuzi wa fumbatio wa ACT pia utaonyesha kukunjana kwa kibofu au haidronefrosis, hata hivyo, katika hali ya kibofu kushindwa kabisa, matumizi ulinganuzi wa IV hayakubaliwi. Kwenye sehemu muhimu za metaboli, uwiano wa BUN kwa kreatini unaweza kuashiria kushindwa kwa figo kutekeleza kazi yake. ==Utambuzi wa Ugonjwa== Ugonjwa wa figo kujeruhiwa vibaya hutambuliwa kwa misingi ya historia ya kliniki na data ya maabara. utambuzi huwa wakati kuna kupunguza kasi ambayo figo inafanya kazi, kama kipimo seram kreatini, au kulingana na kupunguza kasi ya kutoa mkojo, iitwayooliguria. ===Ufafanuzi=== Kama inavyoelezewa na Mtandao wa Ugonjwa wa figo kujeruhiwa vibaya (AKIN), kuna vigezo maalum vya kumbua AKI:<ref name="pmid17331245">{{cite journal |author=Mehta RL, Kellum JA, Shah SV, ''et al.'' |title=Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury |journal=Critical Care (London, England) |volume=11 |issue=2 |pages=R31 |year=2007 |pmid=17331245 |pmc=2206446 |doi=10.1186/cc5713 |url=http://ccforum.com/content/11/2/R31 |access-date=2010-12-01 |archive-date=2010-10-30 |archive-url=https://web.archive.org/web/20101030021219/http://ccforum.com/content/11/2/R31 |dead-url=yes }}</ref> # Kipimo cha kasi ya muda (chini ya masaa 48) # Kupunguza utendakazi wa figo #* Ongezeko la seramu ya kreatini #** Ongezeko kubwa la kreatini ya seram ya ≥ 0.3 mg / DL (≥ 26.4 μmol / l) #** Asilimia ya ongezeko la saram la % ≥ 50 #* Kupungua utoaji mkojo, inayofafanuliwa kama <0.5 ml / kilo / hr kwa zaidi ya saa 6 ===Hatua za dalili za ugonjwa=== ''Vigezo RIFLE,'' vilivyopendekezwa na kikundi cha Acute Dialysis Quality Initiative (ADQI) kundi, husaidia katika kuonyesha hatua za dalili za wagonjwa wa AKI:<ref>{{cite journal |author=Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P |title=Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group |journal=Crit Care |volume=8 |issue=4 |pages=R204–12 |year=2004 |pmid=15312219 |pmc=522841 |doi=10.1186/cc2872 |url=}}</ref><ref>{{cite journal |author=Lameire N, Van Biesen W, Vanholder R |title=Acute renal failure |journal=[[The Lancet|Lancet]] |volume=365 |issue=9457 |pages=417–30 |year=2005 |pmid=15680458 |doi=10.1016/S0140-6736(05)17831-3 |url=https://archive.org/details/sim_the-lancet_january-29-february-4-2005_365_9457/page/417}}</ref> * Hatari: seram ya kreatini kuongezeka mara 1.5 au uzalishaji wa mkojo wa ml <0.5 kwa kila kilo kwa saa 6. * Jeraha: Kuongezeka mara mbili kwa uzalishaji wa mkojo ml <0.5 kwa kila kilo kwa saa 12. * Kushindwa: Kuongezeka mara tatu > kreatini au kreatini 355 μmol / l (na ongezeko la > 44) (> 4 mg / dl) AU utoaji mkojo chini ya ml 0.3 kwa kila kilo kwa saa 24 * Kupoteza: kuendelea kwa ugonjwa wa AKI au kupotea kabisa kwa utendakazi wa figo kwa majuma zaidi ya 4 * Hatua ya mwisho ya ugonjwa wa figo: Kupoteza kabisa kwa utendakazi wa figo kwa zaidi ya miezi 3 ===Upimaji zaidi=== Mara tu baada ya utambuzi wa ugonjwa wa AKI ukifanywa, mara nyingi upimaji zaidi unahitajika ili kugundua kilichousababisha. Hii inaweza kuwa ni pamoja na picha za ndani za figo na bayopsi ya figo. Dalili za bayopsi ya figo katika mazingira ya ugonjwa wa AKI ni pamoja na:<ref name="isbn0-07-159124-9">{{cite book |author=Papadakis, Maxine A.; McPhee, Stephen J. |title=Current Medical Diagnosis and Treatment |publisher=McGraw-Hill Professional |location= |year=2008 |pages= |isbn=0-07-159124-9 |oclc= |doi= |accessdate=}}</ref> # AKI isiyoelezeka # AKI katika hali ya ugonjwa wa nefreti # Utaratibu wa ugonjwa unaohusishwa na AKI ==Tiba== Kudhibiti matatizo ya ugonjwa wa AKI baada ya kuutambua na matibabu ya sababu msingi. Mbali na kutibu ugonjwa msingi, kwa kawaida udhibiti wa ugonjwa wa AKI huhusisha kuepukana na vitu vyenye sumu inayoathiri figo, iitwayo nefrotoksini. Hizi ni pamoja na NSAID kama vile ibuprofeni, vikinza vyenye madini ya iodini kama vile vinayotumika kwa ajili ya picha za ndani za CT, na vingine. Ufuatiliaji wa utendakazi wa figo, kwa vipimo vya seram ya kreatini na ufuatiliaji wa utoaji wa mkojo, hufanywa mara kwa mara. Hospitalini, utiaji wa katheta ya nkojo husaidia kufuatilia utoaji wa mkojo na kupunguza uwezekano wa kufungika kwa kibofu, kama vile ya tezi kubwa. ===Tiba mahsusi=== Katika ugonjwa wa AKI bila ongezeko kupita kiasi cha ugiligili, kumpa mgonjwa ugiligili waintravenas nkimsingi ndiyo hatua ya kwanza ya kuboresha kazi figo. Hali ya kiwango inaweza kufuatiliwa kwa kutumia katheta ya katikati ya vena ili kuzuia kupungua au kuongezeka kwa ubadilishaji wa ugiligili. Iwapo shinikizo dogo la damu litadhihirisha tatizo la kudumu la kupungua kwa ugiligili kwa mgonjwa, inotropi kama vile norepinefrine na dobutamine zinaweza kupewa mgonjwa ili kuboresha utendakazi wa moyo hivyo basi kuleta upiliziaji wa figo. Ingawa ni kidhibiti muhimu, hakuna ushahidi wowote wa kuonyesha kwamba dopamine ina faida yoyote ile maalum,<ref>{{cite journal |author=Holmes CL, Walley KR |title=Bad medicine: low-dose dopamine in the ICU |url=https://archive.org/details/sim_chest_2003-04_123_4/page/1266 |journal=Chest |volume=123 |issue=4 |pages=1266–75 |year=2003 |pmid=12684320|doi=10.1378/chest.123.4.1266}}</ref> na inaweza kuwa na madhara. Sababu kadhaa zinazoleta AKI asilia zinahitaji matibabu maalum. Kwa mfano, AKi asilia inayotokana na granulomatosi za Wegener inaweza kutibiwa na dawa za steroid. Aghalabu ugonjwa wa AKI unaoletwa na sumu ya kusababishwa hutibiwa kwa kusitisha kikolezo kinachousababisha, kama vile aminoglaikosidi, penisillin, NSAIDs, au acetaminofeni. Kama sababu ni kuziba kwa njia ya mkojo, unafuu wa kizuizi (kwa nefrostomi au katheta ya mkojo) ni muhimu. ===Vikolezo vya Duretiki=== Ingawa matumizi ya diuretics kama vile furosemide, yameenea na wakati mwingine huwa mwafaka kwa kuharibu ongezeko la ugiligili, huwa haipunguzi uwezekano wa madhara ama kifo.<ref>{{cite journal |author=Uchino S, Doig GS, Bellomo R, ''et al'' |title=Diuretics and mortality in acute renal failure |url=https://archive.org/details/sim_critical-care-medicine_2004-08_32_8/page/1669 |journal=Crit. Care Med. |volume=32 |issue=8 |pages=1669–77 |year=2004 |pmid=15286542|doi=10.1097/01.CCM.0000132892.51063.2F}}</ref> ===Matibabu ya kubadilisha figo=== Matibabu ya kubadilisha figo, kama pamoja nausafishaji wa damu, inaweza kutumika katika baadhi ya hali za ugonjwa wa AKI. Kupitia uchunguzi wa kina wa machapisho ya mwaka 2008 ulidhihirisha kuwa hakuna tofauti katika matokeo kati ya matumizi ya usafishaji wa damu wa vipindi na kuendelea kuchuja damu ya venonenasi (CVVH).<ref name="pmid18285591">{{cite journal |author=Pannu N, Klarenbach S, Wiebe N, Manns B, Tonelli M |title=Renal replacement therapy in patients with acute renal failure: a systematic review |journal=JAMA : the Journal of the American Medical Association |volume=299 |issue=7 |pages=793–805 |year=2008 |month=Februari |pmid=18285591 |doi=10.1001/jama.299.7.793 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18285591}}</ref> Miongoni mwa wagonjwa mahututi, matibabu ya kinaya ubadilishaji wa figo na CVVH hayaboreshi matokeo ikilinganishwa na usafishaji damu usiyo wa kina.<ref name="pmid19846848">{{cite journal |author=Bellomo R, Cass A, Cole L, ''et al.'' |title=Intensity of continuous renal-replacement therapy in critically ill patients |journal=The New England Journal of Medicine |volume=361 |issue=17 |pages=1627–38 |year=2009 |month=Oktoba |pmid=19846848 |doi=10.1056/NEJMoa0902413 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=19846848&promo=ONFLNS19}}</ref><ref name="pmid18492867">{{cite journal |author=Palevsky PM, Zhang JH, O'Connor TZ, ''et al.'' |title=Intensity of renal support in critically ill patients with acute kidney injury |journal=The New England Journal of Medicine |volume=359 |issue=1 |pages=7–20 |year=2008 |month=Julai |pmid=18492867 |pmc=2574780 |doi=10.1056/NEJMoa0802639 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18492867&promo=ONFLNS19}}</ref> ==Matatizo== Asidi ya metaboli, kiwango cha juu cha potasiamu katika damu, na uvimbegiligili wa mapafu<ref>{{Rejea tovuti |url=http://beavermedic.wordpress.com/2010/01/19/the-kidneys/ |title=Nakala iliyohifadhiwa |accessdate=2010-12-01 |archivedate=2011-07-18 |archiveurl=https://web.archive.org/web/20110718090647/http://beavermedic.wordpress.com/2010/01/19/the-kidneys/ }}</ref> inaweza hitaji matibabu ya dawa yenye magadi ya kuumulia, hatua za kukinza kiwango cha juu cha potasiamu katika damu, na diuretiki. Ukosefu wa kuboresha ufufuzi wa ugiligili,-matibabu ya kuzuia ongezeko la potasiamu katika damu, asidi ya metaboli, au ongezeko la ugiligili inaweza kuhitaji msaada badala kwa njia ya kusafisha damu au kuchuja damu. Idadi fulani ya wagonjwa hawatarudia hali yao ya kawaida ya utendakazi wa figo kwa kutegemea kilichosababisha ugonjwa wa AKI, hivyo basi kuwa na hatua ya mwisho ya kushindwa kwa figo iayohitaji usafishaji damu wa kudumu au kupandikiza figo. ==Historia== Kabla ya maendeleo ya taalumaya uuguzi ya hivi sasa, kujeruhiwa kwa figo vibya kungejulikana kama ''sumu ya yuremiki.'' Uremia ni neno lililotumiwa kuelezea kuchafuliwa kwa [[damu]] na mkojo. Kuanzia karibu mwaka 1847 neno hili lilitumika kuelezea kupungua kwa utoaji mkojo, ambalo sasa linajulikana kama oliguria, ambayo iliaminika kwamba ilitokana na mchanganyiko wa mkojo na damu badala ya kutenganishwakupitia kwa njia ya mkojo. Kujeruhiwa vibaya kwa figo kunakotokana na ulainikaji kasini wa mirija (ATN) uligunduliwa miaka ya 1940 [[Ufalme wa Muungano|nchini]] Uingereza, ambapo wahasiriwa walikuwa na majeraha kama hayo wakati wa London Blitz walianza kuwa na mapaka kwenye mirija ya figo, iliyosababisha upungufu fulani wa ghafla katika utendakazi wa figo.<ref>{{cite journal |author=Bywaters EG, Beall D |title=Crush injuries with impairment of renal function. |journal=[[British Medical Journal|Br Med J]] |volume= 1|issue=1 |pages=427–32 |year=1941 |pmid=9527411 |doi= 10.1136/bmj.1.4185.427|url=http://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=9527411}}</ref> Wakati wa vita vya [[Vita ya Korea|Korea]] na [[Vita ya Vietnam|vita vya Vietnam]], visa vya ugonjwa wa AKI vilipungua kutokana na usimamizi na udhibiti wa ugiligili wa mishipa.<ref>{{cite journal |author=Schrier RW, Wang W, Poole B, Mitra A |title=Acute renal failure: definitions, diagnosis, pathogenesis, and therapy |journal=J. Clin. Invest. |volume=114 |issue=1 |pages=5–14 |year=2004 |pmid=15232604 |pmc=437979 |doi=10.1172/JCI22353 |url=https://archive.org/details/sim_journal-of-clinical-investigation_2004-07_114_1/page/5}}</ref> ==Marejeo== {{Marejeo}} {{Sisterlinks}} [[Category:Magonjwa ya figo]] olxdvx3lzd7shmf0s6q2207czmdr9nf 0 55905 1578125 1275371 2026-07-02T21:04:13Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578125 wikitext text/x-wiki {{Infobox_Disease | Name = Vaginitis | Image = | Caption = | DiseasesDB = 14017 | ICD10 = {{ICD10|N|76|0|n|70}}-{{ICD10|N|76|1|n|70}} | ICD9 = {{ICD9|616.1}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 3369 | eMedicine_mult = {{eMedicine2|med|2358}} {{eMedicine2|emerg|631}} {{eMedicine2|emerg|639}} | MeshID = D014627 }} '''Kufifia uke ''' (kwa [[Kiingereza]]: ''vaginitis'') ni kuvimba kwa [[uke]]. <ref name="mayoclinic">[http://www.mayoclinic.com/health/vaginitis/DS00255 www.mayoclinic.com - Magonjwa na Masharti - Kufifia uke - Enye besi - Ufafanuzi] 6 Februari 2009</ref> Inaweza kusababisha [[usaha]], kuwashwa na maumivu<ref name="mayoclinic"></ref>. Kwa kawaida hutokana na [[maambukizi]]. ==Dalili== Mwanamke katika hali hiyo anaweza kuwa na [[mwasho]] au [[maumivu]] makali ya kuchoma, kutokwa na usaha. Kwa ujumla, hizi ni dalili za kufifia kwa uke: *mwasho eneo la [[uzazi]] *kuvimba (mwasho, chuchu, na uvimbe unaotokana na mbele ya seli kinga ya ziada) wa mashavu makubwa ya uke, mashavu madogo ya uke, au eneo la uke *uke kuvuja usaha *uke kutoa harufu mbaya *usumbufu au kuungua wakati wa kukojoa *maumivu / mwasho wakati wa kufanya mapenzi ==Sababu== Vulvovaginitis unaweza kuathiri wanawake wa [[umri]] wowote na ni ya kawaida sana. === Maambukizi=== 1. Maambukizi ya vaginitis yanachukua asilimia 90 kati ya matatizo yote wakati wa umri wa kuzaa wa mwanamke na inawakilishwa katika makundi matatu: * Candidiasis: vaginitis unaosababishwa na albicans Candida (fangasi). * Bakteria vaginosis: vaginitis unaosababishwa na ''Gardnerella'' (bakteria). * Trichomoniasis: vaginitis unaosababishwa na ''Trichomonas vaginalis'' (protozoa). Kawaida chini ya maambukizi mengine inasababishwa na kisonono, klamidia, mycoplasma, malengelenge, campylobacter, usafi mbaya, na vimelea vya na baadhi ya wadudu tegemezi. Maambukizi ya uke mara nyingi (yanatofautiana kati ya nchi na nchi, kati ya 20-40% ya maambukizi ya uke) una mchanganyiko wa visababishi mbalimbali, ambavyo vinaleta changamoto kwenye matibabu. Hakika, wakati chanzo (kisababishi) kimoja kikipatiwa tiba, vimelea vingine vinapata ukinzani na kusababisha tatizo kujirudia baada ya muda mfupi. Kitu muhimu ni Kupata utambuzi sahihi na kutibu na wigo mpana Wa dawa za kuzuia maambukizi (mara nyingi pia huleta madhara). 2. Wasichana ambao hawajabalehe wanaweza pia kuambukizwa vaginitis, ingawa kwa sababu tofauti na zile za wanawake: * Bakteria vaginosis: vaginitis unaosababishwa na ''spp Streptococcus.'' * Uchafu wa mazingira, ambao unaleta bakteria au vyanzo vingine vya uchafu kutoka sehemu ya haja kubwa na eneo la uke. Urari pH katika wasichana si mzuri kwa ukuaji wa albicans Candida, hivyo ni ngumu kupata maambukizi ya fangasi. ===Njia za kupanga uzazi za homoni=== Homoni vaginitis pamoja na vaginitis atrophic kawaida hupatikana katika wanawake ambao uwezo wa kupata mimba umekwisha au baada ya kujifungua. Wakati mwingine inaweza kutokea kwa wasichana kabla ya [[ubalehe]]. Katika hali hii ya msaada estrogen ya uke ni dhaifu. ===Mwasho / aleji=== Vaginitis inayowasha husababishwa na aleji kuhusu [[kondomu]], dawa za kuua mbegu za kiume, sabuni, ubani, douches, kilainisha na shahawa. Inaweza kuwa imesababishwa na mirija ya moto, kidonda ambacho ngozi ya juu imeharibika, tishu, visodo au dawa za topical. ===Vitu kutoka nje ya mwili=== Vitu kutoka nje ya mwili (kwa kawaida visodo au kondomu) husababisha sana kutoka usaha wenye harufu mbaya ukeni. Matibabu hujumuisha kuviondoa. Matibabu zaidi si lazima kwa ujumla. ===Magonjwa ya zinaa=== Magonjwa ya zinaa yanaweza kuwa sababu ya usaha ukeni. Upimaji wa [[klamidia]] na [[kisonono]] ufanyike kwa mtu binafsi ambaye ana hali ya kujamiana endapo analalamika kutokwa na usaha ukeni hata wakati mfuko wa uzazi unaonekana wa kawaida. === Kisukari === Wanawake walio na ugonjwa wa kisukari hukuza haraka maambukizi ya vaginatis kuliko wanawake ambao hawana kisukari. ==Uaguzi== Takwimu ya kimataifa kuhusu aina za magonjwa na uhusiano na vyanzo kadhaa vya vaginitis ni: {| class="wikitable" |- ! Ratibu ! Maelezo ! pH |- | Kandida kufifia uke ( {{ICD10|B|37|3|b|35}} ) | Kawaida inajulikana kama chachu ya kuambukizwa, ''kufifia uke '' ni maambukizi ya vimelea ambao kwa kawaida husababisha watery, nyeupe, Cottage cheese kama utsläpp uke. Kutokwa inakera uke na ngozi jirani. | Asili (4.0-4.5) |- | Kufifia uke (au uzee ya uke) ( {{ICD10|N|95|2|n|80}} ) | Kawaida husababisha uke bila ya ute, uke kavu na ngono chungu. Dalili hizi ni kawaida kutokana na homoni kupungua, hutokea hasa wakati na baada ya kukoma hedhi. | |- | Bakteria kufifia uke ( {{ICD10|B|96|3|b|95}} ). | ''Gardnerella'' kawaida husababisha kuachilia harufu kama ya samaki, kujikuna na mwasho, maumivu wakati wa ngono. | nyanyuliwa |- | Trikomonasi kufifia uke ( {{ICD10|A|59|0|a|50}} ) | Unaweza kusababisha kutokwa na harufu ya samaki-kama, maumivu ya kukojoa, ngono chungu, na kuvimba ya siri ya nje. | nyanyuliwa (5.0-6.0) |- | Aina yoyote ya ugonjwa wa malengelenge ya neva ngozini ( {{ICD10|A|60|0|a|50}} ) | kwa kawaida hutokea kama maji malengelenge juu ya uzazi kanda, kuhusu wiki moja baada ya kuambukizwa. Kuna huruma, tezi kuvimba, na homa. uwati maji ni chungu sana na kuponya katika muda wa wiki tatu. Hata hivyo, aina yoyote ya ugonjwa wa malengelenge ya neva ngozini ni kawaida malengelenge ya maambukizi ya nje na si jamii ya kufifia uke. | |} ==Matatizo yanajitokeza== * kuendelea kupata usumbufu * maambukizi ya juu ya ngozi (kutoka scratching) * utata wa sababu (kama vile ugonjwa wa kisonono au kandida) ==Matibabu== Njia ya maambukizi inaamua juu ya matibabu sahihi. ==Tanbihi== {{reflist}} ==Marejeo== *{{cite journal |author=Jaquiery A, Stylianopoulos A, Hogg G, Grover S |title=Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract |journal=Arch. Dis. Child. |volume=81 |issue=1 |pages=64–7 |year=1999 |pmid=10373139 |pmc=1717979 |doi= 10.1136/adc.81.1.64|url=http://adc.bmj.com/cgi/pmidlookup?view=long&pmid=10373139}} *{{cite journal |author=Brook I |title=Microbiology and management of polymicrobial female genital tract infections in adolescents |journal=J Pediatr Adolesc Gynecol |volume=15 |issue=4 |pages=217–26 |year=2002 |pmid=12459228 |doi= 10.1016/S1083-3188(02)00159-6|url=http://linkinghub.elsevier.com/retrieve/pii/S1083318802001596}} *{{cite journal |author=Joesoef MR, Schmid GP, Hillier SL |title=Bacterial vaginosis: review of treatment options and potential clinical indications for therapy |journal=Clin. Infect. Dis. |volume=28 Suppl 1 |issue= |pages=S57–65 |year=1999 |pmid=10028110 |doi= 10.1086/514725|url=}} *{{cite journal |author=Ozkinay E et al. |title=The effectiveness of live lactobacilli in combination with low dose estriol to restore the vaginal flora after treatment of vaginal infections |journal=IBJOG |volume=112 |issue= 2|pages=234–240; quiz 440–1 |year=2005|doi= 10.1111/j.1471-0528.2004.00329.x|url=https://archive.org/details/sim_bjog_2005-02_112_2/page/234|pmid=15663590}} *{{cite journal |author=Reed BD, Slattery ML, French TK |title=The association between dietary intake and reported history of Candida vulvovaginitis |journal=J Fam Pract |volume=29 |issue=5 |pages=509–15 |year=1989 |pmid=2553850 |doi= |url=https://archive.org/details/sim_journal-of-family-practice_1989-11_29_5/page/509}} {{mbegu-tiba}} [[Category:Magonjwa]] fr8zo1z2g000o1e27fty0fc35yge148 0 55913 1578224 1517542 2026-07-03T04:03:32Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578224 wikitext text/x-wiki {{tafsiri kompyuta}} [[File:Smoke-by-a-window-in-a-pub.jpg|thumb|right|200px|Moshi wa tumbaku katika pub ya Ireland kabla ya kupiga marufuku ya kuvuta sigara tarehe 29 Machi 2004.]] '''Kupatwa na moshi wa sigara za wengine''' (kwa [[Kiingereza]]: ''Second hand smoke'') ni hali ya kuvuta [[hewa]] yenye [[moshi]] unaotokana na [[mtu]] anayevuta [[sigara]] au [[mazingira]] ya moshi wa [[tumbaku]] (ETS), kutoka bidhaa za [[Mtumbaku]] zinazotumiwa na watu wengine. Hutokea wakati moshi wa tumbaku unapoenea katika mazingira yoyote na kusababisha athari ya kuvuta hewa kwa watu wanaoishi hapo. Ushahidi wa kisayansi unaonyesha kwamba kuvuta hewa ya moshi utokanao na mtu anayevuta tumbaku husababisha [[ugonjwa]], [[ulemavu]] na hata [[kifo]]. <ref name="sg-report">{{cite web |url = http://www.surgeongeneral.gov/library/secondhandsmoke |title = The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General |publisher = [[Surgeon General of the United States]] |date = 2006-06-27 |accessdate = 2009-01-12 |quote = Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke}}</ref> <ref name="iarc-monograph">{{cite web |url = http://monographs.iarc.fr/ENG/Monographs/vol83/index.php |title = Tobacco Smoke and Involuntary Smoking |publisher = [[International Agency for Research on Cancer]] |year = 2004 |accessdate = 2009-01-12 |quote = There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) causes lung cancer in humans |format = PDF |archivedate = 2018-06-07 |archiveurl = https://web.archive.org/web/20180607085206/http://monographs.iarc.fr/ENG/Monographs/vol83/index.php }}</ref> Kuvuta moshi wa sigara inayotumiwa na mtu mwingine kumechangia pakubwa mjadala juu ya madhara na udhibiti wa bidhaa za tumbaku. Tangu mapema [[miaka ya 1970]], sekta ya tumbaku imekuwa na wasiwasi kuhusu kuvuta moshi wa sigara inayotumiwa na mtu mwingine kama tishio kubwa kwa maslahi ya [[biashara]] yake, madhara kwa walioko ambao hawavuti sigara. Ilionekana kama shinikizo kuu la kudhibiti bidhaa za tumbaku. Licha ya ufahamu wa mapema kuhusu uwezekano wa kuwepo madhara ya moshi wa sigara inayovutwa na mtu mwingine, sekta ya tumbaku iliratibu [[uhandisi]] wa pambano la kisayansi kwa lengo la kuzuia udhibiti wa bidhaa zao. <ref name="kessler"></ref> Hivi sasa, hatari za [[Afya|kiafya]] za moshi wa sigara ni suala la makubaliano ya kisayansi, na hizi hatari zimekuwa moja ya motisha kubwa kwa ajili ya kupiga [[marufuku]] kuvuta sigara katika maeneo ya [[kazi]] na ndani ya maeneo ya [[umma]], ikiwa ni pamoja na [[Mgahawa|mikahawa]], [[baa]] na [[klabu za usiku]]. == Madhara ya muda mrefu == Kuna ushahidi wa kutosha wa kisayansi kwamba moshi usiokuwa moja kwa moja husababisha magonjwa sawa kama sigara inayovutwa moja kwa moja, ikiwa ni pamoja na ugonjwa wa moyo na mishipa, mapafu, na ugonjwa wa upumuaji. Magonjwa haya ni kama: * Saratani: ** Jumla: hatari zilizoongezeka, <ref>{{harvnb|Surgeon General|2006|pp=30–46}}</ref> kupitia ushahidi uliokusanywa duniani kote, na Shirika la Kimataifa la Utafiti wa [[Saratani]] ilitamatishwa mwaka wa 2004 kuwadhibitika na utashi "Kushinikizwa kuvuta hewa ya sigara,au kuwekwa hatarini ya moshi wa tumbaku au 'mazingira' yenye moshi wa tumbaku) husababisha [[kansa]] kwa binadamu". <ref name="iarc-monograph"></ref> ** Kansa ya mapafu: mathari za sigara isiyo vutwa moja kwa moja juu ya kansa ya mapafu imefanyiwa uchunguzi sana. Mfululizo wa masomo kutoka Marekani kuanzia 1986-2003, Uingereza mwaka 1998, Australia mwaka 1997 na kimataifa katika 2004 umeonyesha mara kwa mara kuwa na ongezeko kubwa la hatari miongoni mwa wale kwenye hatari ya hewa ya moshi usiovutwa moja kwa moja. ** Kansa ya matiti: Shirika la Ulinzi wa mazingira la Kalifornia lilitamatisha mwaka 2005 kuwa uvutaji wa hewa ya moshi wa sigara huongeza hatari ya saratani ya matiti kwa wanawake wachanga ambao hawajakoma hedhi kwa asilimia. 70% Na mpasuaji mkuu wa Marekani amebainisha kwamba ushahidi "unakisia tu," lakini bado hautoshi kuleta uhusiano vile. Kwa kinyume, Wakala wa Kimataifa wa Taasisi ya Utafiti wa Saratani ulitamatisha mwaka 2004 kuwa kulikuwa "hakuna thibitisho kwa uhusiano baina ya hewa ya moshi wa tumbaku na kansa ya matiti katika wasiovutwa sigara kamwe ". ** Mafigo Saratani ya chembechembe za Figo (RCC): Utafiti wa hivi karibuni unaonyesha kuongezeka kwa hatari ya (RCC) miongoni mwa wasio vuta sigara kamwe ingawa nyubani/kazini walikumbana na hiya hewa nyumbani au kazini<ref>{{cite journal |author=Theis RP, Dolwick Grieb SM, Burr D, Siddiqui T, Asal NR |title=Smoking, environmental tobacco smoke, and risk of renal cell cancer: a population-based case-control study |journal=BMC Cancer |volume=8 |pages=387 |year=2008 |pmid=19108730 |pmc=2633310 |doi=10.1186/1471-2407-8-387 |ref=harv }}</ref> ** Hewa ya moshi wa sigara haionekani kuwa uhusiano na kansa ya uvimbe wa kongosho. <ref>{{cite journal |author=Hassan MM, Abbruzzese JL, Bondy ML, ''et al.'' |title=Passive smoking and the use of noncigarette tobacco products in association with risk for pancreatic cancer: a case-control study |url=https://archive.org/details/sim_cancer_2007-06-15_109_12/page/2546 |journal=Cancer |volume=109 |issue=12 |pages=2547–56 |year=2007 |pmid=17492688 |pmc=2215306 |doi=10.1002/cncr.22724 |ref=harv}}</ref> ** Uvimbe wa ubongo: hatari huongezeka kwa watoto kwa kiasi kikubwa zaidi hata kama mama havuti lakini amehatarishwa na hiyo hewa ya moshi, hivyo si kuzuia hatari kwa mtoto wakati wa ujauzito. * Sikio, pua na koo: maambukizi hatari ya sikio. <ref>{{cite book |last=Bull |first=P.D. |title=Diseases of the Ear, Nose and Throat |url=https://archive.org/details/lecturenotesondi0000bull_a3x1 |publisher=Blackwell Science |year=1996 |isbn=0-86542-634-1 }}</ref> * Mfumo wa mzunguko wa damu: hatari ya ugonjwa wa moyo, <ref>{{harvnb|Surgeon General|2006|loc=Ch. 8}}</ref> kupunguza kiwango cha upigaji moyo, kiwango cha juu cha upigaji moyo. <ref>{{cite journal |author=Dietrich DF, Schwartz J, Schindler C, ''et al.'' |title=Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study |url=https://archive.org/details/sim_international-journal-of-epidemiology_2007-08_36_4/page/834 |journal=Int J Epidemiol |volume=36 |issue=4 |pages=834–40 |year=2007 |pmid=17440032 |doi=10.1093/ije/dym031 |ref=harv}}</ref> **Masomo juu ya magonjwa inaonyesha kwamba kuvuta sigara kwenyewe na kuingiza hewa ya aliyevuta huongeza hatari ya atherosklerosi. * Matatizo ya mapafu: ** Hatari ya pumu. <ref>{{harvnb|Surgeon General|2006|pp=555–8}}</ref> * Kuharibika kwa uelewaji na shida ya akili: Mfiduo kwa hewa ya moshi huweza kuongeza hatari ya kuharibika kwa utambuzi na shida ya akili kwa watu wazima miaka 50 na zaidi. * Ujauzito ** Uzito wa kuzaliwa wa chini, sehemu B, ch.^3. <ref>{{harvnb|Surgeon General|2006|pp=198–205}}</ref> ** Kuzaliwa kabla ya kupevuka, sehemu B, ch.3 (Kumbuka kwamba ushahidi wa uhusiano umeelezewa tu kama "kukisia" na Mpasuaji mkuu wa Marekani katika taarifa yake ya mwaka wa 2006.) * Kwa ujumla: ** Kuongezeka kwa pumu, mzio na hali nyingine. * Hatari kwa watoto: <ref>{{cite news |title=Parents warned not to smoke at home |url=http://observer.guardian.co.uk/uk_news/story/0,,2110076,00.html |work = [[The Guardian]] |accessdate = 2007-06-24 |location=London |first=Denis |last=Campbell |date=24 Juni 2007}}</ref> ** Dalili za kifo cha ghafla cha watoto au (SIDS). <ref>{{cite journal |author=McMartin KI, Platt MS, Hackman R, Klein J, Smialek JE, Vigorito R, Koren G |title=Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS) |url=https://archive.org/details/sim_journal-of-pediatrics_2002-02_140_2/page/205 |journal=[[Journal of Pediatrics|J. Pediatr.]] |volume=140 |issue=2 |pages=205–9 |year=2002 |pmid=11865272 |doi=10.1067/mpd.2002.121937 |ref=harv }}</ref> <ref>{{cite journal |author=Milerad J, Vege A, Opdal SH, Rognum TO |title=Objective measurements of nicotine exposure in victims of sudden infant death syndrome and in other unexpected child deaths |url=https://archive.org/details/sim_journal-of-pediatrics_1999-07_135_1/page/132 |journal=J. Pediatr. |volume=135 |issue=1 |pages=132–3 |year=1999 |pmid=9709711 |ref=harv }}</ref> Katika taarifa yake 2006, Mpasuaji Mkuu wa Marekani anasema:"Ushahidi huo ni wa kutosha kuleta uhusiano sababishi kati ya kuvuta hewa ya moshi wa sigara na dalili za kifo cha ghafla cha mtoto ". ** Pumu <ref>{{harvnb|Surgeon General|2006|pp=311–9}}</ref> <ref>{{cite journal |author=Vork KL, Broadwin RL, Blaisdell RJ |title=Developing asthma in childhood from exposure to secondhand tobacco smoke: insights from a meta-regression |journal=[[Environ. Health Perspect.]] |volume=115 |issue=10 |pages=1394–400 |year=2007 |pmid=17938726 |pmc=2022647 |doi=10.1289/ehp.10155 |ref=harv}}</ref> ** Maambukizi ya mapafu <ref>{{cite journal |author=Spencer N, Coe C |title=Parent reported longstanding health problems in early childhood: a cohort study |journal=[[Arch. Dis. Child.]] |volume=88 |issue=7 |pages=570–3 |year=2003 |pmid=12818898 |pmc=1763148 |doi=10.1136/adc.88.7.570 |ref=harv}}</ref> <ref>{{cite journal |author=de Jongste JC, Shields MD |title=Cough. 2: Chronic cough in children |url=https://archive.org/details/sim_thorax_2003-11_58_11/page/998 |journal=Thorax |volume=58 |issue=11 |pages=998–1003 |year=2003 |pmid=14586058 |pmc=1746521 |doi=10.1136/thorax.58.11.998 |ref=harv}}</ref> <ref>{{cite journal |author=Dybing E, Sanner T |title=Passive smoking, sudden infant death syndrome (SIDS) and childhood infections |url=https://archive.org/details/sim_human-and-experimental-toxicology_1999-04_18_4/page/202 |journal=Hum Exp Toxicol |volume=18 |issue=4 |pages=202–5 |year=1999 |pmid=10333302|doi=10.1191/096032799678839914 |ref=harv}}</ref> <ref name="Difranza 2004">{{cite journal |author=DiFranza JR, Aligne CA, Weitzman M |title=Prenatal and postnatal environmental tobacco smoke exposure and children's health |journal=[[Pediatrics (journal)|Pediatrics]] |volume=113 |issue=4 Suppl |pages=1007–15 |year=2004 |pmid=15060193 |doi=10.1542/peds.113.4.S1.1007 |url=http://pediatrics.aappublications.org/cgi/content/full/113/4/S1/1007 |ref=harv |doi_brokendate=2010-06-20 |access-date=2010-12-14 |archive-date=2010-02-03 |archive-url=https://web.archive.org/web/20100203081032/http://pediatrics.aappublications.org/cgi/content/full/113/4/S1/1007 |dead-url=yes }}</ref> ** Magonjwa makali zaidi yakiwa na bronkioiolitis , na matokeo mabaya zaidi ** Kuongezeka kwa hatari ya kupatwa na kifua kikuu kama ikipata mwenezaji ** Mzio ** Ugonjwa wa Chrohn. <ref>{{cite journal |author=Mahid SS, Minor KS, Stromberg AJ, Galandiuk S |title=Active and passive smoking in childhood is related to the development of inflammatory bowel disease |journal=Inflamm. Bowel Dis. |volume=13 |issue=4 |pages=431–8 |year=2007 |pmid=17206676 |doi=10.1002/ibd.20070 |ref=harv}}</ref> ** Ugumu wa kujifunza, ucheleweshaji wa kukua, na kuathiri mienendo ya kiakili. Mifano ya wanyama hupendekeza jukumu kwa Nikotini na monoksidi ya kaboni katika matatizo ya mishipa ya akili. <ref name="Difranza 2004"></ref> ** Ongezeko katika kuoza kwa meno (pamoja na kuhusiana biyoishara za mate umeshirikishwa na hewa ya moshi wa sigara kwa watoto. ** Kuongezeka kwa hatari ya maambukizi ya sikiokati. * Kuongezeka kwa ujumla hatari ya kifo katika watu wazima, ambapo inakadiriwa kuua wasiovuta sigara 53,000 kwa mwaka, na kuifanya nambari 3 baadhi ya sababu za 1} vifo vinavyoweza kuzuiliwa nchini Marekani na kwa watoto. == Utaratibu wa visababu == Utafiti wa 2004 na Shirika la Kimataifa la Utafiti wa Saratani ya Shirika la Afya Duniani lilitamatisha kuwa wasiovuta sigara wamehatarishwa na kasinojeni sawa za kusababisha kansa kama wale wanaovuta. Moshi wa kando una zaidi ya kemikali 4,000, ikiwa ni pamoja na kasinojeni 69 zinazojulikana. Wasiwasi maalum ni polinyukilia hidrokaboni zenye kunukia, N-naitrosamini maalum za tumbaku na amaini zenye kunukia , kama vile 4-Aminobiphenyl, ambayo imejulikana kuwa yenye kusababisha kansa. Moshi wa moja kwa moja, moshi wa kando, na moshi wa sigara unaopumuliwa bila hiari na mtu asiyevuta sigara una vipengele sawa, hata hivyo ukolezi wake unatofautiana kulingana na aina ya moshi. Kasinojeni kadhaa zenye nguvu zimeonyeshwa na 'makampuni ya tumbaku yenyewe kupitia utafiti kuwa sasa wa viwango vya juu katika moshi wa kando kuliko katika moshi tawala. Moshi wa tumbaku kwenye mazingira (ETS) umebainika kuwa unazalisha uchafuzi wa mazingira katika chembechembe ya mata zaidi (PM) kuliko injini ya dizeli iliyo na mchirizo wa chini Katika majaribio yaliofanywa na Taasisi ya Saratani ya Taifa la Italia, sigara tatu ziliachwa zikiwaka, moja baada ya nyingine, katika karakana 60m³ na hewa kidogo ikibadilishwa. Hizo sigara zilizalisha uchafuzi wa PM mno hadi mipaka ya nje, kama vile viwango vya mchana hadi mara 10 ile ya injini inayonguruma. Uvutaji kuwekwa kwenye hatari ya moshi wa tumbaku kuna madhara makubwa ya haraka juu ya damu na mishipa ya damu katika njia ambayo huongeza hatari ya mashambulizi ya moyo, hasa katika watu walio tayari kwenye hatari. <ref>{{cite journal |author=Barnoya J, Glantz SA |title=Cardiovascular effects of secondhand smoke: nearly as large as smoking |url=https://archive.org/details/sim_circulation_2005-05-24_111_20/page/n159 |journal=Circulation |volume=111 |issue=20 |pages=2684–98 |year=2005 |pmid=15911719 |doi=10.1161/CIRCULATIONAHA.104.492215 |ref=harv}}</ref> Kuwekwa kwenye hatari ya moshi wa tumbaku kwa muda wa dakika 30 kwa kiasi kikubwa hupunguza hifadhi ya kasimwelekeo kwenye mtiririko wa moyo katika watu wasiovuta sigara na wenye afya. Ugonjwa wa mapafu ambao hukatiza kupumua unaweza sababishwa katika panya kutokana na moshi mkali wa kando wa tumbaku (sigara 30 kwa siku) kwa kipindi cha siku 45. Kuharibiwa kwa seli za masti} na kuchangia uharibifu wa mapafu pia umegunduliwa. Neno "moshi wa aina ya mkono wa tatu" umebuniwa hivi karibuni kutambua uchafuzi kutokana na mabaki ya moshi wa tumbaku unaosalia baada ya sigara kuzimwa na moshi uliotolewa inje na mvutaji kuondolewa kutoka kwa hewa. Utafiti wa awali unaonyesha kwamba matokeo ya moshi wa aina ya mkono wa tatu yanaweza kuhatarisha afya, ingawa ukubwa wa hatari, kama upo, bado haujulikani. == Masomo ya Epidemologia == Masomo ya Epidemologia yanaonyesha kuwa watu wasiovuta sigara wakipumua hewa ya moshi wa sigara huhatarishwa kiafya na matatizo yanayohusiana na uvutaji wa moja kwa moja. Mwaka wa 1992, ''gazeti la American Medical Association'' lilichapisha mapitio ya ushahidi wa kutosha kuhusu uhusiano kati ya moshi wa sigara inayopumuliwa bila hiari na mtu asiyevuta sigara na maradhi ya moyo, na inakadiriwa kuwa sigara tulivu iliwajibika kwa vifo 35,000 kufikia 40,000 kwa mwaka katika [[Marekani|nchi]] ya [[Marekani]] mapema miaka ya 1980. <ref name="steenland">{{cite journal |author=Steenland K |title=Passive smoking and the risk of heart disease |journal=JAMA |volume=267 |issue=1 |pages=94–9 |year=1992 |month=Januari |pmid=1727204 |doi= 10.1001/jama.267.1.94|url=http://jama.ama-assn.org/cgi/content/abstract/267/1/94 |ref=harv}}</ref> Hatari halisi ya ongezeko la maradhi ya moyo kutokana na ETS ilikuwa 2.2%, huku asilimia ya hatari husishi ikiwa asilimia 23%. Utafiti kwa kutumia hatua halisi zaidi ya mfiduo kwa moshi usiovutwa moja kwa moja unaonyesha kuwa hatari kwa wasiovuta sigara inaweza kuwa hata zaidi kuliko makisio haya. Utafiti wa Uingereza ulisema kwamba mfiduo kwa moshi usiovutwa moja kwa moja huongeza hatari ya ugonjwa wa moyo kati-ya wasio vuta kwa kiasi kama 60%, sawa na sigara mwanga. Ushahidi pia unaonyesha kwamba kuvuta pumzi ya moshi wa kando, ambayo ndio sehemu kubwa ya moshi usio kuwa moja kuwa moja kwa moja, una sumu mara nne zaidi kuliko moshi tawala, ukweli ambao umejulikana kwa sekta ya tumbaku tangu miaka ya 1980, matoke ambayo yaliwekwa siri. <ref name="glantz2005">{{cite journal |author=Schick S, Glantz S |title=Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke |journal=Tobacco control |volume=14 |issue=6 |pages=396–404 |year=2005 |pmid=16319363 |doi=10.1136/tc.2005.011288 |pmc=1748121 |ref=harv}}</ref> <ref name="schick2006">{{cite journal |author=Schick S, Glantz SA |title=Sidestream cigarette smoke toxicity increases with aging and exposure duration |journal=Tobacco control |volume=15 |issue=6 |pages=424–9 |year=2006 |pmid=17130369 |doi=10.1136/tc.2006.016162 |pmc=2563675 |ref=harv}}</ref> Baadhi ya wanasayansi wanaamini kwamba hatari ya uvutaji tulivu, hasa katika hatari ya kupatwa na magonjwa ya koronari ya moyo, inaweza kuwa ilikadiriwa chini sana. Wanaepidemiolojia wachache huona ugumu kuelewa jinsi mazingira ya moshi wa tumbaku, ambayo yame zimua zaidi kuliko pumzi ya moshi uliovutwa moja kwa moja, inaweza kuwa na athari ambayo ni sehemu kubwa kama hiyo inayoongeza hatari ya ugonjwa wa moyo kati ya uvutaji halisi. Mojawapo ya maelezo yaliyopendekezwa ni kwamba moshi usiokuwa wa moja kwa moja siyo tu 'ugeuzi uliyozimuliwa kutoka kwa moshi tawala', lakini ina muundo tofauti wenye dutu sumu zaidi kwa kila gramu ya chembechembe jumla. Sigara tulivu inaonekana kuwa na uwezo wa kutuama papo hapo maonyesho-ya magonjwa ya utomvu wa moyo(atherothrombosis) na pia kuwa na athari hasi juu ya matokeo ya wagonjwa wanaoteseka ugonjwa hatari wa moyo. Mwaka wa 2004, Shirika la Kimataifa la Utafiti wa Saratani (IARC) la [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] (WHO) lilirejelea ushahidi wote muhimu uliochapishwa kuhusiana na uvutaji wa tumbaku na saratani. Ilihitimisha: {{quote|These meta-analyses show that there is a statistically significant and consistent association between lung cancer risk in spouses of smokers and exposure to secondhand tobacco smoke from the spouse who smokes. The excess risk is of the order of 20% for women and 30% for men and remains after controlling for some potential sources of bias and confounding.<ref name="iarc-monograph"/>}} Uchambuzi zaidi wa baadaye umethibitisha matokeo hayo, na masomo ya ziada yamebainisha kuwa mfiduo wa jumla wa juu kwa moshi tulivu hata kati ya watu wenye wapenzi ambao hawavuti sigara imehusishwa na hatari kubwa zaidi kuliko mpenzi mvutaji na imeenea katika wasio vuta. Baraza la kitaifa la pumu la Australia linataja tafiti zinazo onyesha kuwa mazingira ya moshi wa tumbaku (ETS) pengine ndio muhimu katika uchafuzi wa mazingira ya ndani, hasa karibu na watoto wadogo: * Kuvuta sigara na aidha mzazi, hasa mama, huongeza hatari ya pumu kwa watoto. * Matazamio ya pumu mapema utotoni hayatiliwi maanani katika boma zenye kuvuta sigara. * Watoto wenye pumu ambao wamewekwa wazi kwa sigara nyumbani kwa ujumla huwa na ugonjwa mkali zaidi. * Baadhi ya watu wazima wenye pumu hutambua ETS kama chanzo kwa dalili zao. * Pumu ilio tambuliwa na Daktari ya kawaida zaidi miongoni mwa watu wazima wasio vuta sigara na waliowekwa wazi kwa ETS kuliko wale ambao hawajawekwa wazi. Kati ya watu wenye pumu, mfiduo wa juu kwa ETS umehusishwa na hatari ya zaidi ya mashambulizi makali. Ufaransa, sigara tulivu imekuwa inakadiriwa kusababisha vifo vya mapema kati ya 3,000 na 5000 kwa mwaka, na takwimu kubwa ikitajwa na Waziri Mkuu Dominique de Villepin wakati wa matangazo yake ya kitaifa ya kupiga marufuku uvutaji: "Hiyo inafikisha zaidi ya vifo 13 kwa siku. Ni ukweli ambao haukubaliki kwenye nchi yetu katika suala la afya ya umma". Kuna ushahidi mzuri kuwa sheria ya kutovuta sigara hupunguza idadi ya wanaolazwa hospitalini kwa ajili ya maradhi ya moyo. Katika 2009 masomo mawili nchini Marekani yalithibitisha ufanisi wa kupiga marufuku uvutaji kwa umma katika kuzuia mashambulizi ya moyo. Utafiti wa kwanza kufanyika katika Chuo Kikuu cha Kalifornia, San Francisco ukifadhiliwa na Taasisi ya Saratani ya Taifa, ulikuta kushuka na asilimia 15 katika waliolazwa hospitali na mashambulizi ya moyo katika mwaka wa kwanza baada ya sheria ya kutovuta sigara kupitishwa, na asilimia 36 baada ya miaka mitatu. Utafiti wa pili uliofanyika katika Chuo Kikuu cha Kansas Shule ya Tiba, ulionyesha matokeo sawa. Kwa ujumla, wanawake wasiovuta, na watu chini ya umri wa miaka 60 walikuwa na hatari iliopunguka zaidi juu ya mashambulizi ya moyo. Wengi wa walionufaika walikuwa wafanyikazi wa sekta ya hoteli na burudani. ===Masomo katika wanyama=== ====Mfiduo wa moja kwa moja katika mazingira ya majaribio==== Kumbukumbu ya kwanza ya majaribio kusababisha uvimbe katika wanyama kwa njia ya kutia bidhaa za tumbaku ilitokea katika 1911. Mfululizo wa 2004 wa monographs uliyotolewa na Shirika la Kimataifa la Utafiti wa Saratani, sehemu ya Shirika la Afya Duniani, lilitoa muhtasari wa utafiti kutoka miaka ya 1960 na kuendelea juu ya kazi yakasinojeni ya tumbaku katika maabara ya wanyama mbalimbali. =====Mbinu===== Kwa mujibu wa mono-grafi za IARC,sumu ya kasinojeni ya moshi wa sigara huamuliwa kwa njia mbili. Ya kwanza ni kwa njia ya kuweka tonesha za moshi wa sigara kwa ngozi. Hizi tonesha za moshi wa sigara hukusanywa kwa kupitisha moshi kenye mitego ya baridi na kisha kuchukua hizo nyezo. Sigara kawaida huvutwa na mashine na nyenzo inaoshwa kutoka kwenye mitego kwa kutumia dutu fukivu kama vile asetoni, ambayo huondolewa baadaye. Taratibu mingi za kukusanya hizi tonesha za moshi wa sigara hazijasanifishwa katika maabara, ikiwa ni pamoja na jinsi ya kuhifadhi tonesha, kwa idadi gani na mtindo wa kuvuta sigara, na aina ya kiyeyusha kilichotumika. Mara tu tonesha inapokusanywa, inapakwa kwenye ngozi ya wanyama wa kujaribiwa, ambao baadaye huchunguzwa kwa ukuaji wa uvimbe katika vipindi vilivyowekwa. Njia ya pili, kama ilivyoelezwa na monografi ya IARC, ambayo hutumika kupima kasinojeni ya moshi wa sigara kwa wanyama ni kwa kuwasababishia wao kuingiza moshi wa sigara. Monografi ya IARC inaelezea moshi wa sigara tawala kama ule ambao unatolewa kwa kinywa cha mwisho wa sigara na kwa hivyo moshi ule binadamu wanaovuta huhatarishwa nao zaidi. Uwandikishanji wa IARC kueleza mbinu na vifaa vya kwamba wanasayansi kuwa na maendeleo na kufanya bora zaidi na vya ya ukombozi wa moshi tawala sigara. Hivi vifaa hutofautiana kati ya mwili mzima na mfiduo wa pua-tu, lakini kwa kawaida kuhusisha moshi uliovutwa na mashine na kupulizwa kwenye chumba kidogo ambacho kina wanyama walioko katika uchunguzi. Baadhi ya visababu hutofautisha uzoefu wa binadamu mvutaji kutokana na hawa wanyama walioko katika uchunguzi. Binadamu wanaovuta sigara huvuta ndani moshikwa hiari na hivyo kufanya hivyo kwa undani zaidi kuliko wanyama wanyama wanaochunguzwa ambao kwa kawaida hu hemahema iwapo kuna moshi. Wanyama walio kwenye uchunguzi, hasa panya na mbwa, pia kwa kiasi kikubwa wana mofolojia tofauti za mfumo wa kupumukutoka kwa binadamu. Pamoja na tofauti hizi, vipimo vya moshi unaopatiwa wanyama hao vinaweza kudhamiria kwa kuchunguza tishu na sampuli ya damu. Mbwa, ambao hawawezi kuwa wazi kwa moshi kupitia vyumba vya kuvuta sigara kwa urahisi kama panya wadogo, wanahitaji mbinu tofauti ya mfiduo kwa moshi wa sigara. Mbinu hizi ni pamoja na thrakeostomi, ambapo moshi hupulizwa kwa njia ya neli moja kwa moja kwenye shimo lililokatwa katika koo la mbwa au kupitia barakoa iliowekwa usoni mwa umbwa. =====Matokeo===== Monografia za IARC zilihitimisha kuwa kupaka tonesha za moshi wa sigara kwenye ngozi ya panya husababisha uvimbe hafifu na hata vidonda vyenye kudhuru. Ingawa kasinojeni za moshi wa tombako zilitambulika kwa mara ya kwanza katika binadamu, aina mbalimbali ya wanyama pia wamepata kuwekwa wazi kwa kuvuta moshi wa tumbaku katika majaribio ya mavuno zaidi ya ushahidi na udhibiti kwa ajili ya mambo mbalimbali ya majaribio, ikiwa ni pamoja na aina ya tumbaku na kiwango cha mfiduo, ambayo haingekuwa na utu katika masomo ya binadamu. Monografia za IARC, zikihusisha masomo yaliyotumia mbinu mbalimbali za kuvuta moshi, zilihitimisha kuwa kikubwa zaidi uvimbe wa mapafu ulitokea kati ya panya waliopata moshi kuliko wale wa makundi ya kudhibiti. Tangu miaka wa 1960, mnyama aliyetumika sana kwa majaribio ya kasinogeni ya moshi wa tumbaku amekuwa Golden Hamster wa Siria kutokana na upinzani wake kwa maambukizi ya mapafu na kiasi kidogo ambacho anapata uvimbe wa mapafu. <ref name="iarc-monograph"></ref> Kwa mujibu wa monografi za IARC, utafiti huo umebainisha na kurudia kuthibitisha ukasinojeni wa moshi wa tumbaku kwa wanyama wa hamsters. Masomo yanayotazamwa na monografi za IARC pia yalipata kuwa moja, lakini si wote kwenye makundi ya panya ikipata moshi tawala kuna uwezekano wa uvimbe wa mapafu kukua. Monografi za IARC pia zilitazama masomo yanayohusiana na sungura na mbwa ambazo yalikuwa kidogo bainifu. Waandishi, hata hivyo, walitoa mfano wa majaribio ya upungufu mbalimbali, kama vile idadi ndogo ya vikundi vya uchunguzi au kudhibiti na data iliokosekana, ambayo inaweza kuelezea sababu ya ukosefu wa matokeo ya kutamatisha. ====Mathara ya Moshi wa Tombako ulio kwenye Mazingira==== Baadhi ya utafiti pia umefanyika ili kubainisha ukasinojenecity wa moshi wa tumbaku kwa wanyama. Utafiti huu kawaida huwa chini ya makundi yaliyosawa na mazingira ya moshi wa tombako, upakaji wa tonesha za moshi wa kando kando au masomo ya utazamaji wa kansa miongoni mwa wanyama wapendwa. =====Uigaji wa mazingira ya moshi wa tumbaku===== Kuiga mazingira ya moshi wa tumbaku, wanasayansi huleta moshi wa kando kando kwenye wanyama,ambao huanza hutoka katika koni ya sigara inayochomeka na kwa karatasi yake, au mchanganyiko wa moshi tawala na moshi wa kando kando. Monografi ya IARC zinatimisha kwamba panya waliowekwa wazi kwa mazingira yaliyoigwa ya moshi wa tumbaku kwa muda mrefu, kama masaa 6 kwa siku, siku 5 kwa wiki, kwa muda wa miezi mitano kisha nafasi ya miezi 4 kabla ya kuchanguliwa, itakuwa na msururu wa uvimbe kuliko kwa vikundi dhibiti. =====Tonesha za Moshi wa kandokando===== Monografi za IARC zilihitimisha kuwa tonesha za moshi wa kandokando zilikuwa na athari za kansa ya kiasi kikubwa kenye panya kuliko tonesha za moshi tawala. =====Utambuzi wa Utafiti katika wanyama wapendwa===== Moshi wa sigara inayopumuliwa bila hiari na mtu asiyevuta sigara una umaarufu kwa hatari zake kwa ajili ya saratani katika wanyama wapendwa. Utafiti uliofanywa na Chuo Kikuu cha Tufts Shule ya Tiba ya Mifugo na [[Chuo Kikuu cha Massachusetts wanaohusishwa tukio la kansa ya mdomo feline na yatokanayo na tombako moshi wa mazingira kwa njia ya overexpression ya p53 gene. Utafiti mwingine uliofanywa katika moja ya vyuo vikuu alihitimisha kuwa paka wanaoishi na mvutaji ni walikuwa zaidi uwezekano wa kupata feline lymphoma, hatari ya kuongezeka kwa muda wa yatokanayo na moshi secondhand na idadi ya wavutaji katika kaya. <ref>{{cite journal |author= Bertone ER, Snyder LA, Moore AS. |title= Environmental Tobacco Smoke and Risk of Malignant Lymphoma in Pet Cats. |journal=American Journal of Epidemiology |volume=156 |issue=3 |pages=268–273 |year=2002 |pmid=12142262 |doi= 10.1093/aje/kwf044 |ref= harv}}</ref> Utafiti na watafiti wa Chuo Kikuu cha Kolorado Nchi, kuangalia matukio ya kansa ya mapafu canine, inconclusive kwa ujumla, ingawa waandishi taarifa ya uhusiano dhaifu kwa kansa ya uvimbe katika mbwa wazi kwa tumbaku moshi wa mazingira. Idadi ya smokers ndani ya nyumba, idadi ya Packs kuvuta katika nyumba kwa siku, na kiasi cha wakati huo mbwa alitumia ndani ya nyumba hawakuwa na athari mbwa hatari ya kansa ya mapafu. <ref>{{cite journal |author=Reif JS, Dunn K, Ogilvie GK, Harris CK. |title=Passive smoking and canine lung cancer risk. |journal=Am J Epidemiol. |volume=135 |issue=3 |pages=234–9 |year=1992 |pmid=1546698 |ref=harv}}</ref> Mwaka wa 1990, sekta ya-mtafiti wa tumbaku nchini [[Ujerumani]] mapendekezo ya utafiti wa madhara ya wanyama yatokanayo na maisha ya Secondhand moshi. Mapendekezo ya utafiti ilikuwa imefungwa na Philip Morris, <ref>{{cite journal |author=Drope J, Chapman S |title=Tobacco industry efforts at discrediting scientific knowledge of environmental tobacco smoke: a review of internal industry documents |journal=Journal of epidemiology and community health |volume=55 |issue=8 |pages=588–94 |year=2001 |pmid=11449018|doi=10.1136/jech.55.8.588 |pmc=1731959 |ref=harv}}</ref> kama ilivyoelezwa katika ripoti ya kampuni ya ndani: {{quote|PM [Philip Morris] recently succeeded in blocking Adlkofer's plan to conduct lifetime animal inhalation study of sidestream smoke. (. . .an INBIFO study has shown that in 90-day inhalation test, no non-reversible changes has [sic] been detected. In a lifetime study, the results were almost certain to be less favorable. Based on the analysis, the other members of the German industry agreed that the proposed study should not proceed).<ref>{{cite web |url = http://www.pmdocs.com/PDF/2023036828_6838_0.PDF |title = Smoking and health research activities in Europe |publisher = [http://www.pmdocs.com/ Philip Morris document archive] |accessdate = 2007-08-10 |archiveurl = https://web.archive.org/web/20200414091927/http://www.pmdocs.com/PDF/2023036828_6838_0.PDF |archivedate = 2020-04-14 }}</ref>}} Utafiti wa 2008 uliofanywa na Henry Ford Mfumo wa Afya kupatikana kuwa taarifa kutolewa kuhusu madhara ya madhara ya sigara passiv juu ya wanyama wao, asilimia 28.4% ya wamiliki wa mnyama ambaye moshi itakuwa motisha kwa kujiondoa, asilimia 8.7% bila kuuliza wale ambao wanaishi pamoja nao kwa kujiondoa, asilimia 14.2% na bila kuacha sigara ndani ya nyumba. ====Maoni ya Wanaharakati wa Haki za wanyama==== Utata sana juu ya mnyama ipo kupima hasa kwa Nikotini na bidhaa za tumbaku. Wanyama harakati za makundi ni hasa mijadala kuhusu madai ya makampuni kama Phillip Morris utafiti wa fedha za wanyama tombako. Baadhi ya makundi ya kijamii mabadiliko kama change.org kutangaza kwamba makampuni ya tumbaku fedha kupima wanyama katika majaribio Nikotini, pamoja na baadhi ya masomo haya kuwa mtoto au mimba wanyama. change.org pia madai kwamba NIH ina unafadhiliwa milioni $ 16,500,000 katika Nikotini utafiti ya wanyama. Kuna mengi daima mvutano kati ya wanaharakati wa makundi ya wanyama, na watafiti na hii kuwa hasa yanayoonekana kwa shambulizi kubwa dhidi ya mtafiti wa. Edythe D. London, profesa UCLA mwaka kuongoza utafiti 3 alikuwa walengwa na wanaharakati na nyumba yake mafuriko na wanyama Liberation Front. Pia kulikuwa firebomb kushoto mbele ya nyumba yake na Amerika ya Kaskazini wanyama Ukombozi. <ref>{{cite web |last=Hermes |first=JJ |title=Animal Rights|url=http://chronicle.com/article/Animal-Rights-Militants/160 |date of access= 28 Aprili 2010}}</ref>. Baada ya tukio Edyth London, aliandika makala yenye kichwa "Kwa nini mimi kutumia wanyama katika utafiti wangu" <ref>{{cite news |last=London |first=Edythe |title=Why I Use Animals In My Research |url=http://articles.latimes.com/2007/nov/01/opinion/oe-london1/2 |work=Los Angeles Times |date=1 Novemba 2007 |accessdate=2010-05-21 |archivedate=2012-07-09 |archiveurl=https://archive.today/20120709171754/http://articles.latimes.com/2007/nov/01/opinion/oe-london1/2 }}</ref>. Katika makala, London inasisitiza upendo wake kwa ajili ya kutatua tatizo la madawa ya kulevya na kusaidia sadaka kwa wale wanaotaka na anahitaji msaada wa kuacha tumbaku yao kulevya. Yeye hakuwa na kukubali kwa kuwa unafadhiliwa na Philip Morris Marekani na anaona hakuna tatizo na hilo. Juu ya Philip Morris tovuti <ref>{{cite web |last=PhillipMorrisUSA |title=Philip Morris USA |url=http://www.philipmorrisusa.com/en/cms/Products/Cigarettes/Research_Development/Animal_Care_Use_Statement/default.aspx |accessdate=2010-12-14 |archiveurl=https://web.archive.org/web/20150201052953/http://www.philipmorrisusa.com/en/cms/Products/Cigarettes/Research_Development/Animal_Care_Use_Statement/default.aspx |archivedate=2015-02-01 }}</ref> wanadai kwamba hawana sasa kufanya utafiti wa ndani na matumizi ya wanyama maabara. Wao kufanya utafiti wa mfuko wa nje, lakini madai ya kufanya hivyo katika awali na namna ya kuwajibika kama inavyoonekana kwa kupewa leseni zao na Chama kwa ajili ya Tathmini na kupewa leseni ya Maabara ya wanyama. Mwaka 2001, American Spirit ilidai kurejea kwa-free sigara ukatili katika kampuni ambayo haina mwenendo sigara kupima kwa kutumia wanyama. <ref>{{cite web |title=Smoking Animals |url=http://www.smokinganimals.com/aspirit.html |date of access=28 Aprili 2010 |accessdate=2010-12-14 |archiveurl=https://web.archive.org/web/20100725025914/http://www.smokinganimals.com/aspirit.html |archivedate=2010-07-25 }}</ref>. Hatua hii ilikuwa kusifiwa na makundi ya wanyama wanaharakati na kutumika kuhamasisha makampuni ya tumbaku nyingine kufanya kufuata uongozi wa America Spirit. Hoja kuu ya wanaharakati wa wanyama, badala ya matibabu ya wanyama ni hakuna uhakika katika kuendelea kufanya majaribio hayo ya wanyama kuthibitisha madhara mabaya ya tumbaku, ambayo tayari yanajulikana. Uvumi wa uatagazaji kama madai kwamba "katika majaribio moja, kukata vivisectors mashimo katika 'kooni beagles na alimfanya kupumua moshi iliyokolea sigara kwa mwaka mzima wa" <ref>{{cite web |last=Moore |first=Healther |title=Dying For a Cigarette |url= http://www.impactpress.com/articles/febmar02/cigs2302.html }}</ref>. Kikundi pia madai kwamba katika Mkoa Oregon nyani Kituo cha Utafiti, ya nyani rhesus kuishi katika tight, mabwawa chuma na nyani mimba ni wazi nikotini. Pia kuna wanyama disapproval na wanaharakati wa Machi ya utafiti unafadhiliwa Dimes ambayo Nikotini ilitolewa kwa panya na mimba, na kisha watoto walikuwa kupimwa ili kuona namna ya kutumbuiza katika maze a " <ref>{{cite web |last= Physicians Committee for Responsible Medicine |title= Concerns About the March of Dimes |url= http://www.pcrm.org/resch/charities/mod_common_qs.html |accessdate= 2010-12-14 |archivedate= 2010-07-16 |archiveurl= https://web.archive.org/web/20100716211005/http://www.pcrm.org/resch/charities/mod_common_qs.html }}</ref> .Makundi kama PETA ni kutumia misemo kama "Je, si kupata kuchomwa na Philip Morris. Wao ni kutumia pesa yako ya kuumiza wanyama. PETA pia madai kwamba bado kuna swali la kuaminika wa kupima matokeo ya wanyama kwa ajili ya masomo ya tumbaku lakini makala ya "nini Maabara Wanyama bado wanatumia" <ref>{{cite web |last=Wanjek |first= Christopher |title=Why Lab Animals Are Still Used |url=http://www.livescience.com/health/080212-bad-animal-testing.html }}</ref> asserts kuwa serikali kadhaa udhibiti na vyombo vya utafiti na kipimo kilichopo karibu kwamba njia 200 kuhakikisha ufanisi katika masomo ya wanyama. Kamati ya Uratibu ya Interagency juu ya Njia Mbadala ipo kwa ajili ya mapitio ya njia hizi. Kuna longitudomasomo wa sigara huathiri kwamba bado ni haja ya kuwa uliofanywa, na hivyo watafiti wenyewe kuona sasa wanyama masomo na si lazima kuwa chepesi, lakini muhimu. ====Nikotini wanyama sumu==== Wanyama kama mbwa, paka, kichakuro, na wanyama wengine wadogo walioathirika na si ya pili mkono moshi kuvuta pumzi tu, bali pia Nikotini sumu. Pets ya ndani, hasa mbwa, kwa kawaida kuanguka vibaya wakati wamiliki kuondoka Nikotini bidhaa kama liwato la sigara, ugolo, au fizi nikotini ndani ya kufikia ya mnyama. Imejaa liwato la sigara kutoka kwa wavutaji sigara ni tatizo kwa wanyama wadogo makosa yao kwa ajili ya chakula kama kupata yao sidewalks au trashcans. Liwato la sigara ni bado ya sigara baada ya sigara ambayo yana filter ambayo ni maana ya zina lami chembe,, na sumu kutoka kwenye sigara kama vile amonia, arseniki, benzini, tapentaini na sumu nyingine. Liwato la sigara inaweza kupatikana kwa wingi mkubwa kama uchafu. Inaweza kuchukua muda wa miezi 18 na miaka 10 kwa ajili ya chujio na kuharibu <ref>{{cite web|last= Martin|first= Terry|title= Cigarette Litter and How It Affects Us|url= http://quitsmoking.about.com/od/cigaretteingredients/a/ciglitter.htm|accessdate= 2010-12-14|archivedate= 2010-12-02|archiveurl= https://web.archive.org/web/20101202124428/http://quitsmoking.about.com/od/cigaretteingredients/a/ciglitter.htm}}</ref>. Ingawa machela ya sigara ufahamu kampeni <ref>{{cite web |title=Butt out!|url=http://savannahnow.com/stories/061103/LOCcigbutts.shtml }}</ref>. moyo smokers kuepuka littering na hata kubeba ashtrays mfukoni, sigara cheo liwato la sigara namba moja katika orodha ya matatizo mbaya uchafu katika Marekani inafanya huu rahisi kwa wanyama wadogo kama puppies, squirrels, na raccoons kupata na unsuspectingly kutosheleza Nikotini. A taarifa 4500000000000 sigara butts upepo juu kama uchafu duniani kote kwa mwaka. Sigara butts zimeripotiwa akaunti ya asilimia 30% ya kupoteza vitu ya kupatikana shorelines Marekani <ref>{{cite web |last=Carlozo |first=Louis R. |title=Kicking butts |url=http://articles.chicagotribune.com/2008-06-18/features/0806170174_1_cigarette-butts-secondhand-beach-house |accessdate=2010-12-14 |archive-date=2011-08-13 |archive-url=https://web.archive.org/web/20110813050558/http://articles.chicagotribune.com/2008-06-18/features/0806170174_1_cigarette-butts-secondhand-beach-house |url-status=dead }}</ref>. Hii ni hatari kwa wanyama kama seagulls na turtles kwa sababu wakati kuwekwa katika miili kubwa ya maji kama bahari, na Sumu ya kitako sigara inaweza kuwa madhara kwa maisha ya viumbe wa majini. Watafiti katika Chuo Kikuu cha Jimbo San Diego kudai kwamba filter-tipped butts sigara ni sumu hasa kwa ajili ya maji safi na samaki baharini <ref>{{cite web |last=Joyce |first=Ed |title=SDSU Study Says Cigarette Butts Kill Fish |url=http://www.kpbs.org/news/2009/may/01/sdsu-study-says-cigarette-butts-kill-fish}}</ref>. Hata moja tu sigara kitako peke yake soaking kwenye maji kwa siku ni madhara ya kutosha kwa kuua 50% ya samaki katika lita moja ya maji <ref>{{cite web |last=Ramos |first=Will |title=Cigarette Butts Toxic to Fish |url=http://www.oceanleadership.org/2009/cigarette-butts-toxic-to-fish/ |accessdate=2010-12-14 |archivedate=2013-01-13 |archiveurl=https://archive.today/20130113095222/http://www.oceanleadership.org/2009/cigarette-butts-toxic-to-fish/ }}</ref>. Pombo kuwa na blubber wengi katika majini maisha na sumu kujihusisha pale, hivyo pombo hasa ni wengi walioathirika na sumu ya <ref>{{cite web |title= Effect of cigarette butt pollution on marine life |url=http://www.docstoc.com/docs/22910665/Effect-of-cigarette-butt-pollution-on-marine-life/ }}</ref> . Ya sumu ya kitako sigara unaweza kusababisha matatizo ya afya kwa wanyama kama kutapika kutetemeka, na hypersalivation. Dawa za mifugo iliyochapishwa kesi ya retriever 10 na umri wa miaka kike Labrador ingesting butts sigara. Ya Labrador vomited mara kadhaa na alikuwa na kuongezeka kwa damu urea nitrojeni, protini jumla, na viwango albumin na kupasuka kwa chembe na lipemia pia aliona. <ref>{{cite journal |author=Hackendahl NC, Sereda CW |title=The Dangers of Nicotine Ingestion In Dogs |journal=Veterinary Medicine |pages=218–224 |month=Machi |year=2004 |url=http://www.aspcapro.org/animal-poison-control/documents/zj-toxbrief_0304.pdf |format=PDF |ref=harv |access-date=2010-12-14 |archive-date=2011-10-07 |archive-url=https://wayback.archive-it.org/all/20111007155524/http://www.aspcapro.org/animal-poison-control/documents/zj-toxbrief_0304.pdf |dead-url=yes }}</ref>. Apomorphia HYDROCHLORIDE na mkaa ulioamilishwa alikuwa na unasimamiwa pamoja na vinywaji vingine. siku 5 baada ya tukio hilo, afya ya mbwa akarudi kawaida. Ngazi ya sumu ya nikotini katika mbwa au paka ni taarifa kama 2-10 mg ambayo ni kuhusu 04:59 sigara. A mpya Nikotini bidhaa katika soko ni Nikotini dissolvables ambayo ina kuhusu 1 mg ya nikotini kwa kidonge. Bidhaa nyingine kama bidragen Ngamia ambayo yana 0.6 mg ya Nikotini kwa kufinya ili kuondoa na vijiti <ref>{{cite web |publisher=Harvard School of Public Health|title=Tobacco company’s new, dissolvable nicotine products could lead to accidental poisoning |url=http://www.sciencedaily.com/releases/2010/04/100419090943.htm }}</ref>. Ingawa maudhui hii Nikotini ni ndogo kwa kulinganisha na sigara, vitu hivi inaweza kuwa zaidi ya kuvutia na wanyama unwary ndogo kama puppies. === Ngazi ya hatari === <span class="wikiEditor-tab"></span> Shirika la Kimataifa la Utafiti wa Saratani ya Shirika la Afya Duniani alihitimisha mwaka wa 2004 kwamba kuna ushahidi wa kutosha kwamba Secondhand moshi uliosababishwa na kansa kwa binadamu. <span class="wikiEditor-tab"></span> Wataalamu wengi kuamini kwamba wastani, wakavumilia yatokanayo na moshi Secondhand inatoa ndogo lakini kupimika kansa ya hatari kwa nonsmokers. Hatari ya jumla inategemea kipimo cha ufanisi walipata muda. Ngazi ya hatari ni kubwa kama non-smokers kutumia masaa mengi katika mazingira ambayo sigara moshi sana, kama vile biashara ambapo wafanyakazi au wateja wengi ni sigara kwa siku, au makazi kituo huduma ambapo wakazi wa moshi kwa uhuru. <ref name="environmental1440">{{cite journal |author=Boffetta P, Agudo A, Ahrens W, ''et al.'' |title=Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe |url=https://archive.org/details/sim_journal-of-the-national-cancer-institute_1998-10-07_90_19/page/n33 |journal=J. Natl. Cancer Inst. |volume=90 |issue=19 |pages=1440–50 |year=1998 |pmid=9776409|doi=10.1093/jnci/90.19.1440 |ref=harv}}</ref> <span class="wikiEditor-tab"></span> Marekani upasuaji Mkuu, katika ripoti yake ya 2006, inakadiriwa kuwa hai au kufanya kazi katika mahali ambapo sigara inaruhusiwa kuongeza yasiyo ya wavuta 'hatari ya ugonjwa wa moyo zinazoendelea na asilimia 25-30% na saratani ya mapafu na 20-30%. Hata hivyo, wakosoaji wa masomo vile kumbuka kuwa jamaa hatari (au tabia mbaya uwiano) chini ya 2.0, hasa wakati wa vipindi kujiamini ni kubwa, ni kiasi uhakika katika kuamua mahusiano causal. == Maoni ya mamlaka ya afya ya umma == Kuna mkubwa wa kisayansi makubaliano kuwa yatokanayo na Secondhand moshi ni ya hatari. <ref name="kessler">{{harvnb|Kessler|2006}}</ref> kiungo kati ya sigara passiv na hatari ya afya ni kukubaliwa na shirika karibu kila kuu ya kimatibabu na kisayansi, ikiwa ni pamoja na: * [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] <ref name="iarc-monograph"></ref> * Marekani ya Taifa ya Mashirika ya Afya <ref>{{cite web |url = http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s176toba.pdf |title = Environmental Tobacco Smoke |work = 11th Report on Carcinogens |publisher = U.S. [[National Institutes of Health]] |accessdate = 2007-08-27}}</ref> * Kituo cha Udhibiti wa Magonjwa <ref>{{cite web |url = http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/secondhandsmoke.htm |title = Secondhand Smoke Fact Sheet |publisher = U.S. [[Centers for Disease Control and Prevention]] |accessdate = 2007-08-27}}</ref> * Marekani ya Taifa ya Mashirika ya Afya * Marekani Shirika la Kulinda Mazingira <ref>{{cite web |url = http://www.epa.gov/smokefree/healtheffects.html |title = Health Effects of Exposure to Secondhand Smoke |publisher = [[United States Environmental Protection Agency]] |accessdate = 2007-09-24}}</ref> * Kalifornia Shirika la Kulinda Mazingira <ref name="calepa2005"></ref> * Ya Moyo American Association, American Lung Association , na Marekani Cancer Society * The Matokeo ya Utafutaji kwa Amerika <ref>{{cite press release |url = http://www.ama-assn.org/ama/pub/category/16496.html |title = AMA: Surgeon General's secondhand smoke report a wake-up call to lawmakers |publisher = [[American Medical Association]] |accessdate = 2007-08-27 |archivedate = 2016-03-05 |archiveurl = https://web.archive.org/web/20160305094448/http://www.ama-assn.org/ama/pub/category/16496.html |deadurl = yes }}</ref> * American Academy of Pediatrics <ref>{{cite web |url = http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b107/4/794 |title = Tobacco's Toll: Implications for the Pediatrician |publisher = [[American Academy of Pediatrics]] |accessdate = 2007-10-02 |archiveurl = https://web.archive.org/web/20120227154536/http://aappolicy.aappublications.org/cgi/content/full/pediatrics;107/4/794 |archivedate = 2012-02-27 }}</ref> * Ya Australia ya Taifa ya Afya na Medical Research Council <ref name="nphp">{{cite web |url = http://www.nphp.gov.au/publications/legislation/smoke_passive.pdf |title = National Response to Passive Smoking in Enclosed Public Places and Workplaces |publisher = Australian National Public Health Partnership |date = Novemba 2000 |accessdate = 2007-09-11 |archiveurl = https://web.archive.org/web/20140212191352/http://www.nphp.gov.au/publications/legislation/smoke_passive.pdf |archivedate = 2014-02-12 }}</ref> * [[Ufalme wa Muungano|Uingereza]] Kamati ya kisayansi juu ya Tumbaku na Afya <ref>ripoti mbili husika na kuchapishwa na Kamati ya kisayansi: * [http://www.archive.official-documents.co.uk/document/doh/tobacco/part-2.htm Ripoti ya mwaka wa 1998 ya SCOTH ya] alihitimisha kuwa sigara passiv ilikuwa ni sababu ya kansa ya mapafu, maradhi ya moyo, na afya matatizo mengine. * [http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4101474 ] {{Wayback|url=http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4101474 |date=20120206182922 }}Sasisha 2,004 kwa SCOTH ya , kupitia ushahidi mpya iliyochapishwa tangu ripoti ya 1998, kukuta kwamba utafiti wa hivi karibuni alikuwa alithibitisha taarifa kuhusiana awali kati ya sigara passiv na hatari ya afya.</ref> * Serikali ya mataifa 168 saini na sasa 170 na kuridhiwa na [[Shirika la Afya Duniani]] Mfumo wa Mkataba wa Kudhibiti Tumbaku, ambayo inasema kwamba "Vyama kutambua kwamba ushahidi wa kisayansi inaunga imara kwamba yatokanayo na moshi wa tumbaku husababisha mauti, magonjwa na ulemavu." == Maoni ya umma == Makubwa hivi karibuni tafiti uliofanywa na Taasisi ya Saratani ya Taifa ya Marekani na Kituo cha Udhibiti wa Magonjwa nimepata kuenea umma imani kwamba moshi Secondhand ni ya hatari. Katika tafiti zote mbili 1992 na 2000, zaidi ya 80% ya washiriki walikubaliana na kauli kwamba moshi Secondhand kilikuwa hatari. Utafiti 2001 iligundua kwamba 95% ya watu wazima walikubaliana kuwa moshi Secondhand kilikuwa hatari kwa watoto, na 96% kuchukuliwa-sekta madai kuwa moshi wa tumbaku Secondhand haikuwa na madhara kwa kuwa untruthful. <ref>{{harvnb|Surgeon General|2006|p=588 Ch. 10}}</ref> Mwaka wa 2007 Gallup uchaguzi kukuta kwamba asilimia 56% ya washiriki waliona kuwa moshi Secondhand ilikuwa "hatari sana", idadi ambayo ina uliofanyika kiasi thabiti tangu mwaka wa 1997. Mwingine asilimia 29% kuamini kwamba moshi Secondhand ni "madhara fulani "; 10% akajibu "si madhara", wakati asilimia 5% alisema "si wakati wote madhara." == Utata juu ya madhara == Kama sehemu ya jitihada zake za kuzuia au kuchelewesha stramare udhibiti wa sigara, sekta ya tumbaku unafadhiliwa na idadi ya masomo ya sayansi na, ambapo matokeo ya kutupwa shaka juu ya hatari zinazohusiana na sigara passiv, walitaka PR hela kwa ajili ya matokeo hayo. Sekta hiyo pia unafadhiliwa na kihafidhina libertarian kufikiri, mizinga kama vile Taasisi ya Cato katika Umoja wa Mataifa na Taasisi ya Masuala ya Umma nchini Australia ambayo kukosoa wote utafiti wa kisayansi katika uvutaji passiv na mapendekezo ya sera ya kuzuia uvutaji wa sigara. Sekta hizi hela uratibu wa shughuli za kuanzisha moja ya kwanza ya maneno ya kunyimwa haki ya ushirika. Leo, si upinzani wote huja kutoka sekta ya tumbaku au mbele vikundi: kujenga juu ya kuenea kwa tumbaku desinformation sekta, na ''tumbaku kunyimwa haki harakati imeibuka, kushirikiana sifa nyingi za aina nyingine ya kunyimwa haki , kama vile '' kunyimwa haki ya UKIMWI. ===Sekta unaofadhiliwa na masomo na ufafanuzi=== ====Enstrom na Kabat==== Utafiti wa 2003 na Enstrom na Kabat, iliyochapishwa katika ''British Medical Journal,'' alisema kuwa inaleta madhara ya kuvuta sigara passiv alikuwa overstated. <ref>{{cite journal |author=Enstrom JE, Kabat GC |title=Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98 |journal=BMJ |volume=326 |issue=7398 |page=1057 |year=2003 |pmid=12750205 |doi=10.1136/bmj.326.7398.1057 |pmc=155687 |ref=harv}}</ref> uchambuzi wao hakuna taarifa muhimu uhusiano kati ya kitakwimu sigara passiv na saratani ya mapafu, ingawa wahariri kompletterande alibainisha kuwa "wanaweza overemphasise asili hasi ya matokeo yao." <ref>{{cite journal |author=Davey Smith G |title=Effect of passive smoking on health |journal=BMJ |volume=326 |issue=7398 |pages=1048–9 |year=2003 |pmid=12750182 |doi=10.1136/bmj.326.7398.1048 |pmc=1125974 |ref=harv}}</ref> Makaratasi huu umebadilisha sana kukuzwa na sekta ya tumbaku kama ushahidi kwamba skadar wa sigara passiv walikuwa unproven. <ref>{{harvnb|Kessler|2006|p=1383}}</ref> <ref name="tong2007">{{cite journal |author=Tong EK, Glantz SA |title=Tobacco industry efforts undermining evidence linking secondhand smoke with cardiovascular disease |url=https://archive.org/details/sim_circulation_2007-10-16_116_16/page/n120 |journal=Circulation |volume=116 |issue=16 |pages=1845–54 |year=2007 |pmid=17938301 |doi=10.1161/CIRCULATIONAHA.107.715888 |ref=harv}}</ref> The American Cancer Society (ACS), ambaye database Enstrom na Kabat kutumika kukusanya data zao, kukosoa karatasi kama "wala kuaminika wala huru", na kusema kuwa wanasayansi katika ACS alikuwa kurudia alisema dosari kubwa katika na Kabat ya mbinu Enstrom kabla ya kuchapishwa. Hasa, utafiti walishindwa kubaini kundi kulinganisha unexposed "watu". <ref>{{cite journal |url=http://www.bmj.com/cgi/reprint/327/7418/E237.pdf |author=Thun MJC |title=More misleading science from the tobacco industry |journal=BMJ |volume=327 |page=E237-E238 |year=2003 |doi=10.1136/bmjusa.03070002 |ref=harv |doi_brokendate=2010-06-20}}</ref> Enstrom ya uhusiano na sekta ya tumbaku pia akauchomoa uchunguzi, katika barua 1,997 na Philip Morris , Enstrom aliomba "kikubwa utafiti ili kujitoa ... kwa ajili yangu na kwa ufanisi mkubwa kushindana dhidi ya mlima wa data epidemiologic na maoni kwamba tayari zipo kuhusu afya madhara ya ETS na sigara hai. " Katika racketeering lawsuit Marekani dhidi ya makampuni ya tumbaku , Enstrom na Kabat karatasi alikuwa alitoa na Marekani na Mahakama ya Wilaya kama "mkuu mfano wa jinsi makampuni ya tumbaku tisa kushiriki katika racketeering jinai na udanganyifu na kuficha hatari ya moshi wa tumbaku." Mahakama iligundua kuwa utafiti alikuwa unafadhiliwa na kusimamiwa na Kituo Indoor Air Utafiti, sekta ya tumbaku mbele ya kikundi kazi ya "offsetting" masomo kuharibu katika uvutaji passiv, pamoja na Phillip Morris ambaye alisema kwamba kazi Ernstrom ilikuwa "wazi madai ya -oriented. " Enstrom limetetea usahihi wa utafiti wake dhidi ya kile suala yeye "upinzani haramu na wale ambao wana kujaribu kuzuia na jina baya hivyo." <ref>{{cite journal |author=Enstrom JE |title=Defending legitimate epidemiologic research: combating Lysenko pseudoscience |journal=Epidemiol Perspect Innov|volume=4 |issue=1 |page=11 |year=2007 |pmid=17927827 |doi=10.1186/1742-5573-4-11 |pmc=2164936 |ref=harv}}</ref> ====Gori==== Gio Batta Gori, sekta ya tumbaku msemaji na mshauri na mtaalam wa hatari ya matumizi na utafiti wa kisayansi, aliandika katika [[libertarian [[Taasisi ya Cato s 'journal '''' ]]]]Kanuni ya kuwa "... ya kuchapishwa masomo 75 ya ETS na saratani ya mapafu, baadhi ya asilimia 70 hawakuwa si ripoti ya takwimu tofauti kubwa ya hatari na ni moot. Takribani asilimia 17 kudai ongezeko la hatari na kuashiria asilimia 13 ya kupunguza hatari ". <ref>{{cite journal |author=Gori, Gio Batta |title=Stoking the Rigged Terror of Secondhand Smoke |journal=Regulation |volume=30 |issue=1 |pages=14–7 |date=Spring 2007 |url=http://www.cato.org/pubs/regulation/regv30n1/v30n1-5.pdf |ref=harv |access-date=2010-12-14 |archive-date=2009-01-16 |archive-url=https://web.archive.org/web/20090116012647/http://www.cato.org/pubs/regulation/regv30n1/v30n1-5.pdf |dead-url=yes }}</ref> ====Milloy==== Steven Milloy ya " [[Junk sayansi "maoni kwa ajili ya Fox News na wa zamani Philip Morris mshauri, alidai kwamba "... ya 37 ya masomo [juu passiv sigara], tu 7 - chini ya asilimia 19 - taarifa muhimu ongezeko kitakwimu katika kansa ya mapafu matukio. " Sehemu nyingine ya upinzani kukuzwa na Milloy ililenga katika hatari ya jamaa na mazoea epidemiological katika masomo ya sigara passiv. Milloy alisema kuwa masomo ya kujitoa hatari jamaa wa chini ya 2 walikuwa na maana Junk sayansi. Mbinu hii ya uchambuzi epidemiological alikosolewa katika ''Journal Marekani ya Afya ya Umma:'' {{quote|A major component of the industry attack was the mounting of a campaign to establish a "bar" for "sound science" that could not be fully met by most individual investigations, leaving studies that did not meet the criteria to be dismissed as "junk science."<ref>{{cite journal |author=Samet JM, Burke TA |title=Turning science into junk: the tobacco industry and passive smoking |url=https://archive.org/details/sim_american-journal-of-public-health_2001-11_91_11/page/1742 |journal=Am J Public Health |volume=91 |issue=11 |pages=1742–4 |year=2001 |pmid=11684591 |doi=10.2105/AJPH.91.11.1742 |pmc=1446866 |ref=harv}}</ref>}} Sekta ya tumbaku na wanasayansi kuviimarisha pia kuweka mbele seti ya "Good Epidemologia Desturi" ambayo itakuwa na athari ya vitendo ya kuingilia uhusiano kati ya moshi Secondhand na saratani ya mapafu, na lengo binafsi alisema ya viwango hivyo alikuwa na "kuzuia sheria mbaya." Hata hivyo, juhudi hii kwa kiasi kikubwa kutelekezwa wakati ikawa wazi kuwa hakuna uhuru shirika epidemiological ingekuwa kukubaliana na viwango vya uliopendekezwa na Morris et al Filipo. <ref name="pmid11684593">{{cite journal |author=Ong EK, Glantz SA |title=Constructing "sound science" and "good epidemiology": tobacco, lawyers, and public relations firms |url=https://archive.org/details/sim_american-journal-of-public-health_2001-11_91_11/page/1749 |journal=Am J Public Health |volume=91 |issue=11 |pages=1749–57 |year=2001 |pmid=11684593 |doi=10.2105/AJPH.91.11.1749 |pmc=1446868 |ref=harv}}</ref> ==== Shirika la Afya Duniani utata ==== Ripoti ya mwaka 1998 na Shirika la Kimataifa la Utafiti wa Saratani (IARC) juu ya tumbaku moshi wa mazingira (ETS) found "ushahidi dhaifu wa a-jibu uhusiano kati ya kipimo cha hatari ya kansa ya mapafu na yatokanayo na mahali pa kazi ETS utashi wake." Machi 1998, kabla ya utafiti ilikuwa kutolewa, taarifa za kuonekana katika vyombo vya habari kwa madai kwamba IARC na [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] (WHO) walikuwa kukandamiza habari. Ripoti, kuonekana katika Uingereza ''Jumapili Telegraph'' na '' The Economist, miongoni mwa vyanzo vingine, alidai kuwa WHO hukunizuilia kutoka machapisho ya ripoti yake mwenyewe kwamba allegiance alishindwa kuthibitisha chama kati ya sigara passiv na idadi ya magonjwa mengine (kansa ya mapafu hasa). Katika kujibu, WHO ilitoa vyombo vya habari na kusema kuwa matokeo ya utafiti alikuwa "kabisa misrepresented" katika vyombo vya habari maarufu na walikuwa kwa kweli sana kulingana na masomo sawa na visa inaleta madhara ya kuvuta sigara passiv. <ref>{{cite web |title=Passive Smoking Does Cause Lung Cancer, Do Not Let Them Fool You |url=http://www.who.int/inf-pr-1998/en/pr98-29.html}}</ref> Utafiti huo uliochapishwa katika ''jarida la Taasisi ya Saratani ya Taifa'' katika Oktoba ya mwaka huohuo. Tahariri kompletterande muhtasari: {{quote|When all the evidence, including the important new data reported in this issue of the Journal, is assessed, the inescapable scientific conclusion is that ETS is a low-level lung carcinogen.<ref>{{cite journal |author=Blot WJ, McLaughlin JK |title=Passive smoking and lung cancer risk: what is the story now? |url=https://archive.org/details/sim_journal-of-the-national-cancer-institute_1998-10-07_90_19/page/n9 |journal=J. Natl. Cancer Inst. |volume=90 |issue=19 |pages=1416–7 |year=1998 |pmid=9776401|doi=10.1093/jnci/90.19.1416 |ref=harv}}</ref>}} Pamoja na kutolewa kwa zamani classified hati sekta ya tumbaku kwa njia ya Tumbaku Mwalimu Makazi Mkataba , ilibainika kuwa utata juu ya WHO madai ya ukandamizaji wa takwimu alikuwa engineered na [[Philip Morris]] British American Tobacco, na tumbaku makampuni mengine katika jitihada za discredit kisayansi matokeo ambayo madhara maslahi yao ya biashara. Tume ya uchunguzi wa WHO, uliofanywa baada ya kutolewa kwa hati ya tumbaku ya viwanda, iligundua kuwa utata huu yanayotokana na sekta ya tumbaku kama sehemu ya kampeni yake kubwa ya kupunguza bajeti ya WHO, kupotosha matokeo ya tafiti za kisayansi katika uvutaji passiv, na discredit WHO kama taasisi. Kampeni hii ilifanyika kwa kutumia mtandao wa mashirika ya kujitegemea mbele ostensibly na kisayansi na wataalamu wa kimataifa pamoja na mahusiano ya siri ya fedha kwa sekta ya. <ref>{{cite web |title=Tobacco Companies Strategies to Undermine Tobacco Control Activities at the World Health Organization |url=http://www.who.int/tobacco/media/en/who_inquiry.pdf|format=PDF|accessdate=2008-12-30}}</ref> ==== EPA lawsuit ==== Mwaka 1993, Marekani Shirika la Kulinda Mazingira (EPA) ilitoa taarifa kukadiria kwamba kansa 3,000 vifo kuhusiana katika Marekani walikuwa unasababishwa na sigara passiv kila mwaka. Philip Morris, RJ Reynolds Tobacco Company, na vikundi vya wakulima anayewakilisha wasambazaji na wauzaji wa tumbaku alichukua hatua za kisheria, kwa madai kuwa EPA alikuwa manipulated utafiti huu na kupuuzwa kukubaliwa na mazoea ya takwimu za kisayansi. Mahakama ya Wilaya ya Marekani kwa ajili ya Wilaya ya Kati ya North Carolina ilitawala katika neema ya tumbaku sekta ya mwaka 1998, kutafuta kuwa EPA walishindwa kufuata kisayansi na mazoea epidemiologic sahihi na alikuwa na "Cherry ilichukua" ushahidi kwa msaada slutsatser ambao walikuwa na nia ya mapema. Mahakama alisema katika sehemu, "EPA hadharani nia ya kuhitimisha kabla ya utafiti ilikuwa imeanza ... kurekebishwa kuanzisha utaratibu na kanuni za kisayansi kuhalalisha Shirika la umma hitimisho ... Katika kufanya ETS Hatari ya upimaji, disregarded habari na matokeo yaliyotolewa katika taarifa kuchagua, si kusambaza taarifa muhimu epidemiologic; deviated kutoka Hatari yake Miongozo Tathmini; alishindwa kuweka wazi matokeo muhimu na hoja ... " Mwaka 2002, EPA mafanikio rufaa uamuzi huu na Umoja wa Mataifa kwa Mahakama ya Rufaa ya Nne mzingo. EPA ya kukata rufaa mara fann juu ya awali kwa misingi ya kwamba ripoti yao hakuwa na uzito udhibiti, na mapema kutafuta alikuwa vacated. <ref>{{cite web|title=Flue-Cured Tobacco Cooperative vs. EPA|url=http://pacer.ca4.uscourts.gov/opinion.pdf/982407.P.pdf|format=PDF|accessdate=2008-12-30|archiveurl=https://web.archive.org/web/20120206204403/http://pacer.ca4.uscourts.gov/opinion.pdf/982407.P.pdf|archivedate=2012-02-06}}</ref> Mwaka 1998, Idara ya Marekani ya Afya na Huduma za Binadamu, kwa njia ya uchapishaji na Programu yake ya Taifa ya Toxicology ya Ripoti ya 9 Carcinogens, waliotajwa mazingira tumbaku moshi kati kusababisha kansa ya kujulikana, kwa kufuata wa tathmini ya EPA kuwa "masomo ya mtu binafsi walikuwa makini na muhtasari Nakala ". <ref>{{cite book|url=https://ntp.niehs.nih.gov/ntp/newhomeroc/other_background/environmentalts_noapps_508.pdf|title=Meeting of the NTP Board of Scientific Counselors - Report on Carcinogens Subcommittee|last=|first=|date=2 Desemba–3, 1998|publisher=|year=|isbn=|editor=U.S. Department of Health and Human Services, National Toxicology Program|location=Research Triangle Park, North Carolina|page=24|pages=|contribution=Final Report on Carcinogens - Background Document for Environmental Tobacco Smoke|format=PDF|ref=harv|postscript=<!--None-->}}</ref> ==== Tumbaku sekta ya fedha ya utafiti ==== Sekta ya tumbaku Jukumu la fedha katika utafiti wa kisayansi katika uvutaji passiv imekuwa na utata. <ref>{{cite journal |author=Thun MJ |title=Passive smoking: tobacco industry publishes disinformation |journal=BMJ |volume=327 |issue=7413 |pages=502–3; author reply 504–5 |year=2003 |pmid=12946979 |doi=10.1136/bmj.327.7413.502-c |pmc=188400 |ref=harv}}</ref> Mapitio ya masomo ya kuchapishwa found kwamba sekta ya tumbaku affilation alikuwa correlated sana na matokeo exonerating sigara passiv, watafiti kuviimarisha na sekta ya tumbaku ilikuwa mara 88 zaidi kuliko watafiti wa kujitegemea ili kuhitimisha kwamba sigara passiv alikuwa madhara. <ref name="pmid9605902">{{cite journal |author=Barnes DE, Bero LA |title=Why review articles on the health effects of passive smoking reach different conclusions |url=https://archive.org/details/sim_jama_1998-05-20_279_19/page/n93 |journal=JAMA |volume=279 |issue=19 |pages=1566–70 |year=1998 |pmid=9605902|doi=10.1001/jama.279.19.1566 |ref=harv}}</ref> Katika maalum mfano ambayo alikuja mwanga pamoja na kutolewa kwa hati ya viwanda tumbaku, Philip Morris watendaji mafanikio moyo mwandishi kusahihisha sekta unaofadhiliwa na mapitio yake makala downplay jukumu la moshi Secondhand katika watoto wachanga kifo syndrome ghafla. Ripoti ya 2006 ya Marekani upasuaji Mkuu wa kukosoa jukumu sekta ya tumbaku katika mjadala wa kisayansi: {{quote|The industry has funded or carried out research that has been judged to be biased, supported scientists to generate letters to editors that criticized research publications, attempted to undermine the findings of key studies, assisted in establishing a scientific society with a journal, and attempted to sustain controversy even as the scientific community reached consensus.<ref>[http://www.surgeongeneral.gov/library/secondhandsmoke/report/executivesummary.pdf Executive Summary of the U.S. Surgeon General's 2006 report on passive smoking]; see p. 21.</ref>}} Mkakati huu alikuwa ilivyoainishwa katika mkutano wa kimataifa wa makampuni ya tumbaku mwaka 1988, ambapo Philip Morris mapendekezo ya kuanzisha timu ya wanasayansi, iliyoandaliwa na kampuni ya wanasheria, na "kufanya kazi ETS kushika utata hai." <ref name="whitecoat">{{cite web |url = http://tobaccodocuments.org/landman/2063791182-1187.html |title = Minutes of a meeting of Philip Morris with British tobacco companies to discuss tobacco-industry strategy on passive smoking |accessdate = 2007-08-27 |archiveurl = https://web.archive.org/web/20071013185238/http://tobaccodocuments.org/landman/2063791182-1187.html |archivedate = 2007-10-13 }}</ref> Yote ya utafiti wa kisayansi alikuwa chini ya uangalizi na "filtering" na wanasheria tumbaku ya viwanda; {{quote |Philip Morris then expect the group of scientists to operate within the confines of decisions taken by PM scientists to determine the general direction of research, which apparently would then be 'filtered' by lawyers to eliminate areas of sensitivity.<ref name="whitecoat"/> }} Philip Morris taarifa ya kuwa ni kuweka "... kiasi kikubwa cha fedha katika miradi hii ... katika kujaribu kuratibu na kulipa wanasayansi wengi hivyo kwenye msingi ya kimataifa ya kuhifadhi utata ETS hai." <ref name="whitecoat"></ref> === Tumbaku sekta ya kujibu=== Sigara unaleta suala tishio kubwa kiuchumi na sekta ya tumbaku. Vidgas ina maana ya sigara zaidi tabia ya mtu binafsi na kitu fulani na athari ya kijamii. Katika ripoti ya siri 1978, sekta ya tumbaku ilivyoelezwa kuongeza wasiwasi umma kuhusu sigara passiv kama "hatari zaidi maendeleo ya uwezekano wa sekta ya tumbaku kwamba bado ilitokea." <ref> [http://legacy.library.ucsf.edu/tid/qra99d00 A Study ya mitazamo ya umma kwa Uvutaji sigara na Viwanda Tobacco katika 1978], zinazozalishwa kwa ajili ya Taasisi ya Tumbaku na ilitolewa chini ya sheria ya Makazi Mwalimu Tobacco Mkataba.</ref> Katika ''Marekani v. Philip Morris et al.,'' Mahakama ya Wilaya kwa ajili ya Wilaya ya Columbia kupatikana kwamba sekta ya tumbaku "... kutambuliwa kutoka katikati ya miaka ya 1970 mbele ya kuwa madhara ya afya ya sigara passiv tishio makubwa ya sekta ya uwezekano na sigara faida, "na kwamba sekta ya alijibu kwa" jitihada ya kudhoofisha na jina baya makubaliano ya kisayansi kwamba ETS husababisha ugonjwa. " Ipasavyo, sekta ya tumbaku na mikakati kadhaa ya kupunguza madhara yake katika biashara zao: * Sekta hiyo ina hamu ya msimamo wa passiv sigara mjadala kama kimsingi na wasiwasi na uhuru wa raia na wavuta ' haki badala ya afya, na makundi ya fedha kama vile [[Msitu]]. * Fedha za upendeleo katika utafiti, katika mapitio yote ya madhara ya sigara kwa afya ya kuchapishwa passiv kati ya 1980 na 1995, sababu tu inayohusika na kumaliza kwamba sigara passiv si madhara alikuwa kama mwandishi alikuwa uhusiano na sekta ya tumbaku. Hata hivyo, si wote masomo ambayo imeshindwa kupata ushahidi wa madhara walikuwa na waandishi viwanda-husika. * Kuchelewesha na discrediting utafiti halali (tazama <ref name="smoke-screen"></ref> kwa mfano wa jinsi sekta ya jaribio kwa jina baya la kihistoria Hirayama utafiti, na <ref>{{cite journal |author=Trotter L, Chapman S |title="Conclusions about exposure to ETS and health that will be unhelpful to us": how the tobacco industry attempted to delay and discredit the 1997 Australian National Health and Medical Research Council report on passive smoking. |journal=Tob Control |volume=12 |issue=Suppl 3:iii |pages=102–6 |year=2003 |pmid=14645955 |doi=10.1136/tc.12.suppl_3.iii102 |pmc=1766130 |ref=harv}}</ref> kwa mfano wa jinsi gani alijaribu kuchelewesha na jina baya kubwa ya Australia taarifa juu ya sigara passiv) * Kukuza "nzuri Epidemologia" na kushambulia kinachojulikana Junk sayansi (neno umaarufu na sekta lobbyist [[Steven Milloy ): kushambulia mbinu nyuma ya utafiti kuonyesha hatari ya afya kama kiujanja na kujaribu kukuza [[sayansi ya sauti [http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&amp;contentId=A13994-2004Feb27&amp;notFound=true]]]]] {{Wayback|url=http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&contentId=A13994-2004Feb27&notFound=true |date=20200114062756 }}[334]. Ong &amp; Glantz (2,001) wanaelezea ya ndani Phillip Morris memo kutoa ushahidi wa kama kampuni ya sera hii <ref name="pmid11684593"></ref> * Uumbaji wa maduka kwa ajili ya utafiti mazuri. Mwaka 1989, sekta ya tumbaku imara Society ya Kimataifa ya Built Mazingira, ambayo iliyochapishwa peer-reviewed journal ''Indoor na Built Mazingira.'' jarida hili hawakuwa zinahitaji migogoro ya maslahi matangazo yanayotolewa na waandishi wake. Na hati kupatikana kwa njia ya Makazi Mwalimu, ilibainika kuwa mtendaji wa bodi ya jamii na bodi ya wahariri wa jarida walikuwa inaongozwa na sekta ya tumbaku washauri kulipwa. journal ya kuchapishwa kiasi kikubwa cha nyenzo sigara passiv, mengi ambayo ilikuwa "viwanda-chanya". <ref>{{cite journal |author=Garne D, Watson M, Chapman S, Byrne F |title=Environmental tobacco smoke research published in the journal Indoor and Built Environment and associations with the tobacco industry |url=https://archive.org/details/sim_the-lancet_february-26-march-4-2005_365_9461/page/804 |journal=Lancet |volume=365 |issue=9461 |pages=804–9 |year=2005 |pmid=15733724 |doi=10.1016/S0140-6736(05)17990-2 |ref=harv}}</ref> Akitoa mfano wa uzalishaji wa sekta ya tumbaku ya utafiti wa upendeleo na juhudi za kudhoofisha matokeo ya kisayansi, ripoti ya 2006 Marekani upasuaji Mkuu wa alihitimisha kuwa sekta ya alikuwa na "kujaribu kuendeleza utata hata kama jumuiya ya kisayansi kufikiwa makubaliano ... sekta ya nyaraka zinaonyesha kuwa sekta ya tumbaku ina wanaohusika katika shughuli za kuenea ... kwamba wamekwenda zaidi ya mipaka ya mazoezi ya kukubalika ya kisayansi. " Mahakama ya Wilaya ya Marekani, nchini ''Marekani v. Philip Morris et al.'' Kupatikana kwamba "... licha ya kukiri yao ndani ya hatari ya moshi Secondhand, watetezi na fraudulently alikana kwamba ETS husababisha ugonjwa." <ref>{{harvnb|Kessler|2006|p=1523}}</ref> ==== Nafasi ya makampuni makubwa ya tumbaku ==== Kwa ujumla, makampuni ya tumbaku imeendelea kuhoji njia ya tafiti kuonyesha kuwa sigara passiv ni ya hatari. Baadhi (kama vile British American Tobacco na Philip Morris) kukubali makubaliano ya matibabu kwamba sigara passiv hubeba hatari ya afya, wakati wengine wanaendelea kudai kuwa ushahidi ni inconclusive. Tobacco Imperial inaeleza secondhand moshi kama "annoying" na "unpleasant", lakini anakanusha yanayohusiana afya hatari yoyote. Tumbaku makampuni kadhaa wakili wa uumbaji maeneo moshi ndani ya majengo ya umma kama mbadala kwa wazi kupiga marufuku uvutaji. <ref>sasa nafasi zaidi ya tumbaku makampuni makubwa juu ya suala la sigara passiv inaweza kupatikana kwenye tovuti zao. 13 Januari 2009, ya Nje zifuatazo zina nafasi ya tumbaku sekta ya juu ya mada: * British American Tobacco: [http://www.bat.com/group/sites/uk__3mnfen.nsf/vwPagesWebLive/DO52AMJ4 ] * Imperial Tumbaku: [http://www.imperial-tobacco.com/index.asp?page=82 ] {{Wayback|url=http://www.imperial-tobacco.com/index.asp?page=82 |date=20090116015146 }} * Philip Morris : [http://www.philipmorrisusa.com/en/cms/Products/Cigarettes/Health_Issues/Secondhand_Smoke/default.aspx USA] {{Wayback|url=http://www.philipmorrisusa.com/en/cms/Products/Cigarettes/Health_Issues/Secondhand_Smoke/default.aspx |date=20101006025905 }} na [http://www.philipmorrisinternational.com/PMINTL/pages/eng/smoking/Secondhand_smoke.asp ]Kimataifa * RJ Reynolds Tobacco Company: [http://www.rjrt.com/smoking/summaryCover.asp ] {{Wayback|url=http://www.rjrt.com/smoking/summaryCover.asp |date=20140222145559 }}</ref> === Marekani racketeering lawsuit dhidi ya makampuni ya tumbaku === 22 Septemba 1999, Idara ya Marekani ya Haki filed a lawsuit racketeering dhidi Philip Morris na mengine ya wazalishaji sigara kubwa. <ref>[http://www.usdoj.gov/civil/cases/tobacco2/index.htm rättstvister Dhidi ya Makampuni ya Tumbaku] Idara ya Haki za Marekani</ref> Karibu miaka 7 baadaye, tarehe 17 Agosti 2006 Marekani Mahakama ya Wilaya ya Jaji Gladys Kessler kupatikana kuwa Serikali ilikuwa kuthibitika kesi yake na kwamba kampuni ya tumbaku watuhumiwa alikuwa vunja ya Racketeer Kusukumwa Mashirika ya Sheria ya Rushwa (Rico). Hasa, Jaji Kessler iligundua kuwa mchana na mengine ya tumbaku makampuni na: * fitina na kupunguza, kupotosha na kuwavurugia ya umma kuhusu hatari za afya ya sigara; * alikana hadharani, wakati ndani ya kutambua, kuwa Secondhand moshi wa tumbaku ni hatari kwa nonsmokers, na * kuharibu nyaraka muhimu za madai. tawala ya kupatikana kwamba makampuni ya tumbaku ilifanya jitihada za pamoja na jina baya kudhoofisha makubaliano ya kisayansi kwamba sigara husababisha ugonjwa passiv, hasa kwa kudhibiti matokeo ya utafiti kupitia washauri kulipwa. tawala pia alihitimisha kuwa makampuni ya tumbaku kuendelea leo fraudulently kukataa afya na madhara yatokanayo na ETS. <ref name="kessler"></ref> 22 Mei 2009, jopo la majaji watatu-jaji wa Washington, DCUS Mahakama ya Rufaa bila kupingwa fann ya mahakama chini ya 2,006 tawala. == Sigara marufuku == Kama matokeo ya afya ya hatari ya kuhusishwa na uvutaji passiv, sigara marufuku katika maeneo ya umma ya ndani, ikiwa ni pamoja na [[migahawa]], na klabu ya usiku ya imeanzishwa katika idadi ya mamlaka, saa au ya ndani ya ngazi ya taifa. [[Eire|Jamhuri ya Ireland]] ilikuwa nchi ya kwanza duniani kwa taasisi ya kitaifa ya wazi kupiga marufuku kuvuta sigara katika maeneo ya kazi zote inomhus 29 Machi 2004. Tangu wakati huo, wengine wengi walifuata nyayo. Ya nchi ambazo zimeridhia WHO Framework Convention on Tobacco Control (FCTC) kuwa na wajibu wa kisheria na kutekeleza sheria ''ufanisi'' "kwa ajili ya ulinzi kutoka yatokanayo na moshi wa tumbaku katika maeneo ya kazi ya ndani, usafiri wa umma, inomhus maeneo ya umma, na kama inafaa sehemu nyingine za umma." (Ibara ya 8 ya FCTC) ya vyama na FCTC kuwa zaidi antog '''' Miongozo juu ya Ulinzi kutoka Mfiduo Secondhand Moshi ambayo hali ya kuwa "hatua madhubuti kutoa ulinzi yatokanayo na moshi wa tumbaku ... zinahitaji ya kuondoa jumla ya sigara na moshi wa tumbaku katika nafasi fulani au mazingira ili kujenga% moshi 100 bure mazingira." Maoni uchaguzi umeonyesha msaada makubwa kwa ajili ya kusitisha. Mwezi Juni 2007, na utafiti wa nchi 15 kupatikana idhini ya 80% ya kusitisha sigara. <ref>{{Rejea tovuti |url=http://www.marketresearchworld.net/index.php?option=content&task=view&id=1619&Itemid= |title=Utafiti wa Soko la Dunia |accessdate=2024-07-11 |archive-date=2020-04-14 |archive-url=https://web.archive.org/web/20200414094658/http://www.marketresearchworld.net/index.php?option=content&task=view&id=1619&Itemid= |url-status=dead }}</ref> Utafiti nchini Ufaransa, reputedly taifa ya smokers, ilionyesha 70% kusaidia marufuku. <ref name="France to ban smoking"></ref> === Matokeo ya marufuku uvutaji === Mbalimbali athari chanya na hasi kuwa ulitokana na inapiga marufuku sigara, ambayo baadhi ni utata. ====Chanya madhara==== Katika miezi 18 ya kwanza baada ya mji wa [[Pueblo, Colorado|Pueblo]], [[Colorado]] enacted ya kupiga marufuku kuvuta sigara katika 2003, hospitali kwa ajili ya mashambulizi ya moyo admissions imeshuka asilimia 27%. Waliolazwa katika miji jirani bila marufuku uvutaji ilionyesha hakuna mabadiliko. Raymond Gibbons, MD, American Heart Association rais alisema, "Kushuka kwa idadi ya hospitalini mshtuko wa moyo ndani ya kwanza ya mwaka na nusu baada ya-sigara marufuku yasiyo kuwa mara aliona katika utafiti huu ni uwezekano mkubwa kutokana na kupungua kwa athari moshi Secondhand kama kuchochea sababu kwa ajili ya mashambulizi ya moyo. " Mwezi Aprili 2010 ya Canada Medical Association Journal kuchapishwa na utafiti wa kutathmini athari za a-hatua ya kupiga marufuku uvutaji tatu katika [[Toronto]], [[Ontario]] juu ya moyo na mishipa na ugonjwa wa kupumua. Utafiti kufunikwa muda wa miaka 10 1996-2006 wakati ambao Toronto marufuku kuvuta sigara katika hatua, kuanzia na maeneo ya umma na maeneo ya kazi katika 1999, na kufuatiwa na mahoteli na vituo vya Bowling katika 2001, na kumaliza na baa, kasinon, na racetracks mwaka 2004. Utafiti huo iligundua kuwa wakati wa utekelezaji wa kupiga marufuku kuvuta sigara katika mikahawa, Toronto hospitali admissions kwa hali ya moyo na mishipa ulipungua kwa asilimia 39%, na admissions kwa hali ya upumuaji ulipungua kwa asilimia 33%. Hakuna kupunguza muhimu katika hospitali admissions ilitokea katika miji mingine ambayo hawakuwa kusitisha sigara. Waandishi alihitimisha kwamba utafiti haki juhudi zaidi kupunguza mfiduo umma moshi wa tumbaku. Mei 2006, Ontario aliweka ya kueleweka jimbo hela kupiga marufuku kuvuta sigara ambayo hadi vikwazo kwa miji yote na manispaa katika Ontario. <ref>{{cite journal |author=Naiman A, Glazier RH, Moineddin R |title=Association of anti-smoking legislation with rates of hospital admission for cardiovascular and respiratory conditions |journal=CMAJ |year=2010 |month=Aprili |pmid=20385737 |doi=10.1503/cmaj.091130 |url=http://www.cmaj.ca/cgi/content/abstract/cmaj.091130v1 |volume=182 |issue=8 |pages=761–7 |pmc=2871198 |ref=harv}}</ref> Hata hivyo, si wote watafiti kukubaliana kwamba hii ilikuwa ni uhusiano causal, na utafiti wa 2009 ya kusitisha sigara wengi katika Umoja wa Mataifa unapingana na matamshi hayo. <ref>{{cite paper |author=Shetty, Kanaka D.,'' et al.'' |title=Changes in U.S. Hospitalization and Mortality Rates Following Smoking Bans |journal=NBER |year=2009 |month=Aprili |url=http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1359506}}</ref> ====Athari Hasi==== Baadhi ya masomo kupatikana madhara ya marufuku kuvuta sigara katika maeneo ya umma, hasa baa. Utafiti mmoja ana kupatikana na athari mbaya ya uchumi wa kusitisha vile katika baa na migahawa, <ref>http://www.smokersclubinc.com/economic.html {{Wayback|url=http://www.smokersclubinc.com/economic.html |date=20170214054151 }}, kiuchumi hasara kutokana na sigara ya kusitisha I California na majimbo mengine, By David W. Kuneman na Michael J. McFadden, 2005</ref> ingawa hii inapingana na masomo mengine juu ya suala hilo. <ref>{{cite journal |author=Scollo M, Lal A, Hyland A, Glantz S. |title=Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. |journal=Tobacco Control |year=2003 |month=Mar |pmid=12612356 |pmc=PMC1759095 |url=http://www.ncbi.nlm.nih.gov/pubmed/12612356|volume=12 |issue=1 |pages=108 |ref=harv}}</ref> Aidha, utafiti mwingine ameona kwamba marufuku kuvuta sigara katika baa mara yanayohusiana na kunywa kuendesha vifo kuongezeka, labda kutoka smokers kuendesha umbali mrefu na baa noncompliant, mamlaka ili kuruhusu sigara, na / au baa na Seating nje. <ref>{{cite journal |author=Adams S, Cotti C |title=Drunk driving after the passage of smoking bans in bars |journal=Journal of Public Economics |year=2008 |month=Juni |doi=10.1016/j.jpubeco.2008.01.001 |url=http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V76-4RHWP04-2&_user=10&_coverDate=06%2F30%2F2008&_rdoc=23&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%235834%232008%23999079994%23683681%23FLA%23display%23Volume)&_cdi=5834&_sort=d&_docanchor=&_ct=34&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8216c409f343787f02fa9e4dea9ae231 |volume=92 |issue=5-6 |pages=1288–1305 |ref=harv |access-date=2010-12-14 |archive-date=2020-04-14 |archive-url=https://web.archive.org/web/20200414091917/http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V76-4RHWP04-2&_user=10&_coverDate=06%2F30%2F2008&_rdoc=23&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%235834%232008%23999079994%23683681%23FLA%23display%23Volume)&_cdi=5834&_sort=d&_docanchor=&_ct=34&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8216c409f343787f02fa9e4dea9ae231 |dead-url=yes }}</ref> === Mbadala aina ya kukabiliana na === Njia mbadala ya kusitisha sigara pia wamekuwa mapendekezo kama njia ya kupunguza madhara, hasa katika baa na migahawa. Kwa mfano, wakosoaji wa kusitisha masomo wanaelezea kupendekeza uingizaji hewa kama njia ya kupunguza uchafuzi moshi wa tumbaku na kuboresha hewa. <ref>{{cite web |work = Building Sustainable Design |url = http://www.bsjonline.co.uk/story.asp?storyType=85&sectioncode=95&storyCode=3047478 |title = No ifs or butts |date = Machi 2005 |accessdate = 2009-01-28 |first = Andrew |last = Geens |coauthors = Max Graham |archiveurl = https://web.archive.org/web/20090106002930/http://www.bsjonline.co.uk/story.asp?storyType=85&sectioncode=95&storyCode=3047478 |archivedate = 2009-01-06 }}</ref> Uingizaji hewa pia imekuwa uzito kukuzwa na sekta ya tumbaku kama mbadala kwa kusitisha wazi, kupitia mtandao wa kujitegemea wataalamu ostensibly na undisclosed mahusiano ya mara kwa mara ili sekta hiyo. <ref>{{cite journal |author=Drope J, Bialous SA, Glantz SA |title=Tobacco industry efforts to present ventilation as an alternative to smoke-free environments in North America |journal=Tob Control |volume=13 |issue=Suppl 1 |pages=i41–7 |year=2004 |month=Machi |pmid=14985616 |pmc=1766145 |doi= 10.1136/tc.2003.004101|url=http://tc.bmjjournals.com/cgi/pmidlookup?view=long&pmid=14985616 |quote = The industry developed a network of ventilation 'experts' to promote its position that smoke-free environments were not necessary, often without disclosing the financial relationship between these experts and the industry. |ref=harv}}</ref> Hata hivyo, si wote wakosoaji uhusiano na sekta hiyo. Society ya Marekani ya Kukanza, Refrigerating na viyoyozi Wahandisi (ASHRAE) alihitimisha rasmi mwaka 2005 kuwa wakati wametengwa kabisa sigara vyumba kufanya kuondokana na hatari kwa wasio-sigara maeneo ya jirani, sigara marufuku ni njia pekee ya kuondoa kabisa hatari ya afya zinazohusiana na ya ndani kuambukizwa. Wao zaidi alihitimisha kuwa hakuna mfumo wa dilution au kusafisha alikuwa bora katika kuondoa hatari. <ref name="ASHRAE">{{cite web |url = http://www.ashrae.org/content/ASHRAE/ASHRAE/ArticleAltFormat/20058211239_347.pdf |format = PDF |publisher = [[American Society of Heating, Refrigerating and Air-Conditioning Engineers]] |date = 30 Juni 2005 |accessdate = 2009-01-28 |title = Environmental Tobacco Smoke: Position Document |archivedate = 2009-03-27 |archiveurl = https://web.archive.org/web/20090327101819/http://www.ashrae.org/content/ASHRAE/ASHRAE/ArticleAltFormat/20058211239_347.pdf }}</ref> Marekani upasuaji Mkuu na Tume ya Ulaya Pamoja wa Kituo cha Utafiti na kufikiwa slutsatser sawa. <ref name="sg-exec-summary">{{cite web |title = The Health Consequences of Involuntary Exposure to Tobacco Smoke |publisher = [[Surgeon General of the United States]] |work = Executive Summary |year = 2006 |accessdate =2009-01-28 |url = http://www.surgeongeneral.gov/library/secondhandsmoke/report/executivesummary.pdf |format = PDF}}</ref> <ref name="ecjrc">{{cite web |publisher = [[European Commission]] [[Joint Research Centre]] |title = Institute for Health and Consumer Protection Activity Report 2003 |year = 2003 |url = http://ihcp.jrc.ec.europa.eu/docs/IHCP_annual_report/ihcp03.pdf |format = PDF |accessdate =2009-01-28}}</ref> miongozo ya utekelezaji wa Mkakati wa WHO Mkataba juu ya Udhibiti wa majimbo Tobacco kwamba uhandisi, mbinu kama vile uingizaji hewa, ni ineffektiv wala kulinda dhidi ya moshi mfiduo secondhand. <ref name="fctc-guidelines"></ref> Hata hivyo, hii ''haimaanishi'' kuwa hatua hiyo ni ya bure katika kupunguza madhara, ila ni kupungukiwa na lengo la kupunguza mfiduo kabisa na sifuri. Wengine wamependekeza mfumo wa tradable vibali uchafuzi sigara, sawa na wa-na-biashara uchafuzi cap vibali mifumo ya kutumiwa na Shirika la Kulinda Mazingira katika miongo ya hivi karibuni ili kuzuia aina nyingine ya uchafuzi wa mazingira. <ref>{{cite news |title = Let Bars Buy, Sell Smoking Permits |url = http://www.madison.com/archives/read.php?ref=/madison.com/html/archive_files/wsj/2005/09/25/0509240280.php |first = Robert |last = Haveman |coauthors = John Mullahy |work = [[Wisconsin State Journal]] |date = 25 Septemba 2005 |accessdate =2009-01-28 |page = B2}}</ref> Hii inaweza kuhakikisha kwamba sehemu ya baa / migahawa katika mamlaka a itakuwa moshi huru, wakati akitoka uamuzi wa soko. == Tazama pia == * [[Madhara ya kuvuta sigara]] == Marejeo == {{reflist|colwidth=30em}} == Viungo vya nje == ;Kisayansi miili {{refbegin}} * [http://cancercontrol.cancer.gov/tcrb/monographs/10/index.html Madhara ya afya yatokanayo na mazingira ya Tumbaku Moshi] {{Wayback|url=http://cancercontrol.cancer.gov/tcrb/monographs/10/index.html |date=20070905172350 }} , kutoka Taasisi ya Saratani ya Taifa ya Marekani * {{PDFlink|[http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s176toba.pdf Environmental Tobacco Smoke]|219&nbsp;KB}}. Kutokana na Ripoti ya 11 ya kusababisha kansa ya Marekani ya Taifa ya Mashirika ya Afya *{{cite paper |author1=U.S. Dept. of Health and Human Services |author2=Centers for Disease Control and Prevention |author3=Coordinating Center for Health Promotion |author4=National Center for Chronic Disease Prevention and Health Promotion |author5=Office on Smoking and Health |url=http://www.surgeongeneral.gov/library/secondhandsmoke |title=The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General |publisher=[[Surgeon General of the United States]] |date=2006-06-27 |location=Atlanta, Ga. |id=O2NLM: WA 754 H4325 2006<br/> |ref=CITEREFSurgeon_General2006 |quote=Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke }} * [http://monographs.iarc.fr/ENG/Monographs/vol83/volume83.pdf Tumbaku Moshi na Involuntary Uvutaji] , a monograph wa [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] na Shirika la Kimataifa ya Utafiti wa Saratani * [http://www.cdc.gov/tobacco/data_statistics/Factsheets/SecondhandSmoke.htm Karatasi ya Ukweli Moshi Secondhand] kutoka vituo vya Marekani Kudhibiti na Kuzuia Magonjwa * [http://www.oehha.ca.gov/air/environmental_tobacco/2005etsfinal.html Madhara ya afya yatokanayo na mazingira ya Tumbaku Moshi] , kutoka Shirika la Kulinda Mazingira California {{refend}} ;Sekta ya tumbaku {{refbegin}} * {{PDFlink|[http://www.who.int/tobacco/media/en/who_inquiry.pdf Tobacco Company Strategies to Undermine Tobacco Control Activities]|1.55&nbsp;MB}} : Ripoti ya Kamati ya Wataalamu juu ya Tumbaku Documents Viwanda kutoka [[Shirika la Afya Duniani|Shirika]] la [[Shirika la Afya Duniani|Afya Duniani]] * [http://legacy.library.ucsf.edu/ Documents Tobacco ya urithi Library] na [http://bat.library.ucsf.edu British American Tobacco Documents Archive] {{Wayback|url=http://bat.library.ucsf.edu/ |date=20040604015252 }} kutoka Chuo Kikuu cha California, San Francisco * [http://www.pmdocs.com/ Philip Morris USA Hati Archive] , kwa umma kama matokeo ya Makazi Mwalimu Tobacco Mkataba {{refend}} ;Viungo vingine {{refbegin}} * [http://www.who.int/fctc/cop/art%208%20guidelines_english.pdf Miongozo ya Ulinzi kutoka Mfiduo Secondhand Moshi] , na WHO Mfumo wa Mkataba wa Kudhibiti Tumbaku * [http://www.who.int/tobacco/resources/publications/wntd/2007/pol_recommendations/en/index.html Sera WHO mapendekezo juu ya ulinzi yatokanayo na mkono wa pili moshi wa tumbaku] * [http://www.sciencedaily.com/releases/2009/12/091208132536.htm Moshi panya screen: wadudu mfano inaonyesha tumbaku moshi mfiduo induces mabadiliko ubongo dalili ya utegemezi Nikotini] , katika Sayansi Daily *{{cite web |url=http://www.tobacco.neu.edu/litigation/cases/DOJ/20060817KESSLEROPINIONAMENDED.pdf |title=United States of America v. Philip Morris ''et al.'': Final Opinion of Judge Gladys Kessler |publisher=[[United States District Court for the District of Columbia]] |last=Kessler |first=Gladys |date=17 Agosti 2006 |format=PDF |ref=CITEREFKessler2006 |accessdate=2010-12-14 |archiveurl=https://web.archive.org/web/20160310000811/http://www.tobacco.neu.edu/litigation/cases/DOJ/20060817KESSLEROPINIONAMENDED.pdf |archivedate=2016-03-10 }} * [http://www.time.com/time/health/article/0,8599,2012103,00.html "Jinsi Secondhand sigara Moshi Mabadiliko jeni yako"] {{Wayback|url=http://www.time.com/time/health/article/0,8599,2012103,00.html |date=20130817124311 }} {{refend}} [[Category:Afya]] [[Category:Tumbaku]] 4cr8ae54zs2ped74l7t5phq3slpj9v9 0 55915 1578057 1337553 2026-07-02T17:05:32Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578057 wikitext text/x-wiki [[File:Earwax on swab.jpg|right|thumb|150px|Aina nyevu ya nta ya sikio ya binadamu juu ya usufi wa pamba.]] '''Nta ya sikio''' (hujulikana pia kama '''serumeni''', kutoka [[Kiingereza]]: [[w:cerumen|cerumen]]) ni [[dutu]] kama [[nta]] iliyo na [[rangi]] ya [[kijivu]], ya [[chungwa|machungwa]] au ya [[manjano]] na hutolewa katika mifereji ya [[sikio|masikio]] ya [[binadamu]] na [[wanyama]] wa jamii ya [[mamalia]]. Hufanya kazi ya kulinda [[ngozi]] ya [[mfereji wa sikio]], inasaidia kusafisha na kulainisha mfereji, na pia hukinga masikio dhidi ya [[bakteria]], [[kuvu]], [[wadudu]] na [[maji]]. Nta ya sikio inafanyizwa kwa [[seli]] za ngozi zilizoambuka, [[nywele]] na nyuto za [[tezi]] za ndani ya mfereji wa sikio la nje. Viambato vingi vya nta ya sikio ni [[asidi ya shahamu|asidi za shahamu]] zenye minyororo mirefu (zilizojaa na zisizojaa), [[alkoholi]], [[skwalini]] na [[kolesteroli]]. Serumeni ya ziada au iliyogandamizika inaweza kubana dhidi ya kiwambo cha sikio au kupinga mfereji wa nje au visaidizi vya kusikia, ambayo inaweza kuchombea upotevu wa uwezo wa kusikia. ==Uzalishaji, muundo, aina== [[File:Dry earwax.jpg|thumb|right|Aina kavu ya nta ya sikio ya binadamu.]] [[File:Earwax on swab (uv).jpg|thumb|right|150px|Aina nyevu ya nta ya sikio katika mmuliko nususi wa kiukaurujuani.]] Nta ya sikio huzalishwa katika sehemu ya tatu ya [[gegedu]] katika sikio la binadamu. Ni mchanganyiko wa vitu vinavyonata ambavyo huzalishwa katika tezi za mafuta na vile vinavyonata kiasi huzalishwa na tezi maalum za [[jasho]]. <ref name="Alvord">{{cite journal |author=Alvord LS, Farmer BL |title=Anatomy and orientation of the human external ear |url=https://archive.org/details/sim_journal-of-the-american-academy-of-audiology_1997-12_8_6/page/383 |journal=Journal of the American Academy of Audiology |volume=8 |issue=6 |pages=383–90 |year=1997 |month=Desemba |pmid=9433684}}</ref> Vipengele msingi vya nta ya sikio ni kumwaga matabaka ya ngozi, na 60% ya nta ya sikio likijumuisha keratini, 12-20% dabwadabwa na isiyo kolezi; mlolongo mrefu, mafuta asidi, alkoholi, squalene na 6-9% [[kolestro]]. Hofu, dhiki na wasiwasi huongeza uzalishaji wa nta ya sikio kutoka tezi ya ceruminous. Kuna aina mbili tofauti za kijenetikia ambayo huamua aina ya nta ya sikio: aina ya majimaji ambayo inatawala na aina kavu ambayo imefichwa. Asia ya Mashariki na Waindio wana uwezekano wa kuwa na aina kavu ya nta ya sikio (kijivu na flaky), ambapo Wazungu na Waafrika wanakuwa na aina ya majimaji (asali-kahawia, weusi-kahawia na unyevu). Aina ya serumeni imetumiwa na [[wataalamu]] wa [[wadudu]] kufuatilia njia za wanadamu wanaohamahama, kama zile za [[Wainuit]]. <ref name="Bass">{{cite journal |author=Bass EJ, Jackson JF |title=Cerumen types in Eskimos |url=https://archive.org/details/american-journal-of-physical-anthropology_1977-09_47_2/page/209 |journal=American Journal of Physical Anthropology |volume=47 |issue=2 |pages=209–10 |year=1977 |month=Septemba |pmid=910884 |doi=10.1002/ajpa.1330470203}}</ref> Kuwepo kwa aina ya majimaji ya nta ya sikio kumesababishwa na kuwepo kwa kiasi kikubwa cha mafuta na chembechembe zenye rangi za kiasili (50% mafuta) katika dutu kuliko ile aina kavu (30% mafuta). Tofauti katika aina za nta ya sikio imekuwa na msisimko kwa moja msingi mabadiliko katika [[jeni]] inayojulikana kama "binding mkanda ATP C11 gene." Mbali na kuathiri aina serumeni, mabadiliko ya jeni pia hupunguza uzalishaji jasho. Watafiti wanasema kwamba kupungua kwa jasho kulikuwa na manufaa kwa binadamu wa mashariki ya Asia na wenyeji wa Amerika ambao walikadiriwa kuwa wanaishi katika mazingira ya baridi. <ref name="Yoshiura">{{cite journal |author=Yoshiura K, Kinoshita A, Ishida T, ''et al.'' |title=A SNP in the ABCC11 gene is the determinant of human earwax type |journal=Nature Genetics |volume=38 |issue=3 |pages=324–30 |year=2006 |month=Machi |pmid=16444273 |doi=10.1038/ng1733}}</ref> ==Kazi== ===Usafishaji=== Kusafisha mfereji wa sikio hutokea kama matokeo ya "conveyor belt", mchakato ya uhamaji wa epithelial, unaosababishwa na harakati za kusogea kwa taya. <ref name="Alberti">{{cite journal |author=Alberti PW |title=Epithelial migration on the tympanic membrane |url=https://archive.org/details/sim_journal-of-laryngology-and-otology_1964-08_78_8/page/n101 |journal=The Journal of Laryngology and Otology |volume=78 |issue= |pages=808–30 |year=1964 |month=Septemba |pmid=14205963}}</ref> Seli hutengenezwa katika kituo cha utando wa tympanic ambayo huhama nje kutoka kwenye umbo (kwa kiwango cha kulinganishwa na kile cha ukuaji wa kucha za vidole) kuelekea kwenye kuta za mfereji wa sikio, na baadaye husogea kuelekea kwenye mlango wa mfereji wa sikio. serumeni katika mfereji pia hutolewa nje,hutoka na uchafu wowote, vumbi, na chembechembe zilizokusanyika kwenye mferji wa sikio. Kusogea kwa taya husaidia mchakato huu kwa kuondoa debris iliyoshikiliwa kwenye kuta za mfereji wa sikio, pia huongeza kasi yake ya kutolewa nje. ===Ulainishaji=== Kulainisha huzuia desiccation, kuwasha, na uchomaji wa ngozi ndani ya mfereji wa sikio (inayojulikana kama ''asteatosi).'' Vitu vinavyolainisha vinatokana na vitu vyenye mafuta mengi ya sebum ambayo huzalishwa na tezi za mafuta katika aina ya majimaji ya serumini angalau, mafuta hayo yanahusisha kolestroli, squalene, asidi ya shahamu yenye mnyororo mrefu na pombe. <ref name="Harvey">{{cite journal |author=Harvey DJ |title=Identification of long-chain fatty acids and alcohols from human cerumen by the use of picolinyl and nicotinate esters |journal=Biomedical & Environmental Mass Spectrometry |volume=18 |issue=9 |pages=719–23 |year=1989 |month=Septemba |pmid=2790258 |doi=10.1002/bms.1200180912}}</ref> <ref name="Bortz">{{cite journal |author=Bortz JT, Wertz PW, Downing DT |title=Composition of cerumen lipids |url=https://archive.org/details/sim_american-academy-of-dermatology-journal_1990-11_23_5/page/n76 |journal=Journal of the American Academy of Dermatology |volume=23 |issue=5 Pt 1 |pages=845–9 |year=1990 |month=Novemba |pmid=2254469 |doi=10.1016/0190-9622(90)70301-W}}</ref> ===Athari za bakteria na kizuia vimelea=== Wakati utafiti ulipofanywa hadi miaka ya 1960 ulipatikana ushahidi kidogo kwa ajili ya kusaidia shughuli za kuzuia baceria kwa serumeni, <ref name="Perry">{{cite journal |author=Nichols AC, Perry ET |title=Studies on the growth of bacteria in the human ear canal |journal=The Journal of Investigative Dermatology |volume=27 |issue=3 |pages=165–70 |year=1956 |month=Septemba |pmid=13367525}}</ref> zaidi utafiti wa hivi karibuni umegundua kuwa nta ya sikio ina athari za bactericidal juu ya matatizo ya baadhi ya bakteria. serumeni imekuwa kupatikana ili kupunguza uwezekano wa anuwai ya bakteria, ikiwa ni pamoja na ''influenzae Haemofilasi , ''[[Staphylococcus aureus]]'', na aina nyingi za ''[[Escherichia coli]]'', wakati mwingine kwa kiasi kama 99%. Ukuaji [[Kuvu| wa aina kuu mbili zilizopo za kuvu]] katika otomikosisi pia huzuiliwa na serumeni ya binadamu. <ref name="Megarry">{{cite journal |author=Megarry S, Pett A, Scarlett A, Teh W, Zeigler E, Canter RJ |title=The activity against yeasts of human cerumen |url=https://archive.org/details/sim_journal-of-laryngology-and-otology_1988-08_102_8/page/671 |journal=The Journal of Laryngology and Otology |volume=102 |issue=8 |pages=671–2 |year=1988 |month=Agosti |pmid=3047287}}</ref> Vitu vinavyozuia bakteria kimsingi vinatokana na asidi yenye mafuta kolezi zilizopo, lysozyme na hasahasa kwenye kiasi kidogo cha asid ya nta ya sikio, [[laisozim]] (pH iko karibu 6.1 kwa mtu wa kawaida. <ref name="Roland">{{cite journal |author=Roland PS, Marple BF |title=Disorders of the external auditory canal |url=https://archive.org/details/sim_journal-of-the-american-academy-of-audiology_1997-12_8_6/page/367 |journal=Journal of the American Academy of Audiology |volume=8 |issue=6 |pages=367–78 |year=1997 |month=Desemba |pmid=9433682}}</ref>). ==Matibabu== Nta ya sikio nyingi inaweza kuzuia sauti kupita katika mfereji wa sikio, na kupunguza uwezo wa kusikia Pia inakadiriwa kuwa chanzo cha kutoskia kati ya aslimia 60-80%. Kusogea kwa taya kiasilia kunasaidia kusafisha sikio. kulainisha nta ya sikio kwa kutumia mafuta ya oliva au mchanganyiko wa urea na vitu vingine mara nyingi vinasaidia nta kulainika na kuisaidia kutoka nje, kwa msaada wa bomba na maji ya uvuguvugu yanayoingia kwenye mfereji wa sikio baada ya mchanganyiko pia husaidia kulainisha nta. Kama hii haitafaa, njia inayotumiwa mara kwa mara na madaktari ni <ref name="Sharp">{{cite journal |author=Sharp JF, Wilson JA, Ross L, Barr-Hamilton RM |title=Ear wax removal: a survey of current practice |journal=BMJ |volume=301 |issue=6763 |pages=1251–3 |year=1990 |month=Desemba |pmid=2271824 |pmc=1664378 |doi=10.1136/bmj.301.6763.1251}}</ref> kuinyonya kwa maji ya uvuguvuvgu na inatuika kwa 95% ya GPs huko Edinburgh. Njia salama inatumiwa zaidi na wataalamu wa sikio wakati mfereji wa sikio unapoziba kwa muda na vitu kushindwa kupita katika ngozi ya mfereji wa sikio. Pamba,kwa upande mwingine inasukuma nta nyingi kwenye mfereji wa sikio na kuondoa kiasi kidogo cha juu cha nta ambayo inatokea kuingia kwaenye pamba. Katika mwaka wa 2008 maelezo mapya yalitolewa na wataalamu wa masikio wa chuo kikuu cha Marekani wakishauri nta ya sikio kutotolewa vinginevyo kuzidi kwa nta ya sikio kuna sababisha madhara kiafya. <ref> Bryner, Jeanna. [http://www.livescience.com/health/080829-earwax-removal.html "Sasa sikizeni haya: Je, usiteo nta ya skio"] , ''liveScience,'' 29 Agosti 2008. kupatikana 7 Septemba 2008.</ref> ===Kutolewa kwa serumeni=== [[File:De medicina V00117 00000006.tif|thumb|''De medicina'']] mchakato huu unajulikana kama ''cerumenolysis'' na unafanikiwa kwa kutumia mchanganyiko unaojulikana kama cerumenolytic kikolezi ambao huingizwa kwenye mfereji wa sikio. Mara nyingi inasaidia nta kuja nje na kama haijawa inasaidia kuondoa serumeni kwa kunyonya au ukwanguaji. <ref>ufundisanifu huu uligunduliwa na Aulus Cornelius Celsus in De Medicina katika karne ya 1: When a man is becoming dull of hearing, which happens most often after prolonged headaches, in the first place, the ear itself should be inspected: for there will be found either a crust such as comes upon the surface of [[ulceration]]s, or concretions of wax. If a crust, hot oil is poured in, or [[verdigris]] mixed with [[honey]] or [[leek]] juice or a little [[sodium carbonate|soda]] in [[honey wine]]. And when the crust has been separated from the ulceration, the ear is irrigated with tepid water, to make it easier for the crusts now disengaged to be withdrawn by the [[ear scoop]]. If it be wax, and if it be soft, it can be extracted in the same way by the ear scoop; but if hard, [[vinegar]] containing a little [[Salsola soda|soda]] is introduced; and when the wax has softened, the ear is washed out and cleared as above. ... Further, the ear should be syringed with [[castoreum]] mixed with vinegar and [[bay laurel|laurel]] oil and the juice of young [[radish]] rind, or with [[cucumber]] juice, mixed with crushed [[rose]] leaves. The dropping in of the juice of unripe [[grape]]s mixed with [[rose oil]] is also fairly efficacious against deafness. {{cite web |first=Aulus Cornelius |last=Celsus |authorlink=Aulus Cornelius Celsus |url=http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/6*.html|title=Book VI |work=[[De Medicina]] |coauthors=W.G. Spencer translation}}</ref> Kibiashara au kawaida cerumenolytics inapatikana pamoja na: <ref name="Fraser">{{cite journal |author=Fraser JG |title=The efficacy of wax solvents: in vitro studies and a clinical trial |url=https://archive.org/details/sim_journal-of-laryngology-and-otology_1970-10_84_10/page/1055 |journal=The Journal of Laryngology and Otology |volume=84 |issue=10 |pages=1055–64 |year=1970 |month=Oktoba |pmid=5476901}}</ref> * Mafuta ya zeituni, mafuta ya madini, mafuta ya watoo, mafuta ya almond, na mafuta mengine ya majimaji (gliseroli) * [Chini ya majina ya bidhaa nyingi] kabamidi peroksidi (6.5%) na glycerine * Mchanganyiko wa sodium bicarbonate kwenye maji,au sodium bicarbonate B.P.C (sodium bicarbonate na glycerine) * Cerumol (mafuta ya arachis,, tapentaini na dichlorobenzene) * Cerumenex (Triethanolamine, polypeptide s na oleate-condensate) * Exterol, Otex (jina la UK brand ) (urea, peroksidi hidrojeni na glycerine) * Docusate, a detergent,na ingredient ilyohai hupatikana katika dawa za kuhadharisha s A cerumenolytic itumike mara 2-3 kwa siku kwa muda wa siku 3-5 kabla ya utoaji wa serumeni. <ref name="Wilson">{{cite journal |author=Wilson PL, Roeser RJ |title=Cerumen management: professional issues and techniques |url=https://archive.org/details/sim_journal-of-the-american-academy-of-audiology_1997-12_8_6/page/421 |journal=Journal of the American Academy of Audiology |volume=8 |issue=6 |pages=421–30 |year=1997 |month=Desemba |pmid=9433688}}</ref> Utafiti umeonesha kwamba maandalizi ya kitropki kwa ajili ya matibabu ya nta ya sikio na kwamba kuna tofauti ndogo kati ya msingi wa mafuta na msingi wa maji katika maandalizi (ikiwa ni pamoja na maji wazi). <ref>{{cite journal |author=Burton MJ, Doree C |title=Ear drops for the removal of earwax |journal=Cochrane Database of Systematic Reviews |volume= |issue=1 |pages=CD004326 |year=2009 |pmid=19160236 |doi=10.1002/14651858.CD004326.pub2}}</ref> ===Mbinu za mitambo=== ====Kunyonya==== [[File:Cerumen.jpg|thumb|right|200px|nta ya skio ya binadamu kuondolewa kwa kilimo cha umwagiliaji (ikilinganishwa na sigara nyepesi)]] Mara baada ya serumeni kulainishwa,huondolewa kutoka mfereji wa sikio kwa usafishaji. mbinu ya unyonyaji wa sikio imeelezewa kwa undani zaidi na Wilson na Roeser,na hatimaye Blake ambaye alishauri kuvuta sikio la nje mbele na nyuma na ncha ya kinyonyeo kusogezwa taratibu juu na nyuma ili maji yaweze kusanjari kwenye paa la mfereji.<ref name="Wilson"></ref> <ref name="Blake">{{cite journal |author=Blake P, Matthews R, Hornibrook J |title=When not to syringe an ear |journal=The New Zealand Medical Journal |volume=111 |issue=1077 |pages=422–4 |year=1998 |month=Novemba |pmid=9861921}}</ref> Mchanganyiko wa kumwagilia unatoka nje ya mfereji kwenye sehemu yake ya kutokea ikitoka na nta pamoja na vitu vingine. Mchanganyiko unaotumika kumwagilia mfereji wa sikio ni maji ya moto,chumvi ya kawida,mchanganyiko wa sodiamu bikarbonati au mchanganyiko wa maji na siki kusaidia kuzuia mambukizi ya huduma ya pili. <ref name="Blake"></ref> <ref name="Bull">{{cite book |author=Bull, P. D. |title=Lecture notes on diseases of the ear, nose, and throat |url=https://archive.org/details/lecturenotesondi0000bull_f6b9 |publisher=Blackwell Science |location=Oxford |year=2002 |pages= |isbn=0-632-06506-0 |edition=6th}}{{pn}}</ref> <ref name="Blake"></ref> Wagonjwa mara nyingi wanapenda mchanganyiko wa kumwagilia upashwe joto mpaka kufikia lile joto la mwili.kizunguzungu ni tatizo kuu la unyonyaji kwa kutumia vimiminika ambavyo ni vya baridi au vya joto kuliko joto la mwili. </ref> Sharp et al. <ref name="Sharp"></ref> Alipendekeza 37°C, naye Blake et al. <ref name="Blake"></ref> alipendekeza maji yawe 38°C, zaidi kuliko joto la mwili, na kwamba hii lazima ichunguzwe na kipima joto. Joto jingine yoyote inaweza kusababisha kisulisuli, kama hutumika wakati wa upimaji wa jaribio la kalori tendohiari. Sindano inapaswa kutumika kwa umakini kuingiza maji kwenye sikio. Kwa watoto kiwango na kasi lazima iwe chini. Baada ya umwagiliaji,kichwa kina inamishwa kuruhusu maji kukauka.Umwagiliaji unatakiwa kurudiwa mara nyingi. Kama mtiririko wa maji una chungu lazima kasi yake iwe ndogo. Ni bora kusafisha kidonda taratibu kwa muda mrefu kuliko kutumia nguvu na kusababisha nta kutoka kwa haraka. Utaratibu huu unaweza kufanywa nyumbani ukioga kwa kutumia sindano ya kumwagilia katika pembe 90. Baada ya nta kuondolewa,sikio lina weza kukaushwa kwa kuinamisha kichwa na kuvuta sikio juu kwa taratibu ili kunyosha mfereji wa sikio. ====Kikwangulaji na pamba/ kichomoza ==== Nta ya sikio inaweza kuondolewa kwa kutumia kikwangulaji ya sikio ambayo kwa kawaida ina dislodges nta ya sikio na kuzitoa nje ya mfereji wa sikio. Huko magharibi, matumizi ya pick ya sikio mara nyingi hufanywa kwa mikono ya wataalamu wa afya;curette iliyotengenezwa kitaalamu ambayo ina kizuizi cha kuzuia curette kuingia ndani zaidi wakati mtu anaitumia mwenyewe inapatikana. Utoaji wa nta ya sikio kwa kutumia pick hutumiwa zaidi na watu wa [[Asia ya Mashariki]]. Kama nta ya sikio ya watu wengi wa Asia ya mashariki ni aina kavu,inaweza kuondolewa kirahisi kabisa kwa kusugua na pick, kama inavyoanguka chini kirahisi katika mabonge makubwa au vitu vikavu, kama ilivyo yenyewe. Kwa ujumla inashauriwa kutokutumia pamba (Q-Tips au cottonbuds) kwa kufanya hivyo inaweza kusukuma nta ndani zaidi kwenye mfereji wa sikio,hasa ikitumika kizembe inaweza kuharibu ngoma ya sikio. <ref>{{cite web |url=http://www.tchain.com/otoneurology/disorders/hearing/wax2.html |title=Ear wax |publisher=Tchain.com |date= |accessdate=2010-05-02 |archivedate=2018-09-23 |archiveurl=https://web.archive.org/web/20180923161203/http://www.tchain.com/otoneurology/disorders/hearing/wax2.html }}</ref> Abrasion ya mfereji wa sikio, hasa baada ya maji kuingia katika kuogelea au kuoga, unaweza kusababisha maambukizi ya sikio. Aidha, kichwa cha pamba kinaweza kutoka na kuingia kwenye mfereji wa sikio. Pamba itumike kusafisha sikio la nje tu. ====Uvunguzaji==== Vacuuming ya sikio inaweza kufanywa na wataalamu au kwa vacuum kits ya nyumbani. Hata hivyo, uchunguzi katika ''kliniki ya otolaryngology'' umeonesha vacs ya sikio ya nyumbani si nzuri wakati wa kuondoa nta ya sikio, hasa ilipolinganishwa na prob ya nyumba ya Jobson. <ref>{{cite journal |author=Leong AC, Aldren C |title=A non-randomized comparison of earwax removal with a 'do-it-yourself' ear vacuum kit and a Jobson-Horne probe |journal=Clinical Otolaryngology |volume=30 |issue=4 |pages=320–3 |year=2005 |month=Agosti |pmid=16209672 |doi=10.1111/j.1365-2273.2005.01020.x}}</ref> ====Matatizo yanayohusiana na kuondolewa==== Utafiti wa kupelekwa na watendaji wa Uingeraza <ref name="Sharp"></ref>umeonesha kuwa cerumen ya sikio inajiopndoa yenyewe; wengi wanasema hiyo kazi inafanywa na wauguzi, ambapo baadhi yao hawana maelekezo yoyote. Ni matatizo kama kuondolewa kwa nta ya sikio hakuna matatizo. Umwagiliaji unaweza kufanywa nyumbani kwa kutumia vifaa sahihi hasa pale mtu anapokuwa makini na sio kumwagilia kwa nguvu. Njia zingine zote inaweza kutumiwa na mtu mwenyewe ambaye alishawahi kufanya majaribio. Mwandishi wa Bull anashauri wanafizikia kuwa:''"Baada ya kuondolewa kwa nta,ni lazima kukagua vizuri ili kuhakikisha hakuna kilicho baki.'' ''ushauri huu unaonekana superfluous, lakini mara nyingi hupuuzwa ".'' <ref name="Bull"></ref> Hii ilithibitishwa na Sharp et al ambaye ni mtafiti wa <ref name="Sharp"></ref>320 kwa watendaji wa jumla,imeonekana kuwa 68% tu ya madaktariwalikagua mfereji wa sikio baada ya unyonyaji kuhakikisha nta zimeondolewa. Matokeo yake, kushindwa kuondoa nta kutoka mfereji wa sikio kumefanya takribani 30% ya matatizo yanayotokana na hatua hizo. matatizo mengine ni pamoja na uvimbe wa sikio la nje, maumivu, kisulisuli, tiniti, na kutobolewa kwa ngoma ya sikio. Kulingana na utafiti huu, matatizo makubwa katika maskio 1 / 1000 ya unyonyaji ilipendekezwa <ref name="Sharp"></ref> Madai yanayotokana na kunyonya sikio yamesema kwa karibu 25% ya madai yote yamepokelewa na shirika la New Zealands la Accident Compensation Corporation ENT Medical Misadventure committee. Wakati ikiwa juu, hii si ajabu, kwa kuwa kunyonya sikio ni njia ya kawaida kabisa. Grossan alipendekeza kuwa takriban masikio 150,000 yanamwagiliwani kila wiki huko Marekani na 40,000 kwa wiki nchini Uingereza. <ref name="Grossan">{{cite journal |author=Grossan M |title=Cerumen removal--current challenges |url=https://archive.org/details/sim_ear-nose-throat-journal_1998-07_77_7/page/541 |journal=Ear, Nose, & Throat Journal |volume=77 |issue=7 |pages=541–6, 548 |year=1998 |month=Julai |pmid=9693470}}</ref> Uchafuzi kutokana na takwimu zilizopatikana huko Edinburgh kwa Sharp et al. <ref name="Sharp"></ref> takwimu hapa zikojuu zaidi, kukadiria kuwa takribani masikio 7000 yanaangaliwa kati ya idadi ya watu 100,000 kila mwaka. Katika madai ya New Zealand yaliyotajwa hapo juu, utoboaji wa utando wa tympanic ulikuwa na majerahamara kwa mara pia unaoweza kusababisha matatizo ya ulemavu. ===Candling ya sikio=== Sikio candling, pia hujulikana kama sikio coning joto-skio tiba ya mafuta, ni dawa mbadala mazoezi alidai kuboresha afya kwa ujumla na ustawi na taa moja ya mashimo mwisho na kuweka mshumaa mwisho wengine katika mfereji wa sikio. Kulingana na watafiti matibabu, ni hatari na ufanisi. <ref name="Seely">{{cite journal |author=Seely DR, Quigley SM, Langman AW |title=Ear candles--efficacy and safety |url=https://archive.org/details/sim_laryngoscope_1996-10_106_10/page/1226 |journal=The Laryngoscope |volume=106 |issue=10 |pages=1226–9 |year=1996 |month=Oktoba |pmid=8849790 |doi=10.1097/00005537-199610000-00010}}</ref> Mawakili kusema kwamba mabaki giza ambayo inaonyesha baada ya utaratibu huu ni nta ya skio iliotolewa, na kudhibitisha ufanisi wa utaratibu. utafiti umeonyesha kwamba kwa kweli mabaki huwa ikiwa mshumaa (ambayo yameundwa na pamba na nta ya nyuki na kuwacha mabaki baada ya moto) uliigizwa kwa skio au laa ==Matumizi== ===Matumizi ya kihistoria ya nta ya sikio=== * Katika nyakati nta ya skio, na dutu zingine kama vile mkojo, zilitumika kuandaa rangi asili ya kutumiwa na mwandishi wa kuonyesha mwanga muswada . * Toleo la 1832 ya ''Marekani Frugal Housewife'' alisema kuwa "hamna chochote bora kuliko nta ya skio kuzuia machungu yanayotokana na kidonda cha msumari au skewer", na pia ilipendekeza nta ya skio kama dawa ya kupasuka midomo. <ref>{{cite web|url=http://books.google.ca/books?id=D3AEAAAAYAAJ&dq=%22The+American+Frugal+Housewife%22&pg=PP1&ots=eLJ6iZTszR&sig=tuzVuoZW00DDuVENejLpNGG_CmE&hl=en&sa=X&oi=book_result&resnum=1&ct=result#PPA116,M1 |title=The American frugal housewife ... - Google Books |publisher=Books.google.ca |date= |accessdate=2010-05-02}}</ref> ===Matumizi ya kisasa=== * Aina nyingi za nyangumihuwa na nta ya skio ambayo huongezaka kwa muda; na ukubwa wa amana wakati mwingine ndio njia pekee ya kujua umri wa nyangumi asiye na meno. <ref>{{cite web|url=http://www.cs.ucf.edu/~MidLink/baldrige.jan.two.html |title=What can you tell us about whale ear wax? |author=Craig S. Nelson |publisher=Cs.ucf.edu |date= |accessdate=2010-06-20}}</ref> * Katika sehemu ya mpango ''MythBusters'' televisheni, ilionyesh mishumaa ilojengwa kwa kutumia nta ya skio ya binadamu inaweza kuendeleza moto, lakini si kwa muda mrefu au kuchoma kwa mwangaza wa juu kutosha kama mafuta ya taa au mishumaa nta ya nyuki. <ref>{{cite web |url=http://community.discovery.com/eve/forums/a/tpc/f/7501919888/m/4821920499 |title=Do "ear candles" really work? - Topic Powered by Social Strata |publisher=Community.discovery.com |date= |accessdate=2010-05-02 |archivedate=2010-11-07 |archiveurl=https://web.archive.org/web/20101107040910/http://community.discovery.com/eve/forums/a/tpc/f/7501919888/m/4821920499 }}</ref> ==Marejeo== {{Marejeo|2}} ==Kwa masomo zaidi== * {{cite journal |author=Roeser RJ, Ballachanda BB |title=Physiology, pathophysiology, and anthropology/epidemiology of human earcanal secretions |url=https://archive.org/details/sim_journal-of-the-american-academy-of-audiology_1997-12_8_6/page/391 |journal=Journal of the American Academy of Audiology |volume=8 |issue=6 |pages=391–400 |year=1997 |month=Desemba |pmid=9433685}} * {{cite journal |author=Stone M, Fulghum RS |title=Bactericidal activity of wet cerumen |url=https://archive.org/details/sim_annals-of-otology-rhinology-laryngology_march-april-1984_93_2/page/183 |journal=The Annals of Otology, Rhinology, and Laryngology |volume=93 |issue=2 Pt 1 |pages=183–6 |year=1984 |pmid=6370076}} * {{cite news |last=Wade |first=Nicholas | title=Japanese Scientists Identify Ear Wax Gene |work=[[The New York Times]] |date=29 Januari 2006 }} * Nicholas Wade. wanasayansi wapata jeni ambayo inadthibiti aina ya nta ya skio katika watu. ''[[The New York Times]],'' januari 30, 2006 ==Viungo vya nje== {{Wiktionary}} * [http://www.deafnessresearch.org.uk/?lid=1902 Uangalizi wa masikio yako] {{Wayback|url=http://www.deafnessresearch.org.uk/?lid=1902 |date=20100129072510 }} uziwi Utafiti wa Uingereza * [http://www.patient.co.uk/showdoc/23068727 Sikio nta na matibabu yake] {{Wayback|url=http://www.patient.co.uk/showdoc/23068727 |date=20100712102103 }} Mgonjwa Uingereza * [http://www.medinfo.co.uk/conditions/earwax.html Sikio nta na matibabu yake] Medinfo Uingereza * [http://www.deafnessresearch.org.uk/?lid=1887 Sikio nta na matibabu yake] {{Wayback|url=http://www.deafnessresearch.org.uk/?lid=1887 |date=20110927144006 }} uziwi Utafiti wa uingereza * [http://www.abc.net.au/science/news/stories/s1558166.htm Gooey nta ya skio iliokatika jeni yako] , ABC Sayansi kwenye mtandao, 30 Januari 2006 * [http://www.entnet.org/Practice/upload/FINAL-CerumenImpaction-Journal-2008.pdf mwongozo wa mozoezi ya kliniki: kuweka pamoja serumeni (The Academy Marekani ya otolaringolojia -upasuaji wa kichwa na shingo )] {{Wayback|url=http://www.entnet.org/Practice/upload/FINAL-CerumenImpaction-Journal-2008.pdf |date=20121004164401 }} [[Category:Sikio]] g151jwrmu8swbg5k63mwgp37k1mr3q3 0 57406 1578043 1536181 2026-07-02T14:58:11Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578043 wikitext text/x-wiki [[Image:Louis de Montfort.jpg|200px|thumb|right|Mt. Louis-Marie Grignion de Montfort.]] '''Alois Maria wa Montfort''' ([[Montfort-sur-Meu]], [[Ufaransa]], [[31 Januari]] [[1673]] - [[Saint-Laurent-sur-Sèvre]], [[28 Aprili]] [[1716]]) alikuwa [[padri]] maarufu kwa mahubiri aliyoyatoa kote Ufaransa [[Magharibi]], akitangaza [[fumbo]] la [[Hekima]] ya [[milele]], na kurudisha wengi kwenye [[toba]]. Tena kwa [[maandishi]] yake, ambayo mpaka leo yanazidi kuathiri [[Kanisa Katoliki]] hasa upande wa [[heshima ya pekee]] kwa [[Bikira Maria]] katika [[maisha ya kiroho]], lakini pia kuhusu [[Msalaba wa Yesu]] <ref>https://www.santiebeati.it/dettaglio/51100</ref>. Alikuwa pia [[mwanzilishi]] wa [[shirika|mashirika]] matatu ya [[utawa|kitawa]]: [[Shirika la Maria]], [[Mabinti wa Hekima]] na [[Mabruda wa Mt. Gabriel]]. Alitangazwa na [[Papa Leo XIII]] kuwa [[mwenye heri]] [[mwaka]] [[1888]], halafu [[Papa Pius XII]] alimtangaza [[mtakatifu]] mwaka [[1947]]. [[Sikukuu]] yake huadhimishwa [[tarehe]] [[mauti|aliyofariki]] [[dunia]] <ref>''[[Martyrologium Romanum]]: ex Decreto Sacrosancti oecumenici Concilii Vaticani II instauratum auctoritate Ioannis Pauli P.P. II promulgatum'', Romae 2001, ISBN 8820972107</ref>. ==Heshima halisi kwa Maria== Alois Maria wa Montfort anapoizungumzia katika [[kitabu]] chake maarufu hasemi kuhusu heshima ya nje tu, yenye [[kiburi]], isiyodumu, ya kinafiki au ya kujitafutia [[faida]], bali ile halisi ambayo ni “[[utashi]] kuwa tayari kutenda mara yanayohusu [[utumishi]] wa Mungu” ([[Thoma wa Akwino]]). Utayari huo, unaotakiwa kudumu hata [[Hisia|hisi]] zikiwa kavu, unatuelekeza kumuabudu Bwana na kumpatia Mama yake heshima ya pekee anayostahili. Wengine wanadanganyika wakidai kuufikia [[muungano na Mungu]] pasipo kumpitia mfululizo Yesu Kristo: hivyo wataufikia [[ujuzi]] wa kinadharia tu kumhusu Mungu, si ule mtamu unaoitwa [[hekima]] ambao ni wa juu, hai, wenye kung’amua [[njia]] za [[Maongozi ya Mungu|maongozi yake]] hata katika mambo madogo. [[Watulivu]] walidai eti! Ubinadamu wa Yesu ni njia ya kufaa mwanzoni tu mwa [[Maisha ya kiroho|maisha ya Kiroho]]. [[Uzushi]] huo ni kutotambua [[upana]] usio na mipaka wa [[ushenga]] wa [[Mwokozi]]. Uzushi mwingine ni ule wa wale wanaotaka kumuendea Bwana pasipo Maria. Hata baadhi ya Wakatoliki hawaoni inavyofaa kumkimbilia Bikira ili kuwa wandani wa Kristo. Wanamjua Maria “kinadharia tu, kwa namna kavu, kame, isiyojali… Wanaogopa kuzidisha heshima kwake na kumchukiza Bwana wetu kwa kumstahi mno Mama yake mtakatifu… Wakisema juu ya heshima kwa Maria, si kwa kuihimiza, bali hasa kwa kuondoa matumizi yake yasiyofaa” (Alois Maria wa Montfort). Wanaonekana kudhani Maria ni kizuio kwa kuufikia muungano na Mungu, kumbe athari yake yote inalenga kutufikisha huko. Ingekuwa sawa na kusema [[Yohane Maria Vianney]] alikuwa kizuio kwa [[parokia|wanaparokia]] wake wasimuendee Mungu. Ni kukosa [[unyenyekevu]] kupuuzia washenga ambao Mungu ameujalia udhaifu wetu. ===Ngazi za heshima hiyo=== Heshima hiyo, ambayo inatakiwa kuwemo ndani ya kila [[Ukristo|Mkristo]] na kustawi pamoja na [[upendo]], [[ngazi]] yake ya kwanza ni kumuomba Bikira mara kwa mara, k.mf. kusali vizuri [[Malaika wa Bwana]]. Ngazi ya pili ni kuwa na heshima, [[tumaini]] na upendo kamili zaidi kwake, ambavyo mtu asali kila siku walau robo ya Rozari kwa kutafakari matendo ya furaha, ya mwanga, ya uchungu na ya utukufu yaliyo njia ya kufikia uzima wa milele. Ngazi ya tatu, ambayo ndiyo inayowafaa wanaoendelea, ni kujiaminisha kwa Bwana kwa njia ya Mama yake: “Heshima hiyo ni kujiaminisha kabisa kwa Bikira mtakatifu ili kwa njia yake tuwe [[mali]] ya Yesu kabisa. Tunapaswa kumtolea: 1) [[mwili]] wetu pamoja na hisi zake zote na [[kiungo|viungo]]; 2) [[roho]] yetu na vipawa vyake vyote; 3) mali yetu ya nje... ya sasa na ya kesho; 4) mema yetu ya ndani na ya Kiroho, yaani [[stahili]] zetu, [[adili|maadili]] yetu na matendo yetu mema ya jana, ya leo na ya kesho”. Ili tuelewe vema tendo hilo tunapaswa kutofautisha katika matendo mema mambo yasiyoshirikishwa na yale yanayoweza kushirikishwa. Yasiyoshirikishwa ni zile stahili hasa ambazo zinatupa haki ya kustawishiwa upendo na kupata [[uzima wa milele]]. Tukizitoa kwa Bikira mtakatifu si kusudi awagawie wengine, bali atudumishie na kutuzalishia na, tukija kuzipoteza kwa [[Dhambi ya mauti|dhambi ya mauti]], atupatie [[neema]] ya [[toba|kutubu]] vizuri ili turudishiwe si neema inayotia utakatifu tu bali [[kiwango]] chake tulichokuwa nacho. Yanayoweza kushirikishwa ni stahili za kufaa tu na [[thamani]] ya matendo yetu mema kwa kufidia na kuombea. Stahili za kufaa hazitegemei haki bali upendo au [[urafiki]] unaotuunganisha na Mungu; kwa [[msingi]] huo tunaweza kumpatia jirani neema, kama vile mama mwema anavyowavutia wanae, kwa kuwa Mungu anajali nia na matendo yake maadilifu. Tunaweza kuwaombea majirani, wakosefu sugu, walio mahututi, [[marehemu]] n.k. Tunaweza kulipa kwa niaba ya wengine, kupokea kwa [[hiari]] [[adhabu]] za dhambi zao, kama Maria alivyofanya chini ya [[Msalaba wa Yesu|msalaba]] ili kuwavutia [[huruma ya Mungu]]. Tunaweza pia kuwapatia waliopo [[toharani]] [[rehema]] kwa kuwafungulia [[hazina]] ya stahili za Yesu na ya [[Mtakatifu|watakatifu]] ili kuharakisha [[ukombozi]] wao. Tukimtolea Maria matatizo na tabu zetu zote, atatupatia [[msalaba|misalaba]] inayolingana na [[nguvu]] tulizonazo kwa msaada wa neema, ili tuchangie wokovu wa watu. Tumshauri nani ajiaminishe hivyo? Si wale watakaokubali kwa kufuata hisia za moyoni tu au kiburi kuhusu mambo ya Kiroho, wasielewe [[uzito]] wake, bali watu wenye [[juhudi]]: nao wajiaminishe kwanza kwa [[muda]] mfupi, halafu kwa [[mwaka]] mmoja, ili wapenywe na hiyo roho ya kujiaminisha, hadi waweze kujitoa kwa faida [[maisha]] yao yote. Baadhi wanabisha wakisema tendo hilo ni kujinyima yote tusilipe madeni yetu, hivyo litarefusha tohara yetu. Bwana alimjalia [[Birgita wa Sweden]] kuelewa jinsi wazo hilo linavyotokana na [[umimi]] na linavyosahau wema wa Maria, ambaye hashindwi na yeyote katika [[ukarimu]]. Tukijinyima hivyo tutapokea mara mia. Upendo wenyewe, unaoshuhudiwa na tendo hilo, unatuondolea tayari sehemu ya tohara. Wengine wanauliza tutafanyeje kuwaombea ndugu na marafiki kisha kumtolea Maria sala zetu zote? Jibu ni kwamba Bikira anajua [[wajibu]] wetu kwa ndugu na marafiki, na kama tungesahau kuwaombea angetukumbusha. Tena mara nyingi hatujui nani kati yao anahitaji zaidi kuombewa, kumbe Maria anajua na kutumia [[sala]] zetu kwa ajili yake. Hatimaye tunaweza kumuomba amsaidie fulani au fulani. ===Matunda ya heshima hiyo=== [[Njia]] hiyo ya kumuendea Mungu ni rahisi na inastahili zaidi, kwa hiyo ni fupi, kamili na ya hakika zaidi. Kwanza ni rahisi zaidi. “Kwa kusema ukweli tunaweza kuufikia muungano na Mungu kwa njia nyingine; lakini itakuwa kwa misalaba mingi zaidi sana na kwa vifo vya ajabuajabu na kwa matatizo mengi zaidi sana ambayo tutayashinda kwa shida kubwa zaidi. Itatupasa kupitia giza la usiku, mapambano na mafadhaiko yasiyosemekana, milima yenye magenge, misitu ya miba inayochoma na majangwa ya kutisha. Kumbe kwa njia ya Maria tunapita kwa utamu na utulivu mkubwa zaidi. Ni kweli kuwa huko vinapatikana vita vikali ambavyo tuvipige na matatizo makubwa ambayo tuyashinde, lakini huyo Mama mwema anawakaribia watumishi wake waaminifu ili kuwaangazia giza lao, kuwashauri katika wasiwasi wao, kuwategemeza katika mapambano na matatizo yao, kiasi kwamba njia hiyo ya Kibikira ya kumpata Yesu Kristo ni ya mawaridi na asali ukiilinganisha na nyingine”. Hiyo inathibitishwa na watakatifu waliofuata njia hiyo kwa namna ya pekee. Ingawa njia hiyo ni rahisi zaidi, kwa kuwa Bikira anatutegemeza, haiachi kustahili zaidi, kwa kuwa Maria anatupatia upendo mkubwa ulio asili ya stahili. Matatizo ni nafasi ya kustahili, lakini [[asili]] ya stahili ndiyo upendo ambao tunayashinda. Maria kwa matendo rahisi alistahili kuliko [[Mfiadini|wafiadini]] katika mateso yao yote, kwa jinsi alivyotumia upendo mwingi katika kuyatenda. Njia ya Maria ni fupi zaidi, kwa maana tunaifuata kwa urahisi na hivyo tunakwenda [[kasi]] zaidi. Kwa muda mfupi wa kumfuata Mama wa Mungu tunasonga mbele kuliko kwa miaka ya kufuata [[busara]] yetu. Chini yake, ambaye [[Neno (Biblia)|Neno]] aliyefanyika mwili alimtii, tunapiga hatua za [[jitu]]. Njia hiyo ndiyo kamili zaidi, kwa kuwa Neno alitushukia kwa njia ya Maria asipoteze chochote cha Umungu wake; basi kwa njia yake walio wadogo wanaweza kupanda vizuri kwa Aliye Juu wasiogope chochote. Mwenyewe anatakasa matendo yetu mema na kuzidisha thamani yake akiyatoa kwa Mwanae. Hatimaye ndiyo njia ya hakika zaidi inayotukinga dhidi ya udanganyifu wa [[shetani]] ambaye kwanza anajaribu kutupotosha kidogokidogo ili baadaye atufikishe kutenda makosa makubwa. Pia inatukinga dhidi ya udanganyifu wa ndoto na hisia za moyoni, kwa kuwa Maria kama chombo cha neema anatuliza na kuratibu hisi zetu ili roho ipokee athari ya Bwana kwa manufaa zaidi. Tena Maria ni kiumbe kitakatifu: hivyo akizingatiwa na hisi zetu anainua roho iungane na Mungu. Anatupatia [[uhuru]] mkubwa wa ndani, na pengine tukimuomba kwa udumifu atatupatia neema ya kukombolewa mara na upotovu wa hisi unaozuia sala na muungano wa dhati na Bwana. Kila athari ya Maria inalenga kutufikisha huko, kama vile Yesu anavyotufikisha kwa [[Mungu Baba|Baba]]. Inafaa kuomba msaada wake wa pekee wakati na baada ya [[Komunyo]], ili atushirikishe [[ibada]] yake ya dhati pamoja na upendo wake, kana kwamba tungeazima [[Moyo Safi wa Maria|moyo wake safi]] tumpokee Yesu inavyotakiwa. [[Kiini]] cha kujiaminisha kwa Yesu kwa [[Mkono|mikono]] ya Maria ni kama ifuatavyo: “Ee Yesu mpendwa, unayestahili kuabudiwa, Mungu kweli na mtu kweli! Nakushukuru kwa jinsi ulivyojishusha kabisa ukitwaa namna ya mtumwa ili kunikomboa kutoka utumwa wa shetani… Nakimbilia maombezi ya Mama yako mtakatifu uliyenipa awe mtetezi wangu kwako; kwa njia hiyo natumaini utanijalia majuto na msamaha wa dhambi zangu, nipate na kutunza hekima. Nakusalimu Maria usiye na doa, malkia wa mbingu na nchi, ambaye vyote vilivyo chini ya Mungu viko chini yako. Nakusalimu, kimbilio la hakika la wakosefu, wewe ambaye huruma yako haimpungui yeyote: unitimizie hamu yangu ya kupata hekima ya Kimungu, na kwa lengo hilo pokea nadhiri na matoleo ninavyokutolea kwa unyonge wangu. Mimi, mkosefu nisiye mwaminifu narudia leo na kuthibitisha mikononi mwako ahadi za ubatizo wangu. Namkataa moja kwa moja shetani, fahari zake na mambo yake yote na kujitoa kabisa kwa Yesu Kristo, Hekima aliyefanyika mwili, ili nyuma yake nibebe msalaba wangu siku zote za maisha yangu. Basi, ili niwe mwaminifu kwake kuliko nilivyokuwa mpaka sasa, nakuteua Maria uwe Mama yangu. Nakuachia na kukukabidhi mwili wangu na roho yangu, mema yangu ya ndani na vitu vya nje, hata thamani ya matendo yangu mema ya jana, ya leo na ya kesho… kwa hiyo uniweke miongoni mwa wale ambao unawapenda, unawafundisha, unawaongoza, unawalisha na kuwalinda. Ee Bikira mwaminifu, unifanye niwe katika yote mwanafunzi mkamilifu na mwigaji wa Hekima aliyefanyika mwili, Yesu Kristo Mwanao, hata nifikie kwa maombezi na mifano yako kwenye utimilifu wa ukomavu wake hapa duniani na wa utukufu wake mbinguni. Amina”. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{Reflist}} ==Marejeo ya Kiswahili== * Mt. Louis-Marie Grignon wa Montfort – tafsiri ya A. Nyenza, B.F. – ed. Mabratha wa Montfort wa Mt. Gabriel Tanzania -2000 ==Marejeo mengine== ;''Vitabu vyake'': * de Montfort, St. Louis. ''Preparation for Total Consecration according to the Method of St. Louis de Montfort.'' Bay Shore NY: Montfort Publications, 2001. * de Montfort, St. Louis-Marie Grignion. ''True Devotion to Mary.'' translated by Mark L. Jacobson, [[Aventine Press]], 2007 ISBN 1593304706. * de Montfort, St. Louis. ''Secret of the Rosary'' ISBN 978-0895550569. * de Montfort, St. Louis. ''God Alone: The Collected Writings of St. Louis Marie De Montfort'' Montfort Publications, 1995 ISBN 0910984557 ;''Maisha yake'': * Biography of Saint Louis de Montfort [http://ebisreligiousicons.com/montfort/bgraphy.html] {{Wayback|url=http://ebisreligiousicons.com/montfort/bgraphy.html |date=20091124094207 }} * Biography of Saint Louis de Montfort [http://www.montfort.org/English/LifeLM.htm] {{Wayback|url=http://www.montfort.org/English/LifeLM.htm |date=20080109234734 }} * Doherty, Eddie. ''Wisdom's Fool: A biography of St. Louis de Montfort.'' Bay Shore NY: Montfort Publications, 1993. * Fiores, Stefano ''Dictionnaire de Spiritualité Montfortaine.'' (1360 pag.)Novalis, 1994 * Raja Rao, Joseph ''The Mystical Experience and Doctrine of St. Louis-Marie Grignion de Montfort'' Loyola Press, 2005, ISBN 9788878390300 ;''Hati za [[Papa Yohane Paulo II]]'': * On de Montfort [http://www.catholicregister.org/content/view/1402/857/] {{Wayback|url=http://www.catholicregister.org/content/view/1402/857/ |date=20081202070615 }} * Encyclical ''[[Redemptoris Mater]]'' [http://www.vatican.va/holy_father/john_paul_ii/encyclicals/documents/hf_jp-ii_enc_25031987_redemptoris-mater_en.html] * Apostolic Letter ''[[Rosarium Virginis Mariae]]'' [http://www.vatican.va/holy_father/john_paul_ii/apost_letters/documents/hf_jp-ii_apl_20021016_rosarium-virginis-mariae_en.html] ==Viungo vya nje== *[http://www.montfort.org/English/SpiritLM.htm A Guide to Montfortian Spirituality] {{Wayback|url=http://www.montfort.org/English/SpiritLM.htm |date=20080509185857 }} *[http://www.newadvent.org/cathen/09384a.htm Entry on the Catholic Encyclopedia about Saint Louis de Montfort] *[[Catholic Encyclopedia]] [http://www.newadvent.org/cathen/09749d.htm article on Missionaries of the Company of Mary] - founded by de Montfort *[http://www.legionofmarytidewater.com/aids.htm Catholic Books] {{Wayback|url=http://www.legionofmarytidewater.com/aids.htm |date=20150223085512 }} including True Devotion to Mary free online *[http://www.montfortcentre.org Montfort Center] *[http://www.saintpetersbasilica.org/Statues/Founders/LouisdeMontfort/Louis%20de%20Montfort.htm Founder Statue in St Peter's Basilica] *[http://catholicism.org/louis-de-montfort.html "Saint Louis Marie de Montfort"] article at Catholicism.org {{mbegu-Mkristo}} {{DEFAULTSORT:Montfort, Louis De}} [[Category:Waliozaliwa 1673]] [[Category:Waliofariki 1716]] [[Category:Mapadri]] [[Category:Watawa waanzilishi]] [[Category:Wamontfort]] [[Category:Watakatifu wa Ufaransa]] py4euw9h9lppppxcicx5e6hb7pse9c9 10 58965 1577982 1522894 2026-07-02T13:56:28Z ~2026-37999-72 90645 1577982 wikitext text/x-wiki {{Navbox | name = Katuni za Disney | title = [[Walt Disney Animated Classics|Katuni za Disney]] | state = {{{state<includeonly>|autocollapse</includeonly>}}} | bodyclass = hlist | nowrapitems = yes | group1 = [[Walt Disney Animated Classics|Filamu]]<br>[[Walt Disney Animation Studios|Walt Disney<br>Animation Studios]] | list1 = * ''[[Snow White and the Seven Dwarfs (filamu ya 1937)|Snow White and the Seven Dwarfs]]'' (1937) * ''[[Pinocchio (filamu ya 1940)|Pinocchio]]'' (1940) * ''[[Fantasia (filamu ya 1940)|Fantasia]]'' (1940) * ''[[Dumbo]]'' (1941) * ''[[Bambi]]'' (1942) * ''[[Saludos Amigos]]'' (1942) * ''[[The Three Caballeros]]'' (1944) * ''[[Make Mine Music]]'' (1946) * ''[[Fun and Fancy Free]]'' (1947) * ''[[Melody Time]]'' (1948) * ''[[The Adventures of Ichabod and Mr. Toad]]'' (1949) * ''[[Cinderella (filamu ya 1950)|Cinderella]]'' (1950) * ''[[Alice in Wonderland (filamu ya 1951)|Alice in Wonderland]]'' (1951) * ''[[Peter Pan (filamu ya 1953)|Peter Pan]]'' (1953) * ''[[Lady and the Tramp]]'' (1955) * ''[[Sleeping Beauty (filamu ya 1959)|Sleeping Beauty]]'' (1959) * ''[[One Hundred and One Dalmatians]]'' (1961) * ''[[The Sword in the Stone (filamu ya 1963)|The Sword in the Stone]]'' (1963) * ''[[The Jungle Book (filamu ya 1967)|The Jungle Book]]'' (1967) * ''[[The Aristocats]]'' (1970) * ''[[Robin Hood (filamu ya 1973)|Robin Hood]]'' (1973) * ''[[The Many Adventures of Winnie the Pooh]]'' (1977) * ''[[The Rescuers]]'' (1977) * ''[[The Fox and the Hound]]'' (1981) * ''[[The Black Cauldron (filamu)|The Black Cauldron]]'' (1985) * ''[[The Great Mouse Detective]]'' (1986) * ''[[Oliver & Company]]'' (1988) * ''[[The Little Mermaid (filamu ya 1989)|The Little Mermaid]]'' (1989) * ''[[The Rescuers Down Under]]'' (1990) * ''[[Beauty and the Beast (filamu ya 1991)|Beauty and the Beast]]'' (1991) * ''[[Aladdin (filamu ya 1992)|Aladdin]]'' (1992) * ''[[The Lion King]]'' (1994) * ''[[Pocahontas (filamu ya 1995)|Pocahontas]]'' (1995) * ''[[The Hunchback of Notre Dame (filamu ya 1996)|The Hunchback of Notre Dame]]'' (1996) * ''[[Hercules (filamu ya 1997)|Hercules]]'' (1997) * ''[[Mulan (filamu ya 1998)|Mulan]]'' (1998) * ''[[Tarzan (filamu ya 1999)|Tarzan]]'' (1999) * ''[[Fantasia 2000]]'' (1999) * ''[[Dinosaur (filamu ya 2000)|Dinosaur]]'' (2000) * ''[[The Emperor's New Groove]]'' (2000) * ''[[Atlantis: The Lost Empire]]'' (2001) * ''[[Lilo & Stitch]]'' (2002) * ''[[Treasure Planet]]'' (2002) * ''[[Brother Bear]]'' (2003) * ''[[Home on the Range (filamu ya 2004)|Home on the Range]]'' (2004) * ''[[Chicken Little (filamu ya 2005)|Chicken Little]]'' (2005) * ''[[Meet the Robinsons]]'' (2007) * ''[[Bolt (filamu ya 2008)|Bolt]]'' (2008) * ''[[The Princess and the Frog]]'' (2009) * ''[[Tangled]]'' (2010) * ''[[Winnie the Pooh (filamu ya 2011)|Winnie the Pooh]]'' (2011) * ''[[Wreck-It Ralph]]'' (2012) * ''[[Frozen (filamu ya 2013)|Frozen]]'' (2013) * ''[[Big Hero 6 (filamu)|Big Hero 6]]'' (2014) * ''[[Zootopia]]'' (2016) * ''[[Moana]]'' (2016) * ''[[Ralph Breaks the Internet]]'' (2018) * ''[[Frozen 2]]'' (2019) * ''[[Raya and the Last Dragon]]'' (2021) * ''[[Encanto]]'' (2021) * ''[[Strange World]]'' (2022) * ''[[Wish]]'' (2023) * ''[[Moana 2]]'' (2024) * ''[[Zootopia 2]] (2025) | group2 = [[List of Pixar films|Filamu]]<br>[[Pixar]] | list2 = * ''[[Toy Story]]'' (1995) * ''[[A Bug's Life]]'' (1998) * ''[[Toy Story 2]]'' (1999) * ''[[Monsters, Inc.]]'' (2001) * ''[[Finding Nemo]]'' (2003) * ''[[The Incredibles]]'' (2004) * ''[[Cars (filamu)|Cars]]'' (2006) * ''[[Ratatouille (filamu)|Ratatouille]]'' (2007) * ''[[WALL-E]]'' (2008) * ''[[Up (filamu)|Up]]'' (2009) * ''[[Toy Story 3]]'' (2010) * ''[[Cars 2]]'' (2011) * ''[[Brave (filamu ya 2012)|Brave]]'' (2012) * ''[[Monsters University]]'' (2013) * ''[[Inside Out (filamu ya 2015)|Inside Out]]'' (2015) * ''[[The Good Dinosaur]]'' (2015) * ''[[Finding Dory]]'' (2016) * ''[[Cars 3]]'' (2017) * ''[[Coco (filamu ya 2017)|Coco]]'' (2017) * ''[[Incredibles 2]]'' (2018) * ''[[Toy Story 4]]'' (2019) * ''[[Onward (filamu)|Onward]]'' (2020) * ''[[Soul (filamu ya 2020)|Soul]]'' (2020; international release) * ''[[Luca (filamu ya 2021)|Luca]]'' (2021) * ''[[Turning Red]]'' (2022) * ''[[Lightyear (filamu)|Lightyear]]'' (2022) * ''[[Elemental]]'' (2023) * ''[[Inside Out 2]]'' (2024) * ''[[Elio]]'' (2025) * ''[[Hoppers]]'' (2026) * ''[[Toy Story 5]]'' (2026) | group3 = Live-action films<br>with animation | list3 = * ''[[The Reluctant Dragon (filamu ya 1941)|The Reluctant Dragon]]'' (1941) * ''[[Victory Through Air Power (filamu)|Victory Through Air Power]]'' (1943) * ''[[Song of the South]]'' (1946) * ''[[So Dear to My Heart]]'' (1948) * ''[[Mary Poppins (filamu)|Mary Poppins]]'' (1964) * ''[[Bedknobs and Broomsticks]]'' (1971) * ''[[Pete's Dragon (filamu ya 1977)|Pete's Dragon]]'' (1977) * ''[[Who Framed Roger Rabbit]]'' (1988) * ''[[James and the Giant Peach (filamu)|James and the Giant Peach]]'' (1996) * ''[[The Lizzie McGuire Movie]]'' (2003) * ''[[Enchanted (filamu)|Enchanted]]'' (2007) * ''[[Mary Poppins Returns]]'' (2018) | group4 = Filamu<br>[[Disneytoon Studios]] <!--NOTE: This section does not include direct-to-video Disneytoon releases, except those released theatrically in some countries while it was direct-to-video in United States, its country of production, or with a limited release in the US--> | list4 = * ''[[DuckTales the Movie: Treasure of the Lost Lamp]]'' (1990) * ''[[A Goofy Movie]]'' (1995) * ''[[The Tigger Movie]]'' (2000) * ''[[Return to Never Land]]'' (2002) * ''[[The Jungle Book 2]]'' (2003) * ''[[Piglet's Big Movie]]'' (2003) * ''[[Pooh's Heffalump Movie]]'' (2005) * ''[[Bambi II]]'' (2006; international release) * ''[[Tinker Bell and the Great Fairy Rescue]]'' (2010; international release) * ''[[Secret of the Wings]]'' (2012; limited release) * ''[[Planes (filamu)|Planes]]'' (2013) * ''[[The Pirate Fairy]]'' (2014; limited release) * ''[[Planes: Fire & Rescue]]'' (2014) * ''[[Tinker Bell and the Legend of the NeverBeast]]'' (2015; limited release) | group5 = Filamu<br>[[Disney Television Animation|Disney TV Animation]] | list5 = <!--NOTE: This section does not include TV premieres and direct-to-video features. "Phineas and Ferb the Movie: Across the 2nd Dimension" was released theatrically in Spain, while it was premiered on TV in USA and other countries--> * ''[[Doug's 1st Movie]]'' (1999) * ''[[Recess: School's Out]]'' (2001) * ''[[Teacher's Pet (filamu ya 2004)|Teacher's Pet]]'' (2004) * ''[[Phineas and Ferb the Movie: Across the 2nd Dimension]]'' (2011; international release) | group6 = Filamu<br>[[List of animation studios owned by The Walt Disney Company|other Disney units]] | list6 = * ''[[The Brave Little Toaster]]'' (1987) * ''[[The Nightmare Before Christmas]]'' (1993) * ''[[The Wild]]'' (2006) * ''[[A Christmas Carol (filamu ya 2009)|A Christmas Carol]]'' (2009) * ''[[Gnomeo & Juliet]]'' (2011) * ''[[Mars Needs Moms]]'' (2011) * ''[[Frankenweenie (filamu ya 2012)|Frankenweenie]]'' (2012) * ''[[Strange Magic (filamu)|Strange Magic]]'' (2015) * ''[[Spies in Disguise]]'' (2019) * ''[[Ron's Gone Wrong]]'' (2021) * ''[[Bob's Burgers: The Movie]]'' (2022) * ''[[Mufasa: The Lion King]]'' (2024) | group7 = Related lists | list7 = * [[List of unproduced Disney animated shorts and feature films|Unproduced films]] * [[List of Disney live-action remakes of animated films|Live-action remakes]] * [[List of Walt Disney Animation Studios short films|Walt Disney Animation Studios short films]] (''[[Academy Award Review of Walt Disney Cartoons|Academy Award Review]]'') * [[List of Pixar shorts|Pixar short films]] | below = * {{Icon|Book}} [[Book:Disney theatrical animated features|Book]] }}<noinclude> {{Collapsible option}} [[Jamii:Vigezo vya filamu|Katuni za Disney]] </noinclude> 0cnjm7hktvxej81mxgsolesu3vxe3dv 1577983 1577982 2026-07-02T14:07:30Z ~2026-37999-72 90645 1577983 wikitext text/x-wiki {{Navbox | name = Katuni za Disney | title = [[Walt Disney Animated Classics|Katuni za Disney]] | state = {{{state<includeonly>|autocollapse</includeonly>}}} | bodyclass = hlist | nowrapitems = yes | group1 = [[Walt Disney Animated Classics|Filamu]]<br>[[Walt Disney Animation Studios|Walt Disney<br>Animation Studios]] | list1 = * ''[[Snow White and the Seven Dwarfs (filamu ya 1937)|Snow White and the Seven Dwarfs]]'' (1937) * ''[[Pinocchio (filamu ya 1940)|Pinocchio]]'' (1940) * ''[[Fantasia (filamu ya 1940)|Fantasia]]'' (1940) * ''[[Dumbo]]'' (1941) * ''[[Bambi]]'' (1942) * ''[[Saludos Amigos]]'' (1942) * ''[[The Three Caballeros]]'' (1944) * ''[[Make Mine Music]]'' (1946) * ''[[Fun and Fancy Free]]'' (1947) * ''[[Melody Time]]'' (1948) * ''[[The Adventures of Ichabod and Mr. Toad]]'' (1949) * ''[[Cinderella (filamu ya 1950)|Cinderella]]'' (1950) * ''[[Alice in Wonderland (filamu ya 1951)|Alice in Wonderland]]'' (1951) * ''[[Peter Pan (filamu ya 1953)|Peter Pan]]'' (1953) * ''[[Lady and the Tramp]]'' (1955) * ''[[Sleeping Beauty (filamu ya 1959)|Sleeping Beauty]]'' (1959) * ''[[One Hundred and One Dalmatians]]'' (1961) * ''[[The Sword in the Stone (filamu ya 1963)|The Sword in the Stone]]'' (1963) * ''[[The Jungle Book (filamu ya 1967)|The Jungle Book]]'' (1967) * ''[[The Aristocats]]'' (1970) * ''[[Robin Hood (filamu ya 1973)|Robin Hood]]'' (1973) * ''[[The Many Adventures of Winnie the Pooh]]'' (1977) * ''[[The Rescuers]]'' (1977) * ''[[The Fox and the Hound]]'' (1981) * ''[[The Black Cauldron (filamu)|The Black Cauldron]]'' (1985) * ''[[The Great Mouse Detective]]'' (1986) * ''[[Oliver & Company]]'' (1988) * ''[[The Little Mermaid (filamu ya 1989)|The Little Mermaid]]'' (1989) * ''[[The Rescuers Down Under]]'' (1990) * ''[[Beauty and the Beast (filamu ya 1991)|Beauty and the Beast]]'' (1991) * ''[[Aladdin (filamu ya 1992)|Aladdin]]'' (1992) * ''[[The Lion King]]'' (1994) * ''[[Pocahontas (filamu ya 1995)|Pocahontas]]'' (1995) * ''[[The Hunchback of Notre Dame (filamu ya 1996)|The Hunchback of Notre Dame]]'' (1996) * ''[[Hercules (filamu ya 1997)|Hercules]]'' (1997) * ''[[Mulan (filamu ya 1998)|Mulan]]'' (1998) * ''[[Tarzan (filamu ya 1999)|Tarzan]]'' (1999) * ''[[Fantasia 2000]]'' (1999) * ''[[Dinosaur (filamu ya 2000)|Dinosaur]]'' (2000) * ''[[The Emperor's New Groove]]'' (2000) * ''[[Atlantis: The Lost Empire]]'' (2001) * ''[[Lilo & Stitch]]'' (2002) * ''[[Treasure Planet]]'' (2002) * ''[[Brother Bear]]'' (2003) * ''[[Home on the Range (filamu ya 2004)|Home on the Range]]'' (2004) * ''[[Chicken Little (filamu ya 2005)|Chicken Little]]'' (2005) * ''[[Meet the Robinsons]]'' (2007) * ''[[Bolt (filamu ya 2008)|Bolt]]'' (2008) * ''[[The Princess and the Frog]]'' (2009) * ''[[Tangled]]'' (2010) * ''[[Winnie the Pooh (filamu ya 2011)|Winnie the Pooh]]'' (2011) * ''[[Wreck-It Ralph]]'' (2012) * ''[[Frozen (filamu ya 2013)|Frozen]]'' (2013) * ''[[Big Hero 6 (filamu)|Big Hero 6]]'' (2014) * ''[[Zootopia]]'' (2016) * ''[[Moana]]'' (2016) * ''[[Ralph Breaks the Internet]]'' (2018) * ''[[Frozen 2]]'' (2019) * ''[[Raya and the Last Dragon]]'' (2021) * ''[[Encanto]]'' (2021) * ''[[Strange World]]'' (2022) * ''[[Wish]]'' (2023) * ''[[Moana 2]]'' (2024) * ''[[Zootopia 2]] (2025) | group2 = [[List of Pixar films|Filamu]]<br>[[Pixar]] | list2 = * ''[[Toy Story]]'' (1995) * ''[[A Bug's Life]]'' (1998) * ''[[Toy Story 2]]'' (1999) * ''[[Monsters, Inc.]]'' (2001) * ''[[Finding Nemo]]'' (2003) * ''[[The Incredibles]]'' (2004) * ''[[Cars (filamu)|Cars]]'' (2006) * ''[[Ratatouille (filamu)|Ratatouille]]'' (2007) * ''[[WALL-E]]'' (2008) * ''[[Up (filamu)|Up]]'' (2009) * ''[[Toy Story 3]]'' (2010) * ''[[Cars 2]]'' (2011) * ''[[Brave (filamu ya 2012)|Brave]]'' (2012) * ''[[Monsters University]]'' (2013) * ''[[Inside Out]]'' (2015) * ''[[The Good Dinosaur]]'' (2015) * ''[[Finding Dory]]'' (2016) * ''[[Cars 3]]'' (2017) * ''[[Coco (filamu ya 2017)|Coco]]'' (2017) * ''[[Incredibles 2]]'' (2018) * ''[[Toy Story 4]]'' (2019) * ''[[Onward (filamu)|Onward]]'' (2020) * ''[[Soul (filamu ya 2020)|Soul]]'' (2020; international release) * ''[[Luca (filamu ya 2021)|Luca]]'' (2021) * ''[[Turning Red]]'' (2022) * ''[[Lightyear (filamu)|Lightyear]]'' (2022) * ''[[Elemental]]'' (2023) * ''[[Inside Out 2]]'' (2024) * ''[[Elio]]'' (2025) * ''[[Hoppers]]'' (2026) * ''[[Toy Story 5]]'' (2026) | group3 = Live-action films<br>with animation | list3 = * ''[[The Reluctant Dragon (filamu ya 1941)|The Reluctant Dragon]]'' (1941) * ''[[Victory Through Air Power (filamu)|Victory Through Air Power]]'' (1943) * ''[[Song of the South]]'' (1946) * ''[[So Dear to My Heart]]'' (1948) * ''[[Mary Poppins (filamu)|Mary Poppins]]'' (1964) * ''[[Bedknobs and Broomsticks]]'' (1971) * ''[[Pete's Dragon (filamu ya 1977)|Pete's Dragon]]'' (1977) * ''[[Who Framed Roger Rabbit]]'' (1988) * ''[[James and the Giant Peach (filamu)|James and the Giant Peach]]'' (1996) * ''[[The Lizzie McGuire Movie]]'' (2003) * ''[[Enchanted (filamu)|Enchanted]]'' (2007) * ''[[Mary Poppins Returns]]'' (2018) | group4 = Filamu<br>[[Disneytoon Studios]] <!--NOTE: This section does not include direct-to-video Disneytoon releases, except those released theatrically in some countries while it was direct-to-video in United States, its country of production, or with a limited release in the US--> | list4 = * ''[[DuckTales the Movie: Treasure of the Lost Lamp]]'' (1990) * ''[[A Goofy Movie]]'' (1995) * ''[[The Tigger Movie]]'' (2000) * ''[[Return to Never Land]]'' (2002) * ''[[The Jungle Book 2]]'' (2003) * ''[[Piglet's Big Movie]]'' (2003) * ''[[Pooh's Heffalump Movie]]'' (2005) * ''[[Bambi II]]'' (2006; international release) * ''[[Tinker Bell and the Great Fairy Rescue]]'' (2010; international release) * ''[[Secret of the Wings]]'' (2012; limited release) * ''[[Planes (filamu)|Planes]]'' (2013) * ''[[The Pirate Fairy]]'' (2014; limited release) * ''[[Planes: Fire & Rescue]]'' (2014) * ''[[Tinker Bell and the Legend of the NeverBeast]]'' (2015; limited release) | group5 = Filamu<br>[[Disney Television Animation|Disney TV Animation]] | list5 = <!--NOTE: This section does not include TV premieres and direct-to-video features. "Phineas and Ferb the Movie: Across the 2nd Dimension" was released theatrically in Spain, while it was premiered on TV in USA and other countries--> * ''[[Doug's 1st Movie]]'' (1999) * ''[[Recess: School's Out]]'' (2001) * ''[[Teacher's Pet (filamu ya 2004)|Teacher's Pet]]'' (2004) * ''[[Phineas and Ferb the Movie: Across the 2nd Dimension]]'' (2011; international release) | group6 = Filamu<br>[[List of animation studios owned by The Walt Disney Company|other Disney units]] | list6 = * ''[[The Brave Little Toaster]]'' (1987) * ''[[The Nightmare Before Christmas]]'' (1993) * ''[[The Wild]]'' (2006) * ''[[A Christmas Carol (filamu ya 2009)|A Christmas Carol]]'' (2009) * ''[[Gnomeo & Juliet]]'' (2011) * ''[[Mars Needs Moms]]'' (2011) * ''[[Frankenweenie (filamu ya 2012)|Frankenweenie]]'' (2012) * ''[[Strange Magic (filamu)|Strange Magic]]'' (2015) * ''[[Spies in Disguise]]'' (2019) * ''[[Ron's Gone Wrong]]'' (2021) * ''[[Bob's Burgers: The Movie]]'' (2022) * ''[[Mufasa: The Lion King]]'' (2024) | group7 = Related lists | list7 = * [[List of unproduced Disney animated shorts and feature films|Unproduced films]] * [[List of Disney live-action remakes of animated films|Live-action remakes]] * [[List of Walt Disney Animation Studios short films|Walt Disney Animation Studios short films]] (''[[Academy Award Review of Walt Disney Cartoons|Academy Award Review]]'') * [[List of Pixar shorts|Pixar short films]] | below = * {{Icon|Book}} [[Book:Disney theatrical animated features|Book]] }}<noinclude> {{Collapsible option}} [[Jamii:Vigezo vya filamu|Katuni za Disney]] </noinclude> ar8a9vytzjnyy4rjr1wn9mjratgg5q6 10 60490 1577973 1430462 2026-07-02T13:23:36Z Riccardo Riccioni 452 1577973 wikitext text/x-wiki {{Navbox with columns |name = List of African capitals |title=Miji Mikuu Afrika |state=collapsed |colwidth = 25% |col1 = [[Abuja]], ''Nigeria''<br> [[Accra]], ''Ghana''<br> [[Addis Ababa]], ''Ethiopia''<br> [[Aljeri]], ''Algeria''<br> [[Antananarivo]], ''Madagascar''<br> [[Asmara]], ''Eritrea''<br> [[Bamako]], ''Mali''<br> [[Bangui]], ''Jamhuri ya Afrika ya Kati''<br> [[Banjul]], ''Gambia''<br> [[Bisau]], ''Guinea-Bisau''<br> [[Bloemfontein]], ''Afrika Kusini'' {{Smallsup|1}}<br> [[Brazzaville]], ''Jamhuri ya Kongo''<br> [[Cape Town]], ''Afrika Kusini'' {{Smallsup|2}} <br> [[Conakry]], ''Guinea''<br> [[Dakar]], ''Senegal''<br> [[Dodoma]], ''Tanzania'' |col2 = [[Freetown]], ''Sierra Leone''<br> [[Gaborone]], ''Botswana''<br> [[Gitega]], ''Burundi''<br> [[Harare]], ''Zimbabwe''<br> [[Hargeisa]], ''Somaliland'' {{Smallsup|4}}<br> [[Jamestown, Saint Helena|Jamestown]], ''Saint Helena''<br> [[Jibuti (mji)|Jibuti]], ''Jibuti''<br> [[Juba, Sudan Kusini|Juba]], ''Sudan Kusini''<br> [[Kairo]], ''Misri''<br> [[Kampala]], ''Uganda''<br> [[Khartoum]], ''Sudan''<br> [[Kigali]], ''Rwanda''<br> [[Kinshasa]], ''Jamhuri ya Kidemokrasia ya Kongo''<br> [[Libreville]], ''Gabon''<br> [[Lilongwe]], ''Malawi'' <br> |col3 = [[Lobamba]], ''Eswatini'' {{Smallsup|2}}<br> [[Lomé]], ''Togo''<br> [[Luanda]], ''Angola''<br> [[Lusaka]], ''Zambia''<br> [[Malabo]], ''Guinea ya Ikweta''<br> [[Mamoudzou]], ''Mayotte''<br> [[Maputo]], ''Msumbiji''<br> [[Maseru]], ''Lesotho''<br> [[Mbabane]], ''Eswatini'' {{Smallsup|3}}<br> [[Mogadishu]], ''Somalia''<br> [[Monrovia]], ''Liberia''<br> [[Moroni, Komori|Moroni]], ''Comoros''<br> [[Nairobi]], ''Kenya''<br> [[N'Djamena]], ''Chad''<br> [[Niamey]], ''Niger''<br> [[Nouakchott]], ''Mauritania'' |col4 = [[Ouagadougou]], ''Burkina Faso''<br> [[Port Louis]], ''Morisi''<br> [[Porto-Novo]], ''Benin''<br> [[Praia]], ''Cape Verde''<br> [[Pretoria]], ''Afrika Kusini'' {{Smallsup|3}}<br> [[Rabat]], ''Moroko''<br> [[Saint-Denis, Réunion|Saint-Denis]], ''Réunion''<br> [[São Tomé]], ''São Tomé na Príncipe''<br> [[Tripoli]], ''Libya''<br> [[Tunis]], ''Tunisia''<br> [[Victoria, Seychelles|Victoria]], ''Shelisheli''<br> [[Windhoek]], ''Namibia''<br> [[Yaoundé]], ''Kamerun''<br> [[Yamoussoukro]], ''Kodivaa'' |below = {{Nowrap|{{smallsup|1}} Judicial. {{Wrap}} {{Smallsup|2}} Parliamentary. {{Wrap}} {{Smallsup|3}} Executive. {{Smallsup|4}} An unrecognised or partially-recognised state. }} }}<noinclude> == See also == {{Continent-based templates}} [[Category:Vigezo vya Afrika|Miji Mikuu]] [[Category:Capital city templates|{{PAGENAME}}]] [[Category:Miji Mikuu Afrika|τ]] </noinclude> i8juf7xrznjhvtdb4exji9jndnwsu1o 1578016 1577973 2026-07-02T14:33:04Z Riccardo Riccioni 452 1578016 wikitext text/x-wiki {{Navbox with columns |name = List of African capitals |title=Miji Mikuu Afrika |state=collapsed |colwidth = 25% |col1 = [[Abuja]], ''Nigeria''<br> [[Accra]], ''Ghana''<br> [[Addis Ababa]], ''Ethiopia''<br> [[Aljeri]], ''Algeria''<br> [[Antananarivo]], ''Madagascar''<br> [[Asmara]], ''Eritrea''<br> [[Bamako]], ''Mali''<br> [[Bangui]], ''Jamhuri ya Afrika ya Kati''<br> [[Banjul]], ''Gambia''<br> [[Bisau]], ''Guinea-Bisau''<br> [[Bloemfontein]], ''Afrika Kusini'' {{Smallsup|1}}<br> [[Brazzaville]], ''Jamhuri ya Kongo''<br> [[Cape Town]], ''Afrika Kusini'' {{Smallsup|2}} <br> [[Conakry]], ''Guinea''<br> [[Dakar]], ''Senegal''<br> [[Dodoma (mji)|Dodoma]], ''Tanzania'' |col2 = [[Freetown]], ''Sierra Leone''<br> [[Gaborone]], ''Botswana''<br> [[Gitega]], ''Burundi''<br> [[Harare]], ''Zimbabwe''<br> [[Hargeisa]], ''Somaliland'' {{Smallsup|4}}<br> [[Jamestown, Saint Helena|Jamestown]], ''Saint Helena''<br> [[Jibuti (mji)|Jibuti]], ''Jibuti''<br> [[Juba, Sudan Kusini|Juba]], ''Sudan Kusini''<br> [[Kairo]], ''Misri''<br> [[Kampala]], ''Uganda''<br> [[Khartoum]], ''Sudan''<br> [[Kigali]], ''Rwanda''<br> [[Kinshasa]], ''Jamhuri ya Kidemokrasia ya Kongo''<br> [[Libreville]], ''Gabon''<br> [[Lilongwe]], ''Malawi'' <br> |col3 = [[Lobamba]], ''Eswatini'' {{Smallsup|2}}<br> [[Lomé]], ''Togo''<br> [[Luanda]], ''Angola''<br> [[Lusaka]], ''Zambia''<br> [[Malabo]], ''Guinea ya Ikweta''<br> [[Momoju]], ''Mayotte''<br> [[Maputo]], ''Msumbiji''<br> [[Maseru]], ''Lesotho''<br> [[Mbabane]], ''Eswatini'' {{Smallsup|3}}<br> [[Mogadishu]], ''Somalia''<br> [[Monrovia]], ''Liberia''<br> [[Moroni, Komori|Moroni]], ''Comoros''<br> [[Nairobi]], ''Kenya''<br> [[N'Djamena]], ''Chad''<br> [[Niamey]], ''Niger''<br> [[Nouakchott]], ''Mauritania'' |col4 = [[Ouagadougou]], ''Burkina Faso''<br> [[Port Louis]], ''Morisi''<br> [[Porto-Novo]], ''Benin''<br> [[Praia]], ''Cape Verde''<br> [[Pretoria]], ''Afrika Kusini'' {{Smallsup|3}}<br> [[Rabat]], ''Moroko''<br> [[Saint-Denis, Réunion|Saint-Denis]], ''Réunion''<br> [[São Tomé]], ''São Tomé na Príncipe''<br> [[Tripoli]], ''Libya''<br> [[Tunis]], ''Tunisia''<br> [[Victoria, Seychelles|Victoria]], ''Shelisheli''<br> [[Windhoek]], ''Namibia''<br> [[Yaoundé]], ''Kamerun''<br> [[Yamoussoukro]], ''Kodivaa'' |below = {{Nowrap|{{smallsup|1}} Judicial. {{Wrap}} {{Smallsup|2}} Parliamentary. {{Wrap}} {{Smallsup|3}} Executive. {{Smallsup|4}} An unrecognised or partially-recognised state. }} }}<noinclude> == See also == {{Continent-based templates}} [[Category:Vigezo vya Afrika|Miji Mikuu]] [[Category:Capital city templates|{{PAGENAME}}]] [[Category:Miji Mikuu Afrika|τ]] </noinclude> b2napyedphy0tv7o60s01gu2on3ykqj 1578041 1578016 2026-07-02T14:44:50Z Riccardo Riccioni 452 1578041 wikitext text/x-wiki {{Navbox with columns |name = List of African capitals |title=Miji Mikuu Afrika |state=collapsed |colwidth = 25% |col1 = [[Abuja]], ''Nigeria''<br> [[Accra]], ''Ghana''<br> [[Addis Ababa]], ''Ethiopia''<br> [[Aljeri]], ''Algeria''<br> [[Antananarivo]], ''Madagascar''<br> [[Asmara]], ''Eritrea''<br> [[Bamako]], ''Mali''<br> [[Bangui]], ''Jamhuri ya Afrika ya Kati''<br> [[Banjul]], ''Gambia''<br> [[Bisau]], ''Guinea-Bisau''<br> [[Bloemfontein]], ''Afrika Kusini'' {{Smallsup|1}}<br> [[Brazzaville]], ''Jamhuri ya Kongo''<br> [[Cape Town]], ''Afrika Kusini'' {{Smallsup|2}} <br> [[Conakry]], ''Guinea''<br> [[Dakar]], ''Senegal''<br> [[Dodoma (mji)|Dodoma]], ''Tanzania'' |col2 = [[Freetown]], ''Sierra Leone''<br> [[Gaborone]], ''Botswana''<br> [[Gitega]], ''Burundi''<br> [[Harare]], ''Zimbabwe''<br> [[Hargeisa]], ''Somaliland'' {{Smallsup|4}}<br> [[Jamestown, Saint Helena|Jamestown]], ''Saint Helena''<br> [[Jibuti (mji)|Jibuti]], ''Jibuti''<br> [[Juba, Sudan Kusini|Juba]], ''Sudan Kusini''<br> [[Kairo]], ''Misri''<br> [[Kampala]], ''Uganda''<br> [[Khartoum]], ''Sudan''<br> [[Kigali]], ''Rwanda''<br> [[Kinshasa]], ''Jamhuri ya Kidemokrasia ya Kongo''<br> [[Libreville]], ''Gabon''<br> [[Lilongwe]], ''Malawi'' <br> |col3 = [[Lobamba]], ''Eswatini'' {{Smallsup|2}}<br> [[Lomé]], ''Togo''<br> [[Luanda]], ''Angola''<br> [[Lusaka]], ''Zambia''<br> [[Malabo]], ''Guinea ya Ikweta''<br> [[Momoju]], ''Mayotte''<br> [[Maputo]], ''Msumbiji''<br> [[Maseru]], ''Lesotho''<br> [[Mbabane]], ''Eswatini'' {{Smallsup|3}}<br> [[Mogadishu]], ''Somalia''<br> [[Monrovia]], ''Liberia''<br> [[Moroni, Komori|Moroni]], ''Comoros''<br> [[Nairobi]], ''Kenya''<br> [[N'Djamena]], ''Chad''<br> [[Niamey]], ''Niger''<br> [[Nouakchott]], ''Mauritania'' |col4 = [[Ouagadougou]], ''Burkina Faso''<br> [[Port Louis]], ''Morisi''<br> [[Porto-Novo]], ''Benin''<br> [[Praia]], ''Cape Verde''<br> [[Pretoria]], ''Afrika Kusini'' {{Smallsup|3}}<br> [[Rabat]], ''Moroko''<br> [[Saint-Denis, Réunion|Saint-Denis]], ''Réunion''<br> [[São Tomé]], ''São Tomé na Príncipe''<br> [[Tripoli]], ''Libya''<br> [[Tunis]], ''Tunisia''<br> [[Victoria, Seychelles|Victoria]], ''Shelisheli''<br> [[Windhoek]], ''Namibia''<br> [[Yaoundé]], ''Kamerun''<br> [[Yamoussoukro (mji)|Yamoussoukro]], ''Kodivaa'' |below = {{Nowrap|{{smallsup|1}} Judicial. {{Wrap}} {{Smallsup|2}} Parliamentary. {{Wrap}} {{Smallsup|3}} Executive. {{Smallsup|4}} An unrecognised or partially-recognised state. }} }}<noinclude> == See also == {{Continent-based templates}} [[Category:Vigezo vya Afrika|Miji Mikuu]] [[Category:Capital city templates|{{PAGENAME}}]] [[Category:Miji Mikuu Afrika|τ]] </noinclude> 0fdmx776gr7l4q85igcjwrncqtjzrjh 1578042 1578041 2026-07-02T14:47:48Z Riccardo Riccioni 452 1578042 wikitext text/x-wiki {{Navbox with columns |name = List of African capitals |title=Miji Mikuu Afrika |state=collapsed |colwidth = 25% |col1 = [[Abuja]], ''Nigeria''<br> [[Accra]], ''Ghana''<br> [[Addis Ababa]], ''Ethiopia''<br> [[Aljeri]], ''Algeria''<br> [[Antananarivo]], ''Madagascar''<br> [[Asmara]], ''Eritrea''<br> [[Bamako]], ''Mali''<br> [[Bangui]], ''Jamhuri ya Afrika ya Kati''<br> [[Banjul]], ''Gambia''<br> [[Bisau]], ''Guinea-Bisau''<br> [[Bloemfontein]], ''Afrika Kusini'' {{Smallsup|1}}<br> [[Brazzaville]], ''Jamhuri ya Kongo''<br> [[Cape Town]], ''Afrika Kusini'' {{Smallsup|2}} <br> [[Conakry]], ''Guinea'' |col2 = [[Dakar]], ''Senegal''<br> [[Dodoma (mji)|Dodoma]], ''Tanzania''<br> [[Freetown]], ''Sierra Leone''<br> [[Gaborone]], ''Botswana''<br> [[Gitega]], ''Burundi''<br> [[Harare]], ''Zimbabwe''<br> [[Hargeisa]], ''Somaliland'' {{Smallsup|4}}<br> [[Jamestown, Saint Helena|Jamestown]], ''Saint Helena''<br> [[Jibuti (mji)|Jibuti]], ''Jibuti''<br> [[Juba, Sudan Kusini|Juba]], ''Sudan Kusini''<br> [[Kairo]], ''Misri''<br> [[Kampala]], ''Uganda''<br> [[Khartoum]], ''Sudan''<br> [[Kigali]], ''Rwanda''<br> [[Kinshasa]], ''Jamhuri ya Kidemokrasia ya Kongo'' |col3 = [[Libreville]], ''Gabon''<br> [[Lilongwe]], ''Malawi'' <br> [[Lobamba]], ''Eswatini'' {{Smallsup|2}}<br> [[Lomé]], ''Togo''<br> [[Luanda]], ''Angola''<br> [[Lusaka]], ''Zambia''<br> [[Malabo]], ''Guinea ya Ikweta''<br> [[Momoju]], ''Mayotte''<br> [[Maputo]], ''Msumbiji''<br> [[Maseru]], ''Lesotho''<br> [[Mbabane]], ''Eswatini'' {{Smallsup|3}}<br> [[Mogadishu]], ''Somalia''<br> [[Monrovia]], ''Liberia''<br> [[Moroni, Komori|Moroni]], ''Comoros''<br> [[Nairobi]], ''Kenya''<br> [[N'Djamena]], ''Chad'' |col4 = [[Niamey]], ''Niger''<br> [[Nouakchott]], ''Mauritania''<br> [[Ouagadougou]], ''Burkina Faso''<br> [[Port Louis]], ''Morisi''<br> [[Porto-Novo]], ''Benin''<br> [[Praia]], ''Cape Verde''<br> [[Pretoria]], ''Afrika Kusini'' {{Smallsup|3}}<br> [[Rabat]], ''Moroko''<br> [[Saint-Denis, Réunion|Saint-Denis]], ''Réunion''<br> [[São Tomé]], ''São Tomé na Príncipe''<br> [[Tripoli, Libya|Tripoli]], ''Libya''<br> [[Tunis]], ''Tunisia''<br> [[Victoria, Seychelles|Victoria]], ''Shelisheli''<br> [[Windhoek]], ''Namibia''<br> [[Yaoundé]], ''Kamerun''<br> [[Yamoussoukro (mji)|Yamoussoukro]], ''Kodivaa'' |below = {{Nowrap|{{smallsup|1}} Judicial. {{Wrap}} {{Smallsup|2}} Parliamentary. {{Wrap}} {{Smallsup|3}} Executive. {{Smallsup|4}} An unrecognised or partially-recognised state. }} }}<noinclude> == See also == {{Continent-based templates}} [[Category:Vigezo vya Afrika|Miji Mikuu]] [[Category:Capital city templates|{{PAGENAME}}]] [[Category:Miji Mikuu Afrika|τ]] </noinclude> 48mg67yjkxirzvjfszwa39dk4o5ubcw 0 64205 1578167 1434307 2026-07-02T23:14:17Z InternetArchiveBot 41439 Add 4 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578167 wikitext text/x-wiki [[Picha:A malnourished child in an MSF treatment tent in Dolo Ado.jpg|thumbnail|right|200px|Mtoto mwenye Utapiamlo]] {{Infobox medical condition | Name = Utapiamlo | Image = Orange ribbon.svg | Caption =<!-- An orange ribbon—the [[awareness ribbon]] for malnutrition.--> | Width = 120 | DiseasesDB = | ICD10 = | ICD9 = 263.9 | ICDO = | OMIM = | MedlinePlus = 000404 | eMedicineSubj = ped | eMedicineTopic = 1360 | MeshID = D044342 }} '''Utapiamlo''' ni hali ambayo hutokana na kupata [[chakula]] ambacho [[virutubishi]] vyake havitoshi au viko vingi hadi kusababisha matatizo upande wa [[afya]].<ref>{{DorlandsDict|five/000062745|malnutrition}}</ref><ref name=FFL2010>{{cite book|first1=UNICEF|title=Facts for life|date=2010|publisher=United Nations Children's Fund|location=New York|isbn=978-92-806-4466-1|pages=61 and 75|edition=4th ed.|url=http://www.unicef.org/nutrition/files/Facts_for_Life_EN_010810.pdf|access-date=2015-10-24|archive-date=2018-12-12|archive-url=https://web.archive.org/web/20181212170249/https://www.unicef.org/nutrition/files/Facts_for_Life_EN_010810.pdf|dead-url=yes|=https://web.archive.org/web/20181212170249/https://www.unicef.org/nutrition/files/Facts_for_Life_EN_010810.pdf}}</ref> Hutumika mara kwa mara kurejelea hasa '''ukosefu wa lishe''' ambapo hakuna kalori, proteni au [[lishe]] vya kutosha; hata hivyo, hujumuisha pia [[kupata lishe kupita kiasi]].<ref name=Young2012>{{cite book|last1=Young|first1=E.M.|title=Food and development|date=2012|publisher=Routledge|location=Abingdon, Oxon|isbn=9781135999414|pages=36–38|url=http://books.google.ca/books?id=XhwKwNzJVjQC&pg=PA36}}</ref><ref name=Jones2011>{{cite book|title=Essentials of International Health|date=2011|publisher=Jones & Bartlett Publishers|isbn=9781449667719|page=194|url=http://books.google.ca/books?id=lt7TqZPZSlIC&pg=PA194}}</ref> ==Chanzo== Kwa njia ya chakula [[mwili]] unapokea [[virutubishi]] vya lazima kama vileː * [[kalori]] * [[protini]] * [[mafuta]] * [[wanga]] ([[kabohidrati]]) * [[vitamini]] na * [[madini]].<ref name=FFL2010/> Uhaba au wingi mkubwa wa vitu hivyo kwa muda fulani unasababisha utapiamlo. Hivyo kuna aina mbili za utapiamlo: kukosa kiwango cha kutosha cha chakula na kukosa uwiano wa virutubishi katika chakula. Utapiamlo * hutokea kama mtu hana chakula cha kutosha, yaani uhaba wa chakula kwa jumla na kuwa na hali ya njaa ya kudumu * hutokea kama mtu anakosa sehemu muhimu za vyakula kwa mfano protini, vitamini au minerali hata kama vinginevyo anakula chakula kingi * hutokea kama mtu anazoea kushiba vyakula bila kujali uwiano wa virutubishi ndani ya chakula. Kukosa lishe ya kutosha hutokana na kukosa chakula kizuri cha kutosha.<ref name=WHO2014/> Hii hutokana na [[bei]] ya juu ya chakula na [[umaskini]].<ref name=FFL2010/><ref name=WHO2014/> Kukosa [[kunyonya]] [[matiti]] mapema kunaweza kuchangia, pia [[maradhi ya kuambukiza]] kama vile: [[homa ya matumbo]], [[nimonia]], [[malaria]] na [[ukambi]] ambao huongeza mahitaji ya lishe.<ref name=WHO2014/> Ikiwa ukosefu wa lishe utatokea wakati wa [[ujauzito]] au kabla ya [[umri]] wa miaka miwili huenda ukasababisha matatizo ya kudumu katika [[ukuaji]] wa mwili au [[akili]].<ref name=FFL2010/> Ukosefu mkali wa lishe, unaojulikana kama [[kukosa chakula]], unaweza kuwa na [[dalili]] ambazo zinajumuisha: [[kimo]] cha chini; [[wembamba]]; viwango vya chini sana vya [[nguvu]]; na [[miguu]] na [[tumbo]] kuvimba.<ref name=FFL2010/><ref name=Young2012/> Watu hawa hugonjeka na kuwa [[hypothermia|baridi]] mara kwa mara.<!-- <ref name=Young2012/> --> Dalili za [[ukosefu wa lishe]] hutegemea lishe ambayo inakosekana.<ref name=Young2012/> ==Aina== Kuna aina mbili kuu za ukosefu wa lishe: ukosefu wa lishe ya protini inayoleta nguvu na ukosefu wa lishe.<ref name=Jones2011/> Ukosefu wa protini inayoleta nguvu ni ya aina mbili: [[nyongea]] (ukosefu wa protini na kalori) na [[unyafuzi]] (ukosefu wa protini tu).<ref name=Young2012/> Ukosefu wa kawaida wa lishe ni pamoja na: [[ukosefu wa ayoni|madini]], [[ukosefu wa aidini|aidini]] na [[ukosefu wa vitamini A |vitamini A]].<ref name=Young2012/> Wakati wa [[ujauzito]], kwa sababu ya hitaji lililoongezeka, ukosefu huo hutokea sana.<ref>{{cite book|last1=Konje|first1=editor, Mala Arora ; co-editor, Justin C.|title=Recurrent pregnancy loss|date=2007|publisher=Jaypee Bros. Medical Publishers|location=New Delhi|isbn=9788184480061|edition=2nd ed.}}</ref> Katika baadhi ya [[nchi zinazoendelea]] lishe kupita [[kiasi]] kwa njia ya [[unene]] imeanza kutokea katika [[jamii]] sawa kama za walio na upungufu wa lishe.<ref>{{cite web|title=Progress For Children: A Report Card On Nutrition|url=http://www.unicef.org/nutrition/files/Progress_for_Children_-_No._4.pdf|publisher=UNICEF|accessdate=2015-10-24|archivedate=2021-01-12|archiveurl=https://web.archive.org/web/20210112154958/https://www.unicef.org/nutrition/files/Progress_for_Children_-_No._4.pdf}}</ref> Sababu nyingine za utapiamlo hujumuisha [[anorexia nervosa]] na [[bariatric surgery]].<ref>{{cite book|last1=Prentice|first1=editor-in-chief, Benjamin Caballero ; editors, Lindsay Allen, Andrew|title=Encyclopedia of human nutrition|date=2005|publisher=Elsevier/Academic Press|location=Amsterdam|isbn=9780080454283|page=68|edition=2nd ed.|url=http://books.google.ca/books?id=DHtERWm0mrcC&pg=RA1-PA68}}</ref><ref>{{cite book|title=Stoelting's anesthesia and co-existing disease|date=2012|publisher=Saunders/Elsevier|location=Philadelphia|isbn=9781455738120|page=324|edition=6th ed.|url=http://books.google.ca/books?id=yxTtmJYPUV0C&pg=PA324}}</ref> Kwa [[wazee]] utapiamlo hutokea zaidi kwa sababu ya mambo ya kimwili, [[saikolojia|kisaikolojia]] na ya kijamii.<ref>{{cite book|last1=editors|first1=Ronnie A. Rosenthal, Michael E. Zenilman, Mark R. Katlic,|title=Principles and practice of geriatric surgery|date=2011|publisher=Springer|location=Berlin|isbn=9781441969996|page=78|edition=2nd ed.|url=http://books.google.ca/books?id=VcgmpMZE6a8C&pg=PA87}}</ref> ==Tiba== [[Juhudi]] za kuboresha [[lishe]] ni kati ya njia nzuri zaidi za [[kusaidia kukua]].<ref name=UK2012/> Kunyonyesha kunaweza kupunguza viwango vya utapiamlo na [[Kifo|vifo]] katika [[watoto]],<ref name=FFL2010/> na juhudi za kukuza [[tabia]] hii hupunguza viwango vya utapiamlo.<ref name=Bh2013/> Katika watoto wadogo kuwapa chakula kwa kuongezea [[maziwa]] ya matiti kati ya miezi sita na miaka miwili huboresha matokeo.<ref name=Bh2013/> Kuna pia ushahidi mzuri unaounga mkono [[virutubishi]] vya lishe kadhaa wakati wa ujauzito na kati ya watoto wadogo katika nchi zinazoendelea.<ref name=Bh2013/> Njia zinazofaa ni kuwapa chakula watu wanachokihitaji sana, kuwasilisha chakula na kutoa [[pesa]] ili watu waweze kununua chakula katika [[soko|masoko]] yao.<ref name=UK2012/><ref>{{cite web|title=World Food Programme, Cash and Vouchers for Food|url=http://documents.wfp.org/stellent/groups/public/documents/communications/wfp246176.pdf|website=WFP.org|accessdate=5 July 2014|date=April 2012}}</ref> Kuwalisha watu [[Shule|shuleni]] tu hakutoshi.<ref name=UK2012/> Kudhibiti utapiamlo mkali mtu akiwa [[nyumba|nyumbani]] kwa kutumia vyakula vya matibabu ambavyo viko tayari kutumiwa]] inawezekana wakati mwingi.<ref name=Bh2013/> Kwa wale ambao wana utapiamlo mkali unosababishwa na matatizo mengine ya afya wanapendekezwa kupata [[matibabu]] [[hospitali|hospitalini]].<ref name=Bh2013/> Mara kwa mara hii uhusisha kudhibiti [[kiwango cha chini cha sukari kwenye damu]], [[halijoto ya mwili]], [[ukosefu wa maji]], na kupata lishe polepole.<ref name=Bh2013/><ref name=WHO2003>{{cite book|first1=World Health Organization. Authors: Ann Ashworth|title=Guidelines for the inpatient treatment of severely malnourished children|url=https://archive.org/details/guidelinesforinp0000unse|date=2003|publisher=World Health Organization|location=Geneva|isbn=9241546093}}</ref> [[Viuavijasumu]] vya mara kwa mara vinapendekezwa kwa sababu ya [[hatari]] ya juu ya maambukizo.<ref name=WHO2003/> Hatua za muda mrefu zinajumuisha: kuboresha [[kilimo]],<ref name=solcultivateplanet>{{cite journal |author=Jonathan A. Foley, Navin Ramankutty, Kate A. Brauman, Emily S. Cassidy, James S. Gerber, Matt Johnston, Nathaniel D. Mueller, Christine O’Connell, Deepak K. Ray, Paul C. West, Christian Balzer, Elena M. Bennett, Stephen R. Carpenter, Jason Hill1, Chad Monfreda, Stephen Polasky1, Johan Rockström, John Sheehan, Stefan Siebert, David Tilman1, David P. M. Zaks |title=Solutions for a cultivated planet |journal=Nature |volume=478 |issue=7369 |pages=337–342 |date=October 2011|pmid=21993620|url=http://www.nature.com/nature/journal/v478/n7369/full/nature10452.html |doi=10.1038/nature10452}}</ref> kupunguza [[ufukara]], kuondoa [[uchafu]] katika [[mazingira]], na kuwawezesha [[wanawake]].<ref name=UK2012/> ==Uenezi== Kulikuwa na watu [[milioni]] 925 waliokuwa na utapiamlo [[duniani]] katika mwaka wa [[2010]], ongezeko la milioni 80 tangu [[1990]].<ref name=FAO2010>{{cite web|title=Kiwango cha njaa duniani kinapungua, lakini malengo ya juu sana ya njaa kimataifa ni ngumu kuyafikia |url=http://www.fao.org/docrep/012/al390e/al390e00.pdf|website=Food and Agriculture Organization of the United Nations|accessdate=1 July 2014|date=September 2010}}</ref><ref name=Fao2008>{{cite book|last1=Food|last2=(FAO)|first2=Agriculture Organization of the United Nations|title=The state of food insecurity in the world, 2008 : high food prices and food security : threats and opportunities|date=2008|publisher=Food and Agriculture Organization of the United Nations (FAO)|location=Rome|isbn=978-92-5-106049-0|page=2|url=http://www.fao.org/docrep/011/i0291e/i0291e00.htm|quote=Makadirio ya FAO ya hivi karibuni yanaweka idadi ya watu wenye njaa [hawa, wenye utapiamlo] kuwa milioni 923 katika mwaka wa 2007, ongezeko la zaidi ya watu milioni 80 tangu kipindi cha 1990–92.}}</ref> Watu wengine [[bilioni]] moja wanakadiriwa kukosa vitamini na madini.<ref name=UK2012>{{cite web|title=An update of ‘The Neglected Crisis of Undernutrition: Evidence for Action’|url=https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/67319/undernutrition-finalevidence-oct12.pdf|website=www.gov.uk|publisher=Department for International Development|accessdate=5 July 2014|date=Oct 2012}}</ref> Katika mwaka wa 2010 [[utapiamlo wa protini inayoleta nguvu]] ulikadiriwa kusababisha vifo 600,000, vilivyo chini kutoka vifo 883,000 katika mwaka wa 1990.<ref name=Loz2012/> Ukosefu mwingine wa lishe, ambao unaweza kujumuisha [[ukosefu wa aidini]] na [[anemia kutokana na ukosefu wa madini]], ulisababisha vifo vingine 84,000.<ref name=Loz2012>{{cite journal |author=Lozano R, Naghavi M, Foreman K, et al. |title=Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 |journal=Lancet |volume=380 |issue=9859 |pages=2095–128 |date=December 2012 |pmid=23245604 |doi=10.1016/S0140-6736(12)61728-0 |url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2095}}</ref> Ukosefu wa lishe hadi mwaka wa 2010 ulikuwa sababu ya 1.4% ya miaka ya maisha iliyobadilika kwa sababu ya [[ulemavu]].<ref name=UK2012/><ref name=Murray2012>{{cite journal|last1=Murray|first1=CJ|title=Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.|url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2197|journal=Lancet|date=Dec 15, 2012|volume=380|issue=9859|pages=2197–223|pmid=23245608|doi=10.1016/S0140-6736(12)61689-4}}</ref> Takriban [[theluthi]] moja ya vifo katika watoto huaminika kutokana na utapiamlo; hata hivyo, vifo havisemekani kutokana na hiyo.<ref name=WHO2014>{{cite web|title=Maternal, newborn, child and adolescent health|url=http://www.who.int/maternal_child_adolescent/topics/child/malnutrition/en/|website=WHO|accessdate=4 July 2014}}</ref> Katika mwaka wa 2010 ilikadiriwa kwamba ilichangia takriban vifo milioni 1.5 katika wanawake na watoto,<ref name=Lim2012>{{cite journal |author=Lim SS, Vos T, Flaxman AD, et al. |title=A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010 |journal=Lancet |volume=380 |issue=9859 |pages=2224–60 |date=December 2012 |pmid=23245609 |doi=10.1016/S0140-6736(12)61766-8 |url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2224}}</ref> ijapokuwa baadhi ya [[kadirio|makadirio]] ya [[idadi]] hiyo huenda yanatakiwa kuwa zaidi ya milioni 3.<ref name="Bh2013"/> Watoto wengine milioni 165&nbsp; [[wana matatizo ya kukua]] kutokana na [[ugonjwa]] huu.<ref name=Bh2013>{{cite journal|last1=Bhutta|first1=ZA|last2=Das|first2=JK|last3=Rizvi|first3=A|last4=Gaffey|first4=MF|last5=Walker|first5=N|last6=Horton|first6=S|last7=Webb|first7=P|last8=Lartey|first8=A|last9=Black|first9=RE|last10=Lancet Nutrition Interventions Review|first10=Group|last11=Maternal and Child Nutrition Study|first11=Group|title=Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?|url=https://archive.org/details/sim_the-lancet_august-3-9-2013_382_9890/page/452|journal=Lancet|date=Aug 3, 2013|volume=382|issue=9890|pages=452–77|pmid=23746776|doi=10.1016/s0140-6736(13)60996-4}}</ref> Ukosefu wa lishe ni wa kawaida sana katika [[nchi zinazoendelea]].<ref>{{cite book|author1=Liz Young|title=World Hunger Routledge Introductions to Development|date=2002|isbn=9781134774944|page=20|url=http://books.google.ca/books?id=w4CGAgAAQBAJ&pg=PA20}}</ref> Takwimu zaonyesha kwamba Afrika ni mojawapo ya bara ambazo watoto wachanga wako na shida ya kurefuka pamoja na kuwanda kupindukia kwa sababu ya utapiamlo. Kulingana na [https://www.globalnutritionreport.org/files/2017/11/Report_2017.pdf Global Nutrition report] {{Wayback|url=https://www.globalnutritionreport.org/files/2017/11/Report_2017.pdf |date=20180123204113 }}, bara la Afrika lakumbana na shida nyingi za lishe. Licha ya shida ya kutorefuka kupiganwa nayo, watoto millioni sitini wa bara hili hawakui vizuri. Lishe anayopata mtu hutegemea na umri wake kwa sababu watoto wachanga hawawezi kula chakula kinacholiwa na wazee. ==Tanbihi== <references /> ==Viungo vya nje== * https://www.globalnutritionreport.org/files/2017/11/Report_2017.pdf {{Wayback|url=https://www.globalnutritionreport.org/files/2017/11/Report_2017.pdf |date=20180123204113 }} * https://qz.com/1121083/africas-malnutrition-problem-for-chi-is-the-only-continent-where-children-are-growing-both-stunted-and-fat/ {{Wayback|url=https://qz.com/1121083/africas-malnutrition-problem-for-chi-is-the-only-continent-where-children-are-growing-both-stunted-and-fat/ |date=20171120023833 }} {{mbegu-tiba}} [[Jamii:Magonjwa]] [[Jamii:Chakula]] 9me8ai0yvp6zsl7r840v23w4x4tizv1 0 64664 1578161 1465838 2026-07-02T22:49:12Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578161 wikitext text/x-wiki {{Infobox Disease | Name = Croup | Image =Croup steeple sign.jpg | Caption = The [[steeple sign]] as seen on an AP neck X-ray of a child with croup | DiseasesDB = 13233 | ICD10 = {{ICD10|J|05|0|j|00}} | ICD9 = {{ICD9|464.4}} | ICDO = | OMIM = | MedlinePlus = 000959 | eMedicineSubj = ped | eMedicineTopic = 510 | eMedicine_mult = {{eMedicine2|emerg|370}}{{eMedicine2|radio|199}} | MeshID = D003440 }} '''Kifaduro''' (au '''laringotrakeobronkitisi''') ni hali ya upumuaji ambao husababishwa na maambukizi ya virusi kwa njia ya juu ya hewa. Maambukizi husababisha uvimbe ndani ya koo, ambao huharibu upumuaji wa kawaida na kuleta dalili za hali ya juu ya [[kikohozi]] cha ''kubweka'', [[strida]], na [[sauti iliyokauka]]. Inaweza kuleta dalili chache, kiasi, au kali zinazozidi zaidi usiku. Mara nyingi hutibiwa kwa dozi moja ya [[steroidi]] za kunywa; wakati mwingine [[epinephrini]] hutumika zaidi kwa visa kali. Ni nadra kulazwa hospitalini. Kifaduro hutambuliwa kwa kliniki, visababishi kali zaidi vya dalili vinapotengwa (yaani [[epiglotitisi]] au [[kitu kigeni katika njia ya hewa]]). Uchunguzi zaidi—kama vile vipimo vya damu, [[eksirei]], na ukuzaji vimelea kwa kawaida huwa hahitajiki. Ni hali ya kawaida inayoathiri kiasi takriban asilimia 15 ya watoto kwa wakati fulani, kwa kawaida kati ya miezi 6 na miaka 5–6 ya umri. Huwa ni vigumu kupata kwa vijana na watu wazima. Wakati mwingine kwa sababu ya [[dondakoo]], kisababishi hiki sasa ni cha umuhimu wa kihistoria katika Mataifa ya mashariki kwa sababu ya ufanisi wa [[chanjo]], na kuboreshwa kwa usafi na viwango vya maisha. ==Ishara na dalili== {{listen | filename = Stridor 2OGG.ogg | title = Stridor | description = Inspiratory and expiratory stridor in a 13 month child with croup. | format = [[Ogg]] }} Kifaduro huwa na sifa ya [[kikohozi]] cha 'kubweka'', [[strida]], [[sauti iliyokauka]], na [[Upungufu wa pumzi|ugumu wa kupumua]] ambao kwa kawaida huwa mbaya zaidi usiku.<ref name=Au10>{{cite journal | author = Rajapaksa S, Starr M | title = Croup – assessment and management | journal = Aust Fam Physician | volume = 39 | issue = 5 |pages = 280–2 | year = 2010 | month = May | pmid = 20485713 | doi = }}</ref> Kikohozi cha "kubweka" kwa kawaida huelezwa kuwa kinafanana na mlio wa [[Pinniped|seal]] au [[simba wa baharini]].<ref name="Cherry08_NEJM"/> Strida huzidishwa na kufadhaika au [[kulia]], na iwapo unaweza kusikika wakati wa kupumzika, unaweza kuashiria uwembamba hatari kwa njia za hewa. Kifaduro inapokuwa zidi, strida inaweza kupungua sana.<ref name=Au10/> Dalili zingine ni pamoja na [[joto jingi mwilini]], [[mafua]] (dalili za aina ya [[homa]]), na kuingia ndani kwa [[ukuta wa kifua]].<ref name=Au10/><ref name=Alberta07>{{cite web |url=http://www.childhealthbc.ca/resources/category/5-croup?download=13%3Acroup-guideline|format=PDF|title=Diagnosis and Management of Croup |work=BC Children’s Hospital Division of Pediatric Emergency Medicine Clinical Practice Guidelines |accessdate=}}</ref> [[Kudhoofika]] au kuonekana mgonjwa sana huashiria hali zingine za matibabu.<ref name=Alberta07/> ==Visababishi== Kifaduro huchukuliwa kuwa kinasababishwa na maambukizi ya virusi.<ref name=Au10/><ref name=PedN09/> Wengine hutumia jina hili kwa upana zaidi, kujumuisha [[laringotrakeobronkitisi]] kali, kifaduro cha spazimu, dondakoo ya zoloto, [[trakeitisi ya virusi]], laringotrakeobronkitisi, na laringotrakeobronkoniumonitisi. Hali za kwanza mbili huhusisha maambukizi ya virusi na kwa kawaida huwa ndogo kwa kuzingatia simptomatolojia; nne za mwisho husababishwa na maambukizi ya bakteria na kwa kawaida huwa kali zaidi.<ref name="Cherry08_NEJM"/> ===Virusi=== Kifaduro cha virusi au laringotrakeitisi kali husababishwa na [[virusi vya parainfluenza]], hasa aina 1 na 2, katika asilimia 75 ya visa.<ref name=Croup09/> Etiolojia zingine za virusi ni pamoja na [[influenza]] A na B, [[ukambi]], [[virusi vya adeno]] na [[virusi vya sinksia ya kupumua]] (RSV).<ref name="Cherry08_NEJM"/> Kifaduro cha spazimu husababishwa na aina sawa ya kikundi cha virusi kama laringotreikitisi kali, lakini haina dalili za maambukizi (kama vile joto jingi mwilini, vidonda vya koo,na ongezeko la [[seli nyeupe za damu]]).<ref name="Cherry08_NEJM"/> Matibabu na matokeo ya matibabu pia huwa sawa.<ref name=Croup09/> ===Bakteria=== Kifaduro cha bakteria kinaweza kugawanywa kuwa dondakoo la zoloto, trakeitisi ya bakteria, laringotrakeobronkitisi, na laringotracheobronkoniumonitisi.<ref name="Cherry08_NEJM"/> Dondakoo la zoloto husababishwa na ''[[Corynebacterium diphtheriae]]'' ilhali trakeitisi ya bakteria, laringotrakeobronkoniumonitisi kwa kawaida husababishwa na maambukizi ya virusi vilivyo na uvimbe wa baadaye wa bakteria. Bakteria ya kawaida inayohusishwa ni ''[[Stafilokasi aureus]]'', ''[[Streptokokasi niumoniae]]'', ''[[Hemophilasi influenzae]]'', na ''[[Moraxella catarrhalis]]''.<ref name="Cherry08_NEJM"/> ==Pathofisiolojia== Maambukizi ya virusi yanayosababisha dondakoo husababisha kuvimba kwa [[larinksi]], [[Trakea yenye uti wa mgongo|trakea]], na [[bronki]] iliyo kubwa<ref name=PedN09/> kwa sababu ya kupenya kwa [[seli nyeupe za damu]] (hasa [[histiositi]], [[limfositi]], [[seli za plazma]], na [[nutrofilisi]]).<ref name="Cherry08_NEJM"/> Uvimbe husababisha kufungana kwa njia ya hewa ambapo, kunapoongezeka, husababisha ongezeko la tatizo la kupumua na upitaji wa hewa ulio na sifa ya kelele huitwao strida.<ref name=PedN09/> ==Utambuzi== {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |+ '''The Westley Score:Classification of croup severity'''<ref name=Croup09/><ref name=Peds99/> |- ! rowspan="2" |Feature ! colspan="6" |Number of points assigned for this feature |- !0 !1 !2 !3 !4 !5 |- | Chest wall<br /> retraction | style="width:80px;"|None | style="width:80px;"|Mild | style="width:80px;"|Moderate | style="width:80px;"|Severe | style="width:80px;"| | style="width:80px;"| |- | [[Strida]] | None | With<br /> agitation | At rest | | | |- | [[Sinosisi]] | None | | | | With<br /> agitation | At rest |- | [[Kiwango cha ufahamu|Kiwango cha<br />ufahamu]] | Normal | | | | | Disoriented |- | Air entry | Normal | Decreased | Markedly decreased | | | |} Kifaduro ni utambuzi wa kliniki.<ref name=PedN09/> Njia ya kwanza ni kuwacha hali za vizuizi vingine kwa njia ya hewa iliyo juu, hasa [[epiglotitisi]], njia ya hewa [[kifaa kigeni]], [[stenosisi ya subglottic]], [[anjioedema]], [[jipu lililo nyuma ya farinksi]], na [[trakeitisi ya bacteria]].<ref name="Cherry08_NEJM"/><ref name=PedN09/> [[Eksirei]] ya upande wa mbele wa shingo haifanywi mara kwa mara,<ref name=PedN09/> ingawa itakapofanywa, inaweza kuonyesha jinsi trakea inavyokuwa nyembamba, iitwayo [[dalili ya steeple]], kwa sababu ya stenosisi ya subglottic, iliyo sawa na [[(muundo wa) Steeple umbo wa|steeple]]. Dalili ya steeple inashauriwa kufanyiwa utambuzi, lakini hukosekana katika nusu ya kila hali.<ref name=Alberta07/> Uchunguzi mwingine (kama vile [[upimaji wa damu]] na [[ukuzaji wa virusi]]) hazipendekezwi, kwa kuwa zinaweza kusababisha mfadhaiko usiofaa na hivyo kuongeza matatizo zaidi kwa njia ya hewa.<ref name=PedN09/> Wakati ukuzaji wa virusi uliopatikana kupitia [[pua na farinksi]] aspiresheni, inaweza kutumika kutambua kisababishi kikuu, kawaida hayajakubalishwa kwa mbinu za utafiti.<ref name=Au10/> Maambukizi ya bakteria yanapaswa kuangaziwa ikiwa matibabu ya kawaida hayatafaulu, ambapo kiwango cha uchunguzi zaidi unaweza kuonekana.<ref name="Cherry08_NEJM"/> ;Ukali Mfumo unaotumika zaidi kwa kuainisha ukali wa kifaduro ni Westley score. Inatumika hasa kwa matumizi ya utafiti badala ya mazoezi ya kliniki.<ref name="Cherry08_NEJM">{{cite journal | author = Cherry JD |title = Clinical practice. Kifaduro | url = https://archive.org/details/sim_new-england-journal-of-medicine_2008-01-24_358_4/page/384 | journal = N. Engl. J. Med. | volume = 358 | issue = 4 | pages = 384–91 | year = 2008| pmid = 18216359 | doi = 10.1056/NEJMcp072022 }}</ref> Ni ujumla ya vidokezo vilivyotolewa kwa mambo matano: kiwango cha ufahamu, sainosisi, strida, kuingia, na kurudi kwa kwa hewa.<ref name="Cherry08_NEJM"/> Vidokezo vya kila jambo vimetajwa kwa kila jedwali lililokulia, na alama ya mwisho iko katika kiwango cha 0 hadi 17.<ref name=Peds99/> * Rekodi ya ≤&nbsp;2 kwa ujumla inaonyesha kifaduro''isiyo kali''. Kukohoa ulio na sauti wa kubweka na uliokauka unaweza kujitokeza, lakini hakuna strida wakati wa kupumzika.<ref name=Croup09/> * Rekodi ya 3–5 kwa ujumla inaainishwa kama kifaduro''isiyo kali''. Hujitokeza na strida iliyosikika kwa urahisi, ingawa na dalili zingine kiasi.<ref name=Croup09/> * Rekodi ya 6–11 kwa ujumla ni kifaduro ''iliyo kali''. Hujitokeza na strida ya kawaida, lakini pia inaonyesha alama ya [[kuta ya kifua]] inapovutwa ndani.<ref name=Croup09/> * Rekodi ya ≥&nbsp;12 kwa ujumla inaonyesha kukaribia kwa [[kushindwa kupumua]]. Kukohoa kwa sauti ya kubweka na strida inaweza kuwa sio maarufu katika kiwango hiki.<ref name=Croup09/> Asilimia 85 ya watoto walio katika idara ya dharura wana ugonjwa usio mkali; kifaduro iliyo kali ni nadra (asilimia<1).<ref name=Croup09/> ==Uzuiaji== Hali nyingi za kifaduro zimezuiwa kwa [[chanjo]] ya [[influenza]] na [[dondakoo]]. Wakati moja, kifaduro inajulikana kama ugonjwa wa dondakoo, lakini na chanjo, sasa dondakoo ni nadra katika nchi zilizostawi.<ref name="Cherry08_NEJM"/> ==Matibabu== Watoto walio na kifaduro kwa ujumla huwekwa katika hali ya utulivu inavyowezekana.<ref name=PedN09/> Kawaida steroidi hutolewa, na epinefrini hutumika katika hali kali.<ref name=PedN09/> Watoto walio na [[uloweshaji wa oksijeni]] chini ya asilimia 92 wanapaswa kupata oksijeni,<ref name="Cherry08_NEJM"/> na walio na kifaduro mkali wanaweza kulazwa kwa utathmini.<ref name=Alberta07/> Iwapo oksijeni inahitajika, utoaji wa "kupitisha hewa" (kushikilia chanzo cha kutoa oksijeni kwa uso wa mtoto) inahitajika, kwa sababu inasababisha msukosuko ulio chini kuliko matumizi ya [[barakoa ya oksijeni|barakoa]].<ref name="Cherry08_NEJM"/> Kwa matibabu, chini ya asilimia 0.2 ya watu huhitaji [[upishaji neli kooni]].<ref name=Peds99>{{cite journal | author = Klassen TP |title = Croup. A current perspective | url = https://archive.org/details/sim_pediatric-clinics-of-north-america_1999-12_46_6/page/1167 | journal = Pediatr. Clin. North Am. | volume = 46 | issue = 6 | pages = 1167–78 |year = 1999 | month = December | pmid = 10629679 | doi = 10.1016/S0031-3955(05)70180-2 }}</ref> ===Steroidi=== [[Kotikosteroidi]], kama vile [[deksamethasoni]] na [[budesonidi]], zimebainishwa kuwa zinaimarisha matokeo ya matibabu ya kifaduro zote kali kwa watoto.<ref name=Cochrane11>{{cite journal | author = Russell KF, Liang Y, O'Gorman K, Johnson DW, Klassen TP | title = Glucocorticoids for croup | journal = Cochrane Database Syst Rev | volume = 1 | issue = 1 | pages = CD001955 | year = 2011 | pmid = 21249651 | doi = 10.1002/14651858.CD001955.pub3 }}</ref> Mgonjwa hutulia pakubwa kwa kipindi cha saa sita baada ya kupewa dawa hizi.<ref name=Cochrane11/> Huku dawa hizi zikiaminiwa kuwa bora zinapotumika kupitia kinywani, [[nje ya njia ya chakula]], au kwa kuvutwa, njia ya kinywani hupendekezwa.<ref name=PedN09/> Kipimo kimoja tu cha dawa ndicho kinachohitajika, na huaminiwa kuwa salama.<ref name=PedN09/> Kipimo cha miligramu/kilogramu 0.15, 0.3 na 0.6 cha deksamethasoni &nbsp; umebainishwa kuwa bora.<ref>{{cite journal | author = Port C | title = Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4. Dose of dexamethasone in croup |journal = Emerg Med J | volume = 26 | issue = 4 | pages = 291–2 | year = 2009 | month = April | pmid = 19307398 | doi = 10.1136/emj.2009.072090 }}</ref> ===Epinefrini=== Hali ya kifaduro cha kiwango wastani hadi kiwango kali inaweza kutulizwa kwa muda tu kwa kutumia [[kinebulishi|epinefrini]] [[ya kupulizwa]].<ref name=PedN09>{{cite journal | author = Everard ML | title = Acute bronchiolitis and croup | url = https://archive.org/details/sim_pediatric-clinics-of-north-america_2009-02_56_1/page/119 | journal = Pediatr. J. CL. North Am. | volume = 56 | issue = 1 | pages = 119–33, x–xi | year = 2009 | month = February | pmid = 19135584 | doi = 10.1016/j.pcl.2008.10.007 }}</ref> Huku epinefrini ikituliza ukali wa kifaduro kwa muda wa dakika 10–30, manufaa yake hudumu kwa takriban saa 2 tu.<ref name=Au10/><ref name=PedN09/> Ikiwa hali hii itatulia kwa muda wa saa 2–4&nbsp; baada ya matibabu huku ikiwa hakuna mzuko wa matatizo yoyote, mtoto huachiliwa hospitalini.<ref name=Au10/><ref name=PedN09/> ===Matibabu mengine=== Huku matibabu mengine ya kifaduro yakiwa yametafitiwa, hakuna yoyote yaliyo na dhihirisho ya kutosha ili yatumike. Kuvuta mvuke au hewa yenye maji ni njia ya kitamaduni ya [[kujitibu]], lakini utafiti wa kimatibabu haujatibithisha ubora wake<ref name="Cherry08_NEJM"/><ref name=PedN09/> ni nadra kwa sasa.<ref name=Hist2001>{{cite journal | author = Marchessault V | title = Historical review of croup | journal = Can J Infect Dis | volume = 12 |issue = 6 | pages = 337–9 | year = 2001 | month = November | pmid = 18159359 | pmc = 2094841 | doi = }}</ref> Matumizi ya [[dawa za kikohozi]], ambazo kwa kawaida zina [[dextromethorphan]] na/au [[guiafenesin]], pia inakataliwa.<ref name=Au10/> Huku vutaji wa [[heliox]] (mchanganyiko wa [[heliamu]] na [[oksijeni]]) ili kupunguza utendakazi wa upumuaji ulitumika mbeleni, lakini hakuna tibitisho la kutosha kupendekeza matumizi yake.<ref>{{cite journal | author = Vorwerk C, Coats T | title = Heliox for croup in children | journal = Cochrane Database Syst Rev | volume = 2 | issue = 2 | pages = CD006822 | year = 2010 | pmid = 20166089 | doi = 10.1002/14651858.CD006822.pub2 }}</ref> Kwa sababu kifaduro ni ugonjwa unaoambukizwa na virusi, [[antibiotiki]] haitumiki japo tu maambukizi ya pili ya bakteri yanaposhukiwa. <ref name=Au10/> Kwa visa ambavyo vina maambukizi ya pili ya bakteria, antibiotiki aina ya [[vancomycin]] na [[cefotaxime]] inapendekezwa.<ref name="Cherry08_NEJM"/> kwa visa vikali vinavyohusisha influenza&nbsp;A au B, [[dawa dhidi ya virusi aina ya|dhidi ya virusi]][[vizuio vya niuraminidesi]] inaweza kutumika.<ref name="Cherry08_NEJM"/> ==Prognosisi== Kwa kawaida kifaduro inayosababishwa na virusi [[ni ugonjwa unaopotea kivyake (kibayolojia)|unaopotea kivyake]], lakini ni nadra isababishe kifo kufuatia [[kushindwa kupumua]] na/au [[mshtuko wa moyo]].<ref name=Au10/> Dalili za hali hii hupotea kwa kipindi cha siku &nbsp;mbili, laikini zinaweza kudumu kwa hadi siku&nbsp;saba.<ref name=Croup09/> Matatizo mengine ambayo ni nadra kutokea ni pamoja na uvimbe wa bomba la pumzi, [[nimonia]], na [[uvimbe wa mapafu]].<ref name=Croup09>{{cite journal | author = Johnson D | title = Croup | journal = Clin Evid (Online) | volume = 2009 | issue = | pages = | year = 2009 | pmid = 19445760 | pmc = 2907784 | doi = }}</ref> ==Epidemiolojia== Kifaduro huathiri takriban asilimia 15 ya watoto, na hutokea katika umri kati ya miezi 6 na miaka 5-6.<ref name="Cherry08_NEJM"/><ref name=PedN09/> hali hii huchukua asilimia 5 ya takwimu za wagonjwa wote wa umri huu wanaolazwa hospitalini.<ref name=Croup09/> Kwa visa nadra hali hii inaweza kutokea kwa wototo wachanga kama umri wa miezi 3 na kwa wototo wakubwa hadi umri wa miaka 15.<ref name=Croup09/> Watoto wa kiume huathirwa kwa zaidi ya asilimia 50 mara kwa mara kuliko wa kike, na kuna ongezeko la [[maenezi]] ya hali hii katika majira ya kupukutika kwa majani.<ref name="Cherry08_NEJM"/> ==Historia== Neno ''kifaduro'' hutokea kwa [[lugha ya zamani ya Kingereza]] kitenzi ''kifaduro'', kumaanisha "kulia kwa sauti iliyokauka"; jina hili lilitumika kwa ugonjwa huu kwa mara ya kwanza nchini Scotland kisha kuenezwa katika karne ya 18.<ref>Online Etymological Dictionary,[http://www.etymonline.com/index.php?term=croupcroup] {{Wayback|url=http://www.etymonline.com/index.php?term=croupcroup |date=20160304230915 }}. Accessed 2010-09-13.</ref> Kifaduro inayohusisha dondakoo kimejulikana tangu enzi za [[Homer]] [[Kale za Ugiriki]] na hadi 1826 ambapo kifaduro ya virusi ilitafautishwa kutoka kifaduro kwa sababu ya [[dondakoo]] na Bretonneau.<ref name=history>{{cite book |author=Feigin, Ralph D. |title=Textbook of pediatric infectious diseases |url=https://archive.org/details/textbookofpediat0001unse_c7n0 |publisher=Saunders |location=Philadelphia |year=2004 |page=[https://archive.org/details/textbookofpediat0001unse_c7n0/page/252 252] |isbn=0-7216-9329-6|oclc= |doi= |accessdate=}}</ref> Kuanzia hapo kifaduro ya virusi ikaitwa "kifaduro ya kijamba" na Mfaransa, na kisha "kifaduro" ikajulikana kama ugonjwa unaosababishwa na bakteria ya dondakoo.<ref name=Hist2001/> Kifaduro inayosababishwa na dondakoo inakaribia kusahaulika kufuatia kuzinduliwa kwa [[chanjo]] bora.<ref name=history/> ==Marejeo== {{Reflist|2}} [[Jamii:Magonjwa]] 7vm2ydodu7xpr556e6dc1mk5nlpyld2 0 65095 1578242 1138890 2026-07-03T09:20:30Z Riccardo Riccioni 452 1578242 wikitext text/x-wiki '''Apokrifa''' (kutoka neno la [[Kigiriki]] ἀπόκρυφος, ''apókruphos'', yaani "iliyofichika") ni [[jina]] linalotumika katika [[Ukristo]] kuanzia [[karne ya 5]] kutajia [[vitabu]] ambavyo [[madhehebu]] husika [[Kanuni ya Biblia|hayavikubali]] katika [[Biblia]]. Hivyo vitabu vilevile vinaweza kuwa [[Neno la Mungu|vitakatifu]] kwa madhehebu kadhaa ila si kwa mengine. Lakini kuna vitabu vingine ambavyo vinatazamwa na Wakristo wote kuwa ni apokrifa, kwa mfano "[[Maisha ya Adamu na Eva]]". Maelezo ya undani zaidi yanapatikana katika makala [[Deuterokanoni]] kuhusu vitabu maarufu vinavyokubaliwa na [[Kanisa Katoliki]] na wengineo kama [[Neno la Mungu]], lakini si na [[Waprotestanti]] wengi. ==Marejeo== '''Vitabu vyenyewe''' * [[Robert Holmes (mwanabiblial)|Robert Holmes]] and [[James Parsons (mwanabiblia)|James Parsons]], ''Vet. Test. Graecum cum var. lectionibus'' (Oxford, 1798–1827) * [[Henry Barclay Swete]], ''Old Testament in Greek'', i.-iii. (Cambridge, 1887–1894) * [[Otto Fridolinus Fritzsche]], ''Libri Apocryphi V. T. Graece'' (1871). '''Ufafanuzi''' * O. F. Fritzsche and Grimm, ''Kurzgef. exeget. Handbuch zu den Apok. des A.T''. (Leipzig, 1851–1860) * [[Edwin Cone Bissell]], ''Apocrypha of the Old Testament'' (Edinburgh, 1880) * [[Otto Zöckler]], ''Die Apokryphen des Alten Testaments'' (Munchen, 1891) * [[Henry Wace (kasisi)|Henry Wace]], ''The Apocrypha'' ("Speaker's Commentary") (1888) '''Utangulizi''' * [[Emil Schürer]], ''Geschichte des jüdischen Volkes'', vol. iii. 135 sqq., and his article on "Apokryphen" in Herzog's ''Realencykl''. i. 622-653 * {{cite encyclopedia |last=Porter|first=Frank C.|author=|authorlink=|coauthors= |editor=[[James Hastings]] |encyclopedia=[[Hastings' Dictionary of the Bible|A Dictionary of the Bible]] |title=Apocrypha|url=http://www.ccel.org/ccel/hastings/dictv1/Page_110.html |accessdate= |edition= |year= 1898|month= |publisher= |volume=I |location= |id= |isbn= |doi= |pages=pages 110–123 |quote= }} ==Viungo vya nje== *[http://www.newadvent.org/cathen/01601a.htm "Apocrypha" in the Catholic Encyclopaedia at newadvent.org/cathen] *[http://orthodoxanglican.net/downloads/apocrypha.pdf "The Apocrypha, Bridge of the Testaments" by Robert C. Dentan at orthodoxanglican.net] {{Wayback|url=http://orthodoxanglican.net/downloads/apocrypha.pdf |date=20090205074449 }} *[https://web.archive.org/web/20041116051334/http://www.lcms.org/ca/www/cyclopedia/02/display.asp?t1=a&word=APOCRYPHA "Lutheran Cyclopedia: Apocrypha" at lcms.org] {{mbegu-Biblia}} [[Jamii:Biblia]] [[Jamii:Teolojia]] [[jamii:Apokrifa| ]] i67f7c19ph1d9owjh8jjsi92j1h3eyd 0 65291 1578073 1529135 2026-07-02T18:12:35Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578073 wikitext text/x-wiki [[File:Sra. Charo and the Qewar dollmakers.jpg|250px|Thumb|right|[[Wanawake]] wa [[kabila]] la [[Quechua]] katika [[wilaya]] ya [[Andahuaylillas]], [[Peru]], [[2007]].]] '''Waindio''' au '''Wahindi wekundu''' ni watu wanaotokana moja kwa moja na waliokuwa wenyeji wa [[Amerika]] kabla ya [[bara]] hilo kufikiwa na [[Christopher Columbus]] kutoka [[Ulaya]] ([[1492]]). ==Asili== [[File:Spreading homo sapiens la.svg|thumb|250px|[[Ramani]] ya [[uenezi]] wa binadamu [[dunia]]ni<ref>Göran Burenhult: Die ersten Menschen, Weltbild Verlag, 2000. ISBN 3-8289-0741-5</ref>]] [[Utafiti]] uliofanywa kwa muda mrefu na kwa njia mbalimbali umekadiria kwamba ma[[babu]] wao walioenea katika Amerika yote wakitokea [[Asia]] kaskazini mashariki miaka [[14,500 BK]]. Inadhaniwa kwamba hao mababu waliishi muda mrefu na kuzaliana bila [[mawasiliano]] na [[binadamu]] wengine, labda katika eneo ambalo leo limefunikwa na [[maji]] kwenye [[mlangobahari wa Bering]]. Inakadiriwa [[DNA]] yao ilitokana na ile ya Waasia mashariki (2/3) na Waeurasia (1/3). Baada ya kuingia bara hilo, ambalo ni la mwisho kukaliwa na watu (tukiacha [[Antaktiki]]), kwa [[karne]] chache walienea hadi kusini kabisa, kwenye [[Chile]] na [[Argentina]] ya leo. Katika kusambaa kwao, [[lugha]] na [[utamaduni]] vilizidi kutofautiana. ==Hali ya sasa== Idadi yao inaweza kuwa [[milioni]] 60, wengi wao wakiishi [[Meksiko]], [[Peru]], [[Bolivia]] na [[Guatemala]]. [[Hesabu]] hii haijumlishi ma[[chotara]]. ==Tanbihi== {{marejeo}} ==Vyanzo== *{{cite journal | last1 = Gaskins | first1 = S. | year = 1999 | title = Children's daily lives in a Mayan village: A case study of culturally constructed roles and activities | url = | journal = Children's engagement in the world: Sociocultural perspectives | volume = | issue = | pages = 25–61 }} *{{cite journal | last1 = Nimmo | first1 = J. | year = 2008 | title = Young children's access to real life: An examination of the growing boundaries between children in child care and adults in the community | url = | journal = Contemporary Issues in Early Childhood | volume = 9 | issue = 1| pages = 3–13 | doi=10.2304/ciec.2008.9.1.3}} *{{cite journal | last1 = Morelli | first1 = G. | last2 = Rogoff | first2 = B. | last3 = Angelillo | first3 = C. | year = 2003 | title = Cultural variation in young children's access to work or involvement in specialised child-focused activities | url =https://archive.org/details/sim_international-journal-of-behavioral-development-ijbd_2003-05_27_3/page/264| journal = International Journal of Behavioral Development | volume = 27 | issue = 3| pages = 264–274 | doi=10.1080/01650250244000335}} *Woodhead, M. (1998). Children's perspectives on their working lives: A participatory study in Bangladesh, Ethiopia, the Philippines, Guatemala, El Salvador and Nicaragua. *{{cite journal | last1 = Rogoff | first1 = B. | last2 = Morelli | first2 = G. A. | last3 = Chavajay | first3 = P. | year = 2010 | title = Children's Integration in Communities and Segregation From People of Differing Ages | url = | journal = Perspectives on Psychological Science | volume = 5 | issue = 4| pages = 431–440 | doi=10.1177/1745691610375558}} *Gaskins, S. (2006). 13 The Cultural Organization of Yucatec Mayan Children's Social Interactions. Peer relationships in cultural context, 283. ==Marejeo== {{Refbegin|2}} * {{Rejea kitabu | last1 = König | first1 = Eva | title =Indianer 1858-1928, Photographische Reisen von Alaska bis Feuerland| year = 2002 | publisher = Edition Braus| location = Museum für Volkerkunde Hamburg | isbn = 3-89904-021-X}} * {{Rejea kitabu | last1 = Cappel | first1 = Constance | title =The Smallpox Genocide of the Odawa Tribe at L'Arbre Croche, 1763: The History of a Native American People| year = 2007 | publisher = Edwin Mellen Press | location = Lewiston, N.Y. | isbn = 978-0-7734-5220-6 |oclc=175217515}} * {{Rejea kitabu | last=Cappel | first=Constance,(editor) | title=Odawa Language and Legends: Andrew J. Blackbird and Raymond Kiogima | publisher=Xlibris| year= 2006 | isbn=1-59926-920-1}} * {{Rejea kitabu | last1 = Churchill | first1 = Ward | author1-link = Ward Churchill | title = A Little Matter of Genocide: Holocaust and Denial in the Americas, 1492 to the Present|url=http://books.google.com/?id=QXRyTRavzK4C&printsec=frontcover&dq=A+Little+Matter+of+Genocide:+Holocaust+and+Denial+in+the+Americas,+1492+to+the+Present#v=onepage&q=| year = 1997 | publisher = City Lights Books | location = San Francisco | isbn = 978-0-87286-323-1 |oclc=35029491}} * {{Rejea kitabu |last1= Dean|first1= Bartholomew|chapter=State Power and Indigenous Peoples in Peruvian Amazonia: A Lost Decade, 1990–2000|editor1-first= David|editor1-last= Maybury-Lewis|editor1-link=David Maybury-Lewis | title = The Politics of Ethnicity: Indigenous Peoples in Latin American States|series=David Rockefeller Center series on Latin American studies, [[Harvard University]]|volume= 9| year = 2002 | publisher = Harvard University/David Rockefeller Center for Latin American Studies | location = Cambridge, Mass. | isbn = 0-674-00964-9 |oclc=427474742| pages = 199–238}} * {{Rejea kitabu | last1 = Dean | first1 = Bartholomew | last2 = Levi | first2 = Jerome M. | title = At the Risk of Being Heard: Identity, Indigenous Rights, and Postcolonial States |url=http://books.google.com/?id=ESutGButMOAC&printsec=frontcover&dq=At+the+Risk+of+Being+Heard:+Identity,+Indigenous+Rights,+and+Postcolonial+States#v=onepage&q=| year = 2003 | publisher = [[University of Michigan Press]] | location = Ann Arbor | isbn = 978-0-472-09736-4 | oclc =50841012}} * {{cite journal |author=Dean, Bartholomew |date=January 2006 |title=Salt of the Mountain: Campa Asháninka History and Resistance in the Peruvian Jungle (review)|url=http://muse.jhu.edu/login?uri=/journals/the_americas/v062/62.3dean.html |journal=The Americas |volume=62 |issue=3 |pages=464–466 |issn=0003-1615 |doi=10.1353/tam.2006.0013}} * {{cite journal |author=Kane, Katie |year=1999 |title=Nits Make Lice: Drogheda, Sand Creek, and the Poetics of Colonial Extermination |url=https://archive.org/details/sim_cultural-critique_spring-1999_42/page/81 |journal=Cultural Critique |volume=42 |issue=42 |pages=81–103 |issn=0882-4371 |doi=10.2307/1354592 |publisher=University of Minnesota Press |jstor=1354592}} * {{Rejea kitabu | last1 = Krech | first1 = Shepard III| title =The Ecological Indian: Myth and History| year = 1999 | publisher= [[W. W. Norton & Company]] | location = New York|url=http://books.google.com/?id=on7tKuPdlaMC&printsec=frontcover&dq=The+Ecological+Indian:+Myth+and+History#v=onepage&q= | isbn = 978-0-393-04755-4 | oclc =318358852}} * {{Rejea kitabu | last1 = Varese | first1 = Stefano | last2 = Ribeiro | first2 = Darcy | author2-link = Darcy Ribeiro | title =Salt of the Mountain: Campa Ashaninka History and Resistance in the Peruvian Jungle| year = 2004 |origyear= 2002| publisher = University of Oklahoma Press | location = Norman |others= trans. Susan Giersbach Rascón|url=http://books.google.com/?id=NCXw6o3YaMkC&printsec=frontcover&dq=Salt+of+the+Mountain:+Campa+Ashaninka+History+and+Resistance+in+the+Peruvian+Jungle#v=onepage&q=| isbn = 0-8061-3512-3 |oclc=76909908}} {{Refend}} ==Marejeo mengine== *Hamilton, Charles (ed) (1950). ''Cry of the Thunderbird; the American Indian's own story''. New York: Macmillan Company ==Viungo vya nje== {{Commons category|Indigenous peoples of the Americas}} * [http://cogweb.ucla.edu/Chumash/EntryDate.html The Peopling of the American Continents], ''Early California History'' * [http://pib.socioambiental.org/en Indigenous Peoples in Brazil. Instituto Socioambiental (ISA)] * [http://www.pbs.org/wgbh/nova/stoneage/megafauna.html America's Stone Age explorers], ''[[PBS]] [[Nova (TV series)|Nova]]'' * [http://www.civilization.ca/cmc/exhibitions/archeo/hnpc/npint00e.shtml A history of Native people of Canada - The Canadian Museum of Civilization]'' {{mbegu-utamaduni}} [[Jamii:Amerika]] dzhzonhvf6q0cndusqkeetp6n3561fl 0 66733 1578129 1518783 2026-07-02T21:19:36Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578129 wikitext text/x-wiki {{Infobox disease | Name = Mafua ya kawaida | Image = Rhinovirus.PNG | Caption = A representation of the molecular surface of one variant of human [[rhinovirus]]. | ICD10 = {{ICD10|J|00}} | ICD9 = {{ICD9|460}} | DiseasesDB = 31088 | MedlinePlus = 000678 | eMedicineSubj = | eMedicineTopic = | eMedicine_mult = {{EMedicine2|med|2339}} | MeshID = D003139 }} '''Mafua ya kawaida''' (pia '''mafua ya kuku''' au '''mafua''' tu; kwa [[Kiingereza]]: [[w:common cold|common cold]], nasopharyngitis, rhinopharyngitis), ni [[ugonjwa wa kuambukizwa]] unaoathiri sehemu ya juu ya [[mfumo wa upumuaji]], hasa [[pua]] na [[shingo]]. [[Dalili]] ni pamoja na [[kikohozi]], utoaji [[kamasi]] puani ''(rhinorrhea)'', na [[homa]]. Dalili kwa kawaida hupotea baada ya [[siku]] saba hadi kumi, ingawa baadhi ya dalili zake zinaweza zikakaa hadi [[wiki]] tatu. Mafua ya kawaida husababishwa na [[virusi]] mbalimbali; zaidi ya [[mia mbili]] zinajulikana kusababisha mafua ya kawaida. Virusi vya jamii ya rinovirusi ''(rhinovirus)'' ndivyo visababishi vikuu. Maambukizo makali ya pua, mianzi ya pua, koo au [[zoloto]] (maambukizi ya sehemu ya juu ya njia ya hewa: URI au URTI) yanabainishwa na eneo la [[mwili]] ambalo limeathirika zaidi. Mafua ya kawaida yanaathiri pua, yanavimbisha kolomeo, koo, na yanavimbisha mianzi ya pua. Dalili zinatokana na mfumo wa kinga unaopambana na maambukizi, si kwa sababu ya uharibifu wa seli mwilini unaoletwa na virusi. Kuosha [[mikono]] ni njia ya msingi ya kuzuia maambukizi. Kuna ushahidi unaounga mkono uvaaji kitambaa usoni ni bora zaidi. Hakuna [[tiba]] ya mafua ya kawaida, lakini dalili zinaweza kutibiwa. Ni ugonjwa unaoambukiza sana [[binadamu]]. Kwa kawaida [[watu wazima]] wanaambukizwa mara mbili au tatu kwa [[mwaka]]. Kwa kawaida [[watoto]] huwa wanapata mafua mara sita au mara kumi na mbili kwa mwaka. Ugonjwa huo umekuwa ukiambukiza binadamu tangu zamani. ==Dalili na ishara== Dalili za kawaida za mafua ni pamoja na kikohozi, mafua, kuziba kwa pua, na koo linalouma. Dalili nyinginezo ni pamoja na kuumwa [[misuli]] (myalgia), kuwa mchovu, kuumwa na [[kichwa]], na kupoteza [[hamu ya kula]]. <ref name= E24> Eccles uk. 24 </ref> Kuumwa koo huwa hali inayowapata karibia [[asilimia]] 40 ya watu. Kikohozi ni hali inayowapata asilimia 50 ya watu <ref name= CE11 /> Kuumwa misuli hutokea kwa nusu ya watu. <ref name= Eccles2005 /> Homa si dalili ya kawaida inayowapata watu wazima, lakini ni kawaida kwa watoto wachanga, na watoto wadogo <ref name= Eccles2005> {{wanaelezea journal |. author = Eccles R | title = Kuelewa dalili ya kawaida ya baridi na mafua | journal = Lancet kuambukiza }} </ref> Kikohozi kinachosababishwa na mafua ya kawaida si kali sana ukilinganisha na kikohozi kinachosababishwa na [[homa ya mafua]] (influenza). <ref Name= Eccles2005 /> Kikohozi na homa vinaonyesha dalili kubwa ya [[homa ya mafua]] kwa watu wazima <ref> Eccles Pg.26 </ref> Idadi kubwa ya virusi vinavyosababisha mafua ya kawaida, vinaweza visiwe na dalili yoyote <ref> Eccles PG.. 129 </ref> <ref> Eccles Pg.50 </ref> Kamasi wakati wa kukohoa hupita katika njia ya hewa na kamasi na inaweza kutofautiana kwa [[rangi]] nyeupe hadi kuwa ya njano au kijani. Rangi ya kamasi haionyeshi kama ugonjwa huo umesababishwa na [[bakteria]] au na virusi.<ref>Eccles Pg.30 </ref> ===Maendeleo ya ugonjwa=== Mafua kwa kawaida huanza na uchovu, hali ya kusikia [[baridi]], kupiga [[chafya]], na [[maumivu]] ya kichwa. Dalili nyinginezo ni kama vile pua inayotoa kamasi na kikohozi huanza baada ya siku mbili au zaidi. <ref name=E24/> Dalili huwa zinakuwa mbaya siku mbili au tatu baada ya kuambukizwa. <ref name=Eccles2005/> Dalili hizo kwa kawaida huendelea kwa siku saba hadi siku kumi, lakini huweza kuendelea hadi wiki tatu<ref name=Heik2003>{{cite journal |author=Heikkinen T, Järvinen A |title=The common kikohozi kitaendelea kwa zaidi ya siku kumi katika asilimia 35% hadi 40% ya watoto wagonjwa. Hali hii huendelea kwa zaidi ya siku 25 katika asilimia 10 ya watoto wagonjwa</ref><ref>{{cite journal |author=Goldsobel AB, Chipps BE |title=Cough in the pediatric population |journal=J. Pediatr. |volume=156 |issue=3 |pages=352–358.e1 |year=2010 |month=Machi |pmid=20176183|doi=10.1016/j.jpeds.2009.12.004 }}</ref> ==Visababishi== ===Virusi === [[Image: Coronaviruses 004 lores.jpg | thumb |Coronavirus ni kundi la virusi linalojulikana kusababisha mafua ya kawaida. Kimaumbile vina nuru, au taji kama inavyoonekana kwa darubini elektroniki.]] Mafua ya kawaida yanaambukiza kirahisi kwa kupitia njia ya hewa. Virusi aina ya rhinovirus ndio vinavyosababisha asilimia 30 hadi 80 ya mafua ya kawaida. Virusi aina ya rhinovirus vina RNA ya [[Familia (biolojia)|familia]] ya Picornaviridae. Kuna aina 99 inayojulikana ya virusi katika familia hii ya virusi <ref>{{Rejea jarida | doi = 10.1126/science.1165557 | title = Sequencing and Analyses of All Known Human Rhinovirus Genomes Reveals Structure and Evolution | year = 2009 | author = Palmenberg, A. C. | journal = Science | pmid = 19213880 | volume = 324 | pages = 55–9 | last2 = Spiro | first2 = D | last3 = Kuzmickas | first3 = R | last4 = Wang | first4 = S | last5 = Djikeng | first5 = A | last6 = Rathe | first6 = JA | last7 = Fraser-Liggett | first7 = CM | last8 = Liggett | first8 = SB | issue = 5923}}</ref><ref>Eccles Pg.77</ref> Virusi nyingine pia husababisha mafua ya kawaida. Coronavirus husababisha asilimi 10% hadi 15% ya mafua. Mafua (homa) husababisha 5% hadi 15% ya mafua <ref name= Eccles2005/> Mafua mengine yanaweza kusababishwa na virusi vya binadamu vya parainfluenza, virusi vya binadamu vya njia ya hewa viitwavyo syncytial virusi aina ya adenoviruses, enterovirus, na metapneumovirus. <ref name="NIAID2006">{{cite web | title = Common Cold | publisher = [[National Institute of Allergy and Infectious Diseases]] | date = 27 Novemba 2006 | url = http://www3.niaid.nih.gov/healthscience/healthtopics/colds/ | accessdate = 11 Juni 2007 | archivedate = 2007-06-23 | archiveurl = https://web.archive.org/web/20070623234904/http://www3.niaid.nih.gov/healthscience/healthtopics/colds/ }}</ref> Mara nyingi, huwa kuna zaidi ya aina moja ya virusi vinavyosababisha maambukizi <ref> Eccles. Pg.107 </ref> Kawaida huwa kuna zaidi ya aina mia mbili ya virusi tofauti vinavyohusiana na homa. <ref name= Eccles2005/> ==Uenezi== Virusi vya mafua ya kawaida vinaenezwa kwa njia moja kati ya njia kuu mbili. Kujaza hewa mapafu au kumeza vitone vya hewa vyenye virusi. Au kugusa kamasi ya pua iliyoambukizwa au kugusa vitu vilivyoambukizwa <ref name=CE11/><ref name=Cold197>{{cite book|last=editors|first=Ronald Eccles, Olaf Weber,|title=Common cold|year=2009|publisher=Birkhäuser|location=Basel|isbn=9783764398941|pages=197|url=http://books.google.ca/books?id=rRIdiGE42IEC&pg=PA197|edition=Online-Ausg.}}</ref> Which method of transmitting the cold is most common has not been determined <ref name= E211> Eccles Pg.211 </ref> Virusi vinaweza kuishi muda mrefu katika mazingira hayo. Virusi vinaweza kusambaa kutoka mikononi hadi kwenye macho au pua ambapo maambukizi hutokea. <ref Name= Cold197/> Watu waliopo karibu wako katika hatari kubwa ya kuambukizwa. <ref Name= E211/> Maambukizi kawaida hutokea mchana na shuleni kwa sababu watoto hucheza pamoja, hawana kinga ya kutosha na kuna upungufu wa usafi <ref name= Text2007 /> Maambukizi haya yanaletwa nyumbani kwa ndugu wengine wa familia <ref name=Text2007>{{cite book|last=al.]|first=edited by Arie J. Zuckerman ... [et|title=Principles and practice of clinical virology|year=2007|publisher=Wiley|location=Hoboken, N.J.|isbn=9780470517994|pages=496|url=http://books.google.ca/books?id=OgbcUWpUCXsC&pg=PA496|edition=6th ed.}}</ref> Hakuna ushahidi wa kutosha kwamba mzunguko wa hewa ndani ya ndege za abiria ni njia ya maambukizi <ref name=Cold197/>. Homa inayosababishwa na virusi aina ya rhinovirus huwa maambukizi yake ni makali katika siku tatu za mwanzo wa dalili. Baada ya muda huo hawaambukizi sana <ref name="contagiousness">{{cite journal|contribution=Contagiousness of the common cold|author1=Gwaltney JM Jr|author2=Halstead SB|author-separator=,}} Invited letter in {{cite journal|title=Questions and answers|journal=Journal of the American Medical Association|date=16 Julai 1997|volume=278|issue=3|pages=256–257|url=http://jama.ama-assn.org/content/278/3/256|accessdate=16 Septemba 2011}}<!-- I searched PubMed for both the letter and for the "Questions and answers" column. Neither is indexed. Also, the DOI that the website provides is broken, so I've instead provided a URL. --></ref> ===Hali ya hewa=== Tangu zamani mafua yanakisiwa kwamba yanaenezwa kwa mtu aliyepatwa na baridi kwa muda mrefu wakati wa [[mvua]] au wakati wa msimu wa baridi, na ndiyo maana yanaitwa mafua ya baridi <ref>{{cite news |author=Zuger, Abigail |title='You'll Catch Your Death!' An Old Wives' Tale? Well... |newspaper=[[The New York Times]] |date=4 Machi 2003 |url=http://query.nytimes.com/gst/fullpage.html?res=9D02E1DD163FF937A35750C0A9659C8B63}}</ref> Kuna mabishano kwamba wajibu wa mwili kuwa katika hali ya baridi unaleta hatari ya kupata mafua <ref name="Mourtzoukou">{{cite journal|last=Mourtzoukou|first=EG|coauthors=Falagas, ME|title=Exposure to cold and respiratory tract infections.|journal=The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease|date=2007 Sep|volume=11|issue=9|pages=938–43|pmid=17705968}}</ref> Baadhi ya virusi vinavyosababisha homa ya kawaida hujitokeza mara kwa mara wakati wa msimu wa baridi au mvua. <ref> Eccles Pg.79 </ref> Ingawa hii inaaminika kuwa ni kwa sababu watu wanakaa pamoja ndani ya nyumba kwa muda mrefu;.<ref> Eccles Pg.80 </ref> haswa watoto wanaorudi shuleni <ref name= Text2007/> Hata hivyo, inaweza pia kuwa ni kwa sababu ya mabadiliko ya hewa ambayo yanarahisisha maambukizi <ref> Eccles Pg.80 </ref> Upungufu wa unyevu unaweza kuongeza viwango vya maambukizi kutokana na hewa kavu kuruhusu vitone vidogo kuenea kiurahisi kusambaza mbali zaidi na kukaa angani kwa muda mrefu <ref> Eccles PG.. 157 </ref> ==Maambukizo mengine== Kinga ya kikundi, ni kinga ambayo hutokea wakati kikundi kizima cha watu kina kinga ya mwili na maambukizi haswa baada ya kupata maambukizo awali.Hivyo watoto wana uwezo mkubwa wa kuambukizwa na maradhi yanayohusiana upumuaji na watu wazima wana uwezo mdogo wa kuambukizwa na maradhi yanayohusiana upumuaji <ref name=E78/> Upungufu wa kinga pia unaongeza hatari ya kuambukizwa ugonjwa <ref name=E78/> <ref> Eccles PG... 166 </ref> Ukosefu wa usingizi na lishe duni pia zinaleta hatari kubwa ya kuendeleza maambukizi yanayoletwa na rhinovirus. Hii inatokana na athari inayoletwa na virusi ya kupunguza kinga ya mwili <ref>{{cite journal |author=Cohen S, Doyle WJ, Alper CM, Janicki-Deverts D, Turner RB |title=Sleep Habits and Susceptibility to the Common Cold |journal=Arch. Intern. Med. |volume=169 |issue=1|pages=62–7|year=2009 |month=Januari |pmid=19139325 |doi=10.1001/archinternmed.2008.505 |pmc=2629403}}</ref><ref>Eccles Pg.160–165</ref> ==Pathofisiolojia== [[Image:Illu conducting passages.svg|thumb| Mafua ya kawaida ni ugonjwa unaoathiri sehemu ya juu ya kupitisha hewa]] Dalili za mafua ya kawaida zinaaminika kuwa zinajitokeza wakati kinga mwili ikipambana na virusi. Jinsi kinga mwili inavyopambana na virusi inategemea na aina ya virusi.Kwa mfano, ni kawaida rhinovirus kuenezwa kwa kugusana. Inajifunga katika vipokezi vya binadamu I viitwavyo CAM-1 receptor kwa njia isiojulikana na kusababisha kutolewa kwa vichochezi. Vichochezi hivyo ndivyo vinaleta dalili. Kwa kawaida haileti madhara puani <ref name= Eccles2005/> Kwa upande mwingine, virusi vya njia ya hewa (RSV) vinaenezwa kwa kugusana na kwa vitone vinavyopeperuka hewani. Ni kisha vinazaana katika pua na koo kabla ya kuenea sehemu ya chini ya kupitisha hewa RSV inasababisha uharibifu wa ukuta wa pua. Virusi vya binadamu vya parainfluenza vinasababisha uvimbi wa pua, koo, na njia za hewa. Vikiathiri bomba la pumzi la watoto wadogo vinaweza kusababisha kifaduro, kikohozi cha sauti na shida ya kupumua. Hii ni kwa sababu njia ya hewa ya watoto inazidi kuwa ndogo. ==Uaguzi== Tofauti ya maambukizi ya sehemu ya juu ya kupitisha hewa (URTIs) inatokana na eneo lenye dalili. Mafua ya kawaida yanaathiri pua, uvimbe wa koromeo, koo, na mkamba inayoathiri mapafu. <ref name= CE11 /> Mafua ya kawaida husababisha uvimbe wa pua na aina tofauti ya uvimbe wa koo. Ni jambo la kawaida kujifanyia mwenyewe utambuzi. <ref Name= Eccles2005/> Kutengwa kwa virusi kunafanyika mara chache <ref. Name= E51/> Kwa kawaida si rahisi kutambua aina ya virusi kwa kutizama dalili. <ref name= Eccles2005/> ==Uzuiaji== Njia bora ilyopo ya kuzuia mafua ya kawaida ni kupunguza uenezi wa virusi mwilini <ref name=E209> Eccles Pg.209</ref> Hii ni pamoja na kunawa mikono na kuvaa vitambaa usoni. Katika mazingira ya huduma ya afya, magauni na glavu za kinga pia huvaliwa <ref name= E209/> Kuwatenga watu walioathirika, si rahisi kwa sababu ugonjwa huo unaenea sana na dalili haisababishwi na kundi moja la virusi. Chanjo zimeonekana kuwa hazina uwezo mkubwa kwa sababu kuna aina nyingi ya virusi na virusi hubadilika kwa haraka <ref name= E209 /> Utengenezaji wa chanjo wenye uwezo mkubwa si rahisi <ref>{{cite journal|author=Lawrence DM |journal=Lancet Infect Dis |volume=9 |issue=5 |page=278 |date=Mei 2009|doi=10.1016/S1473-3099(09)70123-9|url=http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2809%2970123-9 |title=Gene studies shed light on rhinovirus diversity}}</ref> Kunawa mikono mara kwa mara kunapunguza maambukizi ya virusi ya mafua. Njia hii ni bora zaidi kwa watoto <ref name=CochP11>{{cite journal|last=Jefferson|first=T|coauthors=Del Mar, CB, Dooley, L, Ferroni, E, Al-Ansary, LA, Bawazeer, GA, van Driel, ML, Nair, S, Jones, MA, Thorning, S, Conly, JM|title=Physical interventions to interrupt or reduce the spread of respiratory viruses.|journal=Cochrane database of systematic reviews (Online)|date=2011 Jul 6|issue=7|pages=CD006207|pmid=21735402|doi=10.1002/14651858.CD006207.pub4}}</ref> Haijulikani kama kutumia dawa za kuzuia virusi au bakteria wakati wa kuosha mikono ni njia bora zaidi. Kuvaa vitamba usoni ukiwa karibu ya watu walioathirika inaweza kuwa ni njia nzuri. Kuna ushahidi usiotosha unaokiri kwamba kuwa mbali zaidi kimwili au mbali na jamii kunapunguza maambukizi. Nyongeza ya zinki inaweza kusababisha upungufu wa idadi ya homa mtu anayopata <ref name=Zinc11>{{cite journal|last=Singh|first=M|coauthors=Das, RR|title=Zinc for the common cold.|journal=Cochrane database of systematic reviews (Online)|date=2011 Feb 16|issue=2|pages=CD001364|pmid=21328251|doi=10.1002/14651858.CD001364.pub3}}</ref> Utaratibu wa kujiongezea vitamini C haupunguzi hatari au makali ya mafua. Inaelekea vitamini C hupunguza muda wa mafua. ==Usimamizi== [[Image:Pneumonia strikes like a man eating shark.jpg|thumb|Hmizo la kumkimblia daktari dhidi ya mafua.]] Kwa sasa hakuna dawa au tiba za mitishamba ambazo zimthibitiwa kwa kufupisha muda wa maambukizi.<ref>{{cite web|title = Common Cold: Treatments and Drugs| publisher = Mayo Clinic| url =http://www.mayoclinic.com/health/common-cold/DS00056/DSECTION=treatments-and-drugs| accessdate = 9 Januari 2010}}</ref> Tiba ni pamoja na kutoa tulizo ya ishara. <ref name=AFP07/> Hii ni pamoja na kupata mapumziko ya kutosha, kunywa maji ili kudumisha maji, na kugogomoa na maji ya joto ya chumvi.<ref name="NIAID2006"/> Mengi ya faida kutoka kwa matibabu hata hivyo inahusishwa na athari ya kipozauongo.<ref>Eccles Pg.261</ref> ===Ya dalili=== Matibabu ambayo husaidia kupunguza dalili ni pamoja na kitulizo rahisi cha maumivu (analgesics) na tiba ya kupunguza homa (antipyretics) kama vile ibuprofen<ref>{{cite journal |author=Kim SY, Chang YJ, Cho HM, Hwang YW, Moon YS |editor1-last=Kim |editor1-first=Soo Young |title=Non-steroidal anti-inflammatory drugs for the common cold|journal=Cochrane Database Syst Rev |issue=3 |pages=CD006362 |year=2009 |pmid=19588387 |doi=10.1002/14651858.CD006362.pub2 }}</ref> na acetaminophen/paracetamol.<ref>{{cite journal|journal=Journal of Clinical Pharmacy and Therapeutics|title=Efficacy and safety of over-the-counter analgesics in the treatment of common cold and flu|url=https://archive.org/details/sim_journal-of-clinical-pharmacy-and-therapeutics_2006-08_31_4/page/309|author=Eccles R|volume=31|issue=4|pages=309–319|year=2006|pmid=16882099|doi=10.1111/j.1365-2710.2006.00754.x}}</ref> Ushahidi haionyeshi kwamba dawa za kukohoa si fanisi zaidi kuliko dawa rahisi za kupunguza maumivu (analgesics).<ref>{{cite journal |author=Smith SM, Schroeder K, Fahey T |editor1-last=Smith |editor1-first=Susan M |title=Over-the-counter medications for acute cough in children and adults in ambulatory settings |journal=Cochrane Database Syst Rev |issue=1 |pages=CD001831 |year=2008 |pmid=18253996|doi=10.1002/14651858.CD001831.pub3 }}</ref> Madawa ya kukohoa pia haifai kwa matumizi kwa watoto kutokana na ukosefu wa ushahidi fanisi unaothibitisha na hatari kwa madhara.<ref name=CFP09>{{cite journal |author=Shefrin AE, Goldman RD |title=Use of over-the-counter cough and cold medications in children |journal=Can Fam Physician |volume=55 |issue=11 |pages=1081–3 |year=2009 |month=Novemba |pmid=19910592 |pmc=2776795|url=http://www.cfp.ca/content/55/11/1081.full }}</ref><ref>{{cite journal|last=Vassilev|first=ZP|coauthors=Kabadi, S, Villa, R|title=Safety and efficacy of over-the-counter cough and cold medicines for use in children.|journal=Expert opinion on drug safety|date=2010 Mar|volume=9|issue=2|pages=233–42|pmid=20001764|doi=10.1517/14740330903496410}}</ref> Katika mwaka 2009, Kanada ilizuia matumizi ya tiba ya kukohoa ya dukani na mafua kwa watoto wenye umri wa miaka sita na ndogo kutokana na shauku kuhusu hatari na faida ambazo hazijathibitishwa.<ref name=CFP09/> Matumizi mabaya ya dextromethorphan (dawa ya kuuzwa dukani) imesababisha kupigwa marufuku katika nchi kadhaa.<ref>Eccles Pg. 246</ref> Kwa watu wazima, dalili za mafua inaweza kupunguzwa na antihistamines za kizazi cha kwanza. Hata hivyo, antihistamines za kizazi cha kwanza inahusishwa na athari mbaya kama vile utepetevu.<ref name=AFP07/> Decongestants zingine kama vile pseudoephedrine pia ni bora kwa watu wazima.<ref>{{cite journal |author=Taverner D, Latte J |title=Nasal decongestants for the common cold |journal=Cochrane Database Syst Rev |issue=1|pages=CD001953 |year=2007 |pmid=17253470 |doi=10.1002/14651858.CD001953.pub3 |editor1-last=Latte |editor1-first=G. Jenny }}</ref> Kinyunyizio cha Ipratropium cha pua pia inaweza kupunguza dalili za mafua, lakini kuna athari kidogo kwenye fukuto.<ref>{{cite journal|last=Albalawi|first=ZH|coauthors=Othman, SS, Alfaleh, K|title=Intranasal ipratropium bromide for the common cold.|journal=Cochrane database of systematic reviews (Online)|date=2011 Jul 6|issue=7|pages=CD008231|pmid=21735425|doi=10.1002/14651858.CD008231.pub2}}</ref> Antihistamines za kizazi cha pili haionekani kuwa bora.<ref>{{cite journal|last=Pratter|first=MR|title=Cough and the common cold: ACCP evidence-based clinical practice guidelines.|journal=Chest|date=2006 Jan|volume=129|issue=1 Suppl|pages=72S-74S|pmid=16428695|doi=10.1378/chest.129.1_suppl.72S}}</ref> Kutokana na ukosefu wa masomo, haijulikani kama kuongezeka kwa ulaji wa maji inaboresha dalili au kupunguza ugonjwa kupumua.<ref>{{cite journal|last=Guppy|first=MP|coauthors=Mickan, SM, Del Mar, CB, Thorning, S, Rack, A|title=Advising patients to increase fluid intake for treating acute respiratory infections.|journal=Cochrane database of systematic reviews (Online)|date=2011 Feb 16|issue=2|pages=CD004419|pmid=21328268|doi=10.1002/14651858.CD004419.pub3}}</ref> Ukosaji wa data kama hiyo ipo kwa matumizi ya hewa ya joto.<ref>{{cite journal|last=Singh|first=M|coauthors=Singh, M|title=Heated, humidified air for the common cold.|journal=Cochrane database of systematic reviews (Online)|date= 11 Mei 2011|issue=5|pages=CD001728|pmid=21563130|doi=10.1002/14651858.CD001728.pub4}}</ref> Utafiti mmoja uligundua mvuke wa kusugua kifua ni fanisi katika kutoa baadhi ya tulizo la dalili ya kukohoa usiku, foleni, na ugumu wa usingizi.<ref>{{cite journal |author=Paul IM, Beiler JS, King TS, Clapp ER, Vallati J, Berlin CM |title=Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms |journal=Pediatrics |volume=126 |issue=6 |pages=1092–9 |year=2010 |month=Desemba |pmid=21059712 |doi=10.1542/peds.2010-1601 |url=http://pediatrics.aappublications.org/cgi/reprint/peds.2010-1601v1 |access-date=2012-10-03 |archive-date=2020-07-09 |archive-url=https://web.archive.org/web/20200709071815/https://pediatrics.aappublications.org/content/pediatrics/early/2010/11/08/peds.2010-1601.full.pdf |dead-url=yes }}</ref> ===Viua vijasumu na Kinza virusi=== Viua vijasumu haina athari dhidi ya maambukizi ya virusi na hivyo haina athari dhidi ya homa.<ref name=CochraneAR2005>{{cite journal |author=Arroll B, Kenealy T |editor1-last=Arroll |editor1-first=Bruce |title=Antibiotics for the common cold and acute purulent rhinitis |journal=Cochrane Database Syst Rev |issue=3 |pages=CD000247 |year=2005 |pmid=16034850 |doi=10.1002/14651858.CD000247.pub2}}</ref> Viua vijasumu kwa kawaida huagizwa ingawa madhara ya viua vijasumu husababisha madhara kwa ujumla.<ref name=CochraneAR2005/><ref>Eccles Pg.238</ref> Viua vijasumu kwa kawaida huagizwa kwa sababu watu wanatarajia watabibu kuziagiza na watabibu wanataka kusaidia watu. Maagizo ya viua vijasumu pia hutokea kwa sababu ni vigumu kutenga sababu ya maambukizi ambayo yanaweza kusimamiwa na viua vijasumu.<ref>Eccles Pg.234</ref> Hakuna madawa fanisi za kuzuia virusi za homa ingawa baadhi ya utafiti wa awali imeonyesha faida.<ref name=AFP07/><ref>Eccles Pg.218</ref> ===Matibabu mbadala=== Wakati kuna matibabu mengi mbadala inayotumika kwa homa, kuna upungufu wa ushahidi wa kisayansi wa kuunga mkono matumizi ya matibabu zaidi.<ref name=AFP07/> Kufikia mwaka 2010, hakuna ushahidi wa kutosha wa kupendekeza kwa au dhidi ya aidha asali au umwagiliaji kwa pua.<ref>{{cite journal|last=Oduwole|first=O|coauthors=Meremikwu, MM, Oyo-Ita, A, Udoh, EE|title=Honey for acute cough in children.|journal=Cochrane database of systematic reviews (Online)|date=2010 Jan 20|issue=1|pages=CD007094|pmid=20091616|doi=10.1002/14651858.CD007094.pub2}}</ref><ref>{{cite journal|last=Kassel|first=JC|coauthors=King, D, Spurling, GK|title=Saline nasal irrigation for acute upper respiratory tract infections.|journal=Cochrane database of systematic reviews (Online)|date=2010 Mar 17|issue=3|pages=CD006821|pmid=20238351|doi=10.1002/14651858.CD006821.pub2}}</ref> Virutubisho vya zinki vinaweza kupunguza ukali na muda wa dalili wakati itamezwa ndani ya masaa 24&nbsp ya mwanzo wao.<ref name=Zinc11/> Athari za vitamini C kwa homa, wakati inafanyiwa utafiti sana, inakatisha tamaa.<ref name="Hemilä2010">{{cite journal |doi=10.1002/14651858.CD000980.pub3 |pmid=17636648 |title=Vitamin C for preventing and treating the common cold |journal=Cochrane database of systematic reviews |issue=3 |pages=CD000980 |year=2007 |last1=Hemilä |first1=Harri |last2=Chalker |first2=Elizabeth |last3=Douglas |first3=Bob|last4=Hemilä |first4=Harri |editor1-last=Hemilä |editor1-first=Harri}}</ref><ref name="Heimer2009">{{cite journal |doi= 10.1111/j.1745-7599.2009.00409.x|pmid= 19432914 |title= Examining the evidence for the use of vitamin C in the prophylaxis and treatment of the common cold|journal= Journal of the American Academy of Nurse Practitioners |issue= 5|pages=295–300 |year=2009 |last1=Heiner |first1= Kathryn A |last2= Hart|first2= Ann Marie |last3= Martin |first3= Linda Gore |last4= Rubio-Wallace |first4= Sherrie |volume=21}}</ref> Ushahidi kuhusu manufaa ya echinacea haiendani.<ref name=CochE06>{{cite journal |author=Linde K, Barrett B, Wölkart K, Bauer R, Melchart D |editor1-last=Linde|editor1-first=Klaus |title=Echinacea for preventing and treating the common cold |journal=Cochrane Database Syst Rev |issue=1 |pages=CD000530|year=2006 |pmid=16437427 |doi=10.1002/14651858.CD000530.pub2 }}</ref><ref>{{cite journal|title=Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis|author=Sachin A Shah, Stephen Sander, C Michael White, Mike Rinaldi, Craig I Coleman|journal=The Lancet Infectious Diseases|year=2007|volume=7|issue=7|pmid=17597571|pages=473–480|doi=10.1016/S1473-3099(07)70160-3 }}</ref> Aina tofauti ya virutubisho vya echinacea inaweza kutofautiana katika utendaji wao.<ref name=CochE06/> ==Matokeo== Homa kwa kawaida ni kidogo na hupotea pekee yake na dalili nyingi kuwa bora katika wiki moja.<ref name=CE11/> Matatizo makubwa, kama yatatokea, kwa kawaida huwa katika watu wazee sana, vijana, au wale ambao wanashida ya kinga (wana mfumo dhaifu wa kinga).<ref name=E1/> Maambukizi sekondari ya bakteria yanaweza kutokea na kusababisha sinusitis, pharyngitis, au maambukizi ya masikio.<ref>Eccles Pg.76</ref> Inakadiriwa kuwa sinusitis hutokea katika matukio ya asilimia 8. Maambukizi ya sikio hutokea katika matukio ya asilimia 30.<ref>Eccles Pg.90</ref> ==Uwezekano== Homan ni zaidi ya ugonjwa wa kawaida wa binadamu<ref name=E1>Eccles Pg. 1</ref> na watu wanaathirika kimataifa.<ref name=Text2007/> Watu wazima kwa kawaida huwa na maambukizi mbili hadi tano kwa mwaka.<ref name=CE11>{{cite journal|last=Arroll|first=B|title=Common cold.|journal=Clinical evidence|date=2011 Mar 16|volume=2011|pmid=21406124|issue=03}}</ref><ref name=Eccles2005/> Watoto wanaweza kuwa na homa sita hadi kumi kwa mwaka (na homa hadi kumi na mbili kwa mwaka kwa watoto wa shule).<ref name=AFP07>{{cite journal | author = Simasek M, Blandino DA | title = Treatment of the common cold | journal = American Family Physician | volume = 75 | issue = 4 | pages = 515–20 | year = 2007 | pmid = 17323712 | url = http://www.aafp.org/afp/20070215/515.html | access-date = 2012-10-03 | archive-date = 2007-09-26 | archive-url = https://web.archive.org/web/20070926230125/http://www.aafp.org/afp/20070215/515.html | dead-url = yes }}</ref> Viwango vya maambukizi ya dalili huongezeka katika wazee kutokana na kudhoofika kwa mfumo wa kinga.<ref name=E78>Eccles Pg. 78</ref> ==Historia== Wakati chanzo cha homa imetambuliwa tu tangu [[miaka ya 1950]], ugonjwa umekuwa na ubinadamu tangu nyakati za kale.<ref>Eccles Pg. 3</ref> Dalili zake na matibabu zinaelezwa katika Ebers papyrus ya Misri, maandishi kongwe yaliyopo ya matibabu, iliyoandikwa kabla ya karne ya 16 KK.<ref>Eccles Pg.6</ref> Jina "homa" ilikuja katika matumizi ya karne ya 16, kutokana na kufanana kati ya dalili zake na zile zitokanazo na hali ya hewa baridi.<ref>{{cite web | publisher=Online Etymology Dictionary | url=http://www.etymonline.com/index.php?term=cold | title=Cold |accessdate=12 Januari 2008 }}</ref> Katika Uingereza, Kitengo cha Homa (CCU) kilianzishwa na Baraza la Utafiti wa Afya katika mwaka 1946 na ilikuwa hapa kwamba rhinovirus iligunduliwa katika mwaka 1956.<ref>Eccles Pg.20</ref> Katika miaka ya 1970, CCU imeonesha kwamba matibabu na interferon wakati wa awamu ya kupevuka kwa maambukizi ya rhinovirus inatoa baadhi ya kinga dhidi ya ugonjwa.<ref name="pmid2438740">{{cite journal|author=Tyrrell DA|title=Interferons and their clinical value|url=https://archive.org/details/sim_clinical-infectious-diseases_march-april-1987_9_2/page/n6|journal=Rev. Infect. Dis.|volume=9|issue=2|pages=243–9|year=1987|pmid=2438740|doi=10.1093/clinids/9.2.243}}</ref> Hakuna tiba ya vitendo iliweza kukuzwa. Kitengo kilifungwa katika mwaka 1989, miaka miwili baada ya kukamilisha utafiti wa zinc gluconate lozenges katika kuzuia matibabu ya homa ya rhinovirus. Zinki ilikuwa tu ni matibabu fanisi iliyoundwa katika historia ya CCU.<ref>{{cite journal| journal = J Antimicrob Chemother.| year = 1987| month = Desemba| volume = 20| issue = 6| pages = 893–901| title = Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges|last = Al-Nakib| first = W| pmid = 3440773| doi = 10.1093/jac/20.6.893| last2 = Higgins| first2 = PG| last3 = Barrow| first3 = I| last4 = Batstone|first4 = G| last5 = Tyrrell| first5 = DA}}</ref> == Athari za kiuchumi == [[Image:The Cost Of The Common Cold & Influenza.jpg|thumb|A UK|British poster from World War II describing the cost of the common cold<ref>{{cite web|title=The Cost of the Common Cold and Influenza|work=Imperial War Museum: Posters of Conflict|publisher=vads|url=http://vads.bath.ac.uk/flarge.php?uid=33443&sos=0|accessdate=2012-10-03|archivedate=2011-07-27|archiveurl=https://web.archive.org/web/20110727091037/http://vads.bath.ac.uk/flarge.php?uid=33443&sos=0|=https://web.archive.org/web/20110727091037/http://vads.bath.ac.uk/flarge.php?uid=33443&sos=0}}</ref>]] Athari za kiuchumi ya homa hazifahamiki vizuri katika mengi ya dunia.<ref>Eccles Pg.90</ref> Nchini Marekani, homa inaongoza kwa ziara watabibu milioni 75 hadi milioni 100 kila mwaka katika makisio ya gharama ya $ 7.7 kwa mwaka. Wamarekani wanatumia dola bilioni 2.9 kwa madawa ya dukani (OTC). Wamarekani hutumia dola za ziada milioni 400 kwa maagizo ya madawa kwa tukizo la dalili.<ref name=Frend03>{{cite journal | author = Fendrick AM, Monto AS, Nightengale B, Sarnes M | title = The economic burden of non-influenza-related viral respiratory tract infection in the United States | journal = Arch. Intern. Med. | volume = 163 | issue = 4 | pages = 487–94 | year = 2003 | pmid = 12588210 | url =http://archinte.ama-assn.org/cgi/content/full/163/4/487 | doi = 10.1001/archinte.163.4.487}}</ref> Zaidi ya theluthi moja ya watu ambao walimwona daktari walipokea maagizo ya viua vijasumu. Matumizi ya maagizo ya viua vijasumu ina madhara kwa upinzani wa antibiotiki.<ref name=Frend03/> Makadirio ya siku za shule milioni 22 hadi 189 hazihudhuriwi kila mwaka kutokana na homa. Kama matokeo, wazazi walikosa siku za kazi milioni 126 kukaa nyumbani ili kuwatunza watoto wao. Wakati ikiongezwa kwa siku za kazi milioni 150 ambazo hazikuhudhuriwa na wafanyakazi wanaosumbuliwa na homa, jumla ya athari za kiuchumi za hasara ya kazi inayohusiana na homa inazidi dola bilioni 20 kawa mwaka.<ref name="NIAID2006"/><ref name=Frend03/> Hii inachangia asilimia 40 ya muda uliopotezwa kutoka kazini nchini Marekani.<ref>{{cite journal |author=Kirkpatrick GL|title=The common cold |url=https://archive.org/details/sim_primary-care-clinics-in-office-practice_1996-12_23_4/page/n16|journal=Prim. Care |volume=23 |issue=4 |pages=657–75 |year=1996 |month=Desemba |pmid=8890137|doi=10.1016/S0095-4543(05)70355-9 }}</ref> ==Utafiti== Idadi ya kinzavirusi zimejaribiwa kwa ufanisi katika homa. Kufikia mwaka 2009, hakuna zote zimepatikana kuwa fanisi na kutolewa idhini ya matumizi.<ref>Eccles Pg.218</ref> Kuna majaribio yanayoendelea ya sawa za kinza viruzi ya pleconaril. Inaonyesha ahadi dhidi ya picornaviruses. Pia kuna majaribio yanayoendelea ya BTA-798.<ref name=E226>Eccles Pg.226</ref> Aina ya pleconaril ya kumeza ilikuwa na masuala ya usalama na aina ya erosoli inachunguzwaa.<ref name=E226/> Watafiti kutoka kwa Chuo kikuu cha Maryland, College Park na UChuo kikuu cha Wisconsin–Madison imetambua genome kwa Matatizo yote inayojulikana ya virusi vinavyosababisha homa. <ref name="CTgov">{{cite news| url = http://www.cnn.com/2009/HEALTH/02/12/cold.genome/| title = Genetic map of cold virus a step toward cure, scientists say| month = Machi| year = 2009| accessdate = 28 Aprili 2009| publisher = CNN| work = Val Willingham}}</ref> {{-}} ==Marejeo== {{Marejeo|colwidth=30em}} ;References * {{cite book|last=Ronald Eccles|first=Olaf Weber (eds)|title=Common cold|year=2009|publisher=Birkhäuser|location=Basel|isbn=978-3764398941|url=http://books.google.ca/books?id=rRIdiGE42IEC|edition=Online-Ausg.}} [[Jamii:Maradhi ya kuambukiza]] kbmngtwlktfmopxh0k7x7z06te1oos0 0 66740 1578146 1465834 2026-07-02T22:07:38Z InternetArchiveBot 41439 Add 4 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578146 wikitext text/x-wiki [[Picha:HCV EM picture 2.png|thumbnail|right|200px|Homanyongo C]] ''^{Kwa ugonjwa tofauti ambao wakati mwingine jina lake linachanganywa tazama [[Homa ya manjano]]}'' {{Infobox disease | Name = Homa ya nyongo C (Hepatitis C) | Image = HCV EM picture 2.png | Caption = [[Electron micrograph]] of [[hepatitis C virus]] purified from cell culture (scale = 50&nbsp;[[nanometers]]) | DiseasesDB = 5783 | ICD10 = {{ICD10|B|17|1|b|15}}, {{ICD10|B|18|2|b|15}} | ICD9 = {{ICD9|070.70}},{{ICD9|070.4}}, {{ICD9|070.5}} | OMIM = 609532 | MedlinePlus = 000284 | eMedicineSubj = med | eMedicineTopic = 993 | eMedicine_mult = {{EMedicine2|ped|979}} | MeshID = D006526 }} '''Homa ya nyongo C'''<ref>Wakati mwingine homa ya nyongo inaitwa "homa ya manjano" lakini hii ni ugonjwa tofauti. Taz [[homa ya manjano]] (ing. Yellow fever)</ref> (pia '''homanyongo C''', kwa [[Kiingereza]] '''Hepatitis C''') ni [[ugonjwa wa kuambukiza]] unaoshambulia zaidi [[ini]]. [[Virusi]] vya Homanyongo C ndivyo vinavyosababisha [[ugonjwa]] huu wa ini. <ref name=Sherris>{{cite book | title = Sherris Medical Microbiology | url = https://archive.org/details/sherrismedicalmi0000unse_q1i3 | edition = 4th | publisher = McGraw Hill | year = 2004 | pages=[https://archive.org/details/sherrismedicalmi0000unse_q1i3/page/551 551]–2 | isbn = 0838585299 | editor = Ryan KJ, Ray CG (editors) }}</ref> Kwa kawaida Homa ya nyongo C haionyeshi [[dalili]] zozote kwenye hatua za awali, lakini ugonjwa ukiendelea unaweza ukasababisha makovu katika maini, na baada ya miaka mingi ini linapata vidonda (cirrhosis). Kwa wagonjwa wengine vidonda hivi vinaweza kusababisha ini kukosa kufanya kazi, [[saratani]] ya ini, au [[mishipa]] iliyovimba sana ya [[umio]] na [[tumbo]], ambayo yanaweza kufanya [[mtu]] avuje [[damu]] hadi kufa.<ref name=Sherris/> Watu wanaambukizwa [[virusi vya Homa ya nyongo C]] kwa kupitia [[mkondo wa damu]] kwa njia ya kujidunga [[sindano]] za [[dawa za kulevya]], kutumia vifaa vichafu vya [[hospitali]], na kuongezewa damu. Kadri ya watu [[milioni]] 130–170 wameathirika na Homa ya nyongo C. [[Wataalamu]] walianza kuchunguza HCV katika [[miaka ya 1970]], na walithibitisha kuwepo kwa ugonjwa huo mnamo mwaka [[1989]].<ref name="pmid19781804">{{cite journal |author=Houghton M |title=The long and winding road leading to the identification of the hepatitis C virus |journal=Journal of Hepatology |volume=51 |issue=5 |pages=939–48 |year=2009|month=Novemba |pmid=19781804 |doi=10.1016/j.jhep.2009.08.004 |url=}}</ref> Haijulikani kama ugonjwa huu unawaambukiza [[wanyama]]. Peginterferon na ribavirin ndizo [[dawa]] pekee zinazotumika sana dhidi ya HCV. Kati ya wagonjwa [[asilimia]] 50-80 wanaotibiwa huwa wanapona. Watu wanaopata uharibifu mkubwa na [[kovu]] kwa ini (cirrhosis) au [[saratani ya ini]] wanaweza kuhitaji ini la kupandikizwa, lakini virusi huwa vinarejea baada ya kupandikiza.<ref name=NEJM2011/> hakuna chanjo ya kuzuia Homa ya nyongo C. {{TOC limit|3}} == Viashiria na dalili == Homa ya nyongo C inasababisha dalili katika wagonjwa asilimia 15 tu,<ref>{{cite journal|last=Maheshwari|first=A|coauthors=Ray, S, Thuluvath, PJ|title=Acute hepatitis C.|url=https://archive.org/details/sim_the-lancet_july-26-august-1-2008_372_9635/page/321|journal=Lancet|date=2008-07-26|volume=372|issue=9635|pages=321–32|pmid=18657711|doi=10.1016/S0140-6736(08)61116-2}}</ref> mara nyingi zaidi agonjwa hawaonyeshi dalili zozote. Dalili ni kama zifuatazo: kupungua [[hamu ya kula]], [[uchovu]], [[kichefuchefu]], [[maumivu]] ya [[viungo]] au [[misuli]], kupungua [[uzito wa mwili]].<ref name=AFP2010/> Ni wagonjwa wachache ambao ni mahtuti na wanapata homa ya manjano.<ref name=Book2011p4>{{cite book|title=Chronic Hepatitis C Virus Advances in Treatment, Promise for the Future.|year=2011|publisher=Springer Verlag|isbn=9781461411918|page=4|url=http://books.google.ca/books?id=6G7mff5DnBQC&pg=PA4}}</ref> Kadri ya wagonjwa asilimia 10 hadi 50 wanapona bila kupata matibabu, na kati ya hao wengi ni [[wasichana]] wadogo.<ref name=Book2011p4/> === Uambukizo sugu === Asilimia themanini ya watu walioambukizwa virusi wanapata madhara ya [[uambukizo sugu]].<ref name=Lancet2011/> Wagonjwa wengi hawaonyeshi dalili zozote kwenye hatua za awali za ugonjwa huo, <ref name=Book2011/> ingawa uambukizo sugu wa Homa ya nyongo C unasababisha uchovu.<ref name=ID2010/> Homa ya nyongo C ni chanzo kikubwa cha ini kupata vidonda pamoja na saratani ya ini kwa watu ambao wameathirika na ugonjwa huu kwa muda mrefu.<ref name=NEJM2011>{{cite journal|last=Rosen|first=HR|title=Clinical practice. Chronic hepatitis C infection.|journal=The New England journal of medicine|date=2011-06-23|volume=364|issue=25|pages=2429–38|pmid=21696309|url=http://www.casemedicine.com/ambulatory/Continuity%20Clinic/Clinic%20Articles/1)%20July/2)Week%20of%20July%2025th/chronic%20hep%20c.NEJM.pdf|access-date=2012-10-05|archive-date=2012-12-15|archive-url=https://web.archive.org/web/20121215035840/http://www.casemedicine.com/ambulatory/Continuity%20Clinic/Clinic%20Articles/1)%20July/2)Week%20of%20July%2025th/chronic%20hep%20c.NEJM.pdf|dead-url=yes}}</ref> Kati ya asilimia 10–30 ya watu wameambukizwa baada ya miaka 30 ya kuwa na vidonda katika ini.<ref name=NEJM2011/><ref name=AFP2010/> Pia watu wenye HomanyongoB au UKIMWI, walevi sugu, na wanaumme huwa wanapata vidonda katika ini.<ref name=AFP2010/> Kwa watu wenye vidonda katika ini uwezekano wa kupata saratani ya ini ni mara ishirini zaidi ya kawaida, kiasi cha asilimia 1 hadi 3 kwa mwaka.<ref name=NEJM2011/><ref name=AFP2010/> Kwa walevi sugu, uwezekano wa kupata ugonjwa ni mara 100 zaidi ya kawaida.<ref>{{cite journal|last=Mueller|first=S|coauthors=Millonig, G, Seitz, HK|title=Alcoholic liver disease and hepatitis C: a frequently underestimated combination.|journal=World journal of gastroenterology : WJG|date=2009-07-28|volume=15|issue=28|pages=3462–71|pmid=19630099}}</ref> Homa ya nyongo C inasababisha vidonda vya ini katika asilimia 27 ya wagonjwa na inasababisha saratani ya ini kati ya asilimia 25 ya wagonjwa.<ref name=World2007>{{cite journal|last=Alter|first=MJ|title=Epidemiology of hepatitis C virus infection.|journal=World journal of gastroenterology : WJG|date=2007-05-07|volume=13|issue=17|pages=2436–41|pmid=17552026}}</ref> Vidonda vya ini vinaweza kusababisha msukumo mkubwa wa damu katika mishipa iliyoungana na ini, [[kujaa maji tumboni]], kuumia kirahisi au [[kuvuja damu]], mishipa kuvimba, hasa tumboni na kwenye umio, [[homa ya nyongo]] ([[ngozi]] inakuwa ya [[manjano]]), na [[jeraha|majeraha]] katika [[ubongo]].<ref name=Tah2009>{{cite journal|last=Ozaras|first=R|coauthors=Tahan, V|title=Acute Homa ya nyongo C: prevention and treatment.|journal=Expert review of anti-infective therapy|date=2009 Apr|volume=7|issue=3|pages=351–61|pmid=19344247}}</ref> === Athari nje ya ini === Homa ya nyongo C mara chache inasababisha ugonjwa unaojulikana kama Sjögren's syndrome (madhara dhidi ya kinga ya mwili), upungufu sio kawaida wa idadi ya blood platelets, magonjwa sugu ya ngozi, kisukari, pamoja na aina Fulani ya aina saratani ya damu iitwayo non-Hodgkin lymphomas.<ref name=Extrahepatic>{{cite journal |author=Zignego AL, Ferri C, Pileri SA, Caini P, Bianchi FB |title=Extrahepatic manifestations of Hepatitis C Virus infection: a general overview and guidelines for a clinical approach |journal=Digestive and Liver Disease |volume=39 |issue=1 |pages=2–17 |year=2007 |month=Januari |pmid=16884964 |doi=10.1016/j.dld.2006.06.008}}</ref><ref>{{cite journal|last=Louie|first=KS|coauthors=Micallef, JM, Pimenta, JM, Forssen, UM|title=Prevalence of thrombocytopenia among patients with chronic hepatitis C: a systematic review.|journal=Journal of viral hepatitis|date=2011 Jan|volume=18|issue=1|pages=1–7|pmid=20796208}}</ref> == Chanzo == Virusi vya Homa ya nyongo C ni vidogo, vilivyo ndani ya kibahasha, na kiuzi kimoja, vina [[RNA]] yenye virusi.<ref name=NEJM2011/> Ni jamii ya ''hepacivirus'' ya [[familia]] iitwayo ''Flaviviridae''.<ref name=ID2010>{{cite book|last=Dolin|first=[edited by] Gerald L. Mandell, John E. Bennett, Raphael|title=Mandell, Douglas, and Bennett's principles and practice of infectious diseases|year=2010|publisher=Churchill Livingstone/Elsevier|location=Philadelphia, PA|isbn=978-0443068393|pages=Chapter 154|edition=7th ed.}}</ref> Kuna aina saba muhimu za genotypes of HCV.<ref name=Nakano2011>{{cite journal |author=Nakano T, Lau GM, Lau GM, Sugiyama M, Mizokami M|title=An updated analysis of hepatitis C virus genotypes and subtypes based on the complete coding region |journal=Liver Int. |year=2011|month=Desemba |pmid=22142261 |doi=10.1111/j.1478-3231.2011.02684.x }}</ref> Nchini Marekani, genotype 1 inasababisha asilimia 70 ya magonjwa, genotype 2 inasababisha asilimia 20 ya magonjwa, na kila aina ya genotypes zingine zinasababisha asilimia 1. <ref name=AFP2010/> Genotype 1 ndio inayojulikana zaidi katika nchi za Amerika ya Kusini na Ulaya.<ref name=NEJM2011/> === Maambukizi === Njia ya kawaida ya uambukizaji katika nchi zilizoendelea ni kutumia madawa ya kulevya kwa kujidunga sindano. Katika nchi zinazoendelea njia za kawaida za utoaji damu na utaratibu usio salama wa kimatibabu <ref name=Mah2010>{{cite journal|last=Maheshwari|first=A|coauthors=Thuluvath, PJ|title=Management of acute Homa ya nyongo C.|journal=Clinics in liver disease|date=2010 Feb|volume=14|issue=1|pages=169–76; x|pmid=20123448}}</ref> Katika asilimia 20% ya wagonjwa, chanzo cha uambukizaji hakijulikani;<ref name=Pon2011>{{cite journal|last=Pondé|first=RA|coauthors=Mikhaĭlova, A|title=Hidden hazards of HCV transmission.|journal=Medical microbiology and immunology|date=2011 Feb|volume=200|issue=1|pages=7–11|pmid=20461405}}</ref> lakini vyanzo vingi vinaweza kuwa ni matumizi ya dawa ya kulevya kwa kujidunga sindano.<ref name=Book2011p4/> ==== Madawa ya kulevya kwa kujidunga sindano ==== Matumizi ya madawa ya kulevya kwa kujidunga sindano ndiyo sababu kubwa ya kusambaza Homa ya nyongo C katika nchi nyingi duniani.<ref name=China2008>{{cite journal|last=Xia|first=X|coauthors=Luo, J, Bai, J, Yu, R|title=Epidemiology of HCV infection among injection drug users in China: systematic review and meta-analysis.|url=https://archive.org/details/sim_public-health_2008-10_122_10/page/990|journal=Public health|date=2008 Oct|volume=122|issue=10|pages=990–1003|pmid=18486955|doi=10.1016/j.puhe.2008.01.014}}</ref> Uchunguzi uliofanya katika nchi 77 zimeonyesha kwamba katika nchi 25 ambayo Marekani ni mojawapo, asilimia ya watu wanaopata Homa ya nyongo C kwa kutumia madawa ya kulevya kwa kujidunga sindano ni asilimia 60 hadi 80 <ref name=Lancet2011>{{cite journal|last=Nelson|first=PK|coauthors=Mathers, BM, Cowie, B, Hagan, H, Des Jarlais, D, Horyniak, D, Degenhardt, L|title=Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews.|url=https://archive.org/details/sim_the-lancet_august-13-19-2011_378_9791/page/571|journal=Lancet|date=2011-08-13|volume=378|issue=9791|pages=571–83|pmid=21802134|doi=10.1016/S0140-6736(11)61097-0}}</ref> na Uchina. <ref name=China2008/> Nchi kumi na mbili zina zaidi ya asilimia 80.<ref name=Lancet2011/> Zaidi ya milioni kumi ya watumizi wa madawa ya kulevya kwa kujidunga sindano wameambukizwa na Homa ya nyongo C; Uchina (milioni 1.6), Marekani (milioni 1.5), na Urusi(milioni 1.3) jumla ya wagonjwa walioambukizwa ni wengi sana.<ref name=Lancet2011/> Kiasi kikubwa cha wafungwa Marekani wana Homa ya nyongo C uwezekano wa kupata ugonjwa ni mara kumi hadi ishirini zaidi ya kiwango cha kawaida cha idadi ya watu, na utafiti umeonyesha hii inasababishwa na tabia za hatari za kutumia madawa ya kulevya kwa kujidunga sindano au kujichora chale na sindano ambazo sio safi.<ref name=Jail2010>{{cite journal|last=Imperial|first=JC|title=Chronic hepatitis C in the state prison system: insights into the problems and possible solutions.|journal=Expert review of gastroenterology & hepatology|date=2010 Jun|volume=4|issue=3|pages=355–64|pmid=20528122}}</ref><ref>{{cite journal|last=Vescio|first=MF|coauthors=Longo, B, Babudieri, S, Starnini, G, Carbonara, S, Rezza, G, Monarca, R|title=Correlates of hepatitis C virus seropositivity in prison inmates: a meta-analysis.|journal=Journal of epidemiology and community health|date=2008 Apr|volume=62|issue=4|pages=305–13|pmid=18339822}}</ref> ==== Maambukizi kupitia huduma za afya ==== Utoaji wa damu, [[mazao ya damu]], na upandikizi wa viungo vya mwili bila kuchunguza HCV ndizo zinazoleta matatizo makubwa ya uambukizaji.<ref name=AFP2010/> [[Marekani]] ilirasimisha [[uchunguzi]] mnamo mwaka [[1992]]. "Tangu wakati huo kiwango cha maambukizi imepungua kuanzia kati ya mmoja kati ya 200 kwa kila kipimo cha damu<ref name=Rosen2011>{{cite book |title=Rosen's emergency medicine: concepts and clinical practice 7th edition |last=Marx |first=John |authorlink= |coauthors=|year=2010 |publisher=Mosby/Elsevier|location=Philadelphia, PA |isbn=9780323054720 |page=[https://archive.org/details/rosensemergencym00mdjo/page/n1176 1154] |url=https://archive.org/details/rosensemergencym00mdjo}}</ref> hadi moja kati ya 10,000 mpaka 10,000,000 kwa kila kipimo cha damu.<ref name=Book2011p4/><ref name=Pon2011/> Kuna upungufu wa maambukizi kwa sababu kuna kipindi cha siku 11 hadi 70 ambazo ni siku ambazo mtoaji damu mtarajiwa anayepata Homa ya nyongo C na damu yao kuonyesha kwamba imeambukizwa.<ref name=Pon2011/> Nchi zingine bado hazifanyi uchunguzi wa Homa ya nyongo C kwa sababu ya gharama.<ref name=World2007/> Mtu mwenye jeraha la sindano kutoka kwa mtu aliyeathiriwa na HCV ana uwezo wa asilimia 1.8 ya kupata ugonjwa <ref name=AFP2010/> Hatari inaongezeka kama sindano inayotumika ina shimo kubwa na jeraha ni kubwa.<ref name=World2007/> Kuna hatari kutoka kwa mfichuo wa kamasi hadi kwa damu; ingawa kiwango cha hatari hii ni ndogo, na hakuna hatari yoyote kama damu ikigusa ngozi isiyokuwa na jeraha.<ref name=World2007/> Vifaa vya hospitali pia vinaweza kuambukiza Homa ya nyongo C kama vile: kutumia mara kwa mara sindano na pini,mifuko ya kujaza, na vifaa visivyo visafi vya hospitali.<ref name=World2007/> Hali mbaya ya hospitali au za kliniki za madaktari wa meno ndio sababu kubwa za maambukizi ya HCV nchini Misri, ni nchi yenye kiasi kikubwa cha maambukizi duniani.<ref>{{cite web |url=http://www1.albawaba.com/en/news/highest-rates-hepatitis-c-virus-transmission-found-egypt |title=Highest Rates of Hepatitis C Virus Transmission Found in Egypt |publisher=Al Bawaba |date=2010-08-09 |accessdate=2010-08-27 |archivedate=2012-05-15 |archiveurl=https://web.archive.org/web/20120515221938/http://www.albawaba.com/news/highest-rates-hepatitis-c-virus-transmission-found-egypt }}</ref> ==== Uhusiano wa kimapenzi ==== Haijulikani kama shughuli za [[ngono]] zinaweza kuleta maambukizi ya Homa ya nyongo C.<ref name=Sex2010>{{cite journal|author=Tohme RA, Holmberg SD |title=Is sexual contact a major mode of hepatitis C virus transmission? |journal=Hepatology |volume= 52|issue= 4|pages= 1497–505|year=2010|month=Juni|pmid=20635398 |doi=10.1002/hep.23808}}</ref> Ingawa kuna uhusiano kati ya njia za hatari za kufanya ngono na Homa ya nyongo C, si wazi kama maambukizi ya ugonjwa huo yanatokana na matumizi ya madawa ya kulevya ambayo hayakutajwa au ngono yenyewe. <ref name=AFP2010/> Ushahidi unaonyesha kwamba hakuna hatari ya maambukizi kwa wapenzi wa jinsia tofauti ambao hawana mapenzi na watu wengine.<ref name=Sex2010/> Shughuli za ngono zinazoleta viwango vya juu vya majeraha ndani ya mfereji wa mkundu, kama vile kupenyeza mkunduni, au inayotokea wakati wa maambukizo ya zinaa kama yale yanayotokea wakati wa maambukizo ya zinaa, ikiwa ni pamoja na VVU au vidonda sehemu ya siri, zote hizi zinaleta hatari ya maambukizo.<ref name=Sex2010/> Serikali ya Marekani inapendekeza matumizi ya [[kondomu]] kama njia pekee ya kuzuia maambukizi ya Homa ya nyongo C kwa watu wenye wapenzi wengi.< ref>{{cite web|title=Hepatitis C Group Education Class|url=http://www.hepatitis.va.gov/products/HCV-education-class-script.asp|work=United States Department of Veteran Affairs|accessdate=2012-10-05|archive-date=2011-11-09|archive-url=https://web.archive.org/web/20111109105344/http://www.hepatitis.va.gov/products/HCV-education-class-script.asp|url-status=dead}}</ref> ==== Kutoboa mwili ==== [[Uchoraji wa mwili]] unaongeza hatari mara mbili au tatu zaidi ya kupata Homa ya nyongo C.<ref name=Tato2010>{{cite journal|last=Jafari|first=S|coauthors=Copes, R, Baharlou, S, Etminan, M, Buxton, J|title=Tattooing and the risk of transmission of hepatitis C: a systematic review and meta-analysis.|journal=International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases|date=2010 Nov|volume=14|issue=11|pages=e928-40|pmid=20678951|url=http://natap.org/2010/HCV/tatoohcv.pdf}}</ref> Hii inaweza kuwa kwa sababu vifaa vinavyotumiwa sio visafi au kuambukizwa na rangi iliyotumika.<ref name=Tato2010/> Uchoraji au kujitoboa mwili kama shughuli hizi zilifanywa kabla ya miaka ya kati-1980 au ilifanywa na mtu asiye na ujuzi hasa inaleta wasiwasi, kwa sababu uwezekano wa kusafisha vifaa ni ndogo sana. Hatari ya kuambukizwa inaongezeka mara mbili zaidi kama mchoro ni mkubwa.<ref name=Tato2010/> Karibu nusu ya wafungwa wanatumia kwa pamoja vifaa vya kujichora ambavyo sio visafi. <ref name=Tato2010/> Ni mara chache uchoraji unafanywa katika sehemu zilizosajiliwa kuambukizwa na ugonjwa wa HCV.<ref>{{cite web|title=Hepatitis C|url=http://www.cdc.gov/hepatitis/HCV/PDFs/HepCGeneralFactSheet.pdf|work=Center for Disease Control and Prevention|accessdate=2 Januari 2012}}</ref> ==== Kugusa damu ==== Vifaa vya maangalizi binafsi kama vile mashine ya kunyolea, mswaki, na mashine ya kukata kucha yanaweza kuwa na damu. Kama zikitumiwa za zaidi ya mtu mmoja uwezekano ni mkubwa wa kuambukizana HCV.<ref name="pmid16907842">{{cite journal |author=Lock G, Dirscherl M, Obermeier F, ''et al.'' |title=Hepatitis C —contamination of toothbrushes: myth or reality? |journal=J. Viral Hepat. |volume=13 |issue=9 |pages=571–3 |year=2006 |month=Septemba |pmid=16907842|doi=10.1111/j.1365-2893.2006.00735.x |url=}}</ref><ref name=CDC12/> Watu wanatakiwa wawe waangalifu na mikwaruzo na vidonda au uvujaji wa damu.<ref name=CDC12/> HCV haimbukizwi kwa kushikana kama vile kukumbatiana, kupeana busu, au kula kwa pamoja au kutumia kwa pamoja vyombo vya kulia chakula.<ref name=CDC12>{{cite web |url= http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#section2|title=Hepatitis C |work=FAQ – CDC Viral Hepatitis |accessdate=2 Jan 2012}}</ref> ==== Maambukizi kutoka kwa mama hadi kwa mtoto ==== Maambukizi ya Homa ya nyongo C kutoka kwa [[mama]] hadi kwa [[mtoto]] hutokea kwa asilimia 10 za [[mimba]].<ref name=Preg10>{{cite journal|last=Lam|first=NC|coauthors=Gotsch, PB, Langan, RC|title=Caring for pregnant women and newborns with hepatitis B or C.|url=https://archive.org/details/sim_american-family-physician_2010-11-15_82_10/page/1225|journal=American family physician|date=2010-11-15|volume=82|issue=10|pages=1225–9|pmid=21121533}}</ref> Hakuna njia yoyote ya kupunguza hatari hii<ref name=Preg10/> wakati wa kuzaa.<ref name=Pon2011/> Hatari ya kuambukiza inaongezeka kama muda wa [[uchungu wa uzazi]] ni mrefu.<ref name=World2007/> Hakuna ushahidi wowote unaosema mtoto akinyonyeshwa [[maziwa]] ataambukizwa HCV; lakini, mama aliyeathiriwa hatakiwi amnyonyeshe mtoto kama [[chuchu]] zake zina mpasuko au zinavuja,<ref>{{cite journal |author=Mast EE |title=Mother-to-infant hepatitis C virus transmission and breastfeeding |journal=Advances in Experimental Medicine and Biology|volume=554 |pages=211–6|year=2004|pmid=15384578}}</ref> au kama ana kiwango kikubwa cha virusi.<ref name=Pon2011/> == Uchunguzi wa ugonjwa == [[Picha:Hepatitis C serology.png|thumb|250px|Serologic profile of Homa ya nyongo C infection]] Uchunguzi wa Homa ya nyongo C unaangalia yafuatayo: HCV kingamwili, ELISA, Western blot, pamoja na idadi ya HCV RNA.<ref name=AFP2010/> Polymerase chain reaction (PCR) inagundua HCV RNA wiki mmoja au mbili baada ya kuambukizwa, wakati vikinga mwili huchukua muda mrefu kutengenezwa na kuonekana.<ref name=Tah2009/> Maambukizo ya muda mrefu ya Homa ya nyongo C, yanayoletwa na virusi vya Homa ya nyongo C ambavyo vinaweza kuishi mwilini kwa muda unaoweza kuzidi miezi sita kama RNA ipo au haipo.<ref name=Book2011>{{cite book|title=Chronic Hepatitis C Virus Advances in Treatment, Promise for the Future.|year=2011|publisher=Springer Verlag|isbn=9781461411918|pages=103–104|url=http://books.google.ca/books?id=6G7mff5DnBQC&pg=PA104}}</ref> Kwa sababu ugonjwa huu kali hauonyeshi dalili zozote kwa muda mrefu,<ref name=Book2011/> madaktari huwa kwa kawaida wanagudua ugonjwa huu wanapofanya uchunguzi wa maini au wakati wanapofanya utaratibu wa kawaida wa kuchunguza afya za watu walio hatarini. Uchunguzi hauwezi kutofautisha kati ya ugonjwa mahututi na ugonjwa sugu wa maini.<ref name=World2007/> === Upimaji damu === Upimaji wa Homa ya nyongo C kwa kawaida huanza na vipimo vya damu ili kugundua uwepo wa kingamwili kwa HCV kwa kutumia kimeng'enya immunoassay.<ref name=AFP2010/> Kama upimaji huu ni chanya, kipimo cha itafanywa ili kuthibitisha immunoassay na kuamua ukali.<ref name=AFP2010/> Uchanganuzi wa recombinant immunoblot inathibitisha immunoassay, na mmenyuko wa HCV RNA polimeresi huamua ukali.<ref name=AFP2010/> Kama hakuna RNA na immunoblot ni chanya, mtu alikuwa na maambukizi ya awali lakini ikaisha na aidha kwa matibabu au yenyewe; kama immunoblot ni hasi, immunoassay ilikuwa na makosa.<ref name=AFP2010/> Inachukua wiki sita hadi nane kwa kufuatia maambukizi kabla ya vipimo vya immunoassay kuonekana kuwa yako.<ref name=ID2010/> Vimeng'enya vya ini hubadilika wakati wa sehemu ya awali ya maambukizi;<ref name=Book2011/> kwa wastani huanza kupanda katika wiki ya saba baada ya kuambukizwa.<ref name=ID2010/> Ini za vimeng'enya huhusiana vibaya na ukali wa ugonjwa.<ref name=ID2010/> === Biopsi === [[Biopsi]] za ini zinaweza kuamua kiwango cha uharibifu wa ini, lakini kuna hatari kutokana na utaratibu huo.<ref name=NEJM2011/> Mabadiliko ya kawaida biopsi hutambua ni lymphocytes ndani ya tishu ya ini, vinyeleo vya limfu katika triad portal, na mabadiliko kwa vichirizi vya nyongo.<ref name=NEJM2011/> Kuna idadi ya vipimo vya damu vinavyopatikana ambavyo vinajaribu kuamua kiwango cha uharibifu na kupunguza haja ya biopsi.<ref name=NEJM2011/> === Uchunguzi === Watu wachache, kama asilimia 5-50 walioambukizwa nchini Marekani na [[Canada]], wanafahamu hali yao.<ref name=Tato2010/> Kupima inapendekezwa kwa watu walio na hatari ya juu, ambao ni pamoja na watu wenye chale .<ref name=Tato2010/> Uchunguzi pia inapendekezwa kwa watu wenye muinuko wa kimeng'enya ya ini kwani hii ni ishara ya pekee ya homanyongosugu ya mara kwa mara.<ref>{{cite journal|last=Senadhi|first=V|title=A paradigm shift in the outpatient approach to liver function tests.|url=https://archive.org/details/sim_southern-medical-journal_2011-07_104_7/page/521|journal=Southern medical journal|date=2011 Jul|volume=104|issue=7|pages=521–5|pmid=21886053}}</ref> Uchunguzi wa mara kwa mara hapendekezwi nchini Marekani.<ref name=AFP2010>{{cite journal|last=Wilkins|first=T|coauthors=Malcolm, JK, Raina, D, Schade, RR|title=Hepatitis C: diagnosis and treatment.|journal=American family physician|date=2010-06-01|volume=81|issue=11|pages=1351–7|pmid=20521755|url=http://www.aafp.org/afp/2010/0601/p1351.html }}</ref> == Kinga == Kufikia mwaka 2011, hakuna [[chanjo]] iliyopatikana kwa homa ya nyongo C. Chanjo zinatengenezwa, na baadhi zimeonyesha matokeo ya kutia moyo.<ref>{{cite journal|last=Halliday|first=J|coauthors=Klenerman, P, Barnes, E|title=Vaccination for hepatitis C virus: closing in on an evasive target.|journal=Expert review of vaccines|date=2011 Mei|volume=10|issue=5|pages=659–72|pmid=21604986|doi=10.1586/erv.11.55}}</ref> Mchanganyiko wa mikakati ya kuzuia, kama vile mipango ya kubadilishana sindano na matibabu ya matumizi mabaya ya madawa ya kulevya, hupunguza hatari ya homa ya nyongo C katika watumiaji wa madawa ya kujindunga kwa mishipa kwa karibu asilimia 75.<ref>{{cite journal|last=Hagan|first=H|coauthors=Pouget, ER, Des Jarlais, DC|title=A systematic review and meta-analysis of interventions to prevent hepatitis C virus infection in people who inject drugs.|url=https://archive.org/details/sim_journal-of-infectious-diseases_2011-07-01_204_1/page/74|journal=The Journal of infectious diseases|date=2011-07-01|volume=204|issue=1|pages=74–83|pmid=21628661}}</ref> Kuwachunguza watoaji damu ni muhimu katika kiwango cha kitaifa, kama ni kufuata tahadhari za ulimwenguni ndani ya vituo vya afya.<ref name=ID2010/> Katika nchi ambako kuna ugavi usiotosha wa sindano hasi, watoa huduma wanapaswa kupeana madawa kwa mdomo badala ya kupitia sindano.<ref name=World2007/> == Matibabu == HCV inasababisha maambukizi sugu katika asilimia 50-80 ya watu walioambukizwa. Takriban asilimia 40-80 ya kesi hizi humalizika kwa matibabu.<ref>{{cite journal|last=Torresi|first=J|coauthors=Johnson, D, Wedemeyer, H|title=Progress in the development of preventive and therapeutic vaccines for hepatitis C virus.|journal=Journal of hepatology|date=2011 Jun|volume=54|issue=6|pages=1273–85|pmid=21236312|doi=10.1016/j.jhep.2010.09.040}}</ref><ref>{{cite journal|last=Ilyas|first=JA|coauthors=Vierling, JM|title=An overview of emerging therapies for the treatment of chronic hepatitis C.|journal=Clinics in liver disease|date=2011 Aug|volume=15|issue=3|pages=515–36|pmid=21867934}}</ref> Katika matukio machache, maambukizi yanaweza kuisha bila ya tiba.<ref name=Book2011p4/> Watu wenye homa ya nyongo C sugu ni lazima wajiepushe pombe na madawa yaa sumu kwa ini,<ref name=AFP2010/> na wanapaswa kupatiwa chanjo ya homa y a manjano A na homanyongoB <ref name=AFP2010/> Watu walio na cirrhosis wanapaswa kuwa na vipimo vya ultrasound vya saratani ya ini.<ref name=AFP2010/> === Madawa === Watu wenye maambukizi ya ini ya HCV yaliyothibitika yasiyo ya kawaida wanapaswa kutafuta matibabu. <ref name=AFP2010/> Matibabu ya sasa ni mchanganyiko wa pegylated interferon na madawa ya kupunguza makali ya ukimwi ribavirin kwa muda wa wiki 24 au 48, kulingana na aina ya HCV .<ref name=AFP2010/> Matokeo bora hutokea kwa asilimia 50-60% ya watu waliotibiwa. <ref name=AFP2010/> Kuchanganya ama boceprevir au telaprevir na ribavirin na peginterferon alfa inaboresha matokeo ya homa ya nyongo C genotype 1.<ref name="pmid21828346">{{cite journal | author = Foote BS, Spooner LM, Belliveau PP | title = Boceprevir: a protease inhibitor for the treatment of chronic hepatitis C | url = https://archive.org/details/sim_annals-of-pharmacotherapy_2011-09_45_9/page/1085 | journal = Ann Pharmacother | volume = 45| issue = 9 | pages = 1085–93 | year = 2011 | month = Septemba | pmid = 21828346 | doi = 10.1345/aph.1P744 }}</ref><ref name="pmid21558488">{{cite journal | author = Smith LS, Nelson M, Naik S, Woten J | title = Telaprevir: an NS3/4A protease inhibitor for the treatment of chronic hepatitis C | url = https://archive.org/details/sim_annals-of-pharmacotherapy_2011-05_45_5/page/639 |journal = Ann Pharmacother | volume = 45 | issue = 5 | pages = 639–48 | year = 2011 | month = Mei | pmid = 21558488 | doi = 10.1345/aph.1P430}}</ref><ref name="pmid21898493">{{cite journal | author = Ghany MG, Nelson DR, Strader DB, Thomas DL, Seeff LB | title = An update on treatment of genotype 1 chronic hepatitis C virus infection: 2011 practice guideline by the American Association for the Study of Liver Diseases | journal = Hepatology | volume = 54 | issue = 4 | pages = 1433–44 | year = 2011 | month = Oktoba | pmid = 21898493 | pmc = 3229841 | doi = 10.1002/hep.24641}}</ref> Madhara kwa matibabu ni ya kawaida, nusu ya watu wanaotibiwa hupata dalili kama homa ya mafua, na theluthi ya watu hupata matatizo ya mhemuko.<ref name=AFP2010/> Tiba katika miezi sita za kwanza ni bora zaidi kuliko baada ya homa ya nyongo C kuwa sugu.<ref name=Tah2009/> Kama mtu anapata maambukizi mapya na haijaisha baada ya wiki nane hadi kumi na mbili, wiki 24 ya pegylated interferon inapendekezwa.<ref name=Tah2009/> Kwa watu wenye thalasemia (ugonjwa wa damu), ribavirin inaonekana kuwa muhimu, lakini huongeza haja ya upaji wa damu.<ref>{{cite journal |author=Alavian SM, Tabatabaei SV |title=Treatment of chronic hepatitis C in polytransfused thalassaemic patients: a meta-analysis |journal=J. Viral Hepat.|volume=17 |issue=4 |pages=236–44 |year=2010 |month=Aprili |pmid=19638104|doi=10.1111/j.1365-2893.2009.01170.x }}</ref> <!--===Alternative medicine=== --> Watetezi wanadai tiba kadhaa mbadala kuwa na manufaa kwa homa ya nyongo C ikiwa ni pamoja na maziwa mbigili, ginseng, na colloidal silver <ref name=NCCAM>[http://nccam.nih.gov/health/providers/digest/hepatitisC-science.htm?nav=cd Hepatitis C and CAM: What the Science Says] {{Wayback|url=http://nccam.nih.gov/health/providers/digest/hepatitisC-science.htm?nav=cd |date=20130513220534 }}. ''[[NCCAM]]'' Machi 2011. (Retrieved 7 Machi 2011)</ref> Hata hivyo, hakuna tiba mbadala imeonekana kuboresha matokeo katika homa manjano C, na hakuna ushahidi upo ambao tiba mbadala ina athari yoyote kwenye virusi wakati wote .<ref name=NCCAM/><ref>{{cite journal|last=Liu|first=J|coauthors=Manheimer, E, Tsutani, K, Gluud, C|title=Medicinal herbs for hepatitis C virus infection: a Cochrane hepatobiliary systematic review of randomized trials.|url=https://archive.org/details/sim_american-journal-of-gastroenterology_2003-03_98_3/page/538|journal=The American journal of gastroenterology|date=2003 Mar|volume=98|issue=3|pages=538–44|pmid=12650784}}</ref><ref>{{cite journal|last=Rambaldi|first=A|coauthors=Jacobs, BP, Gluud, C|title=Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases.|journal=Cochrane database of systematic reviews (Online)|date=2007-10-17|issue=4|pages=CD003620|pmid=17943794}}</ref> == Ubashiri == Majibu ya matibabu hutofautiana kulingana na genotype. Majibu endelevu ni kadiri asilimia 40-50 kwa watu wenye HCV genotype 1 kwa muda wa wiki 48 ya matibabu.<ref name=NEJM2011/> Majibu endelevu hutokea katika asilimia 70-80 kwa watu walio na genotypes HCV 2 na 3 kwa muda wa wiki 24 ya matibabu.<ref name=NEJM2011/> Majibu endelevu ni kadiri ya asilimia 65 kwa watu wenye genotype 4 kwa muda wa wiki 48 ya matibabu. Ushahidi wa matibabu katika ugonjwa genotype 6 kwa sasa ni chache, na ushahidi uliopo ni wa muda wa wiki 48 ya tiba katika vipimo sawa na ugonjwa wa genotype 1.<ref>{{cite journal |author=Fung J, Lai CL, Hung I, ''et al.'' |title=Chronic hepatitis C virus genotype 6 infection: response to pegylated interferon and ribavirin |url=https://archive.org/details/sim_journal-of-infectious-diseases_2008-09-15_198_6/page/808 |journal=The Journal of Infectious Diseases |volume=198 |issue=6|pages=808–12 |year=2008 |month=Septemba |pmid=18657036 |doi=10.1086/591252}}</ref> == Uenezi == [[Picha:HCV prevalence 1999.png|thumb| Maambukizi ya homa ya nyongo C duniani kote mwaka 1999]] [[Picha:Hepatitis C world map - DALY - WHO2004.svg|thumb|[[Disability-adjusted life year]] ya homa ya nyongo C mwaka 2004 kwa kila wakazi 100,000 {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<10}} {{legend|#fff200|10-15}} {{legend|#ffdc00|15-20}} {{legend|#ffc600|20-25}} {{legend|#ffb000|25-30}} {{legend|#ff9a00|30-35}} {{Multicol-break}} {{legend|#ff8400|35-40}} {{legend|#ff6e00|40-45}} {{legend|#ff5800|45-50}} {{legend|#ff4200|50-75}} {{legend|#ff2c00|75–100}} {{legend|#cb0000|>100}} {{Multicol-end}}]] Kati ya watu milioni 130 na 170, au ~ asilimia 3 ya idadi ya watu duniani, wanaishi na homa ya nyongo C sugu.<ref name=WHO2011/> Kati ya watu milioni 3-4 huambukizwa kwa mwaka, na zaidi ya watu 350,000 hufariki kila mwaka kutokana na magonjwa-husiana na homa ya nyongo C.<ref name=WHO2011/> Viwango vimeongezeka pakubwa katika karne ya 20 kutokana na mchanganyiko wa IDU na madawa ya kujidunga katika mishipa au vifaa vya matibabu visivyokifishwa.<ref name="World2007"/> Nchini Marekani, kadiri ya asilimia 2 ya watu wana homa ya nyongo C,<ref name=AFP2010/> pamoja na kesi mpya 35,000 hadi 185,000 kwa mwaka. Viwango vimepungua katika nchi za Magharibi tangu miaka ya 1990 kutokana na uchunguzi wa kuboresha damu kabla ya utoaji.<ref name=Tah2009/> Vifo vya kila mwaka kutokana na HCV nchini Marekani ni kadiri kutoka 8,000 hadi 10,000. Matarajio ni kwamba kiwango hiki cha vifo itaongezeka wakati watu walioathirika kwa utoaji damu kabla ya kupimwa HCV kuwa wagonjwa na kufa.<ref>{{cite book|last=Colacino|first=ed. by J. M.|title=Hepatitis prevention and treatment|year=2004|publisher=Birkhäuser|location=Basel|isbn=9783764359560|pages=32|url=http://books.google.ca/books?id=KwSWN_QtVLUC&pg=PA32|coauthors=Heinz, B. A.}}</ref> Viwango vya maambukizi viko juu katika baadhi ya nchi za Afrika na Asia.<ref>{{cite book|last=al.]|first=edited by Gary W. Brunette ... [et|title=CDC health information for international travel : the Yellow Book 2012|publisher=Oxford University|location=New York|isbn=9780199769018|pages=231|url=http://books.google.ca/books?id=597F4ZVu7eQC&pg=PT231}}</ref> Nchi zilizi na viwango vya juu sana vya maambukizi ni Misri (asilimia 22), Pakistani (asilimia 4.8) na Uchina (asilimia 3.2).<ref name=WHO2011>{{cite web | title=WHO Hepatitis C factsheet|url=http://www.who.int/mediacentre/factsheets/fs164/en/index.html | year=2011 |accessdate=2011-07-13}}</ref> Kiwango cha juu nchini Misri inahusishwa na kampeni ya umma ya matibabu ya sasa-iliyositishwa ya schistosomiasis, kwa kutumia sindano za kioo zisizokifishwa vizuri.<ref name=World2007/> == Historia == Katika miaka ya 1970 katikati, Harvey J. Alter, Mkuu wa Sehemu ya Magonjwa ya Maambukizi katika Idara ya Madawa ya Kujidunga kwa mishii katika Taasisi ya Kitaifa ya Afya, na timu yake ya utafiti walionyesha kuwa kesi nyingi za utoaji wa baada-damu ya homanyongohazikutokana na viruzi vya homanyongoA au B. Licha ya ugunduzi huu, jitihada za utafiti wa kimataifa za kutambua virusi zilishindiana kwa miaka kumi ifuatayo. Mwaka 1987, Michael Houghton, qui-Lim Choo, na George Kuo katika Shirika la Chiron, wakishirikiana na Dkt. DW Bradley kutoka Kituo cha Kudhibiti na Kuzuia Magonjwa, walitumia mbinu mpya ya molecular cloning ya kubaini kiumbe kisichojulikana na kukuza uchunguzi wa ubainishaji..<ref name = Boyer>{{cite book | isbn = 9780792387602 | last = Boyer | first = JL | title = Liver cirrhosis and its development: proceedings of the Falk Symposium 115 | pages = [http://books.google.ca/books?id=n5P696E7T0wC&pg=PA344#v=onepage&q&f=false 344] | publisher =[[Springer Science+Business Media|Springer]] | year = 2001 }}</ref> Mwaka 1988, Alter alithibitisha virusi kwa kuthibitisha uwepo wao katika jopo la vielelezo vya homanyongozisizo A zisizo B. Mwezi Aprili 1989, ugunduzi wa HCV ulichapishwa katika makala mbili katika jarida la "Sayansi".<ref name="choo">{{cite journal|author=Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M |title=Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome |url=https://archive.org/details/sim_science_1989-04-21_244_4902/page/n97 |journal=Science |volume=244 |issue=4902 |pages=359–62 |year=1989 |month=Aprili |pmid=2523562 |doi=10.1126/science.2523562}}</ref><ref name="kuo">{{cite journal |author=Kuo G, Choo QL, Alter HJ, ''et al.'' |title=An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis |url=https://archive.org/details/sim_science_1989-04-21_244_4902/page/n100 |journal=Science |volume=244 |issue=4902 |pages=362–4 |year=1989 |month=Aprili |pmid=2496467 |doi=10.1126/science.2496467}}</ref> Ugunduzi ulisababisha mafanikio makubwa katika utambuzi na kuboresha matibabu ya kupunguza makali ya virusi.<ref name = Boyer/> Mwaka 2000, Dkt. Alter na Houghton walitukuzwa na Tuzo ya Lasker ya Utafiti wa Kitabibu ya Hospitali ya "kuongoza kazi inayosababisha ugunduzi wa virusi vinavyosababisha homa ya nyongo C na mbinu za kukuza uchunguzi ambazo zilipunguza hatari ya utoaji damu-ilihusisha homa y a manjano nchini Marekani kutoka asilimia 30 mwaka 1970 hadi karibu sifuri mwaka 2000."<ref>[https://web.archive.org/web/20080225184627/http://www.laskerfoundation.org/awards/library/2000clinical.shtml2000 Winners Albert Lasker Award for Clinical Medical Research], The Lasker Foundation. Retrieved 20 Februari 2008.</ref> Chiron aliwasilisha hataza kadhaa kuhusu virusi na uchunguzi wake.<ref name="houghton">Houghton, M., Q.-L. Choo, and G. Kuo. ''NANBV Diagnostics and Vaccines.'' European Patent No. EP-0-3 18-216-A1. European Patent Office (filed 18 Novemba 1988, published 31 Mei 1989).</ref> Maombi ya mashindano ya hataza na CDC ilikuwa imeshuka mwaka 1990 baada ya Chiron kulipa dola milioni 1,900,000 kwa CDC na dola 337,500 kwa Bradley. Mwaka 1994, Bradley alimshtaki Chiron, wakitaka kubatilisha hataza, alitaka yeye mwenyewe ajumuishwe kama mbunifu mshiriki, na kupokea mapato ya uharibifu na ya mrahaba. Alisitisha mashtaka mwaka 1998 baada ya kupoteza mbele ya mahakama ya rufaa.<ref>{{cite web|last=Wilken|first=Judge|title=United States Court of Appeals for the Federal Circuit|url=http://www.ll.georgetown.edu/federal/judicial/fed/opinions/96opinions/96-1536.html|work=United States Court of Appeals for the Federal Circuit|accessdate=11 Januari 2012}}</ref> == Jamii na utamaduni == Mwungano wa Dunia wa Homanyongo inaratibu siku ya Dunia ya Homa ya nyongo, hufanyika kila mwaka tarehe 28 mwezi Julai.<ref>{{cite journal|last=Eurosurveillance editorial|first=team|title=World Hepatitis Day 2011.|journal=Euro surveillance : bulletin europeen sur les maladies transmissibles = European communicable disease bulletin|date=2011-07-28|volume=16|issue=30|pmid=21813077}}</ref> Gharama za kiuchumi za homa ya nyongo C ni muhimu kwa mtu binafsi na kwa jamii kijumla. Nchini Marekani wastani ya gharama ya maisha ya ugonjwa huo ilikadiriwa kuwa dola 33,407 za marekani mwaka 2003,<ref name=Cost2006>{{cite journal|last=Wong|first=JB|title=Hepatitis C: cost of illness and considerations for the economic evaluation of antiviral therapies.|journal=PharmacoEconomics|year=2006|volume=24|issue=7|pages=661–72|pmid=16802842}}</ref> na gharama ya kupandikiza ini ni takriban dola 200,000 za Marekani kufikia mwaka 2011.<ref name=Cost2011/> Nchini Canada gharama ya matibabu ya kupambana na virusi yalikuwa juu kama dola 30,000 za Canada mwaka 2003,<ref>{{cite web|title=Hepatitis C Prevention, Support and Research ProgramHealth Canada|url=http://www.phac-aspc.gc.ca/hepc/pubs/psrpmideval-ppsrevalinter/i_problem-eng.php|work=Public Health Agency of Canada|accessdate=10 Januari 2012|month=Nov|year=2003}}</ref> wakati Marekani gharama ni kati ya dola 9200 na 17,600 za Marekani mwaka 1998.<ref name=Cost2006/> Katika maeneo mengi ya dunia watu wanashindwa kumudu matibabu na madawa ya kupunguza makali ya virusi kwa sababu ya kukosa bima au bima waliyo nayo haitalipa madawa ya kupunguza makali ya virusi.<ref>{{cite book|last=Zuckerman|first=edited by Howard Thomas, Stanley Lemon, Arie|title=Viral Hepatitis.|year=2008|publisher=John Wiley & Sons|location=Oxford|isbn=9781405143882|pages=532|url=http://books.google.ca/books?id=nT2dauLXoYAC&pg=PA532|edition=3rd ed.}}</ref> == Utafiti == Kufikia mwaka 2011, karibu madawa mia moja yanakuzwa kwa ajili ya homa ya nyongo C.<ref name=Cost2011>{{cite journal|last=El Khoury|first=A. C.|coauthors=Klimack, W. K., Wallace, C., Razavi, H.|title=Economic burden of hepatitis C-associated diseases in the United States|journal=Journal of Viral Hepatitis|date=1 Desemba 2011|doi=10.1111/j.1365-2893.2011.01563.x}}</ref> Dawa hizi ni pamoja na chanjo za kutibu homa ya manjano, immunomodulators, na vizuia vya cyclophilin.<ref>{{cite journal|last=Ahn|first=J|coauthors=Flamm, SL|title=Hepatitis C therapy: other players in the game|journal=Clinics in liver disease|date=2011 Aug|volume=15|issue=3|pages=641–56|pmid=21867942|doi=10.1016/j.cld.2011.05.008}}</ref> Uwezekano wa matibabu haya mapya yamekuja kutokana na uelewa mzuri wa virusi vya homa ya nyongo C.<ref>{{cite journal|last=Vermehren|first=J|coauthors=Sarrazin, C|title=New HCV therapies on the horizon.|journal=Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases|date=2011 Feb|volume=17|issue=2|pages=122–34|pmid=21087349}}</ref> == References == {{Marejeo|colwidth=30em}} [[Jamii:Magonjwa]] [[Jamii:Ini]] [[Jamii:Tiba]] nwows4podbln4hv56ttggohg0xxmj0v 0 67235 1578194 1520399 2026-07-03T02:25:46Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578194 wikitext text/x-wiki {{Italic title}} {{Uainishaji (Mimea) | rangi = lightblue | jina = Metarhizium | picha = Metarhizium_anisopliae_infected_cockroach_(PLoS).jpg | upana wa picha = 250px | maelezo_ya_picha = Mende aliyeuawa na ''Metarhizium anisopliae'' | domeni = [[Eukaryota]] | himaya = [[Fungi]] | nusuhimaya = [[Dikarya]] | faila = [[Ascomycota]] | ngeli = [[Sordariomycetes]] | oda = [[Hypocreales]] | familia = [[Clavicipitaceae]] | jenasi = ''[[Metarhizium]]'' | bingwa_wa_jenasi = Sorokin | spishi-mfano = ''[[Metarhizium anisopliae]]'' | bingwa_wa_spishi-mfano = Sorokin }} ''[[Metarhizium]]'' ni [[jenasi]] ya kuvu [[entomopathojeni]] (kuvu zisababishazo magonjwa kwa [[mdudu|wadudu]]) katika [[familia (biolojia)|familia]] [[Clavicipitaceae]]. Tangu kuwadia kwa [[muhtasari wa jenetiki|mihtasari ya jenetiki]] imewezekana kuweka kuvu hizi kwenye [[taksoni]] (aina) zao za kufaa. Nyingi sana zimetokea kuwa jinsi za kuvu za [[Ascomycota]] ambazo sina jinsia ([[anamorfi]]). == Spishi == Kabla ya mbinu za [[kimolekuli]] kuletwa mwishoni mwa [[karne]] ya 20, spishi za "Metarhizium" zilitambuliwa kwa sifa za [[kimofolojia]] (haswa [[spora]]). Spishi za asili zilijumuishwa: ''[[Metarhizium anisopliae|M. anisopliae]]'' (pamoja na [[Metarhizium majus|''M.a.'' var. ''major'']]), ''[[Metarhizium brunneum|M. brunneum]]'', ''[[Metarhizium cicadinum|M. cicadinum]]'', ''[[Metarhizium cylindrosporum|M. cylindrosporum]]'', ''[[Metarhizium flavoviride|M. flavoviride]]'', ''[[Metarhizium taii|M. taii]]'', ''[[Metarhizium truncatum|M. truncatum]]'' na ''[[Metarhizium viridicolumnare|M. viridicolumnare]]''. [[Mwaka]] 2009 namna tisa za zamani zimepewa hadhi ya spishi pamoja na ''M. anisopliae'' inayojulikana sana<ref name="J.F. Bisch., Rehner & Humber (2009)">{{cite journal | title=A multilocus phylogeny of the ''Metarhizium anisopliae'' lineage | url=https://archive.org/details/mycologia_july-august-2009_101_4/page/512 | journal=Mycologia | volume=101 | pages=512–530 | year=2009 | author=Bischoff J.F., Rehner S.A. Humber R.A. | doi=10.3852/07-202 | pmid=19623931 | issue=4}} </ref>. Spishi mpya zimeendelea kutambuliwa na pengine majina ya asili yalirudishwa (haswa '' [[Metarhizium brunneum | M. Brunneum]] ''). Sasa (Julai 2018) [[index fungorum]] inaorodhesha<ref>[http://www.speciesfungorum.org/Names/Names.asp ''Species fungorum'' search ''Metarhizium'' (retrieved 19 July 2018)]</ref>: * ''[[Metarhizium acridum]]'' <small>(Driver & Milner) J.F. Bisch., S.A. Rehner & Humber (2009)</small> (prev. ''M. anisopliae'' var. ''acridum'') * ''[[Metarhizium anisopliae]]'' <small>(Metschn.) Sorokīn (1883)</small> * ''[[Metarhizium atrovirens]]'' <small>(Kobayasi & Shimizu) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium bibionidarum]]'' <small>O. Nishi & H. Sato (2017)</small> * ''[[Metarhizium blattodeae]]'' <small>C. Montalva, Humber, K. Collier & C. Luz (2016)</small> * ''[[Metarhizium brasiliense]]'' <small>Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium brittlebankisoides]]'' <small>(Zuo Y. Liu, Z.Q. Liang, Whalley, Y.J. Yao & A.Y. Liu) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium brunneum]]'' <small>Petch (1935)</small> * ''[[Metarhizium campsosterni]]'' <small>(W.M. Zhang & T.H. Li) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium carneum]]'' <small>(Duché & R. Heim) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium chaiyaphumense]]'' <small>Tasan., Khons., Thanakitp., Mongkols. & Luangsa-ard (2017)</small> * ''[[Metarhizium cicadinum]]'' <small>(Höhn.) Petch (1931)</small> * ''[[Metarhizium cylindrosporum]]'' <small>Q.T. Chen & H.L. Guo (1986)</small> * ''[[Metarhizium dendrolimatilis]]'' <small>Z.Q. Liang, Wan H. Chen, Y.F. Han & X. Zou (2017)</small> * ''[[Metarhizium flavoviride]]'' <small>W. Gams & Rozsypal (1973)</small> * ''[[Metarhizium frigidum]]'' <small>J.F. Bisch. & S.A. Rehner (2007)</small> * ''[[Metarhizium globosum]]'' <small>J.F. Bisch., S.A. Rehner & Humber (2009)</small> * ''[[Metarhizium granulomatis]]'' <small>(Sigler) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium guniujiangense]]'' <small>(C.R. Li, B. Huang, M.Z. Fan & Z.Z. Li) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium indigoticum]]'' <small>(Kobayasi & Shimizu) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium kalasinense]]'' <small>Tasan., Khons., Thanakitp., Mongkols. & Luangsa-ard (2017)</small> * ''[[Metarhizium khaoyaiense]]'' <small>(Hywel-Jones) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium koreanum]]'' <small>Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium kusanagiense]]'' <small>(Kobayasi & Shimizu) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium lepidiotae]]'' <small>(Driver & Milner) J.F. Bisch., S.A. Rehner & Humber (2009)</small> (prev. ''M. anisopliae'' var. ''lepidiotae'') * ''[[Metarhizium majus]]'' <small>(J.R. Johnst.) J.F. Bisch., S.A. Rehner & Humber (2009)</small> (prev. ''M. anisopliae'' var. ''major'') * ''[[Metarhizium marquandii]]'' <small>(Massee) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium minus]]'' <small>(Rombach, Humber & D.W. Roberts) Kepler, S.A. Rehner & Humber (2014)</small> (prev. ''M. flavoviride'' var. ''minus'') * ''[[Metarhizium novozealandicum]]'' <small>(Driver & Milner) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium owariense]]'' <small>(Kobayasi) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium pemphigi]]'' <small>(Driver & Milner) Kepler, Humber & S.A. Rehner (2014)</small> * ''[[Metarhizium pinghaense]]'' <small>Q.T. Chen & H.L. Guo (1986)</small> * ''[[Metarhizium prachinense]]'' <small>Tasan., Khons., Thanakitp., Mongkols. & Luangsa-ard (2017)</small> * ''[[Metarhizium pseudoatrovirens]]'' <small>(Kobayasi & Shimizu) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium purpureogenum]]'' <small>O. Nishi, S. Shimizu & H. Sato (2017)</small> * ''[[Metarhizium reniforme]]'' <small>(Samson & Evans) Luangsa-ard, Boucias & Hywel-Jones (2017)</small> * ''[[Metarhizium rileyi]]'' <small>(Farl.) Kepler, S.A. Rehner & Humber (2014)</small> (prev. ''[[Nomuraea]] rileyi'') * ''[[Metarhizium robertsii]]'' <small>J.F. Bisch., S.A. Rehner & Humber (2009)</small> * ''[[Metarhizium samlanense]]'' <small>Luangsa-ard, Thanakitp., Tasan., Mongkols. & Hywel-Jones (2017)</small> * ''[[Metarhizium taii]]'' <small>Z.Q. Liang & A.Y. Liu (1991)</small> * ''[[Metarhizium takense]]'' <small>Tasan., Thanakitp., Mongkols. & Luangsa-ard (2017)</small> * ''[[Metarhizium truncatum]]'' <small>Petch (1931)</small> * ''[[Metarhizium viride]]'' <small>(Segretain, Fromentin, Destombes, Brygoo & Dodin ex Samson) Kepler, S.A. Rehner & Humber (2014)</small> * ''[[Metarhizium viridicolumnare]]'' <small>(Matsush.) Matsush. (1993)</small> * ''[[Metarhizium viridulum]]'' <small>(Tzean, L.S. Hsieh, J.L. Chen & W.J. Wu) B. Huang & Z.Z. Li (2004)</small> * ''[[Metarhizium yongmunense]]'' <small>(G.H. Sung, J.M. Sung & Spatafora) Kepler, S.A. Rehner & Humber (2014)</small> ===Majina mengine ya spishi zilizoainishwa tena=== * ''M. album'' <small>Petch, 1931</small> inaainishwa katika ''M. anisopliae'' sasa. * ''[[Metarhizium glutinosum|M. glutinosum]]'' imewekwa katika familia [[Stachybotryaceae]] sasa kama ''[[Albifimbria]] ([[Myrothecium]]) verrucaria'' <small>(Alb. & Schwein.) L. Lombard & Crous</small><ref>Lombard L, Crous PW (2016) in: Lombard, Houbraken, Decock, Samson, Meijer, Réblová, Groenewald & Crous ''Persoonia'' '''36''': 177.</ref>. * ''M. martiale'' inaainishwa kama ''[[Nigelia]] martiale'' <small>(Speg.) Luangsa-ard & Thanakitp.</small> ([[Clavicipitaceae]])<ref>Luangsa-ard, Thanakitpipattana (2017) in: Luangsa-ard, Mongkolsamrit, Thanakitpipattana, Khonsanit, Tasanathai, Noisripoom, Humber. ''Index Fungorum'' '''345''': 1.</ref>. ===Teleomorfi=== Inaonekana kama [[teleomorfi]] za spishi za ''Metarhizium'' ni wana wa jenasi ''[[Metacordyceps]]''<ref name="Sung et al. 2007">{{cite journal | title=Phylogenetic classification of ''Cordyceps'' and the clavicipitaceous fungi | journal=Studies in Mycology | volume=57 | pages=5–59 | year=2007 | author=Sung, G.-H., Hywel-Jones, N.L., Sung, J.-M., Luangsa-ard, J.J., Shrestha, B. and Spatafora1, J.W. | pmid=18490993 | doi=10.3114/sim.2007.57.01 | pmc=2104736 }} </ref>. ''Metacordyceps taii'' (kama ''Cordyceps taii'') imefafanua kama teleomorfi ya ''Metarhizium taii''<ref name="Liang et al. 1991">{{cite journal | title=A new species of the genus ''Cordyceps'' and its ''Metarhizium'' anamorph | journal=Acta Mycologica Sinica | volume=10 | pages=257–262 | year=1991 | author=Liang, Z.-Q., Liu, A.-Y., Liu, J.-L. }} </ref>. Kwa muda fulani imefahamu kuwa kisawe cha ''M. guizhouense, lakini jina ''M. taii'' limerudishwa sasa<ref name="Huang et al. 2005">{{cite journal | title=Molecular evidence for the taxonomic status of ''Metarhizium taii'' and its teleomorph, ''Cordyceps taii'' (Hypocreales, Clavicipitaceae) | journal=Mycotaxon | volume=94 | pages=137–147 | year=2005 | author=Huang B., Li C., Humber R.A., Hodge K.T., Fan M. and Li Z. }} </ref>. Hakuna uhakika kuhusu swali kwamba spishi na namna nyingine za ''Metarhizium'' zina teleomorfi zao zenyewe. Inawezekana kwamba namna nyingi zimepoteza uwezo wa kuzaliana kwa kijinsia. ==Udhibiti wa nzige== Katika miaka ya 1990 [[mradi]] wa [[utafiti]] wa [[LUBILOSA]] ulithibitisha kwamba ''M. acridum'' ilikuwa na [[ufanisi]] katika kuua [[nzige]] na wana wengine wa familia za [[Acrididea]] bila athari mbaya zinazopatikana katika majaribio ya nje kwa spishi zozote zisizolengwa isipokuwa [[kiwavi-hariri|viwavi-hariri]] wa [[ufugaji|kufugwa]] ''[[Bombyx mori]]''<ref>{{cite journal |last=Lomer |first=C.J. |last2=Bateman |first2=R.P. |last3=Johnson |first3=D.L. |last4=Langewald |first4=J. |last5=Thomas |first5=M. |title=Biological Control of Locusts and Grasshoppers |url=https://archive.org/details/sim_annual-review-of-entomology_2001_46/page/667 |journal=Annual Review of Entomology |volume=46 |issue= |pages=667–702 |year=2001 |doi=10.1146/annurev.ento.46.1.667 |pmid=11112183}}</ref>. Hivi sasa inazalishwa kama [[dawa ya kibiolojia]] kwa jina "Novacrid" na [[kampuni]] ya Eléphant Vert katika [[kiwanda]] chao huko [[Meknès]], [[Maroko]]<ref>{{Rejea tovuti |url=http://en.elephant-vert.com/ |title=Tovuti ya kampuni ya Elephant Vert |accessdate=2021-01-17 |archiveurl=https://web.archive.org/web/20170706061747/http://en.elephant-vert.com/ |archivedate=2017-07-06 }}</ref>. Hivi karibuni (2019) kampuni hiyo hiyo ilipata [[leseni]] ya kuzalisha na kuuza [[kifundiro]] asili kilichotengenezwa na LUBILOSA, ambacho kinaitwa Green Muscle. Kifundiro cha tatu, Green Guard, kinazalishwa na BASF ya [[Australia]] kwa udhibiti wa nzige wa tauni wa Australia na panzi bila mabawa<ref>[https://www.basf.com Tovuti ya BASF]</ref>. == Marejeo == {{reflist}} [[Jamii:Fungi]] [[Jamii:Kuvu viuawadudu]] edpjlybf6cxo97a14v20rba56leim6v 0 67262 1578058 1300964 2026-07-02T17:07:16Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578058 wikitext text/x-wiki {{Italic title}} {{Uainishaji (Mimea) | rangi = lightblue | jina = Metarhizium | picha = Metarhizium acridum infecting locust (PLoS).jpg | upana wa picha = 250px | maelezo_ya_picha = Nzige aliyeuawa na ''Metarhizium acridum'' | domeni = [[Eukaryota]] | himaya = [[Fungi]] | nusuhimaya = [[Dikarya]] | faila = [[Ascomycota]] | ngeli = [[Sordariomycetes]] | oda = [[Hypocreales]] | familia = [[Clavicipitaceae]] | jenasi = ''[[Metarhizium]]'' | bingwa_wa_jenasi = Sorokin | spishi = ''[[Metarhizium acridum]]'' | bingwa_wa_spishi = (Driver & Milner) J.F. Bisch., Rehner & Humber (2009) }} ''[[Metarhizium acridum]]''<ref name="Bischoff, Rehner & Humber 2009">{{cite journal | title=A multilocus phylogeny of the ''Metarhizium anisopliae'' lineage | url=https://archive.org/details/mycologia_july-august-2009_101_4/page/512 | journal=Mycologia | volume=101 | pages=512–530 | year=2009 | author=Bischoff J.F., Rehner S.A. and Humber R.A. | doi=10.3852/07-202 | pmid=19623931 | issue=4}} </ref> ni jina jipya la kundi la [[tenganisho|matenganisho]] ya [[kuvu]] ambayo yanajuliwa kusababisha maambukizi dhidi ya [[spishi]] za [[species:Acrididea|Acrididea]] pekee. Zamani spishi hii ilikuwa na hadhi ya namna katika ''[[Metarhizium anisopliae]]'' (var. ''acridum''<ref name="Driver ''et al.'' 2000">{{cite journal | title=A Taxonomic revision of ''Metarhizium'' based on sequence analysis of ribosomal DNA | url=https://archive.org/details/sim_mycological-research_2000-02_104_2/page/135 | journal=Mycological Research | volume=104 | pages=135–151 | year=2000 | author=Driver, F., Milner, R.J. and Trueman, W.H.A. | doi=10.1017/S0953756299001756 | issue=2 }} </ref>). Kabla ya hii matenganisho haya yalitambulishwa kama ''[[Metarhizium flavoviride|M. flavoviride]]'' au ''Metarhizium sp.''<ref name="Bateman ''et al.'' 1996">{{cite journal | title=Screening for virulent isolates of entomopathogenic fungi against the desert locust, ''Schistocerca gregaria'' (Forskål) | url=https://archive.org/details/biocontrol-science-and-technology_1996-12_6_4/page/549 | journal=Biocontrol Science and Technology | volume=6 | pages=549–560 | year=1996 | author=Bateman, R.P., Carey, M., Batt, D., Prior, C., Abraham, Y., Moore, D., Jenkins, N., Fenlon J. | doi=10.1080/09583159631181 | issue=4}} </ref> Yaunda kundi la matenganisho kutoka [[panzi]] na [[nzige]] ambayo yanafanana sana. == Biolojia == ''M. acridum'' inaambukiza takriban pekee panzi wa [[nusuoda]] [[Caelifera]] ya [[Orthoptera]]. Makundi kadhaa ya uchunguzi, k.m. mradi wa mataifa [[LUBILOSA]], ambao umeendeleza [[dawa ya kibiolojia]] “Green Muscle”, yametambua na yameshughulikia changamoto za kifundi za matumizi ya udhibiti wa visumbufu kwa vijidudu, kujumuisha: uchaguzi wa matenganisho, uzalishaji kwa wingi na njia za matumizi (michanganyiko na mapulizaji).<ref name="Lomer et al. 2001">{{cite journal | title=Biological Control of Locusts and Grasshoppers | url=https://archive.org/details/sim_annual-review-of-entomology_2001_46/page/667 | journal=Annual Review of Entomology | volume=46 | pages=667–702 | year=2001 | author=Lomer, C.J., Bateman, R.P., Johnson, D.L., Langewald, J. and Thomas, M. | doi=10.1146/annurev.ento.46.1.667 | pmid=11112183 }} </ref> Kwa maneno mengine udhibiti wa [[mdudu|wadudu]] unaegemea vipengele kama namba ya [[spora]] ipulizwayo juu ya wadudu, mchanganyiko<ref name="Burges 1998">{{cite book | last=Burges | first=H.D. (ed.) | year=1998 | title=Formulation of microbial biopesticides, beneficial microorganisms, nematodes and seed treatments | publisher=Kluwer Academic | location=Dordrecht, Netherlands | page=412 pp. | isbn=0-412-62520-2 }} </ref> na hali ya hewa.<ref name="Thomas and Blanford 2005">{{cite journal | title=Thermal biology in insect-parasite interactions | journal=Trends in Ecology and Evolution | volume=18 | pages=344–350 | year=2003 | author=Thomas, M.H. and Blanford, S. | doi=10.1016/S0169-5347(03)00069-7 | issue=7 }} </ref> Michanganyiko katika mafuta inawezesha upulizaji wa spora za kuvu wakati wa hali kavu na inafalia upulizaji kwa mashine za kiwango kidogo sana zinazotumika kwa udhibiti wa nzige. ''M. acridum'' inaambukiza panzi na nzige tu. Wanasayansi walitaka kujua kwa nini kimelea hiki ni mahususi kwa shabaha yake. Wanafikiri kwamba sababu ni ukosa wa jeni Mest1 katika ''M. acridum''. Utafiti wa wanasayansi wa [[Uchina]] ulijaribu shughuli ya jeni hii. Walikuwa wakitumia aina ya ''[[Metarhizium robertsi|M. robertsi]]'' isiyo na jeni Mest1 ifanyayo kazi, wanasayansi waliona kwamba kuvu hii iliweza kuambukiza panzi na nzige tu kama ''M. acridum'' kabisa.<ref>Wang S, Fang W, Wang C, St. Leger RJ (2011) Insertion of an Esterase Gene into a Specific Locust Pathogen (''Metarhizium acrid'') Enables It to Infect Caterpillars. PLoS Pathog 7(6): e1002097. {{doi|10.1371/journal.ppat.1002097}} http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1002097</ref> Sasa USDA inafikiria kuhusu uachiaji wa ''M. acridum'' katika MMA ya magharibi ili kudhibiti panzi na nyenje wa kienyeji.<ref>{{cite web |url=http://www.aphis.usda.gov/plant_health/plant_pest_info/grasshopper/index.shtml |title=Rangeland Grasshopper and Mormon Cricket Program |work=USDA-APHIS |accessdate=20 Januari 2011 |archiveurl=https://archive.today/20121209161132/http://webcache.googleusercontent.com/search?q=cache:JtCUuMiRUg8J:www.aphis.usda.gov/plant_health/plant_pest_info/grasshopper/index.shtml+http://www.aphis.usda.gov/plant_health/plant_pest_info/grasshopper/index.shtml&cd=1&hl=en&ct=clnk&gl=us |archivedate=2012-12-09 }}</ref> == Matenganisho maalum == * IMI 330189 (= ARSEF 7486) ni mfano wa zamani wa spishi na ilipatwa huko [[Niger]]: kiambato cha utendaji cha “Green Muscle”. * CSIRO FI 485 (= ARSEF 324) ni tenganisho la [[Australia]]: kiambato cha utendaji cha “Green Guard”. == Marejeo == {{Marejeo}} == Tazama pia == * ''[[Metarhizium]]'' * [[LUBILOSA]] [[Jamii:Dawa za kibiolojia]] [[Jamii:Fungi]] [[Jamii:Kuvu viuawadudu]] e1oe90ha9dv5jdcke8rbvuo6xezq8o8 0 68340 1578047 1564472 2026-07-02T16:19:58Z InternetArchiveBot 41439 Add 5 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578047 wikitext text/x-wiki {{Infobox disease | Name = Hypertension | Image = Grade 1 hypertension.jpg | Caption = Automated arm [[sphygmomanometer|blood pressure meter]] showing [[artery|arterial]] hypertension (shown a [[systolic blood pressure]] 158&nbsp;mmHg, [[diastolic blood pressure]] 99&nbsp;mmHg and [[heart rate]] of 80 beats per minute). | DiseasesDB = 6330 | ICD10 = {{ICD10|I|10||i|10}},{{ICD10|I|11||i|10}},{{ICD10|I|12||i|10}},<br/>{{ICD10|I|13||i|10}},{{ICD10|I|15||i|10}} | ICD9 = {{ICD9|401}} | OMIM = 145500 | MedlinePlus = 000468 | eMedicineSubj = med | eMedicineTopic = 1106 | eMedicine_mult = {{eMedicine2|ped|1097}} {{eMedicine2|emerg|267}} | MeshID = D006973 }} '''Shinikizo la juu la damu''' (HTN) au '''presha ya juu ya damu''' (pia huitwa '''shinikizo la mishipa ya damu''', HBP), ni [[ugonjwa]] sugu ambapo [[nguvu ya msukumo wa damu]] katika [[mshipa|mishipa]] ni kubwa kuliko kawaida. Ongezeko hilo husababisha [[moyo]] kufanya kazi kupita kiasi ili uzungushe [[damu]] katika [[mishipa ya damu]]. Kwa kawaida halina dalili, ila likidumu lina madhara makubwa kwa [[afya]]. Shinikizo la juu la damu ndilo sababu kubwa ([[kihatarishi]]) ya [[upoozaji]], [[mshtuko wa moyo]] (mashambulizi ya moyo), [[moyo kushindwa kufanya kazi]], [[kutuna kwa ukuta]] wa mishipa (k.m., [[kutuna kwa ukuta wa aota au mkole]]), [[chujio la mshipa wa kupeleka damu kwenye moyo au peripheral arterial disease]], na inasababishwa na [[ugonjwa sugu wa figo]]. Hata ongezeko la wastani la shinikizo la damu hupunguza [[matarajio ya muda wa kuishi]]. Kuna vipimo viwili vya shinikizo la damu, yaani systolic na diastolic: shinikizo au presha ya systolic ni [[kipimo]] cha damu ambacho kinapima nguvu ya msukumo wa damu katika mishipa ya damu wakati moyo unadunda. Shinikizo au presha ya diastole inapima nguvu ya msukumo wa damu katika mishipa ya damu wakati moyo umetulia au kati ya [[mapigo ya moyo]] (diastole). Kipimo cha kawaida cha shinikizo la damu ni 100–140&nbsp;[[milimita]] za [[zebaki]] (mmHg) upande wa systolic (kipimo cha juu) na 60–90&nbsp; milimita za zebaki upande wa diastolic (kipimo cha chini). Shinikizo la juu la damu hutokea kama kipimo kikiwa zaidi ya 140/90&nbsp;mmHg kwa muda mrefu. Kuna aina mbili za shinikizo la juu la damu: [[shinikizo la juu la damu la asili]] na [[shinikizo la damu linalosababishwa na magonjwa mengine]]. Kadiri ya [[asilimia]] 90–95 za watu wanaathiriwa na "shinikizo la juu la damu la asili", yaani wana ugonjwa huu bila kuwa na chanzo cha kisayansi kinachofahamika.<ref name="pmid10645931">{{cite journal |author=Carretero OA, Oparil S |title=Essential hypertension. Part I: Definition and etiology |journal=Circulation |volume=101 |issue=3 |pages=329–35 |year=2000 |month=January |pmid=10645931 |url=http://circ.ahajournals.org/content/101/3/329.long |doi=10.1161/01.CIR.101.3.329}}</ref> Magonjwa mengine ya [[mafigo]], mishipa, moyo, [[mfumo wa homoni]] huathiri asilimia 5–10 iliyobaki ya watu wenye shinikizo la damu (ndilo shinikizo la damu linalosababishwa na magonjwa mengine). Ili kudhibiti shinikizo la damu, [[lishe bora]] na mabadiliko katika mtindo wa kuishi lazima yazingatiwe pamoja na kupunguza matatizo yanayoathiri [[afya]]. Hata hivyo, matumizi ya [[dawa]] ni muhimu kwa watu ambao mabadiliko ya mtindo wa maisha hautoshelezi kupunguza shinikizo la juu la damu, kutuna kwa [[ukuta wa ateri]] mithili ya puto kutokana na udhaifu wa sehemu hiyo. {{TOC limit|3}} ==Uainishaji wa shinikizo la damu== {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |- ! rowspan=2 | Classification (JNC7)<ref name="jnc7">{{cite journal |author=Chobanian AV, Bakris GL, Black HR, ''et al.'' |title=Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure |journal=Hypertension |volume=42 |issue=6 |pages=1206–52 |year=2003 |month=December |pmid=14656957 |doi=10.1161/01.HYP.0000107251.49515.c2 |url=http://hyper.ahajournals.org/content/42/6/1206.long}}</ref> ! colspan=2 | Systolic pressure ! colspan=2 | Diastolic pressure |- ! [[mmHg]] ! [[Pascal (unit)|kPa]] ! mmHg ! kPa |- | Kawaida | 90–119 | 12–15.9 | 60–79 | 8.0–10.5 |- | Dalili ya shinikizo la juu la damu | 120–139 | 16.0–18.5 | 80–89 | 10.7–11.9 |- | Aina ya 1 shinikizo la juu la damu - kali | 140–159 | 18.7–21.2 | 90–99 | 12.0–13.2 |- | Aina ya 2 shinikizo la juu la damu - kali kiasi | ≥160 | ≥21.3 | ≥100 | ≥13.3 |- | [[Isolated systolic hypertension|Isolated systolic<br/>shinikizo la juu la damu - kali sana]] | ≥140 | ≥18.7 | <90 | <12.0 |} ===Watu wazima=== Kwa watu wenye umri wa miaka 18 au zaidi, shinikizo la juu la damu linaweza kuwa systolic na/au diastolic kama kipimo hicho ni zaidi kuliko kipimo cha kawaida kinachokubalika ambacho ni (139&nbsp;mmHg systolic, 89&nbsp;mmHg diastolic: tazama table — Uainishaji (JNC7)). Kama vipimo vinapatikana baada ya kutumia chombo kinachopima presha kwa masaa 24 (24-hour ambulatory) au kufanya maangalizi nyumbani, vipimo vya chini vinatumiwa (135&nbsp;mmHg systolic or 85&nbsp;mmHg diastolic). Pia miongozo ya kimataifa ya hivi karibuni imegawanya shinikizo la damu katika vikundi mbali mbali vyenye vipimo chini ya kipimo cha shinikizo la juu la damu ili kuthibitisha hatari iliyopo ya shinikizo la juu la damu. JNC7 (2003)<ref name="jnc7" /> anatumia neno dalili ya kuwa na shinikizo la juu la kwa presha ya damu iliyo kati ya 120 na 139&nbsp;mmHg systolic na/au 80–89&nbsp;mmHg diastolic, wakati Miongozo ya ESH-ESC (2007)<ref name=ESH-ESC>{{cite journal |author=Mancia G, De Backer G, Dominiczak A, ''et al.'' |title=2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension |journal=J. Hypertens. |volume=25 |issue=9 |pages=1751–62 |year=2007 |month=September |pmid=17762635 |doi=10.1097/HJH.0b013e3282f0580f |url=}}</ref> and BHS IV (2004)<ref name=BHSIV>{{cite journal |author=Williams B, Poulter NR, Brown MJ, ''et al.'' |title=Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV |journal=J Hum Hypertens |volume=18 |issue=3 |pages=139–85 |year=2004 |month=March |pmid=14973512 |doi=10.1038/sj.jhh.1001683 |url=}}</ref> inatenganisha katika vikundi vya hali inayofaa, vya kawaida, na vya kawaida kiasi kutofautisha presha zilizopo chini ya 140&nbsp;mmHg systolic na 90&nbsp;mmHg diastolic. Shinikizo la juu la damu pia imegawanywa katika vikundi vifuatavyo: JNC7 inatofautisha shinikizo la juu la damu aina ya I, shinikizo la juu la damu aina ya II, na shinikizo la juu la damu hatua kali sana. Shinikizo la juu la damu ambayo ni kali sana (Isolated systolic hypertension) ni presha ya juu sana inayoambatana na presha ya kawaida ya diastolic, hali hii huwatokea sana wazee.<ref name="jnc7"/> The ESH-ESC Guidelines (2007)<ref name=ESH-ESC /> and BHS IV (2004),<ref name = BHSIV /> inatambua aina ya tatu (aina ya III) ya shinikizo la juu la damu kwa watu ambao wana presha ya juu ya systolic inayozidi 179&nbsp;mmHg au presha ya diastolic inayozidi 109&nbsp;mmHg. Shinikizo la juu la damu liko katika kundi la "sugu" kama [[madawa]] hayapunguzi shinikizo la damu hadi vipimo vya kawaida.<ref name="jnc7"/> ===Watoto wadogo na wachanga=== Si kawaida kwa [[watoto waliozaliwa karibuni]] kuwa na shinikizo la juu la damu na ni asilimia 0.2 hadi 3% ya watoto wachanga ambao wanapata. Shinikizo la damu haipimwi mara kwa mara kama watoto ni wadogo na wana afya nzuri. <ref name=Dionne>{{cite journal |author=Dionne JM, Abitbol CL, Flynn JT |title=Hypertension in infancy: diagnosis, management and outcome |journal=Pediatr. Nephrol. |volume=27 |issue=1 |pages=17–32 |year=2012 |month=January |pmid=21258818 |doi=10.1007/s00467-010-1755-z |url=}}</ref> Shinikizo la damu huwapata watoto ambao wako katika hatari kubwa. Kuna masuala tofauti ya kuangalia, kama vile [[kipindi cha ujazito]], umri baada ya utungaji mimba, na [[uzito wakati wa kuzaliwa]] kabla ya kuamua kama kipimo cha shinikizo la damu ni cha kawaida kwa mtoto mchanga.<ref name=Dionne /> ===Watoto na vijana=== Ni kawaida kwa watoto na vijana kupata shinikizo la damu (asilimia 2–9% hutegemea na umri, jinsia, na asili)<ref>{{cite journal |author=Din-Dzietham R, Liu Y, Bielo MV, Shamsa F |title=High blood pressure trends in children and adolescents in national surveys, 1963 to 2002 |journal=Circulation |volume=116 |issue=13 |pages=1488–96 |year=2007 |month=September |pmid=17846287 |doi=10.1161/CIRCULATIONAHA.106.683243 |url=https://archive.org/details/sim_circulation_2007-09-25_116_13/page/n73}}</ref> and is associated with long-term risks of ill-health.<ref name=fourth>{{cite journal |author= |title=The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents |journal=Pediatrics |volume=114 |issue=2 Suppl 4th Report |pages=555–76 |year=2004 |month=August |pmid=15286277 |doi= |url=https://archive.org/details/sim_pediatrics_2004-08_114_2/page/n294}}</ref> Hivi sasa kuna pendekezo la kuwapima damu watoto wenye zaidi ya miaka mitatu na kuangalia kama wana shinikizo la juu la damu kila wanapoenda kupimwa afya yao. Kabla ya kuthibitisha kama mtoto ana shinikizo la juu la damu mtoto lazima apimwe mara kadhaa.<ref name = fourth /> Shinikizo la damu huongezeka utotoni kufuatana na umri , wa watoto, shinikizo la damu linatambulika kama ni systolic ya kawaida au diastolic baada ya kupimwa zaidi ya mara tatu au zaidi ya asilimia 95 ambayo ni kawaida kufuatana na jinsia, umri na urefu wa mtoto. Dalili ya shinikizo la juu la damu (Prehypertension) kwa watoto linatambulika kama shinikizo au presha ya kawaida ya systolic au shinikizo au presha ya diastolic kama ni zaidi au sawa na asilimia 90, lakini ni chini ya asilimia 95.<ref name=fourth />Kwa vijana, inapendekezwa kwamba shinikizo la juu la damu na dalili ya shinikizo la juu la damu zichunguzwe na kuainisha kwa kutumia vigezo vya watu wazima.<ref name=fourth /> ==Ishara na dalili== Mara nyingi watu wenye shinikizo la damu hawana dalili yoyote, na huwa inagundulika baada ya kufanya uchunguzi kwa kawaida kupitia [[Uchunguzi (medicine)|screening]], au wakati maangalizi ya afya yanafanywa kwa sababu nyingine. Watu wengine wenye shinikizo la damu huwa wanapata [[maumivu ya kichwa]] (haswa nyuma ya kichwa na asubuhi), pamoja na [[kuchanganyikiwa]], [[kizunguzungu]], [[sikio kelele]] (mvumo au mazomeo masikioni), kutoweza kuona vizuri au [[Syncope (medicine)|matukio ya kuzirai]].<ref name=Fisher2005>{{cite book |author=Fisher ND, Williams GH |editor=Kasper DL, Braunwald E, Fauci AS, ''et al.'' |title=Harrison's Principles of Internal Medicine|edition=16th |year=2005 |publisher=McGraw-Hill |location=New York, NY |isbn=0-07-139140-1 |pages=1463–81 |chapter=Hypertensive vascular disease}}</ref> Baada ya [[uchunguzi wa mwili]], kunakuwa na wasiwasi wa shinikizo la juu la damu kama [[kuna upanuzi wa mishipa ya damu ya retina]] baada ya kufanya uchunguzi wa [[optic fundus]] iliyopo nyuma ya jicho kwa kutumia [[chombo cha kufanyia uchunguzi yaani ophthalmoscopy]].<ref name=Wong2007>{{cite journal |author=Wong T, Mitchell P |title=The eye in hypertension |url=https://archive.org/details/sim_the-lancet_february-3-9-2007_369_9559/page/425 |journal=Lancet |volume=369 |issue=9559 |pages=425–35 |year=2007 |month=February |pmid=17276782 |doi=10.1016/S0140-6736(07)60198-6}}</ref> Classically, ukali wa mabadiliko ya shinikizo la damu ya retina linagawanya kwenye vikundi kuanzia I hadi IV, ingawa inaweza kuwa vigumu kuzitofautisha aina kali kiasi.<ref name=Wong2007/> Chombo cha kufanyia uchunguzi wa macho kinaweza kuonyesha muda ambao mtu amekuwa na shinikizo la juu la damu=Fisher2005/> ===Shinikizo la juu la damu litokanalo na magonjwa mengine=== Dalili zingine zinaweza kusababishwa na [[magonjwa mengine]], yani shinikizo la damu linaloletwa na sababu zingine zinazojulikana kama vile [[magonjwa ya figo]] au [[mabadiliko ya mfumo wa homoni]]. Kwa mfano, unene wa kifua na tumbo, [[uthibiti mbaya wa sukari]], [[moon facies]] au mkusanyiko wa mafuta usoni, mkusanyiko wa mafuta mgongoni ("buffalo hump") na purple [[striae]] au alama za unene huonyesha dalili ya [[ugonjwa wa homoni wa Cushing's syndrome]].<ref name=ABC>{{cite book |author=O'Brien, Eoin; Beevers, D. G.; Lip, Gregory Y. H. |title=ABC of hypertension |url=https://archive.org/details/abcofhypertensio0000unse |publisher=BMJ Books |location=London |year=2007 |pages= |isbn=1-4051-3061-X |oclc= |doi= |accessdate=}}</ref> [[Ugonjwa unaoathiri kikoromeo]] na [[acromegaly]] yaani mwili hutengeneza homoni ya kukuza umbo pia huweza kuleta shinikizo la juu la damu na dalili zake za kawaida huonekana.<ref name="ABC" /> Wembamba wa mishipa ya tumbo au abdominal [[bruit]] inaweza kuwa ni ishara ya [[renal artery stenosis]] au kuziba kwa mishipa ya damu ipelekayo damu kwenye figo. Shinikizo la chini la damu katika miguu au mapigo ya mshipa wa mguu yanayochelewa au ukosefu wa mapigo [[mshipa wa mguu|mapigo ya mshipa wa mguu]] inaweza kuwa ni dalili ya [[aortic coarctation]] (kupungua kwa upana wa mshipa mkuu utoao damu kwenye moyo kwenda mwilini). Shinikizo la damu ambalo linalotofautiana sana na kuumwa kwa kichwa, mpapatiko wa moyo, kubadilika rangi ya ngozi, na utoaji jasho ni lazima kuwe na wasiwasi wa [[pheochromocytoma yaani saratani ya tezi iliyo juu ya figo]].<ref name="ABC" /> ===Hali ya hatari ya shinikizo la juu la damu=== Shinikizo la damu lililo juu kupita kiasi (sawa au zaidi ya 180 au diastolic ya 110, wakati mwingine huitwa shinikizo la damu linaloweza kuleta kifo au linaloharakisha kifo) inatambulika kama "hali ya hatari ya shinikizo la juu la damu." Shinikizo la damu vinavyozidi vipimo hivi vinaonyesha hali kubwa ya hatari ya ugonjwa huu. Watu wenye viwango hivi vya shinikizo la damu wanaweza wasiwe na dalili zozote, ila wanaweza kulalamika kuumwa kwa kichwa (asilimia 22% ya wagonjwa)<ref>{{cite journal |author=Papadopoulos DP, Mourouzis I, Thomopoulos C, Makris T, Papademetriou V |title=Hypertension crisis |journal=Blood Press. |volume=19 |issue=6 |pages=328–36 |year=2010 |month=December |pmid=20504242 |doi=10.3109/08037051.2010.488052 |url=}}</ref> na kuwa na kizunguzungu kuliko watu wa kawaida.<ref name=Fisher2005/> Dalili zingine za hali ya hatari ya shinikizo la damu ni kutoona vizuri au kutopumua vizuri kwa sababu moyo haufanyi kazi vizuri au kutojisikia vizuri [[uchovu]] kwa sababu mafigo yanashindwa kufanya kazi.<ref name="ABC" /> Watu wengi wenye hali ya hatari ya shinikizo la damu wanatambulika kuwa na msukumo mkubwa wa damu, lakini vichocheo vingine vinaweza kuongezea msukumo.<ref name=Marik2007>{{cite journal |author=Marik PE, Varon J |title=Hypertensive crises: challenges and management |journal=Chest |volume=131 |issue=6 |pages=1949–62 |year=2007 |month=June |pmid=17565029 |doi=10.1378/chest.06-2490 |url=http://chestjournal.chestpubs.org/content/131/6/1949.long |access-date=2013-03-06 |archive-date=2012-12-04 |archive-url=https://archive.today/20121204174126/http://chestjournal.chestpubs.org/content/131/6/1949.long |dead-url=yes }}</ref> "Shinikizo la damu la ghafla", zamani ilikuwa inajulikana kama "shinikizo la damu inayodhuru", hutokea ikiwa kuna ithibati ya madhara yanayotokea katika ogani za mwili kwa sababu ya shinikizo la juu la damu. Madhara haya yanaweza kuwa [[hypertensive encephalopathy]] au shinikizo kichwani, inasababishwa na uvimbe wa ubongo na kutofanya kazi vizuri, na husababisha kichwa kuumwa na [[kupoteza fahamu]] (kuchanganyikiwa au kusinzia). Retinal [[papilloedema]] and fundal [[kuvuja damu kutokana na mpasuko wa mishipa midogo ya macho]] na [[kutoa usaha au maji]] ni dalili nyingine ya madhara ya ogani. [[Maumivu ya kifua]] yanaweza kuwa ni dalili ya uharibifu wa misuli ya moyo (ambayo baadaye yanaleta [[upungufu wa damu kati ya misuli ya moyo]]) au wakati mwingine [[ukuta wa ndani wa aorta huchanika na damu]], kuchanika kwa ukuta wa mshipa mkuu uitwao [[aota/mkole]]. Kukosa pumzi, kukohoa, na kukohoa makohozi yenye damu ni dalili ya [[pulmonary edema au mapafu kujaa maji]]. Hali hii inaleta uvimbe wa seli za mapafu unaosababishwa na [[udhaifu wa upande wa kushoto wa moyo]], na uwezo mdogo wa [[upande wa kushoto]] wa moyo kusukuma damu kutoka kwenye mapafu hadi mishipa ya damu.<ref name=Marik2007/> Figo kupoteza uwezo wake wa kufanya kazi upesi (figo kushindwa kufanya kazi kwa ghafla) na [[microangiopathic hemolytic anemia au upungufu wa damu]] (uharibifu wa seli za damu) unaweza kutokea.<ref name=Marik2007/> Katika hali hizi, shinikizo la chini la damu ni muhimu ili kupunguza madhara ya ogani.<ref name=Marik2007/> Kwa upande mwingine, hakuna ushahidi unaonyesha kuwa shinikizo la damu linatakiwa kupunguzwa kwa kasi wakati wa matatizo ya dharura ya shinikizo la juu la damu iwapo kuna ogani iliyoathirika. Upunguzaji wa ghafla wa shinikizo la damu unaweza kuwa ni hatari.<ref name="ABC" /> Matumizi ya dawa ya kushusha shinikizo la damu hatua kwa hatua zaidi ya masaa 24 hadi 48 yanapendekezwa wakati wa dharura inayotokana na shinikizo la juu la damu.<ref name=Marik2007/> ===Ujauzito=== Shinikizo juu la damu hutokea takriban 8-10% za ujauzito. Wanawake karibu wote wenye shinikizo juu la damu wakiwa na mimba walikwishaumwa na shinikizio la damu la kawaida. Hali hiyo ikitokea katika ujaa uzito ni dalili ya kwanza ya kifafa cha mimba kabla hakijashikika kabisa. Maradhi hayo hutokea katika muda wa pili wa ujaa uzito na majuma machache baada ya kujifungua. Uaguzi wa maradhi hayo ni pamoja na shinikizo la damu kuongezeka na dalili za protini ndani ya mkojo. Maradhi hayo hutokea takribin 5% ya ujaa uzito yakisababisha takribin 16% ya vifo vya wenye ujaa uzito. Hatari ya kifo cha mtoto inaongezeka maradufu kutokana na maradhi hayo dunia nzima. Kwa kawaida hakuna dalili maalum za kifafa cha mimba kabla hakijashikika kabisa hugunduliwa na uchujaji wa kawaida. Zinapotokea dalili za maradhi hayo hizo ndizo ni kuumwa kichwani, taabu za kuona vizuri (mwanga wa kumulika ghafla) kutapika, maumivu ya epigastriumu na kuvimba. Kifafaa cha mimba kabla hakijashikika kabisa wakati mwingine inaweza kuletea hali inayotisha maisha inayoitwa kifafa cha mimba. Kifafa cha mimba kinaleta hali ya dharura ya shinikizo la damu inayotatiza sana. Matatizo hayo ni pamoja na upofu, kuvimba kwa ubongo, utendaji wa kiklonasi ulio katika hali ya kukazika au kuvutika na kutia kifafa, kuharibika kwa mafigo, edema ya mapafu, disseminated intravascular coagulation (kutoganda vizuri kwa damu). Shinikizo juu ya damu ikiathiri uja uzito: Dawa Ukunga na Elimuuzazi:<ref>http://emedicine.medscape.com/article/261435-overview title=Hypertension and Pregnancy author=Gibson, Paul coauthors= date=July 30 2009 work=eMedicine Obstetrics and Gynecology publisher=Medscape pages= accessdate=2009-06=16}</ref> ===Watoto wadogo na wachanga=== Kushindwa kustawi, kutiliwa kifafa, usumbufu, uchovu/kukosa nguvu, hali inayorudiarudia ya kudhikisha kwa mapofu kushindwa kuhema vizuri Shinikizo Juu la Damu: <ref>eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine” url=http://emedicine.medscape.com/article/889877-overview title=Hypertension author=Rodriguez-Cruz, Edwin coauthorsw=Ettinger, Leigh M date=April 6, 2010 wor4k=eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine publisher=Medscape pages= accessdate=2009-06-16}</ref> can be associated with hypertension in neonates and young infants. Kuhusu watoto wachanga ambao wameshahitimu umri zaidi pamoja na wana, shinikizo la juu la damu linaweza kuumiza kichwa, usumbufu usioelezeka, uchovu (uchovu wa kiganga), kushindwa kustawi, macho kutiliwa kiwi, kutokwa na damu puani, hatimaye kiharusi uso kupoozwa baadaye. <ref>Name=Dionne ref name=”urlHpertension: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine.</ref> ===Kuzidi kwa ukali wa shinikizo la juu la damu=== Shinikizo la juu la damu linachangia vifo vya watoto wachanga kuliko athari nyingine, nalo linaweza kupatiwa kinga.<ref>{{cite web|title= Global health risks: mortality and burden of disease attributable to selected major risks.|url=http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf|work=World Health Organization|year=2009|accessdate=10 February 2012}}</ref> It increases the risk of [[ischemic heart disease]]<ref name=pmid12493255>{{cite journal |author=Lewington S, Clarke R, Qizilbash N, Peto R, Collins R |title=Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies |journal=Lancet |volume=360 |issue=9349 |pages=1903–13 |year=2002 |month=December |pmid=12493255 |doi= 10.1016/S0140-6736(02)11911-8|url=https://archive.org/details/sim_the-lancet_2002-12-14_360_9349/page/n13}}</ref> [[strokes]],<ref name="ABC" /> [[peripheral vascular disease]],<ref name="pmid18375152">{{cite journal |author=Singer DR, Kite A |title=Management of hypertension in peripheral arterial disease: does the choice of drugs matter? |journal=European Journal of Vascular and Endovascular Surgery |volume=35 |issue=6 |pages=701–8 |year=2008 |month=June |pmid=18375152 |doi=10.1016/j.ejvs.2008.01.007}}</ref> and other cardiovascular diseases, including [[heart failure]], [[aortic aneurysm]]s, diffuse [[atherosclerosis]], and [[pulmonary embolism]].<ref name="ABC" /> Hypertension is also a risk factor for [[cognitive impairment]], [[dementia]], and [[chronic kidney disease]].<ref name="ABC" /> Other complications include: *[[Hypertensive retinopathy]] *[[Hypertensive nephropathy]]<ref name="pmid19330604">{{cite journal |author=Zeng C, Villar VA, Yu P, Zhou L, Jose PA |title=Reactive oxygen species and dopamine receptor function in essential hypertension |journal=Clinical and Experimental Hypertension |volume=31 |issue=2 |pages=156–78 |year=2009 |month=April |pmid=19330604 |doi=10.1080/10641960802621283}}</ref> ==Sababu== ===Shinikizo la juu la damu la msingi=== Shinikizo la juu la damu la msingi ni aina inayojulikana zaidi, ikiwa chanzo cha 90-95% za waathirika wa shinikizo la juu la damu<ref name="pmid10645931"/> Takriban katika jamii zote za kisasa shinikizo la damu linapanda juu katika nyakati za kuzeeka.<ref>{{cite journal|last=Vasan|first=RS|coauthors=Beiser, A, Seshadri, S, Larson, MG, Kannel, WB, D'Agostino, RB, Levy, D|title=Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study.|url=https://archive.org/details/sim_jama_2002-02-27_287_8/page/1003|journal=JAMA: the journal of the American Medical Association|date=2002 Feb 27|volume=287|issue=8|pages=1003-10|pmid=11866648}}</ref> Shinikizo la juu la damu linatokana katika ushirikiano wa viini-urithi na athari za mazingira. Viini-urithi vingi vya kawaida vikiwa na athari ndogo juu ya shinikizo la damu vimeshatambulika<ref>The International Consortium for Blood Pressure Genome-Wide Association Studies. Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk. Nature 2011; 478: 103–109 doi:10.1038/nature10405</ref> na vilevile vingine vya nadra lakini vyenye athari kubwa katika hilo<ref>{{cite journal|last=Lifton|first=RP|coauthors=Gharavi, AG, Geller, DS|title=Molecular mechanisms of human hypertension.|url=https://archive.org/details/cell_2001-02-23_104_4/page/545|journal=Cell|date=2001 Feb 23|volume=104|issue=4|pages=545-56|pmid=11239411}}</ref> lakini shinikizo juu la damu linalotokana na viini-athari halijaeleweka vizuri hadi leo hii. [[Chumvi]] kidogo tu,<ref>{{cite journal|last=He|first=FJ|coauthors=MacGregor, GA|title=A comprehensive review on salt and health and current experience of worldwide salt reduction programmes.|journal=Journal of human hypertension|date=2009 Jun|volume=23|issue=6|pages=363-84|pmid=19110538}}</ref> matunda na vyakula visivyo na [[mafuta]] mengi (Dietary Approaches to Stop Hypertension ([[DASH diet]])), [[mazoezi]],<ref name="ReferenceA">Dickinson HO, Mason JM, Nicolson DJ, Campbell F, Beyer FR, Cook JV, Williams B, Ford GA. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens. 2006;24:215-33.</ref> [[weight loss]]<ref name=HaslamJames>{{cite journal |author=Haslam DW, James WP |title=Obesity |url=https://archive.org/details/sim_the-lancet_october-1-7-2005_366_9492/page/1197 |journal=Lancet |volume=366 |issue=9492 |pages=1197–209 |year=2005 |pmid=16198769 |doi=10.1016/S0140-6736(05)67483-1}}</ref> na kutokunywa [[vileo]] sana ni misaada dhidi ya presha kupanda.<ref>{{cite journal | author = Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA ''et al.'' | year = 2002 | title = Primary prevention of hypertension: Clinical and public health advisory from The National High Blood Pressure Education Program | url = | journal = JAMA | volume = 288 | issue = 15| pages = 1882–8 | doi = 10.1001/jama.288.15.1882 | pmid = 12377087 }}</ref> Jinsi [[uchovu]],<ref name="ReferenceA"/> [[kahawa]],<ref>Mesas AE, Leon-Muñoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: A systematic review and meta-analysis. Am J Clin Nutr. 2011;94:1113–26.</ref> na upungufu wa [[vitamini D]]<ref>{{cite journal |author=Vaidya A, Forman JP |title=Vitamin D and hypertension: current evidence and future directions |journal=Hypertension |volume=56 |issue=5 |pages=774–9 |year=2010 |month=November |pmid=20937970 |doi=10.1161/HYPERTENSIONAHA.109.140160 |url=}}</ref> vinavyochangia presha ya juu haieleweki vizuri. Kinzano dhidi ya [[insulin]] inafikiriwa pia kupandisha presha.<ref name="pmid12364344">{{cite journal |author=Sorof J, Daniels S |title=Obesity hypertension in children: a problem of epidemic proportions |journal=Hypertension |volume=40 |issue=4 |pages=441–447 |year=2002 |month=October |pmid=12364344 |doi=10.1161/01.HYP.0000032940.33466.12 |url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=12364344 |accessdate=2009-06-03 |archive-date=2012-12-05 |archive-url=https://archive.today/20121205010228/http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=12364344 |dead-url=yes }}</ref> Utafiti wa hivi karibuni umedhulumu matukio ya maisha ya watoto wachanga kwa mfano, [[uzito mdogo wa mtoto mchanga]], tabia ya uvutaji sigara ya akina mama, na [[kutowanyonyesha watoto]] kama athari za hatari zinazoumiza watu wazima na shinikizo la damu la kimsingi.<ref name = "Lawlor 2005">{{cite journal|last=Lawlor|first=DA|coauthors=Smith, GD|title=Early life determinants of adult blood pressure.|journal=Current opinion in nephrology and hypertension|date=2005 May|volume=14|issue=3|pages=259-64|pmid=15821420}}</ref> Hata hivyo, mahusiano hayo yanabaki fumbo.<ref name = "Lawlor 2005"/> ===Shinikizo la juu la damu la hatua ya pili=== Shinikizo la juu la damu la hatua ya pili linatokana na chanzo kinachojulikana. Maradhi ya mafigo ni chanzo kinachozidi cha shinikizo la juu la damu hatua ya pili.<ref name="ABC" /> Chanzo kingine cha shinikizo la juu la damu ni hali tofauti za tezi zenye kunyesa ndani kwa ndani kama kwa mfano [[Cushing's syndrome]], [[hyperthyroidism]], [[hypothyroidism]], [[acromegaly]], [[Conn's syndrome]] or [[hyperaldosteronism]], [[hyperparathyroidism]], and [[pheochromocytoma]].<ref name="ABC" /><ref>Dluhy RG, Williams GH. Endocrine hypertension. In: Wilson JD, Foster DW, Kronenberg HM, eds. Williams Textbook of Endocrinology. 9th ed. Philadelphia, Pa: WB Saunders; 1998:729-49.</ref> Vyanzo vingine vya shinikizo la juu la damu hatua ya pili ni pamoja na [unene], [kushindwa kupumua kunakoleta usingizi wa mang’amung’amu], [kuwa na mimba], [kufinyika kwa aota], ulaji zaidi wa [urukususu] na dawa fulani zilizo halali zikiwa na zile zote zisizo halali pamoja na dawa za kienyeji.<ref name="ABC" /><ref>{{cite journal |author=Grossman E, Messerli FH |title=Drug-induced Hypertension: An Unappreciated Cause of Secondary Hypertension |journal=Am. J. Med. |volume=125 |issue=1 |pages=14–22 |year=2012 |month=January |pmid=22195528 |doi=10.1016/j.amjmed.2011.05.024 |url=https://archive.org/details/sim_american-journal-of-medicine_2012-01_125_1/page/14}}</ref> ==Pathophysiology== [[Image:Arterial pressure diagram.png|thumb|right|350px|A diagram explaining factors affecting [[arterial pressure]]]] Watu karibu wote wakiumia shinikizo la juu la damu la kimsingi linalowekwa imara, kinzi inayoongezeka kwa utiririko wa damu ([[kinzi kabisa ukingoni]]) inasababisha shinikizo la hali ya juu wakati utiririko wa damu kutoka moyoni unaendelea kama kawaida.<ref>{{cite journal |author=Conway J |title=Hemodynamic aspects of essential hypertension in humans |journal=Physiol. Rev. |volume=64 |issue=2 |pages=617–60 |year=1984 |month=April |pmid=6369352 |doi= |url=https://archive.org/details/sim_physiological-reviews_1984-04_64_2/page/617}}</ref> Uthibitisho upo kubainisha vijana wengine wanaoumia shinikizo la juu la damu ambalo halijashikana kabisa wana utiririko wa damu kutoka moyoni wa kiwango cha juu, pigo linalozidi kawaida la moyo na kinzi ya kawaida ukingoni (hyperkinetic borderline hypertension).<ref name = Palatini>{{cite journal |author=Palatini P, Julius S |title=The role of cardiac autonomic function in hypertension and cardiovascular disease |journal=Curr. Hypertens. Rep. |volume=11 |issue=3 |pages=199–205 |year=2009 |month=June |pmid=19442329 |doi= |url=}}</ref> These individuals develop typical features of established essential hypertension in later life as their cardiac output falls and peripheral resistance rises with age.<ref name = Palatini /> Whether this pattern is typical of all people who ultimately develop hypertension is disputed.<ref>{{cite journal |author=Andersson OK, Lingman M, Himmelmann A, Sivertsson R, Widgren BR |title=Prediction of future hypertension by casual blood pressure or invasive hemodynamics? A 30-year follow-up study |journal=Blood Press. |volume=13 |issue=6 |pages=350–4 |year=2004 |pmid=15771219 |doi= |url=}}</ref> Increased peripheral resistance in established hypertension is mainly attributable to structural narrowing of small arteries and arterioles.<ref>{{cite journal |author=Folkow B |title=Physiological aspects of primary hypertension |journal=Physiol. Rev. |volume=62 |issue=2 |pages=347–504 |year=1982 |month=April |pmid=6461865 |doi= |url=https://archive.org/details/sim_physiological-reviews_1982-04_62_2/page/n2}}</ref> Reduction in number or density of capillaries may also contribute to peripheral resistance.<ref>{{cite journal |author=Struijker Boudier HA, le Noble JL, Messing MW, Huijberts MS, le Noble FA, van Essen H |title=The microcirculation and hypertension |journal=J Hypertens Suppl |volume=10 |issue=7 |pages=S147–56 |year=1992 |month=December |pmid=1291649 |doi= |url=}}</ref> Shinikizo juu la damu pia linahusika na ukosefu wa ujikunjaji wa mishipa iliyoko ukingoni,<ref>{{cite journal |author=Safar ME, London GM |title=Arterial and venous compliance in sustained essential hypertension |journal=Hypertension |volume=10 |issue=2 |pages=133–9 |year=1987 |month=August |pmid=3301662 |doi= |url=https://archive.org/details/sim_hypertension_1987-08_10_2/page/133}}</ref> which may increase return of blood to the heart, increase cardiac [[Preload (cardiology)|preload]], and ultimately cause [[diastolic dysfunction]]. Ikiwa kuongezeka kwa finyo linaloendelea la mishipa ya damu huchangia shinikizo la juu la damu la kimsingi linalowekwa imara hakujathibitishwa.<ref>{{cite journal |author=Schiffrin EL |title=Reactivity of small blood vessels in hypertension: relation with structural changes. State of the art lecture |journal=Hypertension |volume=19 |issue=2 Suppl |pages=II1-9 year=1992 month=February pmid=1735561 doi= }</ref> [[Pulse pressure]] (difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This situation can involve systolic pressure that is abnormally high, but diastolic pressure may be normal or low. This condition is called [[isolated systolic hypertension]].<ref>{{cite journal |author=Chobanian AV |title=Clinical practice. Isolated systolic hypertension in the elderly |journal=N. Engl. J. Med. |volume=357 |issue=8 |pages=789–96 |year=2007 |month=August |pmid=17715411 |doi=10.1056/NEJMcp071137 |url=https://archive.org/details/sim_new-england-journal-of-medicine_2007-08-23_357_8/page/788}}</ref> High pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased [[arterial stiffness]], which typically accompanies aging and may be exacerbated by high blood pressure.<ref>{{cite journal |author=Zieman SJ, Melenovsky V, Kass DA |title=Mechanisms, pathophysiology, and therapy of arterial stiffness |journal=Arterioscler. Thromb. Vasc. Biol. |volume=25 |issue=5 |pages=932–43 |year=2005 |month=May |pmid=15731494 |doi=10.1161/01.ATV.0000160548.78317.29 |url=https://archive.org/details/sim_arteriosclerosis-thrombosis-and-vascular-biology_2005-05_25_5/page/932}}</ref> Many mechanisms have been proposed to account for rise in resistance seen within arterial system in hypertension. Most evidence implicates one or both of these causes: * Disturbances in renal salt and water handling, particularly abnormalities of intrarenal [[renin-angiotensin system]]<ref>{{cite journal |author=Navar LG |title=Counterpoint: Activation of the intrarenal renin-angiotensin system is the dominant contributor to systemic hypertension |journal=J. Appl. Physiol. |volume=109 |issue=6 |pages=1998–2000; discussion 2015 |year=2010 |month=December |pmid=21148349 |pmc=3006411 |doi=10.1152/japplphysiol.00182.2010a |url=https://archive.org/details/sim_journal-of-applied-physiology_2010-12_109_6/page/1998}}</ref> * Abnormalities of [[sympathetic nervous system]]<ref>{{cite journal |author=Esler M, Lambert E, Schlaich M |title=Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension |journal=J. Appl. Physiol. |volume=109 |issue=6 |pages=1996–8; discussion 2016 |year=2010 |month=December |pmid=20185633 |doi=10.1152/japplphysiol.00182.2010 |url=https://archive.org/details/sim_journal-of-applied-physiology_2010-12_109_6/page/1996}}</ref> These mechanisms are not mutually exclusive and it is likely that both contribute to some extent in most cases of essential hypertension. Limedokezwa kuwa kutofanya vizuri kwa kuta za ndani za mishipa ya damu pamoja na inflamesheni ya mishipa huenda inachangia kinzi inayoongezeka ukingoni pamoja na kuharibika kwa mishipa<ref>{{cite journal |author=Versari D, Daghini E, Virdis A, Ghiadoni L, Taddei S |title=Endothelium-dependent contractions and endothelial dysfunction in human hypertension |journal=Br. J. Pharmacol. |volume=157 |issue=4 |pages=527–36 |year=2009 |month=June |pmid=19630832 |pmc=2707964 |doi=10.1111/j.1476-5381.2009.00240.x |url=}}</ref><ref>{{cite journal |author=Marchesi C, Paradis P, Schiffrin EL |title=Role of the renin-angiotensin system in vascular inflammation |journal=Trends Pharmacol. Sci. |volume=29 |issue=7 |pages=367–74 |year=2008 |month=July |pmid=18579222 |doi=10.1016/j.tips.2008.05.003 |url=}}</ref> == Utambuzi == {| class="wikitable" style = "float: right; margin-left: 15px; text-align: center" |- |+ Mfano vipimo kutumbukiza katika shinikizo la damu ! Mfumo ! Majaribio |- | [[mfumo mkojo ya figo]] | [[Urinalysis Microscopic urinalysis]], [[proteinuria]], serum bun [[blood urea nitrogen BUN]] <small> ([[damu urea nitrojeni]]) </small> na /au [[creatinine]] |- | [[Endokrini mfumo Endokrini]] | Serum [[sodiamu]], [[potasiamu]], [[calcium]], [[Thyroid-stimulating hormone|TSH]] <small> ([[thyroid-stimulating hormone]]) </small>. |- | [[Umetaboli]] | [[kufunga damu glucose]], cholesterol jumla, [[High-density lipoprotein|HDL]] na [[LDL]] cholesterol, [[triglycerides]] |- | Wengine | [[Hematocrit]], [[electrocardiogram]], na [[radiograph kifua]] |- | colspan=2 | Vyanzo: ''Harrison's ya kanuni ya dawa za ndani''<ref name="isbn0-07-147691-1">{{cite book |author=Loscalzo, Joseph; Fauci, Anthony S.; Braunwald, Eugene; Dennis L. Kasper; Hauser, Stephen L; Longo, Dan L. |editor= |others= |title=Harrison's principles of internal medicine |edition= |publisher=McGraw-Hill Medical |year=2008 |pages= |isbn=0-07-147691-1 |doi= |url= |accessdate=}}</ref> ''others''<ref name="pmid19417858">{{cite journal |author=Padwal RS |title=The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 – blood pressure measurement, diagnosis and assessment of risk |journal=Canadian Journal of Cardiology |volume=25 |issue=5 |pages=279–86 |year=2009 |month=May |pmid=19417858 |doi= 10.1016/S0828-282X(09)70491-X|url= |pmc=2707176 |author-separator=, |author2=Hemmelgarn BR |author3=Khan NA |display-authors=3 |last4=Grover |first4=S |last5=McKay |first5=DW |last6=Wilson |first6=T |last7=Penner |first7=B |last8=Burgess |first8=E |last9=McAlister |first9=FA}}</ref><ref name="pmid18548142">{{cite journal |author=Padwal RJ |title=The 2008 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 – blood pressure measurement, diagnosis and assessment of risk |journal=Canadian Journal of Cardiology |volume=24 |issue=6 |pages=455–63 |year=2008 |month=June |pmid=18548142 |pmc=2643189 |doi= 10.1016/S0828-282X(08)70619-6|url= |author-separator=, |author2=Hemmelgarn BR |author3=Khan NA |display-authors=3 |last4=Grover |first4=S |last5=McAlister |first5=FA |last6=McKay |first6=DW |last7=Wilson |first7=T |last8=Penner |first8=B |last9=Burgess |first9=E}}</ref><ref name="pmid17534459">{{cite journal |author=Padwal RS |title=The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 – blood pressure measurement, diagnosis and assessment of risk |journal=Canadian Journal of Cardiology |volume=23 |issue=7 |pages=529–38 |year=2007 |month=May |pmid=17534459 |pmc=2650756 |doi= 10.1016/S0828-282X(07)70797-3|url= |author-separator=, |author2=Hemmelgarn BR |author3=McAlister FA |display-authors=3 |last4=McKay |first4=DW |last5=Grover |first5=S |last6=Wilson |first6=T |last7=Penner |first7=B |last8=Burgess |first8=E |last9=Bolli |first9=P}}</ref><ref name="pmid16755312">{{cite journal |author=Hemmelgarn BR |title=The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I – Blood pressure measurement, diagnosis and assessment of risk |journal=Canadian Journal of Cardiology |volume=22 |issue=7 |pages=573–81 |year=2006 |month=May |pmid=16755312 |pmc=2560864 |doi= 10.1016/S0828-282X(06)70279-3|url= |author-separator=, |author2=McAlister FA |author3=Grover S |display-authors=3 |last4=Myers |first4=MG |last5=McKay |first5=DW |last6=Bolli |first6=P |last7=Abbott |first7=C |last8=Schiffrin |first8=EL |last9=Honos |first9=G}}</ref><ref name="pmid16003448">{{cite journal |author=Hemmelgarn BR |title=The 2005 Canadian Hypertension Education Program recommendations for the management of hypertension: part 1- blood pressure measurement, diagnosis and assessment of risk |journal=Canadian Journal of Cardiology |volume=21 |issue=8 |pages=645–56 |year=2005 |month=June |pmid=16003448 |doi= |url= |author-separator=, |author2=McAllister FA |author3=Myers MG |display-authors=3 |last4=McKay |first4=DW |last5=Bolli |first5=P |last6=Abbott |first6=C |last7=Schiffrin |first7=EL |last8=Grover |first8=S |last9=Honos |first9=G}}</ref> |} Shinikizo la damu ni kupatikana wakati mgonjwa ana vinavyoendelea shinikizo la damu. Kijadi,<ref name="NICE127 full"/> utambuzi unahitaji vipimo vitatu vya sphygmomanometer tofauti kwa vipindi vya mwezi mmoja.<ref>{{cite book |author=North of England Hypertension Guideline Development Group |chapter=Frequency of measurements |page=53 |title=Essential hypertension (NICE CG18) |publisher=[[National Institute for Health and Clinical Excellence]] |date=1 August 2004 |url=http://guidance.nice.org.uk/index.jsp?action=download&o=48384 |accessdate=2011-12-22 |archive-date=2012-07-14 |archive-url=https://web.archive.org/web/20120714085714/http://guidance.nice.org.uk/index.jsp?action=download&o=48384 |dead-url=yes }}</ref> Ya awali ya ukaguzi ya wagonjwa la damu ni pamoja na historia na uchunguzi wa kimwili [[Medical history|history]] na [[physical examination]]. Pamoja na Upatikanaji wa saa 24 [[ambulatory wachunguzi wa shinikizo la damu]] mashine ya damu nyumbani shinikizo, muhimu wa kuepuka utambuzi sahihi ya wagonjwa na shinikizo la damu kanzu nyeupe imesababisha mabadiliko katika itifaki. Katika Uingereza, sasa ni bora kufuatilia moja alimfufua kliniki ya kusoma na kipimo ambulatory. Kufuatilia pia inaweza kufanyika, lakini chini ya walau, na nyumbani ufuatiliaji shinikizo la damu katika kipindi cha siku saba.<ref name="NICE127 full">{{cite book |author=National Clinical Guideline Centre |title=Hypertension (NICE CG 127) |publisher=[[National Institute for Health and Clinical Excellence]] |chapter=7 Diagnosis of Hypertension, 7.5 Link from evidence to recommendations |page=102 |date=August 2011 |url=http://www.nice.org.uk/nicemedia/live/13561/56007/56007.pdf |accessdate=2011-12-22 |archive-date=2013-07-23 |archive-url=https://web.archive.org/web/20130723014309/http://www.nice.org.uk/nicemedia/live/13561/56007/56007.pdf |dead-url=yes |=https://web.archive.org/web/20130723014309/http://www.nice.org.uk/nicemedia/live/13561/56007/56007.pdf }}</ref> Mara baada ya uchunguzi wa shinikizo la damu yamepatikana, madaktari kujaribu kubaini sababu ya msingi juu ya hatari na dalili nyingine, kama sasa. [[shinikizo la damu sekondari]] ni ya kawaida zaidi kwa watoto karibisha kijani na kesi nyingi husababiswa na ugonjwa wa figo [[renal disease]]. Msingi au shinikizo la damu ni muhimu zaidi ya kawaida katika Vijana na ina hatari nyingi, ikiwa ni pamoja na hatima na historia ya familia ya shinikizo la damu.<ref name="pmid16719248">{{cite journal | author = Luma GB, Spiotta RT | title = Hypertension in children and adolescents | url = https://archive.org/details/sim_american-family-physician_2006-05-01_73_9/page/n79 | journal = Am Fam Physician | volume = 73 | issue = 9 | pages = 1558–68 | month = may | year = 2006 | pmid = 16719248}}</ref> Vipimo vya maabara pia kuwa walifanya kubainisha sababu ya uwezekano wa shinikizo la damu ya sekondari, na kuamua kama shinikizo la damu unaosababisha uharibifu wa moyo, macho, na mafigo. Vipimo vya ziada kama ajali ya ugonjwa wa[[kisukari]] na Viwango vya juu vya cholesterol ni kutumbukiza kwa sababu hizi ni hali ya hatari kwa ajili ya maendeleo ya [[ugonjwa wa moyo]] na kuhitaji matibabu.<ref name="pmid10645931"/> Creatinine [[Serum]] ni kipimo cha kupima kwa uwepo wa ugonjwa wa figo, ambao unaweza kuwa ama sababu au matokeo ya shinikizo la damu. Serum creatinine peke inaweza kuza thamani [[kiwango ya glomerular filtration]]. Miongozo ya hivi karibuni kutetea matumizi ya mamlinganyo uingizaji kama vile [[Muundo wa mpangilio wa chakula katika formula figo Magonjwa]] (MDRD) na makisio ya kiwango cha glomerular filtration (eGFR). <ref name = JNC7 /> eGFR pia yanaweza kutoa kipimo msingi ya kazi ya figo ambayo yanaweza kutumika kwa ajili ya kufuatilia madhara ya dawa kadhaa antihypertensive juu ya kazi ya figo. Upimaji wa sampuli za mkojo kwa ajili ya [[proteinuria|protini]] kutumika kama kiashiria cha sekondari ya ugonjwa wa figo. [[Electrocardiogram]] (EKG/ECG) ni kufanyika kwa kuangalia kwa ushahidi kwamba moyo upo katika matatizo kutokana na shinikizo la damu. Inaweza pia kuonyesha kugandamana kwa misuli ya moyo ([[kushoto ventrikali hypertrophy]]) au kama moyo una uzoefu kabla madogo ya usumbufu kama vile mashambulizi ya kimya moyo. [[Kifua X-ray]] au [[echocardiogram]] pia inaweza kufanywa kwa kuangalia kwa ishara ya moyo utvidgningen au uharibifu wa moyo. <ref name="ABC" /> ==Kinga== Idadi ya watu ambao wanashinikiza la juu la damu ni kubwa japo hawatambui.<ref name="ReferenceB">{{cite journal|last=Williams|first=B|coauthors=Poulter, NR, Brown, MJ, Davis, M, McInnes, GT, Potter, JF, Sever, PS, McG Thom, S, British Hypertension, Society|title=Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV.|journal=Journal of human hypertension date=2004 Mar|volume=18|issue=3|pages=139-85|pmid=14973512}}</ref> Hutua ya kushughulikia idadi ya watu wote wanaotakiwa kupunguza madhara ya shinikizo la damu na kupunguza haja ya tiba ya antihypertensive dawa za kulevya. Mabadiliko ya maisha Ilipendekeza kuwa shinikizo la damu liwe chini, kabla ya kuanza dawa za tiba. 2004 Uingereza shinikizo la damu Society la miongozo<ref name="ReferenceB"/> mapendekezo ya mabadiliko ya maisha yafuatayo sambamba na miongozo ilivyoainishwa na Marekani ya taifa ya mipango ya High BP elimu ya mwaka 2002<ref>{{cite journal | author = Whelton PK ''et al.'' | year = 2002 | title = Primary prevention of hypertension. Clinical and public health advisory from the National High Blood Pressure Education Program | url = | journal = JAMA | volume = 288 | issue = 15| pages = 1882–1888 | doi = 10.1001/jama.288.15.1882 | pmid = 12377087 }}</ref> kwa ajili ya kuzuia msingi wa shinikizo la damu ni kama ifuatavyo: * Kudumisha kawaida uzito wa mwili (kwa mfano. mwili molekuli index 20–25&nbsp;kg/m²). * Kupunguza malazi sodium ujali kwa mmol <100&nbsp; mmol/ siku (<6 g ya kloridi sodium au<2.4 g ya sodium kwa siku). * Kushiriki katika shughuli za mara kwa mara aerobic kimwili kama vile kutembea upesi (≥30 min kwa siku, wengi siku za juma). * Punguza pombe kwa vitengo visivyozidi 3 units/ kwa siku kwa wanaume na vitengo visivyozidi 2 units/ kwa siku kwa wanawake. * Hutumia lishe lenye matunda na mbonga (kwa mfano, angalau tano sehemu kwa siku). Mabadiliko mwafaka ya mtindo wa maisha yanaweza kupunguza shinikizo la damu kama ilivyo kwa dawa ya mtu binafsi ya antihypertensive na kupata matokeo bora zaidi. <ref name="ReferenceB"/> ==Udhibiti== ===Mabadiliko katika mtindo wa maisha === Aina ya kwanza ya matibabu ya shinikizo la damu ni inafanana na mabadiliko ya mtindo wa maisha yaliyopendekezwa,<ref name="npsppr">{{cite web |url=http://www.nps.org.au/health_professionals/publications/prescribing_practice_review/current/prescribing_practice_review_52 |title=NPS Prescribing Practice Review 52: Treating hypertension |date=September 1, 2010 |publisher=NPS Medicines Wise |accessdate=November 5, 2010 |archivedate=2013-06-26 |archiveurl=https://www.webcitation.org/6HefAmPDs?url=http://www.nps.org.au/publications/health-professional/prescribing-practice-review }}</ref> na ni pamoja na mabadiliko ya malazi<ref>{{cite journal|last=Siebenhofer|first=A|coauthors=Jeitler, K, Berghold, A, Waltering, A, Hemkens, LG, Semlitsch, T, Pachler, C, Strametz, R, Horvath, K|title=Long-term effects of weight-reducing diets in hypertensive patients journal=Cochrane database of systematic reviews (Online)|date=2011-09-07|volume=9|pages=CD008274|pmid=21901719|doi=10.1002/14651858.CD008274.pub2|editor1-last=Siebenhofer|editor1-first=Andrea}}</ref> physical exercise, and weight loss. Mazoezi ya viungo, na kupunguza uzito. Mabadiliko haya yote yameonekana kupunguza kwa kiasi kikubwa shinikizo la damu<ref>{{cite journal |author=Blumenthal JA |title=Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study |journal=Arch. Intern. Med. |volume=170 |issue=2 |pages=126–35 |year=2010 |month=January |pmid=20101007 |doi=10.1001/archinternmed.2009.470 |url= |author-separator=, |author2=Babyak MA |author3=Hinderliter A |display-authors=3 |last4=Watkins |first4=L. L. |last5=Craighead |first5=L. |last6=Lin |first6=P.-H. |last7=Caccia |first7=C. |last8=Johnson |first8=J. |last9=Waugh |first9=R.}}</ref> kama shinikizo la damu ni ya juu kiasi cha kuhalalisha matumizi ya haraka ya dawa, mabadiliko ya maisha bado yanapendekezwa.. Mipango mbalimbali iliyoundwa na kupunguza dhiki ya kisaikolojia [[biofeedback]], ulegezaji, au kutafakari hutangazwa ili kupunguza shinikizo la damu. Hata hivyo, tafiti za kisayansi , kwa ujumlahazina usaidi wala ufanisi wao, kwa sababu masomo kwa ujumla ya ubora wa chini.<ref name="pmid19822104">{{cite journal |author=Greenhalgh J, Dickson R, Dundar Y |title=The effects of biofeedback for the treatment of essential hypertension: a systematic review |journal=Health Technol Assess |volume=13 |issue=46 |pages=1–104 |year=2009 |month=October |pmid=19822104 |doi=10.3310/hta13460 |url= |doi_brokendate=2010-08-21}}</ref><ref name="pmid18350109">{{cite journal |author=Rainforth MV, Schneider RH, Nidich SI, Gaylord-King C, Salerno JW, Anderson JW |title=Stress Reduction Programs in Patients with Elevated Blood Pressure: A Systematic Review and Meta-analysis |journal=Curr. Hypertens. Rep. |volume=9 |issue=6 |pages=520–8 |year=2007 |month=December |pmid=18350109 |pmc=2268875 |doi= 10.1007/s11906-007-0094-3|url=}}</ref><ref>{{cite journal |author=Ospina MB |title=Meditation practices for health: state of the research |journal=Evid Rep Technol Assess (Full Rep) |volume= |issue=155 |pages=1–263 |year=2007 |month=June |pmid=17764203 |doi= |url= |author-separator=, |author2=Bond K |author3=Karkhaneh M |display-authors=3 |last4=Tjosvold |first4=L |last5=Vandermeer |first5=B |last6=Liang |first6=Y |last7=Bialy |first7=L |last8=Hooton |first8=N |last9=Buscemi |first9=N}}</ref> Malazi na mabadiliko kama vile chakula [[cha chini sodiamu]] ni faida. Muda mrefu ( zaidi ya wiki 4) chini -sodiamu chakula katika [[Caucasian, race Caucasians]] ni bora katika kupunguza shinikizo la damu, kwa watu na shinikizo la damu na kwa watu wenye shinikizo la damu ya kawaida .<ref name=cochrane2008>{{cite journal|last=He|first=FJ|coauthors=MacGregor, GA|title=Effect of longer-term modest salt reduction on blood pressure. journal=Cochrane database of systematic reviews (Online)|date=2004|issue=3|pages=CD004937|pmid=15266549|url=http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004937/frame.html}}</ref> pia , chakula [[DASH diet]], lishe lenye karanga, nafaka, samaki, kuku, matunda, na mboga, ambayo husaidia kukuza moyo na [[Taifa , Mpafu, na damu Taasisi]], punguza shinikizo la damu. Kipengele kikubwa cha mpango wa [[sodiamu]], ingawa mlo pia ni tajiri [[potassiamu]], [[magnesiamu]], [[calcium]], na [[protini]].<ref name="dashguide">{{cite web|url=http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf|title=Your Guide To Lowering Your Blood Pressure With DASH|format=PDF|accessdate=2009-06-08}}</ref> ===Dawa=== Madarasa kadhaa ya dawa, pamoja inajulikana kama [[antihypertensive madawa]] ya kulevya s, sasa zipo kwa ajili ya kutibu shinikizo la damu. Mtu hatari wa moyo na mishipa ( ikiwa ni pamoja na hatari ya infarction myocardial na kiharusi) na masomo ya shinikizo la damu ni kuchukuliwa wakati maagizo madawa ya kulevya.<ref name=nps01>{{cite journal |url=http://www.australianprescriber.com/magazine/33/4/108/12 |title=Drug treatment of elevated blood pressure |author=Nelson, Mark |journal=Australian Prescriber |issue=33 |pages=108–112 |accessdate=August 11, 2010}}</ref> Ikiwa matibabu ya madawa ya kulevya ni ikianzishwa,Moyo ya taifa,Mapafu,na damu Taasisi ya saba ya pamoja ya kamati ya taifa ya juu ya shinizo la damu (JNC-7)<ref name = JNC7>{{cite journal |author=Chobanian AV, Bakris GL, Black HR, ''et al.'' |title=Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure |journal=Hypertension |volume=42 |issue=6 |pages=1206–52 |year=2003 |month=December |pmid=14656957 |doi=10.1161/01.HYP.0000107251.49515.c2 |url=http://hyper.ahajournals.org/content/42/6/1206.long}}</ref> Inapendezeka kwamba kufuatilia daktari kwa ajili ya Kukabiliana na matibabu kwa ajili ya kutathmini na athari yoyote mbaya kutokana na dawa. Kupunguza [[shinikizo la damu]] na 5&nbsp;mmHg inaweza kupunguza hatari ya kiharusi kwa 34% na hatari ya[[ungonjwa wa moyo ischemic]] kwa 21%. Shinikizo la damu kupunguza pia husaidia kupunguza uwezekano wa [[shida ya akili]], [[moyo kushindwa]], na [[vifo]] kutokana na [[ugonjwa wa moyo na mishipa]].<ref>{{cite journal |author=Law M, Wald N, Morris J |title=Lowering blood pressure to prevent myocardial infarction and stroke: a new preventive strategy |journal=Health Technol Assess |volume=7 |issue=31 |pages=1–94 |year=2003 |pmid=14604498 |url=http://www.hta.ac.uk/fullmono/mon731.pdf |access-date=2013-03-06 |archive-date=2011-03-04 |archive-url=https://web.archive.org/web/20110304150457/http://www.hta.ac.uk/fullmono/mon731.pdf |dead-url=yes }}</ref> Lengo la matibabu ya lazima ya kupunguza shinikizo la damu na chini ya 140/90&nbsp;mmHg kwa ajili ya watu wengi, na chini kwa kale wenye ugonjwa wa kisukari au ugonjwa wa figo. Baadhi ya wataalamu wa afya kupendekeza kuweka Viwango vya chini 120/80&nbsp;mmHg.<ref name=nps01 /><ref>{{cite web|first=Gina |last=Shaw |url=http://www.webmd.com/content/article/73/88927.htm |title=Prehypertension: Early-stage High Blood Pressure |publisher=WebMD |date=2009-03-07 |accessdate=2009-07-03}}</ref> Kama lengo shinikizo la damu si alikutana,matibabu zaidi inahitajika.<ref>{{cite journal|doi=10.1161/01.HYP.0000200702.76436.4b|url=http://hyper.ahajournals.org/cgi/content/abstract/47/3/345|title=Therapeutic Inertia Is an Impediment to Achieving the Healthy People 2010 Blood Pressure Control Goals|author=Eni C. Okonofua; Kit N. Simpson; Ammar Jesri; Shakaib U. Rehman; Valerie L. Durkalski; Brent M. Egan|journal=Hypertension|volume=47|issue=2006;47:345|pages=345–51|date=January 23, 2006|accessdate=2009-11-22|pmid=16432045}}</ref> Miongozo juu ya uchaguzi wa dawa na jinsi ya kuamua bora kwa ajili ya matibabu subgroups mbalimbali vilivyobadilika na tofauti kati ya nchi. Wataalamu wala kukubaliana kuhusu dawa bora.<ref name=Compare10>{{cite journal|last=Klarenbach|first=SW|coauthors=McAlister, FA, Johansen, H, Tu, K, Hazel, M, Walker, R, Zarnke, KB, Campbell, NR, Canadian Hypertension Education, Program|title=Identification of factors driving differences in cost effectiveness of first-line pharmacological therapy for uncomplicated hypertension. journal=The Canadian journal of cardiology|date=2010 May|volume=26|issue=5|pages=e158-63|pmid=20485695}}</ref> The [[Kushirikiana Cochrane]], [[Shirila la Afya ya Duniani]], na Umoja wa Mataifa kusaidi miomgozo ya chini -dozi [[Thiazide|thiazide-makao diuretic]] kama matibabu ina penda zaidi ya awali.<ref>{{cite journal |author=Wright JM, Musini VM |title=First-line drugs for hypertension |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD001841 |year=2009 |pmid=19588327 |doi=10.1002/14651858.CD001841.pub2 |url= |editor1-last=Wright |editor1-first=James M}}</ref><ref name=Compare10/> Uingereza Miongozo kusisitiza [[calcium channel blocker]]s (CCB) kwa ajili ya watu zaidi ya umri wa miaka 55 au ya Afrika au Caribbean asili ya familia. Miongozo kupendekeza [[angiotensin-kuwabadili enzyme kiviza]]s (ACEI)s kama matibabu ina penda zaidi ya awali kwa ajili ya watu wadogo.<ref name="NICE127-drug"/> katika Japan, kwa kunzia na mtu yeyote wa Madarasa sita ya dawa ikiwa ni pamoja na : CCB, ACEI/ARB, thiazide diuretics, [[beta blockers]], na [[blockers alpha]] ni aliona nafuu. Katika Canada, yote ya dawa hizi isopokuwa alpha blockers- ni Ilipendekeza kama inawezekana chaguzi ya kwanza. <ref name=Compare10/> ====Madawa ya mchanganyiko==== Watu wengi wanahitaji zaidi ya moja ya madawa ya kudhibiti shinikizo la damu zao. JNC7<ref name = JNC7/> and ESH-ESC guidelines<ref name=ESH-ESC /> Wakili kuanza matibabu ya madawa ya mbili wakati shinikizo la damu ni zaidi ya 20&nbsp; mmHg hapo juu systolic au zaidi ya 10&nbsp; mmHg juu ya malengo ya diastolic. Michanganyiko ya ku penda zaidi ni rennin-angiotensin na Kalsium channel blockers, au inhibitors renin–angiotensin na diuretics.<ref name = sever>{{cite journal |author=Sever PS, Messerli FH |title=Hypertension management 2011: optimal combination therapy |journal=Eur. Heart J. |volume=32 |issue=20 |pages=2499–506 |year=2011 |month=October |pmid=21697169 |doi=10.1093/eurheartj/ehr177 |url=}}</ref> Michanganyiko kukubalika ni pamoja na yafuatayo: * Calcium channel blockers na diuretics * Beta blockers na diuretics * Dihydropyridine calcium channel blockers na beta blockers * Dihydropyridine calcium channel blockers na ama verapamil or diltiazem Michanganyiko haikubaliki ni kama ifuatavyo: * Yasiyo ya calcium blockers (kama vile verapamil au diltiazem) na beta blockers * Dual renin–angiotensin mfumo blockade (Kwa mfano, angiotensin kuwabadili enzyme kiviza + angiotensin receptor blocker) * Renin–angiotensin mfumo blockers na beta blockers * Beta blockers na madawa ya anti-adrenergic. <ref name = sever /> Kuepuka michanganyiko ya kiviza ACE inhibitor au angiotensin II adui receptor antagonist, a diuretic, na [[NSAID]] ( Ikiwa pamoja na kuchangua COX-2 inhibitors na madawa ya kulevya nonprescribed kama vile ibuprofen) kila inapowezekana kutokana na hatari kubwa ya kushindwa kwa figo papo hapo. Mchanganyiko inajulikana simo kama “whammy triple” katika maandiko ya Australia ya Afya. <ref name="npsppr" /> Vidonge vyenye mchanganyiko za kudumu wa Madarasa mawili ya dawa za kutosha. Wakati wao ni rahisi, wao ni bora akiba kwa ajili ya watu ambao ni amara katika vipengele mtu binafsi. <ref>{{cite book |title=British National Formulary |volume=No. 62 |date=September 2011 |chapter=2.5.5.1 Angiotensin-converting enzyme inhibitors |chapterurl=http://bnf.org/bnf/bnf/current/2578.htm |accessdate=2011-12-22 |archive-date=2021-12-23 |archive-url=https://web.archive.org/web/20211223201747/https://about.medicinescomplete.com/ |dead-url=yes }}</ref> ===Wazee=== Kutibu wastani kwa presha kali itapungua vifo na athari upande wa moyo na mishipa katika watu wenye umri wa miaka 60 na kuendelea.<ref name=Cochrane09/> Katika watu zaidi ya miaka 80 na umri wa tiba haionekani kwa kiasi kikubwa kupunguza vifo vya jumla lakini kupunguza hatari ya ungonjwa wa moyo.<ref name=Cochrane09>{{cite journal |author=Musini VM, Tejani AM, Bassett K, Wright JM |title=Pharmacotherapy for hypertension in the elderly |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD000028 |year=2009 |pmid=19821263 |doi=10.1002/14651858.CD000028.pub2 |url= |editor1-last=Musini |editor1-first=Vijaya M}}</ref> Ilipendekeza shinikizo la damu lengo ni chini ya 140/90&nbsp;mm Hg na [[thiazide diuretic]]s ya kuwa dawa yaku penda zaidi katika Amerika.<ref>{{cite journal |author=Aronow WS, Fleg JL, Pepine CJ, ''et al.'' |title=ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus documents developed in collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension |journal=J. Am. Coll. Cardiol. |volume=57 |issue=20 |pages=2037–114 |year=2011 |month=May |pmid=21524875 |doi=10.1016/j.jacc.2011.01.008 |url=}}</ref> Katika mwongozo mpya Uingereza, [[Kalsiamu-channel blocker]]s ya matibabu ina penda zaidi na masomo kliniki lengo la chini ya 150/90&nbsp;mmHg, au chini ya 145/85&nbsp;mmHg juu ya ufuatiliaji ambulatory au nyumbani shinikizo la damu.<ref name="NICE127-drug">{{cite web |author=National Institute Clinical Excellence |title=1.5 Initiating and monitoring antihypertensive drug treatment, including blood pressure targets |work=GC127 Hypertension: Clinical management of primary hypertension in adults |url=http://publications.nice.org.uk/hypertension-cg127/guidance#initiating-and-monitoring-antihypertensive-drug-treatment-including-blood-pressure-targets-2 |date=August 2011 |accessdate=2011-12-23 |archiveurl=https://www.webcitation.org/6HefEbMNE?url=http://publications.nice.org.uk/hypertension-cg127/guidance#initiating-and-monitoring-antihypertensive-drug-treatment-including-blood-pressure-targets-2 |archivedate=2013-06-26 }}</ref> ===Shinikizo sugu la damu=== Shinikizo sugu la damu ni shinikizo la damu kwamba bado hapo juu lengo shinikizo la damu licha ya matumizi ya mawakala wa tatu antihypertensive mali ya madaraja mbalimbali ya madawa ya kulevya antihypertensive wote mara moja. Miongozo kwa ajili ya kutibu shinikizo la damu sugu yamechapishwa katika Uingereza<ref name="NICE-BP">{{cite web |title=CG34 Hypertension - quick reference guide |publisher=[[National Institute for Health and Clinical Excellence]] |date=28 June 2006 |url=http://www.nice.org.uk/nicemedia/pdf/cg034quickrefguide.pdf |format=PDF |accessdate=2009-03-04 |archivedate=2009-03-13 |archiveurl=https://web.archive.org/web/20090313072133/http://www.nice.org.uk/nicemedia/pdf/cg034quickrefguide.pdf |=https://web.archive.org/web/20090313072133/http://www.nice.org.uk/nicemedia/pdf/cg034quickrefguide.pdf }}</ref> and the US.<ref name="pmid18391085">{{cite journal |author=Calhoun DA |title=Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research |url=https://archive.org/details/sim_hypertension_2008-06_51_6/page/1403 |journal=Hypertension |volume=51 |issue=6 |pages=1403–19 |year=2008 |month=June |pmid=18391085 |doi=10.1161/HYPERTENSIONAHA.108.189141 |author-separator=, |author2=Jones D |author3=Textor S |display-authors=3 |last4=Goff |first4=D. C. |last5=Murphy |first5=T. P. |last6=Toto |first6=R. D. |last7=White |first7=A. |last8=Cushman |first8=W. C. |last9=White |first9=W.}}</ref> ==Uenezi== Mwaka [[2015]] takriban 16-37% ya idadi ya watu wazima wa dunia, walikuwa na shinikizo la juu la damu.<ref name="pmid15652604">{{cite journal |author=Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J |title=Global burden of hypertension: analysis of worldwide data |journal=[[The Lancet]] |volume=365 |issue=9455 |pages=217–23 |year=2005 |pmid=15652604 |doi=10.1016/S0140-6736(05)17741-1}}</ref> Ilikuwa ni kawaida katika nchi zote: zilizoendelea (333 milioni) na zisizostawi (639 milioni).<ref name="pmid15652604"/> Hata hivyo, viwango hutofautiana vikubwa katika mikoa mbalimbali kwa viwango vya chini kama 3.4% (wanaume) na 6.8% (wanawake) katika maeneo ya vijijini [[India]] na kama 68.9% ( wanaume) na 72.5% (wanawake) katika [[Polandi]].<ref>{{cite journal |author=Kearney PM, Whelton M, Reynolds K, Whelton PK, He J |title=Worldwide prevalence of hypertension: a systematic review |journal=J. Hypertens. |volume=22 |issue=1 |pages=11–9 |year=2004 |month=January |pmid=15106785 |doi= |url=}}</ref> Mwaka 1995 ilikadiriwa kuwa milioni 43 watu Marekani walikuwa na shinikizo la juu la damu au walikuwa wakitumia dawa ya kulipunguza. [[Takwimu]] hiyo inawakilisha karibu 24% ya idadi ya watu wazima nchini. <ref name="pmid7875754">{{cite journal |author=Burt VL |title=Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988–1991 |journal=Hypertension |volume=25 |issue=3 |pages=305–13 |year=1995 |month=March |pmid=7875754 |doi= |url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=7875754 |access date=2009-06-05 |author-separator=, |author2=Whelton P |author3=Roccella EJ |display-authors=3 |last4=Brown |first4=C |last5=Cutler |first5=JA |last6=Higgins |first6=M |last7=Horan |first7=MJ |last8=Labarthe |first8=D |access-date=2013-03-06 |archive-date=2012-12-05 |archive-url=https://archive.today/20121205091508/http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=7875754 |dead-url=yes }}</ref> Viwango vya shinikizo la damu nchini Marekani walikuwa kuongezeka na kufikia 29% mwaka 2004.<ref name="pmid7607734"/><ref name="pmid17608879">{{cite journal |author=Ostchega Y, Dillon CF, Hughes JP, Carroll M, Yoon S |title=Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004 |url=https://archive.org/details/sim_journal-of-the-american-geriatrics-society_2007-07_55_7/page/1056 |journal=Journal of the American Geriatrics Society |volume=55 |issue=7 |pages=1056–65 |year=2007 |month=July |pmid=17608879 |doi=10.1111/j.1532-5415.2007.01215.x}}</ref> Kama ilivyo mwaka 2006 shinikizo la damu huathiri watu wazima 76 milioni Marekani (34% ya idadi ya watu) na kuwa miongoni mwa viwango yva juu zaidi vya shinikizo la damu katika dunia kwa 44%.<ref name =AHA2010 /> Ni zaidi ya kawaida katika Wamerikani uliotekea na chini ya kawaida katika Wazungu na [[Hispanics]]. Viwango vya kuongezeka kwa umri, na ni mkubwa [[kusini mashariki mwa Marekani]]. Shinikizo la damu ni la kawaida zaidi ndani ya wanaume kulinganisha na wanawake (ingawa wanakuwa wamemaliza kuelekea kupunguza tofauti hii) na kwa wale wa hali ya [[chini kiuchumi]].<ref name="pmid10645931"/> === Watoto=== Viwango ya shinikizo la damu kwa watoto inaongezeka.<ref name="pmid19421783">{{cite journal |author=Falkner B |title=Hypertension in children and adolescents: epidemiology and natural history |journal=Pediatr. Nephrol. |volume= 25|issue= 7|pages= 1219–24|year=2009 |month=May |pmid=19421783 |pmc=2874036 |doi=10.1007/s00467-009-1200-3}} </ref> Zaidi shinikizo la damu kwa watoto, hasa kabla ya [[ubalehe]], linategemea ugonjwa mwingine wa msingi. Mbali na fetma, figo ugomjwa ni sababu ya kawaida (60–70%) ya shiniko la damu kwa watoto. Vijana kawaida kuwa na msingi au muhimu shinikizo la damu, ambayo akaunti kwa ajili ya 85–95% ya kesi. <ref name=aafp>{{cite journal |author=Luma GB, Spiotta RT |title=Hypertension in children and adolescents |journal=Am Fam Physician |volume=73 |issue=9 |pages=1558–68 |year=2006 |month=May |pmid=16719248 |url=http://www.aafp.org/afp/20060501/1558.html |access-date=2013-03-06 |archive-date=2007-09-26 |archive-url=https://web.archive.org/web/20070926230038/http://www.aafp.org/afp/20060501/1558.html |dead-url=yes }}</ref> ==Historia== [[Image:William Harvey ( 1578-1657) Venenbild.jpg|Mchoro wa [[veni]] katika [[kitabu]] cha [[William Harvey]] ''Exercitatio anatomica de motu cordis et sanguinis in animalibus'' (“An Anatomical Exercise on the Motion of the Heart and Blood in Living Beings”)|right|thumb]] Uelewa wa kisasa wa mfumo wa moyo ulianza na kazi ya mtabibu [[William Harvey]] (1578-1657). Harvey alielezea mzunguko wa damu katika kitabu chake ''De Otu ordis'' ("On Motion of the Heart and Blood"). [[Padri]] wa [[Uingereza]] [[Stephen Hales]] alifanya kipimo cha kwanza cha kuchapishwa cha kipimo cha shinikizo la damu katika mwaka 1733 .<ref name="pmid1744849"/><ref name=Kotchen2011>{{cite journal |author=Kotchen TA |title=Historical trends and milestones in hypertension research: a model of the process of translational research |journal=Hypertension |volume=58 |issue=4 |pages=522–38 |year=2011 |month=October |pmid=21859967 |doi=10.1161/HYPERTENSIONAHA.111.177766}}</ref> Maelezo ya shinikizo la damu kama ugonjwa ulitoka, miongoni mwa wengine, [[Thomas Young]] katika mwaka 1808 na [[Richard Bright (mtabibu)|Richard Bright]] katika mwaka 1836 .<ref name="pmid1744849"/> Ripoti ya kwanza ya muiniko wa shinikizo la damu katika mtu bila ushahidi wa ugonjwa wa figo ilitolewa na [[Frederick Akbar Mahomed]] (1849-1884).<ref>{{cite book |editor=Swales JD|title=Manual of hypertension |url=https://archive.org/details/manualofhyperten0000unse|publisher=Blackwell Science |location=Oxford |year=1995 |pages=xiii |isbn=0-86542-861-1}}</ref> Hata hivyo, shinikizo la damu kama chombo cha kliniki ilikuja kuwa katika mwaka 1896 na uvumbuzi wa cuff [[sphygmomanometer]] na [[Scipione Riva-Rocci]] mwaka 1896.<ref>{{cite book | title=A century of arterial hypertension 1896–1996 | editor=Postel-Vinay N | page=213 | location=Chichester | publisher=Wiley | year=1996 | isbn=0-471-96788-2}}</ref> Uvumbuzi huu uliruhusu shinikizo la damu kupimwa katika [[zahanati]]. Mwaka 1905, [[Nikolai Korotkoff]] aliboresha mbinu kwa kueleza [[Korotkoff sounds]] ambazo zilisikiwa wakati ateri ilikuwa auscultated na stetoskopu wakati sphygmomanometer cuff ilikuwa imwetolewa upepo<ref name=Kotchen2011/> Kihistoria matibabu ya kiitwacho "ugonjwa mgumu wa pigo la moyo" ilihusisha kupunguza kiasi cha damu na [[blood letting]] au kupaka [[leech]]es.<ref name="pmid1744849">{{cite journal |author=Esunge PM |title=From blood pressure to hypertension: the history of research |journal=J R Soc Med |volume=84 |issue=10 |pages=621 |year=1991 |month=October |pmid=1744849 |pmc=1295564}}</ref> [[Yellow Emperor]] wa Uchina, [[Aulus Cornelius Celsus|Cornelius Celsus]], [[Galen]], na [[Hippocrates]] walitetea kuruhusu damu.<ref name="pmid1744849"/> Katika karne za 19 na 20, kabla ya matibabu ya ufanisi ya pharmacological ya shinikizo la damu ilikuwa inawezekana, taratibu tatu za matibabu zilitumika, zote zikiwa na athari mbalimbali. Namna hizi ni pamoja na taratibu kali za kizuizi cha sodiamu, (kwa mfano, lishe la mchele <ref name="pmid1744849"/>), [[sympathectomy]] (upasuaji wa kukausha sehemu za [[sympathetic nervous system]]), na tiba ya pyrogen (kudungwa dutu ambazo zilisababisha homa, pasipo moja kwa moja kupunguza shinikizo la damu).<ref name="pmid1744849"/> Kemikali ya kwanza ya shinikizo la damu, [[sodium thiocyanate]], ilitumika mwaka 1900 lakini ilikuwa na madhara mengi na haikupendwa.<ref name="pmid1744849"/> Mawakala wengine kadhaa waliundwa baada ya [[World War II|Second World War]]. Maarufu zaidi na fanisi kiasi ilikuwa [[tetramethylammonium hidrojeni]] na isio na uasili yake [[hexamethonium]], [[hydralazine]], na [[reserpine]] (inayotokana na mmea wa dawa ''[[Rauwolfia serpentina]]''). Uvumbuzi kubwa ilikuwa ya mafanikio na ugunduzi wa mawakala wa mdomo wa kwanza nzuri wanapatikana wanayovumiliwa. Ya kwanza ilikuwa [[chlorothiazide]], ya kwanza [[thiazide]] [[diuretic]], ambayo iliundwa na kiua vijasumu [[sulfanilamide]] na kupatikana mwaka 1958.<ref name="pmid1744849"/><ref>{{cite journal|author=Novello FC, Sprague JM | title=Benzothiadiazine dioxides as novel diuretics | journal=J. Am. Chem. Soc. | year=1957 | volume=79 | pages=2028 | doi=10.1021/ja01565a079|issue=8}}</ref> Iliongeza takamwili ya chumvi wakati inazuia mkusanyiko wa maji. [[randomized controlled trial]] ambayo ilifadhiliwa na [[United States Department of Veterans Affairs|Veterans Administration]] ikilinganishwa na [[hydrochlorothiazide]] pamoja na reserpine pamoja na hydralazine dhidi ya placebo. Utafiti huo ulisimamishwa mapema kwa sababu wale walio katika kundi la shinikizo la juu la damu ambao walikuwa wanapata tiba walipatwa na matatizo mengi zaidi ya wagonjwa waliotibiwa na ilionekana ni vibaya kumnyima matibabu kutoka kwao. Utafiti uliendelea kwa watu wenye shinikizo la damu ya chini na kuonyesha kwamba matibabu, hata katika watu walio na shinikizo la damu kiasi, kupunguza hatari ya kufa moyo na mishipa kwa zaidi ya nusu. <ref>{{cite journal | author=Freis ED | title=The Veterans Administration Cooperative Study on Antihypertensive Agents. Implications for Stroke Prevention | journal=Stroke | year=1974 | volume=5 | pages=76–77 | pmid=4811316 | url=http://stroke.ahajournals.org/content/5/1/76.long | format=PDF | issue=1 | doi=10.1161/01.STR.5.1.76}}</ref> Mwaka 1975, [[Lasker Award|Lasker Special Public Health Award]] ilitolewa kwa timu ambayo iliunda chlorothiazide. Matokeo ya tafiti hizi ilisababisha kampeni za afya za umma ili kuongeza uelewa wa umma wa shinikizo la damu na ilikuza kipimo na matibabu ya shinikizo la damu. Hatua hizi huonekana zilichangia angalau kwa sehemu kwa kupungua kwa asilimia 50 katika ugonjwa wa kiharusi na ischemic heart kati ya 1972 na 1994. == Jamii na utamaduni == ===Uelewa=== [[Image:HTNstudyupd.png|thumb|right|Grafu inaonyesha kiwango cha ufahamu, matibabu na udhibiti wa shinikizo la damu ikilinganishwa na kati ya utafiti nne ya [[National Health and Nutrition Examination Survey|NHANES]]<ref name="pmid7607734">{{cite journal |author=Burt VL |title=Mwelekeo wa maambukizi, ufahamu, matibabu, na udhibiti wa shinikizo la damu katika idadi ya Marekani ya watu wazima. Takwimu kutoka kwa utafiti wa makadirio ya afya, ya kwama 1960-1991 |journal=Hypertension |volume=26 |issue=1 |pages=60–9 |year=1995 |month=July |pmid=7607734 |doi= |url=http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=7607734 |accessdate=2009-06-05 |author-separator=, |author2=Cutler JA |author3=Higgins M |display-authors=3 |last4=Horan |first4=MJ |last5=Labarthe |first5=D |last6=Whelton |first6=P |last7=Brown |first7=C |last8=Roccella |first8=EJ |archive-date=2012-12-20 |archive-url=https://archive.today/20121220113643/http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=7607734 |dead-url=yes |https://archive.today/20121220113643/http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=7607734 |=https://archive.today/20121220113643/http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=7607734 }}</ref>]] [[Shirika la Afya Duniani]] limebainisha shinikizo la damu kama chanzo kikubwa cha [[cardiovascular]] [[Mortality rate|mortality]]. [[The World Hypertension League]] (WHL), shirika mwamvuli la jamii 85 ya taifa ya shinikizo la damu na ligi, ilitambua kuwa zaidi ya asilimia 50 ya watu walio na shinikizo la damu duniani hawajui hali yao.<ref name="pmid17534457">{{cite journal |author=Chockalingam A |title=Impact of World Hypertension Day |journal=Canadian Journal of Cardiology |volume=23 |issue=7 |pages=517–9 |year=2007 |month=May |pmid=17534457 |pmc=2650754 |doi= 10.1016/S0828-282X(07)70795-X|url= }}</ref> Ili kukabiliana na tatizo hili, WHL imeanzisha kampeni ya kimataifa juu ya shinikizo la damu mwaka 2005 na kutunikia tarehe 17 Mei kila mwaka kama [[World Hypertension Day]] (WHD). Zaidi ya miaka mitatu iliyopita, vyama zaidi vya kitaifa vimekuwa vikishiriki katika WHD na wamekuwa wabunifu katika shughuli zao za kupata ujumbe kwa umma. Mwaka 2007, kulikuwa na rekodi ya ushiriki kutoka nchi ya wanachama 47 ya WHL. Wakati wa wiki ya WHD, nchi hizi zote zilishirikiana na serikali za mitaa, jamii za kitaaluma, mashirika yasiyo ya kiserikali, na viwanda binafsi kukuza ufahamu wa shinikizo la damu kupitia kampeni kadhaa [[Mass media|media]] na umma. Ukitumia [[mass media]] kama vile [[wavuti]] na [[runinga]], ujumbe umewafikia zaidi ya watu milioni 250. Vile kasi inaongezeka mwaka baada yaa mwaka, WHL ina matumaini kuwa karibu watu wote wanaokadiriwa kufikia bilioni 1.5 ambao wameathirika na muinuko wa shinikizo la damu wanaweza kufikiwa.<ref name="pmid18548140">{{cite journal |author=Chockalingam A |title=World Hypertension Day and global awareness |journal=Canadian Journal of Cardiology |volume=24 |issue=6 |pages=441–4 |year=2008 |month=June |pmid=18548140 |pmc=2643187 |doi= 10.1016/S0828-282X(08)70617-2|url= }}</ref> ===Uchumi=== Shinikizo la damu ni shida sugu ya kawaida ya matibabu inayochochea ziara kwa watoa huduma msingi wa afya nchini Marekani. Shirika la Moyo Marekani limekadiria gharama za moja kwa moja na zisizo za moja kwa moja ya shinikizo la damu katika [[dola]] bilioni 76.6 katika mwaka 2010.<ref name = AHA2010>{{cite journal |author=Lloyd-Jones D, Adams RJ, Brown TM, ''et al.'' |title=Heart disease and stroke statistics--2010 update: a report from the American Heart Association |journal=Circulation |volume=121 |issue=7 |pages=e46–e215 |year=2010 |month=February |pmid=20019324 |doi=10.1161/CIRCULATIONAHA.109.192667 |url=}}</ref> Nchini Marekani, asilimia 80 ya watu walio na shinikizo la damu wanafahamu hali zao na asilimia 71 wanachukua baadhi ya dawa dhidi ya shinikizo la damu. Hata hivyo, asilimia 48 tu ya watu ambao wanafahamu wana shinikizo la damu wanadhibiti ipasavyo hali hiyo.<ref name = AHA2010 /><ref name="pmid19124418">{{cite journal |author=Alcocer L, Cueto L |title=Hypertension, a health economics perspective |journal=Therapeutic Advances in Cardiovascular Disease |volume=2 |issue=3 |pages=147–55 |year=2008 |month=June |pmid=19124418 |doi=10.1177/1753944708090572 |url=http://tak.sagepub.com/cgi/pmidlookup?view=long&pmid=19124418 |accessdate=2009-06-20 |archive-date=2012-12-04 |archive-url=https://archive.today/20121204191320/http://tak.sagepub.com/cgi/pmidlookup?view=long&pmid=19124418 |dead-url=yes }}</ref> Madaktari wanakabiliwa na shida nyingi katika kudhibiti shinikizo la damu, ikiwa ni pamoja na upinzani kwa kutumia dawa mbalimbali ili kufikia malengo ya shinikizo la damu. Watu pia wanakabiliwa na changamoto ya kufuata ratiba ya dawa na kufanya mabadiliko ya maisha. Hata hivyo, kufikia malengo ya shinikizo la damu inawezekana. Kupunguza shinikizo la damu inapunguza gharama kwa kiasi kikubwa ambayo inahusishwa na huduma ya matibabu ya juu.<ref name="The Economic Impact of Hypertension">{{cite journal |author=William J. Elliott |title=The Economic Impact of Hypertension |journal=The Journal of Clinical Hypertension |volume=5 |issue=4 |pages=3–13 |year=2003 |month=October |doi= 10.1111/j.1524-6175.2003.02463.x |pmid=12826765}}</ref><ref name="pmid18345711">{{cite journal |author=Coca A |title=Economic benefits of treating high-risk hypertension with angiotensin II receptor antagonists (blockers) |journal=Clinical Drug Investigation |volume=28 |issue=4 |pages=211–20 |year=2008 |pmid=18345711 |doi= 10.2165/00044011-200828040-00002|url= }}</ref> ==Marejeo== {{Reflist|2}} [[Jamii:Tiba]] [[jamii:Magonjwa]] [[Jamii:Damu]] [[Jamii:Moyo]] gfc6s595sdusfwysb6u8paql06t9rdv 0 68341 1578090 1512657 2026-07-02T19:13:34Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578090 wikitext text/x-wiki [[Picha:Gastroenteritis viruses.jpg|thumbnail|right|200px|Gastroenteritisi]] {{Infobox medical condition | Name = Gastroenteritisi | Image = Gastroenteritis viruses.jpg | Caption = Virusi vya Gastroenteritisi: A = rotavirusi, B = adenovirusi, C = norovirusi na D = astrovirusi. <!-- The virus particles are shown at the same magnification to allow size comparison.--> | DiseasesDB = 30726 | ICD10 = {{ICD10|A|02|0|a|00}}, {{ICD10|A|08||a|00}}, {{ICD10|A|09||a|00}}, {{ICD10|J|10|8|j|09}}, {{ICD10|J|11|8|j|09}},{{ICD10|K|52||k|50}} | ICD9 = {{ICD9|008.8}} {{ICD9|009.0}}, {{ICD9|009.1}}, {{ICD9|558}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = emerg | eMedicineTopic = 213 | MeshID = D005759 }} '''Gastroenteritisi''' ni hali mbaya ya [[afya]] yenye sifa ya kuvimba (''"-itis"'') kwa eneo la [[utumbo]] ambayo inahusu [[tumbo]] (''"gastro"''-) pamoja na [[chango]] (''"entero"''-), na kusababisha [[kuhara]], [[kutapika]], [[maumivu ya tumbo]] na kupata [[kiharusi]].<ref name=EBMED2010>{{citejournal|last=Singh|first=Amandeep|title=Pediatric Emergency Medicine Practice Acute Gastroenteritis — An Update|journal=Emergency Medicine Practice|year=2010|month=July|volume=7|issue=7|url=http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=229}}</ref> Ingawa haihusiani na [[mafua]], imeitwa pia ''mafua ya tumbo'' na ''homa ya tumbo''. Kimataifa, kesi nyingi katika [[watoto]] husababiswa na [[rotavirusi]].<ref name="pmid22030330">{{cite journal |author=Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD |title=2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis |journal=The Lancet Infectious Diseases|volume=12 |issue=2 |pages=136–41 |year=2012 |month=February |pmid=22030330 |doi=10.1016/S1473-3099(11)70253-5 }}</ref> Kwa [[watu wazima]], [[norovirusi]]<ref name="pmid21695033">{{cite journal |author=Marshall JA, Bruggink LD |title=The dynamics of norovirus outbreak epidemics: recent insights |journal=International Journal of Environmental Research and Public Health |volume=8 |issue=4 |pages=1141–9 |year=2011 |month=April|pmid=21695033 |pmc=3118882 |doi=10.3390/ijerph8041141}}</ref> na [[kampilobakteria]]<ref name="pmid22025030">{{cite journal |author=Man SM|title=The clinical importance of emerging Campylobacter species |journal=Nature Reviews. Gastroenterology & Hepatology |volume=8 |issue=12|pages=669–85 |year=2011 |month=December |pmid=22025030 |doi=10.1038/nrgastro.2011.191}}</ref> ni kawaida zaidi. Chini ya kawaida ni pamoja na sababu nyingine [[bakteria]] (au [[sumu]] yao) na [[vimelea]]. [[Maambukizi]] yanaweza kutokana na matumizi ya [[vyakula]] visivyo tayari au [[maji]] yenye vimelea au kupitia mahusiano ya karibu na [[watu]] ambao wameambukizwa. Gastroenteritisi kimsingi huathiri watoto na wale walio katika [[nchi zinazoendelea]]. Msaada muhimu zaidi ni kunywa [[maji]] yenye [[chumvi]] na [[sukari]]. Kwa kesi kali zaidi, [[maji]] katika [[mshipa|mishipa]] inaweza kuhitajika. == Dalili na Ishara == [[Image:Bristol stool chart.svg|thumb|300px|[[Bristol Stool Scale]] inoanyesha aina 7 za kuharisha.]] Gastroenteritisi kwa kawaida inahusisha [[kuharisha]] na [[kutapika]],<ref name=Eck2011/> au chini ya kawaida, inatoa moja au nyingine.<ref name=EBMED2010/> kupata kiharusi Msokoto inaweza pia kuwa sasa.<ref name=EBMED2010/> Ishara na dalili kwa kawaida huanza masaa 12–72 baada ya kuambulizwa.<ref name=Web09>{{citebook|last=Webber|first=Roger|title=Communicable disease epidemiology and control : a global perspective|year=2009|publisher=Cabi|location=Wallingford,Oxfordshire|isbn=978-1-84593-504-7|page=79|url=http://books.google.ca/books?id=pZ9fpHtvOGYC&pg=PA79|edition=3rd}}</ref> Ikitokana na virusi, hali kawaida kusudi ndani ya wiki moja.<ref name=Eck2011/> Sababu baadhi ya virusi pia inaweza kuhusishwa na [[homa]], [[uchovu]], [[maumivu ya kichwa]] na [[maumivu ya misuli]].<ref name=Eck2011/> Kama ni [[ugonjwa wa kuhara damu]], sababu ni chini ya uwekano wa kuwa na virusi<ref name=Eck2011/> na uwezekano mkubwa wa kuwa bakteria.<ref name=Bact2007/> Maambukizi ya bakteria baadhi yake yanaweza kuhusishwa na maumivu makali ya tumbo na kudumu kwa wiki kadhaa.<ref name=Bact2007/> Watoto walioambukizwa na rotavirusi kwa kawaida hupona ndani ya siku tatu mpaka nane.<ref name=Rota2011>{{cite journal|last=Meloni|first=A|coauthors=Locci, D, Frau, G, Masia, G, Nurchi, AM, Coppola, RC|title=Epidemiology and prevention of rotavirus infection: an underestimated issue?|journal=The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians|date=2011 Oct|volume=24 Suppl 2|pages=48–51|pmid=21749188|doi=10.3109/14767058.2011.601920}}</ref> Hata hivyo, katika nchi maskini matibabu kwa maambukizi makali ni mara nyingi nje ya urahisi wa kufikiwa na kuendelea kuharisha ni ya kawaida.<ref>{{citeweb|title=Toolkit|url=http://www.defeatdd.org/understandingcrisis/advocacyoutreach/toolkits|work=DefeatDD|accessdate=3 May 2012}}</ref> [[Kuishiwa maji mwilini]] ni matatizo ya kawaida ya kuharisha,<ref name=NICE2009>{{cite web|title=Management of acute diarrhoea and vomiting due to gastoenteritis in children under 5|url=http://guidance.nice.org.uk/CG84|work=National Institute of Clinical Excellence|month=April|year=2009}}</ref><ref name=Tint10>{{cite book |author=Tintinalli, Judith E. |title=Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli))|publisher=McGraw-Hill Companies |location=New York |year=2010 |pages=830–839 |isbn=0-07-1484809 }}</ref>Maambukizo ya kurudia ni kawaida kuonekana katika maeneo yenye usafi duni wa mazingira, na [[utapiamlo]],<ref name=Web09/> kudumaa ukuaji, na ya muda mrefu ucheleweshaji utambuzi inaweza kusababisha.<ref name=M93/> [[Tendaji arthritis]] hutokea katika 1% ya watu kufuatia maambukizi na aina ''kampylobakta'', na [[Dalili ya Guillain-Barre]] hutokea katika 0.1%.<ref name=Bact2007/> [[Dalili ya Hemolytic uremic]] (HUS) yanaweza kutokea kama matokeo ya maambukizi kwa [[Shiga sumu]]- ya kuzalisha ''Escherichia coli'' au ''Shigella'', kusababisha [[thrombocytopenia]], [[figo]] kushindwa kazi, na [[anemia]].<ref name=BMJ2007/> Watoto ni wepesi zaidi kupata HUS kuliko watu wazima.<ref name=M93/> Baadhi ya maambukizi ya virusi huweza kuzalisha [[kifafa cha watoto]].<ref name=EBMED2010/> ==Sababu== [[Virusi]] (hasa [[rotavirusi]]) na [[bakteria]] ''[[Escherichia coli]]'' na aina ''[[Kampilobakteria]]'' ni msingi wa sababu za uvimbe wa tumbo.<ref name=Sz2010/><ref name=Web09/> Hata hivyo kuna mawakala wengine wengi ambao wanaweza kusababisha hii dalili.<ref name=M93/>Sababu zisizo kuambukiza ni kuonekana juu ya tukio, lakini wao mdogo kuliko [[etiolojia]] ya virusi au bakteria.<ref name=EBMED2010/> Hatari ya maambukizi ni kubwa kwa watoto kutokana na ukosefu wao wa [[kingamwili]] na [[usafi]] duni.<ref name=EBMED2010/> === Virusi=== Virusi ambavyo vinajulikana kusababisha uvimbe wa tumbo ni pamoja na [[rotavirusi]], [[norovirusi]], [[adenovirusi]], na [[astrovirusi]].<ref name=Eck2011>{{cite journal |author=Eckardt AJ, Baumgart DC |title=Viral gastroenteritis in adults |journal=Recent Patents on Anti-infective Drug Discovery |volume=6|issue=1 |pages=54–63 |year=2011 |month=January |pmid=21210762}}</ref><ref name="pmid21173676">{{cite journal |author=Dennehy PH |title=Viral gastroenteritis in children |journal=The Pediatric Infectious Disease Journal |volume=30 |issue=1 |pages=63–4 |year=2011 |month=January|pmid=21173676 |doi=10.1097/INF.0b013e3182059102}}</ref> Rotavirus ni sababu ya gastroenteritis katika watoto,<ref name=Sz2010/> na inazalisha viwango vya matukio yanayofanana katika[[developed ulimwengu zinazoendelea]] na [[ulimwengu zilizoendelea]] zote mbili.<ref name=Rota2011/> Virusi kusababisha kuhusu 70% ya matukio ya kuharisha kuambukiza katika kundi watoto umri.<ref name=Webb2005>{{cite journal|last=Webb|first=A|coauthors=Starr, M|title=Acute gastroenteritis in children.|journal=Australian family physician|date=2005 Apr|volume=34|issue=4|pages=227–31|pmid=15861741}}</ref> Rotavirus ni sababu chini ya kawaida kwa watu wazima kutokana na kinga yachuma.<ref name=ID2011>{{cite journal |author=Desselberger U, Huppertz HI |title=Immune responses to rotavirus infection and vaccination and associated correlates of protection |journal=The Journal of Infectious Diseases |volume=203 |issue=2|pages=188–95 |year=2011 |month=January |pmid=21288818 |pmc=3071058 |doi=10.1093/infdis/jiq031 |url=}}</ref> Norovirus ni sababu inayoongoza ya gastroenteritisi miongoni mwa watu wazima nchini Marekani, na kusababisha zaidi ya 90% ya kuzuka.<ref name=Eck2011/> Hizi kufanya ya mahali [[magonjwa ya milipuko]] kawaida kutokea wakati makundi ya watu kutumia muda katika ukaribu wa karibu wa kimwili kwa kila mmoja, kama vile kwenye [[cruise meli]],<ref name=Eck2011/> katika hospitali, au katika migahawa.<ref name=EBMED2010/> Watu wanaweza kubaki kuambukiza hata baada ya kuhara zao kumalizika.<ref name=Eck2011/> Norovirus ni sababu ya juu ya 10% ya kesi katika watoto.<refname=EBMED2010/> ===Bakteria=== [[File:Salmonella Typhimurium Gram.jpg|thumb|''Salmonella enterica'' serovar Typhimurium (ATCC 14028) as seen with a microscope at 1000 fold magnification and following Gram staining.]]Katika dunia ya maendeleo ''[[Kampylobakta jejuni]]'' ni sababu ya msingi ya gastroenteritis bakteria, na nusu ya kesi ya hizi zinazohusiana na yatokanayo ya[[kuku]].<ref name=Bact2007>{{citejournal|last=Galanis|first=E|title=Campylobacter and bacterial gastroenteritis. journal=CMAJ : Canadian Medical Association |date=2007Sep 11|volume=177|issue=6|pages=5701|pmid=17846438|doi=10.1503/cmaj.070660|pmc=1963361}}</ref> Kwa watoto, bakteria ni sababu katika kuhusu 15% ya kesi, na aina ya kawaida kuwa ''[[Escherichia coli]]'', ''[[Salmonella]]'',''[[Shigella]]'',na aina ''kampilobakta''.<ref name=Webb2005/> kama chakula inakuwa kuingiwa na bakteria na kuzidisha kuongeza hatari ya maambukizi katika wale ambao hutumia chakula.<ref name=M93/> Baadi ya vyakula kawaida yanayohusiana na ugonjwa ni pamoja na mbichi au nyama,kuku,daga, mayai na ; sprouts ghafi; maziwa siomalisho na jibini laini; na matunda na juisi za mboga.<ref>{{cite journal|last=Nyachuba|first=DG|title=Foodborne illness: is it on the rise?|journal=Nutrition Reviews|date=2010 May|volume=68|issue=5|pages=25769|pmid=20500787|doi=10.1111/j.1753-4887.2010.00286.x}}</ref> Katika nchi zinazoendelea , hasa Afrika kusini mwa Sahara na Asia, [[kipindupindu]] ni sababu ya kawaida ya gastroenteritis.<!-- <ref name=Cholera11/> -->Maambukizi hii ni kawaida ya zinaa na maji yenye vimelea au chakula.<ref name=Cholera11>{{citejournal|last=Charles|first=RC|coauthors=Ryan, ET|title=Cholera in the 21st century.|journal=Current opinion in infectious diseases|date=2011Oct|volume=24|issue=5|pages=4727|pmid=21799407|doi=10.1097/QCO.0b013e32834a88af}}</ref> ''[[Clostridium difficile]]'' ni sababu muhimu ya kuharisha kwamba hutokea mara nyingi zaidi katika wazee.<ref name=M93/> Watoto wachanga wanaweza kubeba bakteria hawa bila dalili zinazoendelea.<ref name=M93/> Ni sababu ya kawaida ya kuharisha katika wale hospitalini na ni mara nyingi zinazohusiana na matumizi na kiuvijasumu.<ref>{{cite journal|last=Moudgal|first=V|coauthors=Sobel,JD|title=Clostridium difficile colitis: a review.|journal=Hospital practice (1995)|date=2012 Feb|volume=40|issue=1|pages=139-48|pmid=22406889|doi=10.3810/hp.2012.02.954}}</ref>''[[Staphylococcus aureus]]'' kuharisha kuambukiza pia huweza kutokea katika wale ambao wamekuwa wakitumia kiuvijasumu.<ref>{{cite journal|last=Lin|first=Z|coauthors=Kotler, DP; Schlievert, PM; Sordillo, EM|title=Staphylococcal enterocolitis: forgotten but not gone?|url=https://archive.org/details/sim_digestive-diseases-and-sciences_2010-05_55_5/page/1200|journal=Digestive diseases and sciences|date=2010 May|volume=55|issue=5|pages=1200-7|pmid=19609675}}</ref> "[[Kuharisha traveler]]" ni kawaida ya aina ya gastroenteritis bakteria. Acid-kukandamiza dawa inaonekana kuongeza hatari ya maambukizi ya muhimu baada ya kukumbana na idadi ya viumbe, ikiwa ni pamoja''Clostridium difficile'', ''Salmonella'', na aina ''Kampylobakta''.<ref name=PPI2007>{{citejournal|last=Leonard|first=J|coauthors=Marshall, JK, Moayyedi, P|title=Systematic review of the risk of enteric infection in patients taking acid suppression.|url=https://archive.org/details/sim_american-journal-of-gastroenterology_2007-09_102_9/page/2047|journal=The American journal of gastroenterology|date=2007 Sep|volume=102|issue=9|pages=2047–56; quiz 2057|pmid=17509031|doi=10.1111/j.1572-0241.2007.01275.x}}</ref> Hatari ni kubwa zaidi katika wale kuchuku[[proton pump inhibitors]] kuliko na [[H2 antagonist]]s pinzani.<ref name=PPI2007/> ===Vimelea=== Idadi ya [[Protozoa]] inaweza kusababisha uvimbe wa tumbo – kawaida ''[[Giardia lamblia]]'' – lakini ''[[histolytica Entamoeba]]'' na''[[Cryptosporidium]]'' pia wamekuwa wakihusishwa.<ref name=Webb2005/> Kama kikundi, hawa mawakala wanaunda kuhusu 10% ya kesi katika watoto.<ref name=BMJ2007/> ''Giardia'' hutokea zaidi ya kawaida katika nchi zinazoendelea , lakini hii wakala etiologic husababisha aina hii ya ugonjwa kwa kiasi fulani karibu kila mahali.<ref name=Giar2010>{{citejournal|last=Escobedo|first=AA|coauthors=Almirall, P, Robertson, LJ, Franco, RM, Hanevik, K, Mørch, K, Cimerman, S|title=Giardiasis: the ever-present threat of a neglected disease.|journal=Infectious disorders drug targets date=2010Oct|volume=10|issue=5|pages=32948|pmid=20701575}}</ref>Ni kawaida hutokea zaidi katika watu ambao alisafiri kwa maeneo yaliyo na kiwango cha maambukizi ya juu,watoto ambao kuhudhuria [[siku ya huduma]], wanaume wanafanya mapenzi na wanaume, na [[majanga]] kufuatia.<ref name=Giar2010/> ===Uenezi=== Maambukizi yanaweza kutokea kupitia matumizi ya maji machafu, au wakati watu kushiriki vitu binafsi.<ref name=Web09/> Katika maeneo na misimu ya mvua na ukame, ubora wa maji kwa kawaida ina ongezeka wakati wa [[mvua]], na hii ina uwiano na wakati wa milipuko.<ref name=Web09/> Na[[k=katika|maeneo ya dunia na misimu]], maambukizi ni zaidi ya kawaida katika majira ya baridi.<ref name=M93/> [[Chupa-kulisha]] watoto mchanga na chupa yenye ya udhibiti afya ni sababu muhimu kwa kiwango cha kimataifa.<ref name=Web09/> Maambukizi Viwango ni pia kuhusiana na hali duni ya usafi, hasa miongoni mwa watoto,<ref name=Eck2011/> ,Katika kaya inaishi,<ref>{{cite journal last=Grimwood|first=K|coauthors=Forbes, DA|title=Acute and persistent diarrhea. journal=Pediatric clinics of North America|date=2009 Dec|volume=56|issue=6|pages=1343–61|pmid=19962025|doi=10.1016/j.pcl.2009.09.004}}</ref> and in na katika wale walio na hali ya awali iliyopo maskini wa lishe.<ref name=M93/> Baada ya kuendeleza uvumilivu, watu wazima wanaweza kubeba viumbe fulani bila kuonyesha ishara au dalili, na hivyo kitendo kama hifadhi ya asili[[natural reservoirs]] ya uambukizaji.<ref name=M93/> Wakati Baadhi ya mawakala(kama vile ''Shigella'') tu kutokea katika [[jamii ya nyani]], wengine huwezi kutokea katika aina mbalimbali ya wanyama(kama vile ''Giardia'').<ref name=M93/> ===Pasho-Kuambukiza=== Kuna idadi ya sababu zisizokuambukiza ya kuvimba njia ya utumbo.<ref name=EBMED2010/> Baada ya zaidi ya kawaida ni pamoja na dawa (kama[[NSAIDs]]), baadi ya vyakula kama vile [[laktosi]] ( katika wale ambao ni siovumilivu), na [[gluten]] (katika wale wenye[[ugonjwa wa coeliac]]).[[Ugonjwa ya Crohn]] pia ni Chanzo zisizo maambukizi ya ( mara nyingi kali) gastroenteritis.<ref name=EBMED2010/> Mangonjwa ya sekondari kwa [[sumu]]inaweza pia kutokea. Baadi ya chakula kuhusiana hali ya kuhusiana na kichefuchefu, kuhara kutapika, na ni pamoja na: [[Ciguatera ciguatera sumu]] kutokana na matumizi ya samaki zilizosibikwa walao nyama, [[scombroid]] yanayohusiana na matumizi ya aina fulani ya samaki kuharibiwa, [[Tetrodotoxin#sumu|tetrodotoxin sumu]] kutoka matumizi ya [[samaki puffer]] miongoni mwa wengine, na [[botulism]] kawaida kutokana na chakula enye sio vizuri na salama.<ref>{{citejournal|last=Lawrence|first=DT|coauthors=Dobmeier, SG; Bechtel, LK; Holstege, CP|title=Food poisoning.|url=https://archive.org/details/sim_emergency-medicine-clinics-of-north-america_2007-05_25_2/page/357|journal=Emergency medicine clinics of North America|date=2007 May|volume=25|issue=2|pages=357-73; abstract ix|pmid=17482025|doi=10.1016/j.emc.2007.02.014}}</ref> ==Pathofiziolojia== Gastroenteritisi hufafanuliwa kama kutapika au kuharisha kutokana na maambukizi ya [[bowel ndogo]] au [[bowel kubwa]].<ref name=M93>Mandell 2010 Chp. 93</ref> Mabadiliko katika tumbo ni kawaida enye aiko - uvimbe, wakati wale katika matumbo kubwa ni uchochezi .<ref name=M93/>Idadi ya vijidudu ina shurutishwa kusababisha maambukizi inatofautiana kutoka wachache kama moja (kwa ''Cryptosporidium'')kama wengi kama 10⁸ (kwa''Vibrio cholerae'').<ref name=M93/> ==Uagizi== Gastroenteritis ni kawaida kukutwa hospitalini, kwa kuzingatia dalili ya mtu na dalili.<ref name=Eck2011/> Kuamua sababu Halisi ni kawaida si zinahitajika kama haina kubadilisha usimamizi wa hali hiyo.<ref name=Web09/> Hata hivyo, [[kinyesi utamaduni]]lazima kufanywa katika wale walio na damu katika kinyesi, wale ambao wanaweza kuwa wazi kwa[[sumu ya chakula]], na wale ambao hivi karibuni walisafiri kwa nchi zinazoendelea.<ref name=Webb2005/> Kupima uchunguzi pia inaweza kufanyika kwa uchunguzi.<ref name=Eck2011/> kama [[hypoglycemia]] hutokea katika 10% ya watoto wachanga na watoto wadogo ,kupima serum ya [[glucose]] katika idadi hii ni ilipendekeza.<ref name=Tint10/> [[Elektroliti]] na [[creatinini|shuguli ya figo]] lazima pia kuwa kagua wakati kuna wasiwasi kuhusu kupungua maji mwilini.<ref name=Webb2005/> ===Kuishiwa maji=== Uamuzi wa kama au mtu ana upungufu wa maji mwilini ni sehemu muhimu ya tathmini, pamoja na [[upungufu wa maji]] mwilini kawaida kugawanywa katika kali(3–5%), wastani (6–9%), na kali (≥10%)kesi.<ref name=EBMED2010/> Kwa watoto, sahihi zaidi ishara za kuishiwa maji wastani au kali ni wa muda mrefu [[kapilari refill]], maskini [[ngozi turgor]], na kinga isiyo ya kawaida.<ref name=Tint10/><ref>{{cite journal|last=Steiner|first=MJ|coauthors=DeWalt, DA, Byerley, JS|title=Is this child dehydrated?|url=https://archive.org/details/sim_jama_2004-06-09_291_22/page/2746|journal=JAMA : the Journal of the American Medical Association|date=2004 Jun 9|volume=291|issue=22|pages=2746–54|pmid=15187057|doi=10.1001/jama.291.22.2746}}</ref> Nyingine muhimu matokeo(wakati kutumika katika macho ) ni pamoja na macho sunken,shughuli ilipungua, ukosefu wa machozi, na kinywa kavua.<ref name=EBMED2010/> Kawaida ya mkojo pato na ulaji simulizi maji ni ya kuridhisha.<ref name=Tint10/> Maabara ya kupima ni ya faida ndogo ya kliniki katika kuamua kiwango cha upungufu wa maji mwilini..<ref name=EBMED2010/> ===Tofauti ya utambuzi=== Sababu nyingine ya uwezo wa ishara na dalili kwamba mwigaji kuonekana katika gastroenteritis kwamba haja ya kuwa ilitawala nje ni pamoja na [[ugonjwa wa kidole tumbo]],[[volvulus]], [[Ugonjwa wa vuimbe wa tumbo]], [[maambukizi ya njia ya mkojo]],s, na [[kisukari mellitus]].<ref name=Webb2005/> Kutojitosheleza kongosho,[[short bowel syndrome]], [[ugonjwa ya whipple]], [[ugonjwa ya coeliac]], na unyanyasaji [[haluli]] lazima pia kuchukuliwa.<ref name="Oxford">{{cite book |editor=Warrell D.A., Cox T.M., Firth J.D., Benz E.J. |title=The Oxford Textbook of Medicine |publisher=Oxford University Press |year=2003 |isbn=0-19-262922-0 |edition=4th |url=http://otm.oxfordmedicine.com/ |access-date=2013-03-06 |archive-date=2012-03-21 |archive-url=https://web.archive.org/web/20120321002102/http://otm.oxfordmedicine.com/ |dead-url=yes |=https://web.archive.org/web/20120321002102/http://otm.oxfordmedicine.com/ }}</ref> utambuzi tofauti unaweza kuwa mgumu kiasi fulani kama mtu ku onyesha ''tu'' kutapika au kuharisha (kuliko wote).<ref name=EBMED2010/> Kidole tumbo yanaweza kuwasilisha na kutapika, maumivu ya tumbo, na kiasi kidogo cha kuhatisha katika hadi 33% ya kesi .<ref name=EBMED2010/> Hii ni tofauti na kiasi kikubwa cha kuharisha kwamba ni mfano wa gastroenteritis.<ref name=EBMED2010/> Maambukizi ya mapafu au njia ya mkojo kwa watoto huweza pia kusababisha kutapika au kuharahisha.<ref name=EBMED2010/> [[dkisukari ketoasidosisi]] ya zamani (DKA) kwa wakati huu na maumivu ya tumbo, kuchefuchefu, na kutapika, lakini bila kuharisha.<ref name=EBMED2010/> Utafiti mmoja kupatikana kwamba 17% ya watoto wenye DKA awali walikuwa wametambuliwa kama kuwa gastroenteritis.<ref name=EBMED2010/> ==Kinga== [[File:RotavirusV2009.gif|thumb|Percentage of rotavirus tests with positive results, by surveillance week, United States, July 2000 – June 2009.]] ===Mtindo wa maisha=== Usambazaji wa maji kwa urahisi siochafuka na mazoea mazuri ya usafi wa mazingira ni muhimu kwa ajili ya kupunguza Viwango vya maambukizi na gastroenteritis hospitalini muhimu.<ref name=M93/> Hatua ya binafsi ( kama vile [[kuosha mkono]]) wamekuwa kupatikana kupungua matukio na viwango vya maambukizi ya gastroenteritis katika ulimwengu zinazoendelea na maendeleo kwa % kama vile 30%.<ref name=Tint10/> Pombe makao mageli inaweza pia kuwa na ufanisi.<ref name=Tint10/> [[Kunyonyesha]] ni muhimu, hasa katika maeneo na hali duni ya usafi, kama ni uboreshaji wa usafi kwa ujumla.<ref name=Web09/> Maziwa ya Matiti inapunguza wote mzunguko wa maambukizo na muda wao.<ref name=EBMED2010/> Kuepuka zilizosibikwa chakula au kinywaji lazima pia kuwa na ufanisi.<ref>{{cite web title=Viral Gastroenteritis|url=http://www.cdc.gov/ncidod/dvrd/revb/gastro/faq.htm|work=Center for Disease Control and Prevention|accessdate=16 April 2012|month=February|year=2011}}</ref> ===Chanjo=== Kutokana na ufanisi wake wote na usalama, mwaka 2009 Shirika la Afya Duniani ilipendekeza kwamba [[Chanjo rotavirus]] itatolewa kwa watoto wote duniani.<ref name=WHORota2009>{{cite journal|last=World Health Organization|title=Rotavirus vaccines: an update|journal=Weekly epidemiological record|year=2009|month=December|volume=51–52|issue=84|pages=533–540|url=http://www.who.int/wer/2009/wer8451_52.pdf|accessdate=10 May 2012}}</ref><ref name=Sz2010>{{cite journal|last=Szajewska|first=H|coauthors=Dziechciarz,P|title=Gastrointestinal infections in the pediatric population.|journal=Currentopinion in gastroenterology|date=2010 Jan|volume=26|issue=1|pages=3644|pmid=19887936|doi=10.1097/MOG.0b013e328333d799}}</ref> Mbili ya kibiashara chanjo ya rotavirus zipo na zaidi kadhaa ni katika maendeleo.<ref name=WHORota2009/> Katika Afrika na Asia hizi chanjo kupunguzwa ugonjwa kali miongoni mwa watoto wachanga <ref name=WHORota2009/> na nchi ambazo kuweka katika mipango ya kitaifa ya chanjo mahali nimeona kushika kwa viwango na ukali wa ugonjwa huo. <ref>{{citejournal|last=Giaquinto|first=C|coauthors=Dominiak-Felden G, Van Damme P, Myint TT, Maldonado YA, Spoulou V, Mast TC, Staat MA|title=Summary of effectiveness and impact of rotavirus vaccination with the oral pentavalent rotavirus vaccine: a systematic review of the experience in industrialized countries|journal=Human Vaccines|year=July|month=2011|volume=7|series=7|pages=734–748|url=http://www.landesbioscience.com/journals/vaccines/article/15511/?nocache=1111012137|accessdate=10 May 2012|doi=10.4161/hv.7.7.15511|pmid=21734466}}</ref><ref>{{cite journal|last=Jiang|first=V|coauthors=Jiang B, Tate J, Parashar UD, Patel MM|title=Performance of rotavirus vaccines in developed and developing countries|journal=Human Vaccines|year=2010|month=July|volume=6|issue=7|pages=532–542|url=http://www.landesbioscience.com/journals/vaccines/article/11278/?nocache=531156378|accessdate=10 May 2012 | pmid = 20622508 }}</ref> Chanjo hii pia inaweza kuzuia ugonjwa katika watoto wasio chanjo kwa kupunguza idadi ya maambukizi zinazozunguka.<ref>{{citejournal|last=Patel|first=MM|coauthors=Steele, D, Gentsch, JR, Wecker, J, Glass, RI, Parashar, UD|title=Real-world impact of rotavirus vaccination.|journal=The Pediatric Infectious Disease Journal|date=2011 Jan|volume=30|issue=1 Suppl|pages=S1-5|pmid=21183833|doi=10.1097/INF.0b013e3181fefa1f}}</ref> Tangu mwaka 2000, utekelezaji wa programu ya chanjo katika rotavirus Marekani imekuwa kikubwa kupungua idadi ya kesi ya kuhara kwa asilimia nyingi kama 80kwa kila mia.<ref name="CDC Rota">{{cite journal|last=US Center for Disease Control and Prevention|title=Delayed onset and diminished magnitude of rotavirus activity—United States, November 2007 – May 2008|journal=Morbidity and Mortality Weekly Report|year=2008|volume=57|issue=25|pages=697–700|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5725a6.htm|accessdate=3 May 2012}}</ref><ref>{{cite journal |title=Reduction in rotavirus after vaccine introduction—United States, 2000–2009 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=58 |issue=41 |pages=1146–9 |year=2009 |month=October |pmid=19847149|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5841a2.htm}}</ref><ref>{{cite journal|last=Tate|first=JE|coauthors=Cortese, MM, Payne, DC, Curns, AT, Yen, C, Esposito, DH, Cortes, JE, Lopman, BA, Patel, MM, Gentsch, JR, Parashar, UD|title=Uptake, impact, and effectiveness of rotavirus vaccination in the United States: review of the first 3 years of postlicensure data.|journal=The Pediatric Infectious Disease Journal|date=2011 Jan|volume=30|issue=1Suppl|pages=S5660|pmid=21183842|doi=10.1097/INF.0b013e3181fefdc0}}</ref> dozi ya kwanza itolewe kwa watoto wachanga kati ya wiki 6 na 15 ya umri.<ref name=Sz2010/> The [[Cholera vaccine|oral cholera vaccine]] simuiizi chanjo ya kipindupindu imekuwa kupatikana kwa kuwa 50–60% ufanisi zaidi ya miaka 2 &nbsp;.<ref>{{cite journal|last=Sinclair|first=D|coauthors=Abba, K, Zaman, K, Qadri, F, Graves, PM|title=Oral vaccines for preventing cholera.|journal=Cochrane database of systematic reviews (Online)|date=2011Mar16|issue=3|pages=CD008603|pmid=21412922|doi=10.1002/14651858.CD008603.pub2}}</ref> ==Utaratibu wa Kimatibabu== Gastroenteritis ni kawaida ugonjwa papo hapo na kujitegemea kikwazo kwamba hauhitaji dawa.<ref name=NICE2009/> matibabu kupenda zaidi katika wale wenye mpole na [[maji mwilini wastani]] ni [[simulizi kuweka maji tiba]] (ORT).<ref name=BMJ2007>{{cite journal|last=Elliott|first=EJ|title=Acute gastroenteritis in children.|journal=BMJ (Clinical research ed.)|date=2007 Jan 6|volume=334|issue=7583|pages=35–40|pmid=17204802|doi=10.1136/bmj.39036.406169.80|pmc=1764079}}</ref> [[Metoclopramide]] na/au [[ondansetron]], hata hivyo, inaweza kuwa msaada katika baadhi ya watoto,<ref name="Alhashimi2009">{{cite journal |author=Alhashimi D, Al-Hashimi H, Fedorowicz Z|editor1-last=Alhashimi |editor1-first=Dunia |title=Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents|journal=Cochrane Database Syst Rev |issue=2 |pages=CD005506 |year=2009 |pmid=19370620|doi=10.1002/14651858.CD005506.pub4 }}</ref> na[[butylscopolamine]] ni muhimu katika kutibu katika [[maumivu ya tumbo]].<ref>{{cite journal |author=Tytgat GN |title=Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain |journal=Drugs |volume=67 |issue=9 |pages=1343–57 |year=2007 |pmid=17547475 }}</ref> ===Kuongeza maji=== Matibabu ya msingi ya gastroenteritis katika bote watoto na watu ni [[kuweka maji]]. Hii ni ikiwezekana mafanikio kwa tiba ya mdomo ya kuweka maji, ingawa utoaji [[katika mishipa tiba |katika mishipa]] kutakiwa kama kuna[[ngazi ilipungua fahamu]] kama maji mwilini ni kali.<ref>{{cite web |url=http://www.bestbets.org/bets/bet.php?id=1039 |title=BestBets: Fluid Treatment of Gastroenteritis in Adults |accessdate=2013-03-06 |archive-date=2009-02-12 |archive-url=https://web.archive.org/web/20090212164231/http://www.bestbets.org/bets/bet.php?id=1039 |url-status=dead }}</ref><ref>{{cite journal |author=Canavan A, Arant BS |title=Diagnosis and management of dehydration in children |journal=AmFam Physician|volume=80 |issue=7 |pages=692–6 |year=2009 |month=October |pmid=19817339 }}</ref> Mdomo badala tiba bidhaa kufanywa na wanga tata(i.e. yaani wale alifanya kutoka ngano au mchele)inaweza kuwa ni bora kuliko wale makao juu ya sukari.<ref>{{cite journal |author=Gregorio GV, Gonzales ML, Dans LF, Martinez EG |editor1-last=Gregorio |editor1-first=Germana V |title=Polymer-based oral rehydration solution for treating acute watery diarrhoea |journal=Cochrane Database Syst Rev |issue=2 |pages=CD006519 |year=2009 |pmid=19370638 |doi=10.1002/14651858.CD006519.pub2}}</ref> Vinywaji hasa yulu katika sukari, kama vile [[vinywaji baridi]] na juisi matunda, si ilipendekeza kwa watoto chini ya miaka umri 5 kama wanaweza ''kuongeza'' kuharisha.<ref name=NICE2009/> Maji wazi inaweza kutumika kama maalum zaidi na ufanisi ORT maandalizi ni hapayo au si mazuri.<ref name=NICE2009/> A [[tube nasogastric]] inaweza kutumika kwa watoto wadogo kusimamia maji maji kama ya kuhalalisha.<ref name=Webb2005/> ===Malazi=== Inapendekezwa kwamba kunyonyesha watoto wachanga kuendelea kuwa ku muuguzi katika mtindo wa kawaida, na kwamba watoto wachanga fomyula-kulishwa kuendelea fomyula yao mara baada ya kuweka maji na ORT.<ref name=MMWR2003/> Laktosi-free au laktosi- ya kushuka fomyula kawaida si muhimu.<ref name=MMWR2003/>Watoto wanapashwa kuendelea mlo wao wa kawaida wakati wa matukio ya kuharisha na ubaguzi vyakula yulu saana katika ni [[Rahisi sukari]]ziepukwe.<refname=MMWR2003/> [[mlo BRAT]] (ndizi, mchele, sosi ya tufaha, mkati ya kuchoma na chai) ni tena ilipendekeza, kama ina virutubisho haitoshi na haina faida juu ya kulisha kawaida.<ref name=MMWR2003>{{cite journal |author=King CK, Glass R, Bresee JS, Duggan C |title=Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy |journal=MMWR Recomm Rep |volume=52 |issue=RR-16|pages=1–16 |year=2003 |month=November |pmid=14627948 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5216a1.htm}}</ref> [[Probiotics]] Baadhi wamekuwa umeonyesha kuwa na manufaa katika kupunguza muda wote wa ugonjwa na marudio ya stuli<ref>{{cite journal |author=Allen SJ, Martinez EG, Gregorio GV, Dans LF |editor1-last=Allen |editor1-first=StephenJ |title=Probiotics for treating acute infectious diarrhoea |journal=Cochrane DatabaseSystRev |volume=11 |issue=11|pages=CD003048 |year=2010 |pmid=21069673 |doi=10.1002/14651858.CD003048.pub3 }}</ref>Wanaweza pia kuwa na manufaa katika kuzuia na kutibu [[kiuvijasumu kuhusishwa kuharisha]]. <ref>{{citejournal|last=Hempel|first=S|coauthors=Newberry, SJ; Maher, AR; Wang, Z; Miles, JN; Shanman, R; Johnsen, B; Shekelle, PG|title=Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis.|journal=JAMA : the journal of the American MedicalAssociation|date=2012May9|volume=307|issue=18|pages=1959-69|pmid=22570464}}</ref> Maziwa bidhaa mchachuko (kama vile [[mtindi]]) ni vile vile manufaa .<ref>{{cite web|last=Mackway-Jones|first=Kevin|title=Does yogurt decrease acute diarrhoeal symptoms in children with acute gastroenteritis?|url=http://www.bestbets.org/bets/bet.php?id=1000|work=BestBets|month=June|year=2007|accessdate=2013-03-06|archivedate=2013-05-17|archiveurl=https://web.archive.org/web/20130517002703/http://www.bestbets.org/bets/bet.php?id=1000}}</ref> [[Zinki]]nyongeza inaonekana kuwa na ufanisi katika wawili kutibu na kuzuia kuharisha miongoni mwa watoto katika nchi zinazoendelea.<ref>{{citejournal|last=Telmesani|first=AM|title=Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea.|journal=Journal of family and community medicine|date=2010 May|volume=17|issue=2|pages=7982|pmid=21359029|doi=10.4103/1319-1683.71988|pmc=3045093}}</ref> ===Antiemetics=== Dawa [[Antiemetic]] inaweza kuwa na manufaa kwa ajili ya kutibu kutapika katika watoto.[[Ondansetron]] ina baadhi ya shirika, na dozi moja isihusishwe na haja kidogo kwa ajili ya maji katika mishipa, hospitalini wachache, na kutapika inapungua. <ref>{{cite journal |author=DeCamp LR, Byerley JS, Doshi N, Steiner MJ |title=Use of antiemetic agents in acute gastroenteritis: a systematic review and meta-analysis |journal=ArchPediatrAdolescMed|volume=162 |issue=9 |pages=85865 |year=2008 |month=September |pmid=18762604|doi=10.1001/archpedi.162.9.858 }}</ref><ref name="pmid17279195">{{cite journal| author = Mehta S, Goldman RD| title = Ondansetron for acute gastroenteritis in children| journal = Can Fam Physician| volume = 52| issue = 11| pages = 1397–8| year = 2006| pmid17279195 | url=http://www.cfp.ca/cgi/pmidlookup?view=long&pmid=17279195 |pmc = 1783696 }}</ref><ref name=Cochrane2011/> [[Metoclopramide]]ili pia kuwa na manufaa.<ref name=Cochrane2011>{{citejournal|last=Fedorowicz|first=Z|coauthors=Jagannath, VA, Carter, B|title=Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents.|journal=Cochrane database of systematic reviews (Online)|date=2011Sep7|volume=9|pages=CD005506|pmid=21901699|doi=10.1002/14651858.CD005506.pub5|issue=9}}</ref> Hata hivyo, matumizi ya ondansetron pengine kuhusishwa na kiwango cha ongezeko la kurudi katika hospitali ya watoto.<ref>{{cite journal |author=Sturm JJ, Hirsh DA, Schweickert A, Massey R, Simon HK|title=Ondansetron use in the pediatric emergency department and effects on hospitalization and return rates: are we masking alternative diagnoses?|journal=AnnEmerg Med |volume=55 |issue=5 |pages=41522 |year=2010 |month=May |pmid=20031265 |doi=10.1016/j.annemergmed.2009.11.011 }}</ref> Maandalizi katika mishipa ondansetron inaweza kutolewa kwa mdomo ikiwa vibali kliniki hukumu.<ref>{{citeweb|title=Ondansetron|url=http://www.merckmanuals.com/professional/print/lexicomp/ondansetron.html|work=Lexi-Comp|month=May|year=2011}}</ref>[[Dimenhydrinate]],wakati kupunguza kutapika, haionekani kuwa muhimu kliniki faida.<ref name=EBMED2010/> ===Vijasumu=== [[Vijasumu]] si kawaida kutumika kwa ajili ya gastroenteritis, ingawa wakati mwingine ilipendekeza hasa kama dalili ni kali.<ref>{{cite journal |author=Traa BS, Walker CL, Munos M, Black RE |title=Antibiotics for the treatment of dysentery in children |journal=Int J Epidemiol|volume=39 |issue=Suppl 1 |pages=i704 |year=2010 |month=April |pmid=20348130 |pmc=2845863 |doi=10.1093/ije/dyq024 }}</ref> au kama wanahusika sababu bakteria pekee au watuhumiwa.<ref>{{cite journal |author=Grimwood K, Forbes DA |title=Acute and persistent diarrhea |journal=Pediatr. Clin. North Am. |volume=56 |issue=6 |pages=134361 |year=2009 |month=December |pmid=19962025 |doi=10.1016/j.pcl.2009.09.004 }}</ref> Kama kiuvijasumu ni kwa kuajiriwa, [[macrolide]] ( kama vile [[azithromycin]]) ni ku penda zaidi ya [[fluoroquinolone]] kutokana na viwango vya juu vya upinzani na karibuni.<ref name=Bact2007/> [[Pseudomembranous colitis]], kawaida husababishwa na matumizi ya antibiotiki, inasimamiwa na kutoendelea na wakala visababishi na kutibu kwa aidha [[metronidazole]] au [[vancomycin]].<refname="Mandell"/>Bakteria na protozoans kwamba ni amenable kwa matibabu pamoja na ''[[shigellosis|Shigella]]''<ref>{{citejournal|last=Christopher|first=PR|coauthors=David, KV, John, SM, Sankarapandian, V|title=Antibiotic therapy for Shigella dysentery.|journal=Cochrane database of systematic reviews (Online)|date=2010Aug4|issue=8|pages=CD006784|pmid=20687081|doi=10.1002/14651858.CD006784.pub4}}</ref> ''[[Salmonellosis|Salmonellatyphi]]'',<ref>{{citejournal|last=Effa|first=EE|coauthors=Lassi, ZS, Critchley, JA, Garner, P, Sinclair, D, Olliaro, PL, Bhutta, ZA|title=Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever).|journal=Cochrane database of systematic reviews (Online)|date=2011 Oct 5|issue=10|pages=CD004530|pmid=21975746|doi=10.1002/14651858.CD004530.pub4}}</ref> na‘Giardia'' spishi.<refname=Giar2010/> Katika wale wenye na ''Giardia'' spishi au ''Entamoeba histolytica'', matibabu [[tinidazole]] inapendekeza na kushinda metronidazole.<ref>{{citejournal|last=Gonzales|first=ML|coauthors=Dans, LF, Martinez, EG|title=Antiamoebic drugs for treating amoebic colitis.|journal=Cochrane database of systematic reviews (Online)|date=2009Apr15|issue=2|pages=CD006085|pmid=19370624|doi=10.1002/14651858.CD006085.pub2}}</ref><refname=Giar2010/> [[Shirika la afya Duniani]] (WHO) inapendekeza matumizi ya antibiotics kwa watoto wadogo ambao wana wawili wa damu na kuharisha na homa. <ref name=EBMED2010/> ===Antimotility mawakala=== Antimotility dawa ina hatari ya kusababisha matatizo ya kinadharia, na ingawa uzoefu kliniki umeonyesha kuwa huu ni uwezekano, name="Oxford"/> dawa hizi ni tamaa katika watu na umwagaji damu kuhara au kuhara kwamba ni ngumu kwa homa. [[Loperamide]], [[opioidi]] mfano wa afyuni , ni kawaida hutumiwa kwa ajili ya matibabu ya dalili kuharisha.<ref name="SleisengerFordtran">{{citebook |first1=Mark |last1=Feldman |first2=LawrenceS. |last2=Friedman |first3=MarvinH.|last3=Sleisenger |title=Sleisenger & Fordtran's Gastrointestinal and Liver Disease |publisher=Saunders |year=2002 |isbn=0721689736 |edition=7th|url=http://www.elsevierinternational.com/catalogue/title.cfm?ISBN=0721689736}}</ref> Loperamide haifai kwa watoto, hata hivyo, kama inaweza kuvuka machanga damu-ubongo kizuizi na kusababisha kusumisha. [[Bismuth subsalicylate]], tata hakuna wa [[bismuth]] na salicylate, inaweza kutumika katika kesi kali kwa wastani,<ref name="Oxford"/> lakini[[salicylate sumu]] ni kinadharia iwezekanavyo.<ref name=EBMED2010/> ==Epidemiolojia== [[Image:Diarrhoeal diseases world map - DALY - WHO2004.svg|thumb|Uenezi wa kuharisha kati ya wakazi 100,000 mwaka 2004. {{Multicol}} {{legend|#b3b3b3|<small>no data</small>}} {{legend|#ffff65|<small>≤less 500</small>}} {{legend|#fff200|<small>500–1000</small>}} {{legend|#ffdc00|<small>1000–1500</small>}} {{legend|#ffc600|<small>1500–2000</small>}} {{legend|#ffb000|<small>2000–2500</small>}} {{legend|#ff9a00|<small>2500–3000</small>}} {{Multicol-break}} {{legend|#ff8400|<small>3000–3500</small>}} {{legend|#ff6e00|<small>3500–4000</small>}} {{legend|#ff5800|<small>4000–4500</small>}} {{legend|#ff4200|<small>4500–5000</small>}} {{legend|#ff2c00|<small>5000–6000</small>}} {{legend|#cb0000|<small>≥6000</small>}} {{Multicol-end}}]] Inakadiriwa kuwa kesi 3-5000000000 ya gastroenteritis kutokea duniani kila mwaka, <ref> {{citejournal|last=Elliott|first=EJ|title=Acutegastroenteritis in children.|journal=BMJ (Clinical researched.)|date=2007Jan6|volume=334|issue=7583|pages=3540|pmid=17204802|doi=10.1136/bmj.39036.406169.80|pmc=1764079}}</ref> kimsingi unaathiri watoto na[[yanayoendelea duniani]].<ref name=Web09/> ni ulisababisha vifo vya watu milioni 1.3 kwa watoto chini ya miaka mitano kama ya 2008,<ref>{{citejournal|last=Black|first=RE|coauthors=Cousens, S, Johnson, HL, Lawn, JE, Rudan, I, Bassani, DG, Jha, P, Campbell, H, Walker, CF, Cibulskis, R, Eisele, T, Liu, L, Mathers, C, Child Health Epidemiology Reference Group of WHO and, UNICEF|title=Global, regional, and national causes of child mortality in 2008: a systematic analysis.|journal=Lancet|date=2010Jun5|volume=375|issue=9730|pages=196987|pmid=20466419|doi=10.1016/S01406736(10)605491}}</ref> na zaidi ya hayo yanayotokea katika mataifa maskini zaidi duniani.<ref name=M93/>Zaidi ya 450,000 ya vifo haya ni kutokana na rotavirus kwa watoto chini ya miaka umri 5.<ref>{{cite journal|last=Tate|first=JE|coauthors=Burton, AH, Boschi-Pinto, C, Steele, AD, Duque, J, Parashar, UD, WHO-coordinated Global Rotavirus Surveillance, Network|title=2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis.|journal=The Lancet infectious diseases|date=2012 Feb|volume=12|issue=2|pages=13641|pmid=22030330|doi=10.1016/S14733099(11)702535}}</ref><ref>{{cite journal|last=World Health Organization|title=Global networks for surveillance of rotavirus gastroenteritis, 2001–2008|journal=Weekly Epidemiological Record|year=2008|month=November|volume=47|issue=83|pages=421–428|url=http://www.who.int/wer/2008/wer8347.pdf|accessdate=10 May 2012}}</ref>[[Cholera]] Kipindupindu husababisha kesi kuhusu 3-5,000,000 ya ugonjwa na unaua takriban watu 100,000 kila mwaka.<ref name=Cholera11/> Katika watoto kuendeleza dunia chini ya miaka miwili ya umri mara nyingi kupata maambukizi sita au zaidi mwaka kwamba matokeo katika gastroenteritis hospitalini muhimu.<ref name=M93/> Ni chini ya kawaida kwa watu wazima, kutokana na maendeleo ya [[kinga maradhi ( ya tiba)|kinga]].<ref name=Eck2011/> Mwaka 1980, kutokana na sababu zote gastroenteritis yaliyosababisha vifo milioni 4.6 kwa watoto, na wengi kutokea katika nchi zinazoendelea.<ref name="Mandell">{{cite book |first1=Gerald L. |last1=Mandell |first2=John E. |last2=Bennett |first3=Raphael |last3=Dolin |title=Mandell's Principles and Practices of Infection Diseases |publisher=Churchill Livingstone |year=2004 |isbn=0-443-06643-4 |edition=6th |url=http://www.ppidonline.com/ |access-date=2013-03-06 |archive-date=2013-10-18 |archive-url=https://web.archive.org/web/20131018175309/http://www.ppidonline.com/ |dead-url=yes }}</ref> Viwango vya kifo walikuwa kupunguzwa kwa kiasi kikubwa (kwa takriban milioni 1.5 vifo kila mwaka) kwa mwaka 2000, kwa kiasi kikubwa kutokana na kuanzishwa na kuenea kwa matumizi ya[[ tiba ya ndomo ya kuweka maji]].<ref name="Victora2000">{{cite journal |author=Victora CG, Bryce J, Fontaine O, Monasch R |title=Reducing deaths from diarrhoea through oral rehydration therapy |journal=Bull. World Health Organ.|volume=78|issue=10 |pages=124655 |year=2000 |pmid=11100619 |pmc=2560623}}</ref> Nchini Marekani, maambukizi kusababisha uvimbe wa tumbo ni maambukizi ya pili ya kawaida ( baada ya [[kawaida ya baridi]]), na wao kusababisha kesi kati ya 200 na 375 milioni ya kuharisha papo <ref name=Eck2011/><ref name=M93/> na takriban elfu kumi vifo kila mwaka,<ref name=M93/> na 150-300 ya vifo hivi kwa watoto chini ya miaka mitano.<ref name=EBMED2010/> ==Historia== matumizi ya kwanza ya "gastroenteritis" ilikuwa katika 1825.<ref>{{citeweb |url=http://www.oed.com/ |title=Gastroenteritis |format= |work=[[Oxford English Dictionary]] 2011 |accessdate=January 15, 2012}}</ref> Kabla ya wakati huu ni zaidi hasa inayojulikana kama[[homa ya matumbo]] au "kipindupindu morbus", miongoni mwa wengine, au chini hasa kama "kushisha ya matumbo", "wingi", "Flux", "mchango", "malalamiko ya tumbo", au moja ya idadi ya majina mengine ya kizamani kwa kuharisha papo hapo.<ref name="archaic">{{Rejea tovuti |url=http://www.antiquusmorbus.com/English/English.htm |title=Rudy's List of Archaic Medical Terms |accessdate=2013-03-06 |archiveurl=https://web.archive.org/web/20070709111154/http://www.antiquusmorbus.com/English/English.htm |archivedate=2007-07-09 |=https://web.archive.org/web/20070709111154/http://www.antiquusmorbus.com/English/English.htm }}</ref> ==Jamii na utamadumi== Gastroenteritis ni kuhusishwa na majina mengi ya simo, ikiwa ni pamoja na "[[Montezuma wa kisasi]]", "Delhi tumbo", "la turista", na "sprint nyuma mlango", miongoni mwengine.<ref name=M93/> Ni imekuwa na jukumu katika kampeni nyingi za kijeshi na ni kuamini kuwa asili ya neno "matumbo hakuna hakuna utukufu".<ref name=M93/>. Gastroenteritis ni sababu kuu ya ziara milioni 3.7 kwa madaktari mwaka nchini Marekani<ref name=EBMED2010/> na 3,000,000 ya ziara nchini Ufaransa.<ref>{{citejournal|last=Flahault|first=A|coauthors=Hanslik, T|title=[Epidemiology of viral gastroenteritis in France and Europe].|journal=Bulletin de l'Academie nationale de medecine|date=2010Nov|volume=194|issue=8|pages=141524;discussion 1424-5|pmid=22046706}}</ref> In the United States gastroenteritis as a whole is believed to result in costs of 23&nbsp;billion USD per year<ref>{{cite book|last=Albert|first=edited by Neil S. Skolnik ; associate editor, Ross H.|title=Essential infectious disease topics for primary care|year=2008|publisher=Humana Press|location=Totowa, NJ|isbn=9781588295200|pages=66|url=http://books.google.ca/books?id=iGUKPeO9-ygC&pg=PA66}}</ref> Uvimbe wa tumbo na Marekani kwa ujumla inaaminika kusababisha gharama ya bilioni 23 mwaka USD kwa mwaka. Na kwamba kutokana na rotavirus peke kusababisha Makadirio ya gharama za dola bilioni 1 mwaka huu<ref name=EBMED2010/> ==Utafiti== Kuna idadi ya chanjo dhidi ya gastroenteritis katika maendeleo. Kwa mfano, chanjo dhidi ya Shigella na enterotoxigenic ''Escherichia coli'' (ETEC), mbili ya sababu ya kuongoza bakteria wa gastroenteritis duniani kote.<ref name="WHO ETEC">{{cite web|last=World Health Organization|title=Enterotoxigenic Escherichia coli (ETEC)|url=http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index4.html|work=Diarrhoeal Diseases|accessdate=3 May 2012|archivedate=2012-05-15|archiveurl=https://web.archive.org/web/20120515142857/http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index4.html}}</ref><ref name="WHO Shig">{{cite web|last=World Health Organization|title=Shigellosis|url=http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index6.html|work=Diarrhoeal Diseases|accessdate=3 May 2012}}</ref> ==Katika wanyama== Gastroenteritisi katika paka na mbwa inasababishwa na wengi wa mawakala sawa kwa binadamu: wa kawaida ni:''Kampilobakteria'', ''Clostridium difficile'', ''Clostridium perfringens'' na ''Salmonella''.<ref>{{cite journal|last=Weese|first=JS|title=Bacterial enteritis in dogs and cats: diagnosis, therapy, and zoonotic potential.|journal=The Veterinary clinics of North America. Small animal practice|date=2011 Mar|volume=41|issue=2|pages=287-309|pmid=21486637|doi=10.1016/j.cvsm.2010.12.005}}</ref> idadi kubwa ya mimea sumu huweza pia kusababisha dalili. <ref>{{cite book|last=Rousseaux|first=Wanda Haschek, Matthew Wallig, Colin|title=Fundamentals of toxicologic pathology|year=2009|publisher=Academic|location=London|isbn=9780123704696|pages=182|url=http://books.google.ca/books?id=vkox3JS83k8C&pg=PA182|edition=2nd ed.}}</ref> Baadhi ya mawakala ni maalumu zaidi ya aina fulani.[[Magonjwa gastroenteritis coronavirus]](TGEV) hutokea katika nguruwe kusababisha kutapika, kuishiwa maji kuhara.<ref>{{cite book|last=MacLachlan|first=edited na N. James|title=Fenner's veterinary virology|year=2009|publisher=Elsevier Academic Press|location=Amsterdam|page=399|isbn=9780123751584|edition=4th ed.|coauthors=Dubovi, Edward J.|url=http://books.google.ca/books?id=TYFqlYO9eE4C&pg=PA399}}</ref> Inaaminika kuwa vishawishi kwa nguruwe na ndege wa pori na hakuna tiba maalumu inapatikana.<ref>{{cite book|last=al.]|first=edited by James G. Fox ... [et|title=Laboratoryanimal medicine|year=2002|publisher=Academic Press|location=Amsterdam|isbn=9780122639517|pages=649|url=http://books.google.ca/books?id=m2ftfPMJnMMC&pg=PA649|edition=2nd ed.}}</ref> Ni si uambukizaji kwa binadamu. <ref>{{cite book|last=al.]|first=edited by Jeffrey J. Zimmerman ... [et|title=Diseases of swine|publisher=Wiley-Blackwell|location=Chichester,WestSussex|isbn=9780813822679|pages=504|url=http://books.google.ca/books?id=jVaemau17J4C&pg=PA504|edition=10thed.}}</ref>. ==Tanbihi== {{reflist|2}} ==Marejeo== *{{cite book|last=Dolin|first=[edited by] Gerald L. Mandell, John E. Bennett, Raphael|title=Mandell, Douglas, and Bennett's principles and practice of infectious diseases|year=2010|publisher=Churchill Livingstone/Elsevier|location=Philadelphia, PA|isbn=0-443-06839-9|edition=7th ed.}} [[jamii:maradhi ya kuambukiza]] 7eiqrkvlxboumgt12704dqwgcbvns5z 0 68740 1578184 1498067 2026-07-03T01:46:04Z InternetArchiveBot 41439 Add 4 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578184 wikitext text/x-wiki {{Infobox disease | Name = Schizophrenia | Image = Cloth embroidered by a schizophrenia sufferer.jpg | Caption = Cloth embroidered by a patient diagnosed with schizophrenia | Width = | DiseasesDB = 11890 | ICD10 = {{ICD10|F|20||f|20}} | ICD9 = {{ICD9|295}} | ICDO = | OMIM = 181500 | MedlinePlus = 000928 | eMedicineSubj = med | eMedicineTopic = 2072 | eMedicine_mult = {{eMedicine2|emerg|520}} | MeshName = Schizophrenia | MeshNumber = F03.700.750 |}} '''Skizofrenia''' ni [[ugonjwa wa akili]] unaosababisha fikira na hisia zisizo za kawaida.<ref>"Skizofrenia" Concise Medical Dictionary. Oxford University Press, 2010. Oxford Reference Online. [http://www.maastrichtuniversity.nl/web/Library/AboutTheLibrary.htm Maastricht University Library] {{Wayback|url=http://www.maastrichtuniversity.nl/web/Library/AboutTheLibrary.htm |date=20120614062252 }}. 29 June 2010[http://www.oxfordreference.com/views/ENTRY.html?subview=Main&entry=t60.e9060 prepaid subscription only]</ref> Watu wengi walio na ugonjwa huo husikia yasiyokuwemo (kama kuota njozi), na woga na makisio yasiyoeleweka ([[paranoia]]), pia wanaweza kuamini mambo ya kiajabu na yasiyoeleweka, kuzungumza bila [[mantiki]] n.k. Watu hawa huwa na ugumu wa kuhusiana na wengine inavyofaa au kudumisha kazi. [[Dalili]] kwa kawaida huanza katika [[ujana]] baada ya [[umri]] wa miaka 16. Takriban [[asilimia]] 0.3 hadi 0.7 ya [[idadi]] ya watu [[duniani]] watakuwa na hali hiyo wakati mmoja [[Maisha|maishani]] mwao.<ref name=Lancet09/> Mwenendo unaoonekana na matukio yaliyoripotiwa husaidia kubaini iwapo mtu ana ugonjwa huo. Vipengele kadhaa muhimu vinaweza kusababisha skizofrenia. Vipengele hivi ni pamoja na uhusiano wa kijamii na mtu aliye na hali hii, mazingira ya hapo awali ya mtu, mfumo wa neva unaodhibiti mwili na akili ya mtu, na taratibu za kiakili na kijamii. Baadhi ya [[dawa]], zikiwemo dawa za kuagiziwa na daktari, zinaweza kusababisha dalili au kuzifanya mbaya zaidi. Utafiti wa hivi sasa unaangazia jukumu la mfumo wa neva ingawa hakuna mtu aliyepata kisababishi hata kimoja cha kiogani kilichojitenga. Miungano mingi ya dalili zinazoweza kutokea imepelekea mjadala kuhusu iwapo ugonjwa huu ni hali moja au hali nyingi tofauti. Neno "skizofrenia" linatokana na maneno mawili ya [[Lugha ya Kigriki|Griki]] yanayomaanisha "kugawanya" na "akili". Hata hivyo, skizofrenia haimaanishi "akili iliyogawanyika" wala kusababisha watu kuwa na nafsi nyingi (au "zilizogawanyika"). Watu wengi hushindwa kutofautisha skizofrenia na hali kama hizo.<ref name=BMJ07/> Matibabu hasa ni kwa kutumia dawa ili kupunguza dalili kuu. Dawa hizi husitisha nyendo katika sehemu za ubongo zinazochakata kemikali inayoitwa [[dopamine]]. (Baadhi ya dawa hizi pia husitisha shughuli katika sehemu ambazo huchakata kemikali inayoitwa [[serotonin]].) Matibabu ambayo pia ni muhimu ni pamoja na therapi ya kiakili, usaidizi katika kutafuta na kudumisha kazi na pia marekebisho ya kimahusiano. Katika matukio makubwa ambapo kuna hatari kwa mtu binafsi na watu wengine, mtu anaweza kuhitaji kulazwa hospitalini. Hatua hii inaweza kuchukuliwa kwa idhini au bila idhini ya mtu huyu. Hata hivyo, matukio ya kulazwa hospitalini siku hizi yamepunguka na kuwa nadra ikilinganishwa na hapo awali.<ref name="BeckerKilian2006">{{cite journal |author=Becker T, Kilian R|year=2006 |title=Psychiatric services for people with severe mental illness across western Europe: what can be generalized from current knowledge about differences in provision, costs and outcomes of mental health care? |journal=[[Acta Psychiatrica Scandinavica]] Supplement |volume=429 |pages=9–16 |pmid=16445476 |doi=10.1111/j.1600-0447.2005.00711.x|issue=429}}</ref> Skizofrenia hudhaniwa kuathiri hasa michakato ya kiakili, lakini pia huchangia matatizo ya muda mrefu pamoja na mwenendo na hisia. Watu walio na skizofrenia wana uwezekano wa kuwa na hali zingine pia, zikiwemo mfadhaiko na wasiwasi. Takriban asilimia 50 ya watu walio na skizofrenia hutumia madawa ya kulevya wakati mmoja maishani mwao.<ref name="Sim_et_al_2006">{{cite journal |author=Buckley PF, Miller BJ, Lehrer DS, Castle DJ |title=Psychiatric comorbidities and schizophrenia |url=https://archive.org/details/sim_schizophrenia-bulletin_2009-03_35_2/page/383 |journal=Schizophr Bull |volume=35 |issue=2 |pages=383–402|year=2009 |month=March |pmid=19011234 |pmc=2659306 |doi=10.1093/schbul/sbn135}}</ref> Matatizo ya kijamii kama vile ukosefu wa kazi kwa muda mrefu, umaskini na ukosefu wa makao hutokea mara nyingi. Kwa wastani, watu walio na skizofrenia hufa miaka 12 hadi 15 mapema zaidi ya wale wasio na hali hii: Watu walio na skizofrenia wana matatizo ya mwili mengi zaidi, na wana kiwango cha uwezekano wa kujiua cha asilimia 5 zaidi ya watu wa kawaida.<ref name=Lancet09/> == Dalili == Watu walio na skizofrenia wanaweza kusikia au kuona yasiyokuwemo; kusikia sauti ni jambo linalotokea mara nyingi. Watu hawa wanaweza kuwa na fikira za kiajabu na kuwa na wasiwasi wakihofia kuwa kuna mtu anayetaka kuwaumiza. Maneno na fikira zao zinaweza kukosa mpangilio: wanaweza kupoteza msururu wao wa fikra, huku wakitunga sentensi zilizo na maana duni au sentensi zisizo na maana yoyote ile. Mambo yanayofuatia ugonjwa wa skizofrenia ni pamoja na kujitenga na mahusiano ya kijamii, kuvaa ovyo na kutozingatia usafi, na kukosa motisha na uamuzi.<ref name=CarsonNursing>Carson VB (2000). [http://books.google.com/books?id=QM5rAAAAMAAJ Mental health nursing: the nurse-patient journey] W.B. Saunders. ISBN 978-0-7216-8053-8. p. 638.</ref> Mtindo unaoweza kuonekana wa matatizo ya kihisia, kama vile kukosa mwitikio, pia hutokea mara nyingi.<ref name="HirschWeinberger2003p21">{{cite book|author1=Hirsch SR|author2= Weinberger DR|title=Schizophrenia|url=http://books.google.com/books?id=x3fmsV55rigC&pg=PA21|year= 2003|publisher=Wiley-Blackwell|isbn=9780632063888|page=21}}</ref> Ufahamu duni wa mahusiano ya kijamii huhusishwa na skizofrenia <ref>{{cite journal |author=Brunet-Gouet E, Decety J |title=Social brain dysfunctions in schizophrenia: a review of neuroimaging studies |journal=Psychiatry Res|volume=148 |issue=2–3 |pages=75–92 |year=2006 |month=December |pmid=17088049 |doi=10.1016/j.pscychresns.2006.05.001}}</ref> na mara nyingi watu walio na skizofrenia hudhania kuwa watu wengine wanapangia kuwadhuru. Kwa sababu hiyo, watu walio na hali hii mara nyingi hukaa mbali na watu wengine.<ref name="HirschWeinberger2003p481">{{cite book|author1=Hirsch SR|author2= WeinbergerDR|title=Schizophrenia|url=http://books.google.com/books?id=x3fmsV55rigC&pg=PA21|year= 2003|publisher=Wiley-Blackwell|isbn=9780632063888|page=481}}</ref> Katika mojawapo ya aina dogo za hali hii zisizotokea mara nyingi, mtu anaweza kukosa kuzungumza, anaweza kutunduaa katika hali za kiajabu, au kukasirika bila sababu.<ref>{{cite journal |author=Ungvari GS, Caroff SN, Gerevich J|title=The catatonia conundrum: evidence of psychomotor phenomena as a symptom dimension in psychotic disorders |url=https://archive.org/details/sim_schizophrenia-bulletin_2010-03_36_2/page/231|journal=Schizophr Bull |volume=36|issue=2 |pages=231–8 |year=2010 |month=March |pmid=19776208 |doi=10.1093/schbul/sbp105}}</ref> Watu walio na umri wa takriban miaka 18 na walio katika mwanzo wa utu uzima wako katika kiwango cha juu zaidi cha kupata skizofrenia.<ref name=Lancet09>{{cite journal |author=[[Jim van Os|van Os J]], Kapur S |title=Schizophrenia |url=https://archive.org/details/sim_the-lancet_august-22-28-2009_374_9690/page/635 |journal=Lancet |volume=374 |issue=9690 |pages=635–45 |year=2009 |month=August |pmid=19700006|doi=10.1016/S0140-6736(09)60995-8}}</ref> Miaka hii ni muhimu katika kuendelea kijamii na kitaaluma katika maisha ya vijana. <ref name="Addington_et_al_2007"/> Katika asilimia 40 ya wanaume na asilimia 23 ya wanawake wanaotambuliwa na skizofrenia, hali hii hujionyesha kabla ya umri wa miaka 19.<ref name=Cullen>{{cite journal |author=Cullen KR, Kumra S, Regan J ''et al.'' |title=Atypical Antipsychotics for Treatment of Schizophrenia Spectrum Disorders |journal=Psychiatric Times |volume=25 |issue=3 |year=2008 |url=http://www.psychiatrictimes.com/schizophrenia/article/10168/1147536 |access-date=2013-05-11 |archive-date=2008-12-28 |archive-url=https://web.archive.org/web/20081228153056/http://www.psychiatrictimes.com/schizophrenia/article/10168/1147536 |dead-url=yes }}</ref> Ili kupunguza matatizo ya ukuaji yanayohusishwa na skizofrenia, hivi karibuni juhudi nyingi zimefanyika ili kutambua na kutibu awamu ya ugonjwa inayotokea kabla ya dalili kuanza. Awamu hii ya “kabla ya mwanzo” imeshatambuliwa hata miezi 30 kabla ya dalili kuanza.<ref name="Addington_et_al_2007">{{cite journal |author=Addington J, Cadenhead KS, Cannon TD, ''et al.''|year=2007|title=North American prodrome longitudinal study: a collaborative multisite approach to prodromal schizophrenia research |url=https://archive.org/details/sim_schizophrenia-bulletin_2007-05_33_3/page/665|journal=[[Schizophrenia Bulletin]] |volume=33 | issue=3 |pages=665–72 |pmid=17255119|doi=10.1093/schbul/sbl075|pmc=2526151}}</ref>Wakati wa awamu ya kabla ya mwanzo, watu ambao hupata skizofrenia baadaye wanaweza kuwa na dalili za muda mrefu au zilizo na kikomo au dalili kuu sana<ref name="Amminger_et_al_2006">{{cite journal |author=Amminger GP, Leicester S, Yung AR, ''et al.'' |year=2006 |title=Early onset of symptoms predicts conversion to non-affective psychosis in ultra-high risk individuals |url=https://archive.org/details/sim_schizophrenia-research_2006-05_84_1/page/67 |journal=[[Schizophrenia Research]] |volume=84 | issue=1 |pages=67–76|pmid=16677803 |doi=10.1016/j.schres.2006.02.018}}</ref>pamoja na dalili zisizo maalum za kujitenga na watu, hasira na hisia za kijumla za kukosa furaha pakubwa <ref name="ParnasJorgensen1989">{{cite journal |author=Parnas J, Jorgensen A |year=1989 |title=Pre-morbid psychopathology in schizophrenia spectrum|journal=[[British Journal of Psychiatry]] |volume=115 |pages=623–7 |pmid=2611591}}</ref> na kuzembea <ref>{{cite book |ref=harv |last=Coyle|first=Joseph |editor1-first=George J |editor1-last=Siegal |editor2-first=R. Wayne |editor2-last=Albers |editor3-first=Scott T |editor3-last=Brady|editor4-first=Donald |editor4-last=Price |title=Basic Neurochemistry: Molecular, Cellular and Medical Aspects |url=https://archive.org/details/basicneurochemis0000unse_y3l1 |format=Textbook |edition=7th |year=2006|publisher=Elsevier Academic Press |location=Burlington, MA |isbn=0-12-088397-X |page=[https://archive.org/details/basicneurochemis0000unse_y3l1/page/876 876] |chapter=Chapter 54: The Neurochemistry of Schizophrenia}}</ref>. === Uainishaji wa Schneider === Mtaalamu wa magonjwa ya akili, Kurt Schneider, (aliyezaliwa mwaka wa 1887 na kufariki mwaka wa 1967) aliorodhesha dalili mbalimbali ambazo aliamini ziliwezesha kutofautisha skizofrenia na magonjwa mengine makubwa ya kiakili. Dalili hizi hujulikana kama dalili za kiwango cha kwanza, nazo ni pamoja na imani kuwa kuna nguvu za nje zinazoongoza mtu, kutia au kutoa mawazo katika akili ya mtu au kuwasambazia watu wenginefikira za mtu. Dalili hizi pia huhusisha kusikia sauti zisizokuwepo zinazosema kuhusu fikira au matendo ya mtu au pia kuzungumza na sauti zisizokuwepo.<ref name="SchneiderClinicalPsychopathology">{{cite book|last1=Schneider |first1=K |authorlink1=Kurt Schneider |title=Clinical Psychopathology |url=http://books.google.com/?id=ofzOAAAAMAAJ |edition=5 |year=1959 |publisher=Grune & Stratton |location=New York }}</ref> Dalili hizi za kiwango cha kwanza zimechangia kigezo cha hivi sasa cha kutambua iwapo mtu ana skizofrenia. Hata hivyo, kuna swali, iwapo uwepo au ukosefu wa dalili hizi kwa kweli unaweza kutabiri iwapo mtu ana au hana hali hii. Uhakiki wa utafiti uliofanyika kati ya mwaka wa 1970 na 2005 ulionyesha kuwa utafiti huu haukuthibitisha wala kukanusha madai ya Schneider. Uhakiki huu ulieleza kuwa dalili za kiwango cha kwanza hazifai kutiliwa mkazo sana katika kutambua iwapo mtu ana skizofrenia.<ref name="pmid17562695">{{cite journal |author=Nordgaard J, Arnfred SM, Handest P, Parnas J |title=The diagnostic status of first-rank symptoms |url=https://archive.org/details/sim_schizophrenia-bulletin_2008-01_34_1/page/137 |journal=Schizophrenia Bulletin |volume=34 |issue=1 |pages=137–54 |year=2008 |month=January |pmid=17562695 |pmc=2632385|doi=10.1093/schbul/sbm044}}</ref> === Dalili chanya na hasi === Mara nyingi skizofrenia huelezewa kwa kurejelea dalili chanya au hasi (punguzi).<ref name="Sims_2002">{{cite book |author=Sims A |title=Symptoms in the mind: an introduction to descriptive psychopathology |url=https://archive.org/details/symptomsinmindin0000sims_o2s8 |publisher=W. B. Saunders|location=Philadelphia |year=2002 |isbn=0-7020-2627-1 }}</ref> Dalili chanya ni zile zisizopatikana katika watu wengi, lakini zipo katika watu walio na skizofrenia. Dalili chanya ni pamoja na fikira zisizo za kawaida ambazo hazieleweki (delusheni). Fikira hizi pamoja na fikira au maneno yasiyo na mpangilio, na pia zinahusisha kuhisi, kusikia, kuona, kunusia au kuonja vitu visivyokuwemo (kuota njozi). Kuota njozi huku huchukuliwa kama dalili za ugonjwa wa akili ambao humzuia mtu kufahamu iwapo hali fulani ni halisi au ni dhana tu<ref>Kneisl C. and Trigoboff E.(2009). Contemporary Psychiatric- Mental Health Nursing. 2nd edition. London Pearson Prentice Ltd. p. 371</ref> na kwa kawaida huhusiana na delusheni za mtu.<ref name=DSM299/> Positive symptoms usually respond well to medication.<ref name=DSM299>American Psychiatric Association. Task Force on DSM-IV. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Pub. ISBN 978-0-89042-025-6. p. 299</ref> Dalili hasi ni matendo ambayo watu wengi hutenda au uwezo wanaokuwa nao unaokosekana katika watu walio na skizofrenia. Kwa mfano, ukosefu wa mwitikio wa kawaida wa hisia au michakato ya fikira ni dalili hasi. Dalili hizi haziitikii matibabu vyema .<ref name=CarsonNursing/> Dalili hasi ni pamoja na hisia bapa au hafifu. Dalili hizi pia huhusisha uwezo duni wa kuzungumza. Dalili hizi pia ni pamoja na ukosefu wa uwezo wa kuhisi furaha, ukosefu wa hamu ya kuwa na uhusiano na hata kukosa motisha. Utafiti unadokeza kuwa dalili hasi huchangia sana katika kiwango duni cha maisha, ulemavu wa kiutendaji na kuwategemea watu wengine ikilinganishwa na dalili chanya.<ref>{{cite journal |author=Velligan DI and Alphs LD |title=Negative Symptoms in Schizophrenia: The Importance of Identification and Treatment |journal=Psychiatric Times |volume=25 |issue=3 |date=March 1, 2008 |url=http://www.psychiatrictimes.com/schizophrenia/article/10168/1147581 |access-date=2013-05-11 |archive-date=2009-10-06 |archive-url=https://web.archive.org/web/20091006015627/http://www.psychiatrictimes.com/schizophrenia/article/10168/1147581 |dead-url=yes }}</ref> Watu walio na dalili wazi hasi mara nyingi huwa na historia duni ya urekebishaji kabla ya dalili kutokea na mwitikio wao wa matibabu huwa mdogo.<ref name=CarsonNursing/><ref name=AFP10/> == Visababishi == Muungano wa vipengele katika jeni za mtu na mazingira huchangia katika kuendelea kwa skizofrenia.<ref name=Lancet09/><ref name=BMJ07/>Watu walio na historia ya kifamilia ya skizofrenia na pia wanaopata dalili za muda mfupi au zinazogandamiza utendaji wao wana asilimia 20-40 ya kutambuliwa mwaka mmoja baadaye.<ref name="Drake_Lewis_2005">{{cite journal |author=Drake RJ, Lewis SW |title=Early detection of schizophrenia |journal=Current Opinion in Psychiatry|volume=18 |issue=2 |pages=147–50 |year=2005 |month=March |pmid=16639167 |doi=10.1097/00001504-200503000-00007}}</ref> === Vipengele vilivyorithiwa === Makadiro ya iwapo skizofrenia inaweza kurithiwa hutofautiana kwa sababu kutenganisha athari za jeni za mtu na mazingira yake ni jambo gumu.<ref name="ODonovan_et_al_2003">{{cite journal |author=O'Donovan MC, Williams NM, Owen MJ |title=Recent advances in the genetics of schizophrenia|journal=Hum. Mol. Genet. |volume=12 Spec No 2 |pages=R125–33 |year=2003 |month=October |pmid=12952866 |doi=10.1093/hmg/ddg302}}</ref> Hatari iliyo kuu zaidi (asilimia 6.5) ya kuendelea kwa skizofrenia ni kuwa na jamaa wa karibu aliye na hali hii. Mtu aliye na skizofrenia akiwa na ndugu pacha wanaofanana, pacha huyo pia huwa na hali hii katika zaidi ya asilimia 40 ya matukio.<ref name=BMJ07/> Inawezekana kuwa jeni nyingi zinahusika, kila mojawapo kwa kiwango kidogo.<ref name=BMJ07/> Jeni nyingi zinazokisiwa kuhusika zimependekezwa, zikiwemo utofauti katika idadi ya nakala za jeni maalum, jeni aina ya NOTCH4, na eneo la dutu maalumu za kiogani ziitwazo protini histoni.<ref name=Genes10>{{cite journal |author=McLaren JA, Silins E, Hutchinson D, Mattick RP, Hall W |title=Assessing evidence for a causal link between cannabis and psychosis: a review of cohort studies |journal=Int. J. Drug Policy |volume=21 |issue=1 |pages=10–9 |year=2010 |month=January|pmid=19783132 |doi=10.1016/j.drugpo.2009.09.001 |url=}}</ref>Idadi fulani ya mahusiano yanayohusisha protini maalumu zinazorithiwa pia zimeonekana kuhusiana na hali hii.<ref>{{cite journal |author=O'Donovan MC, Craddock NJ, Owen MJ |title=Genetics of psychosis; insights from views across the genome |journal=Hum. Genet. |volume=126 |issue=1 |pages=3–12 |year=2009 |month=July |pmid=19521722|doi=10.1007/s00439-009-0703-0}}</ref>Inaonekana kuwa kuna upishano mkuu katika jeni zinazohusiana na skizofrenia na jeni zinazohusiana na maradhi ya hisia mseto (maradhi ya kimihemko yanayohusisha msururu wa mihemko ya juu na ya chini).<ref>{{cite journal | author = Craddock N, Owen MJ | title = The Kraepelinian dichotomy - going, going... But still not gone | journal = The British Journal of Psychiatry | volume = 196 | pages = 92–95| year = 2010 | doi = 10.1192/bjp.bp.109.073429 | pmid=20118450 | pmc=2815936}}</ref> Ikichukuliwa kuwa skizofrenia inaweza kurithiwa, swali moja ni, ni kwa nini jeni zinazoongeza uwezekano wa dalili kuu zinaweza kufuka. Kufuka kwa hali kama hii si rahisi kutokea. Nadharia moja inagusia jeni zinazohusika katika kufuka kwa lugha na mienendo ya kizazi. Hata hivyo, nadharia zote zimethibitishwa kuwa za uongo au zisizoweza kutibitishwa.<ref name="pmid18502103">{{cite journal |author=Crow TJ|title=The 'big bang' theory of the origin of psychosis and the faculty of language |journal=[[Schizophrenia Research]] |volume=102 |issue=1–3|pages=31–52 |year=2008 |month=July |pmid=18502103 |doi=10.1016/j.schres.2008.03.010 }}</ref><ref>{{cite book|title=Clinical Handbook of Schizophrenia|url=https://archive.org/details/clinicalhandbook00mues|year=2008|isbn=1593856520|pages=[https://archive.org/details/clinicalhandbook00mues/page/n43 22]–23|author=Mueser KT, Jeste DV|publisher=Guilford Press|location=New York}}</ref> === Vipengele vya kimazingira === Vipengele vya kimazingira vinavyohusiana na kuendelea kwa skizofrenia ni pamoja na mazingira anayoishi mtu, utumiaji wa madawa na dhiki ya kabla ya kuzaliwa.<ref name=Lancet09/>Mitindo ya kimalezi inaonekana kutokuwa na athari zozote, ingawa watu walio na wazazi wanaowasaidia hufaulu zaidi ya wale walio na wazazi wasiowasaidia.<ref name=BMJ07/> Kuishi katika mazingira ya miji wakati wa utotoni au utu uzima kumethibitishwa kuongezea hatari ya skizofrenia kwa kigawe cha mbili.<ref name=Lancet09/><ref name=BMJ07/> Hii ni kweli hata baada ya kujumlisha utumizi wa dawa, kabila na ukubwa wa kikundi cha kimahusiano.<ref name="fn_19">{{cite journal |author=[[Jim van Os|Van Os J]] |year=2004 |title=Does the urban environment cause psychosis?|journal=[[British Journal of Psychiatry]] |volume=184 | issue=4 |pages=287–288 |pmid=15056569 |doi=10.1192/bjp.184.4.287}}</ref> Vipengele vingine vinavyochangia pakubwa ni pamoja na iwapo mtu anahisi kutengwa kimausiano pamoja na matatizo ya kimahusiano, ubaguzi wa rangi, kusambaratika kwa mifumo ya kijamii, ukosefu wa kazi na hali duni ya makao.<ref name=BMJ07/><ref name="Selten_et_al_2007">{{cite journal |author=Selten JP, Cantor-Graae E, Kahn RS|year=2007 |month=March |title=Migration and schizophrenia |journal=Current Opinion in Psychiatry |volume=20 |issue=2 |pages=111–115 |pmid=17278906|doi=10.1097/YCO.0b013e328017f68e}}</ref> Kuna ushahidi kuwa matukio ya utotoni ya dhuluma au kiwewe ni vipengele vya hatari ya kuwa na skizofrenia baadaye katika maisha.<ref>{{cite journal |authors=Larkin W, Read J |title=Childhood trauma and psychosis: evidence, pathways, and implications|journal=J Postgrad Med |year=2008 |volume=54 |pages=287-293 |pmid=18953148 |url=http://www.jpgmonline.com/text.asp?2008/54/4/287/41437}}</ref> ==== Madawa ya kulevya ==== Dawa za aina tofauti zimehusishwa na uendeleaji wa skizofrenia.<ref name=BMJ07/>Takriban nusu ya watu walio na skizofrenia hutumia madawa ya kulevya au pombe kwa wingi.<ref name="Gregg_et_al_2007"/> Bangi (pia inayojulikana kama cannabis) inaweza kuwa kisababishi cha hali hii.<ref>{{cite journal|last=Large|first=M|coauthors=Sharma, S, Compton, MT, Slade, T, Nielssen, O|title=Cannabis Use and Earlier Onset of Psychosis: A Systematic Meta-analysis.|journal=Archives of general psychiatry|date=2011 Feb 7|pmid=21300939}}</ref> Hata hivyo, madawa mengiine yanaweza kutumiwa tu kama taratibu za kukabiliana na dhiki, wasiwasi, upweke au ukosefu wa mostisha.<ref name="Gregg_et_al_2007">{{cite journal |author=Gregg L, Barrowclough C, Haddock G |year=2007 |title= Reasons for increased substance use in psychosis |url=https://archive.org/details/sim_clinical-psychology-review_2007-05_27_4/page/494 |journal= Clin Psychol Rev |volume=27 |issue=4 |pages=494–510|pmid=17240501 |doi=10.1016/j.cpr.2006.09.004}}</ref><ref name=Leweke08/> Bangi inahusishwa na ongezeko la hatari ya kuwa na ugonjwa mkuu wa akili kulingana na jinsi mtu alivyoitumia dawa hii mara nyingi.<ref>{{cite journal |author=Moore THM, Zammit S, Lingford-Hughes A ''et al.'' |year=2007 |title= Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review |journal=Lancet |volume=370 |issue=9584 |pages=319–328 |doi=10.1016/S0140-6736(07)61162-3|pmid=17662880}}</ref> Kutumia bangi kila mara kumehusishwa na hatari ya mara mbili ya kupata ugonjwa mkuu wa akili na skizofrenia.<ref name=Leweke08>{{cite journal|author=Leweke FM, Koethe D |title=Cannabis and psychiatric disorders: it is not only addiction |journal=Addict Biol |volume=13 |issue=2 |pages=264–75|year=2008 |month=June |pmid=18482435 |doi=10.1111/j.1369-1600.2008.00106.x |url=}}</ref> Hata hivyo, kisababishi cha uhusiano huu kimetiliwa shaka na hivyo kukumbwa na utata.<ref name="Genes10"/><ref name="Degenhardt2003">{{Cite pmid|12821204}}</ref><ref name="Amar2007">{{Cite pmid|17703707}}</ref>Madawa ya kulevya, na kwa kiwango kidogo pombe, yanaweza kupelekea dalili zinazojitokeza kama skizofrenia.<ref name=BMJ07/><ref name=alcohol>{{cite web|url=http://www.emedicine.com/med/topic3113.htm |title=Alcohol-Related Psychosis |accessdate=September 27, 2006 |author=Larson, Michael |date=2006-03-30 |work=eMedicine |publisher=WebMD}}</ref>Utumizi wa tumbako hauonekani kusababisha skizofrenia. Hata hivyo, watu walio na skizofrenia, kama kikundi, hutumia tumbako kwa kiwango cha juu sana kuliko idadi ya kijumla ya watu.<ref>{{cite journal|last=Sagud|first=M|coauthors=Mihaljević-Peles, A, Mück-Seler, D, Pivac, N, Vuksan-Cusa, B, Brataljenović, T, Jakovljević, M|title=Smoking and schizophrenia.|journal=Psychiatria Danubina|date=2009 Sep|volume=21|issue=3|pages=371–5|pmid=19794359}}</ref> ==== Vipengele vya kabla ya kuzaliwa ==== Vipengele kama kukoseshwa oksijeni, maambukizi au dhiki na mama kukosa virutubishi wakati wa ujauzito, ni mambo yanayoweza kusababisha ongezeko ndogo la kiwango cha hatari ya kupata skizofrenia baadaye katika maisha.<ref name=Lancet09/> Watu walio na skizofrenia wako na uwezekano kuwa walizaliwa katika majira ya baridi au ya joto (angalau katika nusu ya kusini mwa dunia). Hii inaweza kulinganishwa na viwango vya juu vya kukumbana na virusi kabla ya kuzaliwa.<ref name=BMJ07/> Tofauti hii ni takriban asilimia 5 hadi 8.<ref name=yolken>{{cite journal|journal=Herpes |year=2004 |volume=11 |issue=Suppl 2 |pages=83A–88A |month=Jun |title=Viruses and schizophrenia: a focus on herpes simplex virus.|url=http://www.stanleylab.org/publications/VIRUSES.asp |author=Yolken R. |pmid=15319094}}</ref> == Utaratibu wa utendakazi == Juhudi nyingi zimefanywa ili kueleza uhusiano uliopo kati ya utendakazi mbadilifu wa ubongo na skizofrenia.<ref name=Lancet09/> Mojawapo ya juhudi hizi hujulikana kama "nadharia tete ya dopamini". Wazo hili hudokeza kuwa dalili kali za kiakili huhusiana na akili kufasili vibaya uchochezi duni wa seli fulani za neva zinazotolesha kemikali ya dopamini.<ref name=Lancet09/> === Utaratibu wa utendakazi wa akili === Taratibu nyingi za utendakazi wa akili zimehusishwa na uendeleaji na udhibiti wa skizofrenia. Utambuzi mpotovu wa uhasilia, hasa wakati wa dhiki au katika hali zinazochanganya, umetambuliwa katika watu walio na skizofrenia au walio katika hatari ya kuwa na hali hii.<ref>{{cite journal |author=Broome MR, Woolley JB, Tabraham P, ''et al.'' |title=What causes the onset of psychosis? |journal=Schizophr. Res. |volume=79 |issue=1 |pages=23–34 |year=2005 |month=November|pmid=16198238 |doi=10.1016/j.schres.2005.02.007}}</ref>Baadhi ya dalili zinazohusisha uwezo wa kufikiria zinaweza kuonyesha matatizo kama vile kupoteza kumbukumbu. Dalili zingine zinaweza kuhusiana na mambo fulani au matukio.<ref name="Bentall_et_al_2007">{{cite journal |author=Bentall RP, Fernyhough C, Morrison AP, Lewis S, Corcoran R |year=2007 |title=Prospects for a cognitive-developmental account of psychotic experiences |url=https://archive.org/details/sim_british-journal-of-clinical-psychology_2007-06_46_2/page/155 |journal=Br J Clin Psychol|volume=46 | issue=Pt 2 |pages=155–73 |pmid=17524210 | doi = 10.1348/014466506X123011}}</ref><ref name="Kurtz_2005">{{cite journal |author=Kurtz MM|year=2005 |title=Neurocognitive impairment across the lifespan in schizophrenia: an update |journal=[[Schizophrenia Research]] |volume=74 | issue=1|pages=15–26 |pmid=15694750 |doi=10.1016/j.schres.2004.07.005}}</ref> Licha ya ushahidi wa kutokuwepo kwa mwitikio wa kihisia, matokeo ya hivi majuzi ya utafiti yamenyeosha kuwa watu wengi walio na skizofrenia huwa na mwitikio wa kihisia. Watu hawa hasa wanaonekana wenye mwitikio dhidi ya vipengele hasi au vya kudhikisha. Usikivu kama huu unaweza kusababisha hatarisho la dalili au hali hiyo. <ref name="schizophrenia1">{{cite journal |author=Cohen AS, Docherty NM |year=2004 |title=Affective reactivity of speech and emotional experience in patients with schizophrenia |journal=[[Schizophrenia Research]] |volume=69 | issue=1 |pages=7–14 |pmid=15145465 |doi=10.1016/S0920-9964(03)00069-0}}</ref><ref>{{cite journal |author=Horan WP, Blanchard JJ |year=2003 |title=Emotional responses to psychosocial stress in schizophrenia: the role of individual differences in affective traits and coping |journal=[[Schizophrenia Research]] |volume=60 | issue=2–3 |pages=271–83 |pmid=12591589|doi=10.1016/S0920-9964(02)00227-X}}</ref> Ushahidi mwingine unadokeza kuwa maudhui ya delusheni na dalili zinginezo yanaweza kuonyesha kisababishi cha kihisia cha hali hii. Ushahidi huu unadokeza kuwa jinsi mtu anavyotafsiri matukio kama hayo ni jambo linaloweza kuathiri dalili zao.<ref>{{cite journal |author=Smith B, Fowler DG, Freeman D, ''et al.'' |title=Emotion and psychosis: links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations |url=https://archive.org/details/sim_schizophrenia-research_2006-09_86_1-3/page/181 |journal=Schizophr. Res. |volume=86 |issue=1–3 |pages=181–8 |year=2006 |month=September |pmid=16857346|doi=10.1016/j.schres.2006.06.018}}</ref><ref>{{cite journal |author=Beck, AT |year=2004 |title=A Cognitive Model of Schizophrenia |journal=Journal of Cognitive Psychotherapy |volume=18 | issue=3 |pages=281–88 | doi = 10.1891/jcop.18.3.281.65649}}</ref><ref>{{cite journal |author=Bell V, Halligan PW, Ellis HD |year=2006 |title=Explaining delusions: a cognitive perspective |journal=[[Trends (journals)|Trends in Cognitive Science]] |volume=10 |issue=5 |pages=219–26 |pmid=16600666 |doi=10.1016/j.tics.2006.03.004}}</ref> Uwepo wa mienendo fulani ili kuepuka hatari zinazodhaniwa kuwepo unaweza kuchangia katika muda ambao delusheni itadumu na idadi ya marejeo.<ref name="Freeman_BRT_2007">{{cite journal |author=Freeman D, Garety PA, Kuipers E, Fowler D, Bebbington PE, Dunn G |title=Acting on persecutory delusions: the importance of safety seeking |journal=Behav Res Ther |volume=45 |issue=1|pages=89–99 |year=2007 |month=January |pmid=16530161 |doi=10.1016/j.brat.2006.01.014 |url=https://archive.org/details/sim_behaviour-research-and-therapy_2007-01_45_1/page/89}}</ref> Ushahidi zaidi wa jukumu la utaratibu wa kiakili hutokana na jinsi therapi ya kiakili inavyoathiri dalili za skizofrenia.<ref>{{cite journal |author=Kuipers E, Garety P, Fowler D, Freeman D, Dunn G, Bebbington P |title=Cognitive, emotional, and social processes in psychosis: refining cognitive behavioral therapy for persistent positive symptoms |journal=Schizophr Bull |volume=32 Suppl 1 |pages=S24–31 |year=2006 |month=October |pmid=16885206 |pmc=2632539|doi=10.1093/schbul/sbl014 }}</ref> === Utaratibu wa utendakazi wa neva === Watu walio na skizofrenia wana mabadiliko ya muundo na kemia ya akili. <ref name=Lancet09/>Utafiti unaotumia upimaji wa akili na picha za kiteknolojia kuchunguza tofauti za kiutendaji katika akili umeonyesha kuwa tofauti zinaonekana kutokea, kwa kawaida, katika sehemu za akili zinazodhibiti kumbukumbu, utaratibu, hisia, lugha na udhibiti wa mienendo ya kichocheo.<ref>{{cite book |year=2006 |author=Kircher, Tilo and Renate Thienel |title=The Boundaries of Consciousness |isbn=0444528768|page=302 |url=http://books.google.com/?id=YHGacGKyVbYC&pg=PA302 |chapter=Functional brain imaging of symptoms and cognition in schizophrenia|publisher=Elsevier |location=Amsterdam}}</ref> Licha ya kuwa mdogo kuliko ulio katika ugonjwa wa akili wa Alzheimer, kuna upungufu wa ukubwa wa akili uliotambuliwa katika koteksi ya mbele na dewe za muda (sehemu maalum za ubongo). Haijulikani wazi kama mabadiliko haya ya ukubwa ni mabadiliko endelevu au huwepo tu kabla ya dalili za hali hii kuonekana. <ref>{{harvnb|Coyle|2006|p=878}}</ref>Tofauti hizi zimelinganishwa na kupunguliwa kiakili ambako mara nyingi huhusishwa na skizofrenia.<ref name="Green2006">{{cite journal |author=Green kiasiMF |year=2006 |title=Cognitive impairment and functional outcome in schizophrenia and bipolar disorder|journal=Journal of Clinical Psychiatry |volume=67 | issue=Suppl 9 |pages=3–8 |pmid=16965182}}</ref>Kwa sababu saketi fulani za neva huwa zimegeuzwa, wataalamu wanapendekeza kuwa skizofrenia inafaa kutambuliwa kama mkusanyiko wa hali za kimatibabu zinazohusiana kwa karibu badala ya kutambuliwa kama hali moja.<ref name=Insel_2010>{{cite journal |author=Insel TR |title=Rethinking schizophrenia |url=https://archive.org/details/sim_nature-uk_2010-11-11_468_7321/page/186 |journal=Nature |volume=468 |issue=7321 |pages=187–93 |year=2010|month=November |pmid=21068826 |doi=10.1038/nature09552 }}</ref> Uangalifu wa kipekee umepewa utendakazi wa kemikali aina ya dopamini katika ubongo. Lengo hili lilitokana na matokeo ya kiajali ya utafiti yaliyoonyesha kuwa mchanganyiko wa elementi wa kiogani wa aina ya phenothiazine, inayozuia utendakazi wa dopamine,inaweza kupunguza dalili kali za skizofrenia. Isitoshe, dawa zingine changamshi zinazochochea kuzalishwa kwa dopamine zinaweza kufanya dalili kali za skizofrenia kuwa mbaya zaidi.<ref name="Laruelle_et_al_1996">{{cite journal |author=Laruelle M, Abi-Dargham A, van Dyck CH, ''et al.'' |title=Single photon emission computerized tomography imaging of amphetamine-induced dopamine release in drug-free schizophrenic subjects |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=93 |issue=17 |pages=9235–40 |year=1996|month=August |pmid=8799184 |pmc=38625 |doi= 10.1073/pnas.93.17.9235}}</ref> ''Nadharia tete yenye ushawishi ya athari ya dopamine'' ya skizofrenia ilipendekeza kuwa kiwango kikubwa cha uwezeshaji wa ncha fulani za neva zinazopokea dopamine husababisha dalili hasi za skizofrenia. Dhana hii ilipendekezwa miaka 20 iliyopita kulingana na ukweli kuwa dawa zinazotibu dalili mbaya zaidi au hatari huzuia dopamine. Katikati mwa miaka ya 1990, utafiti wa kipicha ulitoa ushahidi wa kuegemeza dhana hii. Nadharia tete ya dopamine sasa inadhaniwa kuwa rahisi sana. Hii ni kwa sababu, kwa upande mmoja, dawa mpya zaidi, zisizokuwa za kawaida (''zinazojulikana kama dawa zisizo za kawaida za kuzuia magonjwa ya akili'') zinaweza kufanya kazi vyema sawasawa na zile za hapo awali. Hii ni kweli hata ingawa dawa hizi mpya zaidi pia huathiri utendakazi wa kemikali aina ya serotonin na pia zinaweza kuzuia kiasi kidogo zaidi cha dopinine.<ref name="JonesPilowsky2002">{{cite journal |author=Jones HM, Pilowsky LS |year=2002 |title=Dopamine and antipsychotic drug action revisited |journal=[[British Journal of Psychiatry]]|volume=181 |pages=271–275 |pmid=12356650 |doi=10.1192/bjp.181.4.271}}</ref> Utafiti pia umelenga glutamate, kemikali inayobeba mawasiliano kati ya neva na ncha za neva ambapo mawasiliano haya hupokewa. Utafiti huu, kwa kiwango kikubwa, ni kwa sababu kiwango kidogo cha ncha hizi za neva hupatikana baada ya kifo, katika ubongo wa watu waliokuwa na skizofrenia<ref name="fn_27">{{cite journal |author=Konradi C, Heckers S |year=2003 |title=Molecular aspects of glutamate dysregulation: implications for schizophrenia and its treatment |journal=Pharmacology and Therapeutics |volume=97 |issue=2 |pages=153–79 |pmid=12559388|doi=10.1016/S0163-7258(02)00328-5 }}</ref> na utambuzi kuwa dawa zinazozuia glutamate zinaweza kusababisha dalili na matatizo ya kusoma zinazofanana na dalili za skizofrenia.<ref name="fn_59">{{cite journal |author=Lahti AC, Weiler MA, Tamara Michaelidis BA, Parwani A, Tamminga CA |year=2001 |title=Effects of ketamine in normal and schizophrenic volunteers |journal=[[Neuropsychopharmacology]] |volume=25|issue=4 |pages=455–67 |pmid=11557159 |doi=10.1016/S0893-133X(01)00243-3 }}</ref>Utendakazi uliopunguka wa glutamate unahusishwa na utendaji mbaya wa vipimo vinavyohitaji utaratibu na kumbukumbu. Glutamate pia inaweza kuathiri utendakazi wa dopamini. Ukweli huu unapendekeza kuwa njia za glutamate zinaweza kuwa na jukumu muhimu katika hali hii.<ref name="fn_28">{{cite journal |author=Coyle JT, Tsai G, Goff D |year=2003 |title=Converging evidence of NMDA receptor hypofunction in the pathophysiology of schizophrenia |journal=Annals of the [[New York Academy of Sciences]] |volume=1003 |pages=318–27 |pmid=14684455 |doi=10.1196/annals.1300.020}}</ref> Hata hivyo, dalili chanya hukataa kuitikia dawa zinazoathiri glutamate.<ref name="fn_60">{{cite journal |author=Tuominen HJ, Tiihonen J, Wahlbeck K |year=2005 |title=Glutamatergic drugs for schizophrenia: a systematic review and meta-analysis |journal=[[Schizophrenia Research]] |volume=72 |pages=225–34 |pmid=15560967|doi=10.1016/j.schres.2004.05.005 |issue=2–3}}</ref> {{clear}} == Utambuzi == [[Picha:John Forbes Nash, Jr. by Peter Badge.jpg|thumb|upright|[[John Forbes Nash|John Nash]], a U.S. [[mathematician]] and joint winner of the 1994 [[Nobel Memorial Prize in Economic Sciences|Nobel Prize for Economics]], who had schizophrenia. His life has been the subject of the 2001 [[Academy Award]]-winning film ''[[A Beautiful Mind (film)|A Beautiful Mind]]''.]] Utaratibu wa [[DSM-IV]]-TR au [[ICD-10]] hutumika kuthibitisha iwapo mtu ana skizofrenia.<ref name=Lancet09/>Taratibu hizi hutumia matukio yaliyoripotiwa na mtu binafsi na mambo yasiyo ya kawaida yanayotambuliwa katika mwenendo wa mtu, huku yakifuatiwa na utambuzi wa kimatibabu unaofanywa na mtaalamu wa nyanja za afya ya akili. Dalili zinazohusishwa na skizofrenia hutokea katika [[wigo]] wa idadi ya watu. Mtu anaweza kutambulika kuwa na ugonjwa huu iwapo tu dalili ni hatari sana.<ref name=BMJ07/> Kufikia mwaka wa 2009, hakuna kipimo cha kimalengo cha kuamua ikiwa mtu ana hali hii.<ref name=Lancet09/> === Utaratibu wa utambuzi === Utaratibu wa aina ya [[ICD-10]], kwa kawaida hutumika katika nchi za Uropa. Utaratibu wa aina ya DSM-IV-TR hutumika [[Marekani]] na kote ulimwenguni. Utaratibu wa aina ya DSM-IV-TR hutumika zaidi katika utafiti. Utaratibu wa aina ya ICD-10 ulisisitiza sana dalili kuu za aina ya Schneideria. Kiutendaji, utangamano kati ya mifumo hii miwili ni wa kiwango cha juu.<ref name="Jakobsen_et_al_2005">{{cite journal |author=Jakobsen KD, Frederiksen JN, Hansen T, ''et al.'' |year=2005 |title=Reliability of clinical ICD-10 schizophrenia diagnoses |journal=Nordic Journal of Psychiatry |volume=59 | issue=3 |pages=209–12 |pmid=16195122 | doi = 10.1080/08039480510027698}}</ref> Kulingana na tafsiri ya nne iliyodurusiwa ya DSM-IV-TR, ni sharti mtu atimize taratibu tatu, (zinazojulikana kama "utaratibu wa kiutambuzi") ili itambuliwe kama ana skizofrenia:<ref name="DSM-IV-TR" /> # Dalili bainifu: Mojawapo au mbili kati ya dalili hizi ni sharti ziwepo kwa wakati mwingi katika kipindi cha mwezi mmoja (au chini ya mwezi, ikiwa dalili zilitolewa kufuatia matibabu): #* Delusheni #* Kuota njozi #* Matatizo ya kimazungumzo, ambayo ni ishara ya matatizo ya fikira. #* Mwenendo uliotatizika pakubwa (kama vile kuvaa kiholela au kulia kila mara) au mwenendo wa [[katatonia|kikatatonia]] au (pigwa na bumbuwazi) #* Dalili hasi kama vile kutopata mwitikio wa kihisia au kiwango cha chini cha mwitikio wa hisia, uwezo wa kuzungumza au motisha. #: Iwapo delusheni ni za kutisha au ikiwa mtu huyu anasikia sauti moja inayoendelea kumwelekeza kuhusu matendo ya mtu huyu au anasikia sauti mbili au zaidi zikijibizana, basi ni dalili hii pekee (delusheni au kuota njozi) inayohitajika. Utaratibu kuhusu matatizo ya uwezo wa kuzungumza hufikiwa iwapo tu utaratibu huu ni hatari kiasi cha kuathiri mawasiliano vibaya au kwa kiwango kikubwa. # Matatizo ya kijamii au kikazi: Katika sehemu kubwa ya muda baada ya dalili kuanza, eneo moja au maeneo mengi ya utendakazi kama vile kazi, mahusiano, utunzaji wa kibinafsi, huwa chini sana ya kiwango alichofikia mtu hapo awali. # Kipindi muhimu: Dalili zinazoendelea za usumbufu huu huendelea kwa angalau miezi sita. Kipindi hiki cha miezi sita ni sharti kijumuishe angalau mwezi mmoja wa dalili (au chini ya mwezi, ikiwa dalili zitaondolewa kufuatia matibabu). Ikiwa dalili za usumbufu zinaonekana kwa zaidi ya mwezi mmoja lakini chini ya miezi sita, basi utambuzi wa hali kama ile ya skizofrenia (inayoitwa “matatizo ya kiskizofrenia”) hutambuliwa.<ref name="DSM-IV-TR">{{cite book |title=Diagnostic and statistical manual of mental disorders: DSM-IV |author=American Psychiatric Association |publisher=American Psychiatric Publishing, Inc. |location=Washington, DC |year=2000 |chapter=Schizophrenia |chapterurl=http://www.behavenet.com/capsules/disorders/schiz.htm |isbn=0-89042-024-6 |accessdate=2008-07-04 |archive-date=2008-06-11 |archive-url=https://web.archive.org/web/20080611030258/http://www.behavenet.com/capsules/disorders/schiz.htm |dead-url=yes }}</ref>Dalili hatari za ugonjwa wa akili zinazodumu kwa chini ya mwezi mmoja zinaweza kutambuliwa kama ugonjwa wa akili wa muda mfupi, na hali tofauti zinaweza kuainishwa kama "tatizo la kiakili ambalo halijatambulika" (ugonjwa wa akili ambao haujapewa jina maalum). Skizofrenia haiwezi kutambuliwa iwapo dalili za tatizo la kimihemko linatambulika kuwepo kwa kiwango cha juu (ingawa tatizo la mathara ya kiakili linaweza kutambuliwa). Hali hii haiwezi kutambuliwa ikiwa dalili za matatizo yaliyoenea ya kiukuaji zipo, isipokuwa delusheni kuu au hali ya kuota njozi pia ipo au dalili zimesababishwa na hali ya kijumla ya kimatibabu au kiini kama vile [[kutumia madawa ya kulevya]]. === Aina ndogo === DSM-IV-TR ina aina tano ndogo za skizofrenia, ingawa watengenezaji wa toleo linalofuata la DSM, DSM-5 wamependekeza aina hizi ndogo kukoma kutolewa:<ref>[[American Psychiatric Association]] DSM-5 Work Groups (2010)[http://www.dsm5.org/ProposedRevisions/Pages/SchizophreniaandOtherPsychoticDisorders.aspx Proposed Revisions – Schizophrenia and Other Psychotic Disorders]. Retrieved 17 February 2010.</ref><ref name=WHOICD/> * Aina ndogo za paranoia: Delusheni au kuota njozi kwa kusikia sauti huwepo. Hata hivyo, aina ya matatizo ya kifikira, mienendo isiyo na utaratibu au ukosefu wa mwitikio wa hisia yote hazipo. Delusheni huhusisha kudhani kuwa kuna mtu anayejaribu kumuumiza mgonjwa huyu au kuwa tata sana. Mawazo mengine kama wivu, imani kuu sana ya kidini au maumivu ya kimwili yanaweza kuwepo(DSM code 295.3/ICD code F20.0). * Aina ndogo zisizo na utaratibu maalum: Aina hii ndogo imepewa jina “skizofrenia hebafreniki” katika ICD. Matatizo ya kimawazo na pia ukosefu wa mwitikio wa kihisia huwepo.(DSM code 295.1/ICD code F20.1). * Aina ndogo ya katatonia: Mtu aliye na hali hii anaweza kuduwaa au kudhihirisha ukosefu wa utulivu, au miendo isiyo na kusudi. Dalili zake zinaweza kuhusisha kufanya mambo kana kwamba amepigwa na bumbuwazi, au mgonjwa anaweza kuwaruhusu watu wengine bila kukusudia, waiweke miguu na mikono yake katika hali fulani, kisha aikalishe katika hali hiyo (DSM code 295.2/ICD code F20.2). * Aina ndogo zisizotofautishwa: Dalili hatari za kiakili zipo lakini utaratibu wa wazimu, ukosefu wa mpangilio au katatonia ungali haujapatikana (DSM code 295.9/ICD code F20.3). * Aina ndogo zilizobakia: Dalili chanya huwepo katika kiwango cha chini pekee (DSM code 295.6/ICD code F20.5). Aina ya ICD-10 hueleza aina zingine mbili ndogo:<ref name=WHOICD>{{cite web |url=http://www.who.int/classifications/icd/en/GRNBOOK.pdf |title=The ICD-10 Classification of Mental and Behavioural Disorders |format=pdf |work=World Health Organization |page=26}}</ref> * Mfadhaiko wa baada ya skizofrenia: Watu wanaweza kuwa na dalili ndogo za skizofrenia na kuwa na [[mfadhaiko]] baada ya aina mojawapo ya zile aina tano ndogo. (ICD code F20.4). * Skizofrenia ya kawaida: Dalili hatari hasi huongezeka polepole baada ya muda, bila kuwepo kwa historia ya matukio ya ugonjwa hatari wa akili (ICD code F20.6). === Magonjwa mengine === Dalili hatari za ugonjwa wa akili zinaweza kuwepo katika matatizo mengine ya akili ikiwa ni pamoja na matatizo yanayohusishwa na utumizi wa madawa. Delusheni zisizokuwa za kutisha na kujitenga na watu pia zinaweza kuwa dalili za hali zingine. Skizofrenia hutokea ikiambatana na [[hali shurutishi shikilizi]] (pia inayoitwa OCD, tatizi inayofanya mtu kushikilia sana mawazo au matendo fulani) inatojirudia mara nyingi zaidi ya inavyoweza kudhaniwa kuwa ya kibahati tu. Hata hivyo, kutofautisha tamaa zinazotokea katika OCD kutokana na delusheni za skizofrenia ni jambo linaloweza kuwa vigumu.<ref>{{cite journal |author=Bottas A |title=Comorbidity Schizophrenia With Obsessive-Compulsive Disorder |journal=Psychiatric Times |volume=26 |issue=4|date=April 15, 2009 |url=http://www.psychiatrictimes.com/display/article/10168/1402540 }}</ref> Uchunguzi wa kijumla zaidi unaweza kuhitajika ili kuthibitisha kuwa hakuna magonjwa mengine yaliyo na dalil kama za skizofrenia. Magonjwa mengine yanayohitaji kuchunguzwa ni pamoja na deliriamu, ambayo ni hali inayohusisha njozi ya kimaono inayotokea ghafla, na mshuko [ufahamu na ambao unaweza kuashiria ugonjwa fiche wa kimatibabu. Ni nadra sana kwa uchunguzi kurudiwa baada ya ugonjwa kutokea kwa mara ya kwanza, iwapo hautakuwa umesababishwa na hali maalum ya kimatibabu au athari mbaya ya dawa. == Kinga == Hakuna ushahidi unaoonyesha manufaa ya matibabu ya mapema.<ref>{{cite journal |author=Marshall M, Rathbone J |title=Early intervention for psychosis |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD004718 |year=2006 |pmid=17054213 |doi=10.1002/14651858.CD004718.pub2|url=}}</ref>Ingawa kuna ushahidi mdogo unaoonyesha kuwa matibabu ya mapema ya watu walio na maradhi makali ya ugonjwa wa akili yanaweza kuboresha matokeo ya muda mfupi, vipimo hivi vimeonyesha manufaa madogo sana miaka 5 baadaye.<ref name=Lancet09/>Kujaribu kuzuia skizofrenia katika kipindi cha kabla ya ugonjwa huu kuanza ni hatua ambayo manufaa yake hayajulikani vyema, na hivyo (haipendekezwi (kufikia mwaka wa 2009).<ref>{{cite journal |author=de Koning MB, Bloemen OJ, van Amelsvoort TA, ''et al.'' |title=Early intervention in patients at ultra high risk of psychosis: benefits and risks |journal=Acta Psychiatr Scand |volume=119 |issue=6 |pages=426–42|year=2009 |month=June |pmid=19392813 |doi=10.1111/j.1600-0447.2009.01372.x |url=}}</ref>Ni vigumu kuzuia ugonjwa huu kwa sababu hakuna viashirizi vya hali yake ya baadaye.<ref name="Cannon_et_al_2007">{{cite journal |author=Cannon TD, Cornblatt B, McGorry P |title=The empirical status of the ultra high-risk (prodromal) research paradigm |url=https://archive.org/details/sim_schizophrenia-bulletin_2007-05_33_3/page/661 |journal=Schizophrenia Bulletin |volume=33 |issue=3 |pages=661–4 |year=2007 |month=May|pmid=17470445 |doi=10.1093/schbul/sbm031 |pmc=2526144}}</ref> == Udhibiti == Matibabu ya kimsingi ya skizofrenia ni yale ya kukabiliana na dalili kali za kiakili. Matibabu haya mara nyingi hufanyika sambamba na usaidizi wa kiakili na kijamii.<ref name=Lancet09/>Iwapo mgonjwa ana maradhi makali ya ugonjwa huu, anaweza kulazwa hospitalini, aidha kwa idhini yake (au, iwapo ni halali, bila idhini yake). Wagonjwa hawajakuwa wakilazwa hospitalini tangu miaka ya 1950, ingawa wangali wanalazwa.<ref name="BeckerKilian2006" />Huduma saidizi za kijamii, ikiwemo huduma ya vituo vidogo, ziara za washiriki wa kikundi cha kijamii cha afya ya kiakili, ajira saidizi<ref>{{cite journal | author = McGurk SR, Mueser KT, Feldman K, Wolfe R, Pascaris A | title = Cognitive training for supported employment: 2–3 year outcomes of a randomized controlled trial. | journal = American Journal of Psychiatry | volume = 164 | issue = 3 | pages = 437–41 | month = Mar | year = 2007 | url = http://ajp.psychiatryonline.org/cgi/content/full/164/3/437 | doi = 10.1176/appi.ajp.164.3.437 | pmid = 17329468 | access-date = 2013-05-11 | archive-date = 2007-03-03 | archive-url = https://web.archive.org/web/20070303025101/http://ajp.psychiatryonline.org/cgi/content/full/164/3/437 | url-status = dead }}</ref>, na vikundi saidizi hutumika mara nyingi. Sehemu fulani ya ushahidi inaonyesha kuwa mazoezi ya mwili ya kila mara huboresha afya ya kimwili na kiakili ya wagonjwa wa skizofrenia.<ref>{{cite journal |author=Gorczynski P, Faulkner G |title=Exercise therapy for schizophrenia |journal=Cochrane Database Syst Rev|issue=5 |pages=CD004412 |year=2010 |pmid=20464730 |doi=10.1002/14651858.CD004412.pub2 |url=}}</ref> === Matibabu === [[Picha:Risperdal tablets.jpg|thumb|left|upright|[[Risperidone]] (trade name Risperdal) is a common [[atypical antipsychotic]] medication.]] Matibabu ya kimsingi ya skizofrenia ni matumizi ya dawa ,<ref name="fn_72">{{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG82FullGuideline.pdf |format=PDF|title=Schizophrenia: Full national clinical guideline on core interventions in primary and secondary care |accessdate=2009-11-25 |author=National Collaborating Centre for Mental Health |date=2009-03-25 |home=Gaskell and the British Psychological Society}}</ref> ambayo yanaweza kupunguza dalili mbaya kwa kati ya siku 7 na 14. Hata hivyo, matibabu hukosa pakubwa kukabiliana na dalili mbaya au walio na matatizo ya kufikiria.<ref name=AFP10/><ref name="pmid18291627">{{cite journal |author=Tandon R, Keshavan MS, Nasrallah HA |title=Schizophrenia, "Just the Facts": what we know in 2008 part 1: overview |journal=[[Schizophrenia Research]] |volume=100|issue=1–3 |pages=4–19 |year=2008 |month=March |pmid=18291627 |doi=10.1016/j.schres.2008.01.022|url=http://download.journals.elsevierhealth.com/pdfs/journals/0920-9964/PIIS0920996408000716.pdf| formt=PDF}}</ref> Uamuzi kuhusu matibabu yatakayotumiwa hutegemea manufaa, hatari na gharama. <ref name=Lancet09/>Utata ungalipo kuhusu matibabu yaliyo bora kati ya yale ya kivikundi, ya kawaida au yasiyo ya kawaida ya kizuia magonjwa ya akili.<ref>{{cite journal |author=Kane JM, Correll CU |title=Pharmacologic treatment of schizophrenia |journal=Dialogues Clin Neurosci |volume=12 |issue=3 |pages=345–57 |year=2010 |pmid=20954430}}</ref>Aina zote za matibabu zina viwango sawa vya wagonjwa kusitisha matibabu na kurejea kwa dalili wakati aina za kawaida za matibabu zimetumika kwa vipimo vya wastani.<ref name=AFP07>{{cite journal |author=Schultz SH, North SW, Shields CG|title=Schizophrenia: a review |url=https://archive.org/details/sim_american-family-physician_2007-06-15_75_12/page/n88|journal=Am Fam Physician |volume=75 |issue=12 |pages=1821–9 |year=2007 |month=June |pmid=17619525}}</ref>Asilimia 40-50 ya watu huitikia matibabu vyema, asilimia 30-40 huwa na mwitikio nusu huku asilimia 20 wakiwa na mwitikio usiotosheleza (baada ya wiki 6 za kutumia aina 2 au 3 za matibabu).<ref name=AFP10/>Matibabu yanayojulikana kama clozapine ni mwafaka kwa watu wasionufaika na matibabu mengine ingawa yanaweza kupunguza idadi ya seli nyeupe za damu (ambayo ni madhara makuu mbadala) katika asilimia 1 - 4 ya watu wanaoyatumia.<ref name=Lancet09/><ref name=BMJ07/><ref>{{cite journal |author=Wahlbeck K, Cheine MV, Essali A |title=Clozapine versus typical neuroleptic medication for schizophrenia|journal=The Cochrane Database of Systematic Reviews |issue=2 |pages=CD000059 |publisher=John Wiley and Sons, Ltd. |year=2007 |pmid=10796289|doi=10.1002/14651858.CD000059}}</ref> Dawa za kawaida za kuzuia magonjwa ya akili huhusishwa na viwango vya juu vya miendo au matendohiari yasiyoweza kudhitiwa. Dawa za kawaida za kuzuia magonjwa ya akili huhusishwa na viwango vya juu vya kuongezeka kwa uzito wa mwili, kisukari na hatari ya kupata usumbufu wa umetaboli, ambalo ni tatizo linaloweza kuongeza hatari ya matatizo ya moyo na maradhi mengine makali.<ref name=AFP07/>Dawa za kawaida za kuzuia magonjwa ya akili huwa na athari chache mbadala za aina ya kwanza. Hata hivyo, tofauti hizi ni chache.<ref name=WPA08>{{cite journal |author=Tandon R, Belmaker RH, Gattaz WF, ''et al.'' |title=World Psychiatric Association Pharmacopsychiatry Section statement on comparative effectiveness of antipsychotics in the treatment of schizophrenia |journal=Schizophr. Res.|volume=100 |issue=1–3 |pages=20–38 |year=2008 |month=March |pmid=18243663 |doi=10.1016/j.schres.2007.11.033}}</ref> Baadhi ya dawa za kawaida za kuzuia magonjwa ya akili huhusishwa na hatari zaidi ya kifo kuliko dawa zingine; clozapine huhusishwa na viwango vya chini zaidi vya kifo.<ref name=Mort09/>Haijulikani bayana iwapo dawa za kisasa hupunguza uwezekano wa kupata matatizo nadra lakini matatizo makali ya neva si bayana.<ref name="Ananth_et_al_2004">{{cite journal |author=Ananth J, Parameswaran S, Gunatilake S, Burgoyne K, Sidhom T |title=Neuroleptic malignant syndrome and atypical antipsychotic drugs |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2004-04_65_4/page/n27 |journal=Journal of Clinical Psychiatry|volume=65 |issue=4 |pages=464–70 |year=2004 |month=April |pmid=15119907 |doi=10.4088/JCP.v65n0403}}</ref> Watu wasiotaka au wasioweza kutumia matibabu kila mara wanaweza kutumia maandalizi ya kudumu ya dawa za kuzuia magonjwa ya akili<ref name=Depo06>{{cite journal |author=McEvoy JP |title=Risks versus benefits of different types of long-acting injectable antipsychotics |journal=J Clin Psychiatry |volume=67 Suppl 5 |issue= |pages=15–8 |year=2006 |pmid=16822092}}</ref>. Maandalizi kama haya yanapotumika pamoja na usaidizi wa kiakili na kijamii yanaweza kuwasaidia watu kuendelea na matibabu yao.<ref name=Depo06/> === Tiba za kiakili === Sehemu kubwa ya usaidizi wa kiakili na kijamii inaweza kuwa na manufaa katika kutibu skizofrenia. Usaidizi huu ni pamoja na aina mbalimbali za therapi, <ref name=FT10>{{cite journal|author=Pharoah F, Mari J, Rathbone J, Wong W |title=Family intervention for schizophrenia |journal=Cochrane Database Syst Rev |volume=12|pages=CD000088 |year=2010 |pmid=21154340 |doi=10.1002/14651858.CD000088.pub3}}</ref>matibabu ya kijamii, ajira saidizi, mafunzo ya kiustadi, usaidizi wa kiuchumi na pia usaidizi wa kiakili wa kudhibiti ulevi na uzito.<ref name=PORT09>{{cite journal |author=Dixon LB, Dickerson F, Bellack AS, ''et al.'' |title=The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements |url=https://archive.org/details/sim_schizophrenia-bulletin_2010-01_36_1/page/48 |journal=Schizophr Bull |volume=36 |issue=1 |pages=48–70 |year=2010 |month=January |pmid=19955389 |doi=10.1093/schbul/sbp115}}</ref>Therapi ya familia au elimu, ambayo huguzia mfumo wote wa familia ya mtu, inaweza kusaidia kuzuia marudio ya dalili au haja ya kulaza hospitalini.<ref name=FT10/>Ushahidi wa manufaa ya therapi ya mienendo ya kiakili (pia inayoitwa "therapi ya kimazungumzo") katika kupunguza dalili au kuzuia marudio ya dalili hizi ni mndogo sana.<ref name=LynchLawsMcKenna>{{cite journal |author=Lynch D, Laws KR, McKenna PJ|title=Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials|url=https://archive.org/details/sim_psychological-medicine_2010-01_40_1/page/n11|journal=Psychol Med |volume=40 |issue=1 |pages=9–24 |year=2010 |month=January |pmid=19476688 |doi=10.1017/S003329170900590X}}</ref><ref>{{cite journal |author=Jones C, Cormac I, Silveira da Mota Neto JI, Campbell C |title=Cognitive behaviour therapy for schizophrenia |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD000524 |year=2004 |pmid=15495000 |doi=10.1002/14651858.CD000524.pub2 |url=}}</ref> Therapi za kisanaa au uigizaji hazijatafitiwa vyema.<ref>{{cite journal | author = Ruddy R, Milnes D | title = Art therapy for schizophrenia or schizophrenia-like illnesses. | journal = Cochrane Database Syst Rev | issue = 4 | pages = CD003728 | url = http://www.cochrane.org/reviews/en/ab003728.html | year = 2005 | doi = 10.1002/14651858.CD003728.pub2 | pmid = 16235338 | archive-date = 2011-10-27 | access-date = 2013-05-11 | archive-url = https://web.archive.org/web/20111027132811/http://www2.cochrane.org/reviews/en/ab003728.html | url-status = dead }}</ref><ref name="Ruddy-2007">{{cite journal | author = Ruddy RA, Dent-Brown K | title = Drama therapy for schizophrenia or schizophrenia-like illnesses. | journal = Cochrane Database Syst Rev | url = http://www.cochrane.org/reviews/en/ab005378.html | issue = 1 | pages = CD005378 | year = 2007 | doi = 10.1002/14651858.CD005378.pub2 | pmid = 17253555 | archive-date = 2011-08-25 | access-date = 2013-05-11 | archive-url = https://web.archive.org/web/20110825024045/http://www2.cochrane.org/reviews/en/ab005378.html | url-status = dead }}</ref> == Mtazamo == [[Picha:Schizophrenia world map - DALY - WHO2004.svg|thumb|[[Disability-adjusted life year]] for schizophrenia per 100,000&nbsp;inhabitants in 2004. {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|≤&nbsp;185}} {{legend|#fff200|185–197}} {{legend|#ffdc00|197–207}} {{legend|#ffc600|207–218}} {{legend|#ffb000|218–229}} {{legend|#ff9a00|229–240}} {{Multicol-break}} {{legend|#ff8400|240–251}} {{legend|#ff6e00|251–262}} {{legend|#ff5800|262–273}} {{legend|#ff4200|273–284}} {{legend|#ff2c00|284–295}} {{legend|#cb0000|≥&nbsp;295}} {{Multicol-end}}]] Skizofrenia ni ugonjwa ulio na gharama kuu za kibinadamu na kiuchumi.<ref name=Lancet09/>Hali hii hupelekea upungufu wa matarajio ya urefu wa maisha wa miaka 12 hadi 15, kwa kimsingi kwa sababu ya hali hii inavyohusiana na mienendo inayoathiri afya. Ongezeko la viwango vya kujiua (mtu kujiua) huathiri kwa kiasi kidogo.<ref name=Lancet09/> Tofauti hizi za matarajio ya urefu wa maisha ziliongezeka kati ya miaka ya 1970 na 1990.<ref name=Mort07>{{cite journal |author=Saha S, Chant D, McGrath J |title=A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? |journal=Arch. Gen. Psychiatry |volume=64 |issue=10 |pages=1123–31 |year=2007 |month=October |pmid=17909124 |doi=10.1001/archpsyc.64.10.1123}}</ref> Hata hivyo, kati ya miaka ya 1990 na miaka ya kwanza 10 ya karne ya 21, tofauti hizi hazikubadilika sana nchini Finland, ambayo ina mfumo wa afya ulio na ufikiaji wazi wa huduma ya afya.<ref name=Mort09>{{cite journal |author=Chwastiak LA, Tek C |title=The unchanging mortality gap for people with schizophrenia |url=https://archive.org/details/sim_the-lancet_august-22-28-2009_374_9690/page/590 |journal=Lancet |volume=374 |issue=9690|pages=590–2 |year=2009 |month=August |pmid=19595448 |doi=10.1016/S0140-6736(09)61072-2}}</ref> Skizofrenia ni kisababishi kikuu cha ulemavu huku ugonjwa mkali wa akili ukiorodheshwa kama ugonjwa wa tatu mkuu unaolemaza.<ref name="fn_35">{{cite journal |author=Ustun TB |coauthors=Rehm J, Chatterji S, Saxena S, Trotter R, Room R, Bickenbach J, and the [[World Health Organization|WHO]]/[[National Institutes of Health|NIH]] Joint Project CAR Study Group|year=1999 |title=Multiple-informant ranking of the disabling effects of different health conditions in 14 countries |url=https://archive.org/details/sim_the-lancet_1999-07-10_354_9173/page/110 |journal=[[The Lancet]]|volume=354 | issue=9173 |pages=111–15 |pmid=10408486 |doi=10.1016/S0140-6736(98)07507-2}}</ref>Takriban 3/4 ya watu walio na skizofrenia wana ulemavu endelevu huku wakiwa na dalili zinazorejea kila mara.<ref name=AFP10>{{cite journal |author=Smith T, Weston C, Lieberman J |title=Schizophrenia (maintenance treatment) |url=https://archive.org/details/sim_american-family-physician_2010-08-15_82_4/page/n31 |journal=Am Fam Physician |volume=82 |issue=4 |pages=338–9 |year=2010 |month=August |pmid=20704164 }}</ref> Baadhi ya wagonjwa hupona kabisa hivyo kuwajibika kikamilifu katika jamii.<ref>{{cite journal |author=Warner R |title=Recovery from schizophrenia and the recovery model|journal=Curr Opin Psychiatry |volume=22 |issue=4 |pages=374–80 |year=2009 |month=July |pmid=19417668 |doi=10.1097/YCO.0b013e32832c920b |url=}}</ref>Watu wengi walio na skizofrenia huishi bila kutegemea wengine ingawa husaidiwa na jamii.<ref name=Lancet09/>Katika watu walio na dalili za maradhi ya kwanza ya magonjwa ya akili, asilimia 42 yao huwa na matokeo bora ya muda mrefu. Asilia 35 ya watu huwa na matokeo ya kisaidizi. Asilimia 35 ya watu hawa huwa na matokeo yasiyo bora.<ref>{{cite journal |author=Menezes NM, Arenovich T, Zipursky RB |title=A systematic review of longitudinal outcome studies of first-episode psychosis |journal=Psychol Med |volume=36 |issue=10|pages=1349–62 |year=2006 |month=October |pmid=16756689 |doi=10.1017/S0033291706007951 |url=https://archive.org/details/sim_psychological-medicine_2006-10_36_10/page/1349}}</ref>Matokeo ya skizofrenia huonekana bora katika nchi zilizoendelea kuliko nchi zinazoendelea<ref name=Isa07>{{cite journal |author=Isaac M, Chand P, Murthy P |title=Schizophrenia outcome measures in the wider international community |journal=Br J Psychiatry Suppl |volume=50 |issue= |pages=s71–7 |year=2007 |month=August|pmid=18019048 }}</ref>,ingawa dhana hii imekosolewa.<ref>{{cite journal |author=Cohen A, Patel V, Thara R, Gureje O|title=Questioning an axiom: better prognosis for schizophrenia in the developing world? |url=https://archive.org/details/sim_schizophrenia-bulletin_2008-03_34_2/page/229|journal=Schizophr Bull |volume=34 |issue=2 |pages=229–44|year=2008 |month=March |pmid=17905787 |pmc=2632419 |doi=10.1093/schbul/sbm105}}</ref><ref>{{cite journal |author=Burns J |title=Dispelling a myth: developing world poverty, inequality, violence and social fragmentation are not good for outcome in schizophrenia |journal=Afr J Psychiatry (Johannesbg) |volume=12 |issue=3 |pages=200–5 |year=2009 |month=August |pmid=19894340}}</ref> Watu walio na skizofrenia huwa na uwezekano wa kujiua kuliko watu wengi wa kawaida. Kima hiki kimetajwa kuwa asilimia 10. Uchambuzi wa hivi karibuni wa tafiti na takwimu ulidurusu makadirio haya hadi asilimia 4.9, huku uchambuzi wa karibu zaidi ukitokea katika kipindi kinachofuata maibuko ya kwanza ya dalili au mara ya kwanza ya kulazwa hospitalini.<ref>{{cite journal|author=Palmer BA, Pankratz VS, Bostwick JM |title=The lifetime risk of suicide in schizophrenia: a reexamination |journal=Archives of General Psychiatry|volume=62 |issue=3 |pages=247–53 |year=2005 |month=March |pmid=15753237 |doi=10.1001/archpsyc.62.3.247}}</ref> Kati ya asilimia 20 na 40 ya wagonjwa hujaribu kujiua angalau mara moja.<ref name=Suicide10/><ref name=DSM304/> Vipengele mbalimbali vya hatari vinahusisha jinsia ya kiume, mafadhaiko, na ujuzi wa hali ya juu.<ref name=Suicide10>{{cite journal |author=Carlborg A, Winnerbäck K, Jönsson EG, Jokinen J, Nordström P|title=Suicide in schizophrenia |journal=Expert Rev Neurother |volume=10 |issue=7 |pages=1153–64 |year=2010 |month=July |pmid=20586695|doi=10.1586/ern.10.82 |url=}}</ref> Skizofrenia imeonyeshwa kuhusiana pakubwa na uvutaji sigara kufuatia utafiti kote ulimwenguni. <ref name="de Leon">{{cite journal|pmid=15949648|year=2005|author=De Leon J, Diaz FJ|title=A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors|volume=76|issue=2-3|pages=135–57|doi=10.1016/j.schres.2005.02.010|journal=Schizophrenia research}}</ref><ref name="Keltner">{{cite journal|doi=10.1111/j.1744-6163.2006.00085.x|title=Smoke, Smoke, Smoke That Cigarette|url=https://archive.org/details/sim_perspectives-in-psychiatric-care_2006-11_42_4/page/256|year=2006|author=Keltner NL, Grant JS|journal=Perspectives in Psychiatric Care|volume=42|pages=256|pmid=17107571|issue=4}}</ref>Uvutaji sigara hasa uko juu katika watu walio na skizofrenia, huku makadirio yakitofautiana kutoka asilimia 80 hadi 90 ya watu hawa wakiwa wavutaji wa kila mara, ikilinganishwa na asilimia 20 ya idadi ya jumla ya watu.<ref name="Keltner"/> Watu wanaovuta sigara mara nyingi huvuta sana na kuvuta sigara zilizo na kiwangi cha juu cha kemikali ya nikotini.<ref name=DSM304>American Psychiatric Association. Task Force on DSM-IV. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Pub. ISBN 978-0-89042-025-6. p. 304</ref> Kuna utafiti unaoonyesha kuwa mgonjwa wa skizofrenia changanyikizi anaweza kuwa na uwezo wa kuishi bila kuwategemea watu wengine na kufanya kazi kikamilifu kinyume na aina zingine ndogo za skizofrenia.<ref name=DSM314>American Psychiatric Task Force on DSM-IV. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Pub. ISBN 978-0-89042-025-6. p. 314</ref> == Visababishi na uwezekano == Kufikia mwaka wa 2011, skizofrenia huathiri takriban asilimia 0.3 hadi 0.7 ya watu, <ref name=Lancet09/> or 24 million people worldwide,<ref>{{cite web |url=http://www.who.int/mental_health/management/schizophrenia/en/ |title=Schizophrenia |publisher=World Health Organization|date= 2011 |accessdate= February 27, 2011}}</ref>katika wakati fulani wa maisha yao. Wanaume huwa na hali hii mara 1.4 zaidi ya wanawake. Kwa kawaida, skizofrenia hutokea katika wanaume.<ref name=BMJ07/>Miaka ya kilele ya mwanzo wa dalili huwa umri wa miaka 20 na 28 kwa wanaume na 26 na 32 kwa wanawake. <ref name="castle1991">{{cite journal |author=Castle D, Wessely S, Der G, Murray RM |title=The incidence of operationally defined schizophrenia in Camberwell, 1965–84 |journal=The British Journal of Psychiatry |volume=159 |pages=790–4 |year=1991 |month=December |pmid=1790446 |doi=10.1192/bjp.159.6.790}}</ref> Dalili zinazoanza utotoni ni adimu zaidi,<ref name="Kumra_et_al_2001">{{cite journal |author=Kumra S, Shaw M, Merka P, Nakayama E, Augustin R |year=2001|title=Childhood-onset schizophrenia: research update |url=https://archive.org/details/sim_canadian-journal-of-psychiatry_2001-12_46_10/page/923 |journal=Canadian Journal of Psychiatry |volume=46 | issue=10 |pages=923–30|pmid=11816313}}</ref>sawa na dalili zinazoanza katika umri wa wastani au uzeeni.<ref>{{cite book| author = Hassett Anne, et al. (eds) | title = Psychosis in the Elderly |publisher = London: Taylor and Francis. |isbn=1841843946 | year = 2005 | page = 6 | url = http://books.google.com/?id=eLaMOJ9oj28C&printsec=frontcover&dq=Psychosis+in+the+Elderly }}</ref>Licha ya maarifa yaliyopo ya kuonyesha kuwa skizofrenia hutokea kwa viwango sawa ulimwengu, viwango vyake vya uwezekano hutofautiana kote ulimwenguni, <ref name="Jablensky_et_al_1992">{{cite journal |author=Jablensky A, Sartorius N, Ernberg G, ''et al.'' |year=1992 |title=Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study|journal=Psychological Medicine Monograph Supplement |volume=20 |pages=1–97 |pmid=1565705 |doi=10.1017/S0264180100000904}}</ref> baina ya mataifa,<ref name="Kirkbride_et_al_2006">{{cite journal |author=Kirkbride JB, Fearon P, Morgan C, ''et al.'' |title=Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study |journal=Archives of General Psychiatry |volume=63 |issue=3|pages=250–8 |year=2006 |month=March |pmid=16520429 |doi=10.1001/archpsyc.63.3.250}}</ref> na katika kiwango cha eneo maalum.<ref name="Kirkbride_et_al_2007">{{cite journal |author=Kirkbride JB, Fearon P, Morgan C, ''et al.'' |year=2007 |title=Neighbourhood variation in the incidence of psychotic disorders in Southeast London |journal=Social Psychiatry and Psychiatric Epidemiology |volume=42 | issue=6 |pages=438–45|pmid=17473901 | doi = 10.1007/s00127-007-0193-0}}</ref> Hali hii husababisha takriban asilimia 1 ya idadi ya miaka ya kuzoea ulemavu kote ulimwenguni (yaani, miaka ambayo mtu ameishi na ulemavu).<ref name=BMJ07>{{cite journal |author=Picchioni MM, Murray RM |title=Schizophrenia |journal=BMJ |volume=335 |issue=7610 |pages=91–5 |year=2007 |month=July|pmid=17626963 |pmc=1914490 |doi=10.1136/bmj.39227.616447.BE}}</ref> Kima cha skizofrenia hutofautiana kulingana na jinsi inavyofasiliwa.<ref name=Lancet09/> == Historia == Matukio ya hali zinazofanana na skizofrenia zilikuwa adimu katika nakala za kihistoria kabla ya karne ya 19, ingawa mienendo isiyo ya kawaida, isiyoeleweka na isiyodhibitiwa iliripotiwa mara nyingi. Ripoti ya kina kuhusu tukio fulani katika mwaka wa 1797 na matukio yaliyoripotiwa katika mwaka wa 1809 mara nyingi huchukuliwa kama matukio ya kale zaidi ya ugonjwa huu katika uandishi wa afya na afya ya kiakili.<ref name="Heinrichs2003">{{cite journal |author=Heinrichs RW |title=Historical origins of schizophrenia: two early madmen and their illness|url=https://archive.org/details/sim_journal-of-the-history-of-the-behavioral-sciences_2003_fall_39_4/page/349 |journal=Journal of the History of the Behavioral Sciences |volume=39 |issue=4 |pages=349–63 |year=2003 |pmid=14601041 |doi=10.1002/jhbs.10152}}</ref>Skizofrenia ilielezewa kwa mara ya kwanza mnamo mwaka wa 1853. Hali hii ilielezwa kuwa dalili za kipekee zilizowaathiri vijana baleghe na vijana wakubwa, na ilijulikana kama “démence précoce” (“demenshia ya mapema”). Neno kama hili lilitumika mnamo mwaka wa 1891, katika ripoti ya tukio la matatizo makali ya akili. Mnamo mwaka wa 1893, utofautishi mpana mpya ulifanywa kati ya hali hii na matatizo ya kihisia (hali iliyojulikana kama "mfadhaiko wa kiwazimu" na kujumuisha mfadhaiko na mabadiliko ya kihisia). Wakati huo ugonjwa huu ulikuwa ukiaminika kuwa ugonjwa wa ubongo,<ref name="fn_2">{{cite book |author=Kraepelin E, Diefendorf AR |title=Text book of psychiatry |edition=7 |year=1907 |publisher=Macmillan|location=London}}</ref>hasa aina ya dimenshia (ugonjwa unaoathiri uwezo wa kukumbuka na utendakazi wa ubongo), iliyotofautiana na dimenshia ambayo kwa kawaida hutokea baadaye maishani.<ref name="fn_49">{{cite book |author=Hansen RA, Atchison B |title=Conditions in occupational therapy: effect on occupational performance |url=https://archive.org/details/conditionsinoccu0000unse_y0e2 |publisher=Lippincott Williams & Wilkins |location=Hagerstown, MD |year=2000 |isbn=0-683-30417-8}}</ref> Eugen Bleuler aliunda jina "skizofrenia", ambalo linalotafsiriwa kama "akili iliyogawanyika",<ref>{{cite journal |author=Kuhn R |title=Eugen Bleuler's concepts of psychopathology|journal=History of Psychiatry|volume=15 |issue=3 |year=2004 |pages=361–6 |doi=10.1177/0957154X04044603 |pmid=15386868 |others=tr. Cahn CH}}</ref> mnamo mwaka wa 1908. Neno hili lilikusudiwa kueleza mgawanyiko wa utendakazi kati ya nafsi, kuwaza, kumbukumbu, na utambuzi. Dalili zake kuu zilielezwa kama "A nne": athari bapa (au mwitikio wa kihisia), otizimu (hali ya kiakili inayotatiza uwezo wa mtu kujibiza na kuwasiliana na wengine, na hisia kinzani (kuchanganyikiwa kiakili).<ref name="fn_78">{{cite journal |author=Stotz-Ingenlath G |title=Epistemological aspects of Eugen Bleuler's conception of schizophrenia in 1911 |journal=Medicine, Health Care and Philosophy |volume=3 |issue=2 |pages=153–9 |year=2000|pmid=11079343|url=http://www.kluweronline.com/art.pdf?issn=1386-7423&volume=3&page=153|format=PDF |doi=10.1023/A:1009919309015}}</ref>Bleuler alitambua kuwa ugonjwa huu haukuwa dimenshia kwa sababu baadhi ya wagonjwa hawa waliboreka kiafya wala sio kudhoofika, hivyo akapendekeza neno skizofrenia badala yake. Matibabu yalibadilika yamkini kikamilifu katika miaka ya katikati mwa 1950 kufuatia kutengenezwa na kutolewa kwa dawa iitwayo chlorpromazine.<ref name="Turner2007">{{cite journal | author=Turner T | title=Unlocking psychosis | journal=British Medical Journal | year=2007 | volume=334 | issue=suppl | pages=s7 |doi=10.1136/bmj.39034.609074.94 | pmid=17204765 }}</ref> [[Picha:Chlorpromazine-3D-vdW.png|thumb|left|Molecule of [[chlorpromazine]] (trade name Thorazine), which revolutionized treatment of schizophrenia in the 1950s]] Katika miaka ya mwanzo ya 1970, utaratibu wa kutambua skizofrenia ulikuwa chini ya utata mwingi, jambo ambalo lilipelekea utaratibu wa kiutendaji ambao hutumika kwa sasa. Kwa mujibu wa matokeo ya Utafiti wa Kiutambuzi wa Marekani na Uingereza wa mwaka wa 1971, ugonjwa wa skizofrenia ulikuwa ukitambuliwa kwa kiwango cha juu zaidi nchini Marekani kuliko ulivyotambuliwa bara Uropa.<ref name="Wing1971">{{cite journal |author=Wing JK |title=International comparisons in the study of the functional psychoses |url=https://archive.org/details/sim_british-medical-bulletin_1971-01_27_1/page/77 |journal=British Medical Bulletin |volume=27 |issue=1 |pages=77–81 |year=1971 |month=January |pmid=4926366}}</ref>Tofauti ilikuwa kwa upande mmoja kufuatia matokeo legevu ya utaratibu wa kutambua iwapo mtu alikuwa na hali hii nchini Marekani, ambapo mwongozo wa DSM-II ulitumika. Katika bara Uropa, mwongozo wa ICD-9 ulitumika. Utafiti wa mwaka wa 1972, ambao ulichapishwa katika jarida liitwalo Science, ulitambua kuwa utambuzi wa skizofrenia nchini Marekani ulikuwa usioweza kutegemewa. <ref>{{cite journal |author=Rosenhan D |year=1973|title=On being sane in insane places |url=https://archive.org/details/sim_science_1973-01-19_179_4070/page/n34 |journal=[[Science (journal)|Science]] |volume=179 |pages=250–8 |pmid=4683124| doi=10.1126/science.179.4070.250|issue=4070}}</ref>Vipengele hivi vilipelekea kudurusu kuhusu jinsi ya kuthibitisha iwapo mtu alikuwa na ugonjwa wa skizofrenia, na pia mwongozo wote wa DSM. Marekebisho haya yalipekea kuchapishwa kwa toleo la mwaka wa 1980 la DSM-III. <ref name="Wilson1993">{{cite journal |author=Wilson M |title=DSM-III and the transformation of American psychiatry: a history |url=https://archive.org/details/sim_american-journal-of-psychiatry_1993-03_150_3/page/399 |journal=[[American Journal of Psychiatry]] |volume=150 |issue=3 |pages=399–410 |year=1993|month=March |pmid=8434655 }}</ref> Neno “skizofrenia” mara nyingi hudhaniwa kumaanisha kuwa watu walioathiriwa wana "nafsi iliyogawanyika". Baadhi ya watu waliotambuliwa kuwa na skizofrenia wanaweza kusikia sauti na kuzisikia kama za nafsi maalum. Skizofrenia haihusishi mtu kubadilika baina ya nafsi maalum. Utatanishi uliopo hutokea kwa sababu ya ufafanuzi halisi wa neno hili. Matumizi mabaya ya kwanza ya "skizofrenia" kama "nafsi iliyogawanyika" yalikuwa katika makala ya T. S Eliot mnamo mwaka wa 1933. <ref name="fn_3">{{cite book|author=Berrios, G. E.; Porter, Roy |title=A history of clinical psychiatry: the origin and history of psychiatric disorders |publisher=Athlone Press |location=London |year=1995|isbn=0-485-24211-7}}</ref> == Jamii na tamaduni == [[Picha:Eugen bleuler.jpg|thumb|upright|The term schizophrenia was coined by [[Eugen Bleuler]].]] Uamuzi hasi wa kijamii umetambulika kama kizuizi kikuu katika uponyaji wa wagonjwa wa skizofrenia.<ref>{{cite book | author = Maj, Mario and Sartorius N. | title = Schizophrenia | date = 15 September 1999 | publisher = Wiley | location = Chichester | isbn = 978-0-471-99906-5 | page = 292}}</ref>Katika utafiti mkubwa wa kisampuli wa mwaka wa 1999, asilimia 12.8 ya Wamarekani waliamini kuwa watu walio na skizofrenia walikuwa na "uwezekano mkuu sana" wa kuzua vurugu dhidi ya wengine, huku asilimia 48.1 wakisema kuwa watu hawa walikuwa "wakikisiwa kuweza" kufanya hivyo. Zaidi ya asilimia 74 ya watu walisema kuwa watu wenye skizofrenia walikuwa aidha "hawana uwezo mkubwa" au "hawawezi kamwe" kufanya uamuzi kuhusu matibabu yao, huku asilimia 70.2 wakisema jambo lili hili kuhusu uamuzi wa matumizi ya pesa.<ref>{{cite journal |author=Pescosolido BA, Monahan J, Link BG, Stueve A, Kikuzawa S |title=The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems |url=https://archive.org/details/sim_american-journal-of-public-health_1999-09_89_9/page/1339 |journal=American Journal of Public Health |volume=89 |issue=9 |pages=1339–45 |year=1999|month=September |pmid=10474550 |pmc=1508769 |doi= 10.2105/AJPH.89.9.1339}}</ref>Mtazamo wa watu waliokuwa na ugonjwa mkali wa akili kama wanaozua ghasia umeongezeka kwa zaidi ya mara mbili tangu miaka ya 1950, kulingana na uchanganuzi mmoja.<ref>{{cite journal |author=Phelan JC, Link BG, Stueve A, Pescosolido BA|year=2000 |month=June |title=Public Conceptions of Mental Illness in 1950 and 1996: What Is Mental Illness and Is It to be Feared? |url=https://archive.org/details/sim_journal-of-health-and-social-behavior_2000-06_41_2/page/188|journal=Journal of Health and Social Behavior |volume=41 |issue=2 |pages=188–207 |doi=10.2307/2676305}}</ref> Mnamo mwaka wa 2002, neno skizofrenia nchini Ujapani lilibadilishwa kutoka “Seishin-Bunretsu-Byō”　精神分裂病 (“ugonjwa wa kugawanyika kwa akili) hadi “Tōgō-shitchō-shō”　統合失調症 (“tatizo la uunganisho”), katika harakati za kupunguza aibu au maudhi.<ref>{{cite journal |author=Kim Y, Berrios GE |title=Impact of the term schizophrenia on the culture of ideograph: the Japanese experience |url=https://archive.org/details/sim_schizophrenia-bulletin_2001_27_2/page/181 |journal=Schizophr Bull |volume=27 |issue=2 |pages=181–5 |year=2001 |pmid=11354585}}</ref> Dhana ya kuwa ugonjwa huu husababishwa na vipengele tofauti (wala sio kisababishi kimoja tu) ilichangia jina hili mpya. Badiliko hili liliongeza idadi ya watu waliokuwa wamehamasishwa kuhusu utambuzi huu kutoka asilimia 37 hadi 70 kwa kipindi cha miaka 3.<ref name="Sato">{{cite journal |author=Sato M |year=2004 |title=Renaming schizophrenia: a Japanese perspective |journal=World Psychiatry |volume=5 |issue=1 |pages=53–55 |pmid=16757998 |pmc=1472254}}</ref> Mnamo mwaka wa 2002 chini Marekani, gharama ya skizofrenia, ikijumuisha gharama za moja kwa moja (watu ambao hawakulazwa hospitalini, watu waliolazwa, dawa na utunzaji wa muda mrefu) na gharama zisizohusu utunzaji wa kiafya (utimizaji sheria, kiwango kilichopungua cha uzalishaji kikazi, na [[kukosa ajira]]), ulikadiriwa kuwa bilioni $62.7.<ref>{{cite journal |author=Wu EQ|year=2005 |title=The economic burden of schizophrenia in the United States in 2002 |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2005-09_66_9/page/1122|journal=J Clin Psychiatry |volume=66 | issue=9|pages=1122–9|pmid=16187769}}</ref> Kitabu "A Beautiful Mind" na filamu iliyo na kichwa kiki hiki inaeleza maisha ya [[John Forbes Nash]]. [[Mwanahesabu]] huyu na mshindi wa tuzo la Nobel katika Uchumi |tuzo la Nobel]] alikuwa na skizofrenia. == Tanbihi == {{reflist|2}} [[Jamii:Maradhi ya ubongo‎]] ngvh0mbyqpnr1piwz7mbnsxbjoq1mke 0 69687 1578217 1444168 2026-07-03T03:43:45Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578217 wikitext text/x-wiki [[Image:Navez Agar et Ismaël.jpg|thumb|right|250px|Agari na Ishmaeli jangwani kadiri ya [[François-Joseph Navez]].]] '''Ishmaeli''' (au '''Ismaili''', kwa [[Kiebrania]] יִשְׁמָעֵאל, Yišmāʻēl: kwa [[Kiarabu]] إسماعيلʾ, Ismāʿīl) alikuwa mtoto wa kwanza wa [[Abrahamu]] (au Ibrahimu) na [[Hagari]] (au Hajiri) kadiri ya [[Biblia]] <ref>[[Mwa]] 16:3</ref>na ya [[Kurani]]. ==Ishmaeli katika Biblia== [[Mungu]] alikuwa amemuahidia Abrahamu uzao mkubwa kama [[nyota]] za mbinguni, naye akaamini ingawa alikuwa hajapata hata mtoto mmoja: ndiyo [[imani]] iliyompendeza sana Mungu (Mwa 15:1-6). Lakini Abrahamu alizidi kuzeeka pamoja na [[Sara]] bila ya kuzaa watoto. Baada ya kusubiri muda mrefu mno Sara akamwambia azaliane na [[Hagari]] aliye mtumishi wa kike. Mwana huyu wa Hagar akaitwa Ishmaeli (Mwa 16:1-15). Lakini baadaye kukawa na [[fitina]] kati ya Sara na Hagari hivyo huyo akafukuzwa pamoja na mtoto, baada ya Sara pia akashika mimba na kumzaa mtoto [[Isaka]]. Mwa 21:1-21 inatusimulia jinsi Mungu alivyotimiza ahadi yake kwa kumjalia Sara amzalie Abrahamu mtoto huyo katika uzee na utasa. Isaka ni mtoto wa imani, si wa mwili, naye ni huru, tofauti na Ishmaeli mtoto wa mtumwa ambaye hastahili kurithi pamoja na mdogo wake. Isaka, baba wa Israeli alipata baraka kuu, naye ni mfano wetu watu wa Agano Jipya. Ishmaeli alibarikiwa pia kwa ajili ya baba yake, naye ni mfano wa [[Agano la Kale]] ambapo watu wanategemea mambo ya kimwili ([[kutahiriwa]], kunawa, kubagua vyakula n.k.) na hivyo ni watumwa ([[Gal]] 4:21-5:1). Kadiri ya [[kitabu cha Mwanzo]] alishiriki pamoja na mdogo wake [[Isaka]] [[mazishi]] ya [[baba]] yake akafariki akiwa na umri wa miaka 137.<ref>Mwa 25:17</ref> Ishmaeli alizaa watoto wa kiume 12 ambao wanahesabiwa mwanzo wa [[Waarabu]], hasa wale wa Kaskazini. ==Ishmaeli katika Uislamu== [[File:Abraham ready to sacrifice his son, Ishmael (top); Abraham cast into fire by Nimrod (bottom).jpg|thumb|Abrahamu akiwa tayari kumchinja Ishmael (upande wa juu wa mchoro mdogo wa [[karne ya 16]] katika ''Zubdat Al-Tawarikh'').]] Ishmaeli anahesabiwa [[nabii]] muhimu na [[babu]] wa [[Muhammad]], [[mwanzilishi]] wa [[dini]] ya [[Uislamu]]. Ingawa [[Kurani]] haitaji jina la mtoto ambaye Abrahamu alikuwa tayari kumchinjia Mungu, wanazuoni walifikia makubaliano kwamba alikuwa Ishmaeli, si Isaka. ==Tanbihi== {{reflist|colwidth=30em}} ==Marejeo== ; Books and journals *{{cite book | last=Metzger | first=Bruce M | coauthors=Michael D Coogan | title=The Oxford Companion To The Bible | url=https://archive.org/details/isbn_9780195046458 | publisher=Oxford University Press | year=1993| isbn=978-0-19-504645-8}} *{{cite journal | last=Nikaido| first=S.| title=Hagar and Ishmael as Literary Figures: An Intertextual Study | url=https://archive.org/details/vetus-testamentum_2001_51_2/page/219| journal=[[Vetus Testamentum]] | volume=51 | year=2001 | doi=10.1163/156853301300102110 | page=219 | issue=2}} *{{cite book | last=Werblowsky| first=R.J. Zwi | coauthors=Geoffrey Wigoder | title=The Oxford Dictionary of Jewish Religion | url=https://archive.org/details/oxforddictionary00werb| publisher=Oxford University Press | year=1997| isbn=0-19-508605-8}} *{{cite book | last=Quinn| first=Daniel | title=Ishmael| publisher=Bantam Dell Pub Group | year=1993| isbn=0-553-56166-9}} ; Encyclopedias *{{cite encyclopedia | editor=Hubert Cancik | editor2=Helmuth Schneider | encyclopedia=Brill's New Pauly: Encyclopaedia of the Ancient World: Antiquity | publisher=Brill Academic Publishers | year=2005| isbn=978-90-04-12270-3}} *{{cite encyclopedia | editor=Paul Lagasse, Lora Goldman, Archie Hobson, Susan R. Norton | encyclopedia=The Columbia Encyclopedia | publisher=Gale Group | year=2000 | edition=6th | isbn=978-1-59339-236-9}} *{{cite encyclopedia | editor=John Bowden | encyclopedia=Encyclopedia of Christianity| publisher=Oxford University Press| year=2005| edition=1st | isbn=0-19-522393-4}} *{{cite encyclopedia | editor=P.J. Bearman, Th. Bianquis, C.E. Bosworth, E. van Donzel, W.P. Heinrichs | encyclopedia=[[Encyclopaedia of Islam]] Online | publisher=Brill Academic Publishers | issn=1573-3912}} *{{cite encyclopedia | editor=Lindsay Jones | encyclopedia=Encyclopedia of Religion| publisher=MacMillan Reference Books| year=2005| edition=2nd | isbn=978-0-02-865733-2}} *{{cite encyclopedia | encyclopedia=The New Encyclopædia Britannica | publisher=Encyclopædia Britannica, Incorporated; Rev Ed edition | year=2005 | isbn=978-1-59339-236-9}} *{{cite encyclopedia | editor=Jane Dammen McAuliffe | encyclopedia=[[Encyclopedia of the Qur'an]] | publisher=Brill Academic Publishers | year=2005 | isbn=978-90-04-12356-4}} ==Viungo vya nje== {{Commons category}} *[http://www.johnpratt.com/items/docs/adam_gen/intro.html Genealogy from Adam to the Twelve Tribes] {{Wayback|url=http://www.johnpratt.com/items/docs/adam_gen/intro.html |date=20130927133719 }} *[http://www.islam101.com/history/people/prophets/Ismael.htm Ishmael in Islam] {{Wayback|url=http://www.islam101.com/history/people/prophets/Ismael.htm |date=20140828024812 }} *[http://www.jewishencyclopedia.com/view.jsp?artid=277&letter=I&search=Ishmael ''The Jewish Encyclopedia'': Ishmael]. *[http://www.anchorite.org/blog/2006/07/31/biographical-study-on-ishmael/ Biographical Study on Ishmael] {{Wayback|url=http://www.anchorite.org/blog/2006/07/31/biographical-study-on-ishmael/ |date=20070104064710 }} *{{CathEncy|url=http://en.wikisource.org/wiki/Catholic_Encyclopedia_(1913)/Ismael|title=Ismael}} *[http://bahai9.com/Ishmael Ishmael in Bahá'í Faith] {{Wayback|url=http://bahai9.com/Ishmael |date=20081226090138 }} {{mbegu-mtu-Biblia}} [[Category:Watu wa Biblia]] [[Category:Watu wa Kurani]] [[Category:Manabii katika Uislamu]] 93zzr43y223nbvzv2yhy0v63mna1vno 0 69849 1578195 1574268 2026-07-03T02:31:01Z InternetArchiveBot 41439 Add 7 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578195 wikitext text/x-wiki {{Infobox disease |Name = Obesity |Image = Obesity-waist_circumference.svg |Alt = Three silhouettes depicting the outlines of a normal sized (left), overweight (middle), and obese person (right). |Caption = Silhouettes and waist circumferences representing normal, overweight, and obese |DiseasesDB = 9099 |ICD10 = {{ICD10|E|66| |e|65}} |ICD9 = {{ICD9|E|66| |e|278}} |MedlinePlus = 003101 |OMIM = 601665 |eMedicineSubj = med |eMedicineTopic =1653 |MeshName = Obesity |MeshNumber = C23.888.144.699.500 | }} '''Unene wa kupindukia''' (kwa [[Kiingereza]] "obesity" kutokana na [[neno]] la [[Kilatini]] ''obesitas'', linalomaanisha "gumu, nono au nene” <ref name=etymol>''Ēsus'' is the past participle of ''edere'' (to eat), with ''ob'' (over) added to it. {{cite web|url=http://www.etymonline.com/index.php?term=obesity |title=Online Etymology Dictionary: Obesity |work=Douglas Harper|accessdate=December 31, 2008}}; ''[[Kamusi ya Kingereza ya Oxford]]'' ilichapisha kutumika kwake kwa mara ya kwanza mnamo mwaka wa 1611 na [[Randle Cotgrave]]. {{cite web |url=http://www.oed.com/ |title=Obesity, n |work=[[Oxford English Dictionary]] 2008|accessdate=March 21, 2009}}</ref>; [[jina la kisayansi]] kwa [[Kilatini]] ni "adipositas") ni hali mbaya ambapo [[mafuta ya ziada ya mwili]] hulimbikizana hadi kiwango kinachoweza kuathiri vikubwa [[afya]], ikipelekea ongezeko la [[maradhi]] na kupungua kwa [[matarajio ya kuishi]]. <ref name="WHO 2000 p.6">WHO 2000 p.6</ref><ref name=HaslamJames/> [[Kipimo]] cha [[mwili]] kuwa mnene na mzito mno ni [[uwiano]] kati ya [[urefu]] wa mtu na [[uzito]] wake. Watu hutajika kuwa na unene wa kupindukia wakati [[nambapeo ya mata ya mwili]] (NMM), kipimo kinachopatikana kwa kugawanya [[uzito]] wa mtu kwa [[kilogramu]] kwa mraba wa [[urefu]] wake katika [[mita]], kimezidi 30&nbsp;kg/m².<ref name="WHO 2000 p.9">WHO 2000 p.9</ref> Kuwa mneme mno kunaleta [[hatari]] ningi kwa [[afya]] na kusababisha au kuongeza uwezekano wa [[magonjwa]] kama vile: * [[Shinikizo la juu la damu]] * Ugonjwa wa [[kisukari]] * [[Maradhi ya moyo]] * [[Ugonjwa wa kupooza]] * Shida za kupumua na [[pumu]]<ref>http://www.medicalnewstoday.com/releases/24118.php</ref><ref name=HaslamJames/> * Matatizo ya viungo vya [[miguu]] na ya [[uti wa mgongo]] * [[Maradhi ya mishipa]], * [[Apnea pingani ya usingizi]] * [[Osteoathritisi]]<ref name=HaslamJames/>. Watu wakinenepa mno hufa mapema na kuwa na magonjwa mengi kuliko watu wembamba wanaokula kiasi tu, jinsi wanavyohitaji [[chakula]]. Tatizo la unene [[duniani]] hukumba [[wanaume]] zaidi ya [[wanawake]]. Unene wa kupindukia mara nyingi husababishwa na ujumuisho wa kula chakula kilicho na nguvu nyingi, ukosefu wa [[mazoezi ya mwili]], na [[urithi]] wa [[jeni]] maalumu, ingawa visa vichache vina msingi wa jeni, matatizo ya [[kiendrosini]], [[matibabu]] au [[maradhi ya akili]]. Ushahidi wa kuthibitisha dhana kuwa baadhi ya watu hunenepa ingawa hula kiasi kidogo hautoshi; kwa wastani, watu wanene hutumia nguvu nyingi kuliko watu wenye mwili mdogo kwa sababu ya nguvu zinazohitajika kuimarisha [[mata]] kubwa ya mwili.<ref>{{cite book |author=Kushner, Robert |title=Treatment of the Obese Patient (Contemporary Endocrinology) |publisher=Humana Press |location=Totowa, NJ|year=2007 |page=158 |isbn=1-59745-400-1 |url=http://books.google.com/?id=vWjK5etS7PMC&pg=PA121&lpg=PA121&dq=measurement+of+metabolism+in+obese+Bessesen |doi= |accessdate=April 5, 2009}}</ref><ref name=Anes2000>{{cite journal |author=Adams JP, Murphy PG |title=Obesity in anaesthesia and intensive care |journal=Br J Anaesth |volume=85 |issue=1 |pages=91–108 |year=2000 |month=July |pmid=10927998 |doi= 10.1093/bja/85.1.91|url=http://bja.oxfordjournals.org/cgi/content/full/85/1/91}}</ref> [[Chakula bora]] na [[mazoezi ya mwili]] ndiyo njia kuu za kutibu unene wa kupindukia. Ubora wa chakula unaweza kuimarishwa kwa kutumia vyakula vilivyo na nguvu nyingi, kama vile vyakula vilivyo na kiwango cha juu cha mafuta na [[sukari]], na kwa kutumia [[unyuzi wa chakula]] kwa wingi zaidi. [[Dawa za kukabiliana na unene]] zinaweza kutumiwa kupunguza hamu ya chakula au kuzuia ufyonzaji wa mafuta, huku mtu akila chakula kinachofaa. Iwapo chakula bora, mazoezi na matibabu hayatoshi, [[mpira wa utumboni]] unaweza kusaidia kupunguza uzito wa mwili, au [[upasuaji]] unaweza kufanywa ili kupunguza ukubwa na/au urefu wa matumbo. Upasuaji huo hupelekea mtu [[kushiba]] upesi na kupunguza uwezo wa kufyonza [[virutubishi]] vilivyomo katika chakula.<ref>NICE 2006 p.10–11</ref><ref name=balloon2008>{{cite journal |author=Imaz I, Martínez-Cervell C, García-Alvarez EE, Sendra-Gutiérrez JM, González-Enríquez J |title=Safety and effectiveness of the intragastric balloon for obesity. Uchanganuzi wa kina|journal=Obes Surg |volume=18 |issue=7 |pages=841–6 |year=2008 |month=July |pmid=18459025|doi=10.1007/s11695-007-9331-8}}</ref> Unene wa kupindukia ni [[kisababishi kinachozuilika cha kifo]] kilicho kikuu ulimwenguni kote, huku kiwango chake cha [[ueneaji]] kikiongezeka kwa watu wazima na [[watoto]]. Viongozi huamini kuwa hili ni mojawapo ya matatizo makuu zaidi ya [[afya ya umma]] katika [[karne ya 21]].<ref name=Barn1999>{{cite journal |author=Barness LA, Opitz JM, Gilbert-Barness E |title=Obesity: genetic, molecular, and environmental aspects |journal=Am. J. Med. Genet. A|volume=143A |issue=24 |pages=3016–34 |year=2007 |month=December |pmid=18000969 |doi=10.1002/ajmg.a.32035 |url=}}</ref> Unene wa kupindukia hufedheheshwa katika sehemu nyingi za [[ulimwengu]] wa kisasa (hasa katika [[Ustaarabu wa Magharibi]]<ref>Huko wengine wanalazimika kutumia vifaa maalum (butt wipers]) kushililia karatasi shashi wakiwa msalani</ref>), ingawa hali hii ilitazamwa na watu wengi kama [[ishara]] ya [[utajiri]] na afya bora katika nyakati za awali za [[historia]], na pia huonekana hivyo katika baadhi ya sehemu za [[dunia]].<ref name=HaslamJames/><ref name=Woodhouse/> ==Uainishaji== Unene wa kupindukia ni hali ya kimatibabu ambapo [[mafuta ya mwili]] ya ziada hulimbikizana hadi kiwango kinachoathiri afya kwa vikubwa.<ref name="WHO 2000 p.6"/> Hali hii hufasiliwa kwa [[Kielezo cha Uzani wa Mwili]] na kukadiriwa zaidi kwa kupima ugawaji wa mafuta kupitia kwa uwiano wa kiuno na nyonga na ujumla wa vipengele hatari vya magonjwa ya mishipa na moyo.<ref>{{cite journal |journal= Nutr J |year=2007 |volume=6 |page=32 |title= Measurement and Definitions of Obesity In Childhood and Adolescence: A field guide for the uninitiated |author= Sweeting HN|doi=10.1186/1475-2891-6-32|pmid=17963490 |url=http://www.nutritionj.com/content/6/1/32 |pmc= 2164947|issue=1}}</ref><ref>NHLBI p.xiv</ref> Kielezo cha Uzani wa Mwili kinahusiana kwa karibu na asilimia ya mafuta ya mwili na jumla ya mafuta ya mwili.<ref>{{cite journal |author=Gray DS, Fujioka K |title=Use of relative weight and Body Mass Index for the determination of adiposity |journal=J Clin Epidemiol |volume=44 |issue=6 |pages=545–50 |year=1991 |pmid=2037859 |doi= 10.1016/0895-4356(91)90218-X|url=https://archive.org/details/sim_journal-of-clinical-epidemiology_1991_44_6/page/545}}</ref> [[File:Obesity6.JPG|thumb|kushoto|alt=mtazamo wa mbele na upande wa kiwiliwili cha mwanamume aliye "mnene kupindukia". Alama za kuvutika kwa ngozi zinaonekana pamoja na jinakomastia.|Mwanamume "mnene kupindukia" aliye na Kielezo cha Uzani wa Mwili cha 47&nbsp;kg/m²: uzito 146&nbsp;kg (322&nbsp;lb), urefu sentimita 177&nbsp; (5&nbsp;ft 10&nbsp;in)]] Katika [[watoto]], uzito ulio bora hutofautiana kwa sababu ya [[umri]] na [[jinsia]]. Katika watoto na [[vijana]] [[baleghe]], unene wa kupindukia hufasiliwa si kwa [[nambari]] kamili, lakini kulingana na kundi la kawaida la wakati huo, hivi kwamba unene wa kupindukia ni wa Kielezo cha Uzani wa Mwili kilichozidi [[asilimia]] 95 <ref name="cdc.gov">{{cite web|url=http://www.cdc.gov/nccdphp/dnpa/healthyweight/assessing/bmi/childrens_BMI/about_childrens_BMI.htm |title=Healthy Weight: Assessing Your Weight: BMI: About BMI for Children and Teens|publisher=[[Center for disease control and prevention]]|accessdate=April 6, 2009}}</ref>Data ya marejeleo ambayo ilitumiwa kukadiria hesabu hii ni ya kutoka mwaka 1963 hadi 1994, hivyo haijaathiriwa na ongezeko la uzito la hivi karibuni.<ref name="Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL 2001 1086–93">{{cite journal |author=Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL|title=Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index |journal=Am. J. Clin. Nutr. |volume=73 |issue=6|pages=1086–93 |year=2001 |month=June |pmid=11382664 |doi= |url=http://www.ajcn.org/cgi/content/full/73/6/1086}}</ref> {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |- ! BMI !! Classification |- |width=50%| < 18.5 ||underweight |- |18.5–24.9 || normal weight |- |25.0–29.9 || overweight |- |30.0–34.9 || class I obesity |- |35.0–39.9 || class II obesity |- |≥ 40.0 || &nbsp;&nbsp;class III obesity&nbsp;&nbsp; |} Kielezo cha Uzani wa Mwili hukadiriwa kwa kugawanya uzito wa mtu kwa kipeo cha uzito wake, na kwa kawaida huandikwa aidha kwa [[Mfumo wa mita]] au kwa [[vipimo vya Marekani]]: :Metric:<math>BMI=kilograms/meters^2</math> :US customary and [[Imperial System|imperial]]: <math>BMI=lb*703/in^2</math> ambapo <math>lb</math> ni uzito wa mtu katika [[pauni (uzito)|pauni]] na<math>in</math> ni urefu wa mtu katika inchi. Fasili zinazotumika mara nyingi, ambazo zilitolewa na [[Shirika la Afya Duniani]] mwaka wa 1997 na kuchapishwa mwaka wa 2000, hutoa ukadiriaji kama ilivyoorodheshwa katika jedwali lililo upande wa kulia.<ref name="WHO 2000 p.9"/> Baadhi ya mashirika yamerekebisha kidogo fasili zilizotolewa na SAD. Habari ya kiupasuaji hugawanya unene wa kupindukia wa "daraja la 3" katika vikundi zaidi, ambavyo ukadiriaji wake ungali unakumbwa na utata.<ref name=morbid2007>{{cite journal|author=Sturm R |title=Increases in morbid obesity in the USA: 2000–2005 |journal=Public Health |volume=121 |issue=7|pages=492–6 |year=2007 |month=July |pmid=17399752 |pmc=2864630 |doi=10.1016/j.puhe.2007.01.006 |url=https://archive.org/details/sim_public-health_2007-07_121_7/page/492}}</ref> * Any BMI ≥ 35 or 40 is ''severe obesity'' * A BMI of ≥ 35 or 40–44.9 or 49.9 is ''morbid obesity'' * A BMI of ≥ 45 or 50 is ''super obesity'' Kwa sababu watu wa asili ya [[Asia]] wameendelea kuathiriwa vibaya katika kiwango cha KUM cha chini kuliko kile cha [[Wazungu]], baadhi ya [[mataifa]] yamefasili upya unene wa kupindukia; [[Wajapani]] wameufasili kama kiwango chochote cha KUM kinachozidi 25<ref>{{cite journal |author=Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S |title=Criteria and classification of obesity in Japan and Asia-Oceania|journal=Asia Pac J Clin Nutr |volume=11 Suppl 8 |issue= |pages=S732–S737 |year=2002 |month=December |pmid=12534701|doi= 10.1046/j.1440-6047.11.s8.19.x|url=}}</ref> huku [[China]] ikitumia kipimo cha KUM cha juu ya 28.<ref>{{cite journal|author=Bei-Fan Z |title=Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults |journal=Asia Pac J Clin Nutr |volume=11 Suppl 8 |issue= |pages=S685–93 |year=2002 |month=December|pmid=12534691 |doi= 10.1046/j.1440-6047.11.s8.9.x|url= |author2=Cooperative Meta-Analysis Group of Working Group on Obesity in China}}</ref> ==Madhara ya kiafya== Uzito uliozidi huhusianishwa na [[magonjwa]] mengi, hasa [[magonjwa ya moyo]] na [[mishipa]], [[kisukari aina ya 2]], [[apnea pingani ya usingizi]], aina fulani za [[saratani]], [[osteoathritisi]]<ref name=HaslamJames/> na [[pumu]]<ref>http://www.medicalnewstoday.com/releases/24118.php</ref><ref name=HaslamJames/>. Matokeo yake ni kwamba unene wa kupindukia umetambulika kupunguza [[matarajio ya kuishi]].<ref name=HaslamJames/> ===Hatari ya kufa=== {{Double image|right|MenBMIMort.png|200|WomenBMIMort.png|200|alt=(Left) A graph showing how the risk of death varies with BMI. The lowest risk is found at a BMI of 20 to 25 and increases in both directions. (Right) A graph showing how the risk of death varies with BMI. The lowest risk is found at a BMI of 20 to 25 and increases in both directions.|Relative risk of death over 10 years for White men (left) and women (right) who have never smoked in the United States by BMI.<ref name=NEJM10>{{cite journal |author=Berrington de Gonzalez A |title=Body-Mass Index and Mortality among 1.46 Million White Adults |journal=N. Engl. J. Med. |volume=363 |issue=23 |pages=2211–9 |year=2010|month=December |pmid=21121834 |doi=10.1056/NEJMoa1000367 |url=https://archive.org/details/sim_new-england-journal-of-medicine_2010-12-02_363_23/page/2210|pmc=3066051 |author-separator=,|display-authors=3}}</ref>||}} Unene wa kupindukia ni kati ya [[visababishi vya kifo vinavyozuilika]] kote ulimwenguni.<ref name=Barn1999/><ref>{{cite journal|author=Mokdad AH, Marks JS, Stroup DF, Gerberding JL |title=Actual causes of death in the United States, 2000|journal=JAMA |volume=291 |issue=10 |pages=1238–45 |year=2004 |month=March |pmid=15010446 |doi=10.1001/jama.291.10.1238|url=http://www.csdp.org/research/1238.pdf|format=PDF}}</ref><ref name=Allison>{{cite journal |author=Allison DB, Fontaine KR, [[JoAnn E. Manson|Manson JE]], Stevens J, VanItallie TB |title=Annual deaths attributable to obesity in the United States |journal=JAMA |volume=282 |issue=16 |pages=1530–8 |year=1999 |month=October |pmid=10546692 |doi= 10.1001/jama.282.16.1530|url=http://jama.ama-assn.org/cgi/content/full/282/16/1530}}</ref> Utafiti mkuu wa Ulaya na Marekani umeonyesha kuwa hatari ya kufa iko chini zaidi katika kiwango cha KUM cha 20–25 kg/m²<ref name=NEJM10/><ref name=Lancet2009>{{cite journal |author=Whitlock G |title=Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies |journal=Lancet |volume=373 |issue=9669 |pages=1083–96 |year=2009|month=March |pmid=19299006 |doi=10.1016/S0140-6736(09)60318-4 |url= |pmc=2662372 |author-separator=,|author2=Lewington S |author3=Sherliker P |display-authors=3 |last4=Sherliker |first4=P |last5=Clarke |first5=R|last6=Emberson |first6=J |last7=Halsey |first7=J |last8=Qizilbash |first8=N |last9=Collins |first9=R}}</ref> katika watu wasiovuta sigara na 24–27 kg/m² katika watu wanaoendelea kuvuta sigara, huku hatari hii ikiongezeka na mabadiliko kuelekea pande zote mbili.<ref>{{cite journal |author=Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW |title=Body-mass index and mortality in a prospective cohort of U.S. adults |journal=N. Engl. J. Med. |volume=341 |issue=15 |pages=1097–105|year=1999 |month=October |pmid=10511607 |doi= 10.1056/NEJM199910073411501|url=http://content.nejm.org/cgi/content/full/341/15/1097}}</ref><ref name=Euro2008>{{cite journal |author=Pischon T |title=General and abdominal adiposity and risk of death in Europe |journal=N. Engl. J. Med.|volume=359 |issue=20 |pages=2105–20 |year=2008 |month=November |pmid=19005195 |doi=10.1056/NEJMoa0801891 |url=https://archive.org/details/sim_new-england-journal-of-medicine_2008-11-13_359_20/page/2104|author-separator=, |author2=Boeing H |author3=Hoffmann K |display-authors=3 |last4=Bergmann |first4=M. |last5=Schulze|first5=M.B. |last6=Overvad |first6=K. |last7=Van Der Schouw |first7=Y.T. |last8=Spencer |first8=E. |last9=Moons|first9=K.G.M.}}</ref>Kipimo cha Kielezo cha Uzani wa Mwili cha zaidi ya 32 kimehusishwa na ongezeko la mara mbili la vifo kwa wanawake kwa muda wa miaka 16.<ref>{{cite journal |author=Manson JE |title=Body weight and mortality among women |url=https://archive.org/details/sim_new-england-journal-of-medicine_the-new-england-journal-of-medicine_1995-09-14_333_11/page/n57 |journal=N. Engl. J. Med.|volume=333 |issue=11 |pages=677–85 |year=1995 |pmid=7637744| doi = 10.1056/NEJM199509143331101 |author-separator=,|author2=Willett WC |author3=Stampfer MJ |display-authors=3 |last4=Colditz |first4=Graham A. |last5=Hunter|first5=David J. |last6=Hankinson |first6=Susan E. |last7=Hennekens |first7=Charles H. |last8=Speizer |first8=Frank E.}}</ref> Nchini Marekani, inakisiwa kuwa unene wa kupindukia husababisha zaidi ya vifo 111,909 hadi 365,000 kila mwaka,<ref name=HaslamJames>{{cite journal |author=Haslam DW, James WP|title=Obesity |url=https://archive.org/details/sim_the-lancet_october-1-7-2005_366_9492/page/1197|journal=Lancet |volume=366 |issue=9492|pages=1197–209 |year=2005 |pmid=16198769 |doi=10.1016/S0140-6736(05)67483-1}}</ref><ref name=Allison/> huku milioni 1 (7.7%) ya vifo katika nchi za Ulaya husababishwa na uzito uliozidi.<ref name=EuroG2008/><ref name=Euro2007>{{cite journal|author=Fried M |title=Inter-disciplinary European guidelines on surgery of severe obesity |journal=Int J Obes (Lond)|volume=31 |issue=4 |pages=569–77 |year=2007 |month=April |pmid=17325689 |doi=10.1038/sj.ijo.0803560 |url=|author-separator=, |author2=Hainer V |author3=Basdevant A |display-authors=3 |last4=Buchwald |first4=H |last5=Deitel|first5=M |last6=Finer |first6=N |last7=Greve |first7=J W M |last8=Horber |first8=F |last9=Mathus-Vliegen|first9=E}}</ref> Kwa wastani, unene hupunguza muda wa maisha miaka 6 hadi 7:<ref name=HaslamJames/><ref>{{cite journal |author=Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L |title=Obesity in adulthood and its consequences for life expectancy: A life-table analysis |journal=Ann. Intern. Med. |volume=138 |issue=1 |pages=24–32 |year=2003 |month=January |pmid=12513041 |doi=|url=http://www.annals.org/cgi/reprint/138/1/24 | format=PDF |last7=Nedcom}}</ref>Kielezo cha Uzani wa Mwili cha 30–35 hupunguza miaka 2 hadi 4 matarajio ya kuishi<ref name=Lancet2009/> ilhali unene uliokithiri (Kielezo cha Uzani wa Mwili&nbsp;>&nbsp;40) hupunguza miaka 10 matarajio ya kuishi <ref name=Lancet2009/> ===Hali ya kuugua=== Unene wa kupindukia huongeza hatari ya hali nyingi za kimwili na kiakili. Ambatani hizi kwa kawaida huonyeshwa sana katika [[dalili]] za magonjwa ya [[metaboli]],<ref name=HaslamJames/> kama: [[kisukari aina ya 2]], [[shinikizo la juu la damu]], [[kolestro]], and [[hypertriglyceridemia]].<ref>{{cite journal |author=Grundy SM |title=Obesity, metabolic syndrome, and cardiovascular disease |journal=J. Clin. Endocrinol. Metab. |volume=89 |issue=6 |pages=2595–600|year=2004 |pmid=15181029 |doi=10.1210/jc.2004-0372}}</ref> Matatizo aidha husababishwa na unene moja kwa moja au kwa njia isiyo ya moja kwa moja inayohusiana kupitia utaratibu ulio na sababu sawa kama vile [[lishe duni]] au [[uzembe maishani]]. Uhusiano mkuu kati ya unene na hali maalum inatofautiana. Mojawapo ni [[kisukari aina ya 2]]. Mafuta ya ziada mwilini ndiyo kisababishi cha 64% ya kisukari kwa wanaume na 77% kwa wanawake.<ref>Seidell 2005 p.9</ref> Madhara ya kiafya huwa katika vikundi viwili vipana: * yale yanayotokana na madhara ya kiasi cha mafuta kilichozidi (kama vile [[osteoarthritisi]], [[apnea pingani ya usingizi]], kutengwa na jamii) na * yale yanayotokana na idadi iliyozidi ya [[seli za mafuta]] ([[kisukari]], [[saratani]], [[ugonjwa wa moyo na mishipa ya damu]], [[ugonjwa wa maini iliyo na mafuta usiohusiana na pombe]]).<ref name=HaslamJames/><ref name=Bray2004>{{cite journal |author=Bray GA |title=Medical consequences of obesity |journal=J. Clin. Endocrinol. Metab. |volume=89 |issue=6 |pages=2583–9 |year=2004 |pmid=15181027|doi=10.1210/jc.2004-0535}}</ref>Ongezeko la mafuta katika mwili hugeuza hali ambavyo mwili huitikia [[insulini]] hata kusababisha [[kupinga insulini]]. Ongezeko la mafuta pia husababisha [[inflamesheni]],<ref>{{cite journal|author=Shoelson SE, Herrero L, Naaz A |title=Obesity, inflammation, and insulin resistance |url=https://archive.org/details/sim_gastroenterology_2007-05_132_6/page/2169 |journal=Gastroenterology|volume=132 |issue=6 |pages=2169–80 |year=2007 |month=May |pmid=17498510|doi=10.1053/j.gastro.2007.03.059}}</ref><ref>{{cite journal |author=Shoelson SE, Lee J, Goldfine AB|title=Inflammation and insulin resistance |journal=J. Clin. Invest. |volume=116 |issue=7 |pages=1793–801 |year=2006|month=July |pmid=16823477 |pmc=1483173 |doi=10.1172/JCI29069 |url=http://www.jci.org/articles/view/29069}}</ref> na kuandaa [[thrombosi]].<ref name=Bray2004/><ref>{{cite journal |author=Dentali F, Squizzato A, Ageno W|title=The metabolic syndrome as a risk factor for venous and arterial thrombosis |journal=Semin. Thromb. Hemost.|volume=35 |issue=5 |pages=451–7 |year=2009 |month=July |pmid=19739035 |doi=10.1055/s-0029-1234140}}</ref> ===Fumbo kuhusu kuendeleza uhai=== Ingawa madhara ya kiafya ya unene wa kupindukia miongoni mwa jumla ya watu imeungwa mkono na ushahidi uliopo, matokeo ya kiafya katika vikundi mahususi yanaonekana kuboreka kwa kiwango cha Kielezo cha Uzani wa Mwili kinachoongezeka. Tukio hilo linajulikana kama fumbo kuhusu kuendelea kuishi kwa watu walio na unene wa kupindukia.<ref name=Schmidt2007>{{cite journal |author=Schmidt DS, Salahudeen AK |title=Obesity-survival paradox-still a controversy? |journal=Semin Dial |volume=20 |issue=6 |pages=486–92 |year=2007 |pmid=17991192|doi=10.1111/j.1525-139X.2007.00349.x}}</ref> Mara ya kwanza fumbo hili lilielezwa mwaka 1999, likiwakumba watu wenye unene wa kupindukia waliokuwa wakisafishwa damu,<ref name=Schmidt2007/> kisha kupatikana katika watu waliokuwa na [[mshtuko wa moyo]] na [[ugonjwa wa ateri za pembeni]] (UAP).<ref name=paradox2003>{{cite journal |author=|title=Behavioral counseling in primary care to promote a healthcite journal y diet: recommendations and rationale |url=https://archive.org/details/sim_american-family-physician_2003-06-15_67_12/page/2572|journal=Am Fam Physician |volume=67 |issue=12 |pages=2573–6 |year=2003 |month=June |pmid=12825847 |doi= |author1= U.S. Preventive Services Task Force }}</ref> Katika watu waliokuwa na mshtuko wa moyo, wale wenye kipimo cha Kielezo cha Uzani wa Mwili cha kati ya 30.0. na 34.9 walikuwa na kima cha vifo cha chini kuliko wenye uzito wa kawaida. Hii ni kwa sababu watu mara nyingi hupoteza uzito kadiri wanavyoendelea kuwa wagonjwa.<ref>{{cite journal |author=Habbu A, Lakkis NM, Dokainish H |title=The obesity paradox: Fact or fiction?|url=https://archive.org/details/sim_american-journal-of-cardiology_2006-10-01_98_7/page/944 |journal=Am. J. Cardiol. |volume=98 |issue=7 |pages=944–8 |year=2006 |month=October |pmid=16996880|doi=10.1016/j.amjcard.2006.04.039}}</ref> Matokeo sawa na haya yamepatikana katika aina nyingine za magonjwa ya moyo. Watu walio na unene wa kupindukia wa daraja la 1 na magonjwa ya moyo hawana kima cha matatizo ya moyo kuliko watu walio na uzito wa kawaida ambao wana matatizo ya moyo. Hata hivyo, katika watu walio na viwango vikubwa zaidi vya unene, hatari ya kutokea kwa matatizo ya ziada huongezeka.<ref>{{cite journal |author=Romero-Corral A |title=Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: A systematic review of cohort studies |url=https://archive.org/details/sim_the-lancet_august-19-25-2006_368_9536/page/666 |journal=Lancet |volume=368|issue=9536 |pages=666–78 |year=2006 |pmid=16920472 |doi=10.1016/S0140-6736(06)69251-9 |author-separator=,|author2=Montori VM |author3=Somers VK |display-authors=3 |last4=Korinek |first4=Josef |last5=Thomas |first5=Randal J|last6=Allison |first6=Thomas G |last7=Mookadam |first7=Farouk |last8=Lopez-Jimenez|first8=Francisco}}</ref><ref>{{cite journal |author=Oreopoulos A, Padwal R, Kalantar-Zadeh K, Fonarow GC, Norris CM, McAlister FA |title=Body mass index and mortality in heart failure: A meta-analysis |journal=Am. Heart J. |volume=156|issue=1 |pages=13–22 |year=2008 |month=July |pmid=18585492 |doi=10.1016/j.ahj.2008.02.014 |url=https://archive.org/details/sim_american-heart-journal_2008-07_156_1/page/13}}</ref> Hata baada ya [[upasuaji wa kipenyo cha moyo]], hakuna ongezeko la vifo linalotambulika katika watu walio na uzito mkubwa.<ref>{{cite journal |author=Oreopoulos A, Padwal R, Norris CM, Mullen JC, Pretorius V, Kalantar-Zadeh K|title=Effect of obesity on short- and long-term mortality postcoronary revascularization: A meta-analysis|journal=Obesity (Silver Spring) |volume=16 |issue=2 |pages=442–50 |year=2008 |month=February |pmid=18239657|doi=10.1038/oby.2007.36}}</ref> Utafiti mmoja ulionyesha kuwa ongezeko la muda wa kuishi kwa watu wenye unene wa kupindukia husababishwa na matibabu madhubuti ambao watu hao hupata baada ya tukio la tatizo la moyo.<ref>{{cite journal| author=Diercks DB | title=The obesity paradox in non-ST-segment elevation acute coronary syndromes: Results from the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association Guidelines Quality Improvement Initiative | url=https://archive.org/details/sim_american-heart-journal_2006-07_152_1/page/140 | journal=Am Heart J | year=2006 | month=July | volume=152 |issue=1 | pages=140–8 | pmid=16824844 | doi=10.1016/j.ahj.2005.09.024| author-separator=,| author2=Roe MT|author3=Mulgund J| display-authors=3| last4=Pollack| first4=Charles V.| last5=Kirk| first5=J. Douglas| last6=Gibler|first6=W. Brian| last7=Ohman| first7=E. Magnus| last8=Smith| first8=Sidney C.| last9=Boden| first9=William E.}}</ref> Utafiti mwingine unaonyesha kuwa mtu anapouchukulia kwa makini [[ugonjwa wa muda mrefu wa kuzibika kwa mapafu]] (COPD) kwa walio na PDA, manufaa ya unene wa kupindukia hayapo tena.<ref name=paradox2003/> ==Visababishi== Katikia kiwango cha mtu binafsi, ujumlisho wa kula [[chakula kinachotoa nguvu]] na kutofanya [[mazoezi ya kimwili]] hudhaniwa kusababisha visa vingi zaidi vya unene wa kupindukia.<ref name=CADG2006/>Matukio machache sana husababishwa hasa na jeni, sababu za kimatibabu au ugonjwa wa akili.<ref>{{cite journal |author=Bleich S, Cutler D, Murray C, Adams A |title=Why is the developed world obese? |journal=Annu Rev Public Health |volume=29 |pages=273–95 |year=2008 |pmid=18173389|doi=10.1146/annurev.publhealth.29.020907.090954}}</ref> Kinyume na matarajio, inakisiwa kuwa viwango vya unene wa kupindukia vinavyoongezeka katika jamii vinasababishwa na urahisi wa kupata chakula kinachovutia,<ref>{{cite journal |author=Drewnowski A, Specter SE|title=Poverty and obesity: the role of energy density and energy costs |journal=Am. J. Clin. Nutr. |volume=79 |issue=1|pages=6–16 |year=2004 |month=January |pmid=14684391 |doi= |url=http://www.ajcn.org/cgi/content/full/79/1/6}}</ref>ongezeko la kutegemea gari na uzalishaji wa bidhaa kwa kutumia mitambo.<ref>{{cite journal |author=Nestle M, Jacobson MF|title=Halting the obesity epidemic: a public health policy approach |journal=Public Health Rep |volume=115 |issue=1|pages=12–24 |year=2000 |pmid=10968581 |pmc=1308552 |doi= 10.1093/phr/115.1.12|url=}}</ref><ref name=James2008>{{cite journal |author=James WP |title=The fundamental drivers of the obesity epidemic |journal=Obes Rev |volume=9 |issue= Suppl 1 |pages=6–13 |year=2008 |month=March |pmid=18307693 |doi=10.1111/j.1467-789X.2007.00432.x}}</ref> Uhakiki mmoja wa 2006 ulionyesha mambo mengine kumi yanayochangia katika ongezeko la unene wa kupindukia wa hivi majuzi: # kukosa usingizi wa kutosha, # [[matatizo ya mfumo wa mwili]] ([[vichafuzi vya mazingira]] vinavyotatiza umetaboli wa lipidi), # upungufu wa mabadiliko ya halijoto ya mazingira, # upungufu wa viwango vya [[kuvuta sigara]], kwa sababu uvutaji sigara hugandamiza hamu ya chakula, # kuendelea kutumia dawa zinazoweza kusababisha ongezeko la uzito wa mwili (kwa mfano, [[dawa ya kuzuia magonjwa ya akili yasiyo ya kawaida]]), # ongezeko la vikundi vya kikabila na umri vinavyoweza kukita zaidi, # ujauzito wa miaka ya uzeeni (jambo ambalo linaweza kusababisha hatari ya unene wa kupindukia katika watoto), # hatari za [[jenetikia|kijenetikia]]zinazoweza kupitishwa kutoka kizazi hadi kingine, # [[uteuzi wa kiasili]] kwa watu wenye kima cha juu zaidi cha Kielezo cha Uzito wa Mwili, na # [[kujamiiana kiubaguzi]] jambo ambalo huongeza vipengele hatari vya unene wa kupindukia (hii inaweza kuongezea idadi ya watu wanene sana kwa kuongezea kiwango cha tofauti kati ya idadi ya watu na uzito).<ref name="pmid16801930">{{cite journal|author=Keith SW |title=Putative contributors to the secular increase in obesity: Exploring the roads less traveled|journal=Int J Obes (Lond) |volume=30 |issue=11 |pages=1585–94 |year=2006 |pmid=16801930 |doi=10.1038/sj.ijo.0803326|url=http://www.nature.com/ijo/journal/v30/n11/full/0803326a.html |author-separator=, |author2=Redden DT|author3=Katzmarzyk PT |display-authors=3 |last4=Boggiano |first4=M M |last5=Hanlon |first5=E C |last6=Benca |first6=R M |last7=Ruden |first7=D |last8=Pietrobelli |first8=A |last9=Barger |first9=J L}}</ref> Ingawa kuna utafiti wa kutosha unaoonyesha jinsi taratibu hizi zinavyopelekea ongezeko la kutokea kwa unene wa kupindukia, utafiti huu bado haujaweza kutoa hitimisho kamili. Watafiti walioufanya wanasema kuwa inawezekana kuwa taratibu hizi zina athari ya kiwango cha chini kuliko zile zilizojadiliwa katika aya iliyotangulia. ===Chakula bora=== {{Double image|right|World map of Energy consumption 1961,2.svg|200|World map of Energy consumption 2001-2003.svg|200|alt=(Left) A world map with countries colored to reflect the food energy consumption of their people in 1961. North America, Europe, and Australia have relatively high intake, while Africa and Asia consume much less.(Right) A world map with countries colored to reflect the food energy consumption of their people in 2001–2003. Consumption in North America, Europe, and Australia has increased with respect to previous levels in 1971 Food consumption has also increased substantially in many parts of Asia. However, food consumption in Africa remains low.|Map of dietary energy availability per person per day in 1961 (left) and 2001–2003 (right) in kcal/person/day. {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<1600}} {{legend|#fff200|1600–1800}} {{legend|#ffdc00|1800–2000}} {{legend|#ffc600|2000–2200}} {{legend|#ffb000|2200–2400}} {{legend|#ff9a00|2400–2600}} {{Multicol-break}} {{legend|#ff8400|2600–2800}} {{legend|#ff6e00|2800–3000}} {{legend|#ff5800|3000–3200}} {{legend|#ff4200|3200–3400}} {{legend|#ff2c00|3400–3600}} {{legend|#cb0000|>3600}} {{Multicol-end}} ||}} [[File:World Per Person Energy Consumption.png|thumb|alt=A graph showing a gradual increase in global food energy consumption per person per day between 1961 and 2002.|Average per capita energy consumption of the world from 1961 to 2002<ref name=Earth09>{{cite web |url=http://earthtrends.wri.org/searchable_db/index.php?theme=8&variable_ID=212&action=select_countries |title=EarthTrends: Nutrition: Calorie supply per capita |work=World Resources Institute |accessdate=Oct. 18, 2009}}</ref>]] Kima cha ugavi wa nguvu za kimlo kwa kila mtu hutofautiana pakubwa katika maeneo na nchi mbali mbali. Kima hiki pia kimebadilika pakubwa kwa muda mrefu sasa.<ref name=Earth09/> Kutoka mwanzoni wa miaka ya 1970 hadi mwishoni wa kiaka ya 1990, wastani wa kalori kwa kila mtu kila siku (kiwango cha chakula kilichonunuliwa) uliongezeka katika maeneo yote duniani ila Mashariki mwa Uropa. Nchi ya Marekani ilikuwa na kima cha juu zaidi cha upatikanaji, ikiwa ni [[kalori]] 3,654 kwa kila mtu katika mwaka wa 1996. Kima hiki kiliongezeka zaidi hadi 3,754 katika mwaka wa 2003.<ref name=Earth09/> Katika miaka ya mwisho ya 1990 Uropa ilikuwa na kalori &nbsp3,394; kwa kila mtu. Katika maeneo yanayostawi kiuchumi ya Asia kulikuwa na kalori&nbsp2,648; kwa kila mtu na katika kusin mwa jangwa la Sahara, watu walikuwa na kalori &nbsp 2,176;kwa kila mtu.<ref name=Earth09/><ref>{{cite web |url=http://www.scribd.com/doc/1470965/USDA-frsept99b|title=USDA: frsept99b |work=[[United States Department of Agriculture]] |accessdate=January 10, 2009}}</ref> Jumla ya kalori inayotumika imetambulika kuwa inahusiana na unene wa kupindukia.<ref>{{cite web|url=http://www.statcan.gc.ca/pub/82-003-x/2009004/article/10933-eng.htm |title=Diet composition and obesity among Canadian adults |work=Statistics Canada |accessdate=}}</ref> Upatikanaji mkubwa wa vielekezo kuhusu lishe<ref>{{cite web |author=National Control for Health Statistics | title=Nutrition For Everyone | publisher=Centers for Disease Control and Prevention | url=http://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone | accessdate=2008-07-09}}</ref>haujafaulu kutatua shida za kula kupita kiasi na uamuzi mbaya kuhusu lishe.<ref>{{cite journal |author=Marantz PR, Bird ED, Alderman MH |title=A call for higher standards of evidence for dietary guidelines |journal=Am J Prev Med|volume=34 |issue=3 |pages=234–40 |year=2008 |month=March |pmid=18312812 |doi=10.1016/j.amepre.2007.11.017|url=https://archive.org/details/sim_american-journal-of-preventive-medicine_2008-03_34_3/page/234}}</ref> Kutoka mwaka wa 1971 hadi 2000, viwango vya unene wa kupindukia viliongezeka kutoka 14.5% hadi 30.9%.<ref name=Flegal2002>{{cite journal | author=Flegal KM, Carroll MD, Ogden CL, Johnson CL| title=Prevalence and trends in obesity among US adults, 1999–2000 | journal=JAMA | year=2002 | month=October | volume=288| pages=1723–1727 |url=http://jama.ama-assn.org/cgi/content/full/288/14/1723 | doi=10.1001/jama.288.14.1723 | pmid=12365955 |issue=14}}</ref> Katika kipindi hicho pia, wastani wa matumizi ya chakula kinachotoa nguvu yaliongezeka. Katika wanawake, wastani wa ongezeko hili ulikuwa kalori 335 kwa siku (1,542 mwaka wa 1971 na kalori 1,877 mwaka wa 2004), ilhali katika wanaume, wastani katika ongezeko hilo ulikuwa kalori 168 kwa siku (kalori 2,450 mwaka wa 1971 na kalori 2,618 mwaka wa 2004). Kiwango kikubwa cha nguvu hizi za ziada kilitokana na ongezeko la kutumia [[kabohidrati]] badala ya mafuta.<ref>{{cite journal | author=Wright JD, Kennedy-Stephenson J, Wang CY, McDowell MA, Johnson CL |title=Trends in intake of energy and macronutrients—United States, 1971–2000 | journal=MMWR Morb Mortal Wkly Rep |year=2004 | month=February | volume=53 | issue=4 | pages=80–2 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5304a3.htm | pmid=14762332}}</ref> Vyanzo vya msingi vya kabohidrati hizi za ziada ni vinywaji vilivyo na sukari ambavyo vinakadiriwa kusababisha karibu 25% ya nguvu za kila siku katika vijana wakomavu Marekani, <ref name=Caballero>{{cite journal |author=Caballero B |title=The global epidemic of obesity: An overview|journal=Epidemiol Rev |volume=29 |issue= |pages=1–5 |year=2007 |pmid=17569676 |doi=10.1093/epirev/mxm012 |url=}}</ref>na [[chipsi]] za [[viazi]].<ref>{{cite journal|last=Mozaffarian|first=D|coauthors=Hao, T, Rimm, EB, Willett, WC, Hu, FB|title=Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men|url=https://archive.org/details/sim_new-england-journal-of-medicine_2011-06-23_364_25/page/2392|journal=The New England Journal of Medicine|date=2011 Jun 23|volume=364|issue=25|pages=2392–404|pmid=21696306|doi=10.1056/NEJMoa1014296|pmc=3151731}}</ref> Utumiaji wa vinywaji vilivyo na sukari unaaminika kuchangia katika ongezeko la viwango vya unene wa kupindukia.<ref>{{cite journal |author=Malik VS, Schulze MB, Hu FB |title=Intake of sugar-sweetened beverages and weight gain: a systematic review work=Statistics Canada | J. Clin. Nutr. |volume=84 |issue=2 |pages=274–88 |year=2006 |month=August |pmid=16895873 |doi=|url=http://www.ajcn.org/cgi/content/full/84/2/274 |pmc=3210834}}</ref><ref>{{cite journal |author=Olsen NJ, Heitmann BL |title=Intake of calorically sweetened beverages and obesity |journal=Obes Rev |volume=10 |issue=1 |pages=68–75|year=2009 |month=January |pmid=18764885 |doi=10.1111/j.1467-789X.2008.00523.x |url=}}</ref> Jinsi jamii nyingi zinavyoendelea kutegemea [[nguvu nyingi za chakula]], viwango vikubwa vya chakula na vyakula duni, ndivyo uhusiano wa utumiaji wa vyakula duni na unene wa kupindukia unavyoendelea kusababisha madhara. <ref>{{cite journal |author=Rosenheck R|title=Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk |journal=Obes Rev |volume=9 |issue=6 |pages=535–47 |year=2008 |month=November |pmid=18346099|doi=10.1111/j.1467-789X.2008.00477.x |url=}}</ref> Nchini Marekani, utumiaji wa vyakula duni uliongezeka mara tatu huku utumiaji wa chakula chenye nguvu ukiongezeka mara nne kati ya mwaka 1977 na 1995.<ref>{{cite book |author=Lin BH, Guthrie J and Frazao E |editor=Frazão E |title=Agriculture Information Bulletin No. 750: America's Eating Habits: Changes and Consequences |url=http://www.ers.usda.gov/publications/aib750/ |year=1999 |publisher=US Department of Agriculture, Economic Research Service |location=Washington, DC |pages=213–239 |chapter=Nutrient contribution of food away from home |access-date=2013-11-28 |archive-date=2002-06-11 |archive-url=https://web.archive.org/web/20020611183104/http://www.ers.usda.gov/publications/aib750/ |dead-url=yes }}</ref> [[Sera za kilimo]] na [[ufundisanifu]] zinazozingatia mazingira nchini Marekani na barani Uropa zimesababisha kushuka kwa bei ya vyakula. Kule Marekani, hatua ya kupunguza bei ya mahindi, soya, ngano na mchele kupitia bili ya ukulima ya Marekani imepelekea kushuka kwa bei ya chakula cha viwandani ikilinganishwa na matunda na mboga.<ref>{{cite news|author=Pollan, Michael|title=You Are What You Grow|work=New York Times|url=http://www.nytimes.com/2007/04/22/magazine/22wwlnlede.t.html?ex=1186027200&en=bbe0f6a2c10e3b3c&ei=5070|date= 22 April 2007|accessdate= 2007-07-30}}</ref> Wakati mwingi, watu wanene kupindukia hawaripoti vyema jinsi wanavyotumia chakula ikilinganishwa na wale walio na uzito wa kawaida.<ref>Kopelman and Caterson 2005:324.</ref> Utafiti huu ni kwa mujibu wa uchunguzi wa watu uliofanyika katika chumba cha kipima kalori <ref>{{cite web|title=Metabolism alone doesn't explain how thin people stay thin |publisher=The Medical Post|work=John Schieszer|format=registration required}}</ref> na kwa kutazama moja kwa moja. ===Mwenendo wa kuzembea=== [[Mwenendo wa kuzembea]] huchangia pakubwa katika unene wa kupindukia.<ref>Seidell 2005 p.10</ref> Kote ulimwenguni, watu wengi wamegeukia kazi isiyohusisha nguvu nyingi za kimwili<ref name=WHO2009>{{cite web |url=http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/ |title=WHO: Obesity and overweight |work=[[World Health Organization]] |accessdate=January 10, 2009 |archiveurl=https://web.archive.org/web/20081218104805/http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/ |archivedate=2008-12-18 }}</ref><ref name=WHOExercise>{{cite web|url=http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/index.html |title=WHO &#124; Physical Inactivity: A Global Public Health Problem |work=[[World Health Organization]] |accessdate=February 22, 2009}}</ref><ref name=Ness2006>{{cite journal |author=Ness-Abramof R, Apovian CM |title=Diet modification for treatment and prevention of obesity |journal=Endocrine |volume=29 |issue=1 |pages=5–9 |year=2006 |month=February |pmid=16622287|doi=10.1385/ENDO:29:1:135 |url=}}</ref> na kwa wakati huu angalau 60% ya idadi ya watu duniani hupata mazoezi yasiyotosheleza.<ref name=WHOExercise/> Hii hasa ni kwa sababu ya ongezeko la kutumia mitambo katika uchukuzi, na teknologia inayosaidia sana kikazi huko nyumbani.T<ref name=WHO2009/><ref name=WHOExercise/><ref name=Ness2006/> Katika watoto, viwango vya kufanya mazoezi vinaonekana kushuka kwa sababu ya kutotembea sana na kutohusika katika somo la mazoezi ya mwili.<ref>{{cite journal |author=Salmon J, Timperio A |title=Prevalence, trends and environmental influences on child and youthphysical activity |journal=Med Sport Sci |volume=50 |issue= |pages=183–99 |year=2007 |pmid=17387258|doi=10.1159/000101391 |series=Medicine and Sport Science |isbn=978-3-318-01396-2 }}</ref> Mienendo ya dunia katika burudani ambapo watu huusika moja kwa moja[[mazoezi ya mwili]] inaendelea kufifia. [[Shirika la Afya Duniani]] linaonyesha kuwa, ulimwenguni kote, watu wanaendelea kuhusika katika burudani isiyohusisha maoezi, ilhali katika utafiti mmoja huko Finland<ref>{{cite journal |author=Borodulin K, Laatikainen T, Juolevi A, Jousilahti P |title=Thirty-year trends of physical activity in relation to age, calendar time and birth cohort in Finnish adults |journal=Eur J Public Health |volume=18 |issue=3 |pages=339–44 |year=2008|month=June |pmid=17875578 |doi=10.1093/eurpub/ckm092 |url=}}</ref> ulionyesha ongezeko, ilhali utafiti mwingine huko Marekani ulionyesha kuwa mazoezi katika burudani hayajabadilika sana.<ref>{{cite journal |author=Brownson RC, Boehmer TK, Luke DA |title=Declining rates of physical activity in the United States: what are the contributors?|journal=Annu Rev Public Health |volume=26 |issue= |pages=421–43 |year=2005 |pmid=15760296|doi=10.1146/annurev.publhealth.26.021304.144437 |url=}}</ref> Katika watoto na watu wazima, kuna uhusiano kati ya kutazama runinga na hatari ya unene wa kupindukia.<ref>{{cite journal |author=Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH |title=Television viewing as a cause of increasing obesity among children in the United States, 1986–1990 |journal=Arch Pediatr Adolesc Med |volume=150 |issue=4 |pages=356–62 |year=1996 |month=April |pmid=8634729|doi=10.1001/archpedi.1996.02170290022003}}</ref><ref>{{cite journal |author=Vioque J, Torres A, Quiles J |title=Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain |journal=Int. J. Obes. Relat. Metab. Disord. |volume=24 |issue=12 |pages=1683–8 |year=2000 |month=December |pmid=11126224 |doi= 10.1038/sj.ijo.0801434|url=https://archive.org/details/sim_international-journal-of-obesity_2000-12_24_12/page/1683}}</ref><ref>{{cite journal |author=Tucker LA, Bagwell M |title=Television viewing and obesity in adult females |journal=Am J Public Health |volume=81 |issue=7 |pages=908–11 |year=1991 |month=July|pmid=2053671 |pmc=1405200 |doi= 10.2105/AJPH.81.7.908|url=http://www.ajph.org/cgi/reprint/81/7/908 |format=PDF}}</ref> Ukaguzi ulitambua kuwa 63 kati ya tafiti 73 (86%) zilionyesha ongezeko katika kiwango cha unene wa kupindukia wa utotoni pindi watoto wanavyofikia vyombo vya mawasiliano, huku viwango hivi vikiongezeka kulingana na muda unaotumika kutazama runinga.ref>{{cite web |url=http://ipsdweb.ipsd.org/uploads/IPPC/CSM%20Media%20Health%20Report.pdf |title=Media + Child and Adolescent Health: A Systematic Review |publisher=Common Sense Media |year=2008 |format=PDF |work=Ezekiel J. Emanuel |accessdate=April 6, 2009 |archive-date=2012-11-22 |archive-url=https://web.archive.org/web/20121122070205/http://ipsdweb.ipsd.org/uploads/IPPC/CSM%20Media%20Health%20Report.pdf |url-status=dead }}</ref> ===Usomijeni=== [[File:La monstrua desnuda (1680), de Juan Carreño de Miranda..jpg|thumb|wima|alt=Mchoro wa msichana mweusi wa kike mwenye nywele nyeusi, mashavu ya waridi aliye uchi akiegemea meza. Msichana huyu ameshika zabibu na majani ya zabibu katika mkono wake wa kushoto ambayo yamezifunika jenitalia zake.| Mchoro uliochorwa mwaka wa 1680 na [[Juan Carreno de Miranda]], wa msichana aliyedhaniwa kuwa na [[sindromu ya Prader-Will]]<ref>{{cite web |url=http://www.esst.org/newsletter2000.htm |title=Case Study: Cataplexy and SOREMPs Without Excessive Daytime Sleepiness in Prader Willi Syndrome. Is This the Beginning of Narcolepsy in a Five Year Old?|author=Mary Jones|publisher=European Society of Sleep Technologists|accessdate=April 6, 2009}}</ref>]] Kama magonjwa mengine mengi, unene wa kupindukia hutokana na mwingiliano kati ya vipengele vya kijeni na vya kimazingira. [[Upolimofi]] katika [[jeni]] nyingi zinazodhibiti [[hamu ya kula[[]] na [[umetaboli]]hupelekea unene wa kupindukia wakati nguvu za kutosha zinazotoka katika chakula zinapatikana. Katika mwaka wa 2006, zaidi ya 41 za sehemu hizi zimehusishwa na kuendelea kwa unene wa kupindukia wakati mazingira mwafaka yanapokuwepo.<ref>{{cite journal |author=Poirier P |title=Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss |journal=Arterioscler. Thromb. Vasc. Biol. |volume=26 |issue=5 |pages=968–76 |year=2006 |month=May |pmid=16627822 |doi=10.1161/01.ATV.0000216787.85457.f3|url=https://archive.org/details/sim_arteriosclerosis-thrombosis-and-vascular-biology_2006-05_26_5/page/968|author-separator=, |author2=Giles TD |author3=Bray GA |display-authors=3 |last4=Hong |first4=Y |last5=Stern|first5=JS |last6=Pi-Sunyer |first6=FX |last7=Eckel |first7=RH}}</ref> Watu walio na aina mbili za[[jeni ya FTO]] (jeni inayohusishwa na wingi wa mafuta na unene wa kupindukia) wamepatikana kwa wastani kuwa na uzito wa kilogramu 3-4]] &nbsp; zaidi na huwa katika hatari mara1.67 zaidi ya kukumbwa na unene wa kupindukia wakilinganishwa na wale wasio na hatari hii [[aleli]].<ref>{{cite journal |author=Loos RJ, Bouchard C |title=FTO: the first gene contributing to common forms of human obesity |journal=Obes Rev |volume=9 |issue=3 |pages=246–50|year=2008 |month=May |pmid=18373508 |doi=10.1111/j.1467-789X.2008.00481.x |url=}}</ref> Asilimia ya unene wa kupindukia unaoweza kuhusishwa visababishi vya kijeni ni ya kubadilika kutoka 6% hadi 85% kulingana na idadi ya watu waliochunguzwa.<ref>{{cite journal|author=Yang W, Kelly T, He J |title=Genetic epidemiology of obesity |journal=Epidemiol Rev |volume=29 |issue=|pages=49–61 |year=2007 |pmid=17566051 |doi=10.1093/epirev/mxm004}}</ref> Unene wa kupindukia ni kipengele kikuu katika sindromu kadhaa kama vile [[sindromu ya Prader-Willi]], [[sindromu ya Bardet-Biedl]], [[sindromu ya Cohen]], na [[sindromu ya MOMO]]. Neno unene wa kupindukia usiosababishwa na sindromu hutumika wakati mwingine kuzitenga hali hizi.<ref name="pmid19506576">{{cite journal |author=Walley AJ, Asher JE, Froguel P |title=The genetic contribution to non-syndromic human obesity |journal=Nat. Rev. Genet. |volume= 10|issue= 7|pages= 431–42|year=2009|month=June |pmid=19506576 |doi=10.1038/nrg2594 |url=}}</ref> Kwa watu walio na mwanzo mkali wa mapema wa unene wa kupindukia (unaofasiliwa na mwanzo kabla ya umri wa miaka 10&nbsp; na kielezo cha uzani wa mwili zaidi ya tatu [[standard deviation]] zaidi ya kawaida), 7% huwa na kipimo kimoja cha mgeuko papale <ref>{{cite journal |author=Farooqi S, O'Rahilly S |title=Genetics of obesity in humans |journal=Endocr. Rev. |volume=27 |issue=7 |pages=710–18 |year=2006 |month=December |pmid=17122358 |doi=10.1210/er.2006-0040 |url=http://edrv.endojournals.org/cgi/content/full/27/7/710 |access-date=2013-11-28 |archive-date=2010-07-10 |archive-url=https://web.archive.org/web/20100710170521/http://edrv.endojournals.org/cgi/content/full/27/7/710 |dead-url=yes }}</ref> Tafiti zilizolenga mitindo ya urithi badala ya jeni maalum zimetambua kuwa asilimia 80 ya watoto wa watu wawili walio wanene kupindukia walikuwa vilevile na unene wa kupindukia, ikilinganishwa na asilimia chini ya 10 ya watoto wa wazazi wawili waliokuwa na uzito wa kawaida.<ref>{{cite book |author=Kolata,Gina |title=Rethinking thin: The new science of weight loss&nbsp;– and the myths and realities of dieting |publisher=Picador |location= |year=2007 |page=122|isbn=0-312-42785-9}}</ref> [[Nadharia tete ya jeni yenye mafanikio]] hudai kuwa watu wana uwezekano mkubwa wa kupatwa na unene wa kupindukia kutokana na ukosefu wa chakula wakati wa mageuko ya binadamu. Uwezo wao wa kujinufaisha katika vipindi visivyo vya kawaida vya wingi kwa kuweka nguvu kama mafuta unaweza kuwafaa katika nyakati ambapo upatikanaji wa chakula si yakini na watu walio na hifadhi kubwa ya mafuta wanaweza kuwa na uwezekano mkubwa wa kuongoka[[njaa]]. Hata hivyo, huenda jamii zilizo na chakula kwa wingi zisizoee kujiwekea mafuta.<ref>{{cite journal |author=Chakravarthy MV, Booth FW |title=Eating, exercise, and "thrifty" genotypes: Connecting the dots toward an evolutionary understanding of modern chronic diseases |url=https://archive.org/details/sim_journal-of-applied-physiology_2004-01_96_1/page/3 |journal=J. Appl. Physiol.|volume=96 |issue=1 |pages=3–10 |year=2004 |pmid=14660491 |doi=10.1152/japplphysiol.00757.2003}}</ref> Nadharia hii imeweza kukosolewa sana na kupelelea kupendekezwa kwa nadharia zingine za kimageuko kama vile [[nadharia tete ya jeni isiyo na mkondo]] na[[fenotipu yenye mafanikio|nadharia tete ya fenotipu yenye mafanikio]]zilizopendekezwa. <ref>{{cite doi|10.1038/ijo.2009.175}}</ref><ref>{{cite doi|10.1002/ajhb.21100}}</ref> ===Maradhi mengine=== Maradhi mengine ya mwili na akili na dawa za kifamasia zinazotumiwa kuyatibu zinaweza kuongeza hatari ya unene wa kupindukia. Maradhi yanayoongeza hatari ya unene huo ni sindromu kadhaa za kijenetikia zisizo za kawaida (zilizoorodheshwa hapo juu) na aidha magonjwa mengine ya kuzaliwa nayo au ya kujitokeza baada ya kuzaliwa: [[uhipothiroidi]], [[Sindromu ya Cushing]], [[kukosa homoni ya kukua]],<ref>{{cite journal |author=Rosén T, Bosaeus I, Tölli J, Lindstedt G, Bengtsson BA |title=Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency |url=https://archive.org/details/sim_clinical-endocrinology_1993-01_38_1/page/63 |journal=Clin. Endocrinol. (Oxf) |volume=38 |issue=1 |pages=63–71 |year=1993 |pmid=8435887| doi = 10.1111/j.1365-2265.1993.tb00974.x}}</ref> na [[matatizo ya kula]]: [[matatizo ya kula yatokanayo na ulevi]] na [[sindromu ya kula usiku]].<ref name=HaslamJames/>.Hata hivyo, unene wa kupindukia hauchukuliwi kuwa tatizo la kiakili na kwa hiyo haujaorodheshwa katika Mwongozo wa Utambuzi na Takwimu za Maradhi ya Akili (DSM-IVR) kama maradhi ya akili.<ref>{{cite journal |author=Zametkin AJ, Zoon CK, Klein HW, Munson S |title=Psychiatric aspects of child and adolescent obesity: a review of the past 10 years |url=https://archive.org/details/sim_journal-american-academy-child-adolescent-psychiatry_2004-02_43_2/page/134 |journal=J Am Acad Child Adolesc Psychiatry |volume=43 |issue=2 |pages=134–50 |year=2004 |month=February |pmid=14726719|doi=10.1097/00004583-200402000-00008}}</ref> Hatari ya uzito wa kupita kiasi na unene wa kupindukia iko juu kwa wagonjwa walio na maradhi ya akili kuliko kwa watu ambao hawana maradhi ya akili.<ref>{{cite journal | author=Chiles C, van Wattum PJ |title=Psychiatric aspects of the obesity crisis | journal=Psychiatr Times | year=2010 | volume=27 | issue=4 |pages=47–51}}</ref> Matibabu mengine yanaweza kusababisha kuongezeka kwa uzito au mabadiliko katika [[mchanganyiko wa mwili]]; nayo ni [[insulini]], [[salfonyilurea]], [[thiasolidinedioni]], [[dawa za magonjwa ya kiakili]], [[dawa ya unyogovu]], [[glucocorticoids|steroidi]], aina nyingine za [[dawa za mitukutiko]] ([[fenitoini]] na [[valproeati]]), [[pisotifeni]], na za [[uzuiaji mimba wa kihomoni]].<ref name=HaslamJames/> ===Vigezo vya kijamii=== Ingawa athari za kijenetiki ni muhimu katika kuelewa unene wa kupindukia, haziwezi kuwajibikia mkondo uliopo wa ongezeko katika nchi fulani au duniani.<ref>{{cite journal |author=Yach D, Stuckler D, Brownell KD |title=Epidemiologic and economic consequences of the global epidemics of obesity and diabetes |journal=Nat. Med. |volume=12 |issue=1|pages=62–6 |year=2006 |month=January |pmid=16397571 |doi=10.1038/nm0106-62 |url=}}</ref> Ingawa imekubalika kuwa utumizi wa nguvu zaidi ya kiasi kinachostahili kutumika husababisha unene wa kupindukia kibinafsi, kisababishi cha mageuko katika vipengele hivi viwili kwa kiwango cha jamii hujadiliwa sana. Kuna nadharia kadhaa zinazohusu visababishi vya unene wa kupindukia. Hata hivyo, nadharia nyingi zimeshikilia kuwa unene husababishwa na mchanganyiko wa vipengele tofauti. Uhusiano kati ya [[hadhi ya kijamii]] na Kielezo cha Uzani wa Mwili huwa tofauti ulimwenguni. Tathmini katika mwaka wa 1989 ilionyesha kuwa wanawake wenye hadhi ya juu ya kijamii katika nchi zinazostawii walikuwa na uwezekano mdogo wa kukumbwa na unene wa kupindukia. Hakuna tofauti muhimu zilizoonekana miongoni mwa wanaume wa hadhi tofauti za kijamii. Katika nchi zinazostawi, wanawake, wanaume na watoto kutoka katika hadhi ya juu ya kijamii walikuwa na viwango vikubwa vya unene wa kupindukia.<ref>{{cite journal |author=Sobal J, Stunkard AJ |title=Socioeconomic status and obesity: A review of the literature |url=https://archive.org/details/sim_psychological-bulletin_1989-03_105_2/page/260 |journal=Psychol Bull |volume=105 |issue=2 |pages=260–75 |year=1989 |month=March |pmid=2648443|doi=10.1037/0033-2909.105.2.260}}</ref>. Toleo la tathmini hii uliofanyika mwaka wa 2007 ulionyesha uhusiano uo huo lakini ulikuwa dhaifu. Upungufu katika uthabiti wa uhusiano huo ulihisika kuwa uliotokana na [[utandawazi]].<ref name=McLaren2007>{{cite journal |author=McLaren L |title=Socioeconomic status and obesity |journal=Epidemiol Rev|volume=29 |issue= |pages=29–48 |year=2007 |pmid=17478442 |doi=10.1093/epirev/mxm001}}</ref> Katika nchi zilizostawi, viwango vya unene wa kupindukia kwa watu wazima, na asilimia ya watoto waliobalehe walio na uzani wa kupindukia vinahusiana na [[tofauti za kiuchumi|tofauti za kimapato]]. Uhusiano kama huu hunekana katika majimbo ya Marekani: watu wengi wazima, hata walio katika matabaka ya juu katika jamii wana unene wa kupindukia hata katika majimbo yaliyo na tofauti za kimapato.<ref name="spirit">{{cite book|title=[[The Spirit Level: Why More Equal Societies Almost Always Do Better]]|last1=Wilkinson|first1=Richard|authorlink1=Richard G. Wilkinson|last2=Pickett|first2=Kate|publisher=Allen Lane|location=London|isbn=978-1-84614-039-6|year=2009|pages=91–101|url=http://www.equalitytrust.org.uk/why/evidence/obesity}}</ref> Maelezo mengi yametolewa yakilinganisha Kielezo cha Uzani wa Mwili na hadhi ya kijamii. Inadhaniwa mwilia mwilizo wa kumudu vyakula bora zaidi, nao huwa katika shinikizo zaidi la kusalia wembamba kutoka kwa jamii, na wana nafasi na matumaini makubwa ya kudumisha [[siha njema ya kimwili]]. Katika [[nchi zisizostawi]] inaaminika kuwa uwezo wa kumudu chakula, utumizi mkubwa wa nguvu katika kufanya kazi za sulubu, na tamaduni zinazothamini miili mikubwa huchangia katika kuleta mitindo hii.<ref name=McLaren2007/> Mitazamo inayoshikiliwa na watu kuhusu ukubwa wa mwili maishani pia inaweza kuchangia unene wa kupindukia. Uhusiano wa mabadiliko katika Kielezo cha Uzani wa Mwili kwa muda mrefu umeonekana miongoni mwa marafiki, ndugu na wachumba.<ref>{{cite journal |author=Christakis NA, [[James H. Fowler|Fowler JH]] |title=The Spread of Obesity in a Large Social Network over 32 Years |url=https://archive.org/details/sim_new-england-journal-of-medicine_2007-07-26_357_4/page/370 |journal= New England Journal of Medicine|volume=357 |issue=4|pages=370–379 |year=2007 |pmid=17652652 |doi=10.1056/NEJMsa066082}}</ref> Stress and perceived low social status appear to increase risk of obesity.<ref name="spirit" /><ref>{{cite journal|author=Bjornstop P|title=Do stress reactions cause abdominal obesity and comorbidities?|journal=Obesity Reviews|volume=2|issue=2|pages=73–86|year=2001|doi=10.1046/j.1467-789x.2001.00027.x|pmid=12119665}}</ref><ref>{{cite journal|author=Goodman E, Adler NE, Daniels SR, Morrison JA, Slap GB, Dolan LM|title=Impact of objective and subjective social status on obesity in a biracial cohort of adolescents|journal=Obesity Reviews|volume=11|issue=8|pages=1018–26|year=2003|pmid=12917508|doi=10.1038/oby.2003.140}}</ref> Uvutaji sigara huathiri pakubwa uzani wa mtu. Watu wanaokoma kuvuta sigara huongeza uzito kwa wastani wa kilo 4.4&nbsp; 9.7&nbsp;lb) katika wanaume na kilo 5.0&nbsp;(11.0&nbsp;lb) katika wanawake kwa muda wa miaka kumi.<ref>{{cite journal |author=Flegal KM, Troiano RP, Pamuk ER, Kuczmarski RJ, Campbell SM |title=The influence of smoking cessation on the prevalence of overweight in the United States |journal=N. Engl. J. Med. |volume=333 |issue=18 |pages=1165–70 |year=1995 |month=November |pmid=7565970 |doi=10.1056/NEJM199511023331801 |url=http://content.nejm.org/cgi/content/full/333/18/1165 |access-date=2013-11-28 |archive-date=2003-04-05 |archive-url=https://web.archive.org/web/20030405192136/http://content.nejm.org/cgi/content/full/333/18/1165 |dead-url=yes }}</ref> Hata hivo mabadiliko katika viwango vya uvutaji yamekuwa na matokeo duni kwa viwango vya jumla vya unene wa kupindukia.<ref>{{cite journal |author=Chiolero A, Faeh D, Paccaud F, Cornuz J |title=Consequences of smoking for body weight, body fat distribution, and insulin resistance|journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=801–9 |date=1 April 2008|pmid=18400700|url=http://www.ajcn.org/cgi/content/full/87/4/801 }}</ref> Nchini Marekani, idadi ya watoto alionao mtu inahusiana na hatarisho lao la unene wa kupindukia. Hatari ya mwanamke huongezeka kwa 7% kwa kila mtoto, ilhali hatarisho la mwanamume huongezeka kwa 4%.<ref>{{cite journal |author=Weng HH, Bastian LA, Taylor DH, Moser BK, Ostbye T |title=Number of children associated with obesity in middle-aged women and men: results from the health and retirement study |journal=J Women's Health (Larchmt) |volume=13 |issue=1 |pages=85–91 |year=2004|pmid=15006281 |doi=10.1089/154099904322836492}}</ref> Hii inaweza kuelezwa kwa kiasi fulani kutokana na ukweli kwamba kuwa na watoto wanaokutegemea hupunguza shughuli za kimwili kwa wazazi katika nchi za Ulaya na Marekani.<ref>{{cite journal |author=Bellows-Riecken KH, Rhodes RE |title=A birth of inactivity? A review of physical activity and parenthood |journal=Prev Med |volume=46|issue=2 |pages=99–110 |year=2008 |month=February |pmid=17919713 |doi=10.1016/j.ypmed.2007.08.003}}</ref> Katika nchi zinazostawi, ukuaji wa miji unachangia katika kiwango kinachoongezeka cha unene wa kupindukia. Nchini [[Uchina]]viwango vya jumla vya unene wa kupindukia viko chini ya asilimia 5; hata hivyo, katika miji mingine, viwango vya unene wa kupindukia ni zaidi ya asilimia 20.<ref>{{cite web|url=http://www.who.int/dietphysicalactivity/media/en/gsfs_obesity.pdf |title=Obesity and Overweight |format=PDF|publisher=[[World Health Organization]] |accessdate=February 22, 2009}}</ref> [[Utapiamlo]] mwanzoni mwa maisha umeaminika kuchangia katika viwango vinavyoongezeka vya unene wa kupindukia katika[[nchi zinazostawi]].<ref name=DC2001>{{cite journal |author=Caballero B |title=Introduction. Symposium: Obesity in developing countries: biological and ecological factors |journal=J. Nutr. |volume=131 |issue=3 |pages=866S–870S |year=2001|month=March |pmid=11238776 |doi= |url=http://jn.nutrition.org/cgi/content/full/131/3/866S}}</ref>Mabadiliko ya endokrini yanayotokea katika vipindi vya utapiamlo yanaweza kuendeleza uhifadhiwaji wa mafuta mara tu chakula zaidi kiletacho nguvu kinapopatikana.<ref name=DC2001/> Sawa na data za [[epidemiolojia tambuzi|epidemiolojia tambuzi]], na tafiti nyingi huthibitisha kuwa unene wa kupindukia unahusiana na upungufu katika utambuzi. <ref name="Smith2011"> {{cite journal|doi=10.1111/j.1467-789X.2011.00920.x|url=http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2011.00920.x/abstract|doi_brokendate=1-1-2012|author1=<Please add first missing authors to populate metadata.>}}</ref> Iwapo unene wa kupindukia husababisha upungufu katika utambuzi kwa vyovyote vile bado haijulikani kwa sasa. ===Vikolezo viambukizi=== Utafiti wa jinsi vikolezo viambukizi vinavyoathiri umetaboli ungali katika hatua zake za kwanza. [[Flora ya utumbo]] imeonekana kutofautiana kati ya watu wembamba na wale walio na unene wa kupindukia. Kuna ishara kuwa flora ya utumbo katika watu wanene kupindukia na wale wembamba inaweza kuathiri uwezo wa umetaboli. Mabadiliko haya dhahiri katika uwezo wa umetaboli yanaaminika kuchangia kwa kiwango kikubwa katika kuvuna nguvu zinazosababisha unene wa kupindukia. Iwapo tofauti hizi ndizo visababishi vya moja kwa moja au ndiyo matokeo ya unene wa kupindukia, bado haijabainishwa kwa kiasi kisichopotosha<ref>{{cite journal |author=DiBaise JK, Zhang H, Crowell MD, Krajmalnik-Brown R, Decker GA, Rittmann BE |title=Gut microbiota and its possible relationship with obesity |url=https://archive.org/details/sim_mayo-clinic-proceedings_2008-04_83_4/page/460 |journal=Mayo Clinic proceedings. Mayo Clinic |volume=83 |issue=4 |pages=460–9 |year=2008 |month=April |pmid=18380992|doi=10.4065/83.4.460}}</ref> Uhusiano kati ya [[virusi]] na unene wa kupindukia umeonekana kwa wanadamu na spishi kadhaa za wanyama. Kiasi ambacho ushirikiano huu unaweza kuwa umechangia katika kuongezeka kwa kiwango cha unene wa kupindukia bado hakijabainishwa.<ref>{{cite journal |author=Falagas ME, Kompoti M |title=Obesity and infection |journal=Lancet Infect Dis |volume=6 |issue=7|pages=438–46 |year=2006 |month=July |pmid=16790384 |doi=10.1016/S1473-3099(06)70523-0 |url=}}</ref> ==Pathofiziolojia== [[File:Fatmouse.jpg|thumb|alt=Panya wawili weupe wenye masikio yanayotoshana, macho meusi na pua za waridi. Hata hivyo upana wa mwili wa panya aliye kushoto ni takribani mara tatu zaidi ya ule wa panya wa kulia aliye na ukubwa wa kawaida.|Ulinganisho wa panya asiyeweza kutoa [[leptini]] na hatimaye kupelekea unene wa kupindukia (kushoto) na panya wa kawaida (kulia)]] Flier anafupisha taratibu nyingi za [[pathofiziolojia]] zinazohusika katika ukuaji na udhibiti wa unene wa kupindukia.<ref name="flier">{{cite journal | author=Flier JS | title=Obesity wars: Molecular progress confronts an expanding epidemic Molecular progress confronts an expanding epidemic | url=https://archive.org/details/cell_2004-01-23_116_2/page/337 | journal=Cell | year=2004 | pages=337–50 | volume=116 | issue=2 | pmid=14744442 | doi = 10.1016/S0092-8674(03)01081-X}}</ref> Kitengo hiki cha utafiti kilikuwa hakijaangaziwa hadi mwaka wa 1994[[leptini]] ilipogunduliwa. Tangu ugunduzi huu ulipofanyika, taratibu zingine nyingi za homoni zinazohusika katika udhibiti wa [[hamu ya kula]] na ulaji, mitindo ya uhifadhi ya [[tishu ya mafuta]] na ukuaji wa [[ukinzani kwa insulini zimefumbuliwa]]. Tangu kuvumbuliwa kwa leptini, [[grelin]], [[insulini]], [[oreksini]], [[PYY 3-36]], [[kolesistokinini]],[[adiponektini]], na vipengele vinginevyo zimechunguzwa. [[Adipokini]] ni chembe zinazoundwa na tishu ya mafuta; utendakazi wake unadhaniwa kubadilisha magonjwa mengi yanayohusiana na unene wa kupindukia. Inachukuliwa kuwa leptini na grelini hufanya kazi pamoja katika jinsi zinavyoathiri hamu ya kula; huku grelini, inayotolewa na tumbo, ikirekebisha uthibiti wa muda mfupi wa hamu ya kula (yaani kula wakati ambapo tumbo liko tupu na kukoma tumbo inapotanuka). Leptini hutolewa na tishu ya mafuta kuchochea hifadhi za mafuta mwilini na kupatanisha uthibiti wa muda mrefu wa hamu ya kula (yaani, kula kwa wingi ambapo hifadhi za mafuta ziko chini na kula kiasi kidogo zinapokuwa juu). Ingawa utoaji wa leptini unaweza kufaa katika kikundi kidogo cha watu wenye unene wa kupindukia walio na upungufu wa leptini, watu wengi wenye unene huu hufikiriwa kuwa wenye ukinzani wa leptini na wamepatikana kuwa na viwango vya juu vya leptini.<ref>{{cite journal|author=Hamann A, Matthaei S |title=Regulation of energy balance by leptin |journal=Exp. Clin. Endocrinol. Diabetes|volume=104 |issue=4 |pages=293–300 |year=1996 |pmid=8886745 |doi=10.1055/s-0029-1211457}}</ref> Ukinzani huu hufikiriwa kueleza kwa kiasi fulani sababu inayofanya utoaji wa leptini usionekane kufaa katika kukandamiza hamu ya kula kwa watu wengi walio na unene wa kupindukia.<ref name="flier"/> [[File:Leptin.png|thumb|kushoto|alt=Modeli ya mitazamo mitatu iliyo na jozi mbili za nguzo mkabala zilizopinda na kushikanishwa pamoja kwenye miisho na sehemu zingine zilizopangwa katika mistari.||Kielelezo cha molekuli ya leptini]] Ingawa leptini na grelini hutolewa pembezoni, zinadhibiti hamu ya kula kupitia jinsi zinavyoathiri[[mfumo mkuu wa neva]]. Hasa, leptini na grelini, na homoni zingine zinazohusiana na hamu ya kula huichochea [[hipothalamasi]], sehemu ya ubongo iliyo muhimu zaidi katika kudhibiti ulaji na utumiaji wa nguvu. Kuna mizunguko kadhaa katika hipothalamasi inayochangia kwenye jukumu lake katika kuongeza na kudumisha hamu ya kula, ambapo[[melanokotini]] ndiyo njia inayoeleweka vizuri sana.<ref name="flier"/> Mzunguko huu huanzia katika sehemu ya hipothalamasi iitwayo [[kiini akueti]], ambayo matokeo yake huenda kwenye [[hipothalamasi ya pembeni]] na [[hipothalamasi inayotambua shibe]], sehemu za ubongo zinazodhibiti kula na shibe mtawalia.<ref>{{cite book |author=Boulpaep, Emile L.; Boron, Walter F. |title=Medical physiologya: A cellular and molecular approach |url=https://archive.org/details/medicalphysiolog0000boro_a6j9 |publisher=Saunders|location=Philadelphia |year=2003 |page=[https://archive.org/details/medicalphysiolog0000boro_a6j9/page/n1227 1227]|isbn=0-7216-3256-4}}</ref> Kiini akueti kina makundi mawili tofauti ya [[nyuroni]].<ref name="flier"/> Kundi la kwanza hudhirisha [[nuropeptaidi Y]] na [[peptaidi inayohusiana na agouti]] kwa pamoja na kuchangia katika kuichochea hipothalamasi ya pembeni na kuikandamiza hipothalamasi inayotambua shibe. Kundi la pili hudhihirisha [[pro-opiomelanokotini]] na [[nakala inayodhitiwa na kokeni na amfetamini]] (NIKA) na huchangia katika kuichochea hipothalamasi inayotambua shibe na kuikandamiza hipothalamasi ya pembeni. Kwa hiyo, nyuroni za nuropetaidi Y/peptaidi inayohusiana na agouti (NPY/AgRP) huchochea kula na kuzuia kushiba, ilhali nuroni za POMC/NIKA huchochea kushiba na kuzuia kula. Makundi yote mawili ya nuroni za kiini akueti nuroni hudhibitiwa kwa kiasi fulani na leptini. Leptini hukandamiza kundi la nuropetaidi Y/peptaidi inayohusiana na agouti (NPY/AgRP) huku ikilichochea kundi la POMC/NIKA. Kwa hivyo, ukosefu wa uchochelezi wa leptini, iwe ni kutokana na ukosefu wa leptini au ukinzani kwa leptin, hupelekea kula zaidi na inaweza kusababisha unene wa kupindukia wa kijenetikia na wa kupatikana maishani.<ref name="flier"/> {{clear}} ==Afya ya umma== [[Shirika la Afya Duniani]] (WHO) linatabiri kuwa hivi karibuni, [[uzito wa kupita kiasi]] na unene wa kupindukia unaweza kuchukua nafasi ya matatizo ya jadi ya [[afya ya umma]] kama vile [[utapiamlo]] na [[magonjwa ya kuambukiza]] kama visababishi vikuu vya afya duni.<ref>{{cite book |author=Loscalzo, Joseph; Fauci, Anthony S.; Braunwald, Eugene; Dennis L. Kasper; Hauser, Stephen L; Longo, Dan L. |title=Harrison's principles of internal medicine |publisher=McGraw-Hill Medical |location=|year=2008 |pages= |isbn=0-07-146633-9 |oclc=|doi= |accessdate=}}</ref> Unene wa kupindukia ni tatizo la afya ya umma na la kisera kwa sababu yaueneaji wake, gharama na athari za kiafya.<ref>{{cite book | author=Satcher D | title=The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity | year=2001 | publisher=U.S. Dept. of Health and Human Services, Public Health Service, Office of Surgeon General | url=http://www.ncbi.nlm.nih.gov/books/NBK44206/|isbn=978-0-16-051005-2}}</ref> Juhudi za afya ya umma hulenga kuelewa na kurekebisha mazingira yanayochangia kukithiri kwa unene wa kupindukia miongoni mwa watu. Suluhisho hutazamia kubadilisha mambo yanayosababisha utumiaji zaidi wa vyakula viletavyo nguvu na kukandamiza shughuli/mazoezi ya mwili. Juhudi ni programu za milo zinazofadhiliwa na serikali katika shule, kupunguza uuzaji wa[[chakula visivyo bora]] kwa watoto, <ref>{{cite news | author=Brook Barnes | title=Limiting Ads of Junk Food to Children |url=http://www.nytimes.com/2007/07/18/business/18food.html | work=New York Times | date=2007-07-18 |accessdate=2008-07-24}}</ref> na kupunguza upatikanaji wa vinywanji vyenye sukari katika shule.<ref>{{cite web |url=http://www.healthfinder.gov/news/newsstory.aspx?docID=625759 |title=Fewer Sugary Drinks Key to Weight Loss -healthfinder.gov |work=U.S.. Department of Health and Human Services |accessdate=Oct 18,2009 |archivedate=2012-11-16 |archiveurl=https://web.archive.org/web/20121116045620/http://www.healthfinder.gov/news/newsstory.aspx?docID=625759 }}</ref> Juhudi zimefanywa katika uundaji wa mazingira ya miji ili kuongeza ufikiaji wa bustani na kutengeneza njia za waendao kwa miguu.<ref>{{cite journal | author=Brennan Ramirez LK | title=Indicators of activity-friendly communities: An evidence-based consensus process | journal=Am J Prev Med | year=2006 | month=December | issue=6 | pages=530–32 | pmid=17169714 | url=https://archive.org/details/sim_american-journal-of-preventive-medicine_2006-12_31_6/page/530|doi=10.1016/j.amepre.2006.07.026 | volume=31 | author-separator=, | author2=Hoehner CM | author3=Brownson RC |display-authors=3 | last4=Cook | first4=R | last5=Orleans | first5=C | last6=Hollander | first6=M | last7=Barker |first7=D | last8=Bors | first8=P | last9=Ewing | first9=R}}</ref> Nchi nyingi pamoja na vikundi vimechapisha ripoti zinazohusu unene wa kupindukia. Mnamo mwaka wa 1998, miongozo ya kwanza ya serikali ya shirikisho ya Marekani ilichapishwa kwa jina "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report" (Mwongozo wa Kitabibu kuhusu Utambuzi, Utathmini na Matibabu ya Unene na Unene wa Kupindukia katika Watu Wazima).<ref>{{cite book |author=National Heart, Lung, and Blood Institute|title=Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults|publisher=International Medical Publishing, Inc |location=|year= 1998 |isbn=1-58808-002-1 |oclc=|url=http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf|format=PDF}}</ref> Mnamo mwaka wa 2006 [[Mfumo wa Unene wa Kupindukia wa Kanada]] ulichapisha "Canadian Clinical Practice Guidelines (CPG) on the Management and Prevention of Obesity in Adults and Children" [Taratibu za Kitabibu za Kanada zinazohusu Udhibiti na uzuiaji wa Unene wa Kupindukia kwa Watu Wazima na Watoto] Huu ni utaratibu wa kina unaozingatia ushahidi ili kushughulikia udhibiti na uzuiaji wa uzani wa kupita kiasi na unene wa kupindukia kwa watu wazima na watoto.<ref>{{cite journal |author=Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E |title=2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children summary |journal=CMAJ |volume=176 |issue=8|pages=S1–13 |year=2007 |month=April |pmid=17420481 |pmc=1839777|doi=10.1503/cmaj.061409 |url=http://www.cmaj.ca/cgi/content/full/176/8/S1}}</ref> Mnamo mwaka wa 2004 nchini Uingereza, [[Chuo cha Mafizishiani cha Royal]], [[Kitengo cha Afya ya Umma]] na [[Chuo cha Pediatria na Afya ya Watoto]] vilitoa ripoti, “Kuhifadhi Matatizo", iliyodokeza kuhusu kuongezeka kwa tatizo la unene wa kupindukia nchini Uingereza. <ref>{{cite book |title=Storing up problems; the medical case for a slimmer nation |date=2004-02-11|publisher=Royal College of Physicians |location= London|isbn=1-86016-200-2 |author=}}</ref> Mwaka huohuo, Kamati Teule ya Afya ya Bunge la Uingereza ilichapisha "uchunguzi wake wa kina zaidi [...] uliowahi kufanywa kuhusu athari ya unene wa kupindukia kwa afya na jamii nchini Uingereza na njia mwafaka zinazoweza kutumiwa katika kutatua tatizo hili.<ref name =GB2004>{{cite book |author=Great Britain Parliament House of Commons Health Committee |title=Obesity– Volume 1 – HCP 23-I, Third Report of session 2003–04. Report, together with formal minutes|url=http://www.publications.parliament.uk/pa/cm200304/cmselect/cmhealth/23/2302.htm|accessdate=2007-12-17|year=2004 |month=May|publisher=TSO (The Stationery Office)|location=London, UK|isbn=978-0-215-01737-6}}</ref> Mwaka wa 2006, [[Taasisi ya Kitaifa ya Afya na Ubora wa Kitabibu]] ilitoa utaratibu wa kutambua na kutibu unene wa kupindukia na vilevile athari za kisera kwa mashirika yasiyo ya kiafya kama vile mabaraza ya mitaa<ref>{{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG43NICEGuideline.pdf |title=Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children|publisher=[[National Health Services]] (NHS)|year= 2006|format=PDF |work=National Institute for Health and Clinical Excellence(NICE)|accessdate=April 8, 2009}}</ref> Ripoti iliyotolewa na Bwana [[Derek Wanless]] mwaka wa 2007 kwa [[Hazina ya Mfalme]] ilionya kuwa iwapo hatua zaidi hazitachukuliwa, unene wa kupindukia una uwezo wa kulemaza [[Huduma ya Afya ya Kitaifa]]kifedha.<ref>{{cite book |last=Wanless |first=Sir Derek |coauthors=John Appleby, Anthony Harrison, Darshan Patel|title=Our Future Health Secured? A review of NHS funding and performance|url=http://www.kingsfund.org.uk/research/publications/our_future.html|accessdate=2007-12-17 |year=2007 |publisher=The King's Fund|location=London, UK |isbn=1-85717-562-X}}</ref> Hatua za kina zinabuniwa ili kuthibiti viwango vinavyoongezeka vya unene wa kupindukia. Mfumo wa Sera ya Kukabiliana na Unene wa Kupindukia hugawanya hatua kwa sera za ‘juu’, sera za ‘katikati’ na sera za ‘chini’. Sera za ‘juu’ zinalenga kubadilisha jamii, sera za ‘kati’ hujaribu kubadilisha mienendo ya watutu ili kuzuia unene wa kupindukia nazo sera za ‘chini’ hujaribu kuwahudumia wale ambao tayari wameathirika.<ref>{{cite journal |author=Sacks G, Swinburn B, Lawrence M|title=Obesity Policy Action framework and analysis grids for a comprehensive policy approach to reducing obesity|journal=Obes Rev |volume=10 |issue=1 |pages=76–86 |year=2009 |month=January|pmid=18761640|doi=10.1111/j.1467-789X.2008.00524.x |url=}}</ref> ==Udhibiti== [[File:Obesity Med2008.JPG|thumb|alt=Kifurushi cha kadibodi kinachotumika kupakia aina mbili za dawa zinazotumika kutibu unene wa kupindukia. Orlistat imeonyeshwa hapo juu chini ya jina la chapa la Xenical kwa kifurushi cheupe kilicho na nembo ya Roche kwa kona hapo chini upande wa kulia (jina Roche lililo kwenye pembe sita). Sibutramine iko hapo chini, chini ya chapa Meridia. Kifurushi kina rangi nyeupe upande wa juu na samawati upande wa chini zilizotenganishwa na utepe wa kupima. Herufi A ya Abbott iko kwenye nusu ya chini ya kifurushi.|kulia|[[Orlistat]] (Xenical), tiba inayotumika sana katika kutibu unene wa kupindukia, na [[sibutramine]](Meridia) dawa iliyoondolewa hivi karibuni kutokana na athari zake kwa moyo]] Matibabu makuu ya unene wa kupindukia ni [[kudhibiti jinsi unavyokula]] and [[mazoezi ya mwili]].<ref name=CADG2006>{{cite journal|author=Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E |title=2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children summary |journal=CMAJ |volume=176 |issue=8|pages=S1–13 |year=2007 |month=April |pmid=17420481 |pmc=1839777 |doi=10.1503/cmaj.061409 |url=}}</ref>Mipango ya lishe inaweza kupelekea [[kupoteza uzito]]kwa kipindi cha muda mfupi<ref name=Strychar>{{cite journal |author=Strychar I |title=Diet in the management of weight loss |journal=CMAJ |volume=174 |issue=1 |pages=56–63 |year=2006 |month=January |pmid=16389240|pmc=1319349 |doi=10.1503/cmaj.045037 |url=http://www.cmaj.ca/cgi/content/full/174/1/56}}</ref> lakini kudumisha kiwango hiki cha kupoteza uzito mara nyingi huwa vigumu na hivyo huhitaji kudumisha mwenendo wa maisha ya mazoezi ya kimwili na kula chakula kilicho na kiwango cha chini cha nguvu.<ref>{{cite journal |author=Shick SM, Wing RR, Klem ML, McGuire MT, Hill JO, Seagle H|title=Persons successful at long-term weight loss and maintenance continue to consume a low-energy, low-fat diet|journal=J Am Diet Assoc |volume=98 |issue=4 |pages=408–13 |year=1998 |month=April |pmid=9550162|doi=10.1016/S0002-8223(98)00093-5}}</ref><ref>{{cite journal |author=Tate DF, Jeffery RW, Sherwood NE, Wing RR|title=Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? |journal=Am. J. Clin. Nutr. |volume=85 |issue=4 |pages=954–9|date=1 April 2007|pmid=17413092 |url=http://www.ajcn.org/cgi/content/full/85/4/954}}</ref>Kufanikiwa kudumisha kiwango cha kupoteza uzani na mabadiliko katika mienenbo ni chini mno kati ya asilimia 2 - asilimia 20.<ref>{{cite journal |author= Wing, Rena R; Phelan, Suzanne|title=Science-Based Solutions to Obesity: What are the Roles of Academia, Government, Industry, and Health Care? Proceedings of a symposium, Boston, Massachusetts, USA, 10–11 March 2004 and Anaheim, California, USA, 2 October 2004 |journal=Am. J. Clin. Nutr. |volume=82 |issue=1 Suppl |pages=207S–273S |date=1 July 2005|pmid=16002825|url=http://www.ajcn.org/cgi/content/full/82/1/222S }}</ref>Mabadiliko ya kilishe na kimienendo ni muhimu katika kudhibiti uongezaji wa kupita kiasi wa uzani katika [[ujauzito]] na kuboresha hali ya mama na mtoto.<ref>{{cite journal|last=Thangaratinam|first=S|coauthors=Rogozinska, E; Jolly, K; Glinkowski, S; Roseboom, T; Tomlinson, JW; Kunz, R; Mol, BW; Coomarasamy, A; Khan, KS|title=Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence|journal=BMJ (Clinical research ed.)|date=2012 May 16|volume=344|pages=e2088|pmid=22596383|pmc=3355191|doi=10.1136/bmj.e2088}}</ref> Aina moja ya dawa, [[Orlistat]] (Xenical), inapatikana kwa urahisi na imeidhinishwa kwa matumizi ya muda mrefu. Hata hivyo, kupoteza uzito ni jambo la kadri kwa wastani wa kilogramu 2.9 &nbsp;kg (6.4&nbsp;lb) kwa mwaka 1 hadi 4&nbsp;na kuna habari kidogo kuhusu jinsi dawa hizi zinavyoathiri matatizo ya muda mrefu ya unene wa kupindukia.<ref name=Orli07>{{cite journal |author=Rucker D, Padwal R, Li SK, Curioni C, Lau DC |title=Long term pharmacotherapy for obesity and overweight: updated meta-analysis |journal=BMJ|volume=335 |issue=7631 |pages=1194–99 |year=2007 |pmid=18006966 |doi=10.1136/bmj.39385.413113.25|url=http://www.bmj.com/cgi/content/full/335/7631/1194 |pmc=2128668}}</ref> Matumizi yake yanahusiana na viwango vya juu vya athari kwa utumbo <ref name=Orli07/> and concerns have been raised about negative effects on the kidneys.<ref>{{cite web|last=Wood|first=Shelley|title=Diet Drug Orlistat Linked to Kidney, Pancreas Injuries|url=http://www.medscape.com/viewarticle/740855?src=mp&spon=30|work=Medscape|publisher=Medscape News|accessdate=26 April 2011}}</ref> Aina zingine mbili za dawa pia zinapatikana [[Lorcaserin]](Belviq) hupelekea upotezaji wa uzito kwa wastani kilogramu 3.1&nbsp; (asilimia 3 ya uzani wa mwili) zaidi ya plasebo kwa muda wa mwaka mmoja.<ref>{{cite journal|last=Bays|first=HE|title=Lorcaserin: drug profile and illustrative model of the regulatory challenges of weight-loss drug development|journal=Expert review of cardiovascular therapy|date=2011 Mar|volume=9|issue=3|pages=265–77|pmid=21438803|doi=10.1586/erc.10.22}}</ref> Mchanganyiko wa [[Phentermine/topiramate|phentermine na topiramate]] (Qsymia) pia ni bora kwa kiwango fulani.<ref>{{cite journal|author=Bays HE, Gadde KM |title=Phentermine/topiramate for weight reduction and treatment of adverse metabolic consequences in obesity |journal=Drugs Today |volume=47 |issue=12 |pages=903–14 |year=2011 |month=December|pmid=22348915 |doi=10.1358/dot.2011.47.12.1718738 |url=}}</ref> Njia mwafaka zaidi ya kutibu unene wa kupindukia ni [[upasuaji wa kibariatriki]]. Upasuaji kwa mujibu wa unene mkali wa kupindukia unahusiana na upotezaji wa uzito kwa muda mrefu na upunguaji katika vifo kwa ujumla. Utafiti mmoja ulitambua upotezaji wa uzito wa kati wa asilimia 14 na 25 (kulingana na utaratibu uliofuatwa) kwa miaka 10&nbsp; na upunguaji wa asilimia 29 katika vifo vitokanavyo na unene huu ikilinganishwa na hatua za kawaida za upotezaji wa uzito.<ref>{{cite journal |author=Sjöström L |title=Effects of bariatric surgery on mortality in Swedish obese subjects |journal=N. Engl. J. Med. |volume=357 |issue=8 |pages=741–52 |year=2007 |month=August|pmid=17715408 |doi=10.1056/NEJMoa066254 |url=https://archive.org/details/sim_new-england-journal-of-medicine_2007-08-23_357_8/page/740|author-separator=, |author2=Narbro K |author3=Sjöström CD|display-authors=3 |last4=Karason |first4=Kristjan |last5=Larsson |first5=Bo |last6=Wedel |first6=Hans |last7=Lystig|first7=Ted |last8=Sullivan |first8=Marianne |last9=Bouchard |first9=Claude}}</ref> Hata hivyo, kutokana na gharama yake na hatari ya matatizo, watafiti wanatafuta tiba zingine mwafaka ilhali zisizo na madhara. {{clear}} ==Epidemiolojia== {{Double image|right|World map of Male Obesity, 2008.svg|200|World map of Female Obesity, 2008.svg|200|World obesity prevalence among males (left) and females (right).<ref name=IOTF2008>{{cite web|url=http://www.iotf.org/database/documents/GlobalPrevalenceofAdultObesity16thDecember08.pdf |title=Global Prevalence of Adult Obesity |format=PDF |work=[[International Obesity Taskforce]] |accessdate=January 29, 2008}}</ref> {{Multicol}} {{legend|#ffff65|<5%}} {{legend|#fff200|5–10%}} {{legend|#ffdc00|10–15%}} {{Multicol-break}} {{legend|#ffc600|15–20%}} {{legend|#ffb000|20–25%}} {{legend|#ff9a00|25–30%}} {{Multicol-break}} {{legend|#ff8400|30–35%}} {{legend|#ff6e00|35–40%}} {{legend|#ff5800|40–45%}} {{Multicol-break}} {{legend|#ff4200|45–50%}} {{legend|#ff2c00|50–55%}} {{legend|#cb0000|>55%}} {{Multicol-end}} |alt=A map of the world with countries colored to reflect the percentage of men who are obese. Obese males and females have higher prevalence (above 30%) in the U.S. and some Middle Eastern and Oceanian countries, medium prevalence in the rest of North America and Europe, and lower prevalence (<5%) in most of Asia and Africa.||}} Kabla ya [[karne ya 20]], unene wa kupindukia ulikuwa wa nadra;<ref name=Haslam2007/> in 1997 the WHO formally recognized obesity as a global epidemic.<ref name=Caballero/> As of 2005 the WHO estimates that at least 400&nbsp;million adults (9.8%) are obese, with higher rates among women than men.<ref name=WHO2009a>{{cite web|url=http://www.who.int/mediacentre/factsheets/fs311/en/index.html |title=Obesity and overweight |work=World Health Organization |accessdate=April 8, 2009}}</ref> Kiwango cha unene wa kupindukia pia huongezeka kulingana na umri kwa angalau kufikia umri wa miaka 50 au 60&nbsp; <ref>Seidell 2005 p.5</ref> na unene mkali wa kupindukia nchini Marekani, Australia, na Canada unaongezeka haraka kuliko kiwango cha jumla cha unene wa kupindukia.<ref name=morbid2007/><ref>{{cite journal |author=Howard, Natasha J.|title=Severe obesity: Investigating the socio-demographics within the extremes of body mass index |journal=Obesity Research &Clinical Practice |volume=2 |issue=1 |pages=51–59 |year=2008|month=March |pmid=|doi=10.1016/j.orcp.2008.01.001 |url= |first2=A |first3=T |first4=C |last2=Taylor |last3=Gill|last4=Chittleborough}}</ref><ref name=Tjepkema2005>{{cite book | author=Tjepkema M | chapter=Measured Obesity–Adult obesity in Canada: Measured height and weight | title=Nutrition: Findings from the Canadian Community Health Survey |publisher=Statistics Canada | date=2005-07-06 | location=Ottawa, Ontario |url=http://www.statcan.gc.ca/pub/82-620-m/2005001/article/adults-adultes/8060-eng.htm}}</ref> Ijapokuwa uliwahi kuchukuliwa kama tatizo la nchi zilizo na mapato ya juu pekee, viwango vya unene wa kupindukia vinaongezeka ulimwenguni kote na kudhuru nchi zilizostaw na aidha zinazostawi<ref name=EuroG2008>{{cite journal |author=Tsigosa Constantine |title=Management of Obesity in Adults: European Clinical Practice Guidelines |journal=The European Journal of Obesity |volume=1 |year=2008 |month=April |pmid=20054170 |doi=10.1159/000126822 |url=http://www.gojaznost.org/gs/dodatak/OMTFManagementofObesityinAdults2008.pdf |first2=Vojtech |issue=2 |first3=Arnaud |first4=Nick |first5=Martin |first6=Elisabeth |first7=Dragan |first8=Maximo |first9=Gabriela |pages=106–16 |last2=Hainer |last3=Basdevant |last4=Finer |last5=Fried |last6=Mathus-Vliegen |last7=Micic |last8=Maislos |last9=Roman |access-date=2013-11-28 |archive-date=2012-04-26 |archive-url=https://web.archive.org/web/20120426034913/http://www.gojaznost.org/gs/dodatak/OMTFManagementofObesityinAdults2008.pdf |dead-url=yes }}</ref>.Ongezeko hili limeonekana sana katika maeneo ya miji.<ref name=WHO2009a/> Sehemu inayobakia ulimwenguni ambayo unene wa kupindukia sio jambo la kawaida ni[[mataifa ya kusini mwa sahara]].<ref name=HaslamJames/> {{clear}} ==Historia== [[File:Charles Mellin zugeschr - Porträt eines Herrn - Gemäldegalerie Berlin.jpg|thumb|wima|alt=Mwanamume mwenye unene zaidi wa kupindukia aliye na kidevu chenye sehemu mbili, masharubu, na kuvalia nguo nyeusi huku akiwa na kitara kwenye upande wake wa kushoto.|Katika[[Enzi za Kati]] na[[kipindi cha mvuvumko]], mara nyingi unene wa kupindukia ulionekana kama ishara ya utajiri na ulikuwa umekithiri kwa tabaka aali: ''The Tuscan General [[Alessandro del Borro]]'', attributed to Charles Mellin, 1645<ref name=Zach2003>{{cite journal |author=Zachary Bloomgarden |title=Prevention of Obesity and Diabetes |journal=Diabetes Care |volume=26 |pages=3172–3178 |year=2003|pmid= 14578257|doi= 10.2337/diacare.26.11.3172|url=http://care.diabetesjournals.org/content/26/11/3172.full|issue=11}}</ref>]] [[File:Venus von Willendorf 01.jpg|thumb|wima|alt= Kisanamu kilichochongwa kutoka kwa jiwe kilionyesha mwanamke mwenye unene wa kupindukia.|''[[Venus of Willendorf]]'' kilichotengenezwa 24,000–22,000 BC]] [[Wagiriki]] ndio waliokuwa wa kwanza kutambua unene wa kupindukia kama tatizo la kiafya.<ref name=Haslam2007>{{cite journal|author=Haslam D |title=Obesity: a medical history |journal=Obes Rev |volume=8 Suppl 1 |issue= |pages=31–6 |year=2007|month=March |pmid=17316298 |doi=10.1111/j.1467-789X.2007.00314.x |url=}}</ref> [["Hippocrates]] aliandika kuwa "Unene wa kupindukia si ugonjwa kivyake tu, bali ni dalili ya magonjwa mengine".<ref name=HaslamJames/> Daktari Mhindi wa upasuaji [[Sushruta]] (karne ya 6 BCE) alihusisha unene wa kupindukia na kisukari na matatizo ya moyo.<ref name=Dwivedi&Dwivedi07/> He recommended physical work to help cure it and its side effects.<ref name=Dwivedi&Dwivedi07>{{cite web |url=http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |format=PDF |title=History of Medicine: Sushruta – the Clinician –Teacher par Excellence |accessdate=2008-09-19 |work=Dwivedi, Girish & Dwivedi, Shridhar |publisher= |year=2007 |archivedate=2008-10-10 |archiveurl=https://web.archive.org/web/20081010045900/http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |=https://web.archive.org/web/20081010045900/http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf }}</ref>Katika historia ya watu, wanadamu wamekumbwa sana na ukosefu wa chakula.<ref>{{cite book |author=Theodore Mazzone; Giamila Fantuzzi |title=Adipose Tissue And Adipokines in Health And Disease (Nutrition and Health) |publisher=Humana Press|location=Totowa, NJ |year=2006 |page=222 |isbn=1-58829-721-7 |oclc= |doi= |accessdate=}}</ref>Kwa hivyo, kihistoria, unene wa kupindukia umeonekana kama ishara ya utajiri na ustawi. Ulikuwa umekithiri kwa maafisa wakuu barani Uropa katika [[Enzi za Kati]] na [[Kipindi cha Mvuvumko]]<ref name=Zach2003/> as well as in Ancient East Asian civilizations.<ref>Keller p. 49</ref> Kwa kuwepo kwa mwanzo wa [[mvuvumko wa viwanda]], iligunduliwa kuwa uwezo wa kijeshi na kiuchumi wa mataifa ulitegemea ukubwa wa mwili na nguvu za wanajeshi na wafanyikazi.<ref name=Caballero/> Kuongeza wastani wa kielezo cha uzito wa mwili kutoka kile kinachofikiriwa kuwa uzito wa chini hadi kwa kile kilicho anuwai ya kawaida kulichangia pakubwa katika ustawi wa jamii zilizo na viwanda.<ref name=Caballero/> Kutokana na hayo, kimo na uzito viliongezeka katika karne ya 19&nbsp; katika nchi zilizostawi. Katika karne ya 20, watu walipofikia kikamilifu uwezo wao wa kijenetiki wa kimo, uzito ulianza kuongezeka sana zaidi ya kimo na kupelekea unene wa kupindukia.<ref name=Caballero/>Katika miaka ya 1950, kuongezeka kwa utajiri katika nchi zilizostawi kulipunguza vifo vya watoto. Hata hivyo, uzito ulipoongezeka, ugonjwa wa moyo na figo ulikithiri.<ref name=Caballero/><ref>{{cite journal | doi=10.2105/AJPH.42.9.1116 | author=Breslow L |title=Public Health Aspects of Weight Control | journal=Am J Public Health Nations Health | year=1952 | month=September| volume=42 | issue=9 | pages=1116–20 | pmid=12976585 | pmc=1526346}}</ref> Katika kipindi hiki, kampuni za bima ziligundua uhusiano kati ya uzito na matarajio ya muda wa kuishi na hivyo basi zikaongeza malipo ya bima kwa walio na unene wa kupindukia.<ref name=HaslamJames/> Tamaduni nyingi katika historia zimeona unene wa kupindukia kama ambayo inatokana na makosa ya kimienendo. Mwigizaji aliyekuwa na ''obesus'' au mafuta katika[[uigizaji wa Kigriki]] aliwakilisha ulafi na utani. Katika nyakati za Ukristo, chakula kilichukuliwa kama njia inayoelekeza kwenye dhambi za [[uzembe]]na[[tamaa]].<ref name=Woodhouse/> Katika tamaduni za kisasa za Ulaya na Marekani, unene wa kupita kiasi unachukuliwa kama jambo lisilovutia na unene wa kupindukia mara nyingi huhusishwa na mambo kadhaa mabaya yasiyo na uasili. Watu wa umri tofauti wanaweza kufedheheshwa na kulengwa na wadhalimu au kutengwa na wenzao. Unene wa kupindukia kwa mara nyingine ni sababu ya ubaguzi<ref name=Bias2001>{{cite journal |author=Puhl R, Brownell KD |title=Bias, discrimination, and obesity|journal=Obes. Res. |volume=9 |issue=12 |pages=788–805 |year=2001 |month=December |pmid=11743063|doi=10.1038/oby.2001.108 |url=}}</ref> Fahamu za umma katika jamii ya Ulaya na Marekani kuhusu uzito bora wa mwili zinatofautiana na zile zinazohusu uzito unaofikiriwa kuwa bora &nbsp;– na zote zimebadilika tangu mwanzo wa karne ya 20. Uzito unaochukuliwa kuwa bora umekuwa chini tangu miaka ya 1920. Marekani uliongezeka kwa asilimia 2 kutoka mwaka wa 1922 hadi 1999 ilhali wastani wa uzito wao ulipungua kwa asilimia 12.<ref>{{cite journal|author=Rubinstein S, Caballero B |title=Is Miss America an undernourished role model? |journal=JAMA |volume=283|issue=12 |page=1569 |year=2000 |pmid=10735392 |doi= 10.1001/jama.283.12.1569|url=https://archive.org/details/sim_jama_march-22-29-2000_283_12/page/1569}}</ref> Kwa upande mwingine, mitazamo ya watu kuhusu uzito bora imebadilika na kuchukua mkondo pinzani. Nchini Uingereza, uzito ambapo watu walijiona kuwa na uzito wa kupita kiasi ulikuwa juu kwa kiasi cha haja katika mwaka wa 2007 kuliko 1999.<ref name=John2008>{{cite journal|author=Johnson F, Cooke L, Croker H, Wardle J |title=Changing perceptions of weight in Great Britain: comparison of two population surveys |journal=BMJ |volume=337 |issue= |pages=a494 |year=2008 |pmid=18617488 |pmc=2500200 |doi= 10.1136/bmj.a494|url=http://www.bmj.com/cgi/content/full/337/jul10_1/a494}}</ref> Mabadiliko haya yanaaminika kusababishwa na viwango vinavyoongezeka vya uadiposi (unene), hali inayopelekekea ukubalifu wa mafuta ya ziada mwilini kama jambo la kawaida.<ref name=John2008/> Unene wa kupindukia ungali unachukuliwa kuwa ishara ya utajiri na ufanisi katika sehemu nyingi za [[Afrika]]. Hili limekuwa jambo la kawaida hasa tangu kuzuka kwa janga la [[VVU]]lilianza. <ref name=HaslamJames/> ==Sanaa== Sanaa ya kwanza ya uchongaji iliyoleta mfano wa mwili wa binadamu kati ya miaka 20,000 - 35,000 &nbsp; iliyopita ilionyesha wanawake walio na unene wa kupindukia. Baadhi ya watu huihusisha [[sanamu ya Zuhura]]na juhudi za kusisitiza uwezo wa kuzaa ilhali wengine huhisi kuwa wao husimamia “unene” kwa watu wa wakati huo.<ref name=Woodhouse/> Hata hivyo, unene wa kupindukia haupo katika sanaa ya Wagiriki na Waroma, yamkini kwa kudumisha ulimbwende wao kwa mujibu wa kiasi. Haya yaliendelea katika sehemu kubwa ya historia ya ukristo barani Uropa ambapo wale tu walio na mapato ya chini wakichukuliwa kuwa wenye unene wa kupindukia.<ref name=Woodhouse/> Katika [[Kipindi cha Mvuvumko]], baadhi ya watu katika tabaka la juu walianza kuuringia ukubwa wao jinsi inavyoonekana katika picha za Henry wa nane na Alessandro del Borro.<ref name=Woodhouse>{{cite journal |author=Woodhouse R |title=Obesity in art: A brief overview |journal=Front Horm Res |volume=36 |issue= |pages=271–86 |year=2008 |isbn=978-3-8055-8429-6|pmid=18230908 |doi=10.1159/000115370 |url=http://books.google.com/?id=nXRU4Ea1aMkC&pg=PA271&lpg=PA271&dq=Obesity+in+art:+a+brief+overview |series=Frontiers of Hormone Research}}</ref>[[Peter Paul Rubens|Rubens]] (1577–1640) alionyesha wanawake wenye miili mikubwa katika picha zake, ambapo anatoa neno [[Rubenesque]]. Hata hivyo, wanawake hawa bado walilidumisha umbo la shisha na uhusiano wake na uwezo wa kuzaa.<ref name=Fumento>{{cite book |author=Fumento, Michael |title=The Fat of the Land: Our Health Crisis and How Overweight Americans Can Help Themselves |url=https://archive.org/details/fatofland00mich |publisher=Penguin (Non-Classics) |year=1997|page=[https://archive.org/details/fatofland00mich/page/n153 126]|isbn=0-14-026144-3}}</ref> Katika karne ya 19 &nbsp; mitazamo kuhusu unene wa kupindukia ilibadilika katika nchi za Ulaya na Amerika. Baada ya karne kadhaa ambapo unene wa kupindukia ulihusiana na mali na hadhi ya kijamii katika jamii, wembamba ulianza kuonekana kama kipimo kifaacho.<ref name=Woodhouse/> ==Jamii na utamaduni== ===Athari za kiuchumi=== Pamoja na athari zake za kiafya, unene wa kupindukia husababisha matatizo mengi yakiwemo ugumu katika ajira <ref name="Puhl R. p.29">Puhl R., Henderson K., and Brownell K. 2005 p.29</ref><ref>{{cite journal |doi=10.1016/j.ehb.2009.01.008|author=Johansson E, Bockerman P, Kiiskinen U, Heliovaara M |title=Obesity and labour market success in Finland: The difference between having a high BMI and being fat |journal=Economics and Human Biology |volume=7 |issue=1 |pages=36–45|year=2009 |pmid=19249259}}</ref> na gharama za juu za biashara. Athari hizi zinazikumba sekta zote za jamii kutoka kwa watu binafsi, hadi kwa mashirika, na hadi kwa serikali. Katika mwaka wa 2005, gharama za kimatibabu zinazoweza kuhusishwa na unene wa kupindukia nchini Marekani zilikuwa takribani dola bilioni &nbsp;190.2 &nbsp; au asilimia 20.6 ya gharama zote za kimatibabu,<ref name=medical-costs>{{cite journal|coauthors=John Cawley, Chad Meyerhoefer|title=The medical care costs of obesity: An instrumental variables approach|journal=Journal of Health Economics|year=2012|month=January|volume=31|issue=1|pages=219–230|url=http://www.sciencedirect.com/science/article/pii/S0167629611001366|accessdate=2 August 2012|doi=10.1016/j.jhealeco.2011.10.003|pmid=22094013|last1=Cawley|first1=J}}</ref> <ref>{{cite journal|author=Finkelstein EA, Fiebelkorn IA, Wang G |title=National medical spending attributable to overweight and obesity: How much, and who's paying |journal= Health Affairs|volume=Online |issue=May |pages=|date=1 January 2003|url=http://content.healthaffairs.org/cgi/content/full/hlthaff.w3.219v1/DC1 }}</ref><ref>{{cite web|url=http://www.cdc.gov/nccdphp/dnpa/obesity/economic_consequences.htm |title=Obesity and overweight: Economic consequences | publisher=[[Centers for Disease Control and Prevention]] | date=22 May 2007 |accessdate=2007-09-05}}</ref> while the cost of obesity in Canada was estimated at CA$2 billion in 1997 (2.4% of total health costs).<ref name="CADG2006"/> Jumla ya gharama ya unene wa kupindukia nchini Kanada ilikuwa imekadiriwa kuwa dola bilioni 2 za Australia katika mwaka wa 2005. Waustralia walio na uzito wa kupita kiasi na wanene kupindukia pia walipokea dola za Australia bilioni 35.6 kama ruzuku kutoka kwa serikali.<ref name=MJA2009>{{Rejea jarida|title=The cost of overweight and obesity in Australia|url=http://www.mja.com.au/public/issues/192_05_010310/col10841_fm.html|year=2009|author=Colagiuri, Stephen|journal=The Medical Journal of Australia|accessdate=2011-06-18|last2=Lee|first2=Crystal M. Y.|last3=Colagiuri|first3=Ruth|display-authors=4|author5=<Please add first missing authors to populate metadata.>}}</ref> Kadiri ya gharama ya bidhaa za lishe imekadiriwa kuwa kati ya dola bilioni 40&nbsp; hadi dola bilioni 100&nbsp&nbsp; nchini Marekani pekee.<ref>{{cite news | last = Cummings | first = Laura|title = The diet business: Banking on failure|publisher = BBC News| date = 5 February 2003| url = http://news.bbc.co.uk/2/hi/business/2725943.stm| accessdate = 25 February 2009}}</ref> Miradi ya kuzuia unene wa kupindukia imezinduliwa ili kupunguza gharama ya kutibu magonjwa yanayohusiana na unene huu. Hata hivyo, jinsi watu wanavyoendelea kuishi ndivyo wanavyogharamika zaidi. Kwa hivyo, watafiti huafiki kuwa kupunguza unene wa kupindukia kunaweza kuidumisha afya ya umma lakini huenda isipunguze gharama ya jumla ya afya..<ref>{{cite journal |author=van Baal PH |title=Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure |journal=PLoS Med. |volume=5 |issue=2 |pages=e29 |year=2008 |month=February |pmid=18254654 |pmc=2225430 |doi=10.1371/journal.pmed.0050029 |url=http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050029 |author-separator=, |author2=Polder JJ |author3=de Wit GA |display-authors=3 |last4=Hoogenveen |first4=Rudolf T. |last5=Feenstra |first5=Talitha L. |last6=Boshuizen |first6=Hendriek C. |last7=Engelfriet |first7=Peter M. |last8=Brouwer |first8=Werner B. F. |access-date=2013-11-28 |archive-date=2015-01-11 |archive-url=https://web.archive.org/web/20150111110729/http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050029 |url-status=dead }}</ref> [[File:Wide Chair.jpg|thumb|kushoto|alt= Kiti cha ziada kipana kando ya viti kadhaa vyenye ukubwa wa kawaida.|Ni sharti huduma ziwazingatie watu walio na unene wa kupindukia kwa vifaa maalumu kama vile viti vipana.<ref>{{cite journal|author=Bakewell J|title=Bariatric furniture: Considerations for use|journal=Int J Ther Rehabil|issue=7|pages=329–33|year=2007|url=http://www.ijtr.co.uk/cgi-bin/go.pl/library/article.cgi?uid=23858;article=IJTR_14_7_329_333|volume=14|access-date=2013-11-28|archive-date=2011-10-08|archive-url=https://web.archive.org/web/20111008202913/http://www.ijtr.co.uk/cgi-bin/go.pl/library/article.cgi?uid=23858;article=IJTR_14_7_329_333|dead-url=yes}}</ref>]] Unene wa kupindukia unaweza kusababisha fedheha ya kijamii na ugumu katika ajira.<ref name="Puhl R. p.29"/> Wakilinganishwa na wenzao walio na uzito wa kawaida, wafanyikazi walio na unene wa kupindukia kwa wastani wana viwango vya juu vya kutokuwa kazini kwao na huchukua likizo ya udhaifu mara kwa mara na kupelekea kuongezeka kwa gharama upande wa waajiri na kupunguka kwa tija.<ref>{{cite journal|author=Neovius K, Johansson K, Kark M, Neovius M|title=Obesity status and sick leave: a systematic review |journal=Obes Rev |volume=10|issue=1 |pages=17–27 |year=2009|month=January |pmid=18778315 |doi=10.1111/j.1467-789X.2008.00521.x |url=}}</ref> Utafiti wa kuwachunguza wafanyikazi wa chuo kikuu cha Duke ulionyesha kuwa watu walio na kielezo cha uzito wa mwili zaidi ya 40 walijiandikisha kufidiwa katika [[fidia ya wafanyikazi]] mara mbili zaidi ya wale ambao kielezo chao cha uzito wa mwili kilikuwa 18.5-24.9. Pia siku zao za kutofika kazini kwao zilikuwa zaidi ya mara 12&nbsp; ikilinganishwa na wenzao wasio na kielezo cha juu cha uzito wa mwili. Majeraha ya mara kwa mara katika kikundi hiki yalitokana na kuanguka na kunyanyuka hivyo ikiathiri miguu, vifundo vya mikono au mikono, na migongo.<ref>{{cite journal |author=Ostbye T, Dement JM, Krause KM|title=Obesity and workers' compensation: Results from the Duke Health and Safety Surveillance System |journal=Arch. Intern. Med. |volume=167 |issue=8|pages=766–73|year=2007 |pmid=17452538 |doi=10.1001/archinte.167.8.766}}</ref> Bodi ya Bima ya Wafanyikazi katika Jimbo la Alabama nchini Marekani iliidhinisha mpango tata wa kuwatoza wafanyikazi walio na unene wa kupindukia dola 25 kila mwezi iwapo hawachukui hatua za kuupunguza uzito wao na kudumisha afya yao. Hatua hizi zilianza Januari 2010 na zinalenga wale walio na Kielezo cha Uzito wa Mwili cha zaidi ya kilo 35 &nbsp;kwa kila mita ² wanaokosa kuboresha afya yao baada ya mwaka mmoja.<ref>{{cite web|url=http://www.webmd.com/diet/news/20080825/alabama-obesity-penalty-stirs-debate |title=Alabama "Obesity Penalty" Stirs Debate |work=Don Fernandez |accessdate=April 5, 2009}}</ref> Utafiti fulani umeonyesha kuwa watu walio na unene wa kupindukia wana uwezekano mdogo wa kuajiriwa na pia wana uwezekano mdogo wa kupandishwa cheo.<ref name=Bias2001/> Watu hawa pia hulipwa mshahara wa chini kuliko wenzao wasio na unene huu wa kupindukia kwa kazi sawa. Wanawake na wanaume walio na unene wa kupindukia kwa wastani hupata asilimia 6 na 3 chini mtawalia.<ref>Puhl R., Henderson K., and Brownell K. 2005 p.30</ref> Nyanja mahususi kama vile shirika la ndege, afya na nyanja za vyakula, zina matatizo maalumu. Kutokana na viwango vinavyoongezeka vya unene wa kupindukia, mashirika ya ndege yanakumbwa na gharama ya juu ya mafuta na shinikizo la kuongeza upana wa viti.<ref>{{cite web | author=Lisa DiCarlo| url=http://www.forbes.com/2002/10/24/cx_ld_1024obese.html |title=Why Airlines Can't Cut The Fat|work=Forbes.com|date=2002-10-24 | accessdate=2008-07-23}}</ref> Katika mwaka wa 2000, uzito wa ziada wa abiria wenye unene wa kupindukia uliyagharimu mashirika ya ndege dola za Marekani milioni 275&nbsp;.<ref>{{cite journal|author=Dannenberg AL, Burton DC, Jackson RJ |title=Economic and environmental costs of obesity: The impact on airlines |url=https://archive.org/details/sim_american-journal-of-preventive-medicine_2004-10_27_3/page/264 |journal=American journal of preventive medicine|volume=27 |issue=3 |page=264|year=2004 |pmid=15450642 |doi=10.1016/j.amepre.2004.06.004}}</ref> Ulimwengu wa afya umelazimika kuwekeza katika vifaa maalumu vya kuwashughulikia wagonjwa walio na unene zaidi wa kupindukia vikiwemo vifaa maalumu vya kunyanyua na [[ambyulensi ya kibariatriki]]s.<ref>{{cite web|url=http://abcnews.go.com/Health/Diet/obese-health-care-bariatric-ambulances/story?id=7981746|title=Who Should Pay for Obese Health Care?|author=Lauren Cox|publisher=ABC News|date=July 2, 2009|accessdate=2012-08-06}}</ref>Gharama za hoteli zimeongezwa na mahakama kwa shutma za kusababisha unene wa kupindukia.<ref name=Govtrack>{{cite web | url=http://www.govtrack.us/congress/bill.xpd?bill=h109-554 | title=109th U.S. Congress (2005–2006) H.R. 554: 109th U.S. Congress (2005–2006) H.R. 554: Personal Responsibility in Food Consumption Act of 2005 | publisher=GovTrack.us | accessdate=2008-07-24 | archivedate=2008-11-01 | archiveurl=https://web.archive.org/web/20081101192335/http://www.govtrack.us/congress/bill.xpd?bill=h109-554 }}</ref> Mnamo mwaka wa 2005, bunge la Marekani lilijadili utungaji sheria ya kuzuia kesi za raia dhidi ya sekta ya vyakula kwa mujibu wa unene wa kupindukia; hata hivyo, haikufanikiwa kuwa sheria..<ref name=Govtrack/> ===Ukubalifu wa ukubwa=== [[File:PresidentTaftTelephoneCrop.jpg|thumb|150px|kulia|kulia|Rais wa Marekani [[William Howard Taft]] alidhihakiwa mara nyingi kwa kuwa na uzito wa kupita kiasi]] Lengo kuu la vuguvugu la ukubalifu wa unene ni kupunguza ubaguzi dhidi ya watu walio na unene na uzito wa kupindukia.<ref>{{cite web |url=http://www.capitalnaafa.org/whatisnaafa.html |title=What is NAAFA |work=[[National Association to Advance Fat Acceptance]] |accessdate=February 17, 2009 |archivedate=2009-03-12 |archiveurl=https://web.archive.org/web/20090312001218/http://www.capitalnaafa.org/whatisnaafa.html }}</ref><ref>{{cite web |url=http://www.size-acceptance.org/mission.html |title=ISAA Mission Statement |work=[[International Size Acceptance Association]] |accessdate=February 17, 2009 |archive-date=2009-02-25 |archive-url=https://web.archive.org/web/20090225005852/http://www.size-acceptance.org/mission.html |url-status=dead }}</ref> Hata hivyo, wengine katika vuguvugu hilo pia wanajaribu kupinga uhusiano uliothibitishwa kati ya unene wa kupindukia na athari mbaya za kiafya.<ref name=Pulver2007>{{cite book |author=Pulver, Adam |title=An Imperfect Fit: Obesity, Public Health, and Disability Anti-Discrimination Law |publisher=Social Science Electronic Publishing |location= |year=2007 |pages= |isbn= |oclc= |doi= |url=http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1316106|accessdate=January 13, 2009}}</ref> Kunayo mashirika kadhaa yanayoendeleza ukubalifu wa unene wa kupindukia. Umaarufu wa mashirika haya umeongezeka katika nusu ya hivi karibuni ya karne ya 20 &nbsp;.<ref>{{cite journal |author=Neumark-Sztainer D |title=The weight dilemma: a range of philosophical perspectives |journal=Int. J. Obes. Relat. Metab. Disord. |volume=23 Suppl 2 |issue= |pages=S31–7|year=1999 |month=March |pmid=10340803 |doi= 10.1038/sj.ijo.0800857|url=}}</ref>Shirika la Kitaifa la Kuendeleza Ukubalifu wa Unene]] nchini Marekani [[lilianzishwa mwaka wa 1969 na hujieleza kama shirika la haki za raia linalolenga kukomesha ubaguzi wa ukubwa.<ref>{{cite | author=National Association to Advance Fat Acceptance | url=http://www.naafaonline.com/dev2/ | title=We come in all sizes | publisher=NAAFA | year=2008 | accessdate=2008-07-29 | archivedate=2018-12-26 | archiveurl=https://web.archive.org/web/20181226125112/https://www.naafaonline.com/dev2/%20 }}</ref> Hata hivyo, uhamasishaji juu ya unene umebaki harakati za pembeni.<ref>[http://www.bitchmagazine.org/article/big-trouble Big Trouble | Bitch Magazine<!--Bot-generated title-->] {{Wayback|url=http://www.bitchmagazine.org/article/big-trouble |date=20121226160246 }}, bitchmagazine.org</ref> [[Shirika la Kimataifa la Ukubalifu wa Ukubwa]]ni [[shirika lisilo la kiserikali]] lililoanzishwa mnamo mwaka wa 1997. Shirika hili ni la kimataifa na hueleza lengo lake kama kuendeleza ukubalifu wa ukubwa na kusaidia kukomesha ubaguzi kwa misingi ya uzito.<ref>{{cite web |url=http://www.size-acceptance.org/ |title=International Size Acceptance Association – ISAA |work=International Size Acceptance Association |accessdate=January 13, 2009 |archive-date=2009-01-05 |archive-url=https://web.archive.org/web/20090105165710/http://size-acceptance.org/ |url-status=dead }}</ref> Vikundi hivi mara nyingi hupigania kutambulika kwa unene wa kupindukia kama ulemavu chini ya [[Sheria ya Wamarekani Walio na Ulemavu]] Hata hivyo, mfumo wa kisheria wa Marekani umeamua kuwa gharama zitakazokuwa za afya ya umma zinazidi faida za kueindeleza sheria hii ya dhidi ya ubaguzi kujumlisha unene wa kupindukia.<ref name=Pulver2007/> ==Unene wa utotoni== Kielezo cha Uzito wa Mwili mwafaka hutofautiana kulingana na umri na jinsia ya mtoto. Unene katika watoto na vijana huelezwa kama Kielezo cha Uzito wa Mwili cha zaidi ya &nbsp;[[asilimia]].<ref name="cdc.gov"/>95. Data ya marejeo yenye ndio mzingi wa asilimia hizi ni kutoka 1963 hadi 1994 na hivyo haijaathiriwa na ongezeko la kiwango cha unene cha hivi karibuni.<ref name="Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL 2001 1086–93"/> Unene wa utotoni umefika kiwango cha mlipuko katika karne ya 21 &nbsp;, kukiwa na ongezeko la kiwango katika nchi zimeendelea na zinazoendelea. Kima cha unene kwa wavulana chini Kanada imeongezeka kutoka 11% miaka ya 1980s hadi zaidi ya 30% miaka ya 1990, bali kwa kipindi cha muda huu kiwango kiliongezeka kutoka 4 hadi 14% katika watoto wa Brazili.<ref name=flynn2006/> Kama ilivyo na unene katika watu wazima, hali nyingi tofauti huchangia kwa viwango vingi ongezeko la unene utotoni. Ubadilishaji wa lishe na upungufu wa mazoezi ya mwili huaminika kuwa ndizo visababishi viwili vya hivi karibu muhimu zaidi vya ongezeko la viwango.<ref>{{cite journal |author=Dollman J, Norton K, Norton L |title=Evidence for secular trends in children's physical activity behaviour |journal=Br J Sports Med |volume=39 |issue=12 |pages=892–7; discussion 897 |year=2005|month=December |pmid=16306494 |pmc=1725088 |doi=10.1136/bjsm.2004.016675 |url=https://archive.org/details/sim_british-journal-of-sports-medicine_2005-12_39_12/page/892}}</ref> Kwa sababu unene wa utotoni huendelea hadi wakati wa utu uzima na unahusishwa na magonjwa mengi yanayodumu, watoto walio wanene mara nyingi huchunguzwa[[shinikizo la juu la damu]], [[Ugonjwa wa kisukari]], [[hipalipidimia]], na [[ini yenye mafuta]].<ref name=CADG2006/> Matibabu yanayotumika kwa watoto hasa ni hatua ya hali ya maisha na mbinu za mwenendo, hata hivyo bidii za kuongezea mazoezi kwa watoto zimekuwa na mafanikio madogo.<ref>{{cite journal|last=Metcalf|first=B.|coauthors=Henley, W.; Wilkin, T.|title=Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54)|journal=BMJ|date=27 September 2012|volume=345|issue=sep27 1|pages=e5888–e5888|doi=10.1136/bmj.e5888}}</ref>Nchini Marekani, dawa hazikubaliwi na Muungano wa Chakula na Dawa kutumika katika kikundi hiki cha umri.<ref name=flynn2006>{{cite journal |author=Flynn MA |title=Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with 'best practice' recommendations|journal=Obes Rev |volume=7 Suppl 1 |issue= |pages=7–66 |year=2006 |month=February |pmid=16371076|doi=10.1111/j.1467-789X.2006.00242.x |url= |author-separator=, |author2=McNeil DA |author3=Maloff B |display-authors=3|last4=Mutasingwa |first4=D. |last5=Wu |first5=M. |last6=Ford |first6=C. |last7=Tough |first7=S. C.}}</ref> ==Katika wanyama== Unono katika [[mifugo]] ni jambo la kawaida katika nchi nyingi. Kiwango cha unono uliozidi katika mbwa kule Marekani ni kutoka 23% hadi 41%, 5.1% yao wakiwa ni wanono.<ref name=Lund2006>{{cite journal|author=Lund Elizabeth M.|title=Prevalence and Risk Factors for Obesity in Adult Dogs from Private US Veterinary Practices|journal=Intern J Appl Res Vet Med|volume=4|issue=2|pages=177–86|year=2006|pmid= |doi= |url=http://www.jarvm.com/articles/Vol4Iss2/Lund.pdf}}</ref>Rates of obesity in cats was slightly higher at 6.4%.<ref name= Lund2006/>Nchini Australia kiwango cha unene wa kupindukia katika mbwa kwa muktadha wa utabibu wa mifugo imepatikana kuwa 7.6%.<ref>{{cite journal |author=McGreevy PD, Thomson PC, Pride C, Fawcett A, Grassi T, Jones B|title=Prevalence of obesity in dogs examined by Australian veterinary practices and the risk factors involved|journal=Vet. Rec.|volume=156|issue=22|pages=695–702|year=2005|month=May |pmid=15923551|doi= |url=}}</ref> Hatari za unono kwa mbwa inahusiana na unene wa wamiliki; hata hivyo, hakuna uhusiano kama huo baina ya [[paka]] na wamiliki.<ref>{{cite journal |author=Nijland ML, Stam F, Seidell JC|title= Overweight in dogs, but not in cats, is related to overweight in their owners|journal=Public Health Nutr|volume=13|issue= 1|pages= 1–5|year=2009|month=June|pmid=19545467|doi=10.1017/S136898000999022X|url= }}</ref> ==Tazama pia== *[[Jon Brower Minnoch]] *[[Manuel Uribe]] *[[Mayra Rosales]] *[[Walter Hudson]] ==Tanbihi== {{Reflist|30em}} ==Marejeo== {{Refbegin|30em}} * {{cite journal | doi = 10.1079/BJN2002739 | last1 = Bhargava | first1 = Alok | last2 = Guthrie | first2 = J. | year = 2002 | title = Unhealthy eating habits, physical exercise and macronutrient intakes are predictors of anthropometric indicators in the Women's Health Trial: Feasibility Study in Minority Populations | url = https://archive.org/details/sim_british-journal-of-nutrition_2002-12_88_6/page/719 | journal = British Journal of Nutrition | volume = 88 | issue = 6 | pages = 719–728 | pmid = 12493094 }} * {{cite journal | last1 = Bhargava | first1 = Alok | year = 2006 | title = Fiber intakes and anthropometric measures are predictors of circulating hormone, triglyceride, and cholesterol concentration in the Women's Health Trial | url = https://archive.org/details/sim_journal-of-nutrition_2006-08_136_8/page/2249 | journal = Journal of Nutrition | volume = 136 | issue = 8 | pages = 2249–2254 | pmid = 16857849 }} * Jebb S. and Wells J. Measuring body composition in adults and children In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/12 12]–28|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}} * Kopelman P., Caterson I. An overview of obesity management In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/319 319]–326|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}} * {{cite book |author=[[National Heart, Lung, and Blood Institute]] (NHLBI) |title=Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults |publisher=International Medical Publishing, Inc |location= |year=1998 |pages= |isbn=1-58808-002-1 |oclc= |url=http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf |format=PDF }} * {{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG43NICEGuideline.pdf|title=Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children|publisher=[[National Health Services]] (NHS)|year=2006|format=PDF|work=[[National Institute for Health and Clinical Excellence]](NICE)|accessdate=April 8, 2009}} * Puhl R., Henderson K., and Brownell K. Social consequences of obesity In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/29 29]–45|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}} * Seidell JC. Epidemiology — definition and classification of obesity In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/3 3]–11|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}} * {{cite book | author=[[World Health Organization]] (WHO) | title=Technical report series 894: Obesity: Preventing and managing the global epidemic. | location=Geneva | publisher=World Health Organization | year=2000 | url=http://whqlibdoc.who.int/trs/WHO_TRS_894_(part1).pdf | format=PDF | isbn=92-4-120894-5 | access-date=2013-11-28 | archive-date=2015-05-01 | archive-url=https://web.archive.org/web/20150501075305/http://whqlibdoc.who.int/trs/WHO_TRS_894_(part1).pdf | dead-url=yes }} {{Refend}} ==Marejeo mengine== {{Refbegin}} * {{dmoz|Health/Conditions_and_Diseases/Nutritional_and_Metabolic_Disorders/Obesity/}} * {{cite book |author=Fumento, Michael | authorlink=Michael Fumento | title=The Fat of the Land: Our Health Crises and How Overweight Americans can Help Themselves |url=https://archive.org/details/fatoflandourheal0000mich |publisher=Penguin Books |location=New York |year=1997|isbn=0-14-026144-3}} * {{cite book |author=Keller, Kathleen |title=Encyclopedia of Obesity |publisher=Sage Publications, Inc|location=Thousand Oaks, Calif |year=2008 |isbn=1-4129-5238-7 |oclc= |url=http://books.google.com/?id=aRp2rJrEqZsC&dq=IOTF+obesity+map|doi= |accessdate=}} * {{cite book |author=Kolata, Gina | authorlink=Gina Kolata |title=Rethinking Thin: The new science of weight loss –and the myths and realities of dieting |url=https://archive.org/details/rethinkingthinne0000kola_i1w5 |publisher=Picador |location= |year=2007 |pages= |isbn=0-312-42785-9}} * {{cite book|author=Kopelman, Peter G.|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location= |year=2005|page=493 |isbn=1-4051-1672-2|url=http://books.google.com/?id=u7RvldSr5M0C&pg=PA87&dq=80+percent+of+the+offspring+of+two+obese+parents+become+obese}} * {{cite book |author=Levy-Navarro, Elena |title=The Culture of Obesity in Early and Late Modernity |url=https://archive.org/details/cultureofobesity0000levy |publisher=Palgrave Macmillan |location= |year=2008 |pages= |isbn=0-230-60123-5}} * {{cite book |author=Pool, Robert |title=Fat: Fighting the Obesity Epidemic |url=https://archive.org/details/fatfightingobesi00pool |publisher=[[Oxford University Press]]|location=Oxford, UK |year=2001 |pages= |isbn=0-19-511853-7}} {{Refend}} == Viungo vya nje == {{commonscat|Obesity}} {{Sister project links|display=Obesity}} * [http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-Obesity.pdf Unene ni nini] {{Wayback|url=http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-Obesity.pdf |date=20090331130222 }} * [http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-ChildhoodObesity.pdf Unene utotoni] {{Wayback|url=http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-ChildhoodObesity.pdf |date=20090331130208 }} * [https://dmoztools.net/Health/Conditions_and_Diseases/Nutritional_and_Metabolic_Disorders/Obesity/ Unene kwenye tovuti ya DMOZ] {{Wayback|url=https://dmoztools.net/Health/Conditions_and_Diseases/Nutritional_and_Metabolic_Disorders/Obesity/ |date=20171112194539 }} [[Jamii:Afya]] [[Jamii:Magonjwa]] [[Jamii:Chakula]] gdj481u72o1kuikgfpnxojgokexumm2 0 69852 1578193 1517159 2026-07-03T02:23:45Z InternetArchiveBot 41439 Add 6 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578193 wikitext text/x-wiki {{Infobox disease |Name = Migraine |Image = Migraine.jpg |Caption = Maumivu ya kipandauso yanaweza kumfanya mtu asiweze kutenda kazi yoyote. |DiseasesDB = 8207 <!-- note that the formatting in this parameter and in DiseasesDB_mult is done as such to allow the word "Migraine" to appear next to the first entry! --> |DiseasesDB_mult = (Migraine)<br />{{DiseasesDB2|31876}} ([[Basilar]])<br />{{DiseasesDB2|4693}} ([[Familial hemiplegic migraine|FHM]]) |ICD9 = {{ICD9|346}} |ICD10 = {{ICD10|G|43||g|40}} |OMIM = 157300 |MedlinePlus = 000709 |eMedicineSubj = neuro |eMedicineTopic = 218 |eMedicine_mult = {{eMedicine2|neuro|517}} {{eMedicine2|emerg|230}} {{eMedicine2|neuro|529}} |MeshID = D008881 |}} '''Kipandauso''' ni tatizo linalotambulika kwa [[maumivu ya kichwa]] yanayojirudia tena makali hadi kiasi cha kupindukia na ambayo wakati mwingi huambatana na [[dalili]] nyingi za [[mfumo wa neva]]. [[Jina]] la [[Kiingereza]] "Migraine" limetoka katika [[neno]] la [[Kigiriki]] ἡμικρανία (''hemikrania''), "uchungu kwa upande mmoja wa kichwa",<ref>{{cite web |first1=Henry George |last1=Liddell |first2=Robert |last2=Scott |title=ἡμικρανία |date= |work=A Greek-English Lexicon |publisher= |url=http://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Dh%28mikrani%2Fa}} on Perseus</ref> kutoka ἡμι- (''hemi-''), "nusu", na κρανίον (''kranion''), "[[fuvu la kichwa]]".<ref>{{cite book |first1=Kenneth |last1=Anderson |first2=Lois E. |last2=Anderson |first3=Walter D. |last3=Glanze |title=Mosby's Medical, Nursing, and Allied Health Dictionary |year=1994 |publisher=Mosby |isbn=978-0-8151-6111-0 |page=998 |edition=4th}}</ref> <!--Ishara na dalili --> Kwa kawaida, [[maumivu]] hayo huathiri sehemu moja ya [[kichwa]], huku kikidunda kwa [[muda]] wa [[saa]] 2 hadi 72. Dalili zinazohusiana na hali hii ni pamoja na [[kichefuchefu]], [[kutapika]], [[fotofobia]], [[haiparakusisi|fonofobia]] (ongezeko la usikivu dhidi ya sauti) na [[uchungu]] wake kwa kawaida huzidishwa na shughuli za kimwili.<ref name=ICHD2004>{{Rejea jarida|title=The International Classification of Headache Disorders: 2nd edition |journal=Cephalalgia |volume=24 |issue=Suppl 1 |pages=9–160 |year=2004 |pmid=14979299 |doi=10.1111/j.1468-2982.2004.00653.x |author1= Headache Classification Subcommittee of the International Headache Society}} [http://www.i-h-s.org/upload/ct_clas/ihc_II_main_no_print.pdf as PDF] {{Wayback|url=http://www.i-h-s.org/upload/ct_clas/ihc_II_main_no_print.pdf |date=20100331095113 }}</ref> Hadi [[thuluthi]] moja ya watu wenye [[ugonjwa]] wa kipandauso kinachoandamana na maumivu ya kichwa hupata [[Aura (dalili)|aura]]: ishara bandia ya matatizo ya [[macho]], [[hisia]], [[lugha]] au mwendo inayoashiria kuwa maumivu ya kichwa yatatokea punde.<ref name=ICHD2004/> <!--Kisababishi na utaratibu wa ugonjwa --> Kipandauso huaminika kutokea kufuatia mchanganyiko wa masuala ya [[Mazingira|kimazingira]] na [[jenetikia|kijeni]].<ref name=Lulli2007>{{cite journal|last=Piane|first=M|coauthors=Lulli, P; Farinelli, I; Simeoni, S; De Filippis, S; Patacchioli, FR; Martelletti, P|title=Genetics of migraine and pharmacogenomics: some considerations.|journal=The journal of headache and pain|date=2007 Dec|volume=8|issue=6|pages=334–9|pmid=18058067}}</ref>Thuluthi [[mbili]] za kesi hizo zinahusika na [[familia]].<ref name=Bart10/> Kiwango cha [[homoni]] kinachoshuka na kupanda pia kinaweza kuwa kisababishi cha ugonjwa huu: kipandauso huathiri [[wavulana]] kwa kiwango cha juu kidogo kuliko [[wasichana]] kabla ya [[kubalehe]], ingawa kinawaathiri [[wanawake]] mara [[mbili]] hadi [[tatu]] kuliko [[wanaume]],<ref name=Broner2009/><ref name=Stovner2007>{{Rejea jarida|author=Stovner LJ, Zwart JA, Hagen K, Terwindt GM, Pascual J |title=Epidemiology of headache in Europe |journal=European Journal of Neurology |volume=13 |issue=4 |pages=333–45 |year=2006 |month=April |pmid=16643310 |doi=10.1111/j.1468-1331.2006.01184.x}}</ref> ila [[ujauzito]] unakipunguza.<ref name=Broner2009>{{Rejea jarida|author=Lay CL, Broner SW|title=Migraine in women |journal=Neurologic Clinics |volume=27 |issue=2 |pages=503–11 |year=2009|month=May |pmid=19289228 |doi=10.1016/j.ncl.2009.01.002}}</ref> Utaratibu wa ugonjwa huu haujatambulika. Hata hivyo, hali hii inaaminika kuwa tatizo la [[mfumo wa neva]].<ref name=Bart10/> [[Nadharia]] ya msingi inahusiana na kuongezeka kwa [[uchangamfu]] wa [[koteksi ya serebramu]] na udhibiti usio wa kawaida wa maumivu ya [[nyuroni]] kwa [[kiiniseli cha trijemia]] cha [[mfumo wa ubongo]].<ref>{{cite journal |author=Dodick DW, Gargus JJ |title=Why migraines strike |journal=Sci. Am. |volume=299 |issue=2 |pages=56–63 |year=2008 |month=August |pmid=18666680 |url=http://www.scientificamerican.com/article.cfm?id=why-migraines-strike |bibcode=2008SciAm.299b..56D |doi=10.1038/scientificamerican0808-56}}</ref> <!--Udhibiti na epidemolojia --> [[Matibabu]] ya kwanza yanayopendekezwa ni [[dawa za kuondoa maumivu]] kama vile [[ibuprofen]] na [[acetaminophen]] ili [[kutuliza maumivu]] ya kichwa na [[antiemetic]] ili kutuliza kichefuchefu na kuepuka vichocheo. [[Dawa]] maalumu kama vile [[triptan]] au [[ergotamine]] zinaweza kutumika kwa watu wasiosaidiwa na dawa za kawaida za kuondoa maumivu. Zaidi ya [[asilimia]] 10 ya watu wote ulimwenguni huathiriwa na kipandauso wakati fulani [[Maisha|maishani]] mwao. {{TOC limit|3}} == Ishara na dalili == Kwa kawaida kipandauso hutokea pamoja na [[maumivu ya kichwa]] makali, yanayojisetiri na yanayojirudiarudia ambayo huhusishwa na dalili za mfumo unaojiongoza wa neva.<ref name=Bart10/><ref name=Prognosis2008/> Takriban asilimia 15-30 za wenye kipandauso hukabiliwa na [[aura]]<ref>{{cite book|last=Gutman|first=Sharon A.|title=Quick reference neuroscience for rehabilitation professionals : the essential neurologic principles underlying rehabilitation practice|year=2008|publisher=SLACK|location=Thorofare, NJ|isbn=9781556428005|pages=231|url=http://books.google.ca/books?id=Ea0czzNxpkQC&pg=PA231|edition=2nd}}</ref><ref name=Gilmore2011/> lakini mara nyingi hupata kipandauso kisicho na dalili za aura.<ref name=HA24/> Ukali wa maumivu ya kichwa, muda yanayochukua na marudio yake hubadilika mara kwa mara.<ref name=Bart10/> Kipandauso kinachodumu zaidi ya saa 72 hujulikana kwa [[Kilatini]] kama [[status migrainosus]].<ref>{{cite book|last=al.]|first=ed. Jes Olesen ... [et|title=The headaches.|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781754002|pages=512|url=http://books.google.ca/books?id=F5VMlANd9iYC&pg=PA512&lpg=PA512|edition=3. ed.}}</ref> Kuna awamu nne zinazoweza kutokea kwa kipandauso, ingawa si sharti mtu azipitie zote :<ref name=ICHD2004/> # [[Dalili za awali]] ambazo hutokea saa au siku chache kabla ya maumivu ya kichwa # [[Aura (dalili)|aura]] hutangulia maumivu ya kichwa # [[Awamu ya maumivu]] ya kichwa. # [[Dalili za baadaye]], athari zinazofuatia kukabiliwa na kipandauso === Awamu ya dalili za awali === [[Dalili za awali]] hutokea kwa asilimia ~60 ya watu wanaopata kipandauso<ref name=Five2004>{{cite book|last=Rae-Grant|first=[edited by] D. Joanne Lynn, Herbert B. Newton, Alexander D.|title=The 5-minute neurology consult|year=2004|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780683307238|pages=26|url=http://books.google.ca/books?id=Atuv8-rVXRoC&pg=PA26}}</ref><ref name=Amin2009>{{cite book|last=Aminoff|first=Roger P. Simon, David A. Greenberg, Michael J.|title=Clinical neurology|year=2009|publisher=Lange Medical Books/McGraw-Hill|location=New York, N.Y|isbn=9780071664332|pages=85–88|edition=7th ed.}}</ref> zinazoanza kwa saa mbili hadi siku mbili kabla ya kuanza kwa maumivu au aura <ref name=Buzzi2005>{{cite journal|last=Buzzi|first=MG|coauthors=Cologno, D; Formisano, R; Rossi, P|title=Prodromes and the early phase of the migraine attack: therapeutic relevance.|journal=Functional neurology|date=2005 Oct-Dec|volume=20|issue=4|pages=179–83|pmid=16483458}}</ref> Dalili hizi zinajumuisha visa mbalimbali <ref>{{cite journal|last=Rossi|first=P|coauthors=Ambrosini, A; Buzzi, MG|title=Prodromes and predictors of migraine attack.|journal=Functional neurology|date=2005 Oct-Dec|volume=20|issue=4|pages=185–91|pmid=16483459}}</ref> pamoja na: mabadiliko kwa halihisi ya moyo, kukereka, [[mfadhaiko wa kimawazo|mfadhaiko]] au [[uforia (hisia)|uforia]], [[uchovu wa kimwili|uchovu]], kushaukia chakula fulani, kukazana misuli (hasa shingoni), uyabisi wa utumbo au kuhara, na kuchukia harufu au kelele.<ref name=Five2004/> Hali hii inaweza kutokea kwa watu wenye kipandauso chenye aura au kisicho na aura<ref name=Sam2009>{{cite book|last=Samuels|first=Allan H. Ropper, Martin A.|title=Adams and Victor's principles of neurology|url=https://archive.org/details/adamsvictorsprin00unse|year=2009|publisher=McGraw-Hill Medical|location=New York|isbn=9780071499927|pages=Chapter 10|edition=9th ed.}}</ref> === Awamu ya aura === {|class="wikitable" style = "float: right; margin-left:15px; text-align:center" |- |[[Picha:Fortifikation (Migräne).jpg|150px|Enhancements reminiscent of a zigzag fort structure]]||[[Picha:Negatives Skotom (Brandenburger Tor Blaue Stunde) 1.jpg|150px|Negative scotoma, loss of awareness of local structures]] |- |[[Picha:Positives Skotom (Brandenburger Tor Blaue Stunde) 1.jpg|150px|Positive scotoma, local perception of additional structures]]||[[Picha:Gesichtsfeldausfall (Brandenburger Tor Blaue Stunde) 1.jpg|150px|Mostly one-sided loss of perception]] |} [[Aura (dalili)|aura]] ni hali ya [[neva za macho]] inayopita na hutokea kabla au wakati wa maumivu ya kichwa.<ref name=Amin2009/>Dalili hizi hutokea polepole kwa dakika kadhaa na kwa jumla hudumu kwa kipindi kisichopita dakika 60&nbsp;.<ref name=Tint2010/> Dalili hizi zinaweza kuwa za kuona, kuhisi au za kimwendo, na watu wengi hupata zaidi ya dalili moja.<ref name=HA44/> Athari za kuona ndizo zinazotokea mara nyingi zaidi, na hutokea kwa hadi visa asilimia 99 na zaidi, nusu yake vikiwa na hatari hizi pekee.<ref name=HA44/> Matatizo ya kuona mara nyingi huhusisha [[skotoma yenye vimulimuli]] (eneo la jicho lisiloona kwa sehemu ya kutazamia inayowaka).<ref name=Amin2009/> Tatizo hili kwa kawaida huanzia karibu na kiini cha sehemu ya kuona, kisha kusambaa kuelekea pande zote kwa mistari ya zigizagi inayofananishwa na nguzo au kuta.<ref name=HA44/> Kwa kawaida, mistari hii huwa nyeusi na nyeupe lakini watu wengine huona mistari yenye rangi.<ref name=HA44/> Baadhi ya watu hupoteza sehemu muhimu ya kuona inayojulikana kama [[hemianopsia]] huku wengine wakipata kiwaa.<ref name=HA44/> Aura ya kihisia ni aura ya pili kati ya aura zinazotokea mara nyingi huku ikitokea kwa asilimia 30-40 ya watu wenye aura.<ref name=HA44/> Mara nyingi hisia kama ya kudungwa kwa vipini- na-sindano huanzia kwa upande mmoja wa mkono kisha kuenea hadi sehemu ya pua na kinywa kwa upande uo huo.<ref name=HA44/> Kufa ganzi mara nyingi hutokea baada ya hisia ya mwasho na kupoteza [[hisia za ubinafsia]].<ref name=HA44/> Dalili zingine za awamu ya aura ni pamoja na: tatizo la kuzungumza, [[kisulisuli|hisia za dunia kuzunguka]], na mara nadra matatizo ya kimwendo.<ref name=HA44/> Kuwepo kwa dalili za kimwendo huashiria kuwa kuna kipandauso cha hemiplejia na udhaifu kudumu kwa zaidi ya saa moja, tofauti na aura zingine.<ref name=HA44/> Ni nadra kwa aura kudumu bila kufuatiwa na maumivu ya kichwa, <ref name=HA44>The Headaches Pg.407-419</ref>na hujulikana kama [[kipandauso kimya]]. === Awamu ya maumivu === Kwa kawaida maumivu ya kichwa huathiri upande mmoja, hudunda, na ukali wake huwa wa kadri hadi mkali mno.<ref name=Tint2010>{{cite book |author=Tintinalli, Judith E. |title=Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)) |publisher=McGraw-Hill Companies |location=New York |year=2010 |pages=1116–1117 |isbn=0-07-148480-9 |oclc= |doi=|accessdate=}}</ref> Kwa kawaida hali hii huja polepole<ref name=Tint2010/> na huzidishwa kwa kujishugulisha sana.<ref name=ICHD2004/>Hata hivyo, kwa visa zaidi ya asilimia 40, maumivu yanaweza kuathiri pande zote mbili huku maumivu ya shingo yakihusishwa na hali hii.<ref>{{cite book|last=Tepper|first=edited by Stewart J. Tepper, Deborah E.|title=The Cleveland Clinic manual of headache therapy|publisher=Springer|location=New York|isbn=9781461401780|pages=6|url=http://books.google.ca/books?id=uaG08nAKG_wC&pg=PA6}}</ref> Maumivu ya pande zote mbili huwa hasa kwa watu walio na kipandauso bila aura.<ref name=Amin2009/> Maumivu yasiyo ya kawaida yanaweza kutokea hasa kwa sehemu ya nyuma au ya juu ya kichwa.<ref name=Amin2009/> Kwa kawaida, maumivu hudumu kwa saa 4 hadi 72 kwa watu wazima<ref name=Tint2010/> ingawa katia watoto mara nyingi yanadumu kwa kipindi kisichozidi saa 1&nbsp;.<ref name=Bigal2010>{{cite journal|last=Bigal|first=ME|coauthors=Arruda, MA|title=Migraine in the pediatric population--evolving concepts.|url=https://archive.org/details/sim_headache_july-august-2010_50_7/page/1130|journal=Headache|date=2010 Jul|volume=50|issue=7|pages=1130–43|pmid=20572878}}</ref> Marudio ya kukabiliwa na hali hii hubadilika mara kwa mara, kutoka visa vichache maishani hadi visa kadhaa kwa wiki, huku wastani ukiwa ni mara moja kwa mwezi .<ref>{{cite book|last=al.]|first=ed. Jes Olesen, ... [et|title=The headaches.|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781754002|pages=238|url=http://books.google.ca/books?id=F5VMlANd9iYC&pg=PA238|edition=3. ed.}}</ref><ref>{{cite book|last=Dalessio|first=edited by Stephen D. Silberstein, Richard B. Lipton, Donald J.|title=Wolff's headache and other head pain|year=2001|publisher=Oxford University Press|location=Oxford|isbn=9780195135183|pages=122|url=http://books.google.ca/books?id=aJRV199FZcoC&pg=PA122|edition=7th ed.}}</ref> Mara nyingi maumivu huandamana na kichefuchefu, kutapika, [[fotofobia|usikivu dhidi ya mwanga]], [[fonofobia|usikivu dhidi ya sauti]], [[osmofobia|usikivu dhidi ya harufu]] , uchovu na kukereka.<ref name=Amin2009/> Kwa[[ateri ya basila|, kipandauso cha basila]], kipandauso chenye dalili za kinurolojia zinazohusiana na [[shina la ubongo]] au chenye dalili za kinurolojia kwenye pande zote za mwili,<ref name=Basil2009>{{cite journal|last=Kaniecki|first=RG|title=Basilar-type migraine.|journal=Current pain and headache reports|date=2009 Jun|volume=13|issue=3|pages=217-20|pmid=19457282}}</ref>athari za kawaida zikiwa ni pamoja na: [[kisulisuli (cha kimatibabu)|kuhisi kana kwamba dunia inazunguka]], wepesi wa kichwan, na kuwa na utatanishi.<ref name=Amin2009/> [[Kichefuchefu]] hutokea kwa takriban watu asilimia 90, huku takriban thuluthi moja wakitapika.<ref name=Walton2009>{{cite book|last=Walton|first=edited by Robert P. Lisak ... [et al.] ; foreword by John|title=International neurology : a clinical approach|year=2009|publisher=Wiley-Blackwell|location=Chichester, UK|isbn=9781405157384|pages=670|url=http://books.google.ca/books?id=L6_L75yvaPQC&pg=PA670}}</ref> Hivyo basi, watu wengi hutafuta chumba kitulivu chenye giza. <ref name=Walton2009/> Dalili zingine ni pamoja na: kiwaa, kufungana pua, kuhara, kukojoa kila mara, [[kuparara]], au kulowa jasho.<ref name=Joel1999>{{cite book|last=contributors|first=edited by Joel S. Glaser ; with 20|title=Neuro-ophthalmology|year=1999|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781717298|pages=555|url=http://books.google.ca/books?id=eVU2CODGj98C&pg=PA555|edition=3rd ed.}}</ref> Uvimbe au uchungu kwenye ngozi ya sehemu ya juu ya kichwa, na shingo kuwa ngumu ni hali zinazoweza kutokea<ref name=Joel1999/> Dalili husika huwa nadra kwa watu wazee.<ref name=ElderlyBook2008/> === Dalili za baadaye === Athari za kipandauso zinaweza kudumu kwa siku kadhaa baada ya maumivu makuu kuisha; hii huitwa [[dalili za baadaye za kipandauso]]. Watu wengi hukisia kuwa na hisia za mwasho kwa eneo lililoathiriwa na kipandauso na wengine kusema wana ulemavu wa kifikra kwa siku chache baada ya maumivu ya kichwa. Mgonjwa anaweza kuchoka au kupata 'maruerue' na maumivu ya kichwa, matatizo ya kiutambuzi, dalili za tumbo na utumbo, mabadiliko ya kihisia, na udhaifu.<ref name="pmid16426278">{{Rejea jarida|author=Kelman L |title=The postdrome of the acute migraine attack |journal=Cephalalgia |volume=26 |issue=2 |pages=214–20 |year=2006 |month=February |pmid=16426278 |doi=10.1111/j.1468-2982.2005.01026.x}}</ref>Kwa muhtasari mmoja, " Baadhi ya watu hupata hisia ya uchangamfu usio wa kawaida baada ya kukabiliwa na hali hii, huku wengine wakiripoti kupata mfadhaiko na [[unyonge wa mwili]]."<ref>{{cite book |author=Halpern, Audrey L.; Silberstein, Stephen D. |chapter=Ch. 9: The Migraine Attack—A Clinical Description |chapterurl=http://www.ncbi.nlm.nih.gov/books/NBK7326/ |editor=Kaplan PW, Fisher RS |title=Imitators of Epilepsy |publisher=Demos Medical |location=New York |year=2005 |isbn=1-888799-83-8 |pages= |url=http://www.ncbi.nlm.nih.gov/books/NBK7321/ |edition=2nd |id=NBK7326}}</ref> == Kisababishi == Kisababishi halisi cha kipandauso hakijulikani<ref name=Rob10>{{cite journal |author=Robbins MS, Lipton RB |title=The epidemiology of primary headache disorders |journal=Semin Neurol |volume=30 |issue=2 |pages=107–19 |year=2010 |month=April |pmid=20352581 |doi=10.1055/s-0030-1249220 }}</ref> Hata hivyo, kipandauso hukisiwa kuhusiana na mchanganyiko wa vipengele vya kimazingira na kijeni.<ref name=Lulli2007/> Hali hii hurithiwa kifamilia - kwa thuluthi mbili ya visa <ref name=Bart10/> na hutokea nadra kufuatia hitilafu moja ya kijeni.<ref>{{cite journal|last=Schürks|first=M|title=Genetics of migraine in the age of genome-wide association studies.|journal=The journal of headache and pain|date=2012 Jan|volume=13|issue=1|pages=1–9|pmid=22072275|doi=10.1007/s10194-011-0399-0|pmc=3253157}}</ref>Baadhi ya [[matatizo ya kiakili|hali za kisaikolojia]] yanayohusishwa ni pamoja na: [[tatizo kuu la mfadhaiko|mfadhaiko]], [[[[tatizo la wasiwasi|wasiwasi]] na [[maradhi ya hisia mseto]]<ref name=HA26>The Headaches, Pg. 246-247</ref> as are many biological events or [[wikt:trigger|trigger]]s. === Jenetikia === Utafiti wa mapacha umedhihirisha uwezekano wa asilimia 34 hadi 51 wa vipengele vya kijeni kuathiri uwepo wa maumivu ya kichwa yanayohusiana na kipandauso.<ref name=Lulli2007/> Uhusiano huu wa kijeni ni mkuu zaidi kwa watu wenye kipandauso chenye aura kuliko wale wasio.<ref name=HA24/>Kuwepo kwa aina maalum za jeni huongeza hatari kutoka kiasi kidogo hadi wastani.<ref name=Schurk2012/> [[Hitilafu ya jeni moja]] inayopelekea kipandauso ni ya nadra.<ref name=Schurk2012>{{cite journal|last=Schürks|first=M|title=Genetics of migraine in the age of genome-wide association studies.|journal=Tdate=2012 Jan|volume=13|issue=1|pages=1–9|pmid=22072275}}</ref> Mojawapo ya hali hizi hujulikana kama [[kipandauso cha familia cha hemiplejia]], aina ya kipandauso chenye aura]] ambacho hurithiwa kwa njia ya [[autosomia kuu]] <ref>.cite journal|last=de Vries|first=B|coauthors=Frants, RR; Ferrari, MD; van den Maagdenberg, AM|title=Molecular genetics of migraine.|journal=Human genetics|date=2009 Jul|volume=126|issue=1|pages=115–32|pmid=19455354}}</ref><ref>{{cite journal|last=Montagna|first=P|title=Migraine genetics.|journal=Expert review of neurotherapeutics|date=2008 Sep|volume=8|issue=9|pages=1321–30|pmid=18759544he journal of headache and pain|}}</ref> Hitilafu hizi zinahusiana na aina za miundo ya jeni za protini zinazohusika kwa [[usafirishaji wa ioni]].<ref name=Amin2009/> Hitilafu nyingine inayosababisha kipandauso ni [[sindromu ya CADASIL]] au ateriofati yenye ukuu wa autosomia na yenye inifarakti na lukoensefalopathia chini ya koteksi.<ref name=Amin2009/> === Vichochezi === Kipandauso kinaweza kuanzishwa na vichochezi, huku baadhi ya watu wakiripoti kuwa hali hii huwa hatari tu kwa visa vichache<ref name=Bart10/> na wengine kwa visa vingine.<ref name=Trigger09/> Vitu vingi vimedaiwa kuwa vichochezi, ingawa uzito na umuhimu wa madai hayo haujadhibitishwa.><ref name=Trigger09>{{cite journal |author=Levy D, Strassman AM, Burstein R |title=A critical view on the role of migraine triggers in the genesis of migraine pain |url=https://archive.org/details/sim_headache_2009-06_49_6/page/953 |journal=Headache |volume=49 |issue=6 |pages=953–7 |year=2009 |month=June |pmid=19545256 |doi=10.1111/j.1526-4610.2009.01444.x }}</ref><ref>{{cite journal |author=Martin PR |title=Behavioral management of migraine headache triggers: learning to cope with triggers |journal=Curr Pain Headache Rep |volume=14 |issue=3 |pages=221–7 |year=2010 |month=June |pmid=20425190 |doi=10.1007/s11916-010-0112-z }}</ref>Kichochezi kinaweza kutokea na kudumu hadi saa 24 kabla ya dalili kuanza.<ref name=Bart10/> ==== Vipengele vya kifiziolojia ==== Vichochezi vilivyotajwa mara nyingi ni mfadhaiko, njaa na uchovu (vichochezi hivi huchangia kutokea kwa [[maumivu ya kichwa yanayotokana na mahangaiko]]).<ref name=Trigger09/>]] Kuna uwezekano mkubwa wa kipandauso kutokea siku zinazokaribiana na [[hedhi]].<ref>{{cite journal|last=MacGregor|first=EA|title=Prevention and treatment of menstrual migraine|journal=Drugs|date=2010-10-01|volume=70|issue=14|pages=1799–818|pmid=20836574|doi=10.2165/11538090-000000000-00000}}</ref>Athari zingine za kihomoni, kama vile [[hedhi ya kwanza]], [[na matumizi ya tembe za kuzuia mimba]], [[ujauzito]], muda unaokaribia ukomohedhi na[[ukomohedhi]] pia huhusishwa na kipandauso.<ref>{{cite journal|last=Lay|first=CL|coauthors=Broner, SW|title=Migraine in women|journal=Neurologic Clinics|date=2009 May|volume=27|issue=2|pages=503–11|pmid=19289228|doi=10.1016/j.ncl.2009.01.002}}</ref> Athari hizi za kihomoni huhusika pakubwa kwa kutokea kwa kipandauso kisicho na aura.<ref name=HA25/> Kwa kawaida kipandauso hakitokei kwa [[trimesta ya pili ya ujauzito|ya pili]] na [[na trimesta ya tatu]] au kufuatia ukomohedhi.<ref name=Amin2009/> ==== Vipengele vya kilishe ==== Utafiti kuhusu vichochezi vinavyohusu lishe umegundua kuwa ushahidi hutegemea utathmini dhahania na hautilii maanani kuthibitisha au kukanusha kichochezi chochote.<ref>{{cite journal|last=Rockett|first=FC|coauthors=de Oliveira, VR; Castro, K; Chaves, ML; Perla Ada, S; Perry, ID|title=Dietary aspects of migraine trigger factors.|url=https://archive.org/details/sim_nutrition-reviews_2012-06_70_6/page/337|journal=Nutrition reviews|date=2012 Jun|volume=70|issue=6|pages=337–56|pmid=22646127}}</ref><ref name="FoodHolzhammer">{{Rejea jarida|author=Holzhammer J, Wöber C |title=[Alimentary trigger factors that provoke migraine and tension-type headache] |language=German |journal=Schmerz |volume=20 |issue=2 |pages=151–9 |year=2006|month=April |pmid=15806385 |doi=10.1007/s00482-005-0390-2}}</ref> Kuhusu vipengele maalum, hakuna ushahidi kuhusu jinsi [[tairamini]] inavyoathiri kipandauso<ref name="pmid14533654 ">{{Rejea jarida |doi=10.1016/S1081-1206(10)63523-5 |author=Jansen SC, van Dusseldorp M, Bottema KC, Dubois AE |title=Intolerance to dietary biogenic amines: a review |journal=Annals of Allergy, Asthma & Immunology |volume=91 |issue=3 |pages=233–40; quiz 241–2, 296 |year=2003 |month=September |pmid=14533654 |url=http://openurl.ingenta.com/content?genre=article&issn=1081-1206&volume=91&issue=3&spage=233&epage=241 |access-date=2013-11-28 |archive-date=2007-02-26 |archive-url=https://web.archive.org/web/20070226232424/http://openurl.ingenta.com/content?genre=article&issn=1081-1206&volume=91&issue=3&spage=233&epage=241 |dead-url=yes |https://web.archive.org/web/20070226232424/http://openurl.ingenta.com/content?genre=article&issn=1081-1206&volume=91&issue=3&spage=233&epage=241 |=https://web.archive.org/web/20070226232424/http://openurl.ingenta.com/content?genre=article&issn=1081-1206&volume=91&issue=3&spage=233&epage=241 }}</ref> nayo [[monosodium glutamate]] (MSG) imeripotiwa mara nyingi kuwa kichochezi cha kilishe<ref>{{Rejea jarida|author=Sun-Edelstein C, Mauskop A |title=Foods and supplements in the management of migraine headaches |url=https://archive.org/details/sim_clinical-journal-of-pain_2009-06_25_5/page/446 |journal=The Clinical Journal of Pain |volume=25 |issue=5 |pages=446–52 |year=2009 |month=June |pmid=19454881 |doi=10.1097/AJP.0b013e31819a6f65}}</ref>, mara nyingi ushahidi hauafikiani na wazo hili.<ref>{{cite journal |author=Freeman M |title=Reconsidering the effects of monosodium glutamate: a literature review |journal=J Am Acad Nurse Pract |volume=18 |issue=10 |pages=482–6 |year=2006 |month=October |pmid=16999713 |doi=10.1111/j.1745-7599.2006.00160.x }}</ref> ==== Vipengele vya kimazingira ==== Vichochezi kwa mazingira ya ndani na nje ni thibithisho kuwa ushahidi wa kijumla ilikuwa duni, lakini ulishauri kuwa watu wenye kipandauso wachukue hatua za kuzuia kipandauso zinazohusiana na ubora wa hewa ya ndani na mwangaza.<ref>{{cite journal |author=Friedman DI, De ver Dye T |title=Migraine and the environment |url=https://archive.org/details/sim_headache_2009-06_49_6/page/941 |journal=Headache |volume=49 |issue=6 |pages=941–52 |year=2009 |month=June |pmid=19545255 |doi=10.1111/j.1526-4610.2009.01443.x }}</ref> Wazo kuwa vichochezi hivi hupatikana mara nyingi kwa watu werevu zaidi si kweli.<ref name=HA25/> == Pathofisiolojia == [[Picha:Cortical spreading depression.gif|thumb|Animation of [[cortical spreading depression]]]] Kipandauso kinaaminiwa kuwa tatizo la neva na mishipa<ref name=Bart10>{{cite journal |author=Bartleson JD, Cutrer FM |title=Migraine update. Utambuzi na matibabu |journal=Minn Med |volume=93 |issue=5 |pages=36–41 |year=2010 |month=May |pmid=20572569 }}</ref> pamoja na ushahidi unaothibitisha utaratibu wa kipandauso kuanzia ndani ya ubongo kisha kuenea hadi kwenye mishipa ya damu.<ref name=HA29>The Headaches Chp. 29, Pg. 276</ref> Baadhi ya watafiti huamini kuwa taratibu za ki[[niuroni]]huchangia pakubwa,<ref>{{cite journal|last=Goadsby|first=PJ|title=The vascular theory of migraine--a great story wrecked by the facts.|journal=Brain : a journal of neurology|date=2009 Jan|volume=132|issue=Pt 1|pages=6–7|pmid=19098031}}</ref> huku wengine wakiamini kuwa mishipa ya damu huchangia zaidi.<ref>{{cite journal|last=Brennan|first=KC|coauthors=Charles, A|title=An update on the blood vessel in migraine.|journal=Current opinion in neurology|date=2010 Jun|volume=23|issue=3|pages=266–74|pmid=20216215}}</ref> Watafiti wengine huhisi kuwa athari zote mbili huhusika pakubwa.<ref>{{cite journal|last=Dodick|first=DW|title=Examining the essence of migraine--is it the blood vessel or the brain? A debate.|url=https://archive.org/details/sim_headache_2008-04_48_4/page/661|journal=Headache|date=2008 Apr|volume=48|issue=4|pages=661–7|pmid=18377395}}</ref> Kiwango kikubwa cha niurotransmita [[serotonini]], pia inayojulikana kama 5-hydroxytryptamine, inaaminiwa kuhusika.<ref name=HA29/> === Aura === [[Mfadhaiko unaosambaa kwenye koteksi]] au mfadhaiko wa kusambaa kwenye [[Aristides Leão|Leão]] ni mchipuko ghafla wa shughuli za kineva unaofuatiwa na kipindi kisicho na shughuli, hali inayopatikana kwa twatu wenye kipandauso chenye aura.<ref name=HA28>The Headaches, Chp. 28, pg 269-272</ref> Kuna maelezo mengi kuhusu kutokea kwa hali hii, ikiwa ni pamoja na uchochezi wa [[kipokezi cha NMDA]], hali inayopelekea kalisi kuingia kwenye seli.<ref name=HA28/> Baada mchipuko huu wa ghafla wa shughuli, mtiririko wa damu kuelekea [[koteksi ya serebramu]] kwa sehemu iliyoathirika hupungua kwa muda wa saa mbili hadi sita.<ref name=HA28/> Inaaminiwa kuwa uondoaji wa kingamizi unapoelekea kwenye sehemu ya chini ya ubongo, neva za uchungu kichwani na shingoni huchochewa.<ref name=HA28/> === Maumivu === Utaratibu halisi wa maumivu ya kichwa ambayo hutokea wakati wa kipandauso haujulikani.<ref name=Olesen2009>{{cite journal|last=Olesen|first=J|coauthors=Burstein, R; Ashina, M; Tfelt-Hansen, P|title=Origin of pain in migraine: evidence for peripheral sensitiyation.|journal=Lancet neurology|date=2009 Jul|volume=8|issue=7|pages=679–90|pmid=19539239}}</ref>. Ushahidi unaafiki jukumu la kimsingi wa sehemu za [[mfumo mkuu wa neva]] (kama vile [[shina la ubongo]] na [[diensefaloni]]) <ref>{{cite journal|last=Akerman|first=S|coauthors=Holland, PR; Goadsby, PJ|title=Diencephalic and brainstem mechanisms in migraine.|journal=Nature reviews. Neuroscience|date=2011-09-20|volume=12|issue=10|pages=570–84|pmid=21931334}}</ref> huku utafiti mwingine ukiafiki jukumu la uchochezi kwenye sehemu za pembeni( kama vile kupitia kwa[[neva za hisia]] zinayozingira [[mishipa ya damu]]ya kichwa na shingo).<ref name=Olesen2009/> Mishipa inayoweza kuathirika ni pamoja na: [[dura mata|ateri za dura]], [[Pia mata|ateri ya pia]] na ateri zilizo nje ya fuvu kama zile za [[ngozi ya kichwa]].<ref name=Olesen2009/> Jukumu la kupanuka kwa ateri, hususan zilizoko nje ya fuvu inaaminiwa kuwa muhimu <ref>{{cite journal|last=Shevel|first=E|title=The extracranial vascular theory of migraine--a great story confirmed by the facts.|url=https://archive.org/details/sim_headache_2011-03_51_3/page/409|journal=Headache|date=2011 Mar|volume=51|issue=3|pages=409–17|pmid=21352215}}</ref> == Utambuzi == Utambuzi wa kipandauso hutegemea ishara na dalili.<ref name=Bart10/> [[uchunguzi wa kupiga picha kichwani|upigaji pichahufanywa]] mara nyingi ili kubainisha visababishi vingine vya maumivu ya kichwa.<ref name=Bart10/> Inaaminika kwamba idadi kubwa ya watu wenye hali hii hawajatambuliwa.<ref name=Bart10/> Utambuzi wa kipandauso bila aura unaweza kufanyika kwa kufuata kanuni ya "5, 4, 3, 2, 1; kulingana na [[International Headache Society]],,:<ref name=ICHD2004/> * Kukabiliwa na kipandauso'' chenye'' aura mara tano au zaidi—, makabiliano mawili yanatosha kufanya utambuzi. * Kipandauso kudumu kwa saa nne hadi siku tatu * Mawili au zaidi ya yafuatayo: ** Maumivu ya upande mmoja (yanayoathiri nusu ya kichwa); ** Kudundadunda; ** "Maumivu ya kadri hadi makali"; ** "Inayoongezeka kuwa chungu au inayotatiza shughuli za kila siku za mwili ." * Moja au zaidi ya haya: ** Kichefuchefu na/au kutapika; ** Usikivu dhidi ya mwanga ([[fotophobia]]) na usikivu dhidi ya sauti ([[fonofobia]]) Ikiwa mtu ataweza kukumbwa na hali mbili kati ya hizi: fotophobia, kichefuchefu, au kutoweza kufanya kazi/kusoma kwa siku moja, kuna uwezekano wa kuwa na kipandauso .<ref>{{cite journal|last=Cousins|first=G|coauthors=Hijazze, S; Van de Laar, FA; Fahey, T|title=Diagnostic accuracy of the ID Migraine: a systematic review and meta-analysis.|url=https://archive.org/details/sim_headache_july-august-2011_51_7/page/1140|journal=Headache|date=2011 Jul-Aug|volume=51|issue=7|pages=1140–8|pmid=21649653|doi=10.1111/j.1526-4610.2011.01916.x}}</ref> Kwa watu wenye hali nne kati ya hali tano zifuatazo: maumivu ya kichwa ya kudundadunda, maumivu kudumu kwa saa 4–72, maumivu kwa upande mmoja wa kichwa, kichefuchefu au dalili zinazotatiza maisha ya mtu, uwezekano wa kipandauso ni asilimia 92<ref name=Gilmore2011/> Kwa watu wenye dalili hizi chini ya tatu uwezekano ni asilimia 17<ref name=Gilmore2011/> === Uainishaji === Mwaka 1988 ndio wakati wa kwanza kwa kipandauso kuainishwa kwa kina.<ref name=HA24>The Headaches, Pg 232-233</ref> Shirika la[[International Headache Society]] hivi karibuni walibadilisha uainishaji wao mwaka wa 2004.<ref name=ICHD2004/>Kulingana na uainishaji huu, kipandauso ni maumivu ya kimsingi ya kichwa yanayoandamana na aina ya maumivu ya kichwa]] yenye [[wasi wasi na [[maumivu ya kichwa mbalimbali]] na mengineyo.<ref>{{cite journal|last=Nappi|first=G|title=Introduction to the new International Classification of Headache Disorders.|journal=The journal of headache and pain|date=2005 Sep|volume=6|issue=4|pages=203–4|pmid=16362664}}</ref> Kipandauso kimeainishwa kwa vitengo saba (baadhi ya vitengo hivi vimegawanywa zaidi kwa vijitengo vingi): * Kipandauso bila aura au "kipandauso cha kawaida", kinahusisha maumivu ya kichwa yasiyoandamana na aura * Kipandauso chenye aura au "kipandauso maalum", kinahusisha maumivu ya kichwa yanayoandamana na aura. Kwa mara nadra, aura inaweza kutokea bila maumivu ya kichwa au kuandamana na maumivu ya kichwa yasiyohusika na kipandauso. Vijitengo vingine viwili ni [[kipandauso cha familia]] na [[kipandauso mtawanyiko]], ambapo mtu anapata kipandauso chenye aura na kinachoandamana na udhaifu wa kimwendo. Ikiwa jamaa kwa familia amewahi kupata hali hii, basi itaitwa "kipandauso cha kifamilia"; la sivyo kipandauso "mtawanyiko". Aina nyingine ni kipanduso cha aina ya basila , ambapo maumivu ya kichwa na aura huandamana na [[kigugumizi|ugumu wa kuongea]], [[kisulisuli (cha kimatibabu)|hisia ya kuwa dunia inazunguka]], [[tinitisi|kelele kama king'ora maskioni]] au dalili zingine nyingi zinazohusiana na shina la ubongo, lakini sio udhaifu wa kimwendo. Awali, aina hii iliaminiwa kufuatia spazimu ya [[ateri ya basila]], ateri inayosafirisha damu kwenye shina la ubongo.<ref name=Basil2009/> * Sindromu ya utotoni ambayo kwa kawaida ni kitangulizi cha kipandauso ni pamoja na [[sindromu ya msururu wa kutapika|msururu wa kutapika]] (vipindi vichache vya kutapika sana), [[kipanduso cha fumbatio]] (maumivu ya fumbatio, mara nyingi huandamana na kichefuchefu), na kisulisuli hafifu cha utotoni kinachotokea ghafla (kukabiliwa na kisulisuli mara chache). * [[Kipandauso cha retinali]] kinajumuisha maumivu ya kichwa yanayoandamana na kutoona vizuri au hata upofu wa jicho moja kwa siku chache. * Matatizo ya kipandauso ni maumivu ya kichwa na/au aura ambayo hudumu kwa muda mrefu au kutokea mara nyingi kuliko inavyokuwa kawaida au kuandamana na kifafa au kidonda kwenye ubongo. * Uwezekano wa kipandauso huashiriwa na hali zilizo na baadhi ya sifa za kipandauso, lakini hakuna ushahidi tosha wa kutambua kwa hakika kama ni kipanduso (wakati kuna matumizi ya dawa kupita kiasi kwa mfululizo). * Kipandauso sugu ni tatizo kufuatia vipandauso, na ni maumivu ya kichwa yanayothibitisha mbinu ya kiutambuzi wa ''maumivu ya kichwa yanayohusiana na kipandauso'' na hujirudia baada ya muda mrefu. Hususan, siku 15 au zaidi kwa mwezi kwa kipindi cha zaidi ya miezi mitatu.<ref>{{cite journal|last=Negro|first=A|coauthors=Rocchietti-March, M; Fiorillo, M; Martelletti, P|title=Chronic migraine: current concepts and ongoing treatments.|journal=European review for medical and pharmacological sciences|date=2011 Dec|volume=15|issue=12|pages=1401–20|pmid=22288302}}</ref> === Kipandauso cha fumbatio === Utambuzi wa [[kipandauso cha fumbatio]] umekumbwa na utata.<ref name=Abdo2002>{{cite book|last=Davidoff|first=Robert A.|title=Migraine : manifestations, pathogenesis, and management|year=2002|publisher=Oxford Univ. Press|location=Oxford [u.a.]|isbn=9780195137057|page=81|url=http://books.google.ca/books?id=PAdn6xC3KlAC&pg=PA81 |edition=2nd }}</ref> Baadhi ya utafiti umeonyesha kuwa visa vya kujirudia ya maumivu ya fumbatio yanaweza kuwa ni aina ya kipandauso <ref name=Abdo2002/><ref>{{cite journal|last=Russell|first=G|coauthors=Abu-Arafeh, I, Symon, DN|title=Abdominal migraine: evidence for existence and treatment options|journal=Paediatric drugs|year=2002|volume=4|issue=1|pages=1–8|pmid=11817981}}</ref> Au angalau ni kitangulizi cha kipandauso<ref name=HA24/> Visa hivi yanaweza au kutoweza kufuatiwa na dalili zinazoashiria kipandauso na kwa kawaida hudumu kwa dakika chache hadi saa kadhaa<ref name=Abdo2002/> Mara nyingi, visa hivi hutokea kwa watu wenye historia ya kipandauso maalumu kwa mtu binafsi au kwa familia.<ref name=Abdo2002/>Sindromu zingine zinazoaminika kuwa viashiria ni pamoja na:[[sindromu ya msururu wa kutapika]] na [[kutokea kwa ghafla kwa kisulisuli hafifu cha utotoni]] .<ref name=HA24/> === Dalili za kifisiolojia === Hali zingine zinazoweza kuleta dalili sawa na maumivu ya kichwa ya kipandauso ni pamoja na: [[maambukizi ya ateri ya panja]], [[maumivu ya kichwa upande mmoja]], [[klaukoma kali]], [[meningitisi]] na [[kuvuja damu kwenye sehemu ya chini ya araknoidi ya ubongo]].<ref name=Gilmore2011/> Kwa kawaida maambukizi ya ateri ya panja hutokea kwa watu wenye umri zaidi ya miaka 50 na huandamana na uchungu kwa [[Panja (anatomia)|panja]], maumivu ya kichwa ya upande mmoja hutambulika kwa kufungana kwa pua moja, machozi na maumivu makali kwa obiti [[obiti]], klaukoma kali huhusika na matatizo ya kuona, meningitisi na [[homa]]na kuvuja damu kwenye sehemu ya chini ya araknoidi ya ubongo.<ref name=Gilmore2011/> [[Maumivu ya kichwa kutokana na wasiwasi]] kwa kawaida hutokea kwa pande zote mbili, hayadhoofishi wala kulemaza sana.<ref name=Gilmore2011/> == Kinga == Matibabu ya kuzuia kipandauso ni pamoja na: dawa, lishe mbadala, kubadilisha mienendo ya maisha, na upasuaji. Kinga hupendekezwa kwa watu wenye maumivu ya kichwa kwa zaidi ya siku mbili kwa wiki, wasioweza kutibika kwa dawa za kupunguza makali au wenye maumivu makali yasiyoweza kudhibitiwa.<ref name=Gilmore2011/> Malengo ya hatua hizi ni kupunguza marudio, maumivu na/au muda wa kudumu wa kipandauso, na kuongeza ubora wa matibabu ya awali.<ref name="AFP0601">{{Rejea jarida|author=Modi S, Lowder DM |title=Medications for migraine prophylaxis |journal=American Family Physician |volume=73 |issue=1 |pages=72–8 |year=2006 |month=January |pmid=16417067 |url=http://www.aafp.org/link_out?pmid=16417067}}</ref> Sababu nyingine ya kinga ni kuepuka [[maumivu ya kichwa yanayohusiana na matumizi ya dawa kupita kiasi]]. Jambo hili ni tatizo linalotolea mara nyingi na linaweza kusababisha maumivu makali ya kichwa kila siku.<ref name="MOHlancet">{{Rejea jarida|author=Diener HC, Limmroth V |title=Medication-overuse headache: a worldwide problem |journal=Lancet Neurology |volume=3 |issue=8 |pages=475–83 |year=2004 |month=August |pmid=15261608 |doi=10.1016/S1474-4422(04)00824-5}}</ref><ref>{{cite journal |pages=331–8 |doi=10.1517/14740338.1.4.331 |title=Medication overuse headaches – what is new? |year=2002 |last1=Fritsche |first1=Guenther |last2=Diener |first2=Hans-Christoph |journal=Expert Opinion on Drug Safety |volume=1 |issue=4 |pmid=12904133}}</ref> === Tiba === Matibabu ya kuzuia kipandauso yanakisiwa kuwa bora ikiwa yatapunguza visa au ukali wa kipandauso kwa asilimia 50<ref name="kaniecki">{{Rejea kitabu|author=Kaniecki R, Lucas S. |chapter=Treatment of primary headache: preventive treatment of migraine |title=Standards of care for headache diagnosis and treatment |location=Chicago |publisher=National Headache Foundation |year=2004 |pages=40–52}}</ref> Miongozo huwa na yamkini viwango thabiti kwa kutathmini [[topiramate]], [[divalproex]]/[[sodium valproate]], [[propranolol]] na[[metoprolol]] kama dawa zilizo na kiwano cha juu zaidi cha ushahidi kuhusu matumizi ya matibabu ya kwanza| [[yanayopendekezwakwanza]] .<ref name=Loder2012/> Mapendekezo kuhusu ubora ulitofautiana kuhusu [[gabapentin]].<ref name=Loder2012/> [[Timolol]] pia ni bora kwa kuzuia kipandauso na kupunguza makali na marudio yake huku [[frovatriptan]] ikizuia kipandauso kinachohusiana na hedhi<ref name=Loder2012>{{cite journal|last=Loder|first=E|coauthors=Burch, R; Rizzoli, P|title=The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines.|url=https://archive.org/details/sim_headache_2012-06_52_6/page/930|journal=Headache|date=2012 Jun|volume=52|issue=6|pages=930–45|pmid=22671714}}</ref> [[Amitriptyline]] na [[venlafaxine]] vile vile ni bora.<ref>{{cite journal|last=Silberstein|first=SD|coauthors=Holland, S; Freitag, F; Dodick, DW; Argoff, C; Ashman, E; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society|title=Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society.|url=https://archive.org/details/sim_neurology_2012-04-24_78_17/page/1337|journal=Neurology|date=2012-04-24|volume=78|issue=17|pages=1337–45|pmid=22529202}}</ref> [[Botox]] imegunduliwa kuwa bora kwa watu wenye kipandauso cha kudumu wala sio wenye kipandauso cha muda tu.<ref>{{cite journal |author=Jackson JL, Kuriyama A, Hayashino Y |title=Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis |journal=JAMA |volume=307 |issue=16 |pages=1736–45 |year=2012 |month=April |pmid=22535858 |doi=10.1001/jama.2012.505 |url=https://archive.org/details/sim_jama_2012-04-25_307_16/page/n79}}</ref> === Tiba mbadala === [[Picha:Butterbur.jpg|thumb|160px|[[Dawa ya Petasites|Petasites hybridus]] inayotolewa kwenye mizizi ya mti wa (butterbur) imedhibitishwa kuwa bora kwa kuzuia kipandauso.<ref>Pringsheim T, Davenport W, Mackie G, ''et al.'' Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci. 2012 Mar;39(2 Suppl 2):S1-59. PMID 22683887</ref>]] [[Akupancha]] ni matibabu bora ya kipandauso.<ref name="pmid21359919">{{cite pmid |21359919}}</ref> Matumizi ya akupancha "halisi" siyo bora kuliko matumizi ya akupancha "bandia". Hata hivyo, aina zote zimegunduliwa kuwa bora kuliko utunzanji kidesturi, kwani zinaandamana na mathara machache zaidi kuliko matumizi ya dawa ya profilaktiki.<ref name = Linde2009>{{cite journal |last1=Linde |first1=K |last2=Allais |first2=G |last3=Brinkhaus |first3=B |last4=Manheimer |first4=E|last5=Vickers |first5=A |last6=White |first6=AR |editor1-last=Linde |editor1-first=Klaus |title=Acupuncture for migraine prophylaxis|journal=Cochrane Database of Systematic Reviews (Online) |issue=1 |pages=CD001218 |year=2009 |pmid=19160193|doi=10.1002/14651858.CD001218.pub2 |pmc=3099267}}</ref> Tibamwili, tibamaungo, kupapasa na kupumzika huwa bora sawa na matumizi ya dawa ya [[propranolol]] au [[topiramate]] kwa kuzuia maumivu ya kichwa yanayohusiana na kipandauso; hata hivyo mbinu iliyotumika kwa utafiti huu ina walakini.<ref>{{cite journal |pages=127–33 |doi=10.1007/s10194-011-0296-6 |pmc=3072494 |title=Manual therapies for migraine: A systematic review |year=2011 |last1=Chaibi |first1=Aleksander |last2=Tuchin |first2=Peter J. |last3=Russell |first3=Michael Bjørn |journal=The Journal of Headache and Pain |volume=12 |issue=2 |pmid=21298314}}</ref> Kuna ushahidi ulio na tashwishi wa ubora wa: [[magnisiamu]], [[enzaimu pacha Q10]], [[riboflavin]], [[Vitamini B12|vitamini B(12)]],<ref>{{cite journal |pages=297–312 |doi=10.1016/S0083-6729(04)69011-X |chapter=Role of Magnesium, Coenzyme Q10, Riboflavin, and Vitamin B12 in Migraine Prophylaxis |title=Vitamins &amp; Hormones Volume 69 |series=Vitamins & Hormones |year=2004 |last1=Bianchi |first1=A |last2=Salomone |first2=S |last3=Caraci |first3=F |last4=Pizza |first4=V |last5=Bernardini |first5=R |last6=Damato |first6=C |isbn=978-0-12-709869-2 |volume=69 |pmid=15196887 |journal=Vitamins and hormones}}</ref> and [[feverfew|Fever-few]], ingawa majaribio mwafaka yanafaa kufanywa ili kuthibitisha matokeo haya ya mwanzo.<ref>{{cite journal |pages=251–6 |doi=10.1111/j.1745-7599.2004.tb00447.x |title=Evidence-Based Use of Botanicals, Minerals, and Vitamins in the Prophylactic Treatment of Migraines |year=2004 |last1=Rios |first1=Juanita |last2=Passe |first2=Megan M. |journal=Journal of the American Academy of Nurse Practitioners |volume=16 |issue=6 |pmid=15264611}}</ref>Matumizi ya [[butterbur]] yamethibitiwa kuwa bora kati ya matibabu mbadala.<ref>{{cite journal|last=Holland|first=S|coauthors=Silberstein, SD; Freitag, F; Dodick, DW; Argoff, C; Ashman, E; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache, Society|title=Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society.|url=https://archive.org/details/sim_neurology_2012-04-24_78_17/page/1346|journal=Neurology|date=2012-04-24|volume=78|issue=17|pages=1346–53|pmid=22529203}}</ref> === Vifaa na upasuaji === Vifaa vya kimatibabu kama vile [[bayomwitiko]] na [[vichochea neva]] vina manufaa fulani kwa kuzuia kipandauso, hasa wakati dawa ya kuzuia kipandauso zimetumika bila kuzingatia maagizo kama vile kutumia dawa kupita kiasi. Bayomwitiko husaidia watu kufahamu baadhi ya parameta za kifiziolojia ili waweze kuzidhibiti na kujaribu kutulia, hivyo inaweza kuwa bora kwa kutibu kipandauso.<ref>{{cite journal |pages=111–27 |doi=10.1016/j.pain.2006.09.007|title=Efficacy of biofeedback for migraine: A meta-analysis|url=https://archive.org/details/sim_pain_2007-03_128_1-2/page/111 |year=2007 |last1=Nestoriuc |first1=Yvonne |last2=Martin |first2=Alexandra |journal=Pain |volume=128 |pmid=17084028 |issue=1–2}}</ref><ref>{{cite journal |pmid=18726688 |year=2008|last1=Nestoriuc|first1=Y |last2=Martin |first2=A |last3=Rief |first3=W |last4=Andrasik |first4=F |title=Biofeedback treatment for headache disorders: A comprehensive efficacy review |url=https://archive.org/details/sim_applied-psychophysiology-and-biofeedback_2008-09_33_3/page/125 |volume=33 |issue=3 |pages=125–40 |doi=10.1007/s10484-008-9060-3 |journal=Applied psychophysiology and biofeedback}}</ref> Uchochezi neva hutumia vichocheaneva vya kubandika vilivyo sawa na viongozamwendo vya kutibu kipandauso sugu huku matokeo bora yakiwepo hasa kwa visa vya kipandauso kikali<ref>{{cite journal |pmid=20816443 |year=2010 |last1=Schoenen |first1=J|last2=Allena |first2=M |last3=Magis |first3=D |title=Neurostimulation therapy in intractable headaches |volume=97|pages=443–50 |doi=10.1016/S0072-9752(10)97037-1 |journal=Handbook of clinical neurology / edited by P.J. Vinken and G.W. Bruyn |series=Handbook of Clinical Neurology |isbn=9780444521392}}</ref><ref>{{cite journal |pmid=19732075 |year=2010|last1=Reed |first1=KL |last2=Black |first2=SB |last3=Banta Cj |first3=2nd |last4=Will |first4=KR |title=Combined occipital and supraorbital neurostimulation for the treatment of chronic migraine headaches: Initial experience |volume=30 |issue=3|pages=260–71 |doi=10.1111/j.1468-2982.2009.01996.x |journal=Cephalalgia}}</ref> [[Upasuaji wa kipandauso]] , unaohusu kugandamua [[neva]] fulani kwa sehemu ya kichwa na shingo, inaweza kuwa chaguo kwa watu ambao afya yao haijaimarika kufuatia matibabu mengine.<ref name=Surgery2011>{{cite journal|last=Kung|first=TA|coauthors=Guyuron, B, Cederna, PS|title=Migraine surgery: a plastic surgery solution for refractory migraine headache|url=https://archive.org/details/sim_plastic-and-reconstructive-surgery_2011-01_127_1/page/181|journal=Plastic and reconstructive surgery|date=2011 Jan|volume=127|issue=1|pages=181–9|pmid=20871488|doi=10.1097/PRS.0b013e3181f95a01}}</ref> == Udhibiti == Kuna njia tatu kuu za matibabu: kuepuka vichochezi, kudhibiti dalili kali za ghafla na kuzuia kwa kutumia dawa.<ref name=Bart10/> Dawa ni bora ikiwa itatumika punde tu mtu anapokabiliwa na hali hii.<ref name=Bart10/> Marudio ya kutumia dawa mara nyingi husababisha [[maumivu ya kichwa yanayohusiana na matumizi ya dawa kupita kiasi]] na maumivu ya kichwa huzidi kuwa makali na kutokea mara nyingi zaidi.<ref name=ICHD2004/> Hii inaweza kutokea kwa [[triptani]], [[ergotamines]]na [[vitoa maumivu]] hasa [[vya aina ya]] narkotia.<ref name=ICHD2004/> === Viondoa maumivu === Matibabu ya kwanza yanayopendekezwa kwa watu wenye dalili zisizo kali hadi za wastani ni vitoa maumivu vya kawaida [[dawa ya inflamesheni isiyo na steroidi]] au mchanganyiko wa [[acetaminophen]], [[asidi ya asitilsalikiliki]] na [[kafeni]].<ref name=Gilmore2011>{{cite journal|last=Gilmore|first=B|coauthors=Michael, M|title=Treatment of acute migraine headache.|url=https://archive.org/details/sim_american-family-physician_2011-02-01_83_3/page/271|journal=American family physician|date=2011-02-01|volume=83|issue=3|pages=271–80|pmid=21302868}}</ref> Dawa kadhaa za kutibu inflamesheni zisizo na steroidi zimetambulika kuwa bora. [[Ibuprofen]] imegunduliwa kupunguza maumivu kikamilifu kwa takriban nusu ya watu wanaoitumia<ref>{{cite journal |author=Rabbie R, Derry S, Moore RA, McQuay HJ |journal=Cochrane Database Syst Rev |volume=10 |issue= 10|pages=CD008039 |year=2010 |pmid=20927770 |doi=10.1002/14651858.CD008039.pub2 |editor1-last=Moore |editor1-first=Maura |title=Ibuprofen with or without an antiemetic for acute migraine headaches in adults}}</ref> [[Diclofenac]]imethibitiwa kuwa bora pia<ref>{{cite journal |author=Derry S, Rabbie R, Moore RA |title=Diclofenac with or without an antiemetic for acute migraine headaches in adults |journal=Cochrane Database Syst Rev |volume=2 |issue= |pages=CD008783 |year=2012 |pmid=22336852 |doi=10.1002/14651858.CD008783.pub2 |url=}}</ref> [[Aspirin]] inaweza kupunguza maumivu wastani ya kipandauso hadi yaliyo makali huku ikiwa na ubora sawa na sumatriptan.<ref>{{Rejea jarida|author=Kirthi V, Derry S, Moore RA, McQuay HJ |journal=Cochrane Database Syst Rev |volume=4 |issue= 4|pages=CD008041 |year=2010 |pmid=20393963 |doi=10.1002/14651858.CD008041.pub2 |editor1-last=Moore|editor1-first=Maura |title=Aspirin with or without an antiemetic for acute migraine headaches in adults}}</ref> [[Ketorolac]] inapatikana kwa muundo wa kudungia mishipani <ref name=Gilmore2011/> [[Paracetamol]] (pia inayojulikana kama acetaminophen), aidha ikiwa pekee au ikiwa imechanganywa na [[metoclopramide]] ni tiba nyingine yenye madhara machache.<ref>{{cite journal |author=Derry S, Moore RA, McQuay HJ |journal=Cochrane Database Syst Rev |volume=11 |issue= 11|pages=CD008040 |year=2010 |pmid=21069700 |doi=10.1002/14651858.CD008040.pub2 |editor1-last=Moore |editor1-first=Maura |title=Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults}}</ref> Kwa ujauzito, acetaminophen na metoclopramide huaminika kuwa dawa salama na bora zaidi hadi [[trimesta ya tatu ya ujauzito]].<ref name=Gilmore2011/> === Triptani === [[Triptani]], kama vile [[sumatriptan]], ni dawa bora ya kutibu maumivu na kichefuchefu hadi asilimia 75 ya watu.<ref name=Bart10/><ref>{{cite journal |author=Johnston MM, Rapoport AM |title=Triptans for the management of migraine |journal=Drugs |volume=70 |issue=12 |pages=1505–18 |year=2010 |month=August |pmid=20687618 |doi=10.2165/11537990-000000000-00000}}</ref> Dawa hizi hupendekezwa kutumika mwanzoni kwa watu wenye maumivu ya wastani hadi makali au kwa watu wenye dalili hafifu zisizotibika kwa vitoa maumivu vya kawaida.<ref name=Gilmore2011/> Njia za kutumia dawa hizi ni pamoja na kumeza, kudungia, [[kunyunyisia puani]], na kumumunya.<ref name=Bart10/> Kwa jumla, triptani zote zinaonekana kuwa bora huku zikiwa na madhara sawa. Hata hivyo, watu binafsi wanaweza kuafikiana na dawa maalum.<ref name=Gilmore2011/> Madhara mengi huwa si makal, kama vile wekundu usoni; ingawa, visa vichache vya [[iskemia ya miokadiumu]] vimeripotiwa.<ref name=Bart10/> Hivyo basi dawa hizi hazipendekezwi kwa watu wenye magonjwa ya [[mfumo wa moyo na mishipa]].<ref name=Gilmore2011/> Kwa historia, dawa hizi hazipendekezwi kwa watu wenye kipandauso cha basila, ingawa hakuna ushahidi maalum wa hatari unaothibitisha tahadhari hii.<ref name=Basil2009/> Dawa hizi hazipelekei uraibu wowote lakini zinaweza kusababisha maumivu ya kichwa yanayohusiana na matumizi ya dawa kupita kiasi hasa zikitumiwa kwa zaidi ya siku 10 kwa mwezi.<ref>{{cite journal |last1=Tepper Stewart J. |last2=Tepper |first2=Deborah E. |title=Breaking the cycle of medication overuse headache |url=https://archive.org/details/sim_cleveland-clinic-journal-of-medicine_2010-04_77_4/page/236 |journal=Cleveland Clinic Journal of Medicine |volume=77 |issue=4 |pages=236–42 |year=2010 |month=April |pmid=20360117 |doi=10.3949/ccjm.77a.09147 |first1=S. J.}}</ref> === Ergotamini === [[Ergotamini]]na [[dihidroergotamini]] ni aina ya dawa za kitambo ambazo zingali zinapendekezwa kutumika kutibu kipandauso, za hivi punde zikiwa na muundo wa kunyunyisia pua na kudungia.<ref name=Bart10/> Dawa hizi zimethibitishwa kuwa bora sawa na triptani,<ref name=Kelly2012>{{cite journal|last=Kelley|first=NE|coauthors=Tepper, DE|title=Rescue therapy for acute migraine, part 1: triptans, dihydroergotamine, and magnesium.|url=https://archive.org/details/sim_headache_2012-01_52_1/page/114|journal=Headache|date=2012 Jan|volume=52|issue=1|pages=114–28|pmid=22211870|doi=10.1111/j.1526-4610.2011.02062.x}}</ref> ni zaa bei nafuu zaidi,<ref>{{cite book|last=al.]|first=ed. Jes Olesen, ... [et|title=The headaches.|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781754002|pages=516|url=http://books.google.ca/books?id=F5VMlANd9iYC&pg=PA516|edition=3. ed.}}</ref> na huwa na madhara makali ambayo kawaida ni hafifu.<ref name=DHE2010/> Dawa hizi ni chaguo bora zaidi kwa watu wenye visa vikali ya kipandauso.<ref name=DHE2010>{{cite journal|last=Morren|first=JA|coauthors=Galvez-Jimenez, N|title=Where is dihydroergotamine mesylate in the changing landscape of migraine therapy?|journal=Expert opinion on pharmacotherapy|date=2010 Dec|volume=11|issue=18|pages=3085–93|pmid=21080856|doi=10.1517/14656566.2010.533839}}</ref> === Dawa nyingine === Metoclopramide ya kudungia mishipani au [[lidocaine]]ya kuingizia puani ni chaguo zingine zilizoko.<ref name=Gilmore2011/> Metoclopramide inapendekezwa kwa watu wanaoletwa hospitalini ili kupata usaidizi wa dharura.<ref name=Gilmore2011/> Kipimo kimoja cha [[dexamethasone]]ya kudungia mishipani kikiongezwa kwenye tiba iliyoafikiwa ya kipandauso huhusika kwa kupunguza kurejea kwa maumivu ya kichwa kwa asilimia 26 kwa saa 72 zinazofuata.<ref>{{Rejea jarida|author=Colman I |title=Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence |journal=BMJ |volume=336|issue=7657 |pages=1359–61 |year=2008 |month=June |pmid=18541610 |pmc=2427093|doi=10.1136/bmj.39566.806725.BE|author-separator=,|author2=Friedman BW|author3=Brown MD|display-authors=3|last4=Innes|first4=G. D|last5=Grafstein|first5=E.|last6=Roberts|first6=T. E|last7=Rowe|first7=B. H }}</ref> Njia ya kutibu mfululizo wa maumivu ya kichwa yanayohusiana na kipandauso kwa kutumia kunyoosha uti wa mgongo haina ushahidi wowote.<ref>{{cite journal|last=Posadzki|first=P|coauthors=Ernst, E|title=Spinal manipulations for the treatment of migraine: a systematic review of randomized clinical trials.|journal=Cephalalgia : an international journal of headache|date=2011 Jun|volume=31|issue=8|pages=964–70|pmid=21511952|doi=10.1177/0333102411405226}}</ref> Inapendekezwa kuwa dawa ya [[opioid]] na [[barbiturate]] isitumike<ref name=Gilmore2011/> == Prognosisi == Prognosisi ya muda mrefu kwa watu wenye kipandauso hubadilika mara kwa mara.<ref name=Prognosis2008>{{cite journal|last=Bigal|first=ME|coauthors=Lipton, RB|title=The prognosis of migraine.|journal=Current opinion in neurology|date=2008 Jun|volume=21|issue=3|pages=301–8|pmid=18451714|doi=10.1097/WCO.0b013e328300c6f5}}</ref> Watu wengi wenye kipandauso hupoteza wakati mwingi wa kufanya kazi kufuatia ugonjwa huu<ref name=Bart10/>. Hata hivyo, kwa kawaida hali hii si hatari sana<ref name=Prognosis2008/> na haihusishwi na kuongezeka kwa hatari ya kifo.<ref name=Death2011>{{cite journal|last=Schürks|first=M|coauthors=Rist, PM; Shapiro, RE; Kurth, T|title=Migraine and mortality: a systematic review and meta-analysis.|journal=Cephalalgia : an international journal of headache|date=2011 Sep|volume=31|issue=12|pages=1301–14|pmid=21803936|doi=10.1177/0333102411415879}}</ref> Ugonjwa huu una mikondo minne mikuu: dalili kutoweka kabisa, dalili kuendelea huku zikipunguka wakati unapopita, dalili kuendelea kwa kiwango sawa na ukali uo huo au makabiliano kuzidi kuwa mabaya na kujirudia mara nyingi zaidi.<ref name=Prognosis2008/> Kipandauso chenye aura huonekana kuwa hatari ya[[kiharusi ya iskemia]]<ref name=Stroke2009>{{cite journal|last=Schürks|first=M|coauthors=Rist, PM; Bigal, ME; Buring, JE; Lipton, RB; Kurth, T|title=Migraine and cardiovascular disease: systematic review and meta-analysis.|journal=BMJ (Clinical research ed.)|date=2009-10-27|volume=339|pages=b3914|pmid=19861375|pmc=2768778}}</ref> doubling the risk.<ref>{{cite journal|last=Kurth|first=T|coauthors=Chabriat, H; Bousser, MG|title=Migraine and stroke: a complex association with clinical implications.|journal=Lancet neurology|date=2012 Jan|volume=11|issue=1|pages=92–100|pmid=22172624}}</ref>Kuwa kijana, mtu wa jinsia ya kike, kutumia[[vizuia mimba vyenye homoni]] na kuvuta sigara huongeza hatari ya kupata ugonjwa huu.<ref name=Stroke2009/>. Pia hatari hii huonekana kuwa na uhusiano na [[kupasuka kwa ateri ya seviksi]].<ref>{{cite journal|last=Rist|first=PM|coauthors=Diener, HC; Kurth, T; Schürks, M|title=Migraine, migraine aura, and cervical artery dissection: a systematic review and meta-analysis.|journal=Cephalalgia : an international journal of headache|date=2011 Jun|volume=31|issue=8|pages=886–96|pmid=21511950|doi=10.1177/0333102411401634|pmc=3303220}}</ref> Kipandauso bila aura hakionekani kuwa kipengele.<ref name=Kurth2010>{{cite journal|last=Kurth|first=T|title=The association of migraine with ischemic stroke.|journal=Current neurology and neuroscience reports|date=2010 Mar|volume=10|issue=2|pages=133–9|pmid=20425238|doi=10.1007/s11910-010-0098-2}}</ref>. Uhusiano wa hali hii na matatizo ya moyo sio wazi, huku utafiti mmoja ukiafiki uhusiano huo. <ref name=Stroke2009/> Kwa ujumla, kipandauso hakionekani kuongeza hatari ya kufa kufuatia kiharusi au ugonjwa wa moyo.<ref name=Death2011/> Matibabu ya kipandauso kwa wenye kipandauso chenye aura yanaweza kuzuia kiharusi husika.<ref>{{cite journal|last=Weinberger|first=J|title=Stroke and migraine.|journal=Current cardiology reports|date=2007 Mar|volume=9|issue=1|pages=13–9|pmid=17362679}}</ref> == Epidemolojia == [[Picha:Migraine world map - DALY - WHO2004.svg|thumb|[[Disability-adjusted life year]] for migraines per 100,000&nbsp;inhabitants in 2004 {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<45}} {{legend|#fff200|45–65}} {{legend|#ffdc00|65–85}} {{legend|#ffc600|85–105}} {{legend|#ffb000|105–125}} {{legend|#ff9a00|125–145}} {{Multicol-break}} {{legend|#ff8400|145–165}} {{legend|#ff6e00|165–185}} {{legend|#ff5800|185–205}} {{legend|#ff4200|205–225}} {{legend|#ff2c00|225–245}} {{legend|#cb0000|>245}} {{Multicol-end}}]] Kote ulimwenguni, kipandauso huathiri zaidi ya asilimia 10 ya watu <ref name=Rob10/> Kule Marekani, takriban asilimia 6 ya wanaume na asilimia 18 ya wanawake hupata kipandauso kila mwaka huku wakiwa na hatari ya daima ya asilimia 18 na 43 mtawalia.<ref name=Bart10/> Barani Uropa, kipandauso huathiri asilimia 12–28 ya watu maishani mwao huku takriban asilimia 6–15 ya wanaume wazima na asilimia 14–35 ya wanawake wazima wakipata angalau tukio moja kila mwaka.<ref name=Stovner2007/> Kima cha kipanduso ni chini kiasi barani Asia na Afrika ikilinganishwa na nchi za Magharibi.<ref name=HA25>The Headaches Pg. 238-240</ref><ref name=AsiaEpi2003>{{Rejea jarida|author=Wang SJ |title=Epidemiology of migraine and other types of headache in Asia |journal=Curr Neurol Neurosci Rep |volume=3 |issue=2 |pages=104–8 |year=2003|pmid=12583837|doi = 10.1007/s11910-003-0060-7}}</ref> Kipandauso sugu hutokea kwa takriban asilimia 1.4 ya watu hadi 2.2.<ref>{{cite journal|last=Natoli|first=JL|coauthors=Manack, A; Dean, B; Butler, Q; Turkel, CC; Stovner, L; Lipton, RB|title=Global prevalence of chronic migraine: a systematic review.|journal=Cephalalgia : an international journal of headache|date=2010 May|volume=30|issue=5|pages=599–609|pmid=19614702|doi=10.1111/j.1468-2982.2009.01941.x}}</ref> [[Picha:Migraine gender age.png|gumba|thumb|Visa vya ugonjwa wa kipandauso kwa umri na jinsia]] Takwimu hizi hutofautiana sana kwa umri: mara nyingi zaidi, kipandauso huanza kati ya umri wa miaka 15 na 24 na hutokea mara nyingi kwa watu wenye umri wa miaka 35 hadi 45.<ref name=Bart10/> Kwa watoto, takriban asilimia 1.7 ya watoto wenye umri wa miaka 7&nbsp;na asilimia 3.9 kwa wale wa kati ya miaka 7 na 15&nbsp; wana kipandauso, huku hali hii ikitokea mara nyingi kwa wavulana kabla ya [[kubalehe]].<ref name=Hershey2010>{{cite journal|last=Hershey|first=AD|title=Current approaches to the diagnosis and management of pediatric migraine.|journal=Lancet neurology|date=2010 Feb|volume=9|issue=2|pages=190–204|pmid=20129168}}</ref> Wakati wa kubaleghe, kipandauso hutokea mara nyingi kwa wanawake <ref name=Hershey2010/> na hali hii huendelea maishani, ikitokea mara mbili zaidi kwa wanawake wazee kuliko wanaume.<ref name=Pol2009/> Kipandauso bila aura hutokea mara nyingi zaidi kwa wanawake kuliko kipandauso chenye aura, ingawa aina hizi mbili hutokea kwa kiwango sawa kwa wanaume.<ref name=HA25/> Kwa [[kipindi kilichokaribia ukomohedhi]] mara nyingi dalili huzidi kabla ya kupunguka ukali.<ref name=Pol2009>{{cite journal|last=Nappi|first=RE|coauthors=Sances, G; Detaddei, S; Ornati, A; Chiovato, L; Polatti, F|title=Hormonal management of migraine at menopause.|journal=Menopause international|date=2009 Jun|volume=15|issue=2|pages=82–6|pmid=19465675}}</ref> Huku dalili zikitokomea kwa takriban thuluthi mbili ya wazee, dalili hizi hudumu kwa kati ya asilimia 3 na 10.<ref name=ElderlyBook2008>{{cite book|last=Malamut|first=edited by Joseph I. Sirven, Barbara L.|title=Clinical neurology of the older adult|year=2008|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781769471|pages=197|url=http://books.google.ca/books?id=c1tL8C9ryMQC&pg=PA197|edition=2nd ed.}}</ref> == Historia == [[Picha:Cruikshank - The Head Ache.png|thumb|''The Head Ache'', George Cruikshank (1819)]] Maelezo ya mwanzo ya yaliyozingatia kipandauso yamo kwa [[mafunjo ya Eber]], yaliyoandikwa takriban mwaka wa 1200&nbsp;BCE kwa kale za Misri<ref name=Miller2005>{{cite book|last=Miller|first=Neil|title=Walsh and Hoyt's clinical neuro-ophthalmology.|year=2005|publisher=Lippincott Williams & Wilkins|location=Philadelphia, Pa.|isbn=9780781748117|pages=1275|url=http://books.google.ca/books?id=9RA2ZOPRuhgC&pg=PA1275|edition=6th ed}}</ref> Kwa mwaka wa 200 BC, maandishi kutoka kwa [[Hippocrates|Shule ya madaktari ya Hippocrates]] yalieleza aura inayohusiana na kuona inayotokea kabla ya maumivu ya kichwa na kupata nafuu kidogo kufuatia kutapika.<ref name=Borsook2012>{{cite book|last=Borsook|first=David|title=The migraine brain : imaging, structure, and function|year=2012|publisher=Oxford University Press|location=New York|isbn=9780199754564|pages=3–11|url=http://books.google.ca/books?id=5GVVJS_fCAkC&pg=PA3&lpg=PA3}}</ref> [[Picha:Trepanated skull of a woman-P4140363-black.jpg|thumb|left|A trepanated skull, from the [[Iron age]]. Mzunguko wa shimo kwa fuvu la kichwa unazingirwa na ukuaji wa tishu gumu kama mifupa kuashiria kuwa mtu huyo alipona baada ya upasuaji.]] Maelezo ya karneya pili ya [[Aretaeus of Cappadocia]] yaliainisha maumivu ya kichwa kwa aina tatu: sefalejia, sefalea na heterokrania.<ref name=Waldman2011>{{cite book|last=Waldman|first=[edited by] Steven D.|title=Pain management|year=2011|publisher=Elsevier/Saunders|location=Philadelphia, PA|isbn=9781437736038|pages=2122–2124|url=http://books.google.ca/books?id=O6AojTbeXoEC&pg=PT2122&lpg=PT2122|edition=2nd ed.}}</ref> [[Galen|Galen wa Pergamon]] alitumia neno hemikrania (nusu ya kichwa), ambapo neno kipandauso hatimaye lilikopwa.<ref name=Waldman2011/> Galen pia alipendekeza kuwa maumivu huanzia kwenye meninjesi na mishipa ya damu kichwani.<ref name=Borsook2012/>Hapo awali, kipanduso kilikuwa kimeainishwa kwa aina mbili zinazotumika hata sasa - kipandauso chenye aura(''migraine ophthalmique'') na kipanduso bila aura (''migraine vulgaire'') kwa mwaka wa 1887 na Louis Hyacinthe Thomas Mkutubi Mfaransa.<ref name=Borsook2012/> [[Utoboaji]], yaani kutoboa tundu kwa hiari kwenye fuvu la kichwa, ulifanyika hata mwaka wa 7,000&nbsp;BCE.<ref name=Miller2005/> Huku baadhi ya watu wakipona, wengi wao huenda walikufa kufuatia maambukizi.<ref>{{cite book|last=Mays|first=eds. Margaret Cox, Simon|title=Human osteology : in archaeology and forensic science|year=2002|publisher=Cambridge University Press|location=Cambridge [etc.]|isbn=9780521691468|pages=345|url=http://books.google.ca/books?id=-UqAnk-n7wgC&pg=PA345|edition=Repr.}}</ref> Tendo hili liliaminika kufanya kazi kwa kupitia "kufungulia mapepo watoroke".<ref>{{cite book|last=Colen|first=Chaim|title=Neurosurgery|year=2008|publisher=Colen Publishing|isbn=9781935345039|pages=1|url=http://books.google.ca/books?id=zHg53Gw0JrAC&pg=PA1}}</ref> [[Kwa karne ya 17, William Harvey]] alipendekeza utoboaji tundu kama matibabu ya kipandauso.<ref>{{cite book|last=Daniel|first=Britt Talley|title=Migraine|year=2010|publisher=AuthorHouse|location=Bloomington, IN|isbn=9781449069629|pages=101|url=http://books.google.ca/books?id=YSoSECeCudIC&pg=PA101&lpg=PA101}}</ref> Huku majaribio mengi ya matibabu ya kipandauso yakifanyika, ni mpaka mwaka 1868 ambapo matumizi ya dutu ambazo hatimaye ziliweza kuwa bora yalianza.<ref name=Borsook2012/> Dutu hizi ni[[erogoti]] ya kuvu ambapo dawa ya ergotamine ilitolewa kwa mwaka wa 1918.<ref name=Hanson2011>{{cite journal|last=Tfelt-Hansen|first=PC|coauthors=Koehler, PJ|title=One hundred years of migraine research: major clinical and scientific observations from 1910 to 2010.|url=https://archive.org/details/sim_headache_2011-05_51_5/page/752|journal=Headache|date=2011 May|volume=51|issue=5|pages=752–78|pmid=21521208}}</ref> [[Methysergide]]ilitolewa mwaka wa 1959, na triptani ya kwanza, [[sumatriptan]], kutolewa mwaka wa 1988.<ref name=Hanson2011/> Kufuatia utafiti mwafaka, dawa bora za kukinga kipandauso zilipatikana na kuthibitishwa kwa karne ya 20.<ref name=Borsook2012/> == Jamii na Utamaduni == Kipandauso ni chanzo kikuu cha gharama ya kimatibabu na kukosa matokeo mema kazini. Imekadiriwa kwamba kipandauso ni ugonjwa wenye gharama kali mno kati ya magonjwa mengine yanayohusika na mfumo wa neva kwa Jumuiya ya Ulaya, ukigharimu zaidi ya bilioni €27 kwa mwaka<ref name=EU2008>{{cite journal|last=Stovner|first=LJ|coauthors=Andrée, C; Eurolight Steering, Committee|title=Impact of headache in Europe: a review for the Eurolight project.|journal=The journal of headache and pain|date=2008 Jun|volume=9|issue=3|pages=139–46|pmid=18418547}}</ref> Huko Marekani gharama ya moja kwa moja imekadiriwa kuwa [[Dolar ya Marekani|dola]] [[bilioni]] 17.<ref name=EcoUSA2008>{{cite journal|last=Mennini|first=FS|coauthors=Gitto, L; Martelletti, P|title=Improving care through health economics analyses: cost of illness and headache.|journal=The journal of headache and pain|date=2008 Aug|volume=9|issue=4|pages=199–206|pmid=18604472}}</ref>. Takriban asilimia 10 ya gharama hii ni ya triptani.<ref name=EcoUSA2008/> Gharama isiyo ya moja kwa moja ni takriban dola bilioni 15 za Marekani, ambapo kukosa kazi ni kipengele kikuu.<ref name=EcoUSA2008/> Ubora wa wanaoweza kuendelea na kazi licha ya kuwa na kipandauso hupunguka kwa takriban theluthi moja. <ref name=EU2008/> Mathara mabaya mara nyingi pia hutokea kwa familia ya mtu.<ref name=EU2008/> == Utafiti == [[Peptidi]] inayohusiana na jeni ya kidhibiti kalisi imethibitiwa kuhusika kwa pathojenesisi ya maumivu yanayohusiana na kipandauso.<ref name=Gilmore2011/> Vipokezi pinzani vya peptidi inayohusiana na jeni ya kidhibiti kalisi, kama vile [[olcegepant]] na [[telcagepant]], vimechunguzwa kwa utafiti wa'' [[vitro]]]'' na kwa utafiti wa kiafya ya matibabu ya kipandauso.<ref name="pmid18808506">{{Rejea jarida|author=Tepper SJ, Stillman MJ |title=Clinical and preclinical rationale for CGRP-receptor antagonists in the treatment of migraine |url=https://archive.org/details/sim_headache_2008-09_48_8/page/1259 |journal=Headache |volume=48 |issue=8 |pages=1259–68 |year=2008 |month=September |pmid=18808506 |doi=10.1111/j.1526-4610.2008.01214.x }}</ref> Mwaka wa 2011, kampuni ya Merck ilisitisha [[awamu ya III ya majaribio ya kimatibabu]] ya uchunguzi wao wa dawa ya [[telcagepant]].<ref name=telcagepant>{{cite web|last=Merck & Co., Inc.|title=SEC Annual Report, Fiscal Year Ending Dec 31, 2011|url=http://www.merck.com/investors/financials/form-10-k-2011.pdf|publisher=SEC|accessdate=21 May 2012|page=65|date=February 28, 2012|format=PDF|archivedate=2013-08-27|archiveurl=https://www.webcitation.org/6JBJX4a8R?url=http://www.merck.com/investors/financials/form-10-k-2011.pdf}}</ref><ref name=NCT01315847>{{ClinicalTrialsGov|NCT01315847|Position Emission Tomography Study of Brain CGRP Receptors After MK-0974 Administration (MK-0974-067 AM1)}}</ref> == Tanbihi== {{Reflist|2}} == Marejeo== * {{cite book|last=Olesen|first=Jes|title=The headaches.|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781754002|url=http://books.google.ca/books?id=F5VMlANd9iYC&|edition=3. ed.}} == Viungo vya nje == * {{DMOZ|/Health/Conditions_and_Diseases/Neurological_Disorders/Headaches/Migraine/}} [[Jamii:Magonjwa]] kvo46pb1sr8ypsa6dyz4gmmlfr07dd1 0 69855 1578213 1465888 2026-07-03T03:30:22Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578213 wikitext text/x-wiki {{Infobox disease | Name = Pneumonia | Image = PneumonisWedge09.JPG |Alt = A black and white X-ray picture showing a triangle white area on the left side. A circle highlights the area. | Caption = A chest X-ray showing a very prominent wedge-shape [[bacterial pneumonia]] in the right lung. | Alt = An X-ray: showing a white wedge in the right lung field of a chest X-ray. | DiseasesDB = 10166 | ICD10 = {{ICD10|J|12||j|09}}, {{ICD10|J|13||j|09}}, {{ICD10|J|14||j|09}}, {{ICD10|J|15||j|09}}, {{ICD10|J|16||j|09}}, {{ICD10|J|17||j|09}}, {{ICD10|J|18||j|09}}, {{ICD10|P|23||p|20}} | ICD9 = {{ICD9|480}}-{{ICD9|486}}, {{ICD9|770.0}} | ICDO = | OMIM = | MedlinePlus = 000145 | eMedicineSubj = search | eMedicineTopic = pneumonia | MeshID = D011014 }} <!--Ufafanuzi na kisababishi--> '''Nimonia''' (kutoka [[Kiingereza]] "Pneumonia") ni hali ya [[Inflamesheni|kuvimba]] kwa [[pafu]] inayoathiri hasa vifuko vya hewa viitwavyo [[alveoli]].<ref name=RespText09>{{cite book|last=McLuckie|first=[editor] A.|title=Respiratory disease and its management|url=https://archive.org/details/respiratorydisea0000mclu|year=2009|publisher=Springer|location=New York|isbn=978-1-84882-094-4|page=[https://archive.org/details/respiratorydisea0000mclu/page/51 51]}}</ref><ref name=AcuteCare09>{{cite book |author=Leach, Richard E. |title=Acute and Critical Care Medicine at a Glance |edition=2nd |publisher=Wiley-Blackwell|year=2009 |isbn=1-4051-6139-6 |url= http://books.google.co.uk/books?id=7u_wu5VCsVQC&pg=PT168|accessdate=2011-04-21}}</ref> Husababishwa na [[maambukizi]] ya [[virusi]] au [[bakteria]] na kwa nadra kwa [[vimelea]], baadhi ya [[dawa]] na [[magonjwa]] mengine kama [[ugonjwa wa kinga nafsia]].<ref name=RespText09/> <!--Dalili, uzuiaji na matibabu--> [[Dalili]] hasa ni [[kikohozi]], [[maumivu ya kifua]], [[joto]] jingi [[Mwili|mwilini]] na [[upumuaji mgumu]]. Vifaa vya [[utambuzi wa kiafya|utambuzi]] ni [[eksirei]] na ukuzaji wa vimelea vya [[makohozi]]. [[Chanjo]] za kuzuia baadhi ya aina za nimonia zipo. [[Matibabu]] hutegemea kisababishi cha msingi. Nimonia inayotazamiwa ya bakteria hutibiwa kwa [[antibiotiki]]. Iwapo nimonia hiyo ni kali, mwathiriwa hulazwa [[Hospitali|hospitalini]]. <!--Prognosisi na epidemolojia--> Kila mwaka, nimonia huathiri takriban watu milioni 450&nbsp; ambao ni asilimia saba ya idadi kamili ya watu duniani na husababisha takriban vifo milioni 4&nbsp;. Ingawa nimonia ilichukuliwa na [[William Osler]] katika karne ya ¹⁹ kuwa "nahodha wa visababishi vya vifo",<ref>{{cite book|last=Osler|first=William|title=Principles and Practice of Medicine, 4th Edition|year=1901|publisher=D. Appleton and Company|location=New York|pages=108|url=http://mcgovern.library.tmc.edu/data/www/html/people/osler/PPM4th/OP400067.htm|access-date=2013-11-28|archive-date=2007-07-08|archive-url=https://web.archive.org/web/20070708201758/http://mcgovern.library.tmc.edu/data/www/html/people/osler/PPM4th/OP400067.htm|dead-url=yes}}</ref> majilio ya tiba ya antibiotiki na chanjo katika karne ya²⁰ yameendeleza kuongoka.<ref name=Lancet11/>Hata hivyo katika nchi zinazostawi, na kwa wazee sana na wachanga sana na walio na [[ugonjwa sugu|wanaougua mara kwa mara]], nimonia bado ndicho kisababishi kikuu cha vifo.<ref name=Lancet11/><ref>{{cite book|last=George|first=Ronald B.|title=Chest medicine : essentials of pulmonary and critical care medicine|year=2005|publisher=Lippincott Williams & Wilkins|location=Philadelphia, PA|isbn=9780781752732|pages=353|url=http://books.google.ca/books?id=ZzlX2zJMbdgC&pg=PA353|edition=5th ed.}}</ref> == Ishara and dalili == {|class="wikitable" align="right" !colspan=2| Kiwango cha kutokea kwa dalili<ref name=Tint10/> |- ! Dalili !! Kiwango cha kutokea |- | Kikohozi ||<center>asilimia 79–91</center> |- | Uchovu || <center>asilimia 90</center> |- | Kiwango cha juu cha joto || <center>asilimia 71–75</center> |- | Upungu wa pumzi || <center>asilimia 67–75</center> |- | maKohozi || <center>asilimia 60–65</center> |- | Maumivu ya kifua || <center>asilimia 39–49</center> |- |} [[File:Symptoms of pneumonia.svg|thumb|left|alt=Mchoro wa mwili wa binadamu ukionyesha dalili kuu za nimonia|300px|Dalili kuu za nimonia ya kuambukiza]] Watu walio na nimonia ya kuambukiza mara nyingi huwa na [[kikohozi|kikohozi chenye kohozi]], [[joto jingi mwilini]] pamoja na[[kutetemeka|baridi inayotetemesha]],[[upungufu wa pumzi]], [[maumivu ya kifua]] makali wakati wa kuvuta pumzi, na ongezeko la [[kiwango cha kupumua]].<ref name=BMJ06/> Kwa wazee, ishara inayoonekana sana inaweza kuwa kuchanganyikiwa. Kwa watoto chini ya miaka mitano, ishara na dalili hasa ni joto jingi mwilini, kikohozi, upumuaji wa haraka au mgumu.<ref name=Develop11/> Joto jingi mwilini si mahususi kabisa kwa sababu hutokea katika maradhi mengine mengi, na hali hii inaweza kukosa kwa walio na ugonjwa mkali sana au[[utapiamlo]]. Zaidi ya hayo, kikohozi hukosa mara nyingi kwa watoto wenye umri wa chini ya miezi miwili<ref name=Develop11/> Ishara na dalili zaidi kali ni:[[sinosisi ya kati|ngozi yenye rangi ya bluu kidogo]], kiu kilichopungua, matukutiko, kutapika kunakoendelea, halijoto iliyopungua sana au iliyozidi sana, au [[kiwango kilichopungua cha fahamu]].<ref name=Develop11/><ref name=Clinic2011/> Visa vya nimonia ya bakteria na ya virusi hujitokeza kwa dalili sawa.<ref name=WHOPrevent2012/> Visababishi vingine huhusishwa na sifa bainifu za kiafya zinazotokea sana bali zisizo maalum. Nimonia inayosababishwa na ''[[Legionella]]'' inaweza kutokea pamoja na maumivu ya fumbatio, [[kuhara]], au kuchanganyikiwa,<ref>{{cite journal|last=Darby|kwanza=J|coauthors=Buising, K|title=Could it be Legionella?|journal=Australian family physician|date=Oktoba 2008 |volume=37|issue=10|pages=812–5|pmid=19002299}}</ref> ilhali nimonia inayosababishwa na ''[[Streptokokasi numoniae]]'' huhusishwa na makohozi yenye rangi ya kutu,<ref>{{cite journal|last=Ortqvist|first=A|coauthors=Hedlund, J, Kalin, M|title=Streptococcus pneumoniae: epidemiology, risk factors, and clinical features|url=https://archive.org/details/sim_seminars-in-respiratory-and-critical-care-medicine_2005-12_26_6/page/563|journal=Seminars in respiratory and critical care medicine|date=December 2005|volume=26|issue=6|pages=563–74|pmid=16388428|doi=10.1055/s-2005-925523}}</ref> na nimonia inayosababishwa na ''[[Klebsiella]]''inaweza kuwa na makohozi yenye damu ambayo mara nyingi huelezwa kama "jeli ya zambarau".<ref name=Tint10>{{cite book |author=Tintinalli, Judith E.|title=Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli))|publisher=McGraw-Hill Companies|location=New York|year=2010|pages=480 |isbn=0-07-148480-9 |oclc= |doi= |accessdate=}}</ref> Makohozi yenye damu (yaitwayo[[hemoptisisi]]) pia yanaweza kutokea katika [[kifua kikuu]], nimonia isiyo na gram, usaha kwenye mapafu na aidha mara nyingi katika[[bronkitisi kali]].<ref name=Clinic2011/> Nimonia ya ''maikoplasma'' inaweza kutokea kwa kuhusiana na [[limfadenopathi ya seviksi |kuvimba kwa tezi za shingo]], [[arthralgia|maumivu ya jointi]], au [[otitisi ya kati|maambukizi kwenye sikio la kati]].<ref name=Clinic2011/> Nimonia ya virusi hujitokeza sana kwa [[kukoroma]] kuliko nimonia ya bakteria.<ref name=WHOPrevent2012/> == Visababishi == [[File:Streptococcus pneumoniae.jpg|thumb|alt=Vitu vitatu vya mviringo mmoja sehemu yake ya nyuma ikiwa nyeusi| bakteria ''[[sreptokokasi numoniae]]'', kisababishi kikuu cha nimonia, ikionyeshwa kwa picha ya [[hadubini ya elektroni]]]] Nimonia hutokana hasa na maambukizi yanayosababishwa na [[bakteria]] au [[virusi]] na kwa viwango vidogo na [[kuvu]] na[[parasiti]]. Ingawa kuna zaidi ya aina 100 za ajenti za maambukizi zilizogunduliwa, ni chache tu zinahusika kwa vingi vya visa. Maambukizi yanayohusisha mchanganyiko wa virusi na bakteria yanaweza kutokea kwa hadi asilimia 45 ya maambukizi kwa watoto na asilimia 15 ya maambukizi kwa watu wazima.<ref name=Lancet11/> Huenda ajenti inayosababisha isiweze kubainishwa katika takriban nusu ya visa licha ya kupima kwa makini.<ref name=EBMED05/> Wakati mwingine neno''nimonia'' hutumika sana kwa ugonjwa wowote unaotokana na [[inflamesheni]] ya mapafu (inayosababishwa kwa mfano na [[magonjwa ya kinga nafsia]], kuchomwa na kemikali au athari za dawa); hata hivyo kwa usahihi zaidi, inflamesheni hii huitwa[[nimonitisi]].<ref name="isbn0-7234-3200-7">{{cite book |author=Lowe, J. F.; Stevens, Alan |authorlink=|editor= |others= |title=Pathology |edition=2nd |publisher=Mosby |location=St. Louis |year=2000 |page=197 |isbn=0-7234-3200-7|oclc= |doi= |url=http://books.google.co.uk/books?id=AfVxLi4QTZQC&pg=PA197|accessdate=}}</ref><ref>{{cite book|last=Snydman|first=editors, Raleigh A. Bowden, Per Ljungman, David R.|title=Transplant infections|year=2010|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-58255-820-2|page=187|url=http://books.google.com/books?id=NWa4FJv-eBYC&pg=PA447|edition=3rd}}</ref> Ajenti zinazoambukiza zilikuwa zimegawanya kihistoria katika "za kawaida" na "zisizo kawaida" kwa msingi wa zilivyodhaniwa kujitokeza lakini ushahidi haujaunga mkono tofauti hii, kwa hivyo haitiliwi mkazo tena.<ref name=M32/> Hali na visababishi vya hatari vinavyopelea nimonia ni: uvutaji, ukosefu wa kinga mwilini, ulevi [[ugonjwa sugu wa kufunga kwa mapafu]], [[ugonjwa sugu wa figo]], na [[ugonjwa wa ini]].<ref name=Clinic2011/> Utumizi wa tiba zinazokandamiza asidi – kama vile [[kinza pampu ya protoni]] au [[H2 blockers]]- unahusishwa na ongezeko la hatari<ref>{{cite journal|last=Eom|first=CS|coauthors=Jeon, CY; Lim, JW; Cho, EG; Park, SM; Lee, KS|title=Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis|journal=CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne|date=22 February 2011|volume=183|issue=3|pages=310–9|pmid=21173070|doi=10.1503/cmaj.092129|pmc=3042441}}</ref> ya nimonia. Uzee pia hupelekea nimonia.<ref name=Clinic2011/> === Bakteria === Bakteria ndizo kisababishi kikuu cha [[nimonia iambukizayo katika jamii]], ambapo ''[[Streptokokasi numoniae]]'' ilionekana kuhusika katika takriban asilimia 50 ya visa.<ref name=Rad07/><ref name=EOP10>{{cite journal |author=Anevlavis S | coauthors = Bouros D |title=Community acquired bacterial pneumonia|journal=Expert Opin Pharmacother |volume=11 |issue=3 |pages=361–74 |year=2010|monthi=February|pmid=20085502|doi=10.1517/14656560903508770 }}</ref> Bakteria zingine zinazohusika sana ni: ''[[Himofilasi influenzae]]'' katika asilimia 20, ''[[klamidofila numoniae]]'' katika asilimia 13, na ''[[Maikoplasma numoniae]]'' katika asilimia 3 ya visa;<ref name=Rad07/> ''[[Stafilokokasi aureasi]]''; ''[[Moraksela kataralisi]]''; ''[[Lejionela numofila]]'' na [[Basili isiyo na gram]].<ref name=EBMED05/> Aina kadhaa za maambukizi [[yenye ukinzani kwa dawa|yanayokinza dawa]] yaliyo hapo juu yamezidi kutokea sana, yakiwemo ''Streptokokasi numoniae'' kinzani na [[stafilokokasi aureasi-kinzani kwa methicillin]].<ref name=Clinic2011/> Ueneaji wa vimelea huendelezwa visababishi vya hatari vinapokuwa.<ref name=EBMED05/> [[Ulevi]] unahusiana na''Streptokokasi numoniae'', [[vimelea vya anerobi]] na ''Kifuakikuu cha maikobakteria''; uvutaji huendeleza athari za''Streptokokasi numoniae'', ''Himofilasi influenzae'', ''Moraksela kataralisi'', na ''Legionella numofila''. Kutangamana na ndege kunahusiana na ''[[Klamidia sitasi]]''; wanyama wa shambani na ''[[Kosiela baneti]]''; aspiresheni ya vitu vya tumboni na [[vimelea vya anerobi]]; nayo [[faibrosi ya uvimbe]] na ''[[Seudomona erujinosa]]'' na ''Stafilokokasi aureasi''.<ref name=EBMED05/>''Streptokokasi numoniae'' hutokea sana katika majira ya baridi,<ref name=EBMED05/> na inapaswa kushukiwa kwa watu wanaopumua kiasi kikubwa cha [[vimelea vya anerobi]].<ref name=Clinic2011/> === Virusi === Kwa watu wazima, [[virusi]] huchangia takriban thuluthi moja<ref name =Lancet11/> na kwa watoto taktiban asilimia 15 ya visa vya nimonia.<ref name=M31/> Ajenti zinazoshukiwa sana ni: [[virusi vya raino]], [[virusi vya korona]], [[virusi vya influenza]],[[virusi vya kupumua vya sinsitia]], [[virusi vya adeno]], na [[virusi vya parainfluenza].<ref name=Lancet11/><ref name=Viral09/> [[Virusi vya hepesi simpleksi]] havisababishi nimonia sana, isipokuwa kwa vikundi kama vile: watoto wachanga, watu walio na saratani, waliopokea ogani za mwili, na watu walio na majeraha makubwa ya moto.<ref name=Text2010>{{cite book|last=Behera|first=D.|title=Textbook of pulmonary medicine|year=2010|publisher=Jaypee Brothers Medical Pub.|location=New Delhi|isbn=8184487495|pages=391–394|url=http://books.google.ca/books?id=0TbJjd9eTp0C&pg=PA391|edition=2nd }}</ref> Watu [[waliopokea ogani]] au wale ambao kwa njia nyingine [[miili yao imepoteza uwezo wa kujikinga na maradhi]] huwa na viwango vikubwa vya nimonia ya [[virusi vya kuvimba kwa seli]]`.<ref name=M31/><ref name=Text2010/> Walio na maambukizi ya virusi wanaweza kuambukizwa tena na bakteria''Streptokokasi numoniae'', ''Stafilokokasi aureasi'', au ''Himofilasi influenzae'', hasa panapokuwa na matatizo mengine ya kiafya.<ref name=Clinic2011/><ref name=M31/> Virusi tofauti huzidi katika vipindi tofauti vya mwaka, kwa mfano katika msimu wa influenza, influenza inaweza kuchangia zaidi ya nusu ya visa vyote vya virusi.<ref name=M31/> Milipuko ya virusi vingine pia hutokea mara chache, vikiwemo ''[[virusi vya hanta]]'' na ''[[virusi vya korona]]''.<ref name=M31/> === Kuvu === Nimonia ya kuvu haitokei sana, lakini hutokea sana kwa watu [[wasio na kinga mwilini|wenye mfumo dhaifu wa kingamwili]] kutokana na[[UKIMWI]], [dawa zinazozuia utendaji kazi wa kingamwili]], au matatizo mengine ya kiafya.<ref name=EBMED05/><ref name=Fungus2009>{{cite book|last=Maskell|first=Nick|title=Oxford desk reference.|year=2009|publisher=Oxford University Press|location=Oxford|isbn=9780199239122|pages=196|url=http://books.google.ca/books?id=MfEUkzQQ1BEC&pg=PA196|coauthors=Millar, Ann}}</ref> Mara nyingi husababishwa na ''[[Histoplasmosisi|Histoplasma capsulatum]]'', blastomaisesi, ''[[Kryptokokasi niofomani]]'', ''[[Numosisitisi jirovesi]]'', na ''[[Koksidiodi imitisi]]''. [[Histoplasmosisi]] hutokea sana katika [[Ghuba ya Mississippi |Bonde la mto wa Mississippi]], na [[koksidioidomikosi]] hutokea sana katika [[Kusini magharibi mwa Marekani]].<ref name=EBMED05/> Idadi ya visa imekuwa ikiongezeka katika nusu ya mwisho ya karne ya 20 kutokana na ongezeko la usafiri na viwango vya ukandamizaji kinga kwa watu.<ref name=Fungus2009/> === Parasiti === Aina tofauti za [[parasiti]] zinaweza kuathiri mapafu, zikiwemo: ''[[Toxoplasma gondii]]'', ''[[Strongiloidi stakoralisi]]'',''[[Minyoo mviringo]]'', na ''[[Plasmodiamu malariae]]''.<ref name=M37>Murray and Nadel (2010). Chapter 37.</ref> Vimelea hivi huingia mwilini kupitia mgusano wa moja kwa moja wa ngozi, kumeza au kupitia mdudu ambaye ni vekta.<ref name=M37/>Isipokuwa ''[[Paragonimasi westamani]]'', parasiti nyingi haziathiri mapafu hasa, bali huhusisha mapafu baadaye baada ya sehemu zingine.<ref name=M37/> Parasiti zingine, hasa zile za jenera ya ''mnyoo wa Askaris'' na''Strongiloidi '' huchochea mwitiko mkali wa [[esinofili]], ambao unaweza kusababisha [[nimonia ya kiesinofili]].<ref name=M37/> Katika maambukizi mengine, kama vile malaria, kuhusika kwa mapafu hutokana hasa na inflamesheni inayochochewa na saitokini.<ref name=M37/> Katika [[ulimwengu uliostawi]], maambukizi haya hutokea sana kwa watu wanaorudi kutoka safarini au kwa wahamiaji. <ref name=M37/> Dunani kote, maambukizi haya hutokea sana kwa wasio na kingamwili.<ref>{{cite journal|last=Vijayan|first=VK|title=Parasitic lung infections.|journal=Current opinion in pulmonary medicine|date=2009 May|volume=15|issue=3|kurasa=274–82|pmid=19276810}}</ref> === Yenye asili isiyojulikana === Nimonia ya tishu za mapafu yenye asili isiyojulikana au nimonia isiyoambukiza<ref>{{cite book|first=ed. in chief Richard K. Root. Eds. Francis Waldvogel|title=Clinical infectious diseases : a practical approach|year=1999|publisher=Oxford Univ. Press|location=New York, NY [u.a.]|isbn=978-0-19-508103-9|page=833|url=http://books.google.com/books?id=zvCOpighJggC&pg=PA833}}</ref> ni aina ya[[ugonjwa wa mapafu unaosambaa]]. Nao ni: [[uharibikaji unaosambaa wa alveolasi]], [[nimonia ya organizing]], [[nimonia ya tishu za mapafu isiyo dhahiri]], [[nimonia ya limfosaiti ya tishu za mapafu]], [[nimonia ya kupukutika kwa tabaka la juu la tishu ya epithelia ya mapafu]], [[ugonjwa wa kupumua wa bronkiolitisi wa tishu za mapafu]], na [[nimonia ya kufanyika kunakoendelea kwa kovu kwenye tishu za mapafu]].<ref>{{cite book|first=Volume editors, Ulrich Costabel|title=Diffuse parenchymal lung disease : ... 47 tables|url=https://archive.org/details/diffuseparenchym00cost|year=2007|publisher=Karger|location=Basel|isbn=978-3-8055-8153-0|page=[https://archive.org/details/diffuseparenchym00cost/page/n4 4]|edition=[Online-Ausg.]}}</ref> == Pathofisiolojia == [[File:New Pneumonia cartoon.jpg|thumb|alt=Mchoro wa mapafu ya binadamu ukiwa na mviringo mtupu upande wa kushoto ukiwakilisha alveola ya kawaida na mwingine kulia ukionyesha alveola iliyojaa kiowevu kama katika nimonia|Nimonia hujaza [[alveolasi|alveoli]] za mapafu kwa kiowevu na kuzuia oksijeni kuingia. Alveolasi iliyo upande wa kushoto ni kawaida, ilhali iliyo upande wa kulia imejaa kiowevu kutokana na nimonia.]] Mara nyingi nimonia huanza kama [[maambukizi ya sehemu ya juu ya mfumo wa upumuaji]] yanayoenea kwenye sehemu ya chini ya mfumo wa upumuaji.<ref name=PedNA09>{{cite journal|last=Ranganathan|first=SC|coauthors=Sonnappa, S|title=Pneumonia and other respiratory infections|url=https://archive.org/details/sim_pediatric-clinics-of-north-america_2009-02_56_1/page/135|journal=Pediatric clinics of North America|date=February 2009 |volume=56|issue=1|pages=135–56, xi|pmid=19135585|doi=10.1016/j.pcl.2008.10.005}}</ref> === Ya virusi === Virusi vinaweza kulifikia pafu kwa njia nyingi tofauti. Virusi vya kupumua vya sinsitia huenezwa hasa watu wanapogusa vitu vilivyoambukizwa na kisha waguse macho au pua zao.<ref name=M31>Murray and Nadel (2010). Chapter 31.</ref>Maambukizi mengine ya virusi hutokea matone kwenye hewa yaliyoambukizwa yakivutwa ndani hadi mapafuni kupitia kinywani au puani.<ref name=Clinic2011/>Virusi vinapofika kwenye sehemu ya juu ya njia ya hewa, vinaweza kwenda hadi kwa mapafu ambapo huvamia seli kwenye kuta za njia za hewa, alveoli au [[parenkaima za mapafu]].<ref name=M31/> Virusi vingine kama vya ukambi na hepesi simpleksi vinaweza kufika kwa mapafu kupitia kwa damu.<ref name=Gary2010>{{cite book|last=al.]|first=editors, Gary R. Fleisher, Stephen Ludwig ; associate editors, Richard G. Bachur ... [et|title=Textbook of pediatric emergency medicine|year=2010|publisher=Wolters Kluwer/Lippincott Williams & Wilkins Health|location=Philadelphia|isbn=1605471593|pages=914|url=http://books.google.ca/books?id=a7CqcE1ZrFkC&pg=PA914|edition=6th ed.}}</ref> Uvamizi wa virusi hivi kwa mapafu unaweza kusababisha viwango tofauti vya vifo vya seli.<ref name=M31/> Mfumo wa kingamwili ukijaribu kuitika kwa maambukizi haya, uharibifu zaidi wa mapafu unaweza kutokea.<ref name=M31/> [[Seli nyeupe za damu]], hasa [[seli za mononuklea]], kwa kawaida husababisha inflamesheni hii.<ref name=Gary2010/> Pamoja na kuharibu mapafu, virusi vingi huathiri [[ogani (anatomia)|ogani]] zingine wakati huo huo na kukatiza shughuli zingine za mwilini. Virusi pia huufanya mwili kuwa mwepesi wa kuathiriwa na maambukizi ya bakteria; kwa njia hii nimonia ya bakteria inaweza kutokea kama ugonjwa [[ambatani]]<ref name=Viral09>{{cite journal|author=Figueiredo LT |title=Viral pneumonia: epidemiological, clinical, pathophysiological and therapeutic aspects |journal=J Bras Pneumol |volume=35 |issue=9 |pages=899–906 |year=2009 |month=September |pmid=19820817|doi=10.1590/S1806-37132009000900012}}</ref> === Ya bakteria === Bakteria nyingi huingia kwa mapafu kupitia [[Aspiresheni]] ndogo ndogo za vimelea vinavyoishi katika koo au pua.<ref name=Clinic2011/> Nusu ya watu wenye afya huwa na asipiresheni hizi wanapolala.<ref name=M32/> Ijapokuwa koo huwa na bakteria kila wakati, [[kali|zenye uwezo wa kuambukiza]] huishi hapo nyakati fulani tu na katika hali fulani.<ref name=M32/> Aina chache za bakteria kama ''[[maikobkteria ya kifua kikuu]]'' na ''[[Legionella numofila]]'' hufika kwenye mapafu kwa matone madogo ya hewani yaliyoambukizwa .<ref name=Clinic2011/> Bakteria zinaweza pia kuenea kupitia kwa damu.<ref name=WHOPrevent2012/> Zinapofika mapafuni, zinaweza kuvamia nafasi zilizo kati ya seli na kati ya alveoli, ambapo [[makrofeji]] na [[nutrofili]] ([[seli nyeupe za damu]] zinazolinda) hujaribu kuzilemaza.<ref>{{cite book|last=Hammer|first=edited by Stephen J. McPhee, Gary D.|title=Pathophysiology of disease : an introduction to clinical medicine|year=2010|publisher=McGraw-Hill Medical|location=New York|isbn=0071621679|pages=Chapter 4|edition=6th ed.}}</ref> Nutrofili pia hutoa [[sitokini]], na kusababisha uamsho wa kijumla wa mfumo wa kingamwili.<ref name=Fein2006>{{cite book|last=Fein|first=Alan|title=Diagnosis and management of pneumonia and other respiratory infections|year=2006|publisher=Professional Communications|location=Caddo, OK|isbn=1884735630|pages=28–29|url=http://books.google.ca/books?id=hKdcHK719qgC&pg=PA28|edition=2nd ed.}}</ref> Hii ndiyo inayosababisha joto jingi mwilini, kutetemeka, na uchovu unaoshuhudiwa katika nimonia ya bakteria.<ref name=Fein2006/> Nutrofili, bakteria, na viowevu kutoka kwa mishipa ya damu iliyo karibu hujaa katika alveoli na kusababisha konsolidesheni ionekanayo kwa eksirei ya kifua.<ref>{{cite book|last=Kumar|first=Vinay|title=Robbins and Cotran pathologic basis of disease.|year=2010|publisher=Saunders/Elsevier|location=Philadelphia, PA|isbn=1416031219|pages=Chapter 15|edition=8th ed.}}</ref> == Utambuzi == {{listen | filename =Crackles pneumoniaO.ogg | title = Crackles | description = Crackles heard in the lungs of a person with pneumonia using a stethoscope. | format = [[Ogg]] }} Nimonia hutambuliwa hasa kwa msingi wa mchanganyiko wa ishara zinazoonekana na kwa [[eksirei ya kifua]].<ref name=Diag10>{{cite journal|last=Lynch|first=T|coauthors=Bialy, L, Kellner, JD, Osmond, MH, Klassen, TP, Durec, T, Leicht, R, Johnson, DW|title=A systematic review on the diagnosis of pediatric bacterial pneumonia: when gold is bronze|journal=PLoS ONE|date=2010-08-06|volume=5|issue=8|pages=e11989|pmid=20700510|doi=10.1371/journal.pone.0011989|pmc=2917358|editor1-last=Huicho|editor1-first=Luis}}</ref>Hata hivyo, inaweza kuwa vigumu kudhibitisha kisababishi hasa, kwa sababu hakuna kipimo mahususi kinachoweza kutofautisha kati ya nimonia itokanayo na bakteria na isiyotokana na bakteria.<ref name=Lancet11/><ref name=Diag10/> [[Shirika La Afya Duniani]] limefafanua kiafya nimonia ya watoto kwa msingi wa [[kikohozi]] au upumuaji mgumu na kiwango cha haraka cha kupumua, kujivuta ndani kwa kifua, au kiwango kilichopungua cha fahamu.<ref name=WHOBook/> Kiwango cha haraka cha kupumua hufafanuliwa kama zaidi ya pumzi 60 kwa kila dakika kwa watoto chini ya umri wa miezi 2, pumzi 50 kwa dakika kwa watoto wa umri wa miezi 2 hadi mwaka 1, au zaidi ya pumzi 40 kwa dakika kwa watoto wa umri wa mwaka 1 hadi miaka 5.<ref name=WHOBook>{{cite book|last=Ezzati|first=edited by Majid|title=Comparative quantification of health risks|year=2004|publisher=Organisation mondiale de la santé|location=Genève|isbn=978-92-4-158031-1|page=70|url=http://books.google.com/books?id=ACV1jEGx4AgC&pg=PA70|coauthors=Lopez, Alan D., Rodgers, Anthony, Murray, Christopher J.L.}}</ref> Kwa watoto, kiwango kilichoongezeka cha kupumua na kujivuta ndani kwa sehemu ya chini ya kifua ni [[kiwango cha hisi na umaalum|vyepesi kuhisi]] kuliko kusikiza [[milio]] ya kifua kwa [[stethoskopu]].<ref name=Develop11/> Kwa watu wazima, uchunguzi hauhitajiki katika visa visivyo vikali<ref name=BTS09/>: kuna hatari ndogo sana ya nimonia iwapo [[ishara muhimu]] zote na [[oskalitesheni ya kifua|oskalitesheni]] ni za kawaida.<ref>{{cite journal|last=Saldías|first=F|coauthors=Méndez, JI, Ramírez, D, Díaz, O|title=[Predictive value of history and physical examination for the diagnosis of community-acquired pneumonia in adults: a literature review]|journal=Revista medica de Chile|date=April 2007|volume=135|issue=4|pages=517–28|pmid=17554463}}</ref> Kwa watu wanaohitaji kulazwa hospitalini, [[oksimetiri ya mpwito wa ateri]], [[radiografia ya kifua]] na [[vipimo vya damu]]—vikiwemo [[hesabu kamili ya damu]], [[elektroliti za seramu]], kiwango cha [[protini inayoathiri C]] na hata [[vipimo vya utendaji kazi wa ini]]—vimependekezwa.<ref name=BTS09/> Utambuzi wa [[maradhi mithili ya influenza]] unaweza kufanywa kwa msingi wa ishara na dalili; hata hivyo, udhibitishaji wa maambukizi ya influenza huhitaji kupima.<ref name=ILI05>{{cite journal|last=Call|first=SA|coauthors=Vollenweider, MA, Hornung, CA, Simel, DL, McKinney, WP|title=Does this patient have influenza?|url=https://archive.org/details/sim_jama_2005-02-23_293_8/page/987|journal=JAMA: the Journal of the American Medical Association|date=2005-02-23|volume=293|issue=8|pages=987–97|pmid=15728170|doi=10.1001/jama.293.8.987}}</ref> Kwa hivyo, matibabu mara nyingi hutegemea kuwepo kwa influenza katika jamii au [[Kipimo cha haraka cha utambuzi wa influenza|kipimo cha haraka cha influenza]].<ref name=ILI05/> ===Uchunguzi wa mwili === [[Uchunguzi wa mwili]] wakati mwingine unaweza kuonyesha [[hipotensheni|shinikizo la chini la damu]], [[takikadia|udundaji wa kasi wa moyo kuliko kawaida]] au [[uingizaji wa oksijeni (wa kitiba)|kiwango cha juu sana cha oksijeni]] kidogo.<ref name=Clinic2011/> Kiwango cha kupumua kinaweza kuwa haraka kuliko kawaida na hii inaweza kutokea siku moja au mbili kabla ya ishara zingine.<ref name=Clinic2011/><ref name=M32/> Kipimo cha kifua kinaweza kuwa cha kawaida lakini kionyeshe upanukaji uliopungua wa kifua kwenye upande ulioathiriwa. Sauti kali za pumuzi kutoka kwa njia kubwa za hewa zinazopitishwa kwenye pafu lililovimba huitwa upumuaji wa [[bronkasi|bronkioli]], na husikika kwa [[oskalitesheni]] kwa [[stethoskopu]].<ref name=Clinic2011/> [[milio]] (miparuzo) inaweza kusikika kwenye sehemu iliyoathiriwa wakati wa [[kuvuta hewa ndani|uvutaji pumzi]].<ref name=Clinic2011/> [[Ugongaji (matibabu)|ugongaji]] unaweza kutoa sauti iliyofifia kwenye pafu lililoathiriwa, na [[rizonansi ya sauti|rizonansi ya sauti]] iliyoongezeka badala ya iliyopungua hutofautisha nimonia na [[efusheni ya plura]].<ref name=BMJ06/> === Upigaji picha === [[File:CT scan of the chest, demonstrating right-sided pneumonia.jpg|thumb|alt=Picha yenye rangi nyeusi na nyeupe ikionyesha ogani za ndani jinsi ilivyotolewa na skani ya CT. Mahali ambapo weusi ungetarajiwa kwenye upande wa kushoto, sehemu nyeupe yenye vijiti vyeusi huonekana.|Skani ya CT ya kifua ikionyesha nimonia ya upande wa kulia (upande wa kushoto wa picha).]] [[Radiografu ya kifua]] hutumiwa mara kwa mara kwa utambuzi.<ref name=Develop11/> Kwa watu walio na ugonjwa usio mkali, upigaji picha huhitajika kwa wale tu walio na uwezekano wa kupata matatizo, wale ambao hawajapata nafuu bada ya matibabu, au wale ambao kisababishi hakijulikani.<ref name=Develop11/><ref name=BTS09>{{cite journal|last=Lim|first=WS|coauthors=Baudouin, SV, George, RC, Hill, AT, Jamieson, C, Le Jeune, I, Macfarlane, JT, Read, RC, Roberts, HJ, Levy, ML, Wani, M, Woodhead, MA, Pneumonia Guidelines Committee of the BTS Standards of Care, Committee|title=BTS guidelines for the management of community acquired pneumonia in adults: update 2009|journal=Thorax|date=October 2009 |volume=64 |issue=Suppl 3|pages=iii1–55|pmid=19783532|doi=10.1136/thx.2009.121434}}</ref> Iwapo mtu ni mgonjwa kiasi kwamba anahitaji kulazwa hospitalini, radiografu ya kifua imependekezwa.<ref name=BTS09/> Matokeo hayalingani na ukali wa ugonjwa kila wakati na hayatofautishi kikamilifu kati ya maambuki ya bakteria na ya virusi.<ref name=Develop11/> Nimonia inavyoonyeshwa kwa eksirei inaweza kuainishwa kama [[nimonia ya lobu]], [[nimonia ya bronko]], na [[nimonia ya tishu za mapafu]].<ref>{{cite book|last=Helms|first=editors, William E. Brant, Clyde A.|title=Fundamentals of diagnostic radiology|publisher=Wolters Kluwer/Lippincott Williams & Wilkins|location=Philadelphia|isbn=9781608319114|pages=435|url=http://books.google.ca/books?id=o_4eoeOinNgC&pg=PA435|edition=4th ed.}}</ref> Nimonia isababishwayo na backeria, inayoambukiza kwa jamii huonyesha [[konsolidesheni ya pafu]] ya moja ya [[Sehemu za bronkasi na mapafu|lobu ya vipande vya pafu]] inayojulikana kama nimonia ya lobu.<ref name=Rad07/>Hata hivyo, matokeo yanaweza kuwa tofauti, na mitindo mingine hutokea sana katika aina zingine za nimonia.<ref name=Rad07/> Nimonia ya aspiresheni inaweza kujitokeza na hali ya kutopitisha mwanga kwenye pande zote mbili hasa kwenye sehemu ya chini ya mapafu na upande wa kulia.<ref name=Rad07/> Radiografu za nimonia ya virusi zinaweza kuonekana kuwa kawaida, zimepanuka zaidi, zina sehemu za madoa pande zote mbili, au zinajitokeza sawa na nimonia ya bakteria yenye konsolidesheni ya lobu. <ref name=Rad07/> Huenda matokeo ya radiolojia yasiwepo mwanzoni mwa ugonjwa huo hasa kukiwa na ukosefu wa maji mwilini; au huenda ikawa vigumu kufasiliwa kwa wale walio na [[unene wa kupindukia|unene sana]], au historia ya ugonjwa wa mapafu.<ref name=Clinic2011/> [[Picha za kuchanganua]] zinaweza kutoa habari zaidi katika visa visivyo dhahiri.<ref name=Rad07/> === Mikrobiolojia === Kwa wagonjwa wanaotibiwa katika jamii, kutambua ajenti inayosababisha hugharimu sana na hakubadilishi matibabu.<ref name=Develop11/> Kwa watu wasiopata nafuu baada ya matibabu, [[ukuzaji wa vimelea vya makohozi]] unafaa kuzingatiwa, na ukuzaji wa ''[[maikobakteria za Kifuakikuu]]'' unafaa kufanywa kwa watu walio na kikohozi sugu chenye makohozi .<ref name=BTS09/> Kupimwa kwa vimelea vingine mahususi kunaweza kupendekezwa wakati wa milipuko ya maradhi kwa mujibu wa afya ya umma.<ref name=BTS09/> Kwa wale waliolazwa hospitalini kutokana na ugonjwa mkali, ukuzaji wa vimelea vya makohozi na [[vya damu]] umependekezwa,<ref name=BTS09/> na vile vile kupima mkojo kwa [[antijeni]] za ''Legionella'' na ''Streptokokasi''.<ref name=IDSA2007/> Maambukizi ya virusi yanaweza kudhibitishwa kupitia ugunduzi wa virusi au antijeni zake kwa [[kukuza vimelea au tishu]] au kipimo cha [[msururu wa athari za polima]], miongoni mwa mbinu zingine.<ref name=Lancet11/> Ajenti inayosababisha hali hii hubainishwa katika asilimia 15 tu ya visa kwa vipimo vya mara kwa mara vya mikrobiolojia.<ref name=BMJ06/> === Uainishaji === [[Nimonitisi]] ni [[inflamesheni]] ya pafu; nimonia ni nimonitisi, huwa kutokana na maambukizi lakini wakati mwingine huwa isiyo ya kuambukiza iliyo na hali zaidi ya [[konsolidesheni ya mapafu]].<ref>{{cite book|title=Stedman's medical dictionary.|url=https://archive.org/details/stedmansmedicald00sted_3|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-6450-6|edition=28th}}</ref>Nimonia mara nyingi huainishwa kulingana na ilipopatikana au jinsi ilivyopatikana: [[nimonia inayoambukiza kwa jamii|inayopatikana kwa jamii]],[[nimonia ya aspiresheni |aspiresheni]], [[nimonia inayohusiana na huduma za afya|inayohusiana na huduma za afya]], [[nimonia inayoambukiza hospitalini|inayoambukiza hospitalini]], na [[nimonia inayohusiana na chombo cha kupitisha hewa]].<ref name=Rad07>{{cite journal|last=Sharma|first=S|coauthors=Maycher, B, Eschun, G|title=Radiological imaging in pneumonia: recent innovations|journal=Current Opinion in Pulmonary Medicine|date=May 2007|volume=13|issue=3|pages=159–69|pmid=17414122|doi=10.1097/MCP.0b013e3280f3bff4}}</ref> Pia inaweza kuainishwa kulingana na sehemu ya pafu iliyoathiriwa: [[nimonia ya lobu]], [[nimonia ya bronkasi]] na [[nimonia kali ya tishu za mapafu]];<ref name=Rad07/> au kulingana na kimelea kinachosababisha.<ref>{{cite journal|last=Dunn|first=L|title=Pneumonia: classification, diagnosis and nursing management|journal=Nursing standard (Royal College of Nursing (Great Britain) : 1987)|date=2005 June 29-July 5|volume=19|issue=42|pages=50–4|pmid=16013205}}</ref> Nimonia kwa watoto inaweza pia kuainishwa kulingana na ishara na dalili kama isiyo kali, kali, au kali sana.<ref>{{cite book|last=organization|first=World health|title=Pocket book of hospital care for children : guidelines for the management of common illnesses with limited resources.|year=2005|publisher=World Health Organization|location=Geneva|isbn=978-92-4-154670-6|page=72|url=http://books.google.com/books?id=xbkbRG5XYxsC&pg=PA72}}</ref> === Utambuzi tofauti === Magonjwa kadhaa yanaweza kujitokeza kwa ishara na dalili sawa na za nimonia kama: [[ugonjwa sugu wa kufunga kwa mapafu]], [[pumu]], [[edema ya mapafu]], [[bronkektasisi]], [[saratani ya mapafu]], na [[emboli ya mapafu]].<ref name=BMJ06/> Tofauti na nimonia, pumu na ugonjwa sugu wa kufunga kwa mapafu hujitokeza hasa kwa [[mkoromo]], edema ya mapafu hujitokeza kwa [[elektrokadiogramu]] isiyo ya kawaida, saratani na bronkektasisi hujitokeza kwa kikohozi cha kipindi kirefu, na emboli ya mapafu hujitokeza kwa mauvimu makali ya mwanzo ya kifua na [[upungufu wa pumzi]].<ref name=BMJ06/> == Uzuiaji == Uzuiaji huhusisha [[uchanjaji]], hatua za kimazingira na matibabu yafaayo ya matatizo mengine ya kiafya.<ref name=Develop11/> Huaminika kuwa kama hatua zinazofaa za uzuiaji zingekuwa zimeanzishwa kote ulimwenguni, vifo vya watoto vinaweza kupunguzwa kwa 400,000 na kama matibabu yafaayo yangepatikana kwa wote, vifo vya utotoni vinaweza kupunguzwa kwa vifo 600,000 zaidi.<ref name=WHOPrevent2012/> === Uchanjaji === [[Uchanjaji]] huzuia dhidi ya nimonia fulani za bakteria na za virusi kwa watoto na watu wazima. [[Chanjo ya influenza]] ni bora dhidi ya influenza A na B.<ref name=Lancet11/><ref>{{cite journal|last=Jefferson|first=T|coauthors=Di Pietrantonj, C, Rivetti, A, Bawazeer, GA, Al-Ansary, LA, Ferroni, E|title=Vaccines for preventing influenza in healthy adults|journal=Cochrane database of systematic reviews|date=2010-07-07|issue=7|pages=CD001269|pmid=20614424|doi=10.1002/14651858.CD001269.pub4|editor1-last=Jefferson|editor1-first=Tom}}</ref> [[Taasisi ya Udhibiti na Uzuiaji wa Magonjwa]] imependekeza uchanjaji wa kila mwaka kwa kila mtu aliye na umri wa miezi 6&nbsp; na zaidi.<ref>{{cite web|title=Seasonal Influenza (Flu)|url=http://www.cdc.gov/flu/|work=Center for Disease Control and Prevention|accessdate=29 June 2011}}</ref> Kuwapa wahudumu wa afya kingamaradhi hupunguza hatari ya nimonia ya virusi miongoni mwa wagonjwa wao.<ref name=IDSA2007>{{cite journal|last=Mandell|first=LA|coauthors=Wunderink, RG; Anzueto, A; Bartlett, JG; Campbell, GD; Dean, NC; Dowell, SF; File TM, Jr; Musher, DM; Niederman, MS; Torres, A; Whitney, CG; Infectious Diseases Society of, America; American Thoracic, Society|title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults|journal=Clinical infectious diseases : an official publication of the Infectious Diseases Society of America|date=1 March 2007 |volume=44 |issue=Suppl 2|pages=S27–72|pmid=17278083|doi=10.1086/511159}}</ref> Milipuko ya influenza inapotokea, dawa kama vile [[amantadine]] au[[rimantadine]] zinaweza kusaidia kuzuia ugonjwa huo.<ref name=jefferson>{{cite journal |author=Jefferson T | coauthors = Deeks JJ, Demicheli V, Rivetti D, Rudin M |title=Amantadine and rimantadine for preventing and treating influenza A in adults|journal=Cochrane Database Syst Rev |issue=3 |pages=CD001169 |year=2004 |pmid=15266442|doi=10.1002/14651858.CD001169.pub2|editor1-last=Jefferson |editor1-first=Tom}}</ref> Haijulikani kama [[zanamivir]] au [[oseltamivir]] ni bora kwa sababu kampuni inayotengeneza oseltamivir imedinda kutoa data ya majaribio kwa uchanganuzi wa kibinafsi.<ref>{{cite journal|last=Jefferson|first=T|coauthors=Jones, MA; Doshi, P; Del Mar, CB; Heneghan, CJ; Hama, R; Thompson, MJ|title=Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children|journal=Cochrane database of systematic reviews |date=18 January 2012|volume=1|pages=CD008965|doi=10.1002/14651858.CD008965.pub3|pmid=22258996|editor1-last=Jefferson|editor1-first=Tom}}</ref> Chanjo dhidi ya ''[[Hemofilasi influenzae]]'' na ''[[Streptokokasi nimoniae]]'' zina ushahidi dhabiti wa kuunga mkono matumizi yake.<ref name=PedNA09/> Kuwapa watoto chanjo dhidi ya ''streptokokasi numoniae'' kumepelekea kupungua kwa visa vya maambukizi haya kwa watu wazima kwa sababu wengi wao hupata maambukizi kutoka kwa watoto. [[Chanjo ya polisakaraidi ya numokokasi|Chanjo ya '' Streptokokasi nimoniae'']] ya watu wazima ipo na imeweza kupunguza hatari ya [[ugonjwa vamizi wa numokokasi]]. <ref>{{citejournal|last=Moberley|first=SA|coauthors=Holden, J, Tatham, DP, Andrews, RM|title=Vaccines for preventing pneumococcal infection in adults|journal=Cochrane database of systematic reviews|date=2008-01-23|issue=1|pages=CD000422|pmid=18253977|doi=10.1002/14651858.CD000422.pub2|editor1-last=Andrews|editor1-first=Ross M}}</ref> Chanjo zingine zinazokinga dhidi ya nimonia ni: [[Chanjo ya kifaduro|kifaduro]], [[chanjo ya tetekuwanga|tetekuwanga]], na [[chanjo ya ukambi|ukambi]].<ref name=CDCPrev2012/> === Nyingine === [[Kusitisha uvutaji wa sigara]]<ref name=BTS09/> na kupunguza [[uchafuzi wa hewa]] vyumbani, kama vile kupika kwa kuni vyumbani au[[mavi|samadi]], yote yamependekezwa.<ref name=Develop11/><ref name=WHOPrevent2012/> Uvutaji wa sigara unaonekana kuwa ndicho kisababishi kikuu cha nimonia ya numokokasi kwa watu wazima wenye afya. <ref name=IDSA2007/> Usafi wa mikono na kukohoa kwenye mkono wa nguo kunaweza pia kuwa njia bora ya uzuiaji.<ref name=CDCPrev2012/> Uvaaji wa [[barakoa za upasuaji]] kwa walio wagonjwa pia unaweza kuzuia maradhi.<ref name=IDSA2007/> Kutibu maradhi fiche (kama vile [[VVU/UKIMWI]], [[kisukari melitasi]], na [[utapiamlo]]) ipasavyo kunaweza kupunguza hatari ya nimonia.<ref name=WHOPrevent2012>{{cite web|title=Pneumonia (Fact sheet N°331)|url=http://www.who.int/mediacentre/factsheets/fs331/en/|work=World Health Organization|date=August 2012}}</ref><ref name=CDCPrev2012>{{cite web|title=Pneumonia Can Be Prevented — Vaccines Can Help|url=http://www.cdc.gov/features/Pneumonia/|work=Centers for Disease Control and Prevention|accessdate=22 October 2012}}</ref><ref>{{cite journal|last=Gray|first=DM|coauthors=Zar, HJ|title=Community-acquired pneumonia in HIV-infected children: a global perspective|journal=Current opinion in pulmonary medicine|date=May 2010|volume=16|issue=3|pages=208–16|pmid=20375782|doi=10.1097/MCP.0b013e3283387984}}</ref>Kwa watoto wa umri wa chini ya miezi 6&nbsp;kunyonya bila kupewa chakula kingine chochote hupunguza hatari na ukali wa ugonjwa.<ref name=WHOPrevent2012/> Kwa walio na VVU/UKIMWI na idadi ya CD4 chini ya seli 200 kwa kila uL, antibiotiki iitwayo [[trimethoprim/sulfamethoxazole]] hupunguza hatari ya ''[[Nimonia ya numosisitisi]]''<ref>{{cite journal|last=Huang|first=L|coauthors=Cattamanchi, A; Davis, JL; den Boon, S; Kovacs, J; Meshnick, S; Miller, RF; Walzer, PD; Worodria, W; Masur, H; International HIV-associated Opportunistic Pneumonias (IHOP), Study; Lung HIV, Study|title=HIV-associated Pneumocystis pneumonia|journal=Proceedings of the American Thoracic Society|date=June 2011 |volume=8|issue=3|pages=294–300|pmid=21653531|doi=10.1513/pats.201009-062WR|pmc=3132788}}</ref>huenda ikawa ni ya kufaa kwa walio na kingamwili dhaifu lakini wasio na VVU.<ref>{{cite journal |author=Green H, Paul M, Vidal L, Leibovici L |title=Prophylaxis for Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients|journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD005590 |year=2007 |pmid=17636808|doi=10.1002/14651858.CD005590.pub2 |url= |editor1-last=Green |editor1-first=Hefziba}}</ref> Kuwachunguza wanawake wajawazito kwa [[Streptokokasi ya kundi B]] na ''[[Klamidia trakomatisi]]'', na kutoa matibabu kwa [[antibiotiki]], ikihitajika, hupunguza viwango vya nimonia kwa watoto wachanga;<ref>{{cite journal|last=Taminato|first=M|coauthors=Fram, D; Torloni, MR; Belasco, AG; Saconato, H; Barbosa, DA|title=Screening for group B Streptococcus in pregnant women: a systematic review and meta-analysis|journal=Revista latino-americana de enfermagem|date=November–December 2011|volume=19|issue=6|pages=1470–8|pmid=22249684}}</ref><ref>{{cite journal|last=Darville|first=T|title=Chlamydia trachomatis infections in neonates and young children|journal=Seminars in pediatric infectious diseases|date=October 2005|volume=16|issue=4|pages=235–44|pmid=16210104|doi=10.1053/j.spid.2005.06.004}}</ref> mbinu za kuzuia maambukizi ya VVU kutoka kwa mama hadi kwa mtoto huenda zikafaa pia.<ref>{{cite book|title=Global Action Plan for Prevention and Control of Pneumonia (GAPP)|year=2009|publisher=World Health Organization|url=http://whqlibdoc.who.int/hq/2009/WHO_FCH_CAH_NCH_09.04_eng.pdf|access-date=2013-11-28|archive-date=2013-10-17|archive-url=https://web.archive.org/web/20131017001256/http://whqlibdoc.who.int/hq/2009/WHO_FCH_CAH_NCH_09.04_eng.pdf|url-status=dead}}</ref>Efusheni ya mdomo na koo la watoto wachanga waliochafuliwa kwa [[kiowevu cha amnioni]] chenye [[mekoniamu]] haijaweza kupunguza kiwango cha [[nimonia ya aspiresheni]] na huenda ikasababisha madhara,<ref name=Rog2009>{{cite journal|last=Roggensack|first=A|coauthors=Jefferies, AL; Farine, D; Basso, M; Delisle, MF; Hudon, L; Mundle, WR; Murphy-Kaulbeck, LC; Ouellet, A; Pressey, T|title=Management of meconium at birth|journal=Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC|date=April 2009 |volume=31|issue=4|pages=353–4, 355–7|pmid=19497156}}</ref> hivyo basi, tendo hili halipendekezwi katika hali nyingi.<ref name=Rog2009/> Kwa wazee wadhaifu, huduma nzuri ya afya ya mdomoni inaweza kupunguza hatari ya nimonia ya aspiresheni.<ref>{{cite journal|last=van der Maarel-Wierink|first=CD|coauthors=Vanobbergen, JN; Bronkhorst, EM; Schols, JM; de Baat, C|title=Oral health care and aspiration pneumonia in frail older people: a systematic literature review|journal=Gerodontology|date=6 March 2012|pmid=22390255|doi=10.1111/j.1741-2358.2012.00637.x|pages=no}}</ref> == Udhibiti == {|class="wikitable" align="right" |- !colspan=2| CURB-65 |- ! Symptom!! Points |- | '''C'''onfusion ||<center>1</center> |- | '''U'''rea>7&nbsp; mmol/l ||<center>1</center> |- | '''R'''espiratory rate>30 ||<center>1</center> |- | [[Shinikizo la damu|S'''B'''P]] <90mmHg, D'''B'''P<60mmHg||<center>1</center> |- | Age>='''65''' ||<center>1</center> |- |} Kwa kawaida, antibiotiki za mdomoni, kupumzika, dawa za [[analijesiki]], na viowevu ni bora kwa afueni kamili.<ref name=BTS09/> Hata hivyo, walio na matatizo mengine ya kiafya, wazee au walio na tatizo kubwa la kupumua wanaweza kuhitaji utunzaji wa hali ya juu. Ikiwa dalili zitaendelea kuzorota, nimonia hiyo haiwezi kuisha kwa matibabu ya nyumbani, au matatizo yatokee, huenda kulazwa hospitalini kukahitajika.<ref name=BTS09/> Kote ulimwengumi, takriban asilimia 7-13 ya visa kwa watoto hupelekea kulazwa hospitalini<ref name=Develop11/>ilhali katika nchi zilizostawi, kati ya asilimia 22 na 42 ya watu wazima walio na nimonia waliyopata katika jamii hulazwa.<ref name=BTS09/> Matokeo ya [[CURB-65]] ni muhimu kwa kuamua hitaji la kulazwa kwa watu wazima.<ref name=BTS09/> Ikiwa matokeo ni 0 au 1 watu wanaweza kudhibitiwa nyumbani kikamilifu, yakiwa 2, kulazwa hospitalini kwa muda mfupi au utunzaji zaidi wa kufuatilia wa karibu unahitajika. Yakiwa 3-5, kulazwa hospitalini kunapendekezwa.<ref name=BTS09/> Kwa watoto walio na [[Disnia|tatizo la kupumua]] au kiwango cha oksijeni chini ya asilimia 90 wanafaa kulazwa hospitalini.<ref name=PIDS11>{{cite journal|last=Bradley|first=JS|coauthors=Byington, CL, Shah, SS, Alverson, B, Carter, ER, Harrison, C, Kaplan, SL, Mace, SE, McCracken GH, Jr, Moore, MR, St Peter, SD, Stockwell, JA, Swanson, JT|title=The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Miongozo ya Mazoezi ya Kimatibabu yaliyotolewa na Chama cha Magonjwa ya Watoto Ambukizi na Chama cha Magonjwa Ambukizi cha Marekani|journal=Clinical infectious diseases : an official publication of the Infectious Diseases Society of America|date=2011-08-31|pmid =21880587|volume= 53|issue= 7|pages= e25–76|doi=10.1093/cid/cir531}}</ref> Manufaa ya [[fiziotherapi ya kifua]] kwa nimonia bado hayajabainishwa. <ref>{{cite journal|last=Yang|first=M|coauthors=Yuping, Y, Yin, X, Wang, BY, Wu, T, Liu, GJ, Dong, BR|title=Chest physiotherapy for pneumonia in adults|journal=Cochrane database of systematic reviews |date=2010-02-17|issue= 2|pages=CD006338|pmid=20166082|doi= 10.1002/14651858.CD006338.pub2 |editor1-last=Dong|editor1-first=Bi Rong}}</ref>[[Uingizaji hewa kwa mashine|Uingizaji hewa kwa barakoa]] huenda ukawanufaisha waliolazwa kwenye [[kitengo cha wagonjwa mahututi]].<ref>{{cite journal|last=Zhang|first=Y|coauthors=Fang, C; Dong, BR; Wu, T; Deng, JL|title=Oxygen therapy for pneumonia in adults|journal=Cochrane database of systematic reviews |date=14 March 2012|volume=3|pages=CD006607|pmid=22419316|doi=10.1002/14651858.CD006607.pub4|editor1-last=Dong|editor1-first=Bi Rong}}</ref>[[Dawa ya kikohozi]] ya kununuliwa madukani haijaweza kusaidiaref <ref name=Chang2012>{{cite journal |author=Chang CC, Cheng AC, Chang AB |title=Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults |journal=Cochrane Database Syst Rev |volume=2 |issue= |pages=CD006088 |year=2012 |pmid=22336815|doi=10.1002/14651858.CD006088.pub3 |editor1-last=Chang |editor1-first=Christina C}}</ref> wala matumizi ya [[zinki]] kwa watoto.<ref>{{cite journal|last=Haider|first=BA|coauthors=Lassi, ZS; Ahmed, A; Bhutta, ZA|title=Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age|journal=Cochrane database of systematic reviews |date=5 October 2011|issue=10|pages=CD007368|pmid=21975768|doi=10.1002/14651858.CD007368.pub2|editor1-last=Bhutta|editor1-first=Zulfiqar A}}</ref>Hakuna ushahidi wa kutosha wa [[mukolitiki]].<ref name=Chang2012/> === Ya bakteria === [[Antibiotiki]] huboresha matokeo kwa walio na nimonia ya bakteria.<ref name=CochraneTx10/> Aina ya antibiotiki mwanzoni hutegemea hali ya mtu aliyeathiriwa, kama vile umri, afya yake wakati huo, na eneo ambapo maambukizi yalipatikana. Nchini Uingereza [[Tiba ya jarabati|matibabu ya jarabati]] pamoja na [[amoxicillin]] yamependekezwa kama awamu ya kwanza ya [[nimonia inayoambukiza katika jamii]], pamoja na [[doxycycline]] au [[clarithromycin]] kama aina mbadala.<ref name=BTS09/> [[Kaskazini mwa Marekani]], ambapo aina mahususi za nimonia inayoambukiza katika jamii hutokea sana, [[macrolide]] (kama vile [[azithromycin]] au[[erythromycin]]), na doxycycline zimechukua mahali pa amoxicillin kama awamu ya kwanza ya matibabu kwa watu wazima wasiolazwa hospitalini.<ref name=EOP10/><ref name=Lutfiyya>{{cite journal |author=Lutfiyya MN | coauthors = Henley E, Chang LF, Reyburn SW |title=Diagnosis and treatment of community-acquired pneumonia |journal=Am Fam Physician |volume=73 |issue=3 |pages=442–50 |year=2006|month=February |pmid=16477891 |url=http://www.aafp.org/afp/2006/0201/p442.pdf |format=PDF}}</ref> Kwa watoto walio na dalili ndogo au kiasi, amoxicillin husalia katika awamu ya kwanza.<ref name=PIDS11/> Matumizi ya [[fluoroquinolones]] katika visa visivyo tata yamewekewa vikwazo kwa sababu ya madhara yake na kusababisha upinzani kwa mujibu wa kutokuwa kwao na faida kubwa ya kimatibabu.<ref name=EOP10/><ref>{{cite journal|last=Eliakim-Raz|first=N|coauthors=Robenshtok, E; Shefet, D; Gafter-Gvili, A; Vidal, L; Paul, M; Leibovici, L|title=Empiric antibiotic coverage of atypical pathogens for community-acquired pneumonia in hospitalized adults|journal=Cochrane database of systematic reviews |date=12 September 2012|volume=9|pages=CD004418|pmid=22972070|doi=10.1002/14651858.CD004418.pub4|editor1-last=Eliakim-Raz|editor1-first=Noa}}</ref>Muda wa matibabu kikawaida umekuwa siku saba hadi kumi, lakini ushaidi unaoongezeka unaonyesha kuwa yale ya muda mfupi (siku tatu hadi tano) vile vile ni bora.<ref>{{cite journal |author=Scalera NM | coauthors = File TM |title=How long should we treat community-acquired pneumonia? |journal=Curr. Opin. Infect. Dis. |volume=20 |issue=2 |pages=177–81 |year=2007|month=April |pmid= 17496577|doi= 10.1097/QCO.0b013e3280555072}}</ref> Iliyopendekezwa kwa [[nimonia inayoambukiza hospitalini]] ni awamu ya tatu na ya nne ya [[cephalosporins]], [[carbapenem]], [[fluoroquinolones]], [[aminoglycosides]], na[[vancomycin]].<ref name=HAPGuideline>{{cite journal |author=[[American Thoracic Society]]; [[Infectious Diseases Society of America]] |title=Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia |url=https://archive.org/details/sim_american-journal-respiratory-critical-care-medicine_2005-02-15_171_4/page/388 |journal=Am J Respir Crit Care Med |volume=171 |issue=4 |pages=388–416 |year=2005|month=February |pmid=15699079 |doi=10.1164/rccm.200405-644ST}}</ref>Mara kwa mara antibiotiki hizi hupewa [[kitiba ndani ya mshipa|ndani ya mshipa]] na kutumiwa kwa mchanganyiko.<ref name=HAPGuideline/>kwa wale wanaotibiwa hospitalini, zaidi ya asilimia 90 hupata nafuu baada ya antibiotiki za kwanza.<ref name=M32/> === ya virusi === [[Vizuia nuraminidesi]] vinaweza kutumiwa kutibu [[nimonia ya virusi]] inayosababishwa na virusi vya influenza ([[influenza A]] na[[influenza B]]).<ref name=Lancet11/> Hakuna tiba za [[dawa inayodhibiti virusi|kinzavirusi]] maalum zinazopendekezwa kwa aina zingine za nimonia za virusi zinazoambukiza katika jamii vikiwemo [[SARS|virusi vya korona vya SARs]], [[virusi vya adeno]], [[virusi vya hanta]], na [[virusi vya parainfluenza]].<ref name=Lancet11/> Influenza A inaweza kutibiwa kwa [[rimantadine]] au [[amantadine]], ilhali influenza A au B inaweza kutibiwa kwa [[oseltamivir]], [[zanamivir]] au [[peramivir]].<ref name=Lancet11/>Dawa hizi zina matokeo bora zikianzishwa katika saa 48 za kuanza kwa dalili.<ref name=Lancet11/> Aina nyingi za influenza A ya [[H5N1]], ambayo pia hujulikana kama [[homa ya ndege]] zimeonyesha ukinzani kwa rimantadine na amantadine.<ref name=Lancet11/> Matumizi ya antibiotiki kwa nimonia ya virusi yanapendekezwa na baadhi ya wataalam kwa kuwa ni vigumu kufutilia mbali maambukizi yanayotatiza ya bakteria<ref name=Lancet11/> [[Shirika la Kifua la Uingereza]] linapendekeza kuwa antibiotiki zisitumiwe kwa ugonjwa usio mkali.<ref name=Lancet11/> Matumizi ya [[kotikosteroidi]] yana utata.<ref name=Lancet11/> === Aspiresheni === Kwa ujumla, [[numonitisi ya kemikali|numonitisi ya aspiresheni]] hutibiwa kwa kiasi kwa antibiotiki za [[nimonia ya aspiresheni]] tu.<ref name=PA2011>{{cite journal|last=Marik|first=PE|title=Pulmonary aspiration syndromes|journal=Current Opinion in Pulmonary Medicine|date=May 2011|volume=17|issue=3|pages=148–54|pmid=21311332|doi=10.1097/MCP.0b013e32834397d6}}</ref> Aina ya antibiotiki itakayotumiwa itategemea mambo kadhaa, yakiwemo kimelea kinachodhaniwa kusababisha na iwapo nimonia iliambukiza kwenye jamii au katika mazingira ya hospitali. Aina zinazotumika sana ni [[clindamycin]], mchanganyiko wa [[beta-lactam]] na[[metronidazole]], au [[aminoglycoside]].<ref name=OConnor>{{cite journal |author=O'Connor S |title=Aspiration pneumonia and pneumonitis |journal=Australian Prescriber |volume=26 |issue=1 |year=2003 |pages=14–7 |url=http://www.australianprescriber.com/magazine/26/1/14/7 |access-date=2013-11-28 |archive-date=2009-07-09 |archive-url=https://web.archive.org/web/20090709074607/http://www.australianprescriber.com/magazine/26/1/14/7/ |url-status=dead }}</ref> [[Kotikosteroidi]] hutumika wakati mwingine kwa nimonia ya aspiresheni, lakini kuna ushahidi mdogo wa kuthibitisha ubora wazo.<ref name=PA2011/> == Prognosi == Kwa matibabu, aina nyingi za nimonia ya bakteria zitadhibitiwa katika siku 3-6&nbsp;.<ref name=Behera2010>{{cite book|last=Behera|first=D.|title=Textbook of pulmonary medicine|year=2010|publisher=Jaypee Brothers Medical Pub.|location=New Delhi|isbn=9788184487497|pages=296–297|url=http://books.google.ca/books?id=0TbJjd9eTp0C&pg=PA296|edition=2nd}}</ref>Huchukua majuma machache kabla ya dalili nyingi kuisha. <ref name=Behera2010/> Matokeo ya eksirei huonyesha kuisha kabisa katika majuma manne na kiwango cha vifo kupungua (chini ya asilimia 1).<ref name=Clinic2011/><ref name=C6/> Kwa wazee au watu walio na matatizo mengine ya mapafu, kupona kunaweza kuchukua zaidi ya majuma 12&nbsp;.<!-- <ref name=Clinic2011/> --> Kwa watu wanaohitaji kulazwa hospitalini, kiwango cha vifo kinaweza kuwa juu hadi kama asilimia 10 na kwa wale wanaohitaji uangalizi makini, kinaweza kufika asilimia 30-50.<ref name=Clinic2011/> Nimonia ndiyo [[maambukizi ya hospitalini|maambukizi yanayopatikana hospitalini]] yanayotokea sana yanayosababisha kifo.<ref name=M32>Murray and Nadel (2010). Chapter 32.</ref> Kabla ya majilio ya antibiotiki, kiwango cha vifo kilikuwa asilimia 30 kwa waliolazwa hospitalini.<ref name=EBMED05/> Matatizo yanaweza kutokea hususan kwa wazee na walio na matatizo mengine ya kiafya.<ref name=C6/> Haya yanaweza kuwa haya miongoni mwa mengine: [[empiema]], [[usaha kwenye mapafu]], [[kuvimba na kuziba kwa bronkioli]], [[sindromu ya matatizo makali ya upumuaji]], [[sepsisi]], na kuzorota kwa matatizo mengine ya kiafya.<ref name=C6>Cunha (2010). Pages6-18.</ref> === Kanuni za utabiri wa kiafya === Kanuni za utabiri wa kiafya zimewekwa ili kutabiri kwa usahihi zaidi matokeo katika nimonia.<ref name=M32/> Kanuni hizi hutumika katika kuamua iwapo mtu huyo atalazwa hospitalini au la.<ref name=M32/>kutabiri * [[Kielelezo cha ukali wa nimonia]] (au ''alama ya PSI '')<ref name=M32/> * Alama ya [[CURB-65]], inayozingatia ukali wa dalili, magonjwa mengine yoyote <ref>{{cite journal|last=Rello|first=J|title=Demographics, guidelines, and clinical experience in severe community-acquired pneumonia.|journal=Critical care (London, England)|year=2008|volume=12 Suppl 6|pages=S2|pmid=19105795}}</ref> === Efusheni ya plura, empiema, na jipu=== [[File:Pleural effusion.jpg|thumb|alt=Eksirei inayoonyesha kifua kilicholazwa kwa mlalo. Eneo jeusi upande wa chini ambalo ndilo pafu la kulia ni dogo na eneo jeupe chini yake la efusheni ya mapafu. Kuna mishale miekundu inayoonyesha ukubwa wazo. [[efusheni ya plura]]: inavyoonekana kwenye eksirei ya kifua. Mshale A unaonyesha kiasi cha kiowevu katika upande wa kulia wa kifua. Mshale B unaonyesha upana wa pafu la kulia. Ukubwa wa pafu ni mdogo kwa sababu ya kujikusanya kwa kiowevu kwenye pafu.]] Katika nimonia [[efusheni ya plura|kujikusanya kwa kiowevu]] inaweza kutokea kwenye [[kaviti ya plura|nafasi inayozingira pafu]].<ref name=Yu2011>{{cite journal|last=Yu|first=H|title=Management of pleural effusion, empyema, and lung abscess.|journal=Seminars in interventional radiology|date=2011 Mar|volume=28|issue=1|pages=75–86|pmid=22379278}}</ref> Wakati mwingine, vimelea vitaambukiza kiowevu hiki na kusababisha [[empiema ya plura|empiema]].<ref name=Yu2011/> Ili kutofautisha empiema na [[efusheni ya paranimonia]], kiowevu hicho kinaweza kuchukuliwa kwa sindano ([[thorasentesisi]]), na kuchunguzwa.<ref name=Yu2011/> Ikithibitishwa kuwa kuna empiema, ufyonzaji kikamilifu wa kiowevu ni muhimu, mara nyingi kwa [[tyubu ya kifua|katheta ya ufyonzaji]].<ref name=Yu2011/> katika visa vikali vya empiema huenda [[uponoaji koteksi |upasuaji]] ukahitajika.<ref name=Yu2011/> Kiowevu chenye maabukizi kisipofyonzwa, maambukizi yanaweza kukithiri kwa sababu antibiotiki hazipenyi vizuri kwenye kaviti ya plura. Ikiwa kiowevu hakina maambukizi, kinahitaji kufyonzwa ikiwa kinasababisha dalili au kinabaki kilivyo tu.<ref name=Yu2011/> Kwa hali nadra sana, bakteria kwenye pafu zitatengeneza kibonge cha kiowevu chenye maambukizi kiitwacho [[jipu la pafu]].<ref name=Yu2011/> Jipu kwenye pafu huonekana kwa eksirei ya kifua lakini mara kwa mara huitaji uchunguzi wa kielektroniki wa CT ya kifua ili kuthibitisha utambuzi.<ref name=Yu2011/>Kwa kawaida jipu hutokea katika [[nimonia ya aspiresheni]], na mara kwa mara huwa na aina nyingi tofauti za bakteria. Antibiotiki za muda mrefu hufaa mara nyingi kwa kutibu jipu la pafuni, lakini wakati mwingine ni lazima jipu hilo lifyonzwe kwa [[upasuaji|mpasuaji]] au[[Utatuzi wa kiradiolojia|mrediolojia]].<ref name=Yu2011/> === Matatizo ya upumuaji na mzunguko wa damu === Nimonia inaweza kusababisha matatizo ya upumuaji kwa kuchochea [[sindromu ya matatizo makali ya upumuaji]], inayotokana na mchanganyiko wa maambukizi na inflamesheni<!-- <ref name=M31/> -->Mapafu hujaa kiowevu kwa haraka na kushupaa.<!-- <ref name=M31/> --> Kushupaa huku pamoja na ugumu mkubwa wa kuchukua oksijeni kutokana na kiowevu cha tundu la mapafu kunaweza kuhitaji vipindi virefu vya [[uingizaji hewa kwa mitambo]] ili kuongoka.<ref name=M31/> [[Sepsisi]] ni tatizo linaloweza kutokea katika nimonia lakini hutokea tu kwa watu walio na kingamwili dhaifu au[[kiwango cha chini cha splenizimu]].<!-- <ref name=C250/> --> Vimelea vinavyohusika sana ni ''Streptokokasi numoniae'', ''Haemofilasi influenzae'' na '' Klebsiela Numoniae''.<!-- <ref name=C250/> --> Visababishi vingine vya dalili vinavyopaswa kuzingatiwa ni kama [[infakti ya miokadia]] au [[kuziba kwa ateri za mapafu]].<ref name=C250>Cunha (2010). Pages 250-251.</ref> == Epidemiolojia == [[Image:Lower respiratory infections world map - DALY - WHO2004.svg|thumb|225px|alt=A map of the world with a far bit of dark-red in Africa, orange colors in parts of Asia and South America, and yellow in Europe and North America|[[Age adjustment|Age-standardized]] death rate: [[lower respiratory tract infection]]s per 100,000&nbsp;inhabitants in 2004.<ref>{{cite web|url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=WHO Disease and injury country estimates |year=2004 |publisher = [[World Health Organization]] (WHO) |accessdate=11 November 2009}}</ref> {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<100}} {{legend|#fff200|100–700}} {{legend|#ffdc00|700–1400}} {{legend|#ffc600|1400–2100}} {{legend|#ffb000|2100–2800}} {{legend|#ff9a00|2800–3500}} {{Multicol-break}} {{legend|#ff8400|3500–4200}} {{legend|#ff6e00|4200–4900}} {{legend|#ff5800|4900–5600}} {{legend|#ff4200|5600–6300}} {{legend|#ff2c00|6300–7000}} {{legend|#cb0000|>7000}} {{Multicol-end}}]] Nimonia ni maradhi yanayotokea sana yanayoathiri takriban milioni 450&nbsp; za watu kwa mwaka na yanayotokea katika kila sehemu ya dunia.<ref name=Lancet11>{{cite journal|last=Ruuskanen|first=O|coauthors=Lahti, E, Jennings, LC, Murdoch, DR|title=Viral pneumonia|url=https://archive.org/details/sim_the-lancet_april-9-15-2011_377_9773/page/1264|journal=Lancet|date=2011-04-09|volume=377|issue=9773|pages=1264–75|pmid=21435708|doi=10.1016/S0140-6736(10)61459-6}}</ref>Ni kisababishi kikubwa cha vifo katika kila rika ambapo husababisha milioni 4&nbsp; (asilimia saba ya vifo vyote duniani) kila mwaka.<ref name=Lancet11/><ref name=CochraneTx10/> Viwango ni vya juu zaidi kwa watoto chini ya miaka mitano na watu wazima walio na umri wa zaidi ya miaka 75&nbsp;.<ref name=Lancet11/> Hutokea takriban mara tano zaidi katika [[ulimwengu unaostawi]] kuliko katika[[ulimwengu uliostawi]].<ref name=Lancet11/> Nimonia ya virusi huchangia takriban visa milioni 200&nbsp;.<ref name=Lancet11/> Nchini Marekani, katika mwaka wa 2009, nimonia ilikuwa <sup>kisababishi </sup> cha 8 kati ya visababishi vinavyoongoza vya vifo.<ref name=Clinic2011>{{cite journal|last=Nair|first=GB|coauthors=Niederman, MS|title=Community-acquired pneumonia: an unfinished battle|url=https://archive.org/details/sim_medical-clinics-of-north-america_2011-11_95_6/page/1143|journal=The Medical clinics of North America|date=November 2011|volume=95|issue=6|pages=1143–61|pmid=22032432|doi=10.1016/j.mcna.2011.08.007}}</ref> === Watoto === Katika mwaka wa 2008, nimonia ilitokea katika takriban watoto milioni 156&nbsp; (milioni 151&nbsp; katika ulimwengu unaostawi na milioni 5&nbsp; katika ulimwengu uliostawi).<ref name=Lancet11/> Ilisababisha vifo milioni 1.6 &nbsp; au asilimia 28-34 ya vifo vya waliokuwa chini ya miaka mitano, ambapo asilimia 95 vilitokea katika ulimwengu unaostawi.<ref name=Lancet11/><ref name=Develop11>{{cite journal|last=Singh|first=V|coauthors=Aneja, S|title=Pneumonia — management in the developing world|journal=Paediatric respiratory reviews|date=March 2011 |volume=12|issue=1|pages=52–9|pmid=21172676|doi=10.1016/j.prrv.2010.09.011}}</ref>Nchi zilizoathiriwa pakubwa na ugonjwa huu ni: India (milioni 43&nbsp;), Uchina (milioni 21&nbsp;) na Pakistan (milioni 10&nbsp;).<ref>{{cite journal|last=Rudan|first=I|coauthors=Boschi-Pinto, C, Biloglav, Z, Mulholland, K, Campbell, H|title=Epidemiology and etiology of childhood pneumonia|journal=Bulletin of the World Health Organization|date=May 2008|volume=86|issue=5|pages=408–16|pmid=18545744|doi=10.2471/BLT.07.048769|pmc=2647437}}</ref> Ndicho kisababishi kikuu cha vifo vya watoto katika [[nchi zenye mapato ya chini]].<ref name=Lancet11/><ref name=CochraneTx10>{{cite journal |author=Kabra SK |coauthors = Lodha R, Pandey RM |title=Antibiotics for community-acquired pneumonia in children |journal=Cochrane Database Syst Rev |volume=3 |issue= 3|pages=CD004874 |year=2010 |pmid=20238334 |doi=10.1002/14651858.CD004874.pub3 |editor1-last=Kabra|editor1-first=Sushil K }}</ref>Vingi vya vifo hivi hutokea katika kipindi cha [[mara tu baada ya kuzaliwa|uchanga]]. [[Shirika la Afya Duniani]] linakadiria kuwa kimoja kati ya vifo vitatu vya watoto wachanga hutokana na nimonia.<ref name=garenne>{{cite journal|author=Garenne M | coauthors = Ronsmans C, Campbell H |title=The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries |journal=World Health Stat Q |volume=45 |issue=2–3 |pages=180–91 |year=1992|pmid=1462653 }}</ref> Takriban nusu ya vifo hivi vinaweza kuzuiliwa kinadharia, kwa sababu husababishwa na bakteria ambayo chanjo yake thabiti ipo.<ref>{{cite journal |author=WHO |title=Pneumococcal vaccines. WHO position paper|journal=Wkly. Epidemiol. Rec. |volume=74 |issue=23 |pages=177–83 |year=1999 |pmid=10437429 }}</ref> == Historia == [[Image:WPA Pneumonia Poster.jpg|thumb|alt=Bango lililo na papa katikati na lenye maandishi "Nimonia Hushambulia Kama Papa Mla Watu Akiongozwa na Samaki Rubani wake ambaye ni Mafua"|kushoto| bango la [[Utawala wa Maendeleo ya Kazi|UMK]], 1936/1937]] Nimonia imekuwa ungonjwa wa kawaida katika historia ya binadamu.<ref name=History03>{{cite book|last=al.]|first=Ralph D. Feigin ... [et|title=Textbook of pediatric infectious diseases|year=2003|publisher=W. B. Saunders|location=Philadelphia|isbn=978-0-7216-9329-3|page=299|edition=5th|url=http://books.google.com/books?id=G6k0tpPMRsIC&pg=PA299}}</ref> Dalili zilielezwa na [[Hippocrates]] (c. 460 BC – 370 BC):<ref name=History03/>"Kwa hivyo athari za perinimonia na kuvimba kwa plura zinapaswa kuchunguzwa: Ikiwa kiwango cha juu cha joto ni kikali, na ikiwa kuna maumivu kwa mojawapo ya pande au pande zote, na ikiwa kuna kikohozi akipumua nje, na sputa ya inayotolewa ni ya rangi ya kimanjano au samawati au vile vile iwe nyepesi, yenye povu na yenye rangi nyingi, au kuwa na sifa nyingine yoyote tofauti na za kawaida... Nimonia inapofikia upeo wake, hali hiyo huwa imezidi utatuzi asipotibiwa na ni mbaya akiwa na disnia na mkojo mwepesi na wenye harufu kali, na jasho likitoka shingoni na kichwani, kwani jasho kama hili ni baya, inavyotokana na ukosefu wa hewa, miparuzo na ukali wa ugonjwa unaokithiri".<ref name=hippo>Hippocrates ''On Acute Diseases'' [[s:On Regimen in Acute Diseases|wikisource link]]</ref> Hata hivyo, Hippocrates aliita nimonia ugonjwa "uliopewa jina na watu wa kale". Pia aliripoti matokeo ya efusheni ya ufyonzaji wa empiema. [[Maimonides]] (1135–1204 AD) alitoa wazo: "Dalili za kimsingi zinazotokea katika nimonia na zisizo na upungufu ni kama zifuatazo: kiwango cha juu cha joto kisicho kikali, maumivu ya mchomo [[ya plura]] kwenye upande, pumzi fupi za haraka, [[mpwito wa ateri]] usio wa kawaida na kikohozi".<ref name=maimo>Maimonides, ''Fusul Musa'' ("''Pirkei Moshe''").</ref> Maelezo haya ya kiafya yanafanana na yale yaliyo katika vitabu vya kiada vya kisasa na yaliangazia ukubwa wa maarifa ya kitabibu kupitia[[Enzi za kati]] hadi katika karne <sup>ya</sup> 19. [[Edwin Klebs]] ndiye aliyekuwa wa kwanza kuchunguza na kuona bakteria kwenye njia za hewa za watu waliofariki kutokana na nimonia katika mwaka wa 1875.<ref name=klebs>{{cite journal |author=Klebs E |title=Beiträge zur Kenntniss der pathogenen Schistomyceten. VII Die Monadinen|journal=Arch. Exptl. Pathol. Parmakol. |volume=4 |issue=5/6 |pages=40–488 |date=1875-12-10}}</ref> Utafiti wa kwanza uliotambua visababishi viwili vikuu vya nimonia ya bakteria''Streptokokasi numoniae'' na ''Klebsiela numoniae '' ulifanywa na [[Carl Friedländer]]<ref name=fried>{{cite journal |author=Friedländer C |title=Über die Schizomyceten bei der acuten fibrösen Pneumonie |journal=Virchow's Arch pathol. Anat. U. Physiol. |volume=87 |issue=2 |pages=319–324 |date=1882-02-04|doi=10.1007/BF01880516}}</ref> na [[Albert Fränkel (1848-1916)|Albert Fränkel]]<ref name=fraenkel>{{cite journal|author=Fraenkel A |title=Über die genuine Pneumonie, Verhandlungen des Congress für innere Medicin |journal=Dritter Congress|volume=3 |pages=17–31 |date=1884-04-21}}</ref> katika mwaka wa 1882 na 1884 mtawalia. Utafiti wa kwanza wa Friedländer ulitanguliza [[upakaji wa gram|Doa la gram]], uchunguzi wa kimsingi wa maabarani ambao bado unatumiwa kutambua na kuainisha bakteria. Makala ya [[Christian Gram]] yaliyoeleza utaratibu huu katika mwaka wa 1884 yalisaidia kutofautisha hizo bakteria mbili na kudhibitisha kuwa nimonia inaweza kusababishwa na zaidi ya kimelea kimoja.<ref name=gram>{{cite journal |author=Gram C |title=Über die isolierte Färbung der Schizomyceten in Schnitt- und Trocken-präparaten |journal=Fortschr. Med |volume=2 |issue=6 |pages=185–9|date=1884-03-15}}</ref>+/` 3 [[William Osler]], anayejulikana kama, "baba wa uganga wa kisasa", alitambua vifo na ulemavu unaosababishwa na nimonia huku akiieleza kama "nahodha wa visababishi vya vifo" katika mwaka wa 1918 kwa sababu ilikuwa imezidi [[kifua kikuu]] kama mojawapo ya visababishi vikuu vya vifo wakati huo. Msemo huu ulianzishwa na [[John Bunyan]] akirejelea "uharibifu" (kifua kikuu)<ref>{{cite book|last=al.]|first=edited by J.F. Tomashefski, Jr ... [et|title=Dail and Hammar's pulmonary pathology.|year=2008|publisher=Springer|location=New York|isbn=978-0-387-98395-0|page=228|url=http://books.google.com/books?id=j-eYLc1BA3oC&pg=PA228|edition=3rd}}</ref><ref>{{cite book |author=William Osler, Thomas McCrae |title=The principles and practice of medicine: designed for the use of practitioners and students of medicine |publisher=D. Appleton |year=1920 |page=78|edition=9th |quote=[http://books.google.com/books?lr=&id=JLTgoEc9QOAC&q=Captain+of+the+Men+of+Death&pgis=1#search_anchor One of the most widespread and fatal of all acute diseases, pneumonia has become the "Captain of the Men of Death," to use the phrase applied by John Bunyan to consumption.]}}</ref> Osler pia alieleza nimonia kama "rafiki ya mzee" kwa sababu mara nyingi kifo kilikuwa cha haraka na kisicho na maumivu kulipokuwa na njia nyingi za kufa polepole zenye maumivu.<ref name=EBMED05>{{cite journal|last=Ebby|first=Orin|title=Community-Acquired Pneumonia: From Common Pathogens To Emerging Resistance|journal=Emergency Medicine Practice|year=2005|month=Dec|volume=7|issue=12|url=https://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=118}}</ref> Uvumbuzi zaidi katika miaka ya 1900 uliboresha matokeo kwa waliokuwa na nimonia. Kwa majilio ya [[penicillin]] na antibiotiki zingine, mbinu za kisasa za upasuaji, na uangalizi makini wa wagonjwa katika karne^ya 20, vifo vitokanavyo na nimonia vilivyokuwa vimefika asilimia 30 vilipungua sana katika ulimwengu uliostawi. Uchanjaji wa watoto wachanga dhidi ya ''[[Haemofilasi influenzae]]'' B ulianza katika mwaka wa 1988 na kusababisha kupungua pakubwa kwa visa baadaye.<ref name=adams>{{cite journal |author=Adams WG| coauthors = Deaver KA, Cochi SL, ''et al.'' |title=Decline of childhood Haemophilus influenzae type B (Hib) disease in the Hib vaccine era |url=https://archive.org/details/sim_jama_1993-01-13_269_2/page/6|journal=JAMA |volume=269 |issue=2 |pages=221–6 |year=1993 |month=January |pmid=8417239|doi=10.1001/jama.269.2.221}}</ref> Uchanjaji dhidi ya ''Streptokokasi numoniae'' kwa watu wazima ulianza katika mwaka wa 1977 na kwa watoto katika mwaka wa 2000, na kusababisha kupungua sawa.''<ref name=whit>{{cite journal |author=Whitney CG | coauthors = Farley MM, Hadler J,''et al.'' |title=Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine|url=https://archive.org/details/sim_new-england-journal-of-medicine_2003-05-01_348_18/page/n41 |journal=N. Engl. J. Med. |volume=348 |issue=18 |pages=1737–46 |year=2003 |month=May |pmid=12724479 |doi=10.1056/NEJMoa022823}}</ref> == Jamii na Utamaduni == Kutokana na ongezeko la ugonjwa katika nchi zinazostawi na kiwango cha chini cha uhamasishaji mdogo kuhusu ugonjwa huo katika nchi zilizostawi, jamii ya afya ya kimataifa imetenga tarehe ¹²Novemba kuwa [[Siku ya Nimonia Ulimwenguni]], siku ambapo wananchi wanaojali na watunga sera huchukua hatua dhidi ya ugonjwa huo.<ref>{{cite web|title=World Pneumonia Day Official Website|url=http://worldpneumoniaday.org/|work=World Pneumonia Day Official Website|publisher=Fiinex|accessdate=13 August 2011|archivedate=2011-09-02|archiveurl=https://web.archive.org/web/20110902154617/http://worldpneumoniaday.org/}}</ref> Gharama ya kiuchumi ulimwenguni ya nimonia inayoambukiza kutoka kwa jamii imekadiriwa kuwa dola bilioni 17&nbsp;.<ref name=Clinic2011/> ==Tanbihi== {{reflist|2}} == Marejeo == * {{cite book|first=John F. Murray|title=Murray and Nadel's textbook of respiratory medicine.|url=https://archive.org/details/murraynadelstext0002unse|year=2010|publisher=Saunders/Elsevier|location=Philadelphia, PA|isbn=1416047107|edition=5th}} *{{cite book|last=Cunha|first=edited by Burke A.|title=Pneumonia essentials|year=2010|publisher=Physicians' Press|location=Sudbury, MA|isbn=0763772208|edition=3rd ed.|url=http://books.google.ca/books?id=VVgmFAbnrUgC&printsec=frontcover}} ==Viungo vya nje== * {{dmoz|Health/Conditions_and_Diseases/Respiratory_Disorders/Pneumonia/}} [[jamii:maradhi ya kuambukiza]] [[Jamii:magonjwa ya bakteria]] [[jamii:mapafu]] gvhohqfflb3rklxvedsyplcn656uhg3 0 69857 1578205 1525952 2026-07-03T03:05:02Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578205 wikitext text/x-wiki {{tafsiri kompyuta}} {{Infobox disease | Name = Multiple sclerosis | Image = MS Demyelinisation CD68 10xv2.jpg | Caption = Demyelination by MS. The [[CD68]] colored tissue shows several [[macrophage]]s in the area of the lesion. Original scale 1:100 | DiseasesDB = 8412 | ICD10 = {{ICD10|G|35||g|35}} | ICD9 = {{ICD9|340}} | OMIM = 126200 | MedlinePlus = 000737 | eMedicineSubj = neuro | eMedicineTopic = 228 | eMedicine_mult = {{eMedicine2|oph|179}} {{eMedicine2|emerg|321}} {{eMedicine2|pmr|82}}{{eMedicine2|radio|461}} | MeshID = D009103 | GeneReviewsNBK = NBK1316 | GeneReviewsName = Overview }} '''Sklerosisi ya sehemu nyingi''' (kwa [[Kiingereza]] ''multiple sclerosis'') ambayo pia hujulikana kama '''sklerosisi iliyosambaa''' au '''enkefalomielitisi diseminata''', ni [[ugonjwa]] wa [[inflamesheni|kuvimba]] ambapo [[mielini|vihami]] za [[nyuroni|seli za neva]] kwenye [[ubongo]] na [[uti wa mgongo]] huharibiwa. Kuharibiwa huku hukatiza [[mawasiliano]] baina ya sehemu za [[mfumo wa neva]], na kusababisha [[ishara]] na [[dalili]] anuwai,<ref name="pmid18970977">{{cite journal |author=Compston A, Coles A |title=Multiple sclerosis |journal=Lancet |volume=372 |issue=9648 |pages=1502–17 |year=2008|month=October |pmid=18970977 |doi=10.1016/S0140-6736(08)61620-7 |url=https://archive.org/details/sim_the-lancet_october-25-31-2008_372_9648/page/1502}}</ref><ref name="pmid11955556"/> pamoja na za kimwili, [[ulemavu wa akili]], <ref name="pmid11955556"/> na wakati mwingine [[magonjwa ya akili]].<ref>{{cite book|title=Bradley's neurology in clinical practice.|url=https://archive.org/details/bradleysneurolog00unse|year=2012|publisher=Elsevier/Saunders|location=Philadelphia, PA|isbn=1-4377-0434-4|edition=6th ed.|author=Murray ED, Buttner EA, Price BH|editor=Daroff R, Fenichel G, Jankovic J, Mazziotta J|chapter=Depression and Psychosis in Neurological Practice}}</ref> Sklerosisi ya sehemu nyingi huwa na aina kadhaa zenye dalili mpya zinazotokea katika [[maambukizi]] yasiyoshughulikiwa (aina zinazojirudia) au zinazojijenga kwa muda (aina zinazoendelea).<ref name="pmid8780061"/> Baina ya maambukizi, dalili zinaweza kupotea kabisa; hata hivyo, matatizo ya kudumu ya nyurolojia hutokea mara kwa mara, hasa ugonjwa unapozidi. <ref name="pmid8780061"/> <!--Kisababishi, pathofiziolojia na utambuzi --> Ingawa kisababishi si bayana, kinakisiwa kuwa uharibifu kwa [[mfumo wa kingamwili]] au matatizo ya [[seli]] zinazotoa [[mielini]].<ref>{{cite journal|last=Nakahara|first=J|coauthors=Maeda, M; Aiso, S; Suzuki, N|title=Current concepts in multiple sclerosis: autoimmunity versus oligodendrogliopathy.|journal=Clinical reviews in allergy & immunology|date=2012 Feb|volume=42|issue=1|pages=26–34|pmid=22189514}}</ref> Visababishi vilivyopendekezwa ni visababishi vya [[jenetikia|kijenetikia]] na kimazingira kama vile [[maambukizi]].<ref name="pmid11955556"/><ref name="pmid17444504"/> Sklerosisi ya sehemu nyingi hutambuliwa kulingana na ishara na dalili zinazojitokeza na matokeo ya uchunguzi zaidi wa kitiba. <!--Matibabu, prognosisi --> Hakuna tiba kamili ya sklerosisi ya sehemu nyingi. Tiba hujaribu kuboresha matokeo baada ya maambukizi na kuzuia maambukizi mapya.<ref name="pmid11955556"/> Tiba zinazotumika kutibu sklerosisi ya sehemu nyingi, ingawa ni bora kiasi, zinaweza kuwa na madhara ambayo yasistahimilike. Watu wengi hutafuta matibabu mbadala licha ya ukosefu wa ushahidi. Matokeo ya muda mrefu ni magumu kutabirika; bali matokeo bora huonekana kwa wanawake, wanaopata ugonjwa huo mapema maishani, ambao ugonjwa hurejea na waliopata maambukizi machache hapo awali. <ref name="pmid8017890"/> [[Matarajio ya kuishi]] ni miaka 5 hadi 10 pungufu kuliko watu wasioathiriwa.<ref name="pmid18970977"/> Kufikia mwaka wa 2008, kati ya watu milioni 2 na 2.5 ulimwenguni wameathiriwa huku viwango vikitofautiana pakubwa katika sehemu za dunia na miongoni mwa watu mbalimbali.<ref name=Atlas2008/> Ugonjwa huo huanza kati ya miaka 20 na 50 na hutokea kwa wanawake mara mbili kuliko kwa wanaume.<ref name=Milo2010/> Jina “sklerosisi ya sehemu nyingi” linamaanisha makovu (kwa [[Kigiriki]] "sklero" ni sawa wa [[ugumu]]) hasa katika [[mata nyeupe]] ya ubongo na uti wa mgongo. <ref name="Charcot1"/> Sklerosisi ya sehemu nyingi ilielezwa kwa mara ya kwanza katika mwaka wa 1868 na [[Jean-Martin Charcot]]. <ref name="Charcot1"/> Tiba mpya na mbinu za utambuzi zinaendelea kubuniwa. {{TOC limit|3}} ==Ishara na Dalili== [[File:Symptoms of multiple sclerosis.svg|thumb|left|Dalili kuu za sklerosisi ya sehemu nyingi]] Mtu anayeugua sklerosisi ya sehemu nyingi anaweza kuwa na dalili au ishara yoyote ya [[nyurolojia]]; pamoja na mfumo wa neva wa otonomiki, matatizo ya kuona, kutembea na kuhisi kuonekana sasa.<ref name="pmid18970977"/> Dalili maalum hutambulika kwa sehemu yenye vidonda katika mfumo wa neva na huenda zikawa [[hiposthesia|ukosefu wa hisi]] au [[paresthesia|mabadiliko ya hisi]] kama vile minyweo, mwasho au kufa ganzi, udhaifu wa misuli, [[klonasi|rifleksi dhahiri sana]], [[ukakamavu wa misuli]], au ugumu katika kusonga; ugumu katika kupatanisha usawa ([[ataksia]]); [[disathria|matatizo ya kunena]] au [[disfajia|kumeza]], matatizo ya kuona ([[nistagmasi]], [[uvimbe katika neva ya macho]]<ref name="pmid36179757">{{Rejea jarida |last=Petzold |first=Axel |last2=Fraser |first2=Clare L. |last3=Abegg |first3=Mathias |date=2022 |title=Diagnosis and classification of optic neuritis |url=https://discovery.ucl.ac.uk/id/eprint/10156457/ |journal=The Lancet Neurology |language=en |volume=21 |issue=12 |doi=10.1016/S1474-4422(22)00200-9 |pmid=36179757}}</ref> au [[diplopia|kuona kitu kimoja kana kwamba ni viwili]]), kuhisi [[uchovu]], [[maumivu]] makali sugu, na matatizo ya kibofu na utumbo, miongoni mwa mengine.<ref name="pmid18970977"/> Matatizo ya ugumu wa kufikiria na ya hisia [[dipresheni ya kiafya|dipresheni]] au hisi zisizo thabiti pia hutokea sana.<ref name="pmid18970977"/> [[Tukio la Uhthoff]], kukithiri kwa dalili kutokana na kutangamana na kiwango cha juu cha joto na [[Ishara ya Lhermitte]] hisi ya kielektriki inayohisika kuelekea chini kwenye mgongo shingo linapokunjwa hasa ni sifa bainifu za sklerosisi ya sehemu nyingi.<ref name="pmid18970977"/> Kipimo kikuu cha ulemavu na ukali ni [[kipimo cha hali ya ulemavu ulioenea]], na vipimo vingine kama vile sehemu amilifu za sklerosisi ya sehemu nyingi vinavyotumika sana katika utafiti.<ref>{{cite journal|author=Kurtzke JF |title=Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS) |url=https://archive.org/details/sim_neurology_1983-11_33_11/page/1444 |journal=Neurology |volume=33 |issue=11 |pages=1444–52 |year=1983 |pmid=6685237|doi=10.1212/WNL.33.11.1444 }}</ref><ref name="pmid10467378">{{cite journal |author=Amato MP, Ponziani G |title=Quantification of impairment in MS: discussion of the scales in use |journal=Mult. Scler.|volume=5 |issue=4 |pages=216–9 |year=1999 |month=August |pmid=10467378 |doi= |url=}}</ref><ref name="pmid12356200">{{cite journal |author=Rudick RA, Cutter G, Reingold S |title=The multiple sclerosis functional composite: a new clinical outcome measure for multiple sclerosis trials|journal=Mult. Scler. |volume=8 |issue=5 |pages=359–65 |year=2002 |month=October |pmid=12356200 |doi=|url=}}</ref> Hali hii huanza katika asilimia 85 ya visa kama sindromu isiyoshughulikiwa kiafya kwa siku kadhaa huku asilimia 45 wakiwa na matatizo ya mota na hisi, asilimia 20 wakiwa na uvimbe kwenye neva za macho, na asilimia 10 wakiwa na dalili zinazohusiana na [[shina la ubongo]] kutotekeleza majukumu yake ipasavyo, ilhali asilimia 25 inayobaki ni visa vilivyo na zaidi ya tatizo moja kwa yaliyotajwa awal.<ref name=Tsang2011/> Mkondo wa dalili hutokea katika mipangilio miwili mikuu mwanzoni; kama matukio mabaya ya ghafla yanayodumu siku hadi miezi michache (huitwa [[kurejelewa na ugonjwa]], kuongezeka kwa ukali, maumivu makali ya ghafla, maambukizi au wekundu) na kufuatwa na afueni (asilimia 85 ya visa) au kama kukithiri polepole kwa muda bila vipindi vya afueni (asilimia 10-15 ya visa). <ref name=Milo2010/> Mchanganyiko wa mipangilio hii miwili unaweza pia kutokea <ref name="pmid8780061">{{cite journal|author=[[Fred D. Lublin|Lublin FD]], Reingold SC; National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis |title=Defining the clinical course of multiple sclerosis: results of an international survey|url=https://archive.org/details/sim_neurology_1996-04_46_4/page/907 |journal=Neurology |volume=46|issue=4|pages=907–11|year=1996|month=April|pmid=8780061|doi=10.1212/WNL.46.4.907}}</ref> au watu wanaweza kuanza kwa kutoweka na kurejea kwa ugonjwa ambao huendelea baadaye. <ref name=Milo2010/> Kurejea kwa ugonjwa kwa hakutabiriki, hivyo basi hutokea bila ishara. <ref name="pmid18970977"/> Kuongezeka kwa ukali wa ugonjwa hutokea kinadra zaidi ya mara mbili kwa mwaka. <ref name="pmid18970977"/> Hata hivyo, kurejea kwingine kwa ugonjwa hutangulizwa kwa vichokonozi vya kawaida na kutokea mara kwa mara zaidi wakati wa majira ya kuchipua na majira ya joto.<ref name="pmid16804331">{{cite journal|author=Tataru N, Vidal C, Decavel P, Berger E, Rumbach L|title=Limited impact of the summer heat wave in France (2003) on hospital admissions and relapses for multiple sclerosis |journal=Neuroepidemiology |volume=27 |issue=1 |pages=28–32 |year=2006|pmid=16804331|doi=10.1159/000094233}}</ref> Vile vile, maambukizi ya virusi kama vile [[mafua]], [[influenza]] au [[gastronteritisi]] huongeza hatari. <ref name="pmid18970977"/>[[Fadhaiko]] pia linaweza kuchokonoa shambulizi. <ref name="pmid17439878">{{cite journal |author=Heesen C, Mohr DC, Huitinga I,''et al.''|title=Stress regulation in multiple sclerosis: current issues and concepts |journal=Mult. Scler. |volume=13 |issue=2 |pages=143–8 |year=2007 |month=March |pmid=17439878|doi=10.1177/1352458506070772}}</ref> Ujauzito hupunguza hatari ya kurejea kwa ugonjwa; hata hivyo, katika miezi ya kwanza baada ya kuzaa hatari huongezeka. <ref name="pmid18970977"/> Kwa ujumla, ujauzito hauonekani kusababisha ulemavu wa muda mrefu. <ref name="pmid18970977"/> Matukio mengi hayajaonekana kuathiri viwango vya kurejea kwa ugonjwa yakiwemo chanjo, unyonyeshaji, <ref name="pmid18970977"/> majeraha ya kimwili,<ref name="pmid11205361">{{cite journal |author=Martinelli V |title=Trauma, stress and multiple sclerosis |journal=Neurol. Sci. |volume=21 |issue=4 Suppl 2 |pages=S849–52 |year=2000 |pmid=11205361 |doi=10.1007/s100720070024 |url=http://link.springer-ny.com/link/service/journals/10072/bibs/00214%20Suppl%202/0021S849.htm |access-date=2013-11-28 |archive-date=2013-11-01 |archive-url=https://web.archive.org/web/20131101133811/http://link.springer.com/ |dead-url=yes }}</ref> na tukio la Uhthoff.<ref name="pmid16804331"/> ==Visababishi== Kisababishi cha Sklerosisi ya sehemu nyingi hakijulikani; hata hivyo, inaaminika kutokana na mchanganyiko wa masuala ya kimazingira, kama vile ajenti zinazoambukiza, na jenetikia.<ref name="pmid18970977"/> Nadharia zinajaribu kukusanya data bila mafanikio. Ingawa kuna visababishi kadhaa vya hatari vya kimazingira na baadhi vinaweza kubadilishwa kwa kiasi, utafiti zaidi unahitajika ili kubaini iwapo kuondolewa kwa hivyo kunaweza kuzuia sklerosisi ya sehemu nyingi.<ref name="pmid15556803"/> ===Jiografia=== Sklerosisi ya sehemu nyingi hutokea sana kwa watu wanaoishi mbali na [[ikweta]], ingawa si wote. <ref name="pmid18970977"/><ref name="pmid18606967"/> Wasiohusishwa ni jamii zilizo na hatari ya chini zilizo mbali na ikweta kama vile [[Wasami]], [[Waindio]], [[Wautteriti]] wa [[Kanada]], [[Wamaori]] wa [[New Zealand]],<ref name="pmid12127652">{{cite journal |author=Pugliatti M, Sotgiu S, Rosati G |title=The worldwide prevalence of multiple sclerosis |journal=Clin Neurol Neurosurg |volume=104 |issue=3 |pages=182–91|year=2002 |month=July|pmid=12127652|doi=|url=}}</ref> na [[Wainuti]] wa Canada,<ref name=Milo2010/> na vile vile jamii zilizo na hatari kubwa karibu na ikweta kama vile [[Wasadini]],<ref name=Milo2010/> [[Wapalestina]] na [[Wapasi]].<ref name="pmid12127652"/> Kisababishi cha mtindo huo wa kijiografia si dhahiri.<ref name=Milo2010/> Ingawa mwinamo wa athari ya ugonjwa huu wa kaskazini-kusini unapungua,<ref name="pmid18606967"/> bado upo.<ref name=Milo2010/> Sklerosisi ya sehemu nyingi hutokea sana katika sehemu zilizo na watu wa kaskazini mwa Ulaya<ref name="pmid18970977"/> na tofauti za kijiografia zinaweza kuonyesha kuenea kwa watu hao wenye hatari zaidi ulimwenguni.<ref name=Milo2010/> Upungufu katika kutangamana na mwanga wa jua unaopelekea upungufu katika utengenezaji wa [[vitamini D]] pia umeainishwa kama kisababishi.<ref name="pmid17492755"/><ref name="pmid20494325">{{cite journal|author=Ascherio A, Munger KL, Simon KC |title=Vitamin D and multiple sclerosis|journal=Lancet Neurol|volume=9 |issue=6 |pages=599–612 |year=2010 |month=June|pmid=20494325|doi=10.1016/S1474-4422(10)70086-7 }}</ref> Uhusiano kati ya majira ya kuzaliwa na sklerosisi ya sehemu nyingi hukubaliana na wazo hili, kwani ni watu wachache tu waliozaliwa kaskazini mwa ikweta Novemba wanaoathiriwa baadaye maishani ikilinganishwa na waliozaliwa Mei.<ref name="pmid19897699">{{cite journal |author=Kulie T, Groff A, Redmer J, Hounshell J, Schrager S|title=Vitamin D: an evidence-based review |journal=J Am Board Fam Med|volume=22 |issue=6 |pages=698–706 |year=2009|pmid=19897699|doi=10.3122/jabfm.2009.06.090037|url=}}</ref> Visababishi vya kimazingira vinaweza kuhusika utotoni, kwani tafiti kadhaa zimeonyesha kuwa watu wanaohamia eneo jingine ulimwenguni kabla ya umri wa miaka 15 hupata hatari ya sklerosisi ya sehemu nyingi ya eneo hilo jipya. Hata hivyo, ikiwa uhamiaji huo utafanyika baada ya miaka 15, mtu huyo hubakia na hatari ya nchi yake ya kuzaliwa.<ref name="pmid18970977"/><ref name="pmid15556803"/> Kuna ushahidi kuwa hatari ya kuhama bado inaweza kuwaathiri walio na umri wa zaidi ya miaka 15.<ref name="pmid18970977"/> ===Jenetikia=== [[File:HLA.svg|thumb|Eneo HLA la kromosomu 6&nbsp;. Mabadilikio katika eneo hili huongeza uwezekano wa kupata sklerosisi ya sehemu nyingi.]] Sklerosisi ya sehemu nyingi haizingatiwi kama ugonjwa wa [[kurithiwa]]; hata hivyo, tofauti za kijenetikia zimeonekana kuongeza hatari.<ref name="pmid14747002">{{cite journal|author=Dyment DA, Ebers GC, Sadovnick AD |title=Genetics of multiple sclerosis |journal=Lancet Neurol|volume=3|issue=92|pages=104–10|year=2004|month=February|pmid=14747002|doi=10.1016/S1474-4422(03)00663-X}}</ref> Uwezekano wa kupatwa ni mkubwa kwa jamaa wa mtu aliyeathiriwa, huku hatari zaidi ikiwa kwa walio na uhusiano wa karibu sana naye kijamii.<ref name="pmid11955556"/> Kwa [[pacha wanaofanana]], wote huathiriwa kwa takriban asilimia 30 ya wakati, takriban asilimia 5 kwa pacha wasiofanana na asilimia 2.5 ya ndugu huathiriwa ingawa kwa asilimia ndogo kwa ndugu wa kambo.<ref name="pmid18970977"/><ref name="pmid11955556"/><ref>{{cite journal|last=Hassan-Smith|first=G|coauthors=Douglas, MR|title=Epidemiology and diagnosis of multiple sclerosis.|journal=British journal of hospital medicine (London, England : 2005)|date=2011 Oct|volume=72|issue=10|pages=M146-51|pmid=22041658}}</ref> Iwapo wazazi wote wameathiriwa, hatari kwa watoto wao ni mara 10 zaidi ya watu kwa jumla.<ref name=Milo2010/> Sklerosisi ya sehemu nyingi pia hutokea sana kwa baadhi ya jamii kuliko nyingine.<ref name="pmid11603614">{{cite journal|author=Rosati G|title=The prevalence of multiple sclerosis in the world: an update|journal=Neurol. Sci.|volume=22|issue=2|pages=117–39|year=2001|month=April|pmid=11603614|doi=10.1007/s100720170011}}</ref> [[Jeni]] maalum ambazo zimehusishwa na sklerosisi ya sehemu nyingi ni tofauti katika mfumo wa [[antijeni ya binadamu ya leukositi]] (ABL) —kikundi cha jeni kwenye [[kromosomu]] [[Kromosomu ya 6 (ya binadamu)|6]] zinazotumika kama [[kilinganishi kikuu changamani]] (KKC).<ref name="pmid18970977"/> Habari kuwa mabadiliko kwenye eneo la antijeni ya binadamu ya leukositi yanahusiana na wepesi wa kuathiriwa imejulikana kwa zaidi ya miaka thelathini,<ref name="pmid21247752">{{cite journal|author=Baranzini SE |title=Revealing the genetic basis of multiple sclerosis: are we there yet?|journal=Curr. Opin. Jeni. Dev. |volume=21 |issue=3 |pages=317–24 |year=2011 |month=June|pmid=21247752|pmc=3105160 |doi=10.1016/j.gde.2010.12.006 |url=}}</ref> na vile vile, eneo hili limehusishwa na kuibuka kwa magonjwa ya kinga nafsia kama vile[[aina ya I ya kisukari]] na [[lupasi erithematosusi ya mfumo]].<ref name="pmid21247752"/>Matokeo dhabiti sana ni uhusiano kati ya sklerosisi ya sehemu nyingi na [[aleli]] za KKC zinazofafanuliwa kama ABL-DR15|DR15]] na [[KKC-DQ6|DQ6]].<ref name="pmid18970977"/>Lokasi zingine zinaonyesha athari ya kikinga kama vile [[ABL-C554]] na [[ABL-DRB1]]*11.<ref name="pmid18970977"/> Kwa ujumla, imekadiriwa kuwa mabadiliko ya ABL huchangia kati ya asilimia 20 na 60 ya [[maelekezo ya kijenetiki]].<ref name="pmid21247752"/> Mbinu za kisasa za kijenetiki ([[Utafiti wa uhusiano wa jenomu nzima|Tafiti za uhusiano wa jenomu nzima]]) umetambua angalau jeni zingine kumi na mbili nje ya ABL [[Lokasi (jenetiki)|Lokasi]] zinazoongeza uwezekano kutokea kwa sklerosisi ya sehemu nyingi kwa kiasi.<ref name="pmid21247752"/> ===Ajenti zinazoambukiza=== [[Mikrobu]] nyingi zimependekezwa kama visababishi vya sklerosisi ya sehemu nyingi lakini hakuna iliyothibitishwa.<ref name="pmid11955556"/>Kuhama kutoka eneo moja hadi lingine katika umri mdogo huathiri uwezekano wa mtu wa kupata hatari ya sklerosisi ya sehemu nyingi.<ref name="pmid17444504"/>Maelezo ya haya yanaweza kuwa kwamba aina fulani ya maambukizi yanayosababishwa na mikrobu iliyoenea zaidi kuliko iliyo nadra inahusiana na ugonjwa huo.<ref name="pmid17444504"/> Mbinu zilizopendekezwa ni [[nadharia tete ya usafi]] na nadharia tete ya kuenea. Nadharia tete ya usafi hudai kuwa kutangamana na ajenti fulani za maambukizi mapema maishani hukinga, kwani ugonjwa huu huwa matokeo ya kutangamana na ajenti hizi baadaye. <ref name="pmid18970977"/> Nadharia tete ya kuenea hudai kuwa ugonjwa huu hutokana na ajenti ya maambukizi inayopatikana sana katika maeneo ambapo sklerosisi ya sehemu nyingi ipo kwa wingi na ambapo kwa watu wengi husababisha maambukizi endelevu bila dalili. Uondolewaji wa mielini hutokea katika visa vichache tu na baada ya miaka mingi.<ref name="pmid17444504"/><ref name="pmid8269393"/> Nadharia tete ya usafi imepigiwa upato sana kuliko nadharia tete ya kuenea.<ref name="pmid17444504"/> Ushahidi wa virusi kama kisababishi ni kuwepo kwa [[kanda za oligokloni]] kwenye ubongo na kiowevu cha ubongo na uti wa mgongo kwa watu wengi walio na sklerosisi ya sehemu nyingi, uhusiano wa virusi kadhaa na uondolewaji wa mielini [[uvimbe wa ubongo na uti wa mgongo]] kwa binadamu, na uondolewaji wa mielini kwa wanyama unaotokana na maambukizi fulani ya virusi.<ref name="pmid15721830">{{cite journal|author=Gilden DH|title=Infectious causes of multiple sclerosis|journal=[[The Lancet Neurology]]|volume=4|issue=3|pages=195–202|year=2005|month=March|pmid=15721830|doi=10.1016/S1474-4422(05)01017-3}}</ref> [[Virusi vya hepesi ya binadamu]] ni kikundi cha virusi kinachoweza kusababisha. Watu ambao hawajawahi kuambukizwa na virusi vya [[Epstein-Barr]] wamo katika hatari ndogo ya kupata sklerosisi ya sehemu nyingi ilhali walioambukizwa wakiwa vijana wamo katika hatari kubwa kuliko waliopata wakiwa wadogo.<ref name="pmid18970977"/><ref name="pmid17444504"/> Ingawa wengine huchukulia kuwa hii huenda kinyume na nadharia tete ya usafi , hasa kwa kuwa pengine wasioambukizwa wamekuzwa katika mazingira safi,<ref name="pmid17444504"/> wengine wanaamini kuwa hakuna utata kwa sababu ni kutangamana kwa kwanza na virusi visababishi baadaye maishani kunakosababisha ugonjwa huu.<ref name="pmid18970977"/> Magonjwa mengine ambayo yanaweza kuhusishwa ni [[ukambi]], [[matumbwitumbwi]] na [[rubela]].<ref name="pmid18970977"/> ===Nyingine=== [[Uvutaji tumbaku]] umebainishwa kuwa kisababishi huru cha hatari cha sklerosisi ya sehemu nyingi.<ref name="pmid17492755"/> [[Mfadhaiko (wa kibiolojia)|Mfadhaiko]] unaweza kuwa kisababishi cha hatari ingawa ushahidi ni mchache mno.<ref name="pmid15556803"/> Uhusiano na kutangamana kitaaluma na [[toksini]] —hasa [[viyeyushi]]— umetathminiwa lakini hakuna mapatano dhahiri yaliyoafikiwa.<ref name="pmid15556803"/> [[Chanjo]] zilitafitiwa kama visababishi; hata hivyo, nyingi ya tafiti hazionyeshi uhusiano.<ref name="pmid15556803"/> Visababishi vingine kadhaa vya hatari vinavyoweza kutokea kama vile ulaji wa [[Lishe (chakula)|lishe]] na [[homoni]] vimeangaziwa, hata hivyo, ushahidi wa uhusiano wavyo na ugonjwa ni "mdogo na usioridhisha".<ref name="pmid17492755"/> [[Jongo]]hutokea kwa kiwango kidogo kuliko inavyotarajiwa na viwango vya chini vya [[asidi ya mkojo]] vimepatikana kwa watu walio na sklerosisi ya sehemu nyingi. Hii imepelekea nandharia kuwa asidi ya mkojo ni kinga, ingawa umuhimu wake kamili bado haujulikani.<ref name="pmid18219824">{{cite journal |author=Spitsin S, Koprowski H |title=Role of uric acid in multiple sclerosis |journal=Curr. Top. Microbiol. Immunol. |volume=318 |issue= |pages=325–42 |year=2008|pmid=18219824|doi= |url=}}</ref> ==Pathofiziolojia== Sifa tatu kuu bainifu za sklerosisi ya sehemu nyingi ni kutokea kwa vidonda katika [[mfumo mkuu wa neva]] (pia huitwa baka), inflamesheni, na uharibifu wa [[mielini]] za nuroni. Hali hizi hutangamana kwa namna changamani na ambayo haijaeleweka kikamilifu kupelekea kuharibika kwa tishu ya neva na hatimaye ishara na dalili za ugonjwa kuonekana.<ref name="pmid18970977"/> Mbali na hayo, sklerosisi ya sehemu nyingi inaaminika kuwa tatizo la [[Magonjwa ya inflamesheni yatokanayo na kingamwili |yatokanayo na kingamwili]] linalotokana na uhusiano baina ya jenetiki ya mtu na visababishi visivyojulikana vya kimazingira.<ref name="pmid11955556"/> Uharibifu, hasa kwa kiasi, unaaminika kutokana na mfumo wa kingamwili wa mtu huyo kuathiri mfumo wa neva.<ref name="pmid18970977"/> ===Vidonda=== [[Image:MS Demyelinisation KB 10x.jpg|thumb|Kuondolewa kwa mielini kutokana na sklerosisi ya sehemu nyingi. Katika mbinu ya Klüver-Barrera ya utiaji rangi kwenye mielini, uondoaji wa rangi kwenye eneo lenye vidonda unaweza kuwa bora (Kipimo asilia 1:100).]] Jina ''sklerosisi ya sehemu nyingi'' linarejelea kovu (sklera – zinazojulikana kama tauni au vidonda) zinazotokea kwenye mfumo wa neva. Vidonda hivi huathiri hasa [[mata nyeupe]] kwenye [[neva ya optiki]], [[shina la ubongo]], [[ganglioni msingi]] na [[uti wa mgongo]], au mifumo ya mata nyeupe iliyo karibu na [[mfumo wa ventrikali|ventrikali]] wa kando.<ref name="pmid18970977"/> Jukumu la seli za mata nyeupe ni kupitisha ishara baina ya maeneo ya [[mata ya kijivu]], ambapo hufasiriwa, na kisha kwa mwili wote. [[Mfumo wa neva wa pembeni]] huhusika kinadra.<ref name="pmid11955556">{{cite journal|author=Compston A, Coles A|title=Multiple sclerosis|url=https://archive.org/details/sim_the-lancet_2002-04-06_359_9313/page/n61|journal=Lancet|volume=359|issue=9313|pages=1221–31|year=2002|month=April|pmid=11955556|doi=10.1016/S0140-6736(02)08220-X}}</ref> Hasa, sklerosisi ya sehemu nyingi huhusisha upotezaji wa [[oligodendrosaiti]], seli zinazojenga na kudumisha rusu yenye mafuta—inayojulikana kama [[mielini]]—ambayo husaidia nuroni kubeba [[Ishara za kielektriki|zenye uwezo wa kutenda]] (zenye uwezo wa kutenda).<ref name="pmid18970977"/> Haya husababisha ukondefu au upotezaji kabisa wa mielini, na kuharibika kwa [[aksoni]] za nuroni ugonjwa unapoendelea. Mielini ikipotea nuroni haiwezi kupitisha ishara za kielektriki ifaavyo.<ref name="pmid11955556"/> Mchakato wa ukarabati uitwao [[urejeshaji wa mielini]], hufanyika katika awamu za kwanza za ugonjwa, lakini oligodendrosaiti hushindwa kujenga tena kikamilifu kifuko cha mielini cha seli.<ref name="pmid17531860">{{cite journal |author=Chari DM |title=Remyelination in multiple sclerosis|journal=Int. Rev. Neurobiol. |volume=79 |issue= |pages=589–620 |year=2007|pmid=17531860|doi=10.1016/S0074-7742(07)79026-8 |url=}}</ref>Maambukizi ya mara kwa mara hukandamiza uwezekano bora wa urejeshaji wa mielini, hadi waa mithili ya kovu lijijenge kwenye aksoni iliyoharibiwa.<ref name="pmid17531860"/>Kovu hizi ndizo chanzo cha dalili na wakati wa maambukizi [[upigaji picha wa mwangwi wa sumaku]] huonyesha zaidi ya mawaa kumi mapya.<ref name="pmid18970977"/> Hii inaweza kuashiria kuwa kuna vidonda kadhaa hapo chini ambavyo ubongo unaweza kukarabati wenyewe bila kutoa athari zinazoonekana.<ref name="pmid18970977"/> Mchakato mwingine unaohusika katika utengezaji wa vidonda [[astrositosisi|kuongezeka kwa idadi ya astrositi]] isiyo ya kawaida itokanayo na uharibikaji wa nuroni zilizo karibu.<ref name="pmid18970977"/> [[Pathofisiolojia ya sklerosisi ya sehemu nyingi#Mitindo ya uondolewaji wa mielini| mitindo ya vidonda]] imeelezwa.<ref name="pmid17351524">{{cite journal |author=Pittock SJ, Lucchinetti CF |title=The pathology of MS: new insights and potential clinical applications |journal=Neurologist|volume=13 |issue=2 |pages=45–56 |year=2007 |month=March|pmid=17351524|doi=10.1097/01.nrl.0000253065.31662.37 }}</ref> ===Inflamesheni=== Kando na uondolewaji wa mielini, ishara nyingine ya ugonjwa huu ni [[inflamesheni]]. Sawa na maelezo ya [[elimu ya kingamaradhi]], mchakato wa inflamesheni husababishwa na [[Seli T]], ambazo ni aina ya [[limfositi]] zinazotekeleza jukumu muhimu katika ukingaji wa mwili.<ref name="pmid11955556"/> Seli T huingia ubongoni kupitia matatizo katika [[kizuizi cha damu na ubongo]]. Seli T hutambua mielini kama kitu kigeni na kuishambulia, ndiposa seli hizi huitwa "limfosaiti zenye mjibizo nafsia".<ref name="pmid18970977"/> Maambukizi ya mielini huanzisha mchakato wa inflamesheni ambao huchochea seli zingine za kinga na utoaji wa vitu mumunyifu kama vile [[sitokini]] na [[antibodi]]. Kuharibika zaidi kwa kizuizi cha damu na ubongo kisha husababisha athari zingine za uharibifu kama vile [[edema|kuvimba]], uamilishaji wa [[makrofeji]] na uamilishaji zaidi wa sitokini na protini zingine haribifu.<ref name="pmid11955556"/> Inflamesheni inaweza kupunguza upitishaji wa ishara baina ya nuroni kwa angalau njia tatu.<ref name="pmid18970977"/> Vitu mumunyifu vilivyotolewa vinaweza kuzifanya nuroni zisizoambukizwa zisiweze kupitisha ishara baina yazo. Vitu hivi vinaweza kusababisha au kuzidisha uondolewaji wa mielini, au kusababisha kuvunjika kabisa kwa aksoni.<ref name="pmid18970977"/> [[Kizuizi cha damu na ubongo]] ni sehemu ya mfumo wa [[kapilari]] unaozuia seli T kuingia katika mfumo mkuu wa neva.<!-- <ref name="pmid11955556"/> --> Huenda seli hizi zikapenya na kuingia baada ya maambukizi ya virusi au bakteria.<!-- <ref name="pmid11955556"/> --> Baada ya kujikarabati, hasa baada ya maambukizi kupona, huenda seli T zikabaki ndani ya ubongo.<ref name="pmid11955556"/> ==Utambuzi== [[File:Monthly multiple sclerosis anim cropped no text.gif|thumb|Katuni ikionyesha usambaaji wa vidonda kwenye ubongo kwa wakati na nafasi jinsi inavyoonyeshwa na utafiti wa upigaji picha wa mwangwi wa sumaku wa kila mwezi katika mwaka.]] Sklerosisi ya sehemu nyingi hutambuliwa kulingana na ishara na dalili zinazojitokeza, zikiungwa mkono na [[upigaji picha wa kitiba]] na uchunguzi wa maabarani.<ref name=Tsang2011/> Inaweza kuwa vigumu kuthibitisha, hasa mapema kwa sababu ishara na dalili zinaweza kuwa sawa na za matatizo mengine ya kiafya.<ref name="pmid18970977"/><ref name="pmid11794488">{{cite journal |author=Trojano M, Paolicelli D |title=The differential diagnosis of multiple sclerosis: classification and clinical features of relapsing and progressive neurological syndromes |journal=Neurol. Sci. |volume=22 |issue=Suppl 2 |pages=S98–102 |year=2001 |month=November |pmid=11794488 |doi=10.1007/s100720100044 |url=http://link.springer-ny.com/link/service/journals/10072/bibs/122%20Suppl%202000/122%20Suppl%2020S98.htm |access-date=2013-11-28 |archive-date=2014-10-20 |archive-url=https://web.archive.org/web/20141020114314/http://rd.springer.com/ |dead-url=yes }}</ref> [[Vigezo vya McDonald]], ambavyo huangazia ushahidi wa kiafya, maabara na rediolojia kuhusu vidonda kwa wakati na maeneo tofauti ndiyo mbinu inayotumiwa sana ya utambuzi,<ref name=Atlasi2008/> huku [[vigezo vya Schumacher |Schumacher]] na [[vigezo vya Poser]] vikiwa hasa na umuhimu wa kihistoria.<ref name="pmid15177763">{{cite journal|author=Poser CM, Brinar VV|title=Diagnostic criteria for multiple sclerosis: an historical review |journal=Clin Neurol Neurosurg|volume=106 |issue=3 |pages=147–58 |year=2004|month=June |pmid=15177763|doi=10.1016/j.clineuro.2004.02.004}}</ref> Ingawa vigezo vilivyo hapo juu vinaruhusu utambuzi usioathiri ngozi, wengine wanadai kuwa ushahidi bora wa pekee ni [[otopsi]] au biopsi ambapo vidonda vinavyoashiria sklerosisi ya sehemu nyingi hutambulika.<ref name="pmid18970977"/><ref name="pmid11456302">{{cite journal|author=McDonald WI, Compston A, Edan G, ''et al.'' |title=Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis |url=https://archive.org/details/sim_annals-of-neurology_2001-07_50_1/page/121 |journal=Ann. Neurol.|volume=50 |issue=1 |pages=121–7 |year=2001 |month=July |pmid=11456302|doi=10.1002/ana.1032}}</ref><ref name="pmid16283615">{{cite journal|author=Polman CH, Reingold SC, Edan G, ''et al.''|title=Diagnostic criteria for multiple sclerosis: 2005 revisions to the "kigezo cha McDonald"|url=https://archive.org/details/sim_annals-of-neurology_2005-12_58_6/page/840|journal=Ann. Neurol.|volume=58|issue=6 |pages=840–6 |year=2005 |month=December|pmid=16283615|doi=10.1002/ana.20703}}</ref> Data za kiafya pekee zinaweza kutosha kwa utambuzi wa sklerosisi ya sehemu nyingi iwapo mtu amekuwa na matukio tofauti ya dalili za kinurolojia zinazoashiria ugonjwa huu.<ref name="pmid11456302"/> Kwa wanaotafuta matibabu baada ya kuambukizwa mara moja tu, uchunguzi mwingine unahitajika kwa utambuzi. Vifaa vya utambuzi vinavyotumika sana ni [[upigaji picha wa nuroni]], uchambuzi wa [[kiowevu cha uti wa mgongo na ubongo]] na [[evoked potential]]. [[Upigaji picha wa mwangwi wa sumaku]] wa ubongo na uti wa mgongo unaweza kuonyesha maeneo ambapo mieleni iliondolewa (vidonda au waa). [[Gadoliniamu]] inaweza kuingizwa kupitia [[ndani ya mshipa]] kama [[ajenti tofauti]] ili kuonyesha mawaa, na kwa kuondolewa kuonyesha kuwepo kwa vidonda vya kitambo visivyohusiana na dalili wakati wa utathmini huu.<ref name="pmid11456302"/><ref name="pmid18256986">{{cite journal|author=Rashid W, Miller DH|title=Recent advances in neuroimaging of multiple sclerosis|journal=Semin Neurol|volume=28|issue=1|pages=46–55|year=2008|month=February|pmid=18256986|doi=10.1055/s-2007-1019127}}</ref> Uchunguzi wa [[kiowevu cha ubongo na uti wa mgongo]] kinachotolewa kwa [[sindano ya uti wa mgongo]] unaweza kutoa ushahidi wa [[inflamesheni]] sugu katika mfumo mkuu wa neva. Kiowevu cha uti wa mgongo huchunguzwa kutambua [[kanda za oligokloni]] za imunoglobulini G kwenye[[elektroforesi]], ambazo ni viashiria vya inflamesheni inayopatikana katika asilimia 75-85 ya watu walio na sklerosisi ya sehemu nyingi.<ref name="pmid11456302"/><ref name="pmid16945427">{{cite journal|author=Link H, Huang YM|title=Oligoclonal bands in multiple sclerosis cerebrospinal fluid: an update on methodology and clinical usefulness|journal=J. Neuroimmunol.|volume=180|issue=1–2|pages=17–28|year=2006|month=November|pmid=16945427|doi=10.1016/j.jneuroim.2006.07.006 }}</ref> Mfumo wa neva katika sklerosisi ya sehemu nyingi unaweza kuonyesha mwitikio duni kwa kuchochewa kwa [[neva ya optiki]] na [[nuroni za hisi|neva za hisi]] kutokana na uondolewaji wa mielini kwenye njia hizi. Miitiko hii ya ubongo inaweza kuchunguzwa kwa kutumia [[uwezekano unaoletwa na kuona|wa kuona]] na [[uwezekano unaoletwa]] na hisia.<ref name="pmid10802774">{{cite journal |author=Gronseth GS, Ashman EJ |title=Practice parameter: the usefulness of evoked potentials in identifying clinically silent lesions in patients with suspected multiple sclerosis (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=54 |issue=9 |pages=1720–5 |year=2000|month=May |pmid=10802774 |doi=10.1212/WNL.54.9.1720|url=https://archive.org/details/sim_neurology_2000-05-09_54_9/page/1720}}</ref> ===Mienendo ya kiafya=== [[Image:Ms progression types.svg|thumb|300px|uendeleaji wa aina ndogo za sklerosisi ya sehemu]] Aina ndogo au mitindo kadhaa ya uendeleaji, imeelezwa. Aina ndogo hutumia mwenendo uliopita wa ugonjwa kujaribu [[kutabiri]] mwenendo ujao. Ni muhimu, si kwa prognosi, bali pia kwa uamuzi wa matibabu. Katika mwaka wa 1996 [[Shirika la Kitaifa la Sklerosisi ya Sehemu nyingi]] nchini Marekani lilieleza mienendo minne ya kiafya:<ref name="pmid8780061"/> # inayotoweka na kurejea, # endelevu ya baadaye, # ya kwanza endelevu, na # endelevu inayorejea. Aina ndogo ya vipindi inayotoweka na kurejea inajulikana kwa vipindi vya kuugua visivyotabirika vikifuatwa na vipindi vitulivu vya miezi hadi miaka ya ([[kutoweka kwa ugonjwa (kiafya)|kutoweka kwa ugonjwa]]) bila ishara mpya za kuwepo kwa ugonjwa. Upungufu unaotokea wakati wa maambukizi unaweza kumaliza au kuacha [[sekwela|matatizo]], ya pili ikitokea katika takriban asilimia 40 ya maambukizi na kutokea sana kulingana na urefu wa muda ambao mtu huyo ataishi na ugonjwa huu.<ref name="pmid18970977"/><ref name=Tsang2011/> Hii inaeleza mwenendo wa kwanza wa asilimia 80 ya walio na sklerosisi ya sehemu nyingi.<ref name="pmid18970977"/> Upungufu unapomalizika kila mara kati ya maambukizi, hii mara nyingine hujulikana kama ''Sklerosisi hafifu ya sehemu'',<ref name="pmid18219812">{{cite journal |author=Pittock SJ, Rodriguez M|title=Benign multiple sclerosis: a distinct clinical entity with therapeutic implications|journal=Curr. Top. Microbiol. Immunol. |volume=318 |issue= |pages=1–17 |year=2008 |pmid=18219812|doi=10.1007/978-3-540-73677-6_1 |url=}}</ref> ingawa watu bado watapata kiwango fulani cha ulemavu katika kipindi cha muda mrefu.<ref name="pmid18970977"/> Kwa upande mwingine, jina ''[[sklerosisi malignanti ya sehemu nyingi]]'' hutumiwa kueleza watu walio na sklerosisi ya sehemu nyingi wanaofikia kiwango kikubwa cha ulemavu katika kipindi kifupi cha muda.<ref>{{cite book|last=Feinstein|first=A|title=The clinical neuropsychiatry of multiple sclerosis|url=https://archive.org/details/clinicalneuropsy0000fein_u2q5|year=2007|publisher=Cambridge University Press|location=Cambridge|isbn=052185234X|page=[https://archive.org/details/clinicalneuropsy0000fein_u2q5/page/20 20]|edition=2nd ed.}}</ref> Aina ndogo ya vipindi inayopungua na kuongezeka huanza kwa [[sindromu iliyotengwa kiafya]]. Katika sindromu iliyotengwa kiafya, mtu hupata maambukizi yanayoashiria [[uondolewaji wa mielini]], bali hayatimizi vigezo vya sklerosisi ya sehemu nyingi.<ref name="pmid18970977"/><ref name="pmid15847841">{{cite journal|author=Miller D, Barkhof F, Montalban X, Thompson A, Filippi M|title=Clinically isolated syndromes suggestive of multiple sclerosis, part I: natural history, pathogenesis, diagnosis, and prognosis|journal=Lancet Neurol|volume=4|issue=5|pages=281–8|year=2005|month=May|pmid=15847841|doi=10.1016/S1474-4422(05)70071-5}}</ref>Asilimia 30 hadi 70 ya watu walio na sindromu iliyotengwa kiafya hupata sklerosisi ya sehemu nyingi baadaye.<ref name="pmid15847841"/> [[File:Nerve.nida.jpg|thumb|kushoto|Aksoni ya neva pamoja na kifuko cha mielini]] Aina ndogo endelevu ya baadaye ya sklerosisi ya sehemu nyingi hutokea kwa takriban asilimia 65 ya walio na sklerosisi ya sehemu nyingi ya vipindi inayotoweka na kurejea, ambao hatimaye hupata upungufu endelevu wa nurolojia kati ya maambukizi makali bila vipindi dhahiri vya kutoweka kwa dalili.<ref name="pmid18970977"/><ref name="pmid8780061"/> Huenda akaugua tena mara kwa mara na kupata nafuu kidogo.<ref name="pmid8780061"/> Muda wa kawaida sana kati ya kuanza kwa ugonjwa na ubadilikaji kutoka vipindi vya kutoweka na kurejea hadi sklerosisi ya sehemu nyingi endelevu ya baadaye ni miaka 19&nbsp;.<ref name="pmid16545751">{{cite journal|author=Rovaris M, Confavreux C, Furlan R, Kappos L, Comi G, Filippi M|title=Secondary progressive multiple sclerosis: current knowledge and future challenges|journal=Lancet Neurol|volume=5|issue=4|pages=343–54|year=2006|month=April|pmid=16545751|doi=10.1016/S1474-4422(06)70410-0}}</ref> Aina ndogo endelevu ya kwanza hutokea kwa takriban asilimia 10-20 ya watu, bila upunguaji baada ya dalili za kwanza.<ref name="pmid17884680">{{cite journal|author=Miller DH, Leary SM|title=Primary-progressive multiple sclerosis|journal=Lancet Neurol|volume=6|issue=10|pages=903–12|year=2007|month=October|pmid=17884680|doi=10.1016/S1474-4422(07)70243-0}}</ref><ref name=Tsang2011/> Hujitokeza kwa uendelevu wa ulemavu tangia mwanzo, bila, au na upunguaji mdogo wa mara chache na upataji nafuu.<ref name="pmid8780061"/> Umri wa kawaida wa mwanzo wa aina ndogo ya kwanza endelevu ni zaidi ya ule wa aina ndogo ya vipindi inayotoweka na kurejea. Ni sawa na umri inapoanza aina ndogo ya pili endelevu katika sklerosisi ya sehemu nyingi inayotoweka na kurejea, karibu umri wa miaka 40. <ref name="pmid18970977"/> Sklerosisi ya sehemu nyingi endelevu inayorejea ni kwa watu ambao tangu mwanzo wamekuwa na upungufu wa nurolojia bali pia wana maambukizi zaidi juu yake. Hii ndiyo aina ndogo isiyotokea sana kwa zote.<ref name="pmid8780061"/> [[Magonjwa ya kuvimba yanayoondoa mielini yenye chanzo kisichojulika|Aina za kawaida za sklerosisi ya sehemu nyingi]] yameelezwa; nayo ni [[Ugonjwa wa Devic]], [[Sklerosisi ya ukatikati mmoja ya Balo]], [[Sklerosisi inayosambaa ya mielinoklastiki|Sklerosisi inayosambaa ya Schilder]] na [[Sklerosisi ya sehemu nyingi ya Marburg]]. Kuna mjadala kuhusu iwapo ni aina za sklerosisi ya sehemu nyingi au ni magonjwa tofauti.<ref name="pmid15727225">{{cite journal|author=Stadelmann C, Brück W |title=Lessons from the neuropathology of atypical forms of multiple sclerosis |journal=Neurol. Sci. |issue=Suppl 4 |pages=S319–22 |volume=25 |year=2004 |month=November|pmid=15727225|doi=10.1007/s10072-004-0333-1 }}</ref> Sklerosisi ya sehemu nyingi hujitokeza tofauti kwa watoto, ikichukua muda zaidi kufika kiwango cha uendelevu.<ref name="pmid18970977"/> Hata hivyo, wao bado hufikia kiwango hicho katika umri mdogo kiwastani kuliko watu wazima.<ref name="pmid18970977"/> ==Udhibiti== Ingawa hakuna tiba inayojulikana ya sklerosisi ya sehemu nyingi, baadhi ya matibabu yamethibitisha kusaidia. Malengo makuu ya matibabu ni kurejesha hali ya kawaida baada ya maambukizi, kuzuia maambukizi mapya na kuzuia ulemavu. Jinsi ilivyo katika matibabu yoyote ya kiafya, tiba zinazotumika kwa udhibiti wa sklerosisi ya sehemu nyingi zina [[madhara mabaya (ya kiafya)|madhara mabaya]]. [[Dawa mbadala|Tiba mbadala]] zinatafutwa na watu fulani licha ya uhaba wa ushahidi wa kutosha. ===Maambukizi makali=== Wakati wa maambukizi yenye dalili, kutolewa kwa vipimo vikubwa vya [[matibabu ya ndani ya mishipa| kotikosteroidi]][[za ndani ya mishipa]]kama vile [[methylprednisolone]] ndiyo tiba ya kawaida,<ref name="pmid18970977"/>pamoja na kotikosteroidi za kinywani zinazoonekana kuwa na ubora na usalama sawa.<ref>{{cite cochrane|last=Burton|first=JM|coauthors=O'Connor, PW; Hohol, M; Beyene, J|title=Oral versus intravenous steroids for treatment of relapses in multiple sclerosis.|journal=Cochrane database of systematic reviews (Online)|date=2012 Dec 12|issue=12|review=CD006921|pmid=23235634}}</ref> Ingawa kwa jumla ni bora kwa kupunguza ukali wa dalili kwa muda mfupi, matibabu ya kotikosteroidi hayaonekani kuleta mabadiliko bora kwa uponaji wa muda mrefu.<ref name="RCOP_acute">{{cite book|first=The National Collaborating Centre for Chronic Conditions|title=Multiple sclerosis : national clinical guideline for diagnosis and management in primary and secondary care|year=2004|publisher=Royal College of Physicians|location=London|isbn=1-86016-182-0|pages=54–57|url=http://www.ncbi.nlm.nih.gov/books/NBK48919/pdf/TOC.pdf|accessdate=6 February 2013|format=pdf|pmid=21290636}}</ref> Athari za maambukizi makali yasiotibika kwa kotikosteroidi zinaweza kutibiwa kwa [[kufyonza plazma]].<ref name="pmid18970977"/> ===Tiba zinazobadilisha ugonjwa=== ====Sklerosisi ya sehemu nyingi inayopungua na kuongezeka==== Tiba nane zinazobadilisha ugonjwa zimeidhinishwa na mashirika ya udhibiti kwa sklerosisi ya sehemu nyingi inayotoweka na kurejea zikiwemo: [[interferon beta-1a]], [[interferon beta-1b]], [[glatiramer acetate]], [[mitoxantrone]], [[natalizumab]], [[fingolimod]],<ref name=He2012/> [[teriflunomide]]<ref name=Aubagio>{{cite press release|url=http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm319277.htm |title=FDA approves new multiple sclerosis treatment Aubagio |publisher=USFDA|date=2012-09-12|accessdate=2013-01-21}}</ref> na [[dimethyl fumarate]].<ref name=fumarate>{{cite press release|url=http://www.biogenidec.com/press_release_details.aspx?ID=5981&ReqId=1801165|title=Biogen Idec’s TECFIDERA™ (Dimethyl Fumarate) Approved in US as a First-Line Oral Treatment for Multiple Sclerosis|publisher=Biogen Idec|date=2013-03-27|accessdate=2013-06-04|archivedate=2013-05-12|archiveurl=https://web.archive.org/web/20130512021453/http://www.biogenidec.com/press_release_details.aspx?ID=5981&ReqId=1801165|deadurl=yes}}</ref> Ubora wa bei ya tiba hizi kufikia mwaka wa 2012 haujulikani.<ref>{{cite journal|last=Manouchehrinia|first=A|coauthors=Constantinescu, CS|title=Cost-effectiveness of disease-modifying therapies in multiple sclerosis.|journal=Current neurology and neuroscience reports|date=2012 Oct|volume=12|issue=5|pages=592–600|pmid=22782520}}</ref> Katika sklerosisi ya sehemu nyingi inayotoweka na kurejea, dawa hizi ni bora kwa kiasi katika kupunguza idadi ya maambukizi.<ref name=He2012>{{cite journal|last=He|first=D|coauthors=Xu, Z; Dong, S; Zhang, H; Zhou, H; Wang, L; Zhang, S|title=Teriflunomide for multiple sclerosis|journal=Cochrane database of systematic reviews (Online)|date=2012 Dec 12|volume=12|pages=CD009882|pmid=23235682|doi=10.1002/14651858.CD009882.pub2|editor1-last=Zhou|editor1-first=Hongyu}}</ref> Interferons na glatiramer acetate ni tiba za awamu ya kwanza<ref name=Tsang2011>{{cite journal|last=Tsang|first=BK|coauthors=Macdonell, R|title=Multiple sclerosis- diagnosis, management and prognosis.|journal=Australian family physician|date=2011 Dec|volume=40|issue=12|pages=948–55|pmid=22146321}}</ref> na ni karibu sawa, kwani zote hupunguza kurejea kwa ugonjwa kwa takriban asilimia 30.<ref name=Hassan2011>{{cite journal|last=Hassan-Smith|first=G|coauthors=Douglas, MR|title=Management and prognosis of multiple sclerosis.|journal=British journal of hospital medicine (London, England : 2005)|date=2011 Nov|volume=72|issue=11|pages=M174-6|pmid=22082979}}</ref> Matibabu ya muda mrefu yaliyoanzishwa mapema ni salama na huboresha matokeo.<ref name="pmid21205679">{{cite journal|author=Freedman MS |title=Long-term follow-up of clinical trials of multiple sclerosis therapies|journal=Neurology |volume=76 |issue=1 Suppl 1 |pages=S26–34|year=2011|month=January |pmid=21205679|doi=10.1212/WNL.0b013e318205051d |url=}}</ref><ref name="pmid22284996">{{cite journal|author=Qizilbash N, Mendez I,Sanchez-de la Rosa R |title=Benefit-risk analysis of glatiramer acetate for relapsing-remitting and clinically isolated syndrome multiple sclerosis|journal=Clin Ther|volume=34|issue=1 |pages=159–176.e5 |year=2012 |month=January|pmid=22284996|doi=10.1016/j.clinthera.2011.12.006|url=}}</ref> Natalizumab hupunguza kiwango cha kurejea zaidi ya tiba za awamu ya kwanza; hata hivyo, kutokana na athari mbaya inazosababisha, imetengwa kama tiba ya awamu ya pili kwa wasiopata nafuu kwa tiba zingine<ref name=Tsang2011/> au walio na ugonjwa mkali.<ref name=Hassan2011/> Mitoxantrone, ambayo matumizi yake yamekandamizwa kwa athari kali mbaya, imetengwa kama ya awamu ya tatu kwa wasiopata nafuu kwa matibabu mengine.<ref name=Tsang2011/> Kutibu sindromu isiyoshughulikiwa kiafya kwa [[interferon]] hupunguza uwezekano wa kuendelea hadi katika kiwango cha sklerosisi ya sehemu nyingi ya kiafya.<ref name="pmid18970977"/><ref name="pmid21205678">{{cite journal |author=Bates D |title=Treatment effects of immunomodulatory therapies at different stages of multiple sclerosis in short-term trials|journal=Neurology |volume=76 |issue=1 Suppl 1|pages=S14–25 |year=2011 |month=January |pmid=21205678|doi=10.1212/WNL.0b013e3182050388 |url=}}</ref> Ubora wa interferons na glatiramer acetate kwa watoto umekadiriwa kuwa takriban sawa na ilivyo kwa watu wazima.<ref name="pmid22642799">{{cite journal|author=Johnston J, So TY|title=First-line disease-modifying therapies in paediatric multiple sclerosis: a comprehensive overview|journal=Drugs |volume=72 |issue=9 |pages=1195–211 |year=2012|month=June|pmid=22642799|doi=10.2165/11634010-000000000-00000 |url=}}</ref> Jukumu la baadhi ya tiba mpya kama vile fingolimod, teriflunomide, na dimethyl fumarate kufikia mwaka wa 2011 bado halijajulikana kikamilifu.<ref>{{cite journal |author=Killestein J, Rudick RA, Polman CH |title=Oral treatment for multiple sclerosis |journal=Lancet Neurol |volume=10 |issue=11 |pages=1026–34 |year=2011 |month=November|pmid=22014437 |doi=10.1016/S1474-4422(11)70228-9 |url=}}</ref> ====Sklerosisi endelevu ya sehemu nyingi ==== Hakuna tiba inayoonekana kuweza kubadilisha mwelekeo wa sklerosisi endelevu ya kwanza ya sehemu nyingi<ref name=Tsang2011/> na kufikia mwaka wa 2011 ni dawa moja tu, mitoxantrone, iliyokuwa imeidhinishwa kwa sklerosisi endelevu ya baadaye ya sehemu nyingi.<ref>{{cite book |author=Kellerman, Rick D.; Edward N. Hanley Jr MD |title=Conn's Current Therapy 2012:. Expert Consult - Online and Print |publisher=Saunders |location=Philadelphia |year=2011 |pages=627|isbn=1-4557-0738-4 |url=http://books.google.ca/books?id=pyKjGU5JdqQC&pg=PT662}}</ref> Wakati huu ushahidi wa kujaribia huunga mkono mitoxantrone kupunguza kwa kiasi kuendelea kwa ugonjwa huu na kupunguza viwango vya kurejea kwa miaka miwili.<ref name=CochMit2013>{{cite journal|last=Martinelli Boneschi|first=F|coauthors=Vacchi, L; Rovaris, M; Capra, R; Comi, G|title=Mitoxantrone for multiple sclerosis.|journal=Cochrane database of systematic reviews (Online)|date=2013 May 31|volume=5|pages=CD002127|pmid=23728638}}</ref><ref>{{cite journal|last=Marriott|first=JJ|coauthors=Miyasaki, JM; Gronseth, G; O'Connor, PW; Therapeutics and Technology Assessment Subcommittee of the American Academy of, Neurology|title=Evidence Report: The efficacy and safety of mitoxantrone (Novantrone) in the treatment of multiple sclerosis: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.|url=https://archive.org/details/sim_neurology_2010-05-04_74_18/page/1463|journal=Neurology|date=2010 May 4|volume=74|issue=18|pages=1463–70|pmid=20439849}}</ref> ====Athari mbaya==== [[File:Copaxone Injection Site Reaction.JPG|thumb|Eneo lenye mwasho baada ya sindano ya glatiramer acetate.]] Tiba zinazobadilisha ugonjwa huu zina athari kadhaa mbaya. Mojawapo ya athari zinazotokea sana ni mwasho kwenye sehemu iliyodungwa sindano ya glatiramer acetate na interferons (hadi asilimia 90 kwa sindano za chini ya ngozi na asilimia 33 kwa sindano za ndani ya misuli).<ref name=Balak2012>{{cite journal|last=Balak|first=DM|coauthors=Hengstman, GJ; Çakmak, A; Thio, HB|title=Cutaneous adverse events associated with disease-modifying treatment in multiple sclerosis: a systematic review.|journal=Multiple sclerosis (Houndmills, Basingstoke, England)|date=2012 Dec|volume=18|issue=12|pages=1705–17|pmid=22371220}}</ref> Baada ya muda, kibonyeo kinachoonekana kwenye sehemu iliyodungwa sindano kutokana na kuharibiwa kwa tishu za mafuta ziitwazo [[lipoatrofia]], kinaweza kutokea.<ref name=Balak2012/> Interferons zinaweza kuleta [[dalili kama za mafua]];<ref name="pmid17131933">{{cite journal|author=Sládková T, Kostolanský F |title=The role of cytokines in the immune response to influenza A virus infection |journal=Acta Virol. |volume=50 |issue=3 |pages=151–62 |year=2006 |pmid=17131933}}</ref> watu wengine wanaotumia glatiramer hukumbwa na athari za baada ya kudungwa sindano ambazo ni wekundu usoni, kubana kwa kifua, mpapatiko wa moyo, kukosa pumzi, na wasiwasi, ambazo hudumu chini ya dakika thelathini.<ref name="pmid14974077">{{cite journal |author=Munari L, Lovati R, Boiko A|editor1-last=Munari |editor1-first=Luca M. |title=Therapy with glatiramer acetate for multiple sclerosis |journal=Cochrane database of systematic reviews (Online) |issue=1 |pages=CD004678 |year=2004|pmid=14974077 |doi=10.1002/14651858.CD004678}}</ref> Dalili zingine hatari sana ingawa zisizotokea sana ni[[hepatotoksisiti|uharibifu wa ini]] kutokana na interferons,<ref name="pmid15592724">{{cite journal|author=Tremlett H, Oger J |title=Hepatic injury, liver monitoring and the beta-interferons for multiple sclerosis |journal=J. Neurol. |volume=251 |issue=11 |pages=1297–303 |year=2004 |month=November|pmid=15592724 |doi=10.1007/s00415-004-0619-5 }}</ref> [[utendakazi mbaya wa sistoli]] (asilimia 12), [[utasa]], na [[leukemia kali ya mieloidi]] (asilimia 0.8) kutokana na mitoxantrone,<ref name=CochMit2013/><ref name="pmid19882365">{{cite journal |author=Comi G |title=Treatment of multiple sclerosis: role of natalizumab |journal=Neurol. Sci. |volume=Suppl 2 |issue= S2|pages=S155–8 |series=30|year=2009|month=October |pmid=19882365 |doi=10.1007/s10072-009-0147-2 }}</ref> na [[lukoensefalopathia endelevu ya utazamouwingi]] kutokeakea kutokana na natalizumab (hutokea kwa mtu 1 kati ya kila watu mia 600 waliotibiwa).<ref name=Tsang2011/><ref>{{cite journal|last=Hunt|first=D|coauthors=Giovannoni, G|title=Natalizumab-associated progressive multifocal leucoencephalopathy: a practical approach to risk profiling and monitoring.|journal=Practical neurology|date=2012 Feb|volume=12|issue=1|pages=25–35|pmid=22258169}}</ref> Fingolimod inaweza kupelekea [[hipatensheni]] na [[bradikadia]], [[edema ya makula]], kiwango cha juu cha enzaimu za ini [[limfopenia|upungufu wa seli za limfositi]].<ref name="pmid22014437">{{cite journal|author=Killestein J, Rudick RA, Polman CH |title=Oral treatment for multiple sclerosis |journal=Lancet Neurol |volume=10 |issue=11 |pages=1026–34 |year=2011 |month=November |pmid=22014437|doi=10.1016/S1474-4422(11)70228-9 |url=}}</ref> Ushahidi wa kujaribia unaunga mkono ubora wa muda mfupi wa teriflunomide, huku ikiwa na madhara kama: maumivu ya kichwa, uchovu, kichefuchefu, kupoteza nywele, na maumivu kwa miguu na mikono.<ref name=He2012/> Pia kumekuwa na ripoti za ini kutofanya kazi na lukoensefalopathia endelevu ya utazamouwingi kutokana na matumizi yake, na ni [[Teratologia|hatari kwa ukuaji wa fetasi]].<ref name="pmid22014437"/> Mengi ya madhara yanayotokea sana ya dimethyl fumarate ni wekundu usoni na matatizo ya tumbo na utumbo mdogo.<ref name=fumarate/><ref name="pmid22014437"/> Ingawa dimethyl fumarate ingeweza kusababisha [[nutropenia|upungungu wa kiwango cha seli nyeupe za damu]] hakukuwa na visa vya maambukizi nyemelezi vilivyoripotiwa wakati wa majaribio.<ref name=fumarateNDA>{{cite web |title=NDA 204063 - FDA Approved Labeling Text|url=http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/204063lbl.pdf |date=27 March 2013|accessdate=5 April 2013 |publisher=US Food and Drug Agency }}<br>{{cite web |title=NDA Approval|date=27 March 2013|url=http://www.accessdata.fda.gov/drugsatfda_docs/appletter/2013/204063Orig1s000ltr.pdf |accessdate=5 April 2013 |publisher=US Food and Drug Agency }}</ref><ref name="pmid22224673"/> ===Dalili husika=== Tiba na [[ukarabati wa mfumo wa neva]] yameonekana kuboresha dalili zingine ingawa hakuna inayobadilisha mwelekeo wa ugonjwa huu.<ref name="pmid16168933">{{cite journal |author=Kesselring J, Beer S|title=Symptomatic therapy and neurorehabilitation in multiple sclerosis |journal=Lancet Neurol|volume=4 |issue=10 |pages=643–52 |year=2005 |month=October |pmid=16168933|doi=10.1016/S1474-4422(05)70193-9 |url=}}</ref> Dalili zingine kama vile kibofu kisicho thabiti na mkazoghafla huitika vizuri kwa tiba ilhali zingine hubaki zilivyo.<ref name="pmid18970977"/> Kwa matatizo ya nurolojia, mtazamo [[wa nyanja mbalimbali]] ni muhimu kwa kuendeleza ubora wa maisha; hata hivyo, ni vigumu kueleza bayana 'kikundi halisi' kwa sababu huduma nyingi tofauti za afya zinaweza kuhitajika wakati tofauti.<ref name="pmid18970977"/> Programu za nyanja mbalimbali za kukarabati huongeza shughuli na kuhusika kwa watu walio na sklerosisi ya sehemu nyingi bali haziathiri kiwango cha kudhoofika.<ref name="pmid17443610">{{cite journal |author=Khan F, Turner-Stokes L, Ng L, Kilpatrick T|editor1-last=Khan |editor1-first=Fary |title=Multidisciplinary rehabilitation for adults with multiple sclerosis |journal=Cochrane Database Syst Rev |issue=2 |pages=CD006036 |year=2007 |pmid=17443610|doi=10.1002/14651858.CD006036.pub2 }}</ref> Kuna ushahidi mdogo sana wa ufaafu wa jumla wa kila fani ya matibabu,<ref name="pmid15859525">{{cite journal |author=Steultjens EM, Dekker J, Bouter LM, Leemrijse CJ, van den Ende CH |title=Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews |journal=Clinical rehabilitation|volume=19 |issue=3 |pages=247–54 |year=2005 |pmid=15859525 |doi=10.1191/0269215505cr870oa}}</ref><ref name="pmid15859525"/><ref name="pmid12917976">{{cite journal |author=Steultjens EM, Dekker J, Bouter LM, Cardol M, Van de Nes JC, Van den Ende CH |title=Occupational therapy for multiple sclerosis|journal=Cochrane database of systematic reviews (Online) |volume= |issue=3 |pages=CD003608 |year=2003|pmid=12917976 |doi=10.1002/14651858.CD003608 |editor1-last=Steultjens |editor1-first=Esther EMJ}}</ref> ingawa kuna ushahidi bora kuwa mitazamo mahususi kama vile mazoezi,<ref name="pmid17482708">{{cite journal |author=Gallien P, Nicolas B, Robineau S, Pétrilli S, Houedakor J, Durufle A |title=Physical training and multiple sclerosis |journal=Ann Readapt Med Phys |volume=50|issue=6 |pages=373–6, 369–72 |year=2007 |pmid=17482708|doi=10.1016/j.annrmp.2007.04.004}}</ref><ref>{{cite journal |author=Rietberg MB, Brooks D, Uitdehaag BMJ, Kwakkel G |title=Exercise therapy for multiple sclerosis |journal=Cochrane Database of Systematic Reviews |issue=1 |pages=CD003980 |year=2005 |pmid=15674920 |doi=10.1002/14651858.CD003980.pub2|editor1-last=Kwakkel |editor1-first=Gert}}</ref> na matibabu ya saikolojia, hasa [[tiba tambuzi ya mienendo|mitazamo tambuzi ya mienendo]] hufaa.<ref>{{cite journal |author=Thomas PW, Thomas S, Hillier C, Galvin K, Baker R|title=Psychological interventions for matibabu ya sclerosis|journal=Cochrane Database of Systematic Reviews |issue=1 |pages=CD004431 |year=2006|pmid=16437487|doi=10.1002/14651858.CD004431.pub2 |editor1-last=Thomas |editor1-first=Peter W}}</ref> ===Tiba mbadala=== Zaidi ya asilimia 50 ya watu walio na sklerosisi ya sehemu nyingi wanaweza kutumia [[tiba ya kutimizana na mbadala]], ingawa asilimia hubadilika kulingana na jinsi tiba mbadala zinavyofafanuliwa.<ref name="pmid16420779">{{cite journal|author=Huntley A |title=A review of the evidence for efficacy of complementary and alternative medicines in MS |journal=Int MS J |volume=13 |issue=1 |pages=5–12, 4 |year=2006 |month=January|pmid=16420779 |doi= |url=}}</ref> Ushahidi wa ufaafu wa matibabu kama haya kwa hali nyingi ni duni au haupo.<ref name="pmid16420779"/><ref name="pmid19222053">{{cite journal |author=Olsen SA|title=A review of complementary and alternative medicine (CAM) by people with multiple sclerosis|journal=Occup Ther Int |volume=16 |issue=1 |pages=57–70 |year=2009 |pm definitiveid=19222053 |doi=10.1002/oti.266}}</ref><ref>Ingawa kuna ushahidi wa kujaribia kuwa vitamini D inaweza kusaidia, ushahidi wa kuthibitisha hautoshi.<refni >{{cite journal|last=Jagannath|first=VA|coauthors=Fedorowicz, Z; Asokan, GV; Robak, EW; Whamond, L|title=Vitamin D for the management of multiple sclerosis.|journal=Cochrane database of systematic reviews (Online)|date=2010 Dec 8|issue=12|pages=CD008422|pmid=21154396}}</ref> Matibabu ya faida isiyothibitishwa yanayotumiwa na watu walio na sklerosisi ya sehemu nyingi ni: virutubishi vya ziada kwenye lishe na mazoezi kwa ajili ya kuleta afya,<ref name="pmid16420779"/><ref name="pmid17253500">{{cite journal |author=Farinotti M, Simi S, Di Pietrantonj C, ''et al.'' |editor1-last=Farinotti |editor1-first=Mariangela |title=Dietary interventions for multiple sclerosis |journal=Cochrane database of systematic reviews (Online) |issue=1|pages=CD004192 |year=2007 |pmid=17253500 |doi=10.1002/14651858.CD004192.pub2}}</ref><ref name="pmid21965673">{{cite journal |author=Grigorian A, Araujo L, Naidu NN, Place DJ, Choudhury B, Demetriou M. |title=N-acetylglucosamine inhibits T-helper 1 (Th1)/T-helper 17 (Th17) cell responses and treats experimental autoimmune encephalomyelitis. |journal=J Biol Chem |year=2011 |month=September|pmid=21965673 |doi=10.1074/jbc.M111.277814. Epub 2011 Sep 29. |url=}}</ref> [[mbinu za kupunguza mikazo ya mwili]] kama vile [[yoga]],<ref name="pmid16420779"/> [[miti shamba]] (ikiwemo [[tiba ya bangi]]),<ref name="pmid16420779"/><ref>{{cite journal |author=Chong MS, Wolff K, Wise K, Tanton C, Winstock A, Silber E |title=Cannabis use in patients with multiple sclerosis |journal=Mult. Scler. |volume=12|issue=5 |pages=646–51 |year=2006 |pmid=17086912 |doi=10.1177/1352458506070947}}</ref> [[tiba ya oksijeni ya haipabariki]],<ref name="pmid14974004">{{cite journal |author=Bennett M, Heard R|editor1-last=Bennett |editor1-first=Michael H |title=Hyperbaric oxygen therapy for multiple sclerosis|journal=Cochrane database of systematic reviews (Online) |issue=1 |pages=CD003057 |year=2004|pmid=14974004 |doi=10.1002/14651858.CD003057.pub2}}</ref> [[tiba ya heliminthiki|kujiambukiza minyoo ya safura]], [[refleksolojia]] na [[akupancha]].<ref name="pmid16420779"/><ref>{{cite news | first=Tim| last=Adams | title=Gut instinct: the miracle of the parasitic hookworm |url=http://www.guardian.co.uk/lifeandstyle/2010/may/23/parasitic-hookworm-jasper-lawrence-tim-adams |newspaper=The Observer | date=23 May 2010 }}</ref> Kulingana na sifa bainifu za wanaotumia, mara nyingi ni wanawake ambao wamekuwa na sklerosisi ya sehemu nyingi kwa muda mrefu, na hukumbwa na ulemavu na viwango vya chini vya kuridhishwa kwa huduma za kawaida za afya.<refname="pmid16420779"/> ==Prognosisi== [[File:Multiple sclerosis world map - DALY - WHO2004.svg|thumb|[[Mwaka wa maisha yaliyorekebika kwa ulemavu]] kwa sklerosisi ya sehemu nyingi kwa kila wakaazi 100,000&nbsp; katika mwaka wa 2004 {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<13}} {{legend|#fff200|13–16}} {{legend|#ffdc00|16–19}} {{legend|#ffc600|19–22}} {{legend|#ffb000|22–25}} {{legend|#ff9a00|25–28}} {{Multicol-break}} {{legend|#ff8400|28–31}} {{legend|#ff6e00|31–34}} {{legend|#ff5800|34–37}} {{legend|#ff4200|37–40}} {{legend|#ff2c00|40–43}} {{legend|#cb0000|>43}} {{Multicol-end}}]] Mwelekeo unaotarajiwa baadaye wa ugonjwa huu hulingana na aina ndogo ya ugonjwa huu; jinsia ya mtu, umri, na dalili za kwanza; na kiwango cha [[ulemavu]] alio nao mtu huyo.<ref name="pmid8017890">{{cite journal|author=Weinshenker BG|title=Natural history of multiple sclerosis|journal=Ann. Neurol.|volume=36|issue=Suppl|pages=S6–11|year=1994|pmid=8017890|doi=10.1002/ana.410360704}}</ref> Kwa jinsia ya kike, aina ndogo inayotoweka na kurejea, dalili za nuritisi ya optiki au hisi mwanzoni maambukizi katika miaka ya kwanza na hasa mapema mwanzoni, huhusishwa na mwelekeo bora.<ref name="pmid8017890"/><ref name="pmid3495637">{{cite journal|author=Phadke JG|title=Survival pattern and cause of death in patients with multiple sclerosis: results from an epidemiological survey in north east Scotland |journal=J. Neurol. Neurosurg. Psychiatr. |volume=50 |issue=5 |pages=523–31 |year=1987 |month=May |pmid=3495637 |pmc=1031962|doi=10.1136/jnnp.50.5.523}}</ref> Muda wa wastani wa kutarajiwa kuishi ni miaka 30 tangu mwanzo, ambao ni miaka 5 hadi 10 chini ya muda wa watu wasioathiriwa.<ref name="pmid18970977"/> Takriban asilimia 40 ya watu walio na sklerosisi ya sehemu nyingi hufikia muongo wa saba wa maisha.<ref name="pmid3495637"/> Hata hivyo, thuluthi mbili za vifo huhusiana moja kwa moja na athari za ugonjwa huu<ref name="pmid18970977"/> [[Kujiua]] hutokea sana, huku maambukizi na matatizo mengine yakiwa hatari hasa kwa walio na ulemavu mkubwa. <ref name="pmid18970977"/> Ingawa watu wengi hupoteza uwezo wa kutembea kabla ya kufariki, asilimia 90 wana uwezo wa kutembea bila kusaidiwa kufikia miaka 10 tangu mwanzo, na asilimia 75 kufikia miaka 15.<ref name="pmid3495637"/><ref name="pmid11321195">{{cite journal|author=Myhr KM, Riise T, Vedeler C, ''et al''|title=Disability and prognosis in multiple sclerosis: demographic and clinical variables important for the ability to walk and awarding of disability pension|journal=Mult. Scler.|volume=7|issue=1|pages=59–65|year=2001|month=February|pmid=11321195}}</ref> ==Epidemolojia== Idadi ya watu walio na sklerosisi ya sehemu nyingi kufikia mwaka wa 2010 ni millioni 2-2.5&nbsp; (takriban watu 30 kwa kila 100,000) duniani, na viwango tofauti katika sehemu tofauti.<ref name=Atlas2008>{{cite book |author=World Health Organization |title=Atlas: Multiple Sclerosis Resources in the World 2008 |publisher=World Health Organization |location=Geneva |year=2008 |pages=15-16 |isbn=92-4-156375-3 |url=http://whqlibdoc.who.int/publications/2008/9789241563758_eng.pdf |access-date=2013-11-28 |archive-date=2013-10-04 |archive-url=https://web.archive.org/web/20131004215703/http://whqlibdoc.who.int/publications/2008/9789241563758_eng.pdf |url-status=dead }}</ref><ref name=Milo2010>{{cite journal |author=Milo R, Kahana E |title=Multiple sclerosis: geoepidemiology, genetics and the environment |journal=Autoimmun Rev |volume=9 |issue=5 |pages=A387–94 |year=2010|month=March |pmid=19932200 |doi=10.1016/j.autrev.2009.11.010 |url=}}</ref> Imekadiriwa kuwa ulisababisha vifo 18,000 mwaka huo.<ref name=Loz2012>{{cite journal|last=Lozano|first=R|title=Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.|url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2095|journal=Lancet|date=2012 Dec 15|volume=380|issue=9859|pages=2095-128|pmid=23245604}}</ref> Katika Afrika viwango ni chini ya 0.5 kwa kila 100,000, ilihali ni 2.8 kwa kila 100,000 Kusini Mashariki mwa Asia, 8.3 kwa kila 100,000 katika mabara ya Amerika, na 80 kwa kila 100,000 Uropa.<ref name=Atlas2008/> Kwa watu wengine walio kwenye bonde la Kaskazini mwa Uropa, viwango huzidi 200 kwa kila 100,000 .<ref name=Milo2010/> Idadi ya visa vipya vinavyotokea kila mwaka ni takriban 2.5 kwa kila 100,000.<ref name=Atlas2008/> Viwango vya sklerosisi ya sehemu nyingi vinaonekana vinavyoongezaka, hata hivyo, hii inaweza kuelezwa kwa urahisi kwa utambuzi bora<ref name=Milo2010/> Utafiti juu ya mitindo ya watu na ya kijiografia umeenea sana.<ref name="pmid8269393">{{cite journal|author=Kurtzke JF|title=Epidemiologic evidence for multiple sclerosis as an infection|journal=Clin. Microbiol. Rev.|volume=6|issue=4|pages=382–427|year=1993|month=October|pmid=8269393|pmc=358295|url=http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=8269393|doi=10.1128/CMR.6.4.382|access-date=2013-11-28|archive-date=2012-12-05|archive-url=https://archive.today/20121205073955/http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=8269393|dead-url=yes}}</ref> na umepelekea nadharia kadhaa kuhusu kisababishi .<ref name="pmid17444504">{{cite journal|author=Ascherio A, Munger KL|title=Environmental risk factors for multiple sclerosis. Part&nbsp;I: the role of infection|url=https://archive.org/details/sim_annals-of-neurology_2007-04_61_4/page/288|journal=Ann. Neurol.|volume=61|issue=4|pages=288–99|year=2007|month=April|pmid=17444504|doi=10.1002/ana.21117}}</ref><ref name="pmid15556803">{{cite journal |author=Marrie RA|title=Environmental risk factors in multiple sclerosis aetiology|journal=Lancet Neurol|volume=3|issue=12|pages=709–18|year=2004|month=December|pmid=15556803|doi=10.1016/S1474-4422(04)00933-0}}</ref><ref name="pmid17492755">{{cite journal|author=Ascherio A, Munger KL|title=Environmental risk factors for multiple sclerosis. Part&nbsp;II: Noninfectious factors|url=https://archive.org/details/sim_annals-of-neurology_2007-06_61_6/page/504|journal=Ann. Neurol.|volume=61|issue=6|pages=504–13|year=2007|month=June|pmid=17492755|doi=10.1002/ana.21141}}</ref> Sklerosisi ya sehemu nyingi kikawaida hutokea kwa watu wazima mwishoni mwa miaka yao ya ishirini au mwanzoni mwa miaka yao ya thelathini bali ni nadra ianze utotoni na baada ya umri wa miaka 50.<ref name=Atlas2008/><ref name=Milo2010/> Aina ndogo ya kwanza endelevu hutokea sana kwa watu walio katika miaka ya hamsini.<ref name="pmid17884680"/> Sawa na magonjwa mengi ya kinga nafsia, ugonjwa huu hutokea sana kwa wanawake na huenda mkondo huu unaongezeka.<ref name="pmid18970977"/><ref name="pmid18606967">{{cite journal|author=Alonso A, Hernán MA|title=Temporal trends in the incidence of multiple sclerosis: a systematic review|url=https://archive.org/details/sim_neurology_2008-07-08_71_2/page/128|journal=Neurology|volume=71|issue=2|pages=129–35|year=2008|month=July|pmid=18606967|doi=10.1212/01.wnl.0000316802.35974.34}}</ref> Kufikia mwaka wa 2008, kote duniani, ni takriban mara mbili zaidi kwa wanawake kuliko kwa wanaume.<ref name=Atlas2008/> Kwa watoto hutokea sana kwa wa kike kuliko wa kiume,<ref name="pmid18970977"/> ilhali kwa watu walio na zaidi ya miaka hamsini, huwaathiri wanaume na wanawake karibu sawa.<ref name="pmid17884680"/> ==Historia== ===Ugunduzi wa kitiba=== [[Mnurolojia]] wa Kifaransa [[Jean-Martin Charcot]] (1825–1893) ndiye aliyekuwa mtu wa kwanza kutambua sklerosisi ya sehemu nyingi kama ugonjwa tofauti katika mwaka wa 1868.<ref name="pmid3066846"/> Akiweka pamoja ripoti za awali na kuongeza ugunduzi wake binafsi wa kiafya na patholojia, Charcot aliita ugonjwa huu ''sklerosisi na mawaa''. Ishara tatu za sklerosisi ya sehemu nyingi ambazo kwa sasa zijulikana kama [[seti ya 1 ya Charcot]] ni [[nistagmasi]], [[mtetemo wa hiari]], na [[usemi wa kitelegrafia]] (kunena haraka), ingawa hizi hazitokei kwa sklerosisi ya sehemu nyingi pekee. Charcot pia alichunguza mabadiliko ya ufahamu, akiwataja wagonjwa wake kama walio na "udhaifu unaooneka wa kukumbuku" na "utungaji dhana wa polepole".<ref name="Charcot1">{{cite journal |author=Clanet M |title=Jean-Martin Charcot. 1825 to 1893 |journal=Int MS J |volume=15 |issue=2 |pages=59–61 |year=2008 |month=June |pmid=18782501 |url=http://www.msforum.net/Site/ViewPDF/ViewPDF.aspx?ArticleID=E80DC748-5048-4BD2-9393-18BCAE0A1514&doctype=Article |format=PDF |access-date=2013-11-28 |archive-date=2019-03-30 |archive-url=https://web.archive.org/web/20190330210130/http://www.msforum.net/Site/ViewPDF/ViewPDF.aspx?ArticleID=E80DC748-5048-4BD2-9393-18BCAE0A1514&doctype=Article |dead-url=yes }}<br />* {{cite journal|author=Charcot, J. |year=1868 |title=Histologie de la sclerose en plaques |journal=Gazette des hopitaux, Paris |volume=41 |pages=554–5 }}</ref> Kabla ya Charcot, [[Robert Carswell (mpatholojia)|Robert Carswell]] (1793–1857), profesa wa Uingereza wa[[patholojia]], na [[Jean Cruveilhier]] (1791–1873), profesa wa Kifaransa wa anatomia ya pathologia, walikuwa wameeleza na kufafanua habari nyingi za kiafya za ugonjwa huu, bali hawakuutambua kama ugonjwa tofauti.<ref name="pmid3066846">{{cite journal|author=Compston A|title=The 150th anniversary of the first depiction of the lesions of multiple sclerosis|url=https://archive.org/details/sim_journal-of-neurology-neurosurgery-and-psychiatry_1988-10_51_10/page/1249|journal=J. Neurol. Neurosurg. Psychiatr.|volume=51|issue=10|pages=1249–52|year=1988|month=October|pmid=3066846|pmc=1032909|doi=10.1136/jnnp.51.10.1249}}</ref> Hasa, Carswell alieleza majeraha aliyopata kama "lesheni ya uti wa mgongo isiyo kifani iliyoandamana na atrofi"<ref name="pmid18970977"/> Kwa hadubini, mpatholojia wa Uswizi [[Georg Eduard Rindfleisch]] mwaka wa (1836–1908) alitambua katika mwaka wa 1863 kuwa lesheni zinazohusiana na inflamesheni zilikuwa zimeenea katika mishipa ya damu.<ref name="pmid10603616">{{cite journal |author=Lassmann H |title=Pathologia ya sklerosisi ya sehemu nyingi na mabadiliko yake|journal=Philos. Trans. R. Soc. Lond., B, Biol. Sci. |volume=354 |issue=1390 |pages=1635–40 |year=1999|month=October |pmid=10603616 |pmc=1692680 |doi=10.1098/rstb.1999.0508 |url=}}</ref><ref>{{cite journal|author=Lassmann H |date=July 2005 |title=Multiple sclerosis pathology: evolution of pathogenetic concepts |journal=[[Brain Pathology]] |volume=15 |issue=3 |pages=217–22|doi=10.1111/j.1750-3639.2005.tb00523.x |pmid=16196388 }}</ref> Katika karne ya 20 nadharia kuhusu kisababishi na pathojenesisi zilitolewa na matibabu bora yakaanza kutolewa katika mwaka wa 1990.<ref name="pmid18970977"/> ===Visa vya kihistoria=== [[Picha:Animal locomotion. Plate 541 (Boston Public Library).jpg|thumb|left|Utafiti wa picha wa mwendo wa mgonjwa wa kike wa sklerosisi ya sehemu nyingi aliye na ugumu wa kutembea iliyotengenezwa na [[Muybridge]] katika mwaka wa 1887.]] Kuna maelezo kadhaa ya kihistoria ya watu walioshi kabla au muda mfupi baada ya ugonjwa huu walioelezwa na Charcot na huenda walikuwa na sklerosisi ya sehemu nyingi. Mwanamke aitwaye Halldora aliyeishi [[Iceland]] karibu mwaka wa 12000 alipoteza uwezo wake wa kuona na kutembea kwa ghafla lakini baada ya kuwaomba watakatifu, aliweza kupata tena uwezo wake wa kuona na kutembea. [[Mtakatifu Lidwina]] wa [[Schiedam]] (mwaka wa 1380–1433), aliyekuwa [[mtawa wa kike]] [[wa uholanzi|Mholanzi]] anaweza kuwa mmoja wa watu waliojulika bayana kuwa na sklerosisi ya sehemu nyingi. Tangu umri wa miaka 16 hadi kifo chake akiwa na umri wa miaka 53, alikuwa na vipindi vya maumivu, udhaifu wa miguu na kupoteza uwezo wa kuona&mdash;dalili zinazoashiria sklerosisi ya sehemu nyingi.<ref name="pmid390966">{{cite journal|author=Medaer R|title=Does the history of multiple sclerosis go back as far as the 14th century?|journal=Acta Neurol. Scand.|volume=60|issue=3|pages=189–92|year=1979|month=September|pmid=390966|doi=10.1111/j.1600-0447.1979.tb08970.x}}</ref> Visa vyote viwili vimepelekea pendekezo la nadharia tete ya "jeni ya Viking" kwa uenezaji wa ugonjwa huu.<ref name="pmid16479124">{{cite journal|author=Holmøy T|title=A Norse contribution to the history of neurological diseases |journal=Eur. Neurol.|volume=55|issue=1|pages=57–8|year=2006|pmid=16479124|doi=10.1159/000091431}}</ref> [[Augustus d'Este|Augustus Frederick d'Este]] (1794–1848), mwanawe [[Mwana wa mfalme Augustus Frederick, Mwana mfalme mtawala wa Sussex]] na [[Binti Augusta Murray]] na mjukuwe [[George&nbsp; wa III wa Uingereza]], bila shaka walikuwa na sklerosisi ya sehemu nyingi. D'Este aliacha shajara yenye maelezo kwa kina juu ya jinsi alivyoishi na ugonjwa huu kwa 22. Shajara yake ilianza mwaka wa 1822 na ikaisha mwaka wa 1846 ingawa ulifichika hadi mwaka wa 1948. Dalili zake zilianza akiwa na umri wa miaka 28 kwa kupoteza uwezo wa kuona kwa ghafula kwa muda mfupi ([[kutoweza kuona kwa macho yote kwa wakati mmoja kwa muda mfupi]]) baada ya mazishi ya rafiki yake. Katika mwelekeo wa ugonjwa wake, alikumbwa na udhaifu wa miguu, uzito wa mikono, ganzi, kizunguzungu, matatizo ya kibofu na [[matatizo ya mdiso]]. Katika mwaka wa 1844, alianza kutumia kiti cha magurudumu. Licha ya ugonjwa wake, bado alikuwa na tumaini maishani.<ref>{{cite book|last= Firth|first=D|title= The Case of August D`Esté |year=1948|publisher=Cambridge Univer alisity Press|location=Cambridge}}</ref><ref name="pmid16103678">{{cite journal|author=Pearce JM |title=Historical descriptions of multiple sclerosis|journal=Eur. Neurol.|volume=54|issue=1|pages=49–53|year=2005|pmid=16103678|doi=10.1159/000087387}}</ref> Maelezo mengine ya jadi ya sklerosisi ya sehemu nyingi yaliyokusanywa na mwandishi wa shajara wa Uingereza [[W. N. P. Barbellion]], [[nom-de-plume]] ya Bruce Frederick Cummings (1889–1919), aliyehifadhi nakala ya kina ya utambuzi na matatizo yake.<ref name="pmid16103678"/> Shajara yake ilichapishwa mwaka wa 1919 kama ''[[Jarida la mwanamume mwenye masikitiko]]''.<ref>{{cite book|last= Barbellion|first= Wilhelm Nero Pilate|title= The Journal of a Disappointed Man |url= https://archive.org/details/journaladisappo01wellgoog|year=1919|publisher=George H. Doran|location=New York|isbn= 0-7012-1906-8}}</ref> ==Utafiti== ===Tiba=== [[Image:Alemtuzumab Fab 1CE1.png|thumb|muundo wa kikemekali wa [[alemtuzumab]]]] Kuna utafiti unaoendelea unaotafuta tiba bora, inayofaa, na yenye kustahimilika kwa sklerosisi ya sehemu nyingi inayotoweka na kurejea; kubuni tiba za aina ndogo endelevu; mbinu za [[kukinga nuro]]; na matibabu bora ya dalili. <ref name="pmid19597083">{{cite journal |author=Cohen JA |title=matibabu inayoibuka ya sklerosisi ya sehemu nyingi. |journal=Arch. Neurol.|volume=66 |issue=7|pages=821–8 |year=2009 |month=July |pmid=19597083 |doi=10.1001/archneurol.2009.104 |url=}}</ref> Katika miaka ya 2000 na 2010 kumeidhinishwa dawa kadhaa za kumeza zinazotarajiwa kupata umaarufu na utumiaji wa mara kwa mara.<ref name="pmid21425270">{{cite journal |author=Miller AE|title=Multiple sclerosis: where will we be in 2020? |journal=Mt. Sinai J. Med. |volume=78 |issue=2|pages=268–79 |year=2011 |pmid=21425270 |doi=10.1002/msj.20242 |url=}}</ref> Dawa zaidi za kumeza zinaendelea kufanyiwa utafiti, mojawapo ikiwa [[laquinimod]], iliyotangazwa Agosti 2012 na iko katika awamu ya III ya majaribio baada ya matokeo tofauti katika awamu za awali.<ref>{{cite news|last=Jeffrey|first=susan|title=CONCERTO: A Third Phase 3 Trial for Laquinimod in MS|url=http://www.medscape.com/viewarticle/768902|accessdate=21 May 2013|newspaper=Medscape Medical News|date=09 Aug 2012}}</ref> Vivyo hivyo, tafiti zilizolenga kuendeleza utendakazi na utumiaji rahisi wa tiba zilizoko unaendelea. Hii ni pamoja na utumiaji wa dawa mpya kama vile [[PEGylation|PEGylated]] ambayo ni aina ya interferon-β-1a, ambayo inatarajiwa itatolewa kwa vipimo vidogo na iwe na matokeo sawa.<ref name="pmid22201341">{{cite journal |author=Kieseier BC, Calabresi PA|title=PEGylation of interferon-β-1a: a promising strategy in multiple sclerosis |journal=CNS Drugs|volume=26 |issue=3 |pages=205–14 |year=2012 |month=March |pmid=22201341|doi=10.2165/11596970-000000000-00000 |url=}}</ref><ref name=PEG>{{cite press release|url=http://www.biogenidec.com/press_release_details.aspx?ID=5981&ReqId=1777510|title=Biogen Idec Announces Positive Top-Line Results from Phase 3 Study of Peginterferon Beta-1a in Multiple Sclerosis|publisher=Biogen Idec|date=2013-01-24|accessdate=2013-05-21|archivedate=2013-10-04|archiveurl=https://web.archive.org/web/20131004220459/http://www.biogenidec.com/press_release_details.aspx?ID=5981&ReqId=1777510|deadurl=yes}}</ref> Ombi la kuidhinisha''peginterferon beta-1a'' linatarajiwa katika mwaka wa 2013.<ref name=PEG/> [[Antibodi za monoklonali]] pia zimevutia sana. [[Alemtuzumab]], [[daclizumab]] na antibodi za monoklonali za [[CD20]] kama vile [[rituximab]], [[ocrelizumab]] na [[ofatumumab]] zote zimeonyesha manufaa kiasi na zitafitiwa kama tiba zinazoweza kutumiwa.<ref name="pmid22224673">{{cite journal|author=Saidha S, Eckstein C, Calabresi PA|title=New and emerging disease modifying therapies for multiple sclerosis |journal=Ann. N. Y. Acad. NBBBSci. |volume=1247|issue= |pages=117–37 |year=2012|month=January |pmid=22224673 |doi=10.1111/j.1749-6632.2011.06272.x |url=}}</ref> Matumizi yazo pia yameambatana na athari mbaya zinazoweza kuwa hatari, hasa maambukizi nyemelezi.<ref name="pmid21425270"/> Kinachohusiana na chunguzi hizi ni kutokea kwa kipimo cha antibody za [[virusi vya JC]] kinachoweza kusaidia kutambua aliye katika hatari kubwa zaidi ya kupata lukoensefalopathia endelevu ya utazamouwingi akitumia natalizumab.<ref name="pmid21425270"/> Ingawa antibodi za monoklonali zinaweza kuwa na jukumu katika matibabu ya ugonjwa huu siku zijazo, inaaminika kuwa litakuwa dogo kutokana na hatari zinazohusiana nazo.<ref name="pmid21425270"/> Mkakati mwingine wa utafiti ni kutathmini [[matibabu ya mchanganyiko|ubora wa mchanganyo]] wa dawa mbili au zaidi.<ref name="pmid21111490">{{cite journal |author=Milo R, Panitch H |title=mchanganyiko wa matibabu ya sklerosisi ya sehemu nyingi|journal=J. Neuroimmunol. |volume=231 |issue=1-2 |pages=23–31 |year=2011|month=February |pmid=21111490|doi=10.1016/j.jneuroim.2010.10.021 |url=}}</ref> Sababu kuu ya kutumia tiba kadhaa katika sklerosisi ya sehemu nyingi ni kuwa matibabu yanayohusishwa hulenga taratibu tofauti na kwa hivyo huenda zisiweze kutumika bora zikiwa pekee.<ref name="pmid21111490"/> [[Utendaji kazi kwa ushirikiano#Utendaji kazi kwa ushirikiano wa Dawa|Utendaji kazi kwa ushirikiano]], ambapo dawa moja huongeza athari ya nyingine pia inawezekana, lakini pia kunaweza kuwa na ukandamizaji kama vile dawa moja kuzuia utenda kazi wa nyingine au kuzidisha madhara.<ref name="pmid21111490"/> Kumekuwa na majaribio kadhaa ya matibabu ya mchanganyiko na bado hakuna yaliyoonyesha matokeo ya kuridhisha kuweza kuzingatiwa kama tiba ifaayo ya sklerosisi ya sehemu nyingi.<ref name="pmid21111490"/> Utafiti juu ya kinga ya neva na tiba za kubadilisha, kama vile [[tiba ya shina la seli]], ingawa la muhimu zaidi ni kushughulikia mwanzoni.<ref name="pmid23039386">{{cite journal |author=Luessi F, Siffrin V, Zipp F |title=Neurodegeneration in multiple sclerosis: novel treatment strategies|journal=Expert Rev Neurother |volume=12 |issue=9 |pages=1061–76; quiz 1077 |year=2012 |month=September|pmid=23039386|doi=10.1586/ern.12.59|url=http://www.expert-reviews.com/doi/full/10.1586/ern.12.59}}</ref> Vilevile, hakuna tiba bora kwa aina endelevu za ugonjwa huu. Nyingi za dawa mpya zaidi pamoja na zile zinazoendelea kutengenezwa huenda zikatathminiwa kama tiba za sklerosisi endelevu ya kwanza ya sehemu nyingi.<ref name="pmid21425270"/> ===Biyoishara za ugonjwa huu=== [[File:Journal.pone.0057573.g005 cropped.png|thumb|left|kushoto|[[mwangwi wa sumaku wa upigaji picha]] picha ya ubongo iliyotolewa kwa kutumia''Gradient-echo phase sequence'' ikionyesha kuwepo kwa ayoni katika lesheni kwenye mata nyeupe (ndani ya kisanduku cha kijani kibichi katikati mwa picha;iliyodhihirishwa na kuonyeshwa kwa mshale mwekundu pembeni mwa kushoto upande wa juu).<ref name="pmid23516409">{{cite journal |author=Mehta V, Pei W, Yang G, ''et al.'' |title=Iron is a sensitive biomarker for inflammation in multiple sclerosis lesions |journal=PLoS ONE |volume=8 |issue=3|pages=e57573 |year=2013 |pmid=23516409 |pmc=3597727 |doi=10.1371/journal.pone.0057573 |url=}}</ref>]] Ijapokuwa njia za utambuzi hazitarajiwi kubadilika hivi karibuni jitihada za kubuni [[biyoishara]] zinazosaidia katika utambuzi na ubashiri wa kuendelea kwa ugonjwa zinaendelea.<ref name="pmid21425270"/> Mbinu mpya za utambuzi ambazo zinachunguzwa ni utumiaji wa [[antibodi|antibodi]] kinza-mielini, na tafiti zinazohusisha seramu na[[kiowevu cha ubongo na uti wa mgongo]], bali hakuna uliotoa matokeo ya kutegemewa.<ref name="pmid19712003">{{cite journal |author=Harris VK, Sadiq SA|title=Disease biomarkers in multiple sclerosis: potential for use in therapeutic decision making|journal=Mol Diagn Ther |volume=13 |issue=4 |pages=225–44 |year=2009 |pmid=19712003|doi=10.2165/11313470-000000000-00000}}</ref> Kwa sasa hakuna uchunguzi wa maabara unaoweza kutabiri prognosisi. Mitazamo kadhaa inayoonyesha matumaini imependekezwa ikiwemo:[[interleukin-6]], [[oksidi ya naitrojeni]] na [[sinthesi ya oksidi ya nitrojeni]], [[osteopontini]], na [[fetuin]]-A.<ref name="pmid19712003"/> Kwa kuwa kuendelea kwa ugonjwa huu hutokana na kuharibika kwa nuroni, majukumu ya protini zinazoonyesha kupoteza tishu ya neva kama vile [[filamenti za neva]], [[Protini ya tau|tau]] na [[N-acetylaspartate]] zinafanyiwa uchunguzi.<ref name="pmid19712003"/> Athari zingine ni kutafuta biyoishara zinazotofautisha kati ya watakaopata nafuu kutokana na tiba hizi na wasiopata nafuu.<ref name="pmid19712003"/> Kuboresha mbinu za [[kupiga picha za neva]] kama vile [[picha ya kompyuta ya miale ya gama]] au [[mwangwi wa sumaku wa upigaji picha]] huwa na tumaini la utambuzi bora na utabiri wa prognosisi, ingawa athari ya maendeleo kama haya katika shughuli za kawaida za kitiba inaweza kuchukua miongo kadhaa.<ref name="pmid21425270"/> Kuhusu mwangwi wa sumaku wa upigaji picha, kuna mbinu kadhaa ambazo zishaonyesha umuhimu wazo katika Nyanja za utafiti na zinaweza kuanzishwa katika shughuli za kitabibu kama vile utaratibu wa kujipindua mara mbili kwa mpwito wa ateri, [[uhamisho wa utiaji sumaku]], [[Msambao wa dutu_mwangwi wa sumaku wa upigaji picha#Mtawanyiko wa dutu_tensa_upigaji picha|tensa ya msambao]], na [[mwangwi wa sumaku wa upigaji picha tendaji]].<ref name="pmid22159052">{{cite journal |author=Filippi M, Rocca MA, De Stefano N, ''et al.''|title=Magnetic resonance techniques in multiple sclerosis: the present and the future |journal=Arch. Neurol. |volume=68 |issue=12 |pages=1514–20 |year=2011 |month=December |pmid=22159052|doi=10.1001/archneurol.2011.914 |url=}}</ref> Mbinu hizi ni mahususi zaidi kwa ugonjwa huu kuliko zilizoko, lakini bado hazina itifaki halisi za kupata na hata maadili sanifu hayajabuniwa.<ref name="pmid22159052"/> Kuna mbinu zingine zinazoendelea kubuniwa zinazohusisha ajenti tofauti zinazoweza kupima viwango vya [[makrofeji]] za ukingoni, inflamesheni, au kuathirika kwa utendaji kazi wa nuroni,<ref name="pmid22159052"/> na mbinu zinazopima kuwepo kwa ayoni inayoweza kusaidia kutambua jukumu la dalili hii katika sklerosisi ya sehemu nyingi, au la pefusheni ya ubongo.<ref name="pmid22159052"/>Vilevile, [[vifuatiliaji vinururishi]] vipya vya picha za kompyuta za miale ya gama vinaweza kutumika kama viashiria vya michakato iliyotatizwa kama vile inflamesheni ya ubongo, patholojia ya koteksi, [[apoptosisi]], au utengenezaji tena wa mielini.<ref name="pmid20636368">{{cite journal |author=Kiferle L, Politis M, Muraro PA, Piccini P |title=Positron emission tomography imaging in multiple sclerosis-current status and future applications |journal=Eur. J. Neurol. |volume=18|issue=2 |pages=226–31 |year=2011 |month=February |pmid=20636368 |doi=10.1111/j.1468-1331.2010.03154.x|url=}}</ref> ===Uhaba sugu wa damu ya vena kwenye ubongo na uti wa mgongo. === Katika mwaka wa 2008, daktari mpasuaji wa mishipa [[Paolo Zamboni]] alipendekeza kuwa sklerosisi ya sehemu nyingi huhusisha kupungua kwa ukubwa wa mishipa inayoondoa damu ubongoni, hali iitwayo [[Uhaba sugu wa damu ya vena kwenye ubongo na uti wa mgongo]]. Aligundua uhaba sugu wa damu ya vena kwenye ubongo na uti wa mgongo kwa wagonjwa wote waliokuwa na sklerosisi ya sehemu nyingi katika utafiti wake, akafanya upasuaji, kisha baadaye katika vyombo vya habari akauita “utaratibu wa ukombozi” kurekebisha na akadai kuwa asilimia 73 ya wahusika walipata nafuu.<ref name="pmid19060024">{{Rejea jarida |author=Zamboni P, Galeotti R, Menegatti E, ''et al.''|title=Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis |journal=J. Neurol. Neurosurg. Psychiatr. |volume=80 |issue=4 |pages=392–9 |date=April 2009|pmid=19060024|pmc=2647682 |doi=10.1136/jnnp.2008.157164 |url=http://jnnp.bmj.com/cgi/content/full/80/4/392}}</ref> Nadharia hii ilipokea umaarufu na kuzingatiwa sana katika vyombo vya habari na kwa waliokuwa na sklerosisi ya sehemu nyingi, hasa nchini Canada.<ref name="pmid23402260">{{cite journal |author=Pullman D, Zarzeczny A, Picard A |title=Media, politics and science policy: MS and evidence from the CCSVI Trenches |journal=BMC Med Ethics |volume=14|issue= |pages=6 |year=2013 |pmid=23402260 |pmc=3575396 |doi=10.1186/1472-6939-14-6 |url=}}</ref> Tetezi zimeibuka kuhusu utafiti wa Zamboni kwa sababu dawa iliyotumika haikuwa fiche kwake pamoja na wahusika wala haingeweza kutumiwa kama marejeleo, naa nadharia zake kuhusu kisababishi hasa cha ugonjwa huu hazikuthibitishwa na data inayojulikana.<ref name="pmid20398855">{{cite journal |author=Qiu J |title=Venous abnormalities and multiple sclerosis: another breakthrough claim? |journal=Lancet Neurol |volume=9 |issue=5 |pages=464–5 |year=2010|month=May |pmid=20398855 |doi=10.1016/S1474-4422(10)70098-3 }}</ref> Pia, huenda utafiti zaidi haujapata uhusiano sawa au ulipata uhusiano usioridhisha,<ref name="pmid21161309">{{cite journal |author=Ghezzi A, Comi G, Federico A |title=Chronic cerebro-spinal venous insufficiency (CCSVI) and multiple sclerosis |journal=Neurol. Sci. |volume=32 |issue=1|pages=17–21 |year=2011 |month=February |pmid=21161309 |doi=10.1007/s10072-010-0458-3 }}</ref> na kwa hivyo kuibua upinzani mkali kwa nadharia tete yake.<ref name="Dorne">{{Rejea jarida|author=Dorne H, Zaidat OO, Fiorella D, Hirsch J, Prestigiacomo C, Albuquerque F, Tarr RW.|title=Chronic cerebrospinal venous insufficiency and the doubtful promise of an endovascular treatment for multiple sclerosis|journal=J NeuroIntervent Surg |volume=2|issue=4|pages=309–311|date=October 2010|pmid=21990639|doi=10.1136/jnis.2010.003947 }}</ref> “Utaratibu wa ukombozi” umekosolewa kwa kusababisha matatizo makali na vifo bila faida zinazoonekana.<ref name="pmid20398855"/> Kwa hivyo, kufikia mwaka wa 2013 haujapendekezwa kwa matibabu ya sklerosisi ya sehemu nyingi.<ref>{{cite journal |author=Baracchini C, Atzori M, Gallo P |title=CCSVI and MS: no meaning, no fact |journal=Neurol. Sci. |volume=34 |issue=3|pages=269–79 |year=2013 |month=March |pmid=22569567 |doi=10.1007/s10072-012-1101-2 |url=}}</ref> Utafiti zaidi unaochunguza nadharia tete ya uhaba sugu wa damu ya vena kwenye ubongo na uti wa mgongo unafanywa.<ref name="a1">{{cite journal|last=van Zuuren|first=EJ|coauthors=Fedorowicz, Z; Pucci, E; Jagannath, VA; Robak, EW|title=Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis patients.|journal=Cochrane database of systematic reviews (Online)|date=2012 Dec 12|volume=12|pages=CD009903|pmid=23235683}}</ref> ==Tazama pia== * [[Sklerosisi ya kimiotrofia ya pembezoni]] ==Tanbihi== {{Reflist|2}} ==Kusoma zaidi== * {{cite journal |author=Langgartner M, Langgartner I, Drlicek M |title=The patient's journey: multiple sclerosis |journal=BMJ |volume=330 |issue=7496 |pages=885–8 |year=2005 |month=April|doi=10.1136/bmj.330.7496.885|url=http://bmj.bmjjournals.com/cgi/content/full/330/7496/885}} ==Viungo vya nje== {{dmoz|Health/Conditions_and_Diseases/Neurological_Disorders/Demyelinating_Diseases/Multiple_Sclerosis/}} * [http://www.atlasofms.org/ Database for analysis and comparison of global data on the epidemiology of MS] [[Jamii:Magonjwa]] 29ei41wksu02h8d9flavnxoghncf50u 0 69858 1578156 1527728 2026-07-02T22:40:45Z InternetArchiveBot 41439 Add 4 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578156 wikitext text/x-wiki {{unganisha|Uzazi wa mpango}} {{Infobox disease |Name = Udhibiti wa uzazi |Image= Opened Oral Birth Control.jpg |Caption= [[Vidonge vya kuzuia uzazi]] | ICD10= | ICD9 = | ICD9unlinked = | MeshID = D003267 | LOINC= | other_codes= |MedlinePlus= | eMedicine= }} '''Udhibiti wa uzazi''' (pia '''udhibiti wa uwezo wa kuzaa''' au '''kontraseptivu''') ni juhudi za kuratibu [[uzazi]] kwa sababu mbalimbali. Upangaji, utoaji na utumiaji wa udhibiti wa uzazi huitwa [[uzazi wa mpango]].<ref name=OED2012>{{cite book|title=Oxford English Dictionary|year=June 2012 (online)|publisher=Oxford University Press|url=http://www.oed.com/view/Entry/19395}}</ref><ref name=WHO-health-topic>{{cite web|last=World Health Organization (WHO)|title=Family planning|url=http://www.who.int/topics/family_planning/en/|work=Health topics|publisher=World Health Organization (WHO)}}</ref> Kwa kuacha nafasi kati ya mimba na mimba, udhibiti wa uzazi unaweza ukaboresha matokeo ya kuzaa kwa wanawake wazima na kuishi kwa watoto wao.<ref name="pmid22784533"/> Katika ulimwengu unaokua mapato ya wanawake, [[rasilimali]], [[ukubwa wa mwili|uzito]] na [[elimu]] kwa watoto wao na afya huboreshwa kwa kupunguza idadi ya watoto. Udhibiti wa uzazi huweza kuongeza mapema [[ukuaji wa uchumi]] kwa sababu ya watoto wachache wanaokutegemea, wanawake wengi kushiriki katika [[utendakazi]], na matumizi madogo ya rasilimali haba, ingawa idadi ya watoto ikipungua mno, baada ya muda wazalishaji wachache wanabebeshwa mzigo wa kutunza wazee wengi, inavyotokea katika [[nchi zilizoendelea]]. Kwa kuwa suala hilo linahusu [[binadamu]] na [[uhai]] wake, linahitaji kukabiliwa kwa upana kuanzia maana ya [[utu]], [[mwili]], [[jinsia]], [[upendo]], [[uzazi]] n.k. Kumbe hapa zinazungumziwa tu mbinu au vifaa vinavyotumika pengine kuzuia au kuua [[mimba]], yaani [[teknolojia]] katika [[ngono]].<ref>{{cite web|title=Definition of Birth control|url=http://www.medterms.com/script/main/art.asp?articlekey=53351|work=MedicineNet|accessdate=9 August 2012|archivedate=2012-08-06|archiveurl=https://web.archive.org/web/20120806234913/http://www.medterms.com/script/main/art.asp?articlekey=53351}}</ref> Jambo nyeti zaidi ni suala la [[mimba]] ya [[binadamu]] kuwa binadamu tayari, kiasi kwamba nchi nyingi zinaipatia [[haki]] fulanifulani, k.mf. ile ya kurithi. Kwa msingi huo, baadhi ya watu wanatetea uhai wa binadamu kuanzia mimba ilipotungwa na kulaumu baadhi ya vifaa vya udhibiti wa uzazi kuwa viuamimba na kusababisha vifo vya mamilioni. ==Hali ya sasa== Mbinu za kudhibiti uzazi zimetumika tangu kale, lakini zile zinazofaulu zaidi zilipatikana katika [[karne ya 20]]<ref name=Hopkins2010>{{cite book|last=Hurt|first=K. Joseph, ''et al.''(eds.)|title=The Johns Hopkins manual of gynecology and obstetrics.|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-60547-433-5|page=232|url=http://books.google.ca/books?id=4Sg5sXyiBvkC&pg=PR232|edition=4th|coauthors=Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland|date=2012-03-28}}</ref> zikichangia mabadiliko katika jamii na utamaduni ambayo wengine wanayaita [[mmomonyoko wa maadili]] ambao unachangia hata uenezi wa [[ukimwi]] na [[maradhi]] mengine. Ni kwamba kati ya vifaa hivyo, [[kondomu ya kike]] na [[kondomu ya kiume]] zinaweza pia kupunguza [[maambukizi]] ya [[magonjwa ya zinaa]], ukiwemo ukimwi, lakini vingine vingi sivyo. Watu wanaofanya ngono wakijua mimba haitapatikana, kwa kujisikia salama upande huo pengine wanasahau hatari ya kuambukizwa maradhi hayo.<ref name="pmid22423463">{{cite journal |last1 = Taliaferro | first1 = L. A. |last2 = Sieving | first2 = R. |last3 = Brady | first3 = S. S. |last4 = Bearinger | first4 = L. H. |title = We have the evidence to enhance adolescent sexual and reproductive health--do we have the will? |journal = Adolescent medicine: state of the art reviews |volume = 22 |issue = 3 |pages = 521–543, xii |year = 2011 |pmid = 22423463}}</ref><ref name="pmid22341164">{{cite journal |last1 = Chin |first1 = H. B. |last2 = Sipe |first2 = T. A. |last3 = Elder |first3 = R. |last4 = Mercer |first4 = S. L. |last5 = Chattopadhyay |first5 = S. K. |last6 = Jacob |first6 = V. |last7 = Wethington |first7 = H. R. |last8 = Kirby |first8 = D. |last9 = Elliston |first9 = D. B. |doi = 10.1016/j.amepre.2011.11.006 |title = The Effectiveness of Group-Based Comprehensive Risk-Reduction and Abstinence Education Interventions to Prevent or Reduce the Risk of Adolescent Pregnancy, Human Immunodeficiency Virus, and Sexually Transmitted Infections |journal = American Journal of Preventive Medicine |volume = 42 |issue = 3 |pages = 272–294 |year = 2012 |pmid = 22341164 |pmc = |url = http://www.ajpmonline.org/article/S0749-3797(11)00906-8/abstract |access-date = 2013-11-28 |archive-date = 2020-01-02 |archive-url = https://web.archive.org/web/20200102180246/https://www.ajpmonline.org/article/S0749-3797(11)00906-8/abstract |dead-url = yes }}</ref> Pamoja na hayo, [[dini]] na [[tamaduni]] nyingine huchukulia mbinu hizo kuwa hazifaii kimaadili na kisiasa, na wataalamu wengine wa [[afya]] wanasisitiza madhara ya matumizi yake hasa kwa [[mwanamke]] na [[mazingira]]. Mbinu zinazofaulu zaidi kudhibiti uzazi ni kuondoa kabisa uwezo wa kuzaa kwa kumhasi [[mwanamume]], kwa [[kufunga uzazi]] kwa njia ya [[vasektomi]] kwa wanaume na [[ukataji wa neli]] kwa wanawake. Halafu kuna [[vitanzi]] (IUD) na [[vipandikizi]], [[kontraseptivu za homoni]] zikiwa ni pamoja na [[Dawa za kunywa zilizochanganywa|dawa za kunywa]], [[Doa la Kontraseptivu|doa]], [[pete ya uke]], na [[Depo-Provera|sindano]]. Mbinu nyingine zinazofaulu ni pamoja na [[Uzuiaji mimba wa kizuizi|kizuizi]] kama vile [[kondomu]], [[(kontraseptivu) za daframu|daframu]] na [[sponji ya kontraseptivu]] na [[mbinu ya mafunzo ya uzazi]]. Mbinu zinazofaulu kidogo zaidi ni [[spemesidi|dawa ya kuua mbegu]] na [[mbinu ya kukatiza ngono]] kwa [[mwanamume]] kabla hajamimina [[shahawa|mbegu]] katika [[tumbo la uzazi]]. Ufungaji uzazi, ingawa hufaulu zaidi, hauwezeshi kuurudisha tena kwa hakika; mbinu nyingine zinaweza kuurudisha, lakini mara nyingi baada ya kuziacha mwanamke anakuta utaratibu wa [[hedhi]] umeathirika.<ref name=WHO_FP2011/> Baada ya kuzaliwa kwa mtoto, mwanamke asiyenyonyesha tu anaweza kuwa mjamzito mapema kuanzia wiki nne hadi sita. Njia zingine za kudhibiti uzazi zinaweza kuanzishwa baada ya kuzaa, ilhali zingine hungoja hadi miezi sita. Kwa wanaonyonyesha mbinu za projestini tu hupendekezwa kuliko kontraseptivu za kunywa. Kwa waliofikisha [[ukomohedhi]] imependekezwa kuwa waendelezwe kwa mwaka mmoja baada ya hedhi ya mwisho.<ref name=WHO_FP2011p260>{{cite book|first=World Health Organization Department of Reproductive Health and Research|title=Family planning : a global handbook for providers : evidence-based guidance developed through worldwide collaboration.|year=2011|pages=260-300|publisher=WHO and Center for Communication Programs|location=Geneva, Switzerland|isbn=978-0-9788563-7-3|url=http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|edition=Rev. and Updated ed.|access-date=2013-11-28|archive-date=2013-09-21|archive-url=https://web.archive.org/web/20130921054335/http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|url-status=dead}}</ref> [[Udhibiti wa uzazi wa dharura]] unaweza kuua mimba hadi siku chache baada ya ngono. Tofauti na mbinu za kiteknolojia, [[sayansi]] inawezesha kuzuia mimba bila madhara kwa mwanamke ikipendekeza mbinu zinazoelekeza kufanya [[tendo la ndoa]] wakati asipoweza kupata mimba. Kati ya mbinu hizo, ya kuaminika zaidi ni ile ya kupima [[ute wa uke]] iliyogunduliwa na [[John Billings]] katika [[miaka ya 1950]] na kuboreshwa pamoja na [[mke]] wake [[Evelyn Billings]] hadi kifo chao ([[2007]] na [[2013]]).<ref name="trials">[http://www.woomb.org/bom/trials/index.html Trials of the Billings Ovulation Method] {{Wayback|url=http://www.woomb.org/bom/trials/index.html |date=20051105043554 }} The Billings Method, Dr. Evelyn Billings & Ann Westmore, 2000, p. 215.</ref><ref name="brown">[http://www.woomb.org/bom/science/ovarian.html Ovarian Activity and Fertility and the Billings Ovulation Method] {{Wayback|url=http://www.woomb.org/bom/science/ovarian.html |date=20051226124346 }}: Dr. James B. Brown, 2000.</ref><ref name="cervix">Teaching the Billings Ovulation Method, Dr E. L. Billings AM, MB BS, DCH (London), 2001.</ref> Wengine huchukulia [[kujinyima ngono]] kama njia ya kudhibiti uzazi kwa vijana, ila wengine wanaona mafundisho ya [[usafi wa moyo]] yatumiwapo bila vifaa yanaweza kuongeza mimba kutokana na udhaifu wa wahusika<ref name="pmid12065267">{{cite journal |author=DiCenso A, Guyatt G, Willan A, Griffith L|title=Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials |journal=BMJ|volume=324 |issue=7351|pages=1426 |year=2002 |month=June |pmid=12065267 |pmc=115855 |doi= |url=}}</ref><ref name="pmid18923389">{{cite journal|last1 = Duffy | first1 = K. |last2 = Lynch | first2 = D. A. |last3 = Santinelli | first3 = J. |doi = 10.1038/clpt.2008.188 |title = Government Support for Abstinence-Only-Until-Marriage Education |journal = Clinical Pharmacology &#38; Therapeutics |volume = 84 |issue = 6 |pages = 746–748|year = 2008|pmid = 18923389 |pmc = |url = http://www.nature.com/clpt/journal/v84/n6/full/clpt2008188a.html}}</ref> na wanadai kuwa [[mafunzo ya ngono]] kwa undani pamoja na upatikanaji wa vifaa hupunguza idadi za mimba zisizotarajiwa katika kundi hilo.<ref name="pmid22764559">{{Rejea jarida|last1 = Black | first1 = A. Y. |last2 = Fleming | first2 = N. A. |last3 = Rome | first3 = E. S. |title = Pregnancy in adolescents |journal = Adolescent medicine: state of the art reviews |volume = 23 |issue = 1 |pages = 123–138, xi |year = 2012 |pmid = 22764559}}</ref><ref name="pmid22764557">{{cite journal |last1 = Rowan | first1 = S. P. |last2 = Someshwar | first2 = J. |last3 = Murray | first3 = P. |title = Contraception for primary care providers|journal = Adolescent medicine: state of the art reviews |volume = 23 |issue = 1 |pages = 95–110, x–xi|year = 2012 |pmid = 22764557}}</ref> Ilhali aina zote za udhibiti wa uzazi zinaweza kutumiwa na vijana,<ref name=WHO_FP2011p260/> udhibiti wa uzazi usio wa kudumu unaotenda kazi kwa muda mrefu kama vile vipandikizi, vitanzi na pete za ukeni zinafaa kupunguza idadi ya mimba za vijana bila kuzuia uzazi baadaye.<ref name="pmid22764557"/> Takribani milioni 222&nbsp;ya wanawake wanaokusudia kuzuia mimba katika [[nchi zinazoendelea]] hawatumii teknolojia ya kudhibiti mimba.<ref name="Guttmacher2012">{{cite web|title=Costs and Benefits of Contraceptive Services: Estimates for 2012|url=http://www.guttmacher.org/pubs/AIU-2012-estimates.pdf|work=United Nations Population Fund|pages=1|format=pdf|date=June 2012}}</ref> Utumiaji wa vifaa vya kudhibiti uzazi katika nchi hizo umepunguza idadi ya [[vifo vya kina mama]] kwa asilimia 40 (takribani vifo 270,000 vilizuiwa mwaka [[2008]]) na ungezuia asilimia 70 iwapo masharti yote yangetimizwa.<ref name="pmid22784533">{{cite journal|last=Cleland|first=J|coauthors=Conde-Agudelo, A; Peterson, H; Ross, J; Tsui, A|title=Contraception and health.|url=https://archive.org/details/sim_the-lancet_july-14-20-2012_380_9837/page/149|journal=Lancet|date=2012 Jul 14|volume=380|issue=9837|pages=149-56|pmid=22784533}}</ref> Kwa kuacha nafasi kati ya mimba na mimba, udhibiti wa uzazi unaweza kuboresha matokeo ya kuzaa kwa wanawake wazima na kuishi kwa watoto wao.<ref name="pmid22784533"/> Katika ulimwengu unaokua mapato ya wanawake, [[rasilimali]], [[ukubwa wa mwili|uzito]] na [[elimu]] kwa watoto wao na afya huboreshwa kwa kupunguza uzazi. Udhibiti wa uzazi huongeza [[ukuaji wa uchumi]] kwa sababu ya watoto wachache wanaokutegemea, wanawake wengi kushirikia katika [[utendakazi]], na matumizi madogo ya rasilimali haba. ==Mbinu== {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |+Chance of pregnancy during first year of use:<ref name=Hopkins2010/><ref name=CDC2013>{{cite journal|last=Division of Reproductive Health, National Center for Chronic Disease Prevention and Health|first=Promotion|title=U.s. Selected practice recommendations for contraceptive use, 2013: adapted from the world health organization selected practice recommendations for contraceptive use, 2nd edition.|journal=MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control|date=2013 Jun 21|volume=62|issue=RR-05|pages=1-60|pmid=23784109|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6205a1.htm?s_cid=rr6205a1_w}}</ref> ! Mbinu !! Matumizi ya kawaida !! Matumizi kamili |- | No birth control || 85% || 85% |- | Combination pill || 8% || 0.3% |- | Progestin-only pill || 13% || 1.1% |- | Sterilization (female) || 0.5%|| 0.5% |- | Sterilization (male) || 0.15% || 0.10% |- | Condom (female) || 21% ||5% |- | Condom (male) || 18% || 2% |- | Copper IUD || 0.8% || 0.6% |- | Hormone IUD ||0.2% || 0.2% |- | Patch || 8% || 0.3% |- | Vaginal ring || 9% || 0.3% |- | Depo Provera || 3-6% || 0.2% |- | Implant || 0.05% || 0.05% |- |Diaphragm and spermicide || 12% || 6% |- | Withdrawal || 27% || 4% |- | Standard days method || ~12-25% || ~1-9% |- | Billings ovulation method || ~1-5% || ~0-2.9% |- | Lactational amenorrhea method || 0-7.5%<ref name=Vander2003>{{cite journal|last=Van der Wijden|first=C|coauthors=Kleijnen, J; Van den Berk, T|title=Lactational amenorrhea for family planning.|journal=Cochrane database of systematic reviews (Online)|date=2003|issue=4|pages=CD001329|pmid=14583931}}</ref>||<2%<ref name=Blenning2005/> |} Kufaulu kwa mbinu huelezwa kama asilimia ya wanawake wanaoshika mimba wanapoitumia njia hiyo kwa muda wa mwaka mmoja<ref>{{cite book|last=Brown|first=Gordon Edlin, Eric Golanty, Kelli McCormack|title=Essentials for health and wellness|year=2000|publisher=Jones and Bartlett|location=Sudbury, Mass.|isbn=9780763709099|page=161|url=http://books.google.ca/books?id=_0H4iyS_DFwC&pg=PA162|edition=2nd ed.}}</ref> na wakati mwingine kama kiwango cha kufeli cha maisha kati ya mbinu zinazofaa zaidi, kama vile, [[ukataji wa neli]].<ref name=Dew2012>{{cite book|last=Edmonds|first=edited by D. Keith|title=Dewhurst's textbook of obstetrics & gynaecology|publisher=Wiley-Blackwell|year=2012|location=Chichester, West Sussex|isbn=9780470654576|page=508|url=http://books.google.ca/books?id=HfakBRceodcC&pg=PA508|edition=8th ed.}}</ref> Mbinu zinazofaulu kiteknolojia ni zile ambazo hutenda kazi kwa muda mrefu na hazihitaji ziara za kuendeleza utunzaji wa afya.<ref name=Will2012/> Ufungaji wa uzazi, homoni zinazotiwa mwilini, na vifaa vinavyotiwa ndani ya uterasi huwa na kiwango cha kufeli kwa mwaka wa kwanza chini ya asilimia 1.<ref name=Will2012/> Dawa za kontraseptivu za homoni, madoa au pete, na mbinu ya lactational amenorrhea (LAM), inapotumiwa ipasavyo pia inaweza kuwa na kiwango cha kufeli katika mwaka wa kwanza chini ya asilimia 1 (au kwa lactational amenorrhea (LAM), miezi ya sita ya kwanza).<ref name=Will2012/> Kwa kutumia, viwango vya kufeli katika mwaka wa kwanza ni vya juu, katika kiwango cha asilimia 3-9, kwa sababu ya matumizi mabaya.<ref name=Will2012/> Mbinu zingine kama vile mafunzo ya uzazi, kondomu, daframu, na spematosidi huwa na viwango vya juu zaidi vya kufeli katika mwaka wa kwanza hata kwa matumizi sahihi.<ref name=Will2012/> Ingawa mbinu zote za teknolojia ya kudhibiti uzazi zinaweza kuathiri afya, watetezi wake wanasema hatari ni chache kuliko zile za [[mimba]] hasa wakati wa kujifungua.<ref name=Will2012>{{cite book|last=Hoffman|first=Barbara|title=Williams gynecology|year=2012|publisher=McGraw-Hill Medical|location=New York|isbn=978-0071716727|page=Chapter 5|edition=2nd ed.}}</ref> Baada ya kuacha au kutoa njia nyingi za kudhibiti uzazi, pamoja na kontraseptivu za kunywa, IUD, dawa za kutia mwilini na sindano, idadi ya mimba kwa miaka inayofuata ni sawa na wasiotumia udhibiti wa uzazi.<ref>{{cite journal|last=Mansour|first=D|coauthors=Gemzell-Danielsson, K; Inki, P; Jensen, JT|title=Fertility after discontinuation of contraception: a comprehensive review of the literature|journal=Contraception|date=2011 Nov|volume=84|issue=5|pages=465–77|pmid=22018120|doi=10.1016/j.contraception.2011.04.002|ref=harv}}</ref> Kwa walio na matatizo maalumu ya afya, mbinu za kudhibiti uzazi zinaweza kuhitaji uchunguzi zaidi.<ref name=WHO2009_10/> Kwa kina mama wenye afya, njia nyingi za kudhibiti uzazi hazipaswi kufanyiwa [[uchunguzi wa tiba]] ikiwa ni pamoja na dawa za kudhibiti uzazi, udhibiti wa uzazi unaoweza kudungwa au kutiwa mwilini, na kondomu.<ref>{{cite book|last=Department of Reproductive Health and Research, Family and Community|title=Selected practice recommendations for contraceptive use.|year=2004|publisher=World Health Organization|location=Geneva|isbn=9241562846|page=Chapter 31|url=http://whqlibdoc.who.int/publications/2004/9241562846.pdf|edition=2 ed.|access-date=2013-11-28|archive-date=2013-07-18|archive-url=https://web.archive.org/web/20130718091826/http://whqlibdoc.who.int/publications/2004/9241562846.pdf|url-status=dead}}</ref> Hasa, [[uchunguzi wa pelvisi]], [[uchunguzi wa matiti]], au uchunguzi wa damu kabla ya kutumia dawa za kudhibiti uzazi hauonekani kuathiri matokeo na hivyo hauhitajiki.<ref>{{cite journal|last=Tepper|first=NK|coauthors=Curtis, KM; Steenland, MW; Marchbanks, PA|title=Physical examination prior to initiating hormonal contraception: a systematic review.|journal=Contraception|date=2013 May|volume=87|issue=5|pages=650-4|pmid=23121820}}</ref><ref name=WHO_FP2011p10/> [[Shirika la Afya Ulimwenguni]] katika 2009 lilichapisha kwa undani orodha ya njia ya tiba ya kubaini kufaulu kwa kila aina ya udhibiti wa uzazi.<ref name=WHO2009_10>{{cite book|last=Organization|first=World Health|title=Medical eligibility criteria for contraceptive use|year=2009|publisher=Reproductive Health and Research, World Health Organization|location=Geneva|isbn=9789241563888|page=1-10|url=http://whqlibdoc.who.int/publications/2010/9789241563888_eng.pdf|edition=4th ed.|access-date=2013-11-28|archive-date=2012-07-09|archive-url=https://web.archive.org/web/20120709230021/http://whqlibdoc.who.int/publications/2010/9789241563888_eng.pdf|url-status=dead}}</ref> ===Homoni=== [[Kontraseptivu za homoni]] hutenda kazi kwa kuzuia [[uovuleshaji]] na [[utungaji mimba wa binadamu|utungaji mimba]].<ref name="Nelson 2011">{{cite book|last1=Nelson|first1=Anita L.|last2=Cwiak|first2=Carrie|year=2011|chapter=Combined oral contraceptives (COCs)|editor1-last=Hatcher|editor1-first=Robert A.|editor2-last=Trussell|editor2-first=James|editor3-last=Nelson|editor3-first=Anita L.|editor4-last=Cates|editor4-first=Willard Jr.|editor5-last=Kowal|editor5-first=Deborah|editor6-last=Policar|editor6-first=Michael S. (eds.)|title=Contraceptive technology|edition=20th revised|location=New York|publisher=Ardent Media|pages=249–341|isbn=978-1-59708-004-0|issn=0091-9721|oclc=781956734}}</ref> Hupatikana kwa aina tofautitofauti ikiwa ni pamoja na [[kontraseptivu za kunywa |tembe za kunywa]], dawa za kutia mwilini chini ya ngozi, [[kontraseptivu za kudungwa |sindano]], [[kontraseptivu za doa|madoa]], [[IUD za homoni |IUD]] na [[Pete ya uke]]. Kwa sasa zinazopatikana ni za wanawake tu. Kuna aina mbili za dawa za kunywa [[Tembe za kontraseptivu za kunywa zilizochanganywa]] na [[tembe zilizo na projestojeni tu]].<ref name="Ammer 2009a">{{cite book|last=Ammer|first=Christine|year=2009|chapter=oral contraceptive|title=The encyclopedia of women's health|edition=6th|location=New York|publisher=Facts On File|isbn=978-0-8160-7407-5|pages=312–315|chapterurl=http://books.google.com/books?id=_MRDimrELCIC&pg=PA312&vq=oral+contraceptive}}</ref>Zinapotumiwa wakati wa ujauzito, haziongezi hatari ya [[kuharibika kwa mimba]] wala kusababisha [[matatizo ya kuzaa]].<ref name=WHO_FP2011p10/> <!--Zilizochanganywa--> Kontraseptivu za homoni zilizochanganywa huhusishwa kidogo na ongezeko la [[thrombasi ya vena|vena]] na [[thrombasi ya ateri|madonge ya damu ya ateri]]; hata hivyo, hatari ni kidogo kuliko inayohusishwa na mimba.<ref name=Review2011>{{cite journal|last=Brito|first=MB|coauthors=Nobre, F, Vieira, CS|title=Hormonal contraception and cardiovascular system|journal=Arquivos brasileiros de cardiologia|date=2011 Apr|volume=96|issue=4|pages=e81–9|pmid=21359483|doi=10.1590/S0066-782X2011005000022|ref=harv}}</ref> Kwa sababu ya hatari, hazipendekezwi kwa wanawake walio na umri wa zaidi ya miaka 35&nbsp;amabao huendelea kuvuta [[sigara]].<ref>{{cite journal|last=Kurver|first=MJ|coauthors=van der Wijden, CL; Burgers, J|title=[Summary of the Dutch College of General Practitioners' practice guideline 'Contraception'].|journal=Nederlands tijdschrift voor geneeskunde|date=2012|volume=156|issue=41|pages=A5083|language=Ducth|pmid=23062257}}</ref> Athari kwa hamu ya kufanya ngono hutofautiana, huku kukiwa na ongezeko au kupungua kwa wachache lakini hakuna athari kwa wengi.<ref>{{cite journal|last=Burrows|first=LJ|coauthors=Basha, M; Goldstein, AT|title=The effects of hormonal contraceptives on female sexuality: a review.|journal=The journal of sexual medicine|date=2012 Sep|volume=9|issue=9|pages=2213-23|pmid=22788250}}</ref> Kontraseptivu za kunywa zilizochanganywa hupunguza hatari ya [[saratani ya ovari]] na [[saratani ya endometriu]] na haibadilishi hatari ya [[saratani ya matiti]].<ref name=Shulman2011/><ref>{{cite journal|last=Havrilesky|first=LJ|coauthors=Moorman, PG; Lowery, WJ; Gierisch, JM; Coeytaux, RR; Urrutia, RP; Dinan, M; McBroom, AJ; Hasselblad, V; Sanders, GD; Myers, ER|title=Oral Contraceptive Pills as Primary Prevention for Ovarian Cancer: A Systematic Review and Meta-analysis.|url=https://archive.org/details/sim_obstetrics-and-gynecology_2013-07_122_1/page/139|journal=Obstetrics and gynecology|date=2013 Jul|volume=122|issue=1|pages=139-147|pmid=23743450}}</ref> Mara nyingi hubadilisha hedhi na [[dismenorea|mkakamao wa hedhi uliyo na maumivu]].<ref name=WHO_FP2011p10>{{cite book|first=World Health Organization Department of Reproductive Health and Research|title=Family planning : a global handbook for providers : evidence-based guidance developed through worldwide collaboration.|year=2011|pages=1-10|publisher=WHO and Center for Communication Programs|location=Geneva, Switzerland|isbn=978-0-9788563-7-3|url=http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|edition=Rev. and Updated ed.|access-date=2013-11-28|archive-date=2013-09-21|archive-url=https://web.archive.org/web/20130921054335/http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|url-status=dead}}</ref> Dozi za chini za estrojeni zinazopatikana kwenye pete ya ukeni zinaweza kupunguza hatari ya uchungu wa matiti, [[kichefuchefu]], na maumivu ya kichwa yanayohusishwa na bidhaa zilizo na dozi ya juu ya estrojeni.<ref name=Shulman2011>{{cite journal|last=Shulman|first=LP|title=The state of hormonal contraception today: benefits and risks of hormonal contraceptives: combined estrogen and progestin contraceptives.|journal=American journal of obstetrics and gynecology|date=2011 Oct|volume=205|issue=4 Suppl|pages=S9-13|pmid=21961825}}</ref> <!--Progestini--> [[Tembe zilizo na projestini tu]], sindano na vifaa vya kuzuia mimba vinavyotiwa ndani ya uterasi havihusishwi na ongezeko la hatari ya kuganda kwa damu na vinaweza kutumiwa na wanawake waliokuwa na mgando wa damu hapo awali katika vena zao.<ref name=Review2011/><ref>{{cite journal|last=Mantha|first=S.|coauthors=Karp, R.; Raghavan, V.; Terrin, N.; Bauer, K. A.; Zwicker, J. I.|title=Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis|journal=BMJ|date=7 August 2012|volume=345|issue=aug07 2|pages=e4944–e4944|doi=10.1136/bmj.e4944|ref=harv|pmid=22872710|pmc=3413580}}</ref> Kwa walio na historia ya kuganda kwa damu katika ateri, mbinu za kudhibiti uzazi zisizo na homoni au zilizo na projestini tu kando na zile za sindano zinapaswa kutumiwa.<ref name=Review2011/> Tembe zilizo na projestini tu zinaweza kuboresha dalili za hedhi na zinaweza kutumiwa na kina mama wanaonyonyesha kwa kuwa haziathiri [[unyonyeshaji|kutengenezwa kwa maziwa]].<!-- <ref name="pmid21961819"/> -->Hedhi isiofuatana inaweza kushuhudiwa kwa kutumia njia zilizo na projestini tu, huku baadhi ya wanaotumia wakiripoti [[amenorea|kutopata hedhi]].<ref name="pmid21961819">{{cite journal|last=Burke|first=AE|title=The state of hormonal contraception today: benefits and risks of hormonal contraceptives: progestin-only contraceptives.|journal=American journal of obstetrics and gynecology|date=2011 Oct|volume=205|issue=4 Suppl|pages=S14-7|pmid=21961819}}</ref> Projestini, [[drospirenoni]] na [[desogestreli]] hupunguza athari za [[androjeni]] lakini huongeza hatari ya kuganda kwa damu na hivyo haifai sana.<ref>{{cite journal|last=Rott|first=H|title=Thrombotic risks of oral contraceptives.|journal=Current opinion in obstetrics & gynecology|date=2012 Aug|volume=24|issue=4|pages=235-40|pmid=22729096}}</ref> Kiwango cha kufeli katika mwaka wa kwanza kwa projestini ya sindano, [[Depo-Provera]], hakijaafikiwa huku idadi ikiwa kutoka asilimia 1<ref>{{cite web|author=[[Food and Drug Administration|FDA]]|year=2005|title=Depo-Provera U.S. Prescribing Information|url=http://www.fda.gov/cder/foi/label/2005/020246s013lbl.pdf|accessdate=2007-06-12|archiveurl=https://web.archive.org/web/20070615203907/http://www.fda.gov/cder/foi/label/2005/020246s013lbl.pdf|archivedate=2007-06-15}}</ref>hadi asilimia 6.<ref name=Will2012/> ===Kizuizi=== [[File:Kondom.jpg|thumb|[[kondomu]] ya wanaume iliyofunguliwa.]] [[Kontraseptivu za kizuizi]] ni vifaa vinavyojaribu kuzuia [[mimba]] kwa kuzuia [[mbegu ya kiume]] kuingia katika [[uterasi]].<ref name=Neinstein2008/> Huwa ni pamoja na [[kondomu ya kiume]], [[kondomu ya kike]], [[kofia ya seviksi]], [[daframu (kontraseptivu)|daframu]], na [[sponji ya kontraseptivu]] iliyo na [[spemisidi]].<ref name=Neinstein2008>{{cite book|last=Neinstein|first=Lawrence|title=Adolescent health care : a practical guide|year=2008|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781792561|page=624|url=http://books.google.ca/books?id=XIzo5uo3XIQC&pg=PA624|edition=5th ed.}}</ref> Ulimwenguni, kondomu ndiyo njia ya kawaida sana ya kudhibiti uzazi.<ref>{{cite book|last=Chaudhuri|title=Practice Of Fertility Control: A Comprehensive Manual|year=2007|publisher=Elsevier India|isbn=9788131211502|page=88|url=http://books.google.ca/books?id=pzanxKlcU74C&pg=PA88|edition=7th}}</ref>[[Kondomu ya kiume]] huvalishwa kwa [[uume]] iliyosimama na kuzuia mbegu za kiume zilizotolewa kuingia mwili wa anayefanya ngono naye.<ref name=Hamil2012/> Kondomu za kisasa mara nyingi hutengenezwa kwa [[lateksi]], lakini nyingine hutengenezwa kwa nyenzo kama vile [[polyurethane]], au matumbo ya [[kondoo]].<ref name=Hamil2012>{{cite book|last=Hamilton|first=Richard|title=Pharmacology for nursing care|publisher=Elsevier/Saunders|location=St. Louis, Mo.|isbn=9781437735826|page=799|year=2012|url=http://books.google.ca/books?id=_4SwO2dHcAIC&pg=PA799|edition=8th ed.}}</ref> [[Kondomu ya kike]] pia hupatikana, mara nyingi iliyotengenezwa kwa [[nitrile]], lateksi au poliyourethani.<ref>{{cite book|title=Facts for life|year=2010|publisher=United Nations Children's Fund|location=New York|isbn=9789280644661|page=141|url=http://books.google.ca/books?id=GAFgWda-2NMC&pg=PA141|edition=4th ed.}}</ref> Kondomu za kiume huwa na faida kwa sababu ni bei nafuu, rahisi kutumika, na huwa na athari chache.<ref>{{cite book|last=Pray|first=Walter Steven|title=Nonprescription product therapeutics|year=2005|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781734981|page=414|url=http://books.google.ca/books?id=XU1sMK1djVAC&pg=PA414|edition=2nd ed.}}</ref> Nchini [[Japani]] takribani asilimia 80 ya wachumba wanaotumia udhibiti wa uzazi hutumia kondomu ilhali nchini [[Ujerumani]] kiwango hiki ni takribani asilimia 25,<ref name=Ebe2010>{{cite book|last=Eberhard|first=Nieschlag,|title=Andrology Male Reproductive Health and Dysfunction|year=2010|publisher=Springer-Verlag Berlin Heidelberg|location=[S.l.]|isbn=9783540783558|page=563|url=http://books.google.ca/books?id=mEgckDNkonUC&pg=PA563|edition=3rd ed.}}</ref> na nchini [[Marekani]] ni asilimia 18.<ref>{{cite book|last=Barbieri|first=Jerome F.|title=Yen and Jaffe's reproductive endocrinology : physiology, pathophysiology, and clinical management|year=2009|publisher=Saunders/Elsevier|location=Philadelphia, PA|isbn=9781416049074|page=873|url=http://books.google.ca/books?id=NudwnhxY8kYC&pg=PA873|edition=6th ed.}}</ref> Kondomu za wanaume na daframu iliyo na spemisidi huwa na kiwango sawa cha kufeli katika mwaka wa kwanza kwa asilimia 15 na 16 mtawalia.<ref name=Hopkins2010/> Inapotumiwa ipasavyo huwa bora zaidi ikiwa na kiwango cha kufeli katika mwaka wa kwanza kwa asilimia 2 huku daframu ikiwa na kiwango cha kufeli katika mwaka wa kwanza kwa asilimia 6.<ref name=Hopkins2010/> Kondomu huwa na faida nyingine ya kusaidia kuzuia kuenea kwa maambukizi mengine ya ngono kama vile [[VVU/UKIMWI]].<ref name=WHO_FP2011>{{cite book|first=World Health Organization Department of Reproductive Health and Research|title=Family planning : a global handbook for providers : evidence-based guidance developed through worldwide collaboration.|year=2011|publisher=WHO and Center for Communication Programs|location=Geneva, Switzerland|isbn=978-0-9788563-7-3|url=http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|edition=Rev. and Updated ed.|access-date=2013-11-28|archive-date=2013-09-21|archive-url=https://web.archive.org/web/20130921054335/http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|url-status=dead}}</ref> Sponji za kontraseptivu huunganisha kizuizi na spemisidi.<ref name=Will2012/> Kama daframu, huingizwa ukeni kabla ya ngono na inapaswa kuwekwa juu ya [[seviksi]] kwa matokeo bora.<ref name=Will2012/> Kufeli katika mwaka wa kwanza hulingana na iwapo mwanamke amewahi kuzaa au la, ikiwa asilimia 24 kwa wale wamewahi kuzaa na asilimia 12 kwa wale hawajawahi kuzaa.<ref name=Will2012/> Sponji inaweza kuingizwa hadi masaa 24&nbsp; kabla ya kufanya ngono na inapaswa kuachwa pale kwa angalau masaa sita baadaye.<ref name=Will2012/> Athari ya aleji<ref>{{cite journal|last=Kuyoh|first=MA|coauthors=Toroitich-Ruto, C; Grimes, DA; Schulz, KF; Gallo, MF|title=Sponge versus diaphragm for contraception: a Cochrane review.|url=https://archive.org/details/sim_contraception_2003-01_67_1/page/15|journal=Contraception|date=2003 Jan|volume=67|issue=1|pages=15-8|pmid=12521652}}</ref> na athari zingine kali kama vile [[sindromu ya mshtuko wa sumu]] zimeripotiwa.<ref>{{cite book|last=Organization|first=World Health|title=Medical eligibility criteria for contraceptive use|year=2009|publisher=Reproductive Health and Research, World Health Organization|location=Geneva|isbn=9789241563888|page=88|url=http://books.google.ca/books?id=pouTfH33wF8C&pg=PA88|edition=4th ed.}}</ref> ===Vitanzi=== [[Vitanzi]] (IUD) huwa vifaa vidogo vilivyo na umbo la 'T'-, ambavyo huwa na shaba au levonorgestrel, iliyoingizwa ndani ya uterasi.<ref>{{cite book|last=Chaudhuri|title=Practice Of Fertility Control: A Comprehensive Manual (7Th Edition)|year=2007|publisher=Elsevier India|isbn=9788131211502|page=95|url=http://books.google.ca/books?id=pzanxKlcU74C&pg=PA95}}</ref> Ni aina ya [[udhibiti wa uzazi wa muda mrefu]]. Kiwango cha kufeli katika mwaka wa kwanza kwa kutumia IUD ya shaba ni takribani asilimia 0.8 ilhali IUD ya levonorgestrel huwa na kiwango cha kufeli katika mwaka wa kwanza cha asilimia 0.2.<ref name=Hopkins2010/> Kati ya aina za kudhibiti uzazi pamoja na dawa zinazotiwa mwilini matokeo yake huwa ya kuridhisha kwa wanaotumia<ref name=Comm2012>{{cite journal|last=Committee on Adolescent Health Care Long-Acting Reversible Contraception Working Group, The American College of Obstetricians and|first=Gynecologists|title=Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices.|url=https://archive.org/details/sim_obstetrics-and-gynecology_2012-10_120_4/page/983|journal=Obstetrics and gynecology|date=2012 Oct|volume=120|issue=4|pages=983-8|pmid=22996129}}</ref>, hasa kwa vijana<ref name=Comm2012/> na wale ambao hawajawahi kuzaa.<ref>{{cite journal|last=Black|first=K|coauthors=Lotke, P; Buhling, KJ; Zite, NB; Intrauterine contraception for Nulliparous women: Translating Research into Action (INTRA), group|title=A review of barriers and myths preventing the more widespread use of intrauterine contraception in nulliparous women.|journal=The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception|date=2012 Oct|volume=17|issue=5|pages=340-50|pmid=22834648}}</ref> IUD haziathiri [[unyonyeshaji]] na zinaweza kuingishwa baada ya kuzaa.<ref name=Gabbe2012>{{cite book|last=Gabbe|first=Steven|title=Obstetrics: Normal and Problem Pregnancies|year=2012|publisher=Elsevier Health Sciences|isbn=9781455733958|page=527|url=http://books.google.ca/books?id=x3mJpT2PkEUC&pg=PA527}}</ref> Zinaweza pia kutumiwa baada ya [[uavyaji mimba]].<ref>{{cite journal|last=Steenland|first=MW|coauthors=Tepper, NK; Curtis, KM; Kapp, N|title=Intrauterine contraceptive insertion postabortion: a systematic review.|journal=Contraception|date=2011 Nov|volume=84|issue=5|pages=447-64|pmid=22018119}}</ref> Zinapotolewa, hata baada ya kutumika kwa muda mrefu, uwezo wa kuzaa hurudi kama kawaida mara moja.<ref>{{cite book|last=Hurd|first=[edited by] Tommaso Falcone, William W.|title=Clinical reproductive medicine and surgery|year=2007|publisher=Mosby|location=Philadelphia|isbn=9780323033091|page=409|url=http://books.google.ca/books?id=fOPtaEIKvcIC&pg=PA409}}</ref> Ilhali IUD za shaba zinaweza kuongeza hedhi na kusababisha mikakamo iliyo na maumivu zaidi,<ref name=Grimes2007>{{Rejea jarida | author = Grimes, D.A., MD | title = "Intrauterine Devices (IUDs)" In:Hatcher, RA; Nelson, TJ; Guest, F; Kowal, D | journal = Contraceptive Technology 19th ed. | location = New York |publisher = Ardent Media | year = 2007 }}</ref> IUD za homoni zinaweza kupunguza hedhi au kutokuwepo kwa hedhi yote kwa pamoja.<ref name=Gabbe2012/> Athari nyingine zinaweza kuwa ni pamoja na kutoka (asilimia 2 hadi 5) &ndash; na kwa nadra, kushuka kwa uterasi (chini ya asilimia 0.7).<ref name=Gabbe2012/><ref name=Marnach2013>{{cite journal|last=Marnach|first=ML|coauthors=Long, ME; Casey, PM|title=Current issues in contraception.|journal=Mayo Clinic proceedings. Mayo Clinic|date=2013 Mar|volume=88|issue=3|pages=295-9|pmid=23489454}}</ref> Kuwa na mikakamo kunaweza kutibiwa kwa [[NSAID]].<ref name=Marnach2013/> Matatizo mengine yanazidi kujitokeza <ref>https://www.mwananchi.co.tz/mw/habari/makala/afya/madaktari-wataja-sababu-kitanzi-kupotelea-mwilini-4436504</ref>. Kufikia 2007, IUD ndizo aina za kudhibiti uzazi zisizo za kudumu zinazotumika sana, zikiwa na zaidi ya watu milioni 180&nbsp;wanaozitumia kote ulimwenguni.<ref name=Darney2010>{{cite book|last=Darney|first=Leon Speroff, Philip D.|title=A clinical guide for contraception|year=2010|publisher=Lippincott Williams & Wilkins|location=Philadelphia, Pa.|isbn=9781608316106|page=242-243|url=http://books.google.ca/books?id=f5XJtYkiJ0YC&pg=PT425|edition=5th ed.}}</ref><ref name=Darroch2013/> Hapo awali aina ya kifaa kinachotiwa ndani ya uterasi ([[Kinga ya Dalkon]]) kilihusishwa na ongezeko la hatari ya [[ugonjwa wa inflamesheni ya pelvisi]]; hata hivyo, hatari haihusishwi na aina za kisasa kwa wale wasio na maambukizi ya zinaa karibu na wakati wa kuingishwa.<ref name="guttmacher2007">{{cite web|url=http://www.guttmacher.org/pubs/gpr/10/4/gpr100419.html|title=Popularity Disparity: Attitudes About the IUD in Europe and the United States|publisher=Published by[http://www.guttmacher.org/archive/GPR.jspGuttmacher Policy Review] Published Fall 2007|accessdate=2010-04-27|archive-date=2010-03-07|archive-url=https://web.archive.org/web/20100307124351/http://www.guttmacher.org/pubs/gpr/10/4/gpr100419.html|url-status=dead}}</ref> ===Kufunga uzazi=== [[Ufungaji uzazi kwa upasuaji]] hupatikana kwa njia ya [[kufunga uzazi]] kwa wanawake na [[vasektomi]] kwa wanaume.<ref name=Hopkins2010/> Hakuna athari kuu za muda mrefu, na kufunga uzazi hupunguza hatari ya [[saratani ya ovari]].<ref name=Hopkins2010/> uwezekano wa athari za muda mfupi zinazotokana na vasektomi huwa chini ya mara ishirini na tano kuliko ufungaji uzazi wa mwanamke.<ref name=Hopkins2010/><ref>{{cite journal |author=Adams CE, Wald M |title=Risks and complications of vasectomy |journal=Urol. Clin. North Am. |volume=36 |issue=3 |pages=331–6|year=2009 |month=August |pmid=19643235 |doi=10.1016/j.ucl.2009.05.009 |url=https://archive.org/details/sim_urologic-clinics-of-north-america_2009-08_36_3/page/331}}</ref> Baada ya vasektomi kunaweza kuwa na uvimbe na maumivu ya korodani ambayo kwa kawaida huisha baada ya wiki moja au mbili.<ref>{{cite book |author=Hillard, Paula Adams |title=The 5-minute obstetrics and gynecology consult |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages=265 |isbn=0-7817-6942-6|url=http://books.google.ca/books?id=fOoFIQOdIhkC&pg=PA265}}</ref> Kwa kufunga uzazi wa mwanamke athari hutokea kwa asilimia 1 hadi 2 za taratibu kukiwa na athari kali kwa kawaida zinazosababishwa na [[ganzi]].<ref>{{cite book |author=Hillard, Paula Adams |title=The 5-minute obstetrics and gynecology consult |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages=549 |isbn=0-7817-6942-6|url=http://books.google.ca/books?id=fOoFIQOdIhkC&pg=PA549}}</ref> Kati ya mbinu hizi hakuna inayokinga dhidi ya maambukizi ya zinaa.<ref name=Hopkins2010/> Wanawake wengine hujuta baadaye: takribani asilimia 5 ya walio na umri wa zaidi ya 30, na takribani asilimia 20 walio na umri wa chini ya 30 .<ref name=Hopkins2010/> Wanaume huwa na uwezekano mdogo wa kujuta kwa sababu ya ufungaji uzazi (<asilimia5); huku walio na umri mdogo, walio na watoto wachanga au bila, na ndoa zinazoyumbayumba zikiongeza hatari.<ref>{{cite book|last=Hatcher|first=Robert|title=Contraceptive technology|year=2008|publisher=Ardent Media|location=New York, N.Y.|isbn=9781597080019|page=390|url=http://books.google.ca/books?id=txh0LpjjhkoC&pg=PA390|edition=19th ed.}}</ref> Katika uchunguzi mmoja wa watu waliowahi kuwa na watoto, asilimia 9 walisema kuwa hawangepata watoto tena iwapo wangefunga uzazi tena.<ref>{{cite book|last=Moore|first=David S.|title=The basic practice of statistics|year=2010|publisher=Freeman|location=New York|isbn=9781429224260|page=25|url=http://books.google.ca/books?id=JOMQKI8zj_EC&pg=PR25|edition=5th ed.}}</ref> Ingawaje ufungaji uzazi huchukuliwa kuwa utaratibu wa kudumu,<ref name=Deff2011/> inawezekana kujaribu [[kurejesha uzazi]] kwa kuunganisha tena [[neli ya falopia]] au [[kupindua vasektomi]] ili kutoa [[vasa diferentia]]. Hamu ya wanawake kutaka kurejesha huhusishwa mara nyingi na kubadilisha kwa mwanamume.<ref name=Deff2011/> Viwango vya kufaulu kupata mimba baada ya kurejesha uzazi huwa kati ya asilimia 31 hadi 88, huku athari ikiwa ni pamoja na ongezeko la hatari ya [[mimba bandia]].<ref name=Deff2011>{{cite journal|last=Deffieux|first=X|coauthors=Morin Surroca, M; Faivre, E; Pages, F; Fernandez, H; Gervaise, A|title=Tubal anastomosis after tubal sterilization: a review.|journal=Archives of gynecology and obstetrics|date=2011 May|volume=283|issue=5|pages=1149-58|pmid=21331539}}</ref> Idadi ya wanaume ambao huomba kurejesha ni kati ya asilimia 2 na 6.<ref name=Shri2010>{{cite journal|last=Shridharani|first=A|coauthors=Sandlow, JI|title=Vasectomy reversal versus IVF with sperm retrieval: which is better?|journal=Current opinion in urology|date=2010 Nov|volume=20|issue=6|pages=503-9|pmid=20852426}}</ref> Kiwango cha mwanaume kufaulu kupata mtoto mwingine baada ya kurejesha ni kati ya asilimia 38 na 84; huku kiwango cha kufaulu kikiwa chini kulingana na muda kati ya utaratibu wa kwanza na kurejesha.<ref name=Shri2010/> [[Kutolewa kwa mbegu za kiume]] kukifuatiwa na [[utungisho katika vitro]] pia kunaweza kuwa njia nyingine.<ref>{{cite journal|last=Nagler|first=HM|coauthors=Jung, H|title=Factors predicting successful microsurgical vasectomy reversal.|url=https://archive.org/details/sim_urologic-clinics-of-north-america_2009-08_36_3/page/383|journal=The Urologic clinics of North America|date=2009 Aug|volume=36|issue=3|pages=383-90|pmid=19643240}}</ref> ===Mbinu za kitabia=== Mbinu za kitabia ni pamoja na kufanya ngono kwa kuzuia mbegu kuingia katika njia ya uzazi ya mwanamke, wakati wowote au wakati kuna uwezekano wa kuwepo kwa kijiyai.<ref name=Grim2004/> Inapotumiwa ipasavyo kiwango cha kufeli katika mwaka wa kwanza kinaweza kuwa takribani asilimia 3.4, hata hivyo, isipotumiwa ipasavyo viwango vya kufeli mwaka wa kwanza vinaweza kuwa takribani asilimia 85.<ref>{{cite book|last=Lawrence|first=Ruth|title=Breastfeeding : a guide for the medical professional.|year=2010|publisher=Saunders|location=Philadelphia, Pa.|isbn=9781437707885|page=673|url=http://books.google.ca/books?id=jhQ2zHnKEKwC&pg=PA673|edition=7th ed.}}</ref> ====Mafundisho ya uzazi==== [[Mbinu ya mafundisho ya uzazi]] huhusisha ubainishaji wa siku za kushika mimba katika [[kipindi cha hedhi]] na kuepuka ngono siku hizo.<ref name=Grim2004/> Mbinu hizo ni pamoja na kuchunguza [[halijoto]], [[ute wa uke]], au siku ya hedhi.<ref name=Grim2004>{{cite journal|last=Grimes|first=DA|coauthors=Gallo, MF; Grigorieva, V; Nanda, K; Schulz, KF|title=Fertility awareness-based methods for contraception.|journal=Cochrane database of systematic reviews (Online)|date=2004 Oct 18|issue=4|pages=CD004860|pmid=15495128}}</ref> Huwa na kiwango cha kufeli katika mwaka wa kwanza kwa kati ya asilimia 1 na 5; viwango vya kufeli katika mwaka wa kwanza baada ya matumizi bora hulingana na mfumo uliotumiwa na huwa asilimia 0 hadi 2.9.<ref name="trials"/> Thibitisho linalozingatiwa na makadirio haya, hata hivyo, ni hafifu kwa kuwa watu wengi wanaojaribu kuzitumia huacha mapema.<ref name=Grim2004/> Ulimwenguni, hutumiwa na takribani asilimia 3.6 ya wachumba.<ref name=Sivin2010/> Iwapo itazingatia pia halijoto na ishara zingine kuu, njia hii huitwa symptothermal. Viwango vya mimba zisizotarajiwa vimeripotiwa kati ya asilimia 1 na 20 kwa wanaotumia symptothermal.<ref>{{cite journal|last=Pallone|first=SR|coauthors=Bergus, GR|title=Fertility awareness-based methods: another option for family planning.|journal=Journal of the American Board of Family Medicine : JABFM|date=2009 Mar-Apr|volume=22|issue=2|pages=147-57|pmid=19264938}}</ref> ====Kukatiza ngono==== [[Mbinu ya kukatiza ngono]], ni shughuli ya kukatiza kufanya ngono ("kuvuta nje") kabla ya kumwaga mbegu za kiume.<ref name=WHO2009_100>{{cite book|last=Organization|first=World Health|title=Medical eligibility criteria for contraceptive use|year=2009|publisher=Reproductive Health and Research, World Health Organization|location=Geneva|isbn=9789241563888|page=91-100|url=http://whqlibdoc.who.int/publications/2010/9789241563888_eng.pdf|edition=4th ed.|access-date=2013-11-28|archive-date=2012-07-09|archive-url=https://web.archive.org/web/20120709230021/http://whqlibdoc.who.int/publications/2010/9789241563888_eng.pdf|url-status=dead}}</ref> Hatari kuu ya kukatiza ngono ni kuwa mwanaume anaweza kutotoa kwa usahihi au kwa wakati unaofaa.<ref name=WHO2009_100/> Viwango vya kufeli katika mwaka wa kwanza huwa kati ya asilimia 4 inapotumiwa ipasavyo hadi asilimia 27 isipotumiwa ipasavyo.<ref name=WHO2009_10/> Haichukuliwi kuwa udhibiti wa uzazi na baadhi ya weledi wa afya.<ref name=Will2012/> Kuna dhibitisho ndogo kuhusu idadi ya mbegu za kiume katika [[kiowevu kabla ya kumwaga]].<ref name=Jones2009>{{cite journal|last=Jones|first=RK|coauthors=Fennell, J; Higgins, JA; Blanchard, K|title=Better than nothing or savvy risk-reduction practice? The importance of withdrawal.|journal=Contraception|date=2009 Jun|volume=79|issue=6|pages=407-10|pmid=19442773}}</ref> Ilhali baadhi ya uchunguzi haukupata mbegu,<ref name=Jones2009/> jaribio moja liligundua kuwepo kwa mbegu kwa watu 10 kutoka kwa 27 ya waliojitolea.<ref>{{cite journal|last=Killick|first=SR|coauthors=Leary, C; Trussell, J; Guthrie, KA|title=Sperm content of pre-ejaculatory fluid.|journal=Human fertility (Cambridge, England)|date=2011 Mar|volume=14|issue=1|pages=48-52|pmid=21155689}}</ref> Mbinu ya kukatiza ngono hutumiwa na takribani wachumba asilimia 3.<ref name=Sivin2010>{{cite journal|last=Freundl|first=G|coauthors=Sivin, I; Batár, I|title=State-of-the-art of non-hormonal methods of contraception: IV. Natural family planning.|journal=The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception|date=2010 Apr|volume=15|issue=2|pages=113-23|pmid=20141492}}</ref> ====Kujinyima ngono==== Ingawa makundi mengine hukubaliana na [[kujinyima ngono]], hii humaanisha kuepuka shughuli zote za ngono, katika muktadha wa kudhibiti uzazi neno hili humaanisha kujinyima ngono inayohusisha ukeni.<ref name="ppabst">{{cite web|title=Abstinence|work=Planned Parenthood|year=2009|url=http://www.plannedparenthood.org/health-topics/birth-control/abstinence-4215.htm|accessdate=2009-09-09|archive-date=2009-09-10|archive-url=https://web.archive.org/web/20090910053822/http://www.plannedparenthood.org/health-topics/birth-control/abstinence-4215.htm|url-status=dead}}</ref> Kujinyima ngono hufaulu kwa asilimia 100 katika kuzuia mimba; hata hivyo, si kila anayekusudia hujinyima shughuli zote za ngono, na katika idadi nyingi za watu huwa na hatari nyingi za mimba kutokana na ngono isiyokubaliwa.<ref>{{cite journal |doi=10.1016/j.jadohealth.2005.02.001 |title=The limits of abstinence-only in preventing sexually transmitted infections |url=https://archive.org/details/sim_journal-of-adolescent-health_2005-04_36_4/page/269 |year=2005 |last1=Fortenberry |first1=J. Dennis |journal=Journal of Adolescent Health |volume=36 |issue=4 |pages=269–70 |pmid=15780781 |ref=harv}}, which cites:<br/> {{cite journal |doi=10.1016/j.jadohealth.2005.01.005 |title=After the promise: The STD consequences of adolescent virginity pledges |url=https://archive.org/details/sim_journal-of-adolescent-health_2005-04_36_4/page/271 |year=2005|last1=Brückner |first1=Hannah |last2=Bearman |first2=Peter |journal=Journal of Adolescent Health |volume=36 |issue=4 |pages=271–8 |pmid=15780782|ref=harv}}</ref><ref>{{cite journal|title=Nonconsensual Sex Undermines Sexual Health| journal = Network| year = 2005 | volume = 23 | url =http://www.fhi.org/en/RH/Pubs/Network/v23_4/nt2341.htm| author = Kim Best | issue = 4|ref=harv}}</ref> Watafiti mbalimbali wanasema [[elimu ya kujinyima ngono]] haipunguzi [[mimba za vijana]],<ref name="pmid22341164" /><ref name=Ott2007>{{cite journal|last=Ott|first=MA|coauthors=Santelli, JS|title=Abstinence and abstinence-only education|journal=Current opinion in obstetrics & gynecology|date=2007 Oct|volume=19|issue=5|pages=446–52|pmid=17885460|doi=10.1097/GCO.0b013e3282efdc0b|ref=harv}}</ref> ambazo huwa nyingi kwa wanaopewa elimu ya kujinyima ngono, ikilinganishwa na wale wanaopewa elimu ya ngono. <ref>{{cite journal|last=Duffy|first=K|coauthors=Lynch, DA; Santelli, J|title=Government support for abstinence-only-until-marriage education.|url=https://archive.org/details/sim_clinical-pharmacology-and-therapeutics_2008-12_84_6/page/746|journal=Clinical pharmacology and therapeutics|date=2008 Dec|volume=84|issue=6|pages=746-8|pmid=18923389}}</ref><ref name=Ott2007/> Baadhi ya mamlaka hupendekeza kuwa wanaojinyima ngono wawe na mbinu nyingine za kutumia (kama vile kondomu au tembe za kontraseptivu za dharura).<ref>{{cite book |author=Kowal D|year=2007|chapter=Abstinence and the Range of Sexual Expression|editor=Hatcher, Robert A., et al. |title=Contraceptive Technology|edition=19th rev. |pages=81–86 |location=New York |publisher=Ardent Media |isbn=0-9664902-0-7}}</ref> [[Ngono isiyo ya kuingiliana]] na [[ngono ya mdomo]] bila ngono ya ukeni pia wakati mwingine hutumiwa, ingawa baada ya [[ashiki]] kupata nguvu, pengine ni vigumu kujizuia katika kuishia katika [[tendo la ndoa]].<ref>{{cite journal|last1 = Feldmann | first1 = J. |last2 = Middleman | first2 = A. B. |title = Adolescent sexuality and sexual behavior |journal = Current opinion in obstetrics & gynecology |volume = 14 |issue = 5 |pages = 489–493 |year = 2002 |pmid = 12401976| url =http://journals.lww.com/co-obgyn/Abstract/2002/10000/Adolescent_sexuality_and_sexual_behavior.8.aspx}}</ref> Ingawa kwa kawaida huzuia mimba, ujauzito bado unaweza kupatikana kwa [[ngono ya katikati ya miguu]] na mbinu nyingine za ngono ambapo uume huwa karibu na ukeni (kusugua viungo vya uzazi, na kutoka kwa uume kutoka kwa [[ngono ya unyeo]]) ambapo mbegu ya kiume yanaweza kumwagika karibu na ukeni halafu yanaweza kupitia viowevu vinavyolainisha uke.<ref>{{cite book|last=Thomas|first=R. Murray|title=Sex and the American teenager seeing through the myths and confronting the issues|year=2009|publisher=Rowman & Littlefield Education|location=Lanham, Md.|isbn=9781607090182|page=81|url=http://books.google.ca/books?id=gM9EFgsJHyoC&pg=PA81}}</ref><ref>{{cite book|last=Edlin|first=Gordon|title=Health & Wellness.|year=2012|publisher=Jones & Bartlett Learning|isbn=9781449636470|page=213|url=http://books.google.ca/books?id=csGk6j5rlN0C&pg=PA213}}</ref> ====Unyonyeshaji==== [[Mbinu ya amenorea ya unyonyeshaji]] huhusisha matumizi ya [[utasa asili wa baada ya kuzaa]] wa mwanamke na unaweza kuendelezwa kwa [[kunyonyesha]].<ref name=Blackburn2007>{{cite book|last=Blackburn|first=Susan Tucker|title=Maternal, fetal, & neonatal physiology : a clinical perspective|year=2007|publisher=Saunders Elsevier|location=St. Louis, Mo.|isbn=9781416029441|page=157|url=http://books.google.it/books?id=2y6zOSQcn14C&pg=PA157|edition=3rd ed.}}</ref> Hii kwa kawaida huhitaji kutokuwepo kwa [[hedhi|damu ya hedhi]], kunyonyesha tu mtoto mchanga, na mtoto aliye chini ya miezi sita.<ref name=Blenning2005>{{cite journal|last=Blenning|first=CE|coauthors=Paladine, H|title=An approach to the postpartum office visit.|url=https://archive.org/details/sim_american-family-physician_2005-12-15_72_12/page/2491|journal=American family physician|date=2005 Dec 15|volume=72|issue=12|pages=2491-6|pmid=16370405}}</ref> [[Shrika la Afya Ulimwenguni]] hueleza kuwa iwapo kunyonyesha ndio njia ya pekee ya mtoto kupata chakula, kiwango cha kufeli katika miezi sita ya kwanza baada ya kuzaa ni asilimia 2.<ref>{{cite web |title=WHO 10 facts on breastfeeding |work=World Health Organization|month=April |year=2005|url=http://www.who.int/features/factfiles/breastfeeding/facts/en/index2.html}}</ref> Majaribio yametambua viwango vya kufeli kuwa kati ya asilimia 0 hadi 7.5.<ref name=Vander2003/> Viwango vya kufeli huongezeka hadi asilimia 4-7 katika mwaka moja na asilimia 13 katika miaka miwili.<ref name=Fritz2012>{{cite book|last=Fritz|first=Marc|title=Clinical Gynecologic Endocrinology and Infertility|year=2012|isbn=9781451148473|page=1007-1008|url=http://books.google.it/books?id=KZLubBxJEwEC&pg=PA1007}}</ref> Kulisha watoto, kubembeleza badala ya kutunza, matumizi ya [[mpira wa watoto]], na kulisha chakula kigumu vyote huongeza kiwango chake cha kufeli. <ref>{{cite book|last=Swisher|first=Judith Lauwers, Anna|title=Counseling the nursing mother a lactation consultant's guide|publisher=Jones & Bartlett Learning|location=Sudbury, MA|isbn=9781449619480|page=465-466|url=http://books.google.it/books?id=2X0_Takcr_wC&pg=PA465|edition=5th ed.}}</ref> Kwa wale wanaonyonyesha, takribani asilimia 10 hupata hedhi kabla ya miezi tatu na asilimia 20 kabla ya miezi sita.<ref name=Fritz2012/> Kwa wanaonyonyesha, uwezo wa kuzaa unaweza kurudi wiki nne baada ya kuzaa.<ref name=Fritz2012/> ===Dharura=== Mbinu za [[udhibiti wa uzazi wa dharura]] ni dawa (tembe za asubuhi) au vifaa vinavyotumika baada ya ngono kwa matarajio ya kuua mimba.<ref name=Gizzo2012>{{cite journal|last=Gizzo|first=S|coauthors=Fanelli, T; Di Gangi, S; Saccardi, C; Patrelli, TS; Zambon, A; Omar, A; D'Antona, D; Nardelli, GB|title=Nowadays which emergency contraception? Comparison between past and present: latest news in terms of clinical efficacy, side effects and contraindications.|journal=Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology|date=2012 Oct|volume=28|issue=10|pages=758-63|pmid=22390259}}</ref> Hutenda kazi kwa kuzuia uovulesheni au utungaji mimba.<ref name=Hopkin2012>{{cite book|title=The Johns Hopkins Manual of Gynecology and Obstetrics|year=2012|isbn=9781451148015|page=391|url=http://books.google.ca/books?id=4Sg5sXyiBvkC&pg=PR241|edition=4th|chapter=Fertility Control:Contraception, Sterilization, and Abortion}}</ref> Baadhi ya njia hupatikana, ikiwa ni pamoja na [[Yuzpe regimen|dozi ya juu ya tembe za kudhibiti uzazi]], [[levonorgestrel]], [[mifepristone]], [[ulipristal]] na IUD.<ref name=CochEmerg2012>{{cite journal|last=Cheng|first=L|coauthors=Che, Y; Gülmezoglu, AM|title=Interventions for emergency contraception.|journal=Cochrane database of systematic reviews (Online)|date=2012 Aug 15|volume=8|pages=CD001324|pmid=22895920}}</ref> tembe za [[levonorgestrel]] hupunguza uwezekano wa mimba kwa asilimia 70 (kiwango cha mimba asilimia 2.2) inapotumiwa kati ya siku 3&nbsp; baada ya ngono bila kinga au kufeli kwa kondomu.<ref name=Gizzo2012/>[[Ulipristal]] hupunguza uwezekano wa mimba kwa asilimia 85 (kiwango cha mimba hadi asilimia 1.4) hadi siku 5&nbsp; na inaweza kuwa bora kuliko levonorgestrel.<ref>{{cite journal|last=Richardson|first=AR|coauthors=Maltz, FN|title=Ulipristal acetate: review of the efficacy and safety of a newly approved agent for emergency contraception.|journal=Clinical therapeutics|date=2012 Jan|volume=34|issue=1|pages=24-36|pmid=22154199}}</ref><ref name=CochEmerg2012/><ref name=Gizzo2012/> [[Mifepristone]] pia huwa bora zaidi kuliko levonorgestrel ilhali IUD za shaba ndizo njia bora zaidi.<ref name=CochEmerg2012/> IUD zinaweza kutiwa siku 5&nbsp; baada ya ngono na kuzuia takribani asilimia 99 ya mimba (kiwango cha mimba cha asilimia 0.1 hadi 0.2).<ref name=Hopkin2012/><ref>{{cite web|title=Update on Emergency Contraception|url=http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/EC/Effectiveness|publisher=Association of Reproductive Health Professionals|accessdate=20 May 2013|date=March 2011|archiveurl=https://web.archive.org/web/20130511124153/http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/EC/Effectiveness|archivedate=2013-05-11|=https://web.archive.org/web/20130511124153/http://www.arhp.org/Publications-and-Resources/Clinical-Proceedings/EC/Effectiveness}}</ref> Hii huzifanya kuwa aina mbinu bora zaidi wa kudhibiti uzazi kwa dharura.<ref name=Cleland2012>{{cite journal |author=Cleland K, Zhu H, Goldstruck N, Cheng L, Trussel T |year=2012 |title=The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience |journal=Human Reproduction |volume=27 |issue=7 |pages=1994–2000|doi=10.1093/humrep/des140 |pmid=22570193 |ref=harv}}</ref> Kupeana tembe za asubuhi kwa kina mama mapema haiathiri kiwango cha maambukizi ya ngono, matumizi ya kondomu, viwango cha mimba, au tabia hatari ya ngono.<ref name="pmid17894132">{{cite journal |author=Kripke C |title=Advance provision for emergency oral contraception|journal=Am Fam Physician |volume=76 |issue=5 |pages=654 |year=2007 |month=September |pmid=17894132 |doi= |url=https://archive.org/details/sim_american-family-physician_2007-09-01_76_5/page/n57}}</ref><ref name="pmid21923590">{{cite journal |author=Shrader SP, Hall LN, Ragucci KR, Rafie S |title=Updates in hormonal emergency contraception|journal=Pharmacotherapy |volume=31 |issue=9 |pages=887–95 |year=2011 |month=September |pmid=21923590 |doi=10.1592/phco.31.9.887 |url=}}</ref> Mbinu zote huwa na athari chache.<ref name=CochEmerg2012/> ===Kinga mbili=== Kinga mbili ni matumizi ya mbinu zinazozuia maambukizi ya zinaa na mimba.<ref>{{cite journal |author= |title=Dual protection against unwanted pregnancy and HIV / STDs |journal=Sex Health Exch |volume= |issue=3 |pages=8 |year=1998 |pmid=12294688 |doi=|url=}}</ref> Hii inaweza kuwa kwa kodomu pekee au pamoja na mbinu nyingine ya kudhibiti uzazi au kwa kuepuka [[ngono|ngono ya kuingiliana]].<ref name=Cates2002>{{cite journal|author=Cates, W., Steiner, M. J.|year=2002|title=Dual Protection Against Unintended Pregnancy and Sexually Transmitted Infections: What Is the Best Contraceptive Approach?|journal=Sexually Transmitted Diseases|volume=29|issue=3|pages=168–174|url=http://journals.lww.com/stdjournal/Fulltext/2002/03000/Dual_Protection_Against_Unintended_Pregnancy_and.7.aspx|doi=10.1097/00007435-200203000-00007|pmid=11875378|ref=harv}}</ref><ref>{{cite web|publisher=International Planned Parenthood Federation|year=May 2000|title=Statement on Dual Protection against Unwanted Pregnancy and Sexually Transmitted Infections, including HIV|url=http://www.ippf.org/NR/rdonlyres/534B49A6-4C25-4853-BD8E-527E02FCD5A1/0/IMAPstatementmay2000.pdf|format=PDF|accessdate=2013-11-28|archivedate=2012-02-25|archiveurl=https://web.archive.org/web/20120225124142/http://www.ippf.org/NR/rdonlyres/534B49A6-4C25-4853-BD8E-527E02FCD5A1/0/IMAPstatementmay2000.pdf}}</ref> Iwapo mimba ni hoja kuu kutumia njia zote mbili kwa wakati mmoja kunakubalika,<ref name=Cates2002/> na aina zote mbili zimependekezwa kwa wale wanaotumia dawa isiyo na [[chunusi]][[isotretinoini]], kwa sababu ya hatari kuu ya [[matatizo ya uzazi]] itumiwapo wakati wa ujauzito.<ref name=Gupta2011>{{cite book|last=Gupta|first=Ramesh C.|title=Reproductive and Developmental Toxicology|url=http://books.google.com/books?id=jGHRR32wz5MC|date=2011-02-25|publisher=Academic Press|isbn=978-0-12-382032-7|page=105}}</ref> <center><gallery align="center" perrow="5"> File:Condom unrolled durex.jpg|An unrolled male [[latex]][[condom]]|alt=an unrolled condom File:Préservatif féminin.jpg|A polyurethane [[female condomu]]|alt=a female condom File:Contraceptive diaphragm.jpg|A [[Diaphragm (contraceptive)| Diaphragm]] vaginal-cervical[[Barrier contraception|barrier]], in its case with a [[Quarter (United States coin)|quarter U.S coin]] |alt=a diaphragm File:Éponge spermicide.jpg|A [[contraceptive sponge]] set inside its open package|alt=a contraceptive sponge File:Plaquettes de pilule.jpg|Aina tatu za [[Combined oral contraceptive pill|birth control pills]] alender oriented packaging|alt=birth control pill packages File:BirthControlPatch.JPG|A transdermal [[contraceptive patch]]|alt=a contraceptive patch File:NuvaRing in hand.jpg|A [[NuvaRing]] vaginal ring|alt=a vaginal ring File:Mirena IntraUterine System.jpg|A hormonal [[intrauterine device]] (IUD) against a background showing placement in the [[uterus]]|alt=a hormonal intrauterine device File:Emergency_contraceptive.jpg| A split dose of two [[emergency contraceptive]] pills (most morning after pills now only require one)|alt=emergency contraceptive pills File:Geburtenkontrollkette.jpg|A [[CycleBeads]], used for estimating fertility based on days since menstruation |alt=a birth control chain calendar necklace </gallery></center> ==Athari== ===Afya=== [[File:Maternal mortality rate worldwide.jpg |thumb|alt=maternal mortality rate map|Maternal mortality rate as of 2010<ref name=CIA2010>[https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html?countryName=Australia&countryCode=as&regionCode=aus&rank=156#asCountry Comparison: Maternal Mortality Rate] {{Wayback|url=https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html?countryName=Australia&countryCode=as&regionCode=aus&rank=156#asCountry |date=20121108112903 }} in [[:en:The World Factbook|The CIA World Factbook]]</ref>]] Matumizi ya kontraseptivu katika [[nchi zinazoendelea]] umekadiriwa kupunguza idadi ya [[vifo vya kina mama]] kwa asilimia 40 (takribani vifo 270,000 vilizuiliwa mwaka 2008) na ungepunguza asilimia 70 ya vifo iwapo matakwa yote ya udhibiti wa uzazi yangetimizwa.<ref name="pmid22784533"/> Faida hizi hupatikana kwa kupunguza idadi ya mimba zisizotarajiwa ambazo husababisha [[uavyaji mimba]] usiokuwa salama na kwa kuzuia mimba kwa walio na hatari kuu.<ref name="pmid22784533"/> Udhibiti wa uzazi huboresha kuishi kwa mtoto katika ulimwengu unaokua kwa kuacha nafasi kubwa kati ya mimba.<ref name="pmid22784533"/> Katika idadi hii ya watu matokeo huwa mabaya zaidi mama anaposhika mimba kati ya miezi kumi na nane ya baada ya kujifungua.<ref name="pmid22784533"/><ref name=Shol2010>{{cite journal|last=Sholapurkar|first=SL|title=Is there an ideal interpregnancy interval after a live birth, miscarriage or other adverse pregnancy outcomes?|journal=Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology|date=2010 Feb|volume=30|issue=2|pages=107-10|pmid=20143964}}</ref> Kuchelewesha mimba baada ya [[kuharibika kwa mimba]] hata hivyo hakuonekani kupunguza hatari na wanawake hushauriwa kujaribu kushika mimba katika hali hii wakati wowote wanapokuwa tayari.<ref name=Shol2010/> [[Mimba za utotoni]], yaani za wasichana wadogo, huwa katika hatari kuu ya matokeo mabaya pamoja na [[kuzaa kabla ya wakati]], [[kuzaa mtoto aliye na uzito wa chini]] na [[vifo vya watoto wachanga|kifo cha mtoto]].<ref name="pmid22764559"/> Nchini Marekani asilimia 82 ya mimba kwa walio kati ya miaka 15 na 19 ni zile zisizopangwa.<ref name=Marnach2013 /> [[Mafundisho ya ngono]] kwa kina na utumiaji wa kontraseptivu huwa bora katika idadi ya mimba katika kikundi hiki cha umri.<ref>{{cite journal|last=Lavin|first=C|coauthors=Cox, JE|title=Teen pregnancy prevention: current perspectives.|journal=Current opinion in pediatrics|date=2012 Aug|volume=24|issue=4|pages=462-9|pmid=22790099}}</ref> ===Faida=== [[File:Countriesbyfertilityrate.svg|thumb|left|alt=fertility rate map|Countries by [[fertility rate]] as of 2012. {{col-begin}} {{Multicol-break}} {{legend|#ffc600|7–8}} {{legend|#ffc600|6–7}} {{legend|#ffc600|5–6}} {{legend|#ffc600|4–5}} {{Multicol-break}} {{legend|#ffc600|3–4}} {{legend|#00FF00|2–3 Children}} {{legend|#20DFD8|1–2 Children}} {{legend|#35B0E3|0–1 Children}} {{col-end}}]] Katika nchi zinazokua, udhibiti wa uzazi hukusudia [[ongezeko la uchumi]] kwa sababu ya kuwepo kwa watoto wachache wategemezi na hivyo mama hushiriki kazi. Mapato ya wanawake, rasilimali, [[uzito wa mwili]], na kielelezo cha mwili na usomaji wa watoto vinaweza vikaongezeka kukiwa na udhibiti wa uzazi. Kwa kila dola inayotumiwa, Umoja wa Mataifa hukadiria kuwa karibu dola mbili hadi sita huwekezwa.<ref>{{cite journal|last=Carr|first=B|coauthors=Gates, MF; Mitchell, A; Shah, R|title=Giving women the power to plan their families.|url=https://archive.org/details/sim_the-lancet_july-14-20-2012_380_9837/page/80|journal=Lancet|date=2012 Jul 14|volume=380|issue=9837|pages=80-2|pmid=22784540}}</ref> Huwekezaji huu huhusiana na uzuiaji wa mimba zisizopangwa na upunguzaji wa maradhi ya kuambukiza.<ref name=Tsui2010/> Ilhali mbinu zote zinaleta manufaa ya kifedha, matumizi ya IUD za shaba zilisaida katika uwekezaji.<ref name=Tsui2010>{{cite journal |author=Tsui AO, McDonald-Mosley R, Burke AE |title=Family planning and the burden of unintended pregnancies |journal=Epidemiol Rev |volume=32 |issue=1 |pages=152–74 |year=2010|month=April |pmid=20570955 |pmc=3115338 |doi=10.1093/epirev/mxq012 |url= |ref=harv}}</ref> Kufikia mwaka [[2012]] gharama yote ya matibabu ya ujauzito, kuzaa na utunzaji wa mtoto mchanga nchini Marekani ni takribani dola 21,000 kwa kuzaa kupitia uke na dola 31,000 kupitia [[upasuaji]].<ref name=NYT2013>{{cite news|last=Rosenthal|first=Elisabeth|title=American Way of Birth, Costliest in the World|url=http://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html|newspaper=New York Times|date=June 30th,2013}}</ref> Katika nchi nyingi gharama huwa chini ya nusu.<ref name=NYT2013/> Kwa mtoto aliyezaliwa mwaka [[2011]], familia ya kawaida nchini Marekani hutumia dola 235,000 kwa zaidi ya miaka 17 kumlea.<ref name=USDAChildExpense>{{cite web|title = Expenditures on Children by Families, 2011|publisher = United States Department of Agriculture, Center for Nutrition Policy and Promotion|url = http://www.cnpp.usda.gov/ExpendituresonChildrenbyFamilies.htm|accessdate = 2013-11-28|archiveurl = https://web.archive.org/web/20080308082505/http://www.cnpp.usda.gov/ExpendituresonChildrenbyFamilies.htm|archivedate = 2008-03-08| = https://web.archive.org/web/20080308082505/http://www.cnpp.usda.gov/ExpendituresonChildrenbyFamilies.htm}}</ref> ==Uenezi== [[File:SOWM2010 modern contraception.svg|thumb|alt=prevalence of modern birth control map|Asilimia ya wanawake wanaotumia teknolojia katika kupanga uzazi (mwaka 2010). {{col-begin}} {{Multicol-break}} {{legend|#000000|6%}} {{legend|#550000|12%}} {{legend|#aa0000|18%}} {{legend|#ff0000|24%}} {{legend|#ff5500|30%}} {{legend|#dddd00|36%}} {{Multicol-break}} {{legend|#55aa00|42%}} {{legend|#55aa00|48%}} {{legend|#55aa00|54%}} {{legend|#55aa00|60%}} {{legend|#55aa00|66%}} {{legend|#55aa00|72%}} {{Multicol-break}} {{legend|#aa0000|78%}} {{legend|#aa0000|84%}} {{legend|#aa0000|86%}} {{legend|#b3b3b3|no data}} {{col-end}}]] Kote ulimwenguni, kufikia mwaka [[2009]], karibu asilimia 60 ya waliokuwa wameolewa na kupata watoto walitumia udhibiti wa uzazi.<ref name=Darroch2013/> Namna ambavyo mbinu mbalimbali hutiwa hutofautiana katika nchi.<ref name=Darroch2013/> Mbinu ya kawaida katika nchi zilizoendelea ni kondomu na dawa ya kumeza, ilhali barani Afrika ni dawa ya kumeza na kule Amerika Kusini na Asia ni ufungaji wa uzazi.<ref name=Darroch2013>{{cite journal|last=Darroch|first=JE|title=Trends in contraceptive use.|journal=Contraception|date=2013 Mar|volume=87|issue=3|pages=259-63|pmid=23040137}}</ref> Katika nchi zinazoendelea, asilimia 35 ya udhibiti wa uzazi ni kupitia ufungaji wa uzazi wa kike, asilimia 30 ni kupitia IUD, asilimia 12 ni kupitia dawa ya kumeza, asilimia 11 ni kupitia kondomu, na asimia 4 ni kupitia ufungaji uzazi wa kiume.<ref name=Darroch2013/> Wakati inatumika mara chache kwa nchi zilizoendelea kuliko zile zinazoendelea, kufikia mwaka [[2007]] wanawake zaidi ya milioni 180, walikuwa wakitumia IUD&nbsp;<ref name=Darney2010/> Uepukanaji wa ngono wakati wa kuwa na uwezo wa kupata mimba unatumiwa na wanawake wanaoendelea kuzaa karibu asilimia 3.6, na kutumika sana kwa asilimia 20 kule Amerika Kusini.<ref name=Dar2010p315>{{cite book|last=Darney|first=Leon Speroff, Philip D.|title=A clinical guide for contraception|year=2010|publisher=Lippincott Williams & Wilkins|location=Philadelphia, Pa.|isbn=1-60831-610-6|page=315|edition=5th}}</ref> Kufikia mwaka [[2005]], asilimia 12 ya wachumba walikuwa wanatumia mbinu ya kiume ya kuzuia mimba (mojawapo KATI ya kondomu au utoaji wa mrija wa mbegu), hali nyingi zikiwa katika nchi zilizoendelea.<ref name=Naz2009/> Matumizi ya kudhibiti uzazi kwa kutumia njia ya wanaume imepungua kati ya mwaka wa 1985 na 2009.<ref name=Darroch2013/> Matumizi ya dawa za kuzuia mimba kwa wanawake [[Kusini mwa Jangwa la Sahara]] yameongezeka kutoka karibu asilimia 5 mwaka [[1991]] hadi karibu asilimia 30 mwaka [[2006]].<ref>{{cite journal|last=Cleland|first=JG|coauthors=Ndugwa, RP; Zulu, EM|title=Family planning in sub-Saharan Africa: progress or stagnation?|journal=Bulletin of the World Health Organization|date=2011 Feb 1|volume=89|issue=2|pages=137-43|pmid=21346925}}</ref> Kufika mwaka [[2012]], asilimia 57 ya wanaoendelea kuzaa wanataka kuepukana na ujauzito (milioni 867 kati ya 1520&nbsp;<ref name=Dar2013/> Hata hivyo wanawake karibu milioni 222 hawakuweza kupata udhibiti wa kuzaa, milioni 53&nbsp;wakiwa Kusini mwa Jangwa la Sahara na milioni 97&nbsp;wakiwa Asia.<ref name=Dar2013>{{cite journal|last=Darroch|first=JE|coauthors=Singh, S|title=Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys.|url=https://archive.org/details/sim_the-lancet_may-18-24-2013_381_9879/page/1756|journal=Lancet|date=2013 May 18|volume=381|issue=9879|pages=1756-1762|pmid=23683642}}</ref> Hii inasababisha milioni 54&nbsp;ya mimba zisizopangwa na vifo 80,000 hivi vya kina mama kila mwaka.<ref name=Darroch2013/> Baadhi ya sababu za wanawake kutokuwa na huduma ya udhibiti ni sababu za kidini na kisiasa,<ref name=Hopkins2010/> ilhali [[umaskini]] huchangia pia.<ref name=Rasch2011/> Kwa sababu ya sheria za [[utoaji mimba]] Kusini mwa Jangwa la Sahara, wengi hutafuta watoaji mimba wasiokuwa na kibali [[kwa mimba zisizopangwa]], inayosababisha karibu asimilia 2-4 ya [[utoaji mimba unaoitwa si salama]] kila mwaka.<ref name=Rasch2011>{{cite journal|last=Rasch|first=V|title=Unsafe abortion and postabortion care -an overview.|journal=Acta obstetricia et gynecologica Scandinavica|date=2011 Jul|volume=90|issue=7|pages=692-700|pmid=21542813}}</ref> ==Historia == [[File:Silphium.jpg|thumb|alt=ancient coin depicting silphium|Ancient silver coin from [[Cyrene, Libya|Cyrene]] depicting a stalk of [[silphium]]]] [[Ebers Papyrus]] ya [[Misri]] kutoka 1550&nbsp; na [[Kahun Papyrus]] kutoka 1850&nbsp;KK zina maelezo kuhusu udhibiti wa kuzaa, matumizi ya asali, matawi na nyuzi za pamba ya [[acacia]] zinazowekwa ukeni ili zizuie mbegu ya kiume.<ref name=History2010/><ref name=Lipsey2005>{{cite book|last1=Lipsey |first1= Richard G.|last2=Carlaw |first2=Kenneth|last3=Bekar |first3=Clifford|chapter=Historical Record on the Control of Family Size|chapterurl=http://books.google.com/books?id=tSrGTMtBv50C&pg=PA335|pages=335–40|title=Economic Transformations: General Purpose Technologies and Long-Term Economic Growth|publisher=Oxford University Press |year=2005|isbn=978-0-19-928564-8}}</ref> Michoro ya zamani ya Misri yanaonyesha matumizi ya [[kondomu]].<ref name=Ebe2010/> Hali ya kutoa kiungo cha kiume wakati wa tendo la ndoa (kwa [[Kilatini]] [[coitus interruptus]]), inasimuliwa na [[Kitabu cha Mwanzo]] kama njia ya kudhibiti uzazi wakati [[Onan]] "hutoa mbegu za kiume" (kumwaga) chini ili asimpatie mtoto [[mjane aliyemrithi|bibi ya kakaye aliyekufa]], [[Tamar (Mwanzo)|Tamar]].<ref name=History2010>{{cite book|last=Cuomo|first=Amy|chapter=Birth control|editor-last=O'Reilly|editor-first=Andrea|title=Encyclopedia of motherhood|year=2010|publisher=Sage Publications|location=Thousand Oaks, Calif.|isbn=9781412968461|pages=121–126|chapterurl=http://books.google.ca/books?id=Pcxqzal4bEYC&pg=PA124}}</ref> Inaaminika kuwa hapo zamani nchini [[Ugiriki]][[silphium]] ilitumiwa kudhibiti uzazi, kwa sababu ya kudumu na ubora wake, ulivunwa hadi ukaisha.<ref>{{cite book|author=unspecified|chapter=Herbal contraceptives and abortifacients|editor-last=Bullough|editor-first=Vern L.|title=Encyclopedia of birth control|year=2001|publisher=ABC-CLIO|location=Santa Barbara, Calif.|isbn=9781576071816|pages=125–128|url=http://books.google.ca/books?id=XuX-MGTZnJoC&pg=PA125}}</ref> Katika Ulaya ya leo, juhudi za kutoa mimba unachukuliwa kama uovu na [[Kanisa Katoliki]].<ref name=History2010/> Inaaminika kuwa wanawake hadi leo bado hutumia baadhi ya mbinu za kudhibiti uzazi kama vile coitus interruptus na kuingiza mizizi ya lily na rue katika ukeni (na, zaidi ya hayo, uuaji wa mtoto mchanga baada ya kuzaliwa).<ref>{{cite book|last=McTavish|first=Lianne|chapter=Contraception and birth control|editor-last=Robin|editor-first=Diana|title=Encyclopedia of women in the Renaissance : Italy, France, and England|year=2007|publisher=ABC-CLIO|location=Santa Barbara, Calif.|isbn=9781851097722|pages=91–92|chapterurl=http://books.google.ca/books?id=OQ8mdTjxungC&pg=PA91}}</ref> [[Casanova]] (1725-1798), wakati wa [[kuchipuka upya kwa Italia]] alielezea jinsi ya kutumia ngozi ya kondoo kuzuia ujauzito; hata hivyo, upatikanaji wa kondomu haikutokea hadi karne ya 20.<ref name=History2010/> Mwaka 1909, Richard Richter alitengeneza kifaa cha kuweka ndani ya uterasi kutokana na uzi nyororo ya utumbo, ambacho kilitengenezwa zaidi na kuuza nchini Ujerumani na [[Ernst Gräfenberg]] mwishoni mwa miaka ya 1920.<ref>{{cite book|last1=Fritz|first1=Marc A.|last2=Speroff|first2=Leon|year=2011|chapter=Intrauterine contraception|title=Clinical gynecologic endocrinology and infertility|edition=8th|location=Philadelphia|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|pages=1095–1098|isbn=978-0-7817-7968-5|url=http://books.google.com/books?id=KZLubBxJEwEC&pg=RA1-PA1095}}</ref> Mnamo 1916 [[Margaret Sanger]] alifungua kituo cha kwanza cha kudhibiti uzazi nchini Marekani iliyosababisha akamatwe.<ref name=History2010/>Mwanamke huyo alikuwa pia mtetezi wa [[ubaguzi wa rangi]] na kulenga kupunguza [[Wanegro]] na wengineo<ref name="Marshall">{{cite book | author = Marshall, Robert G. | coauthors = Donovan, Chuck | title = Blessed Are the Barren: The Social Policy of Planned Parenthood | url = https://archive.org/details/blessedarebarren0000mars_j2g5 | authorlink = Robert G. Marshall | year = 1991 | month = October | publisher = Ignatius Press | location = Fort Collins, CO | isbn = 0-89870-353-0; ISBN 978-0-89870-353-5 }}</ref><ref name="NPR">{{cite web|url=http://www.npr.org/templates/story/story.php?storyId=14650805|title=Minority Anti-Abortion Movement Gains Steam|date=September 24, 2007|publisher=NPR|accessdate=2009-01-17}}</ref><ref group="note">A typical pro-life publication critical of Sanger is: Franks, Angela, ''Margaret Sanger's eugenic legacy: the control of female fertility'', McFarland, 2005</ref> Hii ilifuatiwa na kituo cha kwanza barani Ulaya mwaka [[1921]], kilichofunguliwa na [[Marie Stopes]].<ref name=History2010/> [[Gregory Pincus]] na [[John Rock (Mwanasayansi wa Marekani)|John Rock]] kwa msaada wa [[Planned Parenthood Federation of America]] walitengeneza vidonge vya dawa vya kudhibiti uzazi miaka ya 1950 iliyoanza kuuzwa kwa umma [[miaka ya 1960]].<ref>{{cite book|last=Poston|first=Dudley|title=Population and Society: An Introduction to Demography|year=2010|publisher=Cambridge University Press|isbn=9781139489386|page=98|url=http://books.google.ca/books?id=CR-EXq4y8XAC&pg=PA98}}</ref> [[Dawa za kutoa mimba]] zilianza kutumika badala ya [[utoaji mimba]] kwa njia ya upasuaji kwa kuwepo kwa [[prostaglandin analogue|prostaglandin analog]] na kuwepo kwa [[mifepristone]] [[miaka ya 1980]].<ref>{{cite journal|last1=Kulier|first1=Regina|last2=Kapp|first2=Nathalie|last3=Gülmezoglu|first3=A. Metin|last4=Hofmeyr|first4=G. Justus|last5=Cheng|first5=Linan|last6=Campana|first6=Aldo|date=November 9, 2011|title=Medical methods for first trimester abortion|journal=Cochrane Database of Systematic Reviews|issue=11|page=CD002855|doi=10.1002/14651858.CD002855.pub4|pmid=22071804|url=http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002855.pub4/abstract;jsessionid=2D7DDA98B31CD7DACB8391192770991C.d04t01}}</ref> ==Jamii na utamaduni== ===Hali ya sheria=== Baadhi ya maafikiano kuhusu [[Haki za Kibinadamu]] yanadai serikali zitoe huduma na maelezo ya upangaji uzazi.<!-- <ref name="hrintlaw"/> --> Hii ilijumuisha mahitaji ya kutengeneza mpango wa kitaifa wa kupanga uzazi, kuondoa sheria zinazozuia huduma ya kupanga uzazi, kuhakikisha kuna aina mbalimbali za mbinu salama na bora za kupanga uzazi, kuhakikisha kuna wahudumu wa afya waliohitimu na vifaa vya afya kwa bei nafuu, na kubuni utaratibu wa kukagua mpango zilizoidhinishwa.<!-- <ref name="hrintlaw"/> --> Serikali ikikosa kutekeleza inaweza kulaumiwa kwa kuvunja sheria za kimataifa.<ref name="hrintlaw">{{cite journal | author = Cottingham J., Germain A., Hunt P. | year = 2012 |title = Use of human rights to meet the unmet need for family planning | url =https://archive.org/details/sim_the-lancet_july-14-20-2012_380_9837/page/172| journal = The Lancet | volume = 380 | issue = 9837| pages = 172–180 | doi = 10.1016/S0140-6736(12)60732-6 | pmid = 22784536 | ref = harv }}</ref> Miungano ya Kimataifa yalizindua kikundi cha ''Every Woman Every Child'' kinachoshughulikia taratibu za kina mama za kupata dawa za kuzuia mimba.<!-- <ref name=Gutt2012/> --> Shughuli hii inalenga kuongeza wanawake wanaotumia mbinu mpya za kuzuia mimba kwa milioni 120 katika nchi zilizo maskini kufikia mwaka [[2020]].<!-- <ref name=Gutt2012/> --> Vile vile, wanataka kuruhusu hata wasichana wadogo wajitafutie dawa za kuzuia mimba bila ruhusa ya wazazi.<ref name=Gutt2012>{{cite journal|coauthors=Susheela Singh and Jacqueline E. Darroch|title=Adding It Up: Costs and Benefits of Contraceptive Services Estimates for 2012|journal=Guttmacher Institute and United Nations Population Fund (UNFPA), 201|year=2012|month=June|url=http://www.guttmacher.org/pubs/AIU-2012-estimates.pdf}}</ref> ===Mtazamo wa kidini=== [[Dini]] zinatofautiana sana kuhusu [[maadili]] ya udhibiti wa uzazi.<ref name=Srikanthan2008>{{cite journal|last=Srikanthan|first=A|coauthors=Reid, RL|title=Religious and cultural influences on contraception|url=http://www.jogc.org/abstracts/full/200802_WomensHealth_1.pdf|journal=Journal of obstetrics and gynaecology Canada – Journal d'obstetrique et gynecologie du Canada (JOGC)|date=2008 Feb|volume=30|issue=2|pages=129–37|pmid=18254994|ref=harv|access-date=2013-11-28|archive-date=2013-10-04|archive-url=https://web.archive.org/web/20131004213236/http://www.jogc.org/abstracts/full/200802_WomensHealth_1.pdf|dead-url=yes}}</ref> [[Kanisa Katoliki]] hukubali tu [[uzazi wa mpango]] kwa njia za kisayansi bila teknolojia,<ref name="pope1">{{cite web|url=http://www.vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html|title=Humanae Vitae: Encyclical of Pope Paul VI on the Regulation of Birth|author=Pope Paul VI|authorlink=Pope Paul VI|date=1968-07-25|accessdate=2006-10-01|publisher=Vatican}}</ref> ingawa waumini wengi hukubali na kutumia mbinu nyingine.<ref>{{cite book|editor=Rosemary Skinner Keller|author=Rosemary Radford Ruether|authorlink=Rosemary Radford Ruether|title=Encyclopedia of women and religion in North America|chapter=Women in North American Catholicism|chapterurl=http://books.google.ca/books?id=EoJrHDirVQUC&pg=PA127|year=2006|publisher=Indiana Univ. Press|location=Bloomington, Ind. [u.a.]|isbn=978-0-253-34686-5|url=http://books.google.ca/books?id=EoJrHDirVQUC|page=[http://books.google.ca/books?id=EoJrHDirVQUC&pg=PA132132]}}</ref><ref>{{cite book|editor=Bob Digby|title=Heinemann 16-19 Geography: Global Challenges Student Book 2nd Edition|url=http://books.google.com/books?id=-_c7JP6vzd4C|year=2001|publisher=Heinemann|isbn=978-0-435-35249-3|page=[http://books.google.com.ph/books?id=–_c7JP6vzd4C&pg=PA158158]|author=Bob Digby et.al.}}</ref><ref>{{cite book|last=Rengel|first=Marian|title=Encyclopedia of birth control|year=2000|publisher=Oryx Press|location=Phoenix, Ariz|isbn=978-1-57356-255-3|page=202|url=http://books.google.ca/books?id=dx1Kz-ezUjsC&pg=PA202}}</ref> Miongoni mwa [[Waprotestanti]] kuna mitazamo tofauti kutoka wale wasiokubali hadi wanaokubali mbinu zote za kudhibiti uzazi.<ref>{{cite book|last=Bennett|first=Jana Marguerite|title=Water is thicker than blood : an Augustinian theology of marriage and singleness|year=2008|publisher=Oxford University Press|location=Oxford|isbn=978-0-19-531543-1|page=178|url=http://books.google.ca/books?id=bQF4j8nv1VQC&pg=PA178}}</ref> Mtazamo wa [[Uyahudi]] hutoka kwa madhehebu kali ya [[Waorthodoksi wa Kiyahudi]] hadi kwa [[Wayahudi wa mageuzi]]<ref name="jew_BC">{{cite book | title=Birth Control in Jewish Law| url=https://archive.org/details/nlsiu.296.3.fel.26549| last=Feldman| first=David M.|year=1998| publisher=Jason Aronson| location=Lanham, MD| isbn=0-7657-6058-4}}</ref> Katika [[Uislamu]] dawa za kupanga uzazi zinakubalika ikiwa hazidhuru afya, ingawa matumizi yake hukataliwa na wengine.<ref>{{cite journal |author=Khalid Farooq Akbar| title=Family Planning and Islam: A Review| journal=Hamdard Islamicus|volume=XVII| issue= 3|url=http://muslim-canada.org/family.htm| ref=harv}}</ref> [[Kurani]] haitoi maelezo yoyote kuhusiana na [[uadilifu]] wa kupanga uzazi, lakini zina maelezo yanyohimiza [[kuzaa|watoto]]. Mtume [[Muhammad]] huripotiwa kuwa "alioa na kuzaa".<ref>Yusuf Al-Qaradawi, Muhammad Saleh Al-Munajjid. ''[[IslamOnline]]''.</ref> [[Wahindu]] wanaweza kutumia upangaji uzazi wa kawaida na wa kisasa.<ref name="hindu_BC">{{cite web|url=http://www.healthsystem.virginia.edu/internet/chaplaincy/hindu.cfm|title=Hindu Beliefs and Practices Affecting Health Care|accessdate=2006-10-06|publisher=University of Virginia Health System|archiveurl=https://web.archive.org/web/20070515044827/http://www.healthsystem.virginia.edu/internet/chaplaincy/hindu.cfm|archivedate=2007-05-15}}</ref> Mtazamo wa kawaida wa wafuasi wa [[Buddha]] ni kuwa uzuiaji wa mimba unakubalika, lakini utoaji baada ya kutungwa mimba haikubaliki.<ref name="buddhist_BC">{{cite web|url=http://web.singnet.com.sg/~alankhoo/MoreQA.htm#Abortion|title=More Questions & Answers on Buddhism: Birth Control and Abortion|accessdate=2008-06-14|publisher=Alan Khoo|archivedate=2008-05-30|archiveurl=https://web.archive.org/web/20080530023240/http://web.singnet.com.sg/~alankhoo/MoreQA.htm#Abortion|=https://web.archive.org/web/20080530023240/http://web.singnet.com.sg/~alankhoo/MoreQA.htm#Abortion}}</ref> === Siku ya Ulimwengu ya kupanga uzazi === Tarehe [[26 Septemba]] ni [[Siku ya Ulimwengu ya kupanga uzazi]], iliyotengwa kwa uhamasishaji na uboreshaji wa elimu kuhusu afya ya kuzaa na ngono, ikiwa na lengo la ''dunia ambayo mimba inahitajika.''<ref name=WorldContraceptionDay>{{cite web|url =http://www.your-life.com/en/home/world-contraception-day/|title =World Contraception Day|accessdate =|archivedate =2014-08-18|archiveurl =https://web.archive.org/web/20140818081827/http://www.your-life.com/en/home/world-contraception-day/| =https://web.archive.org/web/20140818081827/http://www.your-life.com/en/home/world-contraception-day/}}</ref> Inasaidiwa na kikundi cha Serikali na Mashirika ya kimataifa yasiyo ya kiserikali, ikijumuisha baraza la Asian Pacific Council kuhusu Uzuiaji mimba, Centro Latinamericano Salud y Mujer, European Society of Contraception and Reproductive Health, [[German Foundation for World Population]], International Federation of Pediatric and Adolescent Gynecology, [[International Planned Parenthood Federation]], [[Marie Stopes International]], [[Population Services International]], [[Population Council]], [[United States Agency for International Development]] (USAID), na [[Women Deliver]].<ref name=WorldContraceptionDay/> ===Dhana zisizo sahihi=== Kuna idadi kadhaa ya matatizo ya kawaida kulingana na ngono na ujauzito.<ref>{{cite book|last=Hutcherson|first=Hilda|title=What your mother never told you about s.e.x|year=2002|publisher=Perigee Book|location=New York|isbn=9780399528538|page=201|url=http://books.google.ca/books?id=xu8tb2o66iIC&pg=PA201|edition=1st Perigee ed.}}</ref> [[Usafishaji]] baada ya kufanya ngono si mbinu mwafaka wa kupanga uzazi.<ref>{{cite book|last=Rengel|first=Marian|title=Encyclopedia of birth control|year=2000|publisher=Oryx Press|location=Phoenix, Ariz|isbn=9781573562553|page=65|url=http://books.google.ca/books?id=dx1Kz-ezUjsC&pg=PA65}}</ref> Vile vile, huhusishwa na baadhi ya matatizo ya kiafya na kwa hivyo haipendekezwi.<ref>{{cite journal|last=Cottrell|first=BH|title=An updated review of of evidence to discourage douching.|journal=MCN. The American journal of maternal child nursing|date=2010 Mar-Apr|volume=35|issue=2|pages=102-7; quiz 108-9|pmid=20215951}}</ref> Wanawake wanaweza kuwa wajawazito mara ya kwanza anaposhiriki ngono<ref>{{cite book|last=Alexander|first=William|title=New Dimensions In Women's Health - Book Alone|year=2013|publisher=Jones & Bartlett Publishers|isbn=9781449683757|page=105|url=http://books.google.ca/books?id=GVPHhIM3IZ0C&pg=PA105|edition=6th}}</ref> na katika hali yoyote ya ngono.<ref>{{cite book|last=Sharkey|first=Harriet|title=Need to Know Fertility and Conception and Pregnancy|year=2013|publisher=HarperCollins|isbn=9780007516865|page=17|url=http://books.google.ca/books?id=Mc7qlSypV6UC&pg=PP17}}</ref> Kuna uwezekano, ingawa si rahisi, kuwa mjamzito wakati wa hedhi.<ref>{{cite book|last=Strange|first=Mary|title=Encyclopedia of women in today's world|year=2011|publisher=Sage Reference|location=Thousand Oaks, Calif.|isbn=9781412976855|page=928|url=http://books.google.ca/books?id=bOkPjFQoBj8C&pg=PA928}}</ref> ==Utafiti== ===Wanawake=== Uboreshaji wa upangaji uzazi kwa mbinu zinazoendelea zinahitajika, kwa sababu karibu nusu ya wanaopata mimba kwa bahati mbaya wanatumia upangaji uzazi wakati huo.<ref name=Will2012/> Baadhi ya mbinu tofauti tofauti za uzuiaji mimba zinachunguzwa, ikijumuisha pamoja kondomu bora ya wanawake, [[SILCS daframu|daftramu]], doa lililo na projesteroni pekee, na pete ya ukeni iliyo na projesteroni refu.<ref name=Jensen2011>{{cite journal|last=Jensen|first=JT|title=The future of contraception: innovations in contraceptive agents: tomorrow's hormonal contraceptive agents and their clinical implications.|journal=American journal of obstetrics and gynecology|date=2011 Oct|volume=205|issue=4 Suppl|pages=S21-5|pmid=21961821}}</ref> Pete ya ukeni huwa bora kwa miezi 3 au 4 na inapatikana katika baadhi ya maeneo duniani.<ref name=Jensen2011/> Kuna mbinu kadha za kutekeleza uangamizaji wa vimelea kwa kuchunguza seviksi.<!-- <ref name=Cast2010/> --> Moja inahusisha uwekaji wa [[quinacrine]] ndani ya uterasi inayosababisha kovu na kutoweza kupata mimba.<!-- <ref name=Cast2010/> --> Ingawa utaratibu huo ni rahisi na haihitaji upasuaji, kuna wasiwasi kuhusu madhara ya muda mrefu.<ref name=Cast2010>{{cite journal|last=Castaño|first=PM|coauthors=Adekunle, L|title=Transcervical sterilization.|journal=Seminars in reproductive medicine|date=2010 Mar|volume=28|issue=2|pages=103-9|pmid=20352559}}</ref> Bidhaa nyingine ya, [[polidocanol]], inayofanya kazi sawa inachunguzwa.<ref name=Jensen2011/> Kifaa kinachoitwa [[Essure]], inayopanuka na kufunga inapowekwa ndani ya fallopio, ilikubaliwa Marekani mwaka wa 2002.<ref name=Cast2010/> ===Wanaume=== Mbinu za kiume za kudhibit uzazi zinajumuisha kondomu, ukataji na utoaji wa mrija.<ref name=Glasier2010>{{cite journal|last=Glasier|first=A|title=Acceptability of contraception for men: a review.|journal=Contraception|date=2010 Nov|volume=82|issue=5|pages=453-6|pmid=20933119}}</ref> Wanaume kati ya asilimia 25 na 75 wanaoweza kuzalisha hutumia homoni za kudhibiti uzazi ikiwa wanaweza kupata.<ref name=Glasier2010/><ref name=Naz2009/> Idadi ya mbinu za homoni na zisizo za homoni zinafanyiwa majaribio,<ref name=Naz2009>{{cite journal|last=Naz|first=RK|coauthors=Rowan, S|title=Update on male contraception.|journal=Current opinion in obstetrics & gynecology |date=2009 Jun |volume=21 |issue=3|pages=265-9|pmid=19469045}}</ref> na kuna baadhi ya utafiti unaochunguza uwekezano wa [[chanjo ya kontraseptivu]].<ref>{{cite journal|last=Naz|first=RK|title=Antisperm contraceptive vaccines: where we are and where we are going?|journal=American journal of reproductive immunology (New York, N.Y. : 1989)|date=2011 Jul|volume=66|issue=1|pages=63-70|pmid=21501281}}</ref> Mbinu ya upasuaji wa kugeuza inayochunguzwa ni [[reversible inhibition of sperm under guidance]] (RISUG) inayojumuisha huiingizaji wa polymer gel, [[styrene maleic anhydride]] kwa [[dimethyl sulfoxide]], katika [[vas deferens]].<!-- <ref name=Naz2009/> --> Ukidungwa sindano na sodium bicarbonate hutoa dawa na hurudisha uwezo wa kuzaa tena.<!-- <ref name=Naz2009/> --> Nyingine ni [[intravas device]] inayohusisha uwekaji wa [[Polyurethane|urethane]] ndani ya [[vas deferens]] ili izuie.<!-- <ref name=Naz2009/> --> Mchanganyiko wa [[androgen]] na [[progestin]] huleta matumaini, kwa [[selective androgen receptor modulator]].<ref name=Naz2009/>[[Ultrasound]] na mbinu za kupasha moto makende zimefanyiwa uchunguzi wa kwanza.<ref>{{cite book|last=Ojeda |first=edited by Willaim J. Kovacs, Sergio R. |title=Textbook of endocrine physiology |publisher=Oxford University Press |location=Oxford |isbn=9780199744121 |page=262|year=2011|url=http://books.google.ca/books?id=vrTslOGdBysC&pg=PA262|edition=6th ed.}}</ref> ==Wanyama== [[Upakaji]], unayojumuisha utoaji wa baadhi ya sehemu za [[viungo vya uzazi]],<ref>{{cite book|last=Ackerman|first=[edited by] Lowell|title=Blackwell's five-minute veterinary practice management consult|year=2007|publisher=Blackwell Pub.|location=Ames, Iowa|isbn=9780781759847|page=80|url=http://books.google.ca/books?id=26FZVV40aWwC&pg=PA80|edition=1st ed.}}</ref> ni mbinu inayofanywa mara nyingi kwa [[wanyama]]. [[Hifadhi za wanyama]] huhitaji taratibu hizi kama mkataba wa kuchukua.<ref>{{cite book|last=Millar|first=Lila|title=Infectious Disease Management in Animal Shelters|year=2011|publisher=John Wiley & Sons|isbn=9781119949459|url=http://books.google.ca/books?id=n8NbuhrrFd8C&pg=PT58}}</ref> Udhibiti wa uzazi huchukuliwa kama njia mbadala ya kupunguza [[idadi ya wanyama wa mwituni]].<ref name="Boyle 2009">{{cite web|last=Boyle|first=Rebecca|date=March 3, 2009|title=Birth control for animals: a scientific approach to limiting the wildlife population explosion|work=Popular Science|location=New York|publisher=[http://www.popsci.com/about-usPopSci.com]|url=http://www.popsci.com/environment/article/2009-03/birth-control-animals?single-page-view=true}}</ref> [[Chanjo za kontraseptivu]] zimepatikana kuwa na ubora kwa idadi fulani ya wanyama.<ref>{{cite journal|last=Kirkpatrick|first=JF|coauthors=Lyda, RO; Frank, KM|title=Contraceptive vaccines for wildlife: a review.|journal=American journal of reproductive immunology (New York, N.Y. : 1989)|date=2011 Jul|volume=66|issue=1|pages=40-50|pmid=21501279}}</ref><ref>{{cite journal|last=Levy|first=JK|title=Contraceptive vaccines for the humane control of community cat populations.|journal=American journal of reproductive immunology (New York, N.Y. : 1989)|date=2011 Jul|volume=66|issue=1|pages=63-70|pmid=21501281}}</ref> ==Tazama pia== *[[Uzazi wa mpango]] ==Marejeo== {{Reflist|2}} ==Kusoma zaidi== * Speroff, Leon; Darney, Philip D. (November 22, 2010). [http://books.google.com/books?id=f5XJtYkiJ0YC&lpg=PP1&ots=VIRzj4boJR&dq=isbn%3A9781608316106&pg=PP1#v=onepage&q&f=false''A clinical guide for contraception''] (5th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. ISBN 978-1-60831-610-6. * Stubblefield, Phillip G.; Roncari, Danielle M. (December 12, 2011). [http://books.google.com/books?id=P3erI0J8tEQC&lpg=PP1&ots=l3vsNGaDD2&dq=editions%3AytqC2tqT5BIC&pg=PA247#v=onepage&q&f=false"Family Planning"], pp.&nbsp;211–269, in Berek, Jonathan S. (ed.) ''Berek & Novak's Gynecology, 15th ed.'' Philadelphia: Lippincott Williams & Wilkins, ISBN 978-1-4511-1433-1. * Jensen, Jeffrey T.; Mishell, Daniel R. Jr. (March 19, 2012). [http://books.google.com/books?id=X5KT_w6Nye8C&lpg=PP1&pg=PA215#v=onepage&f=false"Family Planning: Contraception, Sterilization, and Pregnancy Termination"], pp.&nbsp;215–272, in Lentz, Gretchen M.; Lobo, Rogerio A.; Gershenson, David M.; Katz, Vern L. (eds.) ''Comprehensive Gynecology, 6th ed.'' Philadelphia: Mosby Elsevier, ISBN 978-0-323-06986-1. ==Viungo vya nje== {{Commons category|Contraception}} *{{dmoz|Health/Reproductive_Health/Birth_Control/}} *{{cite book|first=World Health Organization Department of Reproductive Health and Research and Johns Hopkins Bloomberg School of Public Health|title=Family planning : a global handbook for providers : evidence-based guidance developed through worldwide collaboration.|year=2011|publisher=WHO and Center for Communication Programs|location=Geneva, Switzerland|isbn=978-0-9788563-7-3|url=http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|edition=Rev. and Updated ed.|access-date=2013-11-28|archive-date=2013-09-21|archive-url=https://web.archive.org/web/20130921054335/http://www.fphandbook.org/sites/default/files/hb_english_2012.pdf|url-status=dead}} *{{cite journal|last=Division of Reproductive Health, National Center for Chronic Disease Prevention and Health|first=Promotion|title=U.s. Selected practice recommendations for contraceptive use, 2013: adapted from the world health organization selected practice recommendations for contraceptive use, 2nd edition.|journal=MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control|date=2013 Jun 21|volume=62|issue=RR-05|pages=1-60|pmid=23784109|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6205a1.htm?s_cid=rr6205a1_w}} *{{cite web|title=Birth Control Comparison Chart|url=http://www.birth-control-comparison.info/|publisher=Cedar River Clinics}} *[http://www.who.int/rhem/procurement/en/Bulk procurement of birth conrtol] by the World Health Organization [[Jamii:Afya]] fgoi7ne5thnyvccefw89qysfkco1d8o 0 70143 1578091 1465839 2026-07-02T19:18:41Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578091 wikitext text/x-wiki {{Infobox disease | Name = Gout | Image = The gout james gillray.jpg | Alt = A small creature with sharp teeth is biting into a swollen foot at the base of the big toe | Caption = ''Gout'', a 1799 caricature by [[James Gillray]] | DiseasesDB = 29031 | ICD10 = {{ICD10|M|10||m|05}} | ICD9 = {{ICD9|274.00}} {{ICD9|274.1}} {{ICD9|274.8}} {{ICD9|274.9}} | ICDO = | OMIM = 138900 | OMIM_mult = {{OMIM2|300323}} | MedlinePlus = 000422 | eMedicineSubj = emerg | eMedicineTopic = 221 | eMedicine_mult = {{eMedicine2|med|924}} {{eMedicine2|med|1112}} {{eMedicine2|oph|506}} {{eMedicine2|orthoped|124}} {{eMedicine2|radio|313}} | MeshID = D006073 }} '''Jongo''' (pia '''podagra''' inapohusisha kidole gumba cha mguu; [[ing.]] ''gout'')<ref name=Egg2007/> huwa [[Ugonjwa|hali ya kimatibabu]]. Kwa kawaida, jongo hutambulika kwa maambukizi makali ya mara kwa mara ya [[athritisi yenye inflamesheni]]—ambayo ni [[efusheni ya jointi|kufura kwa jointi]]iliyo nyekundu, laini, na chungu.[[Jointi ya mifupa ya metatasu na ya vidole vya mguu| jointi ya metatasu na ya mifupa ya vidole vya mguu]] katika mzizi wa mfupa wa kidole gumba cha mguu na metatasu ya kwanza [[haluksi|kidole kikubwa cha mguu]] ndiyo inayoathirika mara nyingi zaidi. Hali hii huchangia takriban asilimia 50 ya maambukizi yote. Jongo pia hujitokeza kama [[tofasi]], [[mawe ya figo]], au [[nefropathi ya figo]]. Jongo pia husababishwa na ongezeko la viwango vya [[asidi ya mkojo]] katika [[damu]] ambayo huganda. Fuwele huwekezwa kwenye viungo, [[kano]], na [[tishu (bayolojia)|tishu]]zilizo karibu. Jongo hutambulika fuwele zinapogunduliwa katika kiowevu cha jointi. Matibau ya kutumia [[dawa zisizo na steroidi zinazoondoa inflamesheni]],[[steroidi]], au [[kolkisini]] huimarisha afya. Punde tu maambukizi yanapopunguka, kiwango cha asidi ya mkojo kinaweza kushushwa kwa kubadili mienendo ya kiafya. Watu wanaopata maambukizi mara kwa mara wanaweza kupendekezewa [[allopurinol]] au [[probenecid]] ili kuzuia dalili kwa muda mrefu. Jongo imeongezeka katika miongo ya hivi karibuni. Ugonjwa huu huathiri takriban asilimia moja hadi mbili ya watu wa[[nchi za magharibi|Magharibi]] katika wakati fulani maishani mwao. Hali hii inahusika na kuongezeka kwa visababishi hatari katika uma.[[Usumbufu wa umetaboli]] (ambao ni mkusanyiko wa matatizo ya kimatibabu ambayo yanapotokea kwa pamoja huongeza hatari ya kupata magonjwa ya moyo na mishipa ya damu na kisukari), [[matarajio ya urefu wa maisha]] marefu, na mabadiliko ya lishe ndivyo vipengele vikuu vya hatari ya kupata ugonjwa huu. Jongo ilikuwa ikijulikana kihistoria kama ugonjwa wa wafalme au matajiri ". ==Ishara na dalili== [[Image:Gout2010.JPG|thumb|alt=|mtazamo wa upande wa mguu kuonyesha eneo lekundu la ngozi ya juu ya jointi chini ya kidole gumba cha mguu|Jongo inayotokea kwenye[[jointi ya mifupa ya metatasu na ya vidole vya mguu| jointi ya metatasu na ya mifupa ya vidole vya mguu]] ya kidole gumba cha mguu. Angalia wekundi wa ngozi juu ya kiungo]] Jongo inaweza kujitokeza kwa njia mbali mbali, ingawa ile iliyo ya kawaida zaidi ni [[athritisi inayosababisha inflamesheni]] (jointi nyekundu, iliyofura na yenye joto na uchungu)inayojirudia mara kwa mara.<ref name=Review08/> Jointi ya metatasu na falaniksi katika mzizi wa [[kidole gumba cha mguu|kidole gumba cha mguu]] huathirika mara nyingi ambapo inajumuisha nusu ya visa vyote<ref name=PM2010/> Viungo vinginge kama visigino, magoti, vifundo na vidole vya mikono vinaweza kuathirika pia.<ref name=PM2010/> Maumivu ya jointi huanza kwa muda wa saa 2–4&nbsp; na wakati wa usiku.<ref name=PM2010/> Dalili hizi hutokea usiku kwa sababu ya kiwango cha chini cha joto mwilini.<ref name =Egg2007/> Dalili zingine zinazoweza kutokea ni kama vile [[uchovu (kimatibabu)|uchovu]] na kiwango cha juu cha [[homa]]. <ref name=Egg2007/><ref name=PM2010/> Kiwango cha juu cha [[asidi ya mkojo]] katika damu kwa muda mwingi ([[hipaurikemia]]) kinaweza kusababisha dalili zingine kama vile uwekezaji wa fuwele gumu za asidi ya mkojo zisizo chungu ziitwazo [[tofasi]]. Tofasi inayokua kwa kasi inaweza kusababisha [[arthritisi ya muda mrefu]] kutokana na mifupa kuisha )<ref name=Egg2007/> Kiwango cha juu cha asidi ya mkojo katika damu pia kinaweza kusababisha mawe kutokea katika [[figo]]. Jambo hili husababisha kuundika kwa [[mawe ya figo|mawe]], likifuatiwa na[[nefrophathi kali ya asidi ya mkojo|nefropathi ya figo]].<ref name=German09/> ==Kisababishi== [[Hipaurikemia]] ndicho kisababishi kikuu cha jongo. Hali hii husababishwa na vipengele kadhaa, ikiwa ni pamoja na chakula, na sifa za kibaolojia. Jongo pia inaweza kusababishwa na mwili kutoweza kuondoa[[asidi ya mkojo# uyeyukaji wa asidi ya mkojo|ya figo]], chumvi za asidi ya mkojo.<rejeo=Review08/> Glandi za figo ambazo haziondoi asidi ya mkojo ya kutosha ni kisababishi kikuu cha hipaurikemia kwa takriban asilimia 90 tukio hizi. Kuwepo kwa asidi nyingi ya mkojo katika damu ni kisababishi katika visa vya chini ya asilimia 10 <rejeo=Lancet2010/> Takriban asilimia 10 ya watu wenye hipaurikemia hupata jongo katika wakati fulani maishani mwao.<ref name="pmid18327257">{{cite journal |author=Vitart V, Rudan I, Hayward C, ''et al.'' |title=SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout |journal=Nat. Genet.|volume=40 |issue=4 |pages=437–42 |year=2008 |month=April |pmid=18327257 |doi=10.1038/ng.106 |url=}}</ref> Hatari ya kupata jongo hutofautiana kulingana na hali ya hipaurikemia. Wakati asidi ya mkojo katika damu ni kati ya 415 na 530&nbsp;μmol/L (7 na 8.9&nbsp;mg/dL), hatari ya kupata jongo ni asilimia 0.5 kwa mwaka. Watu walio na kiwango cha asidi ya mkojo katika damu cha zaidi ya 535&nbsp;μmol/L (9&nbsp;mg/dL) wako katika hatari ya asilimia 4.5 ya kupata jongo.<ref name=Egg2007/> ===Mwenendo wa kimaisha=== Asilimia 12 ya visababishi vyote vya jongo hutokana na lishe.<ref name=Review08/> Unywaji pombe, vinywaji vyenye sukari nyingi ya ki[[fraktosi]], nyama na chakula cha baharini kinaweza kuchangia kuwepo kwa ugonjwa huu.<ref name=Nature2009/><ref>{{cite journal|last=Weaver|first=AL|title=Epidemiology of gout|journal=Cleveland Clinic journal of medicine|date=2008 Jul|volume=75 Suppl 5|pages=S9–12|pmid=18819329}}</ref> Visababisha vingine ni pamoja na [[majeraha ya mwili]] na upasuaji.<ref name=Lancet2010/> Utafiti wa hivi karibuni umefutilia mbali imani kuhusu vipengele vya lishe ambavyo kwa wakati mmoja viliaminiwa kusababisha ugonjwa huu. Utumiaji wa mboga iliyo na[[purini]](k.v., maharagwe, mbaazi, dengu, na mchicha), na protini kwa jumla haiwezi kuchangia kuwepo kwa jongo.<ref>{{cite journal |author=Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G |title=Purine-rich foods, dairy and protein intake, and the risk of gout in men |journal=N. Engl. J. Med. |volume=350|issue=11 |pages=1093–103 |year=2004 |month=March |pmid=15014182 |doi=10.1056/NEJMoa035700 |url=https://archive.org/details/sim_new-england-journal-of-medicine_2004-03-11_350_11/page/1092}}</ref><ref name=Epi2008/> Utumiaji wa [[kahawa]], [[vitamini C]], na [[vyakula vya asili ya maziwa]] pamoja na kufanya mazoezi ya mwili yameonekana kupunguza hatari kupata ugonjwa huu.<ref>{{cite journal |author=Hak AE, Choi HK|title=Lifestyle and gout |journal=Curr Opin Rheumatol |volume=20 |issue=2 |pages=179–86 |year=2008 |month=March |pmid=18349748|doi=10.1097/BOR.0b013e3282f524a2 |url=}}</ref><ref>{{cite journal |author=Williams PT |title=Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men |journal=Am. J. CL. Nutr. |volume=87 |issue=5 |pages=1480–7 |year=2008|month=May |pmid=18469274 |doi= |url=}}</ref><ref name=Life2010>{{cite journal |author=Choi HK |title=A prescription for lifestyle change in people with hyperuricemia and gout |journal=Curr Opin Rheumatol |volume=22 |issue=2 |pages=165–72 |year=2010 |month=March |pmid=20035225|doi=10.1097/BOR.0b013e328335ef38 |url=}}</ref> Hii inaminiwa kuwa ni kwa sababu ya uwezo wake wa kupunguza [[kupinga insulini]].<ref name=Life2010/> ===Vipengele vya kibayolojia vilivyorithiwa=== Vipengele vya kibayolojia vilivyorithiwa huusika kwa asilimia 60 ya [[Mabadiliko ya kijenetiki|mabadiliko]] katika kiwango cha asidi ya mkojo.<ref name=Lancet2010/>[[Jeni]] mbili ziitwazo [[SLC2A9]] na [[ABCG2]] kwa kawaida huhusishwa na jongo. Mabadiliko katika jeni hizi yanaweza kuzidisha maradufu hatari ya kupata ugonjwa huu.<ref>{{cite journal|last=Merriman|first=TR|coauthors=Dalbeth, N|title=The genetic basis of hyperuricaemia and gout.|journal=Joint, bone, spine : revue du rhumatisme|date=2011 Jan|volume=78|issue=1|pages=35–40|pmid=20472486}}</ref> Hali chache za kibayolojia ambazo ni nadra, ikiwa ni pamoja na [[protini ya Tamm-Horsfall | nefropathi ya kihipaurikemi ya watoto katika familia]], [[ugonjwa wa figo aina ya sisitiki ya medula]], [[PRPSAP1|uundaji wa phosphoribosylpyrophosphate]]mazoezi mengi ya mwili, na uchache wa[[hypoxanthine-guanine phosphoribosyltransferase]] kama unavyopatikana katika [[sindromu ya Lesch-Nyhan]], hufanywa tata zaidi na kuwepo kwa jongo.<ref name=Lancet2010/> ===Hali za kimatibabu=== Mara nyingi jongo hutokea pamoja na matatizo mengine ya kimatibabu. [[Sindromu ya kimetaboli]], muungano wa [[unene wa kupindukia wa fumbatio]], [[shinikizo la juu la damu]],[[ukinzani wa insulini]], na [[Disilipidemia|kiwango cha mafuta kisicho cha kawaida]] hutokea kwa karibu asilimia 75 ya visa vyote.<ref name=PM2010/> Hali zingine zinazotokea kufuatia jongo ni pamoja na : [[polisthemia]], [[sumu ya ledi]], [[matatizo ya figo]], [[anemia ya haemolitiki]], [[soriasisi]], na [[uhamisho wa ogani|uhamisho wa ogani yote]].<ref name=Lancet2010/><ref name="pmid16392875">{{cite journal |author=Stamp L, Searle M, O'Donnell J, Chapman P |title=Gout in solid organ transplantation: a challenging clinical problem |journal=Drugs |volume=65 |issue=18 |pages=2593–611 |year=2005 |pmid=16392875 |doi=|url=}}</ref> Hatari ya wanaume kupata jongo huzidi mara tatu ikiwa wana [[kielezo cha uzani wa mwili]] cha zaidi ya 35.<ref name=Epi2008/> Utumizi wa muda mrefu wa pombe iliyo na ledi huchangia katika kuugua jongo kwa sababu ya mathara ya ledi kwenye utendakazi wa figo.<ref>{{cite journal |author=Loghman-Adham M |title=Renal effects of environmental and occupational lead exposure |url=https://archive.org/details/sim_environmental-health-perspectives_1997-09_105_9/page/928 |journal=Environ. Health Perspect. |volume=105 |issue=9 |pages=928–38 |year=1997|month=September |pmid=9300927 |pmc=1470371 |doi= 10.2307/3433873|publisher=Brogan & Partners |jstor=3433873}}</ref> [[sindromu ya Lesch-Nyhan]] mara nyingi huusishwa na athritisi ya jongo ===Matibabu=== [[Diuretiki]] huhusishwa na kuwepo kwa jongo. Hata hivyo, kipimo kidogo cha [[hydrochlorothiazide]] hakionekani kuongeza hatari ya kupata ugonjwa huu<ref name=CFP09/> Dawa zingine zinazohusishwa na kusababisha jongo ni [[niacin]] na [[aspirin]] (asidi ya acetylsalicylic).<ref name=Nature2009/> [[Dawa zinazokandamiza kingamwili]], [[ciclosporin]] na [[tacrolimus]] pia huhusishwa na jongo.,<ref name=Lancet2010/> Matumizi ya[[Tacrolimus]] pamoja na hydrochlorothiazide huwa na uwezekano mkubwa wa kupata jongo.<ref>{{cite book |editor1-first=Gary S. |editor1-last=Firestein, MD |editor2-first=Ralph C. |editor2-last=Budd, MD |editor3-first=Edward D. |editor3-last=Harris Jr., MD |editor4-first= Iain B. |editor4-last=McInnes PhD, FRCP |editor5-last=Ruddy, MD|editor6-last=Sergent, MD |title=KELLEY'S Textbook of Rheumatology |url=https://archive.org/details/textbookofrheuma0000gary |edition=8th |year=2008 |publisher=Elsevier |isbn=978-1-4160-4842-8 |chapter=Chapter 87: Jongo na Hyperuricemia |editor-first=Shaun |editor3-given=John S.}}</ref> ==Pathofisiolojia== [[Image:Harnsäure Ketoform.svg|thumb|alt=muundo wa elementi ya kiogani: 7,9-dihydro-1H-purine-2,6,8(3H)-trione|[[asidi ya mkojo]]]] Jongo ni hali inayotokana na [[umetaboli wa purini]],<ref name=Lancet2010/> na hutokea wakati kipengele chake cha mwisho, [[asidi ya mkojo]], huganda kama monosodiamu ya figo. Damu huwekeza fuwele hizi kwenye jointi, kano na kwenye tishu zilizo karibu.<ref name=Nature2009/> Fuwele hizi baadaye huchochea mwitikio wa mfumo wa[[kingamwili]] [[inflamesheni|ya inflamesheni]] <ref name=Nature2009/> pamoja na protini kuu katika mfumo wa mwili wa kuitikia inflamesheni. Mojawapo ya protini hizi ni[[interleukin 1β]].<ref name=Lancet2010/> [[Urikesi]] huhitajika ili kuyeyusha asidi ya mkojo. Upoteaji wa [[urikesi]] katika harakati ya kubadilika, katika binadamu na [[jamii ya nyani]] umefanya hali hii kuwepo kwa wingi. <ref name=Lancet2010/> Vichochezi vinavyofanya asidi ya mkojo kulimbikizana katika damu havijaeleweka vyema. Ingawa asidi hii inaweza kuganda katika kiwango cha kawaida, kuna uwezekano mkubwa wa kuganda kiwango chake kinapoongezeka.<ref name=Nature2009/><ref name="pmid17595458">{{cite journal |author=Virsaladze DK, Tetradze LO, Dzhavashvili LV, Esaliia NG, Tananashvili DE|title=[Levels of uric acid in serum in patients with metabolic syndrome] |language=Russian |journal=Georgian Med News |volume= |issue=146 |pages=35–7|year=2007 |month=May |pmid=17595458 |trans_title=Levels of uric acid in serum in patients with metabolic syndrome }}</ref> Vipengele vingine vinavyokisiwa kuwa vikuu katika kuchochea tukio kali la athritisi ni pamoja na baridi, mabadiliko ya kasi ya kiwango cha asidi ya mkojo [[asidiosisi]],<ref name="pmid12672211">{{cite journal| author = Moyer RA, John DS| title = Acute gout precipitated by total parenteral nutrition| journal = The Journal of rheumatology| volume = 30| issue = 4| pages = 849–50| year = 2003| month = April| pmid = 12672211| doi = | url =https://archive.org/details/sim_journal-of-rheumatology_2003-04_30_4/page/849| issn = }}</ref><ref name="pmid7783706">{{cite journal| author = Halabe A, Sperling O| title = Uric acid nephrolithiasis| journal = Mineral and electrolyte metabolism|volume = 20| issue = 6| pages = 424–31| year = 1994| pmid = 7783706| doi = | url = | issn = }}</ref> upungufu wa maji ya jointi [[matriksi ya nje ya seli]]protini kama vile [[proteojilikansi]], [[kolajeni]], na [[salfeti ya kodroitini]].<ref name=Lancet2010/> Ongezeko la kutuama wakati wa baridi hueleza kwa kadri sababu ya kuathiriwa kwa jointi za miguu mara nyingi.<ref name=Review08/> Mabadiliko ya kasi ya asidi ya mkojo hutokea kufuatia vipengele kadhaa, ikiwemo, jeraha, upasuaji [[kimotherapi]], diuretiki na kusitisha au kuanzisha [[allopurinol]].<ref name=Egg2007/> ==Utambuzi== [[Picha:Gichtfuss im Roentgenbild 002.png|thumb|Jongo kwenye [[eksirei-]] inayoonyesha mguu wa kushoto. Jongo hutokea kwa kawaida katika eneo la chini ya jointi ya kidole gumba cha mguu. Pia tazama tishu zilizofura katika sehemu ya nje ya mpakani mwa mguu.]] [[Picha:Fluorescent uric acid.JPG|thumb|alt= fuwele nyingi za umbo la sindano za rangi nyingi katika mandhari ya rangi ya zambarau|Fuwele nyembamba za asidi ya mkojo kutoka katika sampuli ya[[kiowevu cha sinovia]] iliyopigwa picha kwa mikroskopu yenye [[Kutawanywa (mawimbi)|mwangaza uliotawanywa]]. Uundaji wa fuwele za asidi ya mkojo kwenye kiungo huhusishwa na jongo.]] Katika mtu mwenye hipaurikemia na podagra klasiki, jongo inaweza kutambuliwa na kutibiwa bila kufanya uchunguzi zaidi. Ikiwa kuna tashwishi kuhusu utambuzi, uchunguzi wa kiowevu cha sinovia unapaswa kufanywa. <ref name=Egg2007/> [[Eksirei]] ni muhimu katika kutambua jongo kali pekee. [[Eksirei]] hazitumiki kutibu maambukizi hatari ya jongo.<ref name=Lancet2010/> ===Kiowevu cha sinovia=== Utambuzi mkamilifu wa jongo hutegemea kutambuliwa kwa [[ya figo|fuwele za figo vya aina ya monosodium]] katika [[kioweveu cha sinovia]] au [[tofasi]].<ref name=PM2010>{{cite journal |author=Schlesinger N |title=Diagnosing and treating gout: a review to aid primary care physicians |journal=Postgrad Med|volume=122 |issue=2 |pages=157–61 |year=2010 |month=March |pmid=20203467 |doi=10.3810/pgm.2010.03.2133 |url=}}</ref> Sampuli zote za kioweveu cha sinovia zilizotolewa kwenye jointi zenye inflamesheni zisizotambuliwa zinapaswa kuchunguzwa kuhahiki kama kuna fuwele hizi<ref name=Lancet2010/> Fuwele hizi huonekana zikiwa na umbo la sindano na zenye nguvu za [[kuchepuka]] zinapotazamwa kwa makroskopu yenye[[mwangaza uliotawanywa]]. Uchunguzi huu ni mgumu kufanywa na mara nyingi huhitaji mtaalamu.<ref name="pmid18299687">{{cite journal |author=Schlesinger N |title=Diagnosis of gout |journal=Minerva Med. |volume=98 |issue=6 |pages=759–67 |year=2007|month=December |pmid=18299687 |doi= |url=}}</ref> Kiowevu pia kinafaa kuchunguzwa haraka baada ya kutolewa kwa kuwa kiwango fulani cha joto na pH huathiri kuyeyuka kwake.<ref name=Lancet2010/> ===Uchunguzi wa damu=== [[Hipaurikemia]] ni dalili maalum ya jongo. Jongo hutokea kwa karibu nusu ya visa vyote visivyoandamana na hipaurikemia.<ref name=PM2010/><ref>{{cite journal | author = Sturrock R | title = Gout. Rahisi kutotambuliwa kisahihi | journal = [[British Medical Journal|BMJ]] | volume = 320 | issue = 7228 | pages = 132–33 | year = 2000 | pmid = 10634714|url=http://bmj.bmjjournals.com/cgi/content/full/320/7228/132 | doi = 10.1136/bmj.320.7228.132 | pmc = 1128728}}</ref> Umuhimu wa kupima kiwango cha asidi ya mkojo ni mdogo.<ref name=PM2010/> Hipaurikemia inafasiliwa kuwa kiwango cha [[plasma ya damu|plasma]] kinachozidi molekuli 420 kwa lita ''μ''mol/L (7.0&nbsp;mg/dL) kwa wanaume na 360 ''μ''mol/L (6.0&nbsp;mg/dL) kwa wanawake.<ref>{{cite journal |author=Sachs L, Batra KL, Zimmermann B |title=Medical implications of hyperuricemia |journal=Med Health R I |volume=92 |issue=11 |pages=353–55 |year=2009 |month=November |pmid=19999892 |doi= |url=}}</ref> Uchunguzi mwingine wa damu ambao kwa kawaida hufanywa ni [[idadi ya seli nyeupe za damu]], [[elektroliti]], [[utendakazi wa figo]], na [[kima cha ushapaji wa elekroliti]] Kima cha ushapaji wa elekroliti pamoja na seli nyeupe zilizo katika damu zinaweza kuongezeka kufuatia jongo hata ikiwa hakuna maambukizi.<ref>{{cite web|url=http://emedicine.medscape.com/article/329958-diagnosis |title=Gout: Differential Diagnoses & Workup - eMedicine Rheumatology |work=|accessdate=}}</ref><ref>{{cite web |url=http://emedicine.medscape.com/article/808628-diagnosis |title=Gout and Pseudogout: Differential Diagnoses & Workup - eMedicine Emergency Medicine |work= |accessdate=}}</ref> Idadi ya juu ya seli nyeupe katika damu, kama 40.0×10⁹/L (40,000/mm³) imetambulika katika watu walio na jongo.<ref name=Egg2007/> ===Utambuzi tofautishi=== Utambuzi [[utambuzi wa kidiferenshia]] ulio muhimu zaidi katika jongo ni[[athritisi yenye maambukizi]].<ref name=PM2010/><ref name=Lancet2010/> Hii inafaa kutiliwa maanani kwa wale wanaoonyesha dalili za maambukizi au wale wasioimarika kiafya kufuatia matibabu.<ref name=PM2010/> Uchunguzi wa kiowevu cha sanovia kupitia [[mbinu ya Gram]]na ukuzaji unaweza kufanywa ili kuimarisha utambuzi.<ref name=PM2010/> Hali zingine zinazofanana na jongo ni [[jongo bandia]] na [[athritisi ya rumatoidi]].<ref name=PM2010/> Tofasi ya jongo, hasa isipopatikana kwenye jointi, inaweza kuonekana kama [[kasinoma ya kimsingi ya seli]],<ref>{{cite journal |author=Jordan DR, Belliveau MJ, Brownstein S, McEachren T, Kyrollos M |title=Medial canthal tophus |journal=Ophthal Plast Reconstr Surg |volume=24 |issue=5|pages=403–4 |year=2008 |pmid=18806664 |doi=10.1097/IOP.0b013e3181837a31 |url=}}</ref> au [[neoplasimu]]zingine.<ref>{{cite journal |author=Sano K, Kohakura Y, Kimura K, Ozeki S |title=Atypical Triggering at the Wrist due to Intratendinous Infiltration of Tophaceous Gout |journal=Hand (N Y)|volume=4 |issue=1 |pages=78–80 |year=2009 |month=March |pmid=18780009 |doi=10.1007/s11552-008-9120-4 |url= |pmc=2654956}}</ref> ==Kinga== Kubadilisha mienendo ya kimaisha na kuzingatia matibabu ni hatua zinazoweza kupunguza kiwango cha asidi ya mkojo. Mienendo bora ya lishe na kimaisha iliyo mwafaka ni pamoja na; kupunguza chakula kama nyama na chakula cha baharini, kutumia [[vitamini C]] ya kutosha, kupunguza utumizi wa [[pombe]] na [[fraktosi]] na kuepuka [[unene wa kupindukia]].<ref name=Review08/> [[Lishe yenye kiwango cha chini cha kalori]] katika wanaume wanene kupindukia hupunguza kiwango cha asidi ya mkojo kwa 100&nbsp;µmol/L (1.7&nbsp;mg/dL).<ref name=CFP09/> Utumizi wa vitamini&nbsp;C wa kiwango cha 1,500&nbsp;mg kwa siku hupunguza hatari ya kupata jongo kwa 45%.<ref>{{cite journal |author=Choi HK, Gao X, Curhan G |title=Vitamin C intake and the risk of gout in men: a prospective study |journal=Arch. Intern. Med. |volume=169 |issue=5 |pages=502–7 |year=2009 |month=March |pmid=19273781|doi=10.1001/archinternmed.2008.606 |url= |pmc=2767211}}</ref>,Kutumia kahawa, wala si chai, huhusishwa na kupungua kwa hatari ya kupata jongo.<ref>{{cite journal |author=Choi HK, Curhan G |title=Coffee, tea, and caffeine consumption and serum uric acid level: the third national health and nutrition examination survey |journal=Arthritis Rheum. |volume=57 |issue=5 |pages=816–21 |year=2007 |month=June |pmid=17530681 |doi=10.1002/art.22762|url=}}</ref> Jongo inaweza kutokea kufuatia [[apnea ya usingizi]] kupitia kutolewa kwa purini na seli zisizo na oksijeni. Matibabu ya apnea ya usingizi yanaweza kupunguza uwezekano wa kutokea kwa jongo.<ref name="pmid16171252">{{cite journal|author=Abrams B |title=Gout is an indicator of sleep apnea |journal=Sleep |volume=28|issue=2 |page=275 |year=2005 |month=February |pmid=16171252|doi= |url=}}</ref> ==Matibabu== Lengo la kwanza la kutibu jongo ni kupunguza dalili za ambukizi kali.<ref name="pmid16707532">{{cite journal |author=Zhang W, Doherty M, Bardin T,''et al.'' |title=EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) |url=https://archive.org/details/sim_annals-of-the-rheumatic-diseases_2006-10_65_10/page/1312 |journal=Ann. Rheum. Dis. |volume=65 |issue=10 |pages=1312–24 |year=2006 |month=October|pmid=16707532 |pmc=1798308 |doi=10.1136/ard.2006.055269}}</ref> Maambukizi yanayojirudia yanaweza kuzuiliwa kwa kutumia dawa mbalimbali zinazopunguza viwango vya majimaji ya damu ya asidi ya mkojo katika damu.<ref name="pmid16707532"/> Barafu inayotumiwa kwa dakika 20 hadi 30 mara nyingi kwa siku hupunguza maumivu.<ref name=Review08/><ref name="pmid11838852">{{cite journal |author=Schlesinger N ''et al.'' |title=Local ice therapy during bouts of acute gouty arthritis |url=https://archive.org/details/sim_journal-of-rheumatology_2002-02_29_2/page/331 |journal=J. Rheumatol. |volume=29 |issue=2 |pages=331–4 |year=2002 |pmid=11838852 |doi=10.1093/rheumatology/29.5.331}}</ref> Njia za kutibu dalili kali za mwanzoni ni pamoja na kutumia [[dawa za kupunguza inflamesheni zisizo na steroidi]] (NSAIDs), [[kolkisini]] na [[steroidi]]<ref name=Review08/>. Njia za kuzuia ni pamaoja na kutumia[[allopurinol]], [[febuxostat]] na [[probenecid]]. Kupunguza kiwango cha asidi ya mkojo kunaweza kuponya ugonjwa huu.<ref name=Lancet2010/> Kutibiwa kwa magonjwa mengine yanayochangia pia ni muhimu.<ref name=Lancet2010/> ===Dawa za kupunguza inflamesheni zisizo na steroidi=== [[Dawa za kupunguza inflamesheni zisizo na steroidi | NSAIDs]] ni matibabu yanayotumika mara nyingi kutibu jongo. Hakuna ajenti iliyo muhimu zaidi ya nyingine.<ref name=Review08/> Afya inaweza kuonekana ikiimarika baada ya saa 4. Matibabu yanapendekezwa kuchukua wiki 1–-2.<ref name=Review08/><ref name=Lancet2010/> Dawa za kupunguza inflamesheni zisizo na steroidi hazipendekezwi kwa watu wenye matatizo ya kiafya kama [[uvujaji wa damu kwenye tumbo na utumbo]], [[matatizo ya figo]], au [[matatizo ya moyo]].<ref name=JFP09/> Huku dawa ya [[indomethacin]] ikiwa dawa iliyotumika sana katika kupunguza inflamesheni isiyo na steroidi,[[ibuprofen]] inaweza kupendekezwa kwa kuwa haina madhara.<ref name=CFP09>{{cite journal |author=Laubscher T, Dumont Z, Regier L, Jensen B |title=Taking the stress out of managing gout |journal=Can Fam Physician|volume=55 |issue=12 |pages=1209–12 |year=2009 |month=December |pmid=20008601 |doi= |url= |pmc=2793228}}</ref> [[Kizuia pampu ya protoni]] kinaweza kupeanwa kwa watu walio katika hatari ya kupata madhara ya tumbo. <ref name="CKS-NLH">{{cite web|author=Clinical Knowledge Summaries|title=Gout - Management -- What treatment is recommended in acute gout?|url=http://cks.library.nhs.uk/gout/management/detailed_answers/managing_acute_gout/treatment|publisher=[[National Library for Health]]|accessdate=2008-10-26|archiveurl=https://web.archive.org/web/20081216120025/http://cks.library.nhs.uk/gout/management/detailed_answers/managing_acute_gout/treatment|archivedate=2008-12-16}}</ref> ===Kolkisini=== [[Kolkisini]] ni matibabu ya mbadala ya watu wasioweza kuvumilia dawa zisizo na steroidi zinazoondoa inflamesheni.<ref name=Review08/> Madhara yake makuu, ambayo hasa ni matatizo ya tumbo na utumbo, hupelekea matibabu haya yasitumike sana.<ref>{{emedicine|med|924|Gout|Medication}}</ref><ref name="FDA Warning">{{cite web | title=Information for Healthcare Professionals: New Safety Information for Colchicine (marketed as Colcrys) |url=http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm174315.htm| publisher= [[U.S. Food and Drug Administration]]}}</ref> Kutokea kwa matatizo ya tumbo na utumbo hutegemea kipimo cha dawa. Hatari ya kupata madhara haya inaweza kupunguzwa kwa kutumia vipimo vidogo lakini vyenye nguvu.<ref name=CFP09/> Kolkisini inaweza kuingiliana na dawa zingine zinazoagizwa kwa kawaida kama vile [[atorvastatin]] na[[erythromycin]].<ref name="FDA Warning" /> ===Steroidi=== [[Glukokotikoidi]]zimetambulika kutenda kazi kama dawa zisizo na steroidi zinazoondoa inflamesheni katika kutibu jongo <ref name="pmid17276548">{{cite journal |author=Man CY, Cheung IT, Cameron PA, Rainer TH |title=Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute goutlike arthritis: a double-blind, randomized, controlled trial |url=https://archive.org/details/sim_annals-of-emergency-medicine_2007-05_49_5/page/670 |journal=Annals of emergency medicine |volume=49 |issue=5 |pages=670–7 |year=2007|pmid=17276548 |doi=10.1016/j.annemergmed.2006.11.014}}</ref>. [[Glukokotikoidi]]zinaweza kutumika iwapo haiwezekani kutumia dawa zisizo na steroidi zinazoondoa inflamesheni.<ref name=Review08/> Kutumia [[glukokotikoidi]]kunaweza kupelekea nafuu ikiwa itatumika kama[[Dawa inayodungwa kwenye jointi|Dawa iliyodungwa kwenye jointi]]. Hatari ya [[athritisi ya kuambukizwa|kiambukizi cha jointi]] ni sharti iondolowe ikiwa hali itaendelea kuwa mbaya.<ref name=Review08/> ===Peglotikasi=== [[Pegloticase]] (Krystexxa) iliidhinishwa nchini Marekani ili kutibu jongo katika mwaka wa 2010.<ref name=FDA2010>{{cite web|url=http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm225810.htm |title=FDA approves new drug for gout |work=FDA |accessdate=}}</ref> Dawa hii itakuwa tiba ya asilimia 3 ya watu ambao huathiriwa na dawa zingine.<ref name=FDA2010/> Pegloticase hudungwa ndani ya mishipa kila baada ya wiki mbili <ref name=FDA2010/> na imetambulika kupunguza kiwango cha asidi ya mkojo katika watu hawa.<ref>{{cite journal|last=Sundy|first=JS|coauthors=Baraf, HS, Yood, RA, Edwards, NL, Gutierrez-Urena, SR, Treadwell, EL, Vázquez-Mellado, J, White, WB, Lipsky, PE, Horowitz, Z, Huang, W, Maroli, AN, Waltrip RW, 2nd, Hamburger, SA, Becker, MA|title=Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trials.|url=https://archive.org/details/sim_jama_2011-08-17_306_7/page/711|journal=JAMA : the journal of the American Medical Association|date=2011 Aug 17|volume=306|issue=7|pages=711–20|pmid=21846852}}</ref> ===Profilaksisi=== Dawa aina nyingi husaidia kuzuia maambukizi ya baadaye ya jongo zikiwemo [[kizuizi cha oksidesi ya zanthini]] (pamoja na [[allopurinol]], [[febuxostat]]), na [[urikosuriki]](pamoja na [[probenecid]] na [[sulfinpyrazone]]). Kwa kawaida, dawa hizi hazipeanwi kwa mtu hadi juma moja au mbili baada ya ambukizi kali limetibiwa. Hii ni kwa sababu inakisiwa kuwa hatua hii inaweza kufanya dalili za maambukizi ziwe kali zaidi.. <ref name=Review08/> Dawa hizi kwa mara nyingi, hutumika pamoja na dawa zisizo na steroidi zinazoondoa inflamesheni au kolkisini katika miezi 3–6&nbsp; ya kwanza.<ref name=Lancet2010/> Matibabu haya hayapendekezwi hadi mtu awe ameathiriwa mara mbili na jongo, <ref name=Review08/> au awe na mabadiliko yanayoathiri jointi, tofasi au [[Nefropathi ya ghafla ya asidi ya mkojo|nefropathi ya figo]].<ref name=German09>{{cite journal|author=Tausche AK, Jansen TL, Schröder HE, Bornstein SR, Aringer M, Müller-Ladner U |title=Gout--current diagnosis and treatment |journal=Dtsch Arztebl Int |volume=106 |issue=34–35 |pages=549–55 |year=2009 |month=August |pmid=19795010 |pmc=2754667 |doi=10.3238/arztebl.2009.0549 }}</ref> Matibabu ya aina hii hukawishwa hadi kiwango hiki kwa sababu yana gharama kubwa iwapo yatatolewa mapema zaidi.<ref name=Review08/> Hatua za kupunguza taratibu za figo zinafaa kuongezewa hadi viwango vya asidi ya mkojo katika majimaji ya damu vishuke chini ya 300–360&nbsp;µmol/L (5.0-6.0&nbsp;mg/dL). Matibabu haya yanafaa kuendelezwa bila kusitishwa.<ref name=Review08/><ref name=Lancet2010/> Matibabu haya yanafaa kuendelezwa hata kama mgonjwa atapa maambukizi mengine ya jongo.<ref name=PM2010/> [[Urikosuriki]] hupendekezwa katika kutibu jongo ikiwa asidi ya mkojo inatoleshwa kwa kiasi kidogo au kiasi cha mkojo uliokusanywa katika saa 24 ni chini ya mililigramu 800. <ref name=agabegi2nd251>Page 251 in: {{cite book |author=Elizabeth D Agabegi; Agabegi, Steven S.|title=Step-Up to Medicine (Step-Up Series) |url=https://archive.org/details/stepuptomedicine0000agab|publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages= |isbn=0-7817-7153-6|oclc= |doi= |accessdate=}}</ref> [[Urikosuriki]] hazipendekezwi ikiwa mgonjwa huyu ana historia ya mawe ya figo]].<ref name=agabegi2nd251/> Kiwango cha zaidi ya miligramu 800 za mkojo uliokusanywa kwa muda wa saa 24 ni dalili ya utolewaji wa kiasi cha juu na [[vizuizi vya oksidesi ya zanthini]] ni dawa zinazopendekezwa katika matibabu.<ref name=agabegi2nd251/> Kumbuka kuwa probenecid huonekana kutotenda kazi kwa ubora ikilinganishwa na allopurinol.<ref name=Review08/> Vizuizi vya oksidesi ya zanthini (ikiwemo [[allopurinol]] na [[febuxostat]]) huzuia uzalishaji wa asidi ya mkojo. Matibabu ya muda mrefu ni salama na yanakubaliwa, na yanaweza kutumiwa na watu walio na matatizo ya figo au mawe ya figo. Allopurinol imetambulika kusababisha ongezeko la hisia katika idadi ndogo ya watu. <ref name=Review08/> Katika tukio kama hili, dawa mbadala,[[febuxostat]] imekuwa ikipendekezwa.<ref>{{cite web |url=http://guidance.nice.org.uk/TA164/Guidance/Considerations_1 |title=Febuxostat for the management of hyperuricaemia in people with gout (TA164) Chapter 4. Consideration of the evidence |publisher=Guidance.nice.org.uk |date= |accessdate=2011-08-20 |archivedate=2010-10-06 |archiveurl=https://web.archive.org/web/20101006212851/http://guidance.nice.org.uk/TA164/Guidance/Considerations_1 }}</ref> ==Uwezekano wa kupona== Bila matibabu, ambukizi la ghafla la jongo linaweza kutatulika kwa kati ya siku 5 na 7. Asilimia 60 ya watu watapata ambukizi la pili katika mwaka mmoja.<ref name=Egg2007/> Wale walio na jongo wako katika hatari kubwa zaidi ya [[shinikizo la juu la damu]], [[ugonjwa wa kisukari]], [[usumbufu wa metaboli]]na magonjwa ya figo na [[ugonjwa wa mishipa ya moyo]] na wako katika hatari zaidi ya kifo.<ref name=Lancet2010/><ref name=Rh2008>{{cite journal |author=Kim SY, De Vera MA, Choi HK |title=Gout and mortality |journal=Clin. Exp. Rimatoli. |volume=26 |issue=5 Suppl 51 |pages=S115–9 |year=2008 |pmid=19026153 |doi= |url=}}</ref> Sababu yake pengine ni kwa kuwa inahusiana,kwa upande mmoja, na [[ukinzani wa insulini]] na [[unene wa kupindukia]], lakini baadhi ya ongezeko za hatari zinaonekana kutotegemea vipengele vingine.<ref name=Rh2008/> Bila matibabu, maambukizi hatari ya jongo yanaweza kukua na kuwa jongo kali huku yakisababisha kuharibika kwa sehemu ya juu ya jointi, ulemavu wa jointi na tofasi zisizo na uchungu.<ref name=Lancet2010/> Tofasi hizi hutokea katika asilimia 30 ya wale wasiotibiwa baada ya miaka mitano, mara nyingi katika [[heliksi (maskio)|heliksi]] ya maskio, juu ya viungo vya[[olekrenoni]] au katika [[kano za Achilles]].<ref name=Lancet2010/> Tofasi hizi zinaweza kuyeyushwa kwa kutumia matibabu mwafaka. [[Mawe ya figo]] mara nyingi hufanya jongo kuwa mbaya zaidi, na huathiri kati ya asilimia 10 na 40 ya watu. Mawe ya figo hutokea kufuatia kiwango cha chini zaidi cha pH, kikipelekea kiwango cha chini cha kutuama kwa asidi ya mkojo.<ref name=Lancet2010/> Aina nyingine za [[matatizo ya figo|matatizo ya muda mrefu ya figo]] zinaweza kutokea.<ref name=Lancet2010/> <gallery> File:Case 30-top.jpg|Vinundu vya vidole na dewe la sikio vikisimamia jongo [[tofasi|tofasi]] Image:ChronicGout.jpg|Tofasi ya goti Image:Case 30-bottom.jpg|Tofasi ya kidole cha mguu, na kupitia juu ya kifundo Image:Tophigout.JPG|Jongo iliyofanywa tata na tofasi (kiowevu kilionyesha uwepo wa fuwele za asidi ya uriki) </gallery> ==Epidemiolojia== Jongo huathiri kati ya asilimia 1 na 2 ya watu wanaoishi Ulaya kwa wakati mmoja katika maisha yao na inaendelea kupatikana mara nyingi zaidi.<ref name=Review08>{{cite journal|author=Chen LX, Schumacher HR |title=Gout: an evidence-based review |journal=J Clin Rheumatol |volume=14 |issue=5 Suppl |pages=S55–62 |year=2008|month=October |pmid=18830092 |doi=10.1097/RHU.0b013e3181896921 |url=}}</ref><ref name=Lancet2010>{{cite journal |author=Richette P, Bardin T|title=Gout |journal=Lancet |volume=375 |issue=9711 |pages=318–28 |year=2010 |month=January |pmid=19692116 |doi=10.1016/S0140-6736(09)60883-7|url=https://archive.org/details/sim_the-lancet_january-23-29-2010_375_9711/page/318}}</ref> Viwango vya jongo takriban vimeongezeka mara mbili kati ya mwaka wa 1990 na 2010.<ref name=Nature2009>{{cite journal |author=Terkeltaub R |title=Update on gout: new therapeutic strategies and options |journal=Nat Rev Rheumatol |volume=6 |issue=1 |pages=30–8 |year=2010 |month=January |pmid=20046204|doi=10.1038/nrrheum.2009.236 |url=}}</ref> Ongezeko hili linaaminiwa kusababishwa na ongezeko la matarajio ya urefu wa maisha, mabadiliko ya lishe na ongezeko la magonjwa yanayohusisiana na jongo kama vile [[usumbufu wa metaboli]] na [[shinikizo la juu la damu]].<ref name=Epi2008>{{cite journal |author=Weaver AL |title=Epidemiology of gout |journal=Cleve Clin J Med |volume=75 Suppl 5 |issue= |pages=S9–12 |year=2008 |month=July |pmid=18819329 |doi= |url=}}</ref> Vipengele kadhaa vimetambulika kuathiri kima cha kutokea kwa jongo. Hii ni pamoja na umri,ukoo na majira ya mwaka. Maambukizi ya jongo ni ya asilimia 2 katika wanaume wa umri wa zaidi ya mia 30 na wanawake wa zaidi ya miaka 50.<ref name=JFP09>{{cite journal |author=Winzenberg T, Buchbinder R |title=Cochrane Musculoskeletal Group review: acute gout. Steroids or NSAIDs? Let this overview from the Cochrane Group help you decide what's best for your patient |journal=J Fam Pract |volume=58 |issue=7 |pages=E1–4|year=2009 |month=July |pmid=19607767 |doi= |url=}}</ref> Nchini Marekani, jongo ina uwezekano mara mbili wa kutokea katika wanaume wa asili ya Kiafrika kuliko inavyotokea katika wanaume wa asili ya Kizungu.<ref>{{cite web | author=Rheumatology Therapeutics Medical Center | title=What Are the Risk Factors for Gout? | url=http://www.arthritisconsult.com/gout.html#risk | accessdate=2007-01-26 | archiveurl=https://web.archive.org/web/20070325104830/http://www.arthritisconsult.com/gout.html#risk | archivedate=2007-03-25 | =https://web.archive.org/web/20070325104830/http://www.arthritisconsult.com/gout.html#risk }}</ref> Kima cha jongo kiko juu katika watu wanaoishi katika kisiwa cha Pacific na [[Wamāori| Māori]] wa New zealand, lakini haipatikani sana katika watu wa kiasili wa Australia hata ingawa kuna kiwango cha juu cha asidi ya mkojo katika majimaji ya damu katika kikundi hiki cha watu wa kiasili.<ref name="pmid10225809">{{cite journal|author=Roberts-Thomson RA, Roberts-Thomson PJ |title=Rheumatic disease and the Australian aborigine |journal=Ann. Rheum. Dis. |volume=58 |issue=5|pages=266–70 |year=1999 |month=May |pmid=10225809 |pmc=1752880 |url=http://ard.bmjjournals.com/cgi/content/full/58/5/266|doi=10.1136/ard.58.5.266}}</ref> Jongo imetambulika mara nyingi nchini Uchina, Polynesia na makao ya miji ya mataifa ya Kusini mwa Afrika.<ref name=Lancet2010/> Baadhi ya tafiti zimeonyesha kuwa maambukizi ya jongo mara nyingi hutokea katika majira ya kuchipua. Hii imehusishwa na mabadiliko ya lishe kufuatia majira tofauti, unywaji pombe, mazoezi ya mwili na kiwangojoto.<ref>{{cite journal |author=Fam AG |title=What is new about crystals other than monosodium urate? |journal=Curr Opin Rheumatol |volume=12|issue=3 |pages=228–34 |year=2000 |month=May |pmid=10803754 |doi= 10.1097/00002281-200005000-00013|url=}}</ref> ==Historia== [[File:Jan Verkolje - Antonie van Leeuwenhoek.jpg|thumb|alt=Mwanaume aliyevaa wigi ndefu iliyojipinda, na kanzu ndefu akiwa ameketi huku akitazama nje. Mwanaume huyu ameulaza mkono wake wa kushoto mezani huku mkono wake wa kulia ukishika sanduku. Nyuma yake kuna globu|[[Antonie van Leeuwenhoek]] alieleza jinsi fuwele za asidi ya mkojo zinavyoonekana kwa hadubini mnamo mwaka wa 1679.<ref name="Pillinger"/>]] Neno''gout'' (jongo)lilitumika kwa mara ya kwanza na Randolphus wa Bocking mwaka wa 1200 a.d. Neno hili limetolewa kutoka kwa neno la Kilatini [[Latini]], ''gutta'' linalomaanisha "tone (la kiowevu).<ref name="Pillinger"/> Kulingana na kamusi ya Oxford, neno hili limetolewa kutokana na mtindo wa [[ucheshi]] na “wazo la ‘kuangusha’ kipengele cha damu kinachohusiana na ugonjwa, ndani ya na karibu na jointi”.<ref>{{cite web |url=http://www.oed.com/view/Entry/80290 |title=gout, n.1. |work=Oxford English Dictionary, Second edition, 1989 |accessdate=18 September 2011}}</ref> Watu wamekuwa wakifahamu kuhusu jongo kutoka enzi za kale. Kihistoria, jongo imejulikana kama “mfalme wa magonjwa na ugonjwa wa wafalme”<ref name=Lancet2010/><ref>Kubitz possibly has gout.{{cite web |url=http://www.forbes.com/2003/04/01/cx_cd_0401feat.html |title=The Disease Of Kings -Forbes.com |work=Forbes |accessdate=}}</ref> au “ugonjwa wa matajiri”.<ref>{{cite web|url=http://medical-dictionary.thefreedictionary.com/Rich+Man%27s+Disease |title=Rich Man's Disease - definition of Rich Man's Disease in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia |work= |accessdate=}}</ref> Rekodi za kwanza za ugonjwa huu zilitoka nchini Misri katika mwaka wa 2,600 b.c katika maelezo kuhusu ugonjwa wa athritisi ya kidole gumba cha mguu. Tabibu [[Hippocrates]] wa nchi ya kale ya [[Ugiriki ya kale|Kigiriki]], katika mwaka wa 400 b.c alidokeza kuhusu jongo katika uandishi wake wa''[[maneno mafupi ya busara]]'' na kusema kuwa jongo haikuwaathiri [[matowashi]] na wanawake wasiofikia [[kikomohedhi]].<ref name="Pillinger">{{cite journal | last=Pillinger | first=MH | coauthors=Rosenthal P, Abeles AM | title=Hyperuricemia and gout: new insights into pathogenesis and treatment | journal=Bulletin of the NYU Hospital for Joint Diseases | volume=65 | issue=3 | pages=215–221 | year=2007 | url=http://www.nyuhjdbulletin.org/Permalink.aspx?permalinkId=0c3ec9d1-8cc8-49d5-850d-4c5a55cb0669 | pmid=17922673 | access-date=2014-01-09 | archive-date=2008-12-16 | archive-url=https://web.archive.org/web/20081216114246/http://www.nyuhjdbulletin.org/Permalink.aspx?permalinkId=0c3ec9d1-8cc8-49d5-850d-4c5a55cb0669 | dead-url=yes }}</ref><ref>{{cite web|url=http://classics.mit.edu/Hippocrates/aphorisms.6.vi.html|title=The Internet Classics Archive Aphorisms by Hippocrates|work=|accessdate=July 27, 2010|archivedate=2010-07-07|archiveurl=https://web.archive.org/web/20100707154253/http://classics.mit.edu/Hippocrates/aphorisms.6.vi.html}}</ref> [[Aulus Cornelius Celsus]] (30 a.d.)alieleza uhusiano wa jongo na pombe, kutokea katika miaka ya baadaye katika wanawake na pia matatizo husishi ya figo <blockquote> Pia, mkojo mzito ulio na masimbi mazito, ni kuwa maumivu na magonjwa yatategewa kwenye sehemu ya viunga na visera... Maumivu ya viunga vya mikono na miguu hutokea mara nyingi na kudumu, kama vile katika visa vya podagra na cheirangra. Maumivu haya yaliyo nadra huwakumba towashi au vijana kabla ya ngono, au wanawake ila wale walio na hedhi iliyogandamizwa...wengine wao wamepata usalama wa muda mrefu kwa kutokunywa mvinyo, pombe ya asali na [[kujamiana | ngono]].<ref>{{cite web |url=http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/4*.html|title=LacusCurtius • Celsus — On Medicine — Book IV |work= |accessdate=}}</ref></blockquote> Katika mwaka wa 1683, tabibu wa Uingereza, [[Thomas Sydenham, ]]alielezea kuhusu kutokea kwa jongo katika saa za alfajiri na kuwaathiri wanaume wazee zaidi: <blockquote>Wagonjwa wa jongo kwa ujumla huwa wanaume wazee waliojiharibu maishani hata wakakumbwa na uzee wa mapema -walio na mitindo mbovu, ambapo hakuna mtindo mbaya unaoshinda kujihusisha na ngono ya mapema na ya kupindukia, na anasa inayoangamiza. Mwathiriwa hurejea kitandani na kulala huku akiwa buheri wa afya. Saa nane hivi za asubuhi, yeye huamshwa na uchungu sugu katika kidole gumba cha mguu; nyakati zingine katika kisigino, kifundo au wayo. Uchungu ule ni kama wa kuteguka ingawa sehemu zenye maumivu huhisi kama ambazo zilimwagiliwa maji baridi. Hali hii kisha hufuatiwa na kutetemeka na homa ndogo... Usiku huo hukeshwa kwa mateso, kukosa usingizi, kugeuzageuza sehemu iliyoumia na kujigeuzageuza kitandani; kujigeuza huku kukilingana na maumivu ya viunga vinavyouma, na kuwa kubaya zaidi pindi maradhi yanavyoendelea.<ref>{{cite web|url=http://www.bbc.co.uk/dna/h2g2/A11102491 |title=BBC - h2g2 - Gout - The Affliction of Kings |work=BBC |accessdate=July 27, 2010}}</ref></blockquote> Mwanasayansi wa Uholanzi, [[Antonie van Leeuwenhoek]], kwanza alieleza jinsi fuwele za mkojo zilivyo mnamo mwaka wa 1679.<ref name="Pillinger"/> Katika mwaka wa 1848, tabibu wa Uingereza [[Alfred Baring Garrod]] alitambua kuwa asidi hii ya ziada ya mkojo katika damu ndiyo iliyokuwa ikisababisha jongo.<ref name="pmid11600751">{{cite journal | author=Storey GD |title=Alfred Baring Garrod (1819-1907) |journal=Rheumatology (Oxford, England) |volume=40 |issue=10 |pages=1189–90|year=2001 |month=October |pmid=11600751 | url=http://rheumatology.oxfordjournals.org/cgi/content/full/40/10/1189 | doi=10.1093/rheumatology/40.10.1189}}</ref> ==Katika wanyama wengine== Njogo ni adimu sana katika wanyama wengine kwa sababu ya uwezo wao wa kutolesha [[yurikasi]]ambayo humeng’enya asidi ya mkojo.<ref name=Animals01>{{cite journal|author=Agudelo CA, Wise CM |title=Gout: diagnosis, pathogenesis, and clinical manifestations |journal=Curr Opin Rheumatol |volume=13 |issue=3|pages=234–9 |year=2001 |month=May |pmid=11333355 |doi= 10.1097/00002281-200105000-00015|url=}}</ref> Binadamu na [[sokwe wakubwa]] wengine hawana uwezo huu, jambo ambalo hufanya jongo kutokea mara nyingi.<ref name=Egg2007>{{cite journal |author=Eggebeen AT |title=Gout: an update |journal=Am Fam Physician |volume=76|issue=6 |pages=801–8 |year=2007 |month=September |pmid=17910294 |doi= |url=https://archive.org/details/sim_american-family-physician_2007-09-15_76_6/page/800}}</ref><ref name=Animals01/> Hata hivyo, sampuli ya ''[[Tyrannosaurus rex]]'' ambayo pia hujulikana kama "[[Sue (dinosaur)|Sue]]" inaaminika kuugua jongo.<ref name="Rothschild">{{cite journal | last=Rothschild | first=BM |coauthors=Tanke D, Carpenter K | title=Tyrannosaurs suffered from gout | journal=Nature | volume=387 | issue=6631 | page=357 | year=1997 |url=http://www.nature.com/nature/journal/v387/n6631/abs/387357a0.html | doi=10.1038/387357a0 | pmid=9163417 }}</ref> ==Utafiti== Aina nyingi za dawa zingali zikifanyiwa utafiti ili kutibu jongo, zikiwemo [[anakinra]], [[canakinumab]] na [[rilonacept]].<ref>{{cite web|url=http://www.musculoskeletalnetwork.com/gout/content/article/1145622/1533314 |title=New therapeutic options for gout here and on the horizon - The Journal of Musculoskeletal Medicine |work= |accessdate=}}</ref> ([[Rasburikasi]]), ambayo ni kimeng’enyi cha [[yurikasi]] cha[[DNA iliyounganishwa tena|iliyounganishwa tena]] pia inapatikana. Matibabu haya hayatumiki sana kwa sababu yanasababisha mwitikio wa [[kingamwili atomatiki]]. Aina nyingine za [[antigeni]] zinazoathiri kwa kiasi kidogo zinatengenezwa.<ref name=Egg2007/> ==Marejeo== {{Reflist|colwidth=2}} [[Jamii:Magonjwa]] 56evwvr3py8mepbmf68hkso1oo67q6c 0 70144 1578123 1517241 2026-07-02T20:51:47Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578123 wikitext text/x-wiki {{Infobox disease | Image = Blue circle for diabetes.svg | Caption = Universal blue circle symbol for diabetes.<ref>{{Rejea tovuti|title=Diabetes Blue Circle Symbol|url=http://www.diabetesbluecircle.org|date=17 March 2006|publisher=International Diabetes Federation|accessdate=2021-01-16|archiveurl=https://web.archive.org/web/20070805042346/http://www.diabetesbluecircle.org/|archivedate=2007-08-05}}</ref> | DiseasesDB = 3661 | ICD10 = {{ICD10|E|11||e|10}} | ICD9 = {{ICD9|250.00}}, {{ICD9|250.02}} | ICDO = | OMIM = 125853 | MedlinePlus = 000313 | eMedicineSubj = article | eMedicineTopic = 117853 | MeshID = D003924 }} '''Kisukari aina ya 2''', uliojulikana awali kama '''kisukari kisichotegemea insulini''' au '''kisukari kinachoanza katika utu uzima''' ni tatizo la [[umetaboli]] linalotambulika kwa [[kiwango cha juu cha glukosi katika damu]] katika muktadha wa [[kukinza insulini]] na upungufu wa [[insulini]] kwa kiasi kidogo.<ref name="Pathologic Basis of Disease"/>Hii ni kinyume na [[kisukari aina ya 1]] ambapo kuna upungufu wa insulini kufuatia kuharibika kwa [[Visiwa vya Langerhans|seli za endokrini]] katika [[kongosho]].<ref name=Green2011>{{cite book|last=Shoback|first=edited by David G. Gardner, Dolores|title=Greenspan's basic & clinical endocrinology|url=https://archive.org/details/greenspansbasicc0000unse|year=2011|publisher=McGraw-Hill Medical|location=New York|isbn=0-07-162243-8|pages=Chapter 17|edition=9th}}</ref> Dalili kuu ni [[polidipsia|kiu kingi]], [[poliuria|kukojoa kila mara]] na [[polifagia|kuhisi njaa kila wakati]]. Kisukari aina ya 2 huchangia hadi [[asilimia]] 90 ya visa vya [[kisukari]] huku asilimia 10 iliyosalia ikisababishwa na [[kisukari aina ya 1]] na [[kisukari katika ujauzito]]. [[Unene wa kupindukia]] unakisiwa kuwa kianzishi kikuu cha aina ya 2 ya kisukari katika watu wenye uhatarisho kwa sababu ya [[jeni]] zao. <!-- Matibabu--> Kisukari aina ya 2 hudhibitiwa mwanzo kwa kuongeza [[mazoezi ya mwili|mazoezi]] na [[lishe la kudhibiti kisukari|urekebishaji wa lishe]]. Ikiwa viwango vya glukosi ya damu havijapunguzwa na hatua hizo, [[dawa]] kama [[metformin]] au [[insulini]] zinaweza kuhitajika. Watu wanaotumia insulini wanahitaji kukaguliwa viwango vya [[sukari ya damu]] kila mara. <!--Prognosisi na Epidemolojia --> Viwango vya kisukari vimeongezeka katika miaka 50 iliyopita, sambamba na unene wa kupindukia. Kufikia [[mwaka]] wa [[2010]] [[watu]] karibu [[milioni]] 285&nbsp; wana kisukari ikilinganishwa na karibu watu milioni 30&nbsp; katika mwaka wa [[1985]]. Matatizo ya baadaye ya kiwango cha juu cha sukari ya damu ni pamoja na [[ugonjwa wa moyo]], [[kiharusi]], [[retinopathi ya kisukari]] inayoathiri uwezo wa kuona, [[matatizo ya figo]], hali inayoweza kuhitaji [[dialisi]], na kutozunguka vyema kwa damu viungoni kukipelekea [[kukatwa viungo]]. Matatizo makali ya [[ketoasidosisi ya kisukari|ketoasidosisi]], ambayo ni pamoja na [[ugonjwa wa aina ya 1 ya kisukari]] ni ya nadra.<ref>{{cite journal|last=Fasanmade|first=OA|coauthors=Odeniyi, IA, Ogbera, AO|title=Diabetic ketoacidosis: diagnosis and management|journal=African journal of medicine and medical sciences|date=2008 Jun|volume=37|issue=2|pages=99–105|pmid=18939392}}</ref>Hata hivyo, [[koma ya haipaosmola isiyo ya ketosisi]] inaweza kutokea. {{TOC limit|3}} ==Ishara na dalili== Dalili kuu za kisukari ni [[poliuria]] (kukojoa kila mara), [[polidipsia]] (ongezeko la kiu), [[polifagia]](ongezeko la njaa) na [[kupoteza uzito wa mwili]].<ref name=Vij2010>{{cite journal|last=Vijan|first=S|title=Type 2 diabetes|journal=Annals of internal medicine|date=2010-03-02|volume=152|issue=5|pages=ITC31–15; quiz ITC316|pmid=20194231|doi=10.1059/0003-4819-152-5-201003020-01003}}</ref> Dalili zingine zinazotambulika mara nyingi wakati wa utambuzi ni pamoja na: historia ya [[kiwaa]], [[mwasho|kujikuna]], [[niuropathia ya pembezoni]], kurejea kwa [[inflamesheni ukeni|maambukizi ya uke]] na [[uchovu (kimatibabu)|uchovu]].<!-- <ref name=Green2011/> --> Hata hivyo, watu wengi hawana dalili mwanzoni na hutambuliwa baada ya vipimo vya mara kwa mara.<!-- <ref name=Green2011/> -->Watu walio na aina ya 2 ya kisukari wanaweza kukosa [[koma ya haipaosmola isiyo ya ketosisi]] (hali ya kuwa na kiwango cha juu cha sukari ya damu inayohusishwa na [[kiwango kilichopungua cha ufahamu]] na [[hipotensheni|kiwango cha chini cha shinikizo la damu]]).<ref name=Green2011/> ===Matatizo=== Aina ya &nbsp;2&nbsp; ya kisukari kwa kawaida ni [[ugonjwa sugu]] unaohusiana na upungufu wa [[matarajio ya kuishi]] kiasi cha miaka [[kumi]]&nbsp;<ref name=Will2011/> Kwa upande mmoja, jambo hili husababishwa na matatizo yanayohusiana na kisukari ikiwa ni pamoja na: hatari ya mara mbili hadi nne ya [[ugonjwa wa moyo na mishipa]] ikijumuisha [[ugonjwa wa moyo wenye iskemia]] na [[kiharusi]], ongezeko la hadi mara 20 &nbsp; la kiwango cha kukatwa [[miguu]] na ongezeko la kulazwa [[Hospitali|hospitalini]].<ref name=Will2011/>. Katika [[nchi zilizostawi]], na sehemu zingine kwa viwango vinavyoongezeka, ugonjwa wa kisukari aina ya &nbsp;2&nbsp; ndio kisababishi kikuu zaidi cha [[upofu]] usiotokana na [[jeraha|majeraha]] na [[matatizo ya figo]].<ref name=AFP09/> Ugonjwa huu pia umehusishwa na ongezeko la hatari ya matatizo ya kiutambuzi na [[dimenshia]] kupitia kwa taratibu za magonjwa kama vile [[Ugonjwa wa Alzeheimer]] na [[dimenshia ya mishipa]].<ref>{{cite journal|last=Pasquier|first=F|title=Diabetes and cognitive impairment: how to evaluate the cognitive status?|journal=Diabetes & metabolism|date=2010 Oct|volume=36 Suppl 3|pages=S100–5|pmid=21211730|doi=10.1016/S1262-3636(10)70475-4}}</ref> Matatizo mengine ni pamoja na: [[akanthosi nigrikani]], [[uhanithi]] na [[maambukizi]] ya kila mara.<ref name=Vij2010/> ==Kisababishi== Kisukari aina ya 2 huendelezwa na mchanganyiko wa masuala ya mtindo wa [[maisha]] na jeni.<ref name=AFP09/><ref name=Fat2009>{{cite journal |author=Risérus U, [[Walter Willett|Willett WC]], Hu FB |title=Dietary fats and prevention of type 2 diabetes |journal=Progress in Lipid Research |volume=48 |issue=1 |pages=44–51 |year=2009 |month=January|pmid=19032965 |doi=10.1016/j.plipres.2008.10.002 |pmc=2654180}}</ref> Ingawa mtu binafsi anaweza kuvidhibiti baadhi ya visababishi, kama vile lishe na [[unene wa kupindukia]], vingine kama [[umri]], [[jinsia]] [[Mwanamke|ya kike]] na [[jenetikia]] haviwezi kudhibitiwa.<ref name=Will2011/> Ukosefu wa usingizi umehusishwa na kisukari aina ya 2.<ref name=Sleep2011>{{cite journal|last=Touma|first=C|coauthors=Pannain, S|title=Does lack of sleep cause diabetes?|url=https://archive.org/details/sim_cleveland-clinic-journal-of-medicine_2011-08_78_8/page/549|journal=Cleveland Clinic journal of medicine|date=2011 Aug|volume=78|issue=8|pages=549–58|pmid=21807927|doi=10.3949/ccjm.78a.10165}}</ref> Uhusiano huu unaaminika kutokea kupitia jinsi umetaboli unavyoathiriwa na ukosefu wa [[usingizi]].<ref name=Sleep2011/> Hali ya [[lishe]] ya [[mama]] wakati wa [[ujauzito]] pia inaweza kuchangia, huku utaratibu mmoja ukiwa ni kubadilika kwa [[umethili]] wa [[DNA]].<ref>{{cite journal|last=Christian|first=P|coauthors=Stewart, CP|title=Maternal micronutrient deficiency, fetal development, and the risk of chronic disease|url=https://archive.org/details/sim_journal-of-nutrition_2010-03_140_3/page/437|journal=The Journal of nutrition|date=2010 Mar|volume=140|issue=3|pages=437–45|pmid=20071652|doi=10.3945/jn.109.116327}}</ref> ===Mtindo wa maisha=== Masuala kadhaa ya kimtindo huchangia ukuaji wa aina ya 2 ya kisukari&nbsp; ikiwa ni pamoja na [[unene wa kupindukia]] (unaofafanuliwa kwa [[kigezo cha uzani wa mwili]] cha zaidi ya [[thelathini]]), ukosefu wa mazoezi, lishe duni, dhiki na [[kuishi mjini]].<ref name=Will2011/> [[Mafuta]] ya ziada [[Mwili|mwilini]] huhusishwa na asilimia 30 ya visa hivi kwa watu wenye asili ya [[China]] na [[Japani]], asilimia 60-80 kwa [[Wazungu]] na [[Waafrika]] na asilimia 100 ya [[Wahindi]] kutoka Pima na watu wanaoishi katika [[Oceania|Visiwa vya Pasifiki]].<ref name=Green2011/> Watu wasio na unene wa kupindukia wana [[uwiano wa kiuno na paja]] wa juu.<ref name=Green2011/> Masuala ya lishe pia huchangia hatari ya kupata aina ya 2 ya kisukari&nbsp;. Kutumia [[vinywaji]] vilivyo na [[sukari]] kwa wingi huhusishwa na ongezeko la hatari.<ref name=SSB2010>{{citejournal|last=Malik|first=VS|coauthors=Popkin, BM, Bray, GA, Després, JP, Hu, FB|title=Sugar Sweetened Beverages, Obesity, Type 2 Diabetes and Cardiovascular Disease risk|journal=Circulation|date=2010-03-23|volume=121|issue=11|pages=1356–64|pmid=20308626|doi=10.1161/CIRCULATIONAHA.109.876185|pmc=2862465}}</ref><ref>{{cite journal|last=Malik|first=VS|coauthors=Popkin, BM, Bray, GA, Després, JP, Willett, WC, Hu, FB|title=Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A meta-analysis|url=https://archive.org/details/sim_diabetes-care_2010-11_33_11/page/2477|journal=Diabetes Care|date=2010 Nov|volume=33|issue=11|pages=2477–83|pmid=20693348|doi=10.2337/dc10-1079|pmc=2963518}}</ref>Aina ya [[mafuta]] katika [[chakula]] pia ni muhimu, huku [[mafuta yasiyo na kifungo]] na [[mafuta yenye asidi zilizo na vifungo vingi]] yakiongeza hatari, na [[mafuta yenye vifungo vingi]] na [[mafuta yenye kifungo kimoja]] yakipunguza hatari.<ref name=Fat2009 /> Kula [[mchele mweupe]] kwa wingi pia huzidisha hatari.<ref>{{cite journal|last=Hu|first=EA|coauthors=Pan, A, Malik, V, Sun, Q|title=White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review|journal=BMJ (Clinical research ed.)|date=2012-03-15|volume=344|pages=e1454|pmid=22422870|doi=10.1136/bmj.e1454|pmc=3307808}}</ref> Ukosefu wa mazoezi unaaminika kuchangia asilimia 7 ya visa.<ref>{{cite journal|last=Lee|first=I-Min|coauthors=Shiroma, Eric J; Lobelo, Felipe; Puska, Pekka; Blair, Steven N; Katzmarzyk, Peter T|title=Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy|journal=The Lancet|date=1 July 2012|doi=10.1016/S0140-6736(12)61031-9}}</ref> ===Jenetikia=== Visa vingi vya kisukari huhusisha jeni nyingi huku kila [[moja]] ikichangia sehemu ndogo ya uwezekano wa kuwa na aina ya 2 ya kisukari.<ref name=Will2011/> Ikiwa mmoja wa [[pacha wanaofanana]] ana kisukari, uwezekano wa yule mwingine kupata ugonjwa huu maishani ni zaidi ya asilimia 90, ilhali kiwango katika pacha wasiofanana ni asilimia 25-50.<ref name=Green2011/> Kufikia mwaka wa [[2011]], zaidi ya [[jeni]] 36 zinazochangia hatari ya kupata aina ya 2 ya kisukari zimetambuliwa.<ref name=Genetic2011>{{cite journal|last=Herder|first=C|coauthors=Roden, M|title=Genetics of type 2 diabetes: pathophysiologic and clinical relevance|journal=European journal of clinical investigation|date=2011 Jun|volume=41|issue=6|pages=679–92|pmid=21198561|doi=10.1111/j.1365-2362.2010.02454.x}}</ref> Jeni hizo kwa pamoja huchangia asilimia 10 tu ya vipengele vya ugonjwa huu vinavyoweza kurithiwa.<!-- <ref name=Genetic2011/> -->Kwa mfano, [[aleli]] ya [[TCF7L2]] huongeza hatari ya kupata kisukari kwa mara 1.5&nbsp;na ndiyo hatari zaidi ya aina nyingi za kijeni.<!-- <ref name=Green2011/> --> Jeni nyingi zinazohusishwa na kisukari huusika katika utendakazi wa seli za beta.<ref name=Green2011/> Kuna aina chache za kisukari zinazotokea kufuatia tatizo katika jeni moja (hali inayojulikana kama aina za [[tatizo la kijeni|la jeni moja]] za kisukari au [[Kisukari #Aina_nyingine|"Aina maalumu za kisukari"]]).<ref name=Green2011/><ref name=Will2011/> Hii ni pamoja na [[kisukari cha watu wachanga]], [[sindromu ya Donohue]] na [[Sindromu ya Rabson-Mendenhall]] na nyinginezo.<ref name=Will2011/> Kisukari cha watoto wachanga huchangia asilimia 1-5 ya matukio yote ya kisukari katika watoto wachanga.<ref>{{cite news|first=|last=|coauthors=|title=Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-onset Diabetes of the Young|date=|publisher=National Institute of Diabetes and Digestive and Kidney Diseases, NIH|url=http://www.diabetes.niddk.nih.gov/dm/pubs/mody/|work=National Diabetes Information Clearinghouse (NDIC)|accessdate=2008-08-04|archiveurl=https://web.archive.org/web/20080704103703/http://diabetes.niddk.nih.gov/dm/pubs/mody/|archivedate=2008-07-04}}</ref> ===Hali za kimatibabu=== Kuna aina kadhaa za matibabu na matatizo mengine ya [[afya]] yanayoweza kusababisha kisukari.<ref name=BookDM2008>{{cite book|last=Bethel|first=edited by Mark N. Feinglos, M. Angelyn|title=Type 2 diabetes mellitus : an evidence-based approach to practical management|year=2008|publisher=Humana Press|location=Totowa, NJ|isbn=978-1-58829-794-5|page=462|url=http://books.google.ca/books?id=NctBmHUOV7AC&pg=PA462}}</ref> Baadhi ya matibabu hayo ni: [[glukokotikoidi]], [[thiasidi]], [[vizuia beta]], [[dawa maalum za kutibu saikosisi]],<ref>{{cite journal|last=Izzedine|first=H|coauthors=Launay-Vacher, V, Deybach, C, Bourry, E, Barrou, B, Deray, G|title=Drug-induced diabetes mellitus|journal=Expert opinion on drug safety|date=2005 Nov|volume=4|issue=6|pages=1097–109|pmid=16255667|doi=10.1517/14740338.4.6.1097}}</ref> na [[statini]].<ref>{{cite journal|last=Sampson|first=UK|coauthors=Linton, MF, Fazio, S|title=Are statins diabetogenic?|journal=Current opinion in cardiology|date=2011 Jul|volume=26|issue=4|pages=342–7|pmid=21499090|doi=10.1097/HCO.0b013e3283470359|pmc=3341610}}</ref> Watu ambao wamekuwa na [[kisukari katika ujauzito]] wako katika hatari kubwa zaidi ya kupata aina ya 2 ya kisukari.<ref name=Vij2010/>Matatizo mengine ya kiafya yanayohusishwa ni pamoja na: [[akromegali]], [[Sindromu ya Chushing]], [[uthiroidi]], [[fekromositoma]] na baadhi ya aina za [[saratani]] kama vile [[glukagonoma]].<ref name=BookDM2008/> Upungufu wa [[testosteroni]] pia unahusishwa na aina ya 2 ya kisukari.<ref name=pmid19444934>{{cite journal |author=Saad F, Gooren L|title=The role of testosterone in the metabolic syndrome: a review |journal=The Journal of Steroid Biochemistry and Molecular Biology |volume=114 |issue=1–2 |pages=40–3 |year=2009 |month=March |pmid=19444934|doi=10.1016/j.jsbmb.2008.12.022}}</ref><ref name=pmid18832284>{{cite journal |author=Farrell JB, Deshmukh A, Baghaie AA |title=Low testosterone and the association with type 2 diabetes |journal=The Diabetes Educator |volume=34 |issue=5|pages=799–806 |year=2008 |pmid=18832284 |doi=10.1177/0145721708323100}}</ref> ==Pathofisiolojia== Aina ya 2 ya kisukari inasababishwa na upungufu katika uzalishaji wa insulini kutoka kwa [[seli za beta]] katika kuanzisha [[kukinza insulini]].<ref name=Green2011/> Kukinza insulini, ambako ni hali ya [[seli]] kutoweza kuitikia vyema kwa viwango vya kawaida vya insulini, hutokea hasa katika [[misuli]], [[ini]] na [[tishu]] zenye mafuta.<ref>{{cite book|title=Diabetes mellitus a guide to patient care.|year=2007|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-58255-732-8|page=15|url=http://books.google.ca/books?id=fiAclxvKblkC&pg=PA15}}</ref>Kwa kawaida, insulini hukandamiza uzalishaji wa glukosi ndani ya ini. Hata hivyo, katika ukinzani wa insulini, ini huzalisha glukosi ndani ya damu isivyohitajika.<ref name=Will2011/> Uwiano kati ya ukinzani wa insulini na utendakazi mbaya wa seli za beta hutofautiana kati ya watu walio na ukinzani wa kimsingi wa insulini na tatizo dogo la utoaji insulini, ikilinganishwa na watu walio na ukinzani mdogo wa insulini lakini hawawezi kuzalisha insulini.<ref name=Green2011/> Taratibu nyingine muhimu zinazohusishwa na aina ya 2 ya kisukari na ukinzani wa insulini ni pamoja na: ongezeko la kumeng’enya [[mafuta]] katika [[seli za mafuta]], ukinzani na ukosefu wa [[inkretini]], kiwango cha juu cha [[glukagoni]] katika damu, ongezeko la kuhifadhi [[chumvi]] na [[maji]] katika figo na pia [[mfumo mkuu wa neva]] kudhibiti umetaboli vibaya.<ref name=Will2011/> Hata hivyo, si watu wote walio na ukinzani wa insulini wanaopata kisukari, kwani hitilafu za seli za beta kwenye kongosho kutoa insulini pia huhitajika.<ref name=Green2011/> ==Utambuzi== [[Shirika la Afya Duniani]] linafasili kisukari (aina ya 1 na 2) kama kipimo kimoja zaidi cha glukosi iliyo na dalili au vipimo vilivyopanda katika visa viwili:<ref name=who-99>{{Rejea tovuti|url=http://www.who.int/diabetes/publications/en/ |author=World Health Organization |title=Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO Consultation. Part 1. Diagnosis and classification of diabetes mellitus |accessdate=29 May 2007}}</ref> * fasting plasma glucose ≥ 7.0&nbsp;mmol/l (126&nbsp;mg/dl) * with a [[glucose tolerance test]], two hours after the oral dose a plasma glucose ≥ 11.1&nbsp;mmol/l (200&nbsp;mg/dl) Mbinu nyingine ya kutambua kisukari ni kuchukua vipimo mbalimbali vya sukari ya damu vya zaidi ya 11.1&nbsp;mmol/l (200&nbsp;mg/dL) huku vikilinganishwa na dalili za kawaida <ref name=Vij2010/> au pia kipimo cha [[himoglobini iliyo na glukojeni]] (HbA_1c) cha zaidi ya asilimia 6.5.<ref name=Will2011/> Mnamo mwaka wa 2009, Kamati ya Kimataifa ya Wataalamu iliyojumuisha wawakilishi kutoka Shirika la Kisukari la Amerika, Kongamano la Kimataifa la Kisukari na Shirika la Masomo ya Kisukari la bara [[Uropa]] ilipendekeza kizingiti cha asilimia ≥6.5 HbA_1ckitumiwe kutambua kisukari.<!-- <ref name=Expert2009/> -->Pendekezo hili lilipitishwa na Shirika la Kisukari la Marekani mwaka wa 2010.<ref>{{cite journal|author= |title=Diagnosis and classification of diabetes mellitus |journal=Diabetes Care |volume=33 Suppl 1 |issue= Supplement_1|pages=S62–9 |year=2010 |month=January |pmid=20042775 |pmc=2797383 |doi=10.2337/dc10-S062 |url= |last1= American Diabetes |first1= Association}}</ref> Vipimo vinafaa kurudiwa iwapo mtu atatambulika kuwa na kisukari, isipokuwa ana dalili za kawaida na sukari ya damu ya >11.1&nbsp;mmol/l (>200&nbsp;mg/dl).<ref name=Expert2009>{{cite journal|last=International Expert|first=Committee|title=International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes|url=https://archive.org/details/sim_diabetes-care_2009-07_32_7/page/1327|journal=Diabetes Care|date=2009 Jul|volume=32|issue=7|pages=1327–34|pmid=19502545|doi=10.2337/dc09-9033|pmc=2699715}}</ref> Kizingiti cha kutambua kisukari hutegemea uhusiano kati ya matokeo ya vipimo vya kubaini uwezo wa kustahimili glukosi, mfungo wa glukosi au HbA_1cna matatizo kama [[retinopathia|matatizo ya retinali]].<ref name=Will2011/> Mfungo au vipimo mbalimbali vya sukari ya damu hupendekezwa kuliko kipimo cha kubaini uwezo wa kustahimili glukosi kwani vipimo hivi ni bora zaidi kwa watu.<ref name=Will2011/>HbA_1cni bora zaidi kwa sababu mfungo hauhitajiki, na matokeo yake huwa dhabiti lakini ni ghali kuliko kipimo cha glukosi ya damu.<ref>{{cite journal |author=|title=Diagnosis and classification of diabetes mellitus |journal=Diabetes Care |volume=35 Suppl 1 |issue=|pages=S64–71 |year=2012 |month=January |pmid=22187472 |doi=10.2337/dc12-s064 |url= |last1= American Diabetes |first1= Association}}</ref>Inakadiriwa kuwa karibu watu asilimia 20 walio na kisukari nchini Marekani hawajatambua kuwa wana ugonjwa huu.<ref name=Will2011/> Aina ya 2 ya kisukari hutambulika kwa kiwango cha juu cha glukosi kwenye damu katika muktadha wa [[ukinzani wa insulini]] kwa kukilinganisha na upungufu wa [[insulini]].<ref name="Pathologic Basis of Disease">{{Rejea kitabu | author=Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Cotran, Ramzi S. ; Robbins, Stanley L. | authorlink= | title=Robbins and Cotran Pathologic Basis of Disease | year=2005| edition=7th| publisher=Saunders | location=Philadelphia, Pa. | isbn=0-7216-0187-1|pages=1194–1195}}</ref>Hii hailingani na [[Hii ni tofauti na[[aina ya 1 ya kisukari]], ambapo kuna upungufu mkuu wa insulini unaosababishwa na kuharibika kwa [[visiwa vya Langherns| seli za endokrini]] ndani ya [[kongosho]] na [[kisukari wakati wa ujauzito]], ambacho ni kuanza upya kwa kiwango cha juu cha sukari ya damu katika ujauzito. <ref name="Green2011"/> Aina ya 1 ya kisukari inaweza kutofautishwa na ya 2 kwa msingi wa hali zilisababisha ugonjwa wenyewe.<ref name=Expert2009/>Ikiwa utambuzi hauaminiki, vipimo vya [[antibodi]] vinaweza kusaidia kudhibitisha aina ya 1 ya kisukari, ilhali viwango vya [[peptidi ya C]] vinaweza kudhibitisha aina ya 2.<ref>{{cite book|title=Diabetes mellitus a guide to patient care.|year=2007|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-58255-732-8|page=201|url=http://books.google.ca/books?id=fiAclxvKblkC&pg=PA201}}</ref> ==Uchunguzi bainifu== Hakuna shirika lolote kuu linalopendekeza ubia wa uchunguzi bainifu wa kisukari kwani hakuna ushahidi kuwa hatua hii huboresha matokeo.<ref name=Screen09>{{cite journal |author=Valdez R |title=Detecting Undiagnosed Type 2 Diabetes: Family History as a Risk Factor and Screening Tool |journal=J Diabetes Sci Technol |volume=3 |issue=4 |pages=722–6|year=2009 |pmid=20144319 |pmc=2769984 |doi= |url=}}</ref> Uchunguzi bainifu umependekezwa na [[Tume ya Marekani ya Huduma za Kinga]] kwa watu wazima wasio na dalili huku wakiwa na [[shinikizo la damu]] la zaidi ya 135/80&nbsp;mmHg.<ref name=US08>{{cite web |url=http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiab.htm |title=Screening: Type 2 Diabetes Mellitus in Adults |year=2008 |work=U.S. Preventive Services Task Force |accessdate= |archiveurl=https://web.archive.org/web/20140207214318/http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiab.htm |archivedate=2014-02-07 }}</ref> Ushahidi hautoshi kupendekeza au kutopendekeza uchunguzi kwa watu walio na kipimo cha chini cha shinikizo la damu.<ref name=US08/> [[Shirika la Afya Duniani]] linapendekeza vipimo kwa watu walio katika hatari kubwa pekee.<ref name=Screen09/> Vikundi vilivyo katika hatari kubwa Marekani ni pamoja na: watu wa umri wa zaidi ya miaka 45&nbsp;walio na [[jamaa wa kiwango cha kwanza]] aliye na kisukari, koo maalumu kama vile Wahispania Wamarekani, Wamarekani wa asili ya Kiafrika na Wamarekani asilia, watu walio na historia ya [[kisukari wakati wa ujauzito]], [[sindromu ya uvimbe wa ovari]], unene wa kupindukia na hali zinazohusishwa na [[sindromu ya umetaboli]].<ref name="Vij2010" /> ==Kinga== Mwanzo wa aina ya 2 ya kisukari unaweza kukawishwa au kuzuiliwa kwa lishe bora na mazoezi.<ref>{{cite journal|author=Raina Elley C, Kenealy T |title=Lifestyle interventions reduced the long-term risk of diabetes in adults with impaired glucose tolerance |journal=Evid Based Med |volume=13 |issue=6 |pages=173 |year=2008 |month=December|pmid=19043031 |doi=10.1136/ebm.13.6.173 }}</ref><ref>{{cite journal |author=Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roqué I Figuls M, Richter B, Mauricio D |title=Exercise or exercise and diet for preventing type 2 diabetes mellitus|journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD003054 |year=2008 |pmid=18646086|doi=10.1002/14651858.CD003054.pub3 |url= |editor1-last=Mauricio |editor1-first=Didac}}</ref> Kuzingatia mtindo bora kunaweza kupunguza hatari kwa zaidi ya nusu.<ref name=AFP09/> Manufaa ya mazoezi hutokea bila kuzingatia uzito wa awali au wa baadaye wa mtu.<ref>{{cite journal|last=O'Gorman|first=DJ|coauthors=Krook, A|title=Exercise and the treatment of diabetes and obesity|url=https://archive.org/details/sim_medical-clinics-of-north-america_2011-09_95_5/page/953|journal=The Medical clinics of North America|date=2011 Sep|volume=95|issue=5|pages=953–69|pmid=21855702|doi=10.1016/j.mcna.2011.06.007}}</ref>Hata hivyo, ithibati za manufaa ya kubadilisha lishe ni haba,<ref>{{cite journal |author=Nield L, Summerbell CD, Hooper L, Whittaker V, Moore H |title=Dietary advice for the prevention of type 2 diabetes mellitus in adults |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD005102 |year=2008 |pmid=18646120 |doi=10.1002/14651858.CD005102.pub2 |url=|editor1-last=Nield |editor1-first=Lucie}}</ref> huku kukiwa na ithibati lishe lililo na mboga<ref>{{cite journal|last=Carter|first=P|coauthors=Gray, LJ, Troughton, J, Khunti, K, Davies, MJ|title=Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis|journal=BMJ (Clinical research ed.)|date=2010-08-18|volume=341|pages=c4229|pmid=20724400|doi=10.1136/bmj.c4229|pmc=2924474}}</ref>na pia kupunguza vinywaji vilivyo na sukari nyingi.<ref name=SSB2010/>Kwa watu walio na [[matatizo ya kustahimili glukosi]], lishe na mazoezi pekee au pamoja na dawa ya [[metformin]] au [[acarbose]] zinaweza kupunguza hatari ya kupata kisukari.<ref name=AFP09/><ref name=AHRQ05>{{cite journal |author=Santaguida PL, Balion C, Hunt D, ''et al.'' |title=Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose |journal=Evid Rep Technol Assess (Summ) |issue=128 |pages=1–11 |year=2005 |month=August |pmid=16194123 |url=http://www.ahrq.gov/downloads/pub/evidence/pdf/impglucose/impglucose.pdf |format=PDF |access-date=2014-01-09 |archive-date=2008-09-10 |archive-url=https://web.archive.org/web/20080910035155/http://www.ahrq.gov/downloads/pub/evidence/pdf/impglucose/impglucose.pdf |dead-url=yes |=https://web.archive.org/web/20080910035155/http://www.ahrq.gov/downloads/pub/evidence/pdf/impglucose/impglucose.pdf }}</ref>Mikakati ya mtindo wa maisha ni bora kuliko metformin.<ref name=AFP09/> ==Udhibiti== Udhibiti wa aina ya 2 ya kisukari huzingatia mikakati ya mtindo wa maisha, kupunguza hatari za magonjwa ya moyo na mishipa na kudumisha viwango vya kawaida vya glukosi ya damu.<ref name=AFP09>{{cite journal |author=Ripsin CM, Kang H, Urban RJ|title=Management of blood glucose in type 2 diabetes mellitus |journal=Am Fam Physician |volume=79 |issue=1|pages=29–36 |year=2009 |month=January |pmid=19145963 |doi= |url=}}</ref> Ufuatilizi wa kibinafsi wa glukosi ya damu kwa watu waliotambulika na aina ya 2 ya kisukari kwa mara ya kwanza ulipendekezwa na [[Huduma ya Afya ya Kitaifa]] ya Uingereza mwaka wa 2008,<ref>{{Rejea tovuti|title=Clinical Guideline:The management of type 2 diabetes (update)|url=http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11983|accessdate=2014-01-09|archivedate=2013-12-16|archiveurl=https://web.archive.org/web/20131216023110/http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11983}}</ref> Hata hivyo, manufaa ya ufuatilizi wa kibinafsi kwa watu wasiotumia insulini ya vipimo vingi sio bayana .<ref name=AFP09/><ref>{{cite journal|last=Farmer|first=AJ|coauthors=Perera, R, Ward, A, Heneghan, C, Oke, J, Barnett, AH, Davidson, MB, Guerci, B, Coates, V, Schwedes, U, O'Malley, S|title=Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes.|journal=BMJ (Clinical research ed.)|date=2012 Feb 27|volume=344|pages=e486|pmid=22371867}}</ref> Kudhibiti vipengele vingine vya hatari za moyo na mishipa kama vile [[shinikizo la juu la damu]], [[kiwango cha juu cha kolesteroli]] na [[mikrolubuminuari]] huongeza miaka ambayo mtu anatarajiwa kuishi.<ref name=AFP09/>Udhibiti wa kina wa shinikizo la damu (chini ya 130/80 mmHg) ikilinganishwa na udhibiti wa kawaida (chini ya 140-160/ 85-100 mmHg) huchangia upungufu mdogo wa hatari, lakini hauathiri hatari ya kijumla ya kifo.<ref>{{cite journal|last=McBrien|first=K|coauthors=Rabi, DM; Campbell, N; Barnieh, L; Clement, F; Hemmelgarn, BR; Tonelli, M; Leiter, LA; Klarenbach, SW; Manns, BJ|title=Intensive and Standard Blood Pressure Targets in Patients With Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis.|journal=Archives of internal medicine|date=2012 Aug 6|pages=1-8|pmid=22868819}}</ref> Upungufu wa sukari ya damu (HbA1C<6%) kinyume na upungufu wa kawaida wa sukari ya damu (HbA1C ya asilimia 7 -7.9) hauonekani kubadilisha idadi ya vifo.<ref>{{cite journal|last=Boussageon|first=R|coauthors=Bejan-Angoulvant, T, Saadatian-Elahi, M, Lafont, S, Bergeonneau, C, Kassaï, B, Erpeldinger, S, Wright, JM, Gueyffier, F, Cornu, C|title=Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials|journal=BMJ (Clinical research ed.)|date=2011-07-26|volume=343|pages=d4169|pmid=21791495|doi=10.1136/bmj.d4169|pmc=3144314}}</ref><ref>{{cite journal|last=Webster|first=MW|title=Clinical practice and implications of recent diabetes trials|journal=Current opinion in cardiology|date=2011 Jul|volume=26|issue=4|pages=288–93|pmid=21577100|doi=10.1097/HCO.0b013e328347b139}}</ref> Lengo la matibabu kwa kawaida ni HbA1C ya chini ya asilimia 7 au glukosi ya mfungo ya chini ya 6.7&nbsp;mmol/L (120&nbsp;mg/dL). Hata hivyo malengo haya yanaweza kubadilishwa baada ya ushauri wa kitaalamu huku ukizingatia hatari maalumu za [[hipoglisemia]] na matarajio ya urefu wa maisha.<ref name=Vij2010/> Inapendekezwa kila mtu aliye na aina ya 2 ya kisukari apate uchunguzi wa [[kiofthamolojia|ofthamolojia]]<ref name=Green2011/> ===Mtindo wa maisha=== Lishe bora na mazoezi ndio msingi wa kudhibiti kisukari<ref name=Vij2010/>huku mazoezi mengi yakileta matokeo bora zaidi.<ref name=Exercise10>{{cite journal |author=Zanuso S, Jimenez A, Pugliese G, Corigliano G, Balducci S |title=Exercise for the management of type 2 diabetes: a review of the evidence |journal=Acta Diabetol|volume=47 |issue=1 |pages=15–22 |year=2010 |month=March |pmid=19495557 |doi=10.1007/s00592-009-0126-3 |url=}}</ref>[[Mazoezi ya kipumzi]] huchangia upungufu wa HbA1C na kuboresha kiwango cha usikivu dhidi ya insulini.<ref name=Exercise10/> [[Mazoezi ya kuinua uzani]] pia husaidia huku matokeo bora yakitarajiwa kwa kujumulisha aina zote mbili za mazoezi.<ref name=Exercise10/> [[Lishe la kudhibiti kisukari]] linaoimarisha uzito wa chini wa mwili ni muhimu.<ref name=Diet09/>Ingawa kuna utata kuhusu aina ya lishe mwafaka katika kuboresha matokeo, <ref name=Diet09>{{cite journal |author=Davis N, Forbes B, Wylie-Rosett J |title=Nutritional strategies in type 2 diabetes mellitus |journal=Mt. Sinai J. Med. |volume=76 |issue=3 |pages=257–68 |year=2009 |month=June|pmid=19421969 |doi=10.1002/msj.20118 |url=}}</ref>[[lishe lenye kielezo cha chini cha glisemia]] limetambulika kuboresha udhibiti wa sukari ya damu.<ref>{{cite journal |author=Thomas D, Elliott EJ |title=Low glycaemic index, or low glycaemic load, diets for diabetes mellitus |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD006296 |year=2009 |pmid=19160276|doi=10.1002/14651858.CD006296.pub2 |url= |editor1-last=Thomas |editor1-first=Diana}}</ref>Elimu bora kwa kawaida inaweza kusaidia watu walio na aina ya 2 ya kisukari kudhibiti kiwango cha sukari ya damu, hadi angalau miezi sita.<ref>{{Rejea jarida | last1 = Hawthorne | first1 = K. | last2 = Robles | first2 = Y. | last3 = Cannings-John |first3 = R. | last4 = Edwards | first4 = A. G. K. | last5 = Robles | first5 = Yolanda | title =Masomo ya utamaduni ya afya inayofaa ya watu walio na aina 2 ya kisukari katika vikundi vidogo vya kabila | journal = Cochrane Database Syst Rev | year = 2008 | pages = CD006424 | issue = 3 | id = CD006424 | pmid = 18646153 | doi = 10.1002/14651858.CD006424.pub2 |editor1-last = Robles | editor1-first = Yolanda}}</ref>Ikiwa mabadiliko ya kimienendo katika watu wenye kisukari kidogo hayajaboresha viwango vya sukari ya damu katika wiki sita, matibabu yanafaa kupendekezwa.<ref name=Vij2010/> ===Matibabu=== Kuna aina kadhaa za [[dawa za kukabiliana na kisukari]]. [[Metformin]] inapendekezwa kijumla kama matibabu ya kwanza, kwani kuna ithibati kuwa inapunguza [[idadi]] ya [[Kifo|vifo]].<ref name=AFP09/> Kikolezi cha pili cha mdomoni cha aina nyingine kinaweza kutumika ikiwa metformin haitoshi. <ref>{{cite journal|last=Qaseem|first=A|coauthors=Humphrey, LL, Sweet, DE, Starkey, M, Shekelle, P, Clinical Guidelines Committee of the American College of, Physicians|title=Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline from the American College of Physicians|url=https://archive.org/details/sim_annals-of-internal-medicine_2012-02-07_156_3/page/218|journal=Annals of internal medicine|date=2012-02-07|volume=156|issue=3|pages=218–31|pmid=22312141|doi=10.1059/0003-4819-156-3-201202070-00011}}</ref>Aina nyingine ya dawa ni pamoja na: [[salfonilurea]], [[vichochezi visivyo vya salfonilurea]], [[vizuizi vya alfa glukosidesi]], [[thiasolidinedionesi]], [[analogi ya peptidi-1 inayofanana na glucagon]] na [[vizuizi vya peptidase-4 ya dipeptidili]].<ref name=AFP09/><ref>{{cite journal |author= |title=Standards of medical care in diabetes--2012|journal=Diabetes Care |volume=35 Suppl 1 |issue= |pages=S11–63 |year=2012 |month=January |pmid=22187469|doi=10.2337/dc12-s011 |url= |last1= American Diabetes |first1= Association}}</ref> Metformin haifai kutumiwa na watu walio na matatizo sugu ya figo au ini.<ref name=Vij2010/> [[Sindano]] za [[insulini]] zinaweza kutumiwa pekee au pamoja na dawa za kumeza.<ref name=AFP09/> Watu wengi mwanzoni hawahitaji [[insulini]].<ref name=Green2011/> Insulini inapotumiwa, muundo wa kudumu kwa kawaida huongezwa usiku, huku dawa za kumeza zikiendelea kutumika.<ref name=Vij2010/><ref name=AFP09/>Vipimo kisha huongezwa hadi kuleta manufaa (viwango vya sukari ya damu vikidhibitiwa vyema).<ref name=AFP09/> Iwapo insulini ya usiku haitoshi, insulini ya mara mbili kwa siku inaweza kuleta udhibiti bora.<ref name=Vij2010/> Insulini za kudumu, [[insulini ya glargine|glargine]] na [[insulin ya detemir|detemir]] hazionekani kuwa bora kuliko neutral protamine Hagedorn [[insulini ya NPH | insulini (NPH)]] lakini ni ghali sana kutengeneza, na kufikia mwaka wa 2010 gharama yake ilikuwa juu.<ref>{{cite journal|last=Waugh|first=N|coauthors=Cummins, E, Royle, P, Clar, C, Marien, M, Richter, B, Philip, S|title=Newer agents for blood glucose control in type 2 diabetes: systematic review and economic evaluation|journal=Health technology assessment (Winchester, England)|date=2010 Jul|volume=14|issue=36|pages=1–248|pmid=20646668|doi=10.3310/hta14360}}</ref> Insulini ndiyo chaguo la tiba kwa [[wajawazito]].<ref name=Vij2010/> ===Upasuaji=== [[Upasuaji]] [[wa kupunguza uzito wa mwili]] ni hatua bora ya kutibu kisukari kwa watu wanene kupita kiasi.<ref>{{cite journal|last=Picot|first=J|coauthors=Jones, J, Colquitt, JL, Gospodarevskaya, E, Loveman, E, Baxter, L, Clegg, AJ|title=The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation|journal=Health technology assessment (Winchester, England)|date=2009 Sep|volume=13|issue=41|pages=1–190, 215–357, iii–iv|pmid=19726018|doi=10.3310/hta13410}}</ref>Wengi wao huweza kudumisha viwango vya kawaida vya sukari ya damu kwa kutumia kiasi kidogo cha dawa au kutotumia matibabu yoyote baada ya upasuaji,<ref>{{cite journal|last=Frachetti|first=KJ|coauthors=Goldfine, AB|title=Bariatric surgery for diabetes management|journal=Current opinion in endocrinology, diabetes, and obesity|date=2009 Apr|volume=16|issue=2|pages=119–24|pmid=19276974|doi=10.1097/MED.0b013e32832912e7}}</ref> hivyo idadi ya muda mrefu ya vifo hupungua.<ref name=Schum2009/> Hata hivyo, kuna hatari ya muda mfupi ya chini ya asilimia 1, ya kufa kutokana na upasuaji.<ref>{{cite journal|last=Colucci|first=RA|title=Bariatric surgery in patients with type 2 diabetes: a viable option|journal=Postgraduate Medicine|date=2011 Jan|volume=123|issue=1|pages=24–33|pmid=21293081|doi=10.3810/pgm.2011.01.2242}}</ref> Kizingiti cha [[kielezo cha uzani wa mwili]] cha wakati mwafaka wa upasuaji hakijulikani vyema.<ref name=Schum2009>{{cite journal|last=Schulman|first=AP|coauthors=del Genio, F, Sinha, N, Rubino, F|title="Metabolic" surgery for treatment of type 2 diabetes mellitus|journal=Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists|date=2009 Sep-Oct|volume=15|issue=6|pages=624–31|pmid=19625245|doi=10.4158/EP09170.RAR}}</ref>Hata hivyo, inapendekezwa kuwa chaguo hili lizingatiwe kwa watu wasioweza kudhibiti uzito na sukari ya damu.<ref>{{cite journal|last=Dixon|first=JB|coauthors=le Roux, CW; Rubino, F; Zimmet, P|title=Bariatric surgery for type 2 diabetes.|url=https://archive.org/details/sim_the-lancet_june-16-22-2012_379_9833/page/2300|journal=Lancet|date=2012 Jun 16|volume=379|issue=9833|pages=2300-11|pmid=22683132}}</ref> ==Epidemolojia== [[File:Diabetes world map - 2000.svg|thumb|250px|Uenezi wa kisukari ulimwenguni mwaka wa 2000 (kwa kila watu 1000). [[Wastani]] ulikuwa asilimia 2.8 duniani. {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|≤&nbsp;7.5}} {{legend|#fff200|7.5–15}} {{legend|#ffdc00|15–22.5}} {{legend|#ffc600|22.5–30}} {{legend|#ffb000|30–37.5}} {{legend|#ff9a00|37.5–45}} {{Multicol-break}} {{legend|#ff8400|45–52.5}} {{legend|#ff6e00|52.5–60}} {{legend|#ff5800|60–67.5}} {{legend|#ff4200|67.5–75}} {{legend|#ff2c00|75–82.5}} {{legend|#cb0000|≥&nbsp;82.5}} {{Multicol-end }} ]] Kote ulimwenguni, kufikia mwaka wa 2010, ilikadiriwa kuwa watu milioni 285&nbsp;walikuwa na aina ya 2 ya kisukari, hii ikiwa karibu asilimia 90 ya matukio haya.<ref name=Will2011>{{cite book|title=Williams textbook of endocrinology.|year=2011|url=https://archive.org/details/williamstextbook00melm_993|publisher=Elsevier/Saunders|location=Philadelphia|isbn=978-1-4377-0324-5|pages=[https://archive.org/details/williamstextbook00melm_993/page/n1365 1371]–1435|edition=12th}}</ref>Hii ni sawa na takriban asilimia 6 ya watu wazima duniani.<ref name=Mee2007>{{cite journal|last=Meetoo|first=D|coauthors=McGovern, P, Safadi, R|title=An epidemiological overview of diabetes across the world|url=https://archive.org/details/sim_british-journal-of-nursing_september-13-26-2007_16_16/page/1002|journal=British journal of nursing (Mark Allen Publishing)|date=2007 Sep 13-27|volume=16|issue=16|pages=1002–7|pmid=18026039}}</ref> Kisukari hupatikana sana katika [[mataifa yaliyostawi|yaliyostawi]] na [[mataifa yanayostawi]].<ref name=Will2011/>Hata hivyo, ugonjwa huu ni nadra katika mataifa maskini.<ref name=Green2011/> Wanawake na vikundi maalumu vya kikabila wanaonekana kuwa katika hatari kuu zaidi <ref name=Will2011/><ref>{{cite journal |author=Abate N, Chandalia M |title=Ethnicity and type 2 diabetes: focus on Asian Indians |journal=J. Diabetes Complicat. |volume=15|issue=6 |pages=320–7 |year=2001 |pmid=11711326 |doi= 10.1016/S1056-8727(01)00161-1|url=}}</ref>kama vile [[makabila ya Asia ya Kusini|Waasia wa Kusini]], [[Watu wa kisiwa cha Pasifiki]], [[Walatino]] na [[Wamarekani wa kiasili|Wamarekani asilia]].<ref name=Vij2010/>Hali hii inaweza kusababishwa na kuiga [[mienendo ya Ulaya]] katika baadhi ya makabila.<ref>{{cite journal|last=Carulli|first=L|coauthors=Rondinella, S, Lombardini, S, Canedi, I, Loria, P, Carulli, N|title=Review article: diabetes, genetics and ethnicity|journal=Alimentary pharmacology & therapeutics|date=2005 Nov|volume=22 Suppl 2|pages=16–9|pmid=16225465|doi=10.1111/j.1365-2036.2005.02588.x}}</ref> Ingawa kisukari kilidhaniwa kuwa ugonjwa wa watu wazima, aina ya 2 ya kisukari inazidi kutambuliwa katika watoto walio na [[unene wa kupindukia wa watoto|unene wa kupindukia]].<ref name=Will2011/>Aina ya 2 ya kisukari sasa inatambuliwa mara nyingi sawa na aina ya 1 katika vijana baleghe wa Marekani.<ref name=Green2011/> Viwango vya kisukari mwaka wa 1985 vilikadiriwa kuwa milioni 30&nbsp;vikiongezeka hadi milioni 135&nbsp;mwaka wa 1995 na milioni 217&nbsp;mwaka wa 2005.<ref name=Epi2006>{{cite journal|last=Smyth|first=S|coauthors=Heron, A|title=Diabetes and obesity: the twin epidemics|journal=Nature Medicine|date=2006 Jan|volume=12|issue=1|pages=75–80|pmid=16397575|doi=10.1038/nm0106-75}}</ref>Ongezeko hili linaaminika kusababishwa na kuongezeka kwa watu wazee ulimwenguni, upungufu wa kufanya mazoezi na kuongezeka kwa viwango vya unene wa kupindukia.<ref name=Epi2006/>Nchi tano zilizo na idadi kubwa ya watu walio na kisukari kufikia mwaka wa 2000 ni India, ikiwa na milioni 31.7&nbsp;, China milioni 20.8&nbsp;, Marekani milioni 17.7&nbsp;, Indonesia milioni 8.4 &nbsp; na Japani milioni 6.8&nbsp;.<ref name = "Wild 2004">{{cite journal |author=Wild S, Roglic G, Green A, Sicree R, King H |title=Global prevalence of diabetes: estimates for the year 2000 and projections for 2030 |journal=Diabetes Care |volume=27 |issue=5|pages=1047–53 |year=2004 |month=May |pmid=15111519|doi= 10.2337/diacare.27.5.1047|url=https://archive.org/details/sim_diabetes-care_2004-05_27_5/page/1047}}</ref> Kisukari kinatambuliwa na [[Shirika la Afya Duniani]] kama [[janga]] la ulimwengu.<ref>{{cite web|title=Diabetes Fact sheet N°312|url=http://www.who.int/mediacentre/factsheets/fs312/en/|work=World Health Organization|accessdate=9 January 2012|month=Aug|year=2011}}</ref> ==Historia== Kisukari ni mojawapo ya magonjwa yaliyoelezwa mwanzo <ref>{{cite book|last=Ripoll|first=Brian C. Leutholtz, Ignacio|title=Exercise and disease management|publisher=CRC Press|location=Boca Raton|isbn=978-1-4398-2759-8|page=25|url=http://books.google.ca/books?id=eAn9-bm_pi8C&pg=PA25|edition=2nd|date=2011-04-25}}</ref> katika mswada wa [[Misri]] kutoka mwaka [[1500]] hivi [[BK]] uliotaja "kukojoa kwa wingi."<ref name=History2010/> Visa vya kwanza kuelezwa yanaaminika kuwa aina ya 1 ya kisukari.<ref name=History2010>{{cite book|last=editor|first=Leonid Poretsky,|title=Principles of diabetes mellitus|year=2009|publisher=Springer|location=New York|isbn=978-0-387-09840-1|page=3|url=http://books.google.ca/books?id=i0qojvF1SpUC&pg=PA3|edition=2nd}}</ref>Matabibu wa India wa enzi hizo pia walitambua ugonjwa huu na kuuainisha kama ''madhumeha'' au ''mkojo wa asali'' wakitambua kuwa mkojo huo ulivutia mchwa.<ref name=History2010/> [[Neno]] "diabitisi” (kisukari) au "kupitia katikati" lilitumika kwa mara ya kwanza mwaka [[230]] KK na [[Mgiriki]] [[Appollonius wa Memphis]].<ref name=History2010/> Ugonjwa huu ulikuwa nadra wakati wa [[Ufalme wa Roma]] huku [[Galen]] akidokeza kuwa alitambua visa viwili tu katika [[taaluma]] yake.<ref name=History2010/> Aina ya 1 ya kisukari na ya 2 zilitambuliwa kama hali mbili tofauti kwa mara ya kwanza na matabibu kutoka India walioitwa Sushruta na Charaka katika mwaka wa [[400]]-[[500]] huku aina ya 1 ikihusishwa na [[vijana]], na aina ya 2 ikuhusishwa na watu wanene kupindukia.<ref name=History2010/> Neno "kisukari" au "kutokwa na asali" liliongezwa na [[Mwingereza]] [[John Rolle]] mwishoni mwa [[miaka ya 1700]] ili kutofautisha [[diabetisi insipedasi]] inayohusishwa na kukojoa kila mara.<ref name=History2010/>Dawa hazikuwa zimetengenezwa hadi kufikia mwanzo wa [[karne ya 20]] ambapo [[Frederick Banting]] na [[Charles Herbert Best|Charles Best]] kutoka Kanada [[waligundua]] insulin, mwaka wa [[1921]] na [[1922]].<ref name=History2010/> Hii ilifuatiwa na kutengenezwa kwa insulini ya kudumu ya NPH [[miaka ya 1940]]. <ref name=History2010/> ==Tanbihi== |{{Reflist|30em}} [[Jamii:Magonjwa]] [[Jamii:Tiba]] 241hjmtv19tfiorpukim5kusfkaubng 0 70146 1578054 1564463 2026-07-02T16:40:19Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578054 wikitext text/x-wiki {{Infobox disease | Name = Pumu | Image = AsthmaInhaler.jpg | Alt = Fluticasone metered dose inhaler | Caption = Peak flow meters are used to measure the [[peak expiratory flow]]rate, important in both monitoring and diagnosing asthma.<ref name=GINA_2011_page18>{{harvnb|GINA|2011|p=18}}</ref> | DiseasesDB = 1006 | ICD10 = {{ICD10|J|45||j|40}} | ICD9 = {{ICD9|493}} | ICDO = | OMIM = 600807 | MedlinePlus = 000141 | eMedicineSubj = article | eMedicineTopic = 806890 | MeshID = D001249 | GeneReviewsID = | GeneReviewsName = }} '''Pumu''' (kwa [[Kiingereza]] ''[[w:Asthma|asthma]]'') ni [[ugonjwa]] wa kudumu wa [[uvimbe]] wa [[koromeo|makoromeo]] ulio na sifa za [[dalili]] zinazobadilika na kujirudia, [[hewa]] kuzibwa na [[bronkospasimu]].<ref name=NHLBI07p11-12>{{harvnb|NHLBI Guideline|2007|pp=11–12}}</ref> Dalili ni pamoja na [[kukoroma]], [[kukohoa]], kujikaza kwa [[kifua]], na [[kukosa pumzi]].<ref name=bts2009p4>{{harvnb|British Guideline|2009|p=4}}</ref> Inashukiwa kusababishwa na [[jenetikia]] pamoja na hali ya [[mazingira]].<ref name=Martinez_geneenvir>{{cite journal |author=Martinez FD |title=Genes, environments, development and asthma: a reappraisal |url=https://archive.org/details/european-respiratory-journal_2007-01_29_1/page/179 |journal=Eur Respir J |volume=29|issue=1 |pages=179–84 |year=2007 |pmid=17197483 |doi=10.1183/09031936.00087906}}</ref> Kwa kawaida huzingatia mtindo wa dalili, matokeo baada ya matibabu ya muda, na [[spirometri]].<ref name=lemanske>{{cite journal |author=Lemanske RF, Busse WW|title=Asthma: clinical expression and molecular mechanisms|journal=J. Allergy Clin. Immuno. |volume=125 |issue=2 Suppl 2 |pages=S95–102 |year=2010|month=February|pmid=20176271 |pmc=2853245 |doi=10.1016/j.jaci.2009.10.047 }}</ref> Imeainishwa kulingana na idadi ya dalili, wingi wa kupumua kwa nguvu ([[Spirometri|FEV1]]), na [[idadi ya juu ya kupumua]].<ref name=Yawn2008/> Inaweza pia kuainishwa kama [[Atopi|atopiki]] (ya nje) au isiyo ya atopiki (ya ndani)<ref name=RobbinsCotran2010/> ambapo atopi inarejelea maelekezo ya kuanzia type 1 hypersensitivity.<ref>{{cite book | title=Stedman's Medical Dictionary | publisher=Lippincott Williams and Wilkins | edition=28 | year=2005 |isbn=0-7817-3390-1 }}</ref> Dalili kali hutibiwa na [[Beta2-adrenergic agonist]] ya kuvuta (kama vile [[salbutamol]]) na kotikosteroidi za [[mdomo]].<ref name=NHLBI07p214>{{harvnb|NHLBI Guideline|2007|p=214}}</ref> Katika visa vikali kotikosteroidi za mishipa, [[salfeti ya magnesia]] na ulazwaji [[hospitali|hospitalini]] unaweza kuhitajika.<ref name=NHLBI07p373>{{harvnb|NHLBI Guideline|2007|pp=373–375}}</ref> Dalili zinaweza kuzuiwa kwa kujiepusha na visababishi, kama vile [[alajeni]]<ref name="NHLBI07p169">{{harvnb|NHLBI Guideline|2007|pp=169–172}}</ref> na [[mwasho|vitu vinavyowasha]], na kwa kutumia kotikosteroidi za kuvuta.<ref name=GINA_2011_page71>{{harvnb|GINA|2011|p=71}}</ref> [[Beta-adrenoceptor agonist zinazofanya kazi kwa muda mrefu]] (LABA) au [[leukotriene antagonist]] inaweza kutumika kando ya kotikosteroidi iwapo dalili za ugonjwa hazitadhibitiwa.<ref name=GINA_2011_page33>{{harvnb|GINA|2011|p=33}}</ref> Uenezi umeongezeka tangu mwaka [[1970]]. Kufikia [[2011]], watu [[milioni]] 235–300 walikuwa wameathiriwa ulimwenguni,<ref name=WHO2011/><ref name=GINA_2011_page3/> ikijumuisha takribani [[Kifo|vifo]] 250,000.<ref name=GINA_2011_page3>{{harvnb|GINA|2011|p=3}}</ref> {{TOC limit|limit=3}} ==Ishara na dalili== {{listen | filename = Wheeze2O noise reduced.ogg | title = Wheezing | maelezo = Sauti ya kukoroma kama inavyosikika kwa stethoskopu. | format = [[Ogg]] }} Ugonjwa huu huwa na visa vya kujirudia vya [[kukoroma]], [[upungufu wa pumzi]], kujikaza kwa kifua, na [[kukohoa]].<ref name=GINA2011p2>{{harvnb|GINA|2011|pp=2–5}}</ref> [[Makohozi]] yanaweza kutoka mapafuni, lakini kwa kawaida huwa vigumu kuyatoa.<ref>{{cite book|last=Jindal|first=editor-in-chief SK|title=Textbook of pulmonary and critical care medicine|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-93-5025-073-0|page=242|url=http://books.google.ca/books?id=EvGTw3wn-zEC&pg=PA242}}</ref> Ukiendelea kupata nafuu yanaweza kutokea uchafu kama [[usaha]] kwa sababu ya kiwango cha juu cha [[seli nyeupe]] za [[damu]] ziitwazo [[esinofili]].<ref>{{cite book|last=George|first=Ronald B.|title=Chest medicine : essentials of pulmonary and critical care medicine|year=2005|publisher=Lippincott Williams & Wilkins|location=Philadelphia, PA|isbn=978-0-7817-5273-2|page=62|url=http://books.google.ca/books?id=ZzlX2zJMbdgC&pg=PA62|edition=5th ed.}}</ref> Dalili huwa mbaya zaidi [[usiku]] na mapema [[asubuhi]] au kwa athari ya mazoezi au [[baridi]].<ref name=bts2009p14>{{harvnb|British Guideline|2009|p=14}}</ref> Baadhi ya watu wenye ugonjwa huu ni nadra kwa kawaida kuhisi dalili, kwa athari za visababishi, ilhali wengine wanaweza kuwa na dalili zinazotambulika na zinazoendelea.<ref name=GINA2011_p8-9>{{harvnb|GINA|2011|pp=8–9}}</ref> ===Hali zinazohusiana=== Hali kadhaa za afya hutokea mara nyingi kwa walio na pumu ikiwa ni pamoja na: [[ugonjwa wa ucheuaji wa astro-esophajeli]] (GERD), [[rhinosinusitisi]], na [[apnea inayosumbua wakati wa kulala]].<ref name=Boulet2009>{{cite journal |author=Boulet LP |title=Influence of comorbid conditions on asthma |url=https://archive.org/details/european-respiratory-journal_2009-04_33_4/page/897 |journal=Eur Respir J |volume=33 |issue=4 |pages=897–906 |year=2009|month=April |pmid=19336592 |doi=10.1183/09031936.00121308 }}</ref> Matatizo ya kisaikolojia huwa ya kawaida<ref name=Boulay2011>{{cite journal|last=Boulet|first=LP|coauthors=Boulay, MÈ|title=Asthma-related comorbidities.|journal=Expert review of respiratory medicine|date=2011 Jun|volume=5|issue=3|pages=377–93|pmid=21702660}}</ref> na [[wasiwasi]] unaotokea kati ya asilimia 16–52 na [[tatizo la sununu]] katika [[asilimia]] 14–41.<ref name=Andrew2010>{{cite book|last=editors|first=Andrew Harver, Harry Kotses,| title=Asthma, health and society a public health perspective|year =2010|publisher=Springer|location=New York|isbn=978-0-387-78285-0|page=315|url=http://books.google.ca/books?id=nkP8_h_ewLMC&pg=PA315}}</ref> Hata hivyo, haijulikani iwapo ugonjwa huu husababisha matatizo ya kisaikolojia au iwapo matatizo ya kisaikolojia husababisha pumu.<ref>{{cite journal|last=Thomas|first=M|coauthors=Bruton, A; Moffat, M; Cleland, J|title=Asthma and psychological dysfunction.|journal=Primary care respiratory journal : journal of the General Practice Airways Group|date=2011 Sep|volume=20|issue=3|pages=250–6|pmid=21674122}}</ref> ==Visababishi== Ugonjwa huu husababishwa na mchanganyiko wa mwingiliano mgumu na usioeleweka kikamilifu wa kimazingira na kijenetiki.<ref name=Martinez_geneenvir/><ref>{{cite journal | last=Miller |first=RL | coauthors=Ho SM|title=Environmental epigenetics and asthma: current concepts and call for studies | journal=American Journal of Respiratory and Critical Care Medicine| volume=177 | issue=6 | pages=567–573 | year=2008 | month=March | pmid=18187692|doi=10.1164/rccm.200710-1511PP | pmc=2267336 }}</ref> Masuala haya huathiri ukali wake na matokeo yake baada ya matibabu.<ref>{{cite journal |author=Choudhry S, Seibold MA, Borrell LN "et al." |title=Dissecting complex diseases in complex populations: asthma in latino americans |journal=Proc Am Thorac Soc |volume=4 |issue=3 |pages=226–33|year=2007 |pmid=17607004 |doi=10.1513/pats.200701-029AW |pmc=2647623}}</ref> Inaaminika kuwa ongezeko la hivi karibuni la ugonjwa huu unasababishwa na kubadilika kwa masuala ya [[kiepijenetiki]] ([[kuridhika]] kando na yanayohusiana na [[Mfuatano wa DNA]]) na kubadilika kwa mazingira ya kuishi.<ref>{{cite journal|last=Dietert|first=RR|title=Maternal and childhood asthma: risk factors, interactions, and ramifications.|journal=Reproductive toxicology (Elmsford, N.Y.)|date=2011 Sep|volume=32|issue=2|pages=198–204|pmid=21575714}}</ref> ===Mazingira=== Masuala mengi ya kimazingira yamehusishwa na kutokea kwa pumu na maumivu ikiwa ni pamoja na: alejeni, kuchafuka kwa hewa na kemikali zingine za kimazingira.<ref>{{cite journal|last=Kelly|first=FJ|coauthors=Fussell, JC|title=Air pollution and airway disease.|journal=Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology|date=2011 Aug|volume=41|issue=8|pages=1059–71|pmid=21623970}}</ref> [[Uvutaji sigara na ujauzito|Kuvuta sigara wakati wa ujauzito]] na baada ya kuzaa huhusishwa na hatari kuu za dalili zinazofanana na za pumu.<ref name=GINA2011_p6>{{harvnb|GINA|2011|p=6}}</ref> [[alama ya kiwango cha chini cha ubora wa hewa|aina ya hewa]], kutoka kwa magari barabarani au ngazi za juu za [[ozoni]] ,<ref name=GINA2011_p61>{{harvnb|GINA|2011|p=61}}</ref> zimehusishwa na kutokea kwa pumu na ongezeko la ukali wake.<ref name=Gold>{{cite journal |author=Gold DR, Wright R |title=Population disparities in asthma |journal=Annu Rev Public Health|volume=26 |pages=89–113|year=2005 |pmid=15760282|doi=10.1146/annurev.publhealth.26.021304.144528 }}</ref> Hatari ya [[mchanganyiko wa ogani fukivu]] inaweza kuchochea kutokea kwa pumu; [[uhatarisho wa fomadeidi]], kwa mfano, huwa na ushirikiano halisi.<ref>{{cite journal|last=McGwin|first=G|coauthors=Lienert, J; Kennedy, JI|title=Formaldehyde exposure and asthma in children: a systematic review.|journal=Environmental health perspectives|date=2010 Mar|volume=118|issue=3|pages=313–7|pmid=20064771}}</ref> Pia, [[fithaleti]] katika [[PVC]] huhusishwa na ugonjwa huu kwa watoto na watu wazima<ref>{{cite journal |author= Jaakkola JJ, Knight TL. |title= The role of exposure to phthalates from polyvinyl chloride products in the development of asthma and allergies: a systematic review and meta-analysis|url= https://archive.org/details/sim_environmental-health-perspectives_2008-07_116_7/page/845 |journal= Environ Health Perspect |volume=116 |issue=7 |pages=845–53 |year=2008 |month=July |pmid= 18629304 |pmc= 2453150 |doi= 10.1289/ehp.10846 }}</ref><ref>{{cite journal|last=Bornehag|first=CG|coauthors=Nanberg, E|title=Phthalate exposure and asthma in children.|journal=International journal of andrology|date=2010 Apr|volume=33|issue=2|pages=333–45|pmid=20059582}}</ref> kama ilivyo kwa viwango vya juu vya [[hatari ya endotoksini]].<ref>{{cite journal |author=Liu AH|title=Something old, something new: indoor endotoxin, allergens and asthma |journal=Paediatr Respir Rev|volume=5|issue=Suppl A |pages=S65–71 |year=2004 |pmid=14980246|doi=10.1016/S1526-0542(04)90013-9 }}</ref> <!--Alejeni--> Pumu huhusishwa na uhatarisho wa alejeni za ndani ya nyumba.<ref>{{cite journal|last=Ahluwalia|first=SK|coauthors=Matsui, EC|title=Mazingira ya ndani ya nyumba na athari zake kwa athma ya utotoni.|journal=Current opinion in allergy and clinical immunology|date=2011 Apr|volume=11|issue=2|pages=137–43|pmid=21301330}}</ref> Alejeni za kawaida za ndani ni pamoja na: [[wadudu wa vumbi]], [[mende]], magamba ya wanyama, na kuvu.<ref name=Arshad>{{cite journal|last=Arshad|first=SH|title=Does exposure to indoor allergens contribute to the development of asthma and allergy?|journal=Current allergy and asthma reports|date=2010 Jan|volume=10|issue=1|pages=49–55|pmid=20425514}}</ref><ref>{{cite journal|last=Custovic|first=A|coauthors=Simpson, A|title=The role of inhalant allergens in allergic airways disease.|journal=Journal of investigational allergology & clinical immunology : official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunologia|year=2012|volume=22|issue=6|pages=393–401; qiuz follow 401|pmid=23101182}}</ref> Juhudi za kupunguza wadudu wa vumbi zimepatikana kutofaa.<ref name=Gotzsche2008/> Maambukizi fulani yanayohusiana na upumuaji yanaweza kuongeza hatari ya kupata pumu yanapopatikana utotoni kama vile:<ref name=NHLBI07p11>{{harvnb|NHLBI Guideline|2007|p=11}}</ref>''[[virusi vya sinksia vya upumuaji]]'' na ''[[virusi vya rhino]]''.<ref name=M38/> Hata hivyo maambukizi mengine yanaweza kupunguza hatari.<ref name=M38/> ====Nadharia ya usafi==== [[Nadharia ya usafi]] hujaribu kuelezea viwango vya kuongezeka kwa pumu kote ulimwenguni kama matokeo ya moja kwa moja na yasiyokusudiwa ya kupungua kwa hatari wakati wa utotoni, hadi kwa bakteria na virusi visivyo na maambukizi.<ref>{{cite journal| last=Ramsey | first=CD |coauthors=Celedón JC | title=The hygiene hypothesis and asthma | journal=Current Opinion in Pulmonary Medicine| volume=11 | issue=1 | pages=14–20 | month=January | year=2005 |pmid=15591883 | doi=10.1097/01.mcp.0000145791.13714.ae }}</ref><ref>{{cite journal |last=Bufford | first=JD | coauthors=Gern JE | title=The hygiene hypothesis revisited |url=https://archive.org/details/sim_immunology-and-allergy-clinics-of-north-america_2005-05_25_2/page/247 |journal=Immunology and Allergy Clinics of North America | volume=25 | issue=2 |pages=247–262 | month=May |year=2005 | pmid=15878454 | doi=10.1016/j.iac.2005.03.005}}</ref> Imependekezwa kuwa kupungua kwa hatari ya bakteria na virusi sehemu yake ni kwa sababu ya kuongezeka kwa usafi na kupungua kwa ukubwa wa familia katika jamii za kisasa.<ref name=Brook2013>{{cite journal|last=Brooks|first=C|coauthors=Pearce, N; Douwes, J|title=The hygiene hypothesis in allergy and asthma: an update.|journal=Current opinion in allergy and clinical immunology|date=2013 Feb|volume=13|issue=1|pages=70–7|pmid=23103806}}</ref> Ushahidi unaodhibitisha nadharia ya usafi ni pamoja na viwango vya chini vya pumu kwa mashamba na maboma yaliyo na wanyama vipenzi.<ref name=Brook2013/> Matumizi ya [[antibiotiki]] mapema maishani yamehusishwa na kutokea kwa pumu.<ref>{{cite journal|last=Murk|first=W|coauthors=Risnes, KR, Bracken, MB|title=Prenatal or early-life exposure to antibiotics and risk of childhood asthma: a systematic review.|journal=Pediatrics|date=2011 Jun|volume=127|issue=6|pages=1125–38|pmid=21606151|doi=10.1542/peds.2010-2092}}</ref> Pia, kuzaa kwa njia ya [[operesheni ya Siza]] huhusishwa na ongezeko la hatari (lililokadiriwa kwa asilimia 20–80) ya pumu—ongezeko hili la hatari linahusishwa na ukosefu wa kudhibiti bora wa bakteria ambao mtoto mchanga angepata kutoka kwa njia inayopitia kwenye njia ya uzazi.<ref>{{harvnb|British Guideline|2009|p=72}}</ref><ref>{{cite journal|last=Neu|first=J|coauthors=Rushing, J|title=Cesarean versus vaginal delivery: long-term infant outcomes and the hygiene hypothesis.|url=https://archive.org/details/sim_clinics-in-perinatology_2011-06_38_2/page/321|journal=Clinics in perinatology|date=2011 Jun|volume=38|issue=2|pages=321–31|pmid=21645799}}</ref> Kuna uhusiano kati ya pumu na kiwango cha utajiri.<ref>{{cite journal|last=Von Hertzen|first=LC|coauthors=Haahtela, T|title=Asthma and atopy -the price of affluence?|journal=Allergy|date=2004 Feb|volume=59|issue=2|pages=124–37|pmid=14763924}}</ref> ===Jenetikia=== {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |+ CD14-endotoxin interaction based on CD14 SNP C-159T<ref name=Martinez_CD14 /> |- ! Endotoxin levels !! CC genotype !! TT genotype |- ! High exposure | Low risk || High risk |- ! Low exposure |High risk || Low risk |} [[Historia]] ya [[familia]] ni suala la hatari huku [[jeni]] nyingi tofauti zikihusishwa.<ref name=El2010>{{cite book|last=Elward|first=Graham Douglas, Kurtis S.|title=Asthma|year=2010|publisher=Manson Pub.|location=London|isbn=978-1-84076-513-7|pages=27–29|url=http://books.google.ca/books?id=gS4BsugTBvoC&pg=PA27}}</ref> Iwapo mmoja wa [[pacha|mapacha]] ataathiriwa, uwezekano wa mwingine kuwa na ugonjwa ni takriban asilimia 25.<ref name=El2010/> Kufikia mwisho wa [[2005]], jeni zilikuwa zimehusishwa na pumu katika idadi sita au zaidi za watu zilizotengana ikiwa ni pamoja na:''[[Glutathione S-transferase Mu 1|GSTM1]]'', ''[[Interleukin 10|IL10]]'',''[[CTLA-4]]'', ''[[SPINK5]]'',''[[Leukotriene C4 synthase|LTC4S]]'', ''[[Interleukin-4 receptor|IL4R]]'' na ''[[ADAM33]]'' kati ya zingine.<ref name=Hoffjan/> Nyingi za jeni hizi zinahusiana na [[mfumo wa kingamwili]] au urekebishaji wa [[inflamesheni]]. Hata kati ya orodha ya jeni zilizodhibitishwa na uchunguzi uliorudiwa, matokeo hayajawa sawa kati ya idadi zote za watu zilizotathminiwa.<ref name=Hoffjan /> Mwaka wa 2006 zaidi ya [[jeni]] 100 zilihusishwa na pumu katika uchunguzi wa [[muungano wa jeni]] moja pekee;<ref name=Hoffjan>{{cite journal|author=Ober C, Hoffjan S |title=Asthma genetics 2006: the long and winding road to gene discovery |journal=Genes Immun |volume=7 |issue=2 |pages=95–100 |year=2006 |pmid=16395390|doi=10.1038/sj.gene.6364284 }}</ref> mengi yanaendelea kutambuliwa.<ref>{{cite journal|last=Halapi|first=E|coauthors=Bjornsdottir, US|title=Overview on the current status of asthma genetics.|journal=The clinical respiratory journal|date=2009 Jan|volume=3|issue=1|pages=2–7|pmid=20298365}}</ref> Baadhi ya tofauti ya jenetikia unaweza kusababisha ugonjwa unapounganishwa na hatari ya kimazingira.<ref name=Martinez_geneenvir /> Kwa mfano [[upolimofi moja ya nunukliotaidi]] katika eneo la [[CD14]] na hatari ya [[endotoksini]] (zao la bakteria). Hatari ya endotoksini unaweza kupatikana kutoka kwa vyanzo kadhaa vya kimazingira ikiwa ni pamoja na moshi wa tobako, mbwa na mashamba. Hatari ya pumu, kisha husababishwa na jenetiki ya mtu na kiwango cha hatari ya endotoksini.<ref name=Martinez_CD14>{{cite journal |author=Martinez FD |title=CD14, endotoxin, and asthma risk: actions and interactions |journal=Proc Am Thorac Soc |volume=4 |issue=3 |pages=221–5 |year=2007|pmid=17607003 |doi=10.1513/pats.200702-035AW |pmc=2647622}}</ref> ===Hali ya tiba=== Seti ya [[kizema ya atopi]], [[aleji ya mafua]] na pumu huitwa atopi.<ref name="Bolognia"/> Suala la hatari kuu zaidi la kupata ugonjwa ni historia ya [[atopi|ugonjwa wa atopi]];<ref name=NHLBI07p11/> huku pumu ikitokea kwa kiwango cha juu kwa walio na [[kizema]] au [[mafua|mafua ya mzio]].<ref name=GINA2011_p4>{{harvnb|GINA|2011|p=4}}</ref> Ugonjwa huu umehusishwa na [[Churg–Strauss syndrome]], ugonjwa wa kipekee wa kingamwili na [[vaskulitisi]]. Watu binafsi walio na aina fulani za [[utikaria]] pia wanaweza kuhisi dalili za pumu.<ref name="Bolognia">{{cite book |author=Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L.|title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007|isbn=1-4160-2999-0 }}</ref> Kuna uhusiano kati ya [[unene]] na hatari ya ugonjwa huku zikiwa zimeongezeka miaka iliyopita hivi karibuni.<ref>{{cite journal |author=Beuther DA |title=Recent insight into obesity and asthma |journal=Curr Opin Pulm Med|volume=16 |issue=1 |pages=64–70|year=2010 |month=January |pmid=19844182 |doi=10.1097/MCP.0b013e3283338fa7}}</ref><ref name=holguin>{{cite journal |author=Holguin F, Fitzpatrick A |title=Obesity, asthma, and oxidative stress|url=https://archive.org/details/sim_journal-of-applied-physiology_2010-03_108_3/page/754 |journal=J. Appl. Physiol. |volume=108 |issue=3 |pages=754–9 |year=2010|month=March |pmid=19926826|doi=10.1152/japplphysiol.00702.2009 }}</ref> Masuala kadhaa yanaweza kusababisha ikiwa ni pamoja na kupungua kwa utendakazi wa upumuo kwa sababu ya ongezeko la mafuta na hasa kwa kuwa tishu ya adiposi husababisha hali ya pro-inflamesheni.<ref name="Woods 2009">{{cite journal |author=Wood LG, Gibson PG |title=Masuala ya chakula husababisha innate immune activation katikia athma |journal=Pharmacol. Ther.|volume=123 |issue=1 |pages=37–53 |year=2009|month=July |pmid=19375453|doi=10.1016/j.pharmthera.2009.03.015 }}</ref> Dawa za [[Beta blocker]] kama vile [[propranolol]] zinaweza kusababisha ugonjwa kwa walio na uwepesi wa kuipata.<ref>{{cite journal|author=O'Rourke ST |title=Antianginal actions of beta-adrenoceptor antagonists |journal=Am J Pharm Educ |volume=71|issue=5 |pages=95|year=2007 |month=October |pmid=17998992 |pmc=2064893 }}</ref> [[Cardioselective beta-blockers]], hata hivyo, huonekana kuwa salama kwa walio na ugonjwa mdogo au wa kiasi.<ref>{{cite journal|last=Salpeter|first=S|coauthors=Ormiston, T; Salpeter, E|title=Cardioselective beta-blocker use in patients with reversible airway disease.|journal=Cochrane database of systematic reviews (Online)|year=2001|issue=2|pages=CD002992|pmid=11406056}}</ref> Dawa zingine zinazoweza kusababisha matatizo ni [[ASA]], [[NSAID]], na [[vizuizi vya enzaimu anjiotensini-badilishi]].<ref>{{cite journal|last=Covar|first=RA|coauthors=Macomber, BA; Szefler, SJ|title=Medications as asthma trigers.|url=https://archive.org/details/sim_immunology-and-allergy-clinics-of-north-america_2005-02_25_1/page/169|journal=Immunology and allergy clinics of North America|date=2005 Feb|volume=25|issue=1|pages=169–90|pmid=15579370}}</ref> ===Ongezeko=== Baadhi ya watu huwa na pumu tulivu kwa majuma au miezi kisha kuwa kali kwa ghafla. Watu tofauti huathirika kwa njia tofauti na masuala mbalimbali.<ref name=Baxi2010>{{cite journal |author=Baxi SN, Phipatanakul W |title=The role of allergen exposure and avoidance in asthma |journal=Adolesc Med State Art Rev |volume=21 |issue=1|pages=57–71, viii–ix |year=2010 |month=April |pmid=20568555 |pmc=2975603 }}</ref> Watu wengi binafsi wanaweza kupata ongezeko kali kutokana na baadhi ya maajenti sababishi.<ref name=Baxi2010/> Visababishi vya kinyumbani vya ugonjwa huu ni pamoja na [[vumbi]], [[magamba]] ya mnyama (hasa manyoya ya paka na mbwa), mende [[alejeni]] na [[kuvu]].<ref name=Baxi2010/> [[marashi]] ni kisababishi cha kawaida cha mashambulizi kali kwa kina mama na watoto. [[Ambukizo]] la [[virusi|virusi]] na bakteria la trakti ya juu ya kupumua unaweza kuongeza ugonjwa.<ref name=Baxi2010/> Mfadhaiko wa kisaikolojia [[(kibiolojia)|mfadhaiko]] unaweza kuzidisha dalili—inakisiwa kuwa mfadhaiko hubadilisha mfumo wa kingamwili na hivyo huongeza athari ya inflamesheni ya njia ya hewa kutokana na alejeni na vitu ambavyo huwasha.<ref name=Gold/><ref name="Chen2007">{{cite journal |author=Chen E, Miller GE |title=Stress and inflammation in exacerbations of asthma|journal=Brain Behav Immun. |volume=21 |issue=8 |pages=993–9|year=2007 |pmid=17493786|doi=10.1016/j.bbi.2007.03.009|pmc=2077080}}</ref> ==Pathofisiolojia== [[File:Asthma.jpg|thumb|alt=Sehemu ya tishu ya njia ya hewa inayoonyesha ukuta ulio na doa la waridi na kamasi ya rangi nyeupe uliojaa upande wa ndani|Kizuizi cha mwanya wa [[bronkioli]] kutoka mucoid exudate, [[goblet cell]] [[metaplasia]], na epitheliumu [[utando msingi]] unaovimba kwa mtu aliye na pumu.]] Pumu husababishwa na uvimbe kwa njia za hewa ikifuatiwa na mikazo katika eneo hilo [[msuli mdogo]].<!-- <ref name=GINA2011p2/> --> Hii pamoja na visababishi vingine husababisha maumivu yanayotokana na njia ya hewa iliyonyembamba na dalili za hali ya juu za kukoroma.<!-- <ref name=GINA2011p2/> --> Uwembamba unaweza kurudi hali yake ya kawaida bila matibabu<!-- <ref name=GINA2011p2/> --> Mara kwa mara njia za hewa hujibadilisha.<ref name=GINA2011p2/> Mabadiliko ya njia za hewa ni pamoja na ongezeko kwa [[esinofili]] na kunenepa kwa [[lamina lililofanana na neti]].<!-- <ref name=M38/> --> Msuli wa njia za hewa inaweza kuwa kubwa kwa ukali na kuongezeka kwa idadi ya tezi ya miukosi.<!-- <ref name=M38/> --> Aina zingine za seli zilizohusika ni pamoja na: [[T lymphocytes]], [[macrophages]], na [[nutrofili]].<!-- <ref name=M38/> --> Pia kunaweza kuwa na vijenzi vya [[mfumo wa kinga]] pamoja na: [[cytokines]], [[chemokines]], [[histamine]], na [[leukotrienes]] miongoni mwa zingine.<ref name=M38/> ==Utambuzi== Pumu umetambulika vizuri, ilhali hakuna ufafanuzi hata moja ulioidhinishwa.<ref name=M38/> Inafafanuliwa na [[Uvumbuzi wa Kidunia wa Pumu]] kama "ulemavu mkali wa inflamesheni katika njia za hewa ambapo seli mingi na elementi za seli huwa na jukumu. Inflamesheni kali inahusishwa na mwitikio uliozidi wa njia ya hewa zinazosababisha matukio ya kukoroma, kushindwa kupumua, mikazo kifuani na kukohoa hasa usiku au asubuhi na mapema. Matukio haya kwa kawaida yanahusiana na kutapakaa kwa hewa mwilini lakini mtiririko wa hewa uliozuiwa ambao unabadilika kwa pafu ambayo mara kwa mara inaweza kurudi kwa hali ya kawaida bila matibabu au na matibabu".<ref name=GINA2011p2 /> Kwa sasa hakuna uchunguzi maalum na utambuzi unaofanana hasa uliokatika muundo wa dalili na mwitikio kwa tiba muda unapoendelea.<ref name=lemanske/><ref name=M38/> Utambuzi unapaswa kushukiwa ikiwa kuna: ukoromaji unaotokea mara kwa mara, kukohoa au kupumua kwa ugumu na hizi dalili hutokea au kuzidi kwa sababu ya mazoezi, maambukizi ya virusi, alejeni au hewa chafu.<ref name=NAEPP42>{{harvnb|NHLBI Guideline|2007|p=42}}</ref> Kisha [[Spirometry]] hutumika kuthibitisha utambuzi.<ref name=NAEPP42/> Utambuzi kwa watoto waliochini ya miaka sita ni vigumu kwa sababu ni wadogo kufanyiwa spirometry.<ref name=GINA2011p20>{{harvnb|GINA|2011|p=20}}</ref> ===Spirometry=== [[Spirometry]] inapendekezwa ili isaidie utambuzi na udhibiti.<ref name="AAAAIfive">{{Citation|author1=American Academy of Allergy, Asthma, and Immunology|author1-link=American Academy of Allergy, Asthma, and Immunology|date=|title=Five things physicians and patients should question|publisher=[[American Academy of Allergy, Asthma, and Immunology]]|work=Choosing wisely: an initiative of the [[ABIM Foundation]]|page=|url=http://choosingwisely.org/wp-content/uploads/2012/04/5things_12_factsheet_AAAAI.pdf|accessdate=August 14, 2012|archive-date=2012-11-03|archive-url=https://web.archive.org/web/20121103151124/http://choosingwisely.org/wp-content/uploads/2012/04/5things_12_factsheet_AAAAI.pdf|dead-url=yes}}</ref><ref name="NIHasthmaguide">{{cite book |author=Third Expert Panel on the Diagnosis and Management of Asthma |title=Guidelines for the diagnosis and management of asthma |year=2007 |publisher=National Heart, Lung, and Blood Institute (US) |url=http://www.ncbi.nlm.nih.gov/books/NBK7232/}}</ref> Hii ndio uchunguzi bora wa pumu.<!-- <ref name=M38/> --> Ikiwa [[FEV1]] kilichopimwa na mbinu hii kitakuwa bora na zaidi ya asilimia 12 kufuatiliwa na utoaji wa kipanua bronkasi kama vile [[sabutamoli]], husaidia kwa utambuzi.<!-- <ref name=M38/> --> Hata hivyo inaweza kuwa sawa kwa walio na historia ya ugonjwa isiyokali, isiyojitokeza.<!-- <ref name=M38/> --> [[Kiwango cha hewa mtu anaweza kuvuta kwa pumzi moja]] inaweza kusaidia kutofautisha pumu [[COPD]].<ref name=M38/> Ni muhimu kufuatilia spirometry kila mwaka moja au mbili ili kufuatilia jinsi ugonjwa unavyodhibitiwa.<ref name=NHLBI07p58>{{harvnb|NHLBI Guideline|2007|p=58}}</ref> ===Njia nyingine=== [[Kipimo]] cha [[tatizo la methacholine]] kinahusisha kuvuta hewa ya kuongeza viwango vya dutu vinavyosababisha njia ya hewa kuwa nyembamba katika eneo linalochangia kupata magonjwa.<!-- <ref name=M38/> --> Ikiwa hakuna dalili inamaanisha hana ugonjwa; ikiwa ana dalili, hata hivyo, si ya ugonjwa hasa.<ref name=M38/> Ushahidi mwingine unaochangia ni: tofauti ya asilimia ≥20 kwa [[kiwango cha mwisho cha kupumua]] angalau siku tatu kwa wiki kwa wiki mbili, uboreshaji kwa asilimia ≥20 ya kiwango cha kupumua ukifuatiliwa na matibabu ya sabutamoli, kotikosteroidi ya kuvuta au prinisoni, au upungufu wa asilimia ≥20 ya kifaa cha kupima hewa kutoka kwa mapafu ikifuatiliwa na hatari ya kisababishi.<ref>{{cite journal|author=Pinnock H, Shah R |title=Asthma |journal=BMJ |volume=334 |issue=7598 |pages=847–50|year=2007 |pmid=17446617 |doi=10.1136/bmj.39140.634896.BE |pmc=1853223}}</ref> Kipimo cha kiwango cha juu cha kupumua hubadilika zaidi kuliko ya spirometry, hata hivyo, haijakubaliwa kwa utambuzi wa mara kwa mara.<!-- <ref name=NAEPP2007p59/> --> Inaweza kuwa ya manufaa ya kujitathmini kila siku kwa wale walio na ugonjwa uliokali kiasi hadi kwa iliyokali na kutathmini matokeo yanayofaa kwa matibabu mapya.<!-- <ref name=NAEPP2007p59/> --> Inaweza pia kuwa ya manufaa ya kuongoza kwa matibabu kwa walio na hali ya kuongezeka kwa ukali wa ugonjwa.<ref name=NAEPP2007p59>{{harvnb|NHLBI Guideline|2007|p=59}}</ref> ===Uainishaji=== {| class="wikitable" style = "float: right; margin-left:1em; text-align:center" |+ Clinical classification (≥ 12 years old)<ref name=Yawn2008/> |- ! scope="col" style="width:6em;" | Severity ! scope="col" style="width:4em;" | Symptom frequency ! scope="col" style="width:4em;" | Night time symptoms ! scope="col" style="width:4em;" | %FEV₁ of predicted ! scope="col" style="width:4em;" | FEV₁ Variability ! scope="col" style="width:4em;" | SABA use |- ! scope="row" | Intermittent | ≤2/week | ≤2/month | ≥80% | <20% | ≤2 days/week |- ! scope="row" | Mild persistent | >2/week | 3–4/month | ≥80% | 20–30% | >2 days/week |- ! scope="row" | Moderate persistent | Daily | >1/week | 60–80% | >30% | daily |- ! scope="row" | Severe persistent | Continuously | Frequent (7×/week) | <60% | >30% | ≥twice/day |} Ugonjwa huu huainishwa kulingana na dalili inavyojitokeza mara kwa mara, kutoka kwa pumzi inayotolewa nje ([[spirometry|FEV₁]]), na [[kiwango cha mwisho cha kupumua]].<ref name=Yawn2008>{{cite journal |author=Yawn BP |title=Factors accounting for asthma variability: achieving optimal symptom control for individual patients |journal=Primary Care Respiratory Journal |volume=17 |issue=3 |pages=138–147 |month=September |year=2008 |url=http://www.thepcrj.org/journ/vol17/17_3_138_147.pdf |archiveurl=https://www.webcitation.org/5nySCf5x8?url=http://www.thepcrj.org/journ/vol17/17_3_138_147.pdf |archivedate=2010-03-04 |pmid=18264646 |doi=10.3132/pcrj.2008.00004 |access-date=2014-01-09 |dead-url=no }}</ref> Pumu inaweza kuainishwa kama atopi (iliyo ya nje) au isiyo ya atopi (iliyo ya ndani), kwa kuzingatia iwapo dalili zimechochewa na alejeni (atopi) au la (zisizo za atopi).<ref name="RobbinsCotran2010">{{cite book |editor1-last=Kumar|editor1-first=Vinay |editor2-last=Abbas |editor2-first=Abul K |editor3-last=Fausto|editor3-first=Nelson |editor4-last=Aster |editor4-first=Jon |title=Robbins and Cotran pathologic basis of disease |publisher=Saunders |edition=8th |year=2010|isbn=978-1-4160-3121-5 |page=688 |oclc=643462931 }}</ref> Pumu unapoainishwa kulingana na ukali, kwa sasa hakuna mbinu halisi ya kuainisha vikundi vidogo mbalimbali vya ugonjwa huu zaidi ya mfumo huu.<ref name=Moore2010>{{cite journal |author=Moore WC, Pascual RM |title=Update in asthma 2009 |url=https://archive.org/details/sim_american-journal-respiratory-critical-care-medicine_2010-06-01_181_11/page/1181 |journal=American Journal of Respiratory and Critical Care Medicine |volume=181 |issue=11 |pages=1181–7 |year=2010 |month=June|pmid=20516492 |doi=10.1164/rccm.201003-0321UP}}</ref> Kutafuta njia za kutambua vikundi vidogo vinavyoitikia vyema kwa aina tofauti za matibabu ni lengo muhimu la utafiti wa pumu.<ref name=Moore2010/> Ingawa pumu ni hali kali [[pingamizi ya ugonjwa wa pafu|pingamizi]], haichukuliwi kama sehemu ya [[ugonjwa kali unaopinga mapafu]] kwa kuwa jina hili linahusu mchanganyiko wa magonjwa zisizoweza kurudi katika hali iliyosawa kama vile [[bronkektasisi]],[[bronkitisi kali]], na [[emphysema]].<ref name="Self, Timothy 2009">{{cite book|editor=Mary Anne Koda-Kimble, Brian K Alldredge, et al. |author1=Self, Timothy|author2=Chrisman, Cary |author3=Finch, Christopher |title=Applied therapeutics: the clinical use of drugs |edition=9th |location=Philadelphia |publisher=Lippincott Williams & Wilkins |year=2009 |chapter=22. Asthma |oclc=230848069 }}</ref> Tofauti na magonjwa haya, kizuizi cha njia ya hewa huweza kurudi katika hali yake ya kawaida; hata hivyo, isipotibiwa, inflamesheni kali kutokana na pumu huweza kusababisha mapafu kuwa na kizuizi kisichorudi kwa hali yake ya kawaida kwa sababu ya njia ya hewa kupata muundo mwingine.<ref name=Delacourt2004>{{cite journal |last=Delacourt|first=C|title=Conséquencesbronchiques de l'asthme non traité|trans_title=Bronchial changes in untreated asthma |journal=Archives de Pédiatrie|volume=11 |issue=Suppl. 2 |pages=71s–73s|month=June |year=2004 |pmid=15301800}}</ref> Tofauti na [[emphysema]], ugonjwa huu huathiri bronkia, sio [[alveoli]].<ref name=Schiffman2009>{{cite web |url=http://www.medicinenet.com/chronic_obstructive_pulmonary_disease_copd/article.htm |title=Chronic obstructive pulmonary disease |first=George |last=Schiffman |date=18 December 2009 |publisher=MedicineNet |accessdate=2 September 2010 |archiveurl=https://web.archive.org/web/20100828011049/http://www.medicinenet.com/chronic_obstructive_pulmonary_disease_copd/article.htm |archivedate=2010-08-28 |deadurl=no }}</ref> ====Kuzidi kwa pumu==== {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |+ Severity of an acute exacerbation<ref name=BTS58/> |- ! style="border-top: 3px solid darkgray;" | Near-fatal | colspan="2" style="border-top: 3px solid darkgray;" | High [[Arterial blood gas|PaCO₂]] and/or requiring mechanical ventilation |- ! rowspan="9" style="border-top: 3px solid darkgray;" | Life threatening</br>(any one of) |- ! Clinical signs ! Measurements |- | Altered [[level of consciousness]] | [[Peak flow]]< 33% |- | Exhaustion | [[Oxygen saturation]]< 92% |- | [[Arrhythmia]] | [[Arterial blood gas|PaO₂]]< 8 kPa |- | Low [[blood pressure]] | "Normal" PaCO₂ |- | [[Cyanosis]] | |- | Silent chest | |- | Poor respiratory effort | |- ! rowspan="5" style="border-top: 3px solid darkgray;" | Acute severe</br>(any one of) |- | colspan="2" | Peak flow 33–50% |- | colspan="2" | Respiratory rate ≥ 25 breaths per minute |- | colspan="2" | Heart rate ≥ 110 beats per minute |- | colspan="2" | Unable to complete sentences in one breath |- ! rowspan="3" style="border-top: 3px solid darkgray; border-bottom: 3 px solid darkgray;"| Moderate | colspan="2" style="border-top: 3px solid darkgray;" | Worsening symptoms |- | colspan="2" | Peak flow 50–80% best or predicted |- | colspan="2" style="border-bottom: 3 px solid darkgray;" | No features of acute severe asthma |} Ugonjwa kali uliozidi huitwa ''shambulizi la pumu''. Dalili zinazotambulika ni [[upungufu wa hewa]], [[kukorota|ukorotaji]], na [[kujikaza kwa kifua]].<ref name=M38/> Wakati hizi ni dalili za kwanza za ugonjwa,<ref name=Barnes2008>{{cite book|last=Barnes |first=PJ |chapter=Asthma |title=Harrison's Principles of Internal Medicine|url=https://archive.org/details/harrisonsprincip00asfa |editor1-last=Fauci|editor1-first=Anthony S |editor2-last=Braunwald|editor2-first=E, |editor3-last=Kasper|editor3-first=DL |location=New York|publisher=McGraw-Hill |year=2008 |edition=17th|isbn=978-0-07-146633-2|pages=[https://archive.org/details/harrisonsprincip00asfa/page/1596 1596]–1607}}</ref> baadhi ya watu huonyesha kwa [[kukohoa]], na katika hali kali, mwendo wa kupumua unaweza kuwa umeharibika sana kiasi kwamba ukoromaji hausikiki.<ref name=BTS58/> Dalili zinzazotokea wakati wa shambulizi la ugonjwa ni pamoja na matumizi zinazosaidia [[misuli]] za kupumua ([[sternocleidomastoid]] na [[misuli ya scalene]] za shingo), kunaweza kuwa na [[pulsus paradoxus|mpwito wa moyo wa kifumbo]] (mpwito uliodhaifu wakati wa kuvuta hewa na ulio na nguvu wakati wa kutoa hewa), na kuvimba kwa kifua.<ref name=Maitre1995>{{cite journal |author=Maitre B, Similowski T, Derenne JP |title=Physical examination of the adult patient with respiratory diseases: inspection and palpation |journal=Eur. Respir. J. |volume=8 |issue=9 |pages=1584–93 |year=1995 |month=September |pmid=8575588 |url=http://erj.ersjournals.com/content/8/9/1584.long |access-date=2014-01-09 |archive-date=2015-04-29 |archive-url=https://web.archive.org/web/20150429223309/http://erj.ersjournals.com/content/8/9/1584.long |url-status=dead }}</ref> [[sinosisi|rangi ya bluu]] ya ngozi na kucha inaweza kutokea kutokana na ukosefu wa oksijeni.<ref name=Werner2001>{{cite journal|last=Werner |first=HA |title=Status asthmaticus in children: a review|url=https://archive.org/details/sim_chest_2001-06_119_6/page/n47 |journal=Chest |volume=119 |issue=6|pages=1596–1607 |year=2001|month=June|pmid=11399724|doi=10.1378/chest.119.6.1913 }}</ref> Katika hali ya maumivu usio kali [[kiwango cha mwisho cha kupumua]] ni ≥200&nbsp;ya lita moja kwa dakika au asilimia ≥50 ya utabiri uliobora.<ref name=Shiber2006>{{cite journal |author=Shiber JR, Santana J|title=Dyspnea |url=https://archive.org/details/sim_medical-clinics-of-north-america_2006-05_90_3/page/453|journal=Med. Clin. North Am. |volume=90|issue=3 |pages=453–79 |year=2006|month=May|pmid=16473100 |doi=10.1016/j.mcna.2005.11.006 }}</ref> Wastani wake unafasiliwa kama kati ya 80 na 200&nbsp;ya lita moja kwa dakika au asilimia 20 na 50 ya utabiri uliobora bali iliokali inafasiliwa kama ≤&nbsp;80 ya lita kwa dakika au asilimia ≤25 ya utabiri uliobora.<ref name=Shiber2006/> [[Pumu iliyo kali mno]], ulioitwa hali ya kuwa na pumu kali mbeleni, na inayoendelea kwa muda mrefu, ni ugonjwa kali uliozidi ambao hautibii na matibabu ya kawaida ya kipanua koromeo na kotikosteroidi.<ref name=Shah2012/> Nusu ya hali hizi zimesababishwa na maambukizi kutoka kwa mengine yaliyosababishwa na alejeni, hewa chafu, ukosefu wa dawa au kuzitumia kwa njia isiyofaa.<ref name=Shah2012>{{cite journal|last=Shah|first=R|coauthors=Saltoun, CA|title=Chapter 14: Athma uliokali mno (hali ya kuwa na athma kali, na inayoendelea kwa muda mrefu).|journal=Allergy and asthma proceedings : the official journal of regional and state allergy societies|date=2012 May–Jun|volume=33 Suppl 1|pages=S47-50|pmid=22794687}}</ref> [[Pumu ya brittle]] ni aina ya ugonjwa unaotambuliwa na mashambulizi makali yanayorudi.<ref name=BTS58>{{harvnb|British Guideline|2009|p=54}}</ref> Aina ya kwanza ya ugonjwa wa brittle ni ugonjwa ulio tofauti na mtiririko wa upeo mpana, licha ya makali ya dawa. Aina ya pili ya ugonjwa wa brittle ni ugonjwa ulio na usuli uliothibitiwa kwa njia inayofaa na ukali wa ghafla.<ref name=BTS58/> ====Yanayosababisha na mazoezi ==== Zoezi linaweza kusababisha [[kuminya bronkasi]] kwa wote walio na wasio kuwa na ugonjwa.<ref name=EIB2012>{{cite journal|last=Khan|first=DA|title=Exercise-induced bronchoconstriction: burden and prevalence.|journal=Allergy and asthma proceedings : the official journal of regional and state allergy societies|date=2012 Jan–Feb|volume=33|issue=1|pages=1–6|pmid=22370526}}</ref> Hutokea kwa watu wengi walio na pumu na hadi asilimia 20 ya watu wasio kuwa na ugonjwa.<ref name=EIB2012/> Hutokea mara nyingi kwa wanariadha wa tabaka la juu, kwa viwango vinavyobadilika kutoka asilimia 3 kwa wanaoshiriki katika mashindano ya [[bobsled]] hadi asilimia 50 kwa [[wanariadha wa baiskeli]] na asilimia 60 kwa [[cross-country skiing]].<ref name=EIB2012/> Ingawa inaweza kutokea katika hali yoyote ya hewa ni ya kawaida zaidi wakati hewa ni kavu na baridi.<ref name=GINA_2011_page17>{{harvnb|GINA|2011|p=17}}</ref> Beta2-agonists ya kuvuta inaonekana kuwa haileti mabadiliko katika matokeo ya wanariadha wasiokuwa na pumu<ref>{{cite journal|last=Carlsen|first=KH|coauthors=Anderson, SD; Bjermer, L; Bonini, S; Brusasco, V; Canonica, W; Cummiskey, J; Delgado, L; Del Giacco, SR; Drobnic, F; Haahtela, T; Larsson, K; Palange, P; Popov, T; van Cauwenberge, P; European Respiratory, Society; European Academy of Allergy and Clinical, Immunology; GA(2)LEN,|title=Treatment of exercise-induced asthma, respiratory and allergic disorders in sports and the relationship to doping: Part II of the report from the Joint Task Force of European Respiratory Society (ERS) and European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA(2)LEN.|journal=Allergy|date=2008 May|volume=63|issue=5|pages=492–505|pmid=18394123}}</ref> hata hivyo dozi za kumeza zinaweza kuboresha uvumilivu na nguvu.<ref>{{cite journal|last=Kindermann|first=W|title=Do inhaled beta(2)-agonists have an ergogenic potential in non-asthmatic competitive athletes?|journal=Sports medicine (Auckland, N.Z.)|year=2007|volume=37|issue=2|pages=95–102|pmid=17241101}}</ref><ref>{{cite journal|last=Pluim|first=BM|coauthors=de Hon, O; Staal, JB; Limpens, J; Kuipers, H; Overbeek, SE; Zwinderman, AH; Scholten, RJ|title=β₂-Agonists and physical performance: a systematic review and meta-analysis of randomized controlled trials.|journal=Sports medicine (Auckland, N.Z.)|date=2011 Jan 1|volume=41|issue=1|pages=39–57|pmid=21142283}}</ref> ====Kazini==== Pumu unaotokea (au kuzidishwa na) mazingira ya kazini, hurejelewa kama [[magonjwa ya kazini]].<ref name=Baur2012/> Hata hivyo hali nyingi haziripotiwi au kutambuliwa.<ref>{{cite book|last=Kunnamo|first=ed.-in-chief: Ilkka|title=Evidence-based medicine guidelines|year=2005|publisher=Wiley|location=Chichester|isbn=978-0-470-01184-3|page=214|url=http://books.google.ca/books?id=frYEiHYtOv0C&pg=PA214}}</ref><ref>{{cite book|last=Kraft|first=editors, Mario Castro, Monica|title=Clinical asthma|year=2008|publisher=Mosby / Elsevier|location=Philadelphia|isbn=978-0-323-07081-2|pages=Chapter 42|url=http://books.google.ca/books?id=y9WYwLVn7pgC&pg=PT1185}}</ref> Inakadiriwa kuwa asilimia 5-25 ya ugonjwa huu kwa watu wazima huhusiana na mahali pa kazi.<!-- <ref name=Baur2012/> --> Maajenti karibu mia moja wamehusishwa na ya kawaida ikiwa: [[isocyanates]], nafaka na uchafu wa mbao, [[colophony]], [[soldering flux]], [[ulimbo wa mpira]], wanyama, na [[aldehydes]].<!-- <ref name=Baur2012/> --> Uajiri uliohusishwa na hatari kubwa ya matatizo inajumuisha: wale ambao [[wanajipaka rangi]], waokaji na watengenezao chakula, wauguzi, wafanyikazi wa kemikali, wanaofanyakazi na wanyama, [[wati weko]], watengenezaji nywele na wafanyikazi wa mabao.<ref name=Baur2012>{{cite journal|last=Baur|first=X|coauthors=Aasen, TB; Burge, PS; Heederik, D; Henneberger, PK; Maestrelli, P; Schlünssen, V; Vandenplas, O; Wilken, D; ERS Task Force on the Management of Work-related, Asthma|title=The management of work-related asthma guidelines: a broader perspective.|journal=European respiratory review : an official journal of the European Respiratory Society|date=2012 Jun 1|volume=21|issue=124|pages=125–39|pmid=22654084}}</ref> ===Utambuzi tofauti=== Hali zingine zinaweza kusababisha dalili zinazofanana na za pumu.<!-- <ref name=NAEPP46/> --> Kwa watoto, magonjwa mengine ya njia ya hewa kama vile [[mzio wa pua]] na [[sinositisi]] zinapaswa kuangiliwa pia kama visababishi vinavyofunga njia ya hewa ikijumuisha: [[Kifaa_kigeni#Kwa njia za hewa|kitu kigeni mwilini]], [[tracheal stenosis]] au [[laryngotracheomalacia]], [[vizingo vya utomvu]], hurefushwa [[Tezi]] au uzito wa shingo.<!-- <ref name=NAEPP46> --> Kwa watu wazima, [[COPD]], [[kutofanya kazi kwa moyo]], uzito wa hewa kupita, vile vile dawa za kukomesha athiri ya ACE zinapaswa kuangaliwa.<!-- <ref name=NAEPP46> --> Kwa watu wote [[kutofanya kazi kwa mshipi wa sauti]] inaweza kutokea pia.<ref name=NAEPP46>{{harvnb|NHLBI Guideline|2007|p=46}}</ref> [[Pumu zibifu wa kudumu]] inaweza kuwa na ugonjwa huu na inaweza kutokea kama tatizo la kudumu. Katika umri wa miaka 65 watu wengi walio na ugonjwa wa njia ya hewa iliyofunganga watakuwa na pumu na COPD. Kati hali hii, COPD inaweza kutofautishwa kwa nutrofili nyingi katika njia ya hewa, inayoongezwa na ukubwa wa ukuta, na kuongezeka kwa msuli mdogo bronkia. Hata hivyo, kiwango hiki cha kuchunguza haiwezi kutekelezwa kwa sababu COPD na pumu huwa na kanuni sawa za usimamizi: kotikosteroidi, kuwepo kwa beta agonists, na hatua za kuacha kuvuta sigara.<ref name=Gibson>{{cite journal |author=Gibson PG, McDonald VM, Marks GB |title=Asthma in older adults |journal=Lancet |volume=376|issue=9743 |pages=803–13 |year=2010 |month=September |pmid=20816547|doi=10.1016/S0140-6736(10)61087-2 }}</ref> Hukaribiana na pumu kwa dalili, huhusiana na uvutaji wa sigara, umri mkubwa, kutobadilika kwa dalili baada ya kuweka kipanua bronkasi, na upungufu wa kuwepo kwa atopi katika familia.<ref name=Hargreave>{{cite journal |author1=Hargreave FE |author2=Parameswaran K |title=Asthma, COPD and bronchitis are just components of airway disease |journal=European Respiratory Journal |volume=28 |issue=2 |pages=264–267 |month=August |year=2006 |url=http://erj.ersjournals.com/content/28/2/264.full |pmid=16880365 |doi=10.1183/09031936.06.00056106 |access-date=2014-01-09 |archive-date=2016-01-13 |archive-url=https://web.archive.org/web/20160113080726/http://erj.ersjournals.com/content/28/2/264.full |url-status=dead }}</ref><ref name="Applied Therapeutics 2009">{{cite book|author=Diaz, P. Knoell |title=Applied therapeutics: the clinical use of drugs|edition=9th |location=Philadelphia |publisher=Lippincott Williams & Wilkins |year=2009|chapter=23. ugonjwa sugu wa mapafu zibifu }}</ref> ==Uzuiaji== Ushahidi wa kufanya kazi kwa mikakati ya kuzuia kutokea kwa ugonjwa ni finyu.<ref name="NHLBI07p184"/> Baadhi huonyesha matumaini ikijumuisha: kuepekuna na sehemu zilizo na moshi [[katika uterasi]] na baada ya kuzaa, [[unyonyeshaji]], na ongezeko la utunzaji au familia kubwa lakini hakuna hata moja inayopendekezwa kwa dalili hii.<ref name="NHLBI07p184">{{harvnb|NHLBI Guideline|2007|pp=184–5}}</ref> Kufichuliwa kwa mnyama mapema inaweza kusaidia.<ref>{{cite journal|last=Lodge|first=CJ|coauthors=Allen, KJ; Lowe, AJ; Hill, DJ; Hosking, CS; Abramson, MJ; Dharmage, SC|title=Perinatal cat and dog exposure and the risk of asthma and allergy in the urban environment: a systematic review of longitudinal studies.|journal=Clinical & developmental immunology|year=2012|volume=2012|pages=176484|pmid=22235226}}</ref> Matokeo ya ufichuzi kwa wanyma wakati mwingine inashida<ref>{{cite journal|last=Chen|first=CM|coauthors=Tischer, C; Schnappinger, M; Heinrich, J|title=The role of cats and dogs in asthma and allergy—a systematic review.|journal=International journal of hygiene and environmental health|date=2010 Jan|volume=213|issue=1|pages=1–31|pmid=20053584}}</ref> na inapendekezwa tu wanyma watolewe nyumbani ikiwa binadamu ana dalili za aleji ya mnyama huyo.<ref name=Au2005/> Upangaji mlo wakati wa ujauzito au unyonyeshaji haibainishi kama njia nzuri na hivyo haipendekezwi.<ref name=Au2005>{{cite journal|last=Prescott|first=SL|coauthors=Tang, ML; Australasian Society of Clinical Immunology and, Allergy|title=The Australasian Society of Clinical Immunology and Allergy position statement: Muhtasari wa uzuiaji wa aleji kwa watoto.|url=https://archive.org/details/sim_medical-journal-of-australia_2005-05-02_182_9/page/464|journal=The Medical journal of Australia|date=2005 May 2|volume=182|issue=9|pages=464–7|pmid=15865590}}</ref> Utoaji au upunguzaji wa vitu vilivyo hatari kwa watu kazini inaweza kuwa salama.<ref name=Baur2012/> ==Udhibiti== Ilhali hakuna matibabu ya pumu, dalili zinaweza kuboreshwa.<ref>{{cite book|last=Ripoll|first=Brian C. Leutholtz, Ignacio|title=Exercise and disease management|publisher=CRC Press|location=Boca Raton|isbn=978-1-4398-2759-8|page=100|url=http://books.google.ch/books?id=eAn9-bm_pi8C&pg=PA100|edition=2nd ed.}}</ref> Mpango maalum, ulioboreshwa kwa kufuatilia na kudhibiti dalili inapaswa kutengenezwa. Mpango huu unapaswa kujumuisha upunguzaji wa alejeni, kwa uchunguzi wa kutathmini ukali, na matumizi ya dawa. Mpango wa matibabu unapaswa kuandikwa chini na kuwashauri kuhusu marekebisho ya matibabu kulingana na mabadiliko ya dalili.<ref name=GINA_2011_page56>{{harvnb|GINA|2011|p=56}}</ref> Njia mwafaka ya kutibu ni kutambua visababishi, kama vile [[Madhara ya uvutaji wa sigara kwa afya|uvutaji wa sigara]], wanyama, au [[aspirin]], na kuepukana nao. Ikiwa haiwezekani, matumizi ya dawa utahitajika. Dawa ya matibabu yanachaguliwa kwa kuzingatia, vitu vingi, ukali wa ugonjwa na marudio ya dalili. Matibabu maalum ya pumu huanishwa kwa jumla katika kategoria zinazojitokeza na zinazochukua muda.<ref name=NHLBI07p213>{{harvnb|NHLBI Guideline|2007|p=213}}</ref><ref name=BGMA08>{{cite web|url=http://www.sign.ac.uk/pdf/sign101.pdf|title=British Guideline on the Management of Asthma|format=PDF|publisher=Scottish Intercollegiate Guidelines Network|year=2008|accessdate=2008-08-04|archiveurl=https://web.archive.org/web/20080819203455/http://www.sign.ac.uk/pdf/sign101.pdf|archivedate=2008-08-19|deadurl=no}}</ref> [[Vipanua bronkasi]] vinapendekezwa kwa dalili za muda mfupi.<!-- <ref name=NAEPP/> --> Matibabu mengine hayahitajiki, kwa wanaokuwa na maumivu kila mara.<!-- <ref name=NAEPP/> --> Ikiwa ugonjwa itaendelea kudumu (kuwa mgonjwa zaidi ya mara mbili kwa wiki moja), dozi ndogo ya kuvuta ya kotikosteroidi au nyingine, ya kunywa [[leukotriene antagonist]] au [[mast cell stabilizer]] inapendekezwa.<!-- <ref name=NAEPP/> --> Kwa walio na maumivu kila siku, dozi kubwa ya kotikosteroidi ya kuvuta inatumiwa. Wakati wa maumivu, kotikosteroidi ya kumeza zinaongezwa kwa matibau haya.<ref name="NHLBI07p214">{{harvnb|NHLBI kielekezie|200707|p=214}}</ref> ===Ubadilishaji wa mtindo wa maisha=== Uepaji wa visababishi ni sehemu kuu ya kuboresha udhibiti na kuzuia kupatwa na ugonjwa. Visababishi vya kawaida sana ni pamoja na [[alejeni]], moshi (tobako na vingine), uchafuzi wa hewa, [[Kizuizi beta#Maajenti wasio chaguzi|vizuizi beta visivyo chaguzi]], na chakula kilicho na salfeti.<ref name=NAEPP2007p69>{{harvnb|NHLBI Guideline|2007|p=69}}</ref><ref name=thomson>{{cite journal |author=Thomson NC, Spears M |title=Athari ya kuvuta sigara kwa matokeo ya matibabu kwa wagonjwa walio na pumu |journal=Curr Opin Allergy Clin Immunol|volume=5 |issue=1 |pages=57–63 |year=2005 |pmid=15643345|doi=10.1097/00130832-200502000-00011}}</ref> Uvutaji sigara na [[uvutaji moshi kutoka kwa anayevuta sigara]](moshi wa mtu mwingine) unaweza kupunguza utendakazi wa dawa kama vile kotikosteroidi.<ref name=Stap2011>{{cite journal| author=Stapleton M, Howard-Thompson A, George C, Hoover RM, Self TH| title=Smoking and asthma. | journal=J Am Board Fam Med | year= 2011 | volume= 24| issue= 3 | pages= 313–22 | pmid=21551404 | doi=10.3122/jabfm.2011.03.100180}}</ref> Juhudi za kudhibiti wadudu wa vumbi, pamoja na kuchunja hewa, kemikali za kuua wadudu, kutumia kivuta vumbi, vitu vya kufunika godoro na njia zingine hazikuwa na mabadiliko kwa dalili za ugonjwa.<ref name=Gotzsche2008>{{cite journal |author=[[Peter C. Gøtzsche|PC Gøtzsche]], HK Johansen|title=House dust mite control measures for asthma|journal=Cochrane Database Syst Rev|issue=2 |pages=CD001187 |year=2008 |doi=10.1002/14651858.CD001187.pub3 |pmid=18425868|editor1-last=Gøtzsche |editor1-first=Peter C}}</ref> ===Dawa=== [[Dawa]] zinazotumika kutibu pumu zimegawanywa mara mbili: zinazotuliza maumivu haraka kwa kutibu dalili kali; na za kudhibiti maumivu kwa muda mrefu ambazo huzuia ongezeko la ugonjwa.<ref name="NHLBI07p213">{{harvnb|NHLBI Guideline|2007|p=560}}</ref> ;Zinazofanya kazi haraka [[File:Salbutamol2.JPG|thumb|alt=Kopo la mviringo juu ya kishikizi cha buluu cha plastiki|[[Sabutamoli]] kivutia dawa cha dozi kinachotumika kwa matibabu.]] * beta2-adrenajiki agonisti[[inayofanya kazi kwa muda mfupi|beta₂-adrenosepta agonistsi]] (SABA), kama vile [[sabutamoli]] (''albuterol'' [[Jina linalotumika Marekani|USAN]]) ni matibabu ya kwanza ya dalili za ugonjwa.<ref name="NHLBI07p214" /> *Dawa za [[Anticholinergic]] kama vile [[ipratropiamu|bromidi ya ipratropiamu]], hupeana faida zinapotumika pamoja na SABA kwa walio na dalili.<ref name="NHLBI07p214" /> Vipanuzi vya bronkasi visivyo na anticholinergic inaweza pia hutumika iwapo mtu hawezi kustahimili SABA.<ref name="Self, Timothy 2009"/> * Kipokezi cha adrenaji cha zamani, kisichochaguliwa sana [[adrenajiki agonistsi]], kama vile [[epinephrine]] ya kuvuta huwa na matokeo sawa na yale ya SABA.<ref name=Rodrigo>{{cite journal|author=Rodrigo GJ, Nannini LJ |title=Comparison between nebulized adrenaline and beta2 agonists for the treatment of acute asthma. Uchunguzi wa meta wa majaribio tofauti meta-analysis of randomized trials|url=https://archive.org/details/sim_american-journal-of-emergency-medicine_2006-03_24_2/page/217 |journal=Am J Emerg Med |volume=24 |issue=2 |pages=217–22 |year=2006 |pmid=16490653|doi=10.1016/j.ajem.2005.10.008}}</ref> Hazipendekezwi kwa sababu ya tatizo la kuchangamsha moyo.<ref name="NHLBI07p351">{{harvnb|NHLBI Guideline|2007|p=351}}</ref> ;Udhibiti wa muda mrefu [[File:Fluticasone.JPG|thumb|alt=Kopo la mviringo juu ya kishikizi cha plastiki cha rangi ya chungwa|[[Fluticasone propionate]] kivutia dawa kwa kawaida kinachotumika kwa udhibiti wa muda mrefu.]] *Kotikosteroidi huchukuliwa kama matibabu yanayofaa kwa udhibiti wa muda mrefu.<ref name=NHLBI07p213/> Aina zinazovutwa hutumika isipokuwa kwa ugonjwa kali unaoendelea, ambapo kotikosteroidi za kumeza zitahitajika.<ref name=NHLBI07p213/> Hupendekezwa kuwa aina za kuvutwa zitumike mara moja au mbili kwa siku, kulingana na ukali wa dalili.<ref name="NHLBI07p218">{{harvnb|NHLBI Guideline|2007|p=218}}</ref> *[[Adrenosepta agonisti beta zinazofanya kazi kwa muda mrefu]] (LABA) kama vile [[salmeterol]] na [[formoterol]] zinaweza kuboresha udhibiti wa ugonjwa, angalau kwa watu wazima, zinapopeanwa pamoja na kotikosteroidi za kuvuta.<ref name=Ducharme2010>{{cite journal|last=Ducharme|first=FM|coauthors=Ni Chroinin, M; Greenstone, I; Lasserson, TJ|title=Addition of long-acting beta2-agonists to inhaled corticosteroids versus same dose inhaled corticosteroids for chronic asthma in adults and children.|journal=Cochrane database of systematic reviews (Online)|date=2010 May 12|issue=5|pages=CD005535|pmid=20464739}}</ref> Kwa watoto faida hii si hakika.<ref name=Ducharme2010/><ref>{{cite journal|last=Ducharme|first=FM|coauthors=Ni Chroinin, M; Greenstone, I; Lasserson, TJ|title=Addition of long-acting beta2-agonists to inhaled steroids versus higher dose inhaled corticosteroids in adults and children with persistent asthma.|journal=Cochrane database of systematic reviews (Online)|date=2010 Apr 14|issue=4|pages=CD005533|pmid=20393943}}</ref> Zinapotumika bila steroidi huongeza hatari ya [[athari]]<ref name=Fanta2009>{{cite journal |author=Fanta CH|title=Asthma |url=https://archive.org/details/sim_new-england-journal-of-medicine_2009-03-05_360_10/page/1002|journal=New England Journal of Medicine |volume=360|issue=10|pages=1002–14 |year=2009|month=March |pmid=19264689 |doi=10.1056/NEJMra0804579 }}</ref> na hata zikitumiwa na kotikosteroidi zinaweza kuongeza hatari kidogo.<ref name=Cates2012>{{cite journal|last=Cates|first=CJ|coauthors=Cates, MJ|title=Regular treatment with formoterol for chronic asthma: serious adverse events.|journal=Cochrane database of systematic reviews (Online)|date=2012 Apr 18|volume=4|pages=CD006923|pmid=22513944}}</ref><ref>{{cite journal|last=Cates|first=CJ|coauthors=Cates, MJ|title=Regular treatment with salmeterol for chronic asthma: serious adverse events.|journal=Cochrane database of systematic reviews (Online)|date=2008 Jul 16|issue=3|pages=CD006363|pmid=18646149}}</ref> *[[Leukotriene antagonist]] (kama vile [[montelukast]] na [[zafirlukast]]) zinaweza kutumika kando na kotikosteroidi za kuvuta, pia pamoja na LABA.<ref name=NHLBI07p213/> Dhibitisho hairuhusu matumizi katika ongezeko la ugonjwa.<ref name=GINA_2011_page74>{{harvnb|GINA|2011|p=74}}</ref><ref>{{cite journal|last=Watts|first=K|coauthors=Chavasse, RJ|title=Leukotriene receptor antagonists in addition to usual care for acute asthma in adults and children.|journal=Cochrane database of systematic reviews (Online)|date=2012 May 16|volume=5|pages=CD006100|pmid=22592708}}</ref> Kwa watoto chini ya umri wa miaka mitano, therapi ya kuongeza baada ya kuvuta kotikosteroidi inapendekezwa.<ref name=bts2009p43>{{harvnb|British Guideline|2009|p=43}}</ref> *[[Mast cell stabilizer]] (kama vile [[sodiamu kromolini]]) haitumiki badala ya kotokosteroidi.<ref name=NHLBI07p213/> ;Njia za kupeana Dawa hupeanwa kama [[kifaa cha kuvutia dawa]] (KKD) pamoja na [[kifaa cha kupeana dawa ya pumu]] au kama [[kivutia dawa cha poda]]. Kifaa kinachopeana dawa ni [[silinda]] ya [[plastiki]] ambayo huchanganya dawa na hewa, na kurahisisha kupata [[dozi]] kamili ya dawa. [[Nebulaiza]] inaweza kutumiwa. Nebulaiza na kifaa cha kutoa nafasi hufaa kwa walio na dalili, hata hivyo hakuna thibitisho kuamua iwapo kuna au hakuna tofauti kwa dalili kali.<ref name="NHLBI07p250">{{harvnb|NHLBI Guideline|2007|p=250}}</ref> ;Athari Matumizi ya muda mrefu ya kotikosteroidi ya kuvuta huwa na hatari ndogo ya athari.<ref name=Safe09>{{cite journal|last=Rachelefsky|first=G|title=Inhaled corticosteroids and asthma control in children: assessing impairment and risk.|journal=Pediatrics|date=2009 Jan|volume=123|issue=1|pages=353–66|pmid=19117903|doi=10.1542/peds.2007-3273}}</ref> Hatari ni pamoja na kutokea kwa [[cataract]] na kurudi nyuma kidogo kwa akili.<ref name=Safe09/><ref>{{cite journal |author=Dahl R |title=Systemic side effects of inhaled corticosteroids in patients with asthma |journal=Respir Med |volume=100 |issue=8|pages=1307–17 |year=2006 |month=August|pmid=16412623|doi=10.1016/j.rmed.2005.11.020}}</ref> ===Dawa nyingine=== Pumu isipobadilika na dawa za kawaida, kuna aina zingine za chaguo zinazopatikana kwa udhibiti wa dharura na uzuizi wa milipuko. Kwa udhibiti wa dharura aina zingine za chaguo ni: *[[Oksijeni]] ili kutuliza [[haipoksia (dawa)|haipoksia]] ikiwa [[kiwango cha juu cha oksijeni|viwango vya juu]] iko chini ya asilimia 92.<ref name=rodrigo>{{cite journal |author=Rodrigo GJ, Rodrigo C, Hall JB |title=Acute asthma in adults: a review |url=https://archive.org/details/sim_chest_2004-03_125_3/page/1081 |journal=Chest |volume=125|issue=3 |pages=1081–102 |year=2004 |pmid=15006973| doi = 10.1378/chest.125.3.1081}}</ref> *[[Salfeti ya magnesia]] matibabu ya mishipa ya ndani yameonyeshwa kusababisha athari ya kupanua bronkasi inapotumika pamoja na matibabu mengine katika mashambulizi makali ya ugonjwa.<ref name="NHLBI07p373">{{harvnb|NHLBI Guideline|2007|p=373}}</ref><ref>{{cite journal|journal=Chest |volume=122 |issue=2 |pages=396–8 |date = August 2002|doi=10.1378/chest.122.2.396 |title=Magnesium Treatment for Asthma : Where Do We Stand? |url=https://archive.org/details/sim_chest_2002-08_122_2/page/396 |last1=Noppen |first1=M. |pmid=12171805 }}</ref> *[[Helioksi]], mchanganyiko wa heli na oksijeni, unaweza kutumiwa kwa visa vikali visivyoonyesha mabadiliko kwa kutumia dawa.<ref name="NHLBI07p373"/> * Sabutamoli ya mishipa ya ndani haitetewi na dhibitisho linalopatikana na hivyo hutumika tu kwa visa vikali zaidi.<ref name=rodrigo/> *[[Methylxanthines]] (kama vile [[theophylline]]) wakati mmoja ilitumika kwa wingi, lakini haiongezi athari za beta-agonistsi.<ref name=rodrigo/> Matumizi yake kwa maumivu makali huwa na pingamizi.<ref name=GINA_2011_page37>{{harvnb|GINA|2011|p=37}}</ref> * Kitiaganzi kinachojitenga [[ketamini]] inaweza kutumiwa kinadharia iwapo [[intubesheni]] na [[uingizaji wa hewa]] utahitajika kwa watu wanaokaribia kuwa na tatizo la upumuo; hata hivyo, hakuna dibitisho kutoka kwa majaribio ya kliniki ili kudhibitisha hili.<ref name="NHLBI07p399">{{harvnb|NHLBI Guideline|2007|p=399}}</ref> Kwa walio na ugonjwa kali unaoendelea usiodhibitiwa na kotikosteroidi za kuvuta na LABAS [[themoplasti ya bronkasi]] inaweza kutumiwa.<ref name=Bronch10>{{cite journal|last=Castro|first=M|coauthors=Musani, AI, Mayse, ML, Shargill, NS|title=Bronchial thermoplasty: a novel technique in the treatment of severe asthma.|journal=Therapeutic advances in respiratory disease|date=2010 Apr|volume=4|issue=2|pages=101–16|pmid=20435668|doi=10.1177/1753465810367505}}</ref> Huhusisha hupeanaji wa nishati joto kwa njia za hewa wakati wa mifululizo ya [[bronkoskopi|bronkoskopi]].<ref name=Bronch10/> Ingawa inaweza kuongeza idadi ya maumivu katika miezi michache ya kwanza huonekana kupunguza idadi ambayo hufuata.<!-- <ref name=GINA_2011_page70> -->Athari za kupita mwaka mmoja hazijulikani.<ref name=GINA_2011_page70>{{harvnb|GINA|2011|p=70}}</ref> ===Dawa mbadala=== Watu wengi, kama wale walio na matatizo ya muda mrefu, hutumia [[dawa mbadala|matibabu mbadala]]; uchunguzi unaonyesha kuwa takribani asilimia 50 hutumia baadhi ya therapi isiyo ya kawaida.<ref name=blanc>{{cite journal |author=Blanc PD, Trupin L, Earnest G, Katz PP, Yelin EH, Eisner MD |title=Alternative therapies among adults with a reported diagnosis of asthma or rhinosinusitis : data from a population-based survey |url=https://archive.org/details/sim_chest_2001-11_120_5/page/1461 |journal=Chest|volume=120 |issue=5 |pages=1461–7 |year=2001 |pmid=11713120| doi = 10.1378/chest.120.5.1461}}</ref><ref name=shenfield>{{cite journal |author=Shenfield G, Lim E, Allen H |title=Survey of the use of complementary medicines and therapies in children with asthma |url=https://archive.org/details/sim_journal-of-paediatrics-and-child-health_2002-06_38_3/page/252 |journal=J Paediatr Child Health |volume=38 |issue=3 |pages=252–7|year=2002 |pmid=12047692| doi = 10.1046/j.1440-1754.2002.00770.x}}</ref> Kuna data chache ya kudhibitisha utendakazi wa therapi hizi. Ushahidi hautoshi kudhibitisha matumizi ya vitamini C.<ref>{{cite journal | last=Kaur | first=B | title=Vitamin C supplementation for asthma | journal=Cochrane Database Syst Rev | issue=1 | pages=CD000993| year=2009 | pmid=19160185 | doi=10.1002/14651858.CD000993.pub3 | coauthors=Rowe BH, Arnold E | editor1-last=Arnold | editor1-first=Elizabeth | unused_data=coauthorsRowe BH, Arnold E }}</ref> [[Acupuncture]] haipendekezwi kwa matibabu maana hakuna ushahidi wa kudhibitisha matumizi yake.<ref name="NHLBI07p240"/><ref name=mccartney>{{cite journal |author=McCarney RW, Brinkhaus B, Lasserson TJ, Linde K|title=Acupuncture for chronic asthma |journal=Cochrane Database Syst Rev |issue=1|pages=CD000008 |year=2004 |pmid=14973944 |doi=10.1002/14651858.CD000008.pub2|editor1-last=McCarney |editor1-first=Robert W}}</ref> [[Kutia aioni kwa hewa]] haionyeshi ushahidi wa mabadiliko ya dalili au kusaidia utendakazi wa mapafu; hii ikitumika sawa kwa jenereta hasi na zisizo hasi.<ref>{{cite journal|last=Blackhall|first=K|coauthors=Appleton, S; Cates, CJ|title=Ionisers for chronic asthma.|journal=Cochrane database of systematic reviews (Online)|date=2012 Sep 12|volume=9|pages=CD002986|pmid=22972060}}</ref> "Therapi za mikono", ikiwa ni pamoja na [[osteopathi|osteopathi]], [[kiropraktiki]], [[therapi ya kimwili|fiziotherapi]] na [[therapi ya pumzi|therapi ya pumzi]] washawishi, wasio na ushahidi wa kudhibitisha matumizi kwa kutibu pumu.<ref name=hondras>{{cite journal |author=Hondras MA, Linde K, Jones AP |title=Manual therapy for asthma |journal=Cochrane Database Syst Rev |issue=2 |pages=CD001002 |year=2005|pmid=15846609 |doi=10.1002/14651858.CD001002.pub2 |editor1-last=Hondras|editor1-first=Maria A}}</ref> [[Mbinu ya Butyko ya kupumua]] ya kudhibiti upitishaji wa hewa nyingi inaweza kusababisha upungufu wa matumizi ya dawa hata hivyo haina athari yoyote kwa pafu.<ref name=BGMA08/> Hivyo kamati ya wastadi ilihisi kuwa ushahidi haukutosha kudhibitisha matumizi yake.<ref name="NHLBI07p240">{{harvnb|NHLBI Guideline|2007|p=240}}</ref> == Prognosisi== [[File:Asthma world map - DALY - WHO2004.svg|thumb|alt=Ramani ya ulimwengu Ulaya ukiwa umepakwa rangi ya manjano, sehemu nyingi za Amerika ukiwa na rangi ya chungwa na Kusini mwa Afrika ukiwa na rangi nyekundu nzito|[[Ulemavu-uliobadilisha miaka ya maisha]] kwa pumu kwa watu 100,000&nbsp;mwaka wa 2004.<ref>{{cite web|url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html|title=WHO Disease and injury country estimates |year=2009 |work=World Health Organization |accessdate=Nov. 11, 2009}}</ref><ref>|archiveurl=https://web.archive.org/web/20091111101009/http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html%7Carchivedate%3D 11 November 2009 <!--DASHBot-->| deadurl= no}}</ref> {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<100}} {{legend|#fff200|100–150}} {{legend|#ffdc00|150–200}} {{legend|#ffc600|200–250}} {{legend|#ffb000|250–300}} {{legend|#ff9a00|300–350}} {{Multicol-break}} {{legend|#ff8400|350–400}} {{legend|#ff6e00|400–450}} {{legend|#ff5800|450–500}} {{legend|#ff4200|500–550}} {{legend|#ff2c00|550–600}} {{legend|#cb0000|>600}} {{Multicol-end}} ]] Prognosi ya pumu ni nzuri, hasa kwa watoto walio na ugonjwa usio mkali.<ref>{{cite book |editor1-first=Allan B. |editor1-last=Wolfson |editor2-first=Ann|editor2-last=Harwood-Nuss |title=Harwood-Nuss' Clinical Practice of Emergency Medicine|chapterurl=http://books.google.com/books?id=Idb0Z658lFQC&pg=PT465 |date=September 2009|publisher=Lippincott Williams & Wilkins |isbn=978-0-7817-8943-1 |pages=432–|first1=Michelle J. |last1=Sergel |first2=Rita K. |last2=Cydulka |chapter=Ch. 75: Asthma|edition=5th}}</ref> Vifo vimepungua katika miongo michache iliyopita kwa sababu ya utambuzi na uboreshaji wa utunzaji.<ref name=NHLBI07p1>{{harvnb|NHLBI Guideline|2007|p=1}}</ref> Ulimwenguni umesababisha [[ulemavu]] wa watu milioni 19.4&nbsp; kufikia mwaka wa 2004 (milioni 16&nbsp;wakiwa katika hali ya chini na ya kawaida katika nchi zinazoendelea).<ref>{{cite book|last=Organization|first=World Health|title=The global burden of disease : 2004 update.|url=https://archive.org/details/globalburdenofdi0000unse_i1e5|year=2008|publisher=World Health Organization|location=Geneva, Switzerland|isbn=978-92-4-156371-0|page=[https://archive.org/details/globalburdenofdi0000unse_i1e5/page/35 35]|edition=[Online-Ausg.]}}</ref> Kwa pumu uliotambuliwa wakati wa utotoni, [[nusu]] ya hali hizi hazitafanyiwa utambuzi baada ya mwongo mmoja.<ref name=El2010/> Upitishaji wa hewa hutengenezwa upya, lakini haijulikani ikiwa italeta faida au madhara.<ref name=Maddox>{{cite journal |author=Maddox L, Schwartz DA |title=The pathophysiology of asthma |journal=Annu. Rev. Med. |volume=53|pages=477–98 |year=2002 |pmid=11818486 |doi=10.1146/annurev.med.53.082901.103921}}</ref> Matibabu ya mapema kwa kutumia kotikosteroidi inaonekana kuzuia au kusaidia kupunguza matumizi kwa pafu.<ref name=beckett>{{cite journal |author=Beckett PA, Howarth PH|title=Pharmacotherapy and airway remodelling in asthma? |url=https://archive.org/details/sim_thorax_2003-02_58_2/page/163|journal=Thorax |volume=58|issue=2 |pages=163–74 |year=2003 |pmid=12554904| doi = 10.1136/thorax.58.2.163|pmc=1746582}}</ref> ==Epidemiolojia== [[Image:Prevalence of Clinical Asthma world map - GINA2004.svg|thumb|left|alt=Ramani ya dunia ikiwa na Ulaya, Marekani Kaskazini, Australia na sehemu nyingi za Marekani Kusini yakichorwa nyekundu, sehemu nyingi za Asia yakiwa manjano, na sehemu nyingi za Afrika yakiwa kijivu|Viwango vya pumu katika nchi tofauti ulimwenguni kufikia mwaka wa 2004. {{Multicol}} {{legend|#e0e0e0|no data}} {{legend|#ffff65|<1%}} {{legend|#fff200|1-2%}} {{legend|#ffdc00|2-3%}} {{legend|#ffc600|3-4%}} {{legend|#ffb000|4-5%}} {{legend|#ff9a00|5-6%}} {{Multicol-break}} {{legend|#ff8400|6-7%}} {{legend|#ff6e00|7-8%}} {{legend|#ff5800|8-10%}} {{legend|#ff4200|10-12.5%}} {{legend|#ff2c00|12.5–15%}} {{legend|#cb0000|>15%}} {{Multicol-end}}]] Kufikia mwaka wa 2011, watu milioni 235–300 ulimwenguni walikuwa wameathiriwa na ugonjwa huu,<ref name=WHO2011>{{cite web|title=World Health Organization Fact Sheet Fact sheet No 307: Asthma|year=2011|url=http://www.who.int/mediacentre/factsheets/fs307/en/|accessdate=Jan 17th,2013|archivedate=2011-06-29|archiveurl=https://web.archive.org/web/20110629035454/http://www.who.int/mediacentre/factsheets/fs307/en/}}</ref><ref name=GINA_2011_page3/> na karibu watu 250,000 hufa kila mwaka.<ref name=GINA2011p2/> Viwango vyao hutofautiana kati ya nchi zilizo na maambukizi kati ya asilimia 1 hadi 18.<ref name=GINA2011p2/> Zinapatikana sana katika [[katika nchi zilizoendelea|zilizoendelea]] kuliko [[nchi zinazokuwa]].<ref name=GINA2011p2/> Kuna viwango vya chini barani Asia, Ulaya Mashariki na Afrika.<ref name=M38/> Katika nchi zilizoendelea ni kawaida kwa wale walio na shida ya kifedha unapolinganisha na nchi zinazokuwa inapatikana sana kwa walio na fedha.<ref name=GINA2011p2/> Sababu ya tofauti hizi haijulikani.<ref name=GINA2011p2/> Nchi zilizo na pato la chini wanajumulisha asilimia 80 ya vifo.<ref>{{cite web|author=World Health Organization|authorlink=World Health Organization|title=WHO: Asthma|url=http://www.who.int/mediacentre/factsheets/fs307/en/|accessdate=2007-12-29|archiveurl=https://web.archive.org/web/20071215181927/http://www.who.int/mediacentre/factsheets/fs307/en/|archivedate=2007-12-15|deadurl=no}}</ref> Ilhali ugonjwa huu unapatikana kwa [[wavulana]] mara mbili zaidi ya [[wasichana]],<ref name=GINA2011p2/> ukali wa ugonjwa hutokea kwa viwango sawa.<ref name=Bush2009>{{cite journal|author=Bush A, Menzies-Gow A|title=Phenotypic differences between pediatric and adult asthma |journal=Proc Am Thorac Soc |volume=6|issue=8 |pages=712–9 |year=2009 |month=December |pmid=20008882|doi=10.1513/pats.200906-046DP }}</ref> Katika utofautishaji, wanawake wana viwango vikubwa vya pumu kuliko wanaume<ref name=GINA2011p2/> na hupatikana sana kwa wachanga kuliko wakubwa.<ref name=M38/> Viwango vya ugonjwa huu ulimwenguni viliongezeka kwa kasi kati ya [[miaka ya 1960]] na [[2008]]<ref>{{cite journal |author=Grant EN, Wagner R, Weiss KB |title=Observations on emerging patterns of asthma in our society |journal=[[J Allergy Clin Immunol]] |year=1999 |month=August|volume=104 |pages=S1–S9 |pmid=10452783 |doi=10.1016/S0091-6749(99)70268-X |issue=2 Pt 2}}</ref><ref>{{cite journal |author=Anandan C, Nurmatov U, van Schayck OC, Sheikh A|title=Is the prevalence of asthma declining? Systematic review of epidemiological studies|journal=Allergy |volume=65 |issue=2 |pages=152–67 |year=2010 |month=February|pmid=19912154 |doi=10.1111/j.1398-9995.2009.02244.x }}</ref> ikipitishwa kama shida kubwa katika [[afya ya umma]] kwanzia miaka ya 1970.<ref name=M38>{{cite book|first=John F. Murray|title=Murray and Nadel's textbook of respiratory medicine.|url=https://archive.org/details/murraynadelstext0002unse|year=2010|publisher=Saunders/Elsevier|location=Philadelphia, PA|isbn=1-4160-4710-7|pages=Chapter 38|edition=5th ed.}}</ref> Viwango vya ugonjwa havijabadilika tangu katikati ya miaka ya 1990 kukiwa na ongezeko katika [[nchi zinazoendelea]].<ref>{{cite journal|last=Bousquet|first=J|coauthors=Bousquet, PJ; Godard, P; Daures, JP|title=The public health implications of asthma.|journal=Bulletin of the World Health Organization|date=2005 Jul|volume=83|issue=7|pages=548–54|pmid=16175830}}</ref> Pumu huathiri takriban asilimia 7 ya watu nchini Marekani<ref name=Fanta2009/> na asilimia 5 nchini Uingereza.<ref name=Anderson2007>{{cite journal | last=Anderson | first=HR | coauthors=Gupta R, Strachan DP, Limb ES | title=50 years of asthma: UK trends from 1955 to 2004 | url=https://archive.org/details/sim_thorax_2007-01_62_1/page/85 |journal=Thorax | volume=62 | issue=1 | pages=85–90 |month=January |year=2007 |pmid=17189533 | doi=10.1136/thx.2006.066407 | pmc=2111282 }}</ref> Kanada, Australia and Nyuzelandi vina viwango vya kati ya asilimia 14-15.<ref>{{cite book|last=Masoli|first=Matthew|title=Global Burden of Asthma|year=2004|page=9|url=http://www.ginasthma.org/pdf/GINABurdenReport.pdf|access-date=2014-01-09|archive-date=2013-05-02|archive-url=https://web.archive.org/web/20130502065938/http://www.ginasthma.org/pdf/GINABurdenReport.pdf|dead-url=yes|=https://web.archive.org/web/20130502065938/http://www.ginasthma.org/pdf/GINABurdenReport.pdf}}</ref> == Historia== Pumu uligunduliwa kitambo nchini [[Misri]] na ulitibiwa kwa kunywa [[ubani]] mchanganyiko unaoitwa [[kyphi]].<ref name="Manniche1999">{{cite book | author = Manniche L |title = Sacred luxuries: fragrance, aromatherapy, and cosmetics in ancient Egypt | pages =[http://books.google.com/books?id=ZCgVdm7UKhIC&pg=PA49 49] | year = 1999 | publisher =[[Cornell University Press]] | isbn=978-0-8014-3720-5 }}</ref> Ulitajwa rasmi kama tatizo la upumuaji na [[Hippocrates]] mwaka [[450 KK]] hivi, kutoka kwa neno la [[Kigriki]] kumaanisha "kuhema" ikiunda asili ya neno la kisasa.<ref name=M38/> Mnamo [[200 KK]] uliaminika kuhusiana kidogo na [[hisia]].<ref name=Andrew2010/> Mwaka wa [[1873]], mmoja kati ya [[karatasi]] za kwanza za dawa za kisasa kuhusu taarifa zilijaribu kuelezea ugonjwa wa [[pathofisiolojia]] ilhali nyingine mwaka wa [[1872]] ilihitimisha kuwa ugonjwa huu unaweza kutibiwa kwa kupanguza kifua na [[A.B.C. Liniment|chloroform liniment]].<ref name="pmid20747287">{{cite journal | author = Thorowgood JC | title = On bronchial asthma| journal =[[British Medical Journal]] | volume = 2 | issue = 673 | pages = 600 | year = 1873 | month = November | pmid = 20747287| pmc = 2294647 |doi = 10.1136/bmj.2.673.600}}</ref><ref name="pmid20746575">{{cite journal | author = Gaskoin G | title = On the treatment of asthma | journal = [[British Medical Journal]] | volume = 1 | issue = 587 |pages = 339 | year = 1872 |month = March | pmid = 20746575 | pmc = 2297349 | doi = 10.1136/bmj.1.587.339 }}</ref> [[Dawa ya kutibu|Matibabu ya afya]] mwaka wa 1880, ilijumuisha matumizi ya [[Kudungiwa sindano ya vena |sindano ya vena]] inayoitwa [[pilocarpin]].<ref name="pmid20749537">{{cite journal | author = Berkart JB | title = The treatment of asthma| journal = [[British Medical Journal]] | volume = 1 | issue = 1016 | pages = 917–8 | year = 1880 | month = June| pmid = 20749537 | pmc = 2240555 | doi = 10.1136/bmj.1.1016.917}}<br/>{{cite journal | author = Berkart JB | title = The treatment of asthma | journal =[[British Medical Journal]] | volume = 1 | issue = 1017 | pages = 960–2 | year = 1880 |month = June | pmid = 20749546 | pmc = 2240530 | doi = 10.1136/bmj.1.1017.960 }}</ref> Mnamo mwaka wa 1886, F.H. Bosworth alieleza uhusiano kati ya pumu na [[mafua ya mzio]].<ref name="pmid21407325">{{cite journal | author = Bosworth FH| title = Hay fever, asthma, and allied affections | journal = Transactions of the Annual Meeting of the American Climatological Association | volume = 2 | pages = 151–70 | year = 1886 | pmid = 21407325 |pmc = 2526599}}</ref> [[epinefrini]] ulirejelewa mara ya kwanza mwaka wa 1905 katika matibabu ya pumu.<ref name="pmid18733372">{{cite journal |author = Doig RL | title = Epinephrin; especially in asthma | journal = California State Journal of Medicine | volume = 3 | issue = 2 | pages = 54–5 | year = 1905 | month = February | pmid = 18733372 | pmc = 1650334}}</ref> Kotikosteroidi za kunywa zilianza kutumiwa miaka ya 1950 ilhali kotikosteroidi za kuvuta na beta agonist za kuchagua zilianza kutumika miaka ya 1960.<ref>{{cite journal|last=von Mutius|first=E|coauthors=Drazen, JM|title=A patient with asthma seeks medical advice in 1828, 1928, and 2012.|url=https://archive.org/details/sim_new-england-journal-of-medicine_2012-03-01_366_9/page/827|journal=New England Journal of Medicine|date=2012 Mar 1|volume=366|issue=9|pages=827–34|pmid=22375974}}</ref><ref>{{cite journal|author=Crompton G |title=A brief history of inhaled asthma therapy over the last fifty years |journal=Primary care respiratory journal : journal of the General Practice Airways Group|date=2006 Dec|volume=15|issue=6|pages=326–31|pmid=17092772}}</ref> Kati ya [[miaka ya 1930]]–[[Miaka ya 1950|1950]], ugonjwa huu ulijulikana kama "takatifu saba" [[maradhi ya saikosomatiki]]. Kisababishi chake kilichukuliwa kama [[saikolojia]], na matibabu kuangaliwa kwa uchunguzi nafsia na matibabu mengine ya [[kuzungumza]].<ref name="pmid16185365"/> Walivyofafanua wachanganuzi ukoromaji wa pumu jinsi [[mtoto]] alivyolilia [[mama]] yake, walibaini kuwa matibabu ya masumbuko ni muhimu kwa walio na pumu.<ref name="pmid16185365">{{cite journal |author=Opolski M, Wilson I |title=Asthma and depression: a pragmatic review of the literature and recommendations for future research |journal=Clin Pract Epidemol Ment Health |volume=1 |page=18 |year=2005|month=September |pmid=16185365 |pmc=1253523 |doi=10.1186/1745-0179-1-18 }}</ref> ==Tanbihi== {{Reflist|colwidth=30em}} ==Viungo vya nje== {{Refbegin}} *{{dmoz|Health/Conditions_and_Diseases/Respiratory_Disorders/Asthma/}} *{{cite web |author=National Asthma Education and Prevention Program (NAEPP) |url=http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf | title=Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma | format=PDF | work=[[National Heart Lung and Blood Institute]] | year=2007 |ref={{harvid|NHLBI Guideline|2007}}}} *{{cite web| url=http://www.sign.ac.uk/pdf/sign101.pdf| format=PDF| title=British Guideline on the Management of Asthma| work=[[British Thoracic Society]]| year=2008 - revised 2012| ref={{harvid|British Guideline|2009}}| accessdate=2014-01-09| archivedate=2008-08-19| archiveurl=https://web.archive.org/web/20080819203455/http://www.sign.ac.uk/pdf/sign101.pdf}} *{{cite web |url=http://www.ginasthma.org/uploads/users/files/GINA_Report2011_May4.pdf |format=PDF |title=Global Strategy for Asthma Management and Prevention |publisher=Global Initiative for Asthma |year=2011 |ref={{harvid|GINA|2011}} |accessdate=2014-01-09 |=https://web.archive.org/web/20121120205023/http://www.ginasthma.org/uploads/users/files/GINA_Report2011_May4.pdf |archivedate=2012-11-20 |archiveurl=https://web.archive.org/web/20121120205023/http://www.ginasthma.org/uploads/users/files/GINA_Report2011_May4.pdf }} [[Jamii:Magonjwa]] [[Jamii:Mapafu]] b2o2kpklj3t8l4dy61vj2y54pcubwc8 0 70147 1578132 1545325 2026-07-02T21:33:41Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578132 wikitext text/x-wiki {{Infobox disease |Name = Lung cancer |Image = LungCACXR.PNG |Caption = A plane [[chest X-ray]] showing a tumor in the lung (marked by arrow) |DiseasesDB = 7616 |ICD10 = {{ICD10|C|33||c|30}}-{{ICD10|C|34||c|30}} |ICD9 = {{ICD9|162}} |ICDO = |OMIM = |MedlinePlus = 007194 |eMedicineSubj = med |eMedicineTopic = 1333 |eMedicine_mult = {{eMedicine2|med|1336}}{{eMedicine2|emerg|335}}{{eMedicine2|radio|807}}{{eMedicine2|radio|405}}{{eMedicine2|radio|406}} |MeshID = D002283 }} '''Saratani ya mapafu''' ni ugonjwa unaohusishwa na [[ukuaji wa seli]] katika [[tishu (biolojia)|tishu]] za [[mapafu]]. Tishu hii isipotibiwa, inaweza kuenea kwa njia inayoitwa [[metastasisi]] kwa tishu zilizokaribu au kwa mwili. Saratani zinazoanzia kwa mapafu, ziitwazo saratani za kwanza, ni [[kasinomasi]] zinazotoka kwa seli za [[epitheliumu|epitheliumu]]. Aina kuu za saratani ni kasinoma ya mapafu ya seli ndogo (KMSN), pia huitwa saratani ya seli ya oat, na kasinoma ya mapafu ya seli kubwa (KMSK). [[Dalili]] inayojulikana sana ni kukohoa (pamoja na [[Hemotisisi|kukohoa damu]]), kupoteza uzito na upungufu wa pumzi.<ref name="Harrison" /> [[Faili:LungCACXR.PNG|235x235px|LungCACXR]] Kisababishi kikuu cha saratani ya mapafu ni kuathiriwa na [[uvutaji tumbaku|moshi wa tumbaku]],<ref name="Merck" /> unaosababisha asilimia 80&ndash;90 ya saratani.<ref name="Harrison" /> Wasiovuta huchangia visa hivi kwa asilimia 10-15&ndash;<ref name="Thun" /> na mara nyingi huhusishwa na muungano wa [[jenetiki|masuala ya kijenetiki]],<ref name="MurrayNadel46" /> gesi ya [[radoni]],<ref name="MurrayNadel46" /> [[asbesto]],<ref name="O'Reilly" /> na [[uchafuzi wa hewa]]<ref name="MurrayNadel46" /> pamoja na [[uvutaji moshi|moshi kutoka kwa anayevuta sigara]].<ref name="AUTOREF" /><ref name="AUTOREF1" /> Saratani ya mapafu inaweza kuonekana kwa [[rediografu ya kifua]] na [[tomografi ya kompyuta]] (ukaguzi wa CT). [[Utambuzi wa kimatibabu|utambuzi]] hudhibitishwa kwa [[biopsi]]<ref name="Holland-Frei78" /> ambao hutekelezwa kwa [[bronkoskopi]] au mwongozo wa CT. Matibabu na matokeo ya muda mrefu hulingana na aina ya saratani, [[hatua ya (patholojia)|hatua]] (kiwango cha uenezi), na afya kwa jumla ya mtu, ikipimwa kwa [[hali ya utendakazi]]. Matibabu ya kawaida ni pamoja na [[upasuaji]], [[kemotherapi]], na [[therapi ya mnururisho|radiotherapi]]. KMSK wakati mwingine hutibiwa na upasuaji, ilhali KMSN huwa bora kwa kemotherapi na radiotherapi.<ref>{{cite book |last=Chapman | first=S | coauthors=Robinson G, Stradling J, West S | title=Oxford Handbook of Respiratory Medicine |url=https://archive.org/details/oxfordamericanha0000unse_k7m5 |edition=2nd | chapter=Chapter 31 | publisher=Oxford University Press | year=2009 | isbn=9-780199-545162 }}</ref> Kwa jumla, asilimia 15 ya waliopatikana na saratani nchini Marekani wana [[uwezekano wa kuishi|kuishi]] miaka mitano.<ref name="Collins" /> Ulimwenguni kote, [[saratani ya mapafu]] ni kisababishi cha kawaida cha vifo vinavyohusiana na saratani kwa wanaume na wanawake, na husababisha [[:aina ya:Vifo kutokana na saratani ya mapafu|Vifo milioni 1.38]] kwa mwaka, kufikia 2008.<ref name="GLOBOCAN" /> {{TOC limit|3}} ==Ishara na dalili== Ishara na dalili zinazoashiria saratani ya mapafu ni pamoja na:<ref name="Harrison" /> * Dalili za upumuaji: [[kukohoa]], [[hemotisisi|kukohoa damu]], [[mkoromo|kukoroma]] au [[disnia|upungufu wa pumzi]] * Dalili za kimfumo: kupoteza uzito, [[homa]], [[kucha zilizopindika|kupindika]] kwa kucha za vidole, au [[uchovu (kimwili)|uchovu]] * Dalili kwa sababu ya kugandamizwa : [[maumivu ya kifua]], [[maumivu ya mifupa]], [[kuzibwa kwa vena kubwa]], [[dysphagia|matatizo ya kumeza]] Ikiwa saratani itatokea katika [[njia ya hewa]], inaweza kuziba mpito wa hewa, na kusababisha [[disinia|matatizo ya kupumua]]. Uzibaji unaweza kusababisha mkusanyiko wa unyesaji nyuma ya kizibo, na kuwa [[nimonia]].<ref name="Harrison" /> Kulingana na aina ya tyuma, inayoitwa [[sindromu ya paraneoplastiki|fenomena ya paraneoplastiki]] inaweza kuleta magonjwa.<ref name="Honnorat" /> Katika saratani ya mapafu, nimonia zinaweza kuwa pamoja na [[Sindromu ya Lambert–Eaton myasthenic]] (udhaifu wa misuli kwa sababu ya [[kutotenda kazi kwa kinganafsia| autoantibodies]]), [[hipakalkemia]], au [[sindromu ya homoni ya antidiuretic isiyofaa]] (SHAI). Tyuma katika [[mwisho wa mapafu|ncha ya mapafu]], inayoitwa [[tyuma ya Pancoast]], inaweza kuingilia sehemu ya [[mfumo neva wa simpathetiki]], na kusababisha [[sindromu ya Horner]] (kuanguka kwa kikawa cha jicho na mboni kwa upande huo), na kuharibika kwa [[brachial plexus]].<ref name="Harrison" /> Dalili nyingi za saratani hii (kukosa hamu ya chakula, kupoteza uzito, homa, uchovu) si bayana.<ref name="Holland-Frei78" /> Kwa wengi, saratani tayari imeenea zaidi kabla ya kuwa na dalili na kutafuta matibabu. Sehemu za kawaida inayoenea ni pamoja na ubongo, mifupa, [[adrenal gland]], pafulililo mkabala, ini, [[perikadiumu]], na [[figo]].<ref name="ajcc" /> Takribani asilimia 10 ya watu walio na saratani hawana dalili wakati wa utambuzi; saratani hizi hupatikana wakati wa radiotherapi ya kifua.<ref name="Collins" /> ==Visababishi== Saratani hujitokeza kufuatia kuharibika kwa jenetiki kwa [[DNA]]. Hii huathiri utendakazi wa seli, pamoja na seli inayozaa, kufa kwa seli ([[apoptosis]]) na urekebishaji wa DNA. Uharibikaji unapoongezeka, ndivyo hatari ya saratani inavyoongezeka .<ref name="Holland-Frei8">{{Rejea kitabu | last=Brown | first=KM | coauthors=Keats JJ, Sekulic A et al. |title=Holland-Frei Cancer Medicine | publisher=People's Medical Publishing House USA | year=2010 | chapter=8 | edition=8th| isbn=978-1607950141 }}</ref> ===Uvutaji wa sigara=== . [[Uvutaji wa tumbaku |Uvutaji]], haswa [[sigara]], ni kisababishi kikuu cha saratani ya mapafu.<ref name="AUTOREF5" /> Moshi wa sigara huwa na [[kasinojeni]] zaidi ya 60 inayojulikana,<ref name="Hecht" /> ikijumuisha [[radioisotopu]] kutoka uozaji wa [[radoni]], [[nitrosamine]], na [[benzopyrene]]. Kwa kuongeza, nikotini huonekana kuvunja matokeo ya kinga kwa uvimbe wa saratani kwa tishu zilizowazi.<ref name="AUTOREF6" /> Katika nchi zilizoendelea, asilimia 90 ya vifo vya saratani kwa wananume mwaka wa 2000 zilihusishwa na uvutaji wa sigara (asilimia 70 kwa wanawake).<ref name="Peto" /> Uvutaji huchangia kwa asilimia 80-90 ya visa vya saratani.<ref name="Harrison" /> [[Uvutaji wa moshi kutoka kwa anayevuta sigara]]—uvutaji moshi kutoka kwa mvuta siagara—ni kisababishi cha saratani kwa wasiovuta sigara. Mtu asiyevuta anaweza kuainishwa kama mtu anayeishi au kufanya kazi na mvutaji. Utafiti kutoka Marekani,<ref name="AUTOREF7">{{Rejea jarida | last=California Environmental Protection Agency | title=Health effects of exposure to environmental tobacco smokeCalifornia Environmental Protection Agency | journal=Tobacco Control | volume=6 | issue=4 | pages=346–353 | year=1997 | url=http://www.druglibrary.org/schaffer/tobacco/caets/ets-main.htm | pmid=9583639 | doi=10.1136/tc.6.4.346 | pmc=1759599 | archive-date=2007-08-08 | access-date=2014-01-09 | archive-url=https://web.archive.org/web/20070808045344/http://druglibrary.org/schaffer/tobacco/caets/ets-main.htm | url-status=dead }}<br />* {{Rejea jarida | last=CDC | authorlink=Centers for Disease Control and Prevention | title=State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke—United States, 2000 | journal=Morbidity and Mortality Weekly Report | volume=50 | issue=49 | pages=1101–1106 | publisher=CDC | location=Atlanta, Georgia | month=December | year=2001 | url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5049a1.htm | pmid=11794619 | author1=Centers for Disease Control and Prevention (CDC) }}</ref><ref name="Alberg">{{Rejea jarida | last=Alberg | first=AJ | coauthors=Samet JM | title=Epidemiology of lung cancer | journal=Chest | volume=132 | issue=S3 | pages=29S–55S | publisher=American College of Chest Physicians | month=September | year=2007 | url=http://chestjournal.chestpubs.org/content/132/3_suppl/29S.long | pmid=17873159 | doi=10.1378/chest.07-1347 | access-date=2014-01-09 | archive-date=2020-03-29 | archive-url=https://web.archive.org/web/20200329053623/http://chestjournal.chestpubs.org/content/132/3_suppl/29S.long | dead-url=yes }}</ref> Ulaya,<ref>{{Rejea jarida | last=Jaakkola | first=MS | coauthors=Jaakkola JJ | title=Impact of smoke-free workplace legislation on exposures and health: possibilities for prevention | journal=European Respiratory Journal | volume=28 | issue=2 | pages=397–408 | year=2006 | month=August | url=http://erj.ersjournals.com/content/28/2/397.long | pmid=16880370 | doi=10.1183/09031936.06.00001306 | access-date=2014-01-09 | archive-date=2013-01-29 | archive-url=https://web.archive.org/web/20130129003845/http://erj.ersjournals.com/content/28/2/397.long | url-status=dead }}</ref> Uingereza,<ref>{{Rejea jarida | last=Parkin | first=DM |title=Tobacco—attributable cancer burden in the UK in 2010 | journal=British Journal of Cancer | volume=105 | issue=Suppl. 2 | pages=S6–S13 | month=December | year=2011 | pmid=22158323 | doi=10.1038/bjc.2011.475 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252064/?tool=pubmed| pmc=3252064}}</ref> na Australia<ref name="NHMRC" /> Umeonyesha ongezeko kubwa la hatari kati ya wasiovuta sigara.<ref name="Taylor">{{Rejea jarida | last=Taylor | first=R | coauthors=Najafi F, Dobson A | title=Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent |journal=International Journal of Epidemiology | volume=36 | issue=5 |pages=1048–1059 | year=2007 | month=October | url=http://ije.oxfordjournals.org/content/36/5/1048.long| pmid=17690135 |doi=10.1093/ije/dym158 }}</ref> Wanaoishi na mvuta sigara huwa na asilimia 20&ndash;na 30 ya ongezeko la hatari ilhali wanaofanya kazi katika mazingira yalio na moshi uliovutwa wana asilimia 16&ndash;19 ya ongezeko la hatari.<ref>{{cite web|title=Frequently asked questions about second hand smoke|url=http://www.who.int/tobacco/research/secondhand_smoke/faq/en/index.html|work=World Health Organization|accessdate=25 July 2012|archivedate=2013-01-01|archiveurl=https://web.archive.org/web/20130101163934/http://www.who.int/tobacco/research/secondhand_smoke/faq/en/index.html}}</ref> Uchunguzi kuhusu [[moshi kutoka kwa wanaovuta]] unadokeza kuwa ni hatari zaidi kuliko moshi anaovuta mvutaji mwenyewe.<ref name="Schick" /> Uvutaji wa moshi husababisha takribani vifo 3,400 kutokana na saratani ya mapafu kila mwaka nchini marekani.<ref name="Alberg" /> ===Gesi ya Radoni=== [[Radoni]] ni [[gesi]] isiyo na rangi na harufu inayotokana na kuharibika kwa mnururisho [[radiumu]], ambayo ni bidhaa zilizooza za [[urani]], zinazopatikana katika [[umbo (jiolojia)|umbo]] la ardhi. Bidhaa za mnururisho zilizooza [[ioni]] vitu vya jenetiki, vikisababisha mabadiliko yanayoleta saratani. Radoni ni kisababishi cha pili cha kawaida cha saratani nchini Marekani baada ya uvutaji wa sigara.<ref name="Alberg" /> Hatari huongezeka asilimia 8–16 kwa kila ongezeko la 100 [[becquerel|Bq]]/[[cubic metre|m³]] katika kuwepo kwa radoni .<ref>{{cite journal |author=Schmid K, Kuwert T, Drexler H |title=Radon in Indoor Spaces: An Underestimated Risk Factor for Lung Cancer in Environmental Medicine |journal=Dtsch Arztebl Int |volume=107|issue=11 |pages=181–6 |year=2010 |month=March |pmid=20386676 |pmc=2853156 |doi=10.3238/arztebl.2010.0181 |url=}}</ref> Viwango vya gesi ya radoni hutofautiana kulingana na maeneo na elementi za mchanga ulio chini na miamba. Kwa mfano, katika maeneo kama [[Cornwall]] nchini Uingereza (iliyo na [[granite]] kama safu ya chini), gesi ya radoni ni tatizo kuu, na majengo yanafaa kuwa na matundu ya kupitishia hewa na fani ili kupunguza kiwango cha gesi ya radoni. [[United States Environmental Protection Agency]] Hukadiria kuwa moja kwa maboma 15 nchini Marekani huwa na viwango vya radoni zaidi ya miongozo iliyopendekezwa ya [[picocurie]] 4 kwa kila lita (pCi/l) (148 Bq/m³).<ref name="EPA radon" /> ===Asbesto=== [[Asbesto]] inaweza kusababisha baadhi ya magonjwa ya mapafu, pamoja na saratani yake. Uvutaji wa tumbaku na asbesto huwa na athari ya [[ushirikiano|inayoshirikiana]] kuanza kwa saratani ya mapafu.<ref name="O'Reilly" /> Pia inaweza kusababisha saratani ya [[pleura]], inayoitwa [[mesothelioma]] (ambayo ni tofauti na saratani ya mapafu).<ref>{{Rejea kitabu | last=Daviesfirst=RJO |coauthors=Lee YCG | title=Oxford Textbook Medicine | publisher=OUP Oxford | year=2010 | chapter=18.19.3 | edition=5th |isbn=978-0199204854 }}</ref> ===Kuchafuka kwa hewa=== Kuchafuka kwa hewa huwa na athari ndogo kwa ongezeko la hatari ya saratani ya mapafu.<ref name="MurrayNadel46">{{Rejea kitabu |author=Alberg AJ, Samet JM | title=Murray & Nadel's Textbook of Respiratory Medicine |url=https://archive.org/details/murraynadelstext0001unse_5ed | publisher=Saunders Elsevier |year=2010 | chapter=Chapter 46 | edition=5th | isbn=978-1-4160-4710-0 }}</ref> [[chembe za angahewa|chembe]] (PM_2.5) na [[stratospheric sulfur aerosols|sulfate aerosols]], inayoweza kutoka kwa ekzozi ya magari barabarani, huhusishwa na hatari kidogo.<ref name="MurrayNadel46" /><ref>{{cite journal |last=Chen | first=H | coauthors=Goldberg MS, Villeneuve PJ | journal=Reviews on Environmental Health | year=2008 |month=Oct-Dec | volume=23 |issue=4 | pages=243–297 | title=A systematic review of the relation between long-term exposure to ambient air pollution and chronic diseases | pmid=19235364 }}</ref> Kwa [[naitrojeni dioksidi]], ongezeko la [[Sehemu 10 kwa kila bilioni]] huongeza hatari kwa asilimia 14.<ref>{{cite journal | last=Clapp | first=RW |coauthors=Jacobs MM, Loechler EL | journal=Reviews on Environmental Health | year=2008 | month=Jan-Mar | volume=23|issue=1 | pages=1–37 | title=Environmental and Occupational Causes of Cancer New Evidence, 2005–2007 | pmid=18557596 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791455/?tool=pubmed| pmc=2791455}}</ref> Kuchafuka kwa hewa huchangia karibu asilimia 1-2 ya saratani.<ref name="MurrayNadel46" /> Pendekezo la dhibitisho kuunga mkono ongezeko la hatari ya saratani kutoka kwa [[uchafuzi wa hewa]] unaohusiana na kuchoma kuni, makaa, kinyesi cha mnyama, au mabaki yao ili kupika au kupasha joto.<ref name=Lim2012>{{cite journal|last=Lim|first=WY|coauthors=Seow, A|title=Biomass fuels and lung cancer.|journal=Respirology (Carlton, Vic.)|date=2012 Jan|volume=17|issue=1|pages=20-31|pmid=22008241}}</ref> Wanawake wanaoathiriwa na moshi ya makaa huwa na hatari mara dufu kama baadhi ya mabaki ya kuchoma [[biomasi]] yanajulikana au ni kasinojeni zinazodhaniwa.<ref name=Sood2012/> Hatari hii huathiri takribani watu bilioni 2.4&nbsp; ulimwenguni,<ref name=Lim2012/> Na kuchangia asilimia 1.5 ya vifo vya saratani ya mapafu.<ref name=Sood2012>{{cite journal|last=Sood|first=A|title=Indoor fuel exposure and the lung in both developing and developed countries: an update.|url=https://archive.org/details/sim_clinics-in-chest-medicine_2012-12_33_4/page/649|journal=Clinics in chest medicine|date=2012 Dec|volume=33|issue=4|pages=649-65|pmid=23153607}}</ref> ===Jenetikia=== Inakadiriwa kuwa asilimia 8 hadi 14 ya saratani ya mapafu husababishwa na masuala ya [[urithi|kuurithi]].<ref>{{cite book|last=Dudley|first=Joel|title=Exploring Personal Genomics|year=2013|publisher=Oxford University Press|isbn=9780199644483|page=25|url=http://books.google.ca/books?id=arCnThIq9LcC&pg=PA25}}</ref> Kwa jamaa walio na saratani, hatari huongezeka mara 2.4. Hii inawezekana kwa sababu ya [[polymorphism ya jenetikia|mchanganyiko wa jeni]].<ref name="Fishman1802">{{Rejea kitabu | author=Kern JA, McLennan G | title=Fishman's Pulmonary Diseases and Disorders |publisher=McGraw-Hill | year=2008 | page=1802 | edition=4th | isbn=0-07-145739-9 }}</ref>s ===Visababishi vingine=== Vitu vingine, Kazi, na maeneo mbalimbali yamehusishwa na saratani ya mapafu. [[International Agency for Research on Cancer]] (IARC) unaeleza kuwa "dhibitisho tosha" kuonyesha yafuatayo ni pafu lililo na kasinojeni:<ref name='Saratani ya mapafu YOte'>{{cite journal|last=Cogliano|first=VJ|coauthors=Baan, R; Straif, K; Grosse, Y; Lauby-Secretan, B; El Ghissassi, F; Bouvard, V; Benbrahim-Tallaa, L; Guha, N; Freeman, C; Galichet, L; Wild, CP|title=Preventable exposures associated with human cancers.|journal=Journal of the National Cancer Institute|date=2011 Dec 21|volume=103|issue=24|pages=1827-39|pmid=22158127|url=http://monographs.iarc.fr/ENG/Classification/Table4.pdf|access-date=2014-01-09|archive-date=2012-09-20|archive-url=https://web.archive.org/web/20120920150724/http://monographs.iarc.fr/ENG/Classification/Table4.pdf|dead-url=yes}}</ref> *Metali zingine (Utengenezaji wa aluminiamu, [[cadmium]] na elementi za kadimiamu, [[chromium]](VI), [[beryllium]] na beriliamu, kupatikana kwa chuma na chuma cha pua, elementi za nikeli, [[arsenic]] na za aseniki isiyo hai, uchimbaji madini wa chini ya ardhi [[hematite]]) *Bidhaa zingine za mwako (mwako usiokamilika, makaa ya moto (moshi wa ndani kutokana na kuchoma makaa kwa nyumba), kugeuza makaa kuwa gesi, kuweka lami, [[makaa (fueli)|utengenezaji wa makaa]], masizi, utoaji dizeli kutoka kwa injini *Mnururisho aionishi (X-radiasheni, radoni-222 na vitu vyake vilivyooza, [[mnururisho wa gama]], [[plutonium]]) *Gesi sumu ingine (methyl ether (technical grade), Bis-(chloromethyl) ether, [[sulfurmustard]], MOPP ([[Mustargen Oncovin Procarbazine Prednisone|vincristine-prednisone-nitrogen mustard-procarbazine mixture]]), harufu kali ya moshi kutokana na upakaji wa rangi) *Utengenezaji wa raba na kristalini [[Silikoni dioksidi|vumbi ya silika]] ==Pathojenesisi== Sawa na saratani nyingine nyingi, saratani ya mapafu huanzishwa na uhai wa [[oncogene]] au kutokuwa hai kwa [[jeni inayokandamiza tyuma]].<ref name="Fong" /> Oncogenes zinaaminiwa huwafanya watu kuwa na uwezekano zaidi wa kupata saratani. [[Proto-oncogene]] zinaaminiwa kubadilika kuwa oncogenes zinapokutana na kasinojeni fulani.<ref name="Salgia" /> [[Mabadiliko]] katika ''[[Ras (protini)|K-ras]]'' proto-oncogene husababisha asilimia 10–30 ya adenocarcinomas ya mapafu.<ref name="NEJM-molecular" /><ref name="Aviel-Ronen" /> [[kipokezi cha suala la ukuaji wa epidemisi]] (KSUE) hudhibiti uzaaji wa seli, [[apoptosis]], [[angiogenesis]], na uvamizi wa tyuma.<ref name="NEJM-molecular" /> Mabadiliko na ukuaji wa KSUE hupatikana sana katika saratani ya seli kubwa ya mapafu na hupeana msingi wa kutibu kwa vizuizi vya KSUE. [[Her2/neu]] huathirika mara chache.<ref name="NEJM-molecular" /> Uharibifu wa [[Chromosome|Chromosomal]] unaweza kusababisha [[kukosekana kwa heterozygosity]]. Hii inaweza kusababisha kutotenda kazi kwa jeni zinazokandamiza tyuma. Kuharibika kwa chromosome 3p, 5q, 13q, na 17p ni kawaida hasa kwa kasinoma ya seli ndogo ya mapafu.''[[p53]]'' jeni inayokandamiza tyuma, iliyo kwa kromosomu 17p, huathirika katika asilimia 60-75 ya visa.<ref name="Devereux" /> Jeni zingine ambazo mara nyingi hubadilika au kukua ni ''[[c-MET]]'', ''[[NKX2-1]]'', ''[[LKB1]]'', ''[[PIK3CA]]'', na''[[BRAF (gene)|BRAF]]''.<ref name="NEJM-molecular" /> ==Utambuzi== [[Picha:Thorax CT peripheres Brronchialcarcinom li OF.jpg|kidole cha thumb|[[ Ukaguzi wa CT]]kuonyesha tyuma ya saratani katika pafu la kushoto]] Kutekeleza [[radiotherapi ya kifua]] ni hatua ya kwanza ya uchunguzi ikiwa mtu ata ripoti dalili zinazoweza kuashiria saratani ya mapafu. Hii inaweza kuonyesha kupanuka kwa [[mediastinum]] (dokezo la kuenea kwa [[nodi ya limfu]]), [[atelectasis]] (kuvunjika), kuimarika ([[nimonia]]), au [[pleural effusion]].<ref name="Merck" /> [[tomografi ya kompyuta ya eksirei|Upigaji picha wa CT]] hutumiwa kupeana habari zaidi kuhusu aina na kiwango cha maradhi. [[Bronkoskopi]] au mwongozo wa CT [[biopsi]] mara nyingi hutumiwa kuchukua sampuli ya tyuma ili kufanyia [[histopatholojia]].<ref name="Collins" /> Saratani ya mapafu hutokea kama [[nodu moja ya mapafu]] katika radiografu ya kifua. Hata hivyo, [[utambuzi wa kutofautisha]] ni mpana. Magonjwa mengine yanaweza kujitokeza hivi, pamoja na [[kifua kikuu]], maambukizi ya kuvu, saratani ya metastasisi, au [[nimonia]]. Kisababishi kisicho cha kawaida cha nodu moja ya mapafu hujumuisha [[hamartoma]], [[bronchogenic cyst]], [[adenoma]], [[ulemavu wa ateri na vena]], [[pulmonary sequestration]], [[rheumatoid nodule]], [[Wegener's granulomatosis]], au [[limfoma]].<ref>{{Rejea kitabu | last=Miller |first=WT | title=Fishman's Pulmonary Diseases and Disorders | publisher=McGraw-Hill | year=2008 | page=486 | edition=4th | isbn=0-07-145739-9 }}</ref> Saratani ya mapafu pia inaweza kuwa [[incidentaloma|utambuzi wa dharura]], kama kifundo kimoja cha mapafu katika radiografu ya kifua au ukaguzi wa CT uliotekelezwa kwa sababu isiyohusiana.<ref name="Fishman1815">{{Rejea kitabu | last=Kaiser | first=LR | title=Fishman's Pulmonary Diseases and Disorders | publisher=McGraw-Hill | year=2008 | pages=1815–1816 | edition=4th | isbn=0-07-145739-9 }}</ref> Utambuzi wa kufafanua saratani ya mapafu huzingatia [[histopatholojia|histolojia]] uchunguzi wa tishu inayodhaniwa katika muktadha wa sifa za kliniki na radiolojia.<ref name="Harrison" /> ===Uainishaji=== {| class="wikitable floatright" style="text-align:center;font-size:90%;width:45%;margin-left:1em" |+ style="background:#E5AFAA;"|'''Age-adjusted [[incidence (epidemiology)|incidence]] of lung cancer by histological type'''<ref name="MurrayNadel46" /> |- style="background: #E5AFAA;text-align:center;font-size:90%;" ! abbr="Type" | Histological type ! abbr="Frequency" | Incidence per 100,000 per year |- | All types | 66.9 |- | Adenocarcinoma | 22.1 |- | Squamous-cell carcinoma | 14.4 |- | Small-cell carcinoma | 9.8 |} Saratani ya mapafu zimeainishwa kulingana na [[histopatholojia|aina ya histolojia]].<ref name="Holland-Frei78" /> Uainishaji huu ni muhimu kwa kubainisha udhibiti na kubashiri matokeo ya maradhi. Saratani nyingi za mapafu ni ya [[kasinoma]]—hatari inayotokana na [[seli za epithelia]]. Kasinoma ya mapafu huainishwa kwa ukubwa na jinsi seli hatari zinavyoonekana ikiangaliwa na histopatholojia kwa [[darubini]]. Aina zote mbili ni kasinoma ya mapafu ya seli ndogo na kasinoma ya mapafu ya seli kubwa.<ref name="Robbins" /> ====Kasinoma ya mapafu ya seli kubwa==== [[Picha:Squamous carcinoma lung 2 cytology.jpg|thumb|[[Mikrografu]] ya [[kasinoma ya squamous]], aina ya kasinoma ya seli kubwa,sampuli ya FNA, [[doa la ubwabwa]]]] Aina tatu ndogo za KMSK ni [[adenocarcinoma]], [[kasinoma ya mapafu ya seli za squamous]], na [[kasinoma ya mapafu ya seli ndogo]].<ref name="Harrison" /> Karibu asilimia 40 ya saratani huwa adenocarcinoma, ambayo kwa kawaida huanzia kwa tishu ya mapafu iliyo pembeni.<ref name="Holland-Frei78">{{cite book | last=Lu | first=C | coauthors=Onn A, Vaporciyan AA et al. | title=Holland-Frei Cancer Medicine |edition=8th | chapter=78: Cancer of the Lung | publisher=People's Medical Publishing House | year=2010 |isbn=9781607950141}}</ref> Visa vingi vya adenocarcinoma huhusishwa na uvutaji; hata hivyo, kati ya watu waliovuta sigara chini ya 100 katika maisha yao ("wasiovuta"),<ref name="Harrison" /> adenocarcinoma ni aina ya saratani ya mapafu inayopatikana.<ref name="Subramanian">{{cite journal | last=Subramanian | first=J | coauthors=Govindan R |title=Lung cancer in never smokers: a review | url=https://archive.org/details/sim_journal-of-clinical-oncology_2007-02-10_25_5/page/560 | journal=Journal of Clinical Oncology | volume=25 | issue=5 | pages=561–570| publisher=American Society of Clinical Oncology | month=February | year=2007 | pmid=17290066 |doi=10.1200/JCO.2006.06.8015 }}</ref> Aina ndogo ya adenocarcinoma, [[bronchioloalveolar carcinoma]], hupatikana sana kwa wanawake wasiovuta, na inaweza kuwa na muda nzuri wa kuishi.<ref name="Raz"/> Kasinoma ya seli ya squamous huchangia kwa takribani asilimia 30 ya saratani za mapafu. Hutokea kwa njia za hewa zilizokubwa. Kaviti tupu na inayohusishwa [[necrosis|kufa kwa seli]] kwa kawaida hupatikana katikati ya tyuma.<ref name="Holland-Frei78" /> Takribani asilimia 9 ya saratani za mapafu ni kasinoma ya seli kubwa. Huitwa hivyo kwa kuwa seli za saratani ni kubwa, na zina [[cytoplasm]] nyingi zaidi, [[nukliasi ya seli|nukliasi]] iliyo kubwa na inayoonekana [[nukleolasi|nucleoli]].<ref name="Holland-Frei78" /> ====Kasinoma ya mapafu ya seli ndogo==== Katika [[kasinoma ya mapafu ya seli ndogo]] (KMSD), seli huwa na granuli nene zinazotoa neurosisi ([[vesicle (biolojia)|vesicles]] zilizo na [[homoni]]), za [[mfumo wa neva na endokrini]] zinazopatia tyuma muungano wa sindromu ya endokrini/paraneoplasti.<ref name="Rosti" /> Mara nyingi hutokea katika njia za hewa zilizokubwa zaidi [[bronkasi|bronkia]](za kwanza na za pili).<ref name="Collins" /> Saratani hizi hukua haraka na kuenea mapema wakati wa maradhi. Asilimia sitini hadi sabini huwa na maradhi ya metastiki inapotokea. Aina hii ya saratani ya mapafu huhusishwa sana na uvutaji.<ref name="Harrison" /> ====Zingine==== Aina nyingine nne kuu za histolojia zimetambuliwa, hata ingawa saratani zingine zinaweza kuwa na mchanganyiko wa aina tofauti za aina ndogo.<ref name=Robbins>{{cite book | last=Maitra | first=A | coauthors=Kumar V | year=2007 | title=Robbins Basic Pathology|edition=8th | publisher=Saunders Elsevier | pages=528–529 | isbn=978-1-4160-2973-1 }}</ref> Aina ndogo zilizo nadra hujumuisha [[Saratani ya glandi ya ute|tyuma za glandi]], [[kasinoidi ya mapafu|tyuma za kasinoidi]], na kasinoma zisizopambanuliwa.<ref name="Harrison" /> ====Metastasisi==== {| class="wikitable floatright" style="text-align:center;font-size:90%;width:45%;margin-left:1em" |+ style="background:#E5AFAA;"|'''Typical [[immunostaining]] in lung cancer'''<ref name="Harrison" /> |- style="background: #E5AFAA;text-align:center;font-size:90%;" ! abbr="Type" | Histological type ! abbr="Frequency" | Immunostain |- | Squamous-cell carcinoma | [[Cytokeratin|CK]]5/6 positive <br>[[Keratin 7|CK7]] negative |- | Adenocarcinoma | CK7 positive <br>[[NK2 homeobox 1|TTF-1]] positive |- | Large-cell carcinoma | TTF-1 negative |- | Small-cell carcinoma | TTF-1 positive <br>[[Neural cell adhesion molecule|CD56]] positive <br>[[Granin|Chromogranin]] positive<br>[[Synaptophysin]] positive |} Mapafu ni sehemu ya kawaida ya uenezi wa tyuma kutoka sehemu zingine za mwili. Saratani za pili zimeainishwa kutokana na chanzo chake; kwa mfano, saratani ya matiti iliyoenea kwa mapafu huitwa saratani ya matiti ya metastasisi. Metastasisi mara nyingi huwa na sifa ya kuonekana mviringo kwa radiografu ya kifua.<ref name="Seo" /> Saratani za kwanza za mapafu kwa kawaida huenea kwa ubongo, mifupa, ini, na [[glandi ya adrenali]].<ref name="Holland-Frei78" /> [[Immunostaining]] ya biopsi mara nyingi husaidia kubaini kiini halisi.<ref name="pmid18784820">{{cite journal |author=Tan D, Zander DS |title=Immunohistochemistry for Assessment of Pulmonary and Pleural Neoplasms: A Review and Update |journal=Int J Clin Exp Pathol |volume=1 |issue=1 |pages=19–31|year=2008|pmid=18784820 |pmc=2480532 }}</ref> ===Hatua ya saratani=== [[Hatua ya saratani]] ni kutathmini maenezi ya saratani kutoka chanzo chake. Ni mojawapo ya masuala yanayoathiri [[prognosisi]] na uwezekano wa kutibu saratani ya mapafu.<ref name="Harrison" /> Utathmini wa kwanza wa hatua ya saratani ya mapafu ya seli kubwa (SMSK) hutumia [[mfumo wa TNM|uainishaji wa TNM]]. Hii huzingatia ukubwa wa '''t'''yuma, limfu huhusishaji '''n'''odi na kwa umbali'''m'''etastasisi. Baadaye, kwa kutumia kielezi TNM, Kikundi hupeanwa, kuanzia saratani ya kwanza kupitia awamu 0, 1-A (moja A), IB, IIA, IIB, IIIA, IIIB na IV (nne). Kikundi hiki cha awamu husaidia kwa uchaguzi wa matibabu na makadirio ya prognosisi.<ref name="Rami-Porta">{{Rejea jarida | last=Rami-Porta | first=R | coauthors=Crowley JJ, Goldstraw P | title=The revised TNM staging system for lung cancer | journal=Annals of Thoracic and Cardiovascular Surgery | volume=15 | issue=1 | pages=4–9 |month=February | year=2009 | url=http://www.atcs.jp/pdf/2009_15_1/4.pdf| pmid=19262443 }}</ref> Kasinoma ya mapafu ya seli ndogo (KMSN) kimapokeo imeainishwa kuwa 'awamu iliyo na mpaka' (iliyofungiwa kwa moja na nusu ya kifua na kati ya eneo la [[radiotherapi]] moja inayoweza kustahimiliwa) au 'awamu pana' (magonjwa yaliyoenea pakubwa zaidi).<ref name="Harrison" /> Hata hivyo, uainishaji wa TNM na upangaji ni muhimu kwa kukadiria prognosisi.<ref name="Rami-Porta" /> Kwa KMSK na KMSK, aina zote mbili za kawaida za utathmini wa hatua ni ule wa kliniki na upasuaji. Hatua ya saratani hubainishwa kabla ya upasuaji wenyewe. Huzingatia matokeo ya masomo ya picha (kama vile [[tomografi ya kompyuta ya eksirei|uchunguzi wa CT]] na [[picha ya kompyuta ya miale ya gama|uchunguzi wa PET]]) na matokeo ya biopsi. Hatua ya upasuaji hutathminiwa wakati wa au baada ya upasuaji, na huzingatia muunganisho wa matokeo ya upasuaji na kliniki, pamoja na kuchukua sampuli za nodi za limfu za kifua.<ref name="Holland-Frei78" /> ==UKingaji== Ukingaji ndio gharama ya chini ya kuzuia kukua kwa saratani ya mapafu. Ilhali katika mataifa mengi kasinojeni za viwanda na zile za nyumbani zimetambuliwa na kupigwa marufuku, uvutaji tumbaku ungali umeenea pakubwa. Kukomesha uvutaji wa tumbaku ni lengo la kwanza katika ukingaji [[kukomesha uvutaji]] ni kifaa muhimu katika utaratibu huu.<ref>{{cite journal | last=Goodman | first=GE | title=Lung cancer. 1: prevention of lung cancer | journal=Thorax |volume=57 | issue=11 | year=2002 | month=November | pages=994–999 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1746232/pdf/v057p00994.pdf| pmid=12403886 | pmc=1746232}}</ref> Sera za kupunguza [[uvutaji wa moshi ya sigara]] Kwenye maeneo kama vile hoteli na pahali pa kufanyia kazi umekuwa wa kawaida katika mataifa mengi ya magharibi.<ref>{{cite journal | last=McNabola | first=A | coauthors=Gill LW | title=The control of environmental tobacco smoke: a policy review | journal=International Journal of Environmental Research and Public Health |volume=6 | issue=2 | year=2009 | month=February | pages=741–758 | doi=10.3390/ijerph6020741 | pmid=19440413 |pmc=2672352}}</ref> [[Bhutan]] imepiga marufuku uvutaji wa sigara tangu mwaka wa 2005<ref name="Bhutan" /> ilhali India ilipiga marufuku uvutaji wa tumbaku mwezi wa kumi 2008.<ref>{{cite news | last=Pandey | first=G | title=Indian ban on smoking in public |url=http://news.bbc.co.uk/1/hi/world/south_asia/7645868.stm| publisher=[[BBC]]| date=2 October 2008 | accessdate=2012-04-25 }}</ref> [[Shirika la Afya la Ulimwengu]] limetoa wito kwa serikali kuanzisha upigaji marufuku wa kutangaza tumbaku ili vijana wasianze kuvuta. Hutathmini unaonyesha kuwa uvutaji umepungua kwa asilimia 16%.<ref name="AUTOREF10">{{Cite press release |title=UN health agency calls for total ban on tobacco advertising to protect young |url=http://www.un.org/apps/news/story.asp?NewsID=26857|publisher=[[United Nations]] News service |date=30 May 2008}}</ref> Utumiaji wa nyongeza ya vitamini A kwa muda mrefu,<ref name="Fabricius">{{cite journal | last=Fabricius | first=P |coauthors=Lange P | title=Diet and lung cancer | journal=Monaldi Archives for Chest Disease | volume=59 | issue=3 |year=2003 | month=July–September |pages=207–211 | pmid=15065316 }}</ref><ref>{{Rejea jarida | last=Fritz | first=H |coauthors=Kennedy D, Fergusson D et al. | title=Vitamin A and Retinoid Derivatives for Lung Cancer: A Systematic Review and Meta Analysis | journal=PLoS ONE | volume=6 | issue=6 | year=2011 | page=e21107 | pmid=21738614 |doi=10.1371/journal.pone.0021107 | pmc=3124481}}</ref> vitamini C,<ref name="Fabricius" /> vitamini D<ref>{{cite journal |last=Herr | first=C |scoauthors=Greulich T, Koczulla RA et al. | title=The role of vitamin D in pulmonary disease: COPD, asthma, infection, and cancer | journal=Respiratory Research | volume=12 | issue=1 | year=2011 | month=March | page=31 |doi=10.1186/1465-9921-12-31 | pmid=21418564 | pmc=3071319}}</ref> au vitamin E<ref name="Fabricius" /> Hupunguzi hatari ya saratani ya mapafu. Uchunguzi mwingine unapendekeza kuwa watu wanaokula chakula kilicho na kiwango cha juu zaidi cha mboga na matunda wana hatari ya chini,<ref name="Alberg" /><ref name="Key">{{cite journal | last=Key | first=TJ | title=Fruit and vegetables and cancer risk | journal=British Journal of Cancer | volume=104 | issue=1 | year=2011 | month=January | pages=6–11 |doi=10.1038/sj.bjc.6606032 | pmid=21119663 | pmc=3039795}}</ref> lakini hii inawezekana kwa sababu ya [[kushangaza]]. Uchunguzi mkali zaidi haujaonyesha ushirikiano dhahiri.<ref name="Key" /> ===Uchunguzi=== [[Uchunguzi (dawa)|Uchunguzi]] ni matumizi ya [[uchunguzi wa matibabu]] ili kubaini ugonjwa kwa watu wanaoonyesha dalili. Uwezekano wa vipimo vya kuchuja saratani ya mapafu ni pamoja na [[sputum]] [[saitopatholojia|saitolojia]], [[radiografu ya kifua]], na [[tomografia ya digitali]]. Utaratibu wa uchunguzi unaotumia radiografu ya kifua au saitologia haijaleta manufaa.<ref>{{Rejea jarida |last=Manser | first=RL | coauthors=Irving LB, Stone C et al. | title=Screening for lung cancer | journal=Cochrane Database of Systematic Reviews | issue=1 | pages=CD001991 | year=2004 | pmid=14973979 |url=http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001991.pub2/full | doi=10.1002/14651858.CD001991.pub2 }}</ref> Kuchuja walio katika hatari kuu (yaani, miaka 55 hadi 79 waliovuta zaidi ya &nbsp; [[pakiti]] 30 kwa mwaka au wale wamewahi kupata saratani ya mapafu hapo awali) kwa mwaka na dozi iliyo chini ya uchunguzi wa picha inaweza kupunguza uwezekano wa kifo kutokana na saratani ya mapafu kwa [[Kupunguza hatari kamili|kiasi kamili]] ya asilimia 0.3 ([[Kupunguza hatari kiasi|hatari kiasi]] ya asilimia 20).<ref>{{cite journal |last=Jaklitsch | first=MT | coauthors=Jacobson FL, Austin JH et al. | title=The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups |url=https://archive.org/details/sim_journal-of-thoracic-and-cardiovascular-surgery_2012-07_144_1/page/33 | journal=Journal of Thoracic and Cardiovascular Surgery | month=July | year=2012 | volume=144 | issue=1 |pages=33&ndash;38 | pmid=22710039 | doi=10.1016/j.jtcvs.2012.05.060}}</ref><ref>{{cite journal | last=Bach | first=PB |coauthors=Mirkin JN, Oliver TK et al. | title=Benefits and harms of CT screening for lung cancer: a systematic review | url=https://archive.org/details/sim_jama_2012-06-13_307_22/page/2418 |journal=JAMA: the Journal of the American Medical Association | month=June | year=2012 | volume=307 | issue=22 |pages=2418–2429 | pmid=22610500 | doi=10.1001/jama.2012.5521}}</ref> Hata hivyo, kuna kiwango cha juu ya matokeo duni kinachoweza kusababisha utaratibu wa upasuaji vile vile gharama kubwa ya fedha.<ref>{{cite journal|last=Boiselle|first=PM|title=Computed tomography screening for lung cancer.|url=https://archive.org/details/sim_jama_2013-03-20_309_11/page/1163|journal=JAMA : the journal of the American Medical Association|date=2013 Mar 20|volume=309|issue=11|pages=1163-70|pmid=23512063}}</ref> Kwa kila tokeo la kipimo halisi kuna zaidi ya 19 ya matokeo duni.<ref>{{cite journal |author=Bach PB, Mirkin JN, Oliver TK, ''et al.''|title=Benefits and harms of CT screening for lung cancer: a systematic review |journal=JAMA |volume=307 |issue=22|pages=2418–29 |year=2012 |month=June |pmid=22610500 |doi=10.1001/jama.2012.5521 |url=https://archive.org/details/sim_jama_2012-06-13_307_22/page/2418}}</ref> Kuwa wazi kwa mnururisho ni njia nyingine ya madhara inayoweza kuwa kutokana na kuchuja.<ref>{{cite journal|last=Aberle|first=DR|coauthors=Abtin, F; Brown, K|title=Computed tomography screening for lung cancer: has it finally arrived? Implications of the national lung screening trial.|journal=Journal of clinical oncology : official journal of the American Society of Clinical Oncology|date=2013 Mar 10|volume=31|issue=8|pages=1002-8|pmid=23401434}}</ref> ==Udhibiti== Matibabu ya saratani ya mapafu hulingana na seli maalum ya saratani [[hali ya saratani|kuenea]], na [[hali ya utendaji]] wa mtu. Matibabu ya kawaida hujumuisha [[huduma ya kupunguza maumivu]],<ref>{{cite journal | last=Ferrell |first=B | coauthors=Koczywas M, Grannis F, Harrington A | title=Palliative care in lung cancer | url=https://archive.org/details/sim_surgical-clinics-of-north-america_2011-04_91_2/page/403 | journal=Surgical Clinics of North America | volume=91 | issue=2 | pages=403–417 | year=2011 | month=April | pmid=21419260 |doi=10.1016/j.suc.2010.12.003}}</ref> [[upasuaji]], [[kemotherapi]], na [[therapi ya mnururisho]].<ref name="Harrison" /> ===Upasuaji=== Ikiwa uchunguzi utathibitisha KSMK, [[hatua ya saratani|hatua]] inatathminiwa ili kuamua ikiwa kuna ugonjwa katika eneo maalum na inaweza kutibiwa kwa upasuaji au iwapo imeenea kwa kiwango kisichoweza kufanyiwa upasuaji. Uchunguzi wa picha na [[picha ya kompyuta ya miale ya gama]] inatumika kwa uamuzi.<ref name="Harrison" /> Ikiwa unashuku tezi ya mediastinamu inahusika, [[upasuaji wa mediastinamu]] inaweza kutumika kutengeneza sampuli nodi na kutathmini kiwango.<ref name="Fishman1853">{{Rejea kitabu |author=Kaiser LR | title=Fishman's Pulmonary Diseases and Disorders | publisher=McGraw-Hill | year=2008 | pages=1853–1854| edition=4th | isbn=0-07-145739-9 }}</ref> [[Upimaji wa damu]] na [[uchunguzi wa utendakazi wa mapafu]] hutumika kutathmini iwapo mtu atafanyiwa upasuaji.<ref name="Collins" /> Ikiwa matokeo ya uchunguzi wa utendakazi wa mapafu yataonyesha kuwa mapafu hayana hewa ya kutosha, upasuaji hautawezekana.<ref name="Harrison" /> Katika hali nyingi za kwanza KSMK, kutoa tundu la pafu matibabu ya upasuaji ya ([[lobektomia]]) huchaguliwa. Watu wasio sawa kwa lobektomia mzima, sublobar kiasi ([[kuondoa kipande cha tishu]]) inaweza kutekelezwa. Hata hivyo, kuondoa kipande hiki kina hatari kubwa ya kurudi tena kuliko lobektomia.<ref name="Fishman1855">{{Rejea kitabu | author=Kaiser LR |title=Fishman's Pulmonary Diseases and Disorders | publisher=McGraw-Hill | year=2008 | pages=1855–1856 | edition=4th |isbn=0-07-145739-9 }}</ref> Mnururisho [[iodini]] [[brachytherapy]] ukingoni mwa kuondoa kipande cha tishu unaweza kupunguza hatari ya kurudi tena.<ref>{{cite journal | last=Odell | first=DD | coauthors=Kent MS, Fernando HC | title=Sublobar resection with brachytherapy mesh for stage I non-small cell lung cancer | journal=Seminars in Thoracic and Cardiovascular Surgery |volume=22 | issue=1 | pages=32–37 | year=2010 | month=Spring | pmid=20813314 | doi=10.1053/j.semtcvs.2010.04.003}}</ref> Ni nadra, kutoa pafu lote ([[numonektomi]]) hufanywa.<ref name="Fishman1855" /> [[Upasuaji wa thoracoscopic unaosaidiwa na video]] na [[lobektomia ya VATS]] hutumia njia itakayoingia ndani katika upasuaji.<ref>{{cite journal | last=Alam| first=N | coauthors=Flores RM | title=Video-assisted thoracic surgery (VATS) lobectomy: the evidence base |journal=Journal of the Society of Laparoendoscopic Surgeons | volume=11 | issue=3 | pages=368–374 | year=2007 |month=July–September | pmid=17931521 | pmc=3015831}}</ref> Lobektomia ya VATS inapendekezwa kwa usawa kulingana na lobektomia ya wazi iliyo kawaida, na magonjwa baada ya upasuaji. <ref>{{cite journal | last=Rueth | first=NM | coauthors=Andrade RS |title=Is VATS lobectomy better: perioperatively, biologically and oncologically? | journal=Annals of Thoracic Surgery |volume=89 | issue=6 | pages=S2107–S2111 | year=2010 | month=June | pmid=20493991 | doi=10.1016/j.athoracsur.2010.03.020}}</ref> Kwa KSMN, kemotherapi na/au radiotherapi hutumika.<ref name='SimonTurrisi'>{{cite journal |author=Simon GR, Turrisi A |title=Management of small cell lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition)|journal=Chest |volume=132 |issue=3 Suppl |pages=324S–339S |year=2007 |month=September |pmid=17873178|doi=10.1378/chest.07-1385 |url=http://chestjournal.chestpubs.org/content/132/3_suppl/324S.long}}</ref> Hata hivyo jukumu la upasuaji kwa KSMN inastahili kufikiriwa tena. Upasuaji unaweza kuboresha matokeo itakapowekwa kwa kemotherapi na mnururisho katika hatua ya kwanza ya KSMN.<ref>{{cite journal | last=Goldstein | first=SD | coauthors=Yang SC | title=Role of surgery in small cell lung cancer | journal=Surgical Oncology Clinics of North America | volume=20 | issue=4 | pages=769–777 | year=2011 |month=October | pmid=21986271 | doi=10.1016/j.soc.2011.08.001}}</ref> ===Radiotherapi=== [[Matibabu ya mnururisho|Radiotherapi]] hutolewa mara kwa mara pamoja na kemotherapi, na inaweza kutumika pamoja na dhamira ya kuponya kwa watu walio na KSMK wasioweza kufanyiwa upasuaji. Hali iliyo kali sana huitwa radiotherapi ya radikali.<ref name="OTO" /> Mabadiliko ya utaratibu huu hugawanywa kulingana na makali ya radiotherapi unaoendelea, ambapo dozi kali ya radiotherapi hutolewa kwa muda mfupi. <ref>{{Rejea jarida | last=Hatton | first=MQ| coauthors=Martin JE | title=Continuous hyperfractionated accelerated radiotherapy (CHART) and non-conventionally fractionated radiotherapy in the treatment of non-small cell lung cancer: a review and consideration of future directions| journal=Clinical Oncology (Royal College of Radiologists) | volume=22 | issue=5 | pages=356–364 | month=June | year=2010| pmid=20399629 | doi=10.1016/j.clon.2010.03.010}}</ref> Radiotherapi ya kifua baada ya upasuaji haipaswi kutumika baada ya upasuaji wa dhamira ya kuponya kwa watu waliona KSMK.<ref name="PORT Meta-analysis Trialists Group" /> Baadhi ya watu walio na mediastinamu ya limfu nodi ya N2 inayohusika wanaweza kufaidika kutokana na radiotherapi ya baada ya upasuaji.<ref>{{Rejea jarida | last=Le Péchoux | first=C |title=Role of postoperative radiotherapy in resected non-small cell lung cancer: a reassessment based on new data |journal=Oncologist | volume=16 | issue=5 | pages=672–681 | year=2011 | pmid=21378080 | doi=10.1634/theoncologist.2010-0150| pmc=3228187}}</ref> Kwa hali ya KSMN, radiotherapi mara nyingi inapendekezwa zaidi pamoja na kemotherapi.<ref name="Holland-Frei78" /> Ikiwa ueneaji wa saratani itaziba sehemu ya bronkasi, [[brachytherapy]] (radiotherapi maalum) inaweza kupewa moja kwa moja ndani ya njia ya hewa ili njia ifunguke.<ref>{{Rejea jarida | last=Cardona | first=AF | coauthors=Reveiz L, Ospina EG et al.| title=Palliative endobronchial brachytherapy for non-small cell lung cancer | journal=Cochrane Database of Systematic Reviews | issue=2 | pages=CD004284 | month=April | year=2008 | pmid=18425900 | doi=10.1002/14651858.CD004284.pub2}}</ref> Kulingana na mwali wa mwanga ya nje ya radiotherapi, brachytherapy inaruhusu kupungua kwa muda wa matibabu na upungufu wa uwazi kwa mnururisho kwa wahudumu wa afya. Prophylactic cranial irradiation (PCI) ni aina ya radiotherapi kwa akili, hutumika kupunguza hatari ya [[metastasisi]]. (PCI) hutumika sana kwa KSMN. Katika hatua za ugonjwa mdogo, (PCI) huongeza miaka mitatu za maisha kutoka asilimia 15 hadi 20; kwa ugonjwa uliozidi, kuishi mwaka mmoja huzidi kutoka asilimia 13 hadi 27.<ref>{{Rejea jarida | last=Paumier | first=A | coauthors=Cuenca X, Le Péchoux C | title=Prophylactic cranial irradiation in lung cancer | journal=Cancer Treatment Reviews | volume=37 | issue=4| pages=261–265 | month=June | year=2011 | pmid=20934256 | doi=10.1016/j.ctrv.2010.08.009}}</ref> Maendeleo ya hivi karibuni yanayolenga na kutoa picha yameleta maendeleo ya upasuaji kwa kutumia mnururisho kwa kutibu saratani iliyo katika hatua ya kwanza. Katika aina hii, dozi kali hutolewa kwa idadi ndogo ya vipindi kwa kutumia mbinu ya kulenga upasuaji. Matumizi yake hasa ni kwa wagonjwa wasiofanyiwa upasuaji kwa sababu ya matibabu [[comorbidities]].<ref>{{Rejea jarida | last=Girard | first=N | coauthors=Mornex F | title=Stereotactic radiotherapy for non-small cell lung cancer: From concept to clinical reality. 2011 update | journal=Cancer Radiothérapie | volume=15 |issue=6–7 | pages=522–526 | month=October | year=2011 | pmid=21889901 | doi=10.1016/j.canrad.2011.07.241}}</ref> Kwa wagonjwa walio na KSMK na KSMN, dozi kiasi cha mnururisho kwa kifua inaweza kutumika ili kudhibiti dalili (radiotherapi ya [[huduma inayopunguza maumivu|inayopunguza maumivu]]).<ref>{{Rejea jarida | last=Fairchild | first=A | coauthors=Harris K, Barnes E et al. |title=Palliative thoracic radiotherapy for lung cancer: a systematic review | journal=Journal of Clinical Oncology |volume=26 | issue=24 | pages=4001–4011 | month=August | year=2008 | pmid=18711191 |url=http://jco.ascopubs.org/content/26/24/4001.full | doi=10.1200/JCO.2007.15.3312}}</ref> ===Kemotherapi=== Mazoezi ya [[kemotherapi]] inalingana na aina ya tyuma.<ref name="Holland-Frei78" /> Kasinoma ya mapafu ya seli ndogo (KMSN), hata kiasi kidogo ya hatua ya kwanza ya ugonjwa, hutibiwa hasa kwa kemotherapi na mnururisho.<ref>{{cite journal |author=Hann CL, Rudin CM |title=Management of small-cell lung cancer: incremental changes but hope for the future |journal=Oncology (Williston Park)|date=2008-11-30|volume=22|issue=13|pages=1486–92 |pmid=19133604}}</ref> Kwa KMSN, [[cisplatin]] na [[etoposide]] kwa kawaida hutumika zaidi.<ref name="Murray"/> Zikiunganishwa na [[carboplatin]], [[gemcitabine]], [[paclitaxel]], [[vinorelbine]], [[topotecan]], na [[irinotecan]] pia zinatumika.<ref name="Azim" /><ref name="MacCallum" /> Kwa kasinoma ya mapafu ya seli kubwa (KMSK) iliyozidi, kemotherapi huboresha maisha na hutumika kama tiba ya kwanza, bora mtu awe sawa kwa kupokea matibabu.<ref name="pmid18678835" /> Kwa kawaida, dawa mbili hutumika, moja yazo mara nyingi huwa besi ya platinamu (ama [[cisplatin]] au [[carboplatin]]). Dawa zingine zinazotumika ni [[gemcitabine]], [[paclitaxel]], [[docetaxel]],<ref name="Fishman1876">{{Rejea kitabu | author=Mehra R, Treat J | title=Fishman's Pulmonary Diseases and Disorders | publisher=McGraw-Hill | year=2008 | page=1876 | edition=4th | isbn=0-07-145739-9 }}</ref><ref name="Clegg" /> [[pemetrexed]],<ref name="pmid20446853">{{cite journal |author=Fuld AD, Dragnev KH, Rigas JR|title=Pemetrexed in advanced non-small-cell lung cancer |journal=Expert Opin Pharmacother |volume=11 |issue=8|pages=1387–402 |year=2010 |month=June |pmid=20446853 |doi=10.1517/14656566.2010.482560 }}</ref> [[etoposide]] au [[vinorelbine]].<ref name="Clegg" /> [[Kemotherapi ya adjuvant]] inamaanisha matumizi ya kemotherapi baada ya matibabu ya upasuaji ili kuboresha matokeo. Katika KMSK, sampuli huchuliwa karibu na [[limfu nodi]] wakati wa upasuaji ili kusaidia [[hatua ya saratani ya mapafu|hatua]]. Ikiwa ugonjwa wa kiwango cha II au cha III kitatambulika, kemotherapi ya adjuvanti inaboresha maisha kwa asilimia 5 kwa miaka mitano.<ref name="Carbone">{{Rejea jarida | last=Carbone | first=DP | coauthors=Felip E | title=Adjuvant therapy in non-small cell lung cancer: future treatment prospects and paradigms | journal=Clinical Lung Cancer | volume=12 | issue=5 | pages=261–271 | month=September |year=2011 | pmid=21831720 | doi=10.1016/j.cllc.2011.06.002 }}</ref><ref name="Le Chevalier">{{Rejea jarida | last=Le Chevalier | first=T | title=Adjuvant chemotherapy for resectable non-small-cell lung cancer: where is it going? |journal=Annals of Oncology | volume=21 | issue=Suppl. 7 | pages=vii196–198 | month=October | year=2010 | pmid=20943614 |url=http://annonc.oxfordjournals.org/content/21/suppl_7/vii196.long | doi=10.1093/annonc/mdq376}}</ref> Matumizi ya vinorelbine pamoja na cisplatin yana matokeo bora kuliko mazoezi.<ref name="Le Chevalier" /> Kemotherapi ya adjuvanti kwa watu waliokuwa na saratani iliyo kiwango IB haijakubalika, kama vipimo vya kliniki havijaonyesha manufaa.<ref name="Horn" /><ref name="Wakelee" /> Vipimo vya kemotherapi kabla ya upasuaji ([[kemotherapi ya neoadjuvant]]) kwa KMSK yanayoweza kugawanywa hayajahitimishwa.<ref name="Clinical evidence" /> ===Huduma ya kupunguza maumivu=== Kwa wagonjwa walio na ugonjwa usiotibika, huduma ya kupunguza au udhibiti wa hospitali inafaa.<ref name="Collins" /> Mbinu hizi hukubali majadiliano zaidi ya matibabu na kutoa nafasi kuafikia kwa maamuzi yaliyozingatiwa vilivyo<ref name="pmid20818881">{{cite journal |author=Kelley AS, Meier DE |title=Palliative care&mdash;a shifting paradigm |url=https://archive.org/details/sim_new-england-journal-of-medicine_2010-08-19_363_8/page/780 |journal=New England Journal of Medicine |volume=363 |issue=8 |pages=781–2|year=2010 |month=August |pmid=20818881|doi=10.1056/NEJMe1004139 }}</ref><ref name="pmid19856592">{{cite journal |author=Prince-Paul M |title=When hospice is the best option: an opportunity to redefine goals|journal=Oncology (Williston Park, N.Y.) |volume=23 |issue=4 Suppl Nurse Ed|pages=13–7 |year=2009 |month=April |pmid=19856592 }}</ref> na yanaweza kuepushwa na huduma isiyosaidia katika maisha.<ref name="pmid19856592"/> Kemotherapi inaweza kuunganishwa na huduma ya kupunguza maumivu kwa matibabu ya KMSK. Kwa hali zilizozidi, kemotherapi inayofaa huboresha maisha [[katikati|wastani]] zaidi ya huduma ya kusaidia pekee, vile vile kuboresha ubora wa maisha.<ref name="pmid7551923">{{cite journal|author=Souquet PJ, Chauvin F, Boissel JP, Bernard JP |title=Meta-analysis of randomised trials of systemic chemotherapy versus supportive treatment in non-resectable non-small cell lung cancer |journal=Lung Cancer |volume=12 Suppl 1 |issue= |pages=S147–54|year=1995 |month=April |pmid=7551923 |doi=10.1016/0169-5002(95)00430-9 }}</ref> Pamoja na [[hali ya utendaji|ubora wa mwili]] unaofaa, kuendeleza kemotherapi wakati wa kutuliza saratani ya mapafu huzidisha maisha kwa miezi 1.5 hadi 3, kutuliza dalili, na kuboresha maisha, pamoja na matokeo mema zinazoonekana na maajenti wa kisasa.<ref name="pmid11441939">{{cite journal |author=Sörenson S, Glimelius B, Nygren P |title=A systematic overview of chemotherapy effects in non-small cell lung cancer |journal=Acta Oncol |volume=40 |issue=2–3|pages=327–39 |year=2001 |pmid=11441939 |doi= }}</ref><ref name="pmid12065068">{{cite journal |author=Clegg A, Scott DA, Sidhu M, Hewitson P, Waugh N |title=A rapid and systematic review of the clinical effectiveness and cost-effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small-cell lung cancer |journal=Health Technol Assess |volume=5|issue=32 |pages=1–195 |year=2001 |pmid=12065068 |doi= }}</ref> Kikundi cha chambuzi cha KMSK inapendekeza kwamba iwapo mgonjwa anahitaji na anaweza kuvumilia matibabu, basi kemotherapi inapaswa kutumiwa kwa KMSK iliyoendelea.<ref name="pmid18678835">{{cite journal |title=Chemotherapy in Addition to Supportive Care Improves Survival in Advanced Non–Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data From 16 Randomized Controlled Trials |journal=J. Clin. Oncol. |volume=26 |issue=28|pages=4617–25 |year=2008 |month=October |pmid=18678835 |pmc=2653127|doi=10.1200/JCO.2008.17.7162 |author1=NSCLC Meta-Analyses Collaborative Group }}</ref><ref name="pmid20464750">{{cite Cochrane |title=Chemotherapy and supportive care versus supportive care alone for advanced non-small cell lung cancer|review=CD007309 |version=2 |issue=5 |year=2010 |pmid=20464750|editor1-last=Burdett |editor1-first=Sarah |author1=Non-Small Cell Lung Cancer Collaborative Group }}</ref> ==Prognosisi== {| class="wikitable floatright" style="text-align:center;font-size:90%;width:45%;margin-left:1em" |+ style="background:#E5AFAA;"| '''Outcomes in lung cancer according to clinical stage '''<ref name="Rami-Porta" /> |- style="background: #E5AFAA;text-align:center;font-size:90%;" ! abbr="Type" rowspan="2" | Clinical stage ! abbr="5-year" colspan="2" | Five-year survival (%) |- style="background: #E5AFAA;text-align:center;font-size:90%;" ! abbr="NSCLC" | Non-small cell lung carcinoma ! abbr="SCLC" | Small cell lung carcinoma |- | IA | 50 | 38 |- | IB | 47 | 21 |- | IIA | 36 | 38 |- | IIB | 26 | 18 |- | IIIA | 19 | 13 |- | IIIB | 7 | 9 |- | IV | 2 | 1 |} Prognosisi huwa duni. Kwa watu wote walio na saratani ya mapafu, asilimia 15 huishi kwa miaka mitano baada ya kutambuliwa.<ref name="Merck" /> Mara kwa mara kiwango huzidi wakati wa utambuzi. Wakati wa kujitokeza, asilimia 30-40 ya hali ya KMSK huwa kiwango cha IV, na asilimia 60 ya KMSN huwa kiwango cha IV.<ref name="Holland-Frei78" /> Visababishi vya prognosisi katika KMSK ni pamoja na kuwepo na kutokuwepo kwa dalili za mapafu, ukubwa wa [[tyuma]], ([[histologia]]) ya aina ya seli, kiwango cha kuenea [[kuainisha (pathologia)|(hatua)]] na [[metastasisi]] kwa [[limfu nodi]] yaliyozidi, na [[kuathiriwa kwa mishipa]]. Kwa watu walio na ugonjwa usiofanyiwa upasuaji, matokeo huwa mabaya kwa walio na [[hali ya utendakazi]] mbaya na upungufu wa uzito zaidi ya asilimia 10.<ref name="AUTOREF17"> {{cite web |url=http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/HealthProfessional/page2 |title=Non-Small Cell Lung Cancer Treatment |publisher=National Cancer Institute |work=PDQ for Health Professionals |accessdate=2008-11-22}}</ref> Visababishi vya prognosisi kwa saratani ya mapafu kwa seli ndogo inahusisha hali ya utendakazi, [[jinsia]], kiwango cha ugonjwa, na kuhusika kwa [[mfumo wa kati wa neva]] au [[ini]] wakati wa utambuzi.<ref name="AUTOREF18" /> Kwa KMSK, prognosisi bora imefanikishwa na upasuaji kamili wa kiwango cha IA cha ugonjwa, ikiwa na asilimia 70 ya kuishi miaka mitano.<ref name="OTM">{{Rejea kitabu | last=Spiro | first=SG | title=Oxford Textbook Medicine | publisher=OUP Oxford |year=2010 | chapter=18.19.1 | edition=5th | isbn=978-0199204854 }}</ref> Kwa KMSK, maisha kwa ujumla ni angalau asilimia 5.<ref name="Harrison" /> Watu walio na kiwango kilichozidi cha KMSK kawaida huwa kiasi cha miaka mitano ya kiwango cha maisha iliyo chini ya asilimia 1. Muda wa kawaida wa kuishi wa kiwango kidogo cha ugonjwa ni miezi 20, na kiwango cha miaka mitano za kuishi zilizo asilimia 20.<ref name="Merck" /> Kulingana na utafiti wa [[Taasisi ya kimataifa ya saratani]], umri wa kati ya kutambua saratani ya mapafu kule Marekani ni miaka 70,<ref>SEER data (SEER.cancer.gov)[http://seer.cancer.gov/csr/1975_2003/results_single/sect_01_table.11_2pgs.pdf Median Age of Cancer Patients at Diagnosis 2002-2003]</ref> na umri kati ya kifo ni miaka 72.<ref>SEER data (SEER.cancer.gov)[http://seer.cancer.gov/csr/1975_2006/results_single/sect_01_table.13_2pgs.pdf Median Age of Cancer Patients at Death 2002-2006]</ref> Nchini Marekani, walio na bima ya matibabu hupata matokeo bora zaidi.<ref>{{cite journal | last=Slatore | first=CG | coauthors=Au DH, Gould MK | title=An official American Thoracic Society systematic review: insurance status and disparities in lung cancer practices and outcomes | date=November 2010 | journal=American Journal of Respiratory and Critical Care Medicine | volume=182 | issue=9 | pages=1195–1205 | pmid=21041563 | url=http://ajrccm.atsjournals.org/content/182/9/1195.long | doi=10.1164/rccm.2009-038ST | archive-date=2020-06-13 | access-date=2014-01-09 | archive-url=https://web.archive.org/web/20200613071318/https://www.atsjournals.org/doi/full/10.1164/rccm.2009-038ST | url-status=dead }}</ref> ==Epidemiolojia== [[Image:Trachea, bronchus, lung cancers world map - Death - WHO2004.svg|thumb|[[urekebishaji wa umri|Umri uliosanifishwa]] vifo kutokana na trakea, bronkasi, na saratani ya mapafu kwa 100,000&nbsp;walioishi mwaka wa 2004<ref name="AUTOREF20" /> {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|≤&nbsp;5}} {{legend|#fff200|5-10}} {{legend|#ffdc00|10-15}} {{legend|#ffc600|15-20}} {{legend|#ffb000|20-25}} {{legend|#ff9a00|25-30}} {{Multicol-break}} {{legend|#ff8400|30-35}} {{legend|#ff6e00|35-40}} {{legend|#ff5800|40-45}} {{legend|#ff4200|45-50}} {{legend|#ff2c00|50-55}} {{legend|#cb0000|≥&nbsp;55}} {{Multicol-end}}]] [[Image:Lung cancer US distribution.gif|thumb|kidole cha thumb|Mgawanyo wa saratani ya mapafu nchini [[Marekani]]]] Ulimwenguni, saratani ya mapafu ni ya kawaida katika swala la [[Tukio (epidemiolojia)|tukio]] na kifo. Katika 2008, kulikuwa na milioni 1.61 za hali mpya, na vifo milioni 1.38 kwa sababu ya saratani ya mapafu. Viwango vilivyo juu sana kiko Uingerezani na Kaskazini Marekani.<ref name="GLOBOCAN">{{cite journal | last=Ferlay | first=J | coauthors=Shin HR, Bray F et al.|title=Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 | journal=International Journal of Cancer |date=December 2010 | volume=127 | issue=12 | pages=2893–2917 | pmid=21351269 |url=http://onlinelibrary.wiley.com/doi/10.1002/ijc.25516/full | doi=10.1002/ijc.25516}}</ref> Sehemu ya watu wanaoweza kupata saratani ya mapafu zaidi ni wale waliozidi umri wa miaka 50 wanao historia ya uvutaji wa sigara. Kwa kutofautisha kiwango cha vifo kwa wanaume, iliyoanza kushuka zaidi miaka ishirini iliyopita, viwango vya vifo kutokana na saratani ya mapafu kwa wanawake vimeongezeka zaidi katika kipindi cha miaka kumi zilizopita, na vinaanza kutulia.<ref name="AUTOREF22" /> Nchini Marekani, [[hatari]] ya kupata saratani ya mapafu ni asilimia 8 kwa wanaume na asilimia 6 kwa wanawake. <ref name="Harrison" /> Kwa kila milioni 3-4 ya sigara iliyovutwa, kifo kimoja hutokea kutokana na saratani ya mapafu.<ref name="Harrison" /><ref>{{cite journal |last=Proctor | first=RN | title=The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll | journal=Tobacco Control | volume=21 | issue=2 | pages=87–91 | month=March | year=2012 |pmid=22345227 | doi=10.1136/tobaccocontrol-2011-050338 }}</ref> Ushawishi wa "[[Tumbaku Kubwa]]" huchukua jukumu kubwa katika utamaduni wa uvutaji wa sigara.<ref name="Lum" /> Vijana wasiovuta sigara wanao tazama matangazo ya uvutaji wa sigara huenda wakavuta.<ref>{{cite journal | last=Lovato | first=C | coauthors=Watts A, Stead LF | title=Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours | date=October 2011 | journal=Cochrane Database of Systematic Reviews | issue=10 | pages=CD003439 | pmid=21975739 | doi=10.1002/14651858.CD003439.pub2}}</ref> Jukumu la [[kuvuta moshi ya sigara]] inaendelea kutambulika kama hatari ya saratani ya mapafu,<ref name="Taylor" /> inayoelekeza kwa sera ya kuingilia upungufu wa wasiovuta kutotaka kuwa karibu wavutaji wanapovuta.<ref>{{cite journal | last=Kemp |first=FB | title=Smoke free policies in Europe. An overview | journal=Pneumologia | volume=58 | issue=3 | pages=155–158 |month=Jul–Sep | year=2009 | pmid=19817310 }}</ref> Moshi kutoka magari, viwanda, na vituo vya umeme pia vinaweza kuwa hatari.<ref name="MurrayNadel46" /> [[Ulaya Mashariki]] ina vifo vilivyosababishwa na saratani ya mapafu vilivyo juu kwa wananume, bali kaskazini mwa Uingereza na Marekani huwa na vifo vingi kwa wanawake. Nchini Marekani, wanaume na wanawake weusi huwa na hali iliyo juu zaidi.<ref>National Cancer Institute; SEER stat fact sheets: Lung and Bronchus. Surveillance Epidemiology and End Results. 2010[http://seer.cancer.gov/statfacts/html/lungb.html#incidence-mortality]</ref> Viwango vya saratani kwa sasa viko chini kwa nchi zinazoendelea.<ref name="AUTOREF23" /> Pamoja na ongezeko la uvutaji kwa nchi zinazoendelea, viwango vinatarajiwa kuongezeka kwa miaka michache yanayokuja, hasa Uchina<ref>{{cite journal | last=Zhang | first=J | coauthors=Ou JX, Bai CX |title=Tobacco smoking in China: prevalence, disease burden, challenges and future strategies | date=November 2011 |journal=Respirology | volume=16 | issue=8 | pages=1165–1172 | pmid=21910781 | doi=10.1111/j.1440-1843.2011.02062.x }}</ref> na India.<ref name="AUTOREF25" /> Kutoka 1960, viwango vya adenocarcinoma vilianza kuzidi kulingana na aina zingine za saratani ya mapafu. Hii ndio sababu ndogo ya kuanzishwa kwa sigara yenye chujio. Matumizi ya chujio hutoa moshi nzito kutoka tumbaku, hivyo kupunguza mabaki kwa njia za kupumua. Hata hivyo, mvutaji lazima avute moshi ndani sana ili apate kiasi sawa cha nikotini, na kuzidisha moshi kuingia kwa njia ndogo za hewa ambapo adenocarcinoma ina panda.<ref name="Charloux" /> Hali ya adenocarcinoma ya mapafu huzidi kupanda.<ref>{{cite journal | last=Kadara | first=H | coauthors=Kabbout M, Wistuba II | title=Pulmonary adenocarcinoma: a renewed entity in 2011 | journal=Respirology | volume=17 | issue=1 |pages=50–65 | month=January | year=2012 | pmid=22040022 | doi=10.1111/j.1440-1843.2011.02095.x }}</ref> ==Historia== Saratani ya mapafu haikujulikana kabla ya matangazo ya uvutaji wa sigara; haikutambulika kama ugonjwa tofauti hadi mwaka wa 1761.<ref name="AUTOREF27" /> Vipengele tofauti vya saratani ya mapafu yameelezwa zaidi mwaka wa 1810.<ref name="AUTOREF28" /> Tyuma ya mapafu ya kuhatarisha yamechangia asilimia 1 pekee kwa saratani yaliyoonekana kwa otopsi mwaka 1878, lakini yalizidi asilimia 10-15 mwanzoni mwa mwaka 1900.<ref name="Witschi" /> Ripoti za uchunguzi katika maandiko ya matibabu yalikuwa 374 pekee duniani mwaka 1912,<ref name="AUTOREF29" /> lakini uchunguzi wa otopsi ulionyesha hali ya saratani ya mapafu yaliongezeka kutoka asilimia 0.3 mwaka 1852 hadi asilimia 5.66 mwaka 1952.<ref name="Grannis" /> Nchini [[Ujerumani]] mwaka 1929, fizishiani Fritz Lickint alitambua uhusiano baina ya uvutaji wa sigara na saratani ya mapafu,<ref name="Witschi" /> iliyoelekeza kwa [[Muungano wa kupinga uvutaji wa sigara nchini Ujerumani|kampeni ya kupinga uvutaji wa sigara]] ulio mkali.<ref name="Proctor" /> [[Uchunguzi ya madaktari wa Uingereza]], uliochapishwa wa 1950, ili kuwa ya kwanza [[epidemiolojia|epidemiolojia]] ili kuwa ushahidi kuu ya kiunganishi baina saratani ya mapafu na uvutaji wa sigara.<ref name="Doll" /> Kama matokeo, mwaka 1964 [[Mpasuaji Mkuu nchini Marekani]] aliwashauri wavutaji sigara kuwacha kuvuta.<ref name="AUTOREF30" /> Uhusiano na gesi ya [[radoni]] ulitambuliwa na wachimbuaji wa madini katika [[Milima za Ore (Ujerumani)|Milima za Ore]] karibu na [[Schneeberg, Saxony]]. [[Fedha]] ime chimbuliwa hapo tangu mwaka wa 1470, na machimbo haya yana [[urani]] nyingi, ikitanguliwa na [[radiamu]] na gesi ya radoni.<ref name="Greaves" /> Wachimbuaji madini walipata kiasi isiyolingana na saratani ya mapafu, baadae kujulikana kama saratani ya mapafu mwaka wa 1870.<ref>{{Rejea jarida | last=Greenberg | first=M | coauthors=Selikoff IJ |title=Lung cancer in the Schneeberg mines: a reappraisal of the data reported by Harting and Hesse in 1879 | url=https://archive.org/details/sim_annals-of-occupational-hygiene_1993-02_37_1/page/n8 |journal=Annals of Occupational Hygiene | volume=37 | issue=1 | pages=5–14 | month=February | year=1993 | pmid=8460878 }}</ref> Licha ya utambulizi huu, kuchimbuliwa kulizidi hadi mwaka wa 1950, kwa sababu ya madai ya urani kutoka [[Urusi]].<ref name="Greaves" /> Radoni ilitambulika kama kisababishi cha saratani ya mapafu mwaka wa 1960.<ref>{{Rejea jarida | last=Samet | first=JM |title=Radiation and cancer risk: a continuing challenge for epidemiologists | journal=Environmental Health | volume=10 |issue=Suppl. 1 | pages=S4 | month=April | year=2011 | pmid=21489214 | doi=10.1186/1476-069X-10-S1-S4 | pmc=3073196}}</ref> Mafanikio ya kwanza ya [[numonektomi]] ya saratani ya mapafu ulifanywa mwaka wa 1933.<ref name="AUTOREF32" /> [[Radiotherapi]] ya kupunguza maumivu imetumika tangu mwaka wa 1940.<ref name="Edwards" /> Radiotherapi ya radikali, iliyotumika awali mwaka wa 1950, ilikuwa jaribio la kutumia dozi kubwa ya mnururisho kwa wagonjwa walio na kiasi cha saratani kinachoanza, lakini hawawezi kufanyiwa upasuaji vinginevyo.<ref name="AUTOREF33" /> Mwaka wa 1997, mkeneko mkali wa radiotherapi uliochapuzwa unaoendelea ulionekana ukiendelea kuliko radiotherapi ya radikali iliyo ya kawaida.<ref name="Saunders" /> Kwa SMSD, majaribio ya hapo awali mwaka wa 1960 katika upasuaji <ref name="AUTOREF34" /> na radiotherapi ya radikali<ref name="AUTOREF35" /> hayakufaulu. Mwaka wa 1970, kemotherapi ya mazoezi yaliyofaulu yaliendelezwa.<ref name="AUTOREF36" /> ==Marejeo== {{reflist|2|refs= <ref name="Harrison">{{Rejea kitabu | last=Horn | first=L | coauthors=Pao W, Johnson DH | title=Harrison's Principles of Internal Medicine | publisher=McGraw-Hill | editor-last=Longo | editor-first=DL | editor-last2=Kasper | editor-first2=DL | editor-last3=Jameson | editor-first3=JL | editor-last4=Fauci | editor-first4=AS | editor-last5=Hauser | editor-first5=SL | editor-last6=Loscalzo | editor-first6=J | year=2012 | chapter=Chapter 89 | edition=18th | isbn=0-07-174889-X }}</ref> <ref name="Thun">{{Rejea jarida | last=Thun | first=MJ | coauthors=Hannan LM, Adams-Campbell LL et al. | title=Lung cancer occurrence in never-smokers: an analysis of 13 cohorts and 22 cancer registry studies | journal=PLoS Medicine | volume=5 | issue=9 | pages=e185 | month=September | year=2008 | doi=10.1371/journal.pmed.0050185 | pmid=18788891 | pmc=2531137 }}</ref> <ref name="O'Reilly">{{Rejea jarida | last=O'Reilly | first=KM | coauthors=Mclaughlin AM, Beckett WS, Sime PJ | title=Asbestos-related lung disease | journal=American Family Physician | volume=75 | issue=5 | pages=683–688 | month=March | year=2007 | url=http://www.aafp.org/afp/20070301/683.html | pmid=17375514 | access-date=2014-01-09 | archive-date=2007-09-29 | archive-url=https://web.archive.org/web/20070929083111/http://www.aafp.org/afp/20070301/683.html | dead-url=yes }}</ref> <ref name="AUTOREF">{{cite web |url=http://www.surgeongeneral.gov/library/secondhandsmoke |author=Carmona, RH |publisher=U.S. Department of Health and Human Services |title=The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General |date=2006-06-27 |quote=Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke.}}</ref> <ref name="AUTOREF1">{{Rejea jarida |url=http://monographs.iarc.fr/ENG/Monographs/vol83/volume83.pdf |format=PDF |publisher=WHO International Agency for Research on Cancer |title=Tobacco Smoke and Involuntary Smoking |journal=IARC Monographs on the Evaluation of Carcinogenic Risks to Humans |volume=83 |year=2002 |quote=There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) causes lung cancer in humans.&nbsp;... 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Tatizo hili huwaathiri takriban [[asilimia]] 6 hadi 7 ya watoto wanaotambulika kupitia kigezo cha [[DSM-IV]]<ref name="pmid22976615"/> na asilimia 1 hadi 2 wanaotambulika kupitia kigezo cha [[ICD-10]].<ref name=Cowen2012/> Viwango vya visa huwa sawa katika nchi zote na hutegemea sana namna ya utambuzi.<ref name=Jones2011>{{cite book|last=Jones|first=edited by Ming Tsuang, Mauricio Tohen, Peter B.|title=Textbook of psychiatric epidemiology|publisher=Wiley-Blackwell|location=Chichester, West Sussex|isbn=9780470977408|page=450|url=http://books.google.ca/books?id=fOc4pdXe43EC&pg=PA450|edition=3rd|date=2011-03-25}}</ref> TKUU hutokea takriban mara tatu au zaidi katika [[wavulana]] kuliko [[wasichana]].<ref name="pmid19393378">{{cite journal |author=Emond V, Joyal C, Poissant H |title=[Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)]|language=French |journal=Encephale |volume=35 |issue=2 |pages=107–14|year=2009 |month=April |pmid=19393378|doi=10.1016/j.encep.2008.01.005}}</ref><ref name="Singh I 2008 957–64">{{Rejea jarida|author=Singh I |title=Beyond polemics: science and ethics of ADHD|journal=Nature Reviews Neuroscience |volume=9 |issue=12 |pages=957–64 |year=2008|month=December|pmid=19020513 |doi=10.1038/nrn2514}}</ref> Karibu asilimia 30 - 50 ya watu wanaotambulika kuwa na tatizo hili wakiwa [[watoto wachanga|wachanga]] huendelea kuwa na dalili hizi katika [[utu uzima]]<ref name="Balint2008" /> na asilimia 2 - 5 ya watu wazima wana hali hii.<ref name="Kooij-2010"/> Hali hii inaweza kuwa ngumu kutofautishwa na matatizo mengine sawia na yale yenye kupepesuka kwa kawaida.<ref name=Lake2011>{{cite book|last=Lake|first=Mina K. Dulcan, MaryBeth|title=Concise guide to child and adolescent psychiatry|publisher=American Psychiatric Pub.|location=Washington, DC|isbn=9781585624164|year=2011|page=34|url=http://books.google.ca/books?id=HvTa2nArhOsC&pg=PA34|edition=4th}}</ref> <!--Udhibiti na prognosisi --> Udhibiti wa tatizo hilo mara nyingi huhusisha mchanganyiko wa [[ushauri nasaha]], mabadiliko ya [[maisha]] na matibabu ya kutumia [[dawa]]. Dawa hupendekezwa kama tiba ya kwanza katika watoto wenye dalili kali na zinaweza kutumika katika wenye dalili za wastani wasiorekebika baada ya kushauriwa.<ref name = NICE2008/>{{Rp|p.317|date=November 2012}} Athari za muda mrefu za dawa hizo hazijulikani na matibabu haya hayapendekezwi katika watoto wasiofikia umri wa kwenda shule. Vijana na watu wazima huelekea kukuza [[stadi za kuhimila]] zinazochukua nafasi ya udhaifu wao.<ref name="psychiatrymmc.com">{{Rejea jarida |last=Gentile |first=Julie |year= 2004|title=Adult ADHD: diagnosis, differential diagnosis and medication management |journal=Psychiatry |volume=3 |issue=8 |pages=24–30 |id= |pmc=2957278|pmid=20963192|last2=Atiq|first2=R|last3=Gillig|first3=PM}}</ref> <!--Jamii na utamaduni --> Tatizo hilo na utambuzi na matibabu yake limeonekana kuwa na utata kwanzia miaka ya 1970.<ref name="Parrillo 2008 63">{{Rejea kitabu|title=Encyclopedia of Social Problems |last=Parrillo |first=Vincent |year=2008 |publisher=SAGE|isbn=978-1-4129-4165-5 |page=63 |url=http://books.google.com/?id=mRGr_B4Y1CEC&pg=PA63&dq=percent+who+consider+ADHD+controversial |accessdate=2009-05-02 |authorlink=Vincent N. Parrillo}}</ref> Utata huu umewahusisha matabibu, walimu, viongozi, wazazi na watangazaji. Mada za utata hujumuisha visababishi vya tatizo hili na utumizi wa vichangamsho kama matibabu.<ref name=autogenerated3>{{Rejea jarida|author=Mayes R, Bagwell C, Erkulwater J |title=ADHD and the rise in stimulant use among children |journal=Harv Rev Psychiatry |volume=16 |issue=3 |pages=151–66 |year=2008 |pmid=18569037 |doi=10.1080/10673220802167782|url=}}</ref><ref name="Cohen, Donald J.; Cicchetti, Dante 2006">{{Rejea kitabu|author=Cohen, Donald J.; Cicchetti, Dante |title=Developmental psychopathology |publisher=John Wiley & Sons|location=Chichester |year=2006 |isbn=0-471-23737-X |oclc= }}</ref> Wahudumu wengi wa afya hukubali kwamba hilo ni tatizo halisi linalozua mjadala katika jamii ya kisayansi, hasa kuhusu jinsi linavyotambuliwa na kutibiwa.<ref name="Sim MG, Hulse G, Khong E 2004 615–8">{{Rejea jarida |author=Sim MG, Hulse G, Khong E |title=When the child with ADHD grows up |journal=Aust Fam Physician |volume=33 |issue=8 |pages=615–8 |year=2004 |month=August |pmid=15373378 |url=http://www.racgp.org.au/afp/200408/20040803sim.pdf |format=PDF |access-date=2014-01-09 |archive-date=2015-09-24 |archive-url=https://web.archive.org/web/20150924083931/http://www.racgp.org.au/afp/200408/20040803sim.pdf |dead-url=yes |=https://web.archive.org/web/20150924083931/http://www.racgp.org.au/afp/200408/20040803sim.pdf }}</ref><ref name="Online">{{cite book|author=Silver, Larry B |title=Attention-deficit/hyperactivity disorder |publisher=American Psychiatric Publishing |edition=3rd |year=2004 |isbn=1-58562-131-5 |page=[http://books.google.com/books?id=gjojY1WoIOIC&pg=PA4&lpg=PP7&output=html 4–7] }}</ref><ref name="Schonwald A, Lechner E 2006 189–95">{{Rejea jarida|author=Schonwald A, Lechner E |title=Attention deficit/hyperactivity disorder: complexities and controversies |journal=Current Opinion in Pediatrics |volume=18 |issue=2 |pages=189–95 |year=2006|month=April |pmid=16601502 |doi=10.1097/01.mop.0000193302.70882.70 }}</ref>{{TOC limit|limit=3}} ==Ishara na dalili== Mara nyingi kutomakinika, kupepesuka (kutotulia kwa watu wazima), tabia ya kuzua vurugu na usukumizi wa ghafla hupatikana katika TKUU.<ref name=ICSI2012>{{cite journal|last=Dobie|first=C|title=Diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents|year=2012|pages=79|url=http://guidelines.gov/content.aspx?f=rss&id=36812|publisher=Institute for Clinical Systems Improvement|journal=|access-date=2014-01-09|archive-date=2013-03-01|archive-url=https://web.archive.org/web/20130301124247/http://guidelines.gov/content.aspx?f=rss&id=36812|dead-url=yes|https://web.archive.org/web/20130301124247/http://guidelines.gov/content.aspx?f=rss&id=36812|=https://web.archive.org/web/20130301124247/http://guidelines.gov/content.aspx?f=rss&id=36812}}</ref><ref>{{cite web |url=http://www.cdc.gov/ncbddd/adhd/facts.html |title=Facts About ADHD |publisher=NCBDDD |author=Centers for Disease Control and Prevention |accessdate=2012-11-13 }}</ref> Kutatizika katika masomo hutokea mara nyingi sawia na matatizo ya kimahusiano.<ref name=ICSI2012/> Dalili zinaweza kuwa ngumu kufasili kwa sababu ya ugumu wa kutambua mwanzo wa viwango vya kawaida vya kutomakinika, kupepesuka na mwisho wa usukumizi na viwango muhimu vinavyohitaji usaidizi.<ref name =Ramsay25>{{cite book|author=Ramsay, J. Russell |title=Cognitive behavioral therapy for adult ADHD|url=https://archive.org/details/cognitivebehavio00rams |publisher=Routledge |year=2007 |isbn=0-415-95501-7 |page=[https://archive.org/details/cognitivebehavio00rams/page/25 25]}}</ref>{{Rp|p.26}} Ili hali hii kutambulika, ni sharti dalili hizi zidhihirike katika mandhari mawili tofauti kwa miezi sita au zaidi na katika kiwango kilicho juu ya kile cha watoto wengine wa umri sawa.<ref name=DSM-IV-TR/>TKUU linaweza kuainishwa katika aina tatu kulingana na dalili zinazojidhihirisha—[[Tatizo la kupepesuka lenye ukosefu wa umakinifu linalozidisha kutomakinika|linalozidisha kutomakinika]], la kupepesuka na usukumizi, au aina changamani ikiwa vigezo vya aina zote mbili zifikiwa.<ref name = Ramsay25/>{{Rp|p.4}} Mtu asiyemakinika anaweza kuonyesha baadhi ya/au dalili hizi zote:<ref name="NIMH1">{{cite web |url=http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml |title=Attention Deficit Hyperactivity Disorder (ADHD) |author=National Institute of Mental Health |authorlink=National Institute of Mental Health |year=2008 |publisher=[[National Institutes of Health]] |location=United States }}</ref> * Kuvurugika mawazo kwa urahisi, kutotambua habari za kina, kusahau na kubadili shughuli kutoka moja hadi nyingine mara nyingi. * Ugumu wa kuzingatia shughuli moja * Kuchoshwa na kazi baada ya muda mfupi isipokuwa pale mtu anapofanya kazi inayomvutia * Ugumu wa kumakinika katika kupanga na kukamilisha kazi fulani au kujifunza jambo jipya * Tatizo la kukamilisha au kuwasilisha kazi ya ziada, mara nyingi kutokana na kupoteza vifaa (kwa mfano penseli, vitu vya kuchezea, kazi ya ziada) vinavyohitajika kukamilisha kazi au shughuli hizi. * Haonekani kusikiza anapoongeleshwa * Kuzubaa, kuchanganyikiwa kwa urahisi na kutembea polepole * Ugumu wa kuchakata habari haraka na kwa usahihi kama watu wengine * Ugumu wa kufuata maagizo Mtu mwenye tatizo la kupepesuka anaweza kuonyesha baadhi ya/au dalili hizi zote:<ref name="NIMH1"/> * Kuhangaika na kufurukuta anapoketi * Kuzungumza bila kukoma * Kukimbia huku na kule, kugusa au kuchezea kitu chochote au kila kitu anachokiona * Ugumu wa kuketi kwa utulivu wakati wa maakuli, shuleni, akifanya kazi ya ziada na wakati wa kusimuliwa hadithi * Kuwa mbioni kila mara * Ugumu wa kufanya kazi au shughuli zinazohitaji unyamavu. Mtu mwenye usukumizi anaweza kuonyesha baadhi ya/au dalili hizi zote:<ref name="NIMH1"/> * Kukosa subira * Kuropoka maoni yasiyo mwafaka, kudhihirisha hisia kwa uwazi na kufanya mambo bila kuzingatia matokeo yake * Ugumu wa kusubiri vitu wanavyotaka au kusubiri zamu yao katika mchezo * Mara nyingi hukatiza mazungumzo au shughuli za wengine. Mara nyingi watu wenye TKUU wana ugumu katika [[stadi za kijamii]], kama vile kuchangamana, kuanzisha na kudumisha mahusiano. Takriban nusu ya watoto na vijana wenye TKUU hukataliwa na wenzao ikilinganishwa na asilimia 10–15 ya wale wasio na hali hii. Kufundisha stadi za kijamii, mabadiliko ya kitabia na matibabu yanaweza kuwa na athari chache zenye manufaa. Kipengele muhimu kabisa katika kupunguza [[uhalifu]], kutofaulu shuleni na [[tatizo la utumizi wa dawa za kulevya]] ni kufanya urafiki na watu wasiojihusisha na uhalifu.<ref name="pmid20490677">{{cite journal |author=Mikami AY |title=The importance of friendship for youth with attention-deficit/hyperactivity disorder |journal=Clin Child Fam Psychol Rev |volume=13 |issue=2 |pages=181–98 |year=2010 |month=June |pmid=20490677 |pmc=2921569 |doi=10.1007/s10567-010-0067-y }}</ref> Watoto wenye TKUU mara nyingi huwa na ugumu wa kudhibiti hasira <ref>http://www.webmd.com/add-adhd/adhd-anger-management-directory</ref> sawa na[[mwandiko]] mbaya<ref name="Racine-2008">{{Rejea jarida | last1 = Racine | first1 = MB. | last2 = Majnemer | first2 = A. | last3 = Shevell | first3 = M. | last4 = Snider | first4 = L. | title = Handwriting performance in children with attention deficit hyperactivity disorder (ADHD) | journal = J Child Neurol | volume = 23 | issue = 4 | pages = 399–406 | month = Apr | year = 2008 | doi = 10.1177/0883073807309244 | pmid = 18401033 }}</ref> kuchelewa kwa[[Patholojia ya lugha na kuzungumza|kuzungumza, lugha]] na kuendeleza mwendo.<ref name=ICD10/><ref name="Bellani-2011">{{Rejea jarida | last1 = Bellani | first1 = M. | last2 = Moretti | first2 = A. | last3 = Perlini | first3 = C. | last4 = Brambilla | first4 = P. | title = Language disturbances in ADHD | journal = Epidemiol Psychiatr Sci | volume = 20 | issue = 4 | pages = 311–5 | month = Dec | year = 2011 | pmid = 22201208 | doi = 10.1017/S2045796011000527 }}</ref> Ingawa hali hii husababisha athari nyingi, hasa katika jamii ya kisasa, watoto wengi wenye TKUU humakinika kwa muda mrefu wanapofanya shughuli zinazowavutia.<ref name="pmid22851461"/> ===Matatizo yanayohusiana na hali hii=== TKUU katika watoto hutokea yakiambatana na matatizo mengine kwa takriban 67%.<ref name="pmid22851461">{{cite journal |author=Walitza S, Drechsler R, Ball J |title=[The school child with ADHD] |language=German |journal=Ther Umsch |volume=69 |issue=8 |pages=467–73 |year=2012 |month=August |pmid=22851461 |doi=10.1024/0040-5930/a000316 }}</ref> Baadhi ya hali zinazohusiana na hali hii mara nyingi hujumuisha: *[[Tatizo la Ukaidi wa Kiupinzani]] na [[tatizo la kimaadili]], hali zinazotokea pamoja zikiambatana na TKUU kwa takriban 50% na 20% ya visa mtawalia.<ref name="pmid19940426">{{cite journal |author=McBurnett K, Pfiffner LJ |title=Treatment of aggressive ADHD in children and adolescents: conceptualization and treatment of comorbid behavior disorders |journal=Postgrad Med |volume=121 |issue=6 |pages=158–65 |year=2009 |month=November |pmid=19940426 |doi=10.3810/pgm.2009.11.2084 |url=}}</ref> Hali hizi hutambulika kwa tabia za kupambana na jamii kama vile usumbufu, uchokozi, [[vipindi vya hasira]] za kila mara, ulaghai, udanganyifu na wizi.<ref name=UTP2008>{{cite web|url=http://www.uptodate.com/online/content/topic.do?topicKey=behavior/8293#5 |author = Krull, K.R. |title=Evaluation and diagnosis of attention deficit hyperactivity disorder in children |format= Subscription required |accessdate=2008-09-12 |publisher=Uptodate |date=5 December 2007 }}</ref> Takriban nusu ya watu wanaopepesuka na wana tatizo la ukaidi wa kiupinzani au tatizo la kitabia hupata [[tatizo la nafsia ya kutochangamana na jamii]] katika utu uzima.<ref>{{cite journal | pmid = 19428109 | doi=10.1016/j.ijlp.2009.04.004 | volume=32 | issue=4 | title=Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition | year=2009 | author=Hofvander B, Ossowski D, Lundström S, Anckarsäter H | journal=Int J Law Psychiatry | pages=224–34}}</ref> Upigaji picha ubongo umedhihirisha kwamba tatizo nafsia na TKUU ni hali tofauti.<ref name="pmid21094938">{{cite journal |author=Rubia K |title="Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review |journal=Biol. Psychiatry |volume=69 |issue=12 |pages=e69–87 |year=2011 |month=June |pmid=21094938 |doi=10.1016/j.biopsych.2010.09.023 }}</ref> * Tatizo la kimsingi la [[Uangalifu (saikolojia)|uangalifu]], linaloashiriwa na viwango vya chini vya umakinifu na uzingatifu, na pia ugumu wa kutolala. Watoto hawa huelekea kuhangaika, kupiga miayo na kujinyoosha na kuonekana kupepesuka sana ili kumakinika.<ref name="UTP2008" /> * [[Matatizo ya hisia]] (hasa [[tatizo la hisia mseto]] na [[tatizo kuu la kufadhaisha]]). Wavulana wanaotambulika na aina changamani ya TKUU wana uwezekano mkubwa wa kupata tatizo la kihisia.<ref name="Wilens-2010">{{Rejea jarida | last1 = Wilens | first1 = TE. | last2 = Spencer | first2 = TJ. | title = Understanding attention-deficit/hyperactivity disorder from childhood to adulthood | journal = Postgrad Med | volume = 122 | issue = 5 | pages = 97–109 | month = Sep | year = 2010 | doi = 10.3810/pgm.2010.09.2206 | pmid = 20861593 | pmc = 3724232 }}</ref> Watu wazima wenye TKUU mara nyingi huwa na tatizo la hisia mseto linalohitaji kadirio la taratibu ili kutambua na kutibu hali zote mbili.<ref name="pmid21717696">{{cite journal |author=Baud P, Perroud N, Aubry JM |title=[Bipolar disorder and attention deficit/hyperactivity disorder in adults: differential diagnosis or comorbidity] |language=French |journal=Rev Med Suisse |volume=7 |issue=297 |pages=1219–22 |year=2011 |month=June |pmid=21717696 }}</ref> * [[Matatizo ya wasiwasi]] yametambulika kutokea mara nyingi katika watu wenye TKUU.<ref name="Wilens-2010"/> * [[Tatizo la tamaa isiyoweza kudhibitika]] linaweza kutokea pamoja na TKUU na sifa zake nyingi huwa sawa.<ref name="UTP2008" /> * [[Matatizo ya utumizi wa dawa za kulevya]]. Vijana na watu wazima wenye TKUU wana hatari zaidi ya kutumia dawa za kulevya na mara nyingi huwa ni [[unywaji pombe|pombe]] au [[bangi (dawa) |bangi]]. Sababu ya hali hii inaweza kutokana na njia ya kuzawadiwa ya ubongo wa mtu mwenye TKUU iliyogeuzwa.<ref name="Kooij-2010"/> Hali hii hufanya tathmini na matibabu ya TKUU kuwa magumu zaidi, huku matatizo ya hatari ya matumizi mabaya ya dawa za kulevya yakitibiwa kwanza kwa sababu ya hatari zake kuu.<ref name = NICE2008/>{{Rp|p.38|date=November 2012}}<ref name="Wilens-2011">{{Rejea jarida | last1 = Wilens | first1 = TE. | last2 = Morrison | first2 = NR. | title = The intersection of attention-deficit/hyperactivity disorder and substance abuse | journal = Current Opinion in Psychiatry | volume = 24 | issue = 4 | pages = 280–5 | month = Jul | year = 2011 | doi = 10.1097/YCO.0b013e328345c956 | pmid = 21483267 | pmc = 3435098 }}</ref> *[[Sindromu ya miguu isiyotulia]] imetambulika mara nyingi katika watu wenye TKUU na mara nyingi husababishwa na [[anemia ya ukosefu wa ayoni]].<ref name="pmid21365608">{{cite journal |author=Merino-Andreu M |title=Trastorno por déficit de atención/hiperactividad y síndrome de piernas inquietas en niños|trans_title=Attention deficit hyperactivity disorder and restless legs syndrome in children |language=Spanish; Castilian |journal=Rev Neurol |volume=52 Suppl 1 |issue= |pages=S85–95 |year=2011 |month=March |pmid=21365608 }}</ref><ref name="pmid20620105">{{cite journal |author=Picchietti MA, Picchietti DL |title=Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment |journal=Sleep Med. |volume=11 |issue=7 |pages=643–51 |year=2010 |month=August |pmid=20620105 |doi=10.1016/j.sleep.2009.11.014 |url=}}</ref> Hata hivyo, miguu isiyotulia inaweza kuwa kipengele cha TKUU hivyo huhitaji ukadiriaji wa makini ili kutofautisha matatizo haya mawili.<ref name="pmid18656214">{{cite journal |author=Karroum E, Konofal E, Arnulf I |title=[Restless-legs syndrome] |language=French |journal=Rev. Neurol. (Paris) |volume=164 |issue=8–9 |pages=701–21 |year=2008 |pmid=18656214 |doi=10.1016/j.neurol.2008.06.006 |url=}}</ref> *[[Ugumu wa kulala]] na TKUU mara nyingi hutokea pamoja. Matatizo haya pia yanaweza kuwa athari za dawa zinazotumika kutibu watoto wenye TKUU. Katika watoto wenye TKUU, [[insomnia]] ni tatizo linalotokea mara nyingi zaidi na matibabu ya kitabia ndiyo matibabu yanayopendekezwa.<ref name="pmid21600348">{{cite journal |author=Corkum P, Davidson F, Macpherson M |title=A framework for the assessment and treatment of sleep problems in children with attention-deficit/hyperactivity disorder |url=https://archive.org/details/sim_pediatric-clinics-of-north-america_2011-06_58_3/page/667 |journal=Pediatr. Clin. North Am. |volume=58 |issue=3 |pages=667–83 |year=2011 |month=June |pmid=21600348 |doi=10.1016/j.pcl.2011.03.004 }}</ref><ref name="pmid20451036">{{cite journal |author=Tsai MH, Huang YS |title=Attention-deficit/hyperactivity disorder and sleep disorders in children |journal=Med. Clin. North Am. |volume=94 |issue=3 |pages=615–32 |year=2010 |month=May |pmid=20451036 |doi=10.1016/j.mcna.2010.03.008 |url=https://archive.org/details/sim_medical-clinics-of-north-america_2010-05_94_3/page/615}}</ref> Ugumu wa kupata usingizi hupatikana mara nyingi katika watu wenye TKUU, lakini mara nyingi wao hulala unono na huwa na ugumu wa kuamka.<ref name="Brown-2008"/> [[Melatonini]] mara nyingine hutumika wakati wa kulala katika watoto wanaokosa usingizi.<ref name="pmid20028959">{{cite journal |author=Bendz LM, Scates AC |title=Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder |url=https://archive.org/details/sim_annals-of-pharmacotherapy_2010-01_44_1/page/185 |journal=Annals of Pharmacotherapy |volume=44 |issue=1 |pages=185–91 |year=2010 |month=January |pmid=20028959 |doi=10.1345/aph.1M365 }}</ref> Kuna uhusiano kati ya [[Enuresisi ya usiku|kukojoa kitandani bila kukoma]],<ref name="pmid19096296">{{cite journal |author=Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR |title=Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among United States children: results from a nationally representative study |journal=J Am Acad Child Adolesc Psychiatry |volume=48 |issue=1 |pages=35–41 |year=2009 |month=January |pmid=19096296 |pmc=2794242 |doi=10.1097/CHI.0b013e318190045c |url=}}</ref> [[kuchelewa kwa uwezo wa kuzungumza]]<ref name="pmid19713073">{{cite journal|author=Hagberg BS, Miniscalco C, Gillberg C |title=Clinic attenders with autism or attention-deficit/hyperactivity disorder: cognitive profile at school age and its relationship to preschool indicators of language delay |journal=Res Dev Disabil |volume=31 |issue=1 |pages=1–8 |year=2010 |pmid=19713073 |doi=10.1016/j.ridd.2009.07.012 }}</ref> na [[tatizo la kuambatanisha ukuaji]], huku takriban nusu ya watu wenye tatizo la kuambatanisha ukuaji wakipata TKUU.<ref name="pmid22186361">{{cite journal |author=Fliers EA, Franke B, Buitelaar JK |title=[Motor problems in children with ADHD receive too little attention in clinical practice] |language=Dutch; Flemish |journal=Ned Tijdschr Geneeskd |volume=155 |issue=50 |pages=A3559 |year=2011 |pmid=22186361 |doi= |url=}}</ref> ==Kisababishi== Kisababishi cha visa vingi vya TKUU hakijulikani: hata hivyo, TKUU linaaminika kuhusishwa na mwingiliano wa [[kijenetiki|kijenetiki]] na vipengele vya kimazingira.<ref name=Gordon2009>{{cite book|last=Millichap|first=J. Gordon|title=Attention Deficit Hyperactivity Disorder Handbook a Physician's Guide to ADHD|year=2010|publisher=Springer Science|location=New York, NY|isbn=9781441913975|page=26|url=http://books.google.ca/books?id=KAlq0CDcbaoC&pg=PA26|edition=2nd}}</ref><ref name="pmid22963644">{{cite journal |author=Thapar A, Cooper M, Eyre O, Langley K |title=What have we learnt about the causes of ADHD? |journal=J Child Psychol Psychiatry |volume=54 |issue=1 |pages=3–16 |year=2013 |month=January |pmid=22963644 |pmc=3572580|doi=10.1111/j.1469-7610.2012.02611.x |url=}}</ref> Visa vingine huhusishwa na maambukizi ya awali au jeraha kwenye ubongo.<ref name=Gordon2009/> ===Jenetikia=== [[Utafiti pacha|Tafiti pacha]] zinaashiria kuwa tatizo hili mara nyingi hurithiwa kutoka kwa wazazi huku [[jenetikia]] ikisababisha takriban asilimia 75 ya visa hivi.<ref name=NICE2008/><ref name="Neale-2010">{{Rejea jarida |displayauthors=9 |last1=Neale |first1=BM |last2=Medland |first2=SE|last3=Ripke |first3=S |last4=Asherson |first4=P |last5=Franke |first5=B. |last6=Lesch |first6=KP |last7=Faraone|first7=SV |last8=Nguyen |first8=TT |last9=Schäfer |first9=H |title=Meta-analysis of genome-wide association studies of attention-deficit/hyperactivity disorder |pmc=2928252 |journal=J Am Acad Child Adolesc Psychiatry |volume=49 |issue=9|pages=884–97 |month=Sep |year=2010 |doi=10.1016/j.jaac.2010.06.008 |pmid=20732625 |last10=Holmans |first10=Peter |last11=Daly |first11=M |last12=Steinhausen |first12=HC |last13=Freitag |first13=C |last14=Reif |first14=A |last15=Renner |first15=TJ |last16=Romanos |first16=M |last17=Romanos |first17=J |last18=Walitza |first18=S |last19=Warnke |first19=A |last20=Meyer |first20=J |last21=Palmason |first21=H |last22=Buitelaar |first22=J |last23=Vasquez |first23=AA |last24=Lambregts-Rommelse |first24=N |last25=Gill |first25=M |last26=Anney |first26=RJ |last27=Langely |first27=K |last28=O'Donovan |first28=M |last29=Williams |first29=N |last30=Owen |first30=M}}</ref><ref name="Burt-2009">{{Rejea jarida | last1 = Burt | first1 = SA | title = Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences | url = https://archive.org/details/sim_psychological-bulletin_2009-07_135_4/page/608 | journal = Psychol Bull | volume = 135 | issue = 4 |pages = 608–37 | month = Jul | year = 2009 | doi = 10.1037/a0015702 | pmid = 19586164 }}</ref> Vipengele vya kijenetiki pia vinaaminika kuhusika katika kutambua ikiwa TKUU huendelea kuwepo katika utu uzima au la.<ref name="pmid22105624">{{cite journal |author=Franke B, Faraone SV, Asherson P, ''et al.'' |title=The genetics of attention deficit/hyperactivity disorder in adults, a review |journal=Mol. Psychiatry |volume=17 |issue=10 |pages=960–87 |year=2012 |month=October |pmid=22105624 |pmc=3449233 |doi=10.1038/mp.2011.138 }}</ref> Kwa kawaida, jeni kadhaa huhusika, na idadi kubwa ya jeni hizi huathiri visafirishaji vya [[dopamini]].<ref name="Gizer-2009"/> Jeni hizi zinaweza kujumuisha: [[DAT1]], [[DRD4]], [[DRD5]], [[5HTT]], [[HTR1B]], [[SNAP25]], [[ADRA2A]], [[TPH2]], [[MAOA]], na [[Dopamine-beta-hydroxylase|dopamine beta hydroxylase]].<ref name="Gizer-2009">{{Rejea jarida | last1 = Gizer | first1 = IR. | last2 = Ficks | first2 = C. | last3 = Waldman | first3 = ID. | title = Candidate gene studies of ADHD: a meta-analytic review | journal = Hum Genet | volume = 126 | issue = 1 | pages = 51–90 | month = Jul | year = 2009 | doi = 10.1007/s00439-009-0694-x | pmid = 19506906 }}</ref> Aina ya jeni inayopatikana mara nyingi inayoitwa [[LPHN3]] hukisiwa kusababisha takriban asilimia 9 ya visa, na jeni hii ikiwepo, watu hutibiwa kwa vichangamsho.<ref name="pmid21432600">{{cite journal |author=Arcos-Burgos M, Muenke M |title=Toward a better understanding of ADHD: LPHN3 gene variants and the susceptibility to develop ADHD |journal=Atten Defic Hyperact Disord |volume=2 |issue=3 |pages=139–47 |year=2010 |month=November |pmid=21432600 |pmc=3280610 |doi=10.1007/s12402-010-0030-2 |url=}}</ref>[[Uchaguzi asilia]] huenda ulipendelea sifa za TKUU kwa, aghalau mtu binafsi, huenda zilimpa mtu fursa ya kuishi, huku zikikosa manufaa zikichangamanishwa tu.<ref name="pmid20200842">{{cite journal |author=Cardo E, Nevot A, Redondo M, ''et al.'' |title=Trastorno por déficit de atención/hiperactividad: ¿un patrón evolutivo? |trans_title=Attention deficit disorder and hyperactivity: a pattern of evolution? |language=Spanish; Castilian |journal=Rev Neurol |volume=50 Suppl 3 |issue= |pages=S143–7 |year=2010 |month=March |pmid=20200842 }}</ref> Isitoshe, baadhi ya wanawake wanaweza kuvutiwa na wanaume wanaopenda kufanya mambo hatari hivyo kuongeza jeni zinazohatarisha mtu kwa TKUU katika [[kidimbwi cha jeni]].<ref name="pmid=16849269"/> Kwa vile hali hii hupatikana mara nyingi katika watoto wenye kina mama wenye wasiwasi au dhiki, wengine husema kuwa TKUU ni adaptesheni inayowasaidia watoto kukabili mazingira yenye dhiki au hatari huku wakiwa na, kwa mfano, usukumizi ulioongezeka au tabia ya kuchunguza.<ref name="pmid21250994">{{cite journal |author=Glover V |title=Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective |journal=J Child Psychol Psychiatry |volume=52 |issue=4 |pages=356–67 |year=2011 |month=April |pmid=21250994 |doi=10.1111/j.1469-7610.2011.02371.x |url=https://archive.org/details/sim_journal-of-child-psychology-and-psychiatry_2011-04_52_4/page/356}}</ref> Kupepesuka kunaweza kuwa na manufaa tukiangazia mtazamo wa kinadharia, katika hali zinazohusisha hatari, mashindano au tabia isiyoeleweka (yaani kutafuta maeneo mapya au kutafuta asili mpya ya vyakula). Katika hali hizi, TKUU inaweza kuwa na manufaa katika jamii huku ikiwa hatari kwa mtu binafsi.<ref name="pmid=16849269">{{Rejea jarida|author=Williams J, Taylor E |title=The evolution of hyperactivity, impulsivity and cognitive diversity |journal=J R Soc Interface |volume=3|issue=8 |pages=399–413 |year=2006 |month=June |pmid=16849269 |pmc=1578754 |doi=10.1098/rsif.2005.0102 }}</ref> Isitoshe, katika mazingira mengine, hali hii inaweza kumnufaisha mtu binafsi, kwa mfano mwitiko wa haraka kwa hatari au stadi kuu ya uwindaji.<ref>{{Rejea kitabu | title = Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment | url = http://books.google.co.uk/books?id=aH2qWZRpcf0C&pg=PA132 | date = 13 January 2012 | publisher = Springer | location = New York | isbn = 978-3-642-24611-1 | pages = 132–134 }}</ref> ===Mazingira=== Vipengele vya kimazingira vinaaminika kuchangia kwa kiwango kidogo. Ulevi wakati wa ujauzito unaweza kusababisha [[tatizo la spektra ya kulewa kwa fetasi]] linaloweza kudhihirisha dalili sawa na TKUU.<ref name="Burger-2011">{{Rejea jarida | last1 = Burger | first1 = PH | last2 = Goecke | first2 = TW | last3 = Fasching | first3 = PA | last4 = Moll | first4 = G | last5 = Heinrich | first5 = H | last6 = Beckmann | first6 = MW | last7 = Kornhuber | first7 = J | title = Einfluss des mütterlichen Alkoholkonsums während der Schwangerschaft auf die Entwicklung von ADHS beim Kind |trans_title=How does maternal alcohol consumption during pregnancy affect the development of attention deficit/hyperactivity syndrome in the child |language=German | journal = Fortschr Neurol Psychiatr | volume = 79 | issue = 9 | pages = 500–6 | month = Sep | year = 2011 | doi = 10.1055/s-0031-1273360 | pmid = 21739408 }}</ref> Kuvuta moshi wa tumbaku katika ujauzito kunaweza kusababisha matatizo ya ukuaji wa mfumo mkuu wa neva na pia kuongeza hatari ya TKUU.<ref name="Abbott-2012">{{Rejea jarida |last1 = Abbott | first1 = LC | last2 = Winzer-Serhan | first2 = UH | title = Smoking during pregnancy: lessons learned from epidemiological studies and experimental studies using animal models | journal = Crit Rev Toxicol | volume = 42 | issue = 4 | pages = 279–303 | month = Apr | year = 2012 | doi = 10.3109/10408444.2012.658506 | pmid = 22394313 }}</ref> Watoto wengi wanaovuta moshi wa tumbaku hawapati TKUU au huwa na dalili hafifu zisizofikia kizingiti cha utambuzi. Mseto wa uhatarisho wa kijenetiki na kunusia tumbaku kunaweza kueleza kwa nini baadhi ya watoto wanaohatarishwa katika ujauzito wanaweza kupata TKUU ilhali wengine hawapati.<ref>{{cite journal|title=Prenatal smoking exposure and dopaminergic genotypes interact to cause a severe ADHD subtype|url=https://archive.org/details/sim_biological-psychiatry_2007-06-15_61_12/page/1320|author=Neuman RJ, Lobos E, Reich W, Henderson CA, Sun LW, Todd RD |journal=Biol Psychiatry|date=2007 Jun 15|volume=61|issue=12|pages=1320–8|pmid=17157268|laysummary=http://www.sciencedaily.com/releases/2007/04/070410190421.htm|doi=10.1016/j.biopsych.2006.08.049 }}</ref><!-- consider update from reviews PMID 22949579, PMID 22372737, PMID 21277451 --> Watoto waliohatarishwa kwa [[ledi]], hata kwa viwango vidogo, au [[bifenili zenye wingi wa klorini]] wanaweza kupata matatizo yanayofanana na TKUU hivyo tatizo hili kutambuliwa.<ref name="Eubig-2010">{{Rejea jarida | last1 = Eubig | first1 = PA | last2 = Aguiar | first2 = A | last3 = Schantz | first3 = SL | title = Lead and PCBs as risk factors for attention deficit/hyperactivity disorder | journal = Environ Health Perspect | volume = 118 | issue = 12 | pages = 1654–67 | month = Dec | year = 2010 | doi = 10.1289/ehp.0901852 | pmid = 20829149 | pmc = 3002184 }}</ref> Kuhatarishwa kwa viuwa wadudu vya [[oganofosfeti]] [[kloripirifosi]] na [[Fosfeti ya alkali | fosfeti ya dialkali]] inahusishwa na hatari zaidi; hata hivyo, ushahidi huu haujadhibitishwa.<ref name="de Cock-2012">{{Rejea jarida | last1 = de Cock | first1 = M | last2 = Maas | first2 = YG | last3 = Van De Bor | first3 = M | title = Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? | url = https://archive.org/details/sim_acta-paediatrica_2012-08_101_8/page/811 |type=Review | journal = Acta Paediatrica | volume = 101 | issue = 8 | pages = 811–8 | month = Aug | year = 2012 | doi = 10.1111/j.1651-2227.2012.02693.x | pmid = 22458970 }}</ref> [[Uzito wa chini sana wa wakati wa kuzaliwa]], [[kuzaliwa kabla ya wakati]] na shida za mapema pia huongeza hatari<ref name="Thapar-2012">{{Rejea jarida | last1 = Thapar | first1 = A. | last2 = Cooper | first2 = M. |last3 = Jefferies | first3 = R. | last4 = Stergiakouli | first4 = E. | title = What causes attention deficit hyperactivity disorder? | journal = Arch Dis Child | volume = 97 | issue = 3 | pages = 260–5 |month = Mar | year = 2012 | doi = 10.1136/archdischild-2011-300482 | pmid = 21903599 }}</ref> sawia na maambukizi katika ujauzito, wakati wa kuzaa na katika utotoni. Baadhi ya maambukizi haya yanajumuisha: virusi mbalimbali ([[ukambi]], [[tetekuwanga]], [[rubela]], [[enterovirusi 71]]) na maambukizi ya bakteria ya [[streptokokali]].<ref>{{Rejea jarida |author=Millichap JG |title=Etiologic classification of attention-deficit/hyperactivity disorder |journal=Pediatrics |volume=121 |issue=2 |pages=e358–65 |year=2008 |month=February |pmid=18245408 |doi=10.1542/peds.2007-1332}}</ref> Angalau asilimia 30 ya watoto wenye [[majeraha ya ubongo]] hupata TKUU baadaye<ref name="Eme-2012">{{Rejea jarida | last1 = Eme | first1 = R | title = ADHD: an integration with pediatric traumatic brain injury | journal = Expert Rev Neurother | volume = 12 | issue = 4 | pages = 475–83 |month = Apr | year = 2012 | doi = 10.1586/ern.12.15 | pmid = 22449218 }}</ref> na takriban asilimia 5 ya visa husababishwa na majeraha ya ubongo.<ref name=Erk2009/> Watoto wachache wanaweza kuonyesha kuathiriwa na rangi za chakula na dawa za kuhifadhi.<ref name=Peds2012>{{cite journal |author=Millichap JG, Yee MM |title=The diet factor in attention-deficit/hyperactivity disorder|journal=Pediatrics |volume=129 |issue=2 |pages=330–7 |year=2012 |month=February |pmid=22232312|doi=10.1542/peds.2011-2199 |url=}}</ref> Kuna uwezekano kuwa baadhi ya rangi za chakula zinaweza kuwa kichocheo kwa watu wenye hatari ya kijenetiki. Uiengereza na Shirika la Uropa imeweka hatua za urekebishaji kutokana na madai haya.<ref name="Kleinman-2011">{{Rejea jarida | last1 = Kleinman | first1 = RE | last2 = Brown | first2 = RT | last3 = Cutter | first3 = GR | last4 = Dupaul |first4 = GJ | last5 = Clydesdale | first5 = FM | title = A research model for investigating the effects of artificial food colorings on children with ADHD | journal = Pediatrics | volume = 127 | issue = 6 |pages = e1575–84 | month = Jun | year = 2011 | doi = 10.1542/peds.2009-2206 | pmid = 21576306 }}</ref> Sukari inayopendekezwa ya lishe, na kikoleza utamu cha [[aspartame]] huonekena kuwa na kiwango kidogo cha athari au kukosa athari; isipokuwa katika watoto wa chini ya miaka sita, ambapo huenda sukari ikaongeza kiwango cha kutomakinika.<ref name=Peds2012/> ===Jamii=== Utambuzi wa TKUU unaweza kuashiria kuathirika kwa utendaji wa familia au mfumo duni wa elimu wala si tatizo la kibinafsi.<ref>{{cite web |url=http://www.euro.who.int/document/MNH/ebrief14.pdf |format=PDF |title=Mental health of children and adolescents |date=12–15 January 2005 |accessdate=13 October 2011 |archiveurl=https://web.archive.org/web/20091024102724/http://www.euro.who.int/document/MNH/ebrief14.pdf |archivedate=2009-10-24 }}</ref> Visa vingine vinaweza kutambulika kwa matarajio ya juu ya kielimu; huku kuthibitishwa kwa hali hii kukitumiwa na wazazi katika baadhi ya nchi kupata msaada zaidi wa kifedha na kielimu kwa watoto wao.<ref name=Erk2009/> Watoto wachanga zaidi darasani wametambulika na uwezekano wa kuwa na TKUU hasa kwa sababu ya kuwa nyuma katika ukuaji wao ikilinganishwa na watoto wakubwa.<ref name="Elder-2010">{{Rejea jarida | last1 = Elder | first1 = TE. |title = The importance of relative standards in ADHD diagnoses: evidence based on exact birth dates | journal = J Health Econ | volume = 29 | issue = 5 | pages = 641–56 | month = Sep | year = 2010 | doi = 10.1016/j.jhealeco.2010.06.003 | pmid = 20638739 |pmc=2933294}}</ref><ref>{{cite book|last=Parritz|first=Robin|title=Disorders of Childhood: Development and Psychopathology|year=2013|publisher=Cengage Learning|isbn=9781285096063|page=151|url=http://books.google.ca/books?id=VAj2rPTN1j0C&pg=PA151}}</ref> Mtindo unaofanana na wa TKUU hutokea mara nyingi katika watoto waliopitia vurugu au dhuluma ya kiakili.<ref name = NICE2008/> Kulingana na [[Nadharia ya TKUU ya muundo wa jamii|nadharia ya muundo wa jamii]], jamii huamua mipaka kati ya tabia ya kawaida na isiyo ya kawaida. Watu katika jamii: ikijumuisha matabibu, wazazi na walimu huamua vigezo vitakavyotumika, na hivyo, idadi ya watu walioambukizwa.<ref>{{Rejea jarida|author=Parens E, Johnston J |title=Facts, values, and Attention-Deficit Hyperactivity Disorder (ADHD): an update on the controversies |journal=Child Adolesc Psychiatry Ment Health |volume=3 |issue=1 |page=1 |year=2009 |pmid=19152690|pmc=2637252 |doi=10.1186/1753-2000-3-1 |url=}}</ref> Matokeo ya hali hii ni kigezo cha DSM IV hufikia viwango vya TKUU mara tatu hadi nne zaidi kuliko cha ICD 10.<ref name="Singh I 2008 957–64"/> [[Thomas Szasz]], muunga mkono wa nadharia hii, amesema kuwa TKUU "ilibuniwa na wala si kutambuliwa."<ref>{{Rejea kitabu|author=Chriss, James J.|title=Social control: an introduction |url=https://archive.org/details/socialcontrolint0000chri|publisher=Polity |location=Cambridge, UK |year=2007 |page=[https://archive.org/details/socialcontrolint0000chri/page/230 230] |isbn=0-7456-3858-9 }}</ref><ref>{{Rejea kitabu|author=Szasz, Thomas Stephen |title=Pharmacracy: medicine and politics in America |url=https://archive.org/details/pharmacracymedic0000szas |publisher=Praeger |location=New York |year=2001 |page=[https://archive.org/details/pharmacracymedic0000szas/page/212 212] |isbn=0-275-97196-1 }}</ref> ==Pathofisiolojia== ===Muundo wa ubongo=== [[File:Illu cerebrum lobes.jpg|thumb|Diagram of the human brain]] [[Pathofisiolojia]] ya TKUU si wazi kwani kuna maelezo mengi yanayobishana.<ref name=UTP2008/> Katika watoto wenye TKUU, kuna upungufu wa kijumla wa kiwango cha ubongo, pamoja na ongezeko sawa katika upungufu wa kiwango cha upande wa kushoto wa [[koteksi inayoitangulia sehemu ya mbele]].<ref name=Krain2006/> Njia za ubongo zinazounganisha koteksi iliyoitangulia sehemu ya mbele na [[striatamu]] pia hukisiwa kuhusika. Hii inadokeza kuwa kukosa umakinifu, kupepesuka na usukumizi unaweza kuashiria [[tatizo la ndewe ya mbele|kuathirika kwa ndewe ya mbele]], huku sehemu za ubongo kama vile [[serebelamu]] pia ikiathirika.<ref name=Krain2006>{{Rejea jarida |last1=Krain|first1=Amy |year=2006 |title=Brain development and ADHD |journal=Clinical Psychology Review |volume=26 |issue=4 |pages=433–444 |id= |url=https://archive.org/details/sim_clinical-psychology-review_2006-08_26_4/page/433|doi=10.1016/j.cpr.2006.01.005 |pmid=16480802 |last2=Castellanos |first2=AL |last3=Castellanos |first3=FX}}</ref> Mifumo ingine ya ubongo inayohusishwa na umakinifu pia imetambulika kuwa tofauti katika watu wenye TKUU na wasio nayo.<ref name="pmid22169776">{{cite journal |author=Castellanos FX, Proal E |title=Large-scale brain systems in ADHD: beyond the prefrontal-striatal model |journal=Trends Cogn. Sci. (Regul. Ed.) |volume=16 |issue=1 |pages=17–26 |year=2012 |month=January |pmid=22169776|pmc=3272832 |doi=10.1016/j.tics.2011.11.007 |url=}}</ref><ref name="pmid22983386">{{cite journal |author=Cortese S, Kelly C, Chabernaud C, ''et al.'' |title=Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies |journal=Am J Psychiatry |volume=169 |issue=10 |pages=1038–55|year=2012 |month=October |pmid=22983386 |doi=10.1176/appi.ajp.2012.11101521 |url=https://archive.org/details/sim_american-journal-of-psychiatry_2012-10_169_10/page/1038}}</ref> ===Nyurotransmita=== Awali, ilifikiriwa kuwa idadi iliyoongezeka ya [[visafirishaji vya dopamini]] kwa watu wenye TKUU ilikuwa sehemu ya pathofisiolojia lakini inaonekana idadi hii ya juu ni kutokana na adaptesheni kwa mfiduo wa vichocheo.<ref name="pmid22294258">{{cite journal |author=Fusar-Poli P, Rubia K, Rossi G, Sartori G, Balottin U |title=Striatal dopamine transporter alterations in ADHD: pathophysiology or adaptation to psychostimulants? A meta-analysis |journal=Am J Psychiatry |volume=169 |issue=3 |pages=264–72 |year=2012 |month=March |pmid=22294258 |doi=10.1176/appi.ajp.2011.11060940 |url=https://archive.org/details/sim_american-journal-of-psychiatry_2012-03_169_3/page/264}}</ref> Watu wenye TKUU wanaweza kuwa na kizingiti cha [[nadharia ya kiwango cha chini cha mwamsho|kiwango cha chini cha mwamsho]]. Watu hawa huifidia hali hii kwa ongezeko la [[Kichocheo (fiziolojia)|vichocheo]], inayosababisha kukatizwa kwa umakinifu na ongezeko la tabia ya kupepesuka. Sababu kuu ya tukio hili ni kasoro ya mwitikio wa [[mfumo wa dopamini]] kwenye kichocheo.<ref>{{Rejea jarida|author=Sikström S, Söderlund G |title=Stimulus-dependent dopamine release in attention-deficit/hyperactivity disorder |journal=Psychol Rev |volume=114 |issue=4 |pages=1047–75 |year=2007 |month=October |pmid=17907872 |doi=10.1037/0033-295X.114.4.1047 |url=http://content.apa.org/journals/rev/114/4/1047}}</ref> Pia, kunaweza kuwa na kasoro katika njia zinazotoa [[adrenalini]], [[serotonini]] na [[kikolini]] au nikotini.<ref name="Kooij-2010"/><ref name="Cortese-2012">{{Rejea jarida | last1 = Cortese | first1 = S. | title = The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know | journal = Eur J Paediatr Neurol | volume = 16 | issue = 5 | pages = 422–33 | month = Sep | year = 2012 | doi = 10.1016/j.ejpn.2012.01.009 | pmid = 22306277 }}</ref> ===Shughuli tendaji=== Nadharia moja inadai kuwa dalili hizi hutokana na ugumu katika [[shughuli za utendaji]].<ref name="Brown-2008">{{Rejea jarida | last1 = Brown | first1 = TE. | title = ADD/ADHD and Impaired Executive Function in Clinical Practice | journal = Curr Psychiatry Rep | volume = 10 | issue = 5 | pages = 407–11 | month = Oct | year = 2008 | doi = 10.1007/s11920-008-0065-7| pmid = 18803914 }}</ref> Shughuli za utendaji huhusu baadhi ya [[ufahamu|michakato ya kiakili]] inayohitajika kurekebisha na kudhibiti shughuli za kila siku za maisha.<ref name="Brown-2008"/> Baadhi ya kasoro hizi hujumuisha: matatizo ya stadi za kupanga, kutumia wakati vyema, [[kuahirisha]] kwingi, ugumu wa kumakinika, kasi ya kufikiria, kudhibiti hisia, kutumia kumbukumbu ya sasa na kuwa na kumbukumbu fupi.<ref name="Brown-2008"/> Kwa kawaida watu huwa na kumbukumbu ya muda mrefu.<ref name="Brown-2008"/> Vigezo vya ukosefu wa shughuli za utendaji hufikiwa katika asilimia 30- 50 ya watoto na vijana wenye TKUU.<ref>{{cite journal | pmid=20406332 | title=Validating neuropsychological subtypes of ADHD: how do children with and without an executive function deficit differ? | url=https://archive.org/details/sim_journal-of-child-psychology-and-psychiatry_2010-08_51_8/page/895 | author=Lambek R, Tannock R, Dalsgaard S, Trillingsgaard A, Damm D, Thomsen PH |journal=Journal of Child Psychology and Psychiatry | year=2010 | volume=51 | issue=8 | pages=895–904 | doi=10.1111/j.1469-7610.2010.02248.x}}</ref> Utafiti mmoja uligundua kuwa asilimia 80 ya watu wenye TKUU walikuwa na kasoro katika angalau mojawapo ya shughuli ya utendaji ikilinganishwa na asilimia 50 ya watu wasio na TKUU.<ref name="Nigg-2005">{{Rejea jarida | last1 = Nigg | first1 = JT. | last2 = Willcutt | first2 = EG. | last3 = Doyle | first3 = AE. | last4 = Sonuga-Barke | first4 = EJ. | title = Causal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes? | format = PDF | url = http://pingpong.ki.se/public/pp/public_courses/course07292/published/0/resourceId/0/content/Nigg_etal_2005%20%28Thorell%29.pdf | journal = Biol Psychiatry | volume = 57 | issue = 11 | pages = 1224–30 | month = Jun | year = 2005 | doi = 10.1016/j.biopsych.2004.08.025 | pmid = 15949992 | archiveurl = https://web.archive.org/web/20131014040108/http://pingpong.ki.se/public/pp/public_courses/course07292/published/0/resourceId/0/content/Nigg_etal_2005%20(Thorell).pdf | archivedate = 2013-10-14 | access-date = 2014-01-09 | dead-url = yes }}</ref> Kutokana na kiwango cha ubongo kukua na matakwa ya juu ya kudhibiti utendaji mtu anapozidi kukua, kasoro za TKUU zinaweza kutojionyesha kikamilifu hadi kufikia ujana au hata utu uzima wa mapema.<ref name="Brown-2008"/> ==Utambuzi== TKUU hutambuliwa kwa kadirio la ukuaji wa tabia za utotoni na za kiakili kwa mtu binafsi; ikijumuisha kutozingatia athari za dawa, matibabu na matatizo mengine ya kimatibabu au kisaikaitria kama maelezo ya dalili.<ref name = NICE2008/>{{Rp|p.19–27|date=March 2013}} Mara nyingi utambuzi huzingatia maoni kutoka kwa wazazi na walimu<ref name=Lake2011/> huku utambuzi mwingi ukianzishwa baada ya mwalimu kutoa madai haya.<ref name=Erk2009>{{cite book |author=Erkulwater, Jennifer L.; Dr Rick Mayes; Dr Catherine Bagwell; Dr Jennifer Erkulwater; Mayes, Rick; Bagwell, Catherine |title=Medicating children: ADHD and pediatric mental health |url=https://archive.org/details/medicatingchildr0000maye |publisher=Harvard University Press |location=Cambridge |year=2009 |pages=[https://archive.org/details/medicatingchildr0000maye/page/4 4]–24 |isbn=0-674-03163-6}}</ref> Hii inaweza kuonekana kama kipeo cha mojawapo ya/au [[tabia za binadamu]] endelevu zinazopatikana katika watu wote.<ref name=NICE2008>{{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG72FullGuideline.pdf|format=PDF|title=CG72 Attention deficit hyperactivity disorder (ADHD): full guideline |publisher=NHS|author=National Institute for Health and Clinical Excellence|authorlink=National Institute for Health and Clinical Excellence |date=24 September 2008 }}</ref>{{Rp|p.130|date=November 2012}} Utambuzi hauthibitishwi au kutupiliwa mbali ikiwa mtu atanufaika na matibabu au la.<ref name=Lake2011/> Kwa vile tafiti za picha za ubongo hazina matokeo imara miongoni mwa watu, picha hizi hutumika kufanya utafiti pekee wala si utambuzi.<ref>{{cite web|url=http://www.merckmedicus.com/pp/us/hcp/diseasemodules/adhd/pathophysiology.jsp|title=MerckMedicus Modules: ADHD&nbsp;–Pathophysiology|archiveurl=https://web.archive.org/web/20100501074844/http://www.merckmedicus.com/pp/us/hcp/diseasemodules/adhd/pathophysiology.jsp|archivedate=2010-05-01|date=August 2002|accessdate=2014-01-09}}</ref> Mara nyingi vigezo vya [[DSM-IV]] hutumika Marekani ya Kaskazini kufanya utambuzi ilhali bara Uropa hutumia vigezo vya [[ICD-10]]. Utambuzi wa TKUU hutumia vigezo vya DSM-IV mara 3-4 kuliko vigezo vya ICD-10.<ref name="Singh I 2008 957–64"/> Tatizo hili huanishwa kama [[tatizo la kisaikaitria]]<ref name="Kooij-2010"/> la aina ya [[tatizo la ukuaji wa nyuro]].<ref name=Caroline2010>{{cite book|last=Caroline S.|first=Clauss-Ehlers|title=Encyclopedia of cross-cultural school psychology|year=2010|publisher=Springer|location=New York|isbn=9780387717982|page=133|url=http://books.google.ca/books?id=PaO3jsaGkeYC&pg=PA133|edition=1st}}</ref> Isitoshe, tatizo hili pia huainishwa kama [[matatizo ya tabia ya vurugu|tatizo la tabia ya vurugu]] pamoja na [[tatizo la ukaidi wa kiupinzani]], [[tatizo la kitabia]] na [[tatizo la kutoafikiana na watu]].<ref name=autogenerated10>{{Rejea kitabu|author=Wiener, Jerry M., Editor |title=Textbook Of Child & Adolescent Psychiatry|publisher=American Psychiatric Association |location=Washington, DC |year=2003|isbn=1-58562-057-2 |url=http://books.google.co.uk/books?id=EIgGKcp0SpkC }}</ref> Utambuzi hauashirii [[tatizo la kinyurolojia]].<ref name=NICE2008/> Inapendekezwa kuwa hali zinazohusishwa zichunguzwe, kama vile: hisia, mfadhaiko, tatizo la ukaidi wa kiupinzani na tatizo la mwenendo, aidha matatizo ya kujifunza na ya lugha. Matatizo zaidi yanayopaswa kuchunguzwa yanajumuisha: matatizo mengine ya ukuaji wa nyuro, [[mtetemo wa kineva]], na [[apnea ya usingizi]].<ref name="Wolraich-2011">{{cite journal|last=Subcommittee on Attention-Deficit/Hyperactivity|first=Disorder|coauthors=Steering Committee on Quality Improvement and, Management; Wolraich, M; Brown, L; Brown, RT; DuPaul, G; Earls, M; Feldman, HM; Ganiats, TG; Kaplanek, B; Meyer, B; Perrin, J; Pierce, K; Reiff, M; Stein, MT; Visser, S|title=ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents.|journal=Pediatrics|date=2011 Nov|volume=128|issue=5|pages=1007–22|doi=10.1542/peds.2011-2654|pmid=22003063|displayauthors=16}}</ref> ===Mwongozo wa Kiutambuzi na Kitakwimu=== Sawa na matatizo mengine ya akili, utambuzi rasmi hufanywa na mtu aliyehitimu kulingana na vigezo vilivyowekwa. Nchini Marekani, vigezo hivi vimewekwa na [[Muungano wa Kisaikiatria wa Marekani]] katika [[Mwongozo wa Kiutambuzi na Kitakwimu wa Matatizo ya Kiakili]]. Kulingana na kigezo cha DSM, kuna aina tatu za TKUU:<ref name=CDC/><ref name=DSM-IV-TR>{{cite book |author= |title=Diagnostic and statistical manual of mental disorders: DSM-IV |url=https://archive.org/details/diagnosticstati00amer|publisher=American Psychiatric Association |location=Washington, DC|year=2000|pages=|isbn=0-89042-025-4 |oclc= |doi= |accessdate=}}</ref> # [[TKUU yenye hali kuu ya kutomakinika|TKUU yenye hali kuu ya kutomakinika]] Aina hii hidhihirika kwa dalili zinazojumuisha kuzubaa kwa urahisi, kusahau, kuduwaa, kukosa mpangilio, umakinifu duni na ugumu wa kukamilisha kazi.<ref name=CDC/> Mara nyingi watu huita tatizo hili "tatizo la ukosefu wa umakinifu". Hata hivyo, neno hili halijakubalika kirasmi kwanzia kusahihishwa kwa DSM mwaka wa 1994. # Aina ya TKUU yenye hali kuu ya kupepesuka na usukumizi hudhihirika kwa wasiwasi mwingi na kutotulia, kupepesuka, ugumu wa kusubiri na kutulia kitini, tabia za kitoto; tabia za vurugu pia zinaweza kuwepo.<ref name=CDC/> # Aina changamani ya TKUU ni mchanganyiko wa aina hizi mbili.<ref name=CDC/> Uainishaji huu hutegemea kuwepo kwa angalau dalili 6 kati ya 9 za muda mrefu (zinazudumu kwa angalau miezi 6) za kukosa umakinifu, kupepesuka na usukumizi au zote mbili.<ref name="pmid23755024">{{cite journal |author=Steinau S |title=Diagnostic Criteria in Attention Deficit Hyperactivity Disorder - Changes in DSM 5 |journal=Front Psychiatry |volume=4 |issue= |pages=49|year=2013 |pmid=23755024 |pmc=3667245 |doi=10.3389/fpsyt.2013.00049 |url=}}</ref> Ili kuzingatiwa, dalili hizi sharti zidhihirike kufikia umri wa miaka 6 hadi 12, na ziwepo katika zaidi ya muktadha mmoja (kwa mfano nyumbani na shuleni au kazini).<ref name=DSM-IV-TR/> Dalili hizi si sharti ziwe mwafaka kwa mtoto wa umri huo<ref name=CDC/><ref name="pmid21991721">{{cite journal |author=Berger I|title=Diagnosis of attention deficit hyperactivity disorder: much ado about something|url=http://www.ima.org.il/FilesUpload/IMAJ/0/40/20032.pdf |format=PDF |journal=Isr. Med. Assoc. J.|volume=13 |issue=9 |pages=571–4 |year=2011 |month=September |pmid=21991721 |doi= }}</ref> na kuwepo kwa ushahidi kuwa dalili hizi husababisha matatizo ya kijamii, shule au kazi.<ref name="pmid23755024"/> Watoto wengi wenye TKUU huwa na aina changamani. Watoto wenye aina ya kutomakinika wana kiwango kidogo cha uwezekano wa kuigiza au ugumu wa kuhusiana na watoto wengine. Watoto hawa wanaweza kuketi bila kuzungumza ilhali hawamakiniki, hivyo kupelekea ugumu wa kuzingatiwa.<ref name=DSM-IV-TR/> ===Uainishaji wa Kimataifa wa Magonjwa=== Katika toleo la kumi la ''[[Uainishaji wa Kimataifa wa Kitakwimu wa Magonjwa na Matatizo ya Afya Yanayohusiana]]'' ishara za TKUU zimetajwa kuwa "[[Hipakinesisi|matatizo ya hipakinetiki]]". [[Tatizo la kitabia]] (linalofasiliwa kama ICD-10)<ref name=ICD10>{{cite web |url=http://apps.who.int/classifications/icd10/browse/2010/en#/F90 |title=International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010 |year=2010 |publisher=World Health Organisation }}</ref> likiwepo, hali hii hujulikana kama ''tatizo la mwenendo la hipakinetiki''. Katika hali zingine, tatizo hili huainishwa kama ''kukatizwa kwa shughuli na umakinifu'', ''matatizo mengine ya hipakinetiki'' au ''matatizo ya hipakinetiki yasiyo bayana''. Tatizo la pili kwa wakati mwingine huitwa, ''sindromu ya hipakinetiki''.<ref name=ICD10/> ===Watu wazima=== Watu wazima wenye TKUU hutambuliwa kutumia kigezo sawa, ikijumuisha kuwa dalili zao sharti ziwe zilidhihirika kufikia umri wa miaka 6 hadi 12. Kuwauliza wazazi au walezi maswali ya jinsi tabia na ukuaji wa utotoni huwa sehemu ya ukadiriaji; historia ya TKUU katika familia pia huongeza uzito utambuzi.<ref name="Kooij-2010">{{Rejea jarida |last1=Kooij |first1=SJ. |last2=Bejerot |first2=S. |last3=Blackwell |first3=A. |last4=Caci |first4=H. |last5=Casas-Brugué |first5=M. |last6=Carpentier |first6=PJ. |last7=Edvinsson |first7=D. |last8=Fayyad |first8=J. |last9=Foeken |first9=K. |title=European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD |journal=BMC Psychiatry |volume=10 |pages=67 |year=2010 |doi=10.1186/1471-244X-10-67 |pmid=20815868 |displayauthors=9 |pmc = 2942810 |last10=Fitzgerald |first10=M |last11=Gaillac |first11=V |last12=Ginsberg |first12=Y |last13=Henry |first13=C |last14=Krause |first14=J |last15=Lensing |first15=MB |last16=Manor |first16=I |last17=Niederhofer |first17=H |last18=Nunes-Filipe |first18=C |last19=Ohlmeier |first19=MD |last20=Oswald |first20=P |last21=Pallanti |first21=S |last22=Pehlivanidis |first22=A |last23=Ramos-Quiroga |first23=JA |last24=Rastam |first24=M |last25=Ryffel-Rawak |first25=D |last26=Stes |first26=S |last27=Asherson |first27=P}}</ref> Ingawa dalili kuu za TKUU ni sawa katika watoto na watu wazima, dalili hizi mara nyingi hudhihirika kwa njia tofauti katika watu wazima kuliko watoto. Kwa mfano, hali ya kupepesuka inayoonekana katika watoto inaweza kudhihirika kama kukosa utulivu na shughuli isiyokoma ya kiakili katika watu wazima.<ref name="Kooij-2010"/> ===Utambuzi mbadala=== {| class="wikitable" style="float:right; width:40em; border:solid 1px #999999; margin:0 0 1em 1em;" |- ! colspan="4" style="background-color: #CCEEEE;" | Dalili za TKUU zinazoweza kuhusishwa na matatizo mengine<ref name="BBDADHD">{{Rejea jarida |author1 = Consumer Reports |author1-link = Consumer Reports |author2 = Drug Effectiveness Review Project |author2-link =Drug Effectiveness Review Project|date =March 2012 |title = Evaluating Prescription Drugs Used to Treat: Attention Deficit Hyperactivity Disorder (ADHD) Comparing Effectiveness, Safety, and Price |publisher = Consumer Reports |work = Best Buy Drugs |page = 2 |url =http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/ADHDFinal.pdf |accessdate = 12 April 2013 |postscript =. }}</ref> |- ![[Mfadhaiko (hisia)|Mfadhaiko]] ![[Tatizo la wasiwasi]] ![[Wazimu]] |- | *Hisia za [[kukosa (hisia)|kukosa]], kukosa matumaini, [[kutojithamini]], au kukosa furaha *Kupoteza hamu ya mambo yanayomvutia mtu, shughuli za kawaida, mapenzi,au kazi *[[Uchovu (kimatibabu)|Uchovu]] *[[Kukosa usingizi|Usingizi mdogo sana]], [[disomnia|usingizi mbaya]], au [[hipasomnia|kulala sana]] *Ugumu wa [[kudhibiti umakinifu|umakinifu]] *Mabadiliko ya [[hamu ya chakula]] *[[Kukasirika]] *Kiwango cha chini cha kuhimili [[Dhiki (kisaikolojia)|dhiki]] *[[mawazo ya kujiua|Fikira za kujiua]] *Maumivu yasiyo na kisababishi | *[[Wasiwasi]] au hisia ya wasiwasi isiyokoma *Kukasirika *Ugumu wa kutulia *Kumakinika zaidi *Kuchoka haraka *Kiwango cha chini cha kuhimili dhiki *Ugumu wa kuwa mwangalifu | *[[Wingi wa furaha|Furaha nyingi]] *[[Kupepesuka]] *[[Mawazo mengi]] *[[Uchokozi]] *Kuzungumza sana *[[Kujidhania makuu yasitokuwepo]] *Hitaji lililopunguka la usingizi *Tabia za kijamii zisizo mwafaka *Ugumu wa kumakinika |} Dalili za TKUU kama vile kiwango cha chini cha hisia na mtazamo duni wa mtu binafsi, mabadiliko ya hisia na kukasirika zinaweza kukanganywa na [[disthimia]], [[siklothimia]] au [[tatizo la hisia mseto]] pamoja na [[tatizo la nafsi la hisia dhaifu]].<ref name="Kooij-2010"/> Baadhi ya dalili zinazotokana na matatizo wa kihisia, tatizo la kutohusiana na watu, ulemavu wa ukuaji au ulemavu wa akili au athari za matumizi ya dawa za kulevya kama vile ulevi na kujitenga zinaweza kuingiliana na baadhi ya zile za TKUU. Matatizo haya wakati mwingine yanaweza kutokea pamoja na TKUU. Hali za kimatibabu zinazoweza kusababisha dalili za aina ya TKUU zinajumuisha: [[uthiroidi]], [[matatizo ya tukutiko]], [[kiwango cha kusumisha cha ledi]], [[upungufu wa uwezo wa kusikia]], [[ugonjwa wa ini]], [[apnea ya usingizi]], [[miingiliano ya dawa]], na [[jeraha la kichwa]].<ref name="Art.218" /> Matatizo ya usingizi ya kimsingi yanaweza kuthuru umakinifu na mtindo na dalili za TKUU zinaweza kuathiri usingizi.<ref name=Owens2008>{{Rejea jarida|author=Owens JA |title=Sleep disorders and attention-deficit/hyperactivity disorder |journal=Current Psychiatry Reports |volume=10 |issue=5 |pages=439–44 |year=2008 |month=October |pmid=18803919 |doi=10.1007/s11920-008-0070-x}}</ref> Hivyo, inapendekezwa kuwa watoto wenye TKUU wakadiriwe kila mara kuhusu matatizo ya usingizi.<ref name=Owens2005 /><ref>{{Rejea jarida|author=Walters AS, Silvestri R, Zucconi M, Chandrashekariah R, Konofal E |title=Review of the possible relationship and hypothetical links between attention deficit hyperactivity disorder (ADHD) and the simple sleep related movement disorders, parasomnias, hypersomnias, and circadian rhythm disorders |journal=Journal of Clinical Sleep Medicine |volume=4 |issue=6 |pages=591–600 |year=2008 |month=December |pmid=19110891 |pmc=2603539}}</ref> Usingizi mwingi katika watoto unaweza kusababisha dalili za kimsingi kama vile kupiga miayo na kusugua macho, usukumizi, kupepesuka, uchokozi, mabadiliko ya hisia na kutomakinika.<ref name=Owens2005>{{Rejea jarida|author=Owens JA |title=The ADHD and sleep conundrum: a review |journal=Journal of Developmental and Behavioral Pediatrics |volume=26 |issue=4 |pages=312–22 |year=2005 |month=August |pmid=16100507 |doi=10.1097/00004703-200508000-00011}}</ref><ref>{{Rejea kitabu|last= Hirshkowitz |first= Max |editor= Yudofsky, Stuart C. and Robert E. Hales, editors |others= |title= Essentials of neuropsychiatry and clinical neurosciences |origdate= |origyear= |origmonth= |url= |format= Google Books preview includes entire chapter 10 |edition= 4 |year= 2004 |publisher= American Psychiatric Publishing |location= Arlington, Virginia, USA |isbn= 978-1-58562-005-0 |oclc= |id= |pages=315–40 |chapter=Neuropsychiatric Aspects of Sleep and Sleep Disorders |chapterurl=http://books.google.com/books?id=XKhu7yb3QtsC&pg=PA315 |quote= }}</ref> [[Apnea tata ya usingizi]] pia inaweza kusababisha dalili za aina ya TKUU.<ref name="pmid22670023">{{cite journal |author=Lal C, Strange C, Bachman D |title=Neurocognitive impairment in obstructive sleep apnea |url=https://archive.org/details/sim_chest_2012-06_141_6/page/1601 |journal=Chest |volume=141 |issue=6 |pages=1601–10 |year=2012 |month=June |pmid=22670023 |doi=10.1378/chest.11-2214 }}</ref> ==Udhibiti== Udhibiti wa TKUU kwa kawaida huhusisha [[saikotherapi|kushauriwa]] au matibabu pekee au changamani. Huku matibabu yakiboresha matokeo ya muda mrefu, matokeo hasi hayawezi kuepukika kabisa.<ref>{{cite journal|last=Shaw|first=M|coauthors=Hodgkins, P; Caci, H; Young, S; Kahle, J; Woods, AG; Arnold, LE|title=A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment|journal=BMC medicine|date=2012 Sep 4|volume=10|pages=99|pmid=22947230|doi=10.1186/1741-7015-10-99|pmc=3520745}}</ref> Matibabu yanayotumika hujumuisha vichangamsho, atomoxetine, [[vichangamsho vya alpha vya adrenalini]] na wakati mwingine dawa za kutuliza mfadhaiko.<ref name="Wilens-2010"/> Dawa hizi zina kiwango kidogo cha athari kwa takriban asilimia 80 ya watu.<ref>{{cite web|title=Canadian ADHD Practice Guidelines|url=http://www.caddra.ca/cms4/pdfs/caddraGuidelines2011Chapter07.pdf|work=Canadian ADHD Alliance|accessdate=4 February 2011}}</ref> Kubadilisha lishe pia kunaweza kuwa na manufaa<ref>{{cite journal|last=Nigg|first=JT|coauthors=Lewis, K; Edinger, T; Falk, M|title=Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives|url=https://archive.org/details/sim_journal-american-academy-child-adolescent-psychiatry_2012-01_51_1/page/n101|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=2012 Jan|volume=51|issue=1|pages=86–97.e8|pmid=22176942|doi=10.1016/j.jaac.2011.10.015}}</ref> huku ushahidi pia ukionyesha manufaa ya [[asidi huru ya shahamu]] na kiwango kidogo cha kuhatarishwa kwa rangi ya chakula.<ref name=Sonu2013>{{cite journal|last=Sonuga-Barke|first=EJ|title=Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments|url=https://archive.org/details/sim_american-journal-of-psychiatry_2013-03_170_3/page/275|journal=The American Journal of Psychiatry|date=2013 Mar 1|volume=170|issue=3|pages=275–89|pmid=23360949|doi=10.1176/appi.ajp.2012.12070991|first2=D|first3=S|first4=D|first5=M|first6=M|first7=J|first8=M|first9=S|first10=M|first11=RW|first12=E|first13=A|first14=T|first15=J|first16=D|first17=C|first18=E|first19=M|first20=IC|first21=J|first22=Group}}</ref> Ushahidi huu hauonyeshi ikiwa kuondoa vyakula vingine katika lishe kuna athari yoyote.<ref name=Sonu2013/> ===Jamii-nafsi=== Kuna ushahidi imara kuhusu matumizi ya [[therapi ya kitabia|therapi za kitabia]] katika TKUU<ref>{{Rejea jarida|author=Fabiano GA, Pelham WE, Coles EK, Gnagy EM, Chronis-Tuscano A, O'Connor BC |title=A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder |url=https://archive.org/details/sim_clinical-psychology-review_2009-03_29_2/page/129 |journal=Clinical Psychology Review |volume=29 |issue=2 |pages=129–40 |year=2009 |month=March |pmid=19131150 |doi=10.1016/j.cpr.2008.11.001}}</ref> na hupendekezwa kama matibabu ya kwanza kwa watu wenye dalili chache au hawajafika umri wa kwenda shuleni.<ref name=Clinics09>{{cite journal |author=Kratochvil CJ, Vaughan BS, Barker A, Corr L, Wheeler A, Madaan V |title=Review of pediatric attention deficit/hyperactivity disorder for the general psychiatrist |journal=Psychiatr. Clin. North Am. |volume=32 |issue=1 |pages=39–56 |year=2009 |month=March |pmid=19248915 |doi=10.1016/j.psc.2008.10.001 |url=https://archive.org/details/sim_psychiatric-clinics-of-north-america_2009-03_32_1/page/39}}</ref> Matibabu ya kisaikolojia yanayotumika huhusisha: juhudi za[[elimu nafsia]], [[therapi ya kitabia]], [[therapi ya ufahamu wa kitabia]], [[saikotherapi baina ya watu]], [[therapi ya familia]], mikakati inayohusiana na elimu, kufunza stadi za kijamii, kufunza wazazi kuhusu udhibiti,<ref name=NICE2008/> na [[mwitikio wa nyuro]].<ref>{{cite journal|last=Arns|first=M|coauthors=de Ridder, S, Strehl, U, Breteler, M, Coenen, A|title=Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis|journal=Clinical EEG and neuroscience : official journal of the EEG and Clinical Neuroscience Society (ENCS)|date=July 2009|volume=40|issue=3|pages=180–9|pmid=19715181|doi=10.1177/155005940904000311}}</ref> Elimu ya wazazi imetambulika kuwa na manufaa ya muda mfupi.<ref>{{Rejea jarida|author=Pliszka S |title=Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=46 |issue=7 |pages=894–921 |year=2007 |month=July |pmid=17581453 |doi=10.1097/chi.0b013e318054e724 |author2=AACAP Work Group on Quality Issues}}</ref> Kuna kiwango kidogo cha utafiti wa hali ya juu kuhusu ubora wa therapi ya familia dhidi ya TKUU, ingawa ushahidi uliopo unaonyesha kuwa therapi hii ni sawa katika utunzaji wa kijamii na bora kuliko dawa za kipoza ungo.<ref>{{cite journal |author=Bjornstad G, Montgomery P |title=Family therapy for attention-deficit disorder or attention-deficit/hyperactivity disorder in children and adolescents |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD005042 |year=2005 |pmid=15846741 |doi=10.1002/14651858.CD005042.pub2 |url=http://www.cochrane.org/reviews/en/ab005042.html |editor1-last=Bjornstad |editor1-first=Gretchen J |archive-date=2011-10-14 |access-date=2014-01-09 |archive-url=https://web.archive.org/web/20111014233627/http://www2.cochrane.org/reviews/en/ab005042.html |url-status=dead }}</ref>[[Orodha ya mashirika ya tatizo la kupepesuka lenye ukosefu wa |makundi maalum ya kusaidia TKUU]] zinatumika kama asili ya habari na zinaweza kusaidia familia kuhimili TKUU.<ref>{{cite book|last=Turkington|first=Carol|title=The Encyclopedia of the Brain and Brain Disorders|year=2009|publisher=Infobase Publishing|isbn=9781438127033|page=47|url=http://books.google.ca/books?id=6hbKkynRxPYC&pg=PA47}}</ref> ===Matibabu=== [[File:Ritalin.jpg|thumb|[[methylphenidate]] (Ritalin) 10 mg tablets]] Matibabu kwa kutumia [[vichocheo]] ndiyo hupendekezwa katika matibabu ya dawa.<ref name=CNS09>{{cite journal |author=Wigal SB |title=Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults |journal=CNS Drugs |volume=23 Suppl 1 |pages=21–31 |year=2009 |pmid=19621975 |doi=10.2165/00023210-200923000-00004 |url=}}</ref> Kuna baadhi ya dawa zisizo za vichocheo kama vile [[atomoxetine]], zinazoweza kutumika kama matibabu mbadala.<ref name=CNS09/> Hakuna utafiti bora unaolinganisha matibabu haya, hivyo hakuna ushahidi kuhusu athari kwenye matokeo ya masomo na mitindo ya kijamii.<ref name="pmid22420008">{{cite journal |author=McDonagh MS, Peterson K, Thakurta S, Low A |title=Drug Class Review: Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder |publisher=United States Library of Medicine |month=December |year=2011 |pmid=22420008 |url=http://www.ncbi.nlm.nih.gov/books/NBK84419}}</ref> Matibabu ya dawa hayapendekezwi katika watoto wa chini ya umri wa kwenda shuleni kwani athari zake za muda mrefu katika umri huu hazijulikani.<ref name = NICE2008 /><ref>{{Rejea jarida|author=Greenhill LL, Posner K, Vaughan BS, Kratochvil CJ |title=Attention deficit hyperactivity disorder in preschool children |journal=Child and Adolescent Psychiatric Clinics of North America|volume=17 |issue=2 |pages=347–66, ix |year=2008 |month=April |pmid=18295150 |doi=10.1016/j.chc.2007.11.004}}</ref> Athari za muda mrefu za vichocheo hazijulikani na utafiti mmoja tu ndio umetambua manufaa yake, utafiti wa pili ukikosa kutambua manufaa huku wa tatu ukitambua ushahidi wa madhara.<ref name="pmid21519262">{{cite journal |author=Hazell P |title=The challenges to demonstrating long-term effects of psychostimulant treatment for attention-deficit/hyperactivity disorder |journal=Current Opinion in Psychiatry|volume=24 |issue=4 |pages=286–90 |year=2011 |month=July |pmid=21519262 |doi=10.1097/YCO.0b013e32834742db |url=}}</ref> Atomoxetine inaweza kupendekezwa kwa watu walio katika hatari ya kutumia matibabu ya vichocheo vibaya kwa sababu haiwezi kutumika vibaya.<ref name="Kooij-2010"/> [[Mwongozo]] kuhusu wakati wa kutumia matibabu ya dawa hutofautiana katika nchi, huku [[Taasisi ya Kitaifa ya Ubora wa Utambuzi]] ya Uingereza, ikipendekeza matumizi yake katika hali kali, nayo miongozo mingi ya Marekani ikipendekeza matumizi yake kwa takriban hali zote.<ref>{{cite web|title=Canadian ADHD Practice Guidelines|url=http://www.caddra.ca/cms4/pdfs/caddraGuidelines2011Introduction.pdf|work=Canadian ADHD Alliance|accessdate=4 February 2011}}</ref> Vichocheo na atomoxetine huwa na athari, ingawa kwa kawaida huwa ziko salama kuzitumia. <ref name=CNS09/> Vichocheo vinaweza kusababisha [[saikosisi]] au [[mania]]; ingawa hali hizi hazitokei mara nyingi.<ref>{{cite journal|last=Mosholder|first=AD|coauthors=Gelperin, K, Hammad, TA, Phelan, K, Johann-Liang, R|title=Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children|journal=Pediatrics|date=February 2009|volume=123|issue=2|pages=611–6|pmid=19171629|doi=10.1542/peds.2008-0185}}</ref> Ufuatiliaji wa kila mara unapendekezwa kwa watu walio chini ya matibabu ya muda mrefu.<ref name="pmid20571380">{{cite journal|author=Kraemer M, Uekermann J, Wiltfang J, Kis B |title=Methylphenidate-induced psychosis in adult attention-deficit/hyperactivity disorder: report of 3 new cases and review of the literature |journal=Clin Neuropharmacol |volume=33|issue=4 |pages=204–6 |year=2010 |month=July |pmid=20571380 |doi=10.1097/WNF.0b013e3181e29174 }}</ref> Therapi ya vichocheo inapaswa kuachishwa baada ya muda ili kukadiria ikiwa kuna haja ya kuendeleza matibabu.<ref name="pmid21530185">{{cite journal |author=van de Loo-Neus GH, Rommelse N, Buitelaar JK |title=To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended? |journal=Eur Neuropsychopharmacol |volume=21 |issue=8 |pages=584–99 |year=2011 |month=August |pmid=21530185 |doi=10.1016/j.euroneuro.2011.03.008 |url=}}</ref> Matibabu ya vichocheo yana uwezekano wa kutumika vibaya na kupelekea [[kutegemea dawa|kutegemea]]<ref>{{cite web|url=http://www.ncbi.nlm.nih.gov/books/NBK47127/|title=Black box warnings of ADHD drugs approved by the US Food and Drug Administration|year=2009|author=Oregon Health & Science University, Portland, Oregon|publisher=United States National Library of Medicine}}</ref> huku watu wenye TKUU wakiwa na hatari ya [[matumizi mabaya ya dawa]], matumizi ya vichocheo kwa jumla huonekana kupunguza hatari au kuwa bila hatari yoyote.<ref name="Kooij-2010"/> Usalama wa matibabu haya katika ujauzito haujulikani.<ref>{{Rejea jarida |author=Ashton H, Gallagher P, Moore B |title=The adult psychiatrist's dilemma: psychostimulant use in attention deficit/hyperactivity disorder |journal=J. Psychopharmacol. (Oxford) |volume=20 |issue=5 |pages=602–10 |year=2006 |month=September |pmid=16478756 |doi=10.1177/0269881106061710 |url=http://jop.sagepub.com/cgi/content/abstract/20/5/602 |access-date=2014-01-09 |archive-date=2009-08-15 |archive-url=https://web.archive.org/web/20090815063002/http://jop.sagepub.com/cgi/content/abstract/20/5/602 |dead-url=yes }}</ref> [[Ukosefu wa zinki|Ukosefu wa zinki]] umehusishwa na dalili za kukosa umakinifu. Pia kuna ushahidi kuwa nyongeza ya zinki inaweza kuwanufaisha watoto wenye TKUU walio na viwango vya chini vya zinki.<ref name="pmid22232312">{{cite journal |author=Millichap JG, Yee MM |title=The diet factor in attention-deficit/hyperactivity disorder |journal=Pediatrics |volume=129 |issue=2 |pages=330–7 |year=2012 |month=February |pmid=22232312 |doi=10.1542/peds.2011-2199 |url=http://pediatrics.aappublications.org/content/129/2/330.long}}</ref> Ayoni, magnesi na aidini pia zinaweza kuwa na athari dhidi ya dalili za TKUU.<ref name="pmid22928358">{{cite journal |author=Konikowska K, Regulska-Ilow B, Rózańska D |title=The influence of components of diet on the symptoms of ADHD in children |journal=Rocz Panstw Zakl Hig |volume=63 |issue=2 |pages=127–34 |year=2012 |pmid=22928358 }}</ref> Kuna ushahidi wa manufaa wastani ya nyongeza ya omega 3.<ref name="pmid21961774">{{cite journal |author=Bloch MH, Qawasmi A |title=Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis |journal=J Am Acad Child Adolesc Psychiatry |volume=50 |issue=10 |pages=991–1000 |year=2011 |month=October |pmid=21961774 |pmc=3625948 |doi=10.1016/j.jaac.2011.06.008 |url=}}</ref> ==Prognosisi== Ufuatiliaji wa miaka minane katika watoto waliotambuliwa kuwa na TKUU (aina changamani) uligundua kuwa watoto hawa huwa na matatizo mara nyingi katika ujana iwapo watapata matibabu au la.<ref name=Molina2009>{{Rejea jarida|author=Molina BS, Hinshaw SP, Swanson JM, et al |title=The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=48 |issue=5 |pages=484–500 |year=2009 |month=May |pmid=19318991|pmc=3063150 |doi=10.1097/CHI.0b013e31819c23d0}}</ref> Barani Marekani, chini ya asilimia 5 ya watu wenye TKUU hupata shahada ya chuo kikuu,<ref>{{Rejea kitabu | last1 = Cimera | first1 = Robert E. | title = Making ADHD a gift : teaching Superman how to fly | url = http://books.google.co.uk/books?id=fLILuifHvmMC&printsec=frontcover#v=onepage&q&f=false | year = 2002 | publisher = Scarecrow Press | location = Lanham, Md. | isbn = 978-0-8108-4318-9 | page = 116 }}</ref> ikilinganishwa na asilimia 28 ya idadi jumla wenye umri wa miaka 25 na zaidi.<ref name="us_census_2005">{{cite web|url=http://www.census.gov/Press-Release/www/releases/archives/education/004214.html|title=College Degree Nearly Doubles Annual Earnings, Census Bureau Reports|accessdate=2 October 2008|archiveurl=https://web.archive.org/web/20050330044033/http://www.census.gov/Press-Release/www/releases/archives/education/004214.html|archivedate=2005-03-30}}</ref> Idadi ya watoto wanaofikia kigezo cha TKUU hushuka hadi nusu katika miaka mitatu kufuatia utambuzi. Hali hii hutokea pasi kutegemea matibabu yanayotumika.<ref name="Jensen PS, Arnold LE, Swanson JM 2007 989–1002">{{Rejea jarida|author=Jensen PS, Arnold LE, Swanson JM |title=3-year follow-up of the NIMH MTA study |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=46 |issue=8 |pages=989–1002 |year=2007 |month=August |pmid=17667478 |doi=10.1097/CHI.0b013e3180686d48}}</ref><ref name=TI2008>{{cite web |url=http://www.ti.ubc.ca/letter69 |title=What is the evidence for using CNS stimulants to treat ADHD in children? &#124; Therapeutics Initiative |archiveurl=https://web.archive.org/web/20100906205955/http://www.ti.ubc.ca/letter69 |archivedate=2010-09-06 |accessdate=2014-01-09 }}</ref> TKUU huendelea kuwepo katika utu uzima katika takriban asilimia 30 hadi 50 ya visa.<ref name=Balint2008>{{Rejea jarida|author=Bálint S, Czobor P, Mészáros A, Simon V, Bitter I |title=[Neuropsychological impairments in adult attention deficit hyperactivity disorder: a literature review] |language=Hungarian |journal=Psychiatr Hung |volume=23|issue=5 |pages=324–35 |year=2008 |pmid=19129549 |url=}}</ref> Waathiriwa wana uwezekano wa kukuza mbinu za kuhimili wanapokomaa, hivyo kufidia dalili zao za awali.<ref name="psychiatrymmc.com"/> ==Epidemolojia== TKUU inakadiriwa kuthuru takriban asilimia 6 hadi 7 ya watu wa umri wa miaka 18 na chini wanapotambuliwa kupitia kigezo cha DSM-IV.<ref name="pmid22976615">{{cite journal |author=Willcutt EG |title=The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490–9 |year=2012 |month=July |pmid=22976615 |doi=10.1007/s13311-012-0135-8 |pmc=3441936 }}</ref> Viwango vya kikundi hiki hukadiriwa kuwa kati ya asilimia 1 hadi 2 wanapotambuliwa kupitia kigezo cha ICD-10 .<ref name=Cowen2012>{{cite book|last=Cowen|first=Philip|title=Shorter Oxford Textbook of Psychiatry|year=2012|publisher=Oxford University Press|isbn=9780191626753|page=546|url=http://books.google.ca/books?id=Y1DtSGq-LnoC&pg=PT546|edition=6th}}</ref> Watoto wa Marekani Kaskazini hutambulika kuwa na kiasi cha juu cha TKUU kuliko wa barani Afrika na Mashariki ya Kati - hata hivyo, hali hii inaaminika kutokana na mbinu tofauti za utambuzi zinazotumika katika maeneo tofauti ulimwenguni wala sio kutokana na tofauti ya viwango vya hali hii.<ref name="Polanczyk">{{Rejea jarida|author=Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA |title=The worldwide prevalence of ADHD: a systematic review and metaregression analysis |url=https://archive.org/details/sim_american-journal-of-psychiatry_2007-06_164_6/page/942 |journal=The American Journal of Psychiatry |volume=164 |issue=6 |pages=942–8 |year=2007 |month=June |pmid=17541055 |doi=10.1176/appi.ajp.164.6.942}}</ref> Ikiwa mbinu sawa za utambuzi zitatumika, viwango hivi huenda vikawa sawa katika nchi hizi.<ref>{{cite book|last=Jones|first=edited by Ming Tsuang, Mauricio Tohen, Peter B.|title=Textbook of psychiatric epidemiology|publisher=Wiley-Blackwell|location=Chichester, West Sussex|isbn=9780470977408|page=450|url=http://books.google.ca/books?id=fOc4pdXe43EC&pg=PA450|edition=3rd}}</ref> TKUU hutambulika takriban mara tatu zaidi katika wavulana kuliko wasichana.<ref name="pmid19393378"/><ref name="Singh I 2008 957–64"/> Tofauti hii katika jinsia inaweza kuashiria tofauti katika hatari ya kuathirika au kuwa jinsia ya kike ina ugumu wa kutambulika kuwa kuliko jinsia ya kiume.<ref>{{Rejea jarida|author=Staller J, Faraone SV |title=Attention-deficit hyperactivity disorder in girls: epidemiology and management |journal=CNS Drugs |volume=20 |issue=2 |pages=107–23 |year=2006 |pmid=16478287 |doi=10.2165/00023210-200620020-00003}}</ref> Viwango vya utambuzi na matibabu vimeongezeka kule Uingereza na Marekani kwanzia miaka ya 1970. Kimsingi, hii inaaminika kutokana na mabadiliko ya jinsi hali hii inavyotambuliwa<ref name=CDCTime2013/> na jinsi watu ilivyo tayari kuitibu kwa dawa wala si kuzingatia ukweli wa badiliko katika kuwepo kwa hali hii.<ref name=Cowen2012/> Inaaminika kuwa mabadiliko katika kigezo cha utambuzi mwaka wa 2013 na kuanzishwa kwa DSM&nbsp;V kutaongeza asilimia ya watu wenye TKUU hasa katika watu wazima.<ref>{{cite journal|last=Dalsgaard|first=S|title=Attention-deficit/hyperactivity disorder (ADHD)|journal=European child & adolescent psychiatry|date=2013 Feb|volume=22 Suppl 1|pages=S43–8|pmid=23202886|doi=10.1007/s00787-012-0360-z}}</ref> ==Historia== Kwa muda mrefu, kupepesuka kumekuwa sehemu ya hali ya binadamu. Bwana [[Alexander Crichton]] anaeleza kuhusu "akili isiyotulia" katika kitabu chake ''An inquiry into the nature and origin of mental derangement'' (Unchunguzi wa asili na chanzo cha ukosefu wa mpangilio wa kiakili)kilichoandikwa mwaka wa 1798.<ref>{{cite journal |year=2001 |month=May |title=An early description of ADHD (inattentive subtype): Dr Alexander Crichton and 'Mental restlessness' (1798) |volume=6 |issue=2 |pages=66–73 |journal=[[Child and Adolescent Mental Health]] |doi=10.1111/1475-3588.00324 |author=Palmer ED, Finger S }}</ref><ref>{{cite book |last1=Crichton |first1=Andrew |title=An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects |url=http://books.google.co.uk/books/about/An_inquiry_into_the_nature_and_origin_of.html?id=OMAtAAAAYAAJ |year=1798 |publisher=AMS Press |location=United Kingdom |isbn=9780404082123 |page=271 }}</ref> TKUU ilielezwa bayana kwa mara ya kwanza na [[George Still]] mwaka wa 1902.<ref name=CDCTime2013>{{cite web|title=ADHD Throughout the Years|url=http://www.cdc.gov/ncbddd/adhd/documents/timeline.pdf|publisher=Center For Disease Control and Prevention|accessdate=2 August 2013}}</ref> Neno linalotumika kuelezea hali hii limebadilika kutoka wakati hadi mwingine ikiwa ni pamoja na: "tatizo la kiwango kidogo la ubongo" katika DSM-I (1952), "athari za utotoni za haipakinetiki" katika DSM-II (1968), tatizo la ukosefu wa umakinifu katika DSM-III (1980)" lenye kupepesuka au bila kupepesuka".<ref name=CDCTime2013/> Mwaka wa 1987, tatizo hili lilibadilishwa kuwa TKUU katika DSM-III-R, nayo DSM-IV mwaka wa 1994 iligawa utambuzi katika aina tatu: aina ya TKUU ya kukosa umakinifu, aina ya TKUU ya kupepesuka na usukumizi na aina changamani ya TKUU.<ref>{{cite book |last1=Millichap |first1=J. Gordon |title=Attention Deficit Hyperactivity Disorder Handbook |url=http://books.google.co.uk/books?id=CTWLzYgQWqEC&pg=PA2 |type= |edition= |series= |volume= |year=2010 |month=April |publisher=Springer Verlag Gmbh |isbn=978-1-4419-1409-5 |pages=2–3 |chapter=1. Definition and History of ADHD }}</ref> Maneno mengine hujumuisha "uharibifu wa kiwango cha chini wa ubongo" yaliyotumika miaka ya 1930.<ref>{{cite book|last=Weiss|first=Margaret|title=ADHD in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment|year=2010|publisher=JHU Press|isbn=9781421401317|url=http://books.google.ca/books?id=bcyI7dvawzMC&pg=PT72}}</ref> Matumizi ya vichocheo kutibu TKUU yalielezwa kwa mara ya kwanza mwaka wa 1937.<ref>{{Rejea jarida|author=Patrick KS, Straughn AB, Perkins JS, González MA |title=Evolution of stimulants to treat ADHD: transdermal methylphenidate |journal=Human Psychopharmacology |volume=24 |issue=1 |pages=1–17 |year=2009 |month=January |pmid=19051222 |pmc=2629554 |doi=10.1002/hup.992}}</ref> Katika miaka ya 1930, mchanganyiko wa [[amphetamine]][[Benzedrine]] ndizo dawa za kwanza zilizopendekezwa kutumika nchini Marekani. Methylphenidate ilianzishwa katika miaka ya 1950 na dextroamphetamine katika miaka ya 1970.<ref name=CDCTime2013/> ==Jamii na utamaduni== ===Utata=== TKUU na utambuzi wake ni maarufu kwa utata kwanzia miaka ya 1970.<ref name="Parrillo 2008 63"/><ref name="autogenerated3" /><ref>{{Rejea jarida|author=Foreman, DM |title=Attention deficit hyperactivity disorder: legal and ethical aspects |url=https://archive.org/details/sim_archives-of-disease-in-childhood_2006-02_91_2/page/192 |journal=Archives of Disease in Childhood |volume=91 |issue=2 |pages=192–4 |year=2006 |month=February |pmid=16428370 |pmc=2082674 |doi=10.1136/adc.2004.064576}}</ref> Utata huu umewajumuisha matabibu, walimu, viongozi, wazazi na vyombo vya habari. Misimamo kuhusu TKUU hutofautiana kutoka imani kwamba hali hii ni mwisho wa kiwango cha kawaida cha tabia<ref name = NICE2008/>{{Rp|p.23|date=March 2013}}<ref name="Faraone 2005">{{cite journal |author = Faraone, Stephen V | year = 2005 | title = The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder | journal = Eur Child Adolesc Psychiatry | volume = 14 | issue = 1| pages = 1–10 | pmid = 15756510 |doi=10.1007/s00787-005-0429-z }}</ref> hadi kuchukuliwa kuwa inatokana na hali iliyopo ya jenetiki. Maeneo mengine yenye utata hujumuisha kutumia matibabu ya vichocheo, hasa matumizi katika watoto,<ref name="autogenerated3"/><ref name="Cohen, Donald J.; Cicchetti, Dante 2006"/><ref name=Cormier2008/> pamoja na mbinu za utambuzi na uwezekano wa utambuzi zaidi.<ref name=Cormier2008>{{cite journal |author=Cormier E |title=Attention deficit/hyperactivity disorder: a review and update |journal=J Pediatr Nurs |volume=23 |issue=5 |pages=345–57 |year=2008 |month=October |pmid=18804015 |doi=10.1016/j.pedn.2008.01.003|url=http://linkinghub.elsevier.com/retrieve/pii/S0882-5963(08)00005-5}}</ref> Huku [[Taasisi ya Kitaifa ya Ubora wa Utambuzi]], ikitambua utata uliopo, inaeleza kuwa matibabu yaliyopo na mbinu za utambuzi zinategemea mitazamo iliyopo ya maelezo ya kitaaluma.<ref name = NICE2008/>{{Rp|p.133|date=November 2012}} Viwango vinavyotofautiana vya utambuzi baina ya nchi, majimbo, tabaka na kabila ya baadhi ya watu ikiwa vipengele vya kuzingatia. Watu wengine huamini kuwa dalili za TKUU huchangia katika utambuzi.<ref name="Elder-2010"/> Wapo wanasosiolojia wanaochukulia TKUU kuwa mfano wa [[kutabibusha]] kwa [[Ukaidi (sosiolojia)|tabia ya kikaidi]], au kwa maneno mengine, kufanya mabadiliko kwa tatizo lisilo la kimatibabu la matokeo ya shuleni kuwa tatizo la kimatibabu.<ref name="Parrillo 2008 63"/><ref name=Erk2009/> Wahudumu wengi wa afya hukubali TKUU kama tatizo halisi; angalau kwa idadi ndogo ya watu wenye dalili kali.<ref name=Erk2009/> Mjadala kati ya wahudumu wa afya mara nyingi huwa kuhusu utambuzi na matibabu kwa idadi kubwa ya watu wenye dalili zisizo kali sana.<ref name="Online"/><ref name="Schonwald A, Lechner E 2006 189–95"/><ref name=Erk2009/> {{Kufikia mwaka wa|2009}}, asilimia nane ya wachezaji wa Marekani wa [[Ligi Kuu ya Besiboli]] walitambuliwa kuwa na TKUU, hivyo kufanya tatizo hili kuwa katika idadi kubwa ya watu Marekani. Ongezeko hili lililingana na marufuku ya Ligi ya mwaka wa 2006 kwa [[vichocheo]] ambayo ina madai kuwa baadhi ya wachezaji wanaiga dalili za TKUU ili kuepuka marufuku hii katika matumizi ya vichocheo kwenye mchezo huu.<ref>{{cite web|url=http://www.slate.com/id/2208429/|title=Doping Deficit Disorder. Need performance-enhancing drugs? Claim ADHD|first=William|last=Saletan|publisher=Slate|date=12 January 2009|accessdate=2009-05-02|archiveurl=https://web.archive.org/web/20090521114505/http://www.slate.com/id/2208429/|archivedate=2009-05-21|deadurl=no}}</ref> ===Maoni ya vyombo vya habari=== Baadhi ya watu mashuhuri wametoa maoni tatanishi kuhusu TKUU. [[Tom Cruise]] ameyataja matibabu ya [[Ritalin]] na [[Adderall]] kama "dawa za vichochoroni". Ushma S. Neill alikosoa mtazamo huu akisema kuwa vipimo vya vichocheo vinavyotumika katika matibabu ya TKUU havisababishi mazoea ya kitabia na kuwa kuna ushahidi mdogo wa upungufu wa hatari ya matumizi mabaya ya dawa baadaye maishani katika watoto wanaotibiwa kwa vichocheo.<ref name="pmid16075033">{{cite journal|author=Neill US |title=Tom Cruise is dangerous and irresponsible |url=https://archive.org/details/sim_journal-of-clinical-investigation_2005-08_115_8/page/1964 |journal=J. Clin. Invest. |volume=115 |issue=8|pages=1964–5 |year=2005 |month=August |pmid=16075033 |pmc=1180571 |doi=10.1172/JCI26200 }}</ref> Nchini Uingereza, [[Susan Greenfield]] alitangaza kwenye umma mwaka wa 2007 katika [[Baraza la Malodi]] kuhusu hitaji la maelezo ya kina katika ongezeko ghafla la utambuzi wa TKUU nchini Uingereza na visababishi vyake. Maoni yake yalifuata programu ya [[Panorama (mfululizo wa televisheni)|BBC Panorama]] iliyoangazia utafiti uliopendekeza kuwa matibabu ya dawa si bora kuliko aina zingine za therapi katika muda mrefu.<ref>{{Rejea habari|url=http://news.bbc.co.uk/2/hi/health/7093944.stm |title=Peer calls for ADHD care review |publisher=BBC News |date=14 November 2007 |accessdate=2012-01-29}}</ref> Mwaka wa 2010 [[Dhamana ya BBC]] ilikosoa programu ya BBC Panorama ya mwaka wa 2007 kwa kufanya muhtasari utafiti na kuonyesha "ukosefu wa kuboreka kwa mtindo wa watoto baada ya kupata matibabu ya TKUU kwa miaka mitatu" ilhali "utafiti huu ulitambua kuwa matibabu yaliboresha waathiriwa baada ya muda" ingawa manufaa ya matibabu ya muda mrefu yalitamvulika "kutokuwa bora kuliko katika watoto waliotibiwa kwa therapi ya tabia."<ref>{{cite news |title=BBC must broadcast apology over inaccurate Panorama programme |author=Singh A |url=http://www.telegraph.co.uk/news/7307972/BBC-must-broadcast-apology-over-inaccurate-Panorama-programme.html |newspaper=The Telegraph |date=25 February 2010 |accessdate=2012-01-29}}</ref> ==Idadi maalum ya watu== ===Watu wazima=== Asilimia 2 - 5 ya watu wazima wana TKUU.<ref name="Kooij-2010"/> Karibu 2/3 ya watoto wenye TKUU huendelea kupata hali hii katika utu uzima. Katika watu wote wanaoendelea kudhihirisha dalili, takriban asilimia 25 hupata tatizo kamili na asilimia 75 hupona 'kwa kiwano fulani.<ref name="Kooij-2010"/> Watu wengi wazima hawatibiwi.<ref name="pmid21494335">{{cite journal |author=Culpepper, L, Mattingly G |title=Challenges in identifying and managing attention-deficit/hyperactivity disorder in adults in the primary care setting: a review of the literature |journal=Prim Care Companion J Clin Psychiatry |volume=12 |issue=6 |pages= PCC.10r00951|year=2010 |pmid=21494335 |pmc=3067998 |doi=10.4088/PCC.10r00951pur |url=}}</ref> Wengi wao huwa na maisha yasiyo na mpangilio na hutumia pombe na dawa zisizoagizwa na wahudumu kama mbinu za kujikimu.<ref name="Art.218" /> Matatizo mengine hujumuisha matatizo ya mahusiano, kazi na viwango vya juu vya shughuli za kigaidi.<ref name="Kooij-2010"/> Matatizo ya afya ya kiakili yanayohusishwa hujumuisha: mfadhaiko, [[tatizo la wasiwasi]] na[[ulemavu wa kujifunza|ulemavu wa kujifunza]].<ref name="Art.218">{{Rejea jarida|title=Adult ADHD: Diagnosis, Differential Diagnosis, and Medication Management |publisher=Psychiatrymmc.com |volume=3 |issue=8 |last=Gentile |first=Julie |pmc=2957278|pmid=20963192 |year=2006 |month=August |pages=25–30|last2=Atiq|first2=R|last3=Gillig|first3=PM|journal=Psychiatry (Edgmont (Pa. : Township))}}</ref>Baadhi ya dalili za TKUU katika watu wazima hutofautiana na dalili zinazodhihirika katika watoto. Huku watoto wenye TKUU wakiweza kupanda na kukimbia kwingi, watu wazima wanaweza kuhisi ugumu wa kutulia, au kuzungumza sana wanapohusiana na wengine. Watu wazima wanaweza kuanzisha mahusiano kwa ghafla, kuonyesha tabia ya kutafuta uchangamfu na kukasirika haraka. Tabia ya kutawaliwa kama vile [[matumizi ya dawa za kulevya]] na kucheza kamari hufanyika mara nyingi. Vigezo vya DSM-IV vimekosolewa kwa kutokuwa mwafaka kwa watu wazima; kwani watu wanaoonyesha dalili tofauti wanaweza kudai kuwa walipita kiwango cha utambuzi.<ref name="Kooij-2010"/> ===Watoto wenye kiwango cha juu cha akili=== Utambuzi wa TKUU na umuhimu wa athari zake katika watoto wenye [[kiwango cha juu cha akili]] una utata.<!-- <ref name=Ant2008/> --> Tafiti nyingi zimepata ulemavu sawa wa kiwango cha akili huku kiasi kikubwa cha watu wakiwa na matokeo sawa na kuwa na matatizo ya kijamii.<!-- <ref name=Ant2008/> --> Isitoshe, zaidi ya nusu ya watu wenye kipimo cha juu cha akili na TKUU hupata [[tatizo kuu la kufadhaisha]] au [[tatizo la ukaidi wa kiupinzani]] katika wakati fulani maishani mwao. [[Tatizo la wasiwasi jumla]], [[tatizo la wasiwasi wa kutenganishwa]] na [[uwoga wa kijamii]] pia hutokea mara nyingi. Kuna ushahidi kuwa watu wenye kiwango cha juu cha akili na TKUU wana kiwango cha chini cha hatari ya matumizi mabaya ya dawa za kulevya na [[mtindo wa kutoafikiana na jamii]] ikilinganishwa na watoto wenye kipimo cha chini na wastani cha akili na TKUU.<!-- <ref name=Ant2008/> --> Kipimo cha ujuzi wa watoto na vijana wenye kipimo cha juu cha akili kinaweza kupimika kimakosa katika tathmini la kimsingi hivyo wanahitaji kupimwa kwa kina zaidi.<ref name=Ant2008>{{cite journal |author=Antshel, KM |title=Attention-Deficit Hyperactivity Disorder in the context of a high intellectual quotient/giftedness |journal=Dev Disabil Res Rev |volume=14 |issue=4 |pages=293–9 |year=2008 |pmid=19072757 |doi=10.1002/ddrr.34 }}</ref> ==Utafiti== [[Picha za shughuli za umeme wa ubongo]], ambazo ni aina ya [[umeme wa kawaida wa ubongo]] huchunguzwa ili kusaidia katika utambuzi wa TKUU.<ref name=San2013>{{cite journal|last=Sand|first=T|coauthors=Breivik, N; Herigstad, A|title=[Assessment of ADHD with EEG].|journal=Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke|date=2013 Feb 5|volume=133|issue=3|pages=312–6|pmid=23381169|doi=10.4045/tidsskr.12.0224}}</ref> Kwa sababu hii, umuhimu wake si bayana.<ref>{{cite journal|last=Millichap|first=JG|coauthors=Millichap, JJ; Stack, CV|title=Utility of the electroencephalogram in attention deficit hyperactivity disorder.|journal=Clinical EEG and neuroscience : official journal of the EEG and Clinical Neuroscience Society (ENCS)|date=2011 Jul|volume=42|issue=3|pages=180–4|pmid=21870470}}</ref> Kuna madai kuwa hii si njia mahususi ya kupima TKUU.<ref name=San2013/> Nchini Marekani, [[Mamalaka ya Vyakula na Dawa]] imeidhinisha mambo wa kuthibitisha hili.<ref>{{cite web|title=FDA permits marketing of first brain wave test to help assess children and teens for ADHD|url=http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm360811.htm|author=FDA|date=July 15, 2013}}</ref> ==Marejeo== {{Reflist|30em}} ==Viungo vya nje== {{Wiktionary|ADHD|ADHD-PI|ADHD-C|ADHD-PH/I}} *{{dmoz|Mental_Health/Disorders/Neurodevelopmental/ADD_and_ADHD/}} *[http://www.nimh.nih.gov/topics/topic-page-adhd.shtml National Institute of Mental Health on ADHD] *{{cite web |url=http://www.nice.org.uk/nicemedia/pdf/ADHDFullGuideline.pdf |format=PDF |title=CG72 Attention deficit hyperactivity disorder (ADHD): full guideline |accessdate=2009-01-08 |publisher=NHS |date=9 March 2009 |archiveurl=https://web.archive.org/web/20100331095410/http://www.nice.org.uk/nicemedia/pdf/ADHDFullGuideline.pdf |archivedate=2010-03-31 }} *[http://www.moh.govt.nz/moh.nsf/c7ad5e032528c34c4c2566690076db9b/4e1c3cddf420bcaecc256a8e007f12d9/$FILE/ADHDGuidelines.pdf New Zealand MOH Guidelines for the Assessment and Treatment of Attention-Deficit/Hyperactivity Disorder] {{Wayback|url=http://www.moh.govt.nz/moh.nsf/c7ad5e032528c34c4c2566690076db9b/4e1c3cddf420bcaecc256a8e007f12d9/$FILE/ADHDGuidelines.pdf |date=20111215210953 }} [[Jamii:Magonjwa]] [[Jamii:Saikolojia]] nsrr5lp8hdawlo4kieuczfk07ero2sc 0 70554 1578062 1564501 2026-07-02T17:28:42Z InternetArchiveBot 41439 Add 9 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578062 wikitext text/x-wiki {{Infobox symptom | Name = Maumivu ya kiuno | Image = Lumbar region in human skeleton.svg | Caption = Maumivu ya kiuno ni tatizo la kawaida na lenye gharama. [[Mchoro]] unaonyesha eneo la [[kiuno]] katika [[kiunzi cha mifupa]] cha binadamu. | DiseasesDB = | ICD10 = {{ICD10|M|54|5|m|50}} | ICD9 = {{ICD9|724.2}} | ICDO = | OMIM = | MedlinePlus = 007422 | MedlinePlus_mult = {{MedlinePlus2|007425}} | eMedicineSubj = pmr | eMedicineTopic = 73 | MeshID = D017116 }} '''Maumivu ya kiuno''' (kwa [[Kiingereza]]: '''lumbago''') ni hali inayotokea mara nyingi na inayohusu [[misuli]] na [[mifupa]] ya upande wa chini wa [[mgongo]]. Hali hii huathiri takriban 40[[%]] ya [[watu]] kwa wakati fulani [[maisha|maishani]] mwao.<!--ref name=hoy_2012/--> [[Maumivu]] ya [[kiuno]] yanaweza kuainishwa kwa [[urefu]] kama [[maumivu]] makali ya ghafla (yanayodumu kwa kipindi cha chini ya [[wiki]] 6), maumivu sugu ya [[wastani]] (wiki 6 hadi 12), au maumivu sugu (zaidi ya wiki 12).<!--ref name=koes_2010/--> Hali hii pia inaweza kuainishwa kulingana na visababishi kama inasababishwa na [[jeraha]] au sivyo au [[maumivu hame]].<!--ref name=manusov_2012_diag/--> Katika visa vingi vya maumivu ya kiuno, kisababishi kikuu maalumu hakitambuliwi wala kukisiwa, kwa kuwa maumivu huaminika kutokana na jeraha kama vile [[mkazo wa misuli]] au [[mkazo wa viunga]].<!--ref name=casazza_2012/><ref name=NIH_2013/--> Ikiwa maumivu hayaponi baada ya kutibiwa kwa njia isiyohusisha [[upasuaji]] au ikiwa maumivu yataandamana na "tahadhari" kama vile kupungua [[uzito]] bila sababu, [[homa]], au matatizo makuu ya kihisia au mwendo, uchunguzi zaidi unaweza kuhitajika kubaini kisababishi kikuu.<!--ref name=manusov_2012_diag/--> Mara nyingi, [[vifaa]] vya [[utambuzi]] kama vile [[tomografia]] iliyohasibiwa kwa [[eksirei]] havihitajiki<!--ref name=AHRQ_2013/--> navyo huandamana na hatari zake. <!--ref name=chou_2009_imaging/-->Licha ya athari hizi, matumizi ya [[pichatiba]] kuchunguza maumivu ya kiuno yameongezeka.<!--ref name=deyo_2009/--> Baadhi ya maumivu ya kiuno husababishwa na kuharibika kwa [[diski]] za baina ya [[pingili]] za [[uti wa mgongo]], na [[uchunguzi wa kunyoosha mguu]] ni muhimu katika kubaini visa hivyo.<!--ref name=manusov_2012_diag/--> Katika watu wenye maumivu sugu, mfumo wa mwili unaochakata maumivu unaweza kutofanya [[kazi]] vyema, hivyo kusababisha maumivu makali ukijaribu kujibiza shughuli zisizo na hatari kubwa.<!--ref name=salzberg_2012/--> [[Matibabu]] ya maumivu ya ghafla ya kiuno kwa kawaida huwa haihusishi upasuaji, kama vile [[dawa za kutuliza maumivu|vituliza maumivu]] na kuendeleza kazi za kawaida jinsi mtu anavyoweza licha ya maumivu.<!--ref name=menezes_2012/--> Matibabu hupendekezwa kwa kipindi ambapo yanamsaidia [[mtu]], huku [[dawa]] aina ya [[acetaminophen]] (inayojulikana pia kama [[paracetamol]]) ni ya kwanza kupendekezwa.<!--ref name=miller_2012/--> [[Dalili]] za maumivu ya kiuno hufifia baada ya wiki chache, huku 40 - 90% ya watu wakipata nafuu kabisa baada ya wiki sita.<!--ref name=menezes_2012/--> Kuna njia nyingi mbadala katika watu wasiopata nafuu baada ya matibabu ya kawaida. [[Opioidi]] zinaweza kusaidia ikiwa vituliza maumivu vya kawaida havitafaulu, ingawa kwa jumla hazipendekezwi kwa sababu zina madhara, hasa [[uraibu]].<!--ref name=miller_2012/--> Upasuaji unaweza kuwafaidisha watu wenye matatizo ya maumivu sugu na [[ulemavu]] unaohusiana na diski.<!--ref name=manusov_2012_surg/-->Upasuaji pia unaweza kuwafaidisha watu wenye [[stenosisi ya uti wa mgongo]].<!--ref name=chou_2009_surgery/--> Hakuna manufaa bayana ya upasuaji yaliyopatikana kwa visa vingine vya maumivu ya kiuno yasiyo na kisababishi cha moja kwa moja.<!--ref name=manusov_2012_surg/--> Isitoshe, kuna matibabu ya [[dawa mbadala]], ambayo ni pamoja na [[mbinu ya Alexander]] na [[mitishamba]], lakini hakuna ushahidi wa kutosha kupendekeza matibabu hayo kikamilifu.<!--ref name=marlowe_2012/--> Ushahidi wa utunzaji wa [[tibamwili]]<!--ref name=walker_2011/--> na [[kunyooshaji uti wa mgongo]] umekumbwa na utata.<!--ref name=dagenais_2010/><ref name=rubinstein_2011/><ref name=rubinstein_2012/><ref name=marlowe_2012/--> Maumivu ya kiuno mara nyingi huathiri [[hisia]], tatizo linaloweza kuimarishwa kupitia [[ushauri]] wa [[saikolojia|kisaikolojia]]<!--ref name=henschke_2010/--> na/au [[dawa za kushusha utendakazi]].<!--ref name=miller_2012/--> {{TOC limit|3}} ==Ishara na dalili== Katika dalili za kawaida za maumivu ya kiuno, maumivu huanza baada ya mwendo wa kunyanyua vitu, kujipinda au kuinama. Dalili za hali hii zinaweza kuanza baada ya mwendo wowote au mtu anapoamka [[asubuhi]] inayofuata.<!--<ref name=casazza_2012/> --> Maelezo ya dalili hizi yanaweza kuwa maumivu katika sehemu fulani au maumivu yanayosambaa. Maumivu yanaweza kutokuwa makali kufuatia shughuli, kama vile kuinua miguu, au hali nyingine kama kuketi au kusimama.<!--<ref name=casazza_2012/> --> Maumivu yanayosambaa chini ya miguu (yanayojulikana kama [[maumivu ya nyonga]]) yanaweza kuwepo.<!--<ref name=casazza_2012/> --> Visa vya kwanza vya maumivu makali ya ghafla ya mgongo huanza katika [[umri]] wa miaka 20-40.<!--<ref name=casazza_2012/> --> Mara nyingi kisa hicho huwa ni sababu ya kwanza katika watu wazima kumwona [[daktari]].<ref name=casazza_2012/> Kisa hicho hurejea katika zaidi ya nusu ya waathiriwa<ref name=Stanton2010/> huku kisa cha kurejea kikiandamana na maumivu makubwa kuliko kisa cha kwanza.<ref name=casazza_2012>{{cite journal |last=Casazza |first=BA |title=Diagnosis and treatment of acute low back pain |url=https://archive.org/details/sim_american-family-physician_2012-02-15_85_4/page/343 |journal=American family physician |date=15 February 2012 |volume=85 |issue=4 |pages=343–50 |pmid=22335313}}</ref> Matatizo mengine yanaweza kuandamana na maumivu ya kiuno. Maumivu sugu ya kiuno huhusishwa na matatizo ya [[usingizi]], ikiwa ni pamoja na wakati mwingi unaohitajika kulala, kusumbuka wakati wa kulala, kulala kwa kipindi kifupi, na kutotosheka na usingizi.<ref name=kelly_2011>{{cite journal |author=Kelly GA, Blake C, Power CK, O'keeffe D, Fullen BM |title=The association between chronic low back pain and sleep: a systematic review |journal=Clin J Pain |volume=27 |issue=2 |pages=169–81 |year=2011 |month=February |pmid=20842008 |doi=10.1097/AJP.0b013e3181f3bdd5 |url=https://archive.org/details/sim_clinical-journal-of-pain_2011-02_27_2/page/169}}</ref> Isitoshe, idadi kubwa ya watu wenye maumivu sugu ya kiuno huonyesha dalili za [[mfadhaiko]]<ref name=miller_2012>{{cite journal |author=Miller SM |title=Low back pain: pharmacologic management |journal=Prim. Care |volume=39 |issue=3 |pages=499–510 |year=2012 |month=September |pmid=22958559 |doi=10.1016/j.pop.2012.06.005 |url=}}</ref> au [[wasiwasi]].<ref name=marlowe_2012/> ==Kisababishi== [[File:Lagehernia.png|thumb|]] Maumivu ya kiuno si [[ugonjwa]], bali ni hali inayoweza kusababishwa na matatizo mengi yanayotofautiana kwa kiwango na hatari.<ref name=borczuk_2013>{{cite journal|last=Borczuk|first=Pierre|title=An Evidence-Based Approach to the Evaluation and Treatment of Low Back Pin in the Emergency Department|journal=Emergency Medicine Practice|year=2013|month=July|volume=15|issue=7|url=http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=371}}</ref> Visa vingi vya maumivu ya mgongo havina kisababishi maalum<ref name=casazza_2012/> ingawa vinaaminika kutokana na masuala ya misuli au mifupa kama vile [[kuteguka]] au [[mkazo wa misuli]].<ref name=NIH_2013>{{cite web |url=http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm |title=Low Back Pain Fact Sheet |work=National Institute of Neurological Disorders and Stroke |publisher=National Institute of Health |accessdate=12 July 2013 |archivedate=2013-07-19 |archiveurl=https://web.archive.org/web/20130719200618/http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm }}</ref> [[Unene wa kupindukia]], kuvuta [[sigara]], kunenepa wakati wa [[ujauzito]], mfadhaiko, matatizo ya mwili, mkao mbaya na kulala vibaya pia huchangia maumivu ya kiuno. <!-- This sentence is copied verbatim from the NIH website, which is public domain --><ref name=NIH_2013/> Orodha ya visababishi vyenye uwezekano wa kusababisha maumivu ya kiuno ni pamoja na hali zisizotokea mara nyingi.<ref name=manusov_2012_diag>{{cite journal |author=Manusov EG |title=Evaluation and diagnosis of low back pain |journal=Prim. Care |volume=39 |issue=3 |pages=471–9 |year=2012 |month=September |pmid=22958556 |doi=10.1016/j.pop.2012.06.003 |url=}}</ref> Matatizo ya kimwili yanaweza kuwa [[osteoathritisi]], [[athritisi ya rumatoidi]], [[kuharibika kwa diski]] zilizo katikati mwa pingili za uti wa mgongo au [[henia ya diski ya uti wa mgongo]], [[kuvunjika kwa pingili za uti wa mgongo]] (kama vile kufuatia [[osteoporosisi]]) au, kwa nadra, maambukizi au tyuma ya uti wa mgongo.<ref name=NIH_2009>{{cite web |url=http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.asp#b |title=Fast Facts About Back Pain|author=<!--Staff writer(s); no by-line.--> |date=September 2009 |website=National Institute of Arthritis and Musculoskeletal and Skin Diseases |publisher=National Institute of Health |accessdate=10 June 2013}}</ref> [[Wanawake]] wanaweza kuwa na maumivu ya kiuno kutokana na hali zinazoathiri [[mfumo wa uzazi]], ikijumuisha [[endometriosisi]], [[sisti ya ovari]], [[saratani ya ovari]] au [[fibroidi ya uterasi]].<ref name=medline_lbp_acute_2012>{{cite web |title=Low back pain – acute |url=http://www.nlm.nih.gov/medlineplus/ency/article/007425.htm |publisher=U.S. Department of Health and Human Services – National Institutes of Health |accessdate=1 April 2013}}</ref> Karibu nusu ya wanawake wajawazito hulalamikia maumivu ya kiuno au ya sehemu ya [[sakramu]] wakati wa ujauzito, kufuatia mabadiliko ya hali ya kukaa na kiuo cha mvuto hivyo kusababisha mkazo wa misuli na kano.<ref name=majchrzycki_2010>{{cite journal |author=Majchrzycki M, Mrozikiewicz PM, Kocur P, ''et al.'' |title=[Low back pain in pregnant women] |language=Polish |journal=Ginekol. Pol. |volume=81 |issue=11 |pages=851–5 |year=2010 |month=November |pmid=21365902 |doi= |url=}}</ref> ==Pathofiziolojia== ===Miundo ya mgongo=== {{double image|right|Illu vertebral column.svg|200|ACDF oblique annotated english.svg|200|The five lumbar vertebrae define the lower back region|The structures surrounding and supporting the vertebrae can be sources of low back pain|The lumbar region in regards to the rest of the spine |The nerve and bone components of the vertebrae}} Sehemu ya kiuno ina [[pingili]] tano (L1-L5). Baina ya pingili za uti wa mgongo kuna [[diski]] zenye [[gegedu]] na [[nyuzi]], ambazo huzuia pingili zisikwaruzane, na pia kuukinga [[uti wa ubongo]]. [[Neva]] hutoka na kuingia katika [[uti wa ubongo]] kupitia [[foramina|vitundu maalum]] baina ya pingili, zikituma hisia na arifa kwenye [[ngozi]] na misuli. Uthabiti wa uti wa mgongo huchangiwa na kano na misuli ya mgongo na ya [[fumbatio]]. Viunga vidogo vinavyoitwa [[viunga vya zigapofizi]] huthibiti na kuelekeza mwendo wa uti wa mgongo.<ref name=floyd_2008>Floyd, R., & Thompson, Clem. (2008). Manual of structural kinesiology. New York, NY: McGraw-Hill Humanities/Social Sciences/Languages.</ref> [[Misuli ya nyuzi nyingi]] hupanda na kushuka katika sehemu ya nyuma ya uti wa mgongo, na ni muhimu kwa kuwa hunyoosha uti wa mgongo na kuuimarisha wakati wa miendo kama vile kuketi, kutembea na kunyanyua vitu.<ref name=salzberg_2012/>. Mara nyingi tatizo la misuli hii hupatikana katika watu wenye maumivu sugu ya kiuno, kwa sababu maumivu haya husababisha mtu kutumia misuli ya mgongo vibaya katika harakati ya kuepuka maumivu.<ref name=freedman_2010>{{cite journal |author=Freedman MD, Woodham MA, Woodham AW |title=The role of the lumbar multifidus in chronic low back pain: a review. |journal=PM & R: the journal of injury, function, and rehabilitation |volume=2 |issue=2 |pages=142-6 |year=2010 |month=March |pmid=20193941 |doi=10.1016/j.pmrj.2009.11.006 |url=}}</ref> Tatizo la hali ya misuli yenye nyuzi nyingi huendelea hata baada ya maumivu kutulia, hivyo huenda ni kisababishi kikuu cha kurejea kwa maumivu.<ref name=freedman_2010/> Inapendekezwa kuwafunza watu wenye maumivu sugu ya kiuno jinsi ya kutumia misuli hii kama njia ya matibabu.<ref name=freedman_2010/> Diski ya baina ya pingili za uti wa mgongo ina [[Kiiniseli chororo|kitovu cha jelatini]] kilichozingirwa na [[kizingo cha nyuzi]].<ref name=hughes_2012>{{cite journal |author=Hughes SP, Freemont AJ, Hukins DW, McGregor AH, Roberts S |title=The pathogenesis of degeneration of the intervertebral disc and emerging therapies in the management of back pain |journal=J Bone Joint Surg Br |volume=94 |issue=10 |pages=1298–304 |year=2012 |month=October |pmid=23015552 |doi=10.1302/0301-620X.94B10.28986 |url=http://www.boneandjoint.org.uk/highwire/filestream/61400/field_highwire_article_pdf/0/1298.full-text.pdf}}</ref> Katika hali ya kawaida, bila jeraha, sehemu kubwa ya diski hii haihuishwi na [[mfumo wa usafirishaji]] wala [[mfumo wa neva]] – [[damu]] na neva hupitia nje ya diski tu.<ref name=hughes_2012/> [[Seli]] maalum zinazoweza kuishi bila kupata damu ya moja kwa moja huwa ndani ya diski.<ref name=hughes_2012/> Wakati unapopita, diski huwa ngumu na kukosa uwezo wa kuhimili shinikizo.<ref name=borczuk_2013/> Hali hii ya diski kukosa kuhimili shinnikizo huongeza shinikizo kwenye sehemu zingine za uti wa mgongo, hivyo kusababisha kano ya uti wa mgongo kuwa nene na pia vifundo vya mfupa kukua kwenye pingili.<ref name=borczuk_2013/> Kufuatia hali hii, kutakuwepo na nafasi ndogo ambapo uti wa ubongo na mizizi ya neva itaweza kupitia.<ref name=borczuk_2013/> Diski inapoharibika kufuatia jeraha au ugonjwa; muundo wake hubadilika: mishipa ya damu na neva zinaweza kuingia ndani ya diski na/au hania ya diski zinaweza kuifinya mizizi ya neva.<ref name=hughes_2012/> Mabadiliko yoyote haya yanaweza kusababisha maumivu ya mgongo.<ref name=hughes_2012/> ===Hisia za maumivu=== Kwa jumla, maumivu ni hisia isiyopendeza inayokujibiza [[Kichangamsho (fiziolojia)|tukio]] linaloharibu au linaloweza kuharibu [[tishu]] za mwili. Kuna hatua tatu kuu katika utaratibu wa kuhisi maumivu: [[Uhamishaji (fiziolojia)|uhamishaji]], usambazaji,[[hisia]], na ubadilishaji kwa kutumia neva.<ref name=salzberg_2012>{{cite journal |author=Salzberg L |title=The physiology of low back pain |journal=Prim. Care |volume=39 |issue=3|pages=487–98 |year=2012 |month=September |pmid=22958558 |doi=10.1016/j.pop.2012.06.014 |url=}}</ref> Seli za neva zinazotambua maumivu zina miili kwenye [[kikundi cha seli za shina la uti wa mgongo]] na nyuzi zinazosambaza arifa za neva hadi kwenye uti wa ubongo.<ref name=patel_2010>{{cite book |title=Guide to Pain Management in Low-Resource Settings |chapter=Chapter 3: Physiology of Pain |author=Patel, NB |editors=Kopf A, Patel NB |year=2010 |url=http://www.iasp-pain.org/AM/Template.cfm?Section=Guide_to_Pain_Management_in_Low_Resource_Settings&Template=/CM/ContentDisplay.cfm&ContentID=12162 |accessdate=2021-01-17 |archiveurl=https://web.archive.org/web/20131005010917/http://www.iasp-pain.org/AM/Template.cfm?Section=Guide_to_Pain_Management_in_Low_Resource_Settings&Template=%2FCM%2FContentDisplay.cfm&ContentID=12162 |archivedate=2013-10-05 }} {{Rejea tovuti |url=http://www.iasp-pain.org/AM/Template.cfm?Section=Guide_to_Pain_Management_in_Low_Resource_Settings&Template=%2FCM%2FContentDisplay.cfm&ContentID=12162 |title=Nakala iliyohifadhiwa |accessdate=2021-01-17 |archive-date=2013-10-05 |archive-url=https://web.archive.org/web/20131005010917/http://www.iasp-pain.org/AM/Template.cfm?Section=Guide_to_Pain_Management_in_Low_Resource_Settings&Template=%2FCM%2FContentDisplay.cfm&ContentID=12162 |url-status=dead }}</ref> Utaratibu wa kuhisi maumivu huanza tukio lililosababisha maumivu linapochochea ncha za [[kipokezi|seli za neva za hisia]]. Seli hii hubadilisha tukio la maumivu kuwa vimuli vya umeme kwa njia ya uhamishaji. Aina mbalimbali za nyuzi za neva husambaza arifa za umeme kutoka kwenye seli zinazotekeleza uhamishaji hadi [[pembe ya nyuma ya uti wa mgongo]]. Kutoka hapa, arifa huelekezwa kwenye [[shina la ubongo|shina la ubongo]], kisha kutoka kwenye shina la ubongo hadi sehemu mbalimbali za ubongo kama vile [[thalamasi]] na [[mfumo wa viungo]]. Katika ubongo, arifa za maumivu huchakatwa na kuainishwa katika utaratibu wa [[hisia]] ya maumivu. Kupitia njia ya uhamishaji, ubongo unaweza kubadilisha jinsi ya kusambaza arifa za neva kwa kupunguza au kuongeza utoaji wa [[nyurotransmita]].<ref name=salzberg_2012/> Sehemu za mfumo wa hisia na utaratibu wa maumivu zinaweza kukosa kufanya kazi kama kawaida; hivyo kusababisha hisia ya maumivu, hata kukiwa hakuna kisababishi chochote nje ya mwili, na kuashiria maumivu makali kutoka kisababishi maalum, au kuashiria maumivu kutoka tukio ambalo kwa kawaida halisababishi maumivu. Isitoshe, utaratibu wa ubadilishaji wa maumivu unaweza kukosa kufanya kazi kama kawaida. Matukio haya huhusika na maumivu sugu.<ref name=salzberg_2012/> ==Utambuzi== ===Uainishaji=== Kuna njia mbalimbali za kuainisha maumivu ya sehemu ya chini ya mgongo.<ref name=manusov_2012_diag/> Kwa kijumla, kuna aina tatu za maumivu ya mgongo, zikiainishwa kulingana na visababishi: Maumivu ya mgongo kufuatia jeraha (hii ni pamoja na mikazo ya misuli na mifupa isiyo na kisababishi bayana, [[hania ya diski]], kufinywa kwa [[mizizi ya neva]], [[magonjwa yanayoharibu diski|diski zilizoharibika]] au [[magonjwa yanayoharibu viunga|ugonjwa wa viunga]], na kuvunjika kwa pingili za uti wa mgongo), maumivu ya mgongo yasiyohusiana na jeraha ([[saratani]], hali za inflamesheni [[spondiliathritisi]], na [[maambukizi]]), na [[maumivu hame]]kutoka viungo vya ndani ([[koliki ya nyongo|magonjwa ya kibofu na nyongo]], [[jiwe la figo]], [[maambukizi ya figo]], na [[aneurisimi ya aota]], miongoni mwa matatizo mengine).<ref name=manusov_2012_diag/> Matatizo yanayohusiana na jeraha au misuli na mifupa huchangia visa vingi (takriban 90% au zaidi),<ref name=manusov_2012_diag/><ref name=cohen_2008>{{cite journal |author=Cohen SP, Argoff CE, Carragee EJ |title=Management of low back pain |journal=BMJ |volume=337 |issue= |pages=a2718 |year=2008 |pmid=19103627 |doi= |url=}}</ref>. Kati ya visa hivi, visa vingi (karibu 75%) havina kisababishi maalum kilichobainishwa, lakini huaminiwa kutokana na mkazo wa misuli au jeraha la kano.<ref name=manusov_2012_diag/><ref name=cohen_2008/> Mara nadra, visa vya maumivu ya sehemu ya chini ya mgongo hutokea kufuatia matatizo ya mifumo ya mwili na ya kisaikolojia, kama vile [[fibromialgia]] na [[tatizo la somatofomu]].<ref name=cohen_2008/>Maumivu ya kiuno yanaweza kuainishwa kulingana na ishara na dalili. Maumivu enezi yasiyobadilika kufuatia mwendo wowote wa mwili, huhisiwa tu kwenye sehemu ya chini ya mgongo bila kuenea aidi ya [[matako]], huainishwa kama ''yasiyo na kisababishi maalum'', ambayo ni aina ya maumivu yanayotokea mara nyingi.<ref name=manusov_2012_diag/> Maumivu yanayoenea kuelekea miguuni chini ya goti huwa katika sehemu moja (katika hania ya diski), au katika sehemu zote mbili (katika stenosisi ya uti wa mgongo), na yanayobadilika kwa uchungu kufuatia miendo fulani ya mwili huainishwa kama ''enezi''. Maumivu haya huchangia 7% ya visa.<ref name=manusov_2012_diag/> Maumivu yanayoandamana na matatizo makali kama vile jeraha, homa, historia ya saratani au ulegevu mkuu wa misuli na matatizo mengine andamizi huainishwa kama ''yanayohitaji kushugulikiwa kwa dharura''.<ref name=manusov_2012_diag/> Dalili pia zinaweza kuainishwa kulingana na muda, kama vile maumivu makali, maumivu sugu kidogo (pia yanayojulikana kama maumivu makali kidogo), au maumivu sugu. Kipindi maalum kinachohitajika ili kutambua kila mojawapo ya aina hizi za maumivu hakijabainishwa kikamilifu, lakini kwa kijumla, maumivu yanayodumu chini ya wiki sita huainishwa kama ''maumivu makali ya ghafla''. Maumivu yanayodumu kati ya wiki sita hadi kumi na mbili ni ''maumivu sugu kidogo '', ilhali maumivu ya zaidi ya wiki kumi na mbili ni ''maumivu sugu''.<ref name=koes_2010>{{cite journal |last=Koes |first=BW |coauthors=van Tulder, M; Lin, CW; Macedo, LG; McAuley, J; Maher, C |title=An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. |journal=European Spine Journal |date=December 2010 |volume=19 |issue=12 |pages=2075–94 |pmid=20602122 |doi=10.1007/s00586-010-1502-y}}</ref> Udhibithi na utambuzi unaweza kubadilika kulingana na kipindi cha dalili. ===Tahadhari=== {| class="wikitable" style="float: right; margin-left:15px; text-align:center" |+ Dalili hatari huashiria matatizo makali |- ! Red flag<ref name=ACR_2011>{{cite journal |author=Davis PC, Wippold II FJ, Cornelius RS, ''et al.'' |title=American College of Radiology ACR Appropriateness Criteria – Low Back Pain |date=2011 |url=http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/LowBackPain.pdf |journal= |access-date=2014-02-03 |archive-date=2012-07-04 |archive-url=https://web.archive.org/web/20120704075652/http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/LowBackPain.pdf |dead-url=yes }}</ref> ! Vipengele vinavyowezekana kuwa visababishi<ref name=casazza_2012/> |- | Historia ya saratani || rowspan="2"|Saratani |- | Kupoteza uzito bila sababu |- | Kupoteza uwezo wa kudhibiti kibofu au kinyweo ||rowspan="3"|[[Sindromu ya kauda ekuina|Kauda<br />ekuina<br />sindromu]] |- |Udhaifu mkuu wa misuli<br />au ukosefu wa hisia |- | Kukosa hisia kwenye <br />matako ([[anestesia ya makalio]]) |- | Jeraha kubwa ikilinganishwa na umri || rowspan="2"|Mvunjiko |- | Matumizi ya steroidi za ubongo kwa muda mrefu |- | Maumivu makali kufuatia<br />upasuaji wa kiunoni mwaka uliotangulia|| rowspan="5"|Maambukizi |- | Homa |- | Maambukizi ya mfumo wa viungo vya mkojo |- | [[Ushinikizaji wa mfumo wa kingamwili]] |- | Kutumia dawa za kudungia mishipani |} Kwa kuwa muundo wa mgongo ni tata, na njia ya kuripoti kuhusu maumivu ni [[uvumi|yenye uvumi]] na huathiriwa na vipengele vya kijamii, utambuzi wa maumivvu ya sehemu ya chini ya mgongo si dhahiri.<ref name=manusov_2012_diag/> Huku idadi kubwa ya maumivu ya mgongo yakisababishwa na matatizo ya misuli na viunga, visababishi hivi vinapaswa kutofautishwa na matatizo ya kineva, tyuma za uti wa mgongo, mvunjiko katika uti wa mgongo na maambukizi, miongoni mwa matatizo mengine.<ref name=casazza_2012/><ref name=koes_2010/> Uwepo wa dalili fulani zinazojulikana kama tahadhari, huashiria haja ya uchunguzi zaidi ili kutathmini matatizo mengine andamizi yanayoweza kuhitaji matibabu maalum au ya dharura.<ref name=manusov_2012_diag/> Uwepo wa dalili hatari haumaamishi kuna tatizo kuu. Dalili hizi ni kidokezo tu,<ref name=henschke_2013_vertfrac>{{cite journal |author=Williams CM, Henschke N, Maher CG, ''et al.'' |title=Red flags to screen for vertebral fracture in patients presenting with low-back pain |journal=Cochrane Database Syst Rev |volume=1 |issue= |pages=CD008643 |year=2013 |pmid=23440831 |doi=10.1002/14651858.CD008643.pub2 |url=}}</ref><ref name=henschke_2013_spinmal>{{cite journal |author=Henschke N, Maher CG, Ostelo RW, de Vet HC, Macaskill P, Irwig L |title=Red flags to screen for malignancy in patients with low-back pain |journal=Cochrane Database Syst Rev |volume=2 |issue= |pages=CD008686 |year=2013 |pmid=23450586 |doi=10.1002/14651858.CD008686.pub2 |url=}}</ref> na watu wengi wenye tahadhari hizi huwa hawana tatizo lolote andamizi la kuhatarisha maisha.<ref name=casazza_2012/><ref name=koes_2010/>Bila dalili hatari, kufanya [[uchunguzi wa pichatiba]] au uchunguzi wa maabarani katika wiki nne za kwanza baada ya dalili kutokea hakujathibitishwa kuwa na umuhimu wowote.<ref name=manusov_2012_diag/> Baada ya sababu zingine kuondolewa, watu wenye maumivu yasiyo na kisababishi bayana hupewa matibabu ya kutuliza dalili.<ref name=casazza_2012/><ref name=koes_2010/> Jitihada za kugundua vipengele vinavyoweza kutatiza utambuzi, kama vile mfadhaiko, matumizi mabaya ya dawa, au swala kuhusu malipo ya bima, zinaweza kuwa na manufaa<ref name=manusov_2012_diag/> ===Uchunguzi=== {{double image|right|Straight-leg-test.gif|200|L4-l5-disc-herniation.png|150|The straight leg raise test can detect pain originating from a herniated disc. When warranted, imaging such as MRI can provide clear detail about disc related causes of back pain (L4–L5 disc herniation shown)}} Uchunguzi wa pichatiba hupendekezwa panapokuwa na tahadhari, mfululizo wa dalili za kineva zisizopona, au maumivu yanayoendelea au yanayozidi kuwa makali.<ref name=manusov_2012_diag/> Hususan, kutumia uchunguzi wa pichatiba mapema(Picha wa Mwangwi wa Sumaku au CT) hupendekezwa katika visa vinavyoshukiwa kuwa saratani, maambukizi, au[[sindromu ya kauda ekuina]].<ref name=manusov_2012_diag/> Picha wa Mwangwi wa Sumaku ni bora kidogo kuliko Tomografia ya Kompyuta katika kutambua ugonjwa wa diski. Mbinu hizi mbili ni muhimu katika utambuzi wa stenosisi ya uti wa mgongo.<ref name=manusov_2012_diag/> Ni vipimo vichache tu vya kimwili vinavyosaidia.<ref name=manusov_2012_diag/> Uchunguzi wa [[kunyoosha miguu]] mara nyingi huwanufaisha watu wenye hania wa diski.<ref name=manusov_2012_diag/> [[Uchunguzi wa diskografi ya kiuno]] unaweza kusaidia kubainisha diski maaluum inayosababisha maumivu katika watu wenye maumivu sugu ya kiwango cha juu.<ref name=manchikanti_2009_disco>{{cite journal |author=Manchikanti L, Glaser SE, Wolfer L, Derby R, Cohen SP |title=Systematic review of lumbar discography as a diagnostic test for chronic low back pain |journal=Pain Physician |volume=12 |issue=3 |pages=541–59 |year=2009 |pmid=19461822 |doi= |url=http://www.painphysicianjournal.com/linkout_vw.php?issn=1533-3159&vol=12&page=541 |access-date=2014-02-03 |archive-date=2013-10-05 |archive-url=https://web.archive.org/web/20131005010848/http://www.painphysicianjournal.com/linkout_vw.php?issn=1533-3159&vol=12&page=541 |dead-url=yes }}</ref> Vile vile, taratibu za kimatibabu kama vile kuziba neva zinaweza kutumika ili kubaini kiini maalum cha maumivu.<ref name=manusov_2012_diag/> Tafiti zingine hupendekeza matumizi ya[[kudunga sehemu za viunga]], kudunga epidura kwenye trasfomina na kudunga sakramu na iliamu kama njia ya kufanya utambuzi<ref name=manusov_2012_diag/> Uchunguzi mwingine wa kimwili kama vile kutathmini [[skoliosisi]], ulegevu au uelemavu wa misuli, hitilafu ya msisimko wa misuli,si muhimu sana.<ref name=manusov_2012_diag/>Maumivu ya sehemu ya chini ya mgongo ni mojawapo ya sababu zinazofanya watu watafute usaidizi wa daktari.<ref name=AHRQ_2013>{{cite journal |title = Use of imaging studies for low back pain: percentage of members with a primary diagnosis of low back pain who did not have an imaging study (plain x-ray, MRI, CT scan) within 28 days of the diagnosis |url = http://www.qualitymeasures.ahrq.gov/content.aspx?id=38884 |year = 2013 |publisher = [[Agency for Healthcare Research and Quality]] |accessdate = 11 June 2013 |journal = |archive-date = 2013-10-04 |archive-url = https://web.archive.org/web/20131004235722/http://www.qualitymeasures.ahrq.gov/content.aspx?id=38884 |dead-url = yes }}</ref><ref name=AAFPfive>{{Citation |author1 = American Academy of Family Physicians |author1-link = American Academy of Family Physicians |date = |title = Ten Things Physicians and Patients Should Question |publisher = [[American Academy of Family Physicians]] |work = [[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |page = |url = http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-family-physicians/ |accessdate = September 5 2012}}</ref> Katika maumivu yaliyodumu kwa wiki chache tu, kuna uwezekano wa maumivu kutulia bila matibabu.<ref name=ACPfive>{{Citation |author1 = American College of Physicians |author1-link = American College of Physicians |date = |title = Five Things Physicians and Patients Should Question |publisher = [[American College of Physicians]] |work = [[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |page = |url = http://www.choosingwisely.org/doctor-patient-lists/american-college-of-physicians/ |accessdate = 5 September 2013}}</ref> Hivyo, ikiwa[[historia ya kimatibabu]] na[[Uchunguzi wa mwili]] wa mtu hazitabaini ugonjwa fulani kuwa kisababishi, jamii za madaktari hazipendekezi uchunguzi kama vile [[eksirei]], [[uchunguzi wa Tomografia ya Kompyuta |uchunguzi wa Tomografia ya Kompyuta]], na [[Picha za Mwangwi za Sumaku|Picha za Mwangwi wa Sumaku]].<ref name=AAFPfive/> Mgonjwa anaweza kuagiza kufanyiwa uchunguzi huo, lakini utafanywa tu ikiwa kuna dalili hatari ,<ref name=chou_2009_imaging>{{cite journal |last=Chou |first=R |coauthors=Fu, R, Carrino, JA, Deyo, RA |title=Imaging strategies for low-back pain: systematic review and meta-analysis. |url=https://archive.org/details/sim_the-lancet_february-7-13-2009_373_9662/page/463 |journal=Lancet |date=7 February 2009 |volume=373 |issue=9662 |pages=463–72 |pmid=19200918 |doi=10.1016/S0140-6736(09)60172-0}}</ref><ref name=crownover_2013>{{cite journal |author=Crownover BK, Bepko JL |title=Appropriate and safe use of diagnostic imaging |journal=Am Fam Physician |volume=87 |issue=7 |pages=494–501 |year=2013 |month=April |pmid=23547591 |doi= |url=}}</ref> uchunguzi huu ni [[huduma za afya zisizohitajika]].<ref name=AHRQ_2013/><ref name=ACPfive/> Uchunguzi wa pichatiba huongeza gharama, na huhusika kwa kiwango kikubwa na upasuaji usio na manufaa ya kijumla, <ref name=chou_2011>{{cite journal |last=Chou |first=R |coauthors=Qaseem, A, Owens, DK, Shekelle, P, Clinical Guidelines Committee of the American College of, Physicians |title=Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians |url=https://archive.org/details/sim_annals-of-internal-medicine_2011-02-01_154_3/page/181 |journal=Annals of internal medicine |date=1 February 2011 |volume=154 |issue=3 |pages=181–9 |pmid=21282698 |doi=10.1059/0003-4819-154-3-201102010-00008}}</ref><ref name=flynn_2011>{{cite journal |author=Flynn TW, Smith B, Chou R |title=Appropriate use of diagnostic imaging in low back pain: a reminder that unnecessary imaging may do as much harm as good |journal=J Orthop Sports Phys Ther |volume=41 |issue=11 |pages=838–46 |year=2011 |month=November |pmid=21642763 |doi=10.2519/jospt.2011.3618 |url=}}</ref>na minunurisho inayotumika inaweza kudhuru afya ya mgonjwa.<ref name=chou_2011/> Chini ya 1% ya vipimo vya pichatiba chini hubaini kisababishi cha tatizo hili.<ref name=AHRQ_2013/> Kupitia uchunguzi wa picha tiba, hitilafu zingine za kimwili zisizodhuru mwili zinaweza kugunduliwa, jambo linaloweza kusababisha watu waagize uchunguzi mwengine usiohitajika au kuingiwa na wasi wasi.<ref name=AHRQ_2013/> Hata hivyo, uchunguzi wa Picha wa Mwangwi wa Sumaku kwenye kiuno uliongezeka kwa zaidi ya 300% miongoni mwa watu walionufaika na huduma ya Medicare nchini Marekani mwaka wa 1994 hadi 2006.<ref name=deyo_2009>{{cite journal |last1=Deyo |first1=RA |last2=Mirza |first2=SK |last3=Turner |first3=JA |last4=Martin |first4=BI |title=Overtreating Chronic Back Pain: Time to Back Off? |journal=Journal of the American Board of Family Medicine : JABFM |volume=22 |issue=1 |pages=62–8 |year=2009 |pmid=19124635 |pmc=2729142 |doi=10.3122/jabfm.2009.01.080102}}</ref> ==Kinga== Njia bora za kuzuia maumivu ya sehemu ya chini ya mgongo hazijakuzwa kikamilifu.<ref name=hoy_2012>{{cite journal |author=Hoy D, Bain C, Williams G, ''et al.'' |title=A systematic review of the global prevalence of low back pain |journal=Arthritis Rheum. |volume=64 |issue=6 |pages=2028–37 |year=2012 |month=June |pmid=22231424 |doi=10.1002/art.34347 |url=}}</ref> [[Mazoezi ya mwili|Mazoezi]] ni muhimu hasa katika kuzuia kurejea kwa maumivu katika watu walioathiriwa kwa zaidi ya wiki sita.<ref name=casazza_2012/><ref name=choi_2010>{{cite journal |author=Choi BK, Verbeek JH, Tam WW, Jiang JY |editor1-last=Choi |editor1-first=Brian KL |title=Exercises for prevention of recurrences of low-back pain |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD006555 |year=2010 |pmid=20091596 |doi=10.1002/14651858.CD006555.pub2 |url=}}</ref> Gondoro zenye uthabiti wastani ni bora zaidi katika watu wenye maumivu sugu kuliko gondoro ngumu.<ref name=chou_2007>{{cite journal |author=Chou R, Qaseem A, Snow V, ''et al.'' |title=Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society |journal=Ann. Intern. Med. |volume=147 |issue=7 |pages=478–91 |year=2007 |month=October |pmid=17909209 |doi= 10.7326/0003-4819-147-7-200710020-00006|url=https://archive.org/details/sim_annals-of-internal-medicine_2007-10-02_147_7/page/n64}}</ref> Kuna ushahidi mdogo unaoonyesha kuwa [[mishipi ya mgongo]] ina manufaa mengi katika kuzuia maumivu ya mgongo kuliko kuwaelimisha watu kuhusu mbinu bora za kunyanyua vitu.<ref name=guild_2012>{{cite journal |author=Guild DG |title=Mechanical therapy for low back pain |journal=Prim. Care |volume=39 |issue=3 |pages=511–6 |year=2012 |month=September |pmid=22958560 |doi=10.1016/j.pop.2012.06.006 |url=}}</ref> [[Soli ya ndani ya viatu]] haisaidii kuzuia maumivu ya sehemu ya chini ya mgongo.<ref name=sahar_2009>{{cite journal |author=Sahar T, Cohen MJ, Uval-Ne'eman V, ''et al.'' |title=Insoles for prevention and treatment of back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group |journal=Spine |volume=34 |issue=9 |pages=924–33 |year=2009 |month=April |pmid=19359999 |doi=10.1097/BRS.0b013e31819f29be |url=https://archive.org/details/sim_spine-us_2009-04-20_34_9/page/924}}</ref> ==Udhibiti== Udhibiti wa maumivu ya sehemu ya chini ya mgongo hutegemea ni kipi kati ya vipengele hivi kilichosababisha hali hii: matatizo yanayohusiana na jeraha, matatizo yasiyohusiana na jeraha, au maumivu hame.<ref name=sprouse_2012>{{cite journal |author=Sprouse R |title=Treatment: current treatment recommendations for acute and chronic undifferentiated low back pain |journal=Prim. Care |volume=39 |issue=3 |pages=481–6 |year=2012 |month=September |pmid=22958557 |doi=10.1016/j.pop.2012.06.004 |url=}}</ref> Katika visa vya maumivu makali ya ghafla yanayosababisha matatizo hafifu hadi ya wastani, lengo la matibabu ni kurejesha utendakazi wa mwili hadi hali ya kawaida, na kupunguza maumivu. Kwa kawaida, hali hii si hatari kwa sababu husuluhika bila matibabu mengi na kupona kwake huwezeshwa na jaribio la kurejesha shughuli za kawaida haraka iwezekanavyo jinsi maumivu yanavyoruhusu.<ref name=koes_2010/> Kuwapa wagonjwa [[stadi za kujikimu]] kupitia kuwahimiza kuhusu ukweli huu ni muhimu katika kuharakisha utaratibu wa kupata nafuu.<ref name=casazza_2012/> Katika watu wenye maumivu sugu kidogo na maumivu sugu, matibabu kutoka kwa wahudumu wa taaluma mbalimbali yanaweza kuwasaidia.<ref name=momsen_2012>{{cite journal |author=Momsen AM, Rasmussen JO, Nielsen CV, Iversen MD, Lund H |title=Multidisciplinary team care in rehabilitation: an overview of reviews |journal=J Rehabil Med |volume=44 |issue=11 |pages=901–12 |year=2012 |month=November |pmid=23026978 |doi=10.2340/16501977-1040 |url=http://www.medicaljournals.se/jrm/content/?doi=10.2340/16501977-1040}}</ref> ===Udhibiti wa mwili=== Imependekezwa kuongeza mazoezi ya kijumla ya mwili, lakini hakuna uhusiano bayana uliotambulika kati ya mazoezi haya na maumivu au ulemavu yanapotumika kama matibabu ya maumivu ya ghafla.<ref name=choi_2010/><ref name=hendrick_2011>{{cite journal |author=Hendrick P, Milosavljevic S, Hale L, ''et al.'' |title=The relationship between physical activity and low back pain outcomes: a systematic review of observational studies |journal=Eur Spine J |volume=20 |issue=3 |pages=464–74 |year=2011 |month=March |pmid=21053026 |pmc=3048226 |doi=10.1007/s00586-010-1616-2 |url=}}</ref> Tafiti za kiwango cha chini hadi za kiwango cha juu zimependekeza kutembea kama njia ya kutibu maumivu ya ghafla.<ref name=hendrick_2010>{{cite journal |author=Hendrick P, Te Wake AM, Tikkisetty AS, Wulff L, Yap C, Milosavljevic S |title=The effectiveness of walking as an intervention for low back pain: a systematic review |journal=Eur Spine J |volume=19 |issue=10 |pages=1613–20 |year=2010 |month=October |pmid=20414688 |pmc=2989236 |doi=10.1007/s00586-010-1412-z |url=}}</ref> Kulingana na [[Mbinu ya McKenzie]] kutibu maumivu ya mgongo ni bora kidogo katika kutibu maumivu ya ghafla ya mgongo, lakini manufaa yake ya muda mfupi hayajaonekana kufaulu kikamilifu.<ref name=casazza_2012/> Kuna ushahidi wa kutosha unaopendekeza matumizi ya [[tibajoto]] kwa maumivu ya mgongo ya ghafla na maumivu sugu kidogo<ref>{{Rejea jarida | last1 = French | first1 = SD. | last2 = Cameron | first2 = M. | last3 = Walker | first3 = BF. | last4 = Reggars | first4 = JW. | last5 = Esterman | first5 = AJ. | title = Superficial heat or cold for low back pain. | journal = Cochrane Database Syst Rev | volume = | issue = 1 | pages = CD004750 | month = | year = 2006 | doi = 10.1002/14651858.CD004750.pub2 | PMID = 16437495 }}</ref> lakini kuna ushahidi mdogo unaopendekeza matumizi ya tibabaridi au tibajoto kwa maumivu sugu.<ref name=middelkoop_2011>{{cite journal |author=van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, van Tulder MW |title=A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain |journal=Eur Spine J |volume=20 |issue=1 |pages=19–39 |year=2011 |pmid=20640863 |doi=10.1007/s00586-010-1518-3 |pmc=3036018}}</ref> Ushahidi dhaifu unapendekeza kuwa mishipi ya kiunoni inaweza kuongeza idadi ya siku za kwenda kazini, ingawa hakuna ushahidi wa kutosha kuonyesha kuwa itasaidia kupunguza maumivu.<ref name=guild_2012/> Matibabu ya sauti kuu na wimbi la sauti hayajatambulika kufaulu, hivyo hayapendekezwi.<ref name=seco_2011>{{cite journal |author=Seco J, Kovacs FM, Urrutia G |title=The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review |journal=Spine J |volume=11 |issue=10|pages=966–77 |year=2011 |month=October |pmid=21482199 |doi=10.1016/j.spinee.2011.02.002 |url=}}</ref><!--Chronic -->[[Matibabu ya mazoezi]] ni bora katika kupunguza maumivu na kuimarisha utendakazi wa mwili katika watu wenye maumivu sugu ya mgongo<ref name=guild_2012/> Mazoezi pia yametambulika kupunguza uwezekano wa maumivu kurejea kwa kipindi cha hadi miezi sita baada ya kukamilisha tiba hii ya mazoezi<ref name=smith_2010>{{cite journal |author=Smith C, Grimmer-Somers K. |title=The treatment effect of exercise programmes for chronic low back pain |journal=J Eval Clin Pract |volume=16 |issue=3 |pages=484–91 |year=2010 |pmid=20438611 |doi=10.1111/j.1365-2753.2009.01174.x}}</ref> na pia kuimarisha utendakazi wa kudumu.<ref name=middelkoop_2011/> Hakuna uhahika kuwa aina moja ya tiba ya mazoezi ni bora kuliko nyingine.<ref name=middelkoop_2010>{{cite journal |author=van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW |title=Exercise therapy for chronic nonspecific low-back pain |journal=Best Pract Res Clin Rheumatol |volume=24 |issue=2 |pages=193–204 |year=2010 |pmid=20227641 |doi=10.1016/j.berh.2010.01.002}}</ref> [[Mbinu ya Alexander]] imekisiwa kufaulu katika kutibu maumivu sugu ya mgongo,<ref name=woodman_2012>{{cite journal |last=Woodman |first=JP |coauthors=Moore, NR |title=Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review. |journal=International journal of clinical practice |date=January 2012 |volume=66 |issue=1 |pages=98–112 |pmid=22171910 |doi=10.1111/j.1742-1241.2011.02817.x}}</ref> na kuna ushahidi wa kutosha unaopendekeza matumizi ya [[yoga]].<ref name=ernst_2011>{{cite journal |last=Posadzki |first=P |coauthors=Ernst, E |title=Yoga for low back pain: a systematic review of randomized clinical trials. |journal=Clinical rheumatology |date=September 2011 |volume=30 |issue=9 |pages=1257–62 |pmid=21590293 |doi=10.1007/s10067-011-1764-8}}</ref> [[Kusisimua neva kupitia ngozi]] hakujatambulika kufaulu katika kutibu maumivu sugu ya mgongo.<ref name=dubinsky_2009>{{cite journal |last1=Dubinsky |first1=R. M. |last2=Miyasaki |first2=J. |title=Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=74 |issue=2 |pages=173–6 |year=2009 |pmid=20042705 |doi=10.1212/WNL.0b013e3181c918fc}}</ref> Utafiti kuhusu matumizi ya soli za ndani za viatu haujatamatishwa.<ref name=sahar_2009/> [[Analjesia ya umeme#Mchangamsho wa neva za pembeni|Mchangamsho wa neva za pembeni]], utaratibu wenye viwango vya chini vya uvamizi neva, ni matibabu yanayoweza kufaulu kwa visa vya maumivu sugu yasiyotibika kwa matibabu mengine, ingawa utafiti unaopendekeza hatua hii haujakamilika, na si bora kwa maumivu yanayosambaa miguuni.<ref name=nizard_2012>{{cite journal |author=Nizard J, Raoul S, Nguyen JP, Lefaucheur JP |title=Invasive stimulation therapies for the treatment of refractory pain |journal=Discov Med |volume=14 |issue=77 |pages=237–46 |year=2012 |month=October |pmid=23114579 |doi= |url=}}</ref> ===Dawa=== Udhibiti wa maumivu ya sehemu ya chini ya mgongo mara nyingi huhusisha kutumia dawa kwa kipindi ambacho zinafanikisha. Katika kutibu kisa cha kwanza cha maumivu ya sehemu ya chini ya mgongo, malengo makuu ni kupata nafuu kabisa. Hata hivyo, ikiwa tatizo litakuwa sugu, lengo linaweza kubadilika kuwa kudhibiti maumivu na kurejesha utendakazi wa mwili haraka iwezekanavyo. Kwa kuwa dawa za kutuliza maumivu ni bora kwa kiasi fulani, malengo ya manufaa ya dawa hizi yanaweza kutofautiana na matokeo halisia, jambo linaloweza kupunguza utoshelezaji.<ref name=miller_2012/>Kwa kawaida, dawa inayopendekezwa mara ya kwanza ni[[acetaminophen]] au[[dawa za kuzuia inflamesheni zisizo na steroidi]] (wala si aspirini), na dawa hizi huwafaa watu wengi. Kipimo cha acetaminophen kinachokubalika huwa ni salama; ingawa kipimo cha juu kinaweza kusababisha [[Kuongezeka kwa sumu|matatizo ya ini]].<ref name=miller_2012/> Dawa za kuzuia inflamesheni zisizo na steroidi ni bora katika kutibu maumivu ya ghafla kuliko acetaminophen. Hata hivyo, kuna hatari kubwa ya kusababisha madhara, ikijumuisha: [[matatizo ya mafigo|matatizo ya mafigo]], [[vidonda vya tumbo]] na uwezekano wa [[magonjwa ya moyo na mishipa|matatizo ya moyo]]. Hivyo, dawa za kuzuia inflamesheni zisozo na steroidi ni chaguo la pili baada ya acetaminophen, inayopendekezwa tu iwapo maumivu hayakushughulikiwa mapema. Dawa za kuzuia inflamesheni zisizo na steroidi hunapatikana katika aina mbalimbali; hakuna utafiti unaopendekeza kutumia[[kizuizi cha COX-2]] kuliko aina yoyote ya dawa ya kuzuia inflamesheni kwa msingi wa manufaa yake.<ref name=miller_2012/> Kwa msingi wa usalama, dawa aina ya [[naproxen]] inaweza kuwa bora zaidi.<ref>{{cite journal|last=Coxib and traditional NSAID Trialists' (CNT)|first=Collaboration|coauthors=Bhala, N; Emberson, J; Merhi, A; Abramson, S; Arber, N; Baron, JA; Bombardier, C; Cannon, C; Farkouh, ME; FitzGerald, GA; Goss, P; Halls, H; Hawk, E; Hawkey, C; Hennekens, C; Hochberg, M; Holland, LE; Kearney, PM; Laine, L; Lanas, A; Lance, P; Laupacis, A; Oates, J; Patrono, C; Schnitzer, TJ; Solomon, S; Tugwell, P; Wilson, K; Wittes, J; Baigent, C|title=Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials.|url=https://archive.org/details/sim_the-lancet_august-31-september-6-2013_382_9894/page/769|journal=Lancet|date=2013 Aug 31|volume=382|issue=9894|pages=769-79|pmid=23726390|doi=10.1016/S0140-6736(13)60900-9}}</ref> [[Kilainisha misuli]] pia kinaweza kunufaisha.<ref name=miller_2012/>Ikiwa maumivu yangali hayajathibitiwa, [[oipioidi]]kama vile [[morphine]] inaweza kutumiwa. Dawa hizi zina hatari ya kusababisha uraibu, na zinaweza kukosa kuchangamana na dawa zingine. Dawa hizi pia zina hatari kubwa ya kusababisha madhara, kama vile kizunguzungu, kichefuchefu, na uyabisi wa utumbo. Opioidi zinaweza kufaa kwa udhibiti wa maumivu makali ya ghafla yanayosababisha matatizo makuu.<ref name=miller_2012/> Makundi ya wataalamu wameshauri dhidi ya matumizi ya muda mrefu ya opioidi kutibu maumivu sugu ya mgongo.<ref name=miller_2012/> Katika watu wazee wenye maumivu sugu, opioidi zinaweza kutumika katika wale wanaoathiriwa vibaya na dawa ya kuzuia inflamesheni zisizo na steroidi, kama vile watu wenye kisukari, matatizo ya tumbo au moyo. Opioidi pia zinaweza kuwa kukinufaisha kikundi fulani cha watu wenye[[maumivu ya neva]].<ref name=de_leon_2013>{{cite journal |author=de Leon-Casasola OA |title=Opioids for chronic pain: new evidence, new strategies, safe prescribing |journal=Am. J. Med. |volume=126 |issue=3 Suppl 1 |pages=S3–11 |year=2013 |month=March |pmid=23414718 |doi=10.1016/j.amjmed.2012.11.011 |url=}}</ref>[[Dawa ya kutuliza mfadhaiko]]inaweza kuwa bora katika kutibu maumivu sugu yenye dalili zinazohusiana na mfadhaiko, lakini ina hatari ya kusababisha madhara.<!--<ref name=miller_2012/> --> Ingawa dawa za kutuliza tukutiko, [[gabapentin]] na [[carbamazepine]], wakati mwingine hutumika kutibu maumivu sugu na zinaweza kutuliza maumivu ya nyonga, hakuna ushahidi wa kutosha kupendekeza matumizi yake.<ref name=miller_2012/> [[Steroidi]] za kumeza hazijathibitishwa kufaulu kutibu maumivu ya sehemu ya chini ya mgongo.<ref name=casazza_2012/><ref name=miller_2012/> Kudunga sehemu ya viunga na kudunga steroidi kwenye diski hakujatibithishwa kuwanufaisha watu wenye maumivu sugu na yasiyosambaa. Hata hivyo, taratibu hizi zinaweza kupendekezwa katika watu wenye maumivu ya nyonga yanayoendelea.<ref name=chou_2009_rehab>{{cite journal |author=Chou R, Loeser JD, Owens DK, Rosenquist RW, Atlas SJ, Baisden J, Carragee EJ, Grabois M, Murphy DR, Resnick DK, Stanos SP, Shaffer WO, Wall EM; American Pain Society Low Back Pain Guideline Panel |title=Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society |url=https://archive.org/details/sim_spine-us_2009-05-01_34_10/page/1066 |journal=Spine |volume=34 |issue=10 |pages=1066–77 |year=2009 |pmid=19363457 |doi=10.1097/BRS.0b013e3181a1390d}}</ref> Kudunga steroidi za ubongo kwenye[[ Epidura]] huimarisha afya, japo kwa muda mfupi kwa njia inayotiliwa shaka katika watu wenye maumivu ya nyonga, lakini hakuna manufaa ya kudumu.<ref name=pinto_2012>{{cite journal |last=Pinto |first=RZ |coauthors=Maher, CG; Ferreira, ML; Hancock, M; Oliveira, VC; McLachlan, AJ; Koes, B; Ferreira, PH |title=Epidural corticosteroid injections in the management of sciatica: a systematic review and meta-analysis.|url=https://archive.org/details/sim_annals-of-internal-medicine_2012-12-18_157_12/page/865 |journal=Annals of internal medicine |date=18 December 2012 |volume=157 |issue=12 |pages=865–77 |pmid=23362516}}</ref> ===Upasuaji=== Upasuaji unaweza kufaa katika watu wenye hania ya diski inayosababisha maumivu makali yanayosambaa miguuni, udhaifu mkuu wa misuli ya miguu, matatizo ya kibofu au kushindwa kuthibiti kinyesi.<ref name=manusov_2012_surg>{{cite journal |last=Manusov |first=EG |title=Surgical treatment of low back pain. |journal=Primary care |date=September 2012 |volume=39 |issue=3 |pages=525–31 |pmid=22958562 |doi=10.1016/j.pop.2012.06.010}}</ref> Upasuaji pia unaweza kufaa katika watu wenye [[stenosisi ya uti wa mgongo]].<ref name=chou_2009_surgery/> Katika visa ambavyo maswala haya hayapo, hakuna ushahidi wa kutosha kuthibisha manufaa ya upasuaji.<ref name=manusov_2012_surg/>[[Utolewaji wa diski]] (Kutoa sehemu ya diski inayosababisha maumivu ya mguu) unaweza kutuliza maumivu haraka kuliko matibabu yasiyohusisha upasuaji.<ref name=manusov_2012_surg/> Utolewaji wa diski hupelekea matokeo bora ukifanywa mwaka wa kwanza, lakini si mwaka wa nne hadi kumi.<ref name=manusov_2012_surg/> Utolewaji wa diski usioingia ndani sana [[utolewaji kadri wa diski]] haujathibitishwa kusababisha matokeo tofauti kuliko utolewaji wa kawaida wa diski.<ref name=manusov_2012_surg/> Katika hali zingine nyingi, hakuna thibitisho la kutosha kupendekeza upasuaji.<ref name=manusov_2012_surg/> Si bayana athari ya kudumu ulio nao upasuaji dhidi ya kuharibika kwa diski.<ref name=manusov_2012_surg/> Upasuaji usioingia ndani ya diski sana hupona haraka, lakini utafiti kuhusu ubora wake hautoshi.<ref name=manusov_2012_surg/> Katika watu wenye maumivu yanayohisiwa kwenye sehemu ya chini ya mgongo pekee kufuatia kuharibika kwa diski, utafiti wa kuaminika umependekeza[[uunganishaji mifupa ya uti wa mgongo]] kuwa sawa na mazoezi mazito, na bora kidogo kuliko hatua nyepesi zisizohusisha upasuaji.<ref name=chou_2009_surgery>{{cite journal |author=Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD |title=Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline |journal=Spine |volume=34 |issue=10 |pages=1094–109 |year=2009 |month=May |pmid=19363455 |doi=10.1097/BRS.0b013e3181a105fc |url=https://archive.org/details/sim_spine-us_2009-05-01_34_10/page/1094}}</ref> Uunganishaji mifupa ya uti wa mgongo unaweza kupendekezwa katika watu wenye maumivu ya mgongo kufuatia[[spondilolisthesisi ya isthmia|hali pokezi ya kuhama kwa pingili]] kwa sababu hali hii haiimariki kwa kutumia matibabu yasiyohusisha upasuaji.<ref name=manusov_2012_surg/> Hata hivyo, ni wachache tu katika watu waliofanyiwa upasuaji wa kuunganisha mifupa ya uti wa mgongo wanaopata matokeo bora.<ref name=chou_2009_surgery/> Kuna taratibu nyingi za upasuaji ili kuunganisha mifupa ya uti wa mgongo,ingawa hakuna utafiti wa kutosha kuthibitisha kwamba mojawapo ni bora kuliko taratibu nyingine.<ref>{{cite journal|last=Lee|first=CS|coauthors=Hwang, CJ; Lee, DH; Kim, YT; Lee, HS|title=Fusion rates of instrumented lumbar spinal arthrodesis according to surgical approach: a systematic review of randomized trials.|journal=Clinics in orthopedic surgery|date=2011 Mar|volume=3|issue=1|pages=39-47|pmid=21369477|doi=10.4055/cios.2011.3.1.39}}</ref> Kuongeza kipandikizi cha uti wakati wa kuunganisha mifupa hiyo huongeza hatari lakini hakuna manufaa zaidi dhidi ya maumivu au utendakazi wa mwili.<ref name=deyo_2009/> ===Matibabu mbadala=== Si wazi ikiwa utunzaji wa[[tibamwili]] au tiba ya[[unyooshaji wa uti wa mgongo]] hupelekea matokeo bora zaidi au chini ya matibabu mengine katika watu wenye maumivu ya mgongo.<ref name=walker_2011>{{cite journal |last=Walker |first=BF |coauthors=French, SD, Grant, W, Green, S |title=A Cochrane review of combined chiropractic interventions for low-back pain |url=https://archive.org/details/sim_spine-us_2011-02-01_36_3/page/230 |journal=Spine |date=1 February 2011 |volume=36 |issue=3 |pages=230–42 |pmid=21248591 |doi=10.1097/BRS.0b013e318202ac73}}</ref> Baadhi ya utafiti umegundua kuwa unyooshaji wa uti wa mgongo hupelekea matokeo sawia au hata bora dhidi ya maumivu na kuwezesha utendakazi, ikilinganishwa na matibabu ya kawaida yanayotumika kwa muda mfupi, muda wa kadri au wa kudumu.<ref name=dagenais_2010>{{cite journal |last1=Dagenais |first1=S |last2=Gay |first2=RE |last3=Tricco |first3=AC |last4=Freeman |first4=MD |last5=Mayer |first5=JM |title=NASS Contemporary Concepts in Spine Care: spinal manipulation therapy for acute low back pain |journal=The spine journal : official journal of the North American Spine Society |volume=10 |issue=10 |pages=918–40 |year=2010 |pmid=20869008 |doi=10.1016/j.spinee.2010.07.389}}</ref><ref name=rubinstein_2011>{{cite journal |journal= [[Cochrane Database Syst Rev]] |year=2011 |issue=2 |pages=CD008112 |title= Spinal manipulative therapy for chronic low-back pain |author= Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW |doi=10.1002/14651858.CD008112.pub2 |pmid=21328304 |url=http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008112.pub2/abstract |volume= |editor1-last= Rubinstein |editor1-first= Sidney M}}</ref> Watafiti wengine walitambua kuwa unyooshaji wa uti wa mgongo si bora katika kupunguza maumivu kuliko matibabu mengine ya kutumia dawa, unyooshaji duni wa maungo, au matibabu mengine. Watafiti hawa walipendekeza kuwa kujumuisha mbinu ya unyooshaji wa uti wa mgongo katika matibabu mengine hupelekea matokeo bora.<ref name=rubinstein_2012>{{cite journal |last=Rubinstein |first=SM |coauthors=Terwee, CB; Assendelft, WJ; de Boer, MR; van Tulder, MW |title=Spinal manipulative therapy for acute low-back pain. |journal=Cochrane database of systematic reviews (Online) |date=12 September 2012 |volume=9 |pages=CD008880 |pmid=22972127 |doi=10.1002/14651858.CD008880.pub2}}</ref><ref name=marlowe_2012>{{cite journal |author=Marlowe D |title=Complementary and alternative medicine treatments for low back pain |journal=Prim. Care |volume=39 |issue=3 |pages=533–46 |year=2012 |month=September |pmid=22958563 |doi=10.1016/j.pop.2012.06.008 |url=}}</ref> Miongozo ya kitaifa imefikia maoni mbalimbali, huku baadhi yao wakikataa kupendekeza unyooshaji wa uti wa mgongo, wengine wakieleza kuwa unyooshaji hutegemea chaguo la mtu, huku wengine wakipendekeza unyooshaji kwa kipindi kifupi katika watu wasioimarishwa na matibabu mengine.<ref name=koes_2010/> [[Unyooshaji wa uti wa mgongo chini ya anestesia]], au unyooshaji kwa usaidizi wa dawa, hauna utafiti wa kutosha ili kuupendekeza kwa ujasiri.<ref name=dagenais_2008>{{cite journal |last1=Dagenais |first1=S |last2=Mayer |first2=J |last3=Wooley |first3=J |last4=Haldeman |first4=S |title=Evidence-informed management of chronic low back pain with medicine-assisted manipulation |journal=The Spine Journal |volume=8 |issue=1 |pages=142–9 |year=2008 |pmid=18164462 |doi=10.1016/j.spinee.2007.09.010}}</ref> Tibapini ni sawa tu na kipoza ungo, utunzaji wa kawaida au [[upasuaji bandia|bandia]] unaohusu tibapini dhidi ya maumivu ya ghafla yasiyo na asili bayana au maumivu sugu kidogo.<ref name=furlan_2012/> Katika watu wenye maumivu sugu, matibabu haya hupunguza maumivu kwa kiwango kidogo kuliko pasipo na matibabu yoyote, na huwa na matokeo sawa na ya kutumia dawa, lakini hayasaidii katika ulemavu.<ref name=furlan_2012/> Manufaa ya dawa hii kwa maumivu hudhihirika baada ya matibabu tu, wala si baadaye katika ufuatilizi.<ref name=furlan_2012>{{cite journal|author=Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, Gagnier J, Ammendolia C, Dryden T, Doucette S, Skidmore B, Daniel R, Ostermann T, Tsouros S |title=A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain |year=2012|journal=Evidence-based complementary and alternative medicine |pmid=22203884 |doi=10.1155/2012/953139 |volume=2012 |pages=953139}}</ref> Tibapini inaweza kuwa hatua bora katika watu wenye maumivu sugu yasiyotatuliwa kwa matibabu mengine kama vile dawa au matibabu yoyote yasiyohusisha upasuaji.<ref name=casazza_2012/><ref name=lin_2011>{{cite journal |author=Lin CW, Haas M, Maher CG, Machado LA, van Tulder MW |title=Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review|journal=Eur Spine J |volume=20 |issue=7 |pages=1024–38 |year=2011 |month=July |pmid=21229367 |pmc=3176706|doi=10.1007/s00586-010-1676-3 |url=}}</ref> Ingawa[[matibabu ya upapasaji]] hayaonekani kupelekea manufaa mengi katika watu wenye maumivu ya ghafla, <ref name=casazza_2012/>upapasaji unaweza kusaidia watu wenye maumivu sugu kidogo, na pia maumivu sugu; hususan ukifanywa pamoja na mazoezi ya mwili na elimu ya afya.<ref name=furlan_2008>{{cite journal |author=Furlan AD, Imamura M, Dryden T, Irvin E |title=Massage for low-back pain|year=2008|journal=Cochrane database of systematic reviews (Online) |pmid=18843627 |doi=10.1002/14651858.CD001929.pub2 |issue=4 |pages=CD001929}}</ref> Utafiti mmoja maarufu umependekeza kuwa tibapini na upapasaji kwa pamoja ni bora kuliko upapasaji pekee.<ref name=furlan_2008/>[[Prolotherafi]] –kudungia viowevu kwenye viunga vya mgongo ili kusababisha inflamesheni, hivyo kuchochea utaratibu wa mwili wa uponyaji – ni mbinu ambayo haijawahi kufaulu ikitumika pekee, lakini inaweza kusaidia inapojumuisha tiba nyingine.<ref name=marlowe_2012/> [[Nurofleksotherapi]], ni matibabu ambapo kipande cha chuma huingizwa chini ya ngozi ya sikio na mgongo. Matibabu haya yamegunduliwa kuwa bora katika kupunguza maumivu ya sehemu ya chini ya mgongo na pia kuimarisha utendakazi wa mgongo wenyewe. Hata hivyo, tafiti zinazopendekeza mbinu hii ni chache.<ref name=marlowe_2012/><ref name=urrutia_2005>{{cite journal |author=Urrútia G, Burton K, Morral A, Bonfill X, Zanoli G |title=Neuroreflexotherapy for nonspecific low back pain: a systematic review |journal=Spine |volume=30 |issue=6 |pages=E148–53 |year=2005 |month=March |pmid=15770167 |doi= |url=}}</ref> Matibabu ya mitishamba kama[[Hapagofitamu|mmea unaobana]] na[[willow nyeupe]]yanaweza kupunguza idadi ya watu wanaoripoti kiwango kikubwa cha maumivu; ingawa katika watu wanotumia dawa za kutuliza maumivu, tofauti yake si kubwa.<ref name=marlowe_2012/> [[Kapsikamu]] – ya muundo wa mafuta au plasta – imetambulika kutuliza maumivu na kuimarisha utendakazi wa mgongo.<ref name=marlowe_2012/> [Matibabu ya kitabia]] yanaweza kusaidia watu wenye maumivu sugu.<ref name=henschke_2010>{{cite journal |author=Henschke N, Ostelo RW, van Tulder MW, ''et al.'' |title=Behavioural treatment for chronic low-back pain |journal=Cochrane Database Syst Rev |volume= |issue=7 |pages=CD002014 |year=2010 |pmid=20614428 |doi=10.1002/14651858.CD002014.pub3 |url=}}</ref> Kuna aina mbalimbali za matibabu haya, ikiwa ni pamoja na [[uratibishaji tabia]], ambayo ni njia ambapo kiimarishi hutumika kupunguza tabia mbaya na kukuza tabia njema; [[matibabu ya utambuzi wa tabia]],ambayo husaidia watu kutambua na kubadilisha mawazo mabaya na tabia; na [[uratibishaji wa mwitikio]], ni hatua zinazoweza kubadilisha mwitikio wa maumivu kisaikolojia kwa mtu binafsi.<!-- ref name=marlowe_2012/ --> Wahudumu wa afya wanaweza kuunda mradi unganifu wa matibabu ya kitabia.<ref name=marlowe_2012/> Utafiti haujaweza kubainii iwapo [[Upunguzaji wa mfadhaiko kupitia uzingatifu]] utapunguza ukali wa maumivu ya mgongo au ulemavu unaohusiana na maumivu ya mgongo. Hata hivyo, utafiti huu unaashiria kuwa hatua hii inaweza kumwezesha mtu kukabiliana na maumivu yaliyopo.<ref name=cramer_2012>{{cite journal |author=Cramer H, Haller H, Lauche R, Dobos G |title=Mindfulness-based stress reduction for low back pain. A systematic review |journal=BMC Complement Altern Med |volume=12 |issue= |pages=162 |year=2012 |pmid=23009599 |pmc=3520871 |doi=10.1186/1472-6882-12-162 |url=}}</ref> ==Matarajio== Kwa kijumla, matokeo ya matibabu ya maumivu ya ghafla ya kiuno huwa mema. Maumivu na ulemavu hutatulika pakubwa katika wiki sita za kwanza, huku asilimia 40 – 90 ya watu wakipona kabisa.<ref name=menezes_2012>{{cite journal |last=Menezes Costa Lda |first=C |coauthors=Maher, CG; Hancock, MJ; McAuley, JH; Herbert, RD; Costa, LO |title=The prognosis of acute and persistent low-back pain: a meta-analysis. |journal=CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne |date=7 August 2012 |volume=184 |issue=11 |pages=E613-24 |pmid=22586331 |doi=10.1503/cmaj.111271 |pmc=3414626}}</ref> Katika watu watakaokuwa na dalili za hali hii baada ya wiki sita, kuimarika kwao huwa taratibu, huku mabadiliko machache yakifikiwa kwa mwaka mmoja. Kufikia mwaka mmoja, kiwango cha maumivu na ulemavu huwa cha chini katika watu wengi. Kwa bahati mbaya, maumivu ya awali ya mgongo na kuridhika kazini hutumika kutabiri matokeo ya maumivu ya mgongo baada ya tukio la ghafla la maumivu.<ref name=menezes_2012/> Matatizo mengine ya kisaikolojia kama vile mfadhaiko au kukosa furaha kufuatia kupoteza kazi kunaweza kuzidisha maumivu ya mgongo kwa muda mrefu.<ref name=miller_2012/> Kurejea kwa maumivu baada ya kisa cha kwanza hutokea katika zaidi ya nusu ya waathiriwa.<ref name=Stanton2010>{{cite journal|last=Stanton|first=TR|coauthors=Latimer, J; Maher, CG; Hancock, MJ|title=How do we define the condition 'recurrent low back pain'? A systematic review.|journal=European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society|date=2010 Apr|volume=19|issue=4|pages=533-9|pmid=19921522|doi=10.1007/s00586-009-1214-3}}</ref> Katika watu wenye maumivu sugu, matokeo ya kipindi kifupi huwa mema, huku kukiwa na mafanikio katika wiki sita za kwanza, lakini kuna mafanikio madogo baadaye. Kufikia mwaka mmoja, watu wenye maumivu sugu huendelea kupata maumivu ya kadri na ulemavu.<ref name=menezes_2012/> Watu walio katika hatari ya kupata ulemavu wa kudumu kwa kipindi kirefu ni pamoja na watu wasio na uwezo wa kukabiliana na maumivu au wanaoogopa kujishugulisha (wana uwezekano wa kupata matokeo mabaya mara 2.5 zaidi kwa mwaka), <ref name=chou_2010>{{cite journal |last1=Chou |first1=R |last2=Shekelle |first2=P |title=Will this patient develop persistent disabling low back pain? |url=https://archive.org/details/sim_jama_2010-04-07_303_13/page/1295 |journal=JAMA: the Journal of the American Medical Association |volume=303 |issue=13 |pages=1295–302 |year=2010 |pmid=20371789 |doi=10.1001/jama.2010.344}}</ref> watu wenye uwezo duni wa kukabiliana na maumivu, ulemavu wa kiutendaji, udhaifu wa afya ya kijumla, au kisababishi kikuu cha kiakili au cha kisaikolojia cha maumivu ([[Dalili za Waddell]]).<ref name=chou_2010/> ==Epidemiolojia== Maumivu ya sehemu ya chini ya mgongo yanayohudumu kwa siku moja na kulemaza kazi ya mtu ni hali inayoripotiwa mara nyingi.<ref name=hoy_2012/>Duniani, takriban 40% ya watu hupata maumivu ya sehemu ya chini ya mgongo wakati mmoja maishani,<ref name=hoy_2012/> huku makadirio yakiwa hata 80% katika watu wa nchi zilizostawi.<ref name=malhotra_2011>{{cite book |author=Vinod Malhotra; Yao, Fun-Sun F.; Fontes, Manuel da Costa |title=Yao and Artusio's Anesthesiology: Problem-Oriented Patient Management |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2011 |pages=Chapter 49 |isbn=1-4511-0265-8 |url=http://books.google.ca/books?id=qOhuwkoN15MC&pg=PT1390}}</ref> Takriban asilimia 9 hadi 12 ya watu (milioni&nbsp;632) hupata maumivu ya mgongo wakati wowote maishani, na karibu robo moja (23.2%) huripoti kuwa wamepata maumivu haya kwa wakati fulani katika kipindi cha mwezi wowote mmoja.<ref name=hoy_2012/><ref name=vos_2012>{{cite journal|last=Vos|first=T|title=Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010.|url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2163|journal=Lancet|date=15 December 2012|volume=380|issue=9859|pages=2163–96|pmid=23245607|doi=10.1016/S0140-6736(12)61729-2}}</ref> Matatizo mara nyingi hutokea kati ya umri wa miaka &nbsp;20 na 40.<ref name=casazza_2012/> Visa vya maumivu ya sehemu ya chini ya mgongo ni vingi katika watu wa umri wa miaka 40-80, huku wastani wa idadi ya watu wanaoathirika ikitarajiwa kuongezeka jinsi watu wanavyoendelea kuzeeka.<ref name=hoy_2012/>Haijulikani wazi iwapo ni wanaume au wanawake wanaoripoti visa vingi vya maumivu ya mgongo.<ref name=hoy_2012/><ref name=vos_2012/> Utafiti wa mwaka wa 2012 uliripoti kima cha 9.6% miongoni mwa wanaume na 8.7% miongoni mwa wanawake.<ref name=vos_2012/> Utafiti mwingine wa mwaka 2012 ulipata kima cha juu kwa wanawake kuliko wanaume. Watafiti walikisia kuwa takwimu hizi huenda zilichangiwa na maumivu kutokana na osteoporosisi, hedhi, na ujauzito miongoni mwa wanawake, au kwa sababu wanawake walikuwa tayari Zaidi kuripoti maumivu kuliko wanaume.<ref name=hoy_2012/> Takriban 70% ya wanawake hupata maumivu ya mgongo katika [[ujauzito]], huku kima cha maumivu kikiongezeka ujauzito unapokomaa.<ref>{{cite book|last=Cunningham|first=F|title=Williams Obstetrics|year=2009|publisher=McGraw Hill Professional|isbn=9780071702850|page=210|url=http://books.google.ca/books?id=PYO2RUc4sQMC&q|edition=23}}</ref> Wavuta sigara katika ujauzito – hususan wanawake wa umri wa kubaleghe – wana uwezekano mkubwa wa kupata maumivu ya mgongo kuliko waliokuwa wakivuta awali, na wanawake waliokuwa wakivuta sigara awali wana uwezekano mkubwa kuliko wale ambao hawajawahi kuvuta.<ref name=shiri_2010>{{cite journal |author=Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E |title=The association between smoking and low back pain: a meta-analysis |journal=Am. J. Med. |volume=123 |issue=1 |pages=87.e7–35 |year=2010 |month=January |pmid=20102998 |doi=10.1016/j.amjmed.2009.05.028 |url=}}</ref> ==Historia== [[File:Harvey Cushing, Doris Ulmann 1920s.jpg|thumb|right|Harvey Williams Cushing, 1920s]] Maumivu ya kiuno yamewaathiri watu tangu [[enzi za shaba]]. Makala ya upasuaji wa kale yanayojulikana kama [[Mafunjo ya Edwin Smith]] katika enzi ya [[1500 KK]] yalieleza kuhusu uchunguzi tambuzi na matibabu ya mkazo wa pingili za uti wa mgongo. [[Hippocrates]] ([[460 KK]] hivi – [[370 KK]] hivi) alikuwa wa kwanza kutumia neno kurejelea maumivu ya [[nyonga]] na ya kiuno; [[Galen]] (enzi za kati hadi mwishoni mwa [[karne ya 2]] [[BK]]) alielezea suala hili kwa kina. Madaktari mwishoni mwa [[milenia ya 1]] hawakujaribu upasuaji wa mgongo. Baadala yake, walipendekeza kusubiri kwa umakinifu. Katika [[enzi za kati]], waganga wa kale walitoa matibabu ya maumivu ya mgongo wakiamini kuwa yalisababishwa na [[mapepo]].<ref name=maharty_2012>{{cite journal |author=Maharty DC |title=The history of lower back pain: a look "back" through the centuries |journal=Prim. Care |volume=39 |issue=3 |pages=463–70 |year=2012 |month=September |pmid=22958555 |doi=10.1016/j.pop.2012.06.002 |url=}}</ref> Mwanzoni mwa [[karne ya 20]], madaktari waliamini kuwa maumivu ya mgongo yalisababishwa na inflamesheni au kuharibika kwa neva,<ref name=maharty_2012/> huku hali ya niuraljia na niuraitisi ikitajika mara nyingi katika fasihi za wakati huo.<ref name=lutz_2003>{{cite journal |author=Lutz GK, Butzlaff M, Schultz-Venrath U |title=Looking back on back pain: trial and error of diagnoses in the 20th century |url=https://archive.org/details/sim_spine-us_2003-08-15_28_16/page/1899 |journal=Spine |volume=28 |issue=16 |pages=1899–905 |year=2003 |month=August |pmid=12923482 |doi=10.1097/01.BRS.0000083365.41261.CF}}</ref> Hata hivyo, katika karne ya 20, imani ya visababishi hivi ilididimia.<ref name=lutz_2003/> Mwanzoni mwa karne wa 20, mpasuaji wa [[mfumoneva]] wa [[Marekani]] [[Harvey Williams Cushing]] aliongeza umaarufu wa matibabu ya maumivu ya mgongo kupitia upasuaji.<ref name=manusov_2012_surg/> Katika [[miaka ya 1920]] na [[Miaka ya 1930|1930]], nadharia geni zilizuka, huku madaktari wakidokeza kuna uhusiano kati ya mfumo wa neva na matatizo ya kisaikolojia kama vile ulegevu wa neva ([[niurasthenia]]) na [[histeria ya wanawake]].<ref name=maharty_2012/> Rimathoidi ya misuli ([[fibromiljia]]) pia ilitajwa sana.<ref name=lutz_2003/> Vifaa vya kisasa vya teknolojia, kama vile [[radiografia|Eksirei]] viliwapa madaktari vifaa vipya vya utambuzi, hivyo kufichua kuwa diski ya kati ya pingili za uti wa mgongo ndizo zilizokuwa chanzo cha maumivu ya mgongo katika baadhi ya visa. Mwaka wa [[1938]] mpasuaji wa mifupa, [[Joseph S. Barr]], aliripoti kuwa maumivu ya nyonga yanayohusiana na diski yaliimarika au kuponywa kupitia upasuaji wa mgongo.<ref name=lutz_2003/> Kufuatia ripoti hii, umbo la mfano wa diski lilitolewa [[miaka ya 1940]],<ref name=maharty_2012/> na kuvuma katika fasihi katika [[miaka ya 1980]] na kusaidia kuzinduliwa kwa pichatiba nyingine kama vile [[Tomografia ya Kompyuta]] na [[Picha za Mwangwi wa Sumaku]].<ref name=lutz_2003/> Mjadala huu ulififia utafiti ulipoonyesha kuwa matatizo ya diski si kisababishi kikuu cha maumivu. Tangu wakati huo, madaktari waligundua kuwa mara nyingi kuna uwezekano ya kisababishi maalumu cha maumivu ya mgongo kutobainika, hivyo wakakosoa haja ya kupata angalau kisababishi kimoja kwa sababu wakati mwingi dalili hizi zilipotea katika wiki 6 hadi 12 matibabu yasipokuwepo au yakiwepo.<ref name=maharty_2012/> ==Jamii na utamaduni== Maumivu ya sehemu ya chini ya mgongo husababisha [[gharama ya kiuchumi]] ya kiwango cha juu. Nchini Marekani, maumivu ya mgongo ni aina kuu ya maumivu katika watu wazima yanayosababisha idadi kubwa ya watu kutokwenda kazini. Halii hii pia ni tatizo kuu la misuli na mifupa linaloripotiwa mara nyingi katika kitengo cha matibabu ya dharura.<ref name=borczuk_2013/>Mwaka wa 1998, ilikadiriwa kuwa gharama ya maumivu haya ni bilioni $90 katika bajeti ya afya ya kila mwaka, huku 5% ya watu wakigharamia kiasi kikubwa zaidi (75%).<ref name=borczuk_2013/> Kati ya 1990 na 2001, kulikuwa na ongezeko la zaidi ya mikunjo miwili ya uunganishaji wa mifupa ya uti wa mgongo nchini Marekani, hata ingawa hakukuwa na mabadiliko ya viashirio vya upasuaji au utafiti kuhusu umuhimu wa upasuaji.<ref name=deyo_2009/> Gharama zaidi huingia kupitia kufifia kwa utendakazi wa mtu na kupata mapato ya chini, huku maumivu ya mgongo yakichangia 40% ya siku zote ambazo watu walikosa kufika kazini nchini Marekani.<ref name=manchikanti_2009_epi>{{cite journal |author=Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA, ASIPP |title=Comprehensive review of epidemiology, scope, and impact of spinal pain |journal=Pain Physician |volume=12 |issue=4 |pages=E35–70 |year=2009 |pmid=19668291 |doi= |url=}}</ref> Maumivu ya mgongo husababisha ulemavu kwa asilimia kubwa ya [[wafanyakazi]] nchini Kanada, Uingereza, Uholanzi na Uswisi kuliko Marekani au Ujerumani.<ref name=manchikanti_2009_epi/> ==Utafiti== [[Athroplasti ya diski|Ubadilishaji wa diski nzima]] ni chaguo la kujaribia,<ref name="hughes_2012" /> lakini hakuna ushahidi wa kutosha unaopendekeza manufaa ya ubadilishaji huu kuliko [[uunganishaji wa mifupa ya kiuno]].<ref name=manusov_2012_surg/> Watafiti wanachunguza uwezekano wa kukuza diski mpya wakitumia [[dawa ya ukuaji]] inayodungwa binadamu; vipandikizo, [[tibaseli]], na [[uhandisi wa tishu]].<ref name="hughes_2012" /> ==Marejeo== {{Reflist|2}} [[Jamii:Afya]] [[Jamii:Mgongo]] 4sh28fe3fk14fqnetoycdd99py2xl3p 14 70555 1577961 921549 2026-07-02T13:02:25Z Riccardo Riccioni 452 1577961 wikitext text/x-wiki [[jamii: Miji ya Misri]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Misri]] jg3j6zych8fo40nytyajapp4mbh34v7 0 70770 1578269 1532752 2026-07-03T10:01:47Z Riccardo Riccioni 452 1578269 wikitext text/x-wiki [[File:Baruch-ben-Neriah.jpg|thumb|220px|Baruku alivyochorwa katika "Promptuarii Iconum Insigniorum".]] [[Image:Baruch (Kirillo-Belozersk).jpg|thumb|right|200px|[[Picha takatifu]] ya [[Kirusian]] ya Baruku.]] '''Nabii Baruku mwana wa Neria''' (kwa [[Kiebrania]] ברוך בן נריה) alikuwa [[mwandishi]] wa [[karne ya 6 KK]], maarufu kama [[karani]], [[mwanafunzi]] na [[rafiki]] mpendwa wa [[nabii Yeremia]]. Tangu kale anaheshimiwa kama [[mtakatifu]] na [[madhehebu]] mbalimbali ya [[Ukristo]]. [[Sikukuu]] yake huadhimishwa kila [[mwaka]] [[tarehe]] [[11 Oktoba]]. ==Maisha== Kadiri ya [[Yosefu Flavius]], alikuwa [[sharifu]] wa [[Uyahudi]], [[Mtoto|mwana]] wa [[Neria]] na [[ndugu]] wa [[Seraia mwana wa Neria]], [[waziri]] wa [[mfalme Zedekia]] wa [[Ufalme wa Yuda]].<ref>[[Yer]] 51:59</ref><ref>"[[Jewish Antiquities]]." x. 9, § 1</ref> Baruku aliandika maneno ya Yeremia alivyoagizwa naye<ref>Yer 36</ref> akabaki mwaminifu kwake hata katika [[dhuluma]]. Yeremia alipokuwa mafichoni alimtuma kusoma katika [[Hekalu la Yerusalemu]] [[utabiri]] wa [[adhabu]] dhidi ya [[mfalme Yehoyakimu]] <ref>Yer 26:1-8</ref> Huenda kama [[shukrani]] kwa kutekeleza agizo hilo gumu, Yeremia alimtabiria mema.<ref>Yer 45</ref> Wote wawili walishuhudia [[maangamizi ya Yerusalemu]] ([[587 KK]]) wakabaki pamoja baada yake<ref>Yer 32</ref><ref>Josephus, "Ant." x. 9, § 1</ref><ref>Yer 43:3)</ref>mpaka walipopelekwa nchini [[Misri]]. Uhusiano huo ulifanya Baruku aheshimiwe sana na vizazi vilivyofuata, hata [[Kitabu|vitabu]] viliandikwa kwa jina lake: * ''[[Kitabu cha Baruku]]'' au ''1 Baruku'', ambacho ni kati ya vile vya [[deuterokanoni]], vinavyoheshimiwa na [[Kanisa Katoliki]] na wengineo kama sehemu ya [[Biblia ya Kikristo]] * ''[[2 Baruku]]'', au ''Ufunuo wa Kisiri wa Baruku'' * ''[[3 Baruku]]'', au ''Ufunuo wa Kigiriki wa Baruku'' * ''[[4 Baruku]]'', au ''Maandishi yaliyobaki ya Yeremia'' ==Tazama pia== *[[Watakatifu wa Agano la Kale]] *[[Orodha ya Watakatifu Wakristo]] *[[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{Reflist}} ==Marejeo== *Wright, J. Edward, ''Baruch ben Neriah: From Biblical Scribe to Apocalyptic Seer'' (University of South Carolina Press, 2003) ISBN 1-57003-479-6 *[[Nahman Avigad|Avigad, Nahman]], ''Jerahmeel & Baruch,'' ''[[Biblical Archaeology Review]]'' 42.2 (1979). 114-118. *[[Hershel Shanks|Shanks, Hershel]], ''Jeremiah's Scribe and Confidant Speaks from a Hoard of Clay Bullae,'' ''Biblical Archaeology Review'' 13.5 (1987) 58-65. *Shanks, Hershel. ''Fingerprint of Jeremiah’s Scribe.'' Biblical Archeology Review 2 (1996): 36-38. *''The Seal of Seraiah,'' ''Eretz Israel'' 14 (1978, Ginsberg festschrift) 86-87. * Baruku katika [[Catholic Encyclopedia]]. ==Viungo vya nje== *[http://ocafs.oca.org/FeastSaintsViewer.asp?SID=4&ID=1&FSID=102745 Prophet Baruch] Eastern Orthodox [[icon]] and [[synaxarion]] {{mbegu-mtu-Biblia}} [[Category:Watu wa Biblia|B]] [[Jamii:Manabii wa Agano la Kale|B]] [[Category:Watakatifu wa Israeli|B]] [[Jamii:Waliofariki karne ya 6 KK]] 6ac4yp74t5jofa6tv2kic4hjrqokst5 0 71717 1578181 1564499 2026-07-03T01:37:42Z InternetArchiveBot 41439 Add 8 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578181 wikitext text/x-wiki [[File:DNA Overview2.png|thumb|right|140px|upright|DNA, msingi wa molekuli kwa ajili ya urithi. Kila ncha ya DNA ni mlolongo wa nyukleotidi, zinazoungana katika sehemu ya kati.]] '''Jenetikia''' (kutoka [[Kigiriki]] [[Kiyunani|cha kale]] γενετικός, genetikos, [[neno]] ambalo tena linatokana na γένεσις, genesis, "[[asili]]"<ref> [http://www.perseus.tufts.edu/cgi-bin/ptext?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3D%2321880 Genetikos, Henry George Liddell, Robert Scott, "A Greek-English Lexicon", at Perseus]</ref><ref>[http://www.perseus.tufts.edu/cgi-bin/ptext?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3D%2321873 Genesis, Henry George Liddell, Robert Scott, "A Greek-English Lexicon", at Perseus]</ref><ref>[http://www.etymonline.com/index.php?search=Genetic&amp;searchmode=none Online Entymology Dictionary]</ref>) ni [[tawi]] la [[biolojia]] linalochunguza [[uritishano]] na [[mwachano]] wa [[viumbe hai]].<ref name="griffiths2000sect60">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.60 |chapter=Genetics and the Organism: Introduction |editor-first=William M.}}</ref><ref name="Hartl_and_Jones"> Hartl D, Jones E (2005)</ref> Kwa namna ya pekee imegundulika kwamba [[chembechembe]] zinazohifadhi [[taarifa]] za [[urithi]] wa viumbe hai zimo katika [[kiini]] cha kila [[seli]] yao kama [[nyuzinyuzi]] zinazoitwa [[kromosomu]]. Hizo zinabeba [[jeni]] kadhaa ambazo kila mojawapo inahusika na urithi wa [[tabia]] na [[umbile]] fulani kutoka kwa wazazi kwenda kwa [[kizazi]] kipya. Ukweli kwamba viumbe hai hurithi sifa kutoka kwa wazazi wao umetumika tangu zamani za kale kuboresha ma[[zao]] ya [[mimea]] na [[wanyama]] kwa njia ya [[uzalishaji teuzi]]. Hata hivyo, [[sayansi]] ya kisasa ya jenetikia, ambayo inajaribu kuelewa utaratibu wa urithi, ilianza tu na kazi ya [[Gregor Mendel]] katikati ya [[karne ya 19]].<ref name="Weiling">{{cite journal |pmid=1887835| doi=10.1002/ajmg.1320400103 |year=1991 |last1=Weiling |first1=F |title=Historical study: Johann Gregor Mendel 1822–1884. |volume=40 |issue=1 |pages=1–25; discussion 26 |journal=American journal of medical genetics}}</ref> Ingawa hakujua msingi halisi wa urithi, Mendel aliona kwamba viumbe hurithi sifa kupitia vitengo maalumu ambavyo sasa vinaitwa jeni. Jeni hufanana na maeneo ndani ya [[DNA]], [[molekuli]] inayoundwa na mlolongo wa [[aina]] nne tofauti za [[nyukleotidi]]. Mpangilio wa nyukleotidi hizo ndio maelezo ya kijeni ambayo viumbe huyarithi. Kwa kawaida DNA ina [[umbo]] la [[ncha]] mbili, ambazo kila moja ina nyukleotidi zinazokamilishana. Kila ncha inaweza kutumika kama [[kiolezo]] katika uumbaji wa ncha nyingine mpya: hii ndiyo njia halisi ya kutengeneza nakala za jeni ambazo zinaweza kurithiwa. Mpangilio wa nyukleotidi katika jeni hutafsiriwa na [[seli]] ili kuzalisha mlolongo wa [[aminoasidi]], hivyo kutengeneza [[protini]]; utaratibu wa aminoasidi katika protini hufanana na utaratibu wa nyukleotidi katika jeni. Uhusiano huo kati ya mpangilio wa nyukleotidi na mpangilio wa aminoasidi hujulikana kama [[kanuni ya maumbile]]. Aminoasidi zilizo katika protini huamua jinsi inavyojikunja katika umbo la pande tatu; kisha, [[utendaji kazi]] wa protini hiyo hutegemea muundo huo. Protini hutekeleza karibu ma[[jukumu]] yote yanayohitajika ili seli ziishi. Mabadiliko ya DNA katika jeni yanaweza kubadilisha aminoasidi za protini, na hivyo kubadilisha umbo lake na utendaji kazi wake: mabadiliko haya yanaweza kuwa na ma[[dhara]] makubwa katika seli na kwa kiumbe kwa jumla. Ingawa jenetikia ina athari kubwa katika sura na tabia za kiumbe, matokeo ya mwisho yanategemea mchanganyiko wa jenetikia na mambo ambayo kiumbe anayapitia wakati wa uhai wake. Kwa mfano, ingawa jeni zinaweza kuamua ukubwa au udogo wa kiumbe, [[lishe]] na mambo mengine ambayo kiumbe hupitia baada ya kuzaliwa pia huwa na athari kubwa. ==Historia== Ingawa sayansi ya jenetikia ilianza na ma[[jaribio]] na [[nadharia]] ya Gregor Mendel katika miaka ya kati ya 1800, nadharia nyingine za urithi zilikuwepo kabla yake. Nadharia maarufu wakati wa Mendel ilikuwa [[dhana]] ya kuchanganya urithi, yaani [[wazo]] la kwamba watu hurithi mchanganyiko laini wa sifa kutoka kwa wazazi wao. Mendel hakukubaliana na wazo hilo na alionyesha kwamba sifa zinajumuisha mchanganyiko wa jeni tofauti kuliko mchanganyiko unaofanana. Nadharia nyingine ambayo ilikuwa imeungwa mkono wakati huo ilikuwa urithi wa sifa zilizopatikana: imani kwamba watu hurithi sifa zilizojengwa na wazazi wao. Nadharia hiyo (ambayo kwa kawaida inahusianishwa na [[Jean-Baptiste Lamarck]]) sasa inajulikana kuwa na makosa.<ref> Lamarck, JB (2008). Katika [[Encyclopedia Britannica|Encyclopædia Britannica]]. Ilirudishwa kutoka [http://www.search.eb.com/eb/article-273180 Encyclopædia Britannica Online] tarehe 16 Machi 2008.</ref> Nadharia nyingine zilikuwa pamoja na [[panjenesisi]] ya [[Charles Darwin]] (ambayo ilikuwa na vipengele vya mambo mtu anayoyapata na yale anayoyarithi) na muundo mpya wa [[Francis Galton]] wa panjenesisi kama nadharia inayohusisha chembechembe na urithi.<ref>Peter J. Bowler, The Mendelian Revolution: The Emergency of Hereditarian Concepts in Modern Science and Society (Baltimore: Johns Hopkins University Press, 1989): sura 2 &amp; 3.</ref> ===Jenetikia ya Mendel na ya kale=== Sayansi ya jenetikia ya kisasa ilianzishwa na [[Gregor Mendel]], [[mmonaki|mtawa]] wa [[Waaugustino|Kiaugustino]] na [[mwanasayansi]] mwenye asili ya [[Kijerumani]] ambaye alichunguza hali ya urithi katika mimea. Katika maandishi yake "Versuche über Pflanzenhybriden" ("Majaribio ya Uvyausaji wa Mimea"), iliyowasilishwa katika mwaka [[1865]] kwa ''Naturforschender Verein'' (Jumuiya ya Utafiti kuhusu Mimea na Viumbe) huko [[Brünn]], Mendel alifuatilia ruwaza za urithi za sifa fulani kwa mimea ya [[njegere]] na kuielezea kupitia [[hisabati]].<ref name="mendel">{{cite web |title= Mendel's Paper in English |url=http://www.mendelweb.org/Mendel.html |first=Roger B. |last=Blumberg}}</ref> Ingawa ruwaza hii ya urithi ingeweza kuonekana katika sifa kadhaa, kazi ya Mendel ilipendekeza kuwa urithi ulikuwa ulihusisha chembechembe, si kupata, na kwamba ruwaza za urithi wa sifa nyingi zinaweza kuelezwa kupitia kanuni na uwiano rahisi. Umuhimu wa kazi ya Mendel haukuweza kueleweka vizuri hadi [[miaka ya 1890]], baada ya [[kifo]] chake, wakati ambapo wanasayansi wengine wakiwa wanashughulikia mambo kama hayo, waligundua upya [[utafiti]] wake. [[William Bateson]], [[mtetezi]] wa kazi ya Mendel, aliunda neno ''jenetikia'' mwaka [[1905]].<ref>genetics, ''n.,'' Oxford English Dictionary, toleo la 3.</ref><ref>{{cite web |url=http://www.jic.ac.uk/corporate/about/bateson.htm |title=Letter from William Bateson to Alan Sedgwick in 1905 |publisher=The John Innes Centre |accessdate=15 Machi 2008 |author=Bateson W |archivedate=2007-10-13 |archiveurl=https://web.archive.org/web/20071013020831/http://www.jic.ac.uk/corporate/about/bateson.htm }}. Kumbuka kwamba barua ilikuwa imeandikiwa Sedgwick Adam, mtaalamu wa zuolojia katika chuo cha Trinity, Cambridge, wala sio "Alan", na asikanganywe na mtaalamu mashuhuri wa jiolojia wa Uingereza, Adam Sedgwick, ambaye aliishi kabla ya wakati huo // hapo awali.</ref> (Kivumishi ''jenetikia'' kilichotokana na neno la Kigiriki ''mwanzo'' - ''γένεσις,'' "asili" na kwamba kutoka kwa neno ''genno'' - ''γεννώ,'' "kujifungua", kinatangulia nomimo na kilitumika kwa mara ya kwanza kwa maana ya kibiolojia mwaka 1860).<ref>genetics, n., Oxford English Dictionary, toleo la 3.</ref> Bateson alieneza matumizi ya neno ''jenetikia'' kuelezea utafiti wa urithi katika [[hotuba]] yake ya [[uzinduzi]] wa Mkutano wa Tatu wa Kimataifa wa Uvyausaji wa Mimea huko [[London]], [[Uingereza]] mwaka [[1906]] <ref name="bateson_genetics">.{{cite conference |author=Bateson, W |title=The Progress of Genetic Research |editor=Wilks, W |booktitle=Report of the Third 1906 International Conference on Genetics: Hybridization (the cross-breeding of genera or species), the cross-breeding of varieties, and general plant breeding|publisher=Royal Horticultural Society |location=London |year=1907}}:Awali lilijulikana kama "Mkutano wa Kimataifa wa Uvyausaji na kuzalishana kwa Mimea", Wilks alibadilisha kichwa cha chapisho kutokana na hotuba ya Bateson.</ref> Baada ya kugunduliwa upya kwa kazi ya Mendel, wanasayansi walijaribu kuamua ni molekuli zipi katika seli zilizohusika na urithi. Mwaka [[1910]] [[Thomas Hunt Morgan]] alisema kuwa jeni ziko juu ya kromosomu, kulingana na matokeo ya mabadiliko ya macho meupe yaliyohusiana na [[jinsia]] katika nzi-tunda.<ref>{{cite journal |doi=10.1093/icb/23.4.855 |title=Thomas Hunt Morgan—The Geneticist |url=https://archive.org/details/sim_integrative-and-comparative-biology_1983_23_4/page/855 |year=1983 |last1=Moore |first1=JOHN A. |journal=Integrative and Comparative Biology |volume=23 |pages=855}}</ref> Mwaka [[1913]] [mwanafunzi]] wake [[Alfred Sturtevant]] alitumia uhusiano wa kijeni kuonyesha kuwa jeni hupangwa kwa ,[[mstari]] kwenye kromosomu.<ref>{{cite journal |author=Sturtevant AH |year=1913 |title=The linear arrangement of six sex-linked factors in Drosophila, as shown by their mode of association |journal=Journal of Experimental Biology |volume=14 |pages=43–59 |url=http://www.esp.org/foundations/genetics/classical/holdings/s/ahs-13.pdf}}</ref><span id="molecular"></span> [[File:Sexlinked inheritance white.jpg|left|thumb|Mawazo ya Morgan kuhusu urithi unaohusishwa na ngono wa mabadiliko uliosababisha nzi za Drosophila kuwa na macho meupe ulimwelekeza kwa nadharia-tete kwamba jeni ziko kwenye kromosomu.]] ===Jenetikia ya molekuli=== Ingawa jeni zilijulikana kuwepo kwenye kromosomu, hizo kromosomu zinajumuisha protini na DNA: wanasayansi hawakujua ni ipi kati ya hizo iliyohusika na urithi. Mwaka [[1928]], [[Frederick Griffith]] aligundua jambo la mabadiliko: bakteria zilizokufa ziliweza kuhamisha nyenzo za kijeni ili "kubadilisha" bakteria zingine zilizokuwa bado hai. Miaka [[kumi]] [[kumi na sita|na sita]] baadaye, mwaka [[1944]], [[Theodore Oswald Avery]], [[Colin McLeod]] na [[Maclyn McCarty]] walitambua [[molekuli]] iliyohusika na mabadiliko ni [[DNA]].<ref name="Avery_et_al"> {{cite journal |doi=10.1084/jem.79.2.137 |title=STUDIES ON THE CHEMICAL NATURE OF THE SUBSTANCE INDUCING TRANSFORMATION OF PNEUMOCOCCAL TYPES: INDUCTION OF TRANSFORMATION BY A DESOXYRIBONUCLEIC ACID FRACTION ISOLATED FROM PNEUMOCOCCUS TYPE III |url=https://archive.org/details/sim_journal-of-experimental-medicine_1944-02_79_2/page/137 |year=1944 |last1=Avery |first1=O. T. |journal=Journal of Experimental Medicine |volume=79 |pages=137 |pmid=19871359 |last2=MacLeod |first2=CM |last3=McCarty |first3=M |issue=2 |pmc=2135445}} Chapisha tena: {{cite journal |pmid=33226 |year=1979 |last1=Avery |first1=OT |last2=Macleod |last3=Mccarty |title=Studies on the chemical nature of the substance inducing transformation of pneumococcal types. Inductions of transformation by a desoxyribonucleic acid fraction isolated from pneumococcus type III. |volume=149 |issue=2 |pages=297–326 |journal=The Journal of experimental medicine |doi=10.1084/jem.149.2.297 |first2=CM |first3=M |pmc=2184805}}</ref> Majaribio ya Hershey-Chase ya mwaka [[1952]] pia yalionyesha kuwa DNA (badala ya protini) ndiyo wenzo wa kijeni wa virusi ambavyo huambukiza bakteria, hivyo kutoa ushahidi zaidi kwamba DNA ndiyo molekuli inayohusika na urithi.<ref>{{cite journal |doi= 10.1085/jgp.36.1.39 |pmid=12981234 |pmc=2147348 |year= 1952 |last1= Hershey |first1= AD |last2= Chase |title= Independent functions of viral protein and nucleic acid in growth of bacteriophage. |url= https://archive.org/details/sim_journal-of-general-physiology_1952-09-20_36_1/page/38 |volume= 36 |issue= 1 |pages= 39–56 |journal= The Journal of general physiology |first2= M}}</ref> [[James D. Watson]] na [[Francis Crick]] walitambua muundo wa DNA mwaka [[1953]], kwa kutumia kazi ya [[kristalografia]] ya [[eksirei]] ya [[Rosalind Franklin]] na [[Maurice Wilkins]] ambayo ilionyesha kuwa DNA ina muundo wa [[msokoto]] (yaani, umbo kama la [[kizibuo]]).<ref>{{cite book |title=The Eighth Day of Creation: Makers of the Revolution in Biology |last=Judson |first=Horace |middle=Freeland |authorlink=Horace Freeland Judson |year=1979 |publisher=Cold Spring Harbor Laboratory Press |isbn=0-87969-477-7 |pages=51–169}}</ref><ref name="watsoncrick_1953a">{{cite journal |url=http://www.nature.com/nature/dna50/watsoncrick.pdf |doi=10.1038/171737a0 |title=Molecular Structure of Nucleic Acids: A Structure for Deoxyribose Nucleic Acid |year=1953 |last1=Watson |first1=J. D. |last2=Crick |journal=Nature |volume=171 |pages=737 |pmid=13054692 |first2=FH |issue=4356}}</ref> Umbo la misokoto miwili lilikuwa na ncha mbili za DNA na nyukleotidi ilikuwa imeangalia ndani, na kila moja ililingana na nyukleotidi kikamilisho kwenye ncha nyingine na kuunda umbo linalofanana na vidato kwenye [[ngazi]] iliyosokotwa.<ref name="watsoncrick_1953b">{{cite journal |url=http://www.nature.com/nature/dna50/watsoncrick2.pdf |doi=10.1038/171964b0 |title=Genetical Implications of the Structure of Deoxyribonucleic Acid |year=1953 |last1=Watson |first1=J. D. |last2=Crick |journal=Nature |volume=171 |pages=964 |pmid=13063483 |first2=FH |issue=4361}}</ref> Umbo hili lilionyesha kuwa maelezo ya kijeni yapo katika mpangilio wa nyukleotidi kwenye kila ncha ya DNA. Umbo hilo pia lilipendekeza njia rahisi ya kurudiarudia: kama ncha hizo zimetenganishwa, ncha zingine mpya za kila ncha iliyotenganishwa zinaweza kuundwa upya kulingana na mpangilio wa ncha za zamani. Ingawa umbo la DNA lilionyesha jinsi urithi unavyofanya kazi, bado haikujulikana jinsi DNA inavyoathiri tabia ya seli. Katika miaka iliyofuata, wanasayansi walijaribu kuelewa jinsi DNA hudhibiti mchakato wa uzalishaji protini. Iligundulika kwamba seli hutumia DNA kama kiolezo ili kujenga kijumbe kinacholingana cha RNA (molekuli iliyo na nyukleotidi, zinazofanana sana na DNA). Mpangilio wa nyukleotidi wa kijumbe RNA hutumiwa kujenga mpangilio wa aminoasidi katika protini; tafsiri hii kati ya mipangilio ya nyukleotidi na aminoasidi hujulikana kama kodi ya kijeni. Tafiti nyingi ziliweza kufanywa kutokana na uelewa huu wa molekuli ya jeni. Uvumbuzi muhimu uliofanywa na [[Frederick Sanger]] mwaka [[1977]]ulikuwa mpangilio wa mlolongo uliokuwa na DNA mwisho. [[Teknolojia]] hii inawaruhusu wanasayansi kusoma mpangilio wa nyukleotidi wa molekuli ya DNA.<ref name="sanger_et_al">{{cite journal |doi=10.1073/pnas.74.12.5463 |pmid=271968 |pmc=431765 |year=1977 |last1=Sanger |first1=F |last2=Nicklen |last3=Coulson |title=DNA sequencing with chain-terminating inhibitors. |url=https://archive.org/details/sim_proceedings-of-the-national-academy-of-sciences-usa_1977-12_74_12/page/5463 |volume=74 |issue=12 |pages=5463–7 |journal=Proceedings of the National Academy of Sciences of the United States of America |first2=S |first3=AR}}</ref> Mwaka [[1983]], [[Kary Banks Mullis]] alitengeneza [[mmenyuko]] wa mlolongo wa [[polimerasi]], hivyo kutoa njia ya haraka ya kutenga na kukuza sehemu maalum ya DNA kutoka kwa mchanganyiko.<ref name="saiki_et_al">{{cite journal |pmid=2999980 |doi=10.1126/science.2999980 |year=1985 |last1=Saiki |first1=RK |last2=Scharf |last3=Faloona |last4=Mullis |last5=Horn |last6=Erlich |last7=Arnheim |title=Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia. |url=https://archive.org/details/sim_science_1985-12-20_230_4732/page/1350 |volume=230 |issue=4732 |pages=1350–4 |journal=Science (New York, N.Y.) |first2=S |first3=F |first4=KB |first5=GT |first6=HA |first7=N}}</ref> Kutoka kwa juhudi za pamoja za "[[Mradi wa Jenomu za Binadamu]]" na juhudi sambamba za binafsi za [[Celera Genomics]], mbinu hizi na zingine zilifikia kilele katika upangiliaji wa jenomu za binadamu mwaka [[2003]].<ref name="human_genome_project"></ref> ==Sifa za urithi== ===Urithi wa kipekee na sheria za Mendel=== [[File:Punnett square mendel flowers.svg|right|thumb|Mraba wa Punnett ulisawirisha ubadilishanaji // uvukaji kati ya mimea miwili ya njegere iliyokuwa na kromosomu tofauti za maua ya rangi ya zambarau (B) na nyeupe (b)]] Katika ngazi yake ya msingi kabisa, urithi katika viumbe hutokea kupitia sifa za kipekee, ziitwazo jeni.<ref name="griffiths2000sect199">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.199 |chapter=Patterns of Inheritance: Introduction |editor-first=William M.}}</ref> Sifa hii ilivumbuliwa kwa mara ya kwanza na Gregor Mendel, ambaye alifanyia utafiti utengaji wa sifa zinazorithika katika mimea ya njegere.<ref name="mendel"></ref><ref name="griffiths2000sect200">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.200 |chapter=Mendel's experiments |editor-first=William M.}}</ref> Katika tafiti zake kuhusu sifa ya rangi ya maua, Mendel aliona kwamba maua ya kila mmea wa njegere yalikuwa ama rangi ya zambarau au nyeupe-lakini kamwe hakukuwa na rangi ya kati ya rangi hizo mbili. Tofauti hizo, matoleo ya kipekee ya jeni moja yanaitwa aleli//aina zinazofanana. Katika kesi ya njegere, ambayo ni [[spishi]] yenye seti mbili za kromosomu, kila mmea una aleli mbili za kila jeni, aleli moja iliyorithiwa kutoka kwa kila mzazi.<ref name="griffiths2000sect484"></ref> Spishi nyingi, ikiwa ni pamoja na binadamu, zina muundo huo wa urithi. Viumbe vyenye seti mbili za kromosomu na vyenye nakala mbili za aleli moja//sawa ya jeni maalum huitwa [[homozigasi]] katika sehemu hiyo ya jeni, wakati viumbe vyenye aleli mbili tofauti za jeni maalum vinaitwa [[heterozigasi]]. Seti ya aleli kiumbe maalum inaitwa [[jenotipu]] yake, wakati sifa zinazoweza kuonekana za kiumbe hicho zinaitwa [[fenotipu]] yake. Wakati viumbe ni heterozigasi kwa jeni, mara nyingi aleli moja husemekana kutawala kwani sifa zake hutawala fenotipu ya kiumbe hicho, wakati aleli nyingine inaitwa [[selipumbazi]] kwani sifa zake hufifia na haziwezi kuonekana. Baadhi ya aleli hazina utawala kamili na badala yake huonyesha ni fenotipu ya kati, au utawala wa pamoja kwa kuonyesha aleli zote mbili kwa wakati moja.<ref name="griffiths2000sect630">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.630 |chapter=Interactions between the alleles of one gene |editor-first=William M.}}</ref> Wakati wa [[jozi]] la viumbe kuzaana, watoto wao kinasibu hurithi aleli moja kati ya hizo mbili kutoka kwa kila mzazi. Matokeo haya ya urithi wa kipekee na utengaji wa aleli kwa pamoja zinajulikana kama [[Sheria ya kwanza ya Mendel]] au [[Sheria ya Utengaji]]. ===Mwandiko na michoro=== [[File:Pedigree-chart-example.svg|thumb|240px|Chati za nasaba za jeni husaidia kufuatilia ruwaza za urithi wa sifa.]] Wataalamu wa jeni hutumia michoro na ishara kueleza urithi. Jeni moja huwakilishwa na herufi moja au herufi kadhaa. Mara nyingi alama ya "+" hutumika kwa aleli ya kawaida ya jeni, isiyobadilika.<ref>{{cite web |url=http://faculty.users.cnu.edu/rcheney/Genetic%20Notation.htm |title=Genetic Notation |first=Richard W. |last=Cheney |accessdate=18 Machi 2008 |archivedate=2006-09-08 |archiveurl=https://web.archive.org/web/20060908110754/http://faculty.users.cnu.edu/rcheney/Genetic%20Notation.htm }}</ref> Katika majaribio ya utungisho na uzalishaji (na hasa wakati wa kujadili sheria za Mendel) wazazi hujulikana kama kizazi "P" na watoto kama kizazi "F1" (watoto wa kwanza). Wakati watoto F1 wanazalishana, watoto wao huitwa kizazi "F2" (watoto wa pili). Mmojawapo wa michoro ambayo hutumika sana kutabiri matokeo ya uzalishaji mtambuka ni [[mraba wa Punnett]]. Wakati wa kufanyia utafiti magonjwa ya binadamu yanayohusiana na jeni, wataalamu mara nyingi hutumia [[chati ya ukoo]] kuwakilisha urithi wa sifa.<ref name="griffiths2000sect229">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.229 |chapter=Human Genetics |editor-first=William M.}}</ref> Chati hizi huonyesha urithi wa sifa katika mti wa nasaba. ===Maingiliano ya jeni mbalimbali=== [[File:Galton-height-regress.png|thumb|right|Urefu wa binadamu sifa changamano ya jeni. Data ya Francis Galton kutoka mwaka [[1889]] inaonyesha uhusiano kati ya urefu wa watoto kama kipengele cha urefu wa wastani wa mzazi. Wakati urefu wa watoto unapolinganishwa, tofauti zinazobaki huonyesha kuwa mazingira pia ni kipengele muhimu katika kuchangia sifa hii.]] Viumbe hai wana maelfu ya jeni, na katika viumbe wanaozaana kupitia ngono jeni hizi hujigawa bila kutegemeana. Hii ina maana kwamba urithi wa aleli ya rangi ya njano au kijani ya njegere haihusiani na urithi wa aleli za maua meupe au ya rangi ya zambarau. Jambo hili, linalojulikana kama "sheria ya pili Mendel" au "Sheria ya ugawaji huru", inamaanisha kwamba aleli za jeni tofauti huchanganywa kati ya wazazi ili kutengeneza watoto walio na michanganyiko mingi na tofauti. (Baadhi ya jeni huwa hazijigawi kivyake, hivyo kuonyesha uhusiano wa kijeni, mada ambayo imejadiliwa katika sehemu nyingine ya makala haya). Mara nyingi jeni tofauti zinaweza kuingiliana kwa njia ambayo inaathiri sifa sawa. Katika mmea wa 'Omphalodes Verna', kwa mfano, kuna jeni iliyo na aleli ambazo huamua rangi ya maua: buluu au majenta. Hata hivyo, jeni nyingine hudhibiti ikiwa maua yana rangi yoyote au ni meupe. Wakati mmea una nakala mbili za aleli nyeupe, maua yake huwa meupe-bila kujali kama jeni ya kwanza ina aleli za rangi ya buluu au majenta. Mwingiliano kati ya jeni huitwa [[epistasisi]], na jeni ya pili hukandamiza ile ya kwanza.<ref name="griffiths2000sect644">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.644 |chapter=Gene interaction and modified dihybrid ratios |editor-first=William M.}}</ref> Sifa nyingi si vipengele vya kipekee (k.m. maua ya rangi ya zambarau au meupe) lakini badala yake ni sifa zinazoendelea (k.m. urefu wa binadamu na rangi ya ngozi yake). Sifa hizi tata hutokana na jeni nyingi.<ref>{{cite journal |pmid=15931374 |doi=10.1172/JCI25421 |year=2005 |last1=Mayeux |first1=R |title=Mapping the new frontier: complex genetic disorders. |url=https://archive.org/details/sim_journal-of-clinical-investigation_2005-06_115_6/page/1404 |volume=115 |issue=6 |pages=1404–7 |journal=The Journal of clinical investigation |pmc=1137013}}</ref> Ushawishi wa jeni hizi huingiliwa kati, kwa viwango tofauti, na mazingira ambayo kiumbe hicho kimepitia. Kiwango ambacho jeni za kiumbe huchangia sifa tata kinaitwa [[urithikaji]].<ref name="griffiths2000sect4009">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.4009 |chapter=Quantifying heritability |editor-first=William M.}}</ref> Kipimo cha urithikaji wa sifa hulingana katika mazingira yanayobadilika zaidi, mazingira yana athari kubwa kwenye tofauti ya jumla ya sifa husika. Kwa mfano, urefu wa binadamu ni [[sifa tata]] iliyo na urithikaji wa asilimia 89 nchini [[Marekani]]. Hata hivyo, huko Nigeria, ambako watu huwa na nafasi tofauti zaidi ya kupata [[lishe bora]] na huduma za [[afya]], urefu una urithikaji wa asilimia 62 tu.<ref>{{cite journal |doi=10.1038/sj.ijo.0801650 |pmid=11443503 |year=2001 |last1=Luke |first1=A |last2=Guo |last3=Adeyemo |last4=Wilks |last5=Forrester |last6=Lowe W |last7=Comuzzie |last8=Martin |last9=Zhu |title=Heritability of obesity-related traits among Nigerians, Jamaicans and US black people. |url=https://archive.org/details/sim_international-journal-of-obesity_2001-07_25_7/page/1034 |volume=25 |issue=7 |pages=1034–41 |journal=International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity |first2=X |first3=AA |first4=R |first5=T |first6=W |first7=AG |first8=LJ |first9=X}}</ref> ==Msingi wa kimolekuli wa urithi== ===DNA na kromosomu=== [[File:DNA chemical structure.svg|thumb|right|Muundo wa molekuli wa DNA. Misingi huungana kupitia mpangilio wa [[hidrojeni]] inayounganisha ncha.]] Msingi wa kimolekuli wa jeni ni deoksiribonyuklei asidi (DNA). DNA imeundwa na mlolongo wa nyukleotidi, ambazo ni za aina nne: [[adenini]] (A), [[sitosini]] (C), [[guanini]] (G), na [[thaimini]] (T). Maelezo ya jeni huwa katika mpangilio wa nyukleotidi hizi, na jeni huwa kama mfululizo wa mpangilio huo katika mnyororo wa DNA.<ref name="Pearson_2006">{{cite journal |pmid=16724031 |doi=10.1038/441398a |year=2006 |last1=Pearson |first1=H |title=Genetics: what is a gene? |url=https://archive.org/details/sim_nature-uk_2006-05-25_441_7092/page/398 |volume=441 |issue=7092 |pages=398–401 |journal=Nature}}</ref> Virusi tu vimeepuka kanuni hii: wakati mwingine virusi hutumia molekuli inayofanana na RNA badala ya DNA kama wenzo wake wa kijenetiki.<ref>{{cite book |title=Microbiology |url=https://archive.org/details/microbiology0001pres |last=Prescott |first=L |year=1993 |publisher=Wm. C. Brown Publishers |isbn=0697013723}}</ref> DNA kwa kawaida hupatikana kama molekuli yenye ncha mbili, zilizojikunja katika sura ya msokoto ulio na sehemu mbili. Kila nyukleotidi katika DNA huambatana na nyukleotidi inayoipendelea ya ncha mkabala: A huambatana na T, na C huambatana na G. Hivyo, katika hali yake ya ncha mbili, kila ncha ina maelezo yote muhimu kama inavyofaa, yasiyohitajika katika ncha iliyoambatana nayo. Muundo huu wa DNA ndio msingi halisi wa urithi: [[urudufishaji]] wa DNA hurudia tena maelezo kwa kugawanya ncha hizo na kutumia kila ncha kama kiolezo cha utengenezaji wa ncha//mwenzi mpya.<ref name="griffiths2000sect1523">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.1523 |chapter=Mechanism of DNA Replication |editor-first=William M.}}</ref> Jeni huwa zimepangwa kwa mstari kando ya minyororo mirefu ya mpangilio wa DNA, iitwayo [[kromosomu]]. Katika [[bakteria]], kila seli kwa kawaida ina kromosomu moja yenye umbo la mviringo, wakati viumbe [[eukaryota]] (ikiwa ni pamoja na mimea na wanyama) wana DNA ambazo zimepangwa katika mistari mingi ya kromosomu. Ncha hizo za DNA mara nyingi huwa ndefu sana; kwa mfano, kromosomu ndefu zaidi ya binadamu ina urefu wa kufikia jozi msingi milioni 247,000,000 .<ref>{{cite journal |doi=10.1038/nature04727 |pmid=16710414 |year=2006 |last1=Gregory |first1=SG |last2=Barlow |last3=Mclay |last4=Kaul |last5=Swarbreck |last6=Dunham |last7=Scott |last8=Howe |last9=Woodfine |title=The DNA sequence and biological annotation of human chromosome 1. |url=https://archive.org/details/sim_nature-uk_2006-05-18_441_7091/page/n82 |volume=441 |issue=7091 |pages=315–21 |journal=Nature |first2=KF |first3=KE |first4=R |first5=D |first6=A |first7=CE |first8=KL |first9=K}}</ref> DNA ya kromosomu inahusishwa na protini za miundo zinazopanga, kuunganisha, na kudhibiti ufikiaji wa DNA, hivyo kutengeneza wenzo uitwao [[kromatini]]; katika viumbe vyenye seli changamano, kromatini kwa kawaida hujumuisha [[nyukleosomu]], makundi ya DNA yaliyozungushwa kwenye misingi ya protini za [[histoni]].<ref> Alberts et al. (2002), [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.608 II.4.][http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.608 DNA and chromosomes: Chromosomal DNA and Its Packaging in the Chromatin Fiber]</ref> Seti kamili ya nyenzo za urithi katika kiumbe (kwa kawaida mchanganyiko wa mipangilio ya DNA ya [[kromosomu]] zote) huitwa [[jenomu]]. Wakati viumbe vyenye seti moja ya kromosomu vina nakala moja tu ya kila kromosomu, wanyama wengi na mimea mingi wana seti mbili za kila kromosomu, hivyo wana nakala mbili za kila jeni.<ref name="griffiths2000sect484">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.484 |chapter=Mendelian genetics in eukaryotic life cycles |editor-first=William M.}}</ref> Aleli mbili za jeni zimewekwa kwenye sehemu zinazofanana za kromatidi za aina moja, kila aleli ikiwa imerithiwa kutoka kwa mzazi tofauti. Kuna upekee kwenye [[kromosomu ya jinsia]], kromosomu zilizo maalum katika wanyama zimetokea. Kromosomu hizo zinahusika katika uamuzi wa jinsia ya kiumbe.<ref name="griffiths2000sect222">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.222 |chapter=Sex chromosomes and sex-linked inheritance |editor-first=William M.}}</ref> Kwa binadamu na wanyama wengine, [[kromosomu Y]] ina jeni chache sana na huchochea ukuaji wa sifa za kijinsia za kiume, wakati [[kromosomu X]] inafanana na kromosomu nyingine na ina jeni nyingi zisizohusiana na uamuzi wa jinsia. Wanawake wana nakala mbili za kromosomu X, lakini wanaume wana kromosomu Y moja na kromosomu X moja tu; tofauti hii katika idadi ya nakala za kromosomu X husababisha ruwaza za urithi zisizo za kawaida za matatizo yanayohusiana na jinsia. ===Uzazi=== Wakati seli zinagawanyika, jenomu yote ya seli hizo hunakiliwa, na kila seli inayotokana na ugawanyikaji huo hurithi nakala moja. Utaratibu huo, uitwao [[mitosisi]], ndio namna rahisi zaidi ya uzazi na ndio msingi wa uzazi usiohusisha ngono. Uzazi usiohusisha ngono pia unaweza kutokea katika viumbe vyenye seli nyingi, hivyo kuzalisha watoto wanaorithi jenomu zao kutoka kwa mzazi mmoja. Watoto walio na jeni zinazofanana kabisa na za mzazi wao huitwa [[kloni]] (kiumbe kilichoumbwa na kimoja bila kujamiana.) Viumbe wenye seli changamano mara nyingi huzaana kupitia ngono na kupata watoto walio na mchanganyiko wa nyenzo za jeni zilizorithiwa kwa wazazi wawili tofauti. Mchakato wa uzazi kupitia ngono hubadilishana kati ya aina zilizo na nakala moja ya jenomu husika (haploidi) na nakala mbili (diploidi).<ref name="griffiths2000sect484"></ref> Seli zilizo na seti moja huungana na kuchanganya jeni kuunda kiini diploid na pea ya kromosomu. Viumbe wenye seti mbili za kromosomu hutengeneza seti moja ya kromosomu kwa kujiga, bila kurudufisha DNA zao, ili kuunda seli zake nyingine ambazo hurithi kila moja ya majozi ya kromosomu kinasibu. Wanyama wengi na mimea mingi huwa na seti mbili za kromosomu katika sehemu kubwa ya maisha yao, na aina zenye seti moja ya kromosomu zikipunguzwa hadi gameti zenye seli moja kama vile [[manii]] au [[ova]]. Ingawa [[bakteria]] huwa hazitumii njia ya uzazi unaohusisha ngono ya seti moja / mbili za kromosomu, zina njia nyingi za kupata maelezo mapya ya jeni. Baadhi ya bakteria zinaweza kuungana, na kuhamisha kipande kidogo cha mviringo cha DNA kwa bakteria nyingine.<ref name="griffiths2000sect1304">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.1304 |chapter=Bacterial conjugation |editor-first=William M.}}</ref> Bakteria pia zinazeza kuchukua vipande ghafi vya DNA vinavyopatikana katika mazingira na kuyaunganisha katika jenomu zao, jambo linalojulikana kama mabadiliko.<ref name="griffiths2000sect1343">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.1343 |chapter=Bacterial transformation |editor-first=William M.}}</ref> Taratibu hizi zinasababisha uhamishaji wa jeni wa mlalo, hivyo kupeleka vipande vya maelezo ya jeni kati ya viumbe ambavyo vinginevyo havihusiani. ===Uunganishaji-tena na uhusiano=== [[File:Morgan crossover 2 cropped.png|thumb|right|Mchoro wa Thomas Hunt Morgan wa 1916 wa uvukaji mara mbili kati ya kromosomu]] Hali ya kromosomu ya kuwa na seti mbili huruhusu jeni zenye kromosomu tofauti kujigawa kivyake wakati wa uzazi kupitia ngono, na kuungana tena ili kuunda mchanganyiko mpya wa jeni. Hata hivyo, jeni zilizoko kwenye kromosomu moja kinadharia haziwezi kuungana tena kamwe, isipokuwa ni mchakato wa [[uvukaji]] wa kromosomu. Wakati wa uvukaji, kromosomu hubadilishana mifululizo ya DNA, hivyo basi kufaulu kuchanganya aleli za jeni kati ya kromosomu.<ref name="griffiths2000sect929">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.929 |chapter=Nature of crossing-over |editor-first=William M.}}</ref> Utaratibo huu wa uvukaji wa kromosomu kwa jumla hutokea wakati wa meiosisi, mfululizo wa mgawanyiko wa seli ambao huunda seli zenye seti mbili za kromosomu. Uwezekano wa uvukaji wa kromosomu kutokea kati ya sehemu mbili maalum kwenye kromosomu unahusiana na umbali kati ya sehemu hizo. Kwa umbali mrefu kwa njia isiyo na msingi, uwezekano wa uvukaji uko juu vya kutosha, hivi kwamba urithi wa jeni hauhusiani kwa njia inayofaa. Hata hivyo, kwa jeni ambazo zimekaribiana kwa pamoja, uwezekano wa uvukaji ulio chini unamaanisha kuwa jeni hizo zinaonyesha uhusiano wa kijeni: aleli za jeni hizo mbili zinaelekea kurithiwa kwa pamoja. Kiasi cha uhusiano kati ya mfululizo wa jeni kinaweza kuunganishwa ili kuunda ramani ya uhusiano wa kimstari ambayo huelezea kwa makisio mpangilio wa jeni kando ya kromosomu.<ref name="griffiths2000sect899">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.899 |chapter=Linkage maps |editor-first=William M.}}</ref> ==Udhihirishaji wa jeni== ===Msimbo-jeni=== [[File:Genetic code.svg|thumb|right|Msimbo jeni: DNA, kupitia mjumbe wa kati wa RNA, husimbia protini kwa misimbo ya aina tatu.]] Kwa jumla jeni huonyesha athari zake za kiutendaji kazi kupitia uzalishaji protini, ambazo ni molekuli changamano zinazohusika katika shughuli nyingi zinazofanyika katika seli. Protini ni mfululizo wa aminoasidi, na mpangilio wa DNA ya jeni (kupitia [[kiingiliakati]] cha RNA) hutumika kuzalisha mpangilio maalum wa protini. Utaratibu huo kuanza kwa uzalishaji wa molekuli ya RNA iliyo na mpangilio unaolingana na ule wa DNA ya jeni, mchakato unaoitwa [[unukuzi]] yaani kunakili. Kisha molekuli ya RNA inayotumika kama mjumbe hutumiwa kuzalisha mpangilio wa aminoasidi zinazofanana kupitia mchakato uitwao "kutafsiri". Kila kundi la nyukleotidi tatu kwenye mpangilio, unaoitwa [[codon]], hufanana na moja ya aminoasidi ishirini zilizo kwenye protini na zinazoweza kutokea; kufanana huku kunaitwa [[msimbo-jeni]].<ref>{{cite book |title=Biochemistry |author=Berg JM, Tymoczko JL, Stryer L, Clarke ND |edition=5th |year=2002 |publisher=W. H. Freeman and Company |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=stryer.section.685 |chapter=I. 5. DNA, RNA, and the Flow of Genetic Information: Amino Acids Are Encoded by Groups of Three Bases Starting from a Fixed Point}}</ref> Mtiririko wa maelezo haufuati mwelekeo maalum: maelezo hupitishwa kutoka mpangilio wa nyukleotidi hadi kwenye mpangilio wa aminoasidi wa protini, lakini kamwe hauhamishwi kutoka protini na kurudi tena kwenye mpangilio wa DNA, jambo ambalo [[Francis Crick]] aliliita [[dogma kuu]] ya biolojia ya molekuli.<ref name="crick1970">{{cite journal |pmid=4913914 |url=http://www.nature.com/nature/focus/crick/pdf/crick227.pdf |year=1970 |last1=Crick |first1=F |title=Central dogma of molecular biology. |volume=227 |issue=5258 |pages=561–3 |journal=Nature |doi=10.1038/227561a0}}</ref> Mpangilio maalum wa aminoasidi husababisha umbo la pekee lenye pande tatu kwa protini husika, na miundo ya protini yenye pande tatu inahusiana na utendaji kazi wa protini hizo.<ref> Alberts et al. (2002), [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.388 I.3.][http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.388 Proteins: The Shape and Structure of Proteins]</ref><ref> Alberts et al. (2002), [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.452 I.3.][http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.452 Proteins: Protein Function]</ref> Nyingine ni molekuli zenye miundo sahili, kama nyuzi zinazoundwa na [[kolajeni]] za protini. Protini zinaweza kujifungilia kwa protini nyingine na [[molekuli sahili]], wakati mwingine zilifanya kazi kama [[Kimeng'enya|vimeng'enya]] kwa kuwezesha mmenyuko wa kemikali ndani ya molekuli zilizofungwa (bila kubadilisha muundo wa protini yenyewe). Muundo wa protini una nguvu; [[himoglobini]] ya protini hujikunja katika aina zilizo tofauti kidogo ikiwa inawezesha kukamatwa, kusafirishwa, na kutolewa kwa molekuli za oksijeni ndani ya damu ya [[mamalia]]. Tofauti moja ya nyukleotidi ndani ya DNA inaweza kusababisha mabadiliko katika mpangilio wa aminoasidi ya protini. Kwa kuwa miundo ya protini hutokana na mpangilio wa aminoasidi zake, baadhi ya mabadiliko yanaweza kubadili kwa ghafla tabia za protini kwa kuvuruga muundo au kubadilisha uso wa protini kwa njia ambayo inabadilisha mahusiano yake na protini nyingine na molekuli. Kwa mfano, [[anemia selimundu]] ni ugonjwa wa binadamu unaohusiana na jeni na ambao husababishwa na tofauti moja kwenye msingi ndani ya eneo la kusimba la sehemu ya β-globin la himoglobini, hivyo kusababisha badiliko la aminoasidi ambalo hubadilisha tabia halisi za himoglobini.<ref>{{cite web |title=How Does Sickle Cell Cause Disease? |url=http://sickle.bwh.harvard.edu/scd_background.html |date=11 Aprili 2002 |accessdate=23 Julai 2007 |publisher=Brigham and Women's Hospital: Information Center for Sickle Cell and Thalassemic Disorders}}</ref> Matoleo ya anemia selimundu hujitenga, huku yakijiweka kwa vituta vinavyounda nyuzi ambazo hupotosha umbo ya [[seli nyekundu]] za damu zinazobeba protini. Seli hizo zilizo na umbo la [[mundu]] haziwezi tena kupita vizuri katika mishipa ya damu, hivyo kuwa na tabia ya kuziba au kuharibu, na kusababisha matatizo ya kitabibu yanayohusiana na ugonjwa huu. Baadhi ya jeni hunakiliwa katika RNA lakini hazitafsiriwi na kuwa bidhaa za protini: molekuli kama hizo za RNA zinaitwa [[RNA zisizosimba]]. Katika kesi nyingine, bidhaa hizo hujikunja na kuwa miundo ambayo inashiriki katika kazi muhimu za seli (kwa mfano [[RNA za ribosomu]] na [[RNA hamishi]]). RNA zinaweza pia kuwa na athari za kudhibiti kupitia mahusiano ya [[uvyausaji]] na molekuli nyingine za RNA (k.m. [[mikroRNA]]). ===Maumbile dhidi ya malezi=== [[File:Niobe050905-Siamese Cat.jpeg|thumb|upright|Paka wa kabila la [[Siamese]] wana mabadiliko ambayo hutokana na [[joto]] katika uzalishaji wa [[pigmenti]].]] Ingawa jeni huwa na maelezo yote ambayo kiumbe hutumia ili kufanya kazi, mazingira huwa na mchango muhimu katika kuamua fenotipu ya mwisho, jambo ambalo mara nyingi hujulikana kama "maumbile dhidi ya malezi". Fenotipu ya viumbe hutegemea mahusiano ya jenetiki na mazingira. Mfano mmoja ni kesi ya mabadiliko yanayohusiana na [[joto-hisi]]. Mara nyingi, badiliko moja la aminoasidi katika mpangilio wa protini huwa halibadilishi tabia za protini hiyo na mwingiliano wake na molekuli nyingine, lakini huwa linavuruga muundo. Katika mazingira yenye kiwango cha juu cha [[Halijoto|joto]], ambapo molekuli zinasonga kwa kasi zaidi na kugongana, mambo haya husababisha protini kupoteza muundo wake na kushindwa kufanya kazi. Hata hivyo, katika mazingira yenye kiwango cha chini cha joto, muundo wa protini ni thabiti na huwa inafanya kazi kama kawaida. Aina hii ya mabadiliko huonekana katika rangi ya ngozi ya aina ya paka inayoitwa Siamese, ambapo mabadiliko katika kimeng'enya kinachohusika na utoaji rangi hukifanya kivurugike na kipoteze uwezo wa kufanya kazi katika viwango vya joto vya juu<ref>{{cite journal |doi=10.1111/j.1365-2052.2005.01409.x |pmid=16573534 |year=2006 |last1=Imes |first1=DL |last2=Geary |last3=Grahn |last4=Lyons |title=Albinism in the domestic cat (Felis catus) is associated with a tyrosinase (TYR) mutation. |volume=37 |issue=2 |pages=175–8 |journal=Animal genetics |first2=LA |first3=RA |first4=LA |pmc=1464423}}</ref>Protini hiyo huendelea kufanya kazi katika maeneo ya ngozi ambayo yana viwango vya joto vya chini (miguu, ma[[sikio]], [[mkia]], na [[uso]], hivyo paka huyu ana manyoya meusi katika sehemu hizo. Mazingira pia huwa na athari kubwa katika madhara ya ugonjwa wa binadamu unaohusiana na jeni wa [[feniketonuria]].<ref>{{cite web |url=http://www.nlm.nih.gov/medlineplus/phenylketonuria.html |title=MedlinePlus: Phenylketonuria |accessdate=15 Machi 2008 |publisher=NIH: National Library of Medicine}}</ref> Mabadiliko yanayosababisha feniketonuria huvuruga uwezo wa mwili wa kuyeyusha aminoasidi [[fenilalanini]], na husababisha kukusanyika kwa [[sumu]] ya molekuli ya kati ambayo, kwa upande mwingine, husababisha [[dalili]] kali za [[ulemavu wa akili]] na mishtuko ya [[moyo]] zinazoendelea kuenea. Hata hivyo, kama mtu mwenye mabadiliko ya feniketonuria atafuata mwongozo kamili wa [[chakula]] ambao unaepuka aminoasidi hiyo, atakuwa na afya nzuri na ataendelea na maisha yake kama kawaida. Njia maarufu ya kupima kiasi cha athari ya mazingira na malezi ni kutazama kwa makini mapacha wanaofanana na wasiofanana au ndugu waliozaliwa kwa nyakati mbalimbali.{{Citation needed|date=Oktoba 2009}} Kwa sababu ndugu wanaofanana kabisa hutoka kwa [[zaigoti]] moja, nao huwa na jeni sawa. Kumbe ndugu wasiofanana wana jeni tofauti kama ilivyo kwa ndugu wa kawaida. Kwa kulinganisha mara ngapi mmojawapo wa mapacha ana tatizo sawa na mwenzake kati ya mapacha wanaofanana na wale wasiofanana, wanasayansi wanaweza kuona kama athari nyingi zinazotokana na mazingira au malezi. Mfano mmoja maarufu wa utafiti wa watoto waliozaliwa wakiwa zaidi ya wawili ni mapacha wanne wa Genain, waliokuwa wanafanana wote na kutambuliwa wana dhiki ileile.<ref name="Genain">{{cite book |title=The Genain quadruplets;a case study and theoretical analysis of heredity and environment in schizophrenia. |url=https://archive.org/details/genainquadruplet0000rose |last= Rosenthal |first=David |year= 1964 |publisher=Basic Books |location=New York |isbn= B0000CM68F}}</ref> ===Usawazishaji wa jeni=== Jenomu ya kiumbe fulani huwa na maelfu ya jeni, lakini si jeni hizo zote zinahitajika kuhaja ya kuwa hai wakati wowote. Jeni hupatikana wakati inanakiliwa katika [[mRNA]] (na kutafsiriwa katika protini), na kuna njia nyingi za mkononi za kudhibiti usemi wa jeni vile protini ni zinazozalishwa tu wakati zinahitajika kwa seli. Vipengele vya kunakili ni [[protini rekebishi]] zinazojifunga na kuanza jeni, ama kukuza au kuzuia unakili wa jeni.<ref>{{cite journal |pmid=11823631 |doi=10.1126/science.1066355 |year=2002 |last1=Brivanlou |first1=AH |last2=Darnell Je |title=Signal transduction and the control of gene expression. |volume=295 |issue=5556 |pages=813–8 |journal=Science (New York, N.Y.) |first2=JE}}</ref><ref> Alberts et al. (2002), [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.1269#1270 II.3.][http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mboc4.section.1269#1270 Control of Gene Expression – The Tryptophan Repressor Is a Simple Switch That Turns Genes On and Off in Bacteria]</ref> [[File:Zinc finger DNA complex.png|thumb|upright|left|Vipengele vya unakili hujifunga kwenye DNA, na kuathiri unakili wa jeni zinazohusishwa.]] Tofauti katika upatikanaji wa jeni hasa huonekana wazi ndani ya viumbe wenye seli nyingi, ambapo seli zote huwa na jenomu sawa lakini miundo na tabia tofauti sana kutokana na upatikanaji wa seti tofauti za jeni. Seli zote katika viumbe wenye seli nyingi hutoka kwa seli moja, na kugawanyika katika aina tofauti za seli hutokana na ishara za nje na ndani ya seli na kuanzisha ruwaza tofauti za upatikanaji wa jeni, polepole, ili kuunda tabia tofauti. Kwa kuwa hakuna jeni moja ambayo inaweza kutengeneza miundo ndani ya viumbe vilivyo na seli nyingi, ruwaza hizi hutokana na mahusiano changamano kati ya seli nyingi. Ndani ya [[Eukaryota|viumbe wenye seli zilizo na miundo changamano]] kuna sehemu za miundo za kromatini ambazo huathiri unakili wa jeni, mara nyingi kupitia marekebisho ya DNA na kromatini ambayo hurithiwa kwa njia thabiti na seli zinazotengenezwa.<ref>{{cite journal |doi=10.1038/ng1089 |pmid=12610534 |year=2003 |last1=Jaenisch |first1=R |last2=Bird |title=Epigenetic regulation of gene expression: how the genome integrates intrinsic and environmental signals. |volume=33 Suppl |pages=245–54 |journal=Nature genetics |first2=A}}</ref> Sehemu hizo zinaitwa "[[epijenetiki]]" kwa sababu zipo "juu" ya mpangilio wa DNA na huhifadhi urithi kutoka kizazi kimoja cha seli hadi kizazi kingine. Kwa sababu ya sehemu hizo epijenetiki, aina tofauti za seli zilizokuzwa ndani ya mazingira mamoja zinaweza kuhifadhi tabia tofauti sana. Ingawa sehemu za epijenetiki kwa jumla zina nguvu juu ya mkondo wa ukuaji, baadhi yake, kama suala la mabadiliko maalum ambapo aleli moja ya heterozigasi hubadilisha ile nyingine kabisa, lina urithi unaohusisha vizazi vingi na hupatikana kama mambo yasiyo ya kawaida kwa kanuni ya jumla ya DNA kama msingi wa urithi.<ref>{{cite journal |doi=10.1016/j.cell.2007.02.007 |pmid=17320501 |year=2007 |last1=Chandler |first1=VL |title=Paramutation: from maize to mice. |url=https://archive.org/details/cell_2007-02-23_128_4/page/641 |volume=128 |issue=4 |pages=641–5 |journal=Cell}}</ref> ==Mabadiliko ya jeni== ===Migeuko=== [[File:Gene-duplication.png|thumb|upright|Utoaji tena wa jeni huruhusu [[uanuwaishaji]] kwa kutoa urudufishaji: jeni moja inaweza kubadilika na kupoteza utendaji kazi wake wa awali bila kukidhuru kiumbe.]] Wakati wa mchakato wa urudufishaji wa DNA, mara kwa mara makosa hutokea katika [[upolimishaji]] wa ncha ya pili. Makosa hayo, yaitwayo mabadiliko, yanaweza kuwa na athari kwenye fenotipu ya kiumbe, hasa kama yatatokea katika mpangilio wa usimbaji wa protini, wa jeni. Viwango vya makosa kwa kawaida huwa chini sana (kosa 1 katika kila misingi milioni 10-100) kutokana na uwezo wa "[[usahihishaji prufu]]" wa polimerasi za DNA.<ref name="griffiths2000sect2706">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.2706 |chapter=Spontaneous mutations |editor-first=William M.}}</ref><ref name="Kunkel">{{cite journal |doi=10.1038/sj.emboj.7600158 |pmid=15057282 |year=2004 |last1=Freisinger |first1=E |last2=Grollman |last3=Miller |last4=Kisker |title=Lesion (in)tolerance reveals insights into DNA replication fidelity. |volume=23 |issue=7 |pages=1494–505 |journal=The EMBO journal |first2=AP |first3=H |first4=C |pmc=391067}}</ref> (Bila usahihishaji prufu viwango vya makosa vingekuwa juu sana; kwa sababu virusi vingi hutegemea polimerasi za DNA na RNA, ambazo hazina uwezo wa kusahihisha prufu, hivyo huwa na viwango vya juu vya mabadiliko). Michakato ambayo huongeza kasi ya mabadiliko katika DNA huitwa [[mutajeniki]]: kemikali zinazohusika na mutajeniki huendeleza makosa katika urudufishaji wa DNA, mara nyingi kwa kuingilia muundo wa uambatanishaji-msingi, huku [[mnururisho]] wa UV ukichochea mabadiliko kwa kusababisha uharibifu kwa muundo wa DNA.<ref name="griffiths2000sect2727">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.2727 |chapter=Induced mutations |editor-first=William M.}}</ref> Uharibifu unaosababishwa na kemikali kwenye DNA pia hutokea kiasili, na seli hutumia utaratibu wa kutengeneza DNA ili kutengeneza sehemu zozote zilizounganishwa vibaya na kuvunjika katika DNA; hata hivyo, utengenezaji wakati mwingine hushindwa kurudisha DNA katika mpangilio wake asili. Katika viumbe vinavyotumia uvukaji wa kromosomu ili kubadilishana DNA na kuunganisha jeni tena, makosa katika mfungamano wakati wa meiosisi pia yanaweza kusababisha mabadiliko.<ref name="griffiths2000sect2844">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.2844 |chapter=Chromosome Mutation I: Changes in Chromosome Structure: Introduction |editor-first=William M.}}</ref> Makosa katika uvukaji hasa yanaweza kutokea wakati mipangilio inayofanana inasababisha kromosomu zilizo pamoja kuchukua mfungamano ulio na makosa; jambo hili huwa linafanya baadhi ya maeneo katika jenomu kuwa na uwezo mkubwa wa kuathiriwa na mabadiliko kwa njia hiyo. Makosa hayo huunda mabadiliko makubwa kwenye muundo katika mpangilio wa DNA-urudufishaji, mageuzo au kufutwa kwa maeneo yote, au ubadilishaji kimakosa wa sehemu nzima kati ya kromosomu tofauti (jambo liitwalo [[ubadilishaji eneo]]). ===Uteuzi wa kimaumbile na mageuko=== Mabadiliko hubadilisha jenotipu ya kiumbe na mara kwa mara mabadiliko hayo husababisha fenotipu tofauti kuonekana. Mabadiliko mengi yana athari ndogo juu ya fenotipu, afya au uzima wa uzazi katika kiumbe. Mabadiliko ambayo huwa na athari kwa kawaida hufuta, lakini mara kwa mara baadhi ya mabadiliko yanaweza kuwa na faida. Utafiti katika [[nzi]] aina ya ''Drosophila melanogaster'' unapendekeza kwamba ikiwa mabadiliko yatabadilisha protini iliyozalishwa na jeni, karibu asilimia 70 ya mabadiliko hayo yatakuwa hatari, yaliyosalia yakiwa ama hayana madhara yoyote au yana manufaa madogo.<ref>{{cite journal |pmid=17409186 |doi=10.1073/pnas.0701572104 |year=2007 |last1=Sawyer |first1=SA |last2=Parsch |last3=Zhang |last4=Hartl |title=Prevalence of positive selection among nearly neutral amino acid replacements in Drosophila. |url=https://archive.org/details/sim_proceedings-of-the-national-academy-of-sciences-usa_2007-04-17_104_16/page/6504 |volume=104 |issue=16 |pages=6504–10 |journal=Proceedings of the National Academy of Sciences of the United States of America |first2=J |first3=Z |first4=DL |pmc=1871816}}</ref> [[File:Eukaryote tree.svg|thumb|left|Mti wa mageuko ya viumbe wenye seli nyingi, uliotengenezwa kwa kulinganisha jeni kadhaa zilizotoka moja kwa moja kwa jeni moja asilia]] Jenetikia wa idadi hutafiti usambazaji wa tofauti za kijeni katika watu na jinsi usambazaji huo unavyobadilika kadiri wakati unavyopita.<ref name="griffiths2000sect3842">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.3842 |chapter=Variation and its modulation |editor-first=William M.}}</ref> Mabadiliko katika mara ambayo aleli inatokea katika idadi ya watu, wanyama na mimea hasa huathiriwa na [[uteuzi asili]], ambapo aleli fulani hutoa faida ya kiuteuzi au kiuzazi kwa kiumbe,<ref name="griffiths2000sect3886">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.3886 |chapter=Selection |editor-first=William M.}}</ref> pamoja na mambo mengine kama vile [[mkondo wa jeni]], [[uteuzi bandia]] na uhamaji.<ref name="griffiths2000sect3906">{{cite book |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=iga.section.3906 |chapter=Random events |editor-first=William M.}}</ref> Kupita vizazi vingi, jenomu ya viumbe inaweza kubadilika kwa kiasi kikubwa, na hivyo kusababisha mageuko. Uteuzi kwa mabadiliko yaliyo na manufaa unaweza kusababisha spishi kugeuka na kuwa aina bora zinazoweza kuishi katika mazingira yake, mchakato uitwao marekebisho.<ref name="Darwin"> {{cite book |last=Darwin |first=Charles |authorlink = Charles Darwin |year=1859 |title=On the Origin of Species |place=London |publisher=John Murray |edition=1st |pages=1 |url=http://darwin-online.org.uk/content/frameset?itemID=F373&viewtype=text&pageseq=16 |isbn=0801413192}} . Mawazo ya hapo awali yaliyohusiana yalikubaliwa katika {{cite book |last=Darwin |first=Charles |authorlink = Charles Darwin |year=1861 |title=On the Origin of Species |place=London |publisher=John Murray |edition=3rd |pages=xiii |url=http://darwin-online.org.uk/content/frameset?itemID=F381&viewtype=text&pageseq=20 |nopp=true |isbn=0801413192}}</ref> Spishi mpya hutengenezwa kwa njia ya mchakato wa mageuko yanayosababisha kuwepo kwa spishi mpya, sanasana yanayosababishwa na utenganishaji wa kijiografia unaozuia idadi za wanyama na mimea kubadilishana jeni.<ref name="Gavrilets">{{cite journal |pmid=14628909 |doi=10.1554/02-727 |year=2003 |last1=Gavrilets |first1=S |title=Perspective: models of speciation: what have we learned in 40 years? |url=https://archive.org/details/sim_evolution_2003-10_57_10/page/n2 |volume=57 |issue=10 |pages=2197–215 |journal=Evolution; international journal of organic evolution}}</ref> Matumizi ya kanuni za kijeni katika utafiti wa biolojia na mageuko ya idadi ya wanyama na mimea yanajulikana kama usanisi wa kisasa. Kwa kulinganisha [[homolojia]] kati ya aina tofauti za jenomu za spishi inawezekana kuhesabu umbali wa mageuko baina ya spishi hizo na wakati ambapo zinaweza kuwa ziliachana (utaratibu huo unaitwa [[saa ya molekuli]]).<ref>{{cite journal |pmid=12175808 |doi=10.1016/S0168-9525(02)02744-0 |year=2002 |last1=Wolf |first1=YI |last2=Rogozin |last3=Grishin |last4=Koonin |title=Genome trees and the tree of life. |url=https://archive.org/details/sim_trends-in-genetics_2002-09_18_9/page/472 |volume=18 |issue=9 |pages=472–9 |journal=Trends in genetics : TIG |first2=IB |first3=NV |first4=EV}}</ref> Ulinganishaji wa jeni kwa jumla hufikiriwa kuwa mbinu sahihi zaidi ya utambazi-sifa za uhusiano kati ya spishi kuliko ulinganifu wa tabia za kifenotipu. Mageuko ya umbali baina ya spishi yanaweza kutumika kutengenezea miti inayoonyesha mageuko; miti hiyo huwakilisha asili moja na kuachana kwa spishi kadiri muda unavyokwenda, ingawa haionyeshi uhamishaji wa nyenzo za jeni kati ya spishi zisizo na uhusiano (jambo linalojulikana kama uhamishaji jeni wa mlalo na ambao hutokea sana katika bakteria). ==Utafiti na teknolojia== ===Viumbe vielelezi na jenetikia=== [[File:Drosophila melanogaster - side (aka).jpg|thumb|right|[[Nzi-tunda]] wa kawaida (Drosophila melanogaster) ni kiumbe maarufu anayetumiwa kama mfano katika utafiti wa jeni.]] Ingawa wataalamu wa jeni mwanzoni walikuwa wakitafiti urithi katika aina mbalimbali za viumbe, watafiti walianza kufanya utafiti maalum wa jenetikia ya vikundi maalum vya viumbe. Ukweli kwamba utafiti mpana wa kiumbe maalum tayari ulikuwepo ulihimiza watafiti wapya kumchagua kiumbe huyo wamfanyie utafiti zaidi, na hatimaye viumbe kadhaa waliotumika kama mfano wakawa msingi wa tafiti nyingi za jeni.<ref>{{cite web |url=http://www.loci.wisc.edu/outreach/text/model.html |title=The Use of Model Organisms in Instruction |accessdate=15 Machi 2008 |publisher=University of Wisconsin: Wisconsin Outreach Research Modules |archivedate=2008-03-13 |archiveurl=https://web.archive.org/web/20080313023531/http://www.loci.wisc.edu/outreach/text/model.html }}</ref> Mada zinazotafitiwa sana katika jenetikia wa viumbe ni pamoja na utafiti wa jeni kanuni na ushiriki wa jeni katika maendeleo na [[kansa]]. Kati ya sababu zilizozingatiwa katika uchaguzi wa viumbe kuna ufupi wa muda kati ya vizazi pamoja na uendeshaji rahisi wa jeni. Hizo zilifanya baadhi ya viumbe kuwa zana maarufu katika utafiti. Viumbe vilivyotumika sana kama mifano ni pamoja na bakteria inayopatikana kwenye tumbo ''Escherichia coli'', mmea wa ''Arabidopsis thaliana', [[chachu]] inayotumiwa katika [[ukokaji]] ("Saccharomyces cerevisiae"), [[nematodi]] ''Caenorhabditis elegans', nzi-tunda wa kawaida ("Drosophila melanogaster"), na [[panya]] wa kawaida wa nyumbani ("Mus musculus"). ===Utafiti wa kimatibabu wa jenetikia=== Jenetikia ya kimatibabu hujaribu kuelewa jinsi tofauti katika jeni zinavyohusiana na afya na maradhi ya binadamu.<ref>{{cite web| url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=gnd&ref=sidebar| title=NCBI: Genes and Disease| publisher=NIH: National Center for Biotechnology Information| accessdate=15 Machi 2008}}</ref> Wakati wa kutafuta jeni ambayo haijulikani na ambayo inaweza kuwa imehusika na ugonjwa, kwa kawaida watafiti hutumia uhusiano katika jeni na chati za ukoo wa jeni ili kupata eneo kwenye jenomu linalohusiana na ugonjwa husika. Katika ngazi ya idadi ya wanyama na mimea, watafiti hutumia uchaguzi wa kinasibu wa Mendel kutafuta maeneo katika jenomu yanayohusishwa na ugonjwa, mbinu ambayo hasa ni muhimu kwa ajili ya sifa za jeni nyingi ambazo hazifafanuliwi wazi na jeni moja.<ref>{{cite journal |doi=10.1093/ije/dyg070 |pmid=12689998 |year=2003 |last1=Davey Smith |first1=G |last2=Ebrahim |title='Mendelian randomization': can genetic epidemiology contribute to understanding environmental determinants of disease? |url=https://archive.org/details/sim_international-journal-of-epidemiology_2003-02_32_1/page/1 |volume=32 |issue=1 |pages=1–22 |journal=International journal of epidemiology |first2=S}}</ref> Baada ya jeni inayoshukiwa kuhusika kupatikana, mara nyingi utafiti zaidi hufanyiwa kuhusu jeni inayofanana (inayoitwa jeni iliyotoka moja kwa moja katika jeni asilia) katika viumbe vinavyotumiwa kama mfano. Mbali na kutafitia magonjwa yanayohusiana na jeni, upatikanaji ulioongezeka wa mbinu za utambuzi wa aina ya jeni umesababisha kuwepo kwa taaluma ya [[famakojenetikia]] ili kutafiti jinsi aina ya jeni inavyoweza kuathiri matokeo ya madawa.<ref>{{cite web |url=http://www.nigms.nih.gov/Initiatives/PGRN/Background/FactSheet.htm |title=Pharmacogenetics Fact Sheet |accessdate=15 Machi 2008 |publisher=NIH: National Institute of General Medical Sciences |archivedate=2008-05-12 |archiveurl=https://web.archive.org/web/20080512012316/http://www.nigms.nih.gov/Initiatives/PGRN/Background/FactSheet.htm }}</ref> Watu hutofautiana katika uwezekano uliorithiwa wa kupatwa na kansa,<ref> http://www.ncbi.nlm.nih.gov/pubmed/15510167</ref> na kansa ni ugonjwa unaohusiana na jeni.<ref>[154] ^ {{cite book| author=Strachan T, Read AP| title=Human Molecular Genetics 2| year=1999| publisher=John Wiley & Sons Inc.| edition=second}} [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hmg.chapter.2342 Chapter 18: Cancer Genetics]</ref> Mchakato wa ukuaji wa kansa katika mwili ni mchanganyiko wa matukio. Mara kwa mara mabadiliko hutokea ndani ya seli katika mwili wakati zinajigawa. Ingawa mabadiliko hayo hayatarithiwa na mtoto yeyote, yanaweza kuathiri tabia ya seli, wakati mwingine yakizifanya zikue na kujigawanya mara nyingi zaidi. Kuna taratibu za kibiolojia ambazo hujaribu kusimamisha mchakato huo; ishara hutumwa kwa seli inayojigawa visivyo ambayo inachochea kifo cha seli, lakini wakati mwingine mabadiliko ziada hutokea ambayo huzifanya seli ziupuuze ujumbe huo. Mchakato wa ndani ya uteuzi asilia hutokea ndani ya mwili na hatimaye mabadiliko hujilimbikiza ndani ya seli na kukuza ukuaji wa seli hizo, hivyo kujenga vivimbe vyenye kansa ambavyo hukua na kushambulia [[tishu]] mbalimbali za mwili. ===Mbinu za utafiti=== DNA inaweza kutawaliwa kiufundi katika [[maabara]]. Vimeng'enya vya uzuiaji ni aina ya [[Kimeng'enya|vimeng'enya]] ambayo hutumiwa sana na mabyo huikata DNA kwa mpangilio maalum, hivyo kuzalisha vipande vinavyoweza kutabirika vya DNA.<ref> Lodish et al. (2000), [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mcb.section.1582 Chapter 7: 7.1.][http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mcb.section.1582 DNA Cloning with Plasmid Vectors]</ref> Vipande vya DNA vinaweza kuonekana kupitia matumizi ya [[elektroforesisi]] ya jeli, ambayo hutenganisha vipande kwa kuzingatia urefu wake. Matumizi ya vimeng'enya ligation huruhusu vipande vya DNA kushikamana, na kwa nguvu ya DNA ligating pamoja kutoka vyanzo mbalimbali, watafiti wanaweza kujenga DNA recombinant. Mara nyingi zinazohusiana na iliyopita viumbe genetiskt, DNA recombinant ni kawaida kutumika katika mazingira ya-fupi mviringo DNA vipande plasmids na wachache jeni ya juu yao. Kwa kuingiza plazmidi katika bakteria na kukuza bakteria hizi kwenye [[sahani za aga]] (ili kutenga seli za bakteria zilizoumbwa bila kuhusisha kujamiana), watafiti wanaweza kukuza kipande cha DNA kilichoingizwa kupitia uumbaji usiohusisha kujamiana (mchakato unaojulikana kama uumbaji wa molekuli usiohusisha kujamiana). (Neno kukloni, yaani kuumba bila kuhusisha kujamiana, pia linaweza kurejelea utengenezaji wa viumbe kwa njia hii, kupitia mbinu mbalimbali.) [[File:Ecoli colonies.png|thumb|right|175px|Vikundi vya E. coli kwenye sahani ya aga, ni mfano wa utengenezaji wa seli bila kujamiana na mara nyingi hutumika katika utengenezaji wa aina hii wa molekuli.]] DNA pia inaweza kukuzwa kwa kutumia utaratibu uitwao maitikio ya mfululizo ya polimerasi (PCR).<ref> Lodish et al. (2000), [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=PCR&amp;rid=mcb.section.1718 Chapter 7: 7.7.][http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=PCR&amp;rid=mcb.section.1718 Polymerase Chain Reaction: An Alternative to Cloning]</ref> Kwa kutumia mipangilio mifupi na maalum ya DNA, utaratibu wa PCR unaweza kutenga na kukuza kipeo eneo lengwa la DNA. Kwa sababu inaweza kukuza kutoka kiasi kidogo mno cha DNA, PCR mara nyingi pia hutumika kugundua kuwepo kwa mwandamano maalum DNA. ===Mpangilio wa DNA na jenomiki=== Mojawapo ya teknolojia za msingi zilizotengenezwa kuchunguza jenetikia, upangaji DNA huruhusu watafiti kuamua mpangilio wa nyukleotidi katika vipande vya DNA. Mpangilio maalum wa upangaji DNA uliobuniwa na [[Frederick Sanger]] na wenzake mwaka [[1977]], sasa hutumika mara kwa mara kupanga vipande vya DNA.<ref>{{cite book |author=Brown TA |title=Genomes 2 |edition=2nd |year=2002 |isbn=1 85996 228 9 |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=genomes.section.6452 |chapter=Section 2, Chapter 6: 6.1. The Methodology for DNA Sequencing |publisher=Bios |location=Oxford}}</ref> Teknolojia hiyo imewawezesha watafiti kuchunguza mipangilio ya molekuli inayohusishwa na magonjwa mengi ya binadamu. Kutokana na kupungua kwa gharama ya upangaji, watafiti wamepanga jenomu za viumbe wengi, kwa kutumia zana za kuhesabu ili kuunganisha mipangilio ya vipande vingi tofauti (mchakato uitwao [[ukusanyaji jenomu]]).<ref>[159] ^ Brown (2002), [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=genomes.section.6481 Section 2, Chapter 6: 6.2.][http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=genomes.section.6481 Assembly of a Contiguous DNA Sequence]</ref> Teknolojia hizo zilitumika kupanga jenomu ya binadamu, na kusababisha kukamilika kwa Mradi wa Jenomu ya Binadamu mwaka [[2003]].<ref name="human_genome_project">{{cite web |url=http://www.ornl.gov/sci/techresources/Human_Genome/home.shtml |title=Human Genome Project Information |accessdate=15 Machi 2008 |publisher=Human Genome Project |archive-date=2008-03-15 |archive-url=https://web.archive.org/web/20080315062131/http://www.ornl.gov/sci/techresources/Human_Genome/home.shtml |url-status=dead }}</ref> Teknolojia mpya zinapunguza kwa kasi gharama ya upangaji wa DNA, huku watafiti wengi wakitumaini kupunguza gharama ya upangaji upya wa jenomu ya binadamu hadi [[dola]] elfu.<ref>{{cite journal |doi=10.1126/science.311.5767.1544 |pmid=16543431 |year=2006 |last1=Service |first1=RF |title=Gene sequencing. The race for the $1000 genome. |url=https://archive.org/details/sim_science_2006-03-17_311_5767/page/1544 |volume=311 |issue=5767 |pages=1544–6 |journal=Science (New York, N.Y.)}}</ref> Kiasi kikubwa cha data ya mpangilio kinachoweza kupatikana kimesababisha taaluma ya [[jenomiki]], utafiti ambao hutumia zana za hesabu kutafuta na kuchunguza ruwaza katika jenomu kamili ya viumbe. Taaluma ya jenomiki pia inaweza kuchukuliwa kama tawi la taaluma ya [[bioinfomatiki]], ambayo hutumia mbinu za hesabu kuchambua seti kubwa za data ya biolojia. ==Tanbihi== {{reflist}} ==Marejeo== * {{Rejea kitabu |author=Alberts B, Johnson A, Lewis J, Raff M, Roberts K, and Walter P |title=Molecular Biology of the Cell |edition=4th |year=2002 |isbn=0-8153-3218-1 |publisher=Garland Science |location=New York}} * {{Rejea kitabu |editor1-first=Anthony J. F. |editor1-last=Griffiths |editor2-first=Jeffrey H. |editor2-last=Miller |editor3-first=David T. |editor3-last=Suzuki |editor4-first=Richard C. |editor4-last=Lewontin |editor5-last=Gelbart |title=An Introduction to Genetic Analysis |url=https://archive.org/details/introductiontoge0000unse_v1d3 |year=2000 |isbn=0-7167-3520-2 |edition=7th |publisher=W. H. Freeman |location=New York |editor-first=William M.}} * {{Rejea kitabu |author=Hartl D, Jones E |title=Genetics: Analysis of Genes and Genomes |url=https://archive.org/details/genetics00dani |edition=6th |publisher=Jones & Bartlett |year=2005 |isbn=0-7637-1511-5}} * {{Rejea kitabu |author=Lodish H, Berk A, Zipursky LS, Matsudaira P, Baltimore D, and Darnell J |title=Molecular Cell Biology |url=https://archive.org/details/molecularcellbio00lodi |edition=4th |year=2000 |isbn=0-7167-3136-3 |publisher=Scientific American Books |location=New York}} * {{Rejea kitabu |editor1-first=Guenther |editor1-last=Witzany |title=Natural Genetic Engineering and Natural Genome Editing |year=2009|publisher=Annals of the New York Academy of Sciences |location=New York |isbn=1573317659}} ISBN 978-57331-765-8 [http://onlinelibrary.wiley.com/doi/10.1111/nyas.2009.1178.issue-1/issuetoc] [[Category:Jenetikia]] [[Category:Tiba]] 1yy3faxjl9jnh33opwhmev8lkdtl9ls 0 71721 1578046 1506637 2026-07-02T16:14:13Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578046 wikitext text/x-wiki {{otheruses2|Pai}} [[Picha:Pi-unrolled-720.gif|thumb|350px|Duara yenye kipenyo cha 1 ina mzingo mwenye urefu wa <big>π</big> ]] [[Picha:Pi eq C over d.svg|alt=A diagram of a circle, with the width labeled as diameter, and the perimeter labeled as circumference|thumb|right|350px|Uwiano wa [[urefu]] wa [[mzingo]] na ule wa [[kipenyo]] ni 3 na kitu. Uwiano kamili unaitwa π, pai.]] '''Pai''' ([[jina]] la [[herufi]] ya [[Kigiriki]] '''[[π]]''') ni [[namba]] ya [[duara]] kwa maana ya [[uwiano]] wa [[urefu]] wa [[mzingo (jiometria)|mzingo]] na ule wa [[kipenyo]]. Jinsi ilivyo kawaida kwa [[herufi]] mbalimbali za [[Kigiriki]], pai pia inatumika kama [[kifupisho]] kwa ajili ya [[maarifa]] na [[dhana]] za [[hesabu]] na [[fisikia]]. Imejulikana hasa kama namba ya duara. Ikiandikwa inanaza 3.141592653589793238462643... lakini haiwezi kuandikwa kamili kwa kuongeza tarakimu baada ya nukta maana hakuna mwisho. Namba za aina hii zisizo sehemu ya namba nyingine au ambazo haziwezi kuonyeshwa kuwa wianisho safi baina namba kamili huitwa [[namba zisizowiana]]. [[Chamkano]] cha 22/7 ni karibu zaidi na pai na 355/113 ni karibu zaidi tena. [[Wanahisabati]] duniani husheherekea [[sikukuu ya Pi|sikukuu ya pai]] tarehe [[14 Machi]] au pia [[22 Julai]]. == Marejeo == {{Reflist|20em}} {{refbegin|30em}} * {{cite book|last=Arndt|first=Jörg|last2=Haenel|first2=Christoph|title=Pi Unleashed|publisher=Springer-Verlag|year=2006|isbn=978-3-540-66572-4 <!--isbn only volume 1-->|url=http://books.google.com/?id=QwwcmweJCDQC&printsec=frontcover#v=onepage&q&f=false|ref=harv|accessdate=2013-06-05}} English translation by Catriona and David Lischka. * {{cite book|last=Ayers|first=Frank|title=Calculus|publisher=McGraw-Hill|year=1964|isbn=978-0-070-02653-7|ref=harv}} * {{cite book|last=Berggren|first=Lennart|last2=Borwein|first2=Jonathan|author2-link=Jonathan Borwein|last3=Borwein|first3=Peter|author3-link=Peter Borwein|title=Pi: a Source Book|publisher=Springer-Verlag|year=1997|isbn=978-0-387-20571-7|ref=harv}} * {{cite book|last=Beckmann|first=Peter|title=History of Pi|url=https://archive.org/details/historyofpisymbo00beck|publisher=St. Martin's Press|year=1989|origyear=1974|isbn=978-0-88029-418-8|ref=harv}} * {{cite book|last=Borwein|first=Jonathan|author1-link=|last2=Borwein|first2=Peter|author2-link=|title=Pi and the AGM: a Study in Analytic Number Theory and Computational Complexity|url=https://archive.org/details/piagmstudyinanal0000borw|publisher=Wiley|year=1987|isbn=978-0-471-31515-5|ref=harv}} * {{cite book|last=Boyer|first=Carl B.|last2=Merzbach|first2=Uta C.|year=1991|title=A History of Mathematics|url=https://archive.org/details/historyofmathema00boye|edition=2|publisher=Wiley|isbn=978-0-471-54397-8|ref=harv}}<!-- Year from ISBN. Original citatation was just to Boyer. Possible that edition is wrong and therefore page is wrong. Editions: Boyer 1968, Boyer/Merzbach 1989, Boyer/Merzbach 1991, Merzbach/Boyer 2010, Merzbach/Boyer 2011. Verify second: Hui and 3072-sided polygon is on cited page 202 of 1991 edition; page 228 of 1968 edition. Google snippet has a hit for 3.1456 on page 168 for 1991, but does not show the number. --> * {{cite book|last=Bronshteĭn|first=Ilia|last2=Semendiaev|first2=K. A.|title=A Guide Book to Mathematics|url=https://archive.org/details/guidebooktomathe0000bron_o8p0|publisher=H. Deutsch|year=1971|isbn= 978-3-871-44095-3|ref=harv}} * {{cite book|last=Eymard|first=Pierre|last2=Lafon|first2=Jean Pierre|title=The Number Pi|publisher=American Mathematical Society|year=1999|isbn=978-0-8218-3246-2|ref=harv}}, English translation by Stephen Wilson. * {{cite book|last=Joseph|first=George Gheverghese|title=The Crest of the Peacock: Non-European Roots of Mathematics|publisher=Princeton University Press|year=1991|isbn=978-0-691-13526-7|url=http://books.google.com/?id=c-xT0KNJp0cC&printsec=frontcover#v=onepage&q&f=false%7C|ref=harv|accessdate=2013-06-05}}<!-- This ISBN is for the third edition from 2011! --> * {{cite book|last=Posamentier|first=Alfred S.|last2=Lehmann|first2=Ingmar|title=Pi: A Biography of the World's Most Mysterious Number|url=https://archive.org/details/pi00alfr_0|publisher=Prometheus Books|year=2004|isbn=978-1-59102-200-8|ref=harv}} * {{cite journal|last=Reitwiesner|first=George|title=An ENIAC Determination of pi and e to 2000 Decimal Places|journal=Mathematical Tables and Other Aids to Computation|year=1950|volume=4|issue= 29|pages=11–15|doi=10.2307/2002695|ref=harv }} * {{cite journal|last=Roy|first=Ranjan|title=The Discovery of the Series Formula for pi by Leibniz, Gregory, and Nilakantha|url=https://archive.org/details/sim_mathematics-magazine_1990-12_63_5/page/291|journal=Mathematics Magazine|volume=63|issue=5|year=1990|pages=291–306|doi=10.2307/2690896|ref=harv }} * {{cite journal|last=Schepler|first=H. C.|title=The Chronology of Pi|url=https://archive.org/details/sim_mathematics-magazine_january-february-1950_23_3/page/165|journal=Mathematics Magazine|publisher=Mathematical Association of America|year=1950|volume=23|issue=3|pages=165–170 (Jan/Feb), 216–228 (Mar/Apr), and 279–283 (May/Jun)|doi=10.2307/3029284|ref=harv }}. [<!-- http://www.jstor.org/stable/3029284 -->http://www.jstor.org/discover/10.2307/3029284 issue 3 Jan/Feb], [http://www.jstor.org/stable/3029832 issue 4 Mar/Apr], [http://www.jstor.org/stable/3029000 issue 5 May/Jun] * {{cite book|last=Blatner|first=David|title=The Joy of Pi|publisher=Walker & Company|year=1999|isbn=978-0-8027-7562-7|doi= }} * [[Jonathan Borwein|Borwein, Jonathan]] and [[Peter Borwein|Borwein, Peter]], "The Arithmetic-Geometric Mean and Fast Computation of Elementary Functions", ''SIAM Review'', '''26'''(1984) 351–365 * Borwein, Jonathan, Borwein, Peter, and [[David H. Bailey|Bailey, David H.]], ''Ramanujan, Modular Equations, and Approximations to Pi or How to Compute One Billion Digits of Pi", ''The American Mathematical Monthly'', '''96'''(1989) 201–219 * [[Chudnovsky brothers|Chudnovsky, David V.]] and [[Chudnovsky brothers|Chudnovsky, Gregory V.]], "Approximations and Complex Multiplication According to Ramanujan", in ''Ramanujan Revisited'' (G.E. Andrews et al. Eds), Academic Press, 1988, pp 375–396, 468–472 * Cox, David A., "The Arithmetic-Geometric Mean of Gauss", ''L' Ensignement Mathematique'', '''30'''(1984) 275–330 * [[Jean-Paul Delahaye|Delahaye, Jean-Paul]], "Le Fascinant Nombre Pi", Paris: Bibliothèque Pour la Science (1997) ISBN 2-902918-25-9 * Engels, Hermann, "Quadrature of the Circle in Ancient Egypt", ''Historia Mathematica'' '''4'''(1977) 137–140 * [[Leonhard Euler|Euler, Leonhard]], "On the Use of the Discovered Fractions to Sum Infinite Series", in ''Introduction to Analysis of the Infinite. Book I'', translated from the Latin by J. D. Blanton, Springer-Verlag, 1964, pp 137–153 * Heath, T. L., ''The Works of Archimedes'', Cambridge, 1897; reprinted in ''The Works of Archimedes with The Method of Archimedes'', Dover, 1953, pp 91–98 * [[Christiaan Huygens|Huygens, Christiaan]], "De Circuli Magnitudine Inventa", ''Christiani Hugenii Opera Varia I'', Leiden 1724, pp 384–388 * [[Lam Lay Yong|Lay-Yong, Lam]] and Tian-Se, Ang, "Circle Measurements in Ancient China", ''Historia Mathematica'' '''13'''(1986) 325–340 * [[Ferdinand von Lindemann|Lindemann, Ferdinand]], [http://gdz.sub.uni-goettingen.de/index.php?id=11&PPN=PPN235181684_0020&DMDID=DMDLOG_0031&L=1 "Ueber die Zahl pi"] {{Wayback|url=http://gdz.sub.uni-goettingen.de/index.php?id=11&PPN=PPN235181684_0020&DMDID=DMDLOG_0031&L=1 |date=20150122054610 }}, ''Mathematische Annalen'' '''20'''(1882) 213–225 * Matar, K. Mukunda, and Rajagonal, C., "On the Hindu Quadrature of the Circle" (Appendix by K. Balagangadharan). ''Journal of the Bombay Branch of the Royal Asiatic Society'' '''20'''(1944) 77–82 * [[Ivan M. Niven|Niven, Ivan]], "A Simple Proof that pi Is Irrational", ''Bulletin of the American Mathematical Society'', '''53''':7 (July 1947), 507 * [[Srinivasa Ramanujan|Ramanujan, Srinivasa]], "Modular Equations and Approximations to π", ''Quarterly Journal of Pure and Applied Mathematics'', '''XLV''', 1914, 350–372. Reprinted in G.H. Hardy, P.V. Seshu Aiyar, and B. M. Wilson (eds), ''Srinivasa Ramanujan: Collected Papers'', 1927 (reprinted 2000), pp 23–29 * [[William Shanks|Shanks, William]], ''Contributions to Mathematics {{sic|hide=y|Comprising}} Chiefly of the Rectification of the Circle to 607 Places of Decimals'', 1853, pp. i–xvi, 10 * [[Daniel Shanks|Shanks, Daniel]] and [[John Wrench|Wrench, John William]], "Calculation of pi to 100,000 Decimals", ''Mathematics of Computation'' '''16'''(1962) 76–99 * Tropfke, Johannes, ''Geschichte Der Elementar-Mathematik in Systematischer Darstellung'' (''The history of elementary mathematics''), BiblioBazaar, 2009 (reprint), ISBN 978-1-113-08573-3 * [[François Viète|Viete, Francois]], ''Variorum de Rebus Mathematicis Reponsorum Liber VII. F. Viete, Opera Mathematica'' (reprint), Georg Olms Verlag, 1970, pp 398–401, 436–446 * [[Stan Wagon|Wagon, Stan]], "Is Pi Normal?", ''The Mathematical Intelligencer'', '''7''':3(1985) 65–67 * [[John Wallis|Wallis, John]], ''Arithmetica Infinitorum, sive Nova Methodus Inquirendi in Curvilineorum Quadratum, aliaque difficiliora Matheseos Problemata'', Oxford 1655–6. Reprinted in vol. 1 (pp 357–478) of ''Opera Mathematica'', Oxford 1693 * Zebrowski, Ernest, ''A History of the Circle: Mathematical Reasoning and the Physical Universe'', Rutgers Univ Press, 1999, ISBN 978-0-8135-2898-4 {{refend}} == Viungo vya nje == {{Commons category}} * {{dmoz|Science/Math/Recreations/Specific_Numbers/Pi/Digits/|Digits of Pi}} * [http://mathworld.wolfram.com/Pi.html "pai"] at Wolfram Mathworld * [http://www.wolframalpha.com/input/?i=Representations+of+Pi Representations of pai] at [[Wolfram Alpha]] * [http://www.subidiom.com/pi pai Search Engine] 2 billion searchable digits of {{pi}}, {{math|{{sqrt|2}}}}, and {{math|''e''}} * {{cite web|last=Eaves|first=Laurence|title=Pi|url=http://www.sixtysymbols.com/videos/pi.htm|work=Sixty Symbols|publisher=[[Brady Haran]] for the [[University of Nottingham]]|authorlink=Laurence Eaves|year=2009|accessdate=2014-06-17|archive-date=2020-07-06|archive-url=https://web.archive.org/web/20200706021225/http://www.sixtysymbols.com/videos/pi.htm|url-status=dead}} * {{cite web|last=Grime|first=Dr. James|title=Pi is Beautiful – Numberphile|url=http://www.youtube.com/watch?v=NPoj8lk9Fo4|work=Numberphile|publisher=[[Brady Haran]]|year=2014}} {{mbegu-hisabati}} [[Jamii:Namba]] 2rewrz7vfpvu3ai2f76z2so0n05cq5e 0 71844 1578066 1527764 2026-07-02T17:38:46Z InternetArchiveBot 41439 Add 7 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578066 wikitext text/x-wiki {{Infobox disease | Name = Chronic obstructive pulmonary disease | Image = Centrilobular emphysema 865 lores.jpg | Caption = [[Gross pathology]] of a lung showing centrilobular-type emphysema characteristic of smoking. This close-up of the [[Fixation (histology)|fixed]], cut lung surface shows multiple cavities lined by heavy [[black carbon]] deposits. | Diseased = 2672 | ICD10 = {{ICD10|J|40||j|40}}–{{ICD10|J|44||j|40}}, {{ICD10|J|47||j|40}} | ICD9 = {{ICD9|490}}–{{ICD9|492}}, {{ICD9|494}}–{{ICD9|496}} | OMIM = 606963 | MedlinePlus = 000091 | eMedicineSubj = med | eMedicineTopic = 373 | eMedicine_mult = {{eMedicine2|emerg|99}} | MeshName = COPD | MeshNumber = C08.381.495.389 }} '''Ugonjwa sugu wa njia za pumzi zilizofungana''' (unaojulikana pia kama '''Ugonjwa sugu wa mapafu yaliyofungana''', '''ugonjwa sugu wa mapafu yaliyofungana''', '''ugonjwa sugu wa njia za pumzi zilizofungana''' na '''ugonjwa sugu wa njia za pumzi zilizofunana''' pamoja na majina mengine), ni aina ya [[ugonjwa wa mapafu yaliyofungana]] unaodhihirika kwa hali duni na sugu ya [[upitaji wa pumzi]].<!-- <ref name=GOLD2013Chp1/> --> Hali hii kwa kawaida huendelea kuwa mbaya zaidi baada ya muda.<!-- <ref name=GOLD2013Chp1/> --> Dalili zake kuu ni [[kupungukiwa na pumzi]], [[kukohoa]], na kutoa [[makohozi]].<ref name=GOLD2013Chp1/> Watu wengi walio na '''[[bronkitisi sugu]]''' wana ugonjwa sugu wa mapafu yaliyofungana.<ref name=Harr2012/> [[Uvutaji tumbaku]] ndio kisababishi kikuu cha ugonjwa sugu wa mapafu yaliyofungana, pamoja na vipengele vingine kama vile [[uchafuzi wa hewa]] huku [[jenetikia]] ikichangia kwa kiwango kidogo.<ref name=Lancet2012>{{cite journal |author=Decramer M, Janssens W, Miravitlles M |title=Chronic obstructive pulmonary disease |url=https://archive.org/details/sim_the-lancet_april-7-13-2012_379_9823/page/1341 |journal=Lancet |volume=379 |issue=9823 |pages=1341–51 |year=2012 |month=April |pmid=22314182 |doi=10.1016/S0140-6736(11)60968-9}}</ref> Katika nchi zinazoendelea, chanzo kikuu cha uchafuzi wa [[hewa]] ni kupikia au kuwasha [[moto]] mahali pasipo hewa ya kutosha. [[Mazingira]] ya muda mrefu wa miwasho hii husababisha [[inflamesheni|mwitikio wa inflamesheni]] kwenye mapafu, hivyo kupelekea njia za pumzi kuwa nyembamba na kuharibika kwa [[tishu]] za ma[[pafu]], hali iitwayo '''[[emfisema]]'''.<ref name=GOLD2007>{{cite journal | author = Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J | title = Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary | journal = Am. J. Respir. Crit. Care Med. | volume = 176 | issue = 6 | pages = 532–55 | year = 2007 | month = September | pmid = 17507545 | doi = 10.1164/rccm.200703-456SO | url = http://ajrccm.atsjournals.org/content/176/6/532.long | archive-date = 2013-01-02 | access-date = 2014-06-23 | archive-url = https://web.archive.org/web/20130102150149/http://ajrccm.atsjournals.org/content/176/6/532.long | url-status = dead }}</ref> Utambuzi huo ni kwa msingi wa hali duni ya kupita kwa pumzi kama ilivyopimwa kwa [[kipimo cha utendakazi wa njia za pumzi|kipimo cha utendakazi wa mapafu]].<ref name=Nathell>{{cite journal | author = Nathell L, Nathell M, Malmberg P, Larsson K | title = COPD diagnosis related to different guidelines and spirometry techniques | journal = Respir. Res. | volume = 8 | issue = 1| pages = 89 | year = 2007 | pmid = 18053200 | pmc = 2217523 | doi = 10.1186/1465-9921-8-89 }}</ref> Ugonjwa sugu wa mapafu yaliyofungana unaweza kuzuiliwa kwa kupunguza uhatarisho wa visababishi vinavyojulikana. Hii hujumuisha juhudi za kupunguza viwango vya uvutaji na kuboresha hali ya hewa ya ndani na nje ya majengo. Mbinu za matibabu ya ugonjwa huu ni [[kuacha uvutaji]], [[chanjo]], [[urekebeshaji mapafu]], na mara nyingi [[vipanua bronkasi]] vya kupumuliwa na [[kotikosteroidi|steroidi]]. Kinyume na [[pumu]], hali ya upitaji wa pumzi haiboreshwi sana na [[matibabu]]. Baadhi ya watu wanaweza kunufaika na [[matibabu ya oksijeni]] ya muda mrefu au [[kupandikiza mapafu]].<ref name=GOLD2007/> Kwa watu walio na vipindi vya kuzidi kwa ugonjwa sugu wa mapafu yaliyofungana, ongezeko la utumiaji [[dawa]] na kulazwa [[hospitali]]ni kunaweza kuhitajika. [[Dunia]]ni kote, ugonjwa sugu wa mapafu yaliyofungana huathiri watu milioni 329&nbsp; au takriban asilimia 5 ya idadi yote ya watu. Mwaka [[2011]], ugonjwa huo ulikadiriwa kuwa kisababishi kikuu cha nne cha [[kifo|vifo]], ukiwaua zaidi ya watu milioni 3&nbsp;.<ref>{{cite web |title=The 10 leading causes of death in the world, 2000 and 2011 |month=July |year=2013 |publisher=World Health Organization |url=http://who.int/mediacentre/factsheets/fs310/en/ |accessdate=November 29, 2013}}</ref> Idadi ya vifo imetabiriwa kuongezeka kutokana na viwango vya juu vya uvutaji na idadi ya watu wanaozeeka katika nchi nyingi.<ref>{{cite journal |author=Mathers CD, Loncar D |title=Projections of Global Mortality and Burden of Disease from 2002 to 2030 |journal=PLoS Med. |volume=3 |issue=11 |pages=e442 |year=2006 |month=November |pmid=17132052 |pmc=1664601 |doi=10.1371/journal.pmed.0030442 |url=http://dx.plos.org/10.1371/journal.pmed.0030442}}</ref> Ugonjwa huu ulisababisha [[hasara]] ya kiuchumi iliyokadiriwa kuwa [[dola]] trilioni 2.1&nbsp;mwaka [[2010]].<ref name=Cost2013>{{cite book|last=Lomborg|first=Bjørn|title=Global problems, local solutions : costs and benefits|year=2013|publisher=Cambridge University Pres|isbn=978-1-107-03959-9|page=143|url=http://books.google.ca/books?id=cRZaAQAAQBAJ&pg=PA143}}</ref> ==Ishara na dalili== {{listen | filename = Wheeze2O.ogg | title = Wheezing | description = The sound of wheezing as heard with a stethoscope. | format = [[Ogg]] }} Dalili kuu za ugonjwa huu ni makohozi, [[dispinia|ugumu wa kupumua]] na kutoa kikohozi.<ref name=GOLD2013Chp2>{{cite book |last=Vestbo |first=Jørgen |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease |year=2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |pages=9–17 |chapter=Diagnosis and Assessment |chapterurl=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#26 |access-date=2014-06-23 |archive-date=2013-10-04 |archive-url=https://web.archive.org/web/20131004234113/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#26 |dead-url=yes }}</ref> Dalili hizi huwepo kwa muda mrefu<ref name=Harr2012>{{cite book |first1=John J. |last1=Reilly |first2=Edwin K. |last2=Silverman |first3=Steven D. |last3=Shapiro |chapter=Chronic Obstructive Pulmonary Disease |pages=2151–9 |editor1-first=Dan |editor1-last=Longo |editor2-first=Anthony |editor2-last=Fauci |editor3-first=Dennis |editor3-last=Kasper |editor4-first=Stephen |editor4-last=Hauser |editor5-first=J. |editor5-last=Jameson |editor6-first=Joseph |editor6-last=Loscalzo |year=2011 |title=Harrison's Principles of Internal Medicine |edition=18th |publisher=McGraw Hill |isbn=978-0-07-174889-6}}</ref> na huzidi jinsi muda unavyopita.<ref name=GOLD2007/> Haijabainika iwapo kuna aina mbalimbali za ugonjwa huu.<ref name=Lancet2012/> Huku ugonjwa huu ukiainishwa katika emfisema na bronkitisi sugu, emfisema ni kielelezo tu cha mabadiliko ya mapafu wala si ugonjwa bayana, nayo bronkitisi sugu ni kielelezo cha dalili tu zinazoweza kutokea au kutotokea pamoja na ugonjwa sugu wa mapafu yaliyofungana.<ref name=GOLD2013Chp1>{{cite book |last=Vestbo |first=Jørgen |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease |year=2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |pages=1–7 |chapter=Definition and Overview |chapterurl=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#18 |access-date=2014-06-23 |archive-date=2013-10-04 |archive-url=https://web.archive.org/web/20131004234113/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#18 |dead-url=yes }}</ref> ===Kikohozi=== Kwa kawaida, kikohozi sugu ndiyo dalili ya kwanza kutokea.<!-- <ref name=GOLD2013Chp2/> --> Inapokuwepo kwa zaidi ya miezi mitatu kwa mwaka kwa zaidi ya miaka miwili ikiandamana na utoaji wa kikohozi na bila kisababishi kingine, basi hali hii itatambulika kama bronkitisi sugu.<!-- <ref name=GOLD2013Chp2/> --> Hali hii inaweza kutokea kabla ugonjwa sugu wa mapafu yaliyofungana kutokea kabisa.<!-- <ref name=GOLD2013Chp2/> --> Kiasi cha makohozi yanayotolewa kinaweza kubadilika baada ya saa hadi siku kadhaa.<!-- <ref name=GOLD2013Chp2/> --> Katika visa vingine, kikohozi kinaweza kutokuwepo au kitokee mara nadra, na kinaweza kutokuwa na makohozi.<!-- <ref name=GOLD2013Chp2/> --> Watu wengine walio na ugonjwa huu hudhani dalili hizi ni "kikohozi cha mvutaji".<!-- <ref name=GOLD2013Chp2/> --> Makohozi yanaweza kumezwa au kutemwa kulingana na jamii na tamaduni.<!-- <ref name=GOLD2013Chp2/> --> Kukohoa sana kunaweza kusababisha [[kuvunjika mbavu]] au [[Kuzirai(matibabu)|kupoteza fahamu kwa muda mfupa]].<!-- <ref name=GOLD2013Chp2/> --> Watu walio na ugonjwa sugu wa mapafu yaliyofungana mara nyingi huwa na historia ya "[[mafua]]" yanayodumu kwa muda mrefu.<ref name=GOLD2013Chp2/> ===Ugumu wa kupumua=== Ugumu wa kupumua mara nyingi ndiyo dalili inayowatatiza watu zaidi.<ref name=NICE2010P60>{{NICE|101|Chronic Obstructive Pulmonary |June 2010|60-70}}</ref> Kwa kawaida watu hueleza tatizo hili kwa kusema: "kupumua kwangu kunahitaji juhudi kuu," "Najihisi nimekosa pumzi," au " sipati pumzi za kutosha".<ref name=Mahler2006>{{cite journal |author=Mahler DA|title=Mechanisms and measurement of dyspnea in chronic obstructive pulmonary disease |journal=Proceedings of the American Thoracic Society|volume=3 |issue=3 |pages=234–8 |year=2006 |pmid=16636091 |doi=10.1513/pats.200509-103SF}}</ref> Hata hivyo, maneno tofauti yanaweza kutumika katika mila tofauti.<ref name=GOLD2013Chp2/> Kwa kawaida, ugumu wa kupumua huzidi mtu anapojaribu kupumua kwa nguvu, baada ya hali hii kudumu kwa muda mrefu, na huzidi baada ya muda.<ref name=GOLD2013Chp2/> Katika awamu za baadaye, ugumu wa kupumua hutokea wakati wa kupumzika na unaweza kuwepo kila wakati.<ref>{{cite web |title=What Are the Signs and Symptoms of COPD? |date=July 31, 2013 |publisher=[[National Heart, Lung, and Blood Institute]] |url=http://www.nhlbi.nih.gov/health/health-topics/topics/copd/signs.html |accessdate=November 29, 2013}}</ref><ref name=MedlinePlus>{{MedlinePlusEncyclopedia|000091|Chronic obstructive pulmonary disease}}</ref> Ugumu wa kupumua ni chanzo cha wasiwasi na hali duni ya maisha kwa watu walio na ugonjwa sugu wa mapafu yaliyofungana.<ref name=GOLD2013Chp2/> Watu wengi walio na ugonjwa sugu wa mapafu yaliyofungana ulioendelea [[kupumua kwa midomo iliyofunguka kidogo|hupumua kupitia midomo iliyofunguka kidogo]] na hatua hii inaweza kuboresha kupumua katika baadhi ya watu.<ref>{{cite book|last=Morrison|first=[edited by] Nathan E. Goldstein, R. Sean|title=Evidence-based practice of palliative medicine|publisher=Elsevier/Saunders|location=Philadelphia|isbn=978-1-4377-3796-7|page=124|url=http://books.google.ca/books?id=j0rCsKtCnq8C&pg=PA124|year=2013}}</ref><ref name=Holland2012>{{cite journal | author = Holland AE, Hill CJ, Jones AY, McDonald CF | title = Breathing exercises for chronic obstructive pulmonary disease | journal = Cochrane Database Syst Rev | volume = 10 | issue = | pages = CD008250 | year = 2012 | pmid = 23076942 | doi=10.1002/14651858.CD008250.pub2 | editor1-last = Holland | editor1-first = Anne E }}</ref> ===Vipengele vingine=== Katika ugonjwa sugu wa mapafu yaliyofungana, inaweza kuchukua muda mrefu zaidi kutoa pumzi kuliko kuivuta.<ref name=EB2008/> Kubanwa kifua kunaweza kutokea<ref name=GOLD2013Chp2/> ingawa hakutokei sana na kunaweza kusababishwa na tatizo lingine.<ref name=NICE2010P60/> Watu walio na njia za pumzi zilizofungana wanaweza kuwa na [[korota|kukorota]] au sauti ndogo pumzi inapoingia mapafuni, wanapochunguzwa kwa [[stethoskopu]].<ref name=EB2008/> [[Kifua cha duara]] ni dalili bayana ya ugonjwa sugu wa mapafu yaliyofungana lakini huwa nadra.<ref name=EB2008/> [[Hali ya kiweko chenye miguu mitatu]]inaweza kutokea ugonjwa unapozidi.<ref name=Harr2012/> Ugonjwa huu ukizidi husababisha[[hipatenshani ya mapafu|shinikizo kwenye ateri za mapafu]], ambayo hushinikiza [[kushindwa kwa moyo#Kushindwa kwa moyo upande wa kulia|ventrikali ya kulia ya moyo]].<ref name=GOLD2007/><ref name=Weit2009>{{cite journal | author = Weitzenblum E, Chaouat A | title = Cor pulmonale | journal = Chron Respir Dis | volume = 6 | issue = 3 | pages = 177–85 | year = 2009 | pmid = 19643833 | doi = 10.1177/1479972309104664 }}</ref><ref>{{cite book |title=Professional guide to diseases |year=2009 |publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins |location=Philadelphia |isbn=978-0-7817-7899-2 |pages=120–2 |chapter=Cor pulmonale |chapterurl=http://books.google.ca/books?id=1h6vu60L6FcC&pg=PA120 |edition=9th}}</ref> Hali hii huitwa [[ugonjwa wa moyo na mapafu]], na husababisha dalili za [[edema ya pembeni|kufura miguu]]<ref name=GOLD2013Chp2/> na [[kupanuka kwa mishipa ya shingo|kufura kwa mishipa ya shingo]].<ref name=GOLD2007/> Ugonjwa sugu wa mapafu yaliyofungana hutokea zaidi kuliko ugonjwa mwingine wowote wa mapafu kama kisababishi cha ugonjwa wa moyo na mapafu.<ref name=Weit2009/> Ugonjwa wa moyo na mapafu umekuwa nadra tangu kuvumbuliwa kwa oksijeni ya mtungi. <ref name=Harr2012/> Mara nyingi ugonjwa sugu wa mapafu yaliyofungana hutokea pamoja na magonjwa mengine kufuatia vipengele vinavyosababisha magonjwa haya yote.<ref name=Lancet2012/> Magonjwa haya ni pamoja na: [[ugonjwa wa moyo wenye iskemia]], [[hipetensheni|shinikizo la juu la damu]], [[kisukari melitasi]], kuharibika kwa misuli, [[osteoporosisi]], [[saratani ya mapafu]], [[hali ya wasiwasi]] na [[mfadhaiko mkuu|mfadhaiko]].<ref name=Lancet2012/> Hisia ya kuwa na [[Uchovu (kimatibabu)|kuchoka]] kila wakati hutokea sana kwa watu walio na ugonjwa mkali.<ref name=GOLD2013Chp2/> [[Kucharungu|Kucha za vidole kurungungika]] ni hali isiyotokea katika ugonjwa sugu wa mapafu yaliyofungana pekee, hivyo inapaswa kuchunguzwa mara moja ili kubaini hali fiche ya saratani ya mapafu.<ref>{{cite book|last=Mandell|first=editors, James K. Stoller, Franklin A. Michota, Jr., Brian F.|title=The Cleveland Clinic Foundation intensive review of internal medicine|year=2009|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-9079-6|page=419|url=http://books.google.ca/books?id=O9F7wtiPWxgC&pg=PA419|edition=5th}}</ref> ===Maumivu zaidi=== Maumivu makali zaidi [[Maumivu zaidi ya ugonjwa sugu wa mapafu yaliyofungana|maumivu makali zaidi ya ugonjwa sugu wa mapafu yaliyofungana]] hufasiliwa kama ongezeko la ugumu wa kupumua, ongezeko la utoaji makohozi, kubalidika kwa rangi ya makohozi kutoka meupe hadi ya kijani kibichi au manjano, au ongezeko la kikohozi kwa mtu aliye na ugonjwa sugu wa mapafu yaliyofungana<ref name=EB2008/> Hali hii inaweza kujidhihirisha pamoja na[[dalili ya kimatibabu|dalili]] za ongezeko la juhudi za kupumua kama vile [[takipnia|kupumua kwa haraka]], [[takikadia|kima cha kasi cha mdundo wa moyo]], [[diaforesi|kutokwa na jasho]], kutumia [[misuli ya kupumua|misuli ya shingo]] sana, [[sianosisi|alama ya buluu ngozini]], na [[Kuchanganyikiwa akili|kuchanganyikiwa]] au tabia ya ukaidi katika maumivu zaidi.<ref name=EB2008>{{cite journal|last=Gruber|first=Phillip|title=The Acute Presentation of Chronic Obstructive Pulmonary Disease In the Emergency Department: A Challenging Oxymoron|journal=Emergency Medicine Practice|year=2008|month=November|volume=10|issue=11|url=http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=63}}</ref><ref name=Burl2012>{{cite journal | author = Brulotte CA, Lang ES | title = Acute exacerbations of chronic obstructive pulmonary disease in the emergency department | journal = Emerg. Med. Clin. North Am. | volume = 30 | issue = 2 | pages = 223–47, vii | year = 2012 | month = May | pmid = 22487106 | doi = 10.1016/j.emc.2011.10.005 }}</ref> [[Sauti]] pia zinaweza kusikika kwenye mapafu yanapochunguzwa kwa stethoskopu.<ref>{{cite book|last=Spiro|first=Stephen|title=Clinical respiratory medicine expert consult|publisher=Saunders|location=Philadelphia, PA|isbn=978-1-4557-2329-4|page=Chapter 43|url=http://books.google.ca/books?id=2sOJk-yKPpUC&pg=PT2420|edition=4th |year=2012}}</ref> ==Kisababishi== Kisababishi kikuu cha ugonjwa sugu wa mapafu yaliyofungana ni moshi wa tumbaku; huku uhatarisho katika mazingira ya kazini na uchafuaji kutokana na mioto ya dani ya nyumba ukiwa kisababishi kikuu katika baadhi ya nchi. <ref name=GOLD2013Chp1/> Kwa kawaida, uhatarisho huu lazima utokee miongo mingi kabla ya dalili kutokea.<ref name=GOLD2013Chp1/> Maumbile ya kijenetiki pia huathiri uhatarisho wa mtu.<ref name=GOLD2013Chp1/> ===Uvutaji=== {{Multiple image|direction=vertical|align=right|image1=Female Smoking by Country.png|image2=Male Smoking by Country.png|width=250|caption1=Percentage of females smoking tobacco as of the late 1990s early 2000s|caption2=Percentage of males smoking tobacco as of the late 1990s early 2000s. Note the scales used for females and males differ.<ref name="isbn92-4-159628-7">{{cite book | author = World Health Organization | title = WHO Report on the Global Tobacco Epidemic 2008: The MPOWER Package | edition = | language = | publisher = World Health Organization | location = Geneva | year = 2008 | isbn = 92-4-159628-7 | url = http://www.who.int/tobacco/mpower/mpower_report_full_2008.pdf |pages=268–309}}</ref>}} Kisababishi hatari kikuu cha ugonjwa sugu wa mapafu yaliyofungana duniani kote ni uvutaji wa tumbaku.<ref name=GOLD2013Chp1/> Takriban aslilimia 20 ya wavutaji hupata ugonjwa sugu wa mapafu yaliyofungana,<ref name=Ward2012>{{cite book|last=Ward|first=Helen|title=Oxford Handbook of Epidemiology for Clinicians|year=2012|publisher=Oxford University Press|isbn=978-0-19-165478-7|pages=289–290|url=http://books.google.ca/books?id=dHLjLwru-l8C&pg=RA1-PT194#v=onepage&q&f=false}}</ref> na kwa watu wanaovuta maisha yao yote, takriban nusu yao hupata ugonjwa sugu wa mapafu yaliyofungana<ref name=La2009>{{cite journal|last=Laniado-Laborín|first=R|title=Smoking and chronic obstructive pulmonary disease (COPD). Parallel epidemics of the 21st century|journal=International journal of environmental research and public health|date=January 2009|volume=6|issue=1|pages=209–24|pmid=19440278|doi=10.3390/ijerph6010209|pmc=2672326}}</ref> Nchini Marekani na Uingereza, katika watu walio na ugonjwa sugu wa mapafu yaliyofungana, asilimia 80-95 ni wavutaji wakati huo au walivuta awali.<ref name=Ward2012/><ref name=Ren2013>{{cite book|last=Rennard|first=Stephen|title=Clinical management of chronic obstructive pulmonary disease|year=2013|publisher=Informa Healthcare|location=New York|isbn=978-0-8493-7588-0|page=23|url=http://books.google.ca/books?id=DiTThQJkc0UC&pg=PA23|edition=2nd}}</ref><ref name=Rich2010>{{cite book|author=Anita Sharma ; with a contribution by David Pitchforth ; forewords by Gail Richards|title=COPD in primary care|year=2010|publisher=Radcliffe Pub.|location=Oxford|isbn=978-1-84619-316-3|page=9|url=http://books.google.com/books?id=CrXFqhezbeMC&pg=PA9|coauthors=Barclay, Joyce}}</ref> Uwezekano wa kupata ugonjwa sugu wa mapafu yaliyofungana huongezeka na [[idadi ya miaka|uhatarisho kamili wa moshi]].<ref>{{cite book|last=Goldman|first=Lee|title=Goldman's Cecil medicine|publisher=Elsevier/Saunders|location=Philadelphia|isbn=978-1-4377-1604-7|page=537|url=http://books.google.ca/books?id=Qd-vvNh0ee0C&pg=PA537|edition=24th|year=2012}}</ref> Isitoshe, wanawake wana uwezekano zaidi wa kuathiriwa na moshi kuliko wanaume.<ref name=Rich2010/> Kwa watu wasio wavutaji, [[moshi unaotokana na watu wengine]] ni kisababishi cha takriban asilimia 20 ya visa.<ref name=Ren2013/> Aina zingine za moshi kama vile bangi, sigara na shisha pia zina athari.<ref name=GOLD2013Chp1/> Wanawake wanaovuta wakati wa[[ujauzito]] wanaweza kuongeza hatari ya ugonjwa sugu wa mapafu yaliyofungana kwa watoto wao.<ref name=GOLD2013Chp1/> ===Uchafuzi wa hewa === Mioto ya kupikia katika vyuma visivyo na hewa safi ya kutosha, na ambayo mara nyingi hutokana na makaa au [[nishati hai]] kama vile kuni na kinyesi cha wanyama, hupelekea [[ubora wa hewa ndani ya nyumba|uchafuzi wa hewa wa ndani ya nyumba]] na ni visababishi vikuu vya ugonjwa sugu wa mapafu yaliyofungana katika [[nchi inayostawi|nchi zinazostawi]].<ref name=Ken2007>{{cite journal |author=Kennedy SM, Chambers R, Du W, Dimich-Ward H|title=Environmental and occupational exposures: do they affect chronic obstructive pulmonary disease differently in women and men?|journal=Proceedings of the American Thoracic Society|volume=4 |issue=8 |pages=692–4 |year=2007 |month=December|pmid=18073405 |url=http://pats.atsjournals.org/cgi/content/full/4/8/692 |doi=10.1513/pats.200707-094SD}}</ref> Mioto hii ni mbinu ya kupikia na kupasha moto kwa takriban watu bilioni 3&nbsp;athari zake za kiafya zikiwa juu katika wanawake kutokana na uhatarisho zaidi.<ref name=GOLD2013Chp1/><ref name=Ken2007/> Mioto hii hutumika kama chanzo kikuu cha nishati katika asilimia 80 za jamii nchini India, China na [[mataifa ya kusini mwa Sahara]].<ref name=Piro2012/> Watu wanaoishi katika miji mikubwa wana kiwango kikubwa zaidi cha ugonjwa sugu wa mapafu yaliyofungana ikilinganishwa na watu wanaoishi vijijini <ref>{{cite journal|author=Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM |title=Global burden of COPD: systematic review and meta-analysis |url=https://archive.org/details/european-respiratory-journal_2006-09_28_3/page/523 |journal=Eur. Respir. J. |volume=28 |issue=3 |pages=523–32 |year=2006 |month=September|pmid=16611654|doi=10.1183/09031936.06.00124605 }}</ref> Huku [[uchafuzi wa hewa]] mijini ni kipengele kisababishi cha maumivu zaidi, jukumu lake la kijumla kama kisababishi cha ugonjwa sugu wa mapafu yaliyofungana si bayana.<ref name=GOLD2013Chp1/> Sehemu zilizo na hali duni za pumzi nje ya nyumba zikijumuisha [[gesi ya mitambo]], kwa kawaida zina viwango vya juu vya ugonjwa sugu wa mapafu yaliyofungana.<ref name=Piro2012/> Hata hivyo, athari ya kijumla ya uchafuzi huu ikilinganishwa na uvutaji inaaminika kuwa ndogo.<ref name=GOLD2013Chp1/> ===Hatari kazini=== Uhatarisho mkali na wa muda mrefu kwa vumbi, kemikali na moshi kazini huongeza hatari ya ugonjwa sugu wa mapafu yaliyofungana kwa wavutaji na wasiovuta.<ref name=Dev2006/> Uhatarisho kazini unaaminika kuwa kisababishi katika asilimia 10-20 ya visa.<ref>{{cite book|last=Laine|first=Christine|title=In the Clinic: Practical Information about Common Health Problems|year=2009|publisher=ACP Press|isbn=978-1-934465-64-6|page=226|url=http://books.google.ca/books?id=bvg9he4FOB0C&pg=PA226}}</ref> Nchini Marekani, uhatarisho huu unaaminika kuhusiana na zaidi ya asilimia 30 ya visa katika watu wasiowahi kuvuta, na inawezekana huwakilisha hatari kubwa zaidi katika nchi zisizo na sheria za kutosha.<ref name=GOLD2013Chp1/> Viwanda na vyanzo kadhaa vimelaumiwa, ikiwa ni pamoja na <ref name=Piro2012/> viwango vya juu vya vumbi katika [[uchimbaji makaa ya mawe]], [[uchimbaji dhahabu]], na viwanda vya nguo za pamba, kazi zinazohusisha [[kadimiamu]] na [[isosianati]], na moshi wa [[kulehemu]].<ref name=Dev2006>{{cite journal |doi=10.1136/bmj.332.7550.1142 |title=Definition, epidemiology and risk factors |year=2006 |last1=Devereux |first1=Graham |journal=BMJ |volume=332 |issue=7550 |pages=1142–4 |pmid=16690673 |pmc=1459603}}</ref> Kufanya kazi ya kilimo pia ni hatari.<ref name=Piro2012/> Katika kazi zingine, hatari imekadiriwa kuwa sawa na pakiti nusu hadi mbili za sigara kila siku.<ref name=Barn2009/> Uhatarisho wa vumbi ya[[silika]] pia unaweza kusababisha ugonjwa sugu wa mapafu yaliyofungana, na hatari isiyohusiana na ile ya [[silikosisi]].<ref>{{cite journal |doi=10.1515/REVEH.2007.22.4.255 |title=Chronic Obstructive Pulmonary Disease and Occupational Exposure to Silica |year=2007 |last1=Rushton |first1=Lesley |journal=Reviews on Environmental Health |volume=22 |issue=4 |pmid=18351226 |pages=255–72}}</ref> Athari za uhatarisho wa vumbi na moshi wa sigara huonekana kuwa ya kikemikali au hata zaidi.<ref name=Barn2009>{{cite book |editor1-first=Peter J. |editor1-last=Barnes |editor2-first=Jeffrey M. |editor2-last=Drazen |editor3-first=Stephen I. |editor3-last=Rennard |editor4-first=Neil C. |editor4-last=Thomson |year=2009 |chapter=Relationship between cigarette smoking and occupational exposures |chapterurl=http://books.google.ca/books?id=HY9PiQL3kQMC&pg=PA464 |title=Asthma and COPD: Basic Mechanisms and Clinical Management |publisher=Academic |location=Amsterdam |isbn=978-0-12-374001-4 |page=464}}</ref> ===Jenetiki=== Jenetiki huchangia pakubwa katika kutokea kwa ugonjwa sugu wa mapafu yaliyofungana.<ref name=GOLD2013Chp1/> Ugonjwa huu hutokea zaidi katika jamaa ya watu walio na ugonjwa huu wanaovuta kuliko watu wasiohusiana na wavutaji.<ref name=GOLD2013Chp1/> Kwa sasa, athari hatari bayana inayorithiwa ni [[ukosefu wa kinza tripsini ya alfa ya 1]].<ref name=Foreman2012>{{cite journal | author = Foreman MG, Campos M, Celedón JC | title = Genes and chronic obstructive pulmonary disease | url = https://archive.org/details/sim_medical-clinics-of-north-america_2012-07_96_4/page/699 | journal = Med. Clin. North Am. | volume = 96 | issue = 4 | pages = 699–711 | year = 2012 | month = July | pmid = 22793939 | pmc = 3399759 | doi = 10.1016/j.mcna.2012.02.006 }}</ref> Hatari hii iko juu zaidi hasa iwapo mtu aliye na upungufu wa [[kinza tripsini ya alfa ya 1]] pia ni mvutaji.<ref name=Foreman2012/> Hatari hii huchangia takriban asilimia 1-5 ya visa<ref name=Foreman2012/><ref name=Brode2012>{{cite journal | author = Brode SK, Ling SC, Chapman KR | title = Alpha-1 antitrypsin deficiency: a commonly overlooked cause of lung disease | journal = CMAJ | volume = 184 | issue = 12 | pages = 1365–71 | year = 2012 | month = September | pmid = 22761482 | pmc = 3447047 | doi = 10.1503/cmaj.111749 }}</ref> na ugonjwa huwepo katika takriban watu 3-4 kwa kila 10,000.<ref name=Harr2012/> Hatari zingine za jenetekia zingali zinachunguzwa,<ref name=Foreman2012/>, ambapo kuna uwezekano wa kutambua nyingi.<ref name=Piro2012>{{cite journal | author = Pirozzi C, Scholand MB | title = Smoking cessation and environmental hygiene | url = https://archive.org/details/sim_medical-clinics-of-north-america_2012-07_96_4/page/849 | journal = Med. Clin. North Am. | volume = 96 | issue = 4 | pages = 849–67 | year = 2012 | month = July | pmid = 22793948 | doi = 10.1016/j.mcna.2012.04.014 }}</ref> ===Vipengele vingine=== Hatari zingine kadhaa huhusiana kwa kiwango kidogo na ugonjwa sugu wa mapafu yaliyofungana. Hatari huwa kubwa zaidi katika watu masikini, ingawa si bayana iwapo hii ni kutokana na [[umasikini]] wenyewe au athari zingine hatari zinazohusiana na umasikini, kama vile uchafuzi wa hewa na utapia mlo.i<ref name=GOLD2013Chp1/> Kuna ushahidi mdogo kuwa watu wenye ugonjwa wa pumu na matatizo ya njia za pumzi wako katika hatari ya juu zaidi ya kuathiriwa na ugonjwa sugu wa mapafu yaliyofungana.<ref name=GOLD2013Chp1/> Vipengele vya kuzaliwa kama kuzaliwa na uzani wa chini vinaweza kuchangua ugonjwa huu kama vile magonjwa kadhaa ya kuambukiza, ikiwa ni pamoja na [[VVU/UKIMWI]] na [[kifua kikuu]] yanavyofanya.<ref name=GOLD2013Chp1/> [[Maambukizi ya njia za pumzi]] kama vile [[nimonia]] hayaonekani kuongeza hatari ya ugonjwa sugu wa mapafu yaliyofungana, angalau katika watu wazima.<ref name=Harr2012/> ===Maumivu zaidi=== Maumivu makali (kuzidiwa ghafla na dalili)<ref name=GOLD2013Chp5>{{cite book |last=Vestbo |first=Jørgen |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease |year=2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |chapter=Management of Exacerbations |pages=39–45 |chapterurl=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#56 |access-date=2014-06-23 |archive-date=2013-10-04 |archive-url=https://web.archive.org/web/20131004234113/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#56 |dead-url=yes }}</ref> mara nyingi huchochewa na maambukizi au vichafuzi vya kimazingira au wakati mwingine na visababishi vingine kama vile kutumia matibabu vibaya.<ref name=Dhar2012>{{cite book|last=Dhar|first=Raja|title=Textbook of pulmonary and critical care medicine|year=2011|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-93-5025-073-0|page=1056|url=http://books.google.ca/books?id=rAT1bdnDakAC&pg=PA1056}}</ref> Maambukizi huonekana kuwa kisababishi cha asilimia 50 hadi 70 ya visa,<ref name=Dhar2012/><ref>{{cite book|last=Palange|first=Paolo|title=ERS Handbook of Respiratory Medicine|year=2013|publisher=European Respiratory Society|isbn=978-1-84984-041-5|page=194|url=http://books.google.ca/books?id=48gaALnXhcQC&pg=PA194}}</ref> huku bakteria ikichangia asilimia 25, virusi asilimia 25 na zote mbili asilimia 25.<ref>{{cite book|last=Lötvall|first=Jan|title=Advances in combination therapy for asthma and COPD|year=2011|publisher=John Wiley & Sons|location=Chichester, West Sussex|isbn=978-1-119-97846-6|page=251|url=http://books.google.ca/books?id=oPDU4xQLVWEC&pg=PT265}}</ref> Vichafuzi vya kimazingira hujumuisha hewa chafu ya ndani na nje ya nyumba. <ref name=Dhar2012/> Uhatarisho wa moshi wa kibinafsi na moshi kutokana na watu wengine huongeza hatari hiyo.<ref name=Piro2012/> Hali ya baridi ya hewa pia inaweza kuchangia, huku maumivu zaidi yakitokea zaidi majira ya baridi. <ref name=Barnes2009>{{cite book|last=Barnes|first=Peter|title=Asthma and COPD : basic mechanisms and clinical management|year=2009|publisher=Academic|location=Amsterdam|isbn=978-0-12-374001-4|page=837|url=http://books.google.ca/books?id=HY9PiQL3kQMC&pg=PA837|edition=2nd}}</ref> Watu walio na magonjwa mengine makali fiche huwa na maumivu zaidi mara nyingi: katika ugonjwa wa kiwango cha chini, 1.8 kwa kila mwak; kiwango cha wastani, 2 hadi 3 kwa mwaka; na kiwango kikali 3.4 kwa mwaka. <ref>{{cite book|last=Hanania|first=Nicola|title=COPD a Guide to Diagnosis and Clinical Management|publisher=Springer Science+Business Media, LLC|location=Totowa, NJ|isbn=978-1-59745-357-8|page=197|url=http://books.google.ca/books?id=wMzWnIdRD1MC&pg=PA197|edition=1st|date=2010-12-09}}</ref> Watu walio na maumivu makali mengi wana kiwango cha juu cha kupunguza utendakazi wa mapafu yao. <ref name=Beasley2012>{{cite journal|last=Beasley|first=V|coauthors=Joshi, PV; Singanayagam, A; Molyneaux, PL; Johnston, SL; Mallia, P|title=Lung microbiology and exacerbations in COPD|journal=International journal of chronic obstructive pulmonary disease|year=2012|volume=7|pages=555–69|pmid=22969296|doi=10.2147/COPD.S28286|pmc=3437812}}</ref> [[Uemboli wa mapafu|Uemboli wa mapafu]] (ganda la damu kwenye mapafu) unaweza kuzidisha dalili kwa watu walio na ugonjwa sugu wa mapafu yaliyofungana tayari.<ref name=Lancet2012/> ==Pathofiziolojia== [[File:Copd 2010Side.JPG|thumb|center|600px|Upande wa kushoto ni mchoro wa mapafu na njia za hewa ukiwa na picha ndogo inayoonyesha sehemu ya ndani ya [[bronkioli]] na [[alveoli]] za kawaida. Upande wa kulia ni mapafu yaliyoharibiwa na ugonjwa sugu wa kufungana kwa mapafu pamoja na picha ndogo inayoonyesha sehemu ya ndani ya bronkioli na alveoli zilizoharibika]] Ugonjwa sugu wa kufungana kwa mapafu ni aina ya [[ugonjwa wa kufungana kwa mapafu]] ambapo upitaji duni sugu wa hewa usioweza kubadilishwa (upungufu wa kupita kwa hewa) na kutoweza kabisa kupumua nje huwepo.<ref name=Lancet2012/> Kupita duni kwa hewa ni matokeo ya kuharibika kwa tishu ya pafu (iitwayo emfisema) na ugonjwa wa njia ndogo za hewa uitwao bronkiolitisi ya kufungana.<!-- <ref name=GOLD2013Chp1/> --> Vinavyochangia visababishi hivi viwili hutofautiana kati ya watu.<ref name=GOLD2013Chp1/> Pia wengine wana kiwango fulani cha [[mwitiko wa kupita kiasi wa bronkasi|mwitiko wa kupita kiasi wa njia za hewa]] kwa miwasho sawa na inayopatikana katika ugonjwa wa pumu.<ref name=Harr2012/> Ugonjwa sugu wa kufungana kwa mapafu hutokea kama mwitiko mkubwa sugu wa kiinflamesheni kwa vitu vyenye miwasho vilivyovutwa ndani kwa hewa.<ref name=GOLD2013Chp1/> Maambukizi sugu ya bakteria pia yanaweza kuongeza inflamesheni hii.<ref name=Beasley2012/> Seli za kuvimba zinazohusika ni [[granulositi za nutrofili]] na [[makrofeji]], aina mbili za seli nyeupe za damu.<!-- <ref name=GOLD2013Chp1/> --> Wanaovuta pia wana kuhusika kwa[[Seli T ya sitotosiki |Tc1]] [[limfositi]] na watu wengine walio na ugonjwa sugu wa kufungana kwa mapafu wana kuhusika kwa [[granulositi ya esinofili|esinofili]] sawa na inayopatikana katika ugonjwa wa pumu.<!-- <ref name=GOLD2013Chp1/> --> Kiwango Fulani cha mwitiko huu wa seli husababishwa na viendelezi vya kuvimba kama [[kemotaksisi|visababishi vya kemotaksisi]].<!-- <ref jina=GOLD2013Chp1/> --> Michakato mingine inayohusiana na uharibifu wa mapafu ni [[msongo wa kioksaidi]]unaotolewa na [[radikali (kemia)|radikali huru]] kwenye moshi wa tumbaku na kuachiliwa na seli za kuvimba, na kuharibika kwa [[tishu unganishi]] za mapafu kwa [[protisi]] ambazo hukinzwa kwa kiasi na [[kikinza protisi (biolojia)|vikinza protisi]].<!-- <ref jina=GOLD2013Chp1/> --> Kuharibiwa kwa tishu unganishi za mapafu ndio unaopelekea emfisema, ambayo kisha huchangia upitaji duni wa hewa, na hatimaye, ufyonzaji na uachiliaji duni wa gesi za kupumua.<ref name=GOLD2013Chp1/> Upotezaji wa kijumla wa misuli unaotokea katika ugonjwa sugu wa kufungana kwa mapafu unaweza kutokana kwa kiasi na viendelezi vya inflamesheni vinavyotolewa na mapafu hadi kwenye damu.<ref name=GOLD2013Chp1/> Kupungua kwa nafasi za njia za hewa hutokea kwa sababu ya inflamesheni na kupata kovu ndani mwazo.<!-- <ref jina=GOLD2013Chp1/> --> Hii huchangia kushindwa kupumua nje kikamilifu.<!-- <ref name=GOLD2013Chp1/> --> Upunguaji mkubwa wa kupita kwa hewa hutokea wakati wa kupumua nje kwa sababu shinikizo ndani mwa kifua linabana njia za hewa wakati huu.<ref name=Cal2005>{{cite journal |author=Calverley PM, Koulouris NG |title=Flow limitation and dynamic hyperinflation: key concepts in modern respiratory physiology|url=https://archive.org/details/european-respiratory-journal_2005-01_25_1/page/186 |journal=Eur Respir J |volume=25 |pages=186–199|year=2005|pmid=15640341 |doi=10.1183/09031936.04.00113204 |issue=1}}</ref> Hii inaweza kupelekea hewa zaidi kutoka kwa pumzi ya awali kusalia mapafuni wakati pumzi inayofuata imeanzishwa na kusababisha ongezeko katika kiwango kamili cha hewa mapafuni wakati wowote ule, mchakato uitwao [[Uvutaji hewa ndani# Kuingiza hewa kupita kiasi|uvutaji hewa ndani kupita kiasi]] au kutega hewa.<ref name=Cal2005/><ref>{{cite book|last=Currie|first=Graeme P.|title=ABC of COPD|year=2010|publisher=Wiley-Blackwell, BMJ Books|location=Chichester, West Sussex, UK|isbn=978-1-4443-2948-3|page=32|url=http://books.google.ca/books?id=eEoYQA4QD_wC&pg=PA32|edition=2nd }}</ref> Uvutaji hewa ndani kupita kiasi kutokana na mazoezi huhusishwa na upungufu wa pumzi katika ugonjwa sugu wa kufungana kwa mapafu kwa sababu si bora kupumua ndani wakati mapafu yamejaa.<ref name=Odon2006>{{cite journal |author=O'Donnell DE|title=Hyperinflation, Dyspnea, and Exercise Intolerance in Chronic Obstructive Pulmonary Disease|journal=The Proceedings of the American Thoracic Society|volume=3 |pages=180–4 |year=2006 |pmid=16565429 |doi=10.1513/pats.200508-093DO |issue=2}}</ref> [[hiposemia|viwango vya chini vya oksijeni]] na hatimaye, [[hipakania|viwango juu vya dioksidi ya kaboni kwenye damu]] vinaweza kutokana na [[mbadilishano wa gesi]] ulio duni kutokana na upitishaji duni wa hewa kutokana na kufungana kwa njia za hewa, uingizaji wa hewa kupita kiasi na tamaa ya chini ya kupumua..<ref name=GOLD2013Chp1/> Wakati wa maumivu zaidi, inflamesheni ya njia ya hewa pia huongezeka na kusababisha ongezeko kupita kiasi la hewa inayoingia,upungufu wa kupita kwa hewa na kuzorota kwa uhamisho wa gesi. Hii pia inaweza kusababisha upitishaji duni wa hewa na hatimaye viwango vya chini vya oksijeni katika damu.<ref name=GOLD2007/>Viwango vya chini vya oksijeni vikiwepo kwa muda mrefu vinaweza kusababisha [[msongo wa mishipa|ateri kuwa nyembamba]] mapafuni ilhali emfisema husababisha kuharibika kwa kapilari kwenye mapafu.<!-- <ref name=GOLD2013Chp1/> --> Mabadiliko haya yote husababisha ongezeko kwenye shinikizo la damu katika [[ateri ya mapafu|arteri za mapafu]], hali inayoweza kusababisha ugonjwa wa kuvimba na kutofanya kazi kwa ventrikali ya kulia ya moyo.<ref name=GOLD2013Chp1/> ==Utambuzi== Utambuzi wa ugonjwa sugu wa kufungana kwa mapafu unapaswa kuzingatiwa kwa yeyote mwenye umri wa zaidi ya miaka 35 hadi 40 na aliye na [[disnia|upungufu wa pumzi]], kikohozi sugu, kutoa makohozi, au homa za mara kwa mara katika majira ya baridi na historia ya kutangamana na visababishi vya hatari vya ugonjwa huo.<ref name=GOLD2013Chp2/><ref name=NICE2010P60/> Kisha [[Kupima pumzi]] hutumiwa kuthibitisha utambuzi huo.<ref name=GOLD2013Chp2/><ref name=Qas2011/> ===Upimaji wa pumzi=== Upimaji wa pumzi hupima kiwango cha kuzuiwa kwa upitaji wa hewa uliopo na kawaida hufanywa baada ya utumizi wa [[kitanua bronkasi]], tiba ya kufungua njia za hewa.<ref name=Qas2011/> Vipengele viwili muhimu hupimwa ili kufanya utambuzi huo: kiasi cha hewa inayopumuliwa nje kwa lazima kwa sekunde moja (FEV₁), ambacho ndicho kiasi kikubwa zaidi cha hewa inayoweza kupumuliwa nje katika sekunde ya kwanza ya pumzi, na [[kiasi muhimu|kiasi muhimu cha kulazimishwa]], ambacho ndicho kiasi kikubwa zaidi cha hewa inayoweza kupumuliwa nje katika pumzi moja kubwa.<ref name=Young2010>{{cite book|last=Young|first=Vincent B.|title=Blueprints medicine|year=2010|publisher=Wolters Kluwer Health/Lippincott William & Wilkins|location=Philadelphia|isbn=978-0-7817-8870-0|page=69|url=http://books.google.ca/books?id=_DHtahEUgXcC&pg=PA69|edition=5th}}</ref> Kawaida, asilimia 75-80 ya kiasi muhimu cha kulazimishwa hutoka nje katika sekunde ya kwanza<ref name=Young2010/> na [[uwiano 1 wa kiasi cha hewa inayopumuliwa nje kwa lazima/uwiano wa kiasi muhimu cha kulazimishwa|uwiano wa kiasi cha hewa inayopumuliwa nje kwa lazima₁/uwiano uwiano wa kiasi muhimu cha kulazimishwa]] chini ya asilimia 70 kwa mtu aliye na dalili za ugonjwa sugu kufungana kwa mapafu huonyesha kuwa mtu huyo ana ugonjwa huo.<ref name=Qas2011/> Kwa msingi wa vipimo hivi, upimaji wa pumzi unaweza kusababisha utambuzi zaidi wa ugonjwa sugu wa kufungana kwa mapafu kwa wazee.<ref name=Qas2011/> Vigezo vya [[Taasisi ya Kitaifa ya Ubora wa Matibabu]] pia huhitaji kiasi cha hewa inayopumuliwa nje kwa lazima₁ cha chini ya asilimia 80 ya kilichobashiriwa.<ref name=NICE2010P60/> Ushahidi wa kutumia upimaji wa pumzi kwa wasio na dalili katika [[kuchunguza (kimatibabu)|kutambua ugonjwa mapema]] ni wa matokeo yasiyobayana na kwa hivyo kwa sasa haupendekezwi.<ref name=GOLD2013Chp2/><ref name=Qas2011>{{cite journal | author = Qaseem A, Wilt TJ, Weinberger SE, Hanania NA, Criner G, van der Molen T, Marciniuk DD, Denberg T, Schünemann H, Wedzicha W, MacDonald R, Shekelle P | title = Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society | url = https://archive.org/details/sim_annals-of-internal-medicine_2011-08-02_155_3/page/178 | journal = Ann. Intern. Med. | volume = 155 | issue = 3 | pages = 179–91 | year = 2011 | month = August | pmid = 21810710 | doi = 10.7326/0003-4819-155-3-201108020-00008}}</ref> [[kilele cha kupita kwa hewa iliyopumuliwa nje]] (kasi ya juu zaidi ya kupumua nje), inayotumika sana katika ugonjwa wa pumu, hakitoshi kwa utambuzi wa ugonjwa sugu wa kufungana kwa mapafu.<ref name=NICE2010P60/> ===Ukali=== {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |+MRC kipimo cha upungufu wa pumzi<ref name=NICE2010P60/> |- ! Kimo!! Shughuli inayoathiriwa |- | 1 || Shughuli za kuchosha tu |- | 2 || Kutembea kwa nguvu |- | 3 || Kwa kutembea kwa kawaida |- | 4 || Baada ya dakika chache za kutembea |- | 5 || Kwa kubadilisha nguo |} {| class="wikitable" style = "float: right; margin-left:15px; text-align:center" |+GOLD grade<ref name=GOLD2013Chp2/> |- ! Ukali!! Kiasi cha hewa inayopumuliwa nje kwa lazima₁ % kilichotabiriwa |- | Isiyo kidogo (GOLD 1) || ≥80 |- | Kali kiasi (GOLD 2)|| 50–79 |- | Kali (GOLD 3)|| 30–49 |- | Kali zaidi (GOLD 4)|| <30 or [[kushindwa sugu kwa kupimua]] |} Kuna mbinu kadhaa za kutambua ni kwa kiasi kipi ugonjwa sugu wa kufungana kwa mapafu unaathiri mtu fulani.<ref name=GOLD2013Chp2/> Hojaji iliyofanyiwa mabadiliko ya [[Shirika la Utafiti wa Afya (Ulaya)|Shirika la Utafiti wa Afya la Ulaya]] au jaribio la ukadiriaji wa ugonjwa sugu wa kufungana kwa mapafu ni hojaji rahisi ambazo zinaweza kuamua ukali wa dalili.<ref name=GOLD2013Chp2/> Hoja za kipimo cha ukadriaji wa ugonjwa sugu wa kufungana kwa mapafu ni kutoka 0-40 ikiwa vile hoja ni nyingi ndivyo ugonjwa ni kali.<ref name=ATS>{{cite web |title=COPD Assessment Test (CAT) |url=http://www.thoracic.org/assemblies/srn/questionaires/copd.php |publisher=[[American Thoracic Society]] |accessdate=November 29, 2013}}</ref> Kupima pumzi kunaweza saidia kuamua ukali kikomo cha kutiririka hewa.<ref name=GOLD2013Chp2/> Hii ni kwa msingi wa kupumulia kulicho lazimishwa₁ ikielezwa kama asilimia ya............kwa umri, jinsia, urefu na uzito wa mtu. <ref name=GOLD2013Chp2/> Miongozo yote ya Amerika na Europa ilipendekeza kwa kiasi kwa msingi wa mapendekezo ya kupumulia kulicho lazimishwa. ₁.<ref name=Qas2011/> Miongozo ya GOLD hupendekeza kugawanya watu katika vikundi vinne kwa msingi ukadriaji na kikomo cha kutiririka hewa.<ref name=GOLD2013Chp2/> Kupunguza uzito na udhaifu wa misuli pamoja na kuwepo kwa magonjwa mengine kunapaswa kuzingatiwa.<ref name=GOLD2013Chp2/> ===Vipimo vingine=== [[Eksirei ya kifua]] na [[kipimo kamili cha damu]] vinaweza kuwa muhimu katika kutenga magonjwa mengine wakati wa utambuzi.<ref name=NICE2010P70/> Ishara bainifu kwenye eksirei ni mapafu yaliopanuka zaidi, [[Daframu ya kifua|daframu]]iliyonyooka, nafasi ya hewa Zaidi ya nyuma ya mfupa wa kidari, na bula ilhali inaweza kuondoa magonjwa mengine kama vile [[nimonia]], [[edema ya mapafu]] au [[numothoraksi]].<ref name=Old2007>{{cite journal |author=Torres M, Moayedi S |title=Evaluation of the acutely dyspneic elderly patient |url=https://archive.org/details/sim_clinics-in-geriatric-medicine_2007-05_23_2/page/307 |journal=Clin. Geriatr. Med. |volume=23 |issue=2 |pages=307–25,vi |year=2007|month=May |pmid=17462519 |doi=10.1016/j.cger.2007.01.007}}</ref> Ukaguzi wa [[tomografia inayokokotolewa kwa eksirei |tomografia inayokokotolewa]] yenye mchanganuo mkubwa wa kifua unaweza kuonyesha jinsi emfisema ilivyoenea mapafuni na pia unaweza kusaidia kutenga magonjwa mengine ya mapafu.<ref name=Harr2012/> Hata hivyo, isipokuwa upasuaji umepangwa, hii haiathiri udhibiti.<ref name=Harr2012/> [[Gesi ya damu ya ateri|uchanganuzi wa damu ya ateri]] hutumiwa kutambua hitaji la oksijen; hii inapendekezwa kwa walio na upumuji wa nje wa kulazimishwa₁ chini ya asilimia 35 iliyobashiriwa, wale walio na kiwango cha oksijeni ya pembezoni chini ya asilimia 92 na walio na dalili za kusongamana na moyo kukosa kufanya kazi kwa moyo.<ref name=GOLD2013Chp2/> Katika sehemu za dunia ambapo ukosefu wa alfa 1-kinza tripsini hupatikana sana, watu walio na ugonjwa sugu wa kufungana kwa mapafu (hasa walio chini ya umri wa miaka 45 na emfisema inayoathiri sehemu za chini za mapafu) wanapaswa kuzingatiwa kupimwa.<ref name=GOLD2013Chp2/> <gallery> File:Ugonjwa sugu wa kufungana kwa mapafu.JPG|alt=Picha yenye weusi na weupe, iliyo na moyo mdogo mweupe katikati na mapafu makubwa meusi kuizunguka|Eksirei ya Kifua inayoonyesha ugonjwa sugu wa kufungana kwa mapafu mkali. Makinikia ukubwa mdogo wa moyo ukilinganisha na mapafu. File:Kifuakiduta.JPG|Eksirei ya mbavuni ya kifua cha mtu aliye na emfisema. Makinikia kifua cha mviringo na daframu iliyonyooka. File:Ekisirei ya bula ya kifua.PNG|Bula ya pafu jinsi inavyoonekana katika eksirei ya kifua kwa mtu aliye na ugonjwa sugu wa kufungana kwa mapafu mkali File:Upigaji picha ya dutu ya Ekisirei ya kimatibabu WFH07 nevit.jpg|Kisa kikali cha emfisema yenye bula. File:Emfisema yenye bulaCT.png|Picha ya kompyuta ya tomografia ya pafu la mtu aliye na emfisema yenye bula iliyo katika hatua ya mwisho. </gallery> ===Utambuzi tofautishi=== Ugonjwa sugu wa kufungana kwa njia za hewa unaweza kuhitaji kutofautishwa na visababishi vingine vya upungufu wa pumzi kama vile [[moyo kusongamana na kushindwa kufanya kazi]], [[uemboli wa mapafu]], [[nimonia]] au [[numothoraksi]]. Watu wengi walio na ugonjwa sugu wa kufungana kwa mapafu kimakosa hufikiria kuwa wana [[pumu]].<ref name=EB2008/> Hata hivyo utofautishaji wa pumu na ugonjwa sugu wa kufungana kwa mapafu hauwezi kufanywa kwa [[kupima pumzi]].<ref name=NICE2010P60/> Kifua kikuu pia kinaweza kujitokeza kwa kikohozi sugu na kinafaa kuzingatiwa katika sehemu ambapo hutokea sana.<ref name=GOLD2013Chp2/> Magonjwa yasiyotokea sana bali yanayoweza kujitokeza sawa ni [[displasia ya mapafu na bronkasi]] na [[bronkiolitisi ya kufungana kwa bronkasi]].<ref name=NICE2010P70>{{NICE|101|Chronic Obstructive Pulmonary Disease|June 2010|70-80}}</ref> Bronkiolitisi sugu inaweza kutokea hata kwa upitaji wa kawaida wa hewa na katika hali hii haiainishwi kama ugonjwa sugu wa kufungana kwa njia za hewa.<ref name=Harr2012/> ==Kuzuia== Visa vingi vya ugonjwa sugu wa kufungana kwa njia za hewa vinaweza kuzuiwa kwa kupunguza kutangamana na moshi na kuendeleza ubora wa hewa.<ref name=Piro2012/> [[Chanjo za influenza]] za mwaka kwa walio na ugonjwa sugu wa kufungana kwa njia za hewa hupunguza maumivu zaidi, kulazwa hospitalini na kifo.<ref name=Mackay2012>{{cite journal | author = Mackay AJ, Hurst JR | title = COPD exacerbations: causes, prevention, and treatment | url = https://archive.org/details/sim_medical-clinics-of-north-america_2012-07_96_4/page/789 | journal = Med. Clin. North Am. | volume = 96 | issue = 4 | pages = 789–809 | year = 2012 | month = July | pmid = 22793945 | doi = 10.1016/j.mcna.2012.02.008 }}</ref><ref>{{cite journal |author=Poole PJ, Chacko E, Wood-Baker RW, Cates CJ |title=Influenza vaccine for patients with chronic obstructive pulmonary disease |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD002733 |year=2006 |pmid=16437444|doi=10.1002/14651858.CD002733.pub2 |editor1-last=Poole |editor1-first=Phillippa}}</ref> [[Chanjo ya numokokasi|Uchanjaji dhidi ya numokokasi]] pia unaweza kuwa ya usaidizi.<ref name=Mackay2012/> ===Kusitisha uvutaji wa sigara=== Kuwakinga watu dhidi ya kuanza uvutaji wa sigara kipengele kikuu cha kuzuia ugonjwa sugu wa kufungana kwa njia za hewa.<ref name=GOLD2013ChpX/> [[Uvutaji wa tumbaku#Masuala ya kisheria na taratibu|kanuni]] za serikali, taasisi za afya ya umma na mashirika yanayopinga uvutaji zinaweza kupunguza viwango vya uvutaji kwa kuwakataza watu kuanza na kuwahimize waache uvutaji.<ref name=WHO2003/> [[Marufuku dhidi ya uvutaji]] katika sehemu za umma na pahali pa kazi ni njia muhimu za kupunguza kutangamana na moshi kutoka kwa watu wengine na ilhali sehemu nyingi zina marufuku ya kisheria, marufuku Zaidi yanahimizwa.<ref name=Piro2012/> Kwa wanaovuta, [[kusitisha uvutaji|kukoma uvutaji]] ndiyo njia pekee iliyothibitishwa kupunguza kukithiri kwa ugonjwa sugu wa kufungana kwa njia za hewa.<ref name=Jim2013>{{cite journal | author = Jiménez-Ruiz CA, Fagerström KO | title = Smoking cessation treatment for COPD smokers: the role of counselling | journal = Monaldi Arch Chest Dis | volume = 79 | issue = 1 | pages = 33–7 | year = 2013 | month = March | pmid = 23741944 | doi = }}</ref> Hata katika kipindi cha mwisho cha ugonjwa, kunaweza kupunguza kiwango cha kudhoofika kwa utendakazi wa mapafu na kudhibiti mwanzo wa ulemavu na kifo.<ref name=kc>{{cite book |author=Kumar P, Clark M |title=Clinical Medicine |publisher=Elsevier Saunders |year=2005 |isbn=0-7020-2763-4 |pages=900–1 |edition=6th }}</ref> Kusitisha uvutaji huanza na uamuzi wa kukoma kuvuta, unaopelekea jaribio la kukoma. Mara nyingi majaribio kadhaa huhitajika kabla ya kukoma kabisa kutimika..<ref name = WHO2003>{{cite book |url=http://www.who.int/tobacco/resources/publications/tobacco_dependence/en/ |publisher=World Health Organization |title=Policy Recommendations for Smoking Cessation and Treatment of Tobacco Dependence |isbn=978-92-4-156240-9 |pages=15–40 |access-date=2014-06-23 |archive-date=2008-09-15 |archive-url=https://web.archive.org/web/20080915105015/http://www.who.int/tobacco/resources/publications/tobacco_dependence/en/ |dead-url=yes }}</ref> Majaribu ya zaidi ya miaka 5 husababisha mafanikio katika takiban asilimia 40 ya watu.<ref name=Ton2013/> Wavutaji wengine wanaweza kutimiza kukoma uvutaji kabisa kwa hiari yao pekee. Hata hivyo uvutaji ni wa mazoea sana,<ref>{{cite web |url=http://www.nhs.uk/chq/Pages/2278.aspx?CategoryID=53&SubCategoryID=536 |title=Why is smoking addictive? |work=NHS Choices |date=December 29, 2011 |accessdate=November 29, 2013 |archive-date=2013-10-13 |archive-url=https://web.archive.org/web/20131013041250/http://www.nhs.uk/chq/Pages/2278.aspx?CategoryID=53&SubCategoryID=536 |url-status=dead }}</ref> na wavutaji wengi wanahitaji usaidizi zaidi. Uwezekano wa kukoma huendelezwa kwa usaidizi wa kijamii, kuhusika katika mpango wa kukomesha uvutaji na kutumia tiba kama vile [[tiba ya kubadili nikotini]], [[bupropion]] au [[varenicline]].<ref name=WHO2003/><ref name=Ton2013>{{cite journal | author = Tønnesen P | title = Smoking cessation and COPD | journal = Eur Respir Rev | volume = 22 | issue = 127 | pages = 37–43 | year = 2013 | month = March | pmid = 23457163 | doi = 10.1183/09059180.00007212 }}</ref> ===Afya Kazini=== Hatua kadhaa zimechukuliwa kupunguza uwezekano kuwa wafanyi kazi katika viwanda vyenye hatari—kama vile kuchimba makaa ya mawe,ujenzi na kuchonga mawe—watapata ugonjwa sugu wa kufungana kwa njia za hewa.<ref name=Piro2012/> Mifano ya hatua hizi ni: kutengeneza sera za umma,<ref name=Piro2012/> mafunzo kwa wafanyi kazi kuhusu hatari hizi, kuendeleza kusitisha uvutaji, [[uchunguzi wa ugonjwa|kuchunguza]] wafanyi kazi kwa ishara za mapema za ugonjwa sugu wa kufungana kwa njia za hewa, kutumia [[kipumulio]], na kuzuia vumbi.<ref>{{cite book|last=Smith|first=Barbara K. Timby, Nancy E.|title=Essentials of nursing : care of adults and children|year=2005|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-5098-1|page=338|url=http://books.google.ca/books?id=LJWDJMoStnMC&pg=PA338}}</ref><ref>{{cite book |editor2-last=Markowitz |editor1-first=William N. |editor1-last=Rom |editor2-first=Steven B.|title=Environmental and occupational medicine|year=2007|publisher=Wolters Kluwer/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-6299-1|pages=521–2|url=http://books.google.ca/books?id=H4Sv9XY296oC&pg=PA521|edition=4th }}</ref> Uzuiaji bora wa vumbi unaweza kutimizwa kwa kuboresha upitaji wa hewa, kutumia vinyunyizio vya maji na kutumia mbinu za uchimbaji migodi zinazothibiti utengenezaji wa vumbi.<ref>{{cite web |url=http://www.hse.gov.uk/copd/casestudies/wetcut.htm |title=Wet cutting |publisher=[[Health and Safety Executive]] |accessdate=November 29, 2013 |archive-date=2013-12-03 |archive-url=https://web.archive.org/web/20131203004449/http://www.hse.gov.uk/copd/casestudies/wetcut.htm |url-status=dead }}</ref> Mfanyi kazi akipata ugonjwa sugu wa kufungana kwa njia za hewa, uharibikaji zaidi wa mapafu unaweza kupunguzwa kwa kuepuka kutangamana na vumbi, kwa mfano kwa kubadilisha majukumu ya kikazi.<ref>{{cite book|last=George|first=Ronald B.|title=Chest medicine : essentials of pulmonary and critical care medicine|year=2005|publisher=Lippincott Williams & Wilkins|location=Philadelphia, PA|isbn=978-0-7817-5273-2|page=172|url=http://books.google.ca/books?id=ZzlX2zJMbdgC&pg=PA172|edition=5th }}</ref> ===Uchafuzi wa hewa=== Ubora wa hewa nje na ndani mwa nyumba unaweza kuendelezwa, hii inaweza kuzuia ugonjwa sugu wa kufungana kwa njia za hewa au kupunguza kiwango cha kukithiri kwa kwa ugonjwa uliopo.<ref name=Piro2012/> Hii inaweza kutimizwa kwa juhudi za sera za umma, mabadiliko ya kitamaduni, na kuhusika kwa watu binafsi.<ref name=GOLD2013Chp4>{{cite book |last=Vestbo |first=Jørgen |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease |year=2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |pages=31–8 |chapter=Management of Stable COPD |url=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#48 |access-date=2014-06-23 |archive-date=2013-10-04 |archive-url=https://web.archive.org/web/20131004234113/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#48 |dead-url=yes |=https://web.archive.org/web/20160328053032/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#48 }}</ref> Baadhi ya nchi zilizostawi zimefanikiwa katika kudumisha ubora wa nje kupitia kanuni.<!-- <ref name=Piro2012/> --> Hii imepelekea kuboresha utendakazi wa mapafu wa watu wao.<ref name=Piro2012/> Walio na ugonjwa sugu wa kufungana kwa njia za hewa wanaweza kupata dalili chache iwapo watakaa ndani ya nyumba katika siku ambazo ubora wa hewa nje ya nyumba ni duni.<ref name=.GOLD2007/> Juhudi moja kuu ni kupunguza kutangamana na moshi wa kupika na kuchoma fueli kwa kuhakikisha upitaji bora wa hewa mabomani na stovu na dohani bora.<ref name=GOLD2013Chp4/> Stovu bora zinaweza kuboresha hewa ya ndani mwa nyumba kwa asilimia 85.<!-- <ref name=Piro2012/> --> Kutumia vyanzo mbadala vya nishati kama vile [[kupika kwa jua]] na kutumia stima ni bora,<!-- <ref name=Piro2012/> --> kama tu kutumia fueli kama vile mafuta ya taa au makaa ya mawe badala ya biomasi.<ref name=Piro2012/> == Kudhibiti == Hakuna tiba inayojulikana ya ugonjwa sugu wa kufungana kwa njia za hewa lakini dalili zinaweza kutibiwa na kukithiri kwake kudhibitiwa.<ref name=GOLD2013ChpX/> Malengo makuu ya udhibiti ni kupunguza visababishi vya hatari, kudhibiti ugonjwa sugu wa kufungana kwa njia za hewa uliojijenga, kuzuia na kutibu maumivu zaidi makali na kudhibiti maradhi husika.<ref name=GOLD2007/> Hatua pekee zilizodhibitishwa kuweza kupunguza vifo ni kusitisha uvutaji na oksijeni ya kuongeza.<ref name=Drummond08>{{cite journal |author=Drummond MB, Dasenbrook EC, Pitz MW, Murphy DJ, Fan E|title=Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis |url=https://archive.org/details/sim_jama_2008-11-26_300_20/page/n78|journal=JAMA |volume=300 |issue=20 |pages=2407–16 |year=2008|month=November |pmid=19033591|doi=10.1001/jama.2008.717 }}</ref> Kukoma uvutaji hupunguza hatari ya kifo kwa asilimia 18.<ref name=Lancet2012/> Mapendekezo mengine ni: chanjo ya influenza mara moja kwa mwaka, chanjo ya numokokasi mara moja kila baada ya miaka 5, na kupunguza kutangamana na uchafuzi wa hewa wa kimazingira.<ref name=Lancet2012/> kwa walio na ugonjwa uliokithiri, [[utunzajia wa kutuliza]] unaweza kupunguza dalili, na morphine kukabiliana na hisia za upungufu wa pumzi.<ref name=Carl2012>{{cite journal |author=Carlucci A, Guerrieri A, Nava S |title=Palliative care in COPD patients: is it only an end-of-life issue? |journal=Eur Respir Rev |volume=21 |issue=126 |pages=347–54 |year=2012 |month=December|pmid=23204123|doi=10.1183/09059180.00001512 |url=}}</ref> [[Upitishaji wa hewa bila kutumia njia za hewa bandia]] unaweza kutumika kusaidia upumuaji.<ref name=Carl2012/> ===Mazoezi=== [[Kurudisha mapafu katika hali ya kawaida]] ni programu ya mazoezi, udhibiti wa ugonjwa na ushauri, vilivyopangwa kumfaidi mtu binafsi.<ref>{{cite web|url=http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_Treatments.html |title=COPD — Treatment |publisher=U.S. National Heart Lung and Blood Institute |accessdate=2013-07-23}}</ref> kwa wale ambao wamekuwa na maumivu zaidi hivi karibuni,kurudisha mapafu katika hali ya kawaida huonekana kuendeleza ubora wa maisha kwa jumla na uwezo wa kufanya mazoezi, na kupunguza vifo.<ref name=Puhan2011>{{cite journal |author=Puhan MA, Gimeno-Santos E, Scharplatz M, Troosters T, Walters EH, Steurer J |editor1-last=Puhan |editor1-first=Milo A |title=Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease |journal=Cochrane Database Syst Rev |issue=10 |pages=CD005305 |year=2011|pmid=21975749 |doi=10.1002/14651858.CD005305.pub3 }}</ref> Pia imeonyeshwa uwezo alio nao mtu katika kuthibiti ugonjwa wake, na vile vile hisia zake.<ref name=Lac2006>{{cite journal | author = Lacasse Y, Goldstein R, Lasserson TJ, Martin S | title = Pulmonary rehabilitation for chronic obstructive pulmonary disease | journal = Cochrane Database Syst Rev | volume = | issue = 4 | pages = CD003793 | year = 2006 | pmid = 17054186 | doi = 10.1002/14651858.CD003793.pub2 | editor1-last = Lacasse | editor1-first = Yves }}</ref> Mazoezi ya kupumua pekee yameonekana kuwa na jukumu dogo sana.<ref name=Holland2012/> Kuwa na uzani wa chini au wa juu zaidi kunaweza kuathiri dalili, kiwango cha ulemavu na prognosi ya ugonjwa sugu wa kufungana kwa njia za hewa. Watu walio na ugonjwa sugu wa kufungana kwa njia za hewa walio na uzani wa chini wanaweza kuboresha nguvu za misuli ya kupumua kwa kuongeza kiwango cha kalori.<ref name=GOLD2007/> Pamoja na mazoezi ya mara kwa mara au mpango wa kurudisha mapafu katika hali ya kawaida inaweza kuleta mabadiliko katika dalili za ugonjwa sugu wa kufungana kwa njia za hewa. Lishe Zaidi inaweza kuwa muhimu kwa walio na[[utapiamlo|wenye utapiamlo]].<ref name=Ferr2012>{{cite journal|author=Ferreira IM, Brooks D, White J, Goldstein R |editor1-last=Ferreira|editor1-first=Ivone M |title=Nutritional supplementation for stable chronic obstructive pulmonary disease |journal=Cochrane Database Syst Rev |volume=12 |pages=CD000998 |year=2012 |pmid=23235577 |doi=10.1002/14651858.CD000998.pub3 }}</ref> ===Kitanua bronkasi=== [[Vitanua bronkasi]] vilivyopumuliwa ndani ndivyo tiba za kimsingi zinazotumika<ref name=Lancet2012/> na husababisha manufaa machache kwa jumla.<ref name=VanD2013>{{cite journal | author = van Dijk WD, van den Bemt L, van Weel C | title = Megatrials for bronchodilators in chronic obstructive pulmonary disease (COPD) treatment: time to reflect | journal = J Am Board Fam Med | volume = 26 | issue = 2 | pages = 221–4 | year = 2013 | pmid = 23471939 | doi = 10.3122/jabfm.2013.02.110342}}</ref> Kuna aina mbili kuu, [[Beta2-adrenergic agonist|β₂ agonists]] na [[kinza kikolini]]; ambazo huwa katika aina ya muda mrefu na ile ya muda mfupi. Hupunguza upungufu wa pumzi, mkoroto na udhibiti wa mazoezi na kupelekea [[ubora wa maisha]].<ref name=Lies2002>{{cite journal |author=Liesker JJ, Wijkstra PJ, Ten Hacken NH, Koëter GH, Postma DS, Kerstjens HA |title=A systematic review of the effects of bronchodilators on exercise capacity in patients with COPD |journal=Chest |volume=121 |issue=2 |pages=597–608 |year=2002 |month=February |pmid=11834677 |doi=10.1378/chest.121.2.597 |url=http://journal.publications.chestnet.org/article.aspx?articleid=1080303 |access-date=2014-06-23 |archive-date=2015-09-28 |archive-url=https://web.archive.org/web/20150928003929/http://journal.publications.chestnet.org/article.aspx?articleid=1080303 |dead-url=yes }}</ref> Haijabainika iwapo zinabadilisha kukithiri kwa ugonjwa uliopo<ref name=Lancet2012/> Kwa walio na ugonjwa kidogo, ajenti za muda mfupi hupendekezwa kwa [[Pro re nata |jinsi inavyohitajika]] <ref name=Lancet2012/> Kwa walio na ugonjwa mkali sana ajenti za muda mrefu hupendekezwa.<ref name=Lancet2012/> Iwapo vitanua bronkasi vya muda mrefu havitoshelezi, kwa kawaida kotikosteroidi huongezwa<ref name=Lancet2012/> Kwa kurejelea ajenti za muda mrefu, haijabainika iwapo [[tiotropium]] (kinza kikolini ya muda mrefu)au [[gnisti za beta za muda mrefu]] ni nzuri, na zinaweza kujaribiwa kwa zamu na kuendelea na iliyo bora zaidi.<ref name=Chong2012>{{cite journal | author = Chong J, Karner C, Poole P | title = Tiotropium versus long-acting beta-agonists for stable chronic obstructive pulmonary disease | journal = Cochrane Database Syst Rev | volume = 9 | issue = | pages = CD009157 | year = 2012 | pmid = 22972134 | doi = 10.1002/14651858.CD009157.pub2 | editor1-last = Chong | editor1-first = Jimmy }}</ref> Aina zote mbili za ajenti huonekana kupunguza hatari za maumivu makali zaidi kwa asilimia 15-25.<ref name=Lancet2012/> Zinapotumiwa kwa wakati mmoja zinaweza kufaidi,hata hivyo, hata faida hii ikiwepo, umuhimu wake si bayana.<ref name=Karner2012>{{cite journal | author = Karner C, Cates CJ | title = Long-acting beta(2)-agonist in addition to tiotropium versus either tiotropium or long-acting beta(2)-agonist alone for chronic obstructive pulmonary disease | journal = Cochrane Database Syst Rev | volume = 4 | issue = | pages = CD008989 | year = 2012 | pmid = 22513969 | doi = 10.1002/14651858.CD008989.pub2 | editor1-last = Karner | editor1-first = Charlotta }}</ref> Kuna aina kadhaa za muda mfupi za β₂ zinazopatikana ikiwa ni pamoja na[[salbutamol]] (Ventolin) na [[terbutaline]].<ref name=GOLD2013Chp3/> Hizi hupunguza ukali wa dalili kwa saa nne hadi sita.<ref name=GOLD2013Chp3/> Agonisti za muda mrefu za β ₂ kama vile [[salmeterol]] na [[formoterol]] mara nyingi hutumiwa kwa matibabu ya kurekebisha. Wengine huhisi kuwa ushahidi wa manufaa ni mdogo<ref name=Cave2011>{{Rejea jarida | last1 = Cave | first1 = AC. | last2 = Hurst | first2 = MM. | title = The use of long acting β₂-agonists, alone or in combination with inhaled corticosteroids, in chronic obstructive pulmonary disease (COPD): a risk-benefit analysis | journal = Pharmacol Ther | volume = 130 | issue = 2 | pages = 114–43 | month = May | year = 2011 | doi = 10.1016/j.pharmthera.2010.12.008 | pmid = 21276815 }}</ref> ilhali wengine huona ushahidi wa manufaa kuwa uliopo.<ref>{{cite journal|last=Spencer|first=S|coauthors=Karner, C; Cates, CJ; Evans, DJ|title=Inhaled corticosteroids versus long-acting beta(2)-agonists for chronic obstructive pulmonary disease|journal=The Cochrane database of systematic reviews|date=2011 Dec 7|issue=12|pages=CD007033|pmid=22161409|doi=10.1002/14651858.CD007033.pub3|editor1-last=Spencer|editor1-first=Sally}}</ref><ref>{{cite journal|last=Wang|first=J|coauthors=Nie, B; Xiong, W; Xu, Y|title=Effect of long-acting beta-agonists on the frequency of COPD exacerbations: a meta-analysis|journal=Journal of clinical pharmacy and therapeutics|date=2012 Apr|volume=37|issue=2|pages=204–11|pmid=21740451|doi=10.1111/j.1365-2710.2011.01285.x}}</ref> Matumizi ya muda mrefu huonekana kuwa salama kwa ugonjwa sugu wa kufungana kwa njia za hewa<ref name=Decr2013>{{cite journal | author = Decramer ML, Hanania NA, Lötvall JO, Yawn BP | title = The safety of long-acting β2-agonists in the treatment of stable chronic obstructive pulmonary disease | journal = Int J Chron Obstruct Pulmon Dis | volume = 8 | issue = | pages = 53–64 | year = 2013 | pmid = 23378756 | pmc = 3558319 | doi = 10.2147/COPD.S39018 }}</ref> huku madhara yakiwa [[tetemeko|kutetemeka]] na [[mpapatiko|mipapatiko ya moyo]].<ref name=Lancet2012/> Zikitumiwa pamoja na steroidi za kupumuliwa ndani, huongeza hatari ya nimonia.<ref name=Lancet2012/> Ingawa steroidi na LABAs zinaweza kufanya kazi vyema pamoja,<ref name=Cave2011/> si bayana ikiwa manufaa haya madogo yanazidi hatari zilizoongezeka. <ref>{{cite journal|last=Nannini|first=LJ|coauthors=Lasserson, TJ; Poole, P|title=Combined corticosteroid and long-acting beta(2)-agonist in one inhaler versus long-acting beta(2)-agonists for chronic obstructive pulmonary disease|journal=The Cochrane database of systematic reviews|date=2012 Sep 12|volume=9|pages=CD006829|pmid=22972099|doi=10.1002/14651858.CD006829.pub2|editor1-last=Nannini|editor1-first=Luis Javier}}</ref> Kuna aina mbili kuu za kinza kikolini zinazotumika katika ugonjwa sugu wa kufungana kwa mapafu, [[ipratropium]] na [[tiotropium]] Ipratropium ni ajenti inayofanya kazi kwa muda mfupi ilhali tiotropium hufanya kazi kwa muda mrefu. Tiotropium inahusiana na kupungua kwa maumivu zaidi na kuboresha hali ya maisha,<ref name=Karner2012/> na tiotropium hutoa manufaa haya zaidi ya ipratropium. <ref>{{cite journal |author=Cheyne L, Irvin-Sellers MJ, White J |editor1-last=Cheyne |editor1-first=Leanne |title=Tiotropium versus ipratropium bromide for chronic obstructive pulmonary disease |journal=Cochrane Database of Systematic Reviews |date=2013 Sep 16 |issue=9 |pages=CD009552 |doi=10.1002/14651858.CD009552.pub2 |pmid=24043433 |volume=9}}</ref> Haionekani kuathiri kiwango cha vifo au kiwango cha jumla cha kulazwa hospitalini.<ref>{{cite journal|last=Karner|first=C|coauthors=Chong, J; Poole, P|title=Tiotropium versus placebo for chronic obstructive pulmonary disease|journal=The Cochrane database of systematic reviews|date=2012 Jul 11|volume=7|pages=CD009285|pmid=22786525|doi=10.1002/14651858.CD009285.pub2|editor1-last=Karner|editor1-first=Charlotta}}</ref> Anticholinergics zinaweza kusababisha dalili za kinywa kukauka na dalili za maambukizi ya bofu la mkojo .<ref name=Lancet2012/> Pia zinahusiana na ongezeko la hatari ya ugonjwa wa moyo na kiharusi<ref name=Singh2008>{{cite journal | author = Singh S, Loke YK, Furberg CD | title = Inhaled anticholinergics and risk of major adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis | url = https://archive.org/details/sim_jama_2008-09-24_300_12/page/n66 | journal = JAMA | volume = 300 | issue = 12 | pages = 1439–50 | year = 2008 | month = September | pmid = 18812535 | doi = 10.1001/jama.300.12.1439 }}</ref><ref name=Singh2013>{{cite journal | author = Singh S, Loke YK, Enright P, Furberg CD | title = Pro-arrhythmic and pro-ischaemic effects of inhaled anticholinergic medications | journal = Thorax | volume = 68 | issue = 1 | pages = 114–6 | year = 2013 | month = January | pmid = 22764216 | doi = 10.1136/thoraxjnl-2011-201275 }}</ref> ===Kotikosteroidi=== [[Kotikosteroidi]] kwa kawaida hutumika kama aina ya kupumua ndani lakini pia zinaweza kutumika kama tembe kutibu na kuzuia maumivu makali zaidi. Ingawa kotikosteroidi za kupumuliwa ndani hazijaonyesha manufaa kwa watu walio na ugonjwa sugu wa kufungana kwa njia za hewa mdogo <ref>{{cite journal |author=Gartlehner G, Hansen RA, Carson SS, Lohr KN |title=Efficacy and Safety of Inhaled Corticosteroids in Patients With COPD: A Systematic Review and Meta-Analysis of Health Outcomes |journal=Ann Fam Med |volume=4 |issue=3 |pages=253–62 |year=2006 |pmid=16735528 |pmc=1479432|doi=10.1370/afm.517 }}</ref>Zinapotumiwa kwa pamoja na LABA hupunguza kiwango cha vifo Zaidi ya kotikosteroidi za kupumuliwa ndani au LABA pekee.<ref name=Shaf2013>{{cite journal | author = Shafazand S | title = ACP Journal Club. Review: inhaled medications vary substantively in their effects on mortality in COPD | journal = Ann. Intern. Med. | volume = 158 | issue = 12 | pages = JC2 | year = 2013 | month = June | pmid = 23778926 | doi = 10.7326/0003-4819-158-12-201306180-02002 }}</ref> Kivyake hazina athari kwa kiwango cha jumla cha vifo vya mwaka mmoja na huhusiana na viwango zaidi vya nimonia .<ref name="Drummond08"/> Si bayana iwapo zinaathiri kuendelea kwa ugonjwa huo.<ref name=Lancet2012/> Matibabu ya muda mrefu na tembe za steroidi huhusiana na madhara makubwa.<ref name=GOLD2013Chp3/> ===Matibabu mengine=== [[Antibiotiki]] za muda mrefu, hasa za kundi la [[macrolide]] kama vile[[azithromycin]], hupunguza kiwango cha kutokea kwa maumivu Zaidi kwa wale wanaokuwa nayo mara mbili au Zaidi kwa mwaka.<ref name=Mammen2012>{{cite journal | author = Mammen MJ, Sethi S | title = Macrolide therapy for the prevention of acute exacerbations in chronic obstructive pulmonary disease | journal = Pol. Arch. Med. Wewn. | volume = 122 | issue = 1–2 | pages = 54–9 | year = 2012 | pmid = 22353707}}</ref> Hii inaweza kuwa ya bei nafuu katika maeneo fulani ulimwenguni.<ref>{{cite journal|last=Simoens|first=S|coauthors=Laekeman, G; Decramer, M|title=Preventing COPD exacerbations with macrolides: a review and budget impact analysis|journal=Respiratory medicine|date=2013 May|volume=107|issue=5|pages=637–48|pmid=23352223|doi=10.1016/j.rmed.2012.12.019}}</ref> [[Xanthine|Methylxanthines]] kama vile [[theophylline]] husababisha madhara zaidi ya manufaa na kwa hivyo kwa kawaida hazipendekezwi,<ref name=Bar2003>{{cite journal |author=Barr RG, Rowe BH, Camargo CA |editor1-last=Barr |editor1-first=R Graham |title=Methylxanthines for exacerbations of chronic obstructive pulmonary disease |journal=Cochrane Database Syst Rev |issue=2 |pages=CD002168 |year=2003 |pmid=12804425 |doi=10.1002/14651858.CD002168 }}</ref> lakini zinaweza kutumika kama ajenti za kundi la pili kwa magonjwa yasiyothibitiwa na hatua zingine.<ref name=GOLD2007/> [[Mucolytic]] zinaweza kuwa bora kwa watu wengine walio na kamasi nzito lakini hazihitajiki.<ref name=Mackay2012/> [[Dawa za kikohozi]] hazipendekezwi.<ref name=GOLD2013Chp3/> ===Oksijeni=== [[Tiba ya oksijeni|oksijeni zaidi]] hupendekezwa kwa walio na viwango vya chini vya oksijeni wakiwa wametulia ([[shinikizo dogo la oksijeni]] la chini ya &nbsp;mmHg 50-55 au ujazo wa chini wa oksijeni kwa asilimia 88).<ref name=GOLD2013Chp3>{{cite book |last=Vestbo |first=Jørgen |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease |year=2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |pages=19–30 |chapter=Therapeutic Options |chapterurl=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#36 |access-date=2014-06-23 |archive-date=2013-10-04 |archive-url=https://web.archive.org/web/20131004234113/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#36 |dead-url=yes }}</ref><ref name=Kundi2012/> Katika kundi hili la watu, hupunguza hatari ya [[moyo kushindwa kufanya kazi]] na kifo iwapo ikitumia saa 15&nbsp;kwa siku<ref name=GOLD2013Chp3/><ref name=Kundi2012>{{cite journal|last=COPD Working|first=Group|title=Long-term oxygen therapy for patients with chronic obstructive pulmonary disease (COPD): an evidence-based analysis|journal=Ontario health technology assessment series|year=2012|volume=12|issue=7|pages=1–64|pmid=23074435|pmc=3384376}}</ref> na inaweza kuongeza uwezo wa watu kufanya mazoezi.<ref name=Brad2005>{{cite journal | author = Bradley JM, O'Neill B | title = Short-term ambulatory oxygen for chronic obstructive pulmonary disease | journal = Cochrane Database Syst Rev | volume = | issue = 4 | pages = CD004356 | year = 2005 | pmid = 16235359 | doi = 10.1002/14651858.CD004356.pub3 | editor1-last = Bradley | editor1-first = Judy M }}</ref> Kwa wale walio na viwango vya kawaida au vidogo vya oksijeni, kupewa oksijeni zaidi kunaweza kuboresha upungufu wa pumzi. <ref name=Uron2011>{{cite journal | author = Uronis H, McCrory DC, Samsa G, Currow D, Abernethy A | title = Symptomatic oxygen for non-hypoxaemic chronic obstructive pulmonary disease | journal = Cochrane Database Syst Rev | volume = | issue = 6 | pages = CD006429 | year = 2011 | pmid = 21678356 | doi = 10.1002/14651858.CD006429.pub2 | editor1-last = Abernethy | editor1-first = Amy }}</ref> Kuna hatari ya moto na manufaa machache kwa wanaopewa oksijeni wakiendelea na uvutaji. <ref>{{cite book|last=Chapman|first=Stephen|title=Oxford handbook of respiratory medicine|year=2009|publisher=Oxford University Press|location=Oxford|isbn=978-0-19-954516-2|page=707|url=http://books.google.ca/books?id=945lM1g_uQoC&pg=PA707|edition=2nd}}</ref> Katika hali hii wengine huipinga.<ref>{{cite book|last=Blackler|first=Laura|title=Managing chronic obstructive pulmonary disease|year=2007|publisher=John Wiley & Sons|location=Chichester, England|isbn=978-0-470-51798-7|page=49|url=http://books.google.ca/books?id=D5n6lqqxkNUC&pg=PA49}}</ref> Wakati wa maumivu Zaidi makali, wengi huhitaji tiba ya oksijeni; utumizi wa viwango vikubwa vya oksijeni bila kuzingatia viwango vya mtu vya oksijeni unaweza kusababisha ongezeko la dioksidi ya kaboni na matokeo mabaya.<ref>{{cite book|last=Jindal|first=Surinder K|title=Chronic Obstructive Pulmonary Disease.|year=2013|publisher=Jaypee Brothers Medical Pub|isbn=978-93-5090-353-7|page=139|url=http://books.google.ca/books?id=PTgIAQAAQBAJ&pg=PA139}}</ref><ref name=BTS2008>{{cite journal|last=O'Driscoll|first=BR|coauthors=Howard, LS; Davison, AG; British Thoracic, Society|title=BTS guideline for emergency oxygen use in adult patients|journal=Thorax|date=2008 Oct|volume=63 Suppl 6|pages=vi1–68|pmid=18838559|doi=10.1136/thx.2008.102947}}</ref> Kwa wale walio katika hatari zaidi ya viwango vya juu vya dioksidi ya kaboni, viwango vya oksijeni vya asilimia 88-92 hupendekezwa, ilhali kwa wale wasio katika hatari hii viwango vinavyopendekezwa ni asilimia 94-98.<ref name=BTS2008/> ===Upasuaji=== Kwa walio na ugonjwa mkali sana, wakati mwingine upasuaji huwa bora na unaweza kuwa [[ubadilishaji wa pafu]] au [[upasuaji wa kupunguza ukubwa wa pafu]].<ref name=Lancet2012/> Upasuaji wa kupunguza ukubwa wa pafu hujumuisha kuondoa sehemu za pafu zilizohariwa sana na emfisema na kuwezesha inayobaki, ambayo ni ndilo pafu zuri kupanuka na kufanya kazi vizuri. <ref name=GOLD2013Chp3/> [[Ubadilishaji wa pafu]] wakati mwingine hufanywa kwa walio na ugonjwa sugu mkali sana wa kufungana kwa njia za pumzi, hasa kwa watu walio na umri mdogo.<ref name=GOLD2013Chp3/> ===Maumivu zaidi=== Kwa kawaida maumivu Zaidi makali hutibiwa kwa kuongeza utumizi wa vitanua bronkasi vya muda mfupi.<ref name=Lancet2012/> Hii mara nyingi hujumuisha mchanganyiko agonisti ya beta ya muda mfupi iliyopumuliwa ndani na kinza kikolini. <ref name=GOLD2013Chp5/> Dawa hizi zinaweza kutumika kupitia [[kifaa cha kutoa kiasi fulani cha tiba kwa mapafu]] na [[Spacer ya asthma|Spacer]] au kupitia [[kinebulishi]] na zote huonekana kufanya kazi vizuri.<ref name=GOLD2013Chp5/> Kinebulishi kinaweza kuwa rahisi kwa walio wagonjwa zaidi. <ref name=GOLD2013Chp5/> Kotikosteroidi za kinywani huboresha nafasi ya kupata nafuu na kupunguza muda wa dalili kwa jumla.<ref name=Lancet2012/><ref name=GOLD2013Chp5/> Kwa wale walio na maumivu zaidi makali, antibiotiki huboresha matokeo. <ref name=Vollen2012>{{cite journal |author=Vollenweider DJ, Jarrett H, Steurer-Stey CA, Garcia-Aymerich J, Puhan MA |editor1-last=Vollenweider |editor1-first=Daniela J|title=Antibiotics for exacerbations of chronic obstructive pulmonary disease |journal=Cochrane Database Syst Rev|volume=12 |pages=CD010257 |year=2012 |pmid=23235687 |doi=10.1002/14651858.CD010257 }}</ref> Antibiotiki tofauti zinaweza kutumiwa zikiwemo: [[amoxicillin]], [[doxycycline]] au [[azithromycin]] si bayana iwapo moja ni bora kuliko zingine.<ref name=Mackay2012/> Hakuna ushahidi bayana kwa walio na visa visivyo vikali.<ref name=Vollen2012/> [[Upitishaji wa shinikizo chanya la sehemu maalum]] kwa wale walio na viwango vya juu Zaidi vya dioksdi ya kaboni ₂ ([[kushindwa kupumua|aina ya 2 ya kushindwa kupumua]]) hupunguza uwezekano wa kifo kutokana na au kuhitaji kulazwa kwa uangilizi makini [[upitishaji hewa wa kimashine]].<ref name=Lancet2012/> Pia, theophylline inaweza kutumiwa kwa wasiopata nafuu kutokana na mbinu zingine.<ref name=Lancet2012/> Chini ya asilimia 20 ya maumivu zaidi huhitaji kulazwa hospitalini. <ref name=GOLD2013Chp5/>Kwa wasio na asidosisi inayotokana na matatizo ya kupumua, [[utunzaji wa nyumbani]] ("hospitali ya nyumbani") unaweza kusaidia kuepuka kulazwa.<ref name=GOLD2013Chp5/><ref>{{cite journal|last=Jeppesen|first=E|coauthors=Brurberg, KG; Vist, GE; Wedzicha, JA; Wright, JJ; Greenstone, M; Walters, JA|title=Hospital at home for acute exacerbations of chronic obstructive pulmonary disease.|journal=The Cochrane database of systematic reviews|date=2012 May 16|volume=5|pages=CD003573|pmid=22592692 | doi=10.1002/14651858.CD003573.pub2}}</ref> ==Prognosi== [[File:Ramani ya dunia ya ugonjwa sugu wa kufungana kwa njia za hewa - DALY – Shirika la Afya Duniani2004.svg|250px|kidole gumba|[[Ulemavu-…mwaka wa maisha yaliyorekebishwa]] kwa ugonjwa sugu wa kufungana kwa njia za hewa kwa kila wakazi 100,000&nbsp;katika mwaka wa 2004.<ref>{{cite web|url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=WHO Disease and injury country estimates |year=2009 |work=World Health Organization |accessdate=Nov. 11, 2009}}</ref> {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|≤110}} {{legend|#fff200|110–220}} {{legend|#ffdc00|220–330}} {{legend|#ffc600|330–440}} {{legend|#ffb000|440–550}} {{legend|#ff9a00|550–660}} {{Multicol-break}} {{legend|#ff8400|660–770}} {{legend|#ff6e00|770–880}} {{legend|#ff5800|880–990}} {{legend|#ff4200|990–1100}} {{legend|#ff2c00|1100–1350}} {{legend|#cb0000|≥1350}} {{Multicol-end}}]] Ugonjwa sugu wa kufungana kwa njia za hewa huzidi polepole na hatimaye unaweza kusababisha kifo. Inakadiriwa kuwa asilimia 3 ya [[miaka ya maisha yaliyorekebishwa kwa ulemavu|ulemavu wote]] inahusiana na ugonjwa sugu wa kufungana kwa njia za hewa. <ref name=DALY2012/> Sehemu ya ulemavu unaotokana na ugonjwa sugu wa kufungana kwa njia za hewa ulimwenguni imepungua tangu mwaka wa 1990 hadi 2010 kutokana na kuboreshwa kwa hali ya hewa ndani ya nyumba hasa Asia.<ref name=DALY2012>{{cite journal | author = Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, ''et al.'' | title = Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 | url = https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2197 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2197–223 | year = 2012 | month = December | pmid = 23245608 | doi = 10.1016/S0140-6736(12)61689-4 | displayauthors = 30 }}</ref> Idadi ya miaka ya kuishi na ulemavu unaotokana na ugonjwa sugu wa kufungana kwa mapafu, hata hivyo, imeongezeka. <ref name=YLD2012>{{cite journal | author = Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, ''et al''. | title = Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2163–96 | year = 2012 | month = December | pmid = 23245607 | doi = 10.1016/S0140-6736(12)61729-2 | url =https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2163| displayauthors = 30 }}</ref> Kiwango ambacho ugonjwa sugu wa kufungana kwa njia za hewa huzidi hutofautiana kulingana na kuwepo kwa mambo yanayoashiria matokeo mabaya kama vile: kufungana sana kwa kupita kwa hewa, uwezo duni wa kufanya mazoezi, upungufu wa pumzi, uzani wa chini au wa juu Zaidi, [[matatizo ya moyo yanayotokana na msongamano]], uvutaji unaoendelea, na maumivu zaidi ya mara kwa mara.<ref name=GOLD2007/> Matokeo ya muda mrefu ya ugonjwa sugu wa kufungana kwa njia za hewa yanaweza kukadiriwa kwa kutumia [[kielezo cha KUASHIRIA]] ambayo hutoa alama ya sufuri hadi kumi kulingana na Kiasi cha hewa inayopumuliwa nje kwa lazima₁, [[kielezo cha uzito wa mwili]], umbali aliotembea kwa dakika 6, na [[kipimo cha disnia kilichobadilishwa cha Halmashauri ya Utafiti wa Tiba]].<ref>{{cite book|last=Medicine|first=prepared by the Department of Medicine, Washington University School of|title=The Washington manual general internal medicine subspecialty consult.|year=2009|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-9155-7|page=96|url=http://books.google.ca/books?id=ZptEP_hDrlwC&pg=PA96|edition=2nd }}</ref> Kupoteza uzani sana ni ishara mbaya. <ref name=Harr2012/> Matokeo ya upimaji wa pumzi pia ni kibashiri kizuri cha hali ya baadaye ya ugonjwa lakini si bora kama kielezo cha KUASHIRIA.<ref name=Harr2012/><ref name=NICE2010P60/> ==Epidemolojia== Kote ulimwenguni kufikia mwaka wa 2010, ugonjwa sugu wa kufungana kwa njia za hewa uliathiri takriban watu milioni 329&nbsp; (asilimi 4.8 ya ya watu wote) na hutokea sana kwa wanaume kuliko wanawake. <ref name=YLD2012/> Hii ni kulinganishwa na milioni 64&nbsp; walioathiriwa mwaka wa 2004.<ref>{{cite web|title=Chronic obstructive pulmonary disease (COPD) Fact sheet N°315|url=http://www.who.int/mediacentre/factsheets/fs315/en/|publisher=WHO|date=November 2012}}</ref> Ongezeko katika nchi zinazostawi kati ya mwaka wa 1970 na miaka ya 2000 inaaminika kuhusiana na viwango vinavyoongezeka vya uvutaji katika eneo hili, ongezeko la idadi ya watu na watu wanaozeeka kutokana na kupungua kwa vifo kutoka kwa visababishi vingine kama vile magonjwa ya kuambukiza. <ref name=Lancet2012/> Nchi zingine zilizostawi zimeshuhudia viwango vya juu, zingine zimebaki imara na zingine zimeshuhudia kupungua katika kuenea kwa ugonjwa sugu wa kufungana kwa njia za hewa.<ref name=Lancet2012/> Idadi za kimataifa zinatarajiwa kuendelea kuongezeka visababishi vya hatari vinapoendelea kutokea sana na watu wakiendelea kuzeeka. <ref name=GOLD2013ChpX>{{cite book |last=Vestbo |first=Jørgen |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease |year=2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |pages=xiii-xv |nopp=yes |chapter=Introduction |url=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#14 |access-date=2014-06-23 |archive-date=2013-10-04 |archive-url=https://web.archive.org/web/20131004234113/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#14 |dead-url=yes |=https://web.archive.org/web/20160328053032/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#14 }}</ref> Kati ya mwaka wa 1990 na 2010 idadi ya vifo kutokana na ugonjwa sugu wa kufungana kwa njia za hewa imepungua kidogo kutoka milioni 3.1&nbsp; hadi milioni 2.9&nbsp; ref name=Lozano2012>{{cite journal | author = Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, ''et al''.| title = Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2095–128 | year = 2012 | month = December | pmid = 23245604 | doi = 10.1016/S0140-6736(12)61728-0 | url =https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2095| displayauthors = 30 }}</ref> Kwa jumla, ugonjwa huu ndicho kisababishi cha nne cha vifo. <ref name=Lancet2012/> Katika nchi zingine, vifo zimepungua kwa wanaume na kuongezeka kwa wananwake. ref name=Ryc2012>{{cite journal | author = Rycroft CE, Heyes A, Lanza L, Becker K | title = Epidemiology of chronic obstructive pulmonary disease: a literature review | journal = Int J Chron Obstruct Pulmon Dis | volume = 7 | issue = | pages = 457–94 | year = 2012 | pmid = 22927753 | pmc = 3422122 | doi = 10.2147/COPD.S32330 }}</ref> Hii inaweza kuwa kutokana na viwango vya uvutaji kwa wananwake na wanaume kuendelea kuwa sawa. <ref name=Harr2012/> Ugonjwa sugu wa kufungana kwa njia za hewa hutokea sana kwa wazee;<ref name=GOLD2013Chp1/> huathiri watu 34-200 kwa kila watu 1000 wenye umri wa Zaidi ya miaka 65&nbsp; kulingana na watu waliozingatiwa. <ref name=GOLD2013Chp1/><ref name="Old2007"/> Uingereza, karibu watu milioni 0.84 (kati ya milioni 50) wamepatikana kuwa na ugonjwa sugu wa kufungana kwa njia za hewa; hii ni takriban mtu mmoja kwa kila watu 59 wanaofanyiwa utambuzi wa ugonjwa sugu wa kufungana kwa njia za hewa wakati fulani maishani mwao. Katika sehemu nyingi maskini za nchi hiyo, mtu mmoja kati ya watu 32 walipatikana kuwa na ugonjwa sugu wa kufungana kwa njia za hewa, wakilinganishwa na mmoja kati ya watu 98 katika sehemu tajiri.<ref name="BJGPref">{{cite journal |author=Simpson CR, Hippisley-Cox J, Sheikh A| title= Trends in the epidemiology of chronic obstructive pulmonary disease in England: a national study of 51 804 patients | journal=Brit J Gen Pract |volume=60 |issue=576 |pages=483–8 |year=2010 |pmid=20594429 |pmc=2894402 |doi= 10.3399/bjgp10X514729}}</ref> Marekani, takriban asilimia 6.3 ya watu wazima, ambayo ni takriban watu milioni 15&nbsp; wamepatikana kuwa na ugonjwa sugu wa kufungana kwa njia za hewa.<ref>{{cite journal |author=Centers for Disease Control and Prevention |title=Chronic Obstructive Pulmonary Disease Among Adults — United States, 2011 |journal=Morbidity and Mortality Weekly Report |date=2012 Nov 23 |volume=61 |issue=46 |pages=938–43 |pmid=23169314 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6146a2.htm}}</ref> Watu milioni 25&nbsp;wanaweza kuwa na ugonjwa sugu wa kufungana kwa njia za hewa visa visivyotambuliwa vikiongezwa.<ref>{{cite web |title=Morbidity & Mortality: 2009 Chart Book on Cardiovascular, Lung, and Blood Diseases |publisher=National Heart, Lung, and Blood Institute |url=http://www.nhlbi.nih.gov/resources/docs/2009_ChartBook.pdf |format=PDF}}</ref> Katika mwaka wa 2011, takriban watu 730,000 walilazwa hospitalini kutokana na ugonjwa sugu wa kufungana kwa njia za hewa.<ref name=Tor2013>{{cite journal | author = Torio CM, Andrews RM | title = National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011: Statistical Brief #160 | journal = Healthcare Cost and Utilization Project (HCUP) Statistical Briefs | year = 2006 | pmid = 24199255 | url = http://hcup-us.ahrq.gov/reports/statbriefs/sb160.jsp | publisher = Agency for Health Care Policy and Research | access-date = 2014-06-23 | archive-date = 2017-03-14 | archive-url = https://web.archive.org/web/20170314171958/https://www.hcup-us.ahrq.gov/reports/statbriefs/sb160.jsp | dead-url = yes | = https://web.archive.org/web/20170314171958/https://www.hcup-us.ahrq.gov/reports/statbriefs/sb160.jsp }}</ref> ==Historia== [[File:Giambattista morgagni.gif|thumb|right|600px|Giambattista Morgagni aliyetengeneza mojawapo ya vielelezo vilivyoandikwa kitambo vya emfisema mnamo mwaka wa 1769]]Neno "emfisema" linatoka katika [[Lugha ya kigiriki|Kigiriki]] {{lang|el|ἐμφυσᾶν}} ''emphysan'' kumaanisha "''kujaa hewa''" -yenyewe ikiwa na ἐν ''en'', ikimaanisha "''ndani''", na φυσᾶν ''physan'', ikimaanisha "''pumzi, blast''".<ref>{{cite web|title=Emphysema|url=http://dictionary.reference.com/browse/emphysema|work=Dictionary.com|accessdate=21 November 2013}}</ref> Jina bronkitisi sugu lilianza kutumika mwaka wa 1808<ref name=Historia1991>{{cite journal |doi=10.1159/000195969 |title=History of the Treatment of Chronic Bronchitis |year=1991 |last1=Ziment |first1=Irwin |journal=Respiration |volume=58 |issue=Suppl 1 |pages=37–42 |pmid=1925077}}</ref> ilhali jina ugonjwa sugu wa kufungana kwa njia za hewa huaminika kutumika kwa mara ya kwanza mwaka wa 1965. <ref name=Historia2006/> Hapo awali umejulikana kwa majina kadhaa tofauti yakiwemo: ugonjwa sugu wa kufungana kwa bronkasi na njia za hewa, ugonjwa sugu wa kupumua wa kufungana, ugonjwa sugu wa kufunga kwa kupita kwa hewa, kupungua sugu kwa kupita kwa hewa, ugonjwa sugu wa kufungana kwa njia za hewa, ugonjwa sugu wa kufungana kwa njia za hewa usiojulikana, na sindromu liyoenea ya kufungana kwa njia za hewa.<!-- <ref name=History2006/> --> Majina bronkitisi sugu na emfisema yalifasiliwa mwaka wa 1959 katika kongamano la [[Novartis|CIBA]] na katika mwaka wa 1962 katika mkutano wa kamati ya [[Shirika la Kifua la Marekani]] kuhusu viwango vya utambuzi.<ref name=History2006/> Maelezo ya kitambo ya uwezekano wa emfisema ni: Katika mwaka wa 1679 na T. Bonet kuhusu ugonjwa wa "mapafu makubwa” na katika mwaka wa 1769 na [[Giovanni Morgagni]] kuhusu mapafu yaliyokuwa yamevimba hasa kutokana na hewa".<ref name=Historia2006>{{cite journal |author=Petty TL |title=The history of COPD |journal=Int J Chron Obstruct Pulmon Dis |volume=1 |issue=1 |pages=3–14 |year=2006 |pmid=18046898 |pmc=2706597 |doi=10.2147/copd.2006.1.1.3}}</ref><ref name=Fish2008/> Katika mwaka wa 1721 michoro ya kwanza ya emfisema ilifanywa na Ruysh.<ref name=Fish2008>{{cite book |first1=Joanne L. |last1=Wright |first2=Andrew |last2=Churg |chapter=Pathologic Features of Chronic Obstructive Pulmonary Disease: Diagnostic Criteria and Differential Diagnosis |chapterurl=http://www.mhprofessional.com/downloads/products/0071457399/0071457399_chap40.pdf |pages=693–705 |editor1-first=Alfred |editor1-last=Fishman |editor2-first=Jack |editor2-last=Elias |editor3-first=Jay |editor3-last=Fishman |editor4-first=Michael |editor4-last=Grippi |editor5-first=Robert |editor5-last=Senior |editor6-first=Allan |editor6-last=Pack |year=2008 |title=Fishman's Pulmonary Diseases and Disorders |edition=4th |publisher=McGraw-Hill |location=New York |isbn=978-0-07-164109-8 |access-date=2014-06-23 |archive-date=2016-03-03 |archive-url=https://web.archive.org/web/20160303202744/http://www.mhprofessional.com/downloads/products/0071457399/0071457399_chap40.pdf |dead-url=yes }}</ref> Michoro hii ilifuatwa na picha za [[Matthew Baillie]] katika mwaka wa 1789 na maelezo ya hali ya uharibifu wa ugonjwa huo.<!-- <ref jina=Historia2006/> --> Katika mwaka wa 1814 [[Charles Badham (fizishiani)|Charles Badham]] alitumia "katara" kueleza kikohozi na kamasi Zaidi katika bronkitisi sugu.<!-- <ref jina=Historia2006/> --> [[René Laennec]], fizishiani aliyevumbua [[stethoskopu]], alitumia neno "emfisema" katika kitabu chake ''A Treatise on the Diseases of the Chest and of Mediate Auscultation'' (1837) kueleza mapafu yasiyosinyaa alipofungua kifua wakati wa otopsi.<!-- <ref jina=Historia2006/> --> Aligundua kuwa hayakusinyaa kikawaida kwa sababu yalikuwa yamejaa hewa na njia za hewa zilikuwa zimejaa kamasi..<!-- <ref name=History2006/> --> Katika mwaka wa 1842, [[John Hutchinson (daktari mpasuaji)|John Hutchinson]] aligundua [[kipima pumzi]], kilichoruhusu kupimwa kwa [[ujazo pumzi]] wa mapafu.<!-- <ref name=History2006/> --> Hata hivyo kipima pumzi chake kingeweza kupima ujazo tu, si kupita kwa hewa. <!-- <ref name=History2006/> --> Tiffeneau and Pinelli katika mwaka wa 1947 walieleza kanuni za kupima kupita kwa hewa. <ref name=History2006/> Matibabu ya kitambo yalikuwa kitunguu saumu, mdalasini na [[ipecac]], miongoni mwa mengine.<ref name=History1991/> Matibabu ya kisasa yalianzishwa katika nusu ya pili ya karne ya 21. <!-- <ref name=History2005> --> Ushahidi wa kuunga mkono utumizi wa steroidi katika ugonjwa sugu wa kufungana kwa njia za hewa ulichapishwa mwishoni mwa miaka ya 1950.<!-- <ref name=History2005> --> Vitanua bronkasi vilianza kutumika katika miaka ya 1960 baada ya majaribio yenye matumaini ya [[isoprenaline]].<!-- <ref name=History2005> --> Vitanua bronkasi zaidi, kama vile salbutamol, vilitengenezwa katika miaka ya 1970, na matumizi ya LABAs yakaanza katikati mwa miaka ya 1990.<ref name=History2005>{{cite journal |author=Fishman AP |title=One hundred years of chronic obstructive pulmonary disease |url=https://archive.org/details/sim_american-journal-respiratory-critical-care-medicine_2005-05-01_171_9/page/941 |journal=Am. J. Respir. Crit. Care Med. |volume=171 |issue=9 |pages=941–8|year=2005|month=May |pmid=15849329 |doi=10.1164/rccm.200412-1685OE}}</ref> ==Jamii na Utamaduni== Ugonjwa sugu wa kufungana kwa mapafu umeitwa "pafu la mvutaji".<ref>{{cite book|last=Yuh-Chin|first=T. Huang|title=A clinical guide to occupational and environmental lung diseases|publisher=Humana Press|location=[New York]|isbn=978-1-62703-149-3|page=266|url=http://books.google.ca/books?id=9bYbE87FbtMC&pg=PA266|date=2012-10-28}}</ref> Walio na emfisema wamejulikana kama "wapumua waridi" au "aina A" kutokana na rangi yao ya waridi ya uso, kiwango cha haraka cha kupumua na midomo iliyofungwa,<ref>{{cite web|url=http://medical-dictionary.thefreedictionary.com/Pink+Puffer |title=Pink Puffer - definition of Pink Puffer in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia|publisher=Medical-dictionary.thefreedictionary.com |accessdate=2013-07-23}}</ref><ref name=Wein2013>{{cite book|last=Weinberger|first=Steven E.|title=Principles of pulmonary medicine|publisher=Elsevier/Saunders|location=Philadelphia|isbn=978-1-62703-149-3|page=165|url=http://books.google.ca/books?id=2F-DPG0c5IMC&pg=PT165|edition=6th|date=2013-05-08}}</ref> na watu walio na bronkitisi sugu wameitwa “blota za bluu" au "aina B" kutokana na [[sinosisi|rangi ya bluu kwenye ngozi na midomo]] mara kwa mara kutokana na viwango vya chini vya oksijeni na kuvimba kwa tindi za miguu.<ref name=Wein2013/><ref>{{cite book|last=Des Jardins|first=Terry|title=Clinical Manifestations & Assessment of Respiratory Disease|year=2013|publisher=Elsevier Health Sciences|isbn=978-0-323-27749-5|page=176|url=http://books.google.ca/books?id=LVtPAQAAQBAJ&pg=PA170|edition=6th}}</ref> Istilahi hii haikubaliki tena kuwa muhimu kwa sababu watu wengi walio na ugonjwa sugu wa kufungana kwa nia za hewa wana mchanganyiko wa hali zote mbili.<ref name=Harr2012/><ref name=Wein2013/> Mifumo mingi ya afya ina ugumu kuhakikisha utambuzi unaofaa, uchunguzi na utunzaji wa watu walio na ugonjwa sugu wa kufungana kwa njia za hewa; [[Idara ya Afya (Uingereza)|Idara ya Afya]] ya Uingereza imetambua hili kuwa suala kuu kwa [[Huduma ya Kitaifa ya Afya (Uingereza)|Huduma ya kitaifa ya Afya]] na imeanzisha mkakati mahususi wa kukabiliana na matatizo haya. <ref>{{cite book |url=https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216139/dh_128428.pdf |title=An outcomes strategy for people with chronic obstructive pulmonary disease (COPD) and asthma in England |date=18 July 2011 |publisher=[[Department of Health (United Kingdom)|Department of Health]]|page=5|accessdate=27 November 2013}}</ref> ===Uchumi=== Ulimwenguni kote, Kufikia mwaka wa 2010, ugonjwa sugu wa kufungana kwa njia za pumzi umekadiriwa kusababisha gharama ya kiuchumi ya dola trilioni 2.1&nbsp; ambayo nusu yake hutokea katika nchi zinazostawi. <ref name=Cost2013/> Kwa idadi hii, takriban dola trilioni 1.9&nbsp; ni gharama za moja kwa moja kama vile matibabu, ilhali dola trilioni 0.2&nbsp; ni gharama zisizo za moja kwa moja kama vile kazi ambayo haikufanywa.<ref>{{cite book|last=Bloom|first=D|title=The Global Economic Burden of Noncommunicable Diseases|year=2011|publisher=World Economic Forum|page=24|url=http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf}}</ref> Hii inatarajiwa kuwa zaidi ya mara mbili katika miaka 20&nbsp;ijayo.<ref name=Cost2013/> Kule Ulaya, Ugonjwa sugu wa kufungana kwa njia za hewa unawakilisha asilimia 3 ya gharama za afya.<ref name=GOLD2013Chp1/> Marekani, gharama za ugonjwa huu zinakadriwa kuwa dola bilioni 50&nbsp;, ambazo nyingi ni kutokana na maumivu zaidi.<ref name=GOLD2013Chp1/> Ugonjwa sugu wa kufungana kwa mapafu ulikuwa mmoja wa ugonjwa wenye gharama ya juu sana katika hospitali za Marekani mwaka wa 2011, na jumla ya gharama ya takriban dola bilioni 5.7 ref name=Tor2013/> ==Utafiti== [[Infliximab]] imejaribiwa katika ugonjwa sugu wa kufungana kwa njia za hewa lakini hakukuwa na ushahidi wa mafanikio bali uwezekano wa madhara.<ref>{{cite book|last=Nici|first=Linda|title=Chronic Obstructive Pulmonary Disease: Co-Morbidities and Systemic Consequences|year=2011|publisher=Springer|isbn=978-1-60761-673-3|page=78|url=http://books.google.ca/books?id=0CXcUnr-0eoC&pg=PA78}}</ref> [[Roflumilast]] huonyesha ahadi katika kupunguza kiwango cha maumivu zaidi lakini haionekani kubadilisha ubora wa maisha.<ref name=Lancet2012/> Ajenti kadhaa za muda mrefu zinaendelea kutengenezwa. <ref name=Lancet2012/> ==Wanyama wengine== Ugonjwa sugu wa kufungana kwa njia za hewa unaweza kutokea kwa wanyama wengine kadhaa na unaweza kutokana na kutangamana na moshi wa sigara.<ref>{{cite book|last=Akers|first=R. Michael|title=Anatomy and Physiology of Domestic Animals|year=2008|publisher=Wiley|location=Arnes, AI|isbn=978-1-118-70115-7|page=852|url=http://books.google.ca/books?id=Ze6J2znDg38C&pg=PT852|coauthors=Denbow, D. Michael}}</ref><ref>{{cite journal|last=Wright|first=JL|coauthors=Churg, A|title=Animal models of cigarette smoke-induced COPD|journal=Chest|date=December 2002|volume=122|issue=6 Suppl|pages=301S–6S|pmid=12475805|doi=10.1378/chest.122.6_suppl.301S}}</ref> Hata hivyo wingi wa ugonjwa huu ni mdogo. <ref>{{cite journal|last=Churg|first=A|coauthors=Wright, JL|title=Animal models of cigarette smoke-induced chronic obstructive lung disease|journal=Contributions to microbiology|year=2007|volume=14|pages=113–25|pmid=17684336|doi=10.1159/000107058|series=Contributions to Microbiology|isbn=3-8055-8332-X}}</ref> Katika [[farasi]] ugonjwa huu pia hujulikana kama [[kufungana kwa mara kwa mara kwa njia za hewa]] na hutokana na mwitiko wa aleji kwa majani makavu yaliyo na [[kuvu]].<ref name=Marin2007>{{cite journal | author = Marinkovic D, Aleksic-Kovacevic S, Plamenac P | title = Cellular basis of chronic obstructive pulmonary disease in horses | journal = Int. Rev. Cytol. | volume = 257 | issue = | pages = 213–47 | year = 2007 | pmid = 17280899 | doi = 10.1016/S0074-7696(07)57006-3 | series = International Review of Cytology | isbn=978-0-12-373701-4 }}</ref> Ugonjwa sugu wa kufungana kwa mapafu hupatina sana kwa mbwa wazee.<ref name=Miller1989>{{cite journal | author = Miller MS, Tilley LP, Smith FW | title = Cardiopulmonary disease in the geriatric dog and cat | journal = Vet. Clin. North Am. Small Anim. Pract. | volume = 19 | issue = 1 | pages = 87–102 | year = 1989 | month = January | pmid = 2646821 | doi = }}</ref> ==Kumbukumbu== <references/> ==Kusoma zaidi== *{{cite web |url=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease, Updated 2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |accessdate=November 29, 2013 |archiveurl=https://web.archive.org/web/20131004234113/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf |archivedate=2013-10-04 |=https://web.archive.org/web/20160328053032/http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf }} *{{NICE|101|Chronic Obstructive Pulmonary Disease|June 2010|1-673}} *{{cite journal |doi=10.7326/0003-4819-155-3-201108020-00008 |title=Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society |url=https://archive.org/details/sim_annals-of-internal-medicine_2011-08-02_155_3/page/178 |year=2011 |last1=Qaseem |first1=Amir |journal=Annals of Internal Medicine |volume=155 |issue=3 |pages=179–91 |pmid=21810710 |last2=Wilt |first2=TJ |last3=Weinberger |first3=SE |last4=Hanania |first4=NA |last5=Criner |first5=G |last6=Van Der Molen |first6=T |last7=Marciniuk |first7=DD |last8=Denberg |first8=T |last9=Schünemann |first9=H |last10=Wedzicha |first10=W |last11=MacDonald |first11=R |last12=Shekelle |first12=P |last13=American College Of |first13=Physicians |author14=American College of Chest Physicians |last15=American Thoracic |first15=Society |last16=European Respiratory |first16=Society}} ==Marejeleo zaidi== {{commons category|Ugonjwa sugu wa kufungana kwa njia za pumzi}} [[Jamii:Magonjwa]] 1iacjqoca4by9wbtlf6b633t7gmj6c4 0 72335 1578200 1516979 2026-07-03T02:51:45Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578200 wikitext text/x-wiki [[Picha:Cristo crucificado.jpg|thumb|250px|[[Mchoro]] wa [[Diego Velázquez]], ''[[Yesu msulubiwa]]'', [[1631]], [[Prado]] ([[Madrid]], [[Hispania]]) unaonyesha anwani juu ya [[kichwa]] chake.]] {{Yesu Kristo}} '''Kifo cha Yesu''' [[msalaba]]ni kilitokea huko [[Yerusalemu]], nchini [[Israeli|Israeli]], [[siku]] ya [[Ijumaa Kuu|Ijumaa]], labda [[tarehe]] [[7 Aprili]] [[30]] [[BK]]<ref name=CambridgeJesus >[[Christopher M. Tuckett]] in ''The Cambridge companion to Jesus'' edited by Markus N. A. Bockmuehl 2001 Cambridge Univ Press ISBN|978-0-521-79678-1 pp.&nbsp;123–124</ref><ref name = "ActJ">{{cite book |last=Funk |first=Robert W. |author2=Jesus Seminar |author-link=Robert W. Funk |title=The acts of Jesus: the search for the authentic deeds of Jesus |year=1998 |publisher=Harper |location=San Francisco |isbn=978-0060629786 |url=https://archive.org/details/actsofjesuswhatd00robe |author2-link=Jesus Seminar }}</ref>. Tukio hilo<ref>{{cite book|author=Eddy, Paul Rhodes and [[Gregory A. Boyd]] |year=2007 |title=The Jesus Legend: A Case for the Historical Reliability of the Synoptic Jesus Tradition |isbn=978-0801031144 |publisher=Baker Academic |page=172 |quote=...if there is any fact of Jesus' life that has been established by a broad consensus, it is the fact of Jesus' crucifixion.}}</ref>, pamoja na [[ufufuko wa Yesu]] unaosadikiwa na [[Ukristo]] kutokea [[siku]] ya [[tatu]] ([[Jumapili]] ya [[Pasaka ya Kikristo|Pasaka]]), ndiyo [[kiini]] cha [[imani]] ya [[dini]] hiyo mpya iliyotokana na ile ya [[Uyahudi]]. Kwa Wakristo [[fumbo]] hilo la [[Pasaka]] ndilo [[kilele]] cha [[historia ya wokovu]] inayotangazwa na [[Biblia ya Kikristo]]. Fumbo hilo lilisababisha kazi nyingi za [[sanaa ya Kikristo]], hasa [[uchoraji]] na [[uchongaji]]. ==Historia== [[Injili]] zote [[nne]] zinasimulia tukio hilo kinaganaga kuliko mengine yote ya [[maisha]] ya [[Yesu]] [[Masiya|Kristo]]: ni kama [[simulizi]] la [[saa]] baada ya saa<ref name=Powell>Powell, Mark A. ''Introducing the New Testament''. Baker Academic, (2009). ISBN 978-0-8010-2868-7</ref>. Kadiri ya ([[Injili ya Marko|Mk]] 14:43–15:45; [[Injili ya Mathayo|Math]] 26:46–27:60; [[Injili ya Luka|Lk]] 22:47–23:53; [[Injili ya Yohane|Yoh]] 18:3–19:42), [[Ponsyo Pilato]], [[liwali]] wa [[Palestina]] ([[26]]-[[36]]), aliamua [[Yesu]] aadhibiwe hivyo kulingana na shtaka la [[Kiongozi|viongozi]] wa [[Wayahudi]] waliodai kwamba mtuhumiwa alijitangaza kuwa [[mfalme]] na kupinga [[mamlaka]] ya [[Kaisari]] wa [[Roma]], kwa wakati huo [[Tiberius]], ingawa Pilato alikuwa ametambua shtaka halikuwa la kweli, bali lilitokana na [[husuda]]<ref name="EECO 2018">{{cite encyclopedia |author-last=Granger Cook |author-first=John |year=2018 |title=Cross/Crucifixion |editor1-last=Hunter |editor1-first=David G. |editor2-last=van Geest |editor2-first=Paul J. J. |editor3-last=Lietaert Peerbolte |editor3-first=Bert Jan |encyclopedia=Brill Encyclopedia of Early Christianity Online |location=[[Leiden]] and [[Boston]] |publisher=[[Brill Publishers]] |doi=10.1163/2589-7993_EECO_SIM_00000808 |issn=2589-7993}}</ref><ref name=Kostenberger104 >''The Cradle, the Cross, and the Crown: An Introduction to the New Testament'' by [[Andreas J. Köstenberger]], L. Scott Kellum 2009 ISBN 978-0-8054-4365-3 pp.&nbsp;104–108</ref><ref name="Evans, Craig A. 2001 page 316">Evans, Craig A. (2001). ''Jesus and His Contemporaries: Comparative Studies'' ISBN|0-391-04118-5 p. 316</ref><ref name="Wansbrough, Henry 2004 page 185">Wansbrough, Henry (2004). ''Jesus and the Oral Gospel Tradition'' ISBN|0-567-04090-9 p. 185</ref>. Kadiri ya [[Injili ya Yohane]], Pilato mwenyewe alisisitiza kwamba, katika [[maandishi]] yaliyotakiwa kuwajulisha [[watu]] sababu ya adhabu hiyo, iwekwe wazi kwamba Yesu aliuawa kama [[mfalme wa Wayahudi]], ingawa [[neno]] hilo lilichukiza viongozi wa [[taifa]]. Maneno ya ilani hiyo yaliandikwa katika [[lugha]] [[tatu]]: *[[Kilatini]]: Iesus Nazarenus Rex Iudeorum, kifupi [[INRI]], *[[Kigiriki]]: Ἰησοῦς ὁ Ναζωραῖος ὁ Bασιλεὺς τῶν Ἰουδαίω. Kutokana na [[herufi]] hizo, [[Wagiriki]] wanaandika INBI. *[[Kiebrania]]: ישוע הנוצרי ומלך היהודים. [[Herufi]] za kwanza za maneno hayo kwa Kiebrania ni יהוה, [[YHWH]], ndilo [[jina]] takatifu la [[Mungu]] katika [[Biblia ya Kiebrania]]. Yesu akiwa msalabani alisema maneno kadhaa. Kati ya hayo, ni maarufu [[maneno saba]] yaliyoripotiwa na Injili yakimuelekea [[Mungu Baba]], [[Bikira Maria]], [[Mtume Yohane]] na [[Dismas Mtakatifu|mhalifu aliyesulubiwa pamoja naye]]. ==Maelezo ya teolojia== Kifo cha Yesu kinaelezwa na Injili na [[Kitabu|vitabu]] vingine vya [[Agano Jipya]] kuwa [[kafara]] kwa [[Fidia ya kifedha|fidia]] ya [[dhambi]] za [[ulimwengu]] mzima.<ref name="David Hawkin">{{cite book | last = Hawkin | first = David J.| title = The twenty-first century confronts its gods: globalization, technology, and war | publisher =SUNY Press | year = 2004 | page =121}}</ref> Yesu alipokufa, [[nafsi]] yake ya Kimungu iliendelea kushikamana na [[roho]] na [[mwili]] vilivyotengana: kwa hiyo mwili wake [[Mazishi|uliozikwa]] haukuweza kuoza [[Kaburi|kaburini]]; roho yake ilishukia [[kuzimu]] kuwatoa [[waadilifu]] waliomtangulia awaingize pamoja naye [[mbinguni]]. “Mwili wake aliuawa, bali roho yake akahuishwa, ambayo kwa hiyo aliwaendea roho waliokaa kifungoni, akawahubiri” ([[1Pet]] 3:19). “Roho yake haikuachwa kuzimu, wala mwili wake haukuona uharibifu” ([[Mdo]] 2:31). ==Mitazamo tofauti== Tangu kale walitokea watu waliokanusha ukweli wa kifo cha Yesu, hasa waliosema yeye hakuwa na mwili halisi, bali alionekana tu kuwa nao.<ref>{{harvnb|Brox|1984|p=306}}.</ref><ref>{{harvnb|Schneemelcher|Maurer|1994|p=220}}.</ref>. [[Waislamu]] wanashikilia msimamo huo, kwamba Yesu hajafa kwa namna yoyote<ref>And [for] their saying, "Indeed, we have killed the Messiah, Jesus the son of Mary, the messenger of Allah." And they did not kill him, nor did they crucify him; but rather, it was made to appear to them so. And indeed, those who differ over it are in doubt about it. They have no knowledge of it except the following of assumption. And they did not kill him, for certain. Rather, Allah raised him to Himself. And ever is Allah Exalted in Might and Wise. [[Quran]] 4:157–158</ref>, bali alipalizwa [[mbinguni]]. ==Tanbihi== {{Reflist}} ==Marejeo== * {{Rejea jarida| title = 'Doketismus' – eine Problemanzeige |periodical = Zeitschrift für Kirchengeschichte |last = Brox |first = Norbert |publisher =[[Kohlhammer Verlag]]|year = 1984 |volume = 95 |pages = 301–314 |issn = 0044-2925 }} * {{cite book |title=A Theology of the Cross: The Death of Jesus in the Pauline Letters |url=https://archive.org/details/theologyofcrossd0000cous |last=Cousar |first=Charles B. |year=1990 |publisher=Fortress Press |isbn=0-8006-1558-1 }} * {{cite journal |last=Dennis |first=John |year=2006 |title=Jesus' Death in John's Gospel: A Survey of Research from Bultmann to the Present with Special Reference to the Johannine Hyper-Texts |journal=[[Currents in Biblical Research]] |volume=4 |issue=3 |pages=331–363 |doi=10.1177/1476993X06064628 |s2cid=170326371 }} * {{cite book|title=The Symbols of the Church|last=Dilasser|first=Maurice|year=1999|isbn=978-0-8146-2538-5|url=https://archive.org/details/symbolsofchurch00dila}} * {{cite book |title=The Death of Jesus: Tradition and Interpretation in the Passion Narrative |url=https://archive.org/details/deathofjesustrad0000gree |last=Green |first=Joel B. |year=1988 |publisher=Mohr Siebeck |isbn=3-16-145349-2 }} * {{cite journal |last=Humphreys |first=Colin J. |date=December 1983 |title=Dating the Crucifixion |url=https://archive.org/details/sim_nature-uk_december-22-29-1983_306_5945/page/743 |journal=Nature |volume=306 |issue=5945 |pages=743–746 |doi=10.1038/306743a0 |author2=W. G. Waddington |bibcode=1983Natur.306..743H|s2cid=4360560 }} * {{cite journal |last=Rosenblatt |first=Samuel |date=December 1956 |title=The Crucifixion of Jesus from the Standpoint of Pharisaic Law |url=https://archive.org/details/sim_journal-of-biblical-literature_1956-12_75_4/page/315 |journal=Journal of Biblical Literature |volume=75 |issue=4 |pages=315–321 |doi=10.2307/3261265 |publisher=The Society of Biblical Literature |jstor=3261265 }} * {{cite book |title=Archaeology and the New Testament |url=https://archive.org/details/archaeologynewte0000mcra |last=McRay |first=John |year=1991 |publisher=Baker Books |isbn=0-8010-6267-5 }} * {{cite book |title=Crucifixion in Antiquity |url=https://archive.org/details/crucifixioninant0000samu |last=Samuelsson |first=Gunnar. |year=2011 |publisher=Mohr Siebeck |isbn=978-3-16-150694-9 }} * {{Rejea kitabu|chapter = The Gospel of Peter |title = New Testament Apocrypha: Gospels and related writings |series = New Testament Apocrypha |last1 = Schneemelcher |first1 = Wilhelm |author-link = Wilhelm Schneemelcher |last2 = Maurer |first2 = Christian |editor1-last = Schneemelcher |editor1-first = Wilhelm |editor1-link = Wilhelm Schneemelcher |editor2-last = Wilson |editor2-first = McLachlan |publisher = Westminster John Knox Press |year = 1994 |orig-year = 1991 |volume = 1 |pages = 216–227 |isbn = 978-0-664-22721-0 |chapter-url = https://books.google.com/books?id=TDW0PeFSvGEC&pg=PA220 |access-date = April 25, 2012 }} * {{cite book |title=The Crucifixion of Jesus |url=https://archive.org/details/crucifixionofjes0000sloy_l5n0 |last=Sloyan |first=Gerard S. |year=1995 |publisher=Fortress Press |isbn=0-8006-2886-1 }} ==Viungo vya nje== {{commons category|Crucifixion of Christ|Icons of the crucifixion of Christ|Paintings of the Crucifixion of Christ}} {{Bikira Maria}} {{mbegu-Ukristo}} [[Jamii:Yesu Kristo]] [[Jamii:Injili]] [[Jamii:Teolojia]] [[Jamii:Rozari]] [[Jamii:Historia ya Israeli]] 4my1pskv195uj0cstn78t4ver9m5w0i 0 72550 1578136 1527844 2026-07-02T21:40:41Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578136 wikitext text/x-wiki [[File:Spread of Christianity to AD 600 - Atlas of World History.png|thumb|right|float|400px| {{legend|#1F63A7|Uenezi wa Ukristo hadi mwaka 325}} {{legend|#6AB4FF|Uenezi wa Ukristo hadi mwaka 600}}]] {{Ukristo}} '''Ukristo katika karne za kwanza''' ni sehemu ya [[historia ya Kanisa]] hadi [[mwaka]] [[325]] [[BK]], ulipofanyika [[mtaguso mkuu]] [[Mtaguso wa kwanza wa Nisea|wa kwanza huko]] [[Nisea]], leo nchini [[Uturuki]]. Kwa kawaida [[karne]] hizo [[tatu]] zinagawiwa pande [[mbili]]: wakati wa [[Mitume wa Yesu]] (hadi mwaka [[100]] hivi) na baada ya [[mauti|kifo]] chao wote. ==Wakati wa Mitume== Habari kuu za kipindi cha kwanza, kama ile ya [[siku]] ya [[Pentekoste]] [[Roho Mtakatifu]] kuwashukia wafuasi wa [[Yesu]], zinapatikana hasa katika [[Matendo ya Mitume]], [[kitabu]] kilichoandikwa na [[mwinjili Luka]] kwenye [[miaka ya 80]]. Humo unasimuliwa hasa [[uenezi]] wa [[Ukristo]] katika maeneo ya upande wa [[kaskazini]] wa [[Bahari ya Kati]]. Tukio lingine muhimu linalosimuliwa na Luka ni [[uongofu]] wa [[Mtume Paulo]], mwenezi mkuu wa Ukristo na [[ufafanuzi|mfafanuzi]] bora wa [[imani]] hiyo mpya.<ref name="ReferenceA">''Oxford Dictionary of the Christian Church'' ed. F.L. Lucas (Oxford) entry on Paul</ref> Pamoja na uenezi, linajitokeza badiliko kubwa la [[Wakristo]]: awali walikuwa wote [[Wayahudi]] ama kwa kuzaliwa ama kwa kuongoka,<ref>[http://www.newadvent.org/cathen/12481c.htm Catholic Encyclopedia: Proselyte]: "The English term "proselyte" occurs only in the New Testament where it signifies a convert to the Jewish religion (Matthew 23:15; Acts 2:11; Acts 6:5; etc.), though the same Greek word is commonly used in the [[Septuagint]] to designate a foreign sojourner in Palestine. Thus the term seems to have passed from an original local and chiefly political sense, in which it was used as early as 300 B.C., to a technical and religious meaning in the Judaism of the [[Apostolic Age|New Testament epoch]]."</ref> nao wanaitwa [[Wakristo wa Kiyahudi]]. Lakini katika [[karne ya 1]] tayari [[idadi]] yao ilizidiwa na ile ya Wakristo wa [[Taifa|mataifa]] mengine. Sambamba na hilo [[lugha]] [[lugha ya kimataifa|ya kimataifa]] ya [[Kigiriki]] ilizidi kutumika badala ya [[Kiaramu]], [[lugha mama]] ya Yesu na mitume wake.<ref>Ehrman, Bart D. (2012). ''Did Jesus Exist?: The Historical Argument for Jesus of Nazareth.'' HarperCollins, pp 87- 90.</ref> Ndiyo sababu [[Agano Jipya]] limeandikwa lote kwa Kigiriki. Vitabu 27 vinavyoliunda vilianza kulinganishwa na vile vya [[Agano la Kale]] kama vitakatifu. Tena [[Yerusalemu]], uliokuwa [[mji mkuu]] wa [[Wayahudi]] na wa [[Wakristo]] wa kwanza, ulizidi kukosa umuhimu, hasa baada ya [[Mtume Petro]] na wenzake kuuhama au kuuawa. Wakati wa [[vita vya kwanza vya Kiyahudi]] hata waumini wa kawaida walihama, na waliporudi hakukuwa tena na [[hekalu la Yerusalemu|hekalu]], kwa kuwa lilibomolewa mwaka [[70]]. Mbali ya hayo, uhusiano na Wayahudi ulizidi kuharibika, na hatimaye Wakristo walikatazwa wasishiriki tena ibada [[sinagogi]]ni. Jumuia ya [[Roma]], [[makao makuu]] ya [[dola]], ilizidi kuwa muhimu, hasa baada ya kufikiwa na Petro na Paulo, ambao walimalizia huko [[kazi]] yao kwa [[kufia dini]] katika [[dhuluma]] ambayo ilianzishwa na [[Kaisari Nero]] mwaka [[64]] na kuendelea kwa [[kwikwi]] hadi mwaka [[313]]. ==Wakati wa watetezi wa imani== Bila kujali [[Mateso ya Wakristo|dhuluma hiyo]] ya nyingine, Ukristo ulizidi kuenea ndani na nje ya [[Dola la Roma]]. [[Ushujaa]] wa [[umati]] wa [[wafiadini]] na [[upendo]] kati ya Wakristo vinafikiriwa kuwa sababu kuu ya uenezi. Kutoka kwenye [[Mji|miji]], imani ilizidi kuenea [[Kijiji|vijijini]] pia. Pamoja na hayo, walianza kujitokeza [[Mwandishi|waandishi]] mbalimbali [[Watetezi wa imani|kutetea]] [[Kanisa]] mbele ya [[serikali]], na wengine kuchambua [[imani]] dhidi ya [[uzushi]] uliozidi kupata nguvu hasa kwa namna ya [[Gnosis]]. Waandishi hao ni kati ya wale wanaoitwa ma[[babu wa Kanisa]] au walau waandishi wa Kikanisa. Wakati huohuo matumizi ya vitabu vya Agano Jipya katika ibada yalizidi kujadiliwa na kutungiwa [[orodha]] rasmi ([[Kanuni ya Biblia]]). ==Tanbihi== {{reflist}} ==Marejeo== * {{Rejea kitabu|last=Vidmar|first=John|title=The Catholic Church Through the Ages: A History|url=https://archive.org/details/catholicchurchth0000vidm|publisher=[[Paulist Press]]|year=2005|isbn=978-0-8091-4234-7|edition=Illustrated, annotated|language=en|author-link=John Vidmar}} * {{cite book|last=Bond|first=Helen K.|author-link=Helen Bond|title=The Historical Jesus: A Guide for the Perplexed|publisher=Bloomsbury Academic|year=2012|url=https://books.google.com/books?id=qXcr1S1d09UC|isbn=978-0-567-12510-1}} * {{cite book|last=Chadwick|first=Henry|author-link=Henry Chadwick (theologian)|title=The Early Church|publisher=Penguin Books|series=The Penguin History of the Church|volume=1|edition=revised|year=1993|url=https://archive.org/details/earlychurch0000chad_l1o5|url-access=registration|isbn=978-0-14-023199-1}} * [[James D.G. Dunn|Dunn, James D.G]]. ''Jews and Christians: The Parting of the Ways'', AD 70 to 135. pp 33–34. Wm. B. Eerdmans Publishing (1999). {{ISBN|978-0-8028-4498-9}}. * {{cite book|last=Fredriksen|first=Paula|author-link=Paula Fredriksen|title=Jesus of Nazareth, King of the Jews: A Jewish Life and the Emergence of Christianity|publisher=Vintage Books|year=1999|url=https://archive.org/details/jesusofnazarethk00paul_0|url-access=registration|isbn=978-0-679-76746-6}} * {{cite book|last=Freeman|first=Charles|author-link=Charles Freeman (historian)|title=A New History of Early Christianity|publisher=Yale University Press|year=2011|isbn=978-0-300-17083-2}} * {{cite book|last=González|first=Justo L.|author-link=Justo L. González|title=A History of Christian Thought|publisher=Abingdon Press|volume=1: From the Beginnings to the Council of Chalcedon|edition=revised|year=1987|url=https://books.google.com/books?id=yMlwT9_KRz4C|isbn=978-0-687-17182-8}} * {{cite book|last=González|first=Justo L.|author-link=Justo L. González|title=The Story of Christianity|publisher=HarperCollins|volume=1 The Early Church to the Dawn of the Reformation|edition=revised and updated|year=2010|url=https://books.google.com/books?id=cQW0ACdLn6kC|isbn=978-0-06-185588-7}} * {{cite journal|last=Hopkins|first=Keith|author-link=Keith Hopkins|title=Christian Number and Its Implications|url=https://archive.org/details/journal-of-early-christian-studies_summer-1998_6_2/page/185|journal=Journal of Early Christian Studies|volume=6|issue=2|pages=185–226|publisher=[[Johns Hopkins University Press]]|date=1998|issn=1086-3184|doi=10.1353/earl.1998.0035|s2cid=170769034|id={{Project MUSE|9960}}}} * {{cite book|last=Klutz|first=Todd|chapter=Paul and the Development of Gentile Christianity|year=2000|title=The Early Christian World|editor-last=Esler|editor-first=Philip F.|editor-link=Philip Esler|pages=178–190|publisher=Routledge|series=Routledge Worlds|url=https://books.google.com/books?id=6fyCAgAAQBAJ|isbn=978-1-032-19934-4}} * {{cite book|last=MacCulloch|first=Diarmaid|author-link=Diarmaid MacCulloch|title=Christianity: The First Three Thousand Years|publisher=Penguin Books|year=2010|url=https://books.google.com/books?id=7x4m20TRYzQC|isbn=978-1-101-18999-3}} * {{cite book|last=Marcus|first=Joel|chapter=Jewish Christianity|year=2006|title=The Cambridge History of Christianity|volume=1: Origins to Constantine|editor-last1=Mitchell|editor-first1=Margaret M.|editor-link1=Margaret M. Mitchell|editor-last2=Young|editor-first2=Frances M.|editor-link2=Frances Young|pages=87–102|publisher=Cambridge University Press|doi=10.1017/CHOL9780521812399|isbn=978-1-139-05483-6}} * {{cite book|last=McGrath|first=Alister|author-link=Alister McGrath|title=Christian History: An Introduction|publisher=Wiley-Blackwell|year=2013|url=https://books.google.com/books?id=gIFfXCyAYmoC|isbn=978-1-118-33780-6}} * {{cite book|last=Mitchell|first=Margaret M.|author-link=Margaret M. Mitchell|chapter=Gentile Christianity|year=2006|title=The Cambridge History of Christianity|volume=1: Origins to Constantine|editor-last1=Mitchell|editor-first1=Margaret M.|editor-last2=Young|editor-first2=Frances M.|editor-link2=Frances Young|pages=103–124|publisher=Cambridge University Press|doi=10.1017/CHOL9780521812399|isbn=978-1-139-05483-6}} * {{cite book|last=Schnelle|first=Udo|author-link=Udo Schnelle|title=The First One Hundred Years of Christianity: An Introduction to Its History, Literature, and Development|translator-last=Thompson|translator-first=James W.|publisher=Baker Academic|year=2020|place=Grand Rapids, Michigan|url=|isbn=978-1-4934-2242-5}} * {{cite book|last=Seifrid|first=Mark A.|title=Justification by Faith: The Origin and Development of a Central Pauline Theme|publisher=[[Brill Publishers]]|year=1992|isbn=978-90-04-09521-2|series=[[Novum Testamentum|Novum Testamentum, Supplements]]|location=[[Leiden]]|issn=0167-9732|author-link=Mark A. Seifrid|url=https://books.google.com/books?id=KdUkuOtOw68C}} * {{cite book | last = Wilken | first = Robert Louis | author-link = | title = The First Thousand Years: A Global History of Christianity | publisher = Yale University Press | year = 2012 | url = https://books.google.com/books?id=oONijpixvLUC | isbn = 978-0-300-11884-1}} ==Marejeo mengine== * {{cite book |last=Pelikan |first=Jaroslav Jan |title=The Christian Tradition: The Emergence of the Catholic Tradition (100–600) |publisher=University of Chicago Press |year=1975 |isbn=978-0-226-65371-6 |location=Chicago }} * {{cite book |last=Stark |first=Rodney |title=The Rise of Christianity |url=https://archive.org/details/riseofchristiani00star |publisher=HarperCollins |year=1997 |isbn=978-0-06-067701-5 |location=New York }} * {{cite book |last=Taylor |first=Joan E. |title=Christians and the Holy Places: The Myth of Jewish-Christian Origins |url=https://archive.org/details/christiansholypl0000tayl_a6f9 |publisher=Oxford University Press |year=1993 |isbn=978-0-19-814785-5 |location=Oxford }} * {{cite book |last=Thiede |first=Carsten Peter |title=The Dead Sea Scrolls and the Jewish Origins of Christianity |publisher=Palgrave Macmillan |year=2003 |isbn=978-1-4039-6143-3 |location=Basingstoke }} ==Viungo vya nje== * [http://early.xpian.info/ Early Christian Sources] English translations of the surviving writings of the early Christians. * [https://web.archive.org/web/20140901043856/http://www.earlychristians.org/ Early Christians] (archived 1 September 2014) * [https://www.pbs.org/wgbh/pages/frontline/shows/religion/first/ PBS Frontline: The First Christians] * [http://www.josemariaescriva.info/index.php?id_cat=1574&id_scat=1572 First Christians and Rome] * [https://web.archive.org/web/20100107002316/http://www.bib-arch.org/online-exclusives/oldest-church.asp Cave in Jordan Said to Have Been Used by Early Christians] Biblical Archaeology Review (archived 7 January 2010) {{mbegu-Ukristo}} [[Jamii:Historia ya Ukristo]] jyhdnphr4325ervfw47a2u8ino7996y 0 72831 1578150 1480770 2026-07-02T22:15:49Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578150 wikitext text/x-wiki [[Picha:AYool topography 15min.png|thumbnail|Sehemu za nchi kavu duniani]] [[Picha:Knight's Point, West Coast.jpg|thumbnail|Nhi kavu huanza na kuishia ufukoni]] '''Nchi kavu''' ni sehemu ya uso wa [[dunia]] isiyofunikwa na maji kama sehemu za [[bahari]], [[maziwa]] au [[mito]]<ref>Michael Allaby, Chris Park, ''A Dictionary of Environment and Conservation'' (2013), page 239, ISBN 0199641668.</ref>. Nchi kavu inaweza kufunikwa na maji kwa muda katika hali ya mafuriko. Maisha ya kibinadamu pamoja na kiasi kikubwa cha shughuli za kibinadamu kama vile [[kilimo]], makazi ya watu na uzalishaji wa bidhaa hutokea kwenye nchi kavu. Sehemu ambako nchi kavu hukutana na [[magimba ya maji]] huitwa pwani au ufuko. Mahali mbalimbali hakuna mstari kamili kati ya nchi kavu na gimba la maji hasa penye kanda la kinamasi au matopetope. ==Historia ya nchi kavu duniani== Nchi kavu ya dunia yetu huwa na eneo la milioni 149.4 [[km²]] ambayo ni sawa na asilimia 29.3 % za uso wa dunia. Eneo hili ni hasa [[mabara]] ya [[Ulaya]] na [[Asia]], [[Amerika ya Kaskazini]] na [[Amerika ya Kusini]], [[Afrika]], [[Antaktiki]] na [[Australia]]. Sehemu ndogo zaidi za nchi kavu ndani ya magimba ya maji huitwa [[kisiwa]]. Nchi kavu ni sehemu ya juu ya [[ganda la dunia]] lililotokea katika historia ya dunia yetu wakati sehemu za nje ya dunia zilipoanza kupoana na mvuke wa maji ulipopoa na kuwa maji [[kiowevu]]. Kuna melezo mawili ya kisayansi kuhusu kutokea kwa nchi kavu<ref name=williams_santosh2004>{{cite book|first1=John James William|last1=Rogers|last2=Santosh|first2=M.|year=2004|title=Continents and Supercontinents|url=https://archive.org/details/continentssuperc00roge|page=[https://archive.org/details/continentssuperc00roge/page/48 48]|publisher=Oxford University Press US|isbn=0-19-516589-6}}</ref> yanayosema ama nchi kavu iliongezeka polepole hadi leo<ref name=science164_1229>{{cite journal|last1=Hurley|first1=P. M.|last2=Rand|first2=J. R.|date=Jun 1969|title=Pre-drift continental nuclei|url=https://archive.org/details/sim_science_1969-06-13_164_3885/page/n12|journal=Science|volume=164 |pages=1229–1242|doi=10.1126/science.164.3885.1229|pmid=17772560|issue=3885 |bibcode = 1969Sci...164.1229H }}</ref> au haraka zaidi tangu kale<ref name=tp322_19>{{cite journal|doi=10.1016/S0040-1951(00)00055-X|title=Early formation and long-term stability of continents resulting from decompression melting in a convecting mantle|year=2000|last1=De Smet|first1=J.|journal=Tectonophysics|volume=322|issue=1–2|page=19|bibcode=2000Tectp.322...19D|last2=Van Den Berg|first2=A.P.|last3=Vlaar|first3=N.J.}}</ref> katika historia ya dunia<ref name=rg6_175>{{cite journal|last1=Armstrong|first1=R. L.|year=1968|title=A model for the evolution of strontium and lead isotopes in a dynamic earth| journal=Reviews of Geophysics|volume=6|issue=2|pages=175–199|doi=10.1029/RG006i002p00175|bibcode=1968RvGSP...6..175A}}</ref> na eneo la nchi kavu halikubadilika kwa muda mrefu.<ref name=science310_5754_1671>{{cite journal|last1=Kleine|first1=Thorsten|last2=Palme|first2=Herbert|last3=Mezger|first3=Klaus|last4=Halliday|first4=Alex N.|title=Hf-W Chronometry of Lunar Metals and the Age and Early Differentiation of the Moon|url=https://archive.org/details/sim_science_2005-12-09_310_5754/page/1671|journal=Science|volume=310|issue=5754|date=2005-11-24|pages=1671–1674|doi=10.1126/science.1118842|pmid=16308422|bibcode = 2005Sci...310.1671K }}</ref><ref name=jaes23_799>{{cite journal|doi=10.1016/S1367-9120(03)00134-2|title=Continental crustal growth and the supercontinental cycle: evidence from the Central Asian Orogenic Belt|year=2004|last1=Hong|first1=D.|journal=Journal of Asian Earth Sciences|volume=23|issue=5|page=799|bibcode = 2004JAESc..23..799H|last2=Zhang|first2=Jisheng|last3=Wang|first3=Tao|last4=Wang|first4=Shiguang|last5=Xie|first5=Xilin }}</ref><ref name=ajes38_613>{{cite journal|last1=Armstrong|first1=R. L.|year=1991|title=The persistent myth of crustal growth|url=https://archive.org/details/sim_australian-journal-of-earth-sciences_1991-12_38_5/page/613|journal=Australian Journal of Earth Sciences|volume=38|issue=5|pages=613–630|doi=10.1080/08120099108727995|bibcode = 1991AuJES..38..613A }}</ref> Mabara yalipokea maumbo yao kutokana na miendo ya [[gandunia]] ambayo ni mchakato unaoendeshwa kwa joto linalopanda juu kutokana na joto la kiini cha dunia. Katika mchakato huo mabara yalitokea na kuvunjika katika kipindi cha miaka mamilioni mara kadhaa. Mabara ya zamani yalikuwa mwanzoni [[Rodinia]], halafu [[Pannotia]], halafu [[Pangaea]] iliyovunjika pia takriban miaka milioni 180 iliyopita na kuwa mabara ya leo. <ref name=as92_324>{{cite journal|last1=Murphy|first1=J. B.|last2=Nance|first2=R. D.|title=How do supercontinents assemble?|journal=American Scientist|year=1965|volume=92|issue=4|pages=324–33|url=http://scienceweek.com/2004/sa040730-5.htm|accessdate=2007-03-05|doi=10.1511/2004.4.324|archive-date=2007-07-13|archive-url=https://web.archive.org/web/20070713194319/http://scienceweek.com/2004/sa040730-5.htm|url-status=dead}}</ref> ==Nchi kavu na halihewa== Kuwepo kwa nchi kavu ni muhimu kwa [[tabianchi]] na [[halihewa]] hasa katika maeneo ya ufukoni. Halijoto ya nchi kavu hubadilika haraka zaidi kulingana na mnururisho wa jua kuliko uso wa magimba ya maji. Kwahiyo halijoto ya nchi kavu hupanda haraka zaidi wakati wa mchana na kupoa haraka zaidi kuliko uso wa maji wakati wa usiku. Hivyo kuna tofauti ya halijoto baina nchi kavu na bahari na hii inasababisha kutokea kwa [[upepo]]. Hewa joto zaidi inapanda juu na hewa baridi zaidi inachukua mahali pake. ==Marejeo== <references/> [[jamii:jiografia]] [[jamii:metorolojia]] mfbxb2ga027j6sbxb5r0z7sk6wbnyeu 0 74523 1578131 1500366 2026-07-02T21:29:47Z InternetArchiveBot 41439 Add 7 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578131 wikitext text/x-wiki {{Infobox disease | Name = Meningitis | Image = Meninges-en.svg | Caption = Tando zinazofunika na kulinda seli ya neva zinaitwa "Meninges"; zukishambuliwa na virusi au bakteria zinaweza kuwaka na kusababisha mvurugo mkali kwenye neva. | DiseasesDB = 22543 | ICD10 = {{ICD10|G|00||g|00}}–{{ICD10|G|03||g|00}} | ICD9 = {{ICD9|320}}–{{ICD9|322}} | MedlinePlus = 000680 | eMedicineSubj = med | eMedicineTopic = 2613 | eMedicine_mult = {{eMedicine2|emerg|309}} {{eMedicine2|emerg|390}} | MeshID = D008581 }} '''Ugonjwa wa uti wa mgongo''' au '''Meninjitisi''' (kutoka [[Kiingereza]] "meningitis") ni [[uvimbe]] au [[inflamesheni]] ya [[tando]] zinazofunika na kuukinga [[ubongo]] na [[uti wa mgongo]], sehemu inayojulikana kwa jumla kama [[meninjesi]].<ref name=Lancet>{{cite journal |author=Sáez-Llorens X, McCracken GH |title=Bacterial meningitis in children |url=https://archive.org/details/sim_the-lancet_2003-06-21_361_9375/page/n55 |journal=Lancet |volume=361 |issue=9375 |pages=2139–48 |year=2003 |month=June |pmid=12826449|doi=10.1016/S0140-6736(03)13693-8}}</ref> Meninjitisi inaweza kuwa ya hatari kwa [[uhai]] kwa jinsi inflamesheni hii ilivyokaribiana na ubongo na uti wa mgongo; kwa hiyo, hali hii imeorodheshwa kama [[dharura ya kimatibabu]] na inadai umwone [[daktari]].<ref name=Lancet/><ref name=IDSA>{{cite journal |author=Tunkel AR |title=Practice guidelines for the management of bacterial meningitis |journal=Clinical Infectious Diseases |volume=39 |issue=9 |pages=1267–84 |year=2004 |month=November|pmid=15494903 |doi=10.1086/425368 |url=http://cid.oxfordjournals.org/content/39/9/1267.full.pdf |author-separator=,|author2=Hartman BJ |author3=Kaplan SL |display-authors=3 |last4=Kaufman |first4=Bruce A. |last5=Roos |first5=Karen L.|last6=Scheld |first6=W. Michael |last7=Whitley |first7=Richard J. }}</ref> [[Dalili]] kuu za ugonjwa huu zinazotokea mara nyingi ni [[maumivu ya kichwa]] na [[kukazika kwa shingo]], pamoja na [[homa]] na kuchanganyikiwa kwa [[akili]], kutapika na kutoweza kustahimili [[mwangaza]] ([[fotofobia]]) au [[kelele]] kali ([[fonofobia]]). Mara nyingi [[watoto]] hudhihirisha dalili za pekee kama vile [[kizunguzungu]] na [[mwasho]]. Uwepo wa [[upele]] unaweza kuwa dalili ya kisababishi maalumu cha meninjitisi; kwa mfano, [[ugonjwa wa meningokokasi|meninjitisi inayosababishwa na bakteria aina ya meningokokasi]] unaweza kuambatana na upele maalumu.<ref name=Lancet/><ref name=NEJM>{{cite journal|author=van de Beek D, de Gans J, Tunkel AR, Wijdicks EF |title=Community-acquired bacterial meningitis in adults|url=https://archive.org/details/sim_new-england-journal-of-medicine_2006-01-05_354_1/page/44 |journal=[[The New England Journal of Medicine]] |volume=354 |issue=1 |pages=44–53 |year=2006 |month=January |pmid=16394301|doi=10.1056/NEJMra052116}}</ref> Inflamisheni hii inaweza kusababishwa na maambukizi ya [[virusi]], [[bakteria]] au [[vimelea]] wengine, na kwa kiasi kidogo na [[dawa]] fulani.<ref name=Ginsberg>{{cite journal |author=Ginsberg L|title=Difficult and recurrent meningitis |journal=Journal of Neurology, Neurosurgery, and Psychiatry |volume=75 Suppl 1|issue= 90001|pages=i16–21 |year=2004 |month=March |pmid=14978146 |pmc=1765649 |doi= 10.1136/jnnp.2003.034272|url=http://jnnp.bmj.com/content/75/suppl_1/i16.full.pdf}}</ref> [[Sindano ya mgongo]] husaidia kutambua uwepo au utovu wa meninjitisi. [[Sindano]] hii huingizwa katika [[mfereji wa uti wa mgongo]] ili kudondoa [[sampuli]] ya [[kiowevu cha mfumo mkuu wa neva]] (KMN), kinachofunika uti wa mgongo na ubongo. Sampuli hii huchunguzwa katika [[maabara]] ya kiuuguzi.<ref name=IDSA/> Matibabu ya kwanza ya meninjitisi kali huhusisha [[antibiotiki]] zinazotolewa upesi, na wakati mwingine [[dawa za kukinza virusi]]. [[Kotisteroidi]] pia zinaweza kutumika kuzuia matatizo yanayofuatia inflamesheni iliyozidi.<ref name=IDSA/><ref name=NEJM/> Meninjitisi inaweza kuchangia madhara makali ya muda mrefu kama vile [[uziwi]], [[kifafa]], [[hidrosifilasi]] na [[uwezo duni wa kiutambuzi]], hasa isipotibiwa haraka.<ref name=Lancet/><ref name=NEJM/> Baadhi ya aina za meninjitisi (kama vile aina zinazohusishwa na [[meningokokasi]], [[Haemophilus influenzae aina B]], [[Streptococcus pneumoniae|numokosi]] au maambukizi ya [[virusi vya machubwichubwi]]) zinaweza kuzuiliwa kwa [[chanjo]].<ref name=Lancet/> {{TOC limit|3}} ==Ishara na dalili== * Kichwa kuuma sana. * Kutokuwa na [[akili timamu]], hii hutokea kwa takriban asilimia 44 ya wagonjwa.<ref>{{cite journal |author=Attia J, Hatala R, Cook DJ, Wong JG |title=The rational clinical examination. Does this adult patient have acute meningitis? |url=https://archive.org/details/sim_jama_1999-07-14_282_2/page/175 |journal=[[Journal of the American Medical Association|JAMA]] |volume=282 |issue=2 |pages=175–81 |year=1999 |month=Julai |pmid=10411200 |doi=10.1001/jama.282.2.175 }}</ref> * Kutoweza kustahimili mwangaza na kelele. * Uvimbe juu ya kichwa hutokea kwa watoto wa umri wa chini ya miezi sita. * Dalili nyingine zinazopatikana kwa watoto ni kuumwa kwa miguu, kuhisi [[baridi]] kali na [[ngozi]] kugeuka [[rangi]]. ===Sifa za kiuchunguzi=== [[File:Neck stiffness.jpg|thumb|Kukazika shingo, janga la meninjitisi la Texas, mwaka wa 1911–1912.]] Kwa watu wazima, dalili ya meninjitisi inayotokea mara nyingi ni [[maumivu ya kichwa]] yaliyo makali, ambayo hutokea kwa karibu asilimia 90 ya visa vya meninjitisi ya kibakteria, ambavyo hufuatwa na kukazika kwa sehemu ya nyuma ya shingo (ukosefu wa uwezo wa kuinamisha shingo kufuatia ongezeko la [[uzito wa misuli]] ya shingo na kukazana). <ref name=vdBeek2004>{{cite journal |author=van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M |title=Clinical features and prognostic factors in adults with bacterial meningitis |journal= [[The New England Journal of Medicine]] |volume=351 |issue=18 |pages=1849–59 |year=2004 |month=October |pmid=15509818 |doi=10.1056/NEJMoa040845|url=http://www.nejm.org/doi/pdf/10.1056/NEJMoa040845 | format = PDF }}</ref>. Dalili tatu maarufu za kiutambuzi huhusisha kukazana kwa sehemu ya nyuma ya shingo, [[homa kali]] na hali ya akili iliyovurugika; hata hivyo, sifa hizi zote tatu hupatikana katika asilimia 44-46 ya visa vya meninjitisi ya kibakteria.<ref name=vdBeek2004/><ref name=Attia>{{cite journal |author=Attia J, Hatala R, Cook DJ, Wong JG |title=The rational clinical examination. Does this adult patient have acute meningitis? |url=https://archive.org/details/sim_jama_1999-07-14_282_2/page/175 |journal=[[Journal of the American Medical Association]] |volume=282 |issue=2 |pages=175–81 |year=1999 |month=July |pmid=10411200|doi=10.1001/jama.282.2.175 }}</ref> Iwapo hakuna mojawapo ya dalili hizi tatu, basi uwezekano wa kuwa na meninjitisi ni mdogo sana. <ref name=Attia/> Dalili nyingine ambazo mara nyingi huhusishwa na meninjitisi ni pamoja na [[fotofobia]] (kutostahimili mwanga mkali) na [[fonofobia]] (kutostahimili kelele kali). Mara nyingi, watoto wadogo huwa hawaonyeshi dalili zilizotajwa hapo mbeleni, na wanaweza kuwa tu na [[mwasho]] na kuonekana wagonjwa.<ref name=Lancet/> [[Fontaneli]] sehemu laini ya juu ya kichwa cha mtoto) inaweza kufura kwa watoto wa umri wa hadi miezi 6. Sifa nyingine zinazotofautisha meninjitisi na magonjwa madogo kwa watoto wachanga ni maumivu ya miguu, makali ya baridi na [[rangi ya ngozi]] isiyo ya kawaida.<ref name=SIGN>{{cite journal|author=Theilen U, Wilson L, Wilson G, Beattie JO, Qureshi S, Simpson D |title=Management of invasive meningococcal disease in children and young people: Summary of SIGN guidelines |journal=[[BMJ]] (Clinical research ed.) |volume=336 |issue=7657|pages=1367–70 |year=2008 |month=June |pmid=18556318 |doi=10.1136/bmj.a129 |pmc=2427067}}</ref><ref>{{cite book | isbn = 978-1-905813-31-5 | title = Management of invasive meningococcal disease in children and young people | publisher = Scottish Intercollegiate Guidelines Network (SIGN) | month = May | year = 2008 | location = Edinburgh | url = http://www.sign.ac.uk/pdf/sign102.pdf | access-date = 2018-02-26 | archive-date = 2016-05-07 | archive-url = https://web.archive.org/web/20160507034426/http://www.sign.ac.uk/pdf/sign102.pdf | dead-url = yes }}</ref> Kukazika shingo hutokea katika asilimia 70 ya visa vya meninjitisi ya kibakteria kwa watu wazima.<ref name=Attia/> Dalili nyingine za [[hali ya meninjitisi]] ni pamoja na uwepo wa [[dalili ya Kernig]] iliyo chanya au [[dalili ya Brudziński]]. Dalili ya Kernig huchunguzwa mtu akiwa amelala [[chali|chali]], huku kiuno na goti likiinuliwa hadi digrii 90 &nbsp;. Kwa mtu aliyetambulika kuwa na dalili ya Kernig, maumivu humzuia mtu kunyoosha goti kwa utulivu. Dalili chanya ya Brudzinski hutokea wakati harakati ya kukunja shingo husababisha kukunjika kwa goti na nyonga bila kukusudia. Ingawa dalili ya Kernig na ya Brudzinski hutumika mara nyingi kuchunguza meninjitisi, [[usikivu na umaalum |usikivu]] wa dalili hizi ni mdogo. <ref name=Attia/><ref name=Thomas_2002>{{cite journal |author=Thomas KE, Hasbun R, Jekel J, Quagliarello VJ |title=The diagnostic accuracy of Kernig's sign, [[Brudzinski neck sign]], and nuchal rigidity in adults with suspected meningitis |journal=Clinical Infectious Diseases |volume=35 |issue=1 |pages=46–52 |year=2002|month=July |pmid=12060874 |doi=10.1086/340979 |url=http://cid.oxfordjournals.org/content/35/1/46.full.pdf }}</ref>Hata hivyo, dalili hizi huwa maalum za meninjitisi: kumbe ni nadra kwa magonjwa mengine.<ref name=Attia/> Uchunguzi mwingine, unaojulikana kama "maneva ya kusisitika kwa mdugudo" husaidia kubaini ikiwa meninjitisi ipo kwa watu wanaoripoti kuwa na homa na maumivu ya kichwa. Mtu huambiwa azungushe kichwa ghafla kwenda upande hadi mwingine; ikiwa kufanya hivi hakuleti maumivu ya kichwa kuwa mabaya zaidi, basi uwezekano wa mtu huyu kuwa na meninjitisi ni mdogo.<ref name=Attia/> Meninjitisi inayosababishwa na bakteria ya ''[[Neisseria meningitidis]]'' (inayojulikana kama "meninjitisi ya meningokokasi") inaweza kutofautishwa na meninjitisi ya visababishi vingine kwa kutambua maenezi ya upesi ya [[upele wa petekia]], ambao unaweza kutangulia dalili zingine.<ref name=SIGN/>Upele huu hujumuisha madoa mengi mekundu ya umbo usio maalum ("petekia") kwenye kiwiliwili, [[Mguu wa mwanadamu| sehemu za chini za mguu]],utando wa ute, konjaktiva na (mara kwa mara) katika kiganja cha mkono au nyayo za miguu. Upele huu kwa kawaida huwa hauparari; wekundu wake hautolewi kwa kufinywa kwa kidole au kifaa cha kioo. Ingawa upele huu si sharti uwepo kwa meninjitisi ya meningokokasi, kwa kawaida upele huu huwa maalum katika ugonjwa huu; hata hivyo, upele huu mara kwa mara hutambulika kwa meninjitisi kwa sababu ya bakteria zingine.<ref name=Lancet/> Viashiria vingine vya visababishi vya ugonjwa huu vinaweza kuwa dalili za ngozi za [[ugonjwa wa mikono, miguu na mdomo]] na [[hepesi ya sehemu za uzazi]], zote ambazo huhusishwa na aina mbali mbali za meninjitisi ya kivirusi.<ref name=LoganMacMahon>{{cite journal |author=Logan SA, MacMahon E |title=Viral meningitis |journal=BMJ (Clinical research ed.) |volume=336 |issue=7634 |pages=36–40 |year=2008 |month=January |pmid=18174598 |doi=10.1136/bmj.39409.673657.AE|pmc=2174764}}</ref> ===Matatizo ya mapema=== [[File:Charlotte Cleverley-Bisman Meningicoccal Disease.jpg|thumb|Mgonjwa [[mahututi]] wa Meningitis:[[Charlotte Cleverley-Bisman]] aliugua maradhi ya meninjitisi kali ya meningokokasi akiwa mtoto mchanga; katika kisa chake, upele huu wa petekia uliendelea na kuwa [[gangrini]], hivyo ukahitaji [[kukatwa kwa viungo]] vyote. Charlotte aliweza kuishi baada ya ugonjwa huu na hata picha yake kuwekwa katika bango la uhamasisho kuhusu chanjo dhidi ya meninjitisi nchini [[New Zealand]].]] Matatizo ya ziada yanaweza kutokea katika awamu za kwanza za ugonjwa huu. Matatizo haya yanaweza kuhitaji matibabu maalumu, na wakati mwingine kuonyesha maradhi hatari au prognosi mbaya zaidi. Maambukizi haya yanaweza kuchochea[[sepsisi]], ambayo ni [[dalili za mfumo za mwitikio za kiinflamesheni]] za kushuka kwa [[shinikizo la damu]], [[takikadia|kiwango cha juu cha mapigo ya moyo]], kiwangojoto cha mwili cha juu au chini kuliko kawaida, na [[takipinea|kupumua kwa kasi]]. Shinikizo la chini sana la damu linaweza kutokea katika awamu ya mapema, hasa katika meninjitisi ya meningokokasi, ingawa dalili hii si ya kipekee katika meninjitisi ya meningokasi. Hali hii inaweza kupelekea kiwango cha chini cha damu inayosambazwa viungoni.<ref name=Lancet/> [[Mgando wa damu inayosambazwa]], kiwango cha juu cha kuwezeshwa kwa hali ya[[kuganda| kuganda kwa damu]], ni hali inayoweza kuzuia[[kusambaa kwa damu]] katika viungo, na hivyo kuongeza hatari ya kuvuja kwa damu hii. [[Gangrini]] ya miguu na mikono inaweza kutokea katika ugonjwa wa unaosababishwa na meningokokasi.<ref name=Lancet/>Maambukizi makali ya kimeningokokasi na kinumonia yanaweza kupelekea kuvuja kwa damu katika [[tezi za adrena]], hali inayopelekea [[sindromu ya Waterhouse-Friderichsen]], ambayo mara nyingi huua.<ref name="pmid9696186">{{cite journal |author=Varon J, Chen K, Sternbach GL |title=Rupert Waterhouse and Carl Friderichsen: adrenal apoplexy |url=https://archive.org/details/sim_journal-of-emergency-medicine_july-august-1998_16_4/page/643 |journal=J Emerg Med |volume=16 |issue=4 |pages=643–7 |year=1998 |pmid=9696186|doi=10.1016/S0736-4679(98)00061-4 }}</ref> [[Edema ya ubongo|tishu za ubongo zinaweza kuvimba]], [[shinikizo la ndani ya fuvu|shinikizo la ndani ya fuvu]] linaweza kuongezeka na ubongo uliovimba kusababisha [[henia ya ubongo|kupata henia]] kupitia shina la fuvu la kichwa. Hali hii inaweza kutambulika kwa kupunguka kwa[[kiwango cha ufahamu]], kupoteza [[tendohiari la mboni la jicho kutokana na mwanga]], na [[mkao usio wa kawaida]].<ref name=NEJM/>Inflamesheni ya tishu ya ubongo inaweza kuzuia mtiririko wa kawaida wa KMN katika ubongo([[hidrosifalasi]]).<ref name=NEJM/> [[Mitukutiko]] inaweza kutokea kufuatia visababishi vingi; kwa watoto, mitukutiko ni kawaida katika awamu za kwanza za meninjitisi (katika asilimia 30 ya matukio) na si sharti yaashirie kisababishi fiche.<ref name=IDSA/> Mitukutiko inaweza kutokea kufuatia ongezeko la shinikizo kutoka maeneo yaliyo na inflamesheni katika tishu za ubongo.<ref name=NEJM/> [[Mitukutiko mikuu]] (mitukutiko inayohusisha mguu au mkono mmoja au sehemu moja ya mwili), mitukutiko ya muda mrefu, mitukutiko inyotokea katika awamu za mwishoni na mitukutiko iliyo ngumu kudhibiti kwa matibabu ni ishara ya matokeo mabaya ya muda mrefu.<ref name=Lancet/> Inflamesheni ya meninjesi inaweza kuchangia hali zisizo za kawaida katika [[neva za fuvu]], kikundi cha neva zinazochipuka kutoka katika[[shina la ubongo]] ambazo husambaa katika eneo la kichwa na shingo na ambazo hudhibiti mwendo wa macho, misuli ya uso, na kusikia, miongoni mwa kazi zingine.<ref name=Lancet/><ref name=Attia/> Dalili zinazohusu kuona na [[kupoteza uwezo wa kusikia]] ni hali zinazoweza kuendelea kwa muda mrefu baada ya kisa cha meninjitisi<ref name=Lancet/>Inflamesheni ya ubongo ([[ensefalitisi]]) au [[mishipa ya damu]] katika ubongo([[vasulitisi ya ubongo]]), na pia kuumbika kwa [[thrombosi|vidonge vya damu]] ndani ya vena([[thrombosi ya sinasi ya vena za ubongo|thrombosi ya ndani ya vena za ubongo]]), zote zinaweza kupelekea unyonge, kupoteza hisia au mwendo usio wa kawaida au utendakazi usio wa kawaida wa sehemu ya mwili inayosambaziwa na eneo lililoathiriwa la ubongo.<ref name=Lancet/><ref name=NEJM/> ==Visababishi== Meninjitisi kwa kawaida husababishwa na [[maambukizi]] na [[vimelea]]. Maambukizi mengi husababishwa na virusi <ref name=Attia/> huku [[bakteria]], [[kuvu]], na [[protosoa]] zikifuatia.<ref name=Ginsberg/> Maambukizi pia yanaweza kuletwa na visababishi vinginge visivyo vya kiambukizi. <ref name=Ginsberg/> Neno ''[[meninjitisi isiyo ya kibakteria]]'' hurejelea visa vya meninjitisi ambapo hakuna maambukizi ya kibakteria yanayotambuliwa. Aina hii ya meninjitisi kwa kawaida husababishwa na virusi, lakini inaweza kuwa imetokea kufuatia maambukizi ya kibakteria ambayo hayakutibiwa kabisa, bakteria zinapotoweka kutoka katika meninjesi, au viini vinapoambukiza nafasi iliyo karibu na meninjesi (kama vile [[sinasitisi]]). [[Endokaditisi]] (maambukizi ya [[vali ya moyo]] ambayo husambaza vidonge vidogo vya bakteria kupitia katika mkondo wa damu) inaweza kusababisha meninjitisi isiyo ya kibakteria. Meninjitisi isiyo ya kibakteria pia inaweza kusababishwa na maambukizi ya [[spirosheti]], aina ya bakteria inayohusisha ''[[Treponema pallidum]]'' (kisababishi cha[[kaswende]]) na ''[[Borrelia burgdorferi]]'' (maarufu kwa kusababisha [[ugonjwa wa Lyme]]). Meninjitisi inaweza kuwepo katika [[malaria ya ubongo]] (malaria inayoathiri ubongo) au [[meninjitisi ya kiamiba]], yaani meninjitisi inayosababishwa na maambukizi ya amiba kama vile ''[[Naegleria fowleri]]'', inayotakana na vitovu vya maji safi.<ref name=Ginsberg/> Kwa watoto wenye umri wa chini ya miezi mitatu, ugonjwa huu husababishwa na ''group B streptococcus''. Wengine ambao hukaa kwenye matumbo ya [[binadamu]] ni kama ''Escherichia coli'' Virusi vinavyosababisha Meningitis ni kama ''enterovirus'', ''herpes simplex virus type 2'', ''varicella zoster virus'', ''herpes zoster'', ''mumps'', ''[[HIV]]'', na ''Lymphocytic choriomeningitis''. Meningitis pia huweza kusababishwa na kuenea kwa [[saratani]] hadi kwenye ubongo. ===Aina za bakteria=== Aina za [[bakteria]] zinazosababisha meninjitisi hutofautiana kulingana na umri wa mwathiriwa. *Katika [[kuzaliwa kabla ya wakati|watoto waliozaliwa kabla ya kupevuka]] na [[watoto wachanga]] wa umri wa hadi miezi mitatu, visababishi vingi huwa ''[[kikundi B cha streptococci]]'' (aina ndogo za III ambazo kawaida huishi kwenye [[uke]]) na hasa huwa visababishi vya ugonjwa katika wiki ya kwanza ya maisha) na bakteria ambazo kwa kawaida huishi katika [[njia ya tumbo na utumbo|njia ya umeng'enyaji]] kama vile ''[[Escherichia coli]]'' (inayobeba antijeni ya K1). ''[[Listeria monocytogenes]]'' (serotaipu ya IVb) inaweza kumwathiri mtoto mchanga na hutokea katika majanga. *Watoto wakubwa zaidi mara nyingi huathiriwa na ''[[Neisseria meningitidis]]'' (meningokokasi) na ''[[Streptococcus pneumoniae]]'' (serotaipu za 6, 9, 14, 18 na 23) huku wale wa umri wa chini ya miaka mitano wakiathiriwa na [[Haemophilus influenzae|''Haemophilus influenzae'' aina ya B]] (katika mataifa yasiyotoa chanjo).<ref name=Lancet/><ref name=IDSA/> *Katika watu wazima, ''Neisseria meningitidis'' na ''Streptococcus pneumoniae'' kwa pamoja husababisha asilimia 80 ya visa vya meninjitisi ya kibakteria. Hatari ya kuambukizwa ''Listeria monocytogenes'' huongezeka katika watu walio na umri wa zaidi ya miaka 50.<ref name=IDSA/><ref name=NEJM/> Kuanzishwa kwa chanjo ya [[numonia]] kumepunguza viwango vya meninjitisi ya kinumonia katika watoto na watu wazima pia.<ref name=Hsu>{{cite journal |doi=10.1056/NEJMoa0800836 |author=Hsu HE |title=Effect of pneumococcal conjugate vaccine on pneumococcal meningitis |url=https://archive.org/details/sim_new-england-journal-of-medicine_2009-01-15_360_3/page/244 |journal=N Engl J Med |volume=360 |issue=3 |pages=244–256 |year=2009 |pmid=19144940 |author-separator=,|author2=Shutt KA |author3=Moore MR |display-authors=3 |last4=Beall |first4=Bernard W. |last5=Bennett |first5=Nancy M.|last6=Craig |first6=Allen S. |last7=Farley |first7=Monica M. |last8=Jorgensen |first8=James H. |last9=Lexau |first9=Catherine A.}}</ref> [[Kiwewe]] cha hivi karibuni huwezesha bakteria za mvungu wa pua kuingia katika nafasi ya meninjesi. Vivyo hivyo, vitu vilivyo katika meninjesi ya ubongo, kama vile [[shanti ya ubongo]], [[kiowevu kilivutika hadi ndani ya mishipa]] au [[hifadhi ya Ommaya]] huwa na hatari zaidi ya kuambukiza meninjitisi. Katika matukio haya, waathiriwa wana uwezekano mkuu zaidi wa kuambukizwa na [[Staphylococci]], [[Pseudomonas]] na bakteria zingine zilizo [[Gram hasi]].<ref name=IDSA/> Viini hivi huhusishwa na meninjitisi katika watu walio na [[UKIMWI|ukosefu wa kinga mwilini]].<ref name=Lancet/> Maambukizi yaliyo katika eneo la kichwani na shingoni, kama vile [[midia ya otitisi]] au [[mastoiditisi]], yanaweza kupelekea meninjitisi katika idadi ndogo ya watu.<ref name=IDSA/> Watu wanaopokea[[pandikizo la koklea]] wanapopoteza uwezo wa kusikia wako katika hatari zaidi ya meninjitisi ya kinumonia.<ref>{{cite journal |author=Wei BP, Robins-Browne RM, Shepherd RK, Clark GM, O'Leary SJ |title=Can we prevent cochlear implant recipients from developing pneumococcal meningitis? |journal=Clin. Infect. Dis. |volume=46 |issue=1 |pages=e1–7 |year=2008 |month=January |pmid=18171202|doi=10.1086/524083 |url=http://cid.oxfordjournals.org/content/46/1/e1.full.pdf }}</ref> [[Meninjitisi ya kifua kikuu]], inayosababishwa na ''[[Mycobacterium tuberculosis]]'', hupatikana zaidi katika watu wa nchi ambapo [[kifua kikuu]] huambukiza watu wengi, lakini pia hutambulika katika watu walio na matatizo ya kingamwili, kama vile [[UKIMWI]].<ref name=Tuberc>{{cite journal |author=Thwaites G, Chau TT, Mai NT, Drobniewski F, McAdam K, Farrar J |title=Tuberculous meningitis|journal=Journal of Neurology, Neurosurgery, and Psychiatry |volume=68 |issue=3 |pages=289–99 |year=2000 |month=March|pmid=10675209 |pmc=1736815 |doi= 10.1136/jnnp.68.3.289|url=http://jnnp.bmj.com/content/68/3/289.full.pdf }}</ref> Meninjitisi ya kibakteria inayorejea inaweza kusababishwa na ulemavu wa muda mrefu wa kimaumbile, ama [[ya kuzaliwa]] au ya kupatikana, au kwa matatizo ya [[mfumo wa kingamwili]].<ref name=Tebruegge>{{cite journal |author=Tebruegge M, Curtis N |title=Epidemiology, etiology, pathogenesis, and diagnosis of recurrent bacterial meningitis |journal=Clinical Microbiology Reviews |volume=21|issue=3 |pages=519–37 |year=2008 |month=July |pmid=18625686 |doi=10.1128/CMR.00009-08 |pmc=2493086}}</ref> Ulemavu wa kimaumbile huwezesha uendeleshaji kati ya mazingira ya nje na [[mfumo wa neva]]. Kisababishi cha mara nyingi cha meninjitisi inayorejea ni [[kuvunjika kwa fuvu]],<ref name=Tebruegge/> hasa kuvunjika kunakoathiri shina la fuvu au kunakotandaza kuelekea [[sinasi za pua|sinasi]] na [[piramidi ngumu]].<ref name=Tebruegge/>Takriban asilimia 59 ya visa vya meninjitisi inayorejea husababishwa na matatizo ya kimaumbile kama hayo, huku asilimia 36 ya matukio haya yakisababishwa na udhaifu wa kingamwili (kama vile [[ukosefu saidizi]], ambao huhatarisha hasa kufuatia meninjitisi ya kimeningokokasi inayorejea), na asilimia 5 ya matukio husababishwa na maambukizi yanayoendelea katika sehemu zinazokaribiana na meninjesi.<ref name=Tebruegge/> ===Meninjitisi ya virusi=== Virusi vinavyosababisha meninjitisi ni pamoja na [[virusi vya utumbo]], [[virusi vya hepesi tata|aina ya 2 ya virusi tata vya hepesi]] (na kwa aina ya 1 kwa mara nadra), [[virusi vya mbwe ya tetekuwanga]] (maarufu kwa kusababisha [[tetekuwanga]] na [[Mbwe ya hepesi|vipele]]), [[matumbwitumbwi|virusi vya matumbwitumbwi]], [[UKIMWI]], na [[koriomeninjitisi ya limfositiki|LCMV]].<ref name=LoganMacMahon/> ===Meninjitisi ya kuvu=== Kuna maswala kadhaa hatari yanayosababisha [[meninjitisi ya kuvu]], ikiwa ni pamoja na kutumia [[kitu kinachozuia mwitikio wa kingamwili]] (kama vile [[baada ya kupandikiza kiungo]]), [[UKIMWI]],<ref>{{cite journal|author=Raman Sharma R|title=Fungal infections of the nervous system: current perspective and controversies in management|journal=International journal of surgery (London, England)|date=2010|volume=8|issue=8|pages=591–601|pmid=20673817|doi=10.1016/j.ijsu.2010.07.293}}</ref> na ukosefu wa kinga kufuatia uzee.<ref name=Sirven2008>{{cite book|author=Sirven JI, Malamut BL|title=Clinical neurology of the older adult|year=2008|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781769471|page=439|url=http://books.google.ca/books?id=c1tL8C9ryMQC&pg=PA439|edition=2nd ed.}}</ref> Hali hii ni nadra katika watu walio na mfumo wa kawaida wa kingamwili<ref>{{cite journal|author=Honda H, Warren DK|title=Central nervous system infections: meningitis and brain abscess|url=https://archive.org/details/sim_infectious-disease-clinics-of-north-america_2009-09_23_3/page/609|journal=Infectious disease clinics of North America|date=2009 Sep|volume=23|issue=3|pages=609–23|pmid=19665086|doi=10.1016/j.idc.2009.04.009}}</ref> lakini imetokea katika [[kituo cha New England cha ujumuishaji kuhusu mlipuko wa meninjitisi|uchafuzi wa dawa]].<ref name=NECC>{{cite journal | author=Kauffman CA, Pappas PG, Patterson TF | title=Fungal infections associated with contaminated methyprednisolone injections—preliminary report |journal=New England Journal of Medicine | volume=Online first | date=19 October 2012 | doi=10.1056/NEJMra1212617}}</ref> Kwa kawaida, mwanzo wa dalili huwa taratibu zaidi, huku zikiambatana na maumivu ya kichwa na homa angalau kwa wiki kadhaa kabla ya utambuzi. <ref name=Sirven2008/> Meninjitisi ya kuvu inayotokea mara nyingi zaidi ni [[meninjitisi ya kiripitokokasi]] inayosababishwa ''[[Cryptococcus neoformans]]''.<ref>{{cite book|author=Kauffman CA, Pappas PG, Sobel JD, Dismukes WE|title=Essentials of clinical mycology|publisher=Springer|location=New York|isbn=9781441966391|page=77|url=http://books.google.ca/books?id=8IySvRT52KkC&pg=PA77|edition=2nd ed.}}</ref> Barani Afrika, meninjitisi ya kiripitokokasi hukadiriwa kuwa kisababishi kikuu cha meninjitisi.<ref>{{cite book|author=Kauffman CA, Pappas PG, Sobel JD, Dismukes WE|title=Essentials of clinical mycology|publisher=Springer|location=New York|isbn=9781441966391|page=31|url=http://books.google.ca/books?id=8IySvRT52KkC&pg=PA31|edition=2nd ed.}}</ref> and it accounts for 20–25% of AIDS-related deaths in Africa.<ref>{{cite journal|last=Park|first=Benjamin J|coauthors=Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM.|title=Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS|journal=AIDS|date=1 February 2009|year=2009|volume=23|issue=4|pages=525–530|doi=10.1097/QAD.0b013e328322ffac|pmid=19182676}}</ref> Vikolezo vingine vya kuvu ni pamoja na ''[[Histoplasma capsulatum]]'', ''[[Coccidioides immitis]]'', ''[[Blastomyces dermatitidis]]'', na''[[Candida (fungus)|Candida]]'' species.<ref name=Sirven2008/> ===Meninjitisi ya vimelea=== Mara nyingi, meninjisiti huchukuliwa kusababishwa na vimelea ikiwa kuna ukuu wa [[granulositi ya ozinofili|ozinofili]] (aina ya seli nyeupe za damu) katika KMN. Vimelea maarufu zaidi vinavyokisiwa kuwa visababishi ni ''[[Angiostrongylus cantonensis]]'', ''[[Gnathostoma spinigerum]]'', ''[[Schistosoma]]'', na pia hali za [[saistikakosisi]], [[tokisokariasi]], [[belisaskaris prosionisi|belisaskaris prosionisi]], [[paragonimiasi]],na maambukizi kadhaa yaliyo nadra na hali zisizoambukizwa.<ref name=Graeff>{{cite journal | author=Graeff-Teixeira C, da Silva AC, Yoshimura K | title=Update on eosinophilic meningoencephalitis and its clinical relevance | journal=Clinical Microbiology Reviews | year=2009 | month=Apr | volume=22 | issue=2 | pages=322–48 | pmid=19366917 | pmc=2668237 | doi=10.1128/CMR.00044-08 | url=http://cmr.asm.org/content/22/2/322.full.pdf | access-date=2018-02-26 | archive-date=2014-02-03 | archive-url=https://web.archive.org/web/20140203154157/http://cmr.asm.org/content/22/2/322.full.pdf | dead-url=yes }}</ref> ===Meninjitisi isoambukizi=== Meninjitisi inaweza kutokea kufuatia visababishi kadhaa visoambukizi: kuenea kwa [[saratani]] hadi kwa meninjesi (''[[neoplastic meningitis|meninjitisi inayodhuru au ya kiuvimbe]]'')<ref name=Chamberlain>{{cite journal |author=Gleissner B, Chamberlain MC|title=Neoplastic meningitis |journal=Lancet Neurol |volume=5 |issue=5 |pages=443–52 |year=2006 |month=May |pmid=16632315|doi=10.1016/S1474-4422(06)70443-4}}</ref> na baadhi ya [[dawa]] (hasa [[dawa zisizo za steroidi za kupunguza uvimbe]],[[antibiotiki]] na [[imunoglobulini ya kudungwa ndani ya misuli]]s).<ref name=ArchInternMed>{{cite journal |author=Moris G, Garcia-Monco JC|title=The Challenge of Drug-Induced Aseptic Meningitis |journal=Archives of Internal Medicine |volume=159 |issue=11|pages=1185–94 |year=1999 |month=June |url=http://archinte.ama-assn.org/cgi/reprint/159/11/1185.pdf | pmid=10371226|doi=10.1001/archinte.159.11.1185}}</ref>Meninjitisi pia inaweza kusababishwa na hali nyingi za kiinflamesheni kama vile [[sakoidosisi]] (ambayo kisha hujulikana kama[[niurosakoidosi]]), matatizo ya tishu unganishi kama vile [[lupasi erithematosusi ya kimfumo]] na aina fulani za [[vaulitisi]] (hali za kiinflamesheni za pembezo mwa mishipa ya damu), kama vile [[ugonjwa wa Behçet]].<ref name=Ginsberg/>[[uvimbe wa sehemu ya nje ya ngozi]] na [[uvimbe wa ngozi]] unaweza kusababisha meninjitisi kwa kuachisha dutu inayowasha katika nafasi ya araknoidi.<ref name=Ginsberg/><ref name=Tebruegge/> [[Meninjitisi ya Mollaret]] ni dalili ya vipindi vinavyorejea vya meninjitisi isiyo ya kibakteria; hali inayoaminika kusababishwa na [[virusi vidogo vya hepesi|aina ya 2 ya virusi vidogo vya hepesi]]. Ni nadra sana kwa [[kipandauso]] kusababisha meninjitisi, lakini utambuzi huu hufanywa tu iwapo visababishi vingine havijatambulika.<ref name=Ginsberg/> ==Utaratibu== Meninjesi hujumuisha tando tatu ambazo, pamoja na [[kiowevu cha mfumo mkuu wa neva]], hufunika na kuukinga [[ubongo]] na [[uti wa mgongo]] [[mfumo mkuu wa neva]]). [[Sehemu ya ubongo ya pia]] ni utando laini sana na usioweza kupitisha dutu, ambao hushikamana na sehemu ya juu ya ubongo huku ukifuata vijitaro vyote vidogo. [[Sehemu ya araknoidi]] (inayoitwa hivi kufuatia umbo lake la utando wa buibui) ni kijifuko kilegevu kilicho juu ya sehemu ya pia. [[Nafasi ya araknoidi]] hutenganisha araknoidi na tando za sehemu ya pia, huku ikiwa imejazwa kwa kiowevu mfumo mkuu wa neva. Sehemu ya nje zaidi ya utando, yaani [[sehemu ya dura]], ni utando mnene imara, ulioshikamanishwa na utando wa araknoidi na fuvu. Katika meninjitisi ya kibakteria, bakteria hufika kwenye meninjesi kwa njia mbili kuu: kupitia mfumo wa damu au kupitia mgusano wa moja kwa moja kati ya meninjesi na aidha njia ya pua au ngozi. Katika matukio mengi zaidi, meninjitisi hufuata uvamizi wa mkondo wa damu kupitia kwa viumbe wanaoishi katika [[utando wa ute|sehemu za juu za ute]] kama vile [[njia ya pua]]. Hali hii kisha hutanguliwa na maambukizi ya virusi ambayo humeng'enya kidhibiti cha kawaida kinachotolewa na sehemu za juu za ute. Bakteria zinapoingia katika mkondo wa damu huingia katika [[nafasi ya araknoidi na pia]] katika sehemu ambapo[[kidhibiti damu ubongoni]]ni hafifu - kama vile [[pleksa ya koroidi]]. Meninjitisi hutokea katika asilimia 25 ya watoto wazawa walio na maambukizi ya mkondo wa damu kufuatia streptokosi ya kikundi cha B; tukio hili ni nadra katika watu wazima.<ref name=Lancet/> Uchafuzi wa moja kwa moja wa kiowevu cha mfumo mkuu wa neva unaweza kutokea kufuatia vifaa vya kindani, kuvunjika kwa fuvu, au maambukizi ya farinki ya pua au sinasi za pua zilizounda mfumo kwa kuungana na nafasi ya araknoidi na pia (tazama hapa juu); mara kwa mara, [[matatizo ya kuzaliwa|ulemavu wa kuzaliwa]] wa [[sehemu ya dura]] yanaweza kutambuliwa.<ref name=Lancet/> [[Inflamesheni]] ya kiwango cha juu inayotokea katika nafasi ya araknoidi na pia wakati wa meninjitisi haisababishwi moja kwa moja na maambukizi ya kibakteria ila inaweza kusababishwa na mwitikio wa [[mfumo wa kingamwili]]kwenye kiingilizi cha bakteria katika[[mfumo mkuu wa neva]]. Kipengele cha [[utando wa seli]]za bakteria kinapotambuliwa na seli za ubongo zenye kinga ([[astrosaiti[[na [[mikrojilia[[, seli hizi hujibiza kwa kuzalisha viwango vikubwa vya [[saitokini[[, vipatanishi vinavyofanana na homoni ambazo hubadilisha seli zingine zenye kinga na kuchochea tishu zingine ili kuhusika katika mwitikio wa kinga. Kidhibiti damu ubongoni huwa chenye kupenyeka zaidi, hivyo kupelekea [[edema ya ubongo#Edema ya Ubongo ya kivasojeni|Edema ya Ubongo ya "kivasojeni"]] (kuvimba kwa ubongo kufuatia kuvuja kwa kiowevu kutoka katika mishipa ya damu). Idadi kubwa ya [[seli nyeupe za damu]] huingia katika KMN, hivyo kusababisha inflamesheni ya meninjesi na kisha kupelekea [[Edema ya ubongo#Edema ya ubongo ya kati ya tishu|edema ya "kati ya tishu"]] (kufura kufuatia kiowevu kuwa kati ya seli). Isitoshe, pembezo za mishipa ya damu zenyewe hufura (vasuliti ya ubongo), hali inayopelekea upungufu wa mtiririko wa damu na aina ya tatu ya edema, [[Edema ya ubongo#Edema sititoksiki ya ubongo|edema "sitotoksiki]]. Aina hizi tatu za edema ya ubongo hupelekea ongezeko la [[shinikizo la ndani ya fuvu]]; pamoja na shinikizo lililoshuka la damu, ambalo mara nyingi hupatikana katika [[Makali (ya kimatibabu) |maambukizi makali]], kumaanisha kuwa ni vigumu zaidi kwa damu kuingia katika ubongo, hivyo[[seli za ubongo]] hukoseshwa oksijeni hivyo kupata [[apoptosi]] ([[kufa kwa seli kimpangilio|kufa kwa seli]]).<ref name=Lancet/> Inatambulika kuwa kupeanwa kwa antibiotiki kunaweza kuathiri mwanzoni utaratibu uliotolewa hapa juu kwa kuongeza idadi ya mazao ya utando wa seli, yanayozalishwa kufuatia kuangamizwa kwa bakteria. Aina fulani za matibabu, kama vile kutumia [[glukokotikoidi|steroidi gamba]], hulenga kupunguza mwitikio wa kingamwili kufuatia tukio hili.<ref name=Lancet/><ref name=NEJM/> ==Utambuzi== {| class="wikitable" style="float:right; font-size:85%; margin-left:15px;" |+ CSF findings in different forms of meningitis<ref>{{cite book |last=Provan |first= Drew |coauthors=Andrew Krentz |title= Oxford Handbook of Clinical and Laboratory Investigation|url=https://archive.org/details/oxfordhandbookof0000unse_a4a5 |year=2005 |publisher=Oxford University Press |location=Oxford|isbn=0-19-856663-8 }}</ref> |- ! Type of meningitis ! &nbsp;&nbsp;[[CSF glucose|Glucose]]&nbsp;&nbsp; ! [[CSF total protein|Protein]] ! [[Pleocytosis|Cells]] |- ! style="text-align: left;"| Acute bacterial | low || high || [[Neutrophil|PMNs]], <br />often > 300/mm³ |- ! style="text-align: left;"| Acute bacterial | normal || normal or high || [[Lymphocyte|mononuclear]],<br /> < 300/mm³ |- ! style="text-align: left;" | Tuberculous | low || high || mononuclear and<br />PMNs, < 300/mm³ |- ! style="text-align: left;" | Fungal | low || high || < 300/mm³ |- ! style="text-align: left;" | [[Neoplasm|Malignant]] | low || high || usually<br /> mononuclear |} ===Kupima damu na kupiga picha=== Kwa mtu anayeshukiwa kuwa na meninjitisi, ni sharti yeye [[kupimwa damu]] ili kutambua viashiria vya inflamesheni (kama vile [[aina ya C ya protini inayoathirika]], [[hesabu kamili ya damu]]), na pia[[kuchunguza viini kwa damu]].<ref name=IDSA/><ref name=EFNS>{{cite journal|author=Chaudhuri A |title=EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults |journal=European Journal of Neurolology |volume=15 |issue=7|pages=649–59 |year=2008 |month=July |pmid=18582342 |doi=10.1111/j.1468-1331.2008.02193.x |author-separator=,|author2=Martinez–Martin P |author3=Martin PM |display-authors=3 |last4=Andrew Seaton |first4=R. |last5=Portegies |first5=P.|last6=Bojar |first6=M. |last7=Steiner |first7=I. |last8=Efns Task |first8=Force}}</ref> Uchunguzi muhimu zaidi katika kutambua au kudhibitisha uwepo wa meninjitisi ni uchambuzi wa kiowevu cha mfumo mkuu wa neva kupitia [[sindano ya mgongo]].<ref name=Straus>{{cite journal |author=Straus SE, Thorpe KE, Holroyd-Leduc J |title=How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis? |url=https://archive.org/details/sim_jama_2006-10-25_296_16/page/2012 |journal=[[Journal of the American Medical Association]] |volume=296 |issue=16 |pages=2012–22 |year=2006 |month=October |pmid=17062865|doi=10.1001/jama.296.16.2012}}</ref> Hata hivyo, sindano ya mgongo hutatizika iwapo kuna donge katika ubongo (tiuma au usaha) au [[shinikizo la ndani ya fuvu]] kupanda, kwa sababu hali hii inaweza kupelekea[[henia ya ubongo]]. Iwapo mtu yuko katika hatari ya kuwa na donge au shinikizo ndani ya fuvu (majeraha ya kichwa hivi karibuni, tatizo la mfumo wa kinga linalojulikana, dalili za kieneo za kinurolojia au ushahidi wa shinikizo lililopanda la ndani ya fuvu), [[tomografia ya kompiuta |TK]] au [[picha ya mwangwi wa sumaku|PMS]] hupendekezwa kabla ya sindano ya mgongo.<ref name=IDSA/><ref name=EFNS/><ref name=BIS>{{cite journal |author=Heyderman RS, Lambert HP, O'Sullivan I, Stuart JM, Taylor BL, Wall RA |title=Early management of suspected bacterial meningitis and meningococcal septicaemia in adults |journal=The Journal of infection |volume=46 |issue=2 |pages=75–7 |year=2003 |month=February |pmid=12634067 |doi=10.1053/jinf.2002.1110 |url=http://www.britishinfection.org/drupal/sites/default/files/meningitisJI2003.pdf |access-date=2018-02-26 |archive-date=2011-07-25 |archive-url=https://web.archive.org/web/20110725103638/http://www.britishinfection.org/drupal/sites/default/files/meningitisJI2003.pdf |dead-url=yes }} – formal guideline at {{cite web | author=British Infection Society & UK Meningitis Research Trust | title=Early management of suspected meningitis and meningococcal septicaemia in immunocompetent adults | url=http://www.meningitis.org/assets/x/51738 | publisher=British Infection Society Guidelines | month=December | year=2004 | accessdate=2008-10-19 | archivedate=2013-10-19 | archiveurl=https://web.archive.org/web/20131019120524/http://www.meningitis.org/assets/x/51738 }}</ref> Hii hufanyika katika asilimia 45 ya matukio katika watu wazima.<ref name=NEJM/>Iwapo TK au PMS inahitajika kabla ya sindano ya mgongo, au sindano hii ni ngumu kudungwa, maelekezo ya kitaalam yanadokeza kuwa antibiotiki zinafaa kupeanwa kwanza ili kuzuia kukawia kwa matibabu, <ref name=IDSA/> hasa iwapo utaratibu huu utachukua zaidi ya dakika 30&nbsp;.<ref name=EFNS/><ref name=BIS/>Mara nyingi, TK au PMS hufanywa katika awamu ya baadaye ili kukadiria matatizo ya meninjitisi.<ref name=Lancet/> Kwa aina kali za meninjitisi, ufuatilizi wa elektrolaiti za damu unaweza kuwa muhimu; kwa mfano, [[hiponatremia[[hutokea mara nyingi katika meninjitisi ya kibakteria, kufuatia mkusanyiko wa vipengele vingi, vikiwemo kuishiwa na maji mwilini, [[Dalili za kiwango cha juu cha utoleshaji usiofaa wa homoni ya kupunguza mkojo|utoleshaji usiofaa]] wa [[homoni ya kupunguza mkojo]], au [[therapi ya ndani ya mishipa|kudunga viowevu ndani ya mishipa]].<ref name=NEJM/><ref name="pmid18254060">{{cite journal |author=Maconochie I, Baumer H, Stewart ME |title=Fluid therapy for acute bacterial meningitis |journal=Cochrane Database of Systematic Reviews |issue=1|id=CD004786 |year=2008 |pmid=18254060 |doi=10.1002/14651858.CD004786.pub3 |editor1-last=MacOnochie |editor1-first=Ian K|pages=CD004786 }}</ref> ===Sindano ya mgongo=== [[File:Neisseria meningitidis.jpg|right|thumb|[[kutia rangi kwa mbinu ya Gram|mbinu ya kutia rangi ya Gram]] ya meningokokasi kutoka kwa uchunguzi viini unaoonyesha bakteria hasi (ya waridi) kwa mbinu ya Gram, ambayo mara nyingi huwa katika jozi]] Sindano ya mgongo hudungwa kwa kumlaza mtu kwa upande mmoja, huku ukitumia[[anaesthesia ya eneo maalum]], kisha kuingiza sindano katika[[kifuko cha dura]] (kifuko kinachozunguka uti wa mgongo) ili kuvuta kiowevu cha mfumo mkuu wa neva (KMN). Jambo hili likishafanywa, "shinikizo la kufungua" la KMN hupimwa kwa kutumia [[manometa]]. Shinikizo hili kwa kawaida huwa kati ya sentimita 6&nbsp; na 18&nbsp; za maji (cmH₂O);<ref name=Straus/> katika meninjitisi ya kibakteria shinikizo hili huwa juu zaidi.<ref name=IDSA/><ref name=EFNS/> Katika[[meninjitisi ya kikriptokosi]], shinikizo la ndani ya fuvu huwa juu zaidi.<ref name=Perfect2010>{{cite journal|author=Perfect JR, Dismukes WE, Dromer F ''et al'' |title=Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america |journal=Clinical Infectious Diseases|year=2010 |volume=50|issue=3|pages=291–322|pmid=20047480|url=http://cid.oxfordjournals.org/content/50/3/291.long |doi=10.1086/649858}}</ref>Uwepo wa kwanza wa kiowevu hiki unaweza kudhihirisha asili ya maambukizi haya: KMN cha rangi nyeupe huashiria viwango vya juu zaidi vya protini, seli nyekundu na nyeupe za damu na/au bakteria, hivyo kuna uwezekano wa meninjitisi ya kibakteria. <ref name=IDSA/> Sampuli ya KMN huchunguzwa ili kubaini uwepo na aina za [[seli nyeupe ya damu]], [[seli nyekundu za damu]], [[protini]] na viwango vya [[glukosi]].<ref name=IDSA/> [[Mbinu ya Gram ya kupaka rangi]]ya sampuli hii inaweza kudhihirisha uwepo wa bakteria katika meninjitisi ya kibakteria, lakini kutokuwepo bakteria hakubainishi kuwa meninjitisi ya kibakteria haipo, kwa sababu bakteria huonekana tu katika asilimia 60 ya matukio; kiwango hiki hupungua kwa asilimia 20 zaidi iwapo antibiotiki zilipeanwa kabla ya kutolewa kwa sampuli. Mbinu ya Gram ya kupaka rangi pia haiaminiki sana katika maambukizi kama vile [[listeriosisi]]. [[Uchunguzi viini wa kimikrobiolojia]] wa sampuli iliyochukuliwa hufaulu zaidi (hutambua viini katika asilimia 70-85 ya visa) lakini matokeo yanaweza kukawia hadi saa 48&nbsp;. <ref name=IDSA/> Aina ya seli nyeupe za damu zikiwepo kwa wingi (tazama jedwali) huonyesha iwapo meninjitisi ni ya kibakteria (hasa yenye wingi wa nutrofili) au ni ya virusi (hasa yenye wingi wa limfosaiti), <ref name=IDSA/> ingawa mwanzoni mwa ugonjwa huu, vipengele hivi sio viashiria vinavyoaminika. Mara nadra sana[[ozinofili]] huwepo kwa wingi, hivyo kuashiria kuwepo kwa viini au kuvu, miongoni mwa dutu zingine.<ref name=Graeff/> Ukolezi wa glukosi katika KMN kwa kawaida huwa zaidi ya asilimia 40 wa kiwango kilicho kwenye damu. Kwa meninjitisi ya kibakteria, kiwango cha glukosi kwa kawaida huwa chini zaidi; kiwango cha glukosi katika KMN basi hugawanywa kwa uwiano wa [[Sukari ya damu|glukosi ya damu]] (uwiano wa glukosi ya KMN na ya seramu). Uwiano wa ≤0.4 huonyesha uwepo wa meninjitisi ya kibakteria; <ref name=Straus/> katika mtoto mzawa, kwa kawaida kiwango cha glukosi katika KMN huwa juu zaidi, na uwiano wa chini ya 0.6 (asilimia 60) hivyo huchukuliwa kuwa wa kawaida.<ref name=IDSA/> Viwango vya juu vya [[asidi ya lakteti|lakteti]] katika KMN huonyesha kiwango cha juu cha uwezekano wa kuwepo kwa meninjitisi ya kibakteria, sawa na idadi ya seli nyeupe za damu.<ref name=Straus/>Iwapo viwango vya lakteti viko chini ya &nbsp;mg/dl 35 na mtu huyu hajapokea antibiotiki hivi karibuni, basi inawezekana kwamba hakuna meninjitisi ya kibakteria.<ref>{{cite journal|last=Sakushima|first=K|coauthors=Hayashino, Y; Kawaguchi, T; Jackson, JL; Fukuhara, S|title=Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis.|journal=The Journal of infection|date=2011 Apr|volume=62|issue=4|pages=255–62|pmid=21382412|doi=10.1016/j.jinf.2011.02.010}}</ref> Vipimo vingine vingi vinaweza kutumiwa kutofautisha baina ya aina tofauti za meninjitisi. [[Uchuguzi wa uambatishaji wa lateksi]] unaweza kutoa matokeo chanya katika meninjitisi inayosababishwa na ''[[Streptococcus pneumoniae]]'', ''[[Neisseria meningitidis]]'',''[[Haemophilus influenzae]]'', ''[[Escherichia coli]]'' na ''[[Streptococcus agalactiae|kikundi cha B cha streptococci]]''; inahimizwa kuwa uchunguzi huu usitumiwe kila mara kwa sababu ni nadra sana kwa uchunguzi huu kupelekea mabadiliko ya kimatibabu, ingawa unaweza kutumika iwapo vipimo vingine si vya kiutambuzi. Vivyo hivyo, [[majimaji ya liseti ya amebositi|uchunguzi wa majimaji ya liseti]] unaweza kuonyesha matokeo chanya katika meninjitisi iliyosababishwa na bakteria isiyotambulika kwa mbinu ya Gram ya kupaka rangi, lakini uchunguzi huu hautumiki sana isipokuwa kama vipimo vingine havijafaulu.<ref name=IDSA/> [[Msururu wa athari za polima]] (MAP) ni mbinu inayotumika kukuza chembe ndogo za DNA ya bakteria ili kubaini uwepo wa DNA ya bakteria au virusi katika kiowevu cha mfumo mkuu wa neva; uchunguzi huu ni maalum na wa kiwango cha juu cha usikivu kwa sababu ni viwango vidogo sana vya DNA ya viini vya maambukizi vinavyohitajika. Uchunguzi huu unaweza kutambua bakteria katika meninjitisi ya kibakteria na inaweza kusaidia katika kubainisha visababishi tofauti vya meninjitisi ya virusi ([[virusi vya RNA]], [[virusi vya hepesi ndogo|aina ya 2 ya virusi vya hepesi ndogo]] na [[matubwitubwi]] kwa watu wasiochanjwa dhidi ya magonjwa haya).<ref name=LoganMacMahon/> [[Serolojia]] (utambuzi wa antibodi na virusi) inaweza kuwa muhimu katika meninjitisi ya virusi.<ref name=LoganMacMahon/> Iwapo mgonjwa anakisiwa kuwa na meninjitisi ya kifua kikuu, sampuli huchunguzwa kwa[[mbinu ya kupaka rangi ya Ziehl-Neelsen]], ambayo ina usikivu wa kiwango cha chini, na uchunguzi wa viini vya kifua kikuu, unaochukua muda mrefu kufanywa; mbinu ya MAP inatumika kwa kiwango kinachoongezeka.<ref name=Tuberc/>Uchunguzi wa meninjitisi ya kriptokokasi unaweza kufanywa kwa gharama ya chini kwa kutumia [[rangi ya India]] kwenye KMN; hata hivyo, kuchunguza antijeni ya kriptokokasi katika damu au KMN ni mbinu sikivu zaidi, hasa katika watu walio na UKIMWI.<ref name=BMB>{{cite journal |author=Bicanic T, Harrison TS |title=Cryptococcal meningitis |journal=British Medical Bulletin |volume=72 |issue= 1|pages=99–118 |year=2004 |pmid=15838017 |doi=10.1093/bmb/ldh043 |url=http://bmb.oxfordjournals.org/content/72/1/99.full.pdf}}</ref><ref name=Sloan2008>{{cite journal |author=Sloan D, Dlamini S, Paul N, Dedicoat M |title=Treatment of acute cryptococcal meningitis in HIV infected adults, with an emphasis on resource-limited settings |journal=Cochrane Database of Systematic Reviews |volume= |issue=4 |id=CD005647 |year=2008 |pmid=18843697 |doi=10.1002/14651858.CD005647.pub2|editor1-last=Sloan |editor1-first=Derek |pages=CD005647 }}</ref> Tatizo la kiutambuzi na kimatibabu ni "meninjitisi iliyotibiwa nusu", ambapo kuna dalili za meninjitisi baada ya kupokea antibiotiki (kama vile [[sinositisi]]inayochukuliwa kuwepo). Jambo hili likifanyika, matokeo ya KMN yanaweza kufanana na yale ya meninjitisi ya virusi, lakini matibabu ya antibiotiki yanaweza kuhitaji kuendelea kufanywa hadi wakati kuna ushahidi kamili wa kutambulika kwa kisababishi kutokana na virusi (kama vile kupatikana kwa RNA ya virusi)<ref name=LoganMacMahon/> ===Uchunguzi wa maiti=== [[File:Meningitis Histopathology.jpg|thumb|Histopatholojia ya meninjitisi ya kibakteria: uchunguzi maiti ya mtu aliyekuwa na meninjitisi ya kinumokokasi unaoonyesha vipenyezo vya uvimbe wa[[sehemu ya ubongo ya pia]]zilizo na granulositi za nutrofili (ndani, ukuzaji wa juu zaidi).]]Meninjitisi inaweza kutambulika baada ya kifo. Matokeo ya [[uchunguzi wa maiti]]kwa kawaida huwa inflamesheni iliyosambaa ya [[sehemu ya ubongo ya pia]] na [[sehemu ya araknoidi, safu za |araknoidi]] za meninjesi.[[Granulositi ya nutrofili]]huwa imehamia katika kiowevu cha mfumo mkuu wa neva na shina la ubongo, pamoja na [[neva ya fuvu]] na [[uti wa mgongo]], unaweza kuzungukwa na [[usaha[[- sawa na mishipa ya meninjesi.<ref name="OTM1">{{cite book | title=Oxford Textbook of Medicine Volume 3 | author=Warrell DA, Farrar JJ, Crook DWM | chapter = 24.14.1 Bacterial meningitis | year=2003 |publisher=Oxford University Press | isbn=0-19-852787-X | pages=1115–29 | edition = Fourth }}</ref> ==Kinga== Katika baadhi ya visababishi vya meningesi, kinga inaweza kutolewa kwa kulenga muda mrefu ujao kupitia [[chanjo]], au kwa kulenga muda mfupi kwa kutumia [[antibiotiki]]. Mbinu za kimtindo pia zinaweza kuwa bora. Katika nchi nyingi, watoto wengi hupewa chanjo ya kuzuia ''Haemophilus influenzae'' ambayo huondoa bakteria hizo kwa miili ya watoto. Hata hivyo, chanjo hii ni ghali. Chanjo ya ''Bacillus Calmette-Guérin'' imeonyesha kupunguza kiwango cha ugonjwa huu kuenea. Dawa zinazotumika kuzuia ni kama ''rifampicin'', ''ciprofloxacin'' au ''ceftriaxone''. ===Tabia=== Meninjitisi ya kibakteria na ya virusi inaweza kusambazwa; hata hivyo, aina zote mbili hazisambazwi kwa kiwango cha juu kama vile[[homa ya kawaida]] au [[mafua]].<ref name="CDCtransmission">{{cite web |url= http://www.cdc.gov/meningitis/about/transmission.html |title=CDC – Meningitis: Transmission |publisher=[[Centers for Disease Control and Prevention]] (CDC) | date = August 6, 2009 |accessdate=18 June 2011}}</ref> Aina hizi mbili zinaweza kusambazwa kupitia vitone vya majimaji ya mwili wakati watu wanapogusana; kama vile kupitia busu, kupiga chafya au kukohoa, lakini haziwezi kusambazwa kwa kupumua tu hewa alimokuwa mtu aliye na meninjitisi.<ref name="CDCtransmission"/>Meninjitisi ya virusi kwa kawaida husababishwa na [[RNA ya virusi]], na mara nyingi husambazwa kupitia kinyesi.<ref name="CDCtransmission"/> Hatari ya kusambazwa inaweza kupunguzwa kwa kubadilishatabia zinazochangia maambukizi. ===Chanjo=== Tangu miaka ya 1980, mataifa mengi yamejumuisha [[Chanjo ya Hib|chanjo dhidi ya''Haemophilus influenzae''aina ya B]]katika mipangilio yao ya kawaida ya kuchanja watoto. Hatua hii imeondoa kabisa viini vya ugonjwa huu kama kisababishi cha meninjitisi katika watoto wachanga katika mataifa hayo. Hata hivyo, katika mataifa ambapo ugonjwa huu unatatiza zaidi, chanjo yake ingali ya bei ghali sana.<ref name=SegalPollard>{{cite journal |author=Segal S, Pollard AJ |title=Vaccines against bacterial meningitis |journal=British Medical Bulletin |volume=72 |issue= 1|pages=65–81 |year=2004 |pmid=15802609 |doi=10.1093/bmb/ldh041|url=http://bmb.oxfordjournals.org/content/72/1/65.full.pdf }}</ref><ref name=Peltola>{{cite journal |author=Peltola H |title=Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates |journal=Clinical Microbiology Reviews |volume=13 |issue=2 |pages=302–17 |year=2000 |month=April |pmid=10756001 |pmc=100154 |doi=10.1128/CMR.13.2.302-317.2000 |url=http://cmr.asm.org/content/13/2/302.full.pdf |access-date=2018-02-26 |archive-date=2014-07-08 |archive-url=https://web.archive.org/web/20140708011906/http://cmr.asm.org/content/13/2/302.full.pdf |dead-url=yes }}</ref>Sawa na haya, chanjo dhidi ya matubwitubwi imepelekea upungufu wa kiwango kikubwa wa visa vya meninjitisi ya matubwitubwi, ambayo ilikuwa ikitokea kwa asilimia 15 katika matukio yote ya matubwitubwi.<ref name=LoganMacMahon/> [[Chanjo dhidi ya meningokokasi|Chanjo dhidi ya meningokokasi]]ipo, dhidi ya vikundi vya A, C W135 na Y.<ref name=Harrison>{{cite journal |author=Harrison LH |title=Prospects for vaccine prevention of meningococcal infection |journal=Clinical Microbiology Reviews |volume=19 |issue=1 |pages=142–64 |year=2006 |month=January |pmid=16418528 |pmc=1360272 |doi=10.1128/CMR.19.1.142-164.2006 |url=http://cmr.asm.org/content/19/1/142.full.pdf |access-date=2018-02-26 |archive-date=2014-07-08 |archive-url=https://web.archive.org/web/20140708012827/http://cmr.asm.org/content/19/1/142.full.pdf |dead-url=yes }}</ref>Katika mataifa ambapo chanjo dhidi ya kikundi cha C ilizinduliwa, visa vyanasababishwa na viini hivi yamepungua pakubwa.<ref name=SegalPollard/> Chanjo yenye valensi nne sasa ipo, ambayo huunganisha chanjo zote nne. Siku hizi mtu hushurutishwa kuchanjwa kwa ACW135Y dhidi ya aina zote nne za ugonjwa huu iwapo anataka kuhusika katika [[Hija]].<ref name=WilderSmith/>Imekuwa vigumu kutengeneza chanjo dhidi ya kikundi cha B cha meningokokasi. Hii ni kwa sababu protini za sehemu yake ya juu (ambazo kwa kawaida zingelitumika kutengeneza chanjo) hutoa[[imunojenisiti dhaifu|mwitikio wa mfumo wa kinga]], au kumenyana na protini za kawaida za binadamu.<ref name=SegalPollard/><ref name=Harrison/> Isitoshe, baadhi ya mataifa ([[New Zealand]], [[Cuba]], [[Norway]] and [[Chile]] yametengeza chanjo dhidi ya aina za maeneo yao ya kikundi cha B cha meningokokasi; baadhi ya chanjo hizi zimeonyesha matokeo bora hivyo zinatunika katika ratiba za kuchanja katika maeneo haya.<ref name=Harrison/> Kufikia majuzi barani Afrika, mtazamo wa kuzuia na kudhibiti majanga ya meningokokasi ulikuwa kwenye msingi wa kutambua ugonjwa huu mapema na chanjo ya dharura ya watu wanaoathirika na walio hatarini ambao wana A/C ya valensi jozi au chanjo za polisakaraidi ya valensi tatu ya A/C/W135, <ref>{{cite journal |author=WHO|title=Detecting meningococcal meningitis epidemics in highly-endemic African countries |journal=Weekly Epidemiological Record |volume=75 |issue=38 |pages=306–9 |year=2000|month=September |pmid=11045076 |format=PDF |url=http://www.who.int/docstore/wer/pdf/2000/wer7538.pdf}}</ref> ingawa kuanzishwa kwa [[MenAfriVac]] (chanjo ya kikundi cha A cha meningokokasi) kumeonyesha ufanisi katika watu wachanga, na kumetajika kuwa kielelezo cha ushirikiano wa kutengeneza bidhaa katika maeneo yenye uhaba wa rasilimali.<ref>{{cite journal|last=Bishai|first=DM|coauthors=Champion, C; Steele, ME; Thompson, L|title=Product development partnerships hit their stride: lessons from developing a meningitis vaccine for Africa.|url=https://archive.org/details/sim_health-affairs_2011-06_30_6/page/1058|journal=Health affairs (Project Hope)|date=2011 Jun|volume=30|issue=6|pages=1058–64|pmid=21653957|doi=10.1377/hlthaff.2011.0295}}</ref><ref>{{cite journal|last=Marc LaForce|first=F|coauthors=Ravenscroft, N; Djingarey, M; Viviani, S|title=Epidemic meningitis due to Group A Neisseria meningitidis in the African meningitis belt: a persistent problem with an imminent solution.|journal=Vaccine|date=2009 Jun 24|volume=27 Suppl 2|pages=B13-9|pmid=19477559|doi=10.1016/j.vaccine.2009.04.062}}</ref> Chanjo ya kila mara dhidi ya ''Streptococcus pneumoniae'' kwa [[chanjo ya muungano wa niumokokasi]], ambayo hutenda kazi dhidi ya aina maarufu saba za viini hivi hupunguza pakubwa kutokea kwa meninjitisi ya niumokokasi.<ref name=SegalPollard/><ref name=Weisfelt>{{cite journal |author=Weisfelt M, de Gans J, van der Poll T, van de Beek D|title=Pneumococcal meningitis in adults: new approaches to management and prevention |journal=Lancet Neurol |volume=5 |issue=4|pages=332–42 |year=2006 |month=April |pmid=16545750 |doi=10.1016/S1474-4422(06)70409-4}}</ref>[[Chanjo ya polisakaraidi ya niumokokasi]], ambayo hutibu aina 23, hupeanwa tu kwa vikundi maalum (kama vile watu waliofanyiwa [[splenektomia]], yaani kutolewa wengu kwa upasuaji); haisababishi mwitikio mkuu wa kinga katika watu wote wanayoipokea, kama vile watoto. <ref name=Weisfelt/>Chanjo ya utotoni ya [[Bacillus Calmette-Guérin]] imeripotiwa kupunguza pakubwa kima cha meninjitisi ya kifua kikuu, lakini ubora wake unaofifia katika watu wazima umepelekea utafiti kufanywa ili kupata chanjo bora zaidi.<ref name=SegalPollard/> ===Antibiotiki=== Profilaksi ya muda mfupi ya antibiotiki ni mbinu nyingine ya kinga, hasa ya meninjitisi ya meningokokasi. Kwa visa vya meninjitisi ya meningokokasi, matibabu ya kiprofilaksi ya watu wa karibu kwa kutumia antibiotiki (kama vile [[rifampicin]], [[ciprofloxacin]] au [[ceftriaxone]]) yanaweza kupunguza hatari yao ya kuambukizwa hali hii, lakini haiwakingi dhidi ya maambukizi ya baadaye.<ref name=EFNS/><ref name=Zal2011>{{cite journal|last=Zalmanovici Trestioreanu|first=A|coauthors=Fraser, A; Gafter-Gvili, A; Paul, M; Leibovici, L|title=Antibiotics for preventing meningococcal infections.|journal=Cochrane database of systematic reviews (Online)|date=2011 Aug 10|issue=8|pages=CD004785|pmid=21833949|doi=10.1002/14651858.CD004785.pub4}}</ref> Upinzani dhidi ya rifampicin umetambulika kuongezeka baada ya kuitumia dawa hii, jambo ambalo limepelekea baadhi ya watu kupendekeza vikolezo vingine. <ref name=Zal2011/>Ingawa antibiotiki hutumika mara nyingi zaidi ili kujaribu kuzuia meninjitisi katika watu walio na hali ya [[kuvunjika kwa basila ya fuvu]], kuna ushahidi usiotosha wa kutambua iwapo hatua hii ina manufaa au hatari.<ref name=CochSk2011>{{cite journal|last=Ratilal|first=BO|coauthors=Costa, J; Sampaio, C; Pappamikail, L|title=Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures.|journal=Cochrane database of systematic reviews (Online)|date=2011 Aug 10|issue=8|pages=CD004884|pmid=21833952|doi=10.1002/14651858.CD004884.pub3}}</ref> Hatua hii hufanywa katika watu walio au wasio na hali ya kuvuja kwa KMN.<ref name=CochSk2011/> ==Udhibiti== Meninjitisi ina uwezo wa kuhatarisha maisha na ni kisababishi kikuu cha kifo isipotibiwa; <ref name=IDSA/> kuchelewesha matibabu kumehusishwa na matokeo duni zaidi.<ref name=NEJM/>Kwa hivyo, matibabu ya kutumia antibiotiki za aina mbalimbali hayafai kucheleweshwa wakati uchunguzi wa kutambua ugonjwa huu ungali unafanywa.<ref name=BIS/> Iwapo ugonjwa wa meningokokasi unakisiwa kuwepo katika utunzaji wa kimsingi, maelekezo yanapendekeza kuwa[[benzylpenicillin]] ipeanwe kabla ya rufaa ya hospitalini.<ref name=SIGN/> [[Mtu anafaa kutiwa kiowevu ndani ya mishipa |ndani ya mishipa]] iwapo ana[[hipotensheni]] (shinikizo la chini la damu) au [[mshtuko (wa kiusambazaji)|mshtuko]]. <ref name=BIS/>Kwa sababu meninjitisi inaweza kusababisha matatizo kadhaa makali, uchunguzi wa kila mara unapendekezwa kufanywa ili kuyatambua mapema <ref name=BIS/> ili kumlaza mtu huyu katika [[kitengo cha wagonjwa mahututi]] iwapo itahitajika.<ref name=NEJM/> [[Mitambo ya kuingiza hewa]] inaweza kuhitajika iwapo mtu ana kiwango cha chini cha ufahamu, au iwapo kuna ushahidi wa [[kushindwa kupumua]]. Iwapo kuna dalili za kupanda kwa shinikizo la ndani ya fuvu, hatua za kulidhibiti zinaweza kuchukuliwa; hatua hizi zitawezesha kuinua [[shinikizo la kupulizia ubongo]] na matibabu mbalimbali ili kupunguza shinikizo la ndani ya fuvu kwa kutumia dawa (kama vile [[mannitol]]).<ref name=NEJM/> Mitukutiko hutibiwa kwa [[kikinza mitukutiko]].<ref name=NEJM/> Hidrosifalasi (kuzuilika kwa mkondo wa KMN) inaweza kupelekea haja ya kuingiza kifaa cha daima au cha muda mfupi cha kutoa kiowevu, kama vile [[kigeuza njia ya ubongoni]].<ref name=NEJM/> ===Meninjitisi ya kibakteria=== ====Antibiotiki==== [[File:Ceftriaxone structure.png|thumb|fomula ya muundo wa ceftriaxone, mojawapo ya antibiotiki za cefalosporin ya kizazi cha tatu inayopendekezwa katika matibabu ya kwanza ya meninjitisi ya kibakteria.]] [[Antibiotiki za kijarabati]] (matibabu bila utambuzi maalum) zinafaa kupeanwa punde, hata kabla ya matokeo ya sindano ya mgongo na uchambuzi wa KMN kujulikana. Matibabu ya kwanza yatakayotumika hutegemea pakubwa aina ya bakteria inayosababisha meninjitisi katika eneo fulani na kikundi maalum cha watu. Kwa mfano, kule[[Uingereza|Uingereza]] [[matibabu ya kijarabati]]hujumuisha kizazi cha tatu cha [[cefalosporin]] kama vile [[cefotaxime]] au [[ceftriaxone]].<ref name=EFNS/><ref name=BIS/> Nchini Marekani ambapo ukinzani dhidi ya cefalosporin hupatikana zaidi katika streptokosi, nyongeza ya [[vancomycin]] juu ya matibabu ya kwanza hupendekezwa.<ref name=IDSA/><ref name=NEJM/><ref name=EFNS/> [[Chloramphenicol]], ikitumika pekee au pamoja na [[ampicillin]], hata hivyo, huonekana kufanya kazi vyema pia.<ref>{{cite journal|last=Prasad|first=K|coauthors=Kumar, A; Gupta, PK; Singhal, T|title=Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis.|journal=Cochrane database of systematic reviews (Online)|date=2007 Oct 17|issue=4|pages=CD001832|pmid=17943757|doi=10.1002/14651858.CD001832.pub3}}</ref> Matibabu ya kijarabati yanaweza kupendelewa kulingana na umri wa mtu, iwe maambukizi yalitanguliwa na [[jeraha la kichwa]], iwa mtu huyu amefanyiwa [[upasuaji unaohusu mfumo wa neva]] hivi karibuni au iwe mtu huyu ana kigeuza njia ya ubongoni au la.<ref name=IDSA/> Katika watoto wachanga na watu wa umri wa zaidi ya miaka 50&nbsp;, na pia wale walio na kingamwili dhaifu, kuongeza[[ampicillin]] hupendekezwa ili kukabiliana na ''[[Listeria monocytogenes]]''.<ref name=IDSA/><ref name=EFNS/> Matokeo ya mbinu ya Gram ya kupaka rangi yanapopatikana na kisababishi cha kijumla cha kibakteria kimejulikana, inawezekana kubadilisha antibiotiki na kupeana zile zinazoaminika kukabiliana na kikundi cha viini kinachokisiwa kusababisha maambukizi.<ref name=IDSA/> Matokeo ya [[microbiological uchunguzi viini vya kimikrobiolojia|uchunguzi viini]] kijumla huchukua muda mrefu zaidi kupatikana (saa 24–48). Matokeo haya yanayopatikana, matibabu ya kijarabati yanaweza kubadilishwa na kuwa matibabu maalum ya antibiotiki inayolenga viini maalum vinavyosababisha maambukizi na pia kulenga mwitikio wake dhidi ya antibiotiki.<ref name=IDSA/>Ili antibiotiki iweze kufaulu kukabiliana na meninjitisi, haifai tu kuwa na uwezo wa kukabiliana na viini vya bakteria lakini pia kufika katika meninjesi kwa viwango vya kutosha; baadhi ya antibiotiki zina uwezo mdogo wa kupenya hivyo zina matumizi madogo dhidi ya meninjitisi. Idadi kubwa ya antibiotiki zinazotumika katika meninjitisi hazijajaribiwa moja kwa moja katika watu wenye meninjitisi katika [[utafiti wa kiafya]]. Badala yake, maarifa yanayotumika yametokana, kwa kiwango kikubwa, na utafiti wa maabara wa [[sungura]]<ref name=IDSA/>Meninjitisi ya kifua kikuu huhitaji matibabu ya muda mrefu kwa kutumia antibiotiki. Ingawa kifua kikuu ya mapafu kwa kawaida hutibiwa kwa miezi 6, watu walio na meninjitisi ya kifua kikuu kwa kawaida hutibiwa kwa mwaka mmoja au zaidi.<ref name=Tuberc/> ====Steroidi==== Matibabu [[saidizi]] ya [[steroidi gamba]] (kwa kawaida [[dexamethasone]]) yameonyesha manufaa kama vile kupunguza [[matatizo ya kusikia]],<ref>{{cite journal |author=van de Beek D|title=Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data |journal=Lancet Neurol|volume=9 |issue=3 |pages=254–63 |year=2010 |month=March|pmid=20138011 |pmc=2835871 |doi=10.1016/S1474-4422(10)70023-5|author-separator=, |display-authors=3}}</ref> na matokeo ya muda mfupi yaliyo bora zaidi yanayohusu neva<ref name=CochDex2010>{{cite journal|author=Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D |title=Corticosteroids for acute bacterial meningitis|journal=Cochrane Database of Systematic Reviews |volume= |issue=9|id=CD004405 |year=2010 |pmid=20824838|doi=10.1002/14651858.CD004405.pub3 |editor1-last=Van De Beek |editor1-first=Diederik|pages=CD004405 }}</ref> katika vijana baleghe na watu wazima wa nchi zilizostawi zilizo na viwango vya chini vya UKIMWI.<ref name=Assiri2009>{{cite journal |author=Assiri AM, Alasmari FA, Zimmerman VA, Baddour LM, Erwin PJ, Tleyjeh IM |title=Corticosteroid administration and outcome of adolescents and adults with acute bacterial meningitis: a meta-analysis |url=https://archive.org/details/sim_mayo-clinic-proceedings_2009-05_84_5/page/403 |journal=Mayo Clin. Proc. |volume=84|issue=5 |pages=403–9 |year=2009 |month=May |pmid=19411436|doi=10.4065/84.5.403 |pmc=2676122}}</ref> Kuna utafiti unaoonyesha kima kilichopunguka cha vifo kufuatia matibabu haya,<ref name=Assiri2009/> huku utafiti mwingine ukiwa hauonyeshi takwimu zozote.<ref name=CochDex2010/>Matibabu haya pia huonekana kuwanufaisha watu walio na meninjitisi ya kifua kikuu, angalau katika wale wasio na viini vya UKIMWI.<ref>{{cite journal|last=Prasad|first=K|coauthors=Singh, MB|title=Corticosteroids for managing tuberculous meningitis.|journal=Cochrane database of systematic reviews (Online)|date=2008 Jan 23|issue=1|pages=CD002244|pmid=18254003|doi=10.1002/14651858.CD002244.pub3}}</ref> Kwa hivyo, maelekezo ya kitaalam hupendekeza kuanzishwa kwa dexamethasone au steroidi gamba sawa na hii, punde kabla ya kipimo cha kwanza cha antibiotiki kupeanwa, na kuendelezwa kwa siku nne&nbsp;.<ref name=EFNS/><ref name=BIS/> Kwa sababu manufaa mengi ya matibabu haya huwa tu kwa watu walio na meninjitisi ya niumokokasi, baadhi ya maelekezo hudokeza kwamba dexamethasone isitishwe iwapo kisababishi kingine cha meninjitisi kitatambulika. <ref name=IDSA/><ref name=EFNS/> The likely mechanism is suppression of overactive inflammation.<ref name=deGans2002>{{cite journal |author=de Gans J, van de Beek D |title=Dexamethasone in adults with bacterial meningitis |journal=[[The New England Journal of Medicine]] |volume=347|issue=20 |pages=1549–56 |year=2002|month=November |pmid=12432041 |doi=10.1056/NEJMoa021334|url=http://www.nejm.org/doi/pdf/10.1056/NEJMoa021334 | format = PDF}}</ref> Kazi ya steroidi gamba saidizi ni tofauti kwa watoto na watu wazima. Ingawa manufaa ya steroidi gamba yametambulika kwa watu wazima na pia kwa watoto wa nchi zalizostawi, matumizi yake kwa watoto wa kutoka nchi zenye [[Umaskini|mapato madogo]] hayajapata ushahidi; sababu ya tofauti hii siyo wazi.<ref name=CochDex2010/>Hata katika nchi zenye mapato makubwa, manufaa ya steroidi gamba huonekana tu zinapopeanwa kabla ya kipimo cha kwanza cha antibiotiki, na huwa juu zaidi katika visa vya ''H. influenzae'' meninjitisi,<ref name=IDSA/><ref name="pmid9302246">{{cite journal|author=McIntyre PB |title=Dexamethasone as adjunctive therapy in bacterial meningitis. A meta-analysis of randomized clinical trials since 1988 |url=https://archive.org/details/sim_jama_1997-09-17_278_11/page/925 |journal=[[Journal of the American Medical Association]] |volume=278 |issue=11 |pages=925–31 |year=1997|month=September |pmid=9302246 |doi=10.1001/jama.1997.03550110063038 |author-separator=, |author2=Berkey CS |author3=King SM|display-authors=3 |last4=Schaad |first4=U. B. |last5=Kilpi |first5=T. |last6=Kanra |first6=G. Y. |last7=Perez |first7=C. M. O.}}</ref>, ambapo mathara yake yamepunguka kwa kiwango kikubwa tangu kuanzishwa kwa [[Chanjo ya Hib]]. Kwa hivyo, steroidi gamba hupendekezwa katika matibabu ya meninjitisi ya watoto iwapo kisababishi chake ni ''H. influenzae'', na iwapo tu zitatumika kabla ya kipimo cha kwanza cha antibiotiki; matumizi mengine yamekumbwa na utata.<ref name=IDSA/> ===Meninjitisi ya virusi=== [[Meninjitisi ya virusi]]kwa kawaida huhitaji matibabu saidizi; idadi nyingi ya virusi vinavyosababisha meninjitisi haviitikii matibabu maalum. Meninjitisi ya virusi mara nyingi huendelea kwa utaratibu hafifu zaidi kuliko meninjitisi ya kibakteria. [[virusi vya hepesi ndogo]] na [[virusi vya mbwe ya tetekuwanga]] vinaweza kuitikia matibabu ya dawa ya kinzavirusi kama vile [[aciclovir]]. Hata hivyo, hakuna utafiti wa kimatibabu unaoonyesha haswa iwapo matibabu haya yamekuwa na ufanisi. <ref name=LoganMacMahon/> Matukio hafifu ya meninjitisi ya virusi yanaweza kutibiwa nyumbani kwa kutumia mbinu za kitamaduni kama vile vinywaji, kupumzika na dawa za kuondoa maumivu.<ref>{{cite web |url=http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm |title=Meningitis and Encephalitis Fact Sheet |publisher=National Institute of Neurological Disorders and Stroke (NINDS) |date=2007-12-11 |accessdate=2009-04-27 |archivedate=2014-01-04 |archiveurl=https://web.archive.org/web/20140104212119/http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm }}</ref> ===Meninjitisi ya kuvu=== Meninjitisi inayosababishwa na kuvu, kama vile meninjitisi ya kriptokokasi, hutibiwa kwa vipimo vyenye nguvu vya muda mrefu vya [[dawa ya kukinza kuvu|kinza kuvu]], kama vile [[amphotericin B]] na [[flucytosine]].<ref name=BMB/><ref>{{cite journal |author=Gottfredsson M, Perfect JR|title=Fungal meningitis |url=https://archive.org/details/sim_seminars-in-neurology_2000_20_3/page/307|journal=Seminars in Neurology |volume=20 |issue=3 |pages=307–22 |year=2000 |pmid=11051295| doi = 10.1055/s-2000-9394}}</ref> Ongezeko la shinikizo la ndani ya fuvu ni tukio la kawaida katika meninjitisi ya kuvu, hivyo sindano za mgongoni zinazodungwa mara nyingi (kwa kawaida kila siku) ili kupunguza shinikizo hupendekezwa.<ref name=BMB/> la sivyo kuvuta kiowevu mgongoni.<ref name=Perfect2010/> ==Prognosi== [[File:Meningitis world map - DALY - WHO2004.svg|thumb|[[miaka ya hasara ya kulemaa]] ya meninjitisi kwa kila watu 100,000&nbsp; mwaka wa 2004.<ref>{{cite web|url=http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls |title=Mortality and Burden of Disease Estimates for WHO Member States in 2002|format=xls |publisher=World Health Organization (WHO)|year=2002 |accessdate=}}</ref> {{Multicol}} {{legend|#b3b3b3|no data}} {{legend|#ffff65|<10}} {{legend|#fff200|10-25}} {{legend|#ffdc00|25-50}} {{legend|#ffc600|50-75}} {{legend|#ffb000|75-100}} {{legend|#ff9a00|100-200}} {{Multicol-break}} {{legend|#ff8400|200-300}} {{legend|#ff6e00|300-400}} {{legend|#ff5800|400-500}} {{legend|#ff4200|500-750}} {{legend|#ff2c00|750–1000}} {{legend|#cb0000|>1000}} {{Multicol-end}}]] Meninjitisi ya kibakteria isiyotibiwa mara nyingi husababisha kifo. Kwa upande mwingine, meninjitisi ya virusi, mara nyingi hutatulika yenyewe na ni nadra kusababisha kifo. Kufuatia matibabu, [[Kima cha vifo|hali ya kuweza kufa]] (hatari ya kifo) kutokana na meninjitisi ya kibakteria hutegemea umri wa mtu na kisababishi cha ugonjwa huu. Katika watoto wazawa, asilimia 20–30 wanaweza kufa kutokana na tukio la meninjitisi ya kibakteria. Hatari hii iko chini kidogo katika watoto. Kima cha uwezo wa kufa kwa watoto ni asilimia 2, lakini hupanda hadi takriban asilimia 19 - 37 katika watu wazima.<ref name=Lancet/><ref name=NEJM/>Hatari ya kufa hutabiriwa kwa kutumia vipengele mbalimbali kando na umri. Vipengele hivi ni kama vile viini vya magonjwa na muda vinavyochukua kutolewa katika kiowevu cha mfumo mkuu wa neva,<ref name=Lancet/> makali ya uginjwa wa kijumla, upungufu wa kujifahamu na kiwango cha chini ya kawaida cha seli nyeupe za damu katika kiowevu cha mfumo mkuu wa neva.<ref name=NEJM/> Meninjitisi inayosababishwa na ''H.&nbsp;influenzae'' na meningokokasi ina prognosi bora zaidi ya meninjitisi inayosababishwa na kikundi cha B cha steptokosi, kolifomu na ''S. pneumonia''.<ref name=Lancet/> Pia katika watu wazima, meninjitisi ya meningokokasi ina kima cha chini cha uwezo wa kufa (3 - 7) zaidi ya ugonjwa numokokasi.<ref name=NEJM/> Watoto wengi wanaweza kulemaa, hali inayoweza kusababishwa na kuhadhiriwa kwa mfumo wa neva, ikiwa ni pamoja na [[uziwi unaotokana na kuhadhiriwa kwa neva]], [[kifafa]], [[kutoweza kujifunza kutokana na ulemavu|kujifunza]] na matatizo ya kimwenendo, na pia upungufu wa kiutambuzi.<ref name=Lancet/> Mambo haya hutokea katika asilimia 15 ya watu wanaoendelea kuishi.<ref name=Lancet/> Baadhi ya visa vya uziwi yanaweza kutibika..<ref name="pmid9068303">{{cite journal |author=Richardson MP, Reid A, Tarlow MJ, Rudd PT |title=Hearing loss during bacterial meningitis |journal=Archives of Disease in Childhood |volume=76 |issue=2 |pages=134–38 |year=1997|month=February |pmid=9068303 |pmc=1717058 |doi= 10.1136/adc.76.2.134|url=http://adc.bmj.com/content/76/2/134.full.pdf }}</ref>Katika watu wazima, asilimia 66 ya matukio yote huisha bila ya kuwa na ulemavu. Matatizo makuu ni [[uziwi]] (katika asilimia 14) na [[ulemavu wa kukua|ulemavu wa kiutambuzi]] (katika asilimia 10).<ref name=NEJM/> ==Epidemolojia== [[File:Meningitis-Epidemics-World-Map.png|right|thumb|Demografia ya [[meningokokasi, meninjitisi ya |meningokokasi]]{{legend|#FF0000|ukanda wa meninjitisi}}{{legend|#E08040|eneo la majanga}}{{legend|#C0C0C0|matukio nadra pekee}}]] Ingawa meninjitisi ni [[ugonjwa unaopaswa kuripotiwa mara moja]] katika nchi nyingi, kima maalum cha [[mathara (epidemolojia)|mathara ya magonjwa]] ya ugonjwa huu hayajulikani.<ref name=LoganMacMahon/>Meninjitisi ya kibakteria hutokea kwa takriban watu 3 kwa kila 100,000 kila mwaka katika[[Ulimwengu wa Magharibi|Mataifa ya Magharibi]]. Utafiti wa idadi kubwa ya watu umeonyesha kuwa meninjitisi ya virusi hutokea mara nyingi zaidi, kwa watu 10.9 kwa kila 100,000, na kutokea mara nyingi zaidi majira ya joto. Nchini Brazil, kima cha meninjitisi ya kibakteria kiko juu zaidi, yaani 45.8 kwa kila watu 1000,000 kila mwaka.<ref name=Attia/>[[Mataifa ya kusini mwa jangwa la Sahara]] yamekuwa yakikubwa na majanga makubwa zaidi ya meninjitisi ya meningokokasi kwa zaidi ya karne moja, <ref>{{cite journal|author=Lapeyssonnie L |title=Cerebrospinal meningitis in Africa |journal=Bulletin of the World Health Organization |volume=28|issue= |pages=SUPPL:1–114 |year=1963 |pmid=14259333 |pmc=2554630}}</ref> hivyo kupelekea kuitwa "ukanda wa meninjitisi." Majanga haya kwa kawaida hutokea katika majira ya kiangazi (Disemba hadi Juni), na wimbi la janga linaweza kudumu kwa miaka miwili hadi minne, huku likikoma katika majira ya mvua yanayoingia. <ref>{{cite journal |author=Greenwood B |title=Manson Lecture. Meningococcal meningitis in Africa |journal=Trans. R. Soc. Trop. Med. Hyg. |volume=93 |issue=4 |pages=341–53 |year=1999 |pmid=10674069|doi=10.1016/S0035-9203(99)90106-2}}</ref> kiwango cha maambukizi katika eneo hili ni matukio 100–800 kwa kila 100,000,<ref name=WHO1998>{{cite book | author=World Health Organization | title=Control of epidemic meningococcal disease, practical guidelines, 2nd edition, WHO/EMC/BA/98 | year=1998 | volume=3 | pages=1–83 | format=PDF |url=http://www.who.int/csr/resources/publications/meningitis/whoemcbac983.pdf}} <!--No ISBN--></ref> ambalo huwa na [[Huduma za kiafya|huduma za kimatibabu]] zilizo duni. Matukio haya hasa husababishwa na meningokokasi.<ref name=Attia/> Janga kuu zaidi kuwahi kurekodiwa katika historia lilitanda katika eneo hili lote mnamo mwaka wa 1996–1997, huku likisababisha matukio 250,000 na vifo 25,000.<ref>{{cite journal |author=WHO|title=Detecting meningococcal meningitis epidemics in highly-endemic African countries |journal=Weekly Epidemiological Record |volume=78 |issue=33 |pages=294–6 |year=2003 | format=PDF |url=http://www.who.int/wer/2003/en/wer7833.pdf |pmid=14509123}}</ref> Ugonjwa wa meningokokasi hutokea katika majanga kwenye maeneo ambapo watu wengi huishi kwa pamoja kwa mara ya kwanza, kama vile kambi za askari wakati wa uhamisho, vyuo vya masomo<ref name=Lancet/> na safari ya [[Hija]] ya kila mwaka.<ref name=WilderSmith>{{cite journal|author=Wilder-Smith A |title=Meningococcal vaccine in travelers |journal=Current Opinion in Infectious Diseases |volume=20|issue=5 |pages=454–60 |year=2007 |month=October |pmid=17762777 |doi=10.1097/QCO.0b013e3282a64700}}</ref>Ingawa mtindo wa marudio ya majanga barani Afrika hayatambuliki vyema, kuna vipengele kadhaa vinavyohusishwa na kuendelea kwa majanga katika mkanda wa meninjitisi. Vipengele hivi hujumuisha: hali za kimatibabu (uhatarisho wa watu unaohusiana na kingamwili), hali za kidemografia (kusafiri na kuhamishwa kwa idadi kubwa ya watu), hali za kijamii na kiuchumi (msongamano wa watu na hali duni za kimakazi), hali za hewa (ukame na dhoruba ya vumbi), na maambukizi yanayoambatana na ugonjwa huu (maambukizi ya makali ya kipumzi).<ref name=WHO1998/> Kuna tofauti kuu kwa kusambaa katika eneo kwa visababishi vya meninjitisi ya kibakteria. Kwa mfano, huku vikundi vya B na C vya ''N. meningitides'' vikisababisha visa vingi zaidi ya magonjwa barani Uropa, magonjwa ya kikundi cha A hupatikana bara Asia na kuendelea kuwa tisho kuu barani Afrika, ambapo husababisha idadi kubwa ya majanga katika ukanda wa meninjitisi, yakijumlisha asilimia 80 hadi 85 ya matukio meninjitisi ya meningokokasi yaliyorekodiwa.<ref name=WHO1998/> ==Historia== Baadhi ya watu hudokeza kuwa huenda [[Hippocrates]] alitambua uwepo wa meninjitisi, <ref name=Attia/> na inaonekana kuwa ugonjwa huu ulijulikana na wauguzi wa zama za Mwamko kama vile [[Avicenna]].<ref name=Walker>{{cite book |author=Arthur Earl Walker, Edward R. Laws, George B. Udvarhelyi |title=The Genesis of Neuroscience |url=http://books.google.com/?id=UaSaRzw8gYEC&pg=PP1 |year=1998|publisher=Thieme|isbn=1-879284-62-6 |pages=219–21 |chapter=Infections and inflammatory involvement of the CNS}}</ref> Maelezo ya meninjitisi ya kifua kikuu, ambayo wakati huo ilijulikana kama "[[dropisi]] ya ubongo", mara nyingi husifika kuwa ya muuguzi wa Edinburgn[[Robert Whytt|Sir Robert Whytt]] katika ripoti ya baada ya kufa kwake iliyotokea mnamo mwaka wa 1768, ingawa uhusiano wa viini vya kifua kikuu na ugonjwa wenyewe haukubainika hadi karne iliyofuatia.<ref name=Walker/><ref>{{cite book | author=Whytt R | title=Observations on the Dropsy in the Brain | year=1768 | location=Edinburgh | publisher=J. Balfour}}</ref> Inaonekana kuwa janga la meninjitisi ni jambo la hivi majuzi kidogo. <ref name=Greenwood>{{cite journal |author=Greenwood B|title=100 years of epidemic meningitis in West Africa – has anything changed? |journal=Tropical Medicine & International health: TM & IH |volume=11 |issue=6 |pages=773–80 |year=2006 |month=June |pmid=16771997 |doi=10.1111/j.1365-3156.2006.01639.x|url=http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2006.01639.x/pdf | format = PDF }}</ref> Mara ya kwanza ya tukio kuu la kuzuka kwa ugonjwa huu ilikuwa mjini [[Geneva]] mnamo mwaka wa 1805.<ref name=Greenwood/><ref>{{cite journal | author=Vieusseux G | year=1806 |title=Mémoire sur le Maladie qui a regne à Génève au printemps de 1805 | journal=Journal de Médecine, de Chirurgie et de Pharmacologie (Bruxelles) | volume=11 | pages=50–53 | language = French }}</ref>Majanga mengine mengi katika Ulaya na Marekani yalielezwa muda mfupi baadaye, kisha ripoti ya kwanza ya janga hili kutokea mnamo mwaka wa 1840. Majanga ya Afrika yalianza kutokea mara nyingi katika karne ya 20&nbsp;, yakianza na janga kuu lililotanda nchini[[Nigeria]] na [[Ghana]] mwaka wa 1905–1908.<ref name=Greenwood/> Tukio la kwanza la maambukizi ya bakteria ya meninjitisi fiche liliripotiwa na msomi wa bakteria wa nchi ya Austria [[Anton Weichselbaum]], ambaye mwaka wa 1887 alieleza kuhusu ''meningokokasi''.<ref>{{cite journal | author=Weichselbaum A | title=Ueber die Aetiologie der akuten Meningitis cerebro-spinalis | journal=Fortschrift der Medizin | year=1887 | volume=5 | pages=573–583 | language = German}}</ref> Kima cha uwezo wa kufa kutokana na meninjitisi kilikuwa juu sana (zaidi ya asilimia 90) katika ripoti za kwanza. Mnamo mwaka wa 1906, [[antisera]] ilitoleshwa kutoka kwa farasi; ambayo baadaye ilikuzwa zaidi na mwana sayansi Mmarekani [[Simon Flexner]], ambayo ilipunguza pakubwa uwezo wa kufa kutokana na ungonjwa unaosababishwa na meningokokasi<ref>{{cite journal | author=Flexner S | title=The results of the serum treatment in thirteen hundred cases of epidemic meningitis | journal=J Exp Med | year=1913 | volume=17 | issue=5 | pages=553–76 | pmid=19867668 |url=http://jem.rupress.org/content/17/5/553.full.pdf | pmc=2125091 | doi=10.1084/jem.17.5.553}}</ref><ref name=Swartz>{{cite journal |author=Swartz MN |title=Bacterial meningitis—a view of the past 90 years |url=https://archive.org/details/sim_new-england-journal-of-medicine_2004-10-28_351_18/page/1826 |journal=[[The New England Journal of Medicine]] |volume=351 |issue=18 |pages=1826–28 |year=2004 |month=October |pmid=15509815 |doi=10.1056/NEJMp048246}}</ref>Mnamo mwaka wa 1944, [[penicillin]] iliripotiwa kwa mara ya kwanza kuweza kukabiliana na meninjitisi.<ref>{{cite journal | author=Rosenberg DH, Arling PA |title=Penicillin in the treatment of meningitis | journal=[[Journal of the American Medical Association]] | year=1944 |volume=125 | pages=1011–17 | doi=10.1001/jama.1944.02850330009002 | issue=15}} reproduced in {{cite journal |author=Rosenberg DH, Arling PA |title=Penicillin in the treatment of meningitis |url=https://archive.org/details/sim_jama_1984-04-13_251_14/page/1870 |journal=[[Journal of the American Medical Association]]|volume=251 |issue=14 |pages=1870–6 |year=1984 |month=April |pmid=6366279 |doi=10.1001/jama.251.14.1870}}</ref>Kuanzishwa kwa chanjo za ''[[Haemophilus]]'' katika karne ya 20 kulipelekea kushuka pakubwa kwa visa vya meninjitisi iliyohusishwa na viini hivi,<ref name=Peltola/>. Mwaka wa 2002, ushahidi ulitokea kuwa matibabu ya kutumia steroidi yangeboresha prognosi ya meninjitisi ya kibakteria.<ref name=deGans2002/><ref name="CochDex2010" /><ref name=Swartz/> ==Marejeo== {{Reflist|2}} ==Viungo vya nje== * {{dmoz|Health/Conditions_and_Diseases/Neurological_Disorders/Meningitis}} * [http://www.cdc.gov/meningitis/index.html Meningitis] [[Centers for Disease Control and Prevention]] (CDC) [[Jamii:Maradhi ya kuambukiza]] c6mtepu217v35wtw95ysks6t9ml3okp 0 75327 1578218 1349423 2026-07-03T03:49:40Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578218 wikitext text/x-wiki [[Picha:Manwithrabies4.png|thumbnail|right|200px|Mtu mwenye Kichaa cha mbwa]] {{Infobox disease | Name = Kichaa cha mbwa | Image = Dog with rabies.jpg | Caption = Mbwa mwenye kichaa aliyepooza baada ya hasira. | DiseasesDB = 11148 | ICD10 = {{ICD10|A|82||a|82}} | ID9 = {{ICD9|071}} | ICDO = | OMIM = | MedlinePlus = 001334 | eMedicineSubj = med | eMedicineTopic = 1374 | eMedicine_mult = {{eMedicine2|eerg|493}} {{eMedicine2|ped|1974}} | MeshID = D011818 }} '''Kichaa cha mbwa''' (kwa [[Kiingereza]]: rabies) ni [[ugonjwa]] hatari unaoathiri [[ubongo]] na kwa kawaida unamwua aliyeambukizwa nao. Inatokana na [[ambukizo]] la [[virusi]] vinavyosababisha [[uvimbe wa ubongo]] (encephalytis). Virusi hivi vinaweza kutokea kwa [[binadamu]] na [[wanyama]] wa aina za [[mamalia]] na [[Ndege (mnyama)|ndege]] <ref name=WHO2013/> lakini ni mara chache kati ya wanyama [[wala majani]]. Mnyama mgugunaji ni nadra sana kuambukizwa na kichaa cha mbwa.<ref name=Tint2010/> ==Jina na njia za kuambukizwa== [[Jina]] la ugonjwa linatokana na hali ya [[mbwa]] wanaoambukizwa na kuwa hatari kwa binadamu kutokana na [[maisha]] ya karibu naye. [[Asilimia]] 99 za watu huambukizwa na mbwa<ref name=Tint2010>{{cite book |author=Tintinalli, Judith E. |title=Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli))|publisher=McGraw-Hill |year=2010 |pages=Chapter 152 |isbn=0-07-148480-9}}</ref>. Lakini inatokea pia mara kwa mara kwa [[paka]], [[mbweha]], [[mbwa mwitu]] na wanyama [[wala nyama]] wengine, pia aina za [[popo]], hasa huko [[Amerika]]<ref name=WHO2013/><ref name=Tint2010/> . Habari za maambukizo kutoka mtu mgonjwa kwenda mtu mwingine ni chache sana.<ref>[http://www.nejm.org/doi/pdf/10.1056/NEJMoa043018 Transmission of Rabies Virus from an Organ Donor to Four Transplant Recipients (pdf)] </ref> Njia za maambukizo ni [[mate]] na [[damu]] kwa hiyo hasa kwa njia ya kung'atwa na mnyama mgonjwa. Mate kutoka kwa mnyama aliyeambukizwa anaweza pia kusambaza kichaa cha mbwa kama mate inakuja kukutana na utando telezi wa mnyama mwingine au binadamu.<ref name=WHO2013/> ==Dalili za ugonjwa== Ugonjwa huo inaweza tu kukutwa baada ya kuanza kwa [[dalili]].<ref name=WHO2013/> Zile za kwanza za kuambukizwa ni pamoja na [[homa]] na kuhisi [[mchonyoto]] katika eneo la mwili ambako mtu aling'atwa. <ref name=WHO2013/> Dalili hizi zinafuatwa na nyingine: * miendo kali ya [[mwili]], * kukasirika au kuogopa sana kwa ghafla, * [[hofu]] ya [[maji]], * kukosa uwezo wa kutawala mwendo wa [[viungo]] vya mwili * [[kupoteza fahamu]].<ref name=WHO2013/> Mara dalili hizi zinapoonekana maana yake ugonjwa umeshaanza kuharibu ubongo na [[neva]] na mgonjwa hawezi kupona tena. [[Kifo]] kinafuata. Muda kati ya kuambukizwa ugonjwa na mwanzo wa dalili ni kawaida [[mwezi]] mmoja hadi miezi mitatu. Hata hivyo, kipindi hiki kinaweza kutofautiana kutoka chini ya [[wiki]] moja hata zaidi ya [[mwaka]] mmoja.<ref name=WHO2013/> Muda unategemea [[umbali]], kwa sababu virusi lazima kusafiri kufikia [[mfumo mkuu wa neva]] kwa kufuata [[mishipa]] ya pembeni.<ref name=Robbins>{{cite book |author=Cotran RS |title=Robbins and Cotran Pathologic Basis of Disease |edition=7th |publisher=Elsevier/Saunders |year=2005 |page=1375 |isbn=0-7216-0187-1|author-separator=, |author2=Kumar V |author3=Fausto N |display-authors=3}}</ref> ==Tiba na kinga== Watu wanaotibiwa mara moja baada ya kuambukizwa wanaweza kupona. Lakini [[tiba]] inahitaji kutekelezwa kabla virusi havijafikia ubongo, kwa hiyo katika [[muda]] wa [[saa]] za kwanza baada ya kung'atwa. Wanyama wa [[kaya]] wanapewa [[chanjo]] dhidi ya ugonjwa huu katika nchi nyingi. Kudhibiti wanyama na mipango ya chanjo vimepungua hatari ya kichaa cha mbwa kutoka mbwa katika nchi kadhaa.<ref name=WHO2013/> Kuchanja watu kulipendekeza kwa wale walio katika hatari kubwa. Kundi hatarishi pamoja na watu wanaofanya kazi na popo au ambao hutumia muda mrefu katika maeneo ya dunia ambapo kichaa cha mbwa ni ya kawaida.<ref name=WHO2013/> Katika watu hao [[chanjo ya kichaa cha mbwa]] na wakati mwingine kichaa cha mbwa [[immunoglobulini]] ina ufanisi katika kuzuia ugonjwa kama mtu anapata matibabu kabla ya kuanza kwa dalili za kichaa cha mbwa.<ref name=WHO2013/> Kuosha palipoumwa na mchukubo kwa [[dakika]] 15 kwa maji na [[sabuni]], [[povidoni iodini]], au sabuni vinaweza kuua virusi pia na kuwa na ufanisi fulani katika kuzuia maambukizi ya kichaa cha mbwa.<ref name=WHO2013>{{cite web|title=Rabies Fact Sheet N°99|url=http://www.who.int/mediacentre/factsheets/fs099/en/|work=World Health Organization|accessdate=28 February 2014|date=July 2013}}</ref> Ni watu wachache walionusurika maambukizi ya kichaa cha mbwa na hii ilikuwa kwa matibabu ya kina, inayojulikana kama [[ifataki ya Milwaukee]].<ref>{{cite journal | author = Hemachudha T, Ugolini G, Wacharapluesadee S, Sungkarat W, Shuangshoti S, Laothamatas J | title = Human rabies: neuropathogenesis, diagnosis, and management. | journal = Lancet neurology | volume = 12 | issue = 5 | pages = 498–513 | date = May 2013 | pmid = 23602163 | doi = 10.1016/s1474-4422(13)70038-3 }}</ref> ==Uenezi== Kichaa cha mbwa husababisha vifo vya watu wapatao 26,000 hadi 55,000 duniani kote kwa mwaka.<ref name=WHO2013/><ref name=Loz2012>{{cite journal | author = Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, et al. | title = Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. | url = https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2095 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2095–128 | date = Dec 15, 2012 | pmid = 23245604 | doi = 10.1016/S0140-6736(12)61728-0 }}</ref> Zaidi ya 95% ya vifo hivi hutokea katika [[Asia]] na [[Afrika]].<ref name=WHO2013/> Kichaa cha mbwa kipo sasa katika nchi zaidi ya 150 na katika mabara yote ila [[Antaktika]].<ref name=WHO2013/> Zaidi ya watu [[bilioni]] 3 huishi katika nchi ambapo kichaa cha mbwa hutokea.<ref name=WHO2013/><ref>{{cite web|title=Presence / absence of rabies in 2007|url=http://www.who.int/rabies/Absence_Presence_Rabies_07_large.jpg?ua=1|work=World Health Organization|accessdate=1 March 2014|year=2007}}</ref><ref>{{cite web|title=Rabies-Free Countries and Political Units|url=http://www.cdc.gov/animalimportation/rabies-free-countries.html|work=CDC|accessdate=1 March 2014}}</ref> ==Tanbihi== <references /> [[Jamii:Maradhi ya kuambukiza]] 0buki57watms5bymqwvtew09x62a88u 0 76995 1578093 1564490 2026-07-02T19:22:50Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578093 wikitext text/x-wiki [[Faili:Handicapped Accessible sign.svg|thumbnail|[[Alama]] ya [[jengo]] linalofaa kwa watu wanaotumia [[Kitimaguru|kiti cha magurudumu]].]] '''Ulemavu''' ni hali ya kuwa na hitilafu ya kudumu [[mwili]]ni au [[akili]]ni inayomzuia mtu kutekeleza [[shughuli]] zilizo kawaida katika [[maisha]] ya [[jamii]]. Unamwekea mtu mipaka asiweze kutekeleza shughuli fulani katika maisha yake, tofauti na watu wengine. ==Hitilafu na ulemavu== [[Shirika la Afya Duniani]] (WHO) limeunda mfumo wa kupanga alama za ulemavu. Hapa kuna tofauti kati ya *hitilafu ''(kwa [[Kiingereza]] impairment)'' kama kukosa uwezo wa kutumia [[kiungo]] cha mwili kama kawaida *ulemavu (''ing. disability)'' kama hitilafu inasababisha kukosa uwezo wa kutekeleza shughuli zinazotekelezwa na "watu wa kawaida". *hasara au kikwazo ''(ing. handicap)'' inayoweza kupatikana kwa mtu mwenye ulemavu akishindwa kutekeleza shughuli katika jamii. Kwa mfano, [[mtoto]] aliyeambukizwa [[ugonjwa wa kupooza]] ''(ing. cerebral palsy)'' anabaki na hitilafu ya viungo vya miguu: hawezi kuvikunja wala haiwezi kustahimili [[uzito]] wa mwili wake. Hitilafu hiyo inamzuia kutembea kwa njia ya kawaida. Kama [[Tiba|hatibiwi]], hitilafu inaweza kuongezeka kwa sababu [[misuli]] ya miguu inajikaza zaidi na zaidi. Kukosa uwezo wa kutembea ni ulemavu. Lakini kiwango chake kinaweza kupunguzwa kwa tiba na vifaa vya pekee. Akijifunza kutembea kwa kutumia vyuma vilivyofungwa kando ya miguu, vizuizi vya kutekeleza shughuli vinapungua sana. Kutegemeana na mazingira anapoishi ataona hasara ndogo au kubwa zaidi akitafuta njia yake katika maisha. [[Faili:Pieter Bruegel d. Ä. 024.jpg|thumb|250px|Vilema, [[picha]] ya [[Pieter Brueghel Mzee]], [[Uholanzi]], mnamo 1568.]] ==Ulemavu wa kimwili== Ulemavu wa kimwili unatokana na hitilafu yoyote inayoiwekea mipaka kazi ya kawaida ya viungo vya mwili kama vile [[mikono]] au miguu na sehemu nyingine za mwili ==Ulemavu wa milango ya fahamu== Hapo ni hasa hitilafu zinazohusu uwezo wa kuona au kusikia. Kuna pia watu wenye hitilafu za kunusa au kuonja. ==Ulemavu wa akili== Hitilafu mbalimbali katika [[ubongo]] na [[mfumo wa neva]] zinaweza kuonekana katika *kuchelewa kwa watoto kuketi, kutambaa, kutembea au kusema *matumizi ya [[lugha]] *matatizo ya kukumbuka *matatizo ya kujifunza kanuni za kijamii *matatizo ya kutambua na kuelewa matatizo na kutafuta [[suluhisho]] *uhaba wa uwezo wa kujitunza, kama kuvaa, kula na kukuta njia. Ulemavu wa kiakili unatokea kwa viwango tofauti sana. Mara nyingi hautambuliki hadi mtoto anapoingia [[shule]] na huko anachelewa kujifunza. Hata hapo ni lazima kutofautisha kama tatizo ni ulemavu wa akili au ulemavu wa kujifunza tu. Wengine wanaishia kiwango cha [[elimu]] kinacholingana na uwezo wa mtoto wa wastani mwenye miaka 9-12<ref>[http://www.aafp.org/afp/2000/0215/p1059.html Identification and Evaluation of Mental Retardation, American Family Physician, Feb 15, 2000]</ref> na wanaweza kujifunza [[kazi]] inayowawezesha kudumisha maisha yao wakiwa [[watu wazima]]. ==Haki za watu wenye ulemavu== [[Mwaka]] [[2006]] [[Umoja wa Mataifa]] ulianzisha [[Mkataba wa kimataifa kuhusu haki za watu wenye ulemavu]] (UN Convention on the Rights of Persons with Disabilities = UNCRPD) kwa [[shabaha]] ya kulinda na kuboresha hali ya walemavu [[milioni]] 650 duniani. Hadi mwaka [[2015]] mataifa 159 yaliutia [[sahihi]] [[mkataba]] huo na 154 kati ya hayo yaliidhinisha hatua hiyo. Mataifa yaliyokubali mkataba huo yamepokea [[wajibu]] wa kuhakikisha [[haki]] sawa za elimu, [[ajira]], kumiliki [[mali]] na [[ndoa|kuoa]] sawa na watu wote. Ni [[marufuku]] kuwatumia bila [[kibali]] kwa [[majaribio ya kiganga]]. [[Taasisi]] na shirika mbalimbali zinafuatilia jinsi gani masharti hayo yanatekelezwa na [[serikali]] mbalimbali. Kwa mfano, katika [[Afrika ya Mashariki]] kuna ''United Disabled Persons of Kenya'' (UDPK) au ''Shirikisho la Vyama vya Watu Wenye Ulemavu'' [[Tanzania]]. Nchini Tanzania katiba ya [[1977]] ilitambua haki za watu wenye ulemavu na kukataza aina zote za [[ubaguzi]]. Mnamo mwaka wa 2004, [[Wizara ya kazi, Maendeleo ya Vijana na Michezo]] ilitoa [[Sera ya Taifa]] ya watu wenye ulemavu, inayosisitiza kujitolea kwa [[wizara]] hiyo katika kuhakikisha kwamba kuna haki sawa kwa watu wenye ulemavu. ==Michezo ya walemavu== [[Faili:Wheelchair basketball at the 2008 Summer Paralympics.jpg|250px|thumbnail|[[Mechi]] ya [[mpira wa kikapu]] kwenye [[Paralimpiki]] mwaka [[2008]]]] Kuna nchi nyingi ambako walemavu wana [[klabu]] za [[michezo]] au kuendesha michezo katika vitengo vya pekee vya klabu za kawaida. Kwa kawaida wanatekeleza michezo ya kawaida lakini kufuatana na kanuni zinazolingana na hitilafu zao. Kwenye ngazi ya kimataifa kuna mashindano makubwa ambayo ni hasa *Michezo ya paralimpiki (Paralympics) kwa walemavu wa mwili *Olimpiki za pekee (Special Olympics) kwa walemavu wa akili *Deaflympics kwa watu wasiosikia ==Marejeo== <references/> ==Kujisomea== * C. G. Mung'ong'o, Njozi iliyopotea, Tanzania Pub. House, 1980, ISBN 9976100205, 9789976100204 * {{cite conference |last1=Arditi |first1=A. |last2=Rosenthal |first2=B. |year=1998 |title=Developing an objective definition of visual impairment |conference=Vision '96: Proceedings of the International Low Vision Conference |pages=331–334 |location=Madrid, Spain: [[ONCE]] |ref=harv}} * {{cite journal |last1=Burkhauser |first1=Richard V. |last2=Schmeiser |first2=Maximilian D.|last3=Weathers II |first3=Robert R.|date=Jan 2012 |title=The Importance of Anti-Discrimination and Workers' Compensation Laws on the Provision of Workplace Accommodations Following the Onset of a Disability |journal=Industrial & Labor Relations Review |volume=65 |issue=1 |ref=harv}} * {{cite journal |last=Darling |first=Peter |date=Aug 2007 |title=Disabilities and the Workplace |journal=Business NH Magazine |volume=24 |issue=8 |ref=harv}} * {{cite book |last1=DePoy |first1=Elizabeth |last2=Gilson |first2=Stephen French |year=2004 |title=Rethinking Disability: Principles for Professional and Social Change |url=https://archive.org/details/rethinkingdisabi0000depo |location=Pacific Grove, CA |publisher=Brooks Cole |isbn=978-0-534-54929-9 |ref=harv}} * {{cite web |last=Donovan |first=Rich |date=March 1, 2012 |title=The Global Economics of Disability |url=http://www.returnondisability.com/pdf-docs/The_Global_Economics_of_Disability_2012.pdf |publisher=Return on Disability |accessdate=August 11, 2012 |ref=harv |archiveurl=https://web.archive.org/web/20120913222254/http://www.returnondisability.com/pdf-docs/The_Global_Economics_of_Disability_2012.pdf |archivedate=2012-09-13 }} * {{cite encyclopedia |last1=Ducy |first1=Elizabeth McAdams |last2=Stough |first2=Laura M. |last3=Clark |first3=M. Carolyn |year=2012 |title=Choosing Agency in the Midst of Vulnerability: Using Critical Disability Theory to Examine a Disaster Narrative |work=Critical Qualitative Research Reader |editor1-last=Steinberg |editor1-first=Shirley R. |editor2-last=Cannella |editor2-first=Gaile S. |location=New York |publisher=Peter Lang |isbn=978-1-4331-0688-0}} * {{cite journal |last=Miles |first=Albert S |year=1994 |title=Brown v. Board of Education and the American with Disabilities Act: Vistas of equal educational opportunities for African Americans |journal=Journal of Negro Education |volume=63 |issue=3 |ref=harv}} * {{cite web |last1=Nikora |first1=Linda Waimari |last2=Karapu |first2=Rolinda |last3=Hickey |first3=Huhana |last4=Te Awekotuku |first4=Ngahuia |year=2004 |title=Disabled Maori and Disability Support Options |url=http://waikato.researchgateway.ac.nz/bitstream/10289/460/1/content.pdf |publisher=Maori&nbsp;& Psychology Research Unit, University of Waikato |accessdate=August 11, 2012 |ref=harv |archivedate=2020-05-13 |archiveurl=https://web.archive.org/web/20200513220653/https://researchcommons.waikato.ac.nz/bitstream/handle/10289/460/content.pdf;jsessionid=CC679321B8E56B193727B2B489F9B94F?sequence=1 }} * {{cite encyclopedia |last=Stough |first=Laura M. |year=2009 |title=The Effects of Disaster on the Mental Health of Individuals With Disabilities |work=Mental Health and Disasters |editor1-last=Neria |editor1-first=Yuval |editor2-last=Galea |editor2-first=Sandro |editor3-last=Norris |editor3-first=Fran H. |publisher=Cambridge University Press |isbn=978-1-107-41282-8 |ref=harv}} * {{cite web |last=Yeo |first=Rebecca |year=2005 |title=Disability, poverty, and the new development agenda |publisher=Disability Knowledge and Research Programme |url=http://www.dfid.gov.uk/r4d/PDF/Outputs/Disability/RedPov_agenda.pdf |accessdate=June 19, 2013 |ref=harv}} * {{cite book |editor-last=Albrecht |editor-first=Gary L. |year=2005 |title=Encyclopedia of disability |location=Thousand Oaks, CA |publisher=[[SAGE Publications]] |isbn=978-0-7619-2565-1}} * {{cite book |last=Bowe |first=Frank |year=1978 |title=Handicapping America: Barriers to disabled people |url=https://archive.org/details/handicappingamer00bowe |location=New York |publisher=Harper & Row |isbn=978-0-06-010422-1}} * {{cite book |last=Charlton |first=James I. |title=Nothing about us without us : disability oppression and empowerment |year=2004 |publisher=Univ. of California Press |location=Berkeley, Calif. [u.a.] |isbn=9780520224810 |edition=[3. Dr]}} * {{cite encyclopedia |last=Glenn |first=Eddie |year=1995 |title=African American Women with Disabilities: An Overview |url=http://www.dinf.ne.jp/doc/english/Us_Eu/ada_e/pres_com/pres-dd/glenn.html |encyclopedia=[http://www.dinf.ne.jp/doc/english/Us_Eu/ada_e/pres_com/pres-dd/glenn.html Disability and diversity: New leadership for a new era] |editor1-last=Walker |editor1-first=S. |editor2-last=Turner |editor2-first=K. A. |editor3-last=Haile-Michael |editor3-first=M.|editor4-last=Vincent |editor4-first=A. |editor5-last=Miles |editor5-first=M. D. |location=Washington, DC |publisher=President’s Committee on Employment of People with Disabilities and Howard University Research and Training Center for Access to Rehabilitation and Economic Opportunity}} * {{cite book |last=Johnstone |first=David |year=2001 |edition=2nd |title=An Introduction to Disability Studies |url=https://archive.org/details/introductiontodi0000john_k7w3 |location= |publisher=Fulton |isbn=978-1-85346-726-4}} * {{cite book |last1=Masala |first1=Carmelo |last2=Petretto |first2=Donatella Rita |year=2008 |title=Psicologia dell'Handicap e della Riabilitazione |trans_title=The Psychology of Handicap and Rehabilitation |language=Italian |location=Rome |publisher=Kappa |isbn=978-88-15-06226-0}} * {{cite book |last=Oliver |first=Michael |year=1997 |title=The Politics of Disablement |location=London |publisher=[[St. Martin's Press]] |isbn=978-0-333-43293-8}} * {{cite book |last=Pearson |first=Charlotte |year=2006 |title=Direct Payments and Personalisation of Care |url=https://archive.org/details/directpaymentspe0000unse |location=Edinburgh |publisher=Dunedin Academic Press |isbn=978-1-903765-62-3}} * {{cite book |last=Shakespeare |first=Tom |author2=with Anne Kerr |year=1999 |title=Genetic Politics: from Eugenics to Genome |location=Cheltenham |publisher=New Clarion Press |isbn=978-1-873797-25-9}} * {{cite journal |last=Burch |first=Susan |date=July 2009 |title=(Extraordinary) Bodies of Knowledge: Recent Scholarship in American Disability History |url=https://archive.org/details/sim_magazine-of-history_2009-07_23_3/page/29 |journal=OAH Magazine of History |volume=23 |pages=29–34|issn=0882-228X |doi=10.1093/maghis/23.3.29 |issue=3}} * {{cite journal |last=Kaushik |first=R. |year=1999 |title=Access Denied: Can we overcome disabling attitudes |journal=Museum International |volume=51 |issue=3 |pages=48–52 |publisher=UNESCO|issn=1468-0033 |doi=10.1111/1468-0033.00217}} * {{cite journal |last=Lansing |first=Michael J. |date=January 2009 |title='Salvaging the Man Power of America': Conservation, Manhood, and Disabled Veterans during World War I |pages=32–57 |journal=Environmental History |volume=14 |location= |publisher=|issn=1084-5453 |doi=10.1093/envhis/14.1.32}} * {{cite journal |last=Longmore |first=Paul |date=July 2009 |title=Making Disability an Essential Part of American History |url=https://archive.org/details/sim_magazine-of-history_2009-07_23_3/page/11 |journal=OAH Magazine of History |volume=23 |pages=11–15|isbn=|issn=0882-228X |doi=10.1093/maghis/23.3.11 |issue=3}} * {{cite journal | author = Masala C, Petretto DR | title = From disablement to enablement: conceptual models of disability in the 20th century | url = https://archive.org/details/sim_disability-and-rehabilitation_2008_30_17/page/n4 | journal = Disability and Rehabilitation | volume = 30 | issue = 17 | pages = 1233–1244 | year = 2008 | pmid = 18821191 | doi = 10.1080/09638280701602418 | issn = 0963-8288 }} ==Viungo vya nje== {{commons cat|Disabled people}} *[http://shivyawata.or.tz/ Shirikisho la Vyama vya watu wenye ulemavu Tanzania SHIVYAWATA - Tanzania Federation of Disabled People’s Organizations] {{Wayback|url=http://shivyawata.or.tz/ |date=20151025010156 }} *[http://shivyawata.or.tz/surveys/download/Fact%20Sheet%20Tanzania%20_Swa.pdf Taarifa: Hali ya haki za watu wenye ulemavu Tanzania, imetolewa na SHIVYAWATA] {{Wayback|url=http://shivyawata.or.tz/surveys/download/Fact%20Sheet%20Tanzania%20_Swa.pdf |date=20160304224638 }} *[http://hakielimu.org/files/publications/document172Sauti_Elimu-22.pdf Walemavu wana haki ya kupata elimu, Hakielimu Sautielimu toleo 9-2009] {{Wayback|url=http://hakielimu.org/files/publications/document172Sauti_Elimu-22.pdf |date=20160306194202 }} *[http://www.unicef.org/tanzania/AdvocacyBrief-DISABILITY-SWA-WEB.pdf Watoto na Ulemavu - ajenda ya watoto, muhtasari wa utetezi watoto; UNICEF Tanzania] {{Wayback|url=http://www.unicef.org/tanzania/AdvocacyBrief-DISABILITY-SWA-WEB.pdf |date=20160304201659 }} *[http://kenya.thebeehive.org/content/29/703 Ishara za ulemavu wa masomo, beehive Kenya] {{Wayback|url=http://kenya.thebeehive.org/content/29/703 |date=20160412130111 }} *[http://chavita.or.tz/about-us/ Tovuti ya Chama cha Viziwi Tanzania CHIVITA - Tanzania Association of the Deaf] {{Wayback|url=http://chavita.or.tz/about-us/ |date=20150510221413 }} *[https://envaya.org/TUSPO/home Tovuti ya Tanzania Users and Survivors of Psychiatry Organisation TUSPO] {{Wayback|url=https://envaya.org/TUSPO/home |date=20160304200635 }} [[Jamii:Afya]] [[Jamii:Ulemavu]] [[Jamii:Ubaguzi]] hhfdzknzo92rl3c3sivabh60x9jnos5 0 77296 1577981 1501886 2026-07-02T13:31:47Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1577981 wikitext text/x-wiki [[Picha:Ahmed Sékou Touré usgov-83-08641.jpg|thumb|Sekou Toure.]] '''Ahmed Sékou Touré''' (au '''Ahmed Sheku Turay'''; [[9 Januari]] [[1922]] - [[26 Machi]] [[1984]]) alikuwa [[kiongozi]] wa kisiasa; mkuu wa PDG kutoka nchini [[Guinea]]. Alichaguliwa kama [[Rais wa Guinea|Rais wa kwanza wa Guinea]] akatumikia kuanzia [[mwaka]] [[1958]] hadi [[kifo]] chake 1984. Touré alikuwa miongoni mwa [[wazalendo]] wa awali wa Guinea waliojishughulisha katika harakati za kupigania [[uhuru]] wa nchi kutoka mikononi mwa [[Ufaransa|Wafaransa]]. Mwaka wa [[1960]], alitangaza [[Chama cha kisiasa|chama]] chake cha [[Parti démocratique de Guinée]] (PDG) kuwa chama halali pekee nchini humo na kuongoza tangu hapo kwa [[utawala wa kiimla]]. Alichaguliwa kwa maneno tu kwa vipindi [[Saba (namba)|saba]] vya miaka saba, lakini Guinea haikuwa na chama kingine cha kisiasa, na aliwafunga au kuwafukuza nchini viongozi wakubwa wa [[upinzani]] dhidi yake . Alikuwa [[kitukuu]] wa [[Samori Ture]], [[mwanzilishi]] wa [[Dola la Wasulu]]. Mnamo Oktoba 2021, kwenye hafla ya maadhimisho ya miaka 50 ya mauaji ya Oktoba 1971, jamaa za watu 70 wa Guinea walioangamizwa chini ya utawala wa Sekou Touré walimwomba Rais Mamady Doumbouya ukarabati na mazishi ya heshima kwa waathiriwa. ==Marejeo== * Henry Louis Gates, Anthony Appiah (eds). ''Africana: The Encyclopedia of the African and African'', "Ahmed Sékou Touré," pp1857–58. Basic Civitas Books (1999). ISBN 0-465-00071-1 * Molefi K. Asante, Ama Mazama. ''Encyclopedia of Black Studies''. Sage Publications (2005) ISBN 0-7619-2762-X * {{fr icon}} Ibrahima Baba Kake. ''Sékou Touré. Le Héros et le Tyran''. Paris, 1987, JA Presses. Collection Jeune Afrique Livres. 254 p * Lansiné Kaba. "From Colonialism to Autocracy: Guinea under Sékou Touré, 1957–1984;" in ''Decolonization and African Independence, the Transfers of Power, 1960-1980''. Prosser Gifford and William Roger Louis (eds). New Haven: Yale University Press, 1988. * Phineas Malinga. [http://www.webguinee.net/bibliotheque/histoire/malinga/pmalinga.html "Ahmed Sékou Touré: An African Tragedy"] {{Wayback|url=http://www.webguinee.net/bibliotheque/histoire/malinga/pmalinga.html |date=20181022150925 }} * [[Baruch Hirson]]. [http://www.marxists.org/archive/hirson/1989/clr-james.htm "The Misdirection of C.L.R. James"], ''Communalism and Socialism in Africa,'' 1989. * John Leslie. [http://www.marxists.org/archive/sedgwick/1960/xx/africansoc.htm Towards an African socialism], [[International Socialism]] (1st series), No.1, Spring 1960, pp.&nbsp;15–19. * {{fr icon}} Alpha Mohamed Sow, "Conflits ethnique dans un État révolutionnaire (Le cas Guinéen)", in ''Les ethnies ont une histoire,'' Jean-Pierre Chrétien, Gérard Prunier (ed), pp.&nbsp;386–405, KARTHALA Editions (2003) ISBN 2-84586-389-6 * Parts of this article were translated from French Wikipedia's [[:fr:Ahmed Sékou Touré]]. ==Viungo vya Nje== * [http://www.time.com/time/covers/0,16641,19590216,00.html] {{Wayback|url=http://www.time.com/time/covers/0,16641,19590216,00.html |date=20130827143647 }} 1959 [[Time Magazine]] cover story about Sékou Touré * [http://www.webguinee.net/sekou_toure/index.html WebGuinee - Sekou Toure] {{Wayback|url=http://www.webguinee.net/sekou_toure/index.html |date=20180318062044 }} Publishes full text of books and articles as well photos of Sekou Toure * [http://www.campboiro.org Camp Boiro Memorial] {{Wayback|url=http://www.campboiro.org/ |date=20260510104325 }}. Extensive list of reports and articles on the notorious political prison where thousands of victims of the dictatorship of Sekou Toure disappeared between 1960 and 1984. * [http://www.sekoutoure.com More information about Ahmed Sékou Touré (French)] {{Wayback|url=http://www.sekoutoure.com/ |date=20070217051051 }} * [http://news.bbc.co.uk/olmedia/1495000/audio/_1496734_guinea_sekoutoure.ram BBC Radio: President Sekou Toure Defends One-Party Rule] (1959). * [http://www.crisisgroup.org/home/index.cfm?action=conflict_search&l=1&t=1&c_country=44 Conflict history: Guinea] {{Webarchive|url=https://archive.today/20070715112632/http://www.crisisgroup.org/home/index.cfm?action=conflict_search&l=1&t=1&c_country=44 |date=2007-07-15 }}, 11 May 2007. [[International Crisis Group]]. *[http://www.assemblee-nationale.fr/sycomore/fiche.asp?num_dept=7111 1st page on the French National Assembly website] *[http://www.assemblee-nationale.fr/histoire/biographies/IVRepublique/toure-sekou-09011922.asp 2nd page on the French National Assembly website] {{Pan-Africanism}} {{Mbegu-mwanasiasa}} {{DEFAULTSORT:Toure, Ahmed Sekou}} [[Category:Waliozaliwa 1922]] [[Category:Waliofariki 1984]] [[Category:Wanasiasa wa Guinea]] [[Category:Marais wa Guinea]] [[Jamii:Viongozi wa Afrika]] 7fkk85dihw1v1w8c8ns6ytrb4zkl72g 14 77503 1577954 952023 2026-07-02T12:55:59Z Riccardo Riccioni 452 1577954 wikitext text/x-wiki [[Jamii:Miji ya Zimbabwe]] [[Jamii:Miji Mikuu Afrika]] s0jye7upg4gw49z0ramwrfb6pidnfas 0 77908 1578097 1349420 2026-07-02T19:32:34Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578097 wikitext text/x-wiki [[Picha:YellowFeverVirus.jpg|thumbnail|right|200px|Virusi vya Homa ya manjano]] {{Infobox disease | Name = njano jack | Image = YellowFeverVirus.jpg | Caption = A [[Transmission electron microscope|TEM]] [[micrograph]] of the yellow fever virus (234,000X magnification) | ICD10 = {{ICD10|A|95||a|90}} | ICD9 = {{ICD9|060}} | ICDO = | OMIM = | DiseasesDB = 14203 | MedlinePlus = 001365 | eMedicineSubj = med | eMedicineTopic = 2432 | eMedicine_mult = {{eMedicine2|emerg|645}} | MeshID = D015004 }} '''Homa ya manjano''' (pia: '''Homanyongo''', inayojulikana kwa [[Kiingereza]] kama '''''yellow'' ''jack''''' ''au '''yellow plague''''',<ref name=Old2009/>) ni [[ugonjwa]] mkali unaosababishwa na [[virusi]].<ref name=WHO2013/> Katika kesi nyingi, [[dalili]] hujumuisha [[homa]], [[homa ya baridi]], [[Anorexia|kukosa hamu ya chakula]], [[kichefuchefu]], [[maumivu]] ya [[misuli]] hasa [[Mgongo|mgongoni]], na maumivu ya [[kichwa]].<ref name=WHO2013/> Kwa kawaida dalili hupona kwa [[siku]] tano.<ref name=WHO2013/> Kwa watu wengine baada ya kupata nafuu, homa hurudi, maumivu ya [[fumbatio]] hutokea, na uharibifu wa [[ini]] huanza na kusababisha [[umanjano|ngozi ya njano]].<ref name=WHO2013/> Ikiwa hii itatokea, hatari ya kuvuja [[damu]] na [[figo kutofanya kazi|matatizo ya figo]] unaongezeka.<ref name=WHO2013/> == Kisababishi na utambuzi== Ugonjwa huu unasababishwa na virusi vya homa ya manjano na kusambazwa kwa kuumwa na [[mbu]] wa kike.<ref name=WHO2013/> Vinaambukiza tu [[binadamu]], [[mamalia wa hali ya juu]] na [[spishi]] nyingi za mbu.<ref name=WHO2013/> Katika miji, husambazwa kwa kawaida na mbu wa spishi wa ''[[Aedesaegypti]]''.<ref name=WHO2013/> Virusi ni [[Virusi vya RNA]] vya [[jenasi]] ''[[Flavivirus]]''.<ref name="lindenbach2007"/> Ugonjwa huu unaweza kuwa ngumu kueleza lakini [[maradhi]] mengine tu, hasa katika awamu za kwanza.<ref name=WHO2013/> Ili kuthibitisha hali hiyo, [[uchunguzi]] wa [[sampuli]] ya damu wa [[polymerase chain reaction]] unahitajika.<ref name=Toll2009>{{cite journal | author = Tolle MA | title = Mosquito-borne diseases | url = https://archive.org/details/sim_current-problems-in-pediatric-and-adolescent-health-care_2009-04_39_4/page/97 | journal = CurrProblPediatrAdolesc Health Care | volume = 39 | issue = 4 | pages = 97–140 | date = April 2009 | pmid = 19327647 | doi = 10.1016/j.cppeds.2009.01.001 }}</ref> == Kinga, tiba na matarajio == [[Chanjo]] bora na salama dhidi ya homa ya manjano ipo, na baadhi ya nchi hudai chanjo ya wanaosafiri.<ref name=WHO2013/> Juhudi nyingine za kuzuia [[maambukizi]] zinajumuisha upunguzaji wa idadi ya mbu wanaosambaza virusi.<ref name=WHO2013/> Katika maeneo ambayo homa ya manjano ni ya kawaida na hakuna chanjo, utambuzi wa mapema wa ugonjwa na uchanjaji wa sehemu kubwa ya idadi ya watu ni muhimu ili kuzuia mlipuko.<ref name=WHO2013/> Ukiwa umeambukizwa, udhibiti ni wa dalili na hakuna hatua maalum dhidi ya virusi haswa.<ref name=WHO2013/> Kwa wale walio na ugonjwa mkali, [[kifo]] hutokea kwa takriban [[nusu]] ya watu wasiokuwa na matibabu.<ref name=WHO2013/> == Uenezi na historia== Homa ya manjano husababisha maambukizi 200,000 na vifo 30,000 kila [[mwaka]],<ref name=WHO2013>{{cite web|title=Yellow fever Fact sheet N°100|url=http://www.who.int/mediacentre/factsheets/fs100/en/|work=World Health Organization|accessdate=23 February 2014|date=May 2013}}</ref> takriban [[asilimia]] 90 ya hayo yakitokea [[bara|barani]] [[Afrika]].<ref name=Toll2009/> Karibu [[bilioni]] moja ya watu wanaishi katika eneo la [[dunia]] mahali ugonjwa huo ni wa kawaida.<ref name=WHO2013/> Inapatikana sana katika maeneo ya [[Tropiki|tropiki]] [[Amerika Kusini]] na [[Afrika]], lakini si [[Asia]].<ref name=CDC2011>{{cite web|url=http://www.cdc.gov/yellowfever/|title=CDC Yellow Fever||accessdate=2012-12-12}}</ref><ref name=WHO2013/> Tangu [[miaka ya 1980]], idadi ya kesi za homa ya manjano zimekuwa zikiongezeka.<ref name=Barr2007>{{cite journal | author = Barrett AD, Higgs S | title = Yellow fever: a disease that has yet to be conquered | journal = Annu. Rev. Entomol. | volume = 52 | pages = 209–29 | year = 2007 | pmid = 16913829 | doi = 10.1146/annurev.ento.52.110405.091454 }}</ref><ref name=WHO2013/> Hii inaaminika ni kwa sababu watu wachache wana [[kingamwili]], watu wengi wakiishi kwa miji, na watu wanaosafiri kila mara, na mabadiliko ya [[hali ya hewa]].<ref name=WHO2013/> Ugonjwa ulianzia barani Afrika, ambapo ulisambaa Amerika Kusini kupitia [[biashara ya utumwa]] katika [[karne ya 17]].<ref name=Old2009>{{cite book|last=Oldstone|first=Michael|title=Viruses, Plagues, and History: Past, Present and Future|date=2009|publisher=Oxford University Press|isbn=9780199758494|pages=102–4|url=http://books.google.com/books?id=2XbHXUVY65gC&pg=PA103}}</ref> Tangu karne ya 17 [[mlipuko wa ugonjwa|milipuko]] ya ugonjwa umetokea [[Marekani]], Afrika na [[Uropa]].<ref name=Old2009/> Katika [[Karne ya 18|karne za 18]] na [[Karne ya 19|19]], homa ya manjano ilionekana kama [[ugonjwa wa kuambukiza]] hatari sana.<ref name=Old2009/> Virusi vya homa ya manjano vilikuwa virusi vya kwanza vya binadamu kugunduliwa.<ref name="lindenbach2007">{{cite book | title=Fields Virology| url=https://archive.org/details/fieldsvirology0002unse_w7i9|edition=5th |publisher=Lippincott Williams &Wilkins | author=Lindenbach, B. D., et al. |editor=Knipe, D. M. and P. M. Howley. (eds.) | year=2007 | location=Philadelphia, PA |page=[https://archive.org/details/fieldsvirology0002unse_w7i9/page/n1101 1101] | isbn=0-7817606-0-7 |chapter=Flaviviridae: Virusi na marudio yake}}</ref> ==Marejeo== {{reflist}} [[Jamii:Maradhi ya kuambukiza]] [[Jamii:Ini]] 4jrucpoye5rh55syfjg3zaatdctl329 0 77910 1578187 1355721 2026-07-03T01:59:06Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578187 wikitext text/x-wiki [[Picha:Defecating into a pit (schematic).jpg|thumb|upright=1.3|Mchoro wa choo cha kawaida kilicho na kikalio na chumba kilicho na paa.<ref name=":0">{{cite book|last1=WEDC|title=Latrine slabs: an engineer’s guide, WEDC Guide 005|publisher=Water, Engineering and Development Centre The John Pickford Building School of Civil and Building Engineering Loughborough University|isbn=978 1 84380 143 6|pages=22|url=http://wedc.lboro.ac.uk/resources/booklets/G005-Latrine-slabs-on-line.pdf}}</ref>]] '''Choo cha shimo''' au '''choo cha zamani''' ni aina ya [[choo]] ambapo [[kinyesi cha binadamu]] hukusanywa kwenye shimo ardhini. == Ufasili na manufaa == Vyoo hivi havitumii maji au hutumia kati ya lita moja na tatu kwa kila mara ya utumiaji kwa vyoo vya shimo vinavyotumia maji ya kumwangwa.<ref name="Till2014">{{cite book|author=Tilley, E., Ulrich, L., Lüthi, C., Reymond, Ph. and Zurbrügg, C.|title=Compendium of Sanitation Systems and Technologies|date=2014|publisher=Swiss Federal Institute of Aquatic Science and Technology (Eawag)|location=Dübendorf, Switzerland|isbn=9783906484570|edition=2|url=http://www.sandec.ch/compendium}}</ref> Vikijengwa na kudumishwa vyema, vinaweza kupunguza kuenea kwa magonjwa kwa kupunguza kiasi cha kinyesi cha binadamu kwenye mazingira kutokana na [[kwenda choo mahali wazi]].<ref name=WHO3.4/><ref name=UN2015>{{cite web|title=Call to action on sanitation|url=http://sanitationdrive2015.org/wp-content/uploads/2013/03/DSG_Sanitation_Fast-Facts_final.pdf|website=United Nations|accessdate=15 August 2014|format=pdf|archiveurl=https://web.archive.org/web/20140819084624/http://sanitationdrive2015.org/wp-content/uploads/2013/03/DSG_Sanitation_Fast-Facts_final.pdf|archivedate=2014-08-19}}</ref> Hii hupungza usambazaji wa [[vimelea]] kutoka kwa kinyesi hadi chakula unaosababishwa na nzi.<ref name=WHO3.4/> Vimelea hivi ni visababishi vikuu vya [[maambukizi ya kuharisha]] na [[helminthiasisi|maambukizi wa minyoo ya utumbo]].<ref name=UN2015/> Maambukizi ya kuharisha yalisababisha takriban vifo milioni 0.7 vya watoto wa umri wa chini ya miaka mitano mwaka wa 2011 na watoto milioni 250 walikosa kwenda shuleni siku kadhaa.<ref name=UN2015/><ref>{{cite journal|last1=Walker|first1=CL|last2=Rudan|first2=I|last3=Liu|first3=L|last4=Nair|first4=H|last5=Theodoratou|first5=E|last6=Bhutta|first6=ZA |last7=O'Brien|first7=KL|last8=Campbell|first8=H|last9=Black|first9=RE|title=Global burden of childhood pneumonia and diarrhoea.|url=https://archive.org/details/sim_the-lancet_april-20-26-2013_381_9875/page/1405|journal=Lancet|date=Apr 20, 2013|volume=381|issue=9875|pages=1405–16|pmid=23582727|doi=10.1016/s0140-6736(13)60222-6}}</ref> Vyoo vya mashimo ni mbinu ya gharama ya chini zaidi ya kuhakikisha kinyesi kimeondolewa karibu na watu.<ref name=WHO3.4/> ==Ujenzi na uondoaji kinyesi== Kwa kijumla, choo cha shimo huwa na sehemu tatu: shimo la ardhini, sakafu iliyo na shimo dogo, na chumba kilicho na paa.<ref name="Till2014" /> Kwa kawaida, shimo la ardhini huwa na kina cha angalau mita 3&nbsp; (futi 10&nbsp;) na upana wa mita 1 (futi 3.2).<ref name="Till2014" /> [[Shirika la Afya Duniani]] kinapendekeza vijengwe mbali kidogo na nyumba, kwa kuzingatia masuala ya harufu inayotoka chooni na ufikiaji wa urahisi.<ref name=WHO3.4/> Umbali na [[maji ya ndani ya ardhi]] na [[maji ya juu ya ardhi]] unafaa kuwa mkubwa iwezekanavyo ili kupunguza hatari ya uchafuzi. Shimo la sakafuni halifai kuzidi upana wa sentimita 25 (inchi 9.8) ili watoto wasije wakaanguka humo.<!-- <ref name=WHO3.4/> --> Mwangaza haufai kuingia humo ili kuzuia inzi wasiingie.<!-- <ref name=WHO3.4/> --> Jambo hili linaweza kuhitaji kutumia kifuniko kwenye shimo la sakafuni ikiwa halitumiki.<ref name=WHO3.4>{{cite web|title=Simple pit latrine (fact sheet 3.4)|url=http://helid.digicollection.org/en/d/Js13461e/3.4.html|website=who.int|date=1996|accessdate=15 August 2014|archivedate=2012-12-19|archiveurl=https://web.archive.org/web/20121219220918/http://helid.digicollection.org/en/d/Js13461e/3.4.html}}</ref> Choo kikishajaa hadi mita 0.5 (futi 1.6) karibu na sehemu ya juu, kinafaa kuondolewa kinyesi chote au choo kipya kijengwe mahali tofauti.<ref name="VIP2003">{{cite book|author1=François Brikké|title=Linking technology choice with operation and maintenance in the context of community water supply and sanitation|date=2003|publisher=World Health Organization|isbn=9241562153|page=108|url=http://whqlibdoc.who.int/publications/2003/9241562153.pdf|access-date=2015-08-17|archive-date=2005-11-05|archive-url=https://web.archive.org/web/20051105100412/http://whqlibdoc.who.int/publications/2003/9241562153.pdf|url-status=dead}}</ref> Udhibiti wa [[maji maji ya kinyesi]] yaliyoondolewa chooni huwa tata. Kuna hatari za kimazingira na kiafya yasipodhibitiwa vyema. == Uboreshaji== Choo cha shimo cha kawaida kinaweza kuboreshwa kwa njia kadhaa. Njia ya kwanza ni kuweka mfereji wa kuingiza hewa shimoni hadi juu ya mjengo wa choo.<!-- <ref name=VIP2003/> --> Mfereji huu huboresha uzungukaji wa hewa na kupunguza harufu mbaya ya choo.<!-- <ref name=VIP2003/> --> Pia unaweza kupunguza nzi ikiwa sehemu ya juu ya mfereji huu imefunikwa kwa waya (ambayo kwa kawaida huwa imetengenezwa kwa [[kioo nyuzi]]).<!-- <ref name=VIP2003/> --> Katika aina hii ya vyoo, si lazima kifuniko kitumike kufunika shimo la sakafuni.<ref name=VIP2003/> Hatua zingine za uboreshaji zinazoweza kutumika ni pamoja na sakafu iliyojengwa kwa njia inayowezesha maji kutiririkia ndani na kuimarisha sehemu ya juu ya sakafu kwa matofali au simiti ili kuongeza uthabiti.<ref name="Till2014" /><ref name=VIP2003/> == Utumizi, Jamii na Utamaduni == Kufikia mwaka wa 2013, vyoo vya shimo vinatumiwa na takriban watu bilioni 1.77.<ref name=Graham2013>{{cite journal|last1=Graham|first1=JP|last2=Polizzotto|first2=ML|title=Pit latrines and their impacts on groundwater quality: a systematic review.|journal=Environmental health perspectives|date=May 2013|volume=121|issue=5|pages=521–30|pmid=23518813|doi=10.1289/ehp.1206028}}</ref> Hii ni hasa katika [[taifa linalostawi|mataifa yanayostawi]] na pia maeneo ya [[mashambani]] na [[majagwa]]. Mwaka wa 2011, takriban watu milioni 2.5 hawakuwa na vyoo vizuri na watu milioni moja walilazimika [[kwenda choo katika sehem wazi]] katika mazingira yao.<ref name="UN2014Report" /> [[Kaskazini mwa Asia]] na [[Mataifa ya Kusini mwa Sahara]] yalikuwa na ufikiaji duni zaidi wa vyoo.<ref name=UN2014Report>{{cite book|title=Progress on sanitation and drinking-water - 2014 update.|date=2014|publisher=WHO|isbn=9789241507240|pages=16–20|url=http://www.unicef.org/publications/files/JMP_report_2014_webEng.pdf|format=pdf|access-date=2015-08-17|archive-date=2016-03-03|archive-url=https://web.archive.org/web/20160303171208/http://www.unicef.org/publications/files/JMP_report_2014_webEng.pdf|dead-url=yes}}</ref> Katika mataifa yanayostawi, gharama ya choo kidogo kwa kawaida ni kati ya dola 25 na 60 za Marekani.<ref name="Wiley-Blackwell">{{cite book|last1=Selendy|first1=Janine M. H.|title=Water and sanitation-related diseases and the environment challenges, interventions, and preventive measures|date=2011|publisher=Wiley-Blackwell|location=Hoboken, N.J.|isbn=9781118148600|page=25|edition=|url=http://books.google.ca/books?id=nZlS4ZfUOZUC&pg=PA25}}</ref> Gharama za kuendelea kuviboresha ni kati ya dola 1.5 na 4 za Marekani kwa kila mtu kwa mwaka, ambazo mara nyingi hazitiliwi maanani.<ref>{{cite book|title=Sanitation and Hygiene in Africa Where Do We Stand?|date=2013|publisher=Intl Water Assn|isbn=9781780405414|page=161|url=http://books.google.ca/books?id=_CkDAwAAQBAJ&pg=PA161}}</ref> Katika baadhi ya sehemu za mashambani mwa [[India]] kampeni ya "Hamna Choo, Hamna Ndoa" imetumika kuhamasisha umma kuhusu vyoo kwa kuwahimiza wanawake wakatae kuolewa na mwanaume asiye na choo.<ref name="Cambridge University Press">{{cite book|title=Global Problems, Smart Solutions: Costs and Benefits|date=2013|publisher=Cambridge University Press|isbn=9781107435247|page=623|url=http://books.google.ca/books?id=g9tRAgAAQBAJ&pg=PA623}}</ref><ref name=":2">{{Cite web|url = http://blogs.worldbank.org/impactevaluations/haryanas-scarce-women-tell-potential-suitors-no-loo-no-i-do-guest-post-by-yaniv-stopnitzky|title = Haryana's scarce women tell potential suitors: "No loo, no I do"|date = 12 December 2011|accessdate = 17 November 2014|website = Development Impact|publisher = Blog of World Bank|last = Stopnitzky|first = Yaniv}}</ref> ==References== <references /> [[Jamii:Afya]] 6wj04spjdct9iuufqowy6wgff3v6ax1 0 78910 1578075 1349426 2026-07-02T18:21:24Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578075 wikitext text/x-wiki [[Picha:Skin ulcer due to leishmaniasis, hand of Central American adult 3MG0037 lores.jpg|thumbnail|right|200px|Mkono wenye Leishmaniasis ]] {{Infobox disease | Name = Leishmaniasis | Image = Skin ulcer due to leishmaniasis, hand of Central American adult 3MG0037 lores.jpg | Caption = Cutaneous leishmaniasis in the hand of a [[Central America]]n adult | Field = [[Infectious disease (medical specialty)|Infectious disease]] | ICD10 = {{ICD10|B|55||b|50}} | ICD9 = {{ICD9|085}} | DiseasesDB = 3266 | DiseasesDB_mult = {{DiseasesDB2|29171}}<!-- {{DiseasesDB2|3266}} {{DiseasesDB2|7070}} --> | MedlinePlus = 001386 | eMedicineSubj = emerg | eMedicineTopic = 296 | MeshID = D007896 }} '''Leishmaniasis''' ni [[ugonjwa]] ambao unasababishwa na [[kidusia]] cha [[Protozoa]] katika [[jenasi]] ''[[Leishmania]]'' ([[familia (biolojia)|familia]] [[Trypanosomatidae]]) na unasambazwa na [[spishi]] fulani za [[Usubi (Phlebotominae)|usubi]] kwa kuuma<ref name=WHO2014/>.  Ugonjwa huu unaweza kuugulia kwa namna tatu: kwa [[ngozi]], kwa ngozi na [[membreni ute]] na kwa [[kiungo|viungo]] vya ndani.<ref name=WHO2014>{{cite web|title=Leishmaniasis Fact sheet N°375|url=http://www.who.int/mediacentre/factsheets/fs375/en/|work=World Health Organization|accessdate=17 February 2014|date=January 2014}}</ref> ̽Namna ya kwanza, ya ngozi, inaonekana katika [[donda|vidonda]] vya ngozi. Ya pili, ya ngozi na membreni ute, inaonekana katika vidonda vya ngozi, [[mdomo]] na [[pua]]. Ya tatu, kwa viungo vya ndani, inaonekana kwanza katika vidonda vya ngozi, halafu [[homa]], [[idadi]] ndogo ya [[selidamu nyekundu]], [[wengu]] inayoongezeka ukubwa, na [[ini]].<ref name=WHO2014/><ref name=Barrett2012/> ==Sababu== [[Ambukizo|Maambukizo]] katika [[binadamu]] yanasababishwa na aina zisizopungua 20 za “Leishmania”.<ref name=WHO2014/> Vipengele vya hatari ni pamoja naː [[umaskini]], [[lishe]] duni, uharibifu wa [[mwitu]] na ukuaji [[Miji|mijini]].<ref name=WHO2014/> ==Uaguaji== Namna zote tatu zinaweza kuaguliwa kwa kutumia [[hadubini]] kutazama [[parasiti]].<ref name=WHO2014/> Pia, [[maradhi]] ya viungo vya ndani yanaweza kuaguliwa kwa kupima [[damu]].<ref name=Barrett2012/> ==Kinga== Kinga muhimu, lakini isiyo salama salamini kabisa, dhidi ya “leishmaniasis” ni kulala chini ya [[chandarua]] kilichonyunyiziwa [[viuatilifu]].<ref name=WHO2014/> Mazuio mengine ni pamoja na kunyunyizia viuatilifu kuwaua [[usubi]] na kuwatibu [[wagonjwa]] mapema ili kuzuia kusambaa kwa ugonjwa.<ref name=WHO2014/> ==Tiba== [[Matibabu]] yafaayo yanategemea mahali mgonjwa alipouguliwa, [[kabila]] la “Leishmania”, na namna ya maambukizo.<ref name=WHO2014/> [[Dawa]] ambazo huenda zinafaa kutibu viungo vya ndani ni pamoja na: “lipsomal amphotericin B<ref name=Sun2013>mkusanyiko wa “pentavalent antimonials” na “paromomycin”{{cite journal|last=Sundar|first=S|author2=Chakravarty, J |title=Leishmaniasis: an update of current pharmacotherapy.|journal=Expert opinion on pharmacotherapy|date=Jan 2013|volume=14|issue=1|pages=53–63]pmid=23256501|doi=10.1517/14656566.2013.755515}}</ref> na [[miltefosine]].<ref name=Dor2012>{{citejournal|last=Dorlo|first=TP|author2=Balasegaram, M |author3=Beijnen, JH |author4= de Vries, PJ |title=Miltefosine: a review of its pharmacology and therapeutic efficacy in the treatment of leishmaniasis.|journal=The Journal of antimicrobial chemotherapy|date=Nov 2012|volume=67|issue=11|pages=2576–97|pmid=22833634|doi=10.1093/jac/dks275}}</ref> kwa maradhi ya ngozi, paromomycin, [[fluconazole]], or [[pentamidine]] huenda zinatibika.<ref name=Min2007>{{cite journal|last=Minodier|first=P|author2=Parola, P |title=Cutaneous leishmaniasis treatment.|journal=Travel medicine and infectious disease|date=May 2007|volume=5|issue=3|pages=150–8|pmid=17448941|doi=10.1016/j.tmaid.2006.09.004}}</ref> ==Uenezi== Siku hizi takriban [[milioni]] 12 wanaambukizwa<ref name=Mag>{{cite web|title=Leishmaniasis Magnitude of the problem|url=http://www.who.int/leishmaniasis/burden/magnitude/burden_magnitude/en/index.html|work=World Health Organization|accessdate=17 February 2014}}</ref> katika nchi zapata 98.<ref name=Barrett2012>{{cite journal|last=Barrett|first=MP|author2=Croft, SL |title=Management of trypanosomiasis and leishmaniasis.|journal=British medical bulletin|year=2012|volume=104|pages=175–96|pmid=23137768|doi=10.1093/bmb/lds031|pmc=3530408}}</ref> Takriban wagonjwa wapya milioni 2<ref name=Barrett2012/> pamoja na [[Kifo|vifo]] kati ya [[elfu]] 20 hadi 50 hutokea kila [[mwaka]].<ref name=WHO2014/><ref name=Loz2012>{{cite journal|last=Lozano|first=R|title=Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.|url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2095|journal=Lancet|date=Dec 15, 2012|volume=380|issue=9859|pages=2095–128|pmid=23245604|doi=10.1016/S0140-6736(12)61728-0}}</ref> Takriban watu milioni 200 barani [[Asia]], [[Afrika]], [[Amerika ya Kati]] na [[Amerika Kusini]] wanaishi sehemu ambako maradhi haya yanaathiri mno.<ref name=Barrett2012/><ref>{{cite journal|last=Ejazi|first=SA|author2=Ali, N |title=Developments in diagnosis and treatment of visceral leishmaniasis during the last decade and future prospects.|journal=Expert review of anti-infective therapy|date=Jan 2013|volume=11|issue=1|pages=79–98|pmid=23428104|doi=10.1586/eri.12.148}}</ref>  [[Shirika la Afya Duniani]] limewahi kutoa punguzo la [[bei]] za dawa kadhaa zitibuzo maradhi.<ref name=Barrett2012/> Maradhi haya pengine yanaugua [[wanyama]] wengine ambao ni pamoja na [[mbwa]] na [[panya]].<ref name=WHO2014/> ==Marejeo== <references /> {{mbegu-biolojia}} [[Jamii:Maradhi ya kuambukiza]] [[Jamii:Vidusia‎]] rl4b5e0mtjsp7tymv9i4846wc7wd1r0 0 80463 1578209 1390487 2026-07-03T03:12:39Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578209 wikitext text/x-wiki [[Image:Yersinia_pestis_fluorescent.jpeg|thumb|250px|''[[Yersinia pestis]]'' iliyokuzwa mara 200 ikiwa na [[lebo ya fluoro]]. [[Bakteria]] hii ndiyo sababu ya aina mbalimbali za [[tauni]].]] [[File:Plague -buboes.jpg|thumb|Tauni ya majipu inasababisha tezi za limfu zifure.]] '''Tauni''' (au '''kipukusa'''; kwa [[Kiingereza]]: [[w:plague|plague]] au pestilence) ni [[ugonjwa]] unaoambukiza [[mtu|watu]] wengi sana unaosababishwa na [[bakteria]] ''[[Yersinia pestis]]'' ya [[familia (biolojia)|familia]] [[Enterobacteriaceae]]. Inapatikana kwa kawaida katika maeneo kadhaa ya [[dunia]] yasiyo na [[maendeleo]].<ref>{{cite web|url=http://www.who.int/ihr/ihr_brief_no_2_en.pdf |title=WHO IHR Brief No. 2. Notification and other reporting requirements under the IHR (2005) |format=PDF |date= |accessdate=2014-08-24}}</ref> Kadiri ya athira juu ya [[mapafu]] na hali nyingine za [[mgonjwa]], inaweza kuenea kupitia [[hewa]], kwa kugusana na kwa nadra kwa njia ya [[chakula]] kisichopikwa vya kutosha. [[Dalili]] zinategemea ugonjwa umemshika mtu wapi zaidi: [[tezi]], [[mishipa ya damu]] au mapafu. [[Tiba]] ikiwahi inaweza kumponya mtu. ==Historia== Zamani tauni iliua watu wengi: kwa miaka michache hata [[nusu]] ya [[Wachina]] wote, halafu [[theluthi]] ya [[Wazungu]] wote. [[Biblia]] inazungumzia ugonjwa huo. [[Bara]]ni [[Afrika]] ugonjwa ulienea mara kadhaa, lakini mtawanyiko wa watu katika maeneo makubwa haukuisaidia tauni kuwapata watu wengi zaidi kama kwenye [[msongamano]] mkubwa. Ni maarufu juhudi za [[Wajerumani]] kukomesha tauni katika [[koloni]] lao la [[Afrika Mashariki ya Kijerumani]] mwishoni mwa [[karne ya 19]] kwa kulipa kiasi kadhaa kwa kila [[mzoga]] wa [[panya]], [[mnyama]] anayesambaza bakteria hizo kupitia [[viroboto]] wake.<ref>Pugu Hadi Peramiho - kimehaririwa na P. Gerold Rupper, OSB, BPNP, Peramiho 1988, ISBN 9967 67 031 1</ref> ==Tanbihi== {{Reflist|30em}} == Tazama Pia == [[Tauni ya Kucheza dansi ya 1518]] ==Marejeo== {{refbegin|30em}} * Weatherford 2004: 242-250 * {{cite book|author=Ole Jrgen Benedictow|title=Black Death 1346-1353: The Complete History| year =2004|isbn=978-1-84383-214-0 }} * Biraben, Jean-Noel. ''Les Hommes et la Peste'' The Hague 1975. * Buckler, John and Bennet D. Hill and John P. McKay. "A History of Western Society, 5th Edition." New York: Houghton Mifflin Co., 1995. * {{cite book| author = Norman F. Cantor| title = In the Wake of the Plague: The Black Death and the World It Made| url = https://archive.org/details/inwakeofplague00norm| date = 2002-04-16| publisher = Harper Perennial| isbn = 978-0-06-001434-6 }} * {{cite journal | pmid = 11500756 | volume=96 | issue=5 | title=Small rodents fleas from the bubonic plague focus located in the Serra dos Orgãos Mountain Range, State of Rio de Janeiro, Brazil | url = https://archive.org/details/memorias-do-instituto-oswaldo-cruz_2001-07_96_5/page/603 |date=July 2001 | author=de Carvalho RW, Serra-Freire NM, Linardi PM, de Almeida AB, da Costa JN | journal=Mem. Inst. Oswaldo Cruz | pages=603–9 | doi=10.1590/S0074-02762001000500003 | ref = harv| last2=Serra-Freire | last3=Linardi | last4=De Almeida | last5=Da Costa }}. ''this manuscript reports a census of potential plague vectors (rodents and fleas) in a Brazilian focus region (i.e. region associated with cases of disease); free PDF download'' Retrieved 2005-03-02 * {{cite book| author = Marilyn Chase| title = The Barbary Plague: The Black Death in Victorian San Francisco| url = https://archive.org/details/barbaryplaguebla0000chas_z5s0| date = 2004-03-09| publisher = Random House Trade Paperbacks| isbn = 978-0-375-75708-2 }} * {{cite book | last = Cohn | first = Samuel K. | authorlink = | title = The Black Death Transformed: Disease and Culture in Early Renaissance Europe | publisher = A Hodder Arnold |year=2003 | location = | page = 336 | url = | isbn= 0-340-70646-5 }} * {{cite book| author = Charles T. Gregg| title = Plague!: The Shocking Story of a Dread Disease in America Today| url = https://archive.org/details/plagueshockingst00greg| year = 1978| isbn = 978-0-684-15372-8 }} * {{cite book| author = Ernest Jawetz| title = 1989 Medical Microbiology| year = 1989| publisher = McGraw-Hill/Appleton & Lange| isbn = 978-0-8385-6238-3 }} * {{cite book| author = John Kelly| title = The Great Mortality: An Intimate History of the Black Death, The Most Devastating Plague of All Time| url = https://archive.org/details/greatmortality00kell| date = 2005-02-01| publisher = Harper| isbn = 978-0-06-000692-1 }} * {{cite book| author = William Hardy McNeill| title = Plagues and peoples| year = 1998| publisher = Anchor| isbn = 978-0-385-12122-4 }} * {{cite book| author = James C. Mohr| title = Plague and Fire:Battling Black Death and the 1900 Burning of Honolulu's Chinatown: Battling Black Death and the 1900 Burning of Honolulu's Chinatown| url = https://archive.org/details/plaguefirebattli0000mohr| date = 2004-11-15| publisher = Oxford University Press, USA| isbn = 978-0-19-516231-8 }} * {{cite book| author = A. Lloyd Moote|author2=Dorothy C. Moote | title = The Great Plague: The Story of London's Most Deadly Year| url = https://archive.org/details/greatplaguestory0000moot| date = 2004-01-20| publisher = Johns Hopkins University Press| isbn = 978-0-8018-7783-4 }} * {{cite book| author = Wendy Orent| title = Plague: The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease| url = https://archive.org/details/plaguemysterious00oren| date = 2004-05-01| publisher = Free Press| isbn = 978-0-7432-3685-0 }} * Patrick, Adam. "Disease in Antiquity: Ancient Greece and Rome," in ''Diseases in Antiquity'', editors: [[Don Brothwell]] and A. T. Sandison. Springfield, Illinois; Charles C. Thomas, 1967. * Platt, Colin. ''King Death: The Black Death and its Aftermath in Late-Medieval England'' [[Toronto University]] Press, 1997. * {{cite book | last = Rosen | first = William | authorlink = | title = Justinian's Flea: Plague, Empire, and the Birth of Europe | publisher = Viking Penguin | year = 2007 | location = | page = [https://archive.org/details/justiniansfleapl00rose/page/367 367] | url =https://archive.org/details/justiniansfleapl00rose | isbn= 978-0-670-03855-8}} * Simpson, W. J. ''A Treatise on Plague''. Cambridge, England: [[Cambridge University Press]], 1905. * {{cite book| author = Jackson J. Spielvogel| title = Western Civilization to 1715: A Brief History| date = 1998-01-01| publisher = Wadsworth Publishing Company| isbn = 978-0-534-56062-1 }} {{refend}} ==Viungo vya nje== * World Health Organization ** [http://www.who.int/topics/plague/en/ Health topic] ** [http://www.who.int/csr/disease/plague/en/ Communicable Disease Surveillance & Response]&nbsp;– Impact of plague & Information resources * Centers for Disease Control and Prevention ** [http://www.cdc.gov/plague CDC Plague] map world distribution, publications, information on bioterrorism preparedness and response regarding plague ** [http://www.cdc.gov/ncidod/diseases/submenus/sub_plague.htm Infectious Disease Information] more links including travelers' health * [http://www.upmc-biosecurity.org/website/focus/agents_diseases/fact_sheets/plague.html Agent Fact Sheet: Plague] {{Wayback|url=http://www.upmc-biosecurity.org/website/focus/agents_diseases/fact_sheets/plague.html |date=20110206215539 }}, Center for Biosecurity * [http://www.emedicine.com/EMERG/topic428.htm Symptoms, causes, pictures of bubonic plague] * [http://www.pbs.org/wnet/secrets/case_plague/ Secrets of the Dead. Mystery of the Black Death] {{Wayback|url=http://www.pbs.org/wnet/secrets/case_plague/ |date=20140325105354 }} [[Public Broadcasting Service|PBS]] * {{PDFlink|[http://www.wood.army.mil/chmdsd/Army_Chemical_Review/pdfs/Jul-Dec%202005/Kirby.pdf Flea As Weapon]|281&nbsp;KB}} * [http://www.pasteur.fr/actu/presse/press/07pesteTIGR_E.htm Researchers sound the alarm: the multidrug resistance of the plague bacillus could spread] {{Wayback|url=http://www.pasteur.fr/actu/presse/press/07pesteTIGR_E.htm |date=20071014012153 }} * [http://www.1911encyclopedia.org/Plague Plague - LoveToKnow 1911] * Genome information is available from the [http://patricbrc.vbi.vt.edu/ NIAID PathoSystems Resource Integration Center (PATRIC)] {{Wayback|url=http://patricbrc.vbi.vt.edu/ |date=20141231185632 }} {{mbegu-tiba}} [[Jamii:Magonjwa ya bakteria]] oazqkx6z2wz7v1etf9acywj5y6u8rye 0 81028 1578145 1349431 2026-07-02T21:55:19Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578145 wikitext text/x-wiki [[Picha:Trichuriasis lifecycle.jpg|thumbnail|right|200px|Maisha ya mzunguko wa Trichuriasis]] {{Infobox disease | Name = Trichuriasis | Image = Trichuriasis_lifecycle.jpg | Caption = Life cycle of Trichuris trichiura.| ICD10 = {{ICD10|B|79||b|65}} | ICD9 = {{ICD9|127.3}} | ICDO = | OMIM = | DiseasesDB = 31146 | MedlinePlus = 001364 | eMedicineSubj = | eMedicineTopic = | MeshID = D014257 | }} '''Trichuriasis''' ni [[ambukizo]] kutoka [[mnyoo-mjeledi]] (''Trichuris trichiura'', [[Kiing.]] [[w:whipworm|whipworm]]).<ref name=CDC2013>{{cite web|title=Parasites - Trichuriasis (also known as Whipworm Infection)|url=http://www.cdc.gov/parasites/whipworm/|work=CDC|accessdate=5 March 2014|date=January 10, 2013}}</ref> Kama uambukizo unatokana na minyoo michache, mara nyingi hakuna dalili zake. <ref name=WHO2013/> Kwa wale ambao wanaambukizwa na minyoo mingi, pengine [[maumivu ya fumbatio]] yanatokea, uchovu pamoja na [[kuharisha]].<ref name=WHO2013/> Mara nyingine kuharisha kumekuwepo na ((damu)).<ref name=WHO2013/> Uambukizo wa watoto unaweza kudhoofisha ukuaji wa akili pamoja na wa mwili.<ref name=WHO2013>{{cite web|title=Soil-transmitted helminth infections Fact sheet N°366|url=http://www.who.int/mediacentre/factsheets/fs366/en/|work=World Health Organization|accessdate=5 March 2014|date=June 2013}}</ref> [[Anemia| Viwango vilivyo chini vya seli nyekundu za damu]] Hali hii huenda inaweza kutokea kutokana na upungufu wa damu.<ref name=CDC2013/> ==Chanzo== Kwa kawaida maradhi haya yanaambukiza kutokana na kula chakula au kunywa maji yenye mayai ya minyoo hii.<ref name=WHO2013/> Mara nyingine maradhi yanatokea katika miboga inayoambukizwa na haijasafishwa wala kupikwa vya kutosha.<ref name=WHO2013/> Mara nyingi mayai haya yamo ndani ya ardhi ya mahali ambapo watu wanaenda haja kubwa ((kunya nje)) pia ambako [[vinyesi]] visivyotiliwa dawa vinatumika kama [[mbolea]]. <ref name=CDC2013/> Mayai haya chanzo chao ni vinyesi vya watu wanaoambukizwa.<ref name="WHO2013" /> Watoto wachanga wanaocheza kwenye ardhi namna hii wakitia vidole mdomoni wanaambukizwa kwa urahisi.<ref name="WHO2013" /> Minyoo wanaishi katika [[utumbo mkubwa]] wakiwa na urefu wa takribin sentimita nne.<ref name=CDC2013/> Whipworm inatambulika kutokana na kuona mayai katika uchunguzi wa kinyesi kwa [[hadubini]].<ref name=CDCDiag2013>{{cite web|title=Parasites - Trichuriasis (also known as Whipworm Infection) Diagnosis|url=http://www.cdc.gov/parasites/whipworm/diagnosis.html|work=CDC|accessdate=20 March 2014|date=January 10, 2013}}</ref> Mayai yana umbo wa pipa la mviringo.<ref>{{cite book|last=Duben-Engelkirk|first=Paul G. Engelkirk, Janet|title=Laboratory diagnosis of infectious diseases : essentials of diagnostic microbiology|year=2008|publisher=Wolters Kluwer Health/Lippincott Williams &Wlkins|location=Baltimore|isbn=9780781797016|page=604|url=http://books.google.ca/books?id=l56-WMdyqzcC&pg=PA604}}</ref> ==Ugangakinga na matibabu== Ukinga unatokana na kupika chakula vizuri cha kutosha na [[kunawa]] kabla ya kupika. <ref name=CDCPre2013>{{cite web|title=Parasites - Trichuriasis (also known as Whipworm Infection) Prevention&Control|url=http://www.cdc.gov/parasites/whipworm/prevent.html|work=CDC|accessdate=20 March 2014|date=January 10, 2013}}</ref> Taratibu nyingine ni pamoja na hali bora ya [[usafi wa mazingira]] mifano ni kuwepo kwa vyoo visafi <ref name=CDCPre2013/> na vinavyofanya kazi vizuri pamoja na kuwepo kwa maji safi.<ref>{{cite journal|last=Ziegelbauer|first=K|author2=Speich, B |author3=Mäusezahl, D |author4=Bos, R |author5=Keiser, J |author6= Utzinger, J |title=Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis.|journal=PLoS medicine|date=Jan 2012|volume=9|issue=1|pages=e1001162|pmid=22291577|doi=10.1371/journal.pmed.1001162 |pmc=3265535}}</ref> Katika maeneo ya dunia ambako uambukizi hutokea kwa wingi, ni kawaida kuwatibu watu katika makundi ukifuatiliwa mchakato wa tiba.<ref name=Lancet2006>{{cite journal|last=Bethony|first=J|author2=Brooker, S |author3=Albonico, M |author4=Geiger, SM |author5=Loukas, A |author6=Diemert, D |author7= Hotez, PJ |title=Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm.|url=https://archive.org/details/sim_the-lancet_may-6-12-2006_367_9521/page/1521|journal=Lancet|date=May 6, 2006|volume=367|issue=9521|pages=1521–32|pmid=16679166|doi=10.1016/S0140-6736(06)68653-4}}</ref> Matibabu yana muda wa siku tatu za kumeza dawa za: albendazole, mebendazole au ivermectin.<ref name=CDCTx2013>{{cite web|title=Parasites - Trichuriasis (also known as Whipworm Infection): Resources for Health Professionals|url=http://www.cdc.gov/parasites/whipworm/health_professionals/index.html|work=CDC|accessdate=5 March 2014|date=January 10, 2013}}</ref> Mara nyingi watu wanaambukizwa upya baada ya tibu.<ref>{{cite journal|last=Jia|first=TW|author2=Melville, S |author3=Utzinger, J |author4=King, CH |author5= Zhou, XN |title=Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis.|journal=PLoS neglected tropical diseases|year=2012|volume=6|issue=5|pages=e1621|pmid=22590656|doi=10.1371/journal.pntd.0001621 |pmc=3348161}}</ref> ==Elimumaambo== Uambukizo kutoka whipworm unaathiri idadi ya watu milioni 600 hadi 800 dunia nzima.<ref name=CDC2013/><ref name=Fen2012>{{cite journal|last=Fenwick|first=A|title=The global burden of neglected tropical diseases.|journal=Public health|date=Mar 2012|volume=126|issue=3|pages=233–6|pmid=22325616|doi=10.1016/j.puhe.2011.11.015}}</ref> Kwa kawaida hutokea katika nchi za joto<ref name=Lancet2006/> Katika dunia inayoendelea, wale watu wanaoambukizwa na whipworm mara nyingi wanaumia maambukizo ya minyoo ya safura pamoja na minyoo ya askari mwilini <ref name=Lancet2006/> Watu hao wanaathiri uchumi wa nchi nyingi. <ref>{{cite book|last=Jamison|first=Dean|title=Disease control priorities in developing countries|year=2006|publisher=Oxford University Press|location=New York|isbn=9780821361801|page=Chapter 24|url=http://www.ncbi.nlm.nih.gov/books/NBK11748/|edition=2nd ed.|chapter=Helminth Infections: Soil-transmitted Helminth Infections and Schistosomiasis}}</ref> Kazi inaendelea kuunda ((dawa ya chanjo)) dhidi ya maradhi haya.<ref name=Lancet2006/> Trichuriasis inaainishwa kama maradhi ya nchi za joto yanayopuuzwa.<ref>{{cite web|title=Neglected Tropical Diseases|url=http://www.cdc.gov/globalhealth/ntd/diseases/index.html|website=cdc.gov|accessdate=28 November 2014|date=June 6, 2011}}</ref> ==Marejeo== <references/> [[jamii:Maradhi ya kuambukiza‎]] [[Jamii:Vidusia]] qiggygetzufvr29j3ijoaxd5indj320 0 82502 1578159 1349541 2026-07-02T22:44:21Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578159 wikitext text/x-wiki [[Picha:An old man diagnosed as suffering from senile dementia. Colo Wellcome L0026689.jpg|thumbnail|right|200px|Mzee mwenye Dimenshia]] {{Infobox disease |Name=Dimenshia |Image=Alzheimer's_disease_brain_comparison.jpg |Caption=Comparison of a normal aged brain (left) and the brain of a person with [[Alzheimer's]] (right). Differential characteristics are pointed out. | Name = Dementia | ICD10 = {{ICD10|F|00||f|00}}-{{ICD10|F|07||f|00}} | ICD9 = {{ICD9|290}}-{{ICD9|294}} | MedlinePlus = 000739 | DiseasesDB = 29283 | MeshID = D003704 }} <!--Ufasili na dalili --> '''Dimenshia''' ni kategoria pana ya [[magonjwa ya ubongo]] yanayosababisha upunguaji wa muda mrefu na mara kwa mara wa polepole katika uwezo wa [[kufikiria]] na kukumbuka kiasi kwamba utendakazi wa kawaida wa mtu unaathiriwa.<ref name=WHO2014/> Dalili zingine zinazotokea sana ni matatizo ya kihisia, matatizo ya [[lugha]], na upungufu katika [[motisha]].<ref name=WHO2014/><ref name=BMJ2009>{{cite journal|last1=Burns|first1=A|last2=Iliffe|first2=S|title=Dementia.|journal=BMJ (Clinical research ed.)|date=5 February 2009|volume=338|pages=b75|pmid=19196746|doi=10.1136/bmj.b75}}</ref> [[Ufahamu]] wa mtu hauathiriwi.<ref name=WHO2014/> Ili utambuzi uweze kufaulu, ni lazima kuwe na mabadiliko kutoka kwa utendakazi wa kawaida wa akili ya mtu na upungufu mkubwa kuliko utokanao na kuzeeka.<ref name=WHO2014/><ref name="Memory Loss">{{cite book|last=Solomon|first=Andrew E. Budson, Paul R.|title=Memory loss : a practical guide for clinicians|url=https://archive.org/details/memorylosspracti0000buds|year=2011|publisher=Elsevier Saunders|location=[Edinburgh?]|isbn=9781416035978}}</ref> Magonjwa haya pia yana athari kubwa kwa watunzaji wa mtu.<ref name=WHO2014/> == Kisababishi, utambuzi, uzuiaji == Aina inayopatikana sana ya dimenshia ni [[ugonjwa wa Alzheimer]] unaochangia asilimia 50 hadi 70 ya visa.<!-- <ref name=WHO2014/><ref name=BMJ2009/> --> Aina zingine zinazopatikana sana ni [[dimenshia ya mishipa]] (asilimia 25), [[dimenshia ya Lewy body]] (asilimia 15), na [[dimenshia ya muda ya upande wa mbele]].<ref name=WHO2014/><ref name=BMJ2009/> Visababishi visivyopatikana sana ni [[hidrosefalasi ya shinikizo la kawaida]], [[ugonjwa wa Parkinson]], [[kaswende]], na [[ugonjwa wa Creutzfeldt–Jakob]] miongoni mwa vingine.<ref>{{cite book|last1=Gauthier|first1=Serge|title=Clinical diagnosis and management of Alzheimer's disease|date=2006|publisher=InformaHealthcare|location=Abingdon, Oxon|isbn=9780203931714|pages=53–54|edition=3rd ed.|url=http://books.google.ca/books?id=a221hX4WuwUC&pg=PA54}}</ref> Zaidi ya aina moja ya dimenshia zinaweza kuwa kwa mtu mmoja.<ref name=WHO2014/> Kiasi kidogo cha visa huathiri familia.<ref name=Genetic2014/> Katika [[DSM-5]], dimenshia iliainishwa upya kama [[DSM-5#matatizo ya neva tambuzi|tatizo la neva tambuzi]], na viwango tofauti vya ukali.<ref name=DSM5>{{cite book|last1=Association|first1=American Psychiatric|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association|location=Washington, D.C.|isbn=9780890425541|pages=591–603|edition=5th ed.}}</ref> Utambuzi hutegemea historia ya maradhi hayo na [[uchunguzi wa utambuzi]] kwa [[picha za mwanga wa kitabibu]] na vipimo vya damu kuondoa visababishi vingine vinavyoweza kuwepo.<ref>{{cite web|title=Dementia diagnosis and assessment|url=http://pathways.nice.org.uk/pathways/dementia/dementia-diagnosis-and-assessment.pdf|website=pathways.nice.org.uk|accessdate=30 November 2014|archivedate=2014-12-05|archiveurl=https://web.archive.org/web/20141205184403/http://pathways.nice.org.uk/pathways/dementia/dementia-diagnosis-and-assessment.pdf}}</ref> [[Uchunguzi mdogo wa hali ya akili]] ni kipimo cha ufahamu kinachotumika sana.<ref name=BMJ2009/> Juhudi za kuzuia dimenshia ni kujaribu kupunguza visababishi vya hatari kama vile [[hipatensheni|shinikizo la juu la damu]], kuvuta, [[kisukari melitasi|kisukari]] na [[unene]].<ref name=WHO2014/> Uchujaji umma kwa jumla kwa ugonjwa huu haupendekezwi.<ref name=NICE2014>{{cite web|title=Dementia overview|url=http://pathways.nice.org.uk/pathways/dementia/dementia-overview.pdf|website=http://pathways.nice.org.uk/|accessdate=30 November 2014|archivedate=2014-12-05|archiveurl=https://web.archive.org/web/20141205184234/http://pathways.nice.org.uk/pathways/dementia/dementia-overview.pdf}}</ref> == Kudhibiti == Hakuna tiba ya dimenshia.<ref name=WHO2014/> [[Kizuio cha asetikolinisteresi|vizuio vya Kolinisteresi]] kama vile [[donepezil]] hutumiwa mara kwa mara na vinaweza kusaidia katika ugonjwa mdogo ili kupunguza.<ref>{{cite journal|last1=Birks|first1=J|title=Cholinesterase inhibitors for Alzheimer's disease.|journal=The Cochrane database of systematic reviews|date=25 January 2006|issue=1|pages=CD005593|pmid=16437532|doi=10.1002/14651858.CD005593}}</ref><ref>{{cite journal|last1=Rolinski|first1=M|last2=Fox|first2=C|last3=Maidment|first3=I|last4=McShane|first4=R|title=Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease.|journal=The Cochrane database of systematic reviews|date=14 March 2012|volume=3|pages=CD006504|pmid=22419314|doi=10.1002/14651858.CD006504.pub2}}</ref><ref name=Kav2007>{{cite journal|last1=Kavirajan|first1=H|last2=Schneider|first2=LS|title=Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials.|journal=The Lancet. Neurology|date=September 2007|volume=6|issue=9|pages=782–92|pmid=17689146|doi=10.1016/s1474-4422(07)70195-3}}</ref> Faida ya jumla, hata hivyo, inaweza kuwa ndogo.<ref name=Kav2007/><ref name=Comm2012>{{cite journal |author=Commission de la transparence |title=Médicaments de la maladied'Alzheimer : à éviter|trans_title=Drugs for Alzheimer's disease: best avoided. No therapeutic advantage |journal=PrescrireInt |volume=21 |issue=128|pages=150 |date=June 2012 |pmid=22822592 |doi= |url=}}</ref> Kwa watu walio na dimenshia na wale wanaowatunza, hatua nyingi zinaweza kuboresha maisha yao.<ref name=WHO2014/> [[Tiba za kiufahamu za kitabia |Tatuzi za kiufahamu za kitabia]] zinaweza kuwa bora.<ref name=WHO2014/> Kuelimisha na kutoa msaada wa kihisia kwa [[mtunzaji]] ni muhimu.<ref name=WHO2014/> Programu za mazoezi ni muhimu kulingana na [[shughuli za maisha ya kawaida]] na huboresha matokeo.<ref name=Forb2013>{{cite journal|last1=Forbes|first1=D.|last2=Thiessen|first2=E.J.|last3=Blake|first3=C.M.|last4=Forbes|first4=S.C.|last5=Forbes|first5=S.|title=Exercise programs for people with dementia.|journal=The Cochrane database of systematic reviews|date=4 December 2013|volume=12|pages=CD006489|pmid=24302466|doi=10.1002/14651858.CD006489.pub3}}</ref> Matibabu ya matatizo ya kitabia au [[saikosisi]] kutokana na dimenshia kwa [[vizuia saikosisi]] hutumika sana lakini hayapendekezwi kutokana na suala kuwa huwa na faida ndogo na hatari zaidi ya kifo.<ref>{{cite web|author1=National Institute for Health and Clinical Excellence|title=Low-dose antipsychotics in people with dementia|url=https://www.nice.org.uk/advice/ktt7/resources/non-guidance-lowdose-antipsychotics-in-people-with-dementia-pdf|website=nice.org.uk|accessdate=29 November 2014|archiveurl=https://web.archive.org/web/20141205183329/https://www.nice.org.uk/advice/ktt7/resources/non-guidance-lowdose-antipsychotics-in-people-with-dementia-pdf|archivedate=2014-12-05|=https://web.archive.org/web/20141205183329/https://www.nice.org.uk/advice/ktt7/resources/non-guidance-lowdose-antipsychotics-in-people-with-dementia-pdf}}</ref><ref>{{cite web|title=Information for Healthcare Professionals: Conventional Antipsychotics|url=http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124830.htm|website=fda.gov|accessdate=29 November 2014|date=June 16 2008}}</ref> == Epidemiolojia, prognosisi, na jamii == Ulimwenguni, dimenshia huathiri watu milioni 36.<ref name=WHO2014>{{cite web|title=Dementia Fact sheet N°362|url=http://www.who.int/mediacentre/factsheets/fs362/en/|website=who.int|accessdate=28 November 2014|date=April 2012}}</ref> Takribani asilimia 10 ya watu hupata ugonjwa huu wakati fulani maishani mwao.<ref name=Genetic2014>{{cite journal|last1=Loy|first1=CT|last2=Schofield|first2=PR|last3=Turner|first3=AM|last4=Kwok|first4=JB|title=Genetics of dementia.|url=https://archive.org/details/sim_the-lancet_march-1-7-2014_383_9919/page/828|journal=Lancet|date=1 March 2014|volume=383|issue=9919|pages=828–40|pmid=23927914|doi=10.1016/s0140-6736(13)60630-3}}</ref> Hupatikana sana umri unapoongezeka.<ref name=Larson2013>{{cite journal|last1=Larson|first1=EB|last2=Yaffe|first2=K|last3=Langa|first3=KM|title=New insights into the dementia epidemic.|url=https://archive.org/details/sim_new-england-journal-of-medicine_2013-12-12_369_24/page/2275|journal=The New England Journal of Medicine|date=12 December 2013|volume=369|issue=24|pages=2275–7|pmid=24283198|doi=10.1056/nejmp1311405}}</ref> Takribani asilimia 3 ya watu wa umri wa kati ya miaka 65–74 wana dimenshia, asilimia 19 kati ya umri wa miaka 75 na 84 na karibu nusu ya walio na umri wa miaka 85.<ref>{{cite book|last1=Umphred|first1=Darcy|title=Neurological rehabilitation|date=2012|publisher=Elsevier Mosby|location=St. Louis, Mo.|isbn=9780323075862|page=838|edition=6th ed.|url=http://books.google.ca/books?id=I9ltC-ZrNOMC&pg=PA838}}</ref> Katika mwaka wa 2013 dimenshia ilisababisha takribani vifo milioni 1.7, juu kutoka milioni 0.8 katika mwaka wa 1990.<ref name=GDB2013>{{cite journal|last1=GBD 2013 Mortality and Causes of Death|first1=Collaborators|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=17 December 2014|pmid=25530442|doi=10.1016/S0140-6736(14)61682-2|volume=385|issue=9963|pages=117–71}}</ref> Watu wengi wanapoishi zaidi, dimenshia inaendelea kupatikana sana kwa watu wote.<ref name=Larson2013/> Kwa watu wa umri mahususi; hata hivyo, huenda ikawa kuwa unapungua, angalau katika nchi zilizostawi, kutokana na kupungua kwa visababishi vya hatari.<ref name=Larson2013/> Ni mojawapo ya visababishi vikuu vya [[ulemavu]] miongoni mwa wazee.<ref name=BMJ2009/> Inaaminika kusababisha gharama za kiuchumi za dola bilioni 604 kila mwaka.<ref name=WHO2014/> watu walio na dimenshia mara nyingi huwa na vizuizi vya kimwili au [[kikemikali]] kwa kiwango kikubwa kupita kiasi, na kuibua masuala ya [[haki za kibinadamu]].<ref name=WHO2014/> [[Shutuma za kijamii]] dhidi ya waathiriwa hutokea sana.ref name=BMJ2009/> ==Marejeo== <references /> [[Jamii:Ubongo]] [[Jamii:Magonjwa]] [[Jamii:Tiba]] [[Jamii:Saikolojia]] a4mipzfh0c2aicdt5q4y4wh8ydi50ef 0 82510 1578083 1514183 2026-07-02T18:50:58Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578083 wikitext text/x-wiki [[Picha:Rheumatic heart disease, gross pathology 20G0013 lores.jpg|thumbnail|right|200px|Homa ya rumatizimu]] {{Infobox disease | Name = Homa ya rumatizimu | Image = Streptococcus_pyogenes_01.jpg | Caption = ''[[Streptococcus pyogenes]]'' bacteria (Pappenheim's stain) the trigger for rheumatic fever. | DiseasesDB = 11487 | ICD10 = {{ICD10|I|00||i|00}}-{{ICD10|I|02||i|00}} | ICD9 = {{ICD9|390}}–{{ICD9|392}} | ICDO = | OMIM = | MedlinePlus = 003940 | eMedicineSubj = med | eMedicineTopic = 3435 | eMedicine_mult = {{eMedicine2|med|2922}} {{eMedicine2|emerg|509}} {{eMedicine2|ped|2006}} | MeshID = D012213}} <!--Ufasili na dalili --> '''Homa ya rumatizimu''' (kwa [[Kiingereza]]: ''rheumatic fever''; [[kifupi]] chake: '''ARF''' yaani ''homa kali ya rumatizimu'') ni [[ugonjwa]] wa [[inflamesheni|kuvimba]] unaoweza kuhusisha [[moyo]], [[jointi]], [[ngozi]], na [[ubongo]].<ref name=Lancet2012/> Ugonjwa huu hujijenga [[Juma|majuma]] mawili hadi manne baada ya [[maambukizi]] ya [[koo]].<ref name=Lee2012>{{cite journal|last1=Lee|first1=KY|last2=Rhim|first2=JW|last3=Kang|first3=JH|title=Kawasaki disease: laboratory findings and an imunopathogenesis on the premise of a "protein homeostasis system".|journal=Yonsei medical journal|date=March 2012|volume=53|issue=2|pages=262-75|pmid=22318812}}</ref> [[Ishara]] na [[dalili]] ni [[joto]] jingi, [[maumivu]] mengi ya jointi, [[kwarea|kwenenda kusikohiari kwa misuli]], na [[kipele|vipele]] visivyo vya kawaida visivyowasha vijulikanavyo kama [[erythema marginatum]].<!-- <ref name=Lancet2012/> --> Moyo huhusika katika takribani [[nusu]] ya visa.<!-- <ref name=Lancet2012/> --> Uharibifu wa kudumu wa [[vali]] za moyo, ujulikanao kama ''ugonjwa wa rumatizimu wa moyo'' (''RHD''), hutokea baada ya mashambulio mengi lakini huenda ukatokea mara kwa mara baada ya kisa kimoja cha ARF.<!-- <ref name=Lancet2012/> --> Vali zilizoharibiwa zinaweza kusababisha [[mshtuko wa moyo]].<!-- <ref name=Lancet2012/> --> Vali hizo zisizo za kawaida pia huongeza hatari ya [[mtu]] huyo kupata [[fibrilesheni ya atriamu]] na [[maambukizi ya vali za moyo]].<ref name=Lancet2012/> == Kisababishi == [[Homa]] kali ya rumatizimu inaweza kutokea kufuatia maambukizi ya koo kwa [[bakteria]] iitwayo ''[[Streptococcus pyogenes]]''.<ref name=Lancet2012/> Isipotibiwa ARF hutokea kwa hadi [[asilimia]] [[tatu]] ya watu.<ref>{{cite book|last1=Ashby|first1=Carol Turkington, Bonnie Lee|title=The encyclopedia of infectious diseases|date=2007|publisher=Facts On File|location=New York|isbn=9780816075072|page=292|edition=3rd ed.|url=https://books.google.ca/books?id=4Xlyaipv3dIC&pg=PA292}}</ref> Mwenendo halisi unaaminiwa kuwa utoaji wa [[antibodi]] dhidi ya [[tishu]] za mtu huyo.<!-- <ref name=Lancet2012/> --> Watu wengine kutokana na [[jenetikia]] yao wana uwezekano mkubwa wa kupata ugonjwa huo kuliko wengine wanapotangamana na bakteria hiyo.<!-- <ref name=Lancet2012/> --> Visababishi vingine vya hatari ni [[utapiamlo]] na [[umaskini]].<ref name=Lancet2012/> [[Utambuzi]] wa ARF hutegemea kuwepo kwa ishara na dalili pamoja na thibitisho la kuwepo kwa maambukizi ya [[streptokokasi]] hivi karibuni.<ref>{{cite web|title=Rheumatic Fever 1997 Case Definition|url=http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=823&DatePub=1/1/1997%2012:00:00%20AM|website=cdc.gov|accessdate=19 February 2015|date=3 February 2015|archivedate=2015-02-19|archiveurl=https://web.archive.org/web/20150219064133/http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=823&DatePub=1%2F1%2F1997%2012%3A00%3A00%20AM}}</ref> ==Kinga na tiba == Kutibu watu walio na maumivu ya koo kwa [[antibiotiki]], kama vile [[penicillin]], hupunguza hatari yao ya kupata homa kali ya rumatizimu.<ref>{{cite journal|last1=Spinks|first1=A|last2=Glasziou|first2=PP|last3=Del Mar|first3=CB|title=Antibiotics for sore throat.|journal=The Cochrane database of systematic reviews|date=5 November 2013|volume=11|pages=CD000023|pmid=24190439|doi=10.1002/14651858.CD000023.pub4}}</ref> Hii huhusisha kupima watu walio na koo zenye maumivu kwa maambukizi, kipimo ambacho huenda kisipatikane katika [[nchi zinazostawi]].<!-- <ref name=Lancet2012/> --> Mbinu zingine za uzuiaji ni [[usafi]] bora.<!-- <ref name=Lancet2012/> --> Kwa walio na ARF na RHD vipindi virefu vya antibiotiki vimependekezwa wakati mwingine.<!-- <ref name=Lancet2012/> --> Urejeleaji wa polepole wa shughuli za kawaida unaweza kufanyika kufuatia shambulio.<!-- <ref name=Lancet2012/> --> Baada ya RHD kujijenga, matibabu ni magumu zaidi.<!-- <ref name=Lancet2012/> --> Mara kwa mara [[upasuaji]] wa [[kubadilisha vali]] au kukarabati huhitajika.<!-- <ref name=Lancet2012/> --> Vinginevyo matatizo hutibiwa namna ya kawaida.<ref name=Lancet2012/> == Epidemiolojia == Homa kali ya rumatizimu hutokea kwa takribani [[watoto]] 325,000 kila mwaka na takribani watu [[milioni]] 18; sasa hivi wana ugonjwa wa rumatizimu wa moyo.<!-- <ref name=Lancet2012/> --> Wanaopata homa kali ya rumatizimu mara nyingi huwa na [[umri]] wa kati ya miaka 5 na 14,<ref name=Lancet2012/> huku asilimia 20 ya mashambulio ya mara ya kwanza ikitokea kwa [[watu wazima]].<ref name=Robbins>{{Rejea kitabu | last1 = Kumar | first1 = Vinay | last2 = Abbas | first2 = Abul K | last3 = Fausto | first3 = Nelson | last4 = Mitchell | first4 = Richard N | year = 2007 | title = Robbins Basic Pathology | edition = 8th | publisher = Saunders Elsevier | pages = 403–6 | isbn = 978-1-4160-2973-1}}</ref> Ugonjwa huu hupatikana sana katika [[nchi zinazostawi]] na katika [[wazawa]] wa [[nchi zilizostawi]].<ref name=Lancet2012>{{cite journal|last1=Marijon|first1=E|last2=Mirabel|first2=M|last3=Celermajer|first3=DS|last4=Jouven|first4=X|title=Rheumatic heart disease.|url=https://archive.org/details/sim_the-lancet_march-10-16-2012_379_9819/page/953|journal=Lancet|date=10 March 2012|volume=379|issue=9819|pages=953–64|pmid=22405798|doi=10.1016/S0140-6736(11)61171-9}}</ref> Katika mwaka wa [[2013]] ulisababisha [[Kifo|vifo]] 275,000, [[idadi]] iliyo chini kuliko vifo 374,000 katika mwaka wa [[1990]].<ref name=GDB2013>{{cite journal|last1=GBD 2013 Mortality and Causes of Death|first1=Collaborators|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=17 December 2014|pmid=25530442|doi=10.1016/S0140-6736(14)61682-2|volume=385|issue=9963|pages=117–171}}</ref> Vifo vingi hutokea katika nchi zinazostawi ambako takribani asilimia 12.5 ya watu walioambukizwa wanaweza kufariki kila mwaka.<ref name=Lancet2012/> Maelezo ya ugonjwa huu yanaaminiwa kuanza angalau katika [[karne ya 5]] katika [[maandishi]] ya [[Hippocrates]].<ref>{{cite journal|last1=Quinn|first1=RW|title=Did scarlet fever and rheumatic fever exist in Hippocrates' time?|journal=Reviews of infectious diseases|date=1991|volume=13|issue=6|pages=1243-4|pmid=1775859}}</ref> Ugonjwa huo ulipewa [[jina]] hilo kwa sababu dalili zake zinafanana na zile za baadhi ya [[magonjwa ya rumatizimu]].<ref>{{DorlandsDict |nine/000956569|rheumatic fever}}</ref> ==Marejeo== <references/> {{mbegu-tiba}} [[Jamii:Magonjwa ya bakteria]] [[Jamii:Tiba]] fyb2zjwx9brscgu2q67fv6v7fzt3czi 0 82525 1578227 1349520 2026-07-03T04:20:38Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578227 wikitext text/x-wiki [[Picha:Normal vaginal flora versus bacterial vaginosis on Pap stain.jpg|thumbnail|right|200px|bakteria bakteria]] {{Infobox disease | Name = Vaginosisi inayosababishwa na bakteria | Image = Vaginose-G15.jpg | Caption = Micrograph of bacterial vaginosis — [[squamous cell|cell]]s of the [[cervix]] covered with rod-shaped bacteria, ''[[Gardnerella vaginalis]]'' (arrows). | DiseasesDB = | ICD10 = {{ICD10|B|96||b|95}}, {{ICD10|N|76||n|70}} | ICD9 = {{ICD9|616.1}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D016585 }} <!-- Ufasili na dalili --> '''Vaginosisi inayosababishwa na bakteria''' ([[kifupisho]] cha [[Kiingereza]]: '''BV'''; pia inajulikana kama '''bakteriosisi ya uke''' au ''' Vaginitisi ya gadinerela''',<ref name=History1997>{{cite book|last1=Borchardt|first1=Kenneth A.|title=Sexually transmitted diseases : epidemiology, pathology, diagnosis, and treatment|date=1997|publisher=CRC Press|location=Boca Raton [u.a.]|isbn=9780849394768|pages=4|url=https://books.google.ca/books?id=k_9sjs-n0nIC&pg=PA4}}</ref> ni [[ugonjwa]] wa [[uke]] unaosababishwa na wingi wa [[bakteria]].<ref name=Don2014/> [[Dalili]] za kawaida ni pamoja na ongezeko la [[mchozo wa uke]] ambao mara nyingi hutoa [[harufu]] ya [[samaki]].<!-- <ref name=NIH2013S/> --> Mchozo huu huwa wa [[rangi]] [[nyeupe]] au ya [[kijivu]].<!-- <ref name=NIH2013S/> --> [[Disuria|Kuchomwa na mkojo]] ni hali inayoweza kutokea.<ref name=NIH2013S/> Kuwashwa huwa kwa nadra.<ref name=Don2014/><ref name=NIH2013S/> Mara kwa mara, hali hii huwa bila dalili.<ref name=NIH2013S>{{cite web|title=What are the symptoms of bacterial vaginosis?|url=http://www.nichd.nih.gov/health/topics/bacterialvag/conditioninfo/Pages/symptoms.aspx|website=http://www.nichd.nih.gov/|accessdate=3 March 2015|date=05/21/2013}}</ref> Uwepo wa BV huongeza hatari ya [[maambukizi]] ya [[maradhi ya zinaa]] ikiwa ni pamoja na [[VVU]]/[[UKIMWI]].<ref name=Ken2013>{{cite journal|last1=Kenyon|first1=C|last2=Colebunders|first2=R|last3=Crucitti|first3=T|title=The global epidemiology of bacterial vaginosis: a systematic review.|url=https://archive.org/details/sim_american-journal-of-obstetrics-and-gynecology_2013-12_209_6/page/505|journal=American journal of obstetrics and gynecology|date=December 2013|volume=209|issue=6|pages=505-23|pmid=23659989}}</ref> Hali hii pia huongeza hatari ya [[kujifungua kabla ya wakati]] miongoni mwa [[wanawake]] [[Ujauzito|wajawazito]].<ref>{{cite web|title=What are the treatments for bacterial vaginosis (BV)?|url=http://www.nichd.nih.gov/health/topics/bacterialvag/conditioninfo/Pages/treatments.aspx|website=http://www.nichd.nih.gov/|accessdate=4 March 2015|date=07/15/2013}}</ref> ==Kisababishi na utambuzi== BV husababishwa na ukosefu wa uwiano wa bakteria asilia ukeni.<ref name=NIH2013O/> Kuna mabadiliko katika aina ya bakteria inayotokea mara nyingi zaidi na ongezeko la mia hadi elfu moja ya idadi jumla ya bakteria zilizopo.<ref name=Don2014/> Vipengele vya hatari hujumuisha [[kupiga bomba]], wapenzi wapya au wengi, [[antibiotiki]], na kutumia [[kifaa cha kuingiza ndani ya uterasi]].<ref name=NIH2013O/> Hata hivyo, ugonjwa huu hauainishwi kama ugonjwa wa zinaa.<ref>{{cite web |url=http://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm |title=Bacterial Vaginosis – CDC Fact Sheet |author= |date=March 11, 2014 |publisher=[[Centers for Disease Control and Prevention]] |accessdate=2 Mar 2015}}</ref> Utambuzi hukisiwa kwa msingi wa dalili na unaweza kuthibitishwa kwa kupima mchozo wa uke na kutambua viwango vya juu kuliko kawaida vya [[pH]] ya ukeni na idadi kubwa ya bakteria.<ref name=Don2014/> Mara nyingi BV hudhaniwa kuwa [[maambukizi ya chachu ya ukeni]] au [[maambukizi ya Trikomonasi]].<ref>{{cite journal|last1=Mashburn|first1=J|title=Etiology, diagnosis, and management of vaginitis.|url=https://archive.org/details/sim_journal-of-midwifery-womens-health_november-december-2006_51_6/page/423|journal=Journal of midwifery & women's health|date=2006|volume=51|issue=6|pages=423-30|pmid=17081932}}</ref> == Kinga na tiba == Kwa kawaida, matibabu huwa ya antibiotiki, [[clindamycin]] au [[metronidazole]].<!-- <ref name=Don2014/> --> Dawa hizi pia zinaweza kutumika katika trimesta ya pili au ya tatu ya [[ujauzito]].<!-- <ref name=Don2014/> --> Hata hivyo, mara nyingi hali hii hurejea baada ya kutibiwa.<!-- <ref name=Don2014> --> [[Probiotiki]] zinaweza kusaidia kuzuia kurejea kwa hali hii.<ref name=Don2014>{{cite journal|last1=Donders|first1=GG|last2=Zodzika|first2=J|last3=Rezeberga|first3=D|title=Treatment of bacterial vaginosis: what we have and what we miss.|journal=Expert opinion on pharmacotherapy|date=April 2014|volume=15|issue=5|pages=645-57|pmid=24579850}}</ref> Haijulikani bayana kama kutumia probiotiki au antibiotiki huathiri matokeo ya ujauzito.<ref name=Don2014/><ref>{{cite journal|last1=Othman|first1=M|last2=Neilson|first2=JP|last3=Alfirevic|first3=Z|title=Probiotics for preventing preterm labour.|journal=The Cochrane database of systematic reviews|date=24 January 2007|issue=1|pages=CD005941|pmid=17253567}}</ref> == Epidemiolojia na historia == BV ni maambukizi ya uke yanayotokea mara nyingi katika wanawake wa umri wa kuzaa.<ref name=NIH2013O>{{cite web|title=Bacterial Vaginosis (BV): Condition Information|url=http://www.nichd.nih.gov/health/topics/bacterialvag/conditioninfo/Pages/default.aspx|website=http://www.nichd.nih.gov/|accessdate=3 March 2015|date=05/21/2013}}</ref> Idadi ya wanawake wanaoathiriwa katika muda fulani ni kati ya asilimia 5 na asilimia 70.<ref name=Ken2013/> BV hutokea mara nyingi zaidi katika maeneo mengi ya Afrika na ni nadra barani Asia na Ulaya.<ref name=Ken2013/> Nchini Marekani, takriban asilimia 30 ya wanawake wa umri wa kati ya miaka 14 na 49 huathiriwa.<ref name=CDC2010Stats>{{cite web|title=Bacterial Vaginosis (BV) Statistics Prevalence|url=http://www.cdc.gov/std/bv/stats.htm|website=cdc.gov|accessdate=3 March 2015|date=September 14, 2010}}</ref> Viwango hutofautiana sana katika [[makundi ya kikabila]] mbalimbali katika nchi.<ref name=Ken2013/> Ingawa BV kama dalili imeainishwa katika kipindi kirefu cha historia, nakala za kwanza bayana ziliwekwa katika mwaka wa 1894.<ref name=History1997/> ==Marejeo== <references /> ==Viungo vya nje== *[https://www.webmd.com/women/guide/what-is-bacterial-vaginosis Vaginosisi inayosababishwa na bakteria ni nini?] *[https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm Kuhusu Vaginosisi inayosababishwa na bakteria toka Center for Disease Control ya Marekani] *[https://www.ncbi.nlm.nih.gov/pubmed/16189947 Makala kuhusu utafiti wa tiba mbadala za Vaginosis inayosababishwa na bakteria] {{mbegu-tiba}} [[Jamii:Maradhi ya zinaa]] [[Jamii:Jinsia]] [[Jamii:Tiba]] [[Jamii:Bakteria]] gi7kjga9ncx9ppa9qkpdbo6d552bvk4 0 82529 1578197 1510544 2026-07-03T02:39:10Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578197 wikitext text/x-wiki {{Infobox disease |Name=Hepatitisi B |ICD10={{ICD10|B|16||b|15}},<br />{{ICD10|B|18|0|b|15}}-{{ICD10|B|18|1|b|15}} |ICD9={{ICD9|070.2}}-{{ICD9|070.3}} |Image=Hepatitis-B virions.jpg |Caption=[[Transmission electron microscopy|Electron micrograph]] of [[hepatitis B virus]] |DiseasesDB=5765 |MedlinePlus=000279 |eMedicineSubj=med |eMedicineTopic=992 |eMedicine_mult={{eMedicine2|ped|978}} |MeshID=D006509 |OMIM=610424 }} [[Picha:Hepatitis-B virions.jpg|thumbnail|right|200px|Virusi vya Hepatitisi B]] '''Hepatitisi B''' (pia: '''homa ya ini B''') ni [[ugonjwa wa kuambukiza]] unaosababishwa na [[virusi vya hepatitis B]] vinavyoathiri [[ini]], hivyo ni aina ya [[homa ya ini]]. Ni kimojawapo kati ya virusi vitano vinavyojulikana vya homa hiyo: [[hepatitisi A|A]], B, [[hepatitisi C|C]], [[hepatitisi D|D]], na [[hepatitisi E|E]]. [[Virusi]] hivyo vinaweza kusababisha [[maambukizi]] makali na ya muda mrefu. [[Watu]] wengi hawana [[dalili]] mwanzoni mwa maambukizi. Wengine huanza kuugua haraka kwa kutapika, kupata [[umanjano|ngozi ya manjano]], kuhisi [[uchovu]], kutoa [[mkojo]] mweusi na kupatwa na [[maumivu]] ya [[fumbatio]].<ref name=WHO2014/> Mara nyingi dalili hizi hudumu kwa [[Juma|majuma]] machache na ni nadra maambukizi ya kwanza yasababishe [[kifo]].<ref name=WHO2014/><ref>{{cite book|author1=Raphael Rubin; David S. Strayer|title=Rubin's Pathology : clinicopathologic foundations of medicine ; [includes access to online text, cases, images, and audio review questions!]|date=2008|publisher=Wolters Kluwer/Lippincott Williams &Wilkins|location=Philadelphia [u.a.]|isbn=9780781795166|page=638|edition=5. ed.|url=http://books.google.ca/books?id=kD9VZ267wDEC&pg=PA638}}</ref> Inaweza kuchukua siku 30 hadi 180 kabla ya dalili kutokea.<ref name=WHO2014/> Kwa wanaoambukizwa wakati wa kuzaliwa, [[asilimia]] 90 hupata ugonjwa wa muda mrefu {{nowrap|hepatitis B}} ilhali chini ya asilimia 10 ya wanaoambukizwa baada ya [[umri]] wa miaka mitano hupona.<ref name=CDC2014T/> Wengi wa walio na ugonjwa wa muda mrefu hawana dalili; hata hivyo, [[sirosisi]] na [[saratani ya ini]] vinaweza kutokea.<ref name="pmid17336170">{{cite journal | authors = Chang MH | title = Hepatitis B virus infection | journal = Semin Fetal Neonatal Med | volume = 12 | issue = 3 | pages = 160–167 | date = June 2007 | pmid = 17336170 | doi = 10.1016/j.siny.2007.01.013 }}</ref> Matatizo hayo husababisha vifo vya asilimia 15 hadi 25 ya walio na ugonjwa wa muda mrefu.<ref name=WHO2014/> ==Visababishi na utambuzi == Virusi hivyo huenezwa kwa kutangamana na [[damu]] au [[viowevu vya mwili]] vinavyoambukiza. Hivyo mwanzoni ulijulikana kama hepatitisi ya seramu.<ref name=Barker1996>{{cite journal | authors = Barker LF, Shulman NR, Murray R, Hirschman RJ, Ratner F, Diefenbach WC, Geller HM | title = Transmission of serum hepatitis. 1970 | url = https://archive.org/details/sim_jama_1996-09-11_276_10/page/n122 | journal = Journal of the American Medical Association | volume = 276 | issue = 10 | pages = 841–844 | year = 1996 | pmid = 8769597 | doi = 10.1001/jama.276.10.841 }}</ref> [[Maambukizi ya wakati wa kuzaliwa]] au kutokana na kutangamana na watu wengine [[Utoto|utotoni]] ndiyo njia kuu ya kuambukiza hepatitisi B katika maeneo ambapo ugonjwa huo hupatikana sana.<!-- <ref name=WHO2014/> --> Katika maeneo ambapo ugonjwa huu ni wa nadra utumiaji wa [[sindano]] za [[mishipa]] na [[ngono]] ndizo njia kuu za kuambukiza.<ref name=WHO2014/> Visababishi vingine vya hatari vinajumuisha: kufanya [[kazi]] katika [[kituo cha afya]], [[ubadilishaji wa damu]], [[dialisisi]], kuishi na mtu aliyeambukizwa, kusafiri katika nchi ambapo maambukizi ni mengi, na kuishi katika [[taasisi]].<ref name=WHO2014/><ref name=CDC2014T>{{cite web|title=Hepatitis B FAQs for the Public — Transmission|url=http://www.cdc.gov/hepatitis/B/bFAQ.htm#transmission|publisher=U.S. [[Centers for Disease Control and Prevention]] (CDC) |accessdate=2011-11-29}}</ref> Kupiga [[chale]] na [[tiba sindano]] vilisababisha visa vingi katika [[miaka ya 1980]]; hata hivyo, hii imepungua kwa kuongezeka kwa [[utasa]].<ref>{{cite book| author = Thomas HC | title = Viral Hepatitis | year = 2013 | publisher = Wiley | location = Hoboken | isbn = 9781118637302 | page = 83 | edition = 4th ed. | url = http://books.google.ca/books?id=7aQeAAAAQBAJ&pg=PA83 }}</ref> Virusi hivyo haviwezi kuenezwa kwa kushikana [[mikono]], kutumia vyombo sawa vya kula, [[busu|kubusu]], kukumbatia, kukohoa, kupiga [[chafya]], au kunyonyesha.<ref name=CDC2014T/> Maambukizi haya yanaweza kutambuliwa siku 30 hadi 60 baada ya mtangamano.<!-- <ref name=WHO2014/> --> Utambuzi hasa ni kwa [[kupima damu]] kwa sehemu za virusi na kwa [[antibodi]] dhidi ya virusi hivyo.<ref name=WHO2014/> ==Kinga na tiba == Maambukizi hayo yameweza kuzuiwa kwa [[Chanjo ya hepatitisi B|chanjo]] tangu mwaka [[1982]].<ref name="pmid17673066">{{cite journal | authors = Pungpapong S, Kim WR, Poterucha JJ | title = Natural History of Hepatitis B Virus Infection: an Update for Clinicians | url = https://archive.org/details/sim_mayo-clinic-proceedings_2007-08_82_8/page/967 | journal = Mayo Clinic Proceedings | volume = 82 | issue = 8 | pages = 967–975 | year = 2007 | pmid = 17673066 | doi = 10.4065/82.8.967 }}</ref><ref name=WHO2014/> Uchanjaji umependekezwa na [[Shirika la Afya Duniani]] katika siku ya kwanza ya [[maisha]] ikiwezekana.<!-- <ref name=WHO2014/> --> [[Dozi]] [[mbili]] au [[tatu]] zaidi zinahitajika baadaye kwa matokeo bora.<!-- <ref name=WHO2014/> --> Chanjo hii hufaulu kwa hadi takribani asilimia 95.<ref name=WHO2014/> Takribani nchi 180 zilitoa chanjo hiyo kama sehemu ya programu za kitaifa kufikia mwaka wa [[2006]].<ref name=Will2006>{{cite journal | authors = Williams R | title = Global challenges in liver disease | url = https://archive.org/details/sim_hepatology_2006-09_44_3/page/n28 | journal = Hepatology (Baltimore, Md.) | volume = 44 | issue = 3 | pages = 521–526 | year = 2006 | pmid = 16941687 | doi = 10.1002/hep.21347 }}</ref> Pia imependekezwa kuwa [[damu]] yote ichunguzwe hepatitisi B kabla ya kumwekea mtu na kuwa [[kondomu]] zitumiwe kupunguza maambukizi.<!-- <ref name=WHO2014/> --> [[Utafiti]] unalenga sasa kutengeneza [[vyakula]] vilivyo na [[dawa]] ya chanjo ya hepatitisi B (HBV).<ref>{{cite book|last1=Thomas|first1=Bruce|title=Production of Therapeutic Proteins in Plants|date=2002|isbn=9781601072542|page=4|url=http://books.google.ca/books?id=D-Nj4x9zXi4C&pg=PA4&dq|accessdate=25 November 2014}}</ref> Ugonjwa huu unaweza kuathiri [[hominoidea|sokwe wakuu]] wengine pia.<ref>{{cite book|last1=Plotkin|first1=[edited by] Stanley A.|last2=Orenstein,|first2=Walter A.|last3=Offit|first3=Paul A.|title=Vaccines|date=2013|publisher=Elsevier/Saunders|location=[Edinburgh]|isbn=9781455700905|page=208|edition=6th ed.|url=http://books.google.ca/books?id=hoigDQ6vdDQC&pg=PA208}}</ref> Katika maambukizi ya kwanza, utunzaji unalingana na dalili alizonazo mhusika.<!-- <ref name=WHO2014/> --> kwa wale wanaopata ugonjwa wa muda mrefu [[dawa zinazodhibiti virusi]] kama vile [[tenofovir]] au [[interferon]] zinaweza kusaidia, hata hivyo, dawa hizi ni ghali.<!-- <ref name=WHO2014/> --> [[Ubadilishaji wa ini]] hutumiwa wakati mwingine kwa sirosisi.<ref name=WHO2014/> == Uenezi == Takribani [[thuluthi]] moja ya watu [[duniani]] wameweza kuambukizwa wakati mmoja maishani mwao, wakiwemo [[milioni]] 240&nbsp; hadi milioni 350&nbsp; walio na maambukizi ya muda mrefu.<ref>{{cite journal | authors = Schilsky ML | title = Hepatitis B "360" | journal = Transplantation Proceedings | volume = 45 | issue = 3 | pages = 982–985 | year = 2013 | pmid = 23622604 | pmc = | doi = 10.1016/j.transproceed.2013.02.099 }}</ref><ref name=WHO2014/> Zaidi ya watu 750,000 hufariki kila mwaka kutokana na hepatitisi B.<ref name=WHO2014>{{cite web|title=Hepatitis B Fact sheet N°204|url=http://www.who.int/mediacentre/factsheets/fs204/en/|website=who.int|accessdate=4 November 2014|date=July 2014}}</ref> Ugonjwa huu sasa hupatikana sana katika [[Mashariki mwa Asia]] na [[Afrika]] [[Kusini kwa Sahara]] ambapo kati ya asilimia 5 na 10 ya [[watu wazima]] wana ugonjwa wa muda mrefu.<!-- <ref name=WHO2014/> --> Viwango kule [[Uropa]] na [[Amerika Kaskazini]] ni chini ya asilimia 1.<ref name=WHO2014/> ==Marejeo== <references/> {{mbegu-tiba}} [[Jamii:Maradhi ya kuambukiza]] [[Jamii:Maradhi ya zinaa]] [[Jamii:Ini]] [[Jamii:Tiba]] 03kpdxfjz4d60gqfzpowyghod9bt3u0 0 82530 1578182 1391390 2026-07-03T01:39:43Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578182 wikitext text/x-wiki [[Picha:Dental Caries Cavity 2.JPG|thumbnail|right|200px|Kuoza kwa meno]] {{Infobox disease | Name = Kuoza kwa meno | ICD10 = {{ICD10|K|02||k|00}} | ICD9 = {{ICD9|521.0}} | ICDO = | Image = Toothdecay.png | Caption = Destruction of a tooth by dental caries. This type of decay is also known as root decay. | Width = 150 | OMIM = | MedlinePlus = 001055 | eMedicineSubj = | eMedicineTopic = | DiseasesDB = 29357 }} <!-- Ufasili --> '''Kuoza kwa meno''' (''caries'' ni neno la Kilatini kutoka "rottenness"<ref name=Taber2013>{{cite book|title=Taber's cyclopedic medical dictionary|date=2013|publisher=F.A. Davis Co.|location=Philadelphia|isbn=9780803639096|page=401|edition=Ed. 22, illustrated in full color|url=https://books.google.ca/books?id=VdY-AAAAQBAJ&pg=PA401}}</ref>), pia hujulikana kama '''kuoza kwa jino''', '''kaviti''', au '''caries''', ni kuharibika kwa [[jino|meno]] kutokana na shughuli za [[bakteria]].<ref name=Silk2014>{{cite journal|last1=Silk|first1=H|title=Diseases of the mouth.|journal=Primary care|date=March 2014|volume=41|issue=1|pages=75-90|pmid=24439882}}</ref> Kaviti inaweza kuwa na aina tofauti za rangi kutoka kijani kibichi hadi nyeusi.<ref name=Lau2014>{{cite journal|last1=Laudenbach|first1=JM|last2=Simon|first2=Z|title=Common Dental and Periodontal Diseases: Evaluation and Management.|url=https://archive.org/details/sim_medical-clinics-of-north-america_2014-11_98_6/page/1239|journal=The Medical clinics of North America|date=November 2014|volume=98|issue=6|pages=1239-1260|pmid=25443675}}</ref> Dalili zinaweza kujumuisha maumivu na ugumu wa kula chakula.<ref name=WHO2012/><ref name=Lau2014/> Matatizo yanaweza kujumuisha [[ugonjwa wa meno|inflamesheni ya tishu zinazozunguka jino]], [[kupoteza jino]], na maambukizi au [[usaha kwa jino|usaha]] hutokea.<ref name=Taber2013/><ref name=Lau2014/> == Kisababishi == Bakteria huharibu tishu ngumu ya meno ([[Enameli ya jino|enameli]], [[dentini]] na [[sementamu]]) kwa kutengeneza [[asidi]] kutoka kwa mabaki ya chakula kwa sehemu ya jino.<ref name=Peads2014/> [[Sukari nyepesi]]katika chakula ni chanzo cha nguvu ya kimsingi ya bakteria na kwa hivyo lishe ya juu iliyo na sukari nyepesi ni swala la hatari.<ref name=Peads2014/> Ikiwa [[Urudishaji wa madini kwa meno|uharibifu wa madini]] ni mkubwa kuliko ujenzi kutoka kwa vyanzo kama vile [[mate]], matokeo ni kuoza kwa meno.<ref name=Peads2014>{{cite journal|last1=SECTION ON ORAL|first1=HEALTH|last2=SECTION ON ORAL|first2=HEALTH|title=Maintaining and improving the oral health of young children.|journal=Pediatrics|date=December 2014|volume=134|issue=6|pages=1224-9|pmid=25422016}}</ref> Maswala ya hatari inajumuisha hali zinazoleta matokeo ya mate kidogo kama vile: [[ugonjwa wa kisukari]], [[Sindromu ya sjogren]] na baadhi ya matibabu.<ref name=Peads2014/> Matibabu yanayopunguza utoaji wa mate yanajumuisha [[antihistamines]] na dawa za kupunguza makali na mengine.<ref name=Peads2014/> Kuoza kwa meno pia kunahusishwa na umasikini [[usafi duni wa mdomo|usafishaji wa mdomo]], na kurudi hali ya hapo awali [[ufizi wa meno]] inayoleta athari kwa mizizi ya meno.<ref>{{cite journal|last1=Schwendicke|first1=F|last2=Dörfer|first2=CE|last3=Schlattmann|first3=P|last4=Page|first4=LF|last5=Thomson|first5=WM|last6=Paris|first6=S|title=Socioeconomic Inequality and Caries: A Systematic Review and Meta-Analysis.|journal=Journal of dental research|date=January 2015|volume=94|issue=1|pages=10-18|pmid=25394849}}</ref><ref name=Silk2014/> == Uzuiaji na matibabu == Uzuiaji hujumuisha: usafishaji wa meno kila wakati, lishe iliyo na sukari ya chini na kiwango kidogo cha [[floridi]].<ref name=Peads2014/><ref name=WHO2012/> Kupiga meno mswaki mara mbili kwa siku na [[kusafisha]] katikati ya meno mara moja kwa siku unapendekezwa na wengi.<ref name=Silk2014/><ref>{{cite journal|last1=SECTION ON ORAL|first1=HEALTH|last2=SECTION ON ORAL|first2=HEALTH|title=Maintaining and improving the oral health of young children.|journal=Pediatrics|date=December 2014|volume=134|issue=6|pages=1224-9|pmid=25422016}}</ref> Floridi inaweza kutokana na [[ongezeko la florini kwenye maji|maji]], chumvi au dawa ya meno na vyanzo vinginevyo.<ref name=WHO2012/> Kutibu meno ya mama yaliyooza kunaweza kupunguza hatari kwa watoto wake kwa kupunguza idadi fulani ya bakteria.<ref name=Peads2014/> Uchunguzi unaweza kuleta utambuzi wa mapema.<ref name=Silk2014/> Kulingana na kiwango cha uharibifu, matibabu kadhaa yanaweza kutumika [[urejeshaji wa meno kwa hali yake|urejeshaji]] meno kwa hali yake ya kufanya kazi au [[utoaji wa meno|jino linaweza kutolewa]].<ref name=Silk2014/> Hakuna mbinu inayojulikana [[kurudisha (kibiolojia)|kurudia hali ya awali]] viwango vikubwa vya jino.<ref>{{cite journal|last1=Otsu|first1=K|last2=Kumakami-Sakano|first2=M|last3=Fujiwara|first3=N|last4=Kikuchi|first4=K|last5=Keller|first5=L|last6=Lesot|first6=H|last7=Harada|first7=H|title=Stem cell sources for tooth regeneration: current status and future prospects.|journal=Frontiers in physiology|date=2014|volume=5|pages=36|pmid=24550845}}</ref> Matibabu yaliyopo katika nchi zinazostawi ni duni kila mara.<ref name=WHO2012/> [[Paracetamol]] (acetaminophen) au [[ibuprofen]] inaweza kutumiwa kutuliza maumivu.<ref name=Silk2014/> ==Epidemiologia== Kote duniani, takribani watu bilioni 2.43 (asilimia 36 ya idadi ya watu) &nbsp;wana meno yaliyooza ya kudumu.<ref name=Lancet2012Epi>{{cite journal|last=Vos|first=T|title=Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.|url=https://archive.org/details/sim_the-lancet_december-15-2012-january-4-2013_380_9859/page/2163|journal=Lancet|date=Dec 15, 2012|volume=380|issue=9859|pages=2163–96|pmid=23245607|doi=10.1016/S0140-6736(12)61729-2}}</ref> Shirika la Afya Duniani linakadiria kuwa karibu watu wote wazima huwa na meno yaliyooza kwa wakati fulani.<ref name=WHO2012>{{cite web|title=Oral health Fact sheet N°318|url=http://www.who.int/mediacentre/factsheets/fs318/en/|website=who.int|accessdate=10 December 2014|date=April 2012}}</ref> Meno ya watoto wachanga huathiri karibu watu milioni 620&nbsp;au asilimia 9 ya idadi ya watu.<ref name=Lancet2012Epi/> Uozaji wa meno hutokea sana kwa watu wazima na watoto kwa miaka ya hivi karibuni.<ref>{{cite journal|last1=Bagramian|first1=RA|last2=Garcia-Godoy|first2=F|last3=Volpe|first3=AR|title=The global increase in dental caries. A pending public health crisis.|journal=American journal of dentistry|date=February 2009|volume=22|issue=1|pages=3-8|pmid=19281105}}</ref> Ugonjwa huu unapatikana sana katika nchi zinazostawi na kiasi kwa nchi zilizostawi kwa sababu ya matumizi ya sukari kiasi.<ref name=Silk2014/> == Marejeo == {{marejeo}} [[Jamii:Magonjwa]] [[Jamii:Meno]] [[Jamii:Tiba]] pen6kxv86z3jb9eo18oycr2elcoyr05 0 82531 1578212 1376315 2026-07-03T03:22:39Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578212 wikitext text/x-wiki {{tafsiri kompyuta}} {{infobox disease | Name = Sklerosisi ya kimiotrofia ya pembezoni | Image = ALS Coronal.jpg | Caption = Dalili za ALS zinaonekana katika picha hii. | DiseasesDB = 29148 | ICD10 = {{ICD10|G|12|2|g|10}} | ICD9 = {{ICD9|335.20}} | ICDO = | OMIM = 105400 | MedlinePlus = 000688 | eMedicineSubj = neuro | eMedicineTopic = 14 | eMedicine_mult = {{eMedicine2|emerg|24}} {{eMedicine2|pmr|10}} | MeshID = D000690 }} <!--Ufasili na dalili --> '''Sklerosisi ya kimiotrofia ya pembezoni''' (kwa [[Kiingereza]] ''amyotrophic lateral sclerosis'', kifupi '''ALS'''), ambayo pia hujulikana kama '''Ugonjwa wa Lou Gehrig''' na '''ugonjwa wa Charcot''', ni hali inayohusisha kuharibika kwa [[nyuroni]].<ref name=Kel2013>{{cite book|last1=Kelly|first1=Evelyn B.|title=Encyclopedia of human genetics and disease|date=2013|publisher=Greenwood|location=Santa Barbara, Calif.|isbn=9780313387135|pages=79–80|url=https://books.google.ca/books?id=gqMYt17klVIC&pg=PA79}}</ref> [[Bara|Barani]] [[Ulaya]] [[jina]] '''ugonjwa wa nyuroni mota''' ('''MND''') hutumika sana,<ref>{{cite web|title=Motor neurone disease|url=http://www.nhs.uk/conditions/Motor-neurone-disease/Pages/Introduction.aspx|website=http://www.nhs.uk/|accessdate=2 January 2015|archive-date=2014-12-29|archive-url=https://web.archive.org/web/20141229064258/http://www.nhs.uk/conditions/Motor-neurone-disease/Pages/Introduction.aspx|url-status=dead}}</ref> ilhali wengine hutumia jina hilo kwa kundi la hali ambapo ALS inapatikana sana.<ref>{{cite book|last1=Ellison|first1=edited by Seth Love, David N. Louis, David W.|title=Greenfield's neuropathology|date=2008|publisher=Hodder Arnold|location=London|isbn=9780340906811|page=947|edition=8th ed.|url=http://books.google.ca/books?id=nrEWkAc7W7IC&pg=PA947}}</ref> ALS hubainishwa kwa [[hali ya mikazo|misuli migumu]], [[mishtuko ya misuli|kushtuka kwa misuli]] na [[udhaifu]] unaokithiri kutokana na [[atrofi ya musuli|kupungua kwa ukubwa wa misuli]].<!-- <ref name=NINDS2014/> --> Hii hupelekea ugumu katika [[disathria|kuongea]], [[disfajia|kumeza]] na hatimaye [[disnia|kupumua]].<ref name=NINDS2014>{{cite web|url=http://www.ninds.nih.gov/disorders/motor_neuron_diseases/detail_motor_neuron_diseases.htm|title=Motor Neuron Diseases Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS)|publisher=www.ninds.nih.gov|accessdate=7 November 2010|archiveurl=https://web.archive.org/web/20140413093035/http://www.ninds.nih.gov/disorders/motor_neuron_diseases/detail_motor_neuron_diseases.htm|archivedate=2014-04-13|=https://web.archive.org/web/20140413093035/http://www.ninds.nih.gov/disorders/motor_neuron_diseases/detail_motor_neuron_diseases.htm}}</ref> ==Visababishi na mienendo== Kisababishi hakijulikani kwa [[asilimia]] 90 hadi 95 za visa.<ref name=NINDS2014/> Takribani asilimia 5-10 za visa ni vya [[Urithi|Kurithiwa]] kutoka kwa [[wazazi]].<ref name="Lancet2011">{{cite journal|last1=Kiernan|first1=MC|last2=Vucic|first2=S|last3=Cheah|first3=BC|last4=Turner|first4=MR|last5=Eisen|first5=A|last6=Hardiman|first6=O|last7=Burrell|first7=JR|last8=Zoing|first8=MC|title=Amyotrophic lateral sclerosis.|url=https://archive.org/details/sim_the-lancet_march-12-18-2011_377_9769/page/942|journal=Lancet|date=12 March 2011|volume=377|issue=9769|pages=942–55|pmid=21296405|doi=10.1016/s0140-6736(10)61156-7}}</ref> Karibu [[nusu]] ya visa hivi vya [[jenetikia]] hutokana na [[moja]] ya [[jeni]] [[mbili]] maalum.<!-- <ref name=NINDS2014/> --> Husababisha kufa kwa nuroni zinazodhibiti [[misuli ya hiari]].<!-- <ref name=NINDS2014/> --> Utambuzi hutegemea [[ishara]] na [[dalili]] za [[mtu]] kwa [[uchunguzi]] ili kuondoa visababishi vingine vinavyoweza kukisiwa.<ref name=NINDS2015>{{cite web|title=Amyotrophic Lateral Sclerosis (ALS) Fact Sheet|url=http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_ALS.htm|website=http://www.ninds.nih.gov/|accessdate=2 January 2015|date=September 19, 2014|archiveurl=https://web.archive.org/web/20150104182638/http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_ALS.htm|archivedate=2015-01-04}}</ref> == Matibabu, prognosis na epidemiolojia == Hakuna [[tiba]] ya ALS.<ref name=NINDS2014/> [[Dawa]] iitwayo [[riluzole]] inaweza kurefusha [[maisha]] kwa takribani miezi miwili hadi mitatu.<ref>{{cite journal|last1=Miller|first1=RG|last2=Mitchell|first2=JD|last3=Moore|first3=DH|title=Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND).|journal=The Cochrane database of systematic reviews|date=14 March 2012|volume=3|pages=CD001447|pmid=22419278|doi=10.1002/14651858.CD001447.pub3}}</ref> [[Uingizaji hewa usio vamizi]] unaweza kupelekea maisha bora na marefu.<ref name=BMJ2008>{{cite journal|last1=McDermott|first1=CJ|last2=Shaw|first2=PJ|title=Diagnosis and management of motor neurone disease.|journal=BMJ (Clinical research ed.)|date=22 March 2008|volume=336|issue=7645|pages=658–62|pmid=18356234|doi=10.1136/bmj.39493.511759.be}}</ref> Ugonjwa huu huanza katika [[umri]] wa miaka 60 na katika visa vya kurithiwa katika umri wa miaka 50.<ref name="Lancet2011"/> Muda wa [[wastani]] wa kuishi kutoka mwanzo hadi kufariki ni miaka mitatu hadi minne.<ref>{{cite book|last1=Malamut|first1=edited by Joseph I. Sirven, Barbara L.|title=Clinical neurology of the older adult|date=2008|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781769471|page=421|edition=2nd ed.|url=http://books.google.ca/books?id=c1tL8C9ryMQC&pg=PA421}}</ref> Takribani asilimia 10 huishi zaidi ya miaka 10.<ref name=NINDS2014/> Wengi hufariki kutokana na matatizo ya kupumua.<!-- <ref name="Lancet2011"> --> Katika sehemu nyingi za [[dunia]], viwango vya ALS havijulikani.<ref name="Lancet2011"/> Barani Uropa na [[Amerika]], ugonjwa huu huathiri takribani watu 2 kati ya 100,000 kila mwaka.<ref name="Lancet2011"/><ref>{{cite web|title=Epidemiology of Sporadic ALS|url=http://aces.stanford.edu/acesmem2/EpiDescSporadic.html|website=http://aces.stanford.edu/|accessdate=2 January 2015|archiveurl=https://web.archive.org/web/20151008192814/http://aces.stanford.edu/acesmem2/EpiDescSporadic.html|archivedate=2015-10-08}}</ref> == Historia == Maelezo ya ugonjwa huu yalianza angalau mwaka wa [[1824]] na [[Charles Bell]].<ref name="Rowland2001"/> Katika mwaka wa [[1869]], uhusiano kati ya dalili na matatizo halisi ya kinurolojia ulielezwa kwa mara ya kwanza na [[Jean-Martin Charcot]], alitumia jina sklerosisi ya kimiotrofia ya pembezoni tangu mwaka wa [[1874]]. Ilijulikana vizuri Marekani ilipomuathiri [[mchezaji]] maarufu wa [[besiboli]] [[Lou Gehrig]],<ref name=Kel2013/> na katika [[karne ya 20]] [[Stephen Hawking]] alipopata umaarufu wa ufanisi wa [[Sayansi|kisayansi]].<ref>{{cite book|last1=Youngson|first1=David B. Jacoby, Robert M.|title=Encyclopedia of family health|date=2004|publisher=Marshall Cavendish|location=Tarrytown, NY|isbn=9780761474869|page=1256|edition=3rd ed.|url=https://books.google.ca/books?id=VUA8DQCONgUC&pg=PA1256}}</ref> Katika mwaka wa [[2014]] [[video]] za [[ice bucket challenge]] zilienea kwenye [[mtandao]] na kuongeza ufahamu wa [[umma]].<ref>{{cite journal|last1=Song|first1=P|title=The Ice Bucket Challenge: The public sector should get ready to promptly promote the sustained development of a system of medical care for and research into rare diseases.|journal=Intractable & rare diseases research|date=August 2014|volume=3|issue=3|pages=94–6|pmid=25364651|doi=10.5582/irdr.2014.01015}}</ref> ==Tazama pia== *[[Sklerosisi ya sehemu nyingi]] ==Marejeo== <references /> [[Jamii:Magonjwa]] [[Jamii:Tiba]] cdfuzc6ab11qf0kajawyrzrwxjviwb7 0 82771 1578151 1520134 2026-07-02T22:16:30Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578151 wikitext text/x-wiki [[Picha:Zacuelu2.jpg|thumbnail|300px|[[Hekalu]] - [[piramidi]] ya Kimaya.]] [[Picha:Madrid Codex 9.jpg|thumbnail|300px|[[Ukurasa]] kutoka [[kitabu]] cha [[Kimaya]] kwa mwandiko ya [[hiroglifi]].]] '''Maya''' ni jina la [[ustaarabu]] uliostawi kusini mwa [[Meksiko]] ya leo ([[rasi]] ya [[Yucatan]]) pamoja na [[Gwatemala]], [[Belize]] na sehemu za [[Honduras]] na [[El Salvador]] kuanzia mwaka [[2000 KK|2000]] hivi [[KK]] hadi waliposhindwa na [[Wahispania]] kutoka [[Ulaya]] ([[karne ya 16]] na [[Karne ya 17|ya 17]] [[BK]]). ==Historia== Watu wa kwanza waliofika huko kutoka kaskazini walikuwa [[Waindio]], wajukuu wa wahamiaji walioingia [[Amerika]] kutoka [[Asia ya Kaskazini]]. Hakuna uhakika kufika huko kulitokea lini: labda miaka 10,000 iliyopita<ref>[https://books.google.com/books?id=Qxp-GWiDPioC&pg=PA386#v=onepage&q&f=false Michael S. Werner (January 2001). Concise Encyclopedia of Mexico. Taylor & Francis. pp. 386–. ISBN 978-1-57958-337-8]</ref>. Hao Waindio walikuwa [[wakulima]] hodari sana na [[mazao]] mbalimbali ambayo leo ni msingi wa [[chakula]] kote [[duniani]] yalianzishwa na kupandishwa nao, yakiwa pamoja na [[mahindi]], [[mboga]] na [[nyanya]]. [[Kilimo]] cha mahindi hukadiriwa kilianzishwa takriban mnamo mwaka [[9000 KK]]<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC122905/ A single domestication for maize shown by multilocus microsatellite genotyping, Proc Natl Acad Sci U S A. 2002 Apr 30; 99(9): 6080–6084. doi: 10.1073/pnas.052125199]</ref><ref>{{Rejea tovuti |url=http://learn.genetics.utah.edu/content/selection/corn |title="The Evolution of Corn". University of Utah HEALTH SCIENCES. Retrieved 2 January 2016 |accessdate=2016-04-01 |archive-date=2016-04-01 |archive-url=https://web.archive.org/web/20160401040226/http://learn.genetics.utah.edu/content/selection/corn/ |url-status=dead }}</ref>. Kilimo kiliweka msingi kwa [[Kijiji|vijiji]] na [[jamii]] zilizoshirikiana katika maeneo makubwa. [[Miji]] ya kwanza inajulikana kuanzia takriban mwaka [[1500 KK]]. Wamaya waliishi katika vijiji na miji iliyojitegemea na kugombana kati yao mara kwa mara. Wamaya walibuni mwandiko wa [[hiroglifi]] wenye [[alama]] nyingi kupita maandishi mengine katika [[Amerika ya Kale]] na kutunga [[vitabu]]. Waliendeleza pia [[hisabati]], wakijua [[namba]] "[[sifuri]]" na kuboresha mfumo wa kalenda. Walikuwa hodari sana katika [[astronomia]] yaani [[elimu]] ya [[nyota]]. Walipamba miji yao kwa [[Jengo|majengo]] makubwa na mazuri na kuwa [[wafanyabiashara]] hodari. Sanaa yao ilijua [[uchongaji]] wa mawe na pia [[uchoraji]]. Jamii ya Wamaya ilifikia kiwango cha juu kuanzia mwaka [[500 KK]] wakati miji mikubwa ya kwanza ilipotokea. Mnamo mwaka [[800]] [[BK]] jamii za Wamaya katika Yucatan ziliporomoka; [[wataalamu]] wengi huamini ya kwamba mabadiliko ya [[ekolojia]] na [[halihewa]] pamoja na kuchoka kwa [[rutuba]] ya [[ardhi]] yalisababisha kutoka kwa watu katika makazi ya awali. Lakini ustaarabu huu uliona tena kipindi cha kustawi katika maeneo mengine hadi kuja kwa [[Wahispania]]. Miji mbalimbali ya Wamaya iliendelea kujitetea dhidi ya wavamizi na [[Nojpeten]], mji wa mwisho wa kujitegemea ulitekwa mwaka [[1696]] tu. ==Tanbihi== {{reflist}} ==Marejeo== {{Refbegin|indent=yes}} <!--BEGIN biblio format. 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Pool |year=2012 |publisher=Oxford University Press |location=New York, US |isbn=978-0-19-539093-3 |oclc=761538187 }} :{{cite web |author=Christenson, Allen J. |title=Popul Vuh: Sacred Book of the Quiché Maya People |url=http://www.mesoweb.com/publications/Christenson/PopolVuh.pdf |origyear=2003 |year=2007 |format=PDF |work=Mesoweb articles |publisher=Mesoweb: An Exploration of Mesoamerican Cultures |accessdate=2010-01-23 |archiveurl=https://web.archive.org/web/20141024062131/http://www.mesoweb.com/publications/Christenson/PopolVuh.pdf |archivedate=2014-10-24 }} :{{cite book |author=Christie, Jessica Joyce |year=2003 |title=Maya Palaces and Elite Residences: An interdisciplinary approach |url=https://archive.org/details/mayapalaceselite00chri |chapter=Conclusions |pages=[https://archive.org/details/mayapalaceselite00chri/page/315 315]–336 |editor=Jessica Joyce Christie |isbn=0-292-71244-8 |publisher=University of Texas Press |location=Austin, Texas, US |oclc=55889753 |series=Linda Schele series in Maya and pre-Columbian studies }} :{{cite journal |author1=Cioffi-Revilla, Claudio |author2=Todd Landman |title=Evolution of Maya Polities in the Ancient Mesoamerican System |journal=International Studies Quarterly |volume=43 |issue=4 |date=December 1999 |pages=559–598 |publisher=Wiley on behalf of The International Studies Association |url=http://www.jstor.org/stable/3014022 |jstor=3014022 |issn=1468-2478 |oclc=52067195 |doi=10.1111/0020-8833.00137 |subscription=y }} :{{cite book |author=Coe, Michael D. |authorlink=Michael D. Coe |origyear=1992 |year=1994 |title=Breaking the Maya Code |url=https://archive.org/details/breakingmayacode0000coem_n9r7 |location=London |publisher=Thames & Hudson |isbn=0-14-023481-0 |oclc=31288285 }} :{{cite book |author=Coe, Michael D. |year=1999 |title=The Maya |url=https://archive.org/details/maya0000coem_h0k7 |edition=Sixth |publisher=Thames & Hudson |location=New York |isbn=0-500-28066-5 |oclc=40771862 }} :{{cite book |author1=Colas, Pierre R. |author2=Alexander Voß |origyear=2006 |year=2011 |chapter=Un juego de vida o muerte: El juego de pelota maya |trans_title=A Game of Life or Death: The Maya Ballgame |language=es |pages=186–191 |publisher=Tandem Verlag |location=Potsdam, Germany |isbn=978-3-8331-6293-0 |type=hardback |title=Los Mayas: Una Civilización Milenaria |editor=Nikolai Grube |oclc=828120761}} :{{cite journal |author1=Colunga-García Marín, Patricia |author2=Daniel Zizumbo-Villarreal |title=Domestication of Plants in Maya Lowlands |journal=Economic Botany |volume=58, Supplement |date=Winter 2004 |pages=S101-S110 |publisher=Springer on behalf of New York Botanical Garden Press |url=http://www.jstor.org/stable/4256911 |jstor=4256911 |doi=10.1663/0013-0001(2004)58[s101:dopiml]2.0.co;2 |subscription=y }} :{{cite book |author=D'Arcy Harrison, Peter |year=2003 |title=Maya Palaces and Elite Residences: An interdisciplinary approach |url=https://archive.org/details/mayapalaceselite00chri |chapter=Palaces of the Royal Court at Tikal |pages=[https://archive.org/details/mayapalaceselite00chri/page/98 98]–119 |editor=Jessica Joyce Christie |isbn=0-292-71244-8 |publisher=University of Texas Press |location=Austin, Texas, US |oclc=55889753 |series=Linda Schele series in Maya and pre-Columbian studies }} :{{cite journal |author1=Dahlin, Bruce H. |author2=Christopher T. Jensen |author3=Richard E. Terry |author4=David R. Wright |author5=Timothy Beach |title=In Search of an Ancient Maya Market |journal=Latin American Antiquity |volume=18 |issue=4 |date=December 2007 |pages=363–384 |publisher=Society for American Archaeology |url=http://www.jstor.org/stable/25478193 |jstor=25478193 |issn=2325-5080 |location=Washington, DC, US |doi=10.2307/25478193 |subscription=y }} :{{cite web |author=del Águila Flores, Patricia |title=Zaculeu: Ciudad Postclásica en las Tierras Altas Mayas de Guatemala |year=2007 |trans_title=Zaculeu: Postclassic City in the Maya Highlands of Guatemala |location=Guatemala City, Guatemala |url=http://www.mcd.gob.gt/wp-content/uploads/2009/03/zaculeu-ciudad-postclasica-en-las-tierras-altas-mayas-de-guatemala.pdf |format=PDF |accessdate=2011-08-06 |publisher=Ministerio de Cultura y Deportes |oclc=277021068 |archiveurl=https://web.archive.org/web/20110721084703/http://www.mcd.gob.gt/wp-content/uploads/2009/03/zaculeu-ciudad-postclasica-en-las-tierras-altas-mayas-de-guatemala.pdf |archivedate=2011-07-21 |language=es }} :{{cite book |author=Demarest, Arthur |authorlink=Arthur Demarest |year=2004 |title=Ancient Maya: The Rise and Fall of a Forest Civilization |url=https://archive.org/details/ancientmayarisef0000dema |publisher=Cambridge University Press |location=Cambridge, UK |isbn=978-0-521-53390-4 |oclc=51438896 }} :{{cite journal |author1=Demarest, Arthur A. |author2=Tomás Barrientos |author3=Federico Fahsen |year=2006 |title=El apogeo y el Colapso del reinado de Cancuen: Resultados e interpretaciones del Proyecto Cancuen, 2004–2005 |trans_title=The Apogee and Collapse of the Kingdom of Cancuen: Results and Interpretations of the Cancuen Project, 2004–2005 |volume=XIX (2005) |journal=Simposio de Investigaciones Arqueológicas en Guatemala |editors=J.P. 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Mejía |pages=826–837 |publisher=Museo Nacional de Arqueología y Etnología |location=Guatemala City, Guatemala |language=es |url=http://www.asociaciontikal.com/pdf/75_-_Demarest.05_-_Digital.pdf |oclc=71050804 |access-date=2016-04-01 |archive-date=2015-09-23 |archive-url=https://web.archive.org/web/20150923190559/http://www.asociaciontikal.com/pdf/75_-_Demarest.05_-_Digital.pdf |dead-url=yes }} :{{cite book |author=Diehl, Richard A. |year=2004 |title=The Olmecs: America's First Civilization |url=https://archive.org/details/olmecsamericasfi0000dieh |series=Ancient peoples and places series |publisher=Thames & Hudson |location=London, UK |isbn=0-500-02119-8 |oclc=56746987 }} :{{cite journal |author=Doyle, James A. |title=Regroup on "E-Groups": Monumentality and Early Centers in the Middle Preclassic Maya Lowlands |journal=Latin American Antiquity |volume=23 |issue=4 |date=December 2012 |pages=355–379 |publisher=Society for American Archaeology |url=http://www.jstor.org/stable/23645603 |jstor=23645603 |issn=2325-5080 |oclc=54395676 |location=Washington, DC, US |doi=10.7183/1045-6635.23.4.355 |subscription=y }} :{{Rejea kitabu|author=Drew, David |year=1999 |title=The Lost Chronicles of the Maya Kings |url=https://archive.org/details/lostchroniclesof0000drew_m2s5 |publisher=Phoenix Press |location=London, UK |isbn=0-7538-0989-3 |oclc=59565970}} :{{cite journal |author=Ellsworth Hamann, Byron |date=March 2008 |title=How Maya Hieroglyphs Got Their Name: Egypt, Mexico, and China in Western Grammatology since the Fifteenth Century |journal=Proceedings of the American Philosophical Society |volume=152 |issue=1 |url=http://www.academia.edu/501178/How_Maya_Hieroglyphs_Got_Their_Name_Egypt_Mexico_and_China_in_Western_Grammatology_since_the_Sixteenth_Century |publisher=American Philosophical Society |location=Philadelphia, Pennsylvania, US |issn=0003-049X |oclc=1480557 }} :{{cite book |editor=Kate Fitz Gibbon |author=Emmerich, André |chapter=Improving the Odds: Preservation through Distribution |title=Who Owns the Past?: Cultural Policy, Cultural Property, and the Law |year=2005 |publisher=Rutgers University Press |isbn=978-0813536873 |oclc=57893247 |url=https://books.google.com/books?id=PigTNxl30ZgC&pg=PA251 |location=New Brunswick, New Jersey, US and London, UK }} :{{cite book |author=Estrada-Belli, Francisco |year=2011 |title=The First Maya Civilization: Ritual and Power Before the Classic Period |publisher=Routledge |location=Abingdon, UK and New York, US |isbn=978-0-415-42994-8 |oclc=614990197}} :{{cite journal |author=Fisher, Chelsea |title=The role of infield agriculture in Maya cities |journal=Journal of Anthropological Archaeology |volume=36 |date=December 2014 |pages=196–210 |issn=0278-4165 |url=http://www.sciencedirect.com/science/article/pii/S0278416514000749 |doi=10.1016/j.jaa.2014.10.001 }} {{Subscription or libraries|sentence|via=[[ScienceDirect]]}} :{{cite book |author=Foias, Antonia E. |year=2014 |origyear=2013 |title=Ancient Maya Political Dynamics |isbn=978-0-8130-6089-7 |publisher=University Press of Florida |location=Gainesville, Florida, US |oclc=878111565}} :{{cite journal |author=Forsyth, Donald W. |year=1993 |title=La arquitectura Preclásica en Nakbe: Un estudio comparativo de dos periodos. |trans_title=The Preclassic Architecture of Nakbe: A Comparative Study of Two Periods |volume=VI (1992) |journal=Simposio de Investigaciones Arqueológicas en Guatemala |editor=J. P. Laporte, H. Escobedo and S. Villagrán de Brady |pages=113–121 |publisher=Museo Nacional de Arqueología y Etnología |location=Guatemala City, Guatemala |url=http://www.asociaciontikal.com/pdf/08.92%20-%20Forsyth.pdf |format=PDF |accessdate=2010-07-21 |language=es |oclc=30671693 |archive-date=2011-09-04 |archive-url=https://web.archive.org/web/20110904131853/http://www.asociaciontikal.com/pdf/08.92%20-%20Forsyth.pdf |dead-url=yes }} :{{cite book |author=Foster, Lynn |title=Handbook to Life in the Ancient Maya World |year=2002 |publisher=Oxford University Press |location=New York, US |isbn=978-0-19-518363-4 |oclc=57319740}} :{{cite book|author=Fox, John W. |origyear=1987|year=2008 |title=Maya Postclassic state formation |publisher=Cambridge University Press |location=Cambridge, UK and New York, US |isbn=978-0-521-10195-0 |oclc=297146853}} :{{cite book |author=Freidel, David A. |authorlink=David Freidel |author2=[[Linda Schele]] |author3=Joy Parker |year=1993 |title=Maya Cosmos: Three Thousand Years on the Shaman's Path |url=https://archive.org/details/mayacosmosthreet0000frei |publisher=William Morrow & Co. |location=New York |isbn=0-688-10081-3 |oclc=27430287 }} :{{cite book |author=Fuente, Beatriz de la |author2=Leticia Staines Cicero and Alfonso Arellano Hernández |year=1999 |chapter=Art: Sentries of Eternity |editor=A. Arellano Hernández|title=The Mayas of the Classic Period |location=Mexico City, Mexico |publisher=Consejo Nacional para la Cultura y las Artes ([[National Council for Culture and the Arts|CONACULTA]]) |pages=141–226 |isbn=970-18-3005-9 |oclc=42213077|display-editors=etal}} :{{cite book |author=Gillespie, Susan D. |year=1991 |chapter=Ballgames and Boundaries |editor=Vernon Scarborough and David R. Wilcox (eds.) |title=The Mesoamerican Ballgame |location=Tucson, Arizona, US |publisher=University of Arizona Press |pages=317–345 |isbn=0-8165-1360-0 |oclc=51873028}} :{{cite book |author=Gillespie, Susan D. |date=September 2000 |title=Rethinking Ancient Maya Social Organization: Replacing "Lineage" with "House" |journal=American Anthropologist |volume=102 |issue=3 |pages=467–484 |publisher=Wiley on behalf of the American Anthropological Association |url=http://www.jstor.org/stable/683405 |jstor=683405 |issn=0002-7294 |oclc=1479294 |subscription=y }} :{{cite book |author=Guillemín, Jorge F. |year=1965 |title=Iximché: Capital del Antiguo Reino Cakchiquel |publisher=Tipografía Nacional de Guatemala |location=Guatemala City, Guatemala |oclc=1498320|language=es |trans_title=Iximche: Capital of the Ancient Kaqchikel Kingdom}} :{{cite journal |author1=Hammond, Norman |author2=Duncan Pring |author3=Rainer Berger |author4=V. R. Switsur |author5=A. P. Ward |url=http://www.nature.com/nature/journal/v260/n5552/abs/260579a0.html |title=Radiocarbon chronology for early Maya occupation at Cuello, Belize |journal=Nature |issue=260 |doi=10.1038/260579a0 |date=1976-04-15 |issn=0028-0836 |accessdate=2010-08-01 |volume=260 |pages=579–581 |bibcode=1976Natur.260..579H }} : {{cite journal |author=Hansen, Richard D. |authorlink=Richard D. Hansen |year=1991 |title=Resultados preliminares de las investigaciones arqueológicas en el sitio Nakbe, Petén, Guatemala |trans_title=Preliminary Results of the Archaeological Investigations of Nakbe, Peten, Guatemala |url=http://www.asociaciontikal.com/pdf/23.88%20-%20Richard%20Hansen%20-%20en%20PDF.pdf |format=PDF |volume=II (1988) |journal=Simposio de Investigaciones Arqueológicas en Guatemala |editor=J.P. Laporte, S. Villagrán, H. Escobedo, D. de González and J. Valdés |pages=163–178 |publisher=Museo Nacional de Arqueología y Etnología |location=Guatemala City, Guatemala |accessdate=2010-07-21 |language=es |oclc=27267772 |archive-date=2011-07-07 |archive-url=https://web.archive.org/web/20110707182102/http://www.asociaciontikal.com/pdf/23.88%20-%20Richard%20Hansen%20-%20en%20PDF.pdf |dead-url=yes }} : :{{cite book |author=Hohmann-Vogrin |origyear=2006 |year=2011 |chapter=Unidad de espacio y tiempo: la arquitectura Maya |language=es |pages=194–215 |trans_title=Unity of Space and Time: Maya Architecture |publisher=Tandem Verlag |location=Potsdam, Germany |isbn=978-3-8331-6293-0 |type=hardback |title=Los Mayas: Una Civilización Milenaria |editor=Nikolai Grube |oclc=828120761}} :{{cite journal |author1=Houston, Stephen |author2=John Robertson |author3=David Stuart |title=The Language of Classic Maya Inscriptions |journal=Current Anthropology |volume=41 |issue=3 |date=June 2000 |pages=321–356 |publisher=University of Chicago Press on behalf of Wenner-Gren Foundation for Anthropological Research |doi=10.1086/300142 |url=http://www.jstor.org/stable/10.1086/300142 |jstor=10.1086/300142 |issn=0011-3204 |location=Chicago, Illinois, US |pmid=10768879 |subscription=y }} :{{cite journal |author=Hutson, Scott R. |date=December 2011 |title=The Art of Becoming: The Graffiti of Tikal, Guatemala |journal=Latin American Antiquity |volume=22 |issue=4 |pages=403–426 |publisher=Society for American Archaeology |url=http://www.jstor.org/stable/23072567 |jstor=23072567 |issn=2325-5080 |location=Washington, DC, US |doi=10.7183/1045-6635.22.4.403 |subscription=y }} :{{cite book |author=Jackson, Sarah E. |title=Politics of the Maya Court: Hierarchy and Change in the Late Classic Period |url=https://archive.org/details/politicsofmayaco0000jack |year=2013 |publisher=University of Oklahoma Press |location=Norman, Oklahoma, US |isbn=978-0-8061-4341-5 |oclc=813300656}} :{{cite book |author1=Johnson, Scott A. J. |title=Translating Maya Hieroglyphs |url=https://books.google.co.uk/books?id=AHdzXz7le3gC |isbn=978-0-8061-4333-0 |oclc=814707434 |year=2013 |publisher=University of Oklahoma Press |location=Norman, Oklahoma, US }} :{{cite book |author=Jones, Grant D. |year=1998 |title=The Conquest of the Last Maya Kingdom |url=https://books.google.co.uk/books?id=PeOWl54Mt7UC&pg=RA2-PT82#v=onepage&q&f=false |publisher=Stanford University Press |location=Stanford, California, US |isbn=978-0-8047-3522-3 }} :{{cite book |author=Justeson, John |year=2010 |title=The Archaeology of Measurement: Comprehending Heaven, Earth and Time in Ancient Societies |chapter=Numerical cognition and the development of 'zero' in Mesoamerica |url=https://books.google.co.uk/books?hl=en&lr=&id=TzrNgAsJY1MC&oi=fnd&pg=PA43 |pages=43–53 |publisher=Cambridge University Press |location=New York, US |isbn=978-0-521-11990-0 |oclc=501396677 }} :{{cite web |author1=Kettunen, Harri |author2=Helmke, Christopher |year=2008 |title=Introduction to Maya Hieroglyphs: Workshop handbook |url=http://www.mesoweb.com/resources/handbook/WH2008.pdf |format=PDF |work=Mesoweb articles |publisher=[[Mesoweb]]: An Exploration of Mesoamerican Cultures |accessdate=2015-03-08 |archiveurl=https://web.archive.org/web/20140808134017/http://www.mesoweb.com/resources/handbook/WH2008.pdf |archivedate=2014-08-08 }} :{{cite web |author=Kimbell Art Museum |year=2015 |title=Presentation of Captives to a Maya Ruler |publisher=Kimbell Art Museum |url=https://www.kimbellart.org/collection/search/view/675?text=maya&page=1 |location=Fort Worth, Texas, US |accessdate=2015-03-07 |archiveurl=https://web.archive.org/web/20150307004136/https://www.kimbellart.org/collection/search/view/675?text=maya&page=1 |archivedate=2015-03-07 }} :{{cite book |author=Koch, Peter O. |title=John Lloyd Stephens and Frederick Catherwood: Pioneers of Mayan Archaeology |publisher=McFarland |year=2013 |isbn=9780786471072 |oclc=824359844 |location=Jefferson, North Carolina, US}} :{{cite book |author1=Kristan-Graham, Cynthia |author2=Jeff Karl Kowalski |year=2007 |chapter=Chichén Itzá, Tula, and Tollan: Changing Perspectives on a Recurring Problem in Mesoamerican Archaeology and Art History |pages=13–84 |title=Twin Tollans: Chichén Itzá, Tula, and the Epiclassic to Early Postclassic Mesoamerican World |publisher=Trustees for Harvard University |location=Washington, DC, US |isbn=978-0-88402-323-4 |oclc=71243931 |url=https://books.google.co.uk/books?hl=en&lr=&id=GZVUd9I0gpAC }} :{{cite journal |author=Laporte, Juan Pedro |authorlink=Juan Pedro Laporte |author2=Vilma Fialko |date=1994 |title=Mundo Perdido, Tikal: Los enunciados actuales |trans_title=Mundo Perdido, Tikal: Current questions |volume=VII (1993) |journal=Simposio de Investigaciones Arqueológicas en Guatemala |editor=J.P. Laporte |editor2=H. Escobedo |pages=335–348 |publisher=Museo Nacional de Arqueología y Etnología |language=es |location=Guatemala City, Guatemala |accessdate=2012-02-26 |url=http://www.asociaciontikal.com/pdf/31.93%20-%20Laporte%20y%20Fialko.pdf |oclc=33865804 |archive-date=2011-09-15 |archive-url=https://web.archive.org/web/20110915002143/http://www.asociaciontikal.com/pdf/31.93%20-%20Laporte%20y%20Fialko.pdf |dead-url=yes }} :{{cite journal|author=Looper, Matthew G. |year=1999 |title=New Perspectives on the Late Classic Political History of Quirigua, Guatemala |url=https://archive.org/details/ancient-mesoamerica_fall-1999_10_2/page/263 |journal=Ancient Mesoamerica |location=Cambridge and New York|publisher=Cambridge University Press |volume=10 |issue=2 |pages=263–280 |issn=0956-5361 |oclc=86542758|doi=10.1017/S0956536199101135}} :{{cite book |author=Looper, Matthew G. |year=2003 |title=Lightning Warrior: Maya Art and Kingship at Quirigua |url=https://archive.org/details/lightningwarrior0000loop |series=Linda Schele series in Maya and pre-Columbian studies |location=Austin, Texas, US |publisher=University of Texas Press |isbn=0-292-70556-5 |oclc=52208614 }} :{{Rejea jarida |author=Love, Michael |date=December 2007 |title=Recent Research in the Southern Highlands and Pacific Coast of Mesoamerica |journal=Journal of Archaeological Research |volume=15 |issue=4 |pages=275–328 |publisher=Springer Netherlands |issn=1573-7756 |doi=10.1007/s10814-007-9014-y |url=http://link.springer.com/article/10.1007%2Fs10814-007-9014-y |accessdate=2006-02-01 }} :{{cite book |author=Lovell, W. George |year=2000 |chapter=The Highland Maya |editor=Richard E.W. Adams and Murdo J. Macleod (eds.) |title=The Cambridge History of the Native Peoples of the Americas, {{nowrap|Vol. II}}: Mesoamerica, {{nowrap|part 2}} |location=Cambridge, UK |publisher=Cambridge University Press |pages=392–444|isbn=0-521-65204-9 |oclc=33359444}} :{{cite book |author=Lovell, W. George |year=2005 |title=Conquest and Survival in Colonial Guatemala: A Historical Geography of the Cuchumatán Highlands, 1500–1821 |publisher=McGill-Queen's University Press |location=Montreal, Canada |edition=3rd |isbn=0-7735-2741-9 |oclc=58051691 |url=https://books.google.co.uk/books?id=05wSqQiu52MC }} :{{cite book |author1=Macri, Martha J. |author2=Matthew George Looper |year=2003 |title=The New Catalog of Maya Hieroglyphs |volume=1: The Classic period inscriptions |publisher=University of Oklahoma Press |location=Norman, Oklahoma, US |series=The civilization of the American Indian series |isbn=9780806134970 |oclc=773482216 |url=https://books.google.co.uk/books?id=tNO424luPRYC }} :{{cite book |author=Marcus, Joyce |year=2004a |title=Ancient Maya Commoners |location=Austin, Texas, US |publisher=University of Texas Press |chapterurl=http://muse.jhu.edu/books/9780292797239/9780292797239-13.pdf |url=http://muse.jhu.edu/books/9780292797239 |isbn=9780292705715 |oclc=60745417 |subscription=yes |via=[[Project MUSE]] |pages=255–284 |chapter=Maya Commoners: The Stereotype and the Reality |editor1=Jon C. Lohse |editor2=Fred Valdez, Jr. }} :{{cite book |author=Marcus, Joyce |year=2004 |chapter=The Maya and Teotihuacan |title=The Maya and Teotihuacan : reinterpreting early classic interaction |url=https://archive.org/details/mayateotihuacanr0000unse |pages=[https://archive.org/details/mayateotihuacanr0000unse/page/n358 337]–356 |editor=Geoffrey E. Braswell |origyear=2003 |publisher=University of Texas Press |location=Austin, Texas |isbn=9780292705876 |oclc=254181446}} :{{cite book |author=Martin, Simon |authorlink=Simon Martin (Mayanist) |author2=Nikolai Grube |year=2000 |title=Chronicle of the Maya Kings and Queens: Deciphering the Dynasties of the Ancient Maya |url=https://archive.org/details/chronicleofmayak00mart |location=London and New York |publisher=Thames & Hudson |isbn=0-500-05103-8 |oclc=47358325 }} :{{cite book |author1=Masson, Marilyn A. |author2=Carlos Peraza Lope |chapter=Commoners in Postclassic Maya society: Social versus economic class constructs |title=Ancient Maya Commoners |url=https://archive.org/details/ancientmayacommo0000unse |publisher=University of Texas Press |location=Austin, Texas, US |year=2004 |pages=[https://archive.org/details/ancientmayacommo0000unse/page/197 197]–223 |isbn=0-292-70571-9 |oclc=803179517 |editors=Jon C. Lohse and Fred Valdez, Jr. }} :{{cite journal |author=Masson, Marilyn A. |date=2012-11-06 |title=Maya collapse cycles |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=109 |issue=45 |pages=18237–18238 |publisher=National Academy of Sciences |url=http://www.jstor.org/stable/41829886 |jstor=41829886 |issn=1091-6490 |location=Washington, DC, US |doi=10.1073/pnas.1213638109 |subscription=y |bibcode=2012PNAS..10918237M }} :{{cite book |author=Matthew, Laura E. |year=2012 |title=Memories of Conquest: Becoming Mexicano in Colonial Guatemala |publisher=University of North Carolina Press |location=Chapel Hill, North Carolina, US |isbn=978-0-8078-3537-1 |oclc=752286995 |series=First Peoples |url=https://books.google.co.uk/books?id=RVAFbknbo_EC&printsec=frontcover#v=onepage&q&f=false |format=hardback }} :{{cite journal |title=The "Mayanized" Mexicans |author=McVicker, Donald |journal=American Antiquity |volume=50 |issue=1 |date=January 1985 |pages=82–101 |publisher=Society for American Archaeology |doi=10.2307/280635 |url=http://www.jstor.org/stable/280635 |jstor=280635 |issn=2325-5080 |location=Washington, D.C., US |subscription=y }} :{{cite book |author=Milbrath, Susan |year=1999 |title=Star Gods of the Maya: Astronomy in Art, Folklore, and Calendars |location=Austin, Texas, US |publisher=University of Texas Press |chapterurl=https://muse.jhu.edu/books/9780292797932/9780292797932-11.pdf |url=https://muse.jhu.edu/books/9780292797932 |isbn=0292752253 |oclc=40848420 |subscription=yes |via=[[Project MUSE]] |pages=249–293 |chapter=Stars, the Milky Way, Comets, and Meteors }} :{{cite book |author=Miles, Susanna W. |chapter=An Analysis of the Modern Middle American Calendars: A Study in Conservation |title=Acculturation in the Americas |editor=Sol Tax |location=Chicago, Illinois, US |publisher=University of Chicago Press |series=Proceedings and selected papers of the International Congress of Americanists |year=1952 |oclc=180504894 |pages=273–284}} :{{cite book |author=Miller, Mary |authorlink=Mary Miller |year=1999 |title=Maya Art and Architecture |url=https://archive.org/details/mayaartarchitect00mill |location=London, UK and New York, US |publisher=Thames & Hudson |isbn=0-500-20327-X |oclc=41659173 }} :{{cite book |author=Miller, Mary |author2=Karl Taube |year=1993 |title=The Gods and Symbols of Ancient Mexico and the Maya |url=https://archive.org/details/godssymbolsofa00mill |publisher=Thames and Hudson |location=London |isbn=0-500-05068-6 |oclc=901448866 }} :{{cite book |author1=Oakley, Francis |author2=Rubin, Benjamin B. |title=Science and the World's Religions: Origins and Destinies |volume=1 |chapter=Sacral Kingship and the Origins of Religious, Social, and Political Orders |chapterurl=https://books.google.co.uk/books?hl=en&lr=&id=3MK5u1_7CLYC&oi=fnd&pg=PA69 |pages=69–90 |oclc=768417915 |isbn=978-0-313-38732-6 |year=2012 |publisher=Praeger/ABC-CLIO |location=Santa Barbara, California, US |editor1=Patrick McNamara |editor2=Wesley J. Wildman }} :{{cite book |author=Olmedo Vera, Bertina |year=1997 |chapter=The Mayas of the Classic Period |editor=A. Arellano Hernández|title=The Mayas of the Classic Period |location=Mexico City, Mexico |publisher=Consejo Nacional para la Cultura y las Artes (CONACULTA) |pages=9–99 |isbn=970-18-3005-9 |oclc=42213077|display-editors=etal}} :{{cite book |author=Phillips, Charles |title=The Complete Illustrated History of the Aztecs & Maya: The definitive chronicle of the ancient peoples of Central America & Mexico&nbsp;– including the Aztec, Maya, Olmec, Mixtec, Toltec & Zapotec |origyear=2006 |year=2007 |publisher=Anness Publishing Ltd |location=London, UK |isbn=1-84681-197-X |oclc=642211652}} :{{cite journal |author=Popenoe de Hatch, Marion |author2=Christa Schieber de Lavarreda |year=2001 |title=Una revisión preliminar de la historia de Tak'alik Ab'aj, departamento de Retalhuleu |trans_title=A Preliminary Revision of the History of Takalik Abaj, Retalhuleu Department |volume=XIV (2000) |journal=Simposio de Investigaciones Arqueológicas en Guatemala |editor=J.P. Laporte, A.C. Suasnávar and B. Arroyo |pages=990–1005 |publisher=Museo Nacional de Arqueología y Etnología |location=Guatemala City, Guatemala |url=http://www.asociaciontikal.com/pdf/77.00.pdf |format=PDF |accessdate=2009-02-01 |language=es |oclc=49563126 |archive-date=2009-12-11 |archive-url=https://web.archive.org/web/20091211140452/http://www.asociaciontikal.com/pdf/77.00.pdf |dead-url=yes }} :{{cite journal |author1=Pugh, Timothy W. |author2=Leslie G. Cecil |year=2012 |title=The contact period of central Petén, Guatemala in color |journal=Social and Cultural Analysis, Department of |volume=Paper 6 |series=Faculty Publications |url=http://scholarworks.sfasu.edu/sca/6/ |publisher=Stephen F. Austin State University |location=Nacogdoches, Texas, US }} :{{cite book |author=Quezada, Sergio |year=2011 |title=La colonización de los mayas peninsulares |trans_title=The Colonisation of the Peninsula Maya |format=PDF |url=http://www.bibliotecabasica.yucatan.gob.mx/archivos_modulos/biblioteca/pdf_201106170236.pdf |isbn=978-607-7824-27-5 |oclc=796677890 |accessdate=2013-01-20 |series=Biblioteca Básica de Yucatán |location=Merida, Yucatan, Mexico |publisher=Secretaría de Educación del Gobierno del Estado de Yucatán |volume=18 |language=es |archiveurl=https://web.archive.org/web/20131104200933/http://www.bibliotecabasica.yucatan.gob.mx/archivos_modulos/biblioteca/pdf_201106170236.pdf |archivedate=2013-11-04 }}{{Rejea tovuti |url=http://www.bibliotecabasica.yucatan.gob.mx/archivos_modulos/biblioteca/pdf_201106170236.pdf |title=Nakala iliyohifadhiwa |accessdate=2016-04-01 |archive-date=2013-11-04 |archive-url=https://web.archive.org/web/20131104200933/http://www.bibliotecabasica.yucatan.gob.mx/archivos_modulos/biblioteca/pdf_201106170236.pdf |url-status=dead }} :{{cite book |author=Recinos, Adrian |authorlink=Adrián Recinos |origyear=1952 |year=1986 |title=Pedro de Alvarado: Conquistador de México y Guatemala |trans_title=Pedro de Alvarado: Conqueror of Mexico and Guatemala |edition=2nd |location=Antigua Guatemala, Guatemala |publisher=CENALTEX Centro Nacional de Libros de Texto y Material Didáctico "José de Pineda Ibarra" |oclc=243309954|language=es}} :{{cite journal |author=Reents-Budet, Dorie |author2=Antonia E. Foias |author3=Ronald L. Bishop |author4=M. James Blackman |author5=Stanley Guenter |year=2007 |title=Interacciones políticas y el Sitio Ik' (Motul de San José): Datos de la cerámica |trans_title=Political Interactions and the Ik' Site (Motul de San Jose): Ceramic Data |url=http://www.asociaciontikal.com/pdf/87_-_Reents_et_al.pdf |format=PDF |volume=XX (2006) |work=Simposio de Investigaciones Arqueológicas en Guatemala |editor=J.P. Laporte, B. Arroyo and H. Mejía |pages=1416–1436 |publisher=Museo Nacional de Arqueología y Etnología, Guatemala |accessdate=2009-11-14 |language=es |oclc=173275417 |journal= |archive-date=2011-09-14 |archive-url=https://web.archive.org/web/20110914133722/http://www.asociaciontikal.com/pdf/87_-_Reents_et_al.pdf |dead-url=yes }}{{Rejea tovuti |url=http://www.asociaciontikal.com/pdf/87_-_Reents_et_al.pdf |title=Nakala iliyohifadhiwa |accessdate=2016-04-01 |archive-date=2011-09-14 |archive-url=https://web.archive.org/web/20110914133722/http://www.asociaciontikal.com/pdf/87_-_Reents_et_al.pdf |url-status=dead }} :{{cite book |author=Restall, Matthew |authorlink=Matthew Restall |author2=Florine Asselbergs |year=2007 |title=Invading Guatemala: Spanish, Nahua, and Maya Accounts of the Conquest Wars |url=https://archive.org/details/invadingguatemal0000unse |publisher=Pennsylvania State University Press |location=University Park, Pennsylvania, US |isbn=978-0-271-02758-6 |oclc=165478850}} :{{cite book |author=Rice, Prudence M. |author2=Don S. Rice |year=2009 |chapter=Introduction to the Kowoj and their Petén Neighbors |editor=Prudence M. Rice and Don S. Rice (eds.) |title=The Kowoj: identity, migration, and geopolitics in late postclassic Petén, Guatemala |url=https://archive.org/details/kowojidentitymig00rice |location=Boulder, Colorado, US |publisher=University Press of Colorado |pages=[https://archive.org/details/kowojidentitymig00rice/page/n25 3]–15 |isbn=978-0-87081-930-8 |oclc=225875268 }} :{{cite book |author=Rice, Prudence M. |author2=Don S. Rice |author3=Timothy W. Pugh |author4=Rómulo Sánchez Polo |year=2009 |chapter=Defensive Architecture and the Context of Warfare at Zacpetén |editor=Prudence M. Rice and Don S. Rice (eds.) |title=The Kowoj: identity, migration, and geopolitics in late postclassic Petén, Guatemala |url=https://archive.org/details/kowojidentitymig00rice |location=Boulder, Colorado, US |publisher=University Press of Colorado |pages=[https://archive.org/details/kowojidentitymig00rice/page/n145 123]–140 |isbn=978-0-87081-930-8 |oclc=225875268 }} :{{cite web |author=Ros, Narin |title=Maya Museum Database |url=http://www.famsi.org/research/museum_database.html |publisher=Foundation for the Advancement of Mesoamerican Studies |accessdate=2015-06-08 |archiveurl=https://web.archive.org/web/20140708162851/http://www.famsi.org/research/museum_database.html |archivedate=2014-07-08 }} [https://web.archive.org/web/20150608160339/http://research.famsi.org/museum_list.php?name=&city=&state=&country=&focus=&x=13&y=19 Full list from FAMSI]archived from [http://research.famsi.org/museum_list.php?name=&city=&state=&country=&focus=&x=13&y=19 the original] on 2015-06-08. :{{cite book |author=Rosenwig, Robert M. |year=2010 |title=The Beginnings of Mesoamerican Civilization: Inter-Regional Interaction and the Olmec |publisher=Cambridge University Press |location=New York, US |url=https://books.google.co.uk/books?id=hMMaL4L_vMsC |isbn=978-0-521-11102-7 |oclc=402542556 }} :{{cite journal |author=Ross, Nanci J. |title=Modern tree species composition reflects ancient Maya "forest gardens" in northwest Belize |journal=Ecological Applications |volume=21 |issue=1 |date=January 2011 |pages=75–84 |publisher=Ecological Society of America |url=http://www.jstor.org/stable/29779638 |jstor=29779638 |issn=1051-0761 |location=Washington, DC, US |doi=10.1890/09-0662.1 |subscription=y }} :{{cite journal |author=Salisbury, David |author2=Mimi Koumenalis |author3=Barbara Moffett |date=19 September 2002 |title=Newly revealed hieroglyphs tell story of superpower conflict in the Maya world |url=http://exploration.vanderbilt.edu/print/pdfs/news/news_dospilas_feature.pdf |journal=Exploration: the online research journal of Vanderbilt University |publisher=Vanderbilt University Office of Science and Research Communications |location=Nashville, Tennessee |oclc=50324967 |accessdate=2015-05-20 |archiveurl=https://web.archive.org/web/20141102134600/http://exploration.vanderbilt.edu/print/pdfs/news/news_dospilas_feature.pdf |archivedate=2015-05-20 }} :{{cite journal |author1=Saturno, William A. |author2=David Stuart |author3=Boris Beltrán |title=Early Maya Writing at San Bartolo, Guatemala |journal=Science |series=New Series |volume=311 |issue=5765 |date=2006-03-03 |pages=1281–1283 |publisher=American Association for the Advancement of Science |url=http://www.jstor.org/stable/3845835 |jstor=3845835 |issn=1095-9203 |oclc=863047799 |doi=10.1126/science.1121745 |pmid=16400112 |subscription=y |bibcode=2006Sci...311.1281S }} :{{cite book |author=Schele, Linda |authorlink=Linda Schele |author2=Peter Mathews |year=1999 |title=The Code of Kings: The language of seven Maya temples and tombs |url=https://archive.org/details/codeofkingslangu00lind |publisher=Simon & Schuster |location=New York, US |isbn=978-0-684-85209-6 |oclc=41423034 }} :{{cite web |author=SFU Museum of Archaeology and Ethnology |title=Featured Artifacts: Mayan Eccentric Flints |url=http://www.sfu.museum/hola/en/artifacts/featured/17/ |publisher=Simon Fraser University Museum of Archaeology and Ethnology |location=Burnaby, British Columbia, Canada |accessdate=2015-03-31 |archiveurl=https://web.archive.org/web/20141102160800/http://www.sfu.museum/hola/en/artifacts/featured/17/ |archivedate=2014-11-02 }} :{{cite book |author=Sharer, Robert J. |authorlink=Robert Sharer |year=2000 |chapter=The Maya Highlands and the Adjacent Pacific Coast |editor=Richard E.W. Adams and Murdo J. Macleod (eds.) |title=The Cambridge History of the Native Peoples of the Americas, {{nowrap|Vol. II}}: Mesoamerica, {{nowrap|part 1}} |location=Cambridge, UK |publisher=Cambridge University Press |pages=449–499|isbn=0-521-35165-0 |oclc=33359444}} :{{cite book |author=Sharer, Robert J. |author2=Loa P. Traxler |year=2006 |title=The Ancient Maya |url=https://archive.org/details/ancientmaya0006shar |edition=6th, fully revised |location=Stanford, California, US |publisher=Stanford University Press |isbn=0-8047-4817-9 |oclc=57577446 }} :{{cite book |author=Stuart, David |author2=George Stuart |year=2008 |title=Palenque: Eternal City of the Maya |url=https://archive.org/details/palenqueeternalc0000stua |location=London, UK |publisher=Thames & Hudson |isbn=978-0-500-05156-6 |oclc=227016561 }} :{{cite web |author=Szymanski, Jan |year=2013 |title=Between Death and Divinity. Rethinking the Significance of Triadic Groups in Ancient Maya Culture |url=https://depotuw.ceon.pl//bitstream/handle/item/358/Between%20Death%20and%20Divinity.pdf?sequence=1 |format=PDF |work=PhD Dissertation |publisher=University of Warsaw |location=Warsaw, Poland |accessdate=2014-01-13 |archiveurl=https://web.archive.org/web/20141103025416/https://depotuw.ceon.pl//bitstream/handle/item/358/Between%20Death%20and%20Divinity.pdf?sequence=1 |archivedate=2014-11-03 }} :{{cite book |author=Taladoire, Eric |author2=Benoit Colsenet |year=1991 |chapter="Bois Ton Sang, Beaumanoir": The Political and Conflictual Aspects of the Ballgame in the Northern Chiapas Area |editor=Vernon Scarborough and David R. Wilcox (eds.) |others=|title=The Mesoamerican Ballgame|location=Tucson, Arizona, US|publisher=University of Arizona Press|pages=161–174|isbn=0-8165-1360-0 |oclc=51873028}} :{{cite book |author=Tanaka, Yuki |year=2008 |title=A Comparative Study of Maya Hieroglyphic Writing and Japanese Orthography in the Quirigua Hieroglyphic Corpus |isbn=9780549999898 |publisher=ProQuest |location=Ann Arbor, Michigan, US}} :{{cite book |author=Taube, Karl A. |year=2004 |chapter=Tetitla and the Maya Presence at Teotihuacan |title=The Maya and Teotihuacan : reinterpreting early classic interaction |url=https://archive.org/details/mayateotihuacanr0000unse |pages=[https://archive.org/details/mayateotihuacanr0000unse/page/n294 273]–314 |editor=Geoffrey E. Braswell |origyear=2003 |publisher=University of Texas Press |location=Austin, Texas, US |isbn=9780292705876 |oclc=254181446}} :{{cite book |author=Tedlock, Barbara |year=1992 |title=Time and the Highland Maya |edition=Revised |origyear=1982 |publisher=University of New Mexico Press |isbn=978-0-8263-1358-4 |location=Albuquerque, New Mexico, US |oclc=45732799 |url=https://books.google.co.uk/books?id=UZnlFVVYe9sC }} :{{cite journal |author=Thompson, J. Eric S. |authorlink=J. Eric S. Thompson |title=A Maya Calendar from the Alta Vera Paz, Guatemala |journal=American Anthropologist |series=New Series |volume=34 |issue=3 |date=July–September 1932 |pages=449–454 |publisher=Wiley on behalf of the American Anthropological Association |url=http://www.jstor.org/stable/661903 |jstor=661903 |issn=0002-7294 |oclc=1479294 |doi=10.1525/aa.1932.34.3.02a00090 |subscription=y }} :{{cite journal |author=Thompson, J. Eric S. |year=1966 |title=The Maya Central Area at the Spanish Conquest and Later: A Problem in Demography |journal=Proceedings of the Royal Anthropological Institute of Great Britain and Ireland |issue=1966 |pages=23–37 |publisher=Royal Anthropological Institute of Great Britain and Ireland |location=London, UK |url=http://www.jstor.org/stable/3031712 |jstor=3031712 |accessdate=2013-12-04 |doi=10.2307/3031712 |subscription=y }} :{{cite book |author=Thompson, J. Eric S. |title=Maya History and Religion |origyear=1970 |year=1990 |publisher=University of Oklahoma Press |location=Norman, Oklahoma |isbn=0-8061-2247-1 |oclc=715926981}} :{{cite journal |author=Thompson, J. Eric S. |title=Maya Astronomy |journal=Philosophical Transactions of the Royal Society of London |series=Series A, Mathematical and Physical Sciences |volume=276 |issue=1257, The Place of Astronomy in the Ancient World |date=2 May 1974 |pages=83–98 |publisher=The Royal Society |url=http://www.jstor.org/stable/74276 |jstor=74276 |issn=0261-0523 |location=London, UK |doi=10.1098/rsta.1974.0011 |subscription=y |bibcode=1974RSPTA.276...83T }} :{{cite journal |author=Tiesler, Vera |author2=Andrea Cucina |date=December 2006 |title=Procedures in Human Heart Extraction and Ritual Meaning: A Taphonomic Assessment of Anthropogenic Marks in Classic Maya Skeletons |journal=Latin American Antiquity |volume=17 |issue=4 |pages=493–510 |publisher=Society for American Archaeology |issn=2325-5080 |jstor=25063069 |url=http://www.jstor.org/stable/25063069 |location=Washington, D.C., US |doi=10.2307/25063069 |subscription=y }} :{{cite web |author=Tobin, Thomas J. |title=The Construction of the Codex in Classic- and Postclassic-Period Maya Civilization |url=http://www.mathcs.duq.edu/~tobin/maya/ |date=2001 |publisher=Duquesne University |location=Pittsburgh, Pennsylvania, US |accessdate=2015-03-09 |archiveurl=https://web.archive.org/web/20021017172935/http://www.mathcs.duq.edu/~tobin/maya/ |archivedate=2002-10-17 }} :{{cite journal |author=Valdés, Juan Antonio |year=1994 |title=El Grupo A de Uaxactun: Manifestaciones arquitectónicas y dinásticas durante el Clásico Temprano. |trans_title=Uaxactun Group A: Architectural Manifestations and Dynasties during the Early Classic |journal=I Simposio de Investigaciones Arqueológicas en Guatemala, 1987 (edited by J.P. Laporte, H. Escobedo and S. Villagrán) |pages=98–111 |publisher=Museo Nacional de Arqueología y Etnología |location=Guatemala |url=http://www.asociaciontikal.com/pdf/16.87%20-%20Juan%20Antonio%20Valdes%20-%20en%20PDF.pdf |archiveurl=https://web.archive.org/web/20141103025416/https://depotuw.ceon.pl//bitstream/handle/item/358/Between%20Death%20and%20Divinity.pdf?sequence=1 |archivedate=2014-11-03 |format=PDF |accessdate=2010-07-21 |language=es |oclc=31177419 }} :{{cite journal|author=Van Stone, Mark|journal=Proceedings of the International Astronomical Union|title=It’s not the End of the World: emic evidence for local diversity in the Maya Long Count|year=2011|issue=278|doi=10.1017/S1743921311012610}} :{{cite book |author=Viqueira, Juan Pedro |year=2004 |origyear=1995 |chapter=Chiapas y sus regiones |trans_chapter=Chiapas and its Regions |editors=Juan Pedro Viqueira and Mario Humberto Ruz (eds.) |title=Chiapas: los rumbos de otra historia |trans_title=Chiapas: The courses of a different history |location=Mexico City, Mexico |publisher=Centro de Investigaciones Filológicas with Centro de Investigaciones y Estudios Superiores en Antropología Social (CIESAS) |url=https://books.google.co.uk/books?id=RhAI3Js9zWcC&pg=PA19 |pages=19–40 |isbn=968-36-4836-3 |oclc=36759921 |language=es }} :{{cite web |author=WAYEB |publisher=European Association of Mayanists (WAYEB) |title=Museums & Collections |url=http://www.wayeb.org/resourceslinks/collections.php |accessdate=2015-06-08 |archiveurl=https://web.archive.org/web/20150511132259/http://www.wayeb.org/resourceslinks/collections.php |archivedate=2015-05-11 }} :{{cite journal |author=Webster, David |title=The Not So Peaceful Civilization: A Review of Maya War |journal=Journal of World Prehistory |volume=14 |issue=1 |date=March 2000 |pages=65–119 |publisher=Springer |url=http://www.jstor.org/stable/25801154 |issn=1573-7802 |jstor=25801154 |doi=10.1023/a:1007813518630 |subscription=y }} :{{cite book |author1=Webster, David |author2=William L. Fash, Jr. |author3=Claude F. Baudez |author4=Berthold Riese |author5=William T. Sanders |url=http://www.jstor.org/stable/pdf/41263469.pdf |jstor=41263469 |title=The House of the Bacabs, Copan, Honduras |journal=Studies in Pre-Columbian Art and Archaeology |issue=29 |date=1989 |pages=i–iv, 1–111, 113–116 |publisher=Dumbarton Oaks, Trustees for Harvard University |isbn=9780884021773 |oclc=18557303 |subscription=y }} :{{cite web |author=Williams, Josh |year=2010 |title=Mississippian and Maya Eccentric Flints |url=http://art.missouristate.edu/arthist/exhibit1.php?E=2&P=49 |archiveurl=https://web.archive.org/web/20141102170643/http://apps.missouristate.edu/art/arthist/exhibit1.php?E=2&P=49 |archivedate=2014-11-02 |publisher=Board of Governors, Missouri State University |location=Springfield, Missouri |accessdate=2012-12-29 }} :{{cite book |author=Wise, Terence |author2=McBride, Angus |title=The Conquistadores |series=Men-at-Arms |volume=101 |publisher=Osprey Publishing |isbn=978-0-85045-357-7 |oclc=12782941 |location=Oxford, UK and New York, US |origyear=1980 |year=2008}} :{{cite book |author1=Witschey, Walter R. T. |author2=Clifford T. Brown |title=Historical Dictionary of Mesoamerica |url=https://books.google.co.uk/books?id=59jPo4mhrOcC |year=2012 |publisher=Scarecrow Press |location=Plymouth, Devon, UK |isbn=978-0-8108-7167-0 |oclc=754105610 }} :{{cite journal |author=Zorich, Zach |title=The Maya Sense of Time |journal=Archaeology |volume=65 |issue=6 |date=November–December 2012 |pages=25–29 |publisher=Archaeological Institute of America |url=http://www.jstor.org/stable/41804605 |jstor=41804605 |location=New York, US |issn=0003-8113 |oclc=1481828 |subscription=y }} {{Refend}}<!-- END biblio format style --> ==Marejeo mengine== {{Refbegin|30em}} *{{cite book |last=Braswell |first=Geoffrey E. |title=The Maya and Teotihuacan: Reinterpreting Early Classic Interaction |url=https://archive.org/details/mayateotihuacanr0000unse |year=2003 |edition= |publisher=University of Texas Press |location=Austin, Texas |isbn=0-292-70914-5 |oclc=49936017}} *{{cite book |last=Braswell |first=Geoffrey E. |title=The Maya and their Central American Neighbors: Settlement patterns, architecture, hieroglyphic texts, and ceramics |year=2014 |edition= |publisher=Routledge |location=Oxford, UK and New York, US |isbn=978-0-415-74487-4 |oclc=857897947}} *{{cite book |last=Christie |first=Jessica Joyce |title=Maya Palaces and Elite Residences: An Interdisciplinary Approach |url=https://archive.org/details/mayapalaceselite0000unse |year=2003 |publisher=University of Texas Press |location=Austin, Texas |isbn=0-292-71244-8 |oclc=50630511}} *{{cite book |last=Demarest |first=Arthur Andrew, Prudence M. Rice, and Don Stephen Rice |title=The Terminal Classic in the Maya Lowlands: Collapse, Transition, and Transformation |url=https://archive.org/details/terminalclassici00arth |year=2004 |publisher=University Press of Colorado |location=Boulder, Colorado |isbn=0-87081-739-6 |oclc=52311867}} *{{cite book |last=Fitzsimmons |first=James L. |title=Death and the Classic Maya Kings |year=2009 |publisher=University of Texas Press |location=Austin, Texas, US |isbn=978-0-292-71890-6 |oclc=699216836}} *{{cite book |last=Garber |first=James |title=The Ancient Maya of the Belize Valley: Half a Century of Archaeological Research |year=2004 |publisher=University Press of Florida |location=Gainesville, Florida |isbn=0-8130-2685-7 |oclc=52334723}} *{{cite book |last=Herring |first=Adam |title=Art and Writing in the Maya cities, AD 600–800: A Poetics of Line |year=2005 |publisher=Cambridge University Press |location=Cambridge, England; New York |isbn=0-521-84246-8 |oclc=56834579}} *{{cite book |last=Lohse |first=Jon C. and Fred Valdez |title=Ancient Maya Commoners |url=https://archive.org/details/ancientmayacommo0000unse |year=2004 |publisher=University of Texas Press |location=Austin, Texas |isbn=0-292-70571-9 |oclc=54529926}} *{{cite book |last=Lucero |first=Lisa Joyce |title=Water and Ritual: The Rise and Fall of Classic Maya Rulers |url=https://archive.org/details/waterritualrisef00luce |year=2006 |publisher=University of Texas Press |location=Austin, Texas |isbn=0-292-70999-4 |oclc=61731425}} *{{cite book |last=McKillop |first=Heather Irene |title=In Search of Maya Sea Traders |year=2005 |publisher=Texas A & M University Press |location=College Station, Texas |isbn=1-58544-389-1 |oclc=55145823}} *{{cite book |last=McKillop |first=Heather Irene |title=Salt: White Gold of the Ancient Maya |url=https://archive.org/details/saltwhitegoldofa0000mcki |year=2002 |publisher=University Press of Florida |location=Gainesville, Florida |isbn=0-8130-2511-7 |oclc=48893025}} *{{cite book |last=Rice |first=Prudence M. |title=Maya Political Science: Time, Astronomy, and the Cosmos |url=https://archive.org/details/mayapoliticalsci0000rice |year=2004 |edition=1st |publisher=University of Texas Press |location=Austin, Texas |isbn=0-292-70261-2 |oclc=54753496}} *{{cite book |last=Tiesler |first=Vera and Andrea Cucina |title= Janaab' Pakal of Palenque: Reconstructing the Life and Death of a Maya Ruler |year=2006 |publisher=University of Arizona Press |location=Tucson, Arizona |isbn=0-8165-2510-2 |oclc=62593473}} *{{cite book |author=Webster, David L. |year=2002 |title=The Fall of the Ancient Maya |url=https://archive.org/details/fallofancientmay0000webs |publisher=Thames & Hudson |location=London |isbn=0-500-05113-5}} {{Refend}} ==Viungo vya nje== {{Commons category|Maya}} *[http://www.famsi.org/ Foundation for the Advancement of Mesoamerican Studies, Inc (FAMSI)] *[http://www.mexconnect.com/articles/539-primary-sources-of-maya-history-part-one Primary sources of Maya history – part one by Ronald A. Barnett] *[http://www.mesoweb.com/ Mesoweb] by Joel Skidmore. *[http://www.mayamap.org/ Maya Map] – A map of the Maya civilization. [[Category:Ustaarabu]] [[Category:Historia ya Mexiko]] [[Category:Historia ya Guatemala]] [[Category:Historia ya Belize]] [[Category:Historia ya El Salvador]] k3zcexvmaaxbpw4rnr3xtgoisl58em2 0 86209 1578133 1123591 2026-07-02T21:34:08Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578133 wikitext text/x-wiki [[Image:Tuzo Nobel.png|left|80px]] [[picha:DavidThouless 1995 UW.jpg|thumbnail|right|200px|David James Thouless]] '''David James Thouless''' (amezaliwa [[21 Septemba]], [[1934]]) ni mwanafizikia kutoka nchi ya [[Uingereza]]. Hasa aligundua m. Mwaka wa [[2016]], pamoja na [[Frederick Duncan Michael Haldane]] na [[John Michael Kosterlitz]], alikuwa mshindi wa '''[[Tuzo ya Nobel ya Fizikia]]'''. Alipewa tuzo kwa utafiti wake wa kinadharia katika maelezo ya tabia za mata katika hali karibu na [[sifuri halisi]] ([[ing.]] ''"for theoretical discoveries of topological phase transitions and topological phases of matter"'')<ref>[https://books.google.com/books?id=Z4PN4GnsrSgC&q=%22Thouless,+david+james%22+1934&dq=%22Thouless,+david+james%22+1934&hl=en&sa=X&ei=k9WWUdjJM-X5iwKd-oGQAw&ved=0CFQQ6AEwCA The international who's who 1991-92]</ref><ref>[https://www.nobelprize.org/nobel_prizes/physics/laureates/2016/ The Nobel Prize in Physics 2016]</ref><ref name=naturenob>{{cite journal|last1=Gibney|first1=Elizabeth|last2=Castelvecchi|first2=Davide|title=Physics of 2D exotic matter wins Nobel: British-born theorists recognized for work on topological phases|url=https://archive.org/details/nature-uk_2016-10-06_538_7623/page/18|journal=Nature|volume=538|issue=7623|year=2016|pages=18–18|publisher=[[Springer Nature]]|location=London||doi=10.1038/nature.2016.20722}}</ref> . ==Marejeo== <references/> ==Viungo vya Nje== [http://qz.com/799938/an-oxford-university-professor-explains-the-2016-nobel-prize-in-physics-in-laymans-terms Profesa John Chalker, mkuu wa idara ya Fizikia ya Kinadharia kwenye Chuo Kikuu cha Oxford anajaribu kueleza tuzo ya Nobel ya 2016 kwa maneno ya kiraia] {{mbegu-Nobel}} {{DEFAULTSORT:Thouless, David}} [[Jamii:Waliozaliwa 1934]] [[Jamii:Wanasayansi wa Uingereza]] [[Jamii:Tuzo ya Nobel ya Fizikia]] b0h16e4c5bdn4dpnckfplwvhmxaps9j 0 86210 1578120 1068284 2026-07-02T20:48:02Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578120 wikitext text/x-wiki [[Image:Tuzo Nobel.png|left|80px]] [[File:Duncan Haldane.jpg|thumb|Haldane (2016)]] '''Frederick Duncan Michael Haldane''' (amezaliwa [[14 Septemba]], [[1951]]) ni mwanafizikia kutoka nchi ya [[Uingereza]]. Mwaka wa [[2016]], pamoja na [[David James Thouless]] na [[John Michael Kosterlitz]], alikuwa mshindi wa '''[[Tuzo ya Nobel ya Fizikia]]'''. Alipewa tuzo kwa utafiti wa kinadharia katika maelezo ya tabia za mata katika hali karibu na [[sifuri halisi]] ([[ing.]] ''"for theoretical discoveries of topological phase transitions and topological phases of matter"'')<ref>[https://books.google.com/books?id=Z4PN4GnsrSgC&q=%22Thouless,+david+james%22+1934&dq=%22Thouless,+david+james%22+1934&hl=en&sa=X&ei=k9WWUdjJM-X5iwKd-oGQAw&ved=0CFQQ6AEwCA The international who's who 1991-92]</ref><ref>[https://www.nobelprize.org/nobel_prizes/physics/laureates/2016/ The Nobel Prize in Physics 2016]</ref><ref name=naturenob>{{cite journal|last1=Gibney|first1=Elizabeth|last2=Castelvecchi|first2=Davide|title=Physics of 2D exotic matter wins Nobel: British-born theorists recognized for work on topological phases|url=https://archive.org/details/nature-uk_2016-10-06_538_7623/page/18|journal=Nature|volume=538|issue=7623|year=2016|pages=18–18|publisher=[[Springer Nature]]|location=London||doi=10.1038/nature.2016.20722}}</ref> . ==Marejeo== <references/> ==Viungo vya Nje== [http://qz.com/799938/an-oxford-university-professor-explains-the-2016-nobel-prize-in-physics-in-laymans-terms Profesa John Chalker, mkuu wa idara ya Fizikia ya Kinadharia kwenye Chuo Kikuu cha Oxford anajaribu kueleza tuzo ya Nobel ya 2016 kwa maneno ya kiraia] {{mbegu-Nobel}} {{DEFAULTSORT:Haldane, Duncan}} [[Jamii:Waliozaliwa 1951]] [[Jamii:Wanasayansi wa Uingereza]] [[Jamii:Tuzo ya Nobel ya Fizikia]] le628w4wi0p7c3akv50i35bpcc1atzh 0 86211 1578175 1121771 2026-07-02T23:48:28Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578175 wikitext text/x-wiki [[Image:Tuzo Nobel.png|left|80px]] [[picha: Jkosterl.jpg|thumbnail|right|200px|John Michael Kosterlitz]] '''John Michael Kosterlitz''' (amezaliwa [[1942]]) ni mwanafizikia kutoka nchi ya [[Marekani]]. Mwaka wa [[2016]], pamoja na [[David James Thouless]] na [[Frederick Duncan Michael Haldane]], alikuwa mshindi wa '''[[Tuzo ya Nobel ya Fizikia]]'''. Alipewa tuzo kwa utafiti wa kinadharia katika maelezo ya tabia za mata katika hali karibu na [[sifuri halisi]] ([[ing.]] ''"for theoretical discoveries of topological phase transitions and topological phases of matter"'')<ref>[https://books.google.com/books?id=Z4PN4GnsrSgC&q=%22Thouless,+david+james%22+1934&dq=%22Thouless,+david+james%22+1934&hl=en&sa=X&ei=k9WWUdjJM-X5iwKd-oGQAw&ved=0CFQQ6AEwCA The international who's who 1991-92]</ref><ref>[https://www.nobelprize.org/nobel_prizes/physics/laureates/2016/ The Nobel Prize in Physics 2016]</ref><ref name=naturenob>{{cite journal|last1=Gibney|first1=Elizabeth|last2=Castelvecchi|first2=Davide|title=Physics of 2D exotic matter wins Nobel: British-born theorists recognized for work on topological phases|url=https://archive.org/details/nature-uk_2016-10-06_538_7623/page/18|journal=Nature|volume=538|issue=7623|year=2016|pages=18–18|publisher=[[Springer Nature]]|location=London||doi=10.1038/nature.2016.20722}}</ref> . ==Marejeo== <references/> ==Viungo vya Nje== [http://qz.com/799938/an-oxford-university-professor-explains-the-2016-nobel-prize-in-physics-in-laymans-terms Profesa John Chalker, mkuu wa idara ya Fizikia ya Kinadharia kwenye Chuo Kikuu cha Oxford anajaribu kueleza tuzo ya Nobel ya 2016 kwa maneno ya kiraia] {{mbegu-Nobel}} {{DEFAULTSORT:Kosterlitz, John}} [[Jamii:Waliozaliwa 1951]] [[Jamii:Wanasayansi wa Marekani]] [[Jamii:Tuzo ya Nobel ya Fizikia]] ghomrfuy32wdy2ctdgxsb4mxfgn0p93 0 86393 1578130 1564465 2026-07-02T21:23:50Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578130 wikitext text/x-wiki [[Picha:Herpes(PHIL 1573 lores).jpg|thumbnail|right|200px|Tutuko]] {{Infobox disease | Image = Herpes(PHIL 1573 lores).jpg | Caption = [[Hepesi ya mdomo]] wa chini. | DiseasesDB = 5841 | DiseasesDB_mult = {{DiseasesDB2|33021}} | ICD10 = {{ICD10|A|60||a|50}}, {{ICD10|B|00||b|00}}, {{ICD10|G|05|1|g|00}}, {{ICD10|P|35|2|p|35}} | ICD9 = {{ICD9|054.0}}, {{ICD9|054.1}}, {{ICD9|054.2}}, {{ICD9|054.3}}, {{ICD9|771.2}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 1006 | MeshID = D006561 }} <!-- Maelezo na dalili --> '''Tutuko''' (kutoka [[kitenzi]] "kututuka"; pia '''Hepesi simpleksi''' kutoka [[jina]] la [[Kiingereza]] lenye [[asili]] ya [[Kigiriki]] ἕρπης, ''herpes'', "unaoenea polepole" au "uliofichika") ni [[ugonjwa wa kuambukiza]] unaosababishwa na [[virusi vya hepesi simpleksi]].<ref name=CDC2014F/> [[Maambukizi]] yameainishwa kulingana na sehemu ya [[mwili]] iliyoambukizwa: * [[Hepesi ya mdomo]] hujumuisha [[uso]] au [[mdomo]]. Inaweza kusababisha [[malengelenge]] madogo katika vikundi yaitwayo vidonda baridi au malengelenge ya joto jingi au inaweza tu kusababisha [[maumivu]] ya [[koo]].<ref name=Bal2014/><ref>{{cite book|last1=Mosby|title=Mosby's Medical Dictionary|date=2013|publisher=Elsevier Health Sciences|isbn=9780323112581|pages=836-837|edition=9|url=https://books.google.ca/books?id=aW0zkZl0JgQC&pg=PA836}}</ref> * [[Hepesi ya viungo vya uzazi]] inaweza kuwa na [[dalili]] chache au kusababisha malengelenge ambayo hupasuka na kusababisha [[vidonda]] vidogo.<!-- <ref name=CDC2014F/> --> Hivyo kwa kawaida hupona kwa [[muda]] wa [[wiki]] [[mbili]] hadi [[nne]].<!-- <ref name=CDC2014F/> --> Maumivu yanayowasha au yanayochoma yanaweza kutokea kabla ya malengelenge kutokea.<!-- <ref name=CDC2014F/> --> Hepesi huzunguka kati ya vipindi vya ugonjwa vilivyo na dalili vikifuatiwa na vipindi visivyo na dalili.<!-- <ref name=CDC2014F/> --> Kwa kawaida kipindi cha kwanza huwa kali zaidi na kinaweza kuhusishwa na [[joto]] jingi, maumivu ya [[misuli]], [[nodi ya limfu]] iliyovimba na maumivu ya [[kichwa]].<!-- <ref name=CDC2014F/> --> Muda unavyosonga, vipindi vya ugonjwa vilivyo na dalili hupungua kwa mara unapotokea na ukali.<ref name=CDC2014F/> Matatizo mengine yanayosababishwa na hepesi simpleksi hujumuisha: [[paronikia ya hepesi]] inapohusisha [[vidole]],<ref>{{cite journal|last1=Wu|first1=IB|last2=Schwartz|first2=RA|title=Herpetic whitlow.|journal=Cutis|date=March 2007|volume=79|issue=3|pages=193-6|pmid=17674583}}</ref> [[hepesi ya macho]],<ref>{{cite journal|last1=Rowe|first1=AM|last2=St Leger|first2=AJ|last3=Jeon|first3=S|last4=Dhaliwal|first4=DK|last5=Knickelbein|first5=JE|last6=Hendricks|first6=RL|title=Herpes keratitis.|journal=Progress in retinal and eye research|date=January 2013|volume=32|pages=88-101|pmid=22944008}}</ref> [[hepesi ya ubongo]],<ref>{{cite journal|last1=Steiner|first1=I|last2=Benninger|first2=F|title=Update on herpes virus infections of the nervous system.|journal=Current neurology and neuroscience reports|date=December 2013|volume=13|issue=12|pages=414|pmid=24142852}}</ref> na [[hepesi ya watoto wachanga]] inapoathiri [[mtoto]] mchanga, n.k.<ref>{{cite journal|last1=Stephenson-Famy|first1=A|last2=Gardella|first2=C|title=Herpes Simplex Virus Infection During Pregnancy.|journal=Obstetrics and gynecology clinics of North America|date=December 2014|volume=41|issue=4|pages=601-614|pmid=25454993}}</ref> == Kisababishi na utambuzi== Kuna aina mbili za [[virusi]] vya hepesi simpleksi: aina ya 1 (HSV-1) na aina ya 2 (HSV-2).<ref name=CDC2014F/> HSV-1 kwa kawaida zaidi husababisha maambukizi ya mdomo huku HSV-2 kwa kawaida zaidi ikisababisha maambukizi ya viungo vya uzazi.<ref name=Bal2014/> Husababishwa kwa kugusana moja kwa moja kwa [[Kiowevu|viowevu]] vya mwili au vidonda vya mtu aliyeambukizwa.<!-- <ref name=CDC2014F/> --> Kuenea bado kunaweza kutokea hata iwapo dalili hazipo.<!-- <ref name=CDC2014F/> --> Hepesi ya [[viungo vya uzazi]] imeainishwa kama maambukizi yanayoenezwa kupitia [[ngono]].<!-- <ref name=CDC2014F/> --> Yanaweza kuenezwa kwa mtoto mchanga wakati wa kuzaliwa.<ref name=CDC2014F/> Baada ya kuambukizwa, maambukizi husafirishwa kupitia [[nyuroni]] inayopitisha [[hisia]] hadi kwa [[seli]] za [[neva]], pale ambapo virusi hukaa kwa maisha yote.<ref name=Bal2014>{{cite journal|last1=Balasubramaniam|first1=R|last2=Kuperstein|first2=AS|last3=Stoopler|first3=ET|title=Update on oral herpes virus infections.|url=https://archive.org/details/sim_dental-clinics-of-north-america_2014-04_58_2/page/n13|journal=Dental clinics of North America|date=April 2014|volume=58|issue=2|pages=265-80|pmid=24655522}}</ref> Visababishi vya kujirudia vinaweza kujumuisha: [[kupungua kwa utenda kazi wa kingamwili]], mafadhaiko na kupatana na [[jua]].<ref name="Saratani">{{cite journal |author=Elad S |title=A systematic review of viral infections associated with oral involvement in cancer patients: a spotlight on Herpesviridea |journal=Support Care Cancer |volume=18 |issue=8 |pages=993–1006 |date=August 2010 |pmid=20544224 |url=http://www.springerlink.com/content/g476114717852h80/ |doi=10.1007/s00520-010-0900-3 |author-separator=, |author2=Zadik Y |author3=Hewson I |display-authors=3 |last4=Hovan |first4=Allan |last5=Correa |first5=M. Elvira P. |last6=Logan |first6=Richard |last7=Elting |first7=Linda S. |last8=Spijkervet |first8=Fred K. L. |last9=Brennan |first9=Michael T. |access-date=2016-11-01 |archive-date=2019-09-15 |archive-url=https://web.archive.org/web/20190915113345/https://link.springer.com/article/10.1007/s00520-010-0900-3 |dead-url=yes |=https://web.archive.org/web/20190915113345/https://link.springer.com/article/10.1007/s00520-010-0900-3 }}</ref><ref name=Bal2014/> Hepesi ya mdomo na ile ya viungo vya uzazi kwa kawaida hutambuliwa kwa kuzingatia dalili zilizodhihirika.<ref name=Bal2014/> Utambuzi unaweza kuthibitishwa na [[tabia ya virusi]] au [[DNA]] ya kutambua hepesi kwenye viowevu vinavyotoka katika malengelenge.<!-- <ref name=CDC2014F/> --> Kuchunguza [[damu]] ili kutambua [[kingamwili]] dhidi ya virusi kunaweza kuthibitisha maambukizi ya hapo awali lakini kutakuwa hasi katika maambukizi mapya.<ref name=CDC2014F/> == Kinga na tiba == Njia inayofaa zaidi ya kuzuia maambukizi ya viungo vya uzazi ni kwa kuzuia ngono kupitia [[uke]], mdomo, au [[unyeo]].<!-- <ref name=CDC2014F/> --> Matumizi ya [[kondomu]] yanaweza kupunguza, lakini si kuondoa kabisa hatari.<!-- <ref name=CDC2014F/> --> [[Dawa]] ya kila siku ya [[kudhibiti virusi]] inayonywewa na [[mtu]] aliyeambukizwa pia inaweza kuzuia kuenea.<!-- <ref name=CDC2014F/> --> Hadi sasa hakuna [[chanjo]] iliyopatikana.<!-- <ref name=CDC2014F/> --> Unapoambukizwa hakuna [[tiba]].<ref name=CDC2014F/> [[Paracetamol]] (acetaminophen) na topical lidocaine zinaweza kutumika ili kupunguza dalili.<ref name=Bal2014/> Matibabu kwa dawa za kudhibiti virusi kama vile [[asiklovia]] au [[valasiklovia]] yanaweza kupunguza ukali wa vipindi vinavyodhihirisha dalili.<ref name=CDC2014F/><ref name=Bal2014/> ==Uenezi == Viwango vya HSV 1 au HSV-2 ulimwenguni kote ni kati ya [[asilimia]] 60 na 95 kwa watu wazima.<ref name=Peds09/> HSV-1 kwa kawaida hupatikana utotoni.<ref name=CDC2014F>{{cite web|title=Genital Herpes - CDC Fact Sheet|url=http://www.cdc.gov/std/herpes/STDFact-Herpes-detailed.htm|website=cdc.gov|accessdate=31 December 2014|date=December 8, 2014}}</ref> Viwango vya zote mbili huongezeka watu wanapozeeka.<ref name=Peds09/> Viwango vya HSV-1 huwa kati ya asilimia 70 na 80 katika watu ambao hali yao ya kijamii na kiuchumi ni ya chini na asilimia 40 hadi 60 kwa watu ambao hali yao ya jijamii na kiuchumi imeboreka.<ref name=Peds09>{{cite journal |author=Chayavichitsilp P, Buckwalter JV, Krakowski AC, Friedlander SF |title=Herpes simplex |journal=Pediatr Rev |volume=30 |issue=4 |pages=119–29; quiz 130 |date=April 2009 |pmid=19339385 |doi=10.1542/pir.30-4-119 |url=}}</ref> Kadirio la watu milioni 536 ulimwenguni kote (asilimia 16 ya watu) walikuwa wameambukizwa HSV-2 kufikia 2003 huku viwango vya juu zaidi vikiwa wanawake na walio katika ulimwengu unaoendelea.<ref name=Looker2008>{{cite journal|last=Looker|first=KJ|author2=Garnett, GP |author3=Schmid, GP |title=An estimate of the global prevalence and incidence of herpes simplex virus type 2 infection.|url=https://archive.org/details/sim_world-health-organization-bulletin_2008-10_86_10/page/805|journal=Bulletin of the World Health Organization|date=October 2008|volume=86|issue=10|pages=805–12, A|pmid=18949218|pmc=2649511|doi=10.2471/blt.07.046128}}</ref> Watu wengi walio na HSV-2 hawatambui kuwa wameambukizwa.<ref name=CDC2014F/> ==Marejeo== <references/> {{mbegu-tiba}} [[Jamii:Maradhi ya ngozi]] [[Jamii:Maradhi ya zinaa]] hkp15fli953bgzqvblcjioe2o5hrl5x 0 86394 1578076 1500378 2026-07-02T18:32:31Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578076 wikitext text/x-wiki {{Infobox disease | Name = Herpes zoster | ICD10 = {{ICD10|B|02||b|00}} | ICD9 = {{ICD9|053}} | ICDO = | Image = Herpes zoster neck.png | Caption = Herpes zoster blisters on the neck and shoulder | OMIM = | MedlinePlus = 000858 | eMedicineSubj = med | eMedicineTopic = 1007 | eMedicine_mult = {{eMedicine2|derm|180}} {{eMedicine2|emerg|823}} {{eMedicine2|oph|257}} {{eMedicine2|ped|996}} | DiseasesDB = 29119 | }} '''Mkanda wa jeshi''' (au '''tutuko zosta''', na hata '''zosta''', kutoka [[Kiingereza]] ''herpes zoster'') ni [[ugonjwa wa kuambukiza]] unaotokana na [[virusi]] vya [[hepesi]], lakini ni kali kuliko [[tutuko]] la kawaida ("hepesi simpleksi"). Unajulikana kama '''ugonjwa wa vipele''' au pia kama '''zona,''' ni [[ugonjwa]] unaosababishwa na virusi vyenye sifa za [[upele]] unaoleta [[maumivu]] kwenye [[ngozi]] na malengelenge katika eneo dogo la upande mmoja wa [[mwili]], mara nyingi katika mstari. Awamu ya awali ya [[maambukizi]] ya virusi vya [[tetekuwanga]] (VZV) husababisha ugonjwa mkali wa tetekuwanga (wa muda mfupi) ambao kwa kawaida hutokea kwa [[watoto]] na [[vijana]]. Mara baada tu ya kusuluhishwa kwa tukio la tetekuwanga, kirusi hicho hakiondolewi kwenye mwili lakini kinaweza kusababisha vipele-ugonjwa wenye [[dalili]] tofauti kabisa - miaka mingi baada ya maambukizi ya awali. Kirusi cha tetekuwanga kinaweza kutulia katika miili ya [[seli]] za [[neva]] na kwa nadra katika seli za satelaiti zisizo za niuroni za shina la [[uti wa mgongo]], neva ya fuvu au ganglioni ya kujiongeza, <ref name="pmid12676845"></ref> bila kuonyesha dalili zozote. <ref name="pmid12211045"></ref> Miaka au miongo kadhaa baada ya kupata maambukizi ya tetekuwanga, virusi hivyo vinaweza kutoka nje ya miili ya seli za neva na kusafiri hadi kwenye mikongo ya neva na kusababisha maambukizi ya ngozi yanayotokana na virusi katika eneo la neva. Kirusi kinaweza kuenea kutoka kwenye ganglioni moja au zaidi katika neva za sehemu iliyoathiriwa na kuambukiza dematomi (eneo la ngozi linalogawiwa virutubishi na neva moja ya uti wa mgongo) na hivyo kusababisha vipele vyenye uchungu. <ref name="pmid1666443">{{cite journal |author=Peterslund NA |title=Herpesvirus infection: an overview of the clinical manifestations |journal=Scand J Infect Dis Suppl |volume=80 |issue= |pages=15–20 |year=1991 |pmid=1666443 }}</ref> <ref name="pmid14583142"></ref> Ingawa upele huu wa kawaida hupona katika muda wa wiki mbili hadi nne, baadhi ya wagonjwa huendelea kuhisi uchungu wa neva kwa miezi au miaka kadhaa, hali iitwayo maumivu ya neva ya baada ya kupona kwa vipele. Haieleweki vyema namna ambavyo kirusi hicho hubaki kikiwa kimejificha kwenye mwili, na hatimaye kujifufua. <ref name="pmid12676845"></ref> Katika [[ulimwengu]] mzima, kiwango cha matukio cha ugonjwa wa tutuko zosta kila mwaka huwa na safu ya kutoka visa 1.2 hadi 3.4 kwa watu 1,000 wenye [[afya]], na kufikia hadi 3.9-11.8 kwa mwaka kwa watu 1,000 kati ya walio na [[umri]] zaidi ya miaka 65. <ref name="pmid17143845"></ref> <ref name="pmid7618983"></ref> <ref name="pmid17939895"></ref> Matibabu ya madawa ya kinzavirusi yanaweza kupunguza ukali na muda wa tutuko zosta ikiwa itatumiwa kwa mfululizo wa siku saba hadi kumi. Madawa haya yanapaswa kuanza kutumika kabla ya kupita kwa masaa 72 tangu kuonekana kwa dalili za vipele. <ref name="pmid17143845"></ref> <ref name="pmid18241179">{{cite journal |author=Cunningham AL, Breuer J, Dwyer DE, Gronow DW, Helme RD, Litt JC, Levin MJ, Macintyre CR |title=The prevention and management of herpes zoster |url=https://archive.org/details/sim_medical-journal-of-australia_2008-02-04_188_3/page/n59 |journal=Med. J. Aust. |volume=188 |issue=3 |pages=171–6 |year=2008 |pmid=18241179 |doi=}}</ref> ==Ufafanuzi== Jina tutuko zosta hutokana na neno la Kigiriki ''zōstēr'', lenye maana ya "mkanda" au "ukanda", kutokana na vipele kwenye ngozi vinavyofanana na [[ukanda]]. Jina la kiingereza la shingles (ugonjwa wa vipele) linawakilisha jina la [[Kilatini]] ''cingulus'', linalotokana na neno ''cingulum'' lenye maana hiyohiyo ya "ukanda." Licha ya usawa wa jina, tutuko zosta si ugonjwa sawa na manawa na wanaweza kupitisha, ingawa wote wa zoster varicella virusi vya UKIMWI na malengelenge yanayoleta vidonda mdomoni na kwenye sehemu za siri ingawa virusi vya tetekuwanga na vya malengelenge yanayoleta vidonda mdomoni na kwenye sehemu za siri zinatoka jamii moja ya virusi ya (Alfahapesvirina). ==Ishara na dalili== Dalili za mapema zaidi za tutuko zosta, ambazo ni pamoja na kuumwa na kichwa, [[homa]] na hitilafu ya mwili, si mahususi, na huenda zikasababisha utambuzi usio sahihi. <ref name="pmid17143845">{{cite journal | author=Dworkin RH, Johnson RW, Breuer J ''et al.''| title=Recommendations for the management of herpes zoster| journal=Clin. Infect. Dis| volume=44 Suppl 1| pages=S1–26| year=2007| pmid=17143845| doi=10.1086/510206| url=http://www.journals.uchicago.edu/doi/full/10.1086/510206 | last12=Oaklander | first12=AL | last13=Oxman | first13=MN | last14=Pavan-Langston | first14=D | last15=Petersen | first15=KL | last16=Rowbotham | first16=MC | last17=Schmader | first17=KE | last18=Stacey | first18=BR | last19=Tyring | first19=SK | last20=Van Wijck | first20=AJ | last21=Wallace | first21=MS | last22=Wassilew | first22=SW | last23=Whitley | first23=RJ}}</ref> <ref name="pmid11458545">[19] ^ {{cite journal| author=Zamula E| title=Shingles: an unwelcome encore| journal=FDA Consumer| volume=35| issue=3| pages=21–5| year=2001| month=Mei-Juni| pmid=11458545| url=permanent.access.gpo.gov/lps1609/www.fda.gov/fdac/features/2001/301_pox.html|accessdate=2010-01-05}} Ilirekebishwa Juni 2005.</ref> Dalili hizi kwa kawaida hufuatwa na hisia za maumivu na joto, kuwashwa, haiparesthesia (kiwango cha juu kupindukia cha hisi), au paresthesia (mwasho baada ya mwili kufa ganzi: Kuwashwa, kudungwa, au kufa ganzi). <ref name="pmid10794584">{{cite journal| author=Stankus SJ, Dlugopolski M, Packer D| title=Management of herpes zoster (shingles) and postherpetic neuralgia| journal=Am Fam Physician| volume=61| issue=8| pages=2437–44, 2447–8| year=2000| pmid=10794584| url=http://www.aafp.org/afp/20000415/2437.html| access-date=2016-11-01| archive-date=2007-09-29| archive-url=https://web.archive.org/web/20070929083747/http://www.aafp.org/afp/20000415/2437.html| dead-url=yes| =https://web.archive.org/web/20070929083747/http://www.aafp.org/afp/20000415/2437.html}}</ref> Maumivu huweza kuwa madogo hadi makuu katika dematomi iliyoathiriwa, na hisia ambazo mara nyingi huelezwa kama ya kuumwa, ya msisimko, kuuma, kukufa ganzi au ya mpigo, na yanaweza kuchanganyika na michomo ya haraka ya maumivu makali. <ref name="pmid15307000">{{cite journal |author=Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH |title=Acute pain in herpes zoster and its impact on health-related quality of life |journal=Clin. Infect. Dis |volume=39 |issue=3 |pages=342–8 |year=2004 |pmid=15307000 |doi=10.1086/421942| url=http://www.journals.uchicago.edu/doi/full/10.1086/421942}}</ref> Malengelenge ya Zoster katika watoto mara nyingi huwa hayana maumivu. Wakati mwingi, baada ya siku 1 hadi 2 (lakini wakati mwingine muda wa hadi wiki 3) awamu ya kwanza hufuatwa na kujitokeza kwa vipele vya ngozi. Maumivu na vipele kwa wa kawaida hutokea katika kiwiliwili, lakini yanaweza kujitokeza kwenye uso, macho au sehemu zingine za mwili. Mara ya kwanza, vipele hivi huonekana kuwa sawa na mwonekano wa kwanza wa ugonjwa wa mabaka ngozini; hata hivyo, tofauti na ugonjwa wa mabaka ngozini, tutuko zosta husababisha mabadiliko kwenye ngozi yanayokoma kwenye dematomi, ambayo kwa kawaida husababisha mfano wa ukanda au mkanda unaojitokeza katika upande mmoja pekee wa mwili na usiovuka sehemu ya katikati ya mwili. <ref name="pmid10794584"></ref> {{Anchor|Zoster sine herpete}} ''Zoster sine hapete'' inaeleza mgonjwa aliye na dalili zote za tutuko zosta isipokuwa sifa hii ya upele. <ref name="pmid10980741">{{cite journal |author=Furuta Y, Ohtani F, Mesuda Y, Fukuda S, Inuyama Y |title=Early diagnosis of zoster sine herpete and antiviral therapy for the treatment of facial palsy |url=https://archive.org/details/sim_neurology_2000-09-12_55_5/page/708 |journal=Neurology |volume=55 |issue=5 |pages=708–10 |year=2000 |pmid=10980741}}</ref> Baadaye, vipele huwa ya lengelenge, na kuunda kutoa malengelenge madogo yaliyojazwa na rishai ya majimaji ya damu, huku homa na hitilafu ya mwili kwa ujumla ikiendelea. The vilengelenge vyenye uchungu hatimaye huwa na mavundevunde au hufifizwa baada ya kujazwa na damu na hupasuka baada ya siku 7 hadi 10, na kwa kawaida, magamba huanguka na ngozi hupona; lakini wakati mwingine, baada ya umalengelenge mkali, uundaji wa kovu na ngozi iliyogeuka rangi hubaki. <ref name="pmid10794584"></ref> {| align="center" |+ <td>'''Ukuaji wa ugonjwa wa vipele''' </td> ! Siku ya 1 ! Siku ya 2 ! Siku ya 5 ! Siku ya 6 |- valign="top" | [[File:ShinglesDay1.JPG|143px]] | [[File:ShinglesDay2 ed.JPG|120px]] | [[File:ShinglesDay5 ed.JPG|145px]] | [[File:ShinglesDay6 ed.JPG|149px]] |} Tutuko zosta zinaweza kuwa na dalili za ziada, ikitegemea dematomi inayohusika. ''Tutuko zosta za ophthalmikasi yanahusisha obiti ya macho na hutokea takriban katika 10% hadi 25% ya visa.'' Hii inasababishwa na kirusi kinachoamsha kitengo cha macho cha neva ya trijemia. Kati ya wagonjwa wachache, dalili zinaweza kuwa ni pamoja na uvimbe wa macho, uvimbe wa konea, uvimbechungu wa uvea, na kupooza kwa neva za macho ambao wakati mwingine unaweza kusababisha uvimbe sugu wa macho, kupoteza uwezo wa kuona na maumivu yanayodhoofisha. <ref name="pmid12449270">{{cite journal| author=Shaikh S, Ta CN| title=Evaluation and management of herpes zoster ophthalmicus| journal=Am Fam Physician| year=2002| volume=66| issue=9| pages=1723–1730| pmid=12449270| url=http://www.aafp.org/afp/20021101/1723.html| access-date=2016-11-01| archive-date=2008-05-14| archive-url=https://web.archive.org/web/20080514021237/http://www.aafp.org/afp/20021101/1723.html| dead-url=yes| =https://web.archive.org/web/20080514021237/http://www.aafp.org/afp/20021101/1723.html}}</ref> ''Tutuko zosta aina ya otikas,'' ambazo pia zinajulikana kama ugonjwa wa Ramsay Hunt aina ya II, zinahusisha sikio. Yanadhaniwa kutokana na virusi vinavyoenea kutoka kwenye neva ya usoni hadi kwenye neva ya vestibulikomboli. Dalili ni pamoja na kupoteza uwezo wa kusikia na kisulisuli (kizunguzungu). <ref name="pmid12676845"></ref> ==Pathofisiolojia== [[File:A Course of Shingles diagram.png|right|thumb|Kusambaa kwa tutuko zosta. Mkusanyiko wa vimbe ndogo ndogo (1) hugeuka na kuwa malengelenge (2). Malengelenge hayo hujazwa na limfu, hupasuka(3), huunda magamba juu yao(4), na hatimaye hupotea. Niuraljia ya baada ya malengelenge wakati mwingine unaweza kutokana na kuharibika kwa neva(5)]], Kisababishi cha tutuko zosta ni kirusi cha tetekuwanga (VZV), kirusi cha DNA chenye kamba mbili kinachohusiana na kikundi cha virusi vya malengelenge ya simpleksi. Watu wengi wameambukizwa na virusi hivi wakiwa wangali watoto, na hushikwa na ugonjwa wa tetekuwanga. Mfumo wa kinga hatimaye huondoa virusi hivi kutoka sehemu nyingi, lakini bado hubaki bwete (au fiche) katika ganglioni iliyo karibu na uti wa mgongo (unaoitwa ganglioni ya shina la uti wa mgongo) au semilunari ya ganglioni (Gaseri ya ganglioni) katika shina la fuvu. <ref name="pmid17945155">{{cite journal|author=Steiner I, Kennedy PG, Pachner AR| title=The neurotropic herpes viruses: herpes simplex and varicella-zoster| journal=[[The Lancet|Lancet Neurol]]| volume=6| issue=11| pages=1015–28| year=2007| pmid=17945155| doi=10.1016/S1474-4422(07)70267-3}}</ref> Ni nadra kupata matukio yanayorudiwarudiwa ya tutuko zosta, <ref name="pmid10794584"></ref> na ni nadra sana kwa wagonjwa kupata zaidi ya matukio matatu. <ref name="pmid17945155"></ref> Tutuko zosta hutokea tu kati ya watu ambao wamewahi kupata tetekuwanga, na ingawa inaweza kutokea katika umri wowote, wengi wagonjwa wana zaidi ya umri wa miaka 50. <ref name="pmid18021864">{{cite journal| author=Weinberg JM| title=Herpes zoster: epidemiology, natural history, and common complications| journal=J Am Acad Dermatol| volume=57| issue=6 Suppl| pages=S130–5| year=2007| pmid=18021864| doi=10.1016/j.jaad.2007.08.046}}</ref> Ugonjwa huo hutoka na kuamshwa kwa virusi katika ganglioni moja ya hisia. <ref name="pmid14583142">{{cite journal| author=Gilden DH, Cohrs RJ, Mahalingam R| title=Clinical and molecular pathogenesis of varicella virus infection| journal=Viral Immunol| volume=16| issue=3| pages=243–58| year=2003| pmid=14583142| doi=10.1089/088282403322396073}}</ref> Tofauti na virusi vya malengelenge ya simpleksi, utulivu wa VZV haueleweki vyema. Kirusi hiki hakijawahi kuondolewa kwenye seli za neva za binadamu kwa kutumia ufugaji vyembe na mahali na muundo wa [[DNA]] ya kirusi hiki hakifahamiki. Protini zenye virusi mahususi huendelea kutengenezwa na seli wakati wa kipindi cha utulivu, kwa hivyo utulivu wa kweli, kinyume na maambukizi 0}sugu ya kiwango cha chini hayajadhibitishwa. <ref name="pmid12211045">{{cite journal |author=Kennedy PG |title=Varicella-zoster virus latency in human ganglia |journal=Rev. Med. Virol. |volume=12 |issue=5 |pages=327–34 |year=2002 |pmid=12211045 |doi=10.1002/rmv.362}}</ref> <ref name="pmid12491156">{{cite journal| author=Kennedy PG| title=Key issues in varicella-zoster virus latency| journal=J. Neurovirol| volume=8 Suppl 2| pages=80–4| year=2002| pmid=12491156| doi=10.1080/13550280290101058}}</ref> Ingawa VZV imetambuliwa katika uchunguzi wa tishu za neva katika maiti, <ref name="pmid12707850">{{cite journal| author=Mitchell BM, Bloom DC, Cohrs RJ, Gilden DH, Kennedy PG| title=Herpes simplex virus-1 and varicella-zoster virus latency in ganglia| journal=J. Neurovirol| volume=9| issue=2| pages=194–204| year=2003| pmid=12707850| doi=10.1080/713831492| url=http://www.jneurovirol.com/o_pdf/9(2)/194-204.pdf| format=PDF}}</ref> hakuna njia za kutambua virusi tulivu katika ganglioni ya watu wanaoishi. Ila tu pale ambapo mfumo wa kinga umeathirika, mfumo huu hukandamiza ufufuaji wa kirusi na kuzuia tutuko zosta. Haifahamiki vyema ni kwa nini mara nyingine ukandamizaji huu haufanyiki ipasavyo, <ref name="pmid7618983">{{cite journal| author=Donahue JG, Choo PW, Manson JE, Platt R| title=The incidence of herpes zoster| journal=[[Archives of Internal Medicine|Arch. Intern. Med]]| volume=155| issue=15| pages=1605–9| year=1995| pmid=7618983| doi=10.1001/archinte.155.15.1605}}</ref> lakini tutuko zosta yana uwezekano zaidi wa kujitokeza kati ya watu ambao mifumo yao ya kinga imeharibika kutokana na uzee, tiba ya kukandamiza mfumo wa kinga, dhiki ya kisaikolojia, au mambo mengine. <ref name="pmid14720565">{{cite journal| author=Thomas SL, Hall AJ| title=What does epidemiology tell us about risk factors for herpes zoster?| journal=[[The Lancet|Lancet Infect Dis]]| volume=4| issue=1| pages=26–33| year=2004| doi=10.1016/S1473-3099(03)00857-0| pmid=14720565}}</ref> Baada ya uhaishaji, kirusi hicho hujirudufu katika seli za neva, na virioni humwaga kutoka kwenye seli na kubebwa hadi kwenye mikongo kwenye eneo la ngozi linaloshughulikiwa na ganglioni. Katika ngozi, kirusi hicho husababisha kuvimba na malengelenge. Maumivu ya muda mfupi na muda mrefu yanayosababishwa na tutuko zosta yanatokana na ukuaji mkubwa virusi hivo kwenye neva zilizoambukizwa, ambayo husababisha kuvimba. <ref name="pmid17631237">{{cite journal |author=Schmader K |title=Herpes zoster and postherpetic neuralgia in older adults |journal=Clin. Geriatr. Med. |volume=23 |issue=3 |pages=615–32, vii–viii |year=2007 |pmid=17631237 |doi=10.1016/j.cger.2007.03.003 |url=http://linkinghub.elsevier.com/retrieve/pii/S0749-0690(07)00021-3}}</ref> Dalili za tutuko zosta haziwezi kuambukizwa kwa mtu mwingine. <ref name="pmid10825029">{{cite journal| author=Schmader K| title=Herpes zoster in the elderly: issues related to geriatrics| url=https://archive.org/details/sim_clinical-infectious-diseases_1999-04_28_4/page/736| journal=Clin. Infect. Dis| volume=28| issue=4| pages=736–9| year=1999| pmid=10825029| doi=10.1086/515205}}</ref> Hata hivyo, wakati wa awamu ya malengelenge, mgusano wa moja kwa moja na upele huo unaweza kueneza VZV kwa mtu asiye na kinga dhidi ya virusi hivo. Mtu huyu aliyepata maambukizi mapya kisha huweza kupata tetekuwanga, lakini hatapata vipele mara moja. Hadi pale ambapo vipele vinapata magamba, mgonjwa anaweza kuwaambukiza watu wengine kwa urahisi sana. Mtu pia hawezi kuambukizana kabla ya malengelenge kujitokeza, au wakati wa maumivu ya neva anayokuja baada ya malengelenge (baada ya upele huu kuisha). Mtu huyo hataweza kuambukiza mtu mwingine tena baada ya upele huu kuisha. <ref name="pmid10794584"></ref> ==Uaguzi== [[File:Herpes zoster chest.png|right|thumb|Tutuko zosta kwenye kifua]] Ikiwa upele huu umejitokeza, kutambua ugonjwa huu (kufanya utambuzi wa kutofautisha) utahitaji uchunguzi wa kuangalia pekee, kwani ni magonjwa machache sana yanayosababisha kujitokeza kwa upele katika mfumo wa dermatomal mfano (tazama ramani). Hata hivyo, virusi vya malengelenge ya simpleksi/0} (HSV) yanaweza kuleta upele mara kwa mara katika mfumo wa namna hiyo. The sampuli ya Tsanck ni muhimu sana kwa utambuaji wa maambukizi sugu ya virusi vya papo hapo na malengelenge, lakini haitofautishi kati ya HSV na VZV. <ref name="pmid2842739">{{cite journal | author = Oranje AP, Folkers E | title = The Tzanck smear: old, but still of inestimable value | journal = Pediatr Dermatol | volume = 5 | issue = 2 | pages = 127–9 | year = 1988 | pmid = 2842739 | doi = 10.1111/j.1525-1470.1988.tb01154.x}}</ref> Wakati ambapo upele huu hauko (katika hatua za awali za ugonjwa au katika tukio la , au katika kesi ya malengelenge), tutuko zosta yanaweza kuwa vigumu kutambua. <ref name="pmid15334402">{{cite journal| author=Chan J, Bergstrom RT, Lanza DC, Oas JG| title=Lateral sinus thrombosis associated with zoster sine herpete| url=https://archive.org/details/sim_american-journal-of-otolaryngology_september-october-2004_25_5/page/357| journal=Am J Otolaryngol| volume=25| issue=5| pages=357–60| year=2004| pmid=15334402| doi=10.1016/j.amjoto.2004.03.007}}</ref> Mbali na vipele, dalili nyingi hutokea pia katika hali nyingine. Majaribio ya maabara zinapatikana kwa utambuzi wa tutuko zosta. Jaribio maarufu zaidi hutambua zindiko maalum ya VZV IgM katika damu; hii hujitokeza tu wakati wa tetekuwanga au tutuko zosta na wala sio wakati virusi vimetulia. <ref name="pmid8809466">{{cite journal| author=Arvin AM| title=Varicella-zoster virus| journal=Clin. Microbiol. Rev| volume=9| issue=3| pages=361–81| year=1996| pmid=8809466| url=http://cmr.asm.org/cgi/reprint/9/3/361.pdf| format=PDF| pmc=172899| access-date=2016-11-01| archive-date=2008-06-25| archive-url=https://web.archive.org/web/20080625213222/http://cmr.asm.org/cgi/reprint/9/3/361.pdf| dead-url=yes}}</ref> Katika maabara makubwa zaidi, limfu zilizokusanywa kutoka kwa malengelenge hupimwa na mmenyuko fululizi wa polimeresi kwa DNA ya VZV, au kuchunguzwa kwa darubini ua kielektroniki ili kutambua chembechembe za virusi. <ref name="pmid9515761">{{cite journal|author=Beards G, Graham C, Pillay D| title=Investigation of vesicular rashes for HSV and VZV by PCR| journal=J. Med. Virol| volume=54| issue=3| pages=155–7| year=1998| pmid=9515761 |doi=10.1002/(SICI)1096-9071(199803)54:3<155::AID-JMV1>3.0.CO;2-4}}</ref> Katika utafiti wa hivi karibuni, sampuli za vidonda kwenye ngozi, macho, na mapafu kutoka kwa wagonjwa 182 waliodhaniwa kuwa na malengelenge ya simpleksi au tutuko zosta walifanyiwa majaribio kwa kutumia PCR halisi au kwa bakteria zenye virusi. Kwa kulinganisha hivi, bakteria zenye virusi zilitambua VZV kwa kiwango cha hisi cha 14.3% pekee, ingawa jaribio hilo lilikuwa na kiwango cha juu sana cha umaalum (umaalumu = 100%). Kwa kuzilinganisha, PCR halisi ilitoa matokeo ya 100% ya unyeti. Kwa ujumla majaribio ya malengelenge ya simpleksi na tutuko zosta kwa kutumia PCR yalionyesha uborekaji wa 60.4% wa bakteria zenye virusi. <ref name="pmid15072752">{{cite journal | author = Stránská R, Schuurman R, de Vos M, van Loon AM. | title = Routine use of a highly automated and internally controlled real-time PCR assay for the diagnosis of herpes simplex and varicella-zoster virus infections | journal = J Clin Virol. | volume=30 | issue=1| pages=39–44 | year=2003 | pmid=15072752 | doi = 10.1016/j.jcv.2003.08.006}}</ref> ==Uzuiaji== Chanjo hai ya VZV linapatikana, na linauzwa kwa jina la Zostavax. <ref name="MMWR_57(05)">{{cite journal | author = Harpaz R, Ortega-Sanchez IR, Seward JF | title = Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP) | journal = MMWR Recomm Rep | volume = 57 | issue = RR-5 | pages = 1–30; quiz CE2–4 | date = 6 Juni 2008 | month = Juni | pmid = 18528318 | doi = | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5705a1.htm | accessdate = 2010-01-04 }}</ref> Katika utafiti wa mwaka 2005 wa watu 38,000 wazima wenye umri wa kamamu zaidi, ilizuia nusu ya kesi za maumivu ya neva yanayokuja baada ya malengelenge kwa theluthi mbili. <ref name=pmid=15930418>[67]</ref> Utafiti wa 2007 ulionyesha kuwa chanjo ya zoster ina uwezekano wa kuwa na gharama nafuu nchini Marekani, na kutabiri uokoaji wa $82 hadi $103,000,000 katika gharama za huduma za afya na uwiano wa gharama wa kuanzia $16,229 hadi $ 27,609 kwa kila mwaka uliopatwa wenye maisha yaliyoboreshwa. <ref>{{cite journal |journal=Vaccine |year=2007 |volume=25 |issue=49 |pages=8326–37 |title= Evaluation of the cost-effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults |author= Pellissier JM, Brisson M, Levin MJ |doi=10.1016/j.vaccine.2007.09.066 |pmid=17980938}}</ref> Mnamo Oktoba 2007 chanjo hiyo ilipendekezwa rasmi nchini Marekani kwa watu wazima wenye afya wenye umri wa miaka 60 na zaidi. <ref name="MMWR_57(05)"></ref> <ref name="pmid17947396">{{cite journal |journal= Ann Intern Med |date=20 Novemba 2007|volume=147 |issue=10 |pages=725–9 |title= Recommended adult immunization schedule: United States, October 2007 – September 2008 |author= Advisory Committee on Immunization Practices |pmid=17947396 |url=http://www.annals.org/cgi/content/full/147/10/725 }}</ref> {{As of|2008|10|df=US}} ,uchunguzi unaodhibitiwa unaendelea kufanywa ili kutathmini ya utendakazi kwa watu wenye umri wa miaka 50 hadi 59. <ref>[74] ^ Jaribio la kiafya la awamu ya III ili kutathmini utendakazi, Uwezo wa kutoa kinga mwilini, Usalama, na Ustahimilivu wa Zostavax kati ya watu waliojitolea kupimwa wenye umri wa kati ya miaka 50 hadi 59 Protocol No. V211-022-00; Mdhamini Marck &amp; Co Inc</ref> Watu wazima pia hupata kuongezewa kinga kwa kuwa wanagusana na watoto walioambukizwa tetekuwanga, njia ya kuongeza nguvu inayozuia kama robo ya matukio ya tutuko zosta kati ya watu wazima ambao hawajapata chanjo, lakini inaendelea kupoteza umaarufu wake nchini Marekani kwa kuwa sasa watoto hupewa chanjo dhidi ya tetekuwanga mara kwa mara. <ref name="pmid18241179"></ref> <ref name="pmid12057605">{{cite journal |author= Brisson M, Gay N, Edmunds W, Andrews N |title= Exposure to varicella boosts immunity to herpes-zoster: implications for mass vaccination against chickenpox |journal=Vaccine |volume=20 |issue=19–20 |pages=2500–7 |year=2002 |doi=10.1016/S0264-410X(02)00180-9 |pmid=12057605}}</ref> Nchini [[Ufalme wa Muungano|Uingereza]] na katika sehemu zingine za Bara Ulaya, utoaji wa chanjo kwa raia halifanywi ipasavyo. Sababu ya msingi ni kwamba, hadi pale ambapo watu wote watapata chanjo, watu wazima ambao wamewahi kupata VZV wangefaidika kutokana na kuwa wazi kwa VZV (kutoka kwa watoto), ambayo huongeza kinga yao kwa kirusi hicho, na unaweza kupunguza hatari ya kupata ugonjwa wa upele baadaye. <ref>{{cite web|author=NHS Direct|authorlink=NHS Direct|url=http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=1032|title=Why isn’t the chickenpox vaccine available in the UK?|accessdate=2008-03-22|date=2008-02-07|archiveurl=https://web.archive.org/web/20080423095454/http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=1032|archivedate=2008-04-23}}</ref> Shirika la kukinga Afya ya Uingereza linasema kwamba, ingawa chanjo imeidhinishwa nchini Uingereza, hakuna mpango wa kuiingiza kwenye utaratibu wa chanjo kwa watoto, ingawa inaweza kutolewa kwa wafanyakazi wa afya wasio na kinga ya VZV. <ref>{{cite web|author=Health Protection Agency|authorlink=Health Protection Agency|url=http://www.hpa.org.uk/infections/topics_az/chickenpox/gen_info.htm|title=Chickenpox / Varicella&nbsp;— General Information|date=2006-05-11|accessdate=2008-03-22|archiveurl=https://web.archive.org/web/20080719182645/http://www.hpa.org.uk/infections/topics_az/chickenpox/gen_info.htm|archivedate=2008-07-19}}</ref> Utafiti wa mwaka wa 2006 wa kesi 243 na vidhibiti 483 vilivyolinganishwa vilionyesha kwamba matunda yanahusishwa na kupunguka kwa kiwango cha atari cha kuambukizwa vipele: watu waliokula kiasi kidogo cha matunda kwa siku walikuwa na hatari ya mara tatu zaidi ikilinganishwa na waliokula zaidi ya vipimo vitatu, baada ya kuangalia vipengele vingine kama vile ulaji wa nishati kwa jumla. Kwa watu wenye umri wa miaka 60 au zaidi, ulaji wa vitamini na mboga ulikuwa na uhusiano sawa. <ref name="pmid16330478">{{cite journal |author=Thomas SL, Wheeler JG, Hall AJ |title=Micronutrient intake and the risk of herpes zoster: a case-control study |journal=Int J Epidemiol |volume=35 |issue=2 |pages=307–14 |year=2006 |pmid=16330478 |doi=10.1093/ije/dyi270 |url=http://ije.oxfordjournals.org/cgi/content/full/35/2/307}}</ref> ==Matibabu== [[File:Herpeszoster.JPG|right|thumb|Tutuko zosta kwenye sehemu ya chini ya mgongo]] Malengo ya matibabu ni kukomesha ukali na muda wa maumivu, kufupisha muda wa vipele, na kupunguza matatizo. Matibabu ya dalili huhitajika mara kwa mara kwa ajili ya matatizo ya niuraljia ya baada ya malengelenge. <ref name="pmid18021865">{{cite journal |journal= J Am Acad Dermatol |year=2007 |volume=57 |issue= 6 Suppl |pages=S136–42 |title= Management of herpes zoster and postherpetic neuralgia |author= Tyring SK |doi=10.1016/j.jaad.2007.09.016 |pmid=18021865}}</ref> Hata hivyo, uchunguzi kuhusu tutuko zosta unaonyesha kuwa ni nadra kwa watu wenye umri wa chini ya miaka 50 kupata maumivu baada ya kuisha kwa upele (niuraljia ya baada ya malengelenge) na huisha baada ya muda; kati ya watu wazeee zaidi, maumivu yalichukua muda mrefu zaidi kuisha, lakini hata kati ya watu wenye zaidi ya miaka 70, 85% walikuwa hawana maumivu mwaka mmoja baada ya kupata vipele. <ref name="pmid11009518">{{cite journal | author= Sigurdur Helgason et al | title = Prevalence of postherpetic neuralgia after a single episode of herpes zoster: prospective study with long term follow up | journal= British Medical Journal | volume=321 | year=2000 | pmid=11009518 |url=http://www.bmj.com/cgi/content/full/321/7264/794|format=PDF | doi= 10.1136/bmj.321.7264.794 | issue= 7264 | pages= 794–6 | pmc= 27491}}</ref> ===Vituliza maumivu=== Wagonjwa wenye maumivu madogo hadi wastani wanaweza kutibiwa kwa kutumia [[vituliza maumivu vinavyouzwa kwenye maduka]]. Losheni za topiki zenye kalamini au mafuta ya nguruwe yanaweza kupakwa juu ya upele au malengelenge na yanaweza kutuliza maumivu. Mara kwa mara, maumivu makali yanaweza kuhitaji madawa ya afyuni, kama vile mofini. Mara baada ya vidonda kufunikwa na magamba, krimu ya kapsaisini (Zostrix) inaweza kutumika. Lidokeini ya topiki na bloku za neva pia zinaweza kupunguza maumivu. <ref name="pmid15061819">{{cite journal| author=Baron R| title=Post-herpetic neuralgia case study: optimizing pain control| journal=Eur. J. Neurol| volume=11 Suppl 1| pages=3–11| year=2004| pmid=15061819| doi=10.1111/j.1471-0552.2004.00794.x}}</ref> Kutumia gabapentini pamoja na kinzavirusi kunaweza kuleta nafuu kwa niuraljia ya baada ya malengelenge. <ref name="pmid18021865"></ref> ===Kinzavirusi=== Madawa ya kinzavirusi huzuia uigaji wa VZV na kupunguza ukali na muda wa tutuko zosta huku yakiwa na madhara madogo sana, lakini hayawezi kutegemewa kuzuia niuraljia ya baada ya malengelenge. Kati ya madawa haya, acyclovir imekuwa ndiyo tiba ya kawaida, lakini kwa madawa mapya valasikloviri na famsikloviri huonyesha utendakazi sawa au bora zaidi na usalama mzuri na ustahimilivu. <ref name="pmid18021865"></ref> Dawa hizo hutumika kama profilaksisi (kwa mfano kuwatibu wagonjwa wa [[Ukimwi|UKIMWI)]] na kama tiba wakati wa awamu kali. Matibabu ya kinzavirusi yanapendekezwa kwa watu wote wenye miili inayoweza kujikinga na maradhi, wanaougua tutuko zosta na wana zaidi ya miaka 50. Ikiwezekana, dawa hizi zinapaswa kutolewa katika muda wa masaa 72 baada ya kuonekana kwa vipele. <ref name="PMID17939892">{{cite journal | author = Breuer J, Whitley R | title = Varicella zoster virus: natural history and current therapies of varicella and herpes zoster | journal = Herpes | volume = 14 | issue = Suppl 2 | pages = 25–9 | year = 2007 | pmid = 17939892 | url = http://www.ihmf.org/journal/download/2%20-%20Herpes%2014.2%20suppl%20Breuer.pdf | format = PDF | access-date = 2016-11-01 | archive-date = 2008-12-16 | archive-url = https://web.archive.org/web/20081216221853/http://www.ihmf.org/journal/download/2%20-%20Herpes%2014.2%20suppl%20Breuer.pdf | dead-url = yes }}</ref> Matatizo kwa watu wenye tutuko zosta na miili isiyoweza kujikinga na maradhi yanaweza kupunguzwa kwa kutumia asaikloviri ya ndani ya vena. Kwa watu wenye hatari kuu ya kwa mashambulizi yanayorudiwarudiwa ya vipele, vipimo vya asaikloviri vya kumezwa kila siku kwa siku tano kwa kawaida huwa na ufanisi. <ref name="pmid12676845">{{cite journal| journal=BMJ| year=2003| volume=326| issue=7392| pages=748| doi=10.1136/bmj.326.7392.748| author=Johnson, RW & Dworkin, RH| title=Clinical review: Treatment of herpes zoster and postherpetic neuralgia | pmid=12676845 | url=http://www.bmj.com/cgi/content/full/326/7392/748| pmc=1125653}}</ref> ===Steroidi=== Steroidi za bongo zinazomezwa hutumika mara nyingi kutibu maambukizi, licha ya kuwa majaribio ya kliniki ya matibabu haya hayashawishi. Hata hivyo, jaribio moja lililochunguza wagonjwa wenye zaidi ya miaka 50 ambao miili yao haiwezi kujikinga na maradhi na waliokuwa ma tutuko zosta, ulionyesha kuwa kutumia prednisoni wenye asikloviri uliboresha muda matibabuna kuboresha ubora wa maisha. <ref name="pmid8702088">{{cite journal |author=Whitley RJ, Weiss H, Gnann JW, Tyring S, Mertz GJ, Pappas PG, Schleupner CJ, Hayden F, Wolf J, Soong SJ |title=Acyclovir with and without prednisone for the treatment of herpes zoster. A randomized, placebo-controlled trial. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group |url=https://archive.org/details/sim_annals-of-internal-medicine_1996-09-01_125_5/page/376 |journal=Ann. Intern. Med. |volume=125 |issue=5 |pages=376–83 |year=1996 |pmid=8702088}}</ref> Baada ya tathmini kwa mwezi mmoja, asikloviri na prednisoni ziliongeza uwezekano wa ufunikaji na kupona kwa vidonda kwa karibu mara mbili, ikilinganishwa na kipozaungo. Jaribio hili pia lilitathmini madhara ya mchanganyiko huu wa madawa kwa ubora wa maisha katika muda wa mwezi mmoja, na kuonyesha kwamba wagonjwa walikuwa na maumivu madogo zaidi, na walikuwa na uwezekano zaidi wa kuacha kutumia vikolezo vya vituliza maumivu, kurudi kwa shughuli zao za kawaida na kulala bila kukatizwa kwa usingizi. Hata hivyo, wakati wa kulinganisha kukomeshwa kwa maumivu yanayohusishwa na tutuko zosta au niuraljia ya baada ya malengelenge, hakukuwa na tofauti kati ya asikloviri plus prednisoni na asiklovir peke yake. Kutokana na hatari ya matibabu ya steroidi za bongo, inashauriwa kuwa mchanganyiko huu wa madawa utumike tu kwa watu wenye zaidi ya miaka 50, kutokana na hatari kubwa zaidi ya kupata niuraljia ya baada ya malengelenge. <ref name="pmid8702088"></ref> ===Ofthalmikasi ya tutuko zosta=== Matibabu kwa ofthalmikasi ya malemgelenge ya zoster ni sawa na matibabu ya kawaida ya tutuko zosta katika maeneo mengine. Jaribio la hivi karibuni lililolinganisha asikloviri na dawa wawa nayo ya hapo awali, valasikloviri, lilionyesha utendakazi sawa katika matibabu ya aina hii ya ugonjwa huo. <ref name="pmid10919899">{{cite journal| author=Colin J, Prisant O, Cochener B, Lescale O, Rolland B, Hoang-Xuan T| title=Comparison of the Efficacy and Safety of Valaciclovir and Acyclovir for the Treatment of Herpes zoster Ophthalmicus| url=https://archive.org/details/sim_ophthalmology_2000-08_107_8/page/1507| journal=Ophthalmology | volume=107| issue = 8| pages=1507–11| year=2000| pmid=10919899| doi=10.1016/S0161-6420(00)00222-0}}</ref> Faida kubwa ya valsikloviri ikilinganishwa na asikloviri ni kipimo chake cha mara tatu tu kwa siku (ikilinganishwa na ile ya asikloviri ya kipimo cha mara 5 kwa siku), jambo ambalo linaweza kuwawezesha zaidi wagonjwa kuzingatia maagizo ya matibabu. <ref name="pmid16079372">{{cite journal| author=Osterberg L, Blaschke T| title=Adherence to medication| url=https://archive.org/details/sim_new-england-journal-of-medicine_2005-08-04_353_5/page/486| journal=[[The New England Journal of Medicine|N. Engl. J. Med.]] | volume=353 |issue=5| pages=487–97| year=2005| pmid=16079372| doi=10.1056/NEJMra050100}}</ref> ==Matatizo== Ingawa tutuko zosta kwa kawaida hupona katika muda wa wiki mbili, matatizo fulani yanaweza kutokea: * Maambukizi ya pili ya bakteria * Kuhusishwa kwa vitengo vya mwendo - ikiwa ni pamoja na udhaifu hasa katika "tutuko zosta ya vitengo vya mwendo" * Kuhusishwa kwa macho - kuhusishwa kwa neva ya trijemia (kama inavyoonekana katika ofthalmikasi ya malengelenge) inafaa kutibiwa mapema na kwa fujo kwa kuwa inaweza kusababisha upofu. Kuathiriwa kwa ncha ya pua kutokana na upele wa zoster upele ni kitabiri cha ofthalmikasi ya malengelenge. <ref>{{cite web|url=http://www.merck.com/mmpe/sec09/ch102/ch102e.html|title=Herpes Zoster Ophthalmicus|work=Merck Manual (Merk.com)|date=Oktoba 2008|accessdate=Juni 2010}}</ref> * Niurlajia ya baada ya malengelenge - hali ya maumivu sugu yanayofuata tutuko zosta ==Ubashiri== Upele na maumivu kwa kawaida hupunguka baada ya kati ya wiki tatu hadi tano, lakini takriban mgonjwa mmoja kati ya watano hupitia hali ya maumivu inayoitwa niuraljia ya baada ya malengelenge, ambayo mara nyingi ni ngumu kudhibiti. Kwa wagonjwa wengine, tutuko zosta yanaweza kufufuka tena na kujitokeza kama ''zoster sine herpete:'' maumivu yanayotokan kwenye njia ya neva moja ya uti wa mgongo ''usambazaji wa chini ya ngozi),'' lakini usioambatana na upele. Hali hii inaweza kuleta matatizo yanayoathiri viwango kadhaa vya mfumo wa neva na kusababisha niuropathia nyingi za fuvu, kuvimba kwa neva, mieliti, au ugonjwa uvimbe wa tando za uti wa mgongo na ubongo usio na bakteria. Madhara mengine makubwa yanayoweza kutokea katika baadhi ya matukio ni pamoja na kupooza usoni (kwa kawaida huwa ni kwa muda), uharibifu wa sikio, au uvimbe ubongo. <ref name="pmid12676845"></ref> Wakati wa ujauzito, maambukizo ya kwanza ya VZV, yanayosababisha tetekuwanga, yanaweza kusababisha maambukizi ya kijusi na kuleta matatizo kwa mtoto mchanga, lakini maambukizi sugu au ufufuaji wa vipele hayahusishwi na maambukizi kwa kijusi. <ref name="pmid3012334">{{cite journal |author=Paryani SG, Arvin AM |title=Intrauterine infection with varicella-zoster virus after maternal varicella |url=https://archive.org/details/sim_new-england-journal-of-medicine_1986-06-12_314_24/page/1542 |journal=[[The New England Journal of Medicine|N. Engl. J. Med.]] |volume=314 |issue=24 |pages=1542–6 |year=1986 |pmid=3012334 |doi=10.1056/NEJM198606123142403}}</ref> <ref name="Enders">{{cite journal |author=Enders G, Miller E, Cradock-Watson J, Bolley I, Ridehalgh M |title=Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases |url=https://archive.org/details/sim_the-lancet_1994-06-18_343_8912/page/1548 |journal=[[The Lancet|Lancet]] |volume=343 |issue=8912 |pages=1548–51 |year=1994 |pmid=7802767 |doi=10.1016/S0140-6736(94)92943-2}}</ref> Kuna hatari lililoongezeka kwa kiasi kidogo ya kupata kansa baada ya kuambukizwa na tutuko zosta. Hata hivyo, utaratibu huo si wazi na vifo vinavyotokana na kansa havikuonekana kuongezeka moja kwa moja kutokana na kuweko kwa virusi. <ref name="pmid15328522">{{cite journal |author=Sørensen HT, Olsen JH, Jepsen P, Johnsen SP, Schønheyder HC, Mellemkjaer L |title=The risk and prognosis of cancer after hospitalisation for herpes zoster: a population-based follow-up study |journal=Br. J. Cancer |volume=91 |issue=7 |pages=1275–9 |year=2004 |pmid=15328522 |doi=10.1038/sj.bjc.6602120 |pmc=2409892}}</ref> Badala yake, hatari iliyoongezeka inaweza kutokana na kukandamizwa kwa kinga ambayo inaruhusu ufufaji wa virusi. <ref name="pmid6979711">{{cite journal |doi=10.1056/NEJM198208123070701 |author=Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO |title=Risk of cancer after herpes zoster: a population-based study |url=https://archive.org/details/sim_new-england-journal-of-medicine_1982-08-12_307_7/page/n41 |journal=[[The New England Journal of Medicine|N. Engl. J. Med.]] |volume=307 |issue=7 |pages=393–7 |year=1982 |pmid=6979711}}</ref> ==Epidemiolojia== [[File:Varicella (Chickenpox) Virus PHIL 1878 lores.jpg|right|thumb|Mikrografu ya kielektroniki ya kirusi cha zoster cha Varisela. Takribani ukuzaji wa mara 150,000]] Kirusi cha Zoster Varisela kina kiwango cha juu cha uambukizaji na kimeenea duniani kote, <ref>{{cite journal |author=Apisarnthanarak A, Kitphati R, Tawatsupha P, Thongphubeth K, Apisarnthanarak P, Mundy LM |title=Outbreak of varicella-zoster virus infection among Thai healthcare workers |url=https://archive.org/details/sim_infection-control-and-hospital-epidemiology_2007-04_28_4/page/430 |journal=Infect Control Hosp Epidemiol |volume=28 |issue=4 |pages=430–4 |year=2007 |pmid=17385149 |doi=10.1086/512639}}</ref> na kina kiwango imara sana chha maambukizi kutoka kizazi kimoja hadi kingine. <ref name="pmid11289797">{{cite journal |author=Abendroth A, Arvin AM |title=Immune evasion as a pathogenic mechanism of varicella zoster virus |journal=Semin. Immunol. |volume=13 |issue=1 |pages=27–39 |year=2001 |pmid=11289797 |doi=10.1006/smim.2001.0293}}</ref> VZV ni ugonjwa hafifu kwa mtoto mwenye afya nzuri katika nchi zilizoendelea. Hata hivyo, varisela inaweza kusababisha kifo kwa watu wanaoambukizwa baadaye maishani au walio na kiwango cha chini cha kinga. Idadi ya watu katika kundi hili la hatari kuu imeongezeka, kutokana na janga la VVU na ongezeko la matibabu ya kukandamiza kinga. <ref>{{cite journal|title=Risk of herpes zoster in patients with rheumatoid arthritis treated With anti–TNF-α agents|url=https://archive.org/details/sim_jama_2009-02-18_301_7/page/737|journal=[[Journal of the American Medical Association|J Am Med Assoc]] |year=2009|volume=301|issue=7|pages=737–744|doi=10.1001/jama.2009.146|pmid=19224750|author1=Strangfeld A, Listing J|author2=Herzer, P.|author3='', ''et al}}</ref> Maambukizi ya varisela katika taasisi kama vile hospitali pia ni tatizo kubwa, hasa katika hospitali zinazowahudumia watu hawa wenye hatari kuu. <ref name="Weller">{{cite book |author=Weller TH |chapter=Varicella-herpes zoster virus |title=Viral Infections of Humans: Epidemiology and Control |editor=Evans AS, Kaslow RA |publisher=Plenum Press |year=1997 |pages=865–92 |isbn=978-0306448553}}</ref> Kwa ujumla, tutuko zosta hayana matukio ya msimu na hayatokani na mikurupuko. <ref name="pmid14720565"></ref> Katika kanda zenye hali wastani za joto, tetekuwanga ni ugonjwa wa watoto, na matukio mengi hutokea wakati wa majira ya baridi na majira ya kuchipua, uwezekano mkubwa ukiwa ni kutokana na kuenda shuleni; hakuna ushahidi kwa majanga ya mara kwa mara. Katika tropiki, tetekuwanga kwa kawaida hutokea kati ya watu wazee zaidi. <ref name="pmid8856352">{{cite journal |journal= Infect Dis Clin North Am |year=1996 |volume=10 |issue= 3 |pages=571–81 |title= The epidemiology of varicella-zoster virus infections |url= https://archive.org/details/sim_infectious-disease-clinics-of-north-america_1996-09_10_3/page/571 |author= Wharton M |pmid=8856352 |doi= 10.1016/S0891-5520(05)70313-5}}</ref> Matukio ni ya juu kabisa kati ya watu wenye zaidi ya miaka 55, pamoja na wagonjwa wenye hali ambapo mwili unapoteza uwezo wa kujikinga na maradhi bila kujali umri, na kati ya watu walio na msongo wa kisaikolojia. Watu wasio wazungu wanaweza kuwa na hatari ya chini zaidi; haieleweki ikiwa hatari hii imeongezeka kwa wanawake. Sababu zingine ambazo huenda ikaleta hatari ni pamoja na majeraha ya kimwili, sababu za kijenetiki, na uwazi kwa imunotoksinimfiduo. <ref name="pmid14720565"></ref> Kiwango cha matukio ya tutuko zosta ni kati ya 1.2 na 3.4 kwa kila miaka ya watu 1,000 kati ya watu wenye afya, na unaongezeka hadi 3.9-11.8 kwa kila miaka ya watu 1,000 kati ya watu wenye zaidi ya umri wa miaka 65. <ref name="pmid17143845"></ref> Matukio sawa ya viwango yamerekodiwa duniani kote. <ref name="pmid17143845"></ref> <ref name="pmid17939895">{{cite journal| author=Araújo LQ, Macintyre CR, Vujacich C| title=Epidemiology and burden of herpes zoster and post-herpetic neuralgia in Australia, Asia and South America| journal=Herpes| volume=14| issue=Suppl 2| pages=40A–4A| year=2007| pmid=17939895| url=http://www.ihmf.org/journal/download/5%20-%20Herpes%2014.2%20suppl%20Araujo.pdf| format=PDF| access-date=2016-11-01| archive-date=2008-12-16| archive-url=https://web.archive.org/web/20081216221902/http://www.ihmf.org/journal/download/5%20-%20Herpes%2014.2%20suppl%20Araujo.pdf| dead-url=yes}}</ref> Tutuko zosta hujitokeza kati ya takribani Waamerika 500,000 kila mwaka. <ref name="pmid16050886">{{cite journal |author=Insinga RP |title=The incidence of herpes zoster in a United States administrative database |journal=J Gen Intern Med |volume=20 |issue=6 |pages=748–753 |year=2005 |pmid=16050886 |doi=10.1111/j.1525-1497.2005.0150.x |pmc=1490195 |last2=Itzler |first2=RF |last3=Pellissier |first3=JM |last4=Saddier |first4=P |last5=Nikas |first5=AA }}</ref> Tafiti mbalimbali na takwimu ya upelelezi, angalau wakati inapotazamwa kijuu juu, hazionyeshi mielekeo yoyote thabiti ya matukio nchini Marekani tangu kuanzishwa kwa mpango wa chanjo dhidi ya tetekuwanga mwaka wa 1995. <ref>{{cite journal |journal= MMWR Recomm Rep |date=22 Juni 2007|month=Juni |volume=56 |issue=RR-4 |pages=1–40 |title= Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP) |author= Marin M, Güris D, Chaves SS, Schmid S, Seward JF |pmid=17585291 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5604a1.htm}}</ref> Hata hivyo, baada ya ukaguzi wa maikini, tafiti hizo mbili ambazo hazikuonyesha kuongezeka kwa matukio ya vipele zilifanywa katika maeneo ambapo chanjo ya varislea bado ilikuwa haijaenea. <ref>{{cite journal |journal=J Infect Dis. |year=2005 |volume=191 |issue=12 |pages=2002–2007 |title=Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992–2002 |url=https://archive.org/details/sim_journal-of-infectious-diseases_2005-06-15_191_12/page/n21 |author= Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF |pmid=15897984 |doi=10.1086/430325}}</ref> <ref>{{cite journal |journal=J Infect Dis. |year=2005 |volume=191 |issue=12 |pages=1999–2001 |title=Changing dynamics of varicella-zoster virus infections in the 21st century: the impact of vaccination |url=https://archive.org/details/sim_journal-of-infectious-diseases_2005-06-15_191_12/page/1998 |author= Whitley RJ |pmid=15897983 |doi=10.1086/430328}}</ref> Utafiti wa hivi karibuni uliofanywa na Patel na wenzake ulihitimisha kuwa tangu kuanzishwa kwa chanjo dhidi ya tetekuwanga, gharama za hospitali kutokana na matatizo ya vipele imeongezeka kwa zaidi ya $ milioni 700 kila mwaka kwa watu wenye zaidi ya miaka 60. <ref>{{cite journal |journal=Control Hosp. Epidemiol. |year=2008 |volume=29 |issue=12 |pages=1157–1163 |title=Herpes zoster-related hospitalizations and expenditures before and after introduction of the varicella vaccine in the United States |url=https://archive.org/details/sim_infection-control-and-hospital-epidemiology_2008-12_29_12/page/1157 |author= Patel MS, Gebremariam A, Davis MM |pmid=18999945 |doi=10.1086/591975}}</ref> Utafiti mwingine uliofanywa na Yih na wenzake uliripoti kuwa usambazaji wa chanjo ya varislea kati ya watoto uliongezeka, matukio ya varisela yalipungua na matukio ya vipele kati ya watu wazima yaliongezeka kwa 90%. <ref>{{cite journal |journal=BMC Public Health |year=2005 |volume=5 |pages=68–68 |title= The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998–2003 |author=Yih WK, Brooks DR, Lett SM, Jumaan AO, Zhang Z. Clements KM, Seward JF |pmid=15960856 |doi=10.1186/1471-2458-5-68 |pmc=1177968}}</ref> Matokeo ya utafiti zaidi uliofanywa na Yawn na wenzake yalionyesha kuongezeka kwa matukio ya vipele kwa 28% kati ya mwaka wa 1996 na 2001. <ref>{{cite journal |journal=Mayo Clin Proc.|year=2007 |volume=82 |issue=11 |pages=1341–1349 |title=A Population-Based Study of the Incidence and Complication Rates of Herpes Zoster Before Zoster Vaccine Introduction|url=https://archive.org/details/sim_mayo-clinic-proceedings_2007-11_82_11/page/1341|author=Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS |pmid=17976353 |doi=10.4065/82.11.1341}}</ref> Zaidi ya hayo, kulikuwa na ongezeko la kitakwimu katika visa vya upele vilivyoripotiwa kwa watu wazima katika Mradi wa Uchunguzi wa Uhai wa Varisela wa Antelope Valley (VASP) kutoka mwaka wa 2000 hadi 2003. Ongezeko la 56.1% kutoka matukio 237 mwaka wa 2000 hadi matukio 370 mwaka wa 2002 unaleta uwiano wa kiwango cha 1.4 (95% CI 1.2-1.7). Ongezeko katika visa vya vipele lililoripotiwa na VASP ilitokea kati ya kila kategoria ya umri (isipokuwa 70 na zaidi) kutoka mwaka wa 2000 hadi 2001. VASP pia iliripoti kuwa visa vilivyohakikiwa vya upele kati ya watu wazima wenye umri wa miaka 50 na zaidi viliongezeka kwa 27.5% kutoka 2006 hadi 2007. (Muhtasari wa kila mwaka, 2001, 2002, 2003, 2006, 2007 Mradi wa Uchunguzi wa Uhai wa Varisela katika Antelope Valley, Idara ya Huduma za Afya katika Mkoa wa Los Angeles, Vituo vya Kudhibiti na Kuzuia Magonjwa (CDC) Mkataba wa Ushirikiano No. U66/CCU911165-10; Mascola L, na wenzake.) Kuna uwezekano kuwa kiwango cha matukio kitabadilika katika siku za usoni kutokana na kuzeeka kwa watu, mabadiliko katika tiba dhidi ya magonjwa ya kudhuru na magonjwa ya kingamwilinafsi, na mabadiliko katika viwango vya chanjo dhidi ya tetekuwanga; kuongezeka kwa ukubalifu wa chanjo dhidi ya zoster kunaweza kupunguza matukio kwa kiwango kikubwa. <ref name="pmid17143845"></ref> Katika utafiti mmoja, ilikadiriwa kwamba 26% ya wagonjwa wanaoambukizwa tutuko zosta hatimaye hupata matatizo. Niuraljia ya baada ya malengelenge hujitokeza katika takriban 20% ya wagonjwa. <ref name="pmid17939894">{{cite journal |author=Volpi A |title=Severe complications of herpes zoster |journal=Herpes |volume=14 |issue=Suppl 2 |pages=35A–9A |year=2007 |pmid=17939894 |url=http://www.ihmf.org/journal/download/4%20-%20Herpes%2014.2%20suppl%20Volpi.pdf |format=PDF |access-date=2016-11-01 |archive-date=2019-01-27 |archive-url=https://web.archive.org/web/20190127051057/http://www.ihmf.org/journal/download/4%20-%20Herpes%2014.2%20suppl%20Volpi.pdf |dead-url=yes }}</ref> Utafiti wa 1994 wa data za California ulipata viwango vya kulazwa hospitalini vya 2.1 kwa kila miaka ya watu 100,000, na kupanda hadi 9.3 kwa kila miaka ya watu 100,000 kwa watu wenye miaka 60 na zaidi. <ref>{{cite journal |journal=Pediatr Infect Dis J |year=2001 |volume=20 |issue=7 |pages=641–5 |title= Incidence and hospitalization rates of varicella and herpes zoster before varicella vaccine introduction: a baseline assessment of the shifting epidemiology of varicella disease |url=https://archive.org/details/sim_pediatric-infectious-disease-journal_2001-07_20_7/page/641 |author= Coplan P, Black S, Rojas C |pmid=11465834 |doi=10.1097/00006454-200107000-00002}}</ref> Uchunguzi wa awali mjini Connecticut uligundua kiwango cha juu zaidi cha kulaza watu hospitalini; tofauti hii inaweza kuwa imesababishwa na maambukizi ya virusi vya ukimwi katika utafiti wa awali, au kutokana na kuanzishwa kwa matumizi ya kinzavirusi mjini California kabla ya mwaka wa 1994. <ref>{{cite journal |journal=J Am Osteopath Assoc |date=1 Machi 2007 |volume=107 |issue=3 Suppl |pages=S2–7 |title=The burden of herpes zoster and postherpetic neuralgia in the United States |author=Weaver BA |pmid=17488884 |url=http://www.jaoa.org/cgi/content/full/107/suppl_1/S2 |access-date=2016-11-01 |archive-date=2008-01-13 |archive-url=https://web.archive.org/web/20080113020412/http://www.jaoa.org/cgi/content/full/107/suppl_1/S2 |dead-url=yes |=https://web.archive.org/web/20080113020412/http://www.jaoa.org/cgi/content/full/107/suppl_1/S2 }}</ref> Utafiti wa mwaka wa 2008 ulionyesha kwamba watu wenye ndugu wa karibu waliokuwa na vipele walikuwa na uwezekano wa mara mbili wa kuipata wenyewe. Utafiti unakisia kwamba sababu za kimaumbile zinachangia pakubwa katika kubainisha kati ya watu walio na uwezekano mkubwa zaidi wa kupata VZV. <ref>{{cite journal |author=Hicks LD, Cook-Norris RH, Mendoza N, Madkan V, Arora A, Tyring SK |title=Family history as a risk factor for herpes zoster: a case-control study |journal=Arch Dermatol |volume=144 |issue=5 |pages=603–8 |year=2008 |month=Mei |pmid=18490586 |doi=10.1001/archderm.144.5.603}}</ref> ==Historia== Tutuko zosta yana historia ndefu iliyorekodiwa, ingawa rekodi za zimeshindwa kutofautisha kati ya malengelenge yanayosababishwa na VZV na yale yanayosababishwa na ndui, <ref name="pmid18021864"></ref> hali ya erogoti na erisipela. Ilikuwa ni mwishoni mwa karne ya kumi na nane ndipo William Heberden alibaini njia ya kutofautisha kati ya tutuko zosta na ndui, <ref>{{cite book|author=Weller TH |year=2000 |chapter=Chapter 1. Historical perspective |title=Varicella-Zoster Virus: Virology and Clinical Management |url=https://archive.org/details/varicellazosterv0000unse |editor=Arvin AM, Gershon AA |publisher=Cambridge University Press |isbn=0521660246}}</ref> na tutuko zosta haikuweza kutofautishwa na erisipela hadi mwisho wa karne ya kumi na tisa. Katika mwaka wa 1831, Richard Bright alitoa nadharia tete kuwa ugonjwa huo ulitoka kwenye ganglioni ya shina la uti wa mgongo, na jambo hili lilithibitishwa katika makala ya 1861 yaliyoandikwa na Felix von Bärunsprung. <ref>{{cite journal |author=Oaklander AL |title=The pathology of shingles: Head and Campbell's 1900 monograph |journal=Arch. Neurol. |volume=56 |issue=10 |pages=1292–4 |year=1999 |month=Oktoba |pmid=10520948 |doi= 10.1001/archneur.56.10.1292|url=}}</ref> Dalili za kwanza zilizoonyesha kuwa tetekuwanga na tutuko zosta yalisababishwa na kirusi kile kile zilitambuliwa mwanzoni mwa karne ya 20. Madaktari walianza kuripoti kuwa visa vya tutuko zosta zilifuatiwa mara nyingi na tetekuwanga kati ya vijana walioishi na wagonjwa waliokuwa na vipele. Dhana la kuyahusisha magonjwa hayo mawili yalidhibitishwa zaidi wakati ambapo ilidhihirika ya kuwa limfu kutoka kwa mgonjwa wa tutuko zosta inaweza kuleta tetekuwanga kati ya vijana waliojitolea. Hatimaye jambo hili lilidhibitishwa na utengaji wa kwanza wa kirusi hiki katika vikuza viini, na [[Thomas Weller]], aliyepata tuzo la Nobel katika mwka wa 1953. <ref name="pmid13064265">{{cite journal |author=Weller TH |title=Serial propagation in vitro of agents producing inclusion bodies derived from varicella and herpes zoster |journal=Proc. Soc. Exp. Biol. Med. |volume=83 |issue=2 |pages=340–6 |year=1953 |pmid=13064265}}</ref> Hadi miaka ya 1940, ugonjwa huo ulichukuliwa kuwa hafifu, na matatizo makubwa yalidhaniwa kuwa nadra sana. <ref>{{cite book |author=Holt LE, McIntosh R |title=Holt's Diseases of Infancy and Childhood |year=1936 |publisher=D Appleton Century Company |pages=931–3}}</ref> Hata hivyo, kufikia mwaka wa 1942, ilitambuliwa kwamba tutuko zosta ulikuwa ni ugonjwa hatari zaidi kati ya watu wazima kuliko kwa watoto, na kwamba matukio yake yaliongezeka jinsi umri wa mtu ulivyoendelea kuongezeka. Tafiti zaidi katika miaka ya 1950 kuhusu watu wenye kinga iliyokandamizwa ilionyesha kuwa ugonjwa huo haukuwa hafifu kama ilivyodhaniwa hapo awali, na utafutaji wa tiba na kinga mbalimbali ukaanza. <ref name="Weller"></ref> Kufikia miaka ya 1960, tafiti kadhaa zilitambua kupunguka polepole kwa kinga ya seli katika umri wa uzeeni, na kutambua kuwa katika kundi la watu 1,000 waliofikisha umri wa miaka 85, takribani watu 500 (yaani, 50%) wangepata kuambukizwa tutuko zosta angalau mara moja, na watu 10 (yaani, 1%) wangepata kuambukizwa angalau mara mbili. <ref>{{cite journal |author=Hope-Simpson RE |year=1965 |title=The nature of herpes zoster; a long-term study and a new hypothesis |journal=Proc R Soc Med |volume=58 | pages=9–20 |pmid=14267505 |pmc=1898279}}</ref> Katika masomo ya kihistoria ya vipele, matukio ya vipele kwa ujumla yaliongezeka kulingana na umri. Hata hivyo, katika karatasi yake ya 1965, Dkt Hope-Simpson alikuwa wa kwanza kupendekeza kuwa, "Usambazaji wa kipekee wa kiumri wa zoster unaweza kuonyesha kwa sehemu marudio ambayo kila kategoria ya umri tofauti hupata matukio ya varisela na kutokana na kuongezeka kwa kinga mwilini mwao, maambukizi yao ya zoster huahirishwa. " Ili kuiunga mkono nadharia hii tete kuwa kuwagusa watoto wenye tetekuwanga huimarisha kinga ya kusaidiwa na chembechembe kati ya watu wazima na hivyo kusaidia kuhairisha au kukandamiza vipele, Thomas na wenzake walifanya utafiti ulioonyesha kuwa watu wazima katika nyumba zenye watoto walikuwa na viwango vya chini vya visa vya upele ikilinganishwa na nyumba zisizo na watoto. <ref>{{cite journal |author=Thomas SL, Wheeler JG, Hall AJ |year=2002 |title=Contacts with varicella or with children and protection against herpes zoster in adults: a case-control study |url=https://archive.org/details/sim_the-lancet_2002-08-31_360_9334/page/n30 |journal=[[The Lancet|Lancet]] |volume=360 | pages=678–682 |pmid=12241874 |doi=10.1016/S0140-6736(02)09837-9 |issue=9334}}</ref> Aidha, utafiti na Terada na wenzake ulionyesha kuwa madaktari wa watotot walionyesha viwango vya matukio kutoka 1 / 2 hadi 1 / 8 kuliko vile vya watu wa kawaida wa umri wao. <ref>{{cite journal |author=Terada K, Hiraga Y, Kawano S, Kataoka N |year=1995 |title=Incidence of herpes zoster in pediatricians and history of reexposure to varicella-zoster virus in patients with herpes zoster |journal=Kansenshogaku Zasshi |volume=69 |issue=8 | pages=908–912 |pmid=7594784}}</ref> == Marejeo == {{Marejeo|2}} ==Viungo vya nje== * [http://www.ninds.nih.gov/disorders/shingles/shingles.htm Ukurasa wa maelezo kuhusu vipele vya NINDS] {{Wayback|url=http://www.ninds.nih.gov/disorders/shingles/shingles.htm |date=20160727221439 }} , Taasisi ya Kiaifa kuhusu matatizo ya neva na kiharusi * {{Dmoz|Health/Conditions_and_Diseases/Infectious_Diseases/Viral/Herpes/Herpes_Zoster/}} * [http://www.nei.nih.gov/health/cornealdisease/index.asp#f Maelezo kuhusu Konea na ugonjwa wa Konea: Malengelenge ya Zoster (Vipele)] {{Wayback|url=http://www.nei.nih.gov/health/cornealdisease/index.asp#f |date=20050327021720 }} , Taasisi ya Kitaifa ya Macho [[Jamii:Maradhi ya ngozi]] [[Jamii:Maradhi ya kuambukiza]] h08vql9pm89qn0t4veuiddgq4cen4z6 0 91920 1578127 1465870 2026-07-02T21:13:54Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578127 wikitext text/x-wiki [[Picha:Stephen Hawking.StarChild.jpg|alt=:Stephen_Hawking.StarChild.jpg|thumb|Stephen William Hawking]] '''Stephen William Hawking''', [[CH]] [[CBE]] [[FRS]] ([[Oxford]], [[8 Januari]] [[1942]] - [[Cambridge]], [[14 Machi]] [[2018]]) alikuwa [[mtaalamu]] wa [[fizikia]] na [[hisabati]] kutoka [[Uingereza]], mmoja kati ya wataalamu wa fizikia wa kinadharia [[ulimwengu]]ni. Aliandika [[vitabu]] mashuhuri kuhusu [[sayansi]] vinavyolenga watu ambao si [[wanasayansi]]. Hawking alikuwa [[profesa]] wa hisabati katika [[Chuo Kikuu cha Cambridge]] (nafasi ambayo [[Isaac Newton]] aliwahi kuwa nayo). Alistaafu tarehe [[1 Oktoba]] [[2009]]. == Maisha ya awali na elimu == Mwaka [[1950]] Hawking alienda Shule ya St Albans, [[shule]] ya [[umma]] ya [[Hertfordshire]]. Akiwa na [[umri]] wa miaka 17, alipitia [[mtihani]] wa kujifunza huko [[Oxford]]. Alijifunza [[fizikia]] na [[kemia]] huko. Kwa sababu aliona ni rahisi sana mwanzoni, hakujifunza mengi kwa ajili ya mitihani ya mwisho. Mnamo [[Oktoba]] [[1962]] alianza [[kozi]] yake ya kuhitimu katika Trinity Hall. Ulikuwa wakati [[ugonjwa]] wake ulianza kujionyesha. Alikuwa na shida katika kujinyoosha na kisha hata tu kutembea. Hata hivyo, alimaliza [[PhD]] yake akaandika kuhusu [[Shimo jeusi|mashimo meusi]] katika [[shahada]] yake. Alipata [[ushirika]] (kazi kama [[mwalimu]] wa [[chuo kikuu]]) katika [[Chuo cha Gonville na Caius]] mwaka wa [[1965]]. Ana [[ugonjwa]] wa [[chembe za neva]] unaohusiana na [[ulemavu]] wa [[akili]] unaosababisha [[mtu]] kuwa na shida ya kusoma na kuandika (''Dyslexia'' kwa [[Kiingereza]]), na kwa sababu hiyo hawezi kutembea au kuzungumza vizuri. Ugonjwa huo ulizidi hata kuwa karibu kabisa na [[Kupooza kwa ubongo|kupooza]]. Alitumia [[gurudumu]] kusonga, na [[kompyuta]] ya Intel ili kuzungumza. ==Vitabu vyake== === Vitabu vinavyolenga wasomaji wote === * ''[[A Brief History of Time]]'' (1988) * ''[[Black Holes and Baby Universes and Other Essays]]'' (1993) * ''[[The Universe in a Nutshell]]'' (2001) * ''[[On the Shoulders of Giants (book)|On The Shoulders of Giants]]'' (2002) * ''[[God Created the Integers|God Created the Integers: The Mathematical Breakthroughs That Changed History]]'' (2005) * ''[[The Dreams That Stuff Is Made of: The Most Astounding Papers of Quantum Physics and How They Shook the Scientific World]]'' (2011)<ref>{{cite news|title=How Physics got Weird|url=https://www.wsj.com/articles/SB10001424052970204791104577110461358473418|publisher=Wall Street Journal|date=5 December 2016}}</ref> * ''[[My Brief History]]'' (2013) === Vitabu kadhaa vya kitaalamu === * {{cite journal |last1=Hawking |first1=S. W. |last2=Penrose |first2=R. |title=The Singularities of Gravitational Collapse and Cosmology |journal=Proceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences |volume=314 |issue=1519 |year=1970 |pages=529–548 |doi=10.1098/rspa.1970.0021 |bibcode=1970RSPSA.314..529H}} * {{cite journal |last1=Hawking |first1=S. |title=Gravitational Radiation from Colliding Black Holes |journal=Physical Review Letters |volume=26 |issue=21 |year=1971 |pages=1344–1346 |doi=10.1103/PhysRevLett.26.1344 |bibcode=1971PhRvL..26.1344H}} * {{cite journal |last1=Hawking |first1=S.W. |title=Black holes in general relativity |journal=Communications in Mathematical Physics |volume=25 |issue=2 |year=1972 |pages=152–166 |url=http://projecteuclid.org/DPubS?service=UI&version=1.0&verb=Display&handle=euclid.cmp/1103857884 |doi=10.1007/BF01877517 |bibcode=1972CMaPh..25..152H}} * {{cite journal |last1=Hawking |first1=S. W. |title=Black hole explosions? |url=https://archive.org/details/sim_nature-uk_1974-03-01_248_5443/page/30 |journal=Nature |volume=248 |issue=5443 |year=1974 |pages=30–31 |doi=10.1038/248030a0 |bibcode=1974Natur.248...30H}} * {{cite journal |last1=Hawking |first1=S.W. |title=The development of irregularities in a single bubble inflationary universe |url=https://archive.org/details/sim_physics-letters-b_physics-letters_1982-09-09_115_4/page/295 |journal=[[Physics Letters B]] |volume=115 |issue=4 |year=1982 |pages=295–297 |doi=10.1016/0370-2693(82)90373-2 |bibcode=1982PhLB..115..295H}} * {{cite journal |last1=Hartle |first1=J. |last2=Hawking |first2=S. |title=Wave function of the Universe |journal=[[Physical Review D]] |volume=28 |issue=12 |year=1983 |pages=2960–2975 |doi=10.1103/PhysRevD.28.2960 |bibcode=1983PhRvD..28.2960H}} * {{cite journal |last1=Hawking |first1=S. |title=Information loss in black holes |journal=Physical Review D |volume=72 |issue=8 |page=084013 |year=2005 |doi=10.1103/PhysRevD.72.084013 |arxiv=hep-th/0507171 |bibcode=2005PhRvD..72h4013H}} === Utangulizi wa kitabu === * ''[[Black Holes and Time Warps|Black Holes & Time Warps: Einstein's Outrageous Legacy]]'' ([[Kip Thorne]], (1994) ==Tanbihi== {{marejeo}} {{mbegu-mwanasayansi}} {{BD|1942|2018|Hawking, Stephen}} [[Jamii:Wanafizikia wa Uingereza]] [[Jamii:Wanahisabati wa Uingereza]] smvtsbemdm55bccnah9swgyqcp9279j 0 93089 1578222 1300333 2026-07-03T03:59:01Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578222 wikitext text/x-wiki [[File:Cornelius Jansen by Evêque d'Ypres (1585-1638).png|right|thumb|[[Cornelius Jansen]] ([[1585]]–[[1638]]), profesa wa [[Louvain]] (katika [[Ubelgiji]] wa leo).]] '''Ujanseni''' ulikuwa [[tapo]] la [[teolojia]] ya [[Kanisa Katoliki]] (hasa nchini [[Ufaransa]]) katika [[karne ya 17]] na [[Karne ya 18|ya 18]]. Tapo hilo lilisisitiza [[dhambi ya asili]], [[uovu]] wa [[binadamu]] uliosababishwa nayo, haja ya [[neema]] ya [[Mungu]] na [[uteule]] kwa kudai linafuata mafundisho ya [[Augustino wa Hippo]]. Tapo lilitokana na [[vitabu]] vya [[mwanateolojia]] wa [[Uholanzi]] [[Cornelius Jansen]] vilivyochapishwa baada ya [[kifo]] chake (1638). [[Rafiki]] yake, [[abati]] [[Jean Duvergier de Hauranne]], alisambaza mafundisho yake kwanza, na alipokufa yeye pia ([[1643]]) juhudi ziliendelezwa na [[Antoine Arnauld]], lakini pia na [[Pierre Nicole]], [[Blaise Pascal]] na [[Jean Racine]]. Ujanseni ulipingwa na wengi, hasa [[Wajesuiti]], kwa kuona unafanana na [[Ukalvini]].<ref name=Carraud>{{cite web|url=http://www.amisdeportroyal.org/articles.php?lng=fr&pg=282|type=lecture|title=Le jansénisme|last=Carraud|first=Vincent|date=2008-01-21|origyear=Created 2007-06-20|website=Bibliothèque électronique de Port-Royal|series= |publisher=Société des Amis de Port-Royal|location=|language=French|issn=1776-0755|archiveurl=https://web.archive.org/web/20081111071230/http://www.amisdeportroyal.org/articles.php?lng=fr&pg=282|archivedate=2008-11-11|deadurl=no|accessdate=}}</ref> Mwaka [[1653]], kwa [[hati]] ''[[Cum occasione]]'', [[Papa Innocent X]] alilaani kama [[uzushi]] [[kauli]] [[tano]] za Wajanseni.<ref name=Carraud/> Viongozi wao walijaribu kulegeza msimamo wao bila kuachana nao kabisa, lakini hatimaye walihukumiwa tena na hati ''[[Unigenitus Dei Filius]]'' ya [[Papa Klementi XI]] mwaka [[1713]].<ref>Toon Quaghebeur, "The Reception of Unigenitus in the Faculty of Theology at Louvain, 1713-1719", ''[[Catholic Historical Review]]'' 93/2 (2007), pp. 265-299.</ref> ==Tanbihi== {{reflist}} ==Marejeo== *{{cite book|last=Abercrombie|first=Nigel|date=1936|title=The origins of Jansenism|location=Oxford|publisher=Clarendon Press|series=Oxford studies in modern languages and literature|oclc=599986225|url=https://books.google.com/books?id=us0EAAAAMAAJ}} *{{cite journal|last=Hamscher|first=Albert N.|title=The Parlement of Paris and the social interpretation of early French Jansenism|journal=Catholic Historical Review|date=1977|volume=63|issue=3|location=|publisher=Catholic University of America Press|pages=392–410|issn=0008-8080|url=https://archive.org/details/sim_catholic-historical-review_1977-07_63_3/page/392|jstor=25020157}} *{{cite book|last=Doyle|first=William|date=1999|title=Jansenism: Catholic resistance to authority from the Reformation to the French Revolution|url=https://archive.org/details/jansenismcatholi0000doyl|location=New York|publisher=St. Martin's Press|series=Studies in European history|isbn=9780312226763}} *{{cite journal|last=Hudson|first=David|title=The 'Nouvelles Ecclésiastiques', Jansenism, and Conciliarism, 1717-1735|journal=Catholic Historical Review|date=1984|volume=70|issue=3|location=|publisher=Catholic University of America Press|pages=389–406|issn=0008-8080|url=https://archive.org/details/sim_catholic-historical-review_1984-07_70_3/page/389|jstor=25021866}} * Ogg, David. ''Europe in the 17th Century'' (6th ed. 1952) pp 323-64. *{{cite journal|last=Schmaltz|first=Tad M.|title=What has Cartesianism to do with Jansenism?|journal=Journal of the History of Ideas|date=Jan 1999|volume=60|issue=1|location=|publisher=University of Pennsylvania Press|pages=37–56|issn=0022-5037|url=https://archive.org/details/sim_journal-of-the-history-of-ideas_1999-01_60_1/page/37|jstor=3653999|doi=10.1353/jhi.1999.0009}} *{{cite journal|last=Van Kley|first=Dale|title=The rejuvenation and rejection of Jansenism in history and historiography: recent literature on eighteenth-century Jansenism in French|url=https://archive.org/details/sim_french-historical-studies_fall-2006_29_4/page/649|journal=French Historical Studies|date=Fall 2006|volume=29|issue=4|location=|publisher=Duke University Press|pages=649–684|issn=0016-1071|doi=10.1215/00161071-2006-016}} * Strayer, E. Brain, ''Suffering Saints: Jensenits and Convulsionaries in France, 1640–1799'' (Eastborne, Sussex Academic Press, 2008) * Crichton. D. J., ''Saints or Sinners?: Jansenism and Jansenisers in Seventeenth Century France'' (Dublin, Veritas Publications, 1996) * Swann Julian, ''Politics and the Parliament of Paris under Louis XV 1754–1774'', (Cambridge, Cambridge University Press, 1995) * Doyle William, ''Jansenism: Catholic Resistance to Authority from the Reformation to the French Revolution: Studies in European History'' (Basingstoke, Macmillan Press Ltd, 2000) ==Viungo vya nje== {{commons category|Jansenism}} * [https://ebooks.adelaide.edu.au/p/pascal/blaise/ ''Provincial Letters'' by Blaise Pascal] {{Wayback|url=https://ebooks.adelaide.edu.au/p/pascal/blaise/ |date=20170824063548 }} (1656) {{mbegu-katoliki}} [[Category:Historia ya Ukristo]] [[Category:Teolojia]] [[Jamii:Historia ya Ufaransa]] ggd5kr9vugyt0j8kso6lofw3jgto604 0 95277 1578207 1527926 2026-07-03T03:09:31Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578207 wikitext text/x-wiki [[Picha:Surgeons_at_Work.jpg|thumb|Wapasuaji wakikarabati mguu wa mtu]] '''Upasuaji''' (kutoka [[kitenzi]] "kupasua": pia '''Operesheni''' kutoka [[Kiingereza]] "operation") ni [[matibabu]] maalumu yanayohusu tendo la kutibu [[mwili]] kwa kukata, na kurekebisha sehemu yenye [[maradhi]] au tatizo lingine lolote. [[Mgonjwa]] ambaye anapasuliwa anaweza kuwa [[mtu]] au [[mnyama]]. [[Mpasuaji]] ni mtu ambaye hufanya upasuaji na mpasuaji msaidizi ni mtu ambaye husaidia katika operesheni. [[Timu]] ya upasuaji huwa na mpasuaji, mpasuaji msaidizi, anayetia [[ganzi]], [[muuguzi]] na fundi wa upasuaji. Upasuaji wa kawaida huchukua [[muda]] wa [[dakika]] hadi [[saa]] kadhaa.  == Ufafanuzi == Upasuaji ni [[teknolojia]] yenye kuingilia [[tishu]] za kimwili . Kwa jumla, utaratibu huchukuliwa kuwa upasuaji wakati unahusisha kukata tishu ya mgonjwa au kufungwa kwa [[jeraha]].  Aina zote za upasuaji huchukuliwa kama taratibu vamizi. Zinazochukuliwa kuwa si vamizi, haziingii [[muundo]] unaokatwa ama zinatumia [[mionzi]]. === Aina za upasuaji === Upasuaji kwa kawaida hujumuishwa kwa uharaka, aina ya utaratibu, mfumo wa mwili unaohusika, kiwango cha uvamizi, na vifaa maalum. * Kulingana na muda: upasuaji wa kuchagua hufanyika kurekebisha hali isiyotishia [[uhai]], na hufanyika wakati mgonjwa ataomba kupasuliwa, baada ya [[Thieta ya upasuaji|chumba cha upasuaji]] na mpasuaji kuwa huru. Upasuaji wa nusu kuchagua ni ule ambao lazima ufanyike ili kuepuka [[ulemavu]] wa kudumu au [[kifo]], lakini inaweza kuahirishwa kwa muda mfupi. Upasuaji wa dharura ni upasuaji ambao lazima ufanyike haraka ili kuokoa uhai, [[mguu]]/[[mkono]], au uwezo wa kimwili. * Kulingana na kusudi: upasuaji ili kuchunguza hufanywa kusaidia au kuthibitisha utambuzi. Upasuaji wa matibabu hufanywa kutibu baada ya utambuzi. Upasuaji wa [[upodozi]] hufanyika 'kuboresha' muonekano. * Na aina ya utaratibu: Kukatwa kunahusisha kukata sehemu ya mwili, kama vile mkono au mguu; kuhasiwa ni pia mfano. ''Resection'' ni kuondolewa kwa [[kiungo]] chote cha au sehemu yote ya [[mwili]], au sehemu muhimu ([[ini]], [[figo]] n.k.) ya kiungo au sehemu ya mwili ambayo ina jina lake maalum. Kupandika kunahusisha kupachika sehemu ya mwili iliyogawanyika. Upasuaji upyaji unahusisha 'kurudisha upya' sehemu ya mwili iliyokatwa, iliyoumizwa au iliyoharibiwa. Ukataji ni kukata au kuondolewa kwa sehemu ya kiungo, tishu, au sehemu nyingine ya mwili kutoka kwa mgonjwa. Upasuaji wa kupandikiza ni kubadilisha kiungo au sehemu ya mwili kwa kuiingiza nyingine kutoka binadamu (au mnyama) mwengine katika mwili mgonjwa. Kuondoa [[kiungo]] au sehemu ya mwili kutoka kwa binadamu au mnyama anayeishi kwa ajili ya matumizi katika kupandikiza pia ni aina ya upasuaji. * Na sehemu ya mwili: Wakati upasuaji unafanyiwa kiungo, mfumo au muundo mmoja, unaweza kujumuishwa kwa kiungo, mfumo wa kiungo au [[tishu]] zinazohusika. Mifano ni pamoja na upasuaji wa moyo (inafanyiwa moyo), upasuaji wa utumbo (hufanyiwa utumbo na viungo njiani yake), na upasuaji wa mifupa (hufanyiwa mifupa au misuli). * Na kiwango cha uvamizi wa upasuaji: Upasuaji vamizi kidogo unahusisha kutengeneza chale(s) ndogo nje ili kuingiza vyombo vidogo zaidi ndani ya muundo wa mwili. Kwa upande wake, upasuaji wazi unahitaji chale kubwa ya kupata eneo linalohitajika. * Na vifaa vya kutumika: Upasuaji wa ''Laser'' inahusisha matumizi ya ''laser'' kwa ajili ya kukata tishu badala ya wembe vyombo vya upasuaji. ''Microsurgery'' inahusisha matumizi ya uendeshaji [[hadubini]] mpasuaji aone miundo midogo. Upasuaji kwa [[roboti]] hufanya upasuaji kutumia [[roboti]]. == Maelezo ya utaratibu wa upasuaji == === Eneo === Katika [[hospitali]] ya kisasa ya upasuaji ni mara nyingi hufanywa ndani ya [[thieta ya upasuaji]] kwa kutumia vifaa vya upasuaji, meza ya upasuaji ya mgonjwa, na vifaa vingine. Vyombo vya upasuaji lazima visafishwe kabisa, na kifaa lazima kibadilishwe au kisafishwe tena kama kimepata uchafu (kwa mfano kwa kugusisha kifaa cha upasuaji kwenye uso wa mpasuaji au mahali ambapo hapajasafishwa kabisa, chombo kinachukuliwa kuwa chafu). Wafanyakazi walio ndani ya thieta lazima wavalie nguo zilizosafishwa kabisa (nguo za daktari, kofia/kitambaa, gauni ya daktari, glavu safi, na barakoa), na lazima wasugue mikono kwa kuipitisha kwenye kemikali ya kuua bakteria kabla ya utaratibu wowote. === Huduma kabla ya upasuaji === Kabla ya upasuaji, mgonjwa anapewa anachunguzwa kimatibabu, anafanyiwa majaribio kabla ya upasuaji, na hali ya mwili kurekodiwa. Kama matokeo haya ni ya kuridhisha, mgonjwa hutia saini katika fomu ya ridhaa na kupewa kibali cha kupasuliwa. Kama utaratibu unatarajiwa kumfanya mpasuliwa kupoteza damu nyingi, ombi la mchango wa damu wiki kadhaa kabla ya upasuaji. Kama upasuaji unahusisha [[Mfumo wa mmeng'enyo wa chakula|mfumo wa utumbo]], mgonjwa anaweza kuelekezwa kutayarisha matumbo kwa kunywa polyethilini glycol usiku kabla ya operesheni. Wagonjwa pia wanafaa kujinyima chakula na vinywaji ili kupunguza hatari ya upumuo wakati wa operesheni. Baadhi ya mifumo ya matibabu hufanya [[eksirei]] mara kwa mara kabla ya upasuaji. Sababu yake ni daktari huenda akagundua hali ya kimatibabu ambayo ingetatiza upasuaji. Akiwa na ujuzi huo, anaweza kubadilisha namna ya upasuaji ule umpendelee mgonjwa.<ref name="ACRfive">{{Rejea jarida|author1=American College of Radiology|author1-link=American College of Radiology|date=|title=Five Things Physicians and Patients Should Question|publisher=[[American College of Radiology]]|work=Choosing Wisely: an initiative of the [[ABIM Foundation]]|page=|url=http://www.choosingwisely.org/doctor-patient-lists/american-college-of-radiology/|accessdate=August 17, 2012|postscript=<!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}}}}, citing </ref> Hata hivyo, wataalamu wengine hawapendelei kufanywa kwa eksirei wakati huu.  Vile vile, majaribio ya damu na mkojo hayafai kufanywa wakati huu.<ref name="ASCPfive">{{Citation|author1=American Society for Clinical Pathology|author1-link=American Society for Clinical Pathology|date=|title=Five Things Physicians and Patients Should Question|publisher=American Society for Clinical Pathology|work=[[Choosing Wisely]]: an initiative of the [[ABIM Foundation]]|page=|url=http://www.choosingwisely.org/doctor-patient-lists/american-society-for-clinical-pathology/|accessdate=August 1, 2013}}, which cites </ref> === Matayarisho kwa ajili ya upasuaji === Mgonjwa huvalia mavazi aliyopewa avalie wakati wa upasuaji. Ishara muhimu hurekodiwa na mgonjwa hupewa dawa za kabla ya upasuaji ([[Kiuavijasumu|viuavijasumu]], dawa za kutuliza maumivu n.k.). Mgonjwa akiingia ndani ya chumba cha upasuaji, [[ngozi]] iliyo mahali patakapopasuliwa husafishwa kwa kutumia antiseptiki kupunguza uwezekano wa [[maambukizi]]. Kama pana nywele, nywele hunyolewa kabla ya kusafishwa. Mgonjwa husaidiwa na anayefanya anaesthesia kutengeneza nafasi ya kupasuliwa, halafu pazia safi hutumiwa kuziba nafasi ile. <ref>{{cite book|last1=Martin|first1=Shirley|title=Minor Surgical Procedures for Nurses and Allied Healthcare Professionals|date=2007|publisher=John Wiley & Sons, Ltd|location=England|isbn=978-0-470-01990-0|page=122|url=https://books.google.com/?id=EaDbhAO3kS8C&pg=PA113#v=onepage&q=osman&f=false}}</ref> ''Ganzi'' au ''nusukaputi'' hutumika kuzuia [[maumivu]] kutoka kwenye chale au tishu kufanyiwa jambo.  === Upasuaji === Chale hufanywa ili kufikia palipo na shida. [[Mishipa ya damu]] inaweza kubanwa au kuchomelewa ili kuzuia kutokwa na damu, na ''retractors'' hutumika nje kuweka sehemu iliyopasuliwa wazi. Mbinu ya kufikia sehemu iliyo na shida inaweza kuhusisha kukata ndani sana. Nyakati nyingine, [[mfupa]] unaweza kukatwa ili kufika ndani ya [[mwili]]; kwa mfano, kukata [[fuvu]] kwa ili kuufikia [[ubongo]].  Kazi ya kusahihisha tatizo katika mwili huendelea. Kazi hii inaweza kuhusisha: {{Anchor|excision}} * Kukata * Kuondolewa sehemu ya kiungo * Kuunganisha viungo, tishu, nk. * Kusahihisha - kama vile pua lililovunjika * Kufunga mishipa. * Kupandikiza * Kuingiza sehemu iliyosanidiwa. * Kutengeneza ufunguzi mwilini. * Kuunganisha mifupa * Kukarabatisha [[Nasuri|fistula]] * taratibu nyinginezo Mgonjwa anaweza kuongezewa damu ili kulipiza aliyopotea. Baada ya upasuaji, palipokuwa pamekatwa hufungwa angalau kwa kushonwa. Baada ya chale kufungwa, gesi za ''anaesthesia'' hukatizwa.<ref name="books.google.com">Askitopoulou, H., Konsolaki, E., Ramoutsaki, I., Anastassaki, E. ''Surgical cures by sleep induction as the Asclepieion of Epidaurus.'' The history of anesthesia: proceedings of the Fifth International Symposium, by José Carlos Diz, Avelino Franco, Douglas R. Bacon, J. Rupreht, Julián Alvarez. Elsevier Science B.V., International Congress Series 1242(2002), pp.&nbsp;11–17. [https://books.google.com/books?id=TM-8NIDPowoC&pg=PA11&dq=History+of+Hospital%2BAsclepieion&lr=lang_en&as_brr=0&cd=1#v=onepage&q=History%20of%20Hospital%2BAsclepieion&f=false]</ref> === Huduma baada ya upasuaji === Baada ya kukamilika kwa upasuaji, mgonjwa huhamishwa kwenye kitengo kingine ili apate nafuu kutokana na ''anaesthesia'' aliyifanyiwa na kufuatiliwa kwa karibu. Wakati mgonjwa anadhaniwa kupata nafuu kutokana na anaesthesia, yeye huhamishiwa mahali pengine katika hospitali au kuruhusiwa kurudi nyumbani. <ref>{{cite journal|author1=Doyle S. L.|author2=Lysaght J.|author3=Reynolds J. V.|year=2010|title=Obesity and post-operative complications in patients undergoing non-bariatric surgery|url=http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2009.00700.x|journal=Obesity Reviews|volume=11|issue=12|pages=875–886|doi=10.1111/j.1467-789X.2009.00700.x}}</ref>  == Historia == [[Picha:Edwin_Smith_Papyrus_v2.jpg|thumb|Insha kuhusu upasuaji kutoka Misri]] === Misri Ya Kale === Matibabu ya upasuaji hurudi nyuma hadi zama za kabla ya historia tunayoijua. Operesheni kuu zaidi ambayo ina ushahidi ni ''trepanation'',<ref>{{Rejea kitabu|author=Capasso, Luigi|year=2002|title=Principi di storia della patologia umana: corso di storia della medicina per gli studenti della Facoltà di medicina e chirurgia e della Facoltà di scienze infermieristiche|location=Rome|publisher=SEU|isbn=88-87753-65-2|oclc=50485765|language=Italian}}</ref> ambapo shimo hutobolewa katika [[fuvu]], ili kutibu matatizo ya afya yanayohusiana na shinikizo la damu kichwani na magonjwa mengine. Shughuli za upasuaji zilifanywa na makuhani, katika matibabu yaliyo karibu na ya kisasa.<ref name="cossurg">{{cite book|last=Shiffman|first=Melvin|title=Cosmetic Surgery: Art and Techniques|publisher=Springer|isbn=978-3-642-21837-8|page=20}}</ref><ref>{{cite journal|author=Sullivan R|year=1996|title=The Identity and Work of the Ancient Egyptian Surgeon|url=https://archive.org/details/sim_royal-society-of-medicine-great-britain-journal_1996-08_89_8/page/469|journal=Journal of the Royal Society of Medicine|volume=89|issue=8|page=469}}</ref> Maambukizo yalitibiwa kwa asali.<ref>James P. Allen, ''The Art of Medicine in Ancient Egypt''. (New York: The Metropolitan Museum of Art, 2005) 72.</ref> === Upasuaji wa kisasa === Udhibiti wa maumivu kwa njia ya ''anesthesia'' uligunduliwa katikati mwa karne ya 19. Kabla ya ujio wa ''anesthesia'', upasuaji ilikuwa utaratibu  wenye uchungu vibaya sana na wapasuaji walijaribu kufanya operesheni haraka iwezekanavyo ili kupunguza mateso kwa mgonjwa.  Matumizi ya [[Eksirei]] kama sehemu muhimu ya zana ya uchunguzi wa kimatibabu ilianza na ugunduzi wa miale ya Eksirei katika 1895 na [[Fizikia|mwanafizikia]] [[Mjerumani]]  [[Wilhelm Conrad Röntgen|Wilhelm Röntgen]]. Yeye aliona kwamba miale hiyo inaweza kupenya ngozi na kuruhusu mfumo wa mifupa kuonekana.<gallery widths="200" heights="200"> Picha:Acquapendente - Operationes chirurgicae, 1685 - 2984755.tif|Hieronymus Fabricius, Upasuaji, 1685 Picha:John Syng Dorsey.jpg|John Syng Dorsey aliyeandika kitabu cha kwanza juu ya upasuaji Marekani Picha:1753 Traversi Operation anagoria.JPG|Operesheni mwaka1753, ilichorwa na Gaspare Traversi. </gallery> == Tanbihi == {{Reflist|30em}} {{mbegu-tiba}} [[Jamii:Tiba]] bd5j35m7b7yojk49iejf95vjawllfm7 0 95849 1578107 1536683 2026-07-02T20:09:03Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578107 wikitext text/x-wiki [[image:Staugustinescanterburygravemellitus.jpg|thumb|220px|[[Kaburi]] la Mt. Melitus huko [[Canterbury]].]] '''Melitus wa Canterbury''' (kwa [[Kilatini]]: Mellitus; alifariki [[24 Aprili]] [[624]]) alikuwa [[askofu mkuu]] wa [[tatu]] wa [[Canterbury]] ([[Uingereza]]) kuanzia [[mwaka]] [[619]] <ref>{{cite web |url=http://www.catholic.org/saints/saint.php?saint_id=5070|title= St. Mellitus of Canterbury |publisher=Catholic Online}} Accessed on 12 November 2009</ref>. Alikuwa ametumwa huko na [[Papa Gregori I]] mwaka [[601]] kama [[abati]] [[mmisionari]] kwa [[Waangli]] na [[Wasaksoni]] kwa ombi la [[Augustino wa Canterbury]]. [[Papa]] huyo alimuandikia [[barua]] maarufu <ref>https://www.santiebeati.it/dettaglio/50670</ref>. Miaka [[604]]-619 alikuwa [[askofu]] wa kwanza wa [[London]] alipopata matatizo mengi. Tangu kale anaheshimiwa na [[Wakatoliki]], [[Waorthodoksi]] na [[Waanglikana]] kama [[mtakatifu]]. [[Sikukuu]] yake huadhimishwa [[tarehe]] 24 Aprili<ref>[[Martyrologium Romanum]]</ref><ref name=Days170>Holford-Strevens and Blackburn ''Oxford Book of Days'' p. 170</ref>. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{Reflist}} ==Marejeo== {{refbegin}} * {{cite book |author=Bede |authorlink=Bede |editor= Sherley-Price, Leo (translator) |title=A History of the English Church and People |publisher=Penguin Classics |location=New York |year=1988 |isbn=0-14-044042-9 }} * {{cite book |author=Blair, Peter Hunter|authorlink= Peter Hunter Blair |title=The World of Bede |publisher=Cambridge University Press |location=Cambridge, UK |year=1990 |edition=Reprint |origyear=1970 |isbn=0-521-39819-3}} * {{cite book |author=Brooks, Nicholas |authorlink=Nicholas Brooks |title=The Early History of the Church of Canterbury: Christ Church from 597 to 1066 |url=https://archive.org/details/earlyhistoryofch0000broo |publisher=Leicester University Press |location=London |year=1984 |isbn=0-7185-0041-5}} * {{cite encyclopedia |author=Brooks, N. P. |title=Mellitus (d. 624) |encyclopedia=[[Oxford Dictionary of National Biography]] |publisher= Oxford University Press |year= 2004 |url=http://www.oxforddnb.com/view/article/18531 |edition=October 2005 revised| accessdate=7 November 2007|doi= 10.1093/ref:odnb/18531}} {{ODNBsub}} * {{cite encyclopedia |author=Campbell, James |title=Observations on the Conversion of England |encyclopedia =Essays in Anglo-Saxon History |publisher=Hambledon Press |location=London |isbn=0-907628-32-X |pages=69–84}} * {{cite journal |author=Church, S. D. |title=Paganism in Conversion-age Anglo-Saxon England: The Evidence of Bede's ''Ecclesiastical History'' Reconsidered |url=https://archive.org/details/sim_history-us_2008-04_93_310/page/162 |journal =[[History (The Journal of the Historical Association)|History]] |volume=93 |issue=310 |pages=162–180 |doi= 10.1111/j.1468-229X.2008.00420.x |date=April 2008}} * {{cite encyclopedia |author=Colgrave, Bertram |authorlink= Bertram Colgrave |editor=Colgrave, Bertram |title=Introduction |encyclopedia=The Earliest Life of Gregory the Great |publisher=Cambridge University Press |location=Cambridge, UK |edition=Paperback reissue |origyear=1968 |year=2007|isbn=978-0-521-31384-1}} * {{cite journal |author=Demacopoulos, George |title=Gregory the Great and the Pagan Shrines of Kent |url=https://archive.org/details/journal-of-late-antiquity_fall-2008_1_2/page/353 |journal= [[Journal of Late Antiquity]] |date=Fall 2008 |volume=1 |issue=2 |pages=353–369 |doi= 10.1353/jla.0.0018}} * {{cite book| author=Farmer, David Hugh |title=Oxford Dictionary of Saints | url=https://archive.org/details/oxforddictionary0000farm_a6q1 |publisher=Oxford University Press |year=2004 |edition=Fifth |location=Oxford, UK |isbn= 978-0-19-860949-0}} * {{cite book |author1=Fryde, E. B. |author2=Greenway, D. E. |author3=Porter, S. |author4=Roy, I. |title=Handbook of British Chronology|url=https://archive.org/details/handbookofbritis0000unse_f1u2 |edition=Third revised |publisher=Cambridge University Press |location=Cambridge, UK |year=1996 |isbn=0-521-56350-X }} * {{cite encyclopedia |author=Gem, Richard |title=The Significance of the 11th-century Rebuilding of Christ Church and St Augustine's, Canterbury, in the Development of Romanesque Architecture |encyclopedia=Medieval Art and Architecture at Canterbury Before 1220 |series = British Archaeological Association Conference Transactions |volume=V |publisher= Kent Archaeological Society |year=1982 |isbn=0-907307-05-1 |pages=1–19 }} * {{cite journal |author=Hayward, Paul Antony |title=An Absent Father: Eadmer, Goscelin and the Cult of St Peter, the First Abbot of St Augustine's Abbey, Canterbury |url=https://archive.org/details/sim_journal-of-medieval-history_2003-09_29_3/page/201 |journal=[[Journal of Medieval History]] |volume=29 |year=2003|pages= 201–218 |doi=10.1016/S0304-4181(03)00030-7 |issue=3}} * {{cite book |author=Higham, N. J. |title=The Convert Kings: Power and Religious Affiliation in Early Anglo-Saxon England |publisher=Manchester University Press |location=Manchester, UK |year=1997 |isbn=0-7190-4827-3 }} * {{cite book |author=Higham, N. J. |title=An English Empire: Bede and the Early Anglo-Saxon Kings |publisher=Manchester University Press |location=Manchester, UK |year=1995 |isbn=0-7190-4423-5}} * {{cite book |author= Hindley, Geoffrey |title=A Brief History of the Anglo-Saxons: The Beginnings of the English Nation |url= https://archive.org/details/briefhistoryofan0000hind_b4f5 |year= 2006|publisher= Carroll & Graf Publishers |location=New York |isbn=978-0-7867-1738-5 }} * {{cite book |author1=Holford-Strevens, Leofranc |author2=Blackburn, Bonnie J. |title=The Oxford Book of Days |url=https://archive.org/details/oxfordbookofdays00blac |publisher=Oxford University Press |location=Oxford, UK |year=2000 |isbn=0-19-866260-2 }} * {{cite book |author=Lapidge, Michael |authorlink=Michael Lapidge |title=The Anglo-Saxon Library |url=https://archive.org/details/anglosaxonlibrar0000lapi |publisher=Oxford University Press |location=Oxford, UK |year=2006 |isbn=0-19-926722-7}} * {{cite encyclopedia|author=Lapidge, Michael |authorlink=Michael Lapidge |title=Mellitus|pages=305–306 |encyclopedia=The Blackwell Encyclopaedia of Anglo-Saxon England |editor1=Lapidge, Michael |editor2=Blair, John |editor3=Keynes, Simon |editor-link3= Simon Keynes |editor4= Scragg, Donald |year=2001 |publisher=Blackwell Publishing |location=Malden, MA |isbn=978-0-631-22492-1 }} * {{cite encyclopedia |author=Markus, R. A. |title=Gregory the Great and a Papal Missionary Strategy |encyclopedia=Studies in Church History 6: The Mission of the Church and the Propagation of the Faith |year=1970 |location=Cambridge, UK |publisher=Cambridge University Press |pages=29–38 |oclc= 94815 }} * {{cite journal|author=Markus, R. A. |title=Gregory the Great's Europe |journal = Transactions of the Royal Historical Society |series=Fifth Series|volume=31 |year=1981 |pages=21–36|doi=10.2307/3679043 |jstor= 3679043}} * {{cite book |author=Mayr-Harting, Henry| authorlink= Henry Mayr-Harting |title=The Coming of Christianity to Anglo-Saxon England |url=https://archive.org/details/comingofchristia0000mayr_a5a2|publisher=Pennsylvania State University Press |location=University Park, PA |year=1991 |isbn=0-271-00769-9 }} * {{cite book |author=Nilson, Ben |title=Cathedral Shrines of Medieval England |publisher=Boydell Press |year=1998 |location=Woodbridge, UK |isbn=0-85115-540-5}} * {{cite encyclopedia |author=Spiegel, Flora |title=The 'tabernacula' of Gregory the Great and the Conversion of Anglo-Saxon England |encyclopedia =Anglo-Saxon England 36 |doi= 10.1017/S0263675107000014 |pages=1–13|publisher=Cambridge University Press|location=Cambridge, UK |year=2007 |volume=36 }} * {{cite book |author=Stenton, F. M. |authorlink= Frank Stenton |title= Anglo-Saxon England |url=https://archive.org/details/anglosaxonenglan0000sten |year= 1971|publisher= Oxford University Press |location=Oxford, UK |edition=Third |isbn=978-0-19-280139-5 }} * {{cite book |author= Wallace-Hadrill, J. M. |authorlink=J. M. Wallace-Hadrill | title= Bede's Ecclesiastical History of the English People: A Historical Commentary |url= https://archive.org/details/bedesecclesiasti0000wall |publisher=Clarendon Press |location=Oxford, UK |year=1988 |series= Oxford Medieval Texts |isbn=0-19-822269-6}} * {{cite book |author=Walsh, Michael J. |title= A New Dictionary of Saints: East and West |url=https://archive.org/details/newdictionaryofs0000wals |year=2007 |publisher= Burns & Oats |location=London |isbn=0-86012-438-X }} * {{cite journal |author=Wood, Ian |title=The Mission of Augustine of Canterbury to the English |url=https://archive.org/details/sim_speculum_1994-01_69_1/page/1 |journal=[[Speculum (journal)|Speculum]] |volume=69 |issue=1 |pages=1–17 |date=January 1994 |doi=10.2307/2864782 |jstor= 2864782 }} {{refend}} ==Viungo vya nje== * [http://la.wikisource.org/wiki/Epistola_ad_Mellitum ''Epistola ad Mellitum'' on Wikisource]&nbsp;– complete [[Latin]] text of the letter to Mellitus from Pope Gregory I. * [http://oll.libertyfund.org/?option=com_staticxt&staticfile=show.php%3Ftitle=1913&chapter=112691&layout=html&Itemid=27 ''Epistola ad Mellitum'' English translation] at libertyfund.org {{mbegu-Mkristo}} {{DEFAULTSORT:Melitus}} [[Jamii:Waliozaliwa karne ya 6]] [[Category:Waliofariki 624]] [[Category:Wamonaki]] [[Category:Wamisionari]] [[Category:Maaskofu Wakatoliki]] [[Jamii:Watakatifu wa Italia]] [[Category:Watakatifu wa Uingereza]] 81pd53yf5knured4hhl6969zqebm044 14 97898 1577941 1028105 2026-07-02T12:44:24Z Riccardo Riccioni 452 1577941 wikitext text/x-wiki [[Jamii:Miji ya Burundi]] 8a4qni84hqle82s1stcp6h3np6okj2r 0 97905 1577963 1181942 2026-07-02T13:04:41Z Riccardo Riccioni 452 /* Viungo vya nje */ 1577963 wikitext text/x-wiki {{coord|1|56|38|S|30|3|34|E|region:RW|display=inline,title}} [[File:Rwanda KigaliDists.png|right|117px]] '''Wilaya ya Kigali''' (kwa [[Kinyarwanda]] "ciɡɑlí") ni [[wilaya]] ya [[mji mkuu]] wa [[Rwanda]]<ref>[http://www.kigalicity.gov.rw/spip.php?article2 "Kigali at a Glance"] {{Wayback|url=http://www.kigalicity.gov.rw/spip.php?article2 |date=20140228100441 }}, Official Website of Kigali City, accessed 15 August 2008</ref> [[Picha:Kigali2018Cropped.jpg|thumb|Kigali]] [[Picha:Ste.-Famille_Church_-_Genocide_Site_-_Viewed_through_Trees_-_Kigali_-_Rwanda_-_cropped.jpg|thumb|Kigali]] ==Tanbihi== {{Reflist}} ==Viungo vya nje== {{Commonscat-inline|Kigali}} {{Wikivoyage|Kigali}} {{Portal|Africa}} *[http://www.kigalicity.gov.rw/ Official Website of Kigali City] *[https://maps.google.com/maps?f=q&hl=en&q=kigali,+rwanda&ie=UTF8&z=12&ll=-1.928766,30.059967&spn=0.154751,0.346069&t=h&om=1&iwloc=A Satellite Image of Kigali from Google Earth.] *[http://www.livinginkigali.com/ Living in Kigali] {{mbegu-jio-Afrika}} [[Category:Kigali| ]] [[Category:Mikoa ya Rwanda]] 78xckuef5tu6uuiyt13hasp6b9yb6mc 0 101261 1578144 1536725 2026-07-02T21:54:29Z InternetArchiveBot 41439 Add 4 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578144 wikitext text/x-wiki [[image:Hexhamfromeddius.jpg|thumb|320px|Nakala ya ''Vita Sancti Wilfrithi'' ([[karne ya 11]]).]] '''Wilfrid wa Ripon''' au '''wa York''' ([[tahajia]] asili: '''Wilfrith'''<ref name=Fraser47>Fraser ''From Caledonia to Pictland'' p. 47</ref>; [[Northumbria]], [[633]] hivi – [[Oundle]], [[Northamptonshire]], [[709]] hivi) alikuwa [[mmonaki]] [[Mbenedikto]], halafu [[abati]] na hatimaye [[askofu]] wa [[York]], [[Uingereza]] kwa miaka 45 kuanzia mwaka [[664]], ingawa alilazimika mara kadhaa kuacha [[Dayosisi|jimbo]] lake hilo kwa wengine. Alishiriki [[Sinodi ya Whitby]] na kwa [[bidii]] yake alichangia sana uenezi wa [[umonaki]] wa [[Benedikto wa Nursia|Kibenedikto]] na [[mapokeo]] yote ya [[Kanisa la Kilatini]] kati ya waamini wa [[Ukristo wa Kiselti]]. Tangu kale anaheshimiwa na [[Wakatoliki]]<ref>"[http://middlesbrough-diocese.org.uk/about About the Diocese]" Roman Catholic Diocese of Middlesbrough</ref>, [[Waorthodoksi]]<ref name=EOC>Hutchinson-Hall ''Orthodox Saints'' p. 78</ref> na [[Waanglikana]] kama [[mtakatifu]]<ref>http://www.santiebeati.it/dettaglio/50680</ref>. [[Sikukuu]] yake huadhimishwa [[tarehe]] [[24 Aprili]]<ref>[[Martyrologium Romanum]]</ref> au [[12 Oktoba]]. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] == Tanbihi== {{reflist}} ==Marejeo ya Kiswahili== * John Kabeya na wengine - Maisha ya Watakatifu – ed. T.M.P. Book Department – Tabora 1965, 1989, uk. 354-355 * Pd. Leandry Kimario, [[Wakapuchini|O.F.M.Cap.]] - Mfahamu Mtakatifu Somo Wako - Maisha ya Watakatifu wa Kila Siku pamoja na Watakatifu Wafransisko - Toleo la pili - Dar es Salaam 2021, uk. 312-313 == Marejeo ya lugha nyingine== {{refbegin|60em}} * {{cite journal |author=Abels, Richard |date=Autumn 1983 |title=The Council of Whitby: A Study in Early Anglo-Saxon Politics |url=https://archive.org/details/sim_journal-of-british-studies_1983_fall_23_1/page/n7 |journal=[[Journal of British Studies]] |volume=23 |issue= 1|pages=1–25 |doi=10.1086/385808 |jstor= 175617}} * {{cite web |url=http://middlesbrough-diocese.org.uk/about |publisher=Roman Catholic Diocese of Middlesbrough |title=About the Diocese |accessdate=15 January 2011 }} * {{cite book |author=Bede |authorlink=Bede |others=Sherley-Price, Leo (translator) |title=A History of the English Church and People |publisher=Penguin Classics |location=New York |year=1988 |isbn=0-14-044042-9 }} * {{cite book |author=Blair, John P. |authorlink=John Blair (historian) |title=The Church in Anglo-Saxon Society |url=https://archive.org/details/churchinanglosax0000blai |publisher=Oxford University Press |location=Oxford, UK |year= 2005 |isbn=0-19-921117-5 }} * {{cite book |author=Blair, Peter Hunter |authorlink= Peter Hunter Blair |title=An Introduction to Anglo-Saxon England|edition=Third |publisher=Cambridge University Press |location=Cambridge, UK |year=2003 |isbn=0-521-53777-0 }} * {{cite book |author=Blair, Peter Hunter|authorlink= Peter Hunter Blair |title=The World of Bede |publisher=Cambridge University Press |location=Cambridge, UK |year=1990 |edition=Reprint of 1970 |isbn=0-521-39819-3 }} * {{cite journal |author=Brown, George Hardin |title=Royal and Ecclesiastical Rivalries in Bede's History |url=https://archive.org/details/sim_renascence_fall-1999_52_1/page/19 |journal= [[Renascence (journal)|Renascence]] |date=Fall 1999 |volume=52 |pages=19–33 |issue=1 |doi=10.5840/renascence19995213}} <!-- Note that DOI 10.1017/CHOL9780521300087.061 is NOT this article. If a bot adds that DOI, revert --> * {{cite book |author=Brown, Peter G. |authorlink=Peter Brown (historian) |title=The Rise of Western Christendom: Triumph and Diversity, A. D. 200–1000 |url=https://archive.org/details/riseofwesternchr0002brow |publisher=Blackwell Publishers |location=Cambridge, MA |year=2003 |isbn=0-631-22138-7 }} * {{cite book |author=Campbell, James E. |title=The Anglo-Saxon State |publisher=Hambledon & London |location=London |year=2003 |isbn=1-85285-176-7 }} * {{cite encyclopedia |author=Campbell, James |title=Bede I |encyclopedia =Essays in Anglo-Saxon History |publisher=Hambledon Press |location=London |isbn=0-907628-32-X |pages=1–28}} * {{cite encyclopedia |author=Campbell, James |title=First Century of Christianity in England |encyclopedia =Essays in Anglo-Saxon History |publisher=Hambledon Press |location=London |isbn=0-907628-32-X |pages=49–68}} * {{cite encyclopedia | author=Chadwick, Henry | authorlink= Henry Chadwick (theologian) |title=Theodore, the English Church, and the Monothelete Controversy |encyclopedia = Archbishop Theodore |series = Cambridge Studies in Anglo-Saxon England No. 11 |publisher=Cambridge University Press |location=Cambridge, UK |year=1995 |isbn=0-521-48077-9 |pages=88–95 |editor = Lapidge, Michael |editor-link=Michael Lapidge }} * {{cite encyclopedia| author=Charles-Edwards, T. M. |author-link = Thomas Charles-Edwards |title='The Continuation of Bede', s.a. 750: High-Kings of Tara and 'Bretwaldas' |editor= Smyth, Alfred P. |encyclopedia=Seanchas: Studies in Early Medieval Irish Archaeology, History and Literature in Honour of Francis J. Byrne |location= Dublin & Portland |publisher=Four Courts Press |year=2000 |isbn= 1-85182-489-8 |pages= 137–145}} * {{cite journal |author=Coates, Simon |title=Ceolfrid: History, Hagiography and Memory in Seventh- and Eighth-century Wearmouth–Jarrow |url=https://archive.org/details/sim_journal-of-medieval-history_1999-06_25_2/page/69 | journal=[[Journal of Medieval History]] |volume=25 |issue=2 |year=1999 |pages=69–86 |doi=10.1016/S0304-4181(98)00020-7}} * {{cite journal |author=Coates, Simon |title=The Construction of Episcopal Sanctity in early Anglo-Saxon England: the Impact of Venantius Fortunatus |url=https://archive.org/details/sim_historical-research_1998-02_71_174/page/n4 |journal=Historical Research |volume=71 |issue=174 |date=February 1998 |pages=1–13 |doi=10.1111/1468-2281.00050 }} * {{cite journal |author=Coates, Simon |title=The Role of Bishops in the Early Anglo-Saxon Church: A Reassessment |url=https://archive.org/details/sim_history-us_1996-04_81_262/page/177 |journal=History |volume=81 |issue=262 |pages=177–196 |doi=10.1111/j.1468-229X.1996.tb02256.x |date=April 1996 }} * {{cite book |author=Coredon, Christopher |title= A Dictionary of Medieval Terms & Phrases |year= 2007 |edition= Reprint |publisher=D. S. Brewer |location=Woodbridge, UK |isbn=978-1-84384-138-8 }} * {{cite encyclopedia |author=Craig, D. J. |title=Oswald (St Oswald) (603/4–642) |encyclopedia=Oxford Dictionary of National Biography |publisher=Oxford University Press |year=2004 |url=http://www.oxforddnb.com/view/article/20916 |accessdate=26 January 2009 |doi=10.1093/ref:odnb/20916 |format={{ODNBsub}} }} * {{cite journal |author=Cubitt, Catherine |date=August 2005 | title=The Clergy of Early Anglo-Saxon England |journal=Historical Research |volume=78 |issue=201 |pages=273–287 |doi=10.1111/j.1468-2281.2005.00236.x}} * {{cite journal |author=Cubitt, Catherine |title=Wilfrid's "Usurping Bishops": Episcopal Elections in Anglo-Saxon England c. 600-c.800 |journal=Northern History |volume=25 |year=1989 |pages=18–38 |doi=10.1179/nhi.1989.25.1.18}} * {{cite book |author=Dodwell, C. R. |authorlink=Charles Reginald Dodwell |title=Anglo-Saxon Art: A New Perspective |url=https://archive.org/details/anglosaxonartnew0000dodw_62 |publisher=Cornell University Press |location=Ithaca, NY |year=1985 |edition=Cornell University Press 1985 |isbn=0-8014-9300-5 }} * {{cite book |author= Ehwald, Rudolf (ed.) |title= Aldhelmi Opera |publisher= Weidmannsche Verlagsbuchhandlung |location=Berlin |year=1919 |oclc= 9631233}} * {{cite encyclopedia |author=Farmer, D. H. |title=Introduction |encyclopedia=The Age of Bede: Bede&nbsp;– Life of Cuthbert, Eddius Stephanus&nbsp;– Life of Wilfrid, Bede&nbsp;– Lives of the Abbots of Wearmouth and Jarrow, The Anonymous History of Abbot Ceolfrith with the Voyage of St Brendan |publisher=Penguin Books |location=London |year=1998| edition=Revised |isbn=978-0-14-044727-9 |translator=Webb, J. F. }} * {{cite encyclopedia |author=Farmer, D. H. |title=Saint Wilfrid |encyclopedia =Saint Wilfrid at Hexham |editor=Kirby, D. P. |publisher=Oriel Press |location=Newcastle upon Tyne, UK |year=1974 |isbn=0-85362-155-1|pages=35–60}} * {{cite book |author=Farmer, David Hugh |title=Oxford Dictionary of Saints |url=https://archive.org/details/oxforddictionary0000farm_a6q1 |publisher=Oxford University Press |year=2004 |edition=Fifth |location=Oxford, UK |isbn=978-0-19-860949-0 }} * {{cite journal |title=Feast of St Wilfrid |journal=Folklore |volume=19 |date=December 1908 |pages=464–466 |issue=4 |jstor= 1254241}} * {{cite book |author=Fletcher, R. A. |authorlink=Richard A. Fletcher |title=The Barbarian Conversion: From Paganism to Christianity |url=https://archive.org/details/barbarianconvers00flet |publisher=H. Holt and Company |location=New York |year=1998 |isbn=0-8050-2763-7 }} * {{cite book |author=Foley, William Trent |title= Images of Sanctity in Eddius Stephanus' 'Life of Bishop Wilfrid', an Early English Saint's Life |publisher= Edwin Mellen Press |year=1992 |isbn= 0-7734-9513-4 }} * {{cite book |author=Forster, W.A.|title=Saint Wilfrid of Ripon|publisher=Dean and Chapter of Ripon Cathedral|location=Ripon, UK |year=1997 |isbn=0-9531979-0-5}} * {{cite book |author=Fraser, James E. |authorlink= James E. Fraser (historian) |title=From Caledonia to Pictland: Scotland to 795 |url=https://archive.org/details/fromcaledoniatop0000fras |publisher=Edinburgh University Press |year=2009 |isbn=978-0-7486-1232-1 |location=Edinburgh, UK }} * {{cite book |author1=Fryde, E. B. |author2=Greenway, D. E. |author3=Porter, S. |author4=Roy, I.|title=Handbook of British Chronology|url=https://archive.org/details/handbookofbritis0000unse_f1u2 |edition=Third revised |publisher=Cambridge University Press |location=Cambridge, UK |year=1996 |isbn=0-521-56350-X }} * {{cite encyclopedia |author=Gem, Richard |title=The Significance of the 11th-century Rebuilding of Christ Church and St Augustine's, Canterbury, in the Development of Romanesque Architecture |encyclopedia=Medieval Art and Architecture at Canterbury Before 1220 |series = British Archaeological Association Conference Transactions |volume=V |publisher= Kent Archaeological Society |year=1982 |isbn=0-907307-05-1 |pages=1–19 }} * {{cite journal |author=Gibbs, Marion |title=The Decrees of Agatho and the Gregorian Plan for York |journal=[[Speculum (journal)|Speculum]] |date=April 1973 |volume=XLVII |pages=213–246 |doi=10.2307/2852771 |issue=2 |jstor= 2852771 }} * {{cite encyclopedia |author=Gilbert, Edward |title=Saint Wilfrid's Church at Hexham |encyclopedia =Saint Wilfrid at Hexham|editor=Kirby, D. P. |publisher=Oriel Press |location=Newcastle upon Tyne, UK |year=1974 |isbn=0-85362-155-1|pages=81–113}} * {{cite book |author=Goffart, Walter A. |authorlink=Walter Goffart |title=The Narrators of Barbarian History (A. D. 550–800): Jordanes, Gregory of Tours, Bede, and Paul the Deacon |url=https://archive.org/details/narratorsofbarba0000goff |publisher=Princeton University Press |location=Princeton, NJ |year=1988 |isbn=0-691-05514-9 }} * {{cite encyclopedia |author=Hall, R. A. |editor1=Lapidge, Michael |editor1-link=Michael Lapidge |editor2=Blair, John |editor3=Keynes, Simon |editor-link3= Simon Keynes |editor4= Scragg, Donald|encyclopedia= The Blackwell Encyclopaedia of Anglo-Saxon England |title= York |year=2001 |publisher= Blackwell Publishing |location=Malden, MA |isbn= 978-0-631-22492-1|pages=497–499 }} * {{cite book |author=Heffernan, Thomas J. |title=Sacred Biography: Saints and Their Biographers in the Middle Ages |url=https://archive.org/details/sacredbiographys0000heff |publisher=Oxford University Press |location=Oxford, UK |year=1988 |isbn=0-19-507907-8 }} * {{cite book |author=Herrin, Judith |authorlink=Judith Herrin |title=The Formation of Christendom |url=https://archive.org/details/formationofchris0000herr_g2x5 |publisher=Princeton University Press |location=Princeton, NJ |year=1989 |isbn=0-691-00831-0 }} * {{cite book |author=Higham, N. J. |title=The Convert Kings: Power and Religious Affiliation in Early Anglo-Saxon England |publisher=Manchester University Press |location=Manchester, UK |year=1997 |isbn=0-7190-4827-3 }} * {{cite book |author=Higham, N. J. |title=The Kingdom of Northumbria: AD 350–1100 |url=https://archive.org/details/kingdomofnorthum0000high |publisher=A. Sutton |location=Gloucester, UK |year=1993 |isbn=0-86299-730-5 }} * {{cite book |author=Higham, N. J. |title=(Re-)reading Bede: The Ecclesiastical History in Context |url=https://archive.org/details/rereadingbedeecc0000high |publisher=Routledge |location=New York |year=2006 |isbn=0-415-35368-8 }} * {{cite book |author= Hindley, Geoffrey |title= A Brief History of the Anglo-Saxons: The Beginnings of the English Nation |url= https://archive.org/details/briefhistoryofan0000hind_b4f5 |year= 2006 |publisher= Carroll & Graf Publishers |location= New York |isbn= 978-0-7867-1738-5 }} * {{cite web |title=History |publisher=Ripon Cathedral |url=http://riponcathedral.info/history-2/ |accessdate=3 October 2016 |archivedate=2016-10-21 |archiveurl=https://web.archive.org/web/20161021185114/http://riponcathedral.info/history-2/ }} * {{cite book |author1=Holford-Strevens, Leofranc |author2=Blackburn, Bonnie J. |title=The Oxford Book of Days |url=https://archive.org/details/oxfordbookofdays00blac |publisher=Oxford University Press |location=Oxford, UK |year=2000 |isbn=0-19-866260-2 }} * {{cite book |author=Hutchinson-Hall, John |title=Orthodox Saints of the British Isles: Volume II&nbsp;— April&nbsp;— June |year=2014 |publisher=St. Eadfrith Press |isbn=9780692022450 }} * {{cite book |author=John, Eric |title=Reassessing Anglo-Saxon England |publisher=Manchester University Press |location=Manchester, UK |year=1996 |isbn=0-7190-5053-7 }} * {{cite encyclopedia |author=John, Eric | title=The Social and Political Problems of the Early English Church |encyclopedia=Land, Church, and People: Essays Presented to Professor [[H. P. R. Finberg]] |editor=Thirsk, Joan | publisher=British Agricultural Historical Society |location=Reading, UK |year=1970 | oclc= 263554885}} * {{cite encyclopedia |author=Keynes, Simon |authorlink=Simon Keynes |title=Heptarchy |page=233 |encyclopedia=The Blackwell Encyclopaedia of Anglo-Saxon England |editor1=Lapidge, Michael |editor1-link=Michael Lapidge |editor2=Blair, John |editor3=Keynes, Simon |editor-link3= Simon Keynes |editor4= Scragg, Donald |year=2001 |publisher=Blackwell Publishing |location=Malden, MA |isbn=978-0-631-22492-1 }} * {{cite journal |author=Kirby, D. P. |date=January 1983 |title=Bede, Eddius Stephanus and the ''Life of Wilfrid'' |url=https://archive.org/details/sim_english-historical-review_1983-01_98_386/page/101 |journal=[[The English Historical Review]] |volume=98 |issue=386 |pages=101–114 |doi=10.1093/ehr/XCVIII.CCCLXXXVI.101 |jstor=570165 }} * {{cite book |author=Kirby, D. P. |title=The Earliest English Kings |publisher=Routledge |location=New York |year=2000 |isbn=0-415-24211-8 }} * {{cite book |author=Kirby, D. 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H. |title=Medieval Monasticism: Forms of Religious Life in Western Europe in the Middle Ages |url=https://archive.org/details/medievalmonastic0000lawr_n3c1 |edition=Third |publisher=Longman |location=New York |year=2001 |isbn=0-582-40427-4 }} * {{cite journal |author=Laynesmith, Mark D. |title=Stephen of Ripon and the Bible: Allegorical and Typological Interpretations of the ''Life of St Wilfrid''|url=https://archive.org/details/sim_early-medieval-europe_2000_9_2/page/163 |journal=Early Medieval Europe |volume=9 |issue=2 |date=July 2000 |pages=163–182 |doi=10.1111/1468-0254.00064}} * {{cite book |author=Levison, Wilhelm |authorlink= Wilhelm Levison |title=England and the Continent in the Eighth Century |publisher=Clarendon Press |location=Oxford, UK |year=1973 |isbn=0-19-821232-1 |edition= Originally published 1946, Reprint}} * {{cite book |author=Loyn, H. R. |authorlink=H. R. Loyn |title=The Governance of Anglo-Saxon England, 500–1087 |url=https://archive.org/details/governanceofangl0000loyn |publisher=Stanford University Press |location=Stanford, CA |year=1984 |isbn=0-8047-1217-4 }} * {{cite book |author=Lyon, Bryce Dale |title=A Constitutional and Legal History of Medieval England|edition=Second |publisher=Norton |location=New York |year=1980 |isbn=0-393-95132-4 }} * {{cite book |author=Mayr-Harting, Henry| authorlink= Henry Mayr-Harting |title=The Coming of Christianity to Anglo-Saxon England |url=https://archive.org/details/comingofchristia0000mayr_a5a2|publisher=Pennsylvania State University Press |location=University Park, PA |year=1991 |isbn=0-271-00769-9 }} * {{cite book|author=Mee, Frances |title= A History of Selsey |publisher=Philimore |location=Chichester, UK |year=1988 |isbn= 0-85033-672-4}} * {{cite journal |author=Mitchell, Barbara |title=Anglo-Saxon Double Monasteries |url=https://archive.org/details/sim_history-today_1995-10_45_10/page/33 |journal=[[History Today]] |date=October 1995 |volume=45 |pages=33–39 }} * {{cite book |author=Nilson, Ben |title=Cathedral Shrines of Medieval England|publisher=Boydell Press |year=1998 |location=Woodbridge, UK |isbn=0-85115-540-5}} * {{cite encyclopedia | author = Ortenberg, Veronica |encyclopedia= The English Church and the Papacy in the Middle Ages |title= The Anglo-Saxon Church and the Papacy | editor=Lawrence, C. H.| pages = 29–62 | place = Stroud, UK | publisher = Sutton Publishing|isbn=0-7509-1947-7 | year = 1965 |edition=Reprint edition 1999}} * {{cite encyclopedia |author=Philpott, Mark |title=Eadmer, his Archbishops and the English State| encyclopedia=The Medieval State: Essays Presented to James Campbell |editor1= Maddicott, J. R. |editor-link1= John Maddicott |editor2=Palliser, D. M. |publisher=Hambledon Press |location=London |year=2000 |pages=93–107|isbn=1-85285-195-3}} * {{cite encyclopedia |author=Rollason, David |authorlink= David Rollason |title=Hagiography and Politics in Early Northumbria |encyclopedia = Holy Men and Holy Women: Old English Prose Saints' Lives and their Contexts |editor= Szarmach, Paul E. |publisher=State University of New York Press |location=Albany, NY |year=1996 |isbn=0-7914-2715-3 |pages=95–114}} * {{cite web |url=http://www.catholic-forum.com/saints/saintw64.htm |title=Saint Wilfrid |work=Patron Saint Index |accessdate=12 September 2007 |deadurl=yes |archiveurl=https://web.archive.org/web/20071014043506/http://catholic-forum.com/saints/saintw64.htm |archivedate=14 October 2007 |df=dmy-all }} * {{cite book |author=Southern, R. W. |authorlink=Richard Southern |title=Western Society and the Church in the Middle Ages |url=https://archive.org/details/westernsocietyc00sout |publisher=Penguin Books |location=New York |year=1970 |isbn=0-14-020503-9 }} * {{cite book |author=Stenton, F. M. |authorlink= Frank Stenton |title= Anglo-Saxon England |url=https://archive.org/details/anglosaxonenglan0000sten |year= 1971|publisher= Oxford University Press |location=Oxford, UK |edition=Third |isbn=978-0-19-280139-5 }} * {{cite encyclopedia |author=Stephen of Ripon|authorlink= Stephen of Ripon |title=Life of Wilfrid |encyclopedia=The Age of Bede: Bede&nbsp;– Life of Cuthbert, Eddius Stephanus&nbsp;– Life of Wilfrid, Bede&nbsp;– Lives of the Abbots of Wearmouth and Jarrow, The Anonymous History of Abbot Ceolfrith with the Voyage of St Brendan |publisher=Penguin Books |location=London |year=1998| edition=Revised |isbn=978-0-14-044727-9 |translator=Webb, J. F. }} * {{cite book |author=Swanton, Michael James (trans.) |authorlink=Michael Swanton |title=The Anglo-Saxon Chronicle |url=https://archive.org/details/anglosaxonchroni0000unse_c2u1 |publisher=Routledge |location=New York |year=1998 |isbn=0-415-92129-5 }} * {{cite encyclopedia |author=Swanton, Michael James |authorlink= Michael Swanton |title=Introduction |pages=i–xxxv |encyclopedia=The Anglo-Saxon Chronicle |publisher=Routledge |location=New York |year=1998 |isbn=0-415-92129-5 }} * {{cite encyclopedia |author=Thacker, Alan |title=Saint-making and Relic Collecting by Oswald and his Communities |editor1=Brooks, Nicholas |editor-link1= Nicholas Brooks |editor2=Cubitt, Catherine R. E. |encyclopedia=St Oswald of Worcester: Life and Influence |publisher=Leicester University Press |location=London |year=1996 |pages=244–268 |isbn=0-7185-0003-2 }} * {{cite encyclopedia |author=Thacker, Alan |editor1=Lapidge, Michael |editor1-link=Michael Lapidge |editor2=Blair, John |editor3=Keynes, Simon |editor-link3= Simon Keynes |editor4= Scragg, Donald |encyclopedia= The Blackwell Encyclopaedia of Anglo-Saxon England |title= St Wilfrid |year=2001 |publisher= Blackwell Publishing |location=Malden, MA |isbn= 978-0-631-22492-1 |pages=474–476 }} * {{cite encyclopedia |author=Thacker, Alan |title=Wilfrid (St Wilfrid) (c.634–709/10) |encyclopedia=Oxford Dictionary of National Biography |publisher=Oxford University Press |year=2004 |url=http://www.oxforddnb.com/view/article/29409 |accessdate=9 November 2007 |doi=10.1093/ref:odnb/29409 |format={{ODNBsub}} }} * {{cite book |author=Thomson, John A. F. |title= The Western Church in the Middle Ages |url=https://archive.org/details/westernchurchinm0000unse |publisher=Arnold |location=London |year=1998 |isbn=0-340-60118-3 }} * {{cite journal |author=Tyler, Damian |title=Reluctant Kings and Christian Conversion in Seventh-Century England |url=https://archive.org/details/sim_history-us_2007-04_92_306/page/144 |journal=[[History (The Journal of the Historical Association)|History]] |date=April 2007 |volume=92 |issue=306 |pages=144–161 |doi=10.1111/j.1468-229X.2007.00389.x }} * {{cite book |author=Wallace-Hadrill, J. M. |authorlink= J. M. Wallace-Hadrill |title=The Long-haired Kings |publisher=University of Toronto Press in association with Medieval Academy of America |location=Toronto |year=1982 |isbn=0-8020-6500-7 }} * {{cite book |author=Walsh, Michael J. |title= A New Dictionary of Saints: East and West |url=https://archive.org/details/newdictionaryofs0000wals |year=2007 |publisher= Burns & Oats |location=London |isbn=0-86012-438-X }} * {{cite book |author=Whitelock, Dorothy (ed.) |authorlink=Dorothy Whitelock |title=English Historical Documents: Volume 1 c. 500–1042 |publisher= Eyre Methuen |location=London |edition=Second |oclc= 23967961}} * {{cite journal| author=Woolf, Alex |authorlink= Alex Woolf |title= Dún Nechtain, Fortriu and the Geography of the Picts | journal =The Scottish Historical Review |volume= 85 |issue= 2 |date=October 2006 |pages= 182–201| doi=10.1353/shr.2007.0029 |jstor= 25529917}} * {{cite encyclopedia|author=Woolf, Alex | authorlink= Alex Woolf |title=The Verturian Hegemony: A Mirror in the North |editor1 =Brown, Michelle P |editor2=Farr, Carol Ann |encyclopedia=Mercia: An Anglo-Saxon Kingdom in Europe |location=London |publisher=Leicester University Press |year=2001 |pages= 106–112 |isbn= 0-7185-0231-0}} * {{cite encyclopedia |author=Yorke, Barbara | authorlink= Barbara Yorke |title=The Adaptation of the Anglo-Saxon Royal Courts to Christianity |encyclopedia=The Cross Goes North: Processes of Conversion in Northern Europe AD 300–1300 |publisher=Boydell Press |location=Woodbridge, UK |editor= Carver, Martin |year=2003 |isbn=1-84383-125-2 |pages=244–257 |editor-link= Martin Carver }} * {{cite book |author=Yorke, Barbara|authorlink= Barbara Yorke |title=The Conversion of Britain: Religion, Politics and Society in Britain c. 600–800 |url=https://archive.org/details/conversionofbrit0000york|publisher=Pearson/Longman |location=London |year=2006 |isbn=0-582-77292-3 }} * {{cite book |author=Yorke, Barbara |authorlink= Barbara Yorke |title=Kings and Kingdoms of Early Anglo-Saxon England |url=https://archive.org/details/kingskingdomsofe0000york |publisher=Routledge |location=New York |year=1997 |isbn=0-415-16639-X }} {{refend}} == Marejeo mengine == {{refbegin|60em}} * {{cite journal |author=Foley, W. T. |title=Imitation Apostoli: St Wilfrid of York and the Andrew Script |url=https://archive.org/details/sim_american-benedictine-review_1989-03_40_1/page/13 |journal= American Benedictine Review |volume=40 |year=1989 |pages= 13–31}} * {{cite encyclopedia |author=Pelteret, David |title=Saint Wilfrid: Tribal Bishop, Civic Bishop or Germanic Lord? |encyclopedia=The Community, the Family and the Saint: Patterns of Power in Early Modern Europe |editor=Hill, Joyce |editor2=Swan, Mary |publisher=Brepols |year=1998 |isbn=2-503-50668-2 |pages=159–180}} * {{cite journal|author=Sims-Williams, Patrick |title=St Wilfrid and Two Charters Dated AD 676 and 680 |url=https://archive.org/details/sim_journal-of-ecclesiastical-history_1988-04_39_2/page/163 |journal=[[Journal of Ecclesiastical History]] |issue=2 |volume=39 |date=April 1988 |pages=163–183|doi=10.1017/S0022046900020649}} * {{cite book |author=Stancliffe, Clare |title=Bede, Wilfrid, and the Irish |year=2003| location=Jarrow, UK | publisher=St Paul's Church Jarrow |series =Jarrow Lecture 46 |isbn= 9780021678822}} * {{cite journal|author=Wood, I. N. |title= Northumbrians and Franks in the age of Wilfrid |journal=Northern History|volume= 31 |date=January 1995 |pages=10–21 |doi=10.1179/007817295790175327}} {{refend}} == Viungo vya nje == * [http://www.fordham.edu/halsall/basis/bede-book5.html ''Ecclesiastical History'' Book V] {{Wayback|url=http://www.fordham.edu/halsall/basis/bede-book5.html |date=20140814160844 }}&nbsp;– Chapter XIX contains Wilfrid's epitaph. From the Medieval Sourcebook [[Category:Waliozaliwa 634]] [[Category:Waliofariki 709]] [[Category:Wamonaki]] [[Category:Wabenedikto]] [[Category:Maaskofu Wakatoliki]] [[Category:Watakatifu wa Uingereza]] s824urkmap64v1pzp77znbembguj7ds 14 109821 1577943 1057793 2026-07-02T12:46:45Z Riccardo Riccioni 452 1577943 wikitext text/x-wiki [[jamii:Miji ya Ethiopia]] [[Jamii:Miji Mikuu Afrika]] 391p4k8z008qz2ujvk0y62wkigaxu9v 0 114758 1578183 1498134 2026-07-03T01:44:37Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578183 wikitext text/x-wiki [[image:Flower poster 2.jpg|thumb|Aina mbalimbali za Angiospermae.]] '''Angiospermae''' (yaani [[mimea]] inayochanua [[maua]]; kwa [[Kiingereza]]: ''angiosperms''<ref name="Lindley">{{cite book | last=Lindley | first=J | year=1830 | url=https://www.biodiversitylibrary.org/item/31944#page/21/mode/1up| title=Introduction to the Natural System of Botany | location=London | publisher= Longman, Rees, Orme, Brown, and Green | pages=xxxvi | nopp=true }}</ref><ref name="Cantino">{{cite journal |last1=Cantino |first1=Philip D. |last2=Doyle |first2=James A. |last3=Graham |first3=Sean W. |last4=Judd |first4=Walter S. |last5=Olmstead |first5=Richard G. |last6=Soltis |first6=Douglas E. |authorlink6=Douglas E. Soltis |last7=Soltis |first7=Pamela S.|authorlink7 = Pamela S. Soltis|last8=Donoghue |first8=Michael J. | year=2007 | title= Towards a phylogenetic nomenclature of ''Tracheophyta'' | journal=Taxon | volume=56 | issue=3 | pages= E1–E44 | ref= harv | doi=10.2307/25065865|jstor=25065865 }}</ref>; pia '''Magnoliophyta''') ndilo kundi kubwa zaidi la mimea ya nchi kavu (Embryophyte) likiwa na [[oda]] 64, [[Familia (biolojia)|familia]] 416, [[jenasi]] 13,000 na [[spishi]] zinazojulikana 300,000 hivi.<ref name="Christenhusz-Byng2016">{{cite journal |author1=Christenhusz, M. J. M. |author2=Byng, J. W. | year = 2016 | title = The number of known plants species in the world and its annual increase | journal = Phytotaxa | volume = 261 | pages = 201–217 | url = http://biotaxa.org/Phytotaxa/article/download/phytotaxa.261.3.1/20598 | doi = 10.11646/phytotaxa.261.3.1 | issue = 3 }}</ref> Mimea inayochanua ya zamani zaidi ilipatikana miaka [[milioni]] 160 iliyopita hivi. ==Tanbihi== {{reflist}} ==Marejeo== {{refbegin|30em}} * {{cite journal|last=APG|authorlink=Angiosperm Phylogeny Group|journal=[[Botanical Journal of the Linnean Society]]|volume=141|pages=399–436|year=2003|title=An update of the Angiosperm Phylogeny Group classification for the orders and families of flowering plants: APG II|doi=10.1046/j.1095-8339.2003.t01-1-00158.x|issue=4|ref=harv}} * {{cite journal|last=APG|authorlink=Angiosperm Phylogeny Group|year=2009|title=An update of the Angiosperm Phylogeny Group classification for the orders and families of flowering plants: APG III|journal=[[Botanical Journal of the Linnean Society]]|volume=161|issue=2|pages=105–121|url=http://www3.interscience.wiley.com/journal/122630309/abstract|archive-url=https://wayback.archive-it.org/all/20170525104318/http://onlinelibrary.wiley.com/doi/10.1111/j.1095-8339.2009.00996.x/abstract|dead-url=yes|archive-date=2017-05-25|accessdate=2010-12-10|doi=10.1111/j.1095-8339.2009.00996.x|ref=harv|=https://wayback.archive-it.org/all/20170525104318/http://onlinelibrary.wiley.com/doi/10.1111/j.1095-8339.2009.00996.x/abstract}} * {{Cite journal |last=APG|authorlink=Angiosperm Phylogeny Group |year=2016 |title=An update of the Angiosperm Phylogeny Group classification for the orders and families of flowering plants: APG IV |journal=[[Botanical Journal of the Linnean Society]] |volume=181 |issue=1 |pages=1–20 |doi= 10.1111/boj.12385|ref=harv}} * {{cite journal|last1=Becker|first1=Kenneth M.|title=A Comparison of Angiosperm Classification Systems|journal=[[Taxon (journal)|Taxon]]|date=February 1973|volume=22|issue=1|pages=19–50|doi=10.2307/1218032|jstor=1218032}} * {{cite book |last1=Bell |first1=Adrian D. |title=Plant Form. An Illustrated Guide to Flowering Plant Morphology |date=2008 |origyear=1991 |publisher=Timber Press |location=Portland, Oregon |isbn=978-0-88192-850-1 |url=https://books.google.com/books?id=SM3khPHXhKEC }} ** [https://archive.org/details/plantform00adri 1st edition published by Oxford University Press in 1991] {{ISBN|978-0-19854-219-3}} * {{cite journal|last=Bell|first=C.D.|last2=Soltis|first2=D.E.|last3=Soltis|first3=P.S.|authorlink3 = Pamela S. Soltis|authorlink2 = Douglas Soltis|year=2010|title=The Age and Diversification of the Angiosperms Revisited|journal=[[American Journal of Botany]]|volume=97|issue=8|pages=1296–1303|doi=10.3732/ajb.0900346|pmid=21616882|ref={{harvid|Bell et al|2010}}}} * {{cite journal|last=Chase|first=Mark W.|last2=Reveal|first2=James L.|year=2009|title=A phylogenetic classification of the land plants to accompany APG III|journal=Botanical Journal of the Linnean Society|volume=161|issue=2|pages=122–127|doi=10.1111/j.1095-8339.2009.01002.x|lastauthoramp=yes|ref={{Harvid|Chase|Reveal|2009}}}} * Cromie, William J. (December 16, 1999). [https://web.archive.org/web/20030714120417/http://www.news.harvard.edu/gazette/1999/12.16/angiosperms.html "Oldest Known Flowering Plants Identified By Genes"]. Harvard University Gazette. * {{cite journal|last1=Cronquist|first1=Arthur|authorlink=Arthur Cronquist|title=The divisions and classes of plants|url=https://archive.org/details/sim_botanical-review_october-december-1960_26_4/page/n2|journal=The Botanical Review|date=October 1960|volume=26|issue=4|pages=425–482|doi=10.1007/BF02940572|ref=harv}} * {{cite book|last = Cronquist|first= Arthur|authorlink=Arthur Cronquist|year=1981|title=An Integrated System of Classification of Flowering Plants|url = https://archive.org/details/integratedsystem0000cron|publisher=Columbia Univ. Press|location= New York| isbn= 978-0-231-03880-5 }} * {{cite journal|last1=Dahlgren|first1=R. M. T.|authorlink=Rolf Dahlgren|title=A revised system of classification of the angiosperms|journal=Botanical Journal of the Linnean Society|date=February 1980|volume=80|issue=2|pages=91–124|doi=10.1111/j.1095-8339.1980.tb01661.x|ref=harv}} * {{cite journal|last1=Dahlgren|first1=Rolf|authorlink=Rolf Dahlgren|title=General aspects of angiosperm evolution and macrosystematics|journal=Nordic Journal of Botany|date=February 1983|volume=3|issue=1|pages=119–149|doi=10.1111/j.1756-1051.1983.tb01448.x}} * {{cite journal | last1 = Dilcher | first1 = D. |doi = 10.1073/pnas.97.13.7030 | pmid = 10860967 | title = Toward a new synthesis: Major evolutionary trends in the angiosperm fossil record | year = 2000 | journal = Proceedings of the National Academy of Sciences | volume = 97 | issue = 13 | pages = 7030–7036 | pmc = 34380 | bibcode = 2000PNAS...97.7030D }} * {{cite web|last1=Dilcher|first1=David L|last2=Cronquist|first2=Arthur|last3=Zimmermann|first3=Martin Huldrych|last4=Stevens|first4=Peter|last5=Stevenson|first5=Dennis William|last6=Berry|first6=Paul E.|authorlink2=Arthur Cronquist|authorlink4=Peter F. Stevens|title=Angiosperm|url=https://www.britannica.com/plant/angiosperm|website=[[Encyclopedia Britannica]]|accessdate=31 January 2017|date=8 March 2016|ref={{harvid|Dilcher et al|2016}}}} * {{cite book|author = Heywood, V. H., Brummitt, R. K., Culham, A. & Seberg, O. |title = Flowering Plant Families of the World|url = https://archive.org/details/floweringplantfa0000unse |edition = | publisher = Firefly Books| year = 2007| location = Richmond Hill, Ontario, Canada|isbn = 978-1-55407-206-4}} * {{cite encyclopedia |last1=Hill |first1=Christopher |last2=Crane |first2=Peter |editor-last1=Joysey |editor-first1=Kenneth Alan |editor-last2=Friday |editor-first2=A.E. |encyclopedia=Problems of Phylogenetic Reconstruction |title=Evolutionary Cladistics and the origin of Angiosperms |url=https://www.researchgate.net/publication/275374707 |access-date= |date=January 1982 |publisher=Systematics Association |series=Special Volumes |volume=21 |location=London |isbn=978-0-12-391250-3 |pages=269–361 |ref=harv}} * {{cite book|last1=Lersten|first1=Nels R.|title=Flowering plant embryology with emphasis on economic species|date=2004|publisher=Blackwell Pub.|location=Ames, Iowa|isbn=9780470752678|url=https://books.google.com/books?id=2YbwF7tH6dUC|ref=harv}} * {{cite book|last1=Pooja|title=Angiosperms|date=2004|publisher=Discovery|location=New Delhi|isbn=9788171417889|url=https://books.google.com/books?id=3pZxuyUllJIC|accessdate=7 January 2016|ref=harv}} * Raven, P.H., R.F. Evert, S.E. Eichhorn. ''Biology of Plants'', 7th Edition. W.H. Freeman. 2004 * Sattler, R. 1973. ''Organogenesis of Flowers. A Photographic Text-Atlas''. University of Toronto Press. * {{cite book|last=Simpson|first=Michael G.|title=Plant Systematics|year=2010|publisher=[[Academic Press]]|isbn=9780080922089|url=https://books.google.com/books?id=dj8KRImgyf4C|edition=2nd|ref=harv}} * {{cite journal|last1=Soltis|first1=Pamela S|last2=Soltis|first2=Douglas E|authorlink1=Pamela Soltis|authorlink2=Douglas Soltis|title=Ancient WGD events as drivers of key innovations in angiosperms|journal=[[Current Opinion in Plant Biology]]|date=April 2016|volume=30|pages=159–165|doi=10.1016/j.pbi.2016.03.015|pmid=27064530}} * {{cite journal|last1=Takhtajan|first1=A.|authorlink=Takhtajan|title=The Taxa of the Higher Plants above the Rank of Order|journal=[[Taxon (journal)|Taxon]]|date=June 1964|volume=13|issue=5|pages=160–164|doi=10.2307/1216134|jstor=1216134|ref=harv }} * {{cite journal|last1=Takhtajan|first1=A.|authorlink=Takhtajan|title=Outline of the Classification of Flowering Plants (Magnoliophyta)|url=https://archive.org/details/sim_botanical-review_july-september-1980_46_3/page/225|journal=Botanical Review|date=July–September 1980|volume=46|issue=3|pages=225–359|jstor=4353970|ref=harv|doi=10.1007/bf02861558}} * {{cite journal|last1=Zeng|first1=Liping|last2=Zhang|first2=Qiang|last3=Sun|first3=Renran|last4=Kong|first4=Hongzhi|last5=Zhang|first5=Ning|last6=Ma|first6=Hong|title=Resolution of deep angiosperm phylogeny using conserved nuclear genes and estimates of early divergence times|journal=[[Nature Communications]]|date=24 September 2014|volume=5|issue=4956|pages=4956|doi=10.1038/ncomms5956|pmid=25249442|pmc=4200517|ref={{harvid|Zeng et al|2014}}|bibcode=2014NatCo...5E4956Z}} {{refend}} ==Viungo vya nje== * {{Commons category-inline|Magnoliophyta}} * {{cite web |last1=Cole |first1=Theodor C.H. |last2=Hilger |first2=Harmut H. |first3=Peter F. |last3=Stevens |date=2017 |url=http://www.biologie.fu-berlin.de/sysbot/poster/poster1.pdf |title=Angiosperm Phylogeny Poster{{spaced ndash}} Flowering Plant Systematics |website= }} * {{cite web |last1=Watson |first1=L. |last2=Dallwitz |first2=M.J. |date=1992 |url=http://www.biologie.uni-hamburg.de/b-online/delta/angio |title=The Families of Flowering Plants: Descriptions, Illustrations, Identification, and Information Retrieval |version=14 December 2000 |website= |archive-url=https://web.archive.org/web/20140802080838/http://www.biologie.uni-hamburg.de/b-online/delta/angio |archive-date=2014-08-02 |dead-url=yes |accessdate=2019-07-21 |archivedate=2014-08-02 |archiveurl=https://web.archive.org/web/20140802080838/http://www.biologie.uni-hamburg.de/b-online/delta/angio }} {{mbegu-mmea}} [[Jamii:Jinsia]] [[Jamii:Angiospermae]] hy15sq7e47ie82sixwwusbh6pdlefec 0 117220 1578137 1535142 2026-07-02T21:43:59Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578137 wikitext text/x-wiki [[image:Shenoute of Atripe.jpg|200px|thumb|[[Picha takatifu]] ya Mt. Shenute.]] [[File:WhiteMonasteryCourtNorth.jpg|thumb|[[Magofu]] ya Monasteri Nyeupe.]] '''Shenute Mkuu''' (pia: '''Shenute Abati''', '''Shenuda'''; [[Shenalolet]], [[348]] hivi</ref> (the date 348 AD, often mentioned but not universally accepted, is based on an inscription in his monastery, dating from the twelfth or thirteen century<ref>Emmel (2004), p. 12</ref> - [[Sohag]], [[1 Julai]] [[465]]) alikuwa [[abati]] wa [[Monasteri Nyeupe]] nchini [[Misri]] kuanzia [[mwaka]] [[385]]. Alishiriki [[Mtaguso wa Efeso]] ([[431]]) pamoja na [[Sirili wa Aleksandria]] na kuacha [[maandishi]] mbalimbali, hasa [[hotuba]] na [[barua]], ambayo yanamfanya [[mwandishi]] bora wa [[lugha]] ya [[Kimisri]]<ref>https://dacb.org/stories/egypt/shenoute/</ref>. Tangu kale anaheshimiwa kama [[mtakatifu]] na [[Makanisa ya Kiorthodoksi ya Mashariki]], hasa na [[Wakopti]]. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{Reflist}} ==Marejeo== * Bell, David N. ''Besa: The Life of Shenoute''. ''Cistercian Studies'' Series, vol. 73. Kalamazoo: Cistercian Publications, 1983. * Brakke, David. ''Demons and the Making of the Monk: Spiritual Combat in Early Christianity''. Cambridge, MA, and London: Harvard University Press, 2006. [Esp. chap. 5, “The Prophet: Shenoute and the White Monastery.”] * Emmel, Stephen. ''Shenoute’s Literary Corpus''. 2 vols. Corpus Scriptorum Christianorum Orientalium, vols. 599–600 (= Subsidia, vols. 111–112). Leuven: Peeters, 2004. [With an extensive bibliography on Shenoute up to 2004.] * Emmel, Stephen. “Shenoute’s Place in the History of Monasticism.” In: ''Christianity and Monasticism in Upper Egypt'', vol. 1: ''Akhmim and Sohag'', edited by Gawdat Gabra and Hany N. Takla, pp.&nbsp;31–46 (with bibliography on pp.&nbsp;321–350). Cairo and New York: The American University in Cairo Press, 2008. *Wolfgang Kosack: {{cite book |title=Schenute von Atripe De judicio finale |others=Papyruskodex 63000.IV im Museo Egizio di Torino. Einleitung, Textbearbeitung und Übersetzung |editor-first=Wolfgang |editor-last=Kosack |location=Berlin |year=2013 |publisher=Verlag Brunner Christoph |isbn=978-3-9524018-5-9 |language=de}} * Wolfgang Kosack: ''Shenoute of Atripe "De vita christiana"'': M 604 Pierpont-Morgan-Library New York/Ms. OR 12689 British-Library/London and Ms. Clarendon Press b. 4, Frg. Bodleian-Library/Oxford. Introduction, edition of the text and translation into German by Wolfgang Kosack / Verlag Christoph Brunner, Basel 2013. {{ISBN|978-3-906206-00-4}} *{{cite book |last=Krawiec |first=Rebecca |title=Shenoute and the Women of the White Monastery: Egyptian Monasticism in Late Antiquity |url=https://archive.org/details/shenoutewomenofw0000kraw |location=Oxford etc. |publisher=Oxford University Press |year=2002 }} *{{cite journal |last=Layton |first=Bentley |title=Rules, Patterns, and the Exercise of Power in Shenoute’s Monastery: The Problem of World Replacement and Identity Maintenance |url=https://archive.org/details/journal-of-early-christian-studies_spring-2007_15_1/page/45 |journal=Journal of Early Christian Studies |volume=15 |year=2007 |issue=1 |pages=45–73 |doi=10.1353/earl.2007.0015 }} *{{cite book |last=Layton |first=Bentley |title=The Canons of Our Fathers: Monastic Rules of Shenoute |location=Oxford |publisher=Oxford University Press |year=2014 }} *{{cite book |last=Schroeder |first=Caroline T. |title=Monastic Bodies: Discipline and Salvation in Shenoute of Atripe |location=Philadelphia |publisher=University of Pennsylvania Press |year=2007 }} *{{cite book |first=Emmanouela |last=Grypeou |chapter=‘The Visions of Apa Shenute of Atripe’: An Analysis in the History of Traditions of Eastern Christian Apocalyptic Motifs |editor-first=Juan Pedro |editor-last=Monferrer-Sala |title=Eastern Crossroads: Essays on Medieval Christian Legacy |location=Piscataway |publisher=Gorgias Press |year=2007 |series=Gorgias Eastern Christian Studies |volume=1 |pages=157–168 |isbn= }} ==Viungo vya nje== *[http://www.stshenouda.com/stshenda.htm St. Shenouda the Archimandrite] *[http://www.smass.co.uk/ St Mary and St. Shenouda, Coulsdon] {{Wayback|url=http://www.smass.co.uk/ |date=20190904034150 }} {{mbegu-Mkristo}} [[Category:Waliozaliwa 348|Shenuda]] [[Category:Waliofariki 465|Shenuda]] [[Category:Wamonaki]] [[Category:Watakatifu wa Misri|Shenuda]] ns0txy76cumv9ekdpba9ba23b9fv3bl 14 119415 1577945 1093892 2026-07-02T12:48:58Z Riccardo Riccioni 452 1577945 wikitext text/x-wiki [[Jamii:Miji Mikuu Afrika]] [[Jamii:Miji ya Eritrea]] 9y9w10oulcbw41v77gyn573lf75ohw6 0 123193 1578044 1105137 2026-07-02T15:08:35Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578044 wikitext text/x-wiki {{elementi | rangi = #ff99cc | jina = Ameriki (americium) | picha = Americium microscope.jpg | maelezo_ya_picha = kipande duara cha ameriki | alama = Am | namba atomia = 95 | mfululizo safu = [[metali]] | uzani atomia = 243 | valensi = 2, 8, 18, 32, 25, 8, 2 | densiti husianifu = 12  g/cm³ | kiwango cha kuyeyuka= 1,449 K | kiwango cha kuchemka= 2,880 K | kiwango utatu = | ugumu = | % ganda dunia = (sintetiki)</sup> % | hali maada = mango | mengineyo = nururifu sana }} '''Ameriki''' ni [[Elementi za kikemia|elementi]] ya [[Metali|kimetali]] yenye [[alama]] '''Am''' na [[namba atomia]] 95. Kwenye [[jedwali la elementi]] inahesabiwa ndani ya [[kundi]] la [[aktinidi]]. Ni metali laini yenye [[rangi]] ya [[kijivu]]-[[Fedha|kifedha]] lakini inaoksidika haraka ikifunikwa na [[tabaka]] la [[oksidi]] kijivu-[[nyeusi]]. Ameriki iligunduliwa [[mwaka]] [[1944]] katika [[maabara]] ya [[Chuo Kikuu cha Kalifornia]] pale [[Berkeley]]. Ameriki ni [[Unururifu|elementi nururifu]] ambayo inatokea kiasili kwa viwango vidogo sana, inaundwa ndani ya [[madini]] ya [[urani]] kutokana [[mbunguo nururifu]] asilia ya urani. [[Nusumaisha]] ya [[isotopi]] zake ni hadi miaka 2,737, hivyo haiwezi kudumu muda mrefu kiasili. Inazalishwa katika [[tanuri nyuklia]] na maabara kwa kufyatulia [[nyutroni]] kwa [[plutoni]]. Matumizi yake ni hasa katika [[vigunduzi moshi]] ambako inatumiwa kwa viwango vidogo ambavyo si hatari kwa [[afya]]. ==Viungo vya Nje== {{Commons|Americium|Ameriki}} * [http://www.periodicvideos.com/videos/095.htm Americium] at ''[[The Periodic Table of Videos]]'' (University of Nottingham) * [http://www.atsdr.cdc.gov/toxprofiles/phs156.html ATSDR – Public Health Statement: Americium] {{Wayback|url=http://www.atsdr.cdc.gov/toxprofiles/phs156.html |date=20060830050012 }} * [https://web.archive.org/web/20081224123105/http://www.world-nuclear.org/info/inf57.html World Nuclear Association – Smoke Detectors and Americium ] {{mbegu-kemia}} [[Jamii:Elementi]] [[Jamii:Aktinidi]] b9xmzqjz7u0x84vydqym58h051scf5d 0 123885 1578164 1528908 2026-07-02T22:59:10Z InternetArchiveBot 41439 Add 7 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578164 wikitext text/x-wiki [[Picha:Hiv budding.jpg | haki | thumb |Namba virusi vya UKIMWI vinavyotoka katika [[seli]].]] '''Virusi vya UKIMWI'''; [[kifupi]]: '''VVU'''; kwa [[Kiingereza]] ''HIV'', yaani "Human Immunodeficiency Virus") ni [[virusi]] vinavyoshambulia [[mwili]] wa [[binadamu]] kwa kuondoa nguvu zake za kupambana na [[maambukizi nyemelezi]] yanayosababisha [[maradhi]]. [[UKIMWI]] ni [[ugonjwa]] wa [[mfumo wa kingamwili]] wa binadamu <ref name="pmid11396444">{{Rejea jarida|author=Sepkowitz KA|title=AIDS—the first 20 years|journal=N. Engl. J. Med.|volume=344|issue=23| pages=1764–72|year=2001|month=June|pmid=11396444|doi=10.1056/NEJM200106073442306}}</ref> ambao ni hatari sana katika [[maisha]] ya [[binadamu]] kwa kuwa husababisha [[kifo|vifo]]. Kwa mujibu wa [[Shirika la Afya Duniani]], kufikia mwaka [[2014]] ugonjwa huu umeua watu [[milioni]] 39, hasa kati ya wanaoishi [[Bara|barani]] [[Afrika]] [[kusini kwa Sahara]]. Kwa [[mwaka]] [[2015]] pekee wamefariki watu milioni 1.2 na kati yao [[watoto]] wengi. UKIMWI umekuwa na madhara makubwa katika [[jamii]], kama ugonjwa wa mwili na kama chanzo cha [[Ubaguzi wa watu wanaoishi na UKIMWI|ubaguzi]]. Kuna sintofahamu kuhusu UKIMWI kama vile kwamba eti, unaweza kusambazwa kwa kugusana tu bila [[ngono]]. Ugonjwa huo pia unasababisha [[madhara ya kiuchumi]] ambayo ni makubwa, hasa kwa nchi maskini. UKIMWI hadi hivi sasa haina [[chanjo]] wala [[tiba]], lakini tunaweza kuuepuka ugonjwa huu kwa kuachana na ngono ambayo huweza kusababisha ugonjwa huo, pia tunaweza kujikinga nao kwa kuepuka kuchangia vifaa au vitu vyenye [[ncha]] kali. Kimsingi zaidi ni kwamba ugonjwa huo umetokana na kuenezwa hasa na [[maadili]] mabovu. Dhidi yake watu wanahitaji kuelewa tangu [[Utoto|utotoni]] na [[Ujana|ujanani]] maana ya [[jinsia]] na [[maisha]] kwa jumla, kwamba vinadai [[upendo]], [[nidhamu]] na [[uwajibikaji]], si kufuata [[tamaa]] tofautitofauti daima<ref>{{cite web|url=http://www.catholicnewsagency.com/news/thirty-years-after-aids-discovery-appreciation-growing-for-catholic-approach/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+catholicnewsagency%2Fdailynews+%28CNA+Daily+News%29|title=Thirty years after AIDS discovery, appreciation growing for Catholic approach |publisher=Catholicnewsagency.com|date=June 5, 2011 |accessdate=November 1, 2011}}</ref>. Tarehe [[1 Desemba]] kila [[mwaka]] ni [[Siku ya Ukimwi duniani|siku ya UKIMWI duniani]]. ==Mfumo wa kingamwili na VVU== Kila mtu huwa na [[Mfumo wa kingamaradhi|mfumo wa kingamwili]] ndani yake. [[Seli]] za ulinzi zinazunguka mwilini na kutafuta [[vidubini]] vya nje vinavyoweza kuleta mvurugo na zinaviharibu. Kati ya seli hizi za [[ulinzi]] ni [[seli nyeupe za damu]] (lukosaiti) ambazo ni muhimu sana. Ukimwi unasababishwa na VVU. Kama virusi vyote, VVU vinaingia katika mwili kwa kusudi la kuzaa. Virusi haviwezi kuzaa peke yake: vinahitaji seli vinamoweza kuingia ndani yake na kutumia mfumo wa seli kwa kunakili [[DNA]] yake. Kwa kawaida virusi vinashambuliwa na mfumo wa kingamwili na kuharibika. Lakini VVU vina tabia mbili za pekee ambazo zinavifanya vvya hatari hasa: * vinafaulu mara nyingi kuepukana na seli za ulinzi mwilini * vinaingia hasahasa katika seli nyeupe za damu za aina "seli za T". VVU vikianza kuongezeka katika seli nyeupe ya damu vinadhoofisha na hatimaye kuharibu seli hii. Maana yake VVU vinashambulia moja kwa moja seli ambazo ni sehemu ya kingamwili na zinazohusika kukinga mwili. Kuenea kwa VVU mwilini kunapunguza idadi ya seli za ulinzi na hivyo kupunguza kiwango cha kingamwili. Baada ya kupungua kwa kingamwili vidubini vingine vinaendelea kufika mwilini lakini sasa vinaenea zaidi kwa sababu seli za ulinzi zimekuwa chache. Kila [[ambukizo]] linaendelea kwa muda mrefu zaidi na hivyo mwili kwa jumla unateswa kwa muda mrefu zaidi. Kadiri Ukimwi unavyoendelea vipindi vya magonjwa vinakuwa virefu zaidi na nguvu za mwili zinapunguapungua. Katika ngazi za mwisho [[idadi]] ya maambukizo inazidi uwezo wa mwili wa kupambana nayo na hapo mtu unakaribia kifo. ==Virusi vyenyewe== [[File:HI-virion-structure en.svg|thumb|alt= Muundo wa duara ulio na miundo ya rangi ya waridi inayochipuka kutoka kwake, na michoro kadhaa ndani ya duara hii ikionyesha vipengele tofauti vya virusi |Mchoro unaoonyesha muundo wa virusi vya VVU]] VVU ndivyo kisababishi cha mkusanyiko wa magonjwa yanayojulikana kijumla kama VVU/UKIMWI. VVU ni [[retrovirusi]] ambavyo hasa huambukiza vipengele vya [[mfumo wa kingamwili]] ya binadamu kama vile seli za CD4<SUP>+</SUP>T, [[makrofaji]] na [[seli za dendraiti]]. Virusi hivi huharibu seli za CD4<SUP>+</SUP> T moja kwa moja au vinginevyo.<ref name=Alimonti>{{Rejea jarida |author=Alimonti JB, Ball TB, Fowke KR | title=Mechanisms of CD4+ T lymphocyte cell death in human immunodeficiency virus infection and AIDS | journal=J. Gen. Virol. | year=2003 | pages=1649–1661 | volume=84 | issue=7 | pmid=12810858 |doi=10.1099/vir.0.19110-0}}</ref> VVU ni mshirika wa [[jenasi]] ya ''[[Lentivirus]]'',<ref name=ICTV61.0.6>{{cite web | author=[[International Committee on Taxonomy of Viruses]] | publisher=[[National Institutes of Health]] | year=2002 | url=http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61060000.htm | archiveurl=https://web.archive.org/web/20060418135608/http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61060000.htm | title=61.0.6. Lentivirus | accessdate=2012-06-25 | archivedate=2006-04-18 }}</ref> sehemu ya [[Familia (biolojia)|familia]] ya [[Retroviridae]].<ref name=ICTV61.>{{cite web |author=International Committee on Taxonomy of Viruses |publisher=National Institutes of Health |year=2002 |url=http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61000000.htm |title=61. Retroviridae |archiveurl=https://web.archive.org/web/20060629180810/http://ncbi.nlm.nih.gov/ICTVdb/ICTVdB/61000000.htm |accessdate=2012-06-25 |archivedate=2006-06-29 }}</ref> Virusi vyote vya lenti huwa na sifa sawa za [[mofolojia (bayolojia)|kimofolojia]] na [[biolojia]]. Spishi nyingi za [[mamalia]] huambukizwa na virusi vya lenti, ambavyo haswa huwa ndivyo visababishi vya maradhi ya muda mrefu yaliyo na [[kipindi cha kupevuka]] kirefu.<ref name=Levy>{{cite journal | author=Lévy, J. A. | title=HIV pathogenesis and long-term survival | journal=AIDS | year=1993 | pages=1401–10| volume=7 | issue=11 | pmid=8280406 | doi=10.1097/00002030-199311000-00001}}</ref>Virusi vya lenti husambazwa kama [[virusi vya RNA]] chanya za uzi mmoja [[hisia]] zilizo ndani ya kigamba. Inapoingia ndani ya seli iliyolengwa, [[jenomu]] ya [[RNA]] ya virusi hugeuzwa (hubadilishwa kinakala) na kuwa [[DNA]] ya nyuzi mbili ambayo husafirishwa pamoja na jenomu ya virusi katika chembe ya virusi vile. DNA ya virusi inayoundika huingia katika kiini cha seli ambapo huchangamana na seli ya DNA kwa kutumia [[integresi]] iliyofasiliwa kama virusi, na pia vipengele husika vya kiini kikuu.<ref name="JASmith">{{cite journal | author= Smith, Johanna A.; Daniel, René (Division of Infectious Diseases, Center for Human Virology, Thomas Jefferson University, Philadelphia)|title= Following the path of the virus: the exploitation of host DNA repair mechanisms by retroviruses |journal=ACS Chem Biol|volume=1|issue=4 |pages= 217–26 |year= 2006 |pmid= 17163676 |doi=10.1021/cb600131q |url= }}</ref> Vinapochangamana na DNA ya seli, virusi hivi vinaweza kuingia katika [[kipindi cha kupevuka|awamu fiche]], hivyo kuwezesha virusi hivi pamoja na seli inayovipokea kuepuka kutambuliwa na mfumo wa kingamwili.<ref>{{cite book|last=Martínez|first=edited by Miguel Angel|title=RNA interference and viruses : current innovations and future trends|year=2010|publisher=Caister Academic Press|location=Norfolk|isbn=9781904455561|pages=73|url=</ref> Aina mbili [[Aina ndogo za VVU|za VVU]] zimetambulika: VVU-1 na VVU-2. VVU-1 ni virusi vilivyotambulika kwanza (na ambavyo mwanzoni vilijulikana pia kama LAV au HTLV-III). Virusi hivi vina [[sumu kali]], vyenye [[uambukizaji|kuambukiza]],<ref>{{cite journal | title=Comparison of HIV-1 and HIV-2 infectivity from a prospective cohort study in Senegal | last=Gilbert | first=PB |journal=Statistics in Medicine | date=28 February 2003| volume=22 |issue=4 | pages=573–593 | pmid=12590415 |doi=10.1002/sim.1342 | last2=McKeague | first2=IW | last3=Eisen | first3=G |last4=Mullins | first4=C | last5=Guéye-Ndiaye| first5=A | last6=Mboup | first6=S | last7=Kanki | first7=PJ |display-authors=1}}</ref> na ndivyo visababishi vikuu vya visa vingi vya maambukizi ya VVU kote ulimwenguni. Kiwango cha chini zaidi cha uambukizaji wa VVU-2 ikilinganishwa na VVU-1 huonyesha kuwa watu wachache zaidi walio katika hatari ya VVU-2 wataambukizwa kila wanapokumbana na virusi hivi. VVU-2 hupatikana zaidi [[Afrika Magharibi]] kwa sababu ya uwezo wake wa chini wa kuambukiza.<ref name="Reeves">{{cite journal | author=Reeves, J. D. and Doms, R. W | title=Human Immunodeficiency Virus Type 2 | journal=J. Gen. Virol. |year=2002 | pages=1253–65 | volume=83 | issue=Pt 6 | pmid=12029140 | doi=10.1099/vir.0.18253-0}}</ref> [[File:HIV-budding-Color.jpg|thumb|alt= Kifaa kikubwa cha duara cha rangi ya buluu, na kifaa chekundu kilichounganishwa nacho. Vifaa vyote viwili vina madoa ya kijani yaliyotapakaa juu yake.|[[Darubini ya elektroni ya ukaguzi|Mikrografu ya elektroni ya ukaguzi]] wa VVU-1, vya rangi ya kijani, vinavyochipuka kutoka kwa [[limfositi]] iliyokaguliwa.]] Baada ya virusi kuingia mwilini, kuna kipindi cha [[kugawanyika kwa virusi]], hali inayopelekea wingi wa virusi katika damu ya pembeni. Katika kipindi cha kwanza cha maambukizi, kiwango cha VVU kinaweza kufika milioni kadhaa za chembe za virusi kwa kila [[mililita]] ya damu.<ref name=Piatak>{{cite journal | author=Piatak, M., Jr, Saag, M. S., Yang, L. C., Clark, S. J., Kappes, J. C., Luk, K. C., Hahn, B. H., Shaw, G. M. and Lifson, J.D. | title=High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR |journal=Science | year=1993 |pages=1749–1754 |volume=259 |issue=5102 | pmid=8096089 | doi=10.1126/science.8096089|bibcode = 1993Sci...259.1749P }}</ref> Mwitikio huu huandamana na kiwango kikubwa cha kushuka kwa idadi ya seli za CD4⁺ T zinazozunguka. [[Viremia]] kali mara nyingi huhusishwa na kuwezeshwa kwa [[seli za T angamizi|CD8⁺ seli za T]], ambazo huangamiza seli zilizoambukizwa VVU na kisha kuhusishwa na kuzalishwa kwa zindiko, au [[kuzalishwa kwa zindiko mpya]]. Mwitikio wa seli za CD8⁺ T huchukuliwa kuwa muhimu katika kudhibiti viwango vya virusi, ambavyo hupanda na kushuka, huku viwango vya seli za CD4⁺ T vikirejea. Mwitikio bora wa seli za CD8⁺ T umehusishwa na kupungua kwa mwendo wa ugonjwa na pia prognosi bora zaidi, ingawa mwitikio huu hauondoi virusi.<ref name=Pantaleo1998>{{cite journal| author=Pantaleo G, Demarest JF, Schacker T, Vaccarezza M, Cohen OJ, Daucher M, Graziosi C, Schnittman SS, Quinn TC, Shaw GM, Perrin L, Tambussi G, Lazzarin A, Sekaly RP, Soudeyns H, Corey L, Fauci AS. | title=The qualitative nature of the primary immune response to HIV infection is a prognosticator of disease progression independent of the initial level of plasma viremia | journal=Proc Natl Acad Sci U S A. | year=1997 |pages=254–258 | volume=94 | issue=1 | pmid=8990195 | doi=10.1073/pnas.94.1.254|pmc=19306|bibcode = 1997PNAS...94..254P }}</ref> Pathofisiolojia ya UKIMWI ni tata.<ref name="pmid8040596">{{Rejea jarida| author=Guss DA| title=The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1| journal=J Emerg Med| volume=12| issue=3|pages=375–84| year=1994| pmid=8040596| doi=10.1016/0736-4679(94)90281-X}}</ref> Mwishowe, VVU husababisha UKIMWI kwa kuharibu [[seli T saidizi|CD4⁺seli za T]]. Hali hii hudhoofisha mfumo wa kingamwili hivyo kuwezesha [[mambukizi vamizi]]. Seli za T ni muhimu kwa mwitikio wa kingamwili, hivyo bila ya seli hizi, mwili hauwezi kukabiliana na maambukizi wala kuharibu seli za saratani. Utendakazi wa kuharibiwa kwa seli za CD4⁺ T hutofautiana katika awamu kali na za muda mrefu.<ref name="pmid16679064">{{Rejea jarida|author=Hel Z, McGhee JR, Mestecky J |title=HIV infection: first battle decides the war |journal=Trends Immunol. |volume=27 |issue=6 |pages=274–81 |year=2006 |month=June |pmid=16679064|doi=10.1016/j.it.2006.04.007 |url=https://archive.org/details/sim_trends-in-immunology_2006-06_27_6/page/274}}</ref> Katika awamu kali, lisisi ya seli inayosababishwa na VVU, na pia kuangamizwa kwa [[seli za T angamizi]] huchangia katika kuharibiwa kwa seli za CD4⁺ T, ingawa [[apoptosi]] pia inaweza kuchangia hali hii. Katika awamu ya muda mrefu, matokeo ya uwezeshaji wa kijumla wa kingamwili ukiandamana na udhaifu wa pole pole wa uwezo wa mfumo wa kingamwili kuzalisha seli mpya za T hukisiwa kuchangia kupungua kwa pole pole kwa idadi ya seli za CD4⁺ T. <ref>{{cite book|author=Arie J. Zuckerman et al. (eds)|title=Principles and practice of clinical virology|year=2007|publisher=Wiley|location=Hoboken, N.J.|isbn=978-0-470-51799-4|page=905|url=http://books.google.ca/books?id=4il2mF7JG1sC&pg=PA905|edition=6th}}</ref> Ingawa dalili za udhaifu wa kingamwili kama ulivyo katika UKIMWI hazitokei kwa miaka mingi baada ya kuambukizwa, kiwango kikubwa cha kuharibika kwa seli za CD4⁺ T hutokea katika wiki za kwanza baada ya kuambukizwa, hasa katika ute wa utumbo, ambao huwa na kiwango kikubwa cha limfosaiti zote za mwili.<ref name="pmid15365095">{{Rejea jarida|author=Mehandru S, Poles MA, Tenner-Racz K, Horowitz A, Hurley A, Hogan C, Boden D, Racz P, Markowitz M|title=Primary HIV-1 infection is associated with preferential depletion of CD4⁺ T cells from effector sites in the gastrointestinal tract |journal=J. Exp. Med. |volume=200 |issue=6 |pages=761–70 |year=2004 |month=September|pmid=15365095 |doi=10.1084/jem.20041196 |url= |pmc=2211967}}</ref> Sababu ya kiwango hiki kikubwa cha kuharibiwa kwa seli za CD4⁺ T ni kuwa kiwango kikubwa cha seli za ute za CD4⁺ T huzalisha protini ya [[CCR5]] inayotumika na VVU kama [[kipokezi kishiriki]] ili kuweza kufikia seli hizo, ilhali kipande kidogo tu cha seli za CD4⁺ T katika mkondo wa damu hufanya hivyo.<ref name="pmid15365096">{{Rejea jarida|author=Brenchley JM, Schacker TW, Ruff LE, Price DA, Taylor JH, Beilman GJ, Nguyen PL, Khoruts A, Larson M, Haase AT, Douek DC |title=CD4⁺ T cell depletion during all stages of HIV disease occurs predominantly in the gastrointestinal tract |journal=J. Exp. Med. |volume=200 |issue=6|pages=749–59 |year=2004 |month=September |pmid=15365096 |doi=10.1084/jem.20040874 |url= |pmc=2211962}}</ref> VVU hutafuta na kuharibu CCR5 inayotolesha seli za CD4⁺ T katika awamu kali ya maambukizi. <ref name=Julio2011>{{cite book|last=editor|first=Julio Aliberti,|title=Control of Innate and Adaptive Immune Responses During Infectious Diseases.|publisher=Springer Verlag|location=New York, NY|isbn=978-1-4614-0483-5|page=145|url=http://books.google.ca/books?id=TKMpo5aINVIC&pg=PA145|year=2011}}</ref> Mwitikio mkubwa wa kingamwili hatimaye huyadhibiti maambukizi hayo kisha kuanzisha awamu fiche ya kiutambuzi. Seli za CD4⁺ T katika tishu za ute husalia zikiwa zimeathiriwa sana. <ref name=Julio2011/> Ugawanyikaji endelevu wa VVU husababisha hali ya uwezeshaji wa kijumla wa kingamwili, ambao hudumu katika awamu yote ya muda mrefu.<ref name="pmid18161758">{{Rejea jarida|author=Appay V, Sauce D |title=Immune activation and inflammation in HIV-1 infection: causes and consequences|journal=J. Pathol. |volume=214 |issue=2 |pages=231–41 |year=2008 |month=January |pmid=18161758 |doi=10.1002/path.2276|url=https://archive.org/details/sim_journal-of-pathology_2008-01_214_2/page/231}}</ref> Uwezeshaji wa kingamwili, ambao hutambulika kwa ongezeko la uwezeshaji wa hali ya seli za kingamwili na kutoleshwa kwa [[saitokini]] inayosababisha inflemesheni, husababishwa na utendakazi wa [[zao la jeni]] na mwitikio wa kingamwili dhidi ya ugawanyikaji wa VVU unaoendelea. Uwezeshaji wa kingamwili pia huhusishwa na kuharibika kwa mfumo wa uchunguzi wa kingamwili wa kizuizi cha ute wa tumbo na utumbo, hali inayosababishwa na kuangamizwa kwa seli za CD4⁺ T za ute katika awamu kali ya ugonjwa huu.<ref name="pmid17115046">{{Rejea jarida|author=Brenchley JM, Price DA, Schacker TW, Asher TE, Silvestri G, Rao S, Kazzaz Z, Bornstein E, Lambotte O, Altmann D, Blazar BR, Rodriguez B, Teixeira-Johnson L, Landay A, Martin JN, Hecht FM, Picker LJ, Lederman MM, Deeks SG, Douek DC |title=Microbial translocation is a cause of systemic immune activation in chronic HIV infection |journal=Nat. Med. |volume=12 |issue=12 |pages=1365–71 |year=2006 |month=December |pmid=17115046|doi=10.1038/nm1511 |url=}}</ref> Hivyo si kila mtu aliye na VVU ana UKIMWI. Wakati watu wanapata VVU, wanaweza kuwa na [[afya]] kwa miaka mpaka akakutwa na aina maalumu ya magonjwa na vipimo vya [[damu]] vikionyesha kuwa ina idadi ndogo sana ya [[seli nyeupe za damu]] ambazo ndizo zinazopambana na maambukizi. Kuna maradhi ambayo kwa kawaida ni ishara kwamba mtu ana UKIMWI kwa kuwa watu wenye afya njema hawapati magonjwa haya, kwa sababu mfumo wa kinga mwilini una nguvu ya kutosha ya kupigana na magonjwa hayo. Hivyo kupata ugonjwa wa aina hiyo ni ishara kwamba mfumo wa kinga umeharibika. Baadhi ya magonjwa hayo ni: * [[Sarkoma ya Kaposi]] - aina ya [[kansa]] ambayo kwa kawaida huathiri [[ngozi]] (mara nyingi husababisha vi[[donda]] vyekundu au [[zambarau]], au ma[[jeraha]] juu ya ngozi). Wakati mwingine huathiri tu ngozi, bali pia mifumo mingine katika mwili. * [[Retinitis]] - [[virusi]] zinashambulia nyuma ya [[jicho]]. * [[Pneumocystis carinii]] ([[kifupi]] PCP) - aina ya [[pneumonia]], [[magonjwa ya kuambukiza]] ya [[mapafu]]. PCP ni maambukizi ya kawaida kwa wagonjwa wa UKIMWI. * [[Toxoplasmosis]] - ugonjwa unaosababishwa na [[vimelea]], ambao unaweza kusababisha matatizo katika mifumo ya [[ubongo]] na mingine katika mwili. * [[Kansa ya kizazi]] - ambayo huwa inaenea.irusi vyenyewe=== [[File:HI-virion-structure en.svg|thumb|alt= Muundo wa duara ulio na miundo ya rangi ya waridi inayochipuka kutoka kwake, na michoro kadhaa ndani ya duara hii ikionyesha vipengele tofauti vya virusi |Mchoro unaoonyesha muundo wa virusi vya VVU]] VVU ndivyo kisababishi cha mkusanyiko wa magonjwa yanayojulikana kijumla kama VVU/UKIMWI. VVU ni [[retrovirusi]] ambavyo hasa huambukiza vipengele vya [[mfumo wa kingamwili]] ya binadamu kama vile seli za CD4<SUP>+</SUP>T, [[makrofaji]] na [[seli za dendraiti]]. Virusi hivi huharibu seli za CD4<SUP>+</SUP> T moja kwa moja au vinginevyo.<ref name=Alimonti/> VVU ni mshirika wa [[jenasi]] ya ''[[Lentivirus]]'',<ref name=ICTV61.0.6/> sehemu ya [[Familia (biolojia)|familia]] ya [[Retroviridae]].<ref name=ICTV61./> Virusi vyote vya lenti huwa na sifa sawa za [[mofolojia (bayolojia)|kimofolojia]] na [[biolojia]]. Spishi nyingi za [[mamalia]] huambukizwa na virusi vya lenti, ambavyo haswa huwa ndivyo visababishi vya maradhi ya muda mrefu yaliyo na [[kipindi cha kupevuka]] kirefu.<ref name=Levy/>Virusi vya lenti husambazwa kama [[virusi vya RNA]] chanya za uzi mmoja [[hisia]] zilizo ndani ya kigamba. Inapoingia ndani ya seli iliyolengwa, [[jenomu]] ya [[RNA]] ya virusi hugeuzwa (hubadilishwa kinakala) na kuwa [[DNA]] ya nyuzi mbili ambayo husafirishwa pamoja na jenomu ya virusi katika chembe ya virusi vile. DNA ya virusi inayoundika huingia katika kiini cha seli ambapo huchangamana na seli ya DNA kwa kutumia [[integresi]] iliyofasiliwa kama virusi, na pia vipengele husika vya kiini kikuu.<ref name="JASmith"/> Vinapochangamana na DNA ya seli, virusi hivi vinaweza kuingia katika [[kipindi cha kupevuka|awamu fiche]], hivyo kuwezesha virusi hivi pamoja na seli inayovipokea kuepuka kutambuliwa na mfumo wa kingamwili.<ref>{{cite book|last=Martínez|first=edited by Miguel Angel|title=RNA interference and viruses : current innovations and future trends|year=2010|publisher=Caister Academic Press|location=Norfolk|isbn=9781904455561|pages=73|url=</ref> Aina mbili [[Aina ndogo za VVU|za VVU]] zimetambulika: VVU-1 na VVU-2. VVU-1 ni virusi vilivyotambulika kwanza (na ambavyo mwanzoni vilijulikana pia kama LAV au HTLV-III). Virusi hivi vina [[sumu kali]], vyenye [[uambukizaji|kuambukiza]],<ref>{{cite journal | title=Comparison of HIV-1 and HIV-2 infectivity from a prospective cohort study in Senegal | last=Gilbert | first=PB |journal=Statistics in Medicine | date=28 February 2003| volume=22 |issue=4 | pages=573–593 | pmid=12590415 |doi=10.1002/sim.1342 | last2=McKeague | first2=IW | last3=Eisen | first3=G |last4=Mullins | first4=C | last5=Guéye-Ndiaye| first5=A | last6=Mboup | first6=S | last7=Kanki | first7=PJ |display-authors=1}}</ref> na ndivyo visababishi vikuu vya visa vingi vya maambukizi ya VVU kote ulimwenguni. Kiwango cha chini zaidi cha uambukizaji wa VVU-2 ikilinganishwa na VVU-1 huonyesha kuwa watu wachache zaidi walio katika hatari ya VVU-2 wataambukizwa kila wanapokumbana na virusi hivi. VVU-2 hupatikana zaidi [[Afrika Magharibi]] kwa sababu ya uwezo wake wa chini wa kuambukiza.<ref name="Reeves"/> [[File:HIV-budding-Color.jpg|thumb|alt= Kifaa kikubwa cha duara cha rangi ya buluu, na kifaa chekundu kilichounganishwa nacho. Vifaa vyote viwili vina madoa ya kijani yaliyotapakaa juu yake.|[[Darubini ya elektroni ya ukaguzi|Mikrografu ya elektroni ya ukaguzi]] wa VVU-1, vya rangi ya kijani, vinavyochipuka kutoka kwa [[limfositi]] iliyokaguliwa.]] Baada ya virusi kuingia mwilini, kuna kipindi cha [[kugawanyika kwa virusi]], hali inayopelekea wingi wa virusi katika damu ya pembeni. Katika kipindi cha kwanza cha maambukizi, kiwango cha VVU kinaweza kufika milioni kadhaa za chembe za virusi kwa kila [[mililita]] ya damu.<ref name=Piatak/> Mwitikio huu huandamana na kiwango kikubwa cha kushuka kwa idadi ya seli za CD4⁺ T zinazozunguka. [[Viremia]] kali mara nyingi huhusishwa na kuwezeshwa kwa [[seli za T angamizi|CD8⁺ seli za T]], ambazo huangamiza seli zilizoambukizwa VVU na kisha kuhusishwa na kuzalishwa kwa zindiko, au [[kuzalishwa kwa zindiko mpya]]. Mwitikio wa seli za CD8⁺ T huchukuliwa kuwa muhimu katika kudhibiti viwango vya virusi, ambavyo hupanda na kushuka, huku viwango vya seli za CD4⁺ T vikirejea. Mwitikio bora wa seli za CD8⁺ T umehusishwa na kupungua kwa mwendo wa ugonjwa na pia prognosi bora zaidi, ingawa mwitikio huu hauondoi virusi.<ref name=Pantaleo1998/> Pathofisiolojia ya UKIMWI ni tata.<ref name="pmid8040596"/> Mwishowe, VVU husababisha UKIMWI kwa kuharibu [[seli T saidizi|CD4⁺seli za T]]. Hali hii hudhoofisha mfumo wa kingamwili hivyo kuwezesha [[mambukizi vamizi]]. Seli za T ni muhimu kwa mwitikio wa kingamwili, hivyo bila ya seli hizi, mwili hauwezi kukabiliana na maambukizi wala kuharibu seli za saratani. Utendakazi wa kuharibiwa kwa seli za CD4⁺ T hutofautiana katika awamu kali na za muda mrefu.<ref name="pmid16679064"/> Katika awamu kali, lisisi ya seli inayosababishwa na VVU, na pia kuangamizwa kwa [[seli za T angamizi]] huchangia katika kuharibiwa kwa seli za CD4⁺ T, ingawa [[apoptosi]] pia inaweza kuchangia hali hii. Katika awamu ya muda mrefu, matokeo ya uwezeshaji wa kijumla wa kingamwili ukiandamana na udhaifu wa pole pole wa uwezo wa mfumo wa kingamwili kuzalisha seli mpya za T hukisiwa kuchangia kupungua kwa pole pole kwa idadi ya seli za CD4⁺ T. <ref>{{cite book|author=Arie J. Zuckerman et al. (eds)|title=Principles and practice of clinical virology|year=2007|publisher=Wiley|location=Hoboken, N.J.|isbn=978-0-470-51799-4|page=905|url=http://books.google.ca/books?id=4il2mF7JG1sC&pg=PA905|edition=6th}}</ref> Ingawa dalili za udhaifu wa kingamwili kama ulivyo katika UKIMWI hazitokei kwa miaka mingi baada ya kuambukizwa, kiwango kikubwa cha kuharibika kwa seli za CD4⁺ T hutokea katika wiki za kwanza baada ya kuambukizwa, hasa katika ute wa utumbo, ambao huwa na kiwango kikubwa cha limfosaiti zote za mwili.<ref name="pmid15365095"/> Sababu ya kiwango hiki kikubwa cha kuharibiwa kwa seli za CD4⁺ T ni kuwa kiwango kikubwa cha seli za ute za CD4⁺ T huzalisha protini ya [[CCR5]] inayotumika na VVU kama [[kipokezi kishiriki]] ili kuweza kufikia seli hizo, ilhali kipande kidogo tu cha seli za CD4⁺ T katika mkondo wa damu hufanya hivyo.<ref name="pmid15365096"/> VVU hutafuta na kuharibu CCR5 inayotolesha seli za CD4⁺ T katika awamu kali ya maambukizi. <ref name=Julio2011/> Mwitikio mkubwa wa kingamwili hatimaye huyadhibiti maambukizi hayo kisha kuanzisha awamu fiche ya kiutambuzi. Seli za CD4⁺ T katika tishu za ute husalia zikiwa zimeathiriwa sana. <ref name=Julio2011/> Ugawanyikaji endelevu wa VVU husababisha hali ya uwezeshaji wa kijumla wa kingamwili, ambao hudumu katika awamu yote ya muda mrefu.<ref name="pmid18161758"/> Uwezeshaji wa kingamwili, ambao hutambulika kwa ongezeko la uwezeshaji wa hali ya seli za kingamwili na kutoleshwa kwa [[saitokini]] inayosababisha inflemesheni, husababishwa na utendakazi wa [[zao la jeni]] na mwitikio wa kingamwili dhidi ya ugawanyikaji wa VVU unaoendelea. Uwezeshaji wa kingamwili pia huhusishwa na kuharibika kwa mfumo wa uchunguzi wa kingamwili wa kizuizi cha ute wa tumbo na utumbo, hali inayosababishwa na kuangamizwa kwa seli za CD4⁺ T za ute katika awamu kali ya ugonjwa huu.<ref name="pmid17115046"/> Hivyo si kila mtu aliye na VVU ana UKIMWI. Wakati watu wanapata VVU, wanaweza kuwa na [[afya]] kwa miaka mpaka akakutwa na aina maalumu ya magonjwa na vipimo vya [[damu]] vikionyesha kuwa ina idadi ndogo sana ya [[seli nyeupe za damu]] ambazo ndizo zinazopambana na maambukizi. Kuna maradhi ambayo kwa kawaida ni ishara kwamba mtu ana UKIMWI kwa kuwa watu wenye afya njema hawapati magonjwa haya, kwa sababu mfumo wa kinga mwilini una nguvu ya kutosha ya kupigana na magonjwa hayo. Hivyo kupata ugonjwa wa aina hiyo ni ishara kwamba mfumo wa kinga umeharibika. Baadhi ya magonjwa hayo ni: * [[Sarkoma ya Kaposi]] - aina ya [[kansa]] ambayo kwa kawaida huathiri [[ngozi]] (mara nyingi husababisha vi[[donda]] vyekundu au [[zambarau]], au ma[[jeraha]] juu ya ngozi). Wakati mwingine huathiri tu ngozi, bali pia mifumo mingine katika mwili. * [[Retinitis]] - [[virusi]] zinashambulia nyuma ya [[jicho]]. * [[Pneumocystis carinii]] ([[kifupi]] PCP) - aina ya [[pneumonia]], [[magonjwa ya kuambukiza]] ya [[mapafu]]. PCP ni maambukizi ya kawaida kwa wagonjwa wa UKIMWI. * [[Toxoplasmosis]] - ugonjwa unaosababishwa na [[vimelea]], ambao unaweza kusababisha matatizo katika mifumo ya [[ubongo]] na mingine katika mwili. * [[Kansa ya kizazi]] - ambayo huwa inaenea. == Lini na wapi VVU vilianza == UKIMWI huchukuliwa kama [[janga]] — yaani [[mlipuko wa ugonjwa]] katika eneo kubwa, na ambao ungali unaenea.<ref name=Kallings/> UKIMWI ulitambuliwa mara ya kwanza na Vituo vya Kuzuia na Kudhibiti Magonjwa huko Marekani mwaka [[1981]]<ref name=M169/>, ilhali kisababishi chake - VVU - kilitambuliwa mwanzoni mwa [[muongo]] huo nchini huko. <ref>{{Rejea jarida|author=Gallo RC|title=A reflection on HIV/AIDS research after 25 years|journal= Retrovirology|volume=3|page=72|year=2006|pmid=17054781|doi=10.1186/1742-4690-3-72|url=http://www.retrovirology.com/content/3//72|pmc=1629027}}</ref> Matukio ya kwanza yalikuwa katika kikundi kidogo cha [[Uraibu|waraibu]] wa dawa za kudungia na [[wanaume]] [[shoga]] wasiokuwa na visababishi bayana vya udhaifu wa kingamwili na walioonyesha dalili za [[numonia]] ya ''[[Pneumocystis carinii]]'', maambukizi nyemelezi yanayotokea kwa nadra na maarufu katika watu wenye kingamwili dhaifu sana.<ref name=MMWR2>{{Rejea jarida| author=Gottlieb MS| title=Pneumocystis pneumonia—Los Angeles. 1981| journal=Am J Public Health| volume=96| issue=6| pages=980–1; discussion 982–3| year=2006| pmid=16714472| url=http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm| accessdate=March 31, 2009| pmc=1470612| archiveurl=https://web.archive.org/web/20090422042240/http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm| archivedate=2009-04-22| deadurl=no}}</ref> Punde baadaye, idadi isiyotarajiwa ya mashoga wakapata [[Sakoma ya Kaposi]] (SK), [[saratani ya ngozi]] iliyokuwa nadra sana hapo awali.<ref name="pmid7287964">{{cite journal|author=Friedman-Kien AE|title=Disseminated Kaposi's sarcoma syndrome in young homosexual men|journal=J. Am. Acad. Dermatol.|volume=5|issue=4|pages=468–71|year=1981|month=October|pmid=7287964|doi=10.1016/S0190-9622(81)80010-2|url=}}</ref><ref name="pmid6116083">{{cite journal|author=Hymes KB|title=Kaposi's sarcoma in homosexual men-a report of eight cases|journal=Lancet|volume=2|issue=8247|pages=598–600|year=1981|month=September|pmid=6116083|doi=|url=https://archive.org/details/sim_the-lancet_1981-09-19_2_8247/page/598|author-separator=,|author2=Cheung T|author3=Greene JB|display-authors=3|last4=Prose|first4=NS|last5=Marcus|first5=A|last6=Ballard|first6=H|last7=William|first7=DC|last8=Laubenstein|first8=LJ}}</ref>Visa vingine vingi vya NPC na SK vilitokea huku vikitahadharisha Vituo vya Kudhibiti na Kuzuia Magonjwa nchini Marekani, hivyo kikosi cha kiutendaji kikaundwa ili kuudhibiti mzuko huu.<ref name="Basavapathruni_2007">{{cite journal | title=Reverse transcription of the HIV-1 pandemic | url=https://archive.org/details/sim_faseb-journal_2007-12_21_14/page/3795 | last1=Basavapathruni |first1=A | last2=Anderson | first2=KS | journal=The FASEB Journal |year=2007 | month=December | volume=21 | issue=14 |pages=3795–3808 | doi=10.1096/fj.07-8697rev | pmid=17639073}}</ref> Katika siku za kwanza, kituo hicho hakikuwa na jina rasmi la ugonjwa huu, mara nyingi wakitumia majina ya magonjwa mengine yaliyohusishwa nao, kwa mfano, [[limfadenopathi]], jina ambalo baadaye wavumbuzi wa VVU waliviita virusi hivi.<ref name=MMWR1982a>{{Rejea jarida | author=Centers for Disease Control (CDC) |title=Persistent, generalized lymphadenopathy among homosexual males|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/00001096.htm | journal=MMWR Morb Mortal Wkly Rep. | year=1982 |pages=249–251 | volume=31| issue=19 | pmid=6808340 | accessdate =August 31, 2011}}</ref><ref name=Barre>{{Rejea jarida|author=Barré-Sinoussi F | title=Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS) |url=https://archive.org/details/sim_science_1983-05-20_220_4599/page/n103 | journal=Science | year=1983 | pages=868–871 | volume=220 | issue=4599 | pmid=6189183 |doi=10.1126/science.6189183 | bibcode=1983Sci...220..868B| author-separator=,| author2=Chermann JC| author3=Rey F|display-authors=3| last4=Nugeyre| first4=M.| last5=Chamaret| first5=S| last6=Gruest| first6=J| last7=Dauguet| first7=C|last8=Axler-Blin| first8=C| last9=Vezinet-Brun| first9=F }}</ref> Wavumbuzi pia walitumia “Sakoma ya Kaposi na Maambukizi nyemelezi”, jina lililokuwa la kikosi cha kiutendaji kilichoanzishwa mwaka wa 1981.<ref name=MMWR1982b>{{Rejea jarida | author=Centers for Disease Control (CDC) | title=Opportunistic infections and Kaposi's sarcoma among Haitians in the United States |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/00001123.htm | journal=MMWR Morb Mortal Wkly Rep. | year=1982 |pages=353–354; 360–361 | volume=31 | issue=26 | pmid=6811853 | accessdate =August 31, 2011}}</ref> Wakati mmoja, Kituo cha Kudhibiti na Kuzuia Magonjwa kiliunda msemo "ugonjwa wa 4H", kwani [[sindromu]] hii ilionekana kuwaathiri watu wa [[Haiti]], mashoga (homosexuals), wenye [[hemofilia]] na watumiaji wa [[heroini]].<ref name=SciRep470b>{{cite web| publisher=[[American Association for the Advancement of Science]]| date=July 28, 2006| url=http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf| title=Making Headway Under Hellacious Circumstances| accessdate=June 23, 2008| format=PDF| archivedate=2008-06-24| archiveurl=https://web.archive.org/web/20080624235131/http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf| =https://web.archive.org/web/20080624235131/http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf}}</ref> Katika vyombo vikuu vya habari liliundwa neno "[[GRID]]" (lililosimamia "gay-related immune deficiency", yaani "ukosefu wa kinga uliohusishwa na mashoga".<ref name=Altman>{{Rejea habari |author=Altman LK |url=http://www.nytimes.com/1982/05/11/science/new-homosexual-disorder-worries-health-officials.html?scp=1&sq=New%20homosexual%20disorder%20worries%20officials&st=cse | title=New homosexual disorder worries health officials | work=The New York Times | date=May 11, 1982 | accessdate =August 31, 2011}}</ref> Hata hivyo, baada ya kutambua kuwa VVU havikuwaathiri jamii ya mashoga pekee,<ref name=MMWR1982b/> ilibainika kuwa neno GRID lilikuwa likipotosha, hivyo neno UKIMWI likaanzishwa kwenye mkutano mnamo Julai 1982.<ref name=Kher>{{Rejea habari| author=Kher U| title=A Name for the Plague| work=Time| date=July 27, 1982| url=http://www.time.com/time/80days/820727.html| accessdate=March 10, 2008| archiveurl=https://web.archive.org/web/20080307015307/http://www.time.com/time/80days/820727.html| archivedate=2008-03-07| deadurl=no}}</ref> Kufikia Septemba 1982, Kituo cha Kudhibiti na Kuzuia Magonjwa kilianza kuuita UKIMWI.<ref name=MMWR1982c>{{Rejea jarida | author=Centers for Disease Control (CDC) | title=Update on acquired immune deficiency syndrome (AIDS)—United States| journal=MMWR Morb Mortal Wkly Rep. | year=1982 | pages=507–508; 513–514 | volume=31 | issue=37 | pmid=6815471}}</ref> [[File:Robert Gallo.jpg|thumb|Alt=Mwanaume aliyevalia shati nyeupe na tai, huku akizingizirwa na wanawake watatu na vifaa vya maabara|Robert Gallo, mzinduzi mwenza wa VVU katika miaka ya kwanza ya 1980, akiwa pamoja na (kushoto kwenda kulia) Sandra Eva, Sandra Colombini, na Ersell Richardson.]] Mnamo 1983, vikundi viwili tofauti vya watafiti vilivyoongozwa na [[Robert Gallo]] na [[Luc Montagnier]] bila kutegemeana vilitangaza kuwa [[retrovirusi]] mpya ilikuwa ikiwaambukiza wagonjwa wa UKIMWI, hivyo wakachapisha matokeo yao katika [[jarida]] la ''[[Science (jarida)|Science]]''.<ref name=Gallo>{{cite journal | author=RC Gallo, PS Sarin, EP Gelmann, M Robert-Guroff, E Richardson, VS Kalyanaraman, D Mann, GD Sidhu, RE Stahl, S Zolla-Pazner, J Leibowitch, and M Popovic |journal=Science |title=Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS) | url=https://archive.org/details/sim_science_1983-05-20_220_4599/page/865 |year=1983 | pages=865–867 | volume=220 | doi=10.1126/science.6601823 | pmid=6601823 | issue=4599|bibcode = 1983Sci...220..865G }}</ref><ref name=Montagnier >{{cite doi|10.1126/science.6189183}}</ref> Gallo alidai kuwa virusi vilivyokuwa vimetambuliwa kwa mara ya kwanza na kikundi chake kilikuwa sawa katika [[muundo wa virusi|umbo]] na [[virusi vya binadamu vya limfotrophia-T]]. Kikundi cha Gallo kiliviita virusi hivi HTLV-III. Wakati huohuo, kikundi cha Montagnier kilitambua virusi kutoka kwa mgonjwa aliyekuwa na [[uvimbe]] wa [[tezi za limfu]] kwenye [[shingo]] na [[asthenia|udhaifu wa mwili]] ambazo ni dalili mbili bainifu za UKIMWI. Huku wakikanusha ripoti ya kikundi cha Gallo, Montagnier na wenzake walionyesha kuwa viini vya [[protini]] vya virusi hivyo vilikuwa tofauti na HTLV-I kiukingamwili. Kikundi cha Montagnier kiliviita virusi walivyovitambua virusi vinavyohusishwa na limfadenopathi.<ref name="Basavapathruni_2007"/> Virusi hivi vilibainika kuwa sawa mwaka wa 1986 na kubadilishwa na kuitwa VVU.<ref>{{cite book|last=Aldrich|first=ed. by Robert|title=Who's who in gay and lesbian history.|year=2001|publisher=Routledge|location=London|isbn=9780415229746|pages=154|url=http://books.google.ca/books?id=9KA7_1s6w-QC&pg=PA154|coauthors=Wotherspoon, Garry}}</ref> Leo [[wanasayansi]] wengi wanaamini VVU-1 na VVU-2 vimetokana na [[jamii ya sokwe]] huko [[Afrika Magharibi]] na [[Afrika ya Kati|ya Kati]] mwishoni mwa [[karne ya 19]] au mwanzoni mwa [[karne ya 20]], wakati virusi vya [[SIV]] kutoka kwa [[nyani]] au [[sokwe]] vilikwenda kwa binadamu.<ref name=Orgin2011>{{cite journal|last=Sharp|first=PM|coauthors=Hahn, BH|title=Origins of HIV and the AIDS Pandemic|journal=Cold Spring Harbor perspectives in medicine|date=2011 Sep|volume=1|issue=1|pages=a006841|pmid=22229120|doi=10.1101/cshperspect.a006841|pmc=3234451}}</ref> VVU-1 vinaaminika kutoka kusini mwa [[Cameroon]] kupitia kugeuka kwa VSVU(cpz), (virusi vya sokwe vinavyosababisha ukosefu wa kinga mwilini) vinavyoambukiza sokwe wa mwituni (VVU-1 hutokana na mzuko wa magonjwa ya VSVUcpz katika [[nususpishi]] ya sokwe iitwayo ''[[Pan]] troglodytes troglodytes'').<ref name="pmid9989410">{{cite journal |author=Gao F |title=Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes |journal=Nature |volume=397 |issue=6718|pages=436–41 |year=1999 |month=February |pmid=9989410|doi=10.1038/17130 |url=https://archive.org/details/sim_nature-uk_1999-02-04_397_6718/page/436|bibcode = 1999Natur.397..436G |author-separator=, |author2=Bailes E |author3=Robertson DL|display-authors=3 |last4=Chen|first4=Yalu |last5=Rodenburg |first5=Cynthia M. |last6=Michael |first6=Scott F.|last7=Cummins |first7=Larry B. |last8=Arthur |first8=Larry O. |last9=Peeters |first9=Martine }}</ref><ref name=Keele>{{cite journal | author=Keele, B. F., van Heuverswyn, F., Li, Y. Y., Bailes, E., Takehisa, J., Santiago, M. L., Bibollet-Ruche, F., Chen, Y., Wain, L. V., Liegois, F., Loul, S., Mpoudi Ngole, E., Bienvenue, Y., Delaporte, E., Brookfield, J. F. Y., Sharp, P. M., Shaw, G. M., Peeters, M., and Hahn, B. H. | title=Chimpanzee Reservoirs of Pandemic andNonpandemic HIV-1 | url=https://archive.org/details/sim_science_2006-07-28_313_5786/page/523 | journal=Science | date=28 July 2006| volume=313 | issue=5786 | pages=523–6 | doi = 10.1126/science.1126531 | pmc=2442710 | pmid=16728595|bibcode = 2006Sci...313..523K }}</ref> Virusi vinavyohusiana kwa karibu na VVU-2 ni VSVU(smm) ambavyo ni virusi vya [[mangabi mwenye masizi]] (''Cercocebus atys atys''), [[tumbili]] wa kale anayeishi Afrika Magharibi (kutoka [[kusini]] mwa [[Senegali]] hadi [[magharibi]] mwa [[Côte d'Ivoire]]).<ref name="Reeves" /> [[Tumbili wa kisasa]] kama vile [[tumbili wa Usiku|tumbili bundi]] wana ukinzani wa maambukizi ya [[VVU-1]] kwa sababu ya [[uunganishaji jeni|uunganishaji]] wa [[jeni]] [[mbili]] zinazokinzana na virusi.<ref name=Goodier>{{cite journal | author=Goodier, J., and Kazazian, H. | title=Retrotransposons Revisited: The Restraint and Rehabilitation of Parasites | url=https://archive.org/details/cell_2008-10-03_135_1/page/23 | journal=Cell |year=2008 | pages=23–35 | volume=135 | issue=1 | doi = 10.1016/j.cell.2008.09.022 | pmid=18854152}}(subscription required)</ref> VVU-2 inadhaniwa kuruka kizuizi cha spishi katika angalau matukio matatu tofauti, hivyo kupelekea vikundi vitatu vya virusi hivi ambavyo ni M, N na O. <ref name=Kalish2005>{{cite journal |author=Kalish ML |title=Central African hunters exposed to simian immunodeficiency virus |journal=Emerg Infect Dis |volume=11 |issue=12 |pages=1928–30 |year=2005 |pmid=16485481|doi=10.3201/eid1112.050394 |author-separator=, |author2=Wolfe ND |author3=Ndongmo CD |author4=McNicholl J|author5=Robbins KE |display-authors=5 |last6=Aidoo |first6=Michael |last7=Fonjungo |first7=Peter N. |last8=Alemnji|first8=George |last9=Zeh |first9=Clement |pmc=3367631}}</ref> Kuna ushahidi kuwa wanadamu wanaoshughulikia [[nyama za mwituni]] kwa kuwinda au kuziuza, kwa kawaida hupata VSVU.<ref name=Kalish2005/>Hata hivyo, virusi hivyo ni dhaifu na hukandamizwa na mfumo wa kingamwili baada ya wiki kadhaa za kuambukizwa. Inadhaniwa kuwa maambukizi kadhaa ya virusi hivyo kutoka kwa mtu hadi mwingine katika mfululizo wa haraka huhitajika ili vipate wakati unaotosha kubadilika na kuwa VVU.<ref name=Marx2001>{{cite journal |author=Marx PA, Alcabes PG, Drucker E |title=Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa |volume=356 |issue=1410 |pages=911–20 |year=2001 |pmid=11405938 |journal=Philos Trans R Soc Lond B Biol Sci |pmc=1088484 |doi=10.1098/rstb.2001.0867 |url=http://rstb.royalsocietypublishing.org/content/356/1410/911.full.pdf |archive-date=2012-03-09 |access-date=2020-03-28 |archive-url=https://web.archive.org/web/20120309105853/http://rstb.royalsocietypublishing.org/content/356/1410/911.full.pdf |url-status=dead }}</ref> Zaidi ya hayo, kwa sababu ya kiwango chake kidogo cha kuambukiza kutoka kwa mtu hadi mwingine, virusi hivyo vinaweza tu kuenea katika wingi wa watu iwapo kuna njia moja au mbili za hatari ya kuambukizana ya kiwango cha juu. Njia hizi zinadhaniwa kutokuwepo barani Afrika kabla ya karne ya 20. Njia maalumu za hatari kubwa ya maambukizi zinazoruhusu virusi hivi kubadilika ili kuweza kuishi katika wanadamu na kuenea katika jamii yote hutegemea wakati uliopendekezwa wa kuvuka kutoka kwa mnyama hadi mwanadamu. Tafiti za kijeni za virusi hivi zinadokeza kuwa chanzo cha hivi karibuni zaidi cha VVU-1 ya kikundi M kilitokea mnamo 1910. <ref name=Worobey2008>{{cite journal|last1=Worobey |first1=Michael |last2=Gemmel |first2=Marlea |last3=Teuwen |first3=Dirk E. |last4=Haselkorn|first4=Tamara |last5=Kunstman |first5=Kevin |last6=Bunce |first6=Michael |last7=Muyembe |first7=Jean-Jacques|last8=Kabongo |first8=Jean-Marie M. |last9=Kalengayi |first9=Raphaël M. |title=Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960 |journal=Nature |volume=455 |issue=7213 |pages=661–4 |year=2008 |pmid=18833279| doi=10.1038/nature07390|url=http://www.nature.com/nature/journal/v455/n7213/pdf/nature07390.pdf |bibcode = 2008Natur.455..661W }} (subscription required)</ref> Wanaotaja kipindi hicho maalumu huhusisha mzuko wa janga la VVU na kuibuka kwa [[ukoloni]] na ukuaji wa [[miji]] mikubwa ya kikoloni ya Afrika, huku ukisababisha mabadiliko ya jamii pamoja na kiwango kikubwa cha [[uasherati]], uenezi wa [[ukahaba]] na matukio mengi ya [[vidonda vya viungo vya uzazi]] (kama vile [[kaswende]]) katika miji iliyochipuka.<ref name=Sousa2010>{{cite journal |last1=Sousa |first1=João Dinis de|last2=Müller |first2=Viktor |last3=Lemey |first3=Philippe |last4=Vandamme |first4=Anne-Mieke |last5=Vandamme|first5=Anne-Mieke |title=High GUD Incidence in the Early 20th Century Created a Particularly Permissive Time Window for the Origin and Initial Spread of Epidemic HIV Strains |journal=PLoS ONE |volume=5 |issue=4 |pages=e9936 |year=2010|pmid=20376191 |pmc=2848574|doi=10.1371/journal.pone.0009936|url=http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0009936|editor1-last=Martin |editor1-first=Darren P.}}</ref> Ingawa viwango vya uambukizaji wakati wa ngono ya kupitia [[uke]] viko chini katika hali ya kawaida, kuna ongezeko kubwa iwapo mmoja wa wapenzi hao ana [[ugonjwa wa zinaa]] unaosababisha vidonda vya [[viungo vya uzazi]]. Miji ya kikoloni ya [[Miaka ya 1900|miaka ya kwanza ya 1900]] ilijulikana kwa maambukizi ya viwango vya juu kutokana na ukahaba na [[vidonda vya viungo vya uzazi]], hivi kwamba, kufikia mwaka [[1928]], 45% ya [[wanawake]] wakazi wa mashariki mwa [[Kinshasa]] walidhaniwa kuwa makahaba. Kufikia mwaka [[1933]], takriban 15% ya wakazi wote wa mji huo walikuwa wameambukizwa aina mojawapo ya kaswende.<ref name=Sousa2010 /> Maoni mengine yanadokeza kuwa hatua zisizo salama za [[uuguzi]] barani Afrika katika miaka ya baada ya [[Vita vya pili vya dunia]], kama vile kutumia tena na tena [[sindano]] zisizosafishwa kuchanja [[umati]], [[antibayotiki]] na kampeni dhidi ya [[malaria]] ndizo njia za kwanza zilizoruhusu virusi hivyo kujibadilisha vikiwa ndani ya wanadamu kisha kuenea.<ref name=Marx2001 /><ref name=Chitnis2000>{{cite journal |last1=Chitnis |first1=Amit |last2=Rawls |first2=Diana |last3=Moore |first3=Jim|title=Origin of HIV Type 1 in Colonial French Equatorial Africa? |journal=AIDS Research and Human Retroviruses|volume=16 |issue=1 |pages=5–8 |year=2000 |pmid=10628811 |doi=10.1089/088922200309548}}(subscription required)</ref><ref name=McNeil>{{cite news |author=[[Donald G. McNeil, Jr.]] |coauthors= |title=Precursor to H.I.V. Was in Monkeys for Millennia |url=http://www.nytimes.com/2010/09/17/health/17aids.html?_r=1&src=me&ref=general|quote=Dr. Marx believes that the crucial event was the introduction into Africa of millions of inexpensive, mass-produced syringes in the 1950s.&nbsp;... suspect that the growth of colonial cities is to blame. Before 1910, no Central African town had more than 10,000 people. But urban migration rose, increasing sexual contacts and leading to red-light districts.|work=[[New York Times]] |date=September 16, 2010 |accessdate=2010-09-17 }}</ref> Visa vilivyonakiliwa vyema vya VVU katika mwanadamu ni vya mwaka [[1959]] katika eneo la nchi ya [[Jamhuri ya Kidemokrasia ya Kongo|Kongo]].<ref name=Zhu>{{cite journal|author=Zhu, T., Korber, B. T., Nahmias, A. J., Hooper, E., Sharp, P. M. and Ho, D. D.|title=An African HIV-1 Sequence from 1959 and Implications for the Origin of the epidemic|journal=Nature|year=1998|pages=594–7|volume=391|issue=6667|pmid=9468138|doi=10.1038/35400|url=http://www.nature.com/nature/journal/v391/n6667/full/391594a0.html|bibcode = 1998Natur.391..594Z }}</ref> Kuna uwezekano kuwa virusi hivyo vilikuwemo huko Marekani mwaka [[1966]],<ref>{{cite news | last = Kolata | first = Gina |title = Boy's 1969 Death Suggests AIDS Invaded U.S. Several Times | publisher = The New York Times | date = 28 October 1987 | url = http://query.nytimes.com/gst/fullpage.html?res=9B0DEFD6173AF93BA15753C1A961948260&sec=health&pagewanted=all | accessdate = 11 February 2009}}</ref>lakini maambukizi mengi yanayotokea nje ya [[Kusini kwa Sahara]] yanaweza kufuatiliwa hadi kwa mtu mmoja aliyeambukizwa na VVU katika nchi ya [[Haiti]] na kisha kuyapeleka maambukizi hayo nchini Marekani takriban mwaka [[1969]].<ref name="Thomas_Gilbert">{{cite journal |last1=Gilbert |first1=M. Thomas P. |last2=Rambaut |first2=Andrew |last3=Wlasiuk |first3=Gabriela |last4=Spira |first4=Thomas J. |last5=Pitchenik |first5=Arthur E. |last6=Worobey |first6=Michael |title=The emergence of HIV/AIDS in the Americas and beyond |journal=PNAS |date=November 20, 2007 |volume=104 |issue=47 |pages=18566–18570 |url=http://www.pnas.org/content/104/47/18566.full.pdf |format=PDF |doi=10.1073/pnas.0705329104 |pmid=17978186 |pmc=2141817 |bibcode=2007PNAS..10418566G |access-date=2020-03-28 |archive-date=2015-09-24 |archive-url=https://web.archive.org/web/20150924144548/http://www.pnas.org/content/104/47/18566.full.pdf |dead-url=yes }}</ref> Janga hili kisha lilienea kwa haraka katika vikundi vilivyo katika hatari kubwa ya kuambukizwa (mwanzoni ilikuwa ni wanaume waliofanya ngono na wanaume). Kufikia mwaka [[1978]], maambukizi ya VVU-1 katika mashoga wenyeji wa [[New York]] na [[San Francisco]] yalikadiriwa kuwa 5%, kuonyesha kuwa maelfu ya watu nchini Marekani tayari walikuwa wameambukizwa.<ref name="Thomas_Gilbert" /> ==Uambukizaji== VVU husambaa hasa kupitia njia tatu kuu: [[ngono]] (ikiwa ni pamoja na [[ulawiti]] na hata [[ngono ya mdomoni]]), kuingiliana na viowevu vya mwili vilivyoambukizwa (hasa [[kuongezewa damu]] au kudungwa [[sindano]]) na [[usambazaji wima|kutoka kwa mama hadi mtoto]] wakati wa [[ujauzito]], kuzaa au kunyonyesha<ref name=TransmissionM2007>{{cite book|last=Markowitz|first=edited by William N. Rom ; associate editor, Steven B.|title=Environmental and occupational medicine|year=2007|publisher=Wolters Kluwer/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-6299-1|page=745|url=http://books.google.ca/books?id=H4Sv9XY296oC&pg=PA745|edition=4th}}</ref>Baadhi ya [[viowevu vya mwili]], kama vile [[mate]] na [[machozi]], havisambazi VVU.<ref name=CDCtransmission>{{cite web|publisher=[[Centers for Disease Control and Prevention]]|year=2003|url=http://www.cdc.gov/HIV/pubs/facts/transmission.htm|title=HIV and Its Transmission|accessdate=May 23, 2006|archiveurl=https://web.archive.org/web/20050204141148/http://www.cdc.gov/HIV/pubs/facts/transmission.htm|archivedate=2005-02-04}}</ref> === Kupitia ngono === Kufanya [[ngono zembe]] kumepelekea visa vingi zaidi vya maambukizi ya VVU kote ulimwenguni, huku mwingiliano baina ya watu wa [[jinsia]] tofauti ukichangia visa zaidi ya mwingiliano wa mashoga kote ulimwenguni (kwa sababu mashoga ni wachache zaidi).<ref name=TransmissionM2007/> Hata hivyo, mtindo wa usambazaji hutofautiana pakubwa baina ya mataifa mbalimbali. Nchini Marekani, visa vingi zaidi vya usambazaji wa kingono vilitokea katika [[wanaume]] wanaofanya ngono na wanaume (kwa sababu huko ushoga umeenea zaidi)<ref name=TransmissionM2007/>huku idadi hii ikichangia 64% ya visa vyote vipya.<ref name=TransmissionCDC2012>{{cite web|title=HIV in the United States: An Overview|url=http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/us_overview.htm|work=Center for Disease Control and Prevention|date=March 2012}}</ref> Kuhusu ngono zembe baina ya watu wa jinsia tofauti, makadirio ya hatari ya kusambazwa kwa VVU kwa kila kitendo cha ngono yanaonekana kuwa zaidi kwa mara 10 katika mataifa yasiyostawi kuliko mataifa yaliyostawi.<ref name=Boily2009/>Katika mataifa yasiyostawi, hatari ya usambazaji wa mwanamke hadi mwanamume imekadiriwa kuwa 0.38% kwa kila kitendo, huku usambazaji wa mwanamume hadi mwanamke ukiwa 0.30%; makadirio mbadala katika mataifa yaliyostawi ni 0.04% kwa kila kitendo katika usambazaji wa mwanamke hadi mwanamume, na 0.08% kwa kila kitendo katika maambukizi ya mwanamume hadi mwanamke.<ref name=Boily2009/> Hatari ya kuambukizwa kutokana na ngono ya kinyeo (ulawiti) iko juu sana, ikikadiriwa kuwa 1.4{{ndash}}1.7% kwa kila kitendo (katika ngono ya watu wa jinsia moja na tofauti pia).<ref name=Boily2009/><ref>{{cite journal|last=Beyrer|first=C|coauthors=Baral, SD; van Griensven, F; Goodreau, SM; Chariyalertsak, S; Wirtz, AL; Brookmeyer, R|title=Global epidemiology of HIV infection in men who have sex with men.|url=https://archive.org/details/sim_the-lancet_july-28-august-3-2012_380_9839/page/367|journal=Lancet|date=2012 Jul 28|volume=380|issue=9839|pages=367-77|pmid=22819660}}</ref> Ingawa hatari ya kuambukizwa kupitia [[ngono ya mdomoni]] iko chini, bado ipo. <ref>{{cite journal|last=Yu|first=M|coauthors=Vajdy, M|title=Mucosal HIV transmission and vaccination strategies through oral compared with vaginal and rectal routes|journal=Expert opinion on biological therapy|date=2010 Aug|volume=10|issue=8|pages=1181–95|pmid=20624114|doi=10.1517/14712598.2010.496776|pmc=2904634}}</ref>Hatari ya kila kitendo imekadiriwa kuwa 0{{ndash}}0.04% kwa ngono pokezi ya mdomoni.<ref name=Dosekun2010>{{cite journal|last=Dosekun|first=O|coauthors=Fox, J|title=An overview of the relative risks of different sexual behaviours on HIV transmission|journal=Current opinion in HIV and AIDS|date=2010 Jul|volume=5|issue=4|pages=291–7|pmid=20543603|doi=10.1097/COH.0b013e32833a88a3}}</ref><ref>{{cite book|last=Stürchler|first=Dieter A.|title=Exposure a guide to sources of infections|year=2006|publisher=ASM Press|location=Washington, DC|isbn=9781555813765|pages=544|url=http://books.google.ca/books?id=MWa5or3Xa9EC&pg=PA544}}</ref> kwa kuwa visa vichache vimeripotiwa.<ref>{{cite book|last=al.]|first=edited by Richard Pattman ... [et|title=Oxford handbook of genitourinary medicine, HIV, and sexual health|year=2010|publisher=Oxford University Press|location=Oxford|isbn=9780199571666|pages=95|url=http://books.google.ca/books?id=Jm1H4EeULmYC&pg=PA95|edition=2nd ed.}}</ref> Katika miktadha inayohusisha [[ukahaba]] kote ulimwenguni, hatari ya maambukizi ya mwanamke hadi mwanamume imekadiriwa kuwa 2.4% kwa kila kitendo, huku maambukizi ya mwanamume kwa mwanamke yakiwa 0.08% kwa kila kitendo.<ref name=Boily2009>{{cite journal|author=Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, Alary M |title=Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies|journal=The Lancet Infectious Diseases|volume=9|issue=2|pages=118–129|year=2009|month=February|pmid=19179227|doi=10.1016/S1473-3099(09)70021-0}}</ref> Hatari ya kuambukizwa huongezeka katika wingi wa [[magonjwa ya zinaa]]<ref name=CochraneSTI2012>{{cite journal|last=Ng|first=BE|coauthors=Butler, LM; Horvath, T; Rutherford, GW|title=Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2011-03-16|issue=3|pages=CD001220|pmid=21412869|doi=10.1002/14651858.CD001220.pub3|editor1-last=Butler|editor1-first=Lisa M}}</ref> na [[vidonda vya uzazi]].<ref name=Boily2009/>Vidonda vya sehemu za uzazi vimekisiwa kuongeza hatari hadi mara tano. <ref name=Boily2009/> Maambukizi mengine ya zinaa, kama vile [[kisonono]], [[klamidia]], [[trikomoniasi]], [[vaginosi ya kibakteria]], huhusishwa na aghalabu ongezeko dogo la hatari ya kuambukizwa.<ref name=Dosekun2010/> [[Wingi wa virusi]] kwa mtu aliyeambukizwa ni suala kuu la hatari katika usambazaji wa kingono na pia wa kutoka kwa mama hadi mtoto.<ref>{{cite journal|last=Anderson|first=J|title=Women and HIV: motherhood and more|journal=Current opinion in infectious diseases|date=2012 Feb|volume=25|issue=1|pages=58–65|pmid=22156896|doi=10.1097/QCO.0b013e32834ef514}}</ref> Katika miezi 2.5 ya kwanza baada ya kuambukizwa VVU, uwezo wa mtu kuambukiza ni mara 12 zaidi kwa sababu ya wingi wa virusi. <ref name=Dosekun2010/> Iwapo mtu yuko katika awamu za mwisho za VVU, viwango vya kuambukizana ni takriban mara 8 zaidi.<ref name=Boily2009/> [[Usadomasoki|Ngono shari]] inaweza kuwa suala linalochangia ongezeko la hatari ya kuambukizwa. <ref>{{cite journal|last=Klimas|first=N|coauthors=Koneru, AO; Fletcher, MA|title=Overview of HIV|url=https://archive.org/details/sim_psychosomatic-medicine_2008-06_70_5/page/523|journal=Psychosomatic Medicine|date=2008 Jun|volume=70|issue=5|pages=523–30|pmid=18541903|doi=10.1097/PSY.0b013e31817ae69f}}</ref> [[Ubakaji]] pia unaaminika kuongezeka hatari ya kusambaza VVU kwa sababu ni nadra [[kondomu]] kutumika, huwa na uwezekano wa kujeruhiwa ukeni au kinyeo, na pia kuna uwezekano wa magonjwa ya zinaa yanayoambatana na VVU. <ref>{{cite journal|last=Draughon|first=JE|coauthors=Sheridan, DJ|title=Nonoccupational post exposure prophylaxis following sexual assault in industrialized low-HIV-prevalence countries: a review|journal=Psychology, health & medicine|year=2012|volume=17|issue=2|pages=235–54|pmid=22372741|doi=10.1080/13548506.2011.579984}}</ref> ===Viowevu vya mwili === [[File:AIDS Poster If You're Dabbling in Drugs 1989.jpg|thumb|alt=Bango la rangi nyeusi na jipya la kijana wa Kiafrika akiwa na taulo kwenye mkono wa kushoto iliyo na maneno "Kucheza na madawa ni kucheza na maisha" juu yake|Bango la mwaka 1989 likisisitiza tishio la UKIMWI unaohusiana na kutumia madawa ya kulevya.]] Njia ya pili maarufu zaidi ya usambazaji wa VVU ni kupitia kwa [[damu]] na mazao yake.<ref name=TransmissionM2007/> Usambazaji wa kupitia damu unaweza kuwa kupitia sindano inayotumiwa na watu wengi wanapoongezwa viowevu mwilini, majeraha ya sindano, kuongezwa damu chafu au mazao ya damu, au kudungwa kwa vifaa visivyotakaswa. Hatari inayotokana na kutumia sindano baina ya watu wengi wakati wa [[kudungwa dawa]] ni kati ya 0.63-2.4% kwa kila kitendo, wastani wake ukiwa 0.8%<ref name=Risk2006>{{cite journal|last=Baggaley|first=RF|coauthors=Boily, MC; White, RG; Alary, M|title=Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis|journal=AIDS (London, England)|date=2006-04-04|volume=20|issue=6|pages=805–12|pmid=16549963|doi=10.1097/01.aids.0000218543.46963.6d}}</ref> Hatari ya kuambukizwa VVU kwa sindano iliyotumiwa na mtu aliyeambukizwa VVU hukadiriwa kuwa 0.3% (takriban mara 1 kwa 133) kwa kila kitendo, ilhali hatari inayofuatia [[tando za ute]] kuingiliana na damu iliyoambukizwa ni 0.09% (takriban 1 kwa 1000) kwa kila kitendo.<ref name=AFP2007>{{cite journal|last=Kripke|first=C|title=Antiretroviral prophylaxis for occupational exposure to HIV|url=https://archive.org/details/sim_american-family-physician_2007-08-01_76_3/page/375|journal=American family physician|date=2007-08-01|volume=76|issue=3|pages=375–6|pmid=17708137}}</ref> Nchini Marekani, watu wanaodungwa dawa ndani ya [[misuli]] walichangia 12% ya visa vyote vipya vya VVU mwaka wa 2009, <ref name=TransmissionCDC2012/> huku 80% ya watu katika sehemu fulani wanaodungwa dawa wakiwa wameambukizwa VVU. <ref name=TransmissionM2007/> [[Kuongezewa damu]] iliyoambukizwa huchangia maambukizi kwa takriban 93% ya visa vyote.<ref name=Risk2006/>Katika mataifa yaliyostawi, hatari ya kuambukizwa VVU kutokana na kuongezewa damu iko chini sana (chini ya 1 kwa 500,000) ambapo viwango vya juu vya kuchagua mtu atakayetoa damu na pia upimaji VVU hufanywa.<ref name=TransmissionM2007/> Kule Uingereza, hatari iliyoripotiwa ni 1 kwa milioni 5.<ref>{{cite web|title=Will I need a blood transfusion?|work=NHS patient information|year=2011|url=http://hospital.blood.co.uk/library/pdf/2011_Will_I_Need_English_v3.pdf|publisher=National Health Services|accessdate=August 29, 2012}}</ref> Hata hivyo, katika mataifa yenye mapato ya chini, [[nusu]] tu ya damu inayoongezwa huwa imepimwa vyema (kufikia mwaka wa 2008). <ref name=UN2011Seventy>UNAIDS 2011 pg. 60–70</ref>Inakadiriwa kuwa hadi 15% ya maambukizi ya VVU katika maeneo hayo hutokana na kuongeza damu au mazao ya damu yaliyoambukizwa, hii ikiwa ni asilimia 5 - 10 ya maambukizi ya ulimwengu mzima. <ref name=TransmissionM2007/><ref name=WHO070401>{{cite web |publisher=[[World Health Organization|WHO]] |year=2001 |url=http://www.who.int/inf-pr-2000/en/pr2000-25.html |title=Blood safety&nbsp;... for too few |accessdate=January 17, 2006 |archivedate=2005-01-17 |archiveurl=https://web.archive.org/web/20050117092135/http://www.who.int/inf-pr-2000/en/pr2000-25.html }}</ref> Sindano za tiba zisizo salama huchangia pakubwa katika kueneza UKIMWI katika eneo la Kusini kwa Sahara. Mnamo 2007, kati ya 12% na 17% ya maambukizi katika eneo hilo yalichangiwa na matumizi ya sindano hizo.<ref>{{cite journal|last=Reid|first=SR|title=Injection drug use, unsafe medical injections, and HIV in Africa: a systematic review|journal=Harm reduction journal|date=2009-08-28|volume=6|page=24|pmid=19715601|doi=10.1186/1477-7517-6-24|pmc=2741434}}</ref> [[Shirika la Afya Duniani]] linakadiria hatari ya kuambukizwa kupitia sindano hizo barani Afrika kuwa 1.2%. Hatari kuu huhusishwa na taratibu vamizi, kusaidiwa kuzaa na utunzaji wa [[meno]] katika sehemu hii ya dunia. Watu wanaochanja au kuchanjwa [[chale]], [[chale za mwili]] na [[kutia kovu]] hudhaniwa kuwa katika hatari ya kuambukizwa, ingawa hakuna visa vilivyothibitishwa ambavyo vimenakiliwa.<ref name=CDCBasics2012>{{cite web|title=Basic Information about HIV and AIDS|url=http://www.cdc.gov/hiv/topics/basic/|work=Center for Disease Control and Prevention|date=April 2012}}</ref> Haiwezekani [[mbu]] au wadudu wengine kusambaza VVU. <ref>{{cite web|url=http://www.rci.rutgers.edu/%7Einsects/aids.htm|title=Why Mosquitoes Cannot Transmit AIDS [HIV virus&#93;|publisher=Rci.rutgers.edu|date=|accessdate=2010-07-28|archiveurl=https://web.archive.org/web/20140329183346/http://www.rci.rutgers.edu/~insects/aids.htm|archivedate=2014-03-29|=https://web.archive.org/web/20140329183346/http://www.rci.rutgers.edu/~insects/aids.htm}}</ref> Mtu anaweza pia kupata VVU kwa kuchanga [[sindano]] na wenzake. Hii ina maana ya kutumia sindano ambayo haijawahi kusafishwa baada ya mtu mwingine kuitumia. Baadhi ya watu ambao, kinyume cha [[sheria]], huchukua madawa ya kulevya kama [[heroin]] na [[cocaine]] huchukua dawa hizo kwa sindano. Baadhi yao wanachanga sindano moja. Kama mmojawao ana virusi ya UKIMWI na anashirikisha sindano yake, anaweza kuambukiza HIV kwa watu wengine. === Mama hadi mtoto === VVU vinaweza kusambazwa kutoka kwa mama hadi mtoto wakati wa ujauzito, kuzaa au kunyonyesha.<ref name=Mother2010/><ref name="fluids of transmission">{{cite web|url=http://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/fluids-of-transmission/|title=Fluids of transmission|date=1 November 2011|work=AIDS.gov|publisher=United States Department of Health and Human Services|accessdate=14 September 2012|archivedate=2013-04-03|archiveurl=https://web.archive.org/web/20130403053447/http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/fluids-of-transmission/}}</ref> Njia hii ni ya tatu kwa umaarufu wa kusambaza VVU kote duniani.<ref name=TransmissionM2007/> Bila matibabu, hatari ya kusambazwa wakati wa au baada ya kuzaliwa ni takriban 20%, na 35% kwa watoto wanaonyonya.<ref name=Mother2010/>Kufikia mwaka wa 2008, usambazaji wima ulichangia takriban 90% ya visa vya VVU katika watoto.<ref name=Mother2010/> Hatari ya kusambazwa kutoka kwa mama hadi mtoto inaweza kupunguzwa hadi 1% kwa kutumia matibabu mwafaka.<ref name=Mother2010/> Matibabu ya kukinga hujumuisha mama kutumia dawa za kudhibiti virusi wakati wa ujauzito na kuzaa, kuchagua [[kuzaa kwa kupasuliwa]], kutonyonyesha na kumpa mtoto dawa za kudhibiti VVU.<ref name=MTC2007>{{cite journal|last=Thorne|first=C|coauthors=Newell, ML|title=HIV|journal=Seminars in fetal & neonatal medicine|date=2007 Jun|volume=12|issue=3|pages=174–81|pmid=17321814|doi=10.1016/j.siny.2007.01.009}}</ref>Hata hivyo, idadi kubwa ya mbinu hizi hazipatikani katika mataifa yanayostawi.<ref name=MTC2007/> Iwapo damu itachafua [[chakula]] wakati wa mtoto kutafuna, itaongeza hatari ya kuambukiza.<ref name=CDCBasics2012/> ==Dalili== Mwanzoni, baada ya kuambukizwa, mtu anaweza kukumbwa na kipindi kifupi cha [[maradhi]] ya aina ya [[mafua]]. Kwa kawaida, hali hii hufuatwa na kipindi kirefu kisicho na [[dalili]]. Ugonjwa huu huendelea kutatiza [[kingamwili]] jinsi unavyozidi, hivyo kumfanya mtu kuwa katika hatari zaidi ya kupata [[maambukizi]], ikiwa ni pamoja na [[maambukizi nyemelezi]], na [[kansa]] ambayo kwa kawaida hayawaathiri watu walio na kingamwili njema. Kuna awamu tatu kuu za maambukizi ya VVU: maambukizi makali, awamu fiche na UKIMWI.<ref name=M121>Mandell, Bennett, and Dolan (2010). Chapter 121.</ref><ref name=AIDS2010GOV>{{cite web|title=Stages of HIV|url=http://aids.gov/hiv-aids-basics/diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/|work=U.S. Department of Health & Human Services|accessdate=13 June 2012|date=Dec 2010|archiveurl=https://web.archive.org/web/20120513062533/http://www.aids.gov/hiv-aids-basics/diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/|archivedate=2012-05-13}}</ref> === Maambukizi makali === [[File:Symptoms of acute HIV infection.svg|thumb|alt=Mchoro wa kiwiliwili cha binadamu kinachoonyesha dalili zinazotokea mara nyingi za maambukizi makali ya VVU|275px|Dalili kuu za maambukizi makali ya VVU]] Kipindi cha kwanza kufuatia maambukizi ya VVU huitwa VVU vikali, VVU vya kimsingi au dalili kali za kudhibiti virusi. <ref name=M121/><ref name=WHOCase2007/> Watu wengi hupata [[maradhi ya mfano wa mafua]] au [[mononyukleosi ambukizi|maambukizi ya mfano wa mononukleosi]] wiki 2 - 4 baada ya kuambukizwa ilhali wengine hawana dalili zozote kuu.<ref>{{cite book|title=Diseases and disorders.|year=2008|publisher=Marshall Cavendish|location=Tarrytown, NY|isbn=978-0-7614-7771-6|page=25|url=http://books.google.ca/books?id=-HRJOElZch8C&pg=PA25}}</ref><ref name=M118/>Dalili hutokea katika asilimia 40-90 ya visa vyote na mara nyingi hujumuisha [[homa]], [[limfadenopathia|tezi kubwa na chungu za limfu]], [[faringitisi|inflamesheni ya koo]], [[upele]], maumivu ya kichwa, na/au vidonda vya kinywa na sehemu za uzazi.<ref name=WHOCase2007/><ref name=M118/>Upele huu, unaotokea katika asilimia 20 - 50 ya visa, hutokea katika kiwiliwili, na kwa kawaida huwa wa [[makiulopapula]].<ref name=Deut2010/> Baadhi ya watu pia hupata [[maambukizi nyemelezi]] katika awamu hii.<ref name=WHOCase2007/>Dalili za tumboni na utumboni kama vile kichefuchefu, kutapika au [[kuharisha]] zinaweza kutokea, sawa na dalili za kinuroni za [[niuropathia ya pembeni]] au [[sindromu ya Guillain-Barre]].<ref name=M118/> Muda ya dalili hutofautiana, ingawa kwa kawaida huwa wiki 1 - 2.<ref name=M118/> Kufuatia sifa zake za kutokuwa dalili maalum, hizi mara nyingi haziwezi kutambulika kama dalili za maambukizi ya VVU. Hata visa vinavyotambuliwa na [[daktari]] wa [[familia]] au katika [[hospitali]] mara nyingi hutambulika vibaya kama baadhi ya visababishi vingi vya [[magonjwa ambukizi]] yaliyo na dalili zinazoingiliana. Kwa hivyo, inapendekezwa kuchunguza VVU katika watu wanaoonyesha homa isiyoelezeka ambao wanaweza kuwa na vipengele hatari vya kuambukizwa.<ref name=M118>Mandell, Bennett, and Dolan (2010). Chapter 118.</ref> === Awamu fiche === Dalili za kwanza hufuatwa na awamu fiche (VVU visivyo na dalili au VVU vya muda mrefu).<ref name=AIDS2010GOV/>Bila ya matibabu, awamu hii ya pili ya historia asilia ya maambukizi ya VVU inaweza kudumu kutoka miaka 3 <ref>{{cite book|last=Evian|first=Clive|title=Primary HIV/AIDS care: a practical guide for primary health care personnel in a clinical and supportive setting|year=2006|publisher=Jacana|location=Houghton [South Africa]|isbn=978-1-77009-198-6|page=29|url=http://books.google.ca/books?id=WauaC7M0yGcC&pg=PA29|edition=Updated 4th}}</ref> hadi zaidi ya miaka 20;<ref>{{cite book|first=J. W. A. J. Reeders; P. C. Goodman (ed.). With contributions by J. Bedford|title=Radiology of AIDS|year=2001|publisher=Springer|location=Berlin [u.a.]|isbn=978-3-540-66510-6|page=19|url=http://books.google.ca/books?id=xmFBtyPGOQIC&pg=PA19}}</ref> (wastani wa miaka 8).<ref>{{cite book|last=Elliott|first=Tom|title=Lecture Notes: Medical Microbiology and Infection|year=2012|publisher=John Wiley & Sons|isbn=978-1-118-37226-5|page=273|url=http://books.google.ca/books?id=M4q3AyDQIUYC&pg=PA273}}</ref>Ingawa kwa kawaida mwanzoni kuna dalili chache, au hata zisiwemo, karibu mwishoni mwa awamu hii, watu wengi hupatwa na homa, kukonda, matatizo ya tumbo na utumbo, na maumivu ya misuli. <ref name=AIDS2010GOV/>Kati ya asilimia 50 na 70 ya wagonjwa pia hupata [[limfadenopathia]] ya mwili wote inayorejea, ambayo hudhihirika kwa uvimbe usio na kisababishi na usio chungu wa zaidi ya kikundi kimoja cha tezi za [[limfu]] (ila katika sehemu za uzazi) kwa zaidi ya miezi 3 hadi 6.<ref name=M121/> Ingawa watu wengi walioambukizwa [[VVU-1]] wana kiwango cha virusi kinachoweza kutambulika, na ambacho bila matibabu kitaendelea na kuwa UKIMWI, idadi ndogo (5%) huwa na kiwango kikubwa cha seli za CD4<SUP>+</SUP>([[seli saidizi za T]]) bila [[Udhibiti wa VVU/UKIMWI|matibabu ya kudhibiti virusi]] kwa zaidi ya miaka 5. <ref name=M118/><ref name=LT2010/>Watu hao huainishwa kama wadhibiti wa VVU au watu wasioendeleza kwa muda mrefu, ilhali wale ambao pia hudumisha kiwango cha chini au kisichotambulika cha virusi bila matibabu hujulikana kama "wadhibiti hodari" au "wagandamizaji hodari" <ref name=LT2010>{{cite journal|last=Blankson|first=JN|title=Control of HIV-1 replication in elite suppressors|journal=Discovery medicine|date=2010 Mar|volume=9|issue=46|pages=261–6|pmid=20350494}}</ref>. === Ukosefu wa Kinga Mwilini=== [[File:Symptoms of AIDS.svg|thumb|275px|alt=Mchoro wa kiwiliwili cha binadamu kinachoonyesha dalili zinazotokea mara nyingi za maambukizi makali ya UKIMWI|Dalili kuu za maambukizi makali ya UKIMWI.]] Ukosefu wa Kinga Mwilini (UKIMWI) hufasiliwa kwa msingi wa kiwango cha seli za CD4 <SUP>+</SUP> cha chini ya seli 200 kwa kila µL au kutokea kwa magonjwa maalumu yanayohusiana na maambukizi ya VVU. <ref name=M118/> Bila matibabu maalum, takriban nusu ya watu walioambukizwa VVU hupata UKIMWI katika muda wa miaka 10.<ref name=M118/>Hali zinazotokea mara nyingi zaidi kudhihirisha uwepo wa UKIMWI ni [[numonia ya numosistisi]] (40%), [[kakeksi]] kwa muundo wa dalili dhoofishi za VVU (20%) na [[kandidiasi ya umio]].<ref name=M118/>Dalili nyingine ni pamoja na maambukizi ya [[njia ya pumzi]]<ref name=M118/>. [[Maambukizi nyemelezi]] yanaweza kusababishwa na [[bakteria]], [[virusi]], [[kuvu]] na [[vimelea]] ambavyo kwa kawaida hudhibitiwa na mfumo wa kingamwili.<ref name=Holmes>{{Rejea jarida|author=Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA|title= Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa|url=https://archive.org/details/sim_clinical-infectious-diseases_2003-03-01_36_5/page/656|journal=Clin. Infect. Dis.|year=2003|pages=656–662|volume=36|issue=5|pmid=12594648|doi=10.1086/367655}}</ref>Maambukizi yanayotokea hutegemea, kwa upande mmoja, aina ya [[viumbehai]] vinavyopatikana kwa wingi katika [[mazingira]] ya mtu.<ref name=M118/>Maambukizi hayo yanaweza kudhuru karibu kila [[mfumo wa kibayolojia|mfumo wa viungo]].<ref name=Complications2011>{{cite journal|last=Chu|first=C|coauthors=Selwyn, PA|title=Complications of HIV infection: a systems-based approach|url=https://archive.org/details/sim_american-family-physician_2011-02-15_83_4/page/395|journal=American family physician|date=2011-02-15|volume=83|issue=4|pages=395–406|pmid=21322514}}</ref> Watu walio na UKIMWI wako katika hatari kuu zaidi ya kupata saratani nyingi zinazosababishwa na virusi, kama vile: [[Sakoma ya Kaposi]], [[limfoma ya Burkitt]], [[limfoma ya mfumo mkuu wa neva]] na [[saratani ya seviksi]].<ref name=Deut2010/>Sakoma ya Kaposi ndiyo saratani inayotokea mara nyingi, yaani katika asilimia 10 hadi 20 ya watu wenye VVU.<ref name=M169>Mandell, Bennett, and Dolan (2010). Chapter 118.</ref>Saratani inayoifuata ni limfoma, ambayo imesababisha vifo vya karibu 16% ya watu wanaoishi na UKIMWI, na ndiyo dalili ya kwanza ya UKIMWI katika asilimia 3 - 4 ya watu.<ref name=M169/>Saratani hizi mbili huhusishwa na [[virusi vya hepesi]] ya binadamu aina ya 8.<ref name=M169/>Saratani ya seviksi hutokea mara nyingi zaidi katika watu walio na UKIMWI kwa sababu ya jinsi inavyohusiana na [[virusi vya papiloma ya binadamu]].<ref name=M169/> Isitoshe, watu hao mara nyingi huwa na dalili za kimfumo, kama vile homa ya muda mrefu, [[jasho la usiku|jasho]] (hasa usiku), tezi za limfu zilizofura, ubaridi, udhaifu na [[kupoteza uzito]].<ref>{{cite web|title=AIDS|url=http://www.nlm.nih.gov/medlineplus/ency/article/000594.htm|work=MedlinePlus|publisher=A.D.A.M.|accessdate=14 June 2012}}</ref>Kuharisha ni dalili nyingine inayotokea katika takriban 90% ya watu wenye UKIMWI.<ref>{{cite journal|author=Sestak K |title=Chronic diarrhea and AIDS: insights into studies with non-human primates |journal=Curr. HIV Res. |volume=3 |issue=3 |pages=199–205 |year=2005 |month=July |pmid=16022653 |doi= 10.2174/1570162054368084|url=}}</ref> ==Utambuzi== [[File:Hiv-timecourse.png|thumb|alt=Grafu iliyo na mistari miwili. Mstari wa buluu unapanda kuelekea kulia kisha kushuka kuelekea kushoto huku ukipanda kidogo katikati. Mstari wa pili mwekundu unapanda kutoka sufuri hadi juu sana, kisha kushuka hadi chini halafu kupanda pole pole hadi juu tena |300px| Grafu ya ujumla ya uhusiano wa nakala za VVU (wingi wa virusi) na viwango vya seli za CD4<SUP>+</SUP> T katika wastani wa kipindi cha maambukizi yasiyotibiwa ya VVU.{{legend-line|blue solid 2px|CD4⁺ T Lymphocyte count (cells/mm³)}} {{legend-line|red solid 2px|HIV RNA copies per mL of plasma}}]] VVU hutambuliwa kupitia uchunguzi wa kimaabara kisha kuainishwa kiawamu kwa msingi wa uwepo wa dalili au ishara fulani.<ref name=WHOCase2007/> Watu walio katika hatari kubwa ya kuambukizwa hupendekezwa kupimwa VVU, ikiwa ni pamoja na mtu yeyote aliye na ugonjwa wa zinaa<ref name=Deut2010/> Katika maeneo mengi ya ulimwengu, 1/3 ya watu wenye VVU hutambua kuwa wameambukizwa katika awamu za mwishoni mwa ugonjwa huu wakati UKIMWI au ukosefu mkuu wa kingamwili umekuwa wazi.<ref name=Deut2010/> === Uchunguzi wa VVU === Watu wengi walioambukizwa VVU huzalisha [[zindiko]] maalum (yaani [[uzalishaji zindiko mpya|kuzalisha zindiko mpya]]) katika wiki 3 hadi 12 tangu maambukizi ya kwanza. <ref name=M118/> Utambuzi wa VVU vya kimsingi hufanywa kabla ya kuzalishwa kwa zindiko mpya kwa kupima [[RNA]] ya VVU au [[antijeni ya P24 #vipimo vya antijeni|antijeni ya p24]].<ref name=M118/> Matokeo chanya yanayopatikana kwa kupima [[msururu wa athari za polima|MAP]] au zindiko huthibitishwa kwa zindiko au MAP tofauti.<ref name=WHOCase2007/> Vipimo vya zindiko kwa watoto wa umri wa chini ya miezi 18&nbsp; kwa kawaida huwa kasoro kwa sababu ya uwepo endelevu wa [[Kingamwili Kimya ya Mama#Kingamwili kimya iliyopokezwa kiasilia|zindiko za mama]].<ref name=ChildDiag2010>{{cite journal|last=Kellerman|first=S|coauthors=Essajee, S|title=HIV testing for children in resource-limited settings: what are we waiting for?|journal=PLoS medicine|date=2010 Jul 20|volume=7|issue=7|pages=e1000285|pmid=20652012|doi=10.1371/journal.pmed.1000285|pmc=2907270}}</ref> Kwa hivyo, maambukizi yanaweza kutambulika tu kwa vipimo vya MAP vya VVU, RNA au DNA, au kupitia kupima uwepo wa antijeni ya p24.<ref name=WHOCase2007/>Sehemu kubwa ya ulimwengu haina uwezo wa kupata vipimo bora vya MAP huku watu wa sehemu nyingi wakisubiri hadi dalili za watoto wao kuendelea au watoto hao kukua hadi kuwa na uwezo wa kupimwa kikamilifu.<ref name=ChildDiag2010/> Kufikia mwaka wa 2007-2009 katika eneo la Kusini mwa Jangwa la Sahara, kati ya asilimia 30-70 ya watu walikuwa wakifahamu hali yao ya VVU.<ref name=UN2011Eighty>UNAIDS 2011 pg. 70–80</ref> Mnamo mwaka wa 2009, kati ya asilimia 4-42 ya watu hawa walipimwa. <ref name=UN2011Eighty/> Takwimu hizi zinaonyesha ongezeko kubwa kutoka miaka ya awali.<ref name=UN2011Eighty/> ===Uainishaji wa maambukizi ya VVU=== Mifumo miwili mikuu ya uainishaji hutumika kuainisha VVU na magonjwa husika kwa ajili ya [[uchunguzi wa magonjwa|uchunguzi]]: mfumo wa uainishaji wa magonjwa wa [[Shirika la Afya Duniani]],<ref name=WHOCase2007/> na [[mfumo wa VKM]] wa uainishaji wa maambukizi ya VVU.<ref name=CDCCase2008/> The [[Vituo vya Kukinga na Kudhibiti Magonjwa|VKM]] hutumika zaidi katika mataifa yaliyostawi. Kwa vile mfumo wa uainishaji wa SAD hauhitaji vipimo vya mahabara, mfumo huu ni mwafaka kwa mataifa yanayostawi ambayo kwa kawaida yana upungufu wa vifaa, ambapo unaweza pia kutumika kuongoza udhibiti wa kimatibabu. Ingawa mifumo hii miwili ni tofauti, yote huwezesha ulinganishaji kwa ajili ya malengo ya kitakwimu.<ref name=M121/><ref name=WHOCase2007/><ref name=CDCCase2008/> Shirika la Afya Duniani lilipendekeza ufasili wa UKIMWI mara ya kwanza mwaka wa 1986.<ref name=WHOCase2007/> Tangu hapo, ufasili wa Shirika hili umedurusiwa na kurefushwa mara kadhaa, toleo la hivi karibuni likiwa la mwaka wa 2007. <ref name=WHOCase2007>{{cite book|title=WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children.|pages=6–16|url=http://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf|format=PDF|year=2007|publisher=World Health Organization|location=Geneva|isbn=978-92-4-159562-9}}</ref> Mfumo wa SAD hutumia vikundi vifuatavyo: * Maambukizi ya kimsingi ya VVU: Yanaweza kuwa bila dalili au yakihusishwa na sindromu kali ya retrovirusi. <ref name=WHOCase2007/> * Awamu ya I: Maambikizi ya VVU huwa [[bila dalili]] yakiwa na kiwango cha seli za CD4<SUP>+</SUP> T (ambacho pia huitwa kiwango cha CD4) cha zaidi ya 500/uL.<ref name=WHOCase2007/> Maambukizi haya yanaweza kujumuisha kuvimba kwa tezi za mwili wote.<ref name=WHOCase2007/> * Awamu ya II: Dalili ndogo zinaweza kuhusisha kiwango cha chini cha kudhihirika kwa [[tando za ute|za tando za ute]] na maambukizi yanayorejea ya [[sehemu ya juu ya njia ya pumzi]]. Kiwango cha seli za CD4 cha chini ya 500/uL..<ref name=WHOCase2007/> *Awamu ya III: Dalili kuu zinazoweza kujumuisha hali ya [[kuharisha]][[ya muda mrefu (kimatibabu)|ya muda mrefu]] isiyo na kisababishi maalum kwa zaidi ya mwezi mmoja, maambukizi makali ya bakteria ikiwa ni pamoja na tiibii ya mapafu na pia kiwango cha seli za CD4 cha chini ya 350/uL. <ref name=WHOCase2007/> *Awamu ya IV ya UKIMWI: dalili kali zinazojumuisha [[toksoplasmosi]] ya ubongo, [[ukungu]] wa [[umio]], [[Vetebra ya trakea|trakea]], [[bronkasi| bronkasi]] au [[mapafu]] na [[sakoma ya Kaposi]]. Kiwango cha seli za CD4 cha chini ya 500/uL..<ref name=WHOCase2007/> Kituo cha Kukinga na Kudhibiti Magonjwa cha Marekani pia kilianzisha mfumo wa uainishaji wa VVU, kilichoudurusu mwaka wa 2008.<ref name=CDCCase2008>{{cite journal|last=Schneider|first=E|coauthors=Whitmore, S; Glynn, KM; Dominguez, K; Mitsch, A; McKenna, MT; Centers for Disease Control and Prevention, (CDC)|title=Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years--United States, 2008|journal=MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control|date=2008-12-05|volume=57|issue=RR–10|pages=1–12|pmid=19052530}}</ref> Katika mfumo huu, maambukizi ya VVU yameainishwa kulingana na kiwango cha CD4 na dalili za kiutambuzi, <ref name=CDCCase2008/> nayo hueleza maambukizi kwa awamu tatu: *Awamu ya 1: Kiwango cha CD4 cha seli ≥ 500&nbsp;/uL na hakuna hali zinazoashiria UKIMWI *Awamu ya 2: Kiwango cha seli za CD4 200 hadi 500&nbsp;/uL na hakuna hali zinazoashiria UKIMWI *Awamu ya 3: Kiwango cha seli za CD4≤ 200&nbsp;cells/uL au hali zinazoashiria UKIMWI. *Tashwishi: iwapo habari iliyopo haitoshi kufanya uainishaji uliopo juu Kwa sababu za kiuchunguzi, utambuzi wa UKIMWI hubakia iwapo baada ya matibabu kiwango cha seli za CD4<SUP>+</SUP> T kitapanda zaidi ya 200 kwa kila µL ya damu au iwapo maradhi mengine yanayoashiria UKIMWI yataponywa.<ref name="M121"/> == Matibabu == Hakuna tiba au [[chanjo dhidi ya VVU|chanjo]]; hata hivyo, matibabu ya kudhibiti [[virusi]] yanaweza kupunguza mwendo wa ugonjwa huu na huenda yakapelekea [[urefu]] wa [[maisha]] kuwa karibu na kawaida. Ingawa [[matibabu]] ya kupunguza makali hupunguza hatari ya kifo na matatizo yanayotokana na ugonjwa huu, matibabu haya ni ya bei ghali, hivyo yanaweza kuhusishwa na madhara mbadala. Kuna dawa za kusaidia watu wenye UKIMWI. Hizi zinaitwa ''dawa za kurefusha maisha''. Dawa za kurefusha maisha haziwezi kutibu UKIMWI. Hii ina maana kwamba haziwezi kufanya virusi vyote kuondoka mwili wa mtu. Lakini zinaweza kuwasaidia watu kupambana na virusi vya UKIMWI kwa mifumo yao ya kinga kufanya kazi vizuri zaidi. Hivyo dawa za kurefusha maisha si tiba kabili kwa virusi ya UKIMWI. Watu wenye VVU/UKIMWI ambao huchukua dawa za kurefusha maisha wanaweza kuishi muda mrefu, bila kupata maradhi yanayothibitisha UKIMWI. Lakini baada ya muda mrefu, virusi za HIV zisizouawa na dawa hizo hujifunza jinsi ya kupambana nazo na hivyo zinakuwa ''sugu'' kwa dawa hizo. Wakati mwingine VVU ni sugu kwa dawa moja, lakini dawa nyingine inaweza kutumika. Ili kupunguza uwezekano wa upinzani kutokea, watu wenye UKIMWI huchukua dawa zaidi ya moja kwa wakati mmoja. Wanaweza kuchukua madawa 2-4 kwa mara moja. Hii wakati mwingine inaitwa ''cocktail'' ya UKIMWI. Lakini baada ya muda mrefu, VVU kujifunza kuwa sugu kwa dawa nyingi. Hapo hakuna zaidi ya kuwatibu. Hivyo [[wanasayansi]] kuendelea kujaribu kupata dawa mpya ya kupambana na VVU. Dawa [[tano]] muhimu za wenye VVU ni: * D4T (stavudine) * 3TC (Lamivudine) * NVP (nevirapine) * AZT (zidovudine) * EFZ (efavirenz) Bila dawa hizo, kwa kawaida mtu mwenye VVU anaweza akaishi miaka 9-11. Utafiti wa kuboresha matibabu ya kisasa unajumuisha kupunguza madhara ya ziada ya dawa zilizopo, kurahisisha kanuni za kutumia dawa na kuboresha ubora na kuamua utaratibu bora wa kanuni ili kudhibiti ukinzani wa dawa. Hata hivyo, chanjo pekee ndiyo inayodhaniwa kuweza kusitisha janga hili. Hii ni kwa sababu chanjo ni ya bei nafuu, hivyo [[Taifa linalostawi|mataifa yanayostawi]] yanaweza kuimudu, na haitahitaji matibabu ya kila siku.<ref name=Ferrantelli>{{cite journal|author=Ferrantelli F, Cafaro A, Ensoli B |title=Nonstructural HIV proteins as targets for prophylactic or therapeutic vaccine|journal=Curr. Opin. Biotechnol. |volume=15 |issue=6 |pages=543–56|year=2004|month=December|pmid=15560981 |doi=10.1016/j.copbio.2004.10.008}}</ref> Hata hivyo, baada ya miaka 20 ya utafiti, imekuwa vigumu kupata chanjo dhidi ya VVU-1,<ref name=Ferrantelli/><ref>{{Rejea jarida|author=Karlsson Hedestam GB, Fouchier RA, Phogat S, Burton DR, Sodroski J, Wyatt RT |title=The challenges of eliciting neutralizing antibodies to HIV-1 and to influenza virus |journal=Nat. Rev. Microbiol. |volume=6 |issue=2 |pages=143–55 |year=2008|month=February |pmid=18197170 |doi=10.1038/nrmicro1819}}</ref> hivyo tiba bado haijapatikana. === Upandikizaji seli kuu=== Mwaka wa 2007, Timothy Ray Brown,<ref name=ghivberlin>{{cite news|title=German HIV patient cured after stem cell transplant|url=http://www.belfasttelegraph.co.uk/news/world-news/german-hiv-patient-cured-after-stem-cell-transplant-15030473.html|accessdate=December 15, 2010|newspaper=[[Belfast Telegraph]]|date=December 15, 2010}}</ref> mwanaume wa umri wa miaka 40 aliyekuwa na VVU, pia anayejulikana kama "the Berlin Patient" alipewa huduma ya [[upandikizaji seli kuu za damu|pandikizo la seli kuu]] kama mojawapo ya matibabu ya [[lukemia sugu ya mieloidi]] (LSM).<ref name = Blood>{{cite journal|last=Allers|first=K|coauthors=Hütter, G; Hofmann, J; Loddenkemper, C; Rieger, K; Thiel, E; Schneider, T|title=Evidence for the cure of HIV infection by CCR5Δ32/Δ32 stem cell transplantation|journal=Blood|date=2011-03-10|volume=117|issue=10|pages=2791–9|pmid=21148083|doi=10.1182/blood-2010-09-309591}}</ref>Pandikizo la pili lilifanyika mwaka uliofuata baada ya kuugua tena. Mfadhili alichanguliwa sio tu kwa kuwa ana [[antijeni ya leukositi ya binadamu|upatanifu wa kijeni]] lakini pia kwa kuwa alikuwa na [[utangamano]] wa kubadilika kwa [[CCR5-Δ32]] ambayo huwezesha ukinzani dhidi ya maambukizi ya VVU.<ref name="Wall Street Journal 2008">{{cite news | author=Mark Schoofs | title=A Doctor, a Mutation and a Potential Cure for AIDS | url=http://online.wsj.com/article/SB122602394113507555.html | accessdate=2008-11-09|publisher=The Wall Street Journal| date=November 7, 2008}}</ref><ref name=Huetter2009>{{cite journal |author=Hütter G, Nowak D, Mossner M, Ganepola S, Ganepola A, Allers K, Schneider T, Hofmann J, Kücherer C, Blau O, Blau IW, Hofmann WK, Thiel E |title=Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation |journal=N Engl J Med |volume=360 |issue=7 |pages=692–698 |year=2009 |pmid=19213682 |doi=10.1056/NEJMoa0802905 |url=http://content.nejm.org/cgi/content/abstract/360/7/692 |accessdate=2009-03-31 |archive-date=2009-02-13 |archive-url=https://web.archive.org/web/20090213112056/http://content.nejm.org/cgi/content/abstract/360/7/692 |dead-url=yes }}</ref> Baada ya miezi 20 bila matibabu ya dawa za kudhibiti VVU, iliripotiwa kuwa viwango vya VVU kwenye damu ya Brown [[uboho]] na matumbo vilikuwa chini ya kiwango cha kutambulika.<ref name=Huetter2009/>Virusi hivi vilibakia katika kiwango hicho kwa miaka mitatu baada ya upandikizo wa kwanza.<ref name=Blood/>Ingawa watafiti na baadhi ya wachambuzi wanasema kuwa matokeo haya ni tiba, wengine wao wanadokeza kuwa virusi hivi vinaweza kuwa vimejificha ndani ya tishu<ref name=NEJMLevy/>kama vile ubongo (unaotumika kama [[ufiche wa virusi|hifadhi]]).<ref>{{cite journal|last=Nath|first=A|coauthors=Clements, JE|title=Eradication of HIV from the brain: reasons for pause|journal=AIDS (London, England)|date=2011-03-13|volume=25|issue=5|pages=577–80|pmid=21160414|doi=10.1097/QAD.0b013e3283437d2f}}(subscription required)</ref> Matibabu ya seli kuu yamebakia chini ya [[utafiti wa kiafya |kuchunguzwa]] kwa sababu ya asili yake ya [[ushahidi wa kinadharia|kinadharia]], ugonjwa wenywe na hatari ya kufa inayohusishwa na upandikizaji wa seli kuu na ugumu wa kupata wafadhili mwafaka.<ref name=NEJMLevy>{{cite journal |author=Levy JA |title=Not an HIV Cure, but Encouraging New Directions |journal=N Engl J Med |volume=360 |issue=7 |pages=724–725 |year=2009 |doi=10.1056/NEJMe0810248 |url=http://content.nejm.org/cgi/content/full/360/7/724 |accessdate=2009-03-31 |pmid=19213687 |archive-date=2009-02-15 |archive-url=https://web.archive.org/web/20090215235206/http://content.nejm.org/cgi/content/full/360/7/724 |dead-url=yes }}</ref><ref>{{Cite pmid|21331536}}(subscription required)</ref> === Matibabu ya kuboresha kingamwili === Matibabu saidizi za kudhibiti uigaji wa virusi, [[matibabu ya kingamwili,|matibabu ya kingamwili]] zinazoweza kusaidia kuboresha mfumo wa kingamwili zilizochunguzwa awali, na juhudi zinazoendelea ni pamoja na [[Interleukin-2|IL-2]] na [[Interleukin-7|IL-7]].<ref name="Tincati-2009">{{cite journal|last=Tincati|first=C|coauthors=d'Arminio Monforte, A; Marchetti, G|title=Immunological mechanisms of interleukin-2 (IL-2) treatment in HIV/AIDS disease|journal=Current molecular pharmacology|date=2009 Jan|volume=2|issue=1|pages=40–5|pmid=20021444|doi=10.2174/1874467210902010040}}</ref> Kutofaulu kwa chanjo kadhaa kukinga dhidi ya maambukizi ya VVU na kuendelea kwa UKIMWI kumepelekea mwelekeo mpya wa kuzingatia taratibu za kibayolojia zinazosababisha ufiche wa VVU. Kipindi kifupi cha matibabu ya kuunganisha dawa za kudhibiti VVU na dawa zinazolenga hifadhi fiche siku moja kinaweza kutokomeza maambukizi ya VVU.<ref name =Bowman>{{cite journal | author=Bowman MC, Archin NM, Margolis DM. | title=Pharmaceutical approaches to eradication of persistent HIV infection | journal=Expert Reviews in Molecular Medicine |year=2009| volume=11 | issue=e6 | pmid=19208267 |doi=10.1017/S1462399409000970 | pages=e6 }}</ref>Watafiti wamegundua [[abusaimu]] inayoweza kuharibu eneo la kufungia protini ya [[gp120]] CD4. Protini hii hupatikana katika aina zote za VVU kwa sababu ndiyo ncha ambapo [[seli za B|limfosaiti za B]] hujishikisha kisha kuafikiana kwa mfumo wa kingamwili.<ref>{{Rejea jarida|author=Planque S, Nishiyama Y, Taguchi H, Salas M, Hanson C, Paul S |title=Catalytic antibodies to HIV: Physiological role and potential clinical utility |journal=Autoimmun Rev |volume=7 |issue=6 |pages=473–9 |year=2008 |month=June|pmid=18558365|doi=10.1016/j.autrev.2008.04.002 |url= |pmc=2527403}}</ref> == Njia za kujikinga na UKIMWI == [[Picha: Red Ribbon.svg|thumb|haki|Utepe mwekundu, ishara ya mapambano dhidi ya UKIMWI.]] [[File:AIDS Clinic, McLeod Ganj, 2010.jpg|thumb|alt=Onyesho la jumba la ghorofa mbili lililo na mabango kadhaa yanayohusiana na kuzuia UKIMWI |Matibabu ya UKIMWI, [[McLeod Ganj]], Himachel Pradesh, India, 2010]] Kuna njia nyingi za watu kupambana na [[janga]] hilo. Kuzuia maambukizi ya VVU, hasa kupitia [[kondomu]] na miradi ya kubadilishabadilisha sindano, ni mikakati mikuu inayotumika kudhibiti kuenea kwa ugonjwa huu. Lakini wengine wanahoji kwamba bila kubadili tabia, [[teknolojia]] peke yake haitaweza kushinda ugonjwa huo<ref>https://c-fam.org/friday_fax/global-south-revolts-against-western-sexual-agenda-at-world-health-assembly/?inf_contact_key=48abd2d5d654a153dbafe6d92d8d5d08842e902fbefb79ab9abae13bfcb46658</ref>. === Chanjo === Njia bora ya kuzuia VVU ni wazo la kuwa na [[chanjo]]. Wanasayansi wengi wanatafuta [[chanjo ya VVU]] ili kuokoa [[uhai]] wa mamilioni ya watu, lakini kufikia mwaka [[2012]], hakuna chanjo mwafaka dhidi ya VVU/UKIMWI.<ref>{{cite news|title=The quest for an HIV vaccine|url=http://www.unaids.org/en/resources/presscentre/featurestories/2012/may/20120518vaccinesday/|date=May 18, 2012|author=UNAIDS|accessdate=2020-03-28|archivedate=2012-05-24|archiveurl=https://web.archive.org/web/20120524051113/http://www.unaids.org/en/resources/presscentre/featurestories/2012/may/20120518vaccinesday/}}</ref>Jaribio moja la chanjo ya [[RV 144]] iliyotolewa mwaka 2009 lilipelekea kupunguza hatari ya kuambukiza kwa takriban 30%, hivyo kuchochea matarajio ya jamii ya utafiti ya kutengeneza chanjo mwafaka zaidi.<ref>{{cite journal|last=Reynell|first=L|coauthors=Trkola, A|title=HIV vaccines: an attainable goal?|journal=Swiss medical weekly|date=2012-03-02|volume=142|pages=w13535|pmid=22389197|doi=10.4414/smw.2012.13535}}</ref> Majaribio zaidi ya chanjo ya RV 144 yanaendelea.<ref>{{cite web| author = U.S. Army Office of the Surgeon General| title = HIV Vaccine Trial in Thai Adults| publisher = ClinicalTrials.gov| date = March 21, 2011| accessdate = June 28, 2011| url =http://clinicaltrials.gov/ct2/show/NCT00223080}}</ref><ref>{{cite web| author = U.S. Army Office of the Surgeon General|title = Follow up of Thai Adult Volunteers With Breakthrough HIV Infection After Participation in a Preventive HIV Vaccine Trial| publisher = ClinicalTrials.gov| date = June 2, 2010| url =http://www.clinicaltrials.gov/ct2/show/NCT00337181}}</ref> ===Kondomu=== Vitendo vya kijinsia ni njia kuu ya kupata VVU. Kama watu wanatumia [[kondomu]] wanapofanya mapenzi, kuna nafasi ndogo zaidi ya kuambukizana VVU, lakini [[ukweli]] kamili ni kwamba hakuna [[ngono salama]] kwa hakika. Matumizi ya [[kondomu]] ya kila mara hupunguza hatari ya kuambukizana UKIMWI kwa takriban 80% katika muda mrefu wa usoni.<ref>{{cite journal|last=Crosby|first=R|coauthors=Bounse, S|title=Condom effectiveness: where are we now?|journal=Sexual health|date=2012 Mar|volume=9|issue=1|pages=10–7|pmid=22348628|doi=10.1071/SH11036}}</ref> Iwapo mwenzi mmoja ameambukizwa, kutumia kondomu kila mara hupelekea viwango vya chini ya 1% kwa mwaka vya huyo mwingine kuambukizwa.<ref name=WHOCondoms>{{cite web| publisher=[[World Health Organization|WHO]]| month=August |year=2003|url=http://www.wpro.who.int/mediacentre/factsheets/fs_200308_Condoms/en/index.html | title=Condom Facts and Figures|accessdate=January 17, 2006 }}</ref> Kuna ushahidi mdogo unaoonyesha kuwa [[kondomu za wanawake]] una kiwango sawa cha kinga.<ref>{{cite journal|last=Gallo|first=MF|coauthors=Kilbourne-Brook, M; Coffey, PS|title=A review of the effectiveness and acceptability of the female condom for dual protection|journal=Sexual health|date=2012 Mar|volume=9|issue=1|pages=18–26|pmid=22348629|doi=10.1071/SH11037}}</ref> ===Dawa za ukeni=== Kutumia mafuta ya ukeni yanaliyo na [[tenofovir]] muda mfupi kabla ya ngono hukisiwa kupunguza viwango vya maambukizi kwa takriban 40% miongoni mwa wanawake wa Kiafrika.<ref name=VagGel2012>{{cite journal|last=Celum|first=C|coauthors=Baeten, JM|title=Tenofovir-based pre-exposure prophylaxis for HIV prevention: evolving evidence|journal=Current opinion in infectious diseases|date=2012 Feb|volume=25|issue=1|pages=51–7|pmid=22156901|doi=10.1097/QCO.0b013e32834ef5ef|pmc=3266126}}</ref> Kinyume na hili, matumizi ya [[spemisidi]] [[nonoxynol-9]] yanaweza kuongeza hatari ya kuambukizwa kwa sababu ya uwezo wake wa kuleta mwasho wa uke na [[rektamu]].<ref>{{cite journal|last=Baptista|first=M|coauthors=Ramalho-Santos, J|title=Spermicides, microbicides and antiviral agents: recent advances in the development of novel multi-functional compounds|journal=Mini reviews in medicinal chemistry|date=2009-11-01|volume=9|issue=13|pages=1556–67|pmid=20205637|doi=10.2174/138955709790361548}}</ref> ===Tohara=== [[Tohara]] katika eneo la [[Kusini kwa Sahara]] "hupunguza uambukizaji wa VVU katika wanaume wanaohusiana na wanawake kimapenzi kwa kati ya 38% na 66% kwa muda wa miezi 24". <ref>{{cite journal|last=Siegfried|first=N|coauthors=Muller, M; Deeks, JJ; Volmink, J|title=Male circumcision for prevention of heterosexual acquisition of HIV in men|journal=Cochrane database of systematic reviews (Online)|date=2009-04-15|issue=2|pages=CD003362|pmid=19370585|doi=10.1002/14651858.CD003362.pub2|editor1-last=Siegfried|editor1-first=Nandi}}</ref> Kwa msingi wa tafiti hizi, mashirika ya SAD na UNAIDS yalipendekeza tohara kama mbinu ya kuzuia uambukizaji VVU kutoka kwa mwanamke hadi mwanamume mwaka 2007.<ref>{{cite web |title=WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention |publisher=World Health Organization |date=Mar 28, 2007 |url=http://www.who.int/mediacentre/news/releases/2007/pr10/en/index.html |accessdate=2020-03-28 |archivedate=2011-07-03 |archiveurl=https://web.archive.org/web/20110703140439/http://www.who.int/mediacentre/news/releases/2007/pr10/en/index.html }}</ref> Haijabainika wazi iwapo njia hii huzuia uambukizaji kutoka kwa mwanamume hadi mwanamke<ref>{{cite journal|last=Larke|first=N|title=Male circumcision, HIV and sexually transmitted infections: a review|url=https://archive.org/details/sim_british-journal-of-nursing_2010-05-27_19_10/page/n11|journal=British journal of nursing (Mark Allen Publishing)|date=2010 May 27 – Jun 9|volume=19|issue=10|pages=629–34|pmid=20622758}}</ref><ref>{{cite journal|last=Eaton|first=L|coauthors=Kalichman, SC|title=Behavioral aspects of male circumcision for the prevention of HIV infection|journal=Current HIV/AIDS reports|date=2009 Nov|volume=6|issue=4|pages=187–93|pmid=19849961|doi=10.1007/s11904-009-0025-9}}(subscription required)</ref> na iwapo mbinu hii ina manufaa katika [[mataifa yaliyostawi]] na haijabainika miongoni mwa mashoga.<ref>{{cite journal|last=Kim|first=HH|coauthors=Li, PS, Goldstein, M|title=Male circumcision: Africa and beyond?|journal=Current opinion in urology|date=2010 Nov|volume=20|issue=6|pages=515–9|pmid=20844437|doi=10.1097/MOU.0b013e32833f1b21}}</ref><ref>{{cite journal|last=Templeton|first=DJ|coauthors=Millett, GA, Grulich, AE|title=Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men|journal=Current opinion in infectious diseases|date=2010 Feb|volume=23|issue=1|pages=45–52|pmid=19935420|doi=10.1097/QCO.0b013e328334e54d}}</ref><ref>{{Rejea jarida | last1 = Wiysonge | first1 = CS. | last2 = Kongnyuy | first2 = EJ. | last3 = Shey | first3 = M. | last4 = Muula | first4 = AS.|last5 = Navti | first5 = OB. | last6 = Akl | first6 = EA. | last7 = Lo | first7 = YR. | title = Male circumcision for prevention of homosexual acquisition of HIV in men | journal = Cochrane Database Syst Rev |volume = | issue = 6 | pages = CD007496 | month = | year = 2011 | doi = 10.1002/14651858.CD007496.pub2 | pmid = 21678366 | editor1-last = Wiysonge |editor1-first = Charles Shey }}</ref> Baadhi ya wataalamu wanahofia kuwa dhana ya kiwango cha chini cha hatari miongoni mwa wanaume waliotahiriwa inaweza kupelekea mienendo hatari zaidi, hivyo wanapinga faida ya mbinu hii katika kukinga.<ref>{{Rejea jarida|author=Eaton LA, Kalichman S |title=Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies |journal=Curr HIV/AIDS Rep |volume=4 |issue=4|pages=165–72 |year=2007|month=December|pmid=18366947|pmc=2937204 |doi=10.1007/s11904-007-0024-7}}</ref> Wanawake waliofanyiwa [[ukeketaji]] wana hatari zaidi ya kuambukizwa.<ref>{{Rejea jarida|author=Utz-Billing I, Kentenich H|title=Female genital mutilation: an injury, physical and mental harm |journal=J Psychosom Obstet Gynaecol|volume=29|issue=4 |pages=225–9|year=2008 |month=December |pmid=19065392 |doi=10.1080/01674820802547087 |url=}}</ref> ===Mawaidha na elimu=== Njia muhimu ya kuzuia VVU/UKIMWI ni [[elimu]] kwa kuwa hiyo inawezesha kuelewa maana ya [[jinsia]] na kukwepa sababu za maambukizi yake. Ni kwamba watu wanaweza kupata VVU kutokana na [[ngono]] na kutokana na [[damu]]. Watoto wanaweza pia kupata VVU kutoka kwa [[mama]] zao (wakati wa kukua ndani ya akina mama wajawazito na wakati wa kunyonya [[maziwa]] ya mama.) Kuna baadhi ya watu ambao hawataki watu wajue kuhusu kondomu na sindano safi, au hawataki wawe na kondomu au sindano safi. Hao wanaamini kuwa watu wakijua kuhusu kondomu na kuwa na kondomu watafanya ngono zaidi na hivyo kuzidisha maambukizi badala ya kuyapunguza kwa sababu kinga hiyo si madhubuti. Vilevile wanaamini kuwa watu wakiwa na sindano safi watatumia dawa za kulevya zaidi. Wengi wa wanaodhani hivyo ni pia kwa sababu ya [[dini]] zao kukataza [[uzinifu]] na [[ulevi]] kama tabia zinazoharibu binadamu binafsi na jamii kwa jumla. Hao huhimiza [[upendo]] na [[uaminifu]] katika [[ndoa]], [[usafi wa moyo]] na utunzaji wa afya. Miradi inayohimiza [[kujinyima ngono]] haijatambulika inaathiri vipi hatari ya kupata VVU.<ref>{{cite journal |author= Underhill K, Operario D, Montgomery P |title= Abstinence-only programs for HIV infection prevention in high-income countries |journal=Cochrane Database of Systematic Reviews |issue=4 |pages= CD005421|year=2008|pmid= 17943855|doi=10.1002/14651858.CD005421.pub2|url=http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD005421/frame.html|editor1-last= Operario|editor1-first= Don}}</ref> Ushahidi wa manufaa ya [[elimu ya rika]] pia hautoshi.<ref>{{cite journal|last=Tolli|first=MV|title=Effectiveness of peer education interventions for HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people: a systematic review of European studies|journal=Health education research|date=2012-05-28|pmid=22641791|doi=10.1093/her/cys055}}</ref> [[Elimu ya ngono]] inayotolewa [[Shule|shuleni]] inaweza kupunguza mitindo hatari,<ref>{{cite journal|last=Ljubojević|first=S|coauthors=Lipozenčić, J|title=Sexually transmitted infections and adolescence|journal=Acta dermatovenerologica Croatica : ADC|year=2010|volume=18|issue=4|pages=305–10|pmid=21251451}}</ref> lakini inaweza pia kuchochea wanafunzi wakajaribu wenyewe ngono. [[Vijana]] wengi wanajihusisha katika vitendo hatari licha ya kufahamu kuhusu VVU/UKIMWI, huku wakipuuza hatari ya kuambukizwa.<ref name="Patel2008">{{Rejea jarida| author=Patel VL, Yoskowitz NA, Kaufman DR, Shortliffe EH | title=Discerning patterns of human immunodeficiency virus risk in healthy young adults | journal=Am J Med | year=2008 | pages=758–764 |volume=121|issue=4 | pmid=18724961 |doi=10.1016/j.amjmed.2008.04.022 | pmc=2597652 }}</ref> ===Dawa kabla ya hatari=== Asilimia 96 ya watu walikingwa dhidi ya maambukizi iwapo wenzi wao walioambukizwa walipata mapema dawa za kudhibiti VVU<ref>National Institute of Allergy and Infectious Diseases (NIAID), [http://www.niaid.nih.gov/news/newsreleases/2011/Pages/HPTN052.aspx "Treating HIV-infected People with Antiretrovirals Protects Partners from Infection"], NIH News, 2011 May</ref><ref>{{cite journal|last=Anglemyer|first=A|coauthors=Rutherford, GW; Baggaley, RC; Egger, M; Siegfried, N|title=Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples|journal=Cochrane database of systematic reviews (Online)|date=2011-08-10|issue=8|pages=CD009153|pmid=21833973|doi=10.1002/14651858.CD009153.pub2|editor1-last=Rutherford|editor1-first=George W}}</ref> Proflaksisi ya kabla ya hatari pamoja na kipimo cha kila siku cha dawa ya [[tenofovir]] (ikiwa na au bila [[emtricitabine]]) ni mwafaka kwa vikundi fulani, ikijumuisha: mashoga, wachumba wa wenye VVU na vijana wa Afrika wanaovutiwa na watu wa jinsia tofauti. <ref name=VagGel2012/> Hadhari za jumla katika mandhari ya utunzaji wa afya zinaaminika kufaulu kupunguza hatari ya VVU.<ref>{{Rejea jarida|title=Recommendations for prevention of HIV transmission in health-care settings|journal=MMWR|volume=36 |issue=Suppl 2 |pages=1S–18S |year=1987|month=August|pmid=3112554|url=http://www.cdc.gov/MMWR/PREVIEW/MMWRHTML/00023587.htm |author1= Centers for Disease Control (CDC)}}</ref> Matumizi ya dawa zinazodungwa mishipani ni kipengele muhimu cha hatari, hivyo mikakati ya [[kupunguza madhara]] kama vile [[miradi ya kubadilisha sindano]] na [[matibabu ya kubadilisha opioidi]] yanaonekana kufaulu kupunguza hatari.<ref name=Kurth2011>{{cite journal|last=Kurth|first=AE|coauthors=Celum, C; Baeten, JM; Vermund, SH; Wasserheit, JN|title=Combination HIV prevention: significance, challenges, and opportunities|journal=Current HIV/AIDS reports|date=2011 Mar|volume=8|issue=1|pages=62–72|pmid=20941553|doi=10.1007/s11904-010-0063-3|pmc=3036787}}</ref> ===Dawa baada ya hatari=== Vipimo vya dawa za kudhibiti VVU zinazotolewa kati ya saa 48 hadi 72 baada ya hatari kwa damu yenye VVU au viowevu vya uzazi hujulikana kama proflaksisi ya baada ya hatari.<ref name=Prevention2012/> Matumizi ya dawa moja ya [[zidovudine]] hupunguza mara tano hatari ya kupata VVU kutokana na jeraha la sindano.<ref name=Prevention2012>{{cite journal |author= |title=HIV exposure through contact with body fluids |journal=Prescrire Int|volume=21 |issue=126 |pages=100–1, 103–5 |year=2012 |month=April |pmid=22515138 |doi= |url= |author1= [No authors listed]}}</ref> Matibabu hupendekezwa baada ya [[ubakaji]] iwapo mshukiwa anatambulika kuwa na VVU lakini yanakumbwa na utata iwapo hali yake haijulikani.<ref name=NEJM2011Sex>{{cite journal|last=Linden|first=JA|title=Clinical practice. Care of the adult patient after sexual assault|url=https://archive.org/details/sim_new-england-journal-of-medicine_2011-09-01_365_9/page/834|journal=The New England Journal of Medicine|date=2011-09-01|volume=365|issue=9|pages=834–41|pmid=21879901|doi=10.1056/NEJMcp1102869}}</ref> Taratibu za matibabu ya sasa hutumia [[lopinavir/ritonavir]] na [[lamivudine/zidovudine]] au [[emtricitabine/tenofovir]] na yanaweza kupunguza hatari zaidi.<ref name=Prevention2012/> Kwa kawaida, muda wa matibabu huwa wiki nne <ref name=CochranePEP2007>{{cite journal|last=Young|first=TN|coauthors=Arens, FJ; Kennedy, GE; Laurie, JW; Rutherford, G|title=Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure|journal=Cochrane database of systematic reviews (Online)|date=2007-01-24|issue=1|pages=CD002835|pmid=17253483|doi=10.1002/14651858.CD002835.pub3|editor1-last=Young|editor1-first=Taryn}}</ref>na mara nyingi huhusishwa na athari kali (zidovudine ikiwa na takriban 70% ya visa, ikijumuisha 24% kichefuchefu, 22% uchovu, 13% mafadhaiko na 9% maumivu ya kichwa.<ref name=AFP2007/> === Kuzuia maambukizi ya mama kwa mtoto === Hatua za kuzuia kusambaza VVU kutoka kwa mama hadi mtoto zinaweza kupunguza kiwango cha maambukizi kwa asilimia 92-99.<ref name=Mother2010>{{cite journal|last=Coutsoudis|first=A|coauthors=Kwaan, L; Thomson, M|title=Prevention of vertical transmission of HIV-1 in resource-limited settings|journal=Expert review of anti-infective therapy|date=2010 Oct|volume=8|issue=10|pages=1163–75|pmid=20954881|doi=10.1586/eri.10.94}}</ref><ref name=Kurth2011/> Kimsingi, hatua hizi hujumuisha kutumia mwungano wa dawa za kudhibiti VVU katika ujauzito na baada ya kuzaa, na pia [[kunywesha kwa chupa]] badala ya [[kunyonyesha]].<ref name=Mother2010/><ref>{{cite journal|last=Siegfried|first=N|coauthors=van der Merwe, L; Brocklehurst, P; Sint, TT|title=Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2011-07-06|issue=7|pages=CD003510|pmid=21735394|doi=10.1002/14651858.CD003510.pub3|editor1-last=Siegfried|editor1-first=Nandi}}</ref>Ikiwa itakubaliwa kulisha, inafaidi, inawezekana kumudu gharama yake, na ni salama, kina mama hawapaswi kuwanyonyesha watoto wao. Hata hivyo, iwapo haiwezekani, kina mama hushauriwa kunyonyesha tu katika miezi ya kwanza.<ref>{{cite web |url=http://www.who.int/hiv/mediacentre/Infantfeedingconsensusstatement.pf.pdf |format=PDF |year=2006 |accessdate=March 12, 2008 |title=WHO HIV and Infant Feeding Technical Consultation Held on behalf of the Inter-agency Task Team (IATT) on Prevention of HIV – Infections in Pregnant Women, Mothers and their Infants –Consensus statement |date=October 25–27, 2006 |archiveurl=https://web.archive.org/web/20080409065845/http://www.who.int/hiv/mediacentre/Infantfeedingconsensusstatement.pf.pdf |archivedate=2008-04-09 |deadurl=no }}</ref> Ikiwa kunyonyesha pekee kutatekelezwa, kumpa mtoto proflaksisi ya kudhibiti VVU kwa muda mrefu zaidi hupunguza hatari ya kuambukizwa.<ref>{{cite journal|last=Horvath|first=T|coauthors=Madi, BC; Iuppa, IM; Kennedy, GE; Rutherford, G; Read, JS|title=Interventions for preventing late postnatal mother-to-child transmission of HIV|journal=Cochrane database of systematic reviews (Online)|date=2009-01-21|issue=1|pages=CD006734|pmid=19160297|doi=10.1002/14651858.CD006734.pub2|editor1-last=Horvath|editor1-first=Tara}}</ref> ===Dawa za kudhibiti virusi === [[File:Abacavir (Ziagen) 300mg.jpg|thumb|alt=Tembe mbili za manjano za umbo la mstatili ambapo mojawapo ya alama za GX623 inaonekana|''[[Abacavir]]'' – kifanani cha nukliosidi kinachozuia kugeuzwa kwa nakala (KNKN)]] Kwa sasa hakuna tiba au [[chanjo ya VVU]] mwafaka. Matibabu hujumuisha dawa tendi za kudhibiti VVU za kiwango cha juu zinazopunguza mwendo wa ugonjwa huu.<ref name=LE2011>{{cite journal|last=May|first=MT|coauthors=Ingle, SM|title=Life expectancy of HIV-positive adults: a review|journal=Sexual health|date=2011 Dec|volume=8|issue=4|pages=526–33|pmid=22127039|doi=10.1071/SH11046}}</ref> Kufikia mwaka 2010, zaidi ya watu milioni 6.6&nbsp; wa nchi za mapato ya chini na ya kati walikuwa wakitumia dawa hizo.<ref name=UN2011Ten/> Matibabu pia huhusisha hatua za kuzuia na kutibu maambukizi nyemelezi. Chaguo za kisasa za KNKN ni michanganyiko ya angalau dawa tatu za angalau aina au "vikundi" viwili vya ajenti za [[dawa za kudhibiti VVU]].<ref name=WHOTx2010Pg19/> Mwanzoni, matibabu kwa kawaida huhusisha kizuizi kisicho cha nukliosidi kinachozuia kugeuzwa kwa nakala (KKNKN) pamoja na vidonge viwili vya kifanani cha nukliosidi kinachozuia kugeuzwa kwa nakala (KNKN).<ref name=WHOTx2010Pg19/> KNKN kwa kawaida hujumuisha: [[zidovudine]] (AZT) au [[tenofovir]] (TDF) na [[lamivudine]] (3TC) au [[emtricitabine]] (FTC).<ref name=WHOTx2010Pg19/> Mwungano wa ajenti zinazojumuisha kizuizi cha protisi (KP) hutumika utaratibu huu ukipoteza utendakazi.<ref name=WHOTx2010Pg19/> Wakati wa kuanzisha matumizi ya dawa za kudhibiti VVU ni mada ambayo ingali inajadiliwa.<ref name=Deut2010/><ref>{{cite journal|last=Sax|first=PE|coauthors=Baden, LR|title=When to start antiretroviral therapy—ready when you are?|journal=The New England Journal of Medicine|date=2009-04-30|volume=360|issue=18|pages=1897–9|pmid=19339713|doi=10.1056/NEJMe0902713}}</ref> Shirika la Afya Duniani, miongozo ya [[Ulaya]] na pia Marekani hupendekeza dawa za kudhibiti VVU kwa vijana waliobalehe, watu wazima na kina mama wajawazito walio na kiwango cha CD4 cha chini ya 350/uL au walio na dalili, bila kuzingatia kiwango chao cha CD4.<ref name=Deut2010/><ref name=WHOTx2010Pg19>{{cite book|title=Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach|year=2010|publisher=World Health Organization|isbn=978-92-4-159976-4|pages=19–20|url=http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf|access-date=2020-03-28|archive-date=2012-07-09|archive-url=https://web.archive.org/web/20120709184257/http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf|url-status=dead}}</ref>Hali hii huwezeshwa na ukweli kwamba kuanzisha matibabu wakati huu hupunguza hatari ya kifo.<ref name=CochraneART2010>{{cite journal|last=Siegfried|first=N|coauthors=Uthman, OA; Rutherford, GW|title=Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults|journal=Cochrane database of systematic reviews (Online)|date=2010-03-17|issue=3|pages=CD008272|pmid=20238364|doi=10.1002/14651858.CD008272.pub2|editor1-last=Siegfried|editor1-first=Nandi}}</ref> Isitoshe, Marekani imependekeza matibabu hayo kwa watu wote wenye VVU bila kuzingatia kiwango cha CD4 au dalili, ingawa inatoa pendekezo hili ikiwahofia watu wenye kiwango cha juu cha CD4.<ref name=Guidelines2009>{{cite book|last=Panel on Antiretroviral Guidelines for Adults and Adolescents|first=|title=Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents|url=http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf|date=2009-12-01|publisher=United States Department of Health and Human Services|page=i|access-date=2020-03-28|archive-date=2009-01-13|archive-url=https://web.archive.org/web/20090113181125/http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf|dead-url=yes}}</ref> Shirika la Afya Duniani pia linapendekeza matibabu kwa watu wenye maambukizi nyongeza ya kifua kikuu na [[hepatitisi B]] tendi ya muda mrefu.<ref name=WHOTx2010Pg19/> Matibabu yanapoanzishwa, inapendekezwa yaendelezwe bila "kupumzika".<ref name=Deut2010/> Watu wengi hutambuliwa punde tu baada ya wakati ambao matibabu yalipaswa kuanzishwa.<ref name=Deut2010/> Katika matibabu, matokeo yanayotarajiwa ni kiwango cha HIV-RNA ya plasma ya muda mrefu cha chini ya nakala 50/mL.<ref name=Deut2010>{{cite journal|last=Vogel|first=M|coauthors=Schwarze-Zander, C; Wasmuth, JC; Spengler, U; Sauerbruch, T; Rockstroh, JK|title=The treatment of patients with HIV|journal=Deutsches Ärzteblatt international|date=2010 Jul|volume=107|issue=28–29|pages=507–15; quiz 516|pmid=20703338|doi=10.3238/arztebl.2010.0507|pmc=2915483}}</ref>Viwango vya kuthibitisha ikiwa matibabu ni mwafaka hupendekezwa kwanza baada ya wiki nne na punde viwango hivi vinaposhuka chini ya nakala 50/mL. Vipimo vya kila baada ya miezi 3-6 kwa kawaida huwa mwafaka.<ref name=Deut2010/> Udhibiti usio mwafaka huchukuliwa kuwa zaidi ya nakala 400/mL.<ref name=Deut2010/> Kulingana na kigezo hiki, matibabu huwa mwafaka kwa zaidi ya 95% ya watu katika mwaka wa kwanza.<ref name=Deut2010/> Manufaa ya matibabu hujumuisha upungufu wa hatari ya kuendelezwa kwa VVU na kupunguka kwa hatari ya kifo.<ref>{{cite journal|last=When To Start|first=Consortium|coauthors=Sterne, JA; May, M; Costagliola, D; de Wolf, F; Phillips, AN; Harris, R; Funk, MJ; Geskus, RB; Gill, J; Dabis, F; Miró, JM; Justice, AC; Ledergerber, B; Fätkenheuer, G; Hogg, RS; Monforte, AD; Saag, M; Smith, C; Staszewski, S; Egger, M; Cole, SR|title=Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies|journal=Lancet|date=2009-04-18|volume=373|issue=9672|pages=1352–63|pmid=19361855|doi=10.1016/S0140-6736(09)60612-7|pmc=2670965}}</ref>Katika mataifa yaliyostawi matibabu pia huboresha afya ya mwili na ya akili.<ref>{{cite journal|last=Beard|first=J|coauthors=Feeley, F; Rosen, S|title=Economic and quality of life outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review|journal=AIDS care|date=2009 Nov|volume=21|issue=11|pages=1343–56|pmid=20024710|doi=10.1080/09540120902889926}}</ref> Matibabu hupelekea kupunguza kwa 70% hatari ya kupata kifua kikuu.<ref name=WHOTx2010Pg19/> Manufaa ya nyongeza hujumuisha upungufu wa hatari ya kusambazwa kwa ugonjwa huu hadi kwa wenzi kingono, na upungufu wa kusambazwa kwa maambukizi kutoka kwa mama hadi mtoto. <ref name=WHOTx2010Pg19/> Ubora wa matibabu hutegemea pakubwa maafikiano.<ref name=Deut2010/> Sababu za kutoafikiana hujumuisha: ufikiaji duni wa huduma za kimatibabu,<ref>{{cite journal|last=Orrell|first=C|title=Antiretroviral adherence in a resource-poor setting|journal=Current HIV/AIDS reports|date=2005 Nov|volume=2|issue=4|pages=171–6|pmid=16343374|doi=10.1007/s11904-005-0012-8}}</ref>huduma duni za kijamii, [[ugonjwa wa akili]] na [[uraibu wa madawa]].<ref>{{cite journal|last=Malta|first=M|coauthors=Strathdee, SA; Magnanini, MM; Bastos, FI|title=Adherence to antiretroviral therapy for human immunodeficiency virus/acquired immune deficiency syndrome among drug users: a systematic review|url=https://archive.org/details/sim_british-journal-of-addiction_2008-08_103_8/page/1242|journal=Addiction (Abingdon, England)|date=2008 Aug|volume=103|issue=8|pages=1242–57|pmid=18855813|doi=10.1111/j.1360-0443.2008.02269.x}}</ref> Isitoshe, utata wa utaratibu wa matibabu (kufuatia idadi ya tembe na idadi ya marudio ya kumeza tembe) na [[athari kali]] zinaweza kusababisha kutoafikiana kwa kimakusudi.<ref>{{cite journal|last=Nachega|first=JB|coauthors=Marconi, VC; van Zyl, GU; Gardner, EM; Preiser, W; Hong, SY; Mills, EJ; Gross, R|title=HIV treatment adherence, drug resistance, virologic failure: evolving concepts|journal=Infectious disorders drug targets|date=2011 Apr|volume=11|issue=2|pages=167–74|pmid=21406048}}</ref>Hata hivyo, viwango vya uafikiano ni sawa katika nchi zinazostawi na zilizostawi<ref>{{cite journal|last=Nachega|first=JB|coauthors=Mills, EJ; Schechter, M|title=Antiretroviral therapy adherence and retention in care in middle-income and low-income countries: current status of knowledge and research priorities|journal=Current opinion in HIV and AIDS|date=2010 Jan|volume=5|issue=1|pages=70–7|pmid=20046150|doi=10.1097/COH.0b013e328333ad61}}</ref> Matukio makuu huhusishwa na ajenti inayotumika.<ref name=Montessori2004/> Baadhi ya visa vinavyotokea mara nyingi hujumuisha: [[lipodistrofi inayohusishwa na VVU|sindromu ya lipodistofi]], [[dislipidemia]] na [[kisukari tamu]] hasa pamoja na vizuizi vya protisi.<ref name=M121/> Dalili zingine zinazotokea mara nyingi hujumuisha: [[kuhara]],<ref name=Montessori2004>{{cite journal| author=Montessori, V., Press, N., Harris, M., Akagi, L., Montaner, J. S. |title=Adverse effects of antiretroviral therapy for HIV infection | journal=CMAJ |year=2004 | pages=229–238 |volume=170 | issue=2 |pmid=14734438 | pmc=315530}}</ref><ref name="Burgoyne2008">{{Rejea jarida|author=Burgoyne RW, Tan DH|title=Prolongation and quality of life for HIV-infected adults treated with highly active antiretroviral therapy (HAART): a balancing act|journal=J. Antimicrob. Chemother. |volume=61 |issue=3 |pages=469–73|year=2008 |month=March|pmid=18174196|doi=10.1093/jac/dkm499</ref> na ongezeko la hatari ya [[ugonjwa wa moyo na mishipa]].<ref>{{cite journal|last=Barbaro|first=G|coauthors=Barbarini, G|title=Human immunodeficiency virus & cardiovascular risk|journal=The Indian journal of medical research|date=2011 Dec|volume=134|issue=6|pages=898–903|pmid=22310821|doi=10.4103/0971-5916.92634|pmc=3284097}}</ref> Hata hivyo, athari kali huwa katika matibabu mapya yaliyopendekezwa.<ref name=Deut2010/> Gharama huenda ikawa tatizo kwani baadhi ya dawa huwa ghali<ref>{{cite journal|last=Orsi|first=F|coauthors=d'almeida, C|title=Soaring antiretroviral prices, TRIPS and TRIPS flexibilities: a burning issue for antiretroviral treatment scale-up in developing countries|journal=Current opinion in HIV and AIDS|date=2010 May|volume=5|issue=3|pages=237–41|pmid=20539080|doi=10.1097/COH.0b013e32833860ba}}</ref>. Hata hivyo, hadi mwaka wa 2010, 47% ya watu waliohitaji dawa hizo walikuwa wakizitumia katika nchi zinazostawi na za mapato ya wastani<ref name=UN2011Ten/> Dawa fulani zinaweza kuhusishwa na [[ulemavu wa kuzaliwa]] hivyo hazifai kutumiwa na wanawake wanaopanga kupata watoto.<ref name=Deut2010/> Matibabu yanayopendekezewa watoto hutofautiana kidogo na ya watu wazima. Katika nchi zinazoendelea, kufikia mwaka wa 2010, 23% ya watoto waliohitaji dawa hizi walikuwa wakizitumia.<ref name=UN2011ONESIXTY>UNAIDS 2011 uk. 150-160</ref> Shirika la Afya Duniani na Marekani inapendekeza matibabu kwa watoto wote wa umri wa chini ya miezi 12.<ref name=USKID2011/><ref name=WHOKID2010>{{cite book|title=Antiretroviral therapy for HIV infection in infants and children|year=2010|publisher=World Health Organization|isbn=978-92-4-159980-1|page=2|url=http://whqlibdoc.who.int/publications/2010/9789241599801_eng.pdf|access-date=2020-03-28|archive-date=2014-02-24|archive-url=https://web.archive.org/web/20140224081130/http://whqlibdoc.who.int/publications/2010/9789241599801_eng.pdf|dead-url=yes}}</ref>Marekani hupendekeza matibabu kwa watoto wa umri wa mwaka 1-5 walio na kiwango cha VVU-RNA cha zaidi ya nakala 100,000&nbsp;/mL na kwa walio zaidi ya miaka mitano watibiwe iwapo kiwango cha CD4 ni chini ya 500/ul.<ref name=USKID2011>{{cite web|title=Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection|url=http://aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf|work=The Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children|format=PDF|date=Aug 11,2011|accessdate=2020-03-28|archivedate=2013-02-16|archiveurl=https://web.archive.org/web/20130216214548/http://www.aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf}}</ref> ===Kuzuia maambukizi nyemelezi=== Mikakati ya kuzuia maambukizi nyemelezi hufaa watu wengi wenye VVU/UKIMWI. Matibabu ya dawa za kudhibiti virusi huboresha na kupunguza hatari ya kupata maambukizi nyemelezi kwa wakati huo na baadaye.<ref name=Montessori2004/>[[Chanjo]] dhidi ya [[hepatitisi]] A na B hupendekezwa kwa watu walio katika hatari ya VVU kabla ya maambukizi, ingawa yanaweza kutolewa baada ya kuambukizwa.<ref name=Laurence>{{Rejea jarida | author=Laurence J | title=Hepatitis A and B virus immunization in HIV-infected persons | journal=AIDS Reader | year=2006 | pages=15–17 | volume=16 | issue=1|pmid=16433468}}</ref> Kinga ya [[Trimethoprim/sulfamethoxazole]] kati ya wiki 4-6 na kukoma kunyonyesha watoto waliozaliwa na mama mwenye VVU hupendekezwa katika sehemu zenye upungufu wa raslimali.<ref name=UN2011ONESIXTY/> Pia inapendekezwa kuzuia PCP kiwango cha CD4 kikiwa chini ya 200&nbsp;/uL na kwa wenye PCP au waliokuwa nayo awali.<ref name=PCP2011>{{cite journal|last=Huang|first=L|coauthors=Cattamanchi, A; Davis, JL; den Boon, S; Kovacs, J; Meshnick, S; Miller, RF; Walzer, PD; Worodria, W; Masur, H; International HIV-associated Opportunistic Pneumonias (IHOP), Study; Lung HIV, Study|title=HIV-associated Pneumocystis pneumonia|journal=Proceedings of the American Thoracic Society|date=2011 Jun|volume=8|issue=3|pages=294–300|pmid=21653531|doi=10.1513/pats.201009-062WR|pmc=3132788}}</ref> Watu wenye ugandamizaji wa kingamwili pia hushauriwa kupata kinga ya [[toksoplasmosisi]] na [[Kriptokokasi|Meninjitisi ya kriptokokasi]].<ref name=PEPpocketguide>{{cite web | publisher=[[United States Department of Health and Human Services|Department of Health and Human Services]] | date=February 2, 2007 | url=http://www.guideline.gov/summary/summary.aspx?ss=14&doc_id=6223&string=infected+AND+patients | title=Treating opportunistic infections among HIV-infected adults and adolescents. Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. | accessdate=2020-03-28 | archiveurl=https://archive.today/20121212000558/http://www.guideline.gov/browse/archive.aspx | archivedate=2012-12-12 | =https://archive.today/20121212000558/http://www.guideline.gov/browse/archive.aspx }}</ref> Mikakati mwafaka ya kinga imepunguza kiwango cha maambukizi kwa 50% katika miaka 1992-1997.<ref name=InfectionBook2008/> ===Matibabu mbadala=== Takriban 60% ya watu wenye VVU nchini Marekani hutumia mbinu mbalimbali za [[matibabu mbadala]].<ref name="pmid18608078">{{Rejea jarida|author=Littlewood RA, Vanable PA |title=Complementary and alternative medicine use among HIV-positive people: research synthesis and implications for HIV care |journal=AIDS Care |volume=20 |issue=8 |pages=1002–18 |year=2008 |month=September |pmid=18608078 |pmc=2570227|doi=10.1080/09540120701767216 |url=https://archive.org/details/sim_aids-care_2008-09_20_8/page/1002}}</ref> Ubora wa matibabu hayo hata hivyo haujathibitishwa.<ref name="pmid15969772">{{Rejea jarida|author=Mills E, Wu P, Ernst E |title=Complementary therapies for the treatment of HIV: in search of the evidence |journal=Int J STD AIDS |volume=16 |issue=6 |pages=395–403 |year=2005|month=June |pmid=15969772 |doi=10.1258/0956462054093962 |url=}}</ref> Kwa kuzingatia [[Lishe na VVU/UKIMWI|ushauri wa kilishe na UKIMWI]], kuna ushahidi unaoonyesha manufaa ya nyongeza za [[virutubishi vidogo]].<ref name="Irlam"/> Ushahidi wa manufaa ya nyongeza za [[seleniamu]] unaonyesha kuwa manufaa yake si mengi sana.<ref>{{cite journal|last=Stone|first=CA|coauthors=Kawai, K; Kupka, R; Fawzi, WW|title=Role of selenium in HIV infection|url=https://archive.org/details/sim_nutrition-reviews_2010-11_68_11/page/671|journal=Nutrition Reviews|date=2010 Nov|volume=68|issue=11|pages=671–81|pmid=20961297|doi=10.1111/j.1753-4887.2010.00337.x|pmc=3066516}}</ref> Kuna ushahidi mdogo kuwa nyongeza ya [[vitamini A]] kwa watoto hupunguza vifo na kuboresha ukuaji.<ref name=Irlam/> Nyongeza ya [[vitamini]] nyingi kwa kina mama wajawazito wenye [[lishe duni]] na wanaonyonyesha imeboresha [[afya]] ya kina mama na watoto barani Afrika<ref name=Irlam>{{cite journal|last=Irlam|first=JH|coauthors=Visser, MM; Rollins, NN; Siegfried, N|title=Micronutrient supplementation in children and adults with HIV infection|journal=Cochrane database of systematic reviews (Online)|date=2010-12-08|issue=12|pages=CD003650|pmid=21154354|doi=10.1002/14651858.CD003650.pub3|editor1-last=Irlam|editor1-first=James H}}</ref> Kutumia virutubishi vidogo ndani ya lishe katika viwango vya [[Kiwango cha Matumizi ya kila Siku|KMS]] kwa watu wazima wenye VVU kumependekezwa na [[Shirika la Afya Duniani]].<ref>{{cite journal|last=Forrester|first=JE|coauthors=Sztam, KA|title=Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?|journal=The American journal of clinical nutrition|date=2011 Dec|volume=94|issue=6|pages=1683S–1689S|pmid=22089440|doi=10.3945/ajcn.111.011999|pmc=3226021}}</ref><ref name='WHO_nutrients'>{{Rejea kitabu | last = [[World Health Organization]] | title = Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation | date = 2003-05 | location = Geneva | url = http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf | id = | isbn = | accessdate = March 31, 2009 | archiveurl = https://web.archive.org/web/20090325030154/http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf | archivedate = 2009-03-25 | deadurl = no }}</ref> SAD linasema kuwa [[takwimu]] kadhaa zimeonyesha nyongeza ya vitamini A, zinki na ayoni inaweza kuwaathiri pakubwa watu wazima walio na VVU.<ref name='WHO_nutrients' /> Hakuna ushahidi wa kutosha kuonyesha manufaa ya [[miti shamba]].<ref>{{Rejea jarida|author=Liu JP, Manheimer E, Yang M|title=Herbal medicines for treating HIV infection and AIDS |journal=Cochrane Database Syst Rev|issue=3 |pages=CD003937|year=2005 |pmid=16034917 |doi=10.1002/14651858.CD003937.pub2|url=|editor1-last=Liu|editor1-first=Jian Ping}}</ref> ==Matarajio ya kuishi== [[File:HIV-AIDS world map-Deaths per million persons-WHO2012.svg|upright=1.3|thumb|Idadi ya vifo kutokana na UKIMWI kati ya watu milioni 1 mwaka 2012 {{refbegin|3}}{{legend|#ffff20|0}}{{legend|#ffe820|1–4}}{{legend|#ffd820|5–12}}{{legend|#ffc020|13–34}}{{legend|#ffa020|35–61}}{{legend|#ff9a20|62–134}}{{legend|#f08015|135–215}}{{legend|#e06815|216–458}}{{legend|#d85010|459-1,402}}{{legend|#d02010|1,403–5,828}}{{refend}}]] [[File:HIV-AIDS world map - DALY - WHO2004.svg|thumb|Alt=Ramani ya ulimwengu ambapo sehemu yake kubwa ni ya rangi ya manjano au ya chungwa isipokuwa Kusini kwa Sahara ambapo kuna rangi nyekundu au nyekundu nzito|[[Miaka ya kulemaza]] ya VVU kwa kila wakaazi 100,000&nbsp; kufikia 2004. {{Multicol}} {{legend|#b3b3b3|<small>no data</small>}} {{legend|#ffff65|<small>≤&nbsp;10</small>}} {{legend|#fff200|<small>10–25</small>}} {{legend|#ffdc00|<small>25–50</small>}} {{legend|#ffc600|<small>50–100</small>}} {{legend|#ffb000|<small>100–500</small>}} {{legend|#ff9a00|<small>500–1000</small>}} {{Multicol-break}} {{legend|#ff8400|<small>1000–2500</small>}} {{legend|#ff6e00|<small>2500–5000</small>}} {{legend|#ff5800|<small>5000–7500</small>}} {{legend|#ff4200|<small>7500-10000</small>}} {{legend|#ff2c00|<small>10000-50000</small>}} {{legend|#cb0000|<small>≥&nbsp;50000</small>}} {{Multicol-end}}]] Katika sehemu nyingi ulimwenguni UKIMWI umekuwa [[ugonjwa wa muda mrefu]], si ugonjwa mkali tu.<ref name=Knoll2007/> [[Prognosi]] ni tofauti katika watu mbalimbali, na kiwango cha CD4 pamoja na wingi wa virusi huwa muhimu katika kutabiri matokeo.<ref name=M118/> Wastani wa muda wa kuishi baada ya kuambukizwa unakadiriwa kuwa kati ya miaka 9-1&nbsp; bila matibabu, ikitegemea aina ya VVU.<ref name=UNAIDS2007>{{cite web| author = [[Joint United Nations Programme on HIV/AIDS|UNAIDS]], [[World Health Organization|WHO]]| month = December| year = 2007| title = 2007 AIDS epidemic update| url = http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf| accessdate = 2008-03-12| format = PDF| archivedate = 2008-05-27| archiveurl = https://web.archive.org/web/20080527201701/http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf}}</ref> Baada ya utambuzi wa UKIMWI, iwapo matibabu hayapo, uwezo wa kuishi huwa kati ya miezi 6-19.<ref name=Morgan2>{{Rejea jarida | author=Morgan D, Mahe C, Mayanja B, Okongo JM, Lubega R, Whitworth JA| title=HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries? | journal=AIDS | year=2002 | pages=597–632 | volume=16 | issue=4 | pmid=11873003 |doi=10.1097/00002030-200203080-00011}}</ref><ref>{{Rejea jarida|title=Progression and mortality of untreated HIV-positive individuals living in resource-limited settings: update of literature review and evidence synthesis|author=Zwahlen M, Egger M|url=http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf|format=PDF|year=2006|accessdate=March 19, 2008|version=UNAIDS Obligation HQ/05/422204|archiveurl=https://web.archive.org/web/20080409065844/http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf|archivedate=2008-04-09|deadurl=no|journal=}}</ref> [[KKNKN]] na uzuiaji mwafaka wa Maambukizi nyemelezi hupunguza kima cha vifo kwa 80% na kuongeza matarajio ya urefu wa maisha hadi miaka 20-50 kwa mtu mzima wa kimo aliyetambuliwa na maambukizi karibuni.<ref name=Knoll2007>{{cite journal |journal= Int J Dermatol |year=2007 |volume=46 |issue=12 |pages=1219–28 |title= Current status of HIV infection: a review for non-HIV-treating physicians |author= Knoll B, Lassmann B, Temesgen Z|pmid=18173512|doi=10.1111/j.1365-4632.2007.03520.x}}</ref><ref name=LifeExpecr2008>{{cite journal |journal= Lancet|year=2008 |volume=372|issue=9635 |pages=293–9 |title=Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies | author= Antiretroviral Therapy Cohort Collaboration |pmid=18657708 |doi=10.1016/S0140-6736(08)61113-7 |pmc= 3130543 }}</ref><ref name=Schack2006>{{cite journal | author=Schackman BR, Gebo KA, Walensky RP, Losina E, Muccio T, Sax PE, Weinstein MC, Seage GR 3rd, Moore RD, Freedberg KA. |title=The lifetime cost of current HIV care in the United States | url=https://archive.org/details/sim_medical-care_2006-11_44_11/page/990 | journal=Med Care | year=2006 |pages=990–997 | volume=44 | issue=11 | pmid=17063130 |doi=10.1097/01.mlr.0000228021.89490.2a}}</ref> Hii ni kati ya 2/3<ref name=LifeExpecr2008/> na karibu na kiwango cha umma.<ref name=Deut2010/><ref>{{cite journal|last=van Sighem|first=AI|coauthors=Gras, LA; Reiss, P; Brinkman, K; de Wolf, F; ATHENA national observational cohort, study|title=Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals|journal=AIDS (London, England)|date=2010-06-19|volume=24|issue=10|pages=1527–35|pmid=20467289|doi=10.1097/QAD.0b013e32833a3946}}</ref> Matibabu huwa hayafaulu yanapoanzishwa yakiwa yamechelewa katika prognosi,<ref name=Deut2010/> kwa mfano, matibabu yakianzishwa kufuatia utambuzi katika kiwango cha UKIMWI, matarajio ya urefu wa maisha huwa miaka~10–40.<ref name=Deut2010/><ref name=Knoll2007/> Wasipotibiwa, nusu ya watoto wachanga wanaozaliwa na VVU hufa kabla ya miaka miwili.<ref name=UN2011ONESIXTY/> Sababu kuu ya vifo vinavyotokana na VVU/UKIMWI ni [[Maambukizi nyemelezi]] na [[saratani]] ambayo mara nyingi hutokana na matatizo endelevu ya mfumo wa kingamwili.<ref name=InfectionBook2008>{{cite book|last=Smith|first=[edited by] Blaine T.|title=Concepts in immunology and immunotherapeutics|year=2008|publisher=American Society of Health-System Pharmacists|location=Bethesda, Md.|isbn=978-1-58528-127-5|page=143|url=http://books.google.ca/books?id=G46DrdlxNJAC&pg=PA143|edition=4th}}</ref><ref name=Cancer2005>{{cite journal|last=Cheung|first=MC|coauthors=Pantanowitz, L; Dezube, BJ|title=AIDS-related malignancies: emerging challenges in the era of highly active antiretroviral therapy|journal=The oncologist|date=2005 Jun–Jul|volume=10|issue=6|pages=412–26|pmid=15967835|doi=10.1634/theoncologist.10-6-412}}</ref> Hatari ya saratani huonekana kuongezeka ikiwa kiwango cha CD4 kitashuka chini ya 500/uL.<ref name=Deut2010/> Kiwango cha kuendelea kwa ugonjwa wa kiutambuzi hutofautiana pakubwa katika watu mbalimbali na kimedhihirika kuathiriwa na vipengele kadhaa, kama vile uhatarisho na utendaji wa kingamwili;<ref name=Tang>{{Rejea jarida | author=Tang J, Kaslow RA | title=The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy | journal=AIDS | year=2003 |pages=S51–S60 | volume=17 | issue=Suppl 4 | pmid=15080180 | doi=10.1097/00002030-200317004-00006}}</ref> uwezo wa kufikia [[huduma ya afya]] na uwepo wa [[maambukizi pacha]];<ref name=Morgan2/><ref name=Lawn>{{cite journal | author=Lawn SD |title=AIDS in Africa: the impact of co-infections on the pathogenesis of HIV-1 infection | journal=J. Infect. Dis. |year=2004 | pages=1–12 |volume=48 | issue=1| pmid=14667787</ref> pamoja na aina ya (au za) virusi husika.<ref name=Campbell>{{cite journal | author=Campbell GR |title=The glutamine-rich region of the HIV-1 Tat protein is involved in T-cell apoptosis | journal=J. Biol. Chem. | year=2004 |pages=48197–48204 | volume=279 | issue=46 | pmid=15331610 |doi=10.1074/jbc.M406195200 | author-separator=, |author2=Pasquier E | author3=Watkins J | display-authors=3 | last4=Bourgarel-Rey | first4=V | last5=Peyrot | first5=V |last6=Esquieu | first6=D | last7=Barbier | first7=P | last8=De Mareuil | first8=J | last9=Braguer |first9=D}}</ref><ref name=Campbell2>{{cite journal | author=Campbell GR, Watkins JD, Esquieu D, Pasquier E, Loret EP, Spector SA | title=The C terminus of HIV-1 Tat modulates the extent of CD178-mediated apoptosis of T cells | journal=J. Biol. Chem. | year=2005 | pages=38376–39382 | volume=280 | issue=46 |pmid=16155003 | doi=10.1074/jbc.M506630200}}</ref> Maambukizi pacha ya [[kifua kikuu]] ni mojawapo ya visababishi vikuu vya vifo vya watu wenye VVU/UKIMWI, huku yakipatikana katika 1/3 ya watu walioambukizwa VVU na husababisha 25% ya vifo vinavyohusiana na VVU.<ref>{{cite web|title=Tuberculosis|url=http://www.who.int/mediacentre/factsheets/fs104/en/|work=Fact sheet 104|publisher=World Health Organization|date=March 2012|accessdate=August 29, 2012}}</ref> VVU pia ni kipengele kikuu zaidi cha hatari ya kifua kikuu.<ref name=WHO2011>{{cite web|title=Global tuberculosis control 2011|author=World Health Organization|url=http://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf|year=2011|ISBN=978 92 4 156438 0|accessdate=August 29, 2012}}</ref> [[Hepatitisi C]] ni maambukizi mengine pacha yanayotokea mara nyingi, ambapo kila ugonjwa huongeza uendeleaji wa ugonjwa mwingine<ref>{{cite book|last=Pennsylvania|first=Editors, Raphael Rubin, M.D., Professor of Pathology, David S. Strayer, M.D., Ph.D., Professor of Pathology, Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University Philadelphia, Pennsylvania ; Founder and Consulting Editor, Emanuel Rubin, M.D., Gonzalo Aponte Distinguished Professor of Pathology, Chairman Emeritus of the Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University, Philadelphia,|title=Rubin's pathology : clinicopathologic foundations of medicine|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-60547-968-2|page=154|url=http://books.google.ca/books?id=wb2TzY9AgJ0C&pg=PA154|edition=Sixth|year=2011}}</ref> Saratani zinazotokea mara nyingi zaidi ambazo huhusishwa na VVU ni [[sakoma ya Kaposi]] na [[limfoma isiyo ya Hodgkin]].<ref name=Cancer2005/> Hata wakitibiwa kwa dawa za kudhibiti VVU, watu walio na VVU huenda wakakumbwa na [[matatizo ya kiniuroni ya ufahamu]],<ref name="Woods2009">{{cite pmid|19462243 }}</ref> [[osteoporosi]],<ref name="Brown2006">{{cite pmid|17086056}}</ref> [[nuropathia ya pembeni|nuropathia]],<ref name="Nicholas2007">{{Rejea jarida|author=Nicholas PK|title=Symptom management and self-care for peripheral neuropathy in HIV/AIDS |journal=AIDS Care | volume=19|issue=2|pages=179–89 |year=2007 |month=February |pmid=17364396|doi=10.1080/09540120600971083|url=https://archive.org/details/sim_aids-care_2007-02_19_2/page/179|author-separator=,|author2=Kemppainen JK|author3=Canaval GE|display-authors=3|last4=Corless|first4=I. B.|last5=Sefcik|first5=E. F.|last6=Nokes|first6=K. M.|last7=Bain|first7=C. A.|last8=Kirksey|first8=K. M.|last9=Sanzero Eller|first9=L.}}</ref> saratani,<ref name="Boshoff2002">{{Rejea jarida| author=Boshoff C, Weiss R |title=AIDS-related malignancies | journal=Nat. Rev. Cancer | year=2002 | pages=373–382 | volume=2 | issue=5 |pmid=12044013 | doi=10.1038/nrc797 }}</ref><ref name="Yarchoan2005">{{Rejea jarida| author=Yarchoan R, Tosato G, Little RF | title=Therapy insight: AIDS-related malignancies – the influence of antiviral therapy on pathogenesis and management | journal=Nat. Clin. Pract. Oncol. |year=2005 | pages=406–415 | volume=2 |issue=8 | pmid=16130937 | doi=10.1038/ncponc0253 }}</ref><!-- Boshoff2002 and Yarchoan2005 cover cancer --> [[nefropathi]],<ref name="Post2009">{{cite pmid|19106702}}</ref> na [[ugonjwa wa moyo na mishipa]] baada ya muda mrefu.<ref name="Burgoyne2008" /> Haijulikani ikiwa hali hizi hutokana na kuambukizwa kwa VVU kwenyewe au ni athari kali za matibabu yake. == Watu wangapi wana UKIMWI? == [[Picha: AIDS cases worldwide 1979-1995.png|haki|thumb|Idadi ya watu duniani wenye VVU miaka 1979-1995.]] [[File:AIDS and HIV prevalence 2008.svg|thumb|upright=1.2|alt= A map of the world where most of the land is colored green or yellow except for sub Saharan Africa which is colored red|[[Asilimia]] ya watu wenye umri wa miaka 15–49 walioambukizwa nchi kwa nchi ([[2011]]).<ref>{{cite web|title=AIDSinfo|url=http://www.unaids.org/en/dataanalysis/datatools/aidsinfo/|work=UNAIDS|accessdate=4 March 2013}}</ref>{{Col-begin}} {{Col-break}} {{legend|#787878|<small>No data</small>}} {{legend|#94bf8b|<small><0.10</small>}} {{legend|#f4e2ba|<small>0.10–0.5</small>}} {{legend|#eaca83|<small>0.5–1</small>}} {{Col-break}} {{legend|#f07568|<small>1–5</small>}} {{legend|#ff4800|<small>5–15</small>}} {{legend|#b00000|<small>15–50</small>}} {{col-end}}]] VVU/UKIMWI ni [[janga]] la kimataifa.<ref name=Cohen2008>{{cite journal|last=Cohen|first=MS|coauthors=Hellmann, N; Levy, JA; DeCock, K; Lange, J|title=The spread, treatment, and prevention of HIV-1: evolution of a global pandemic|journal=The Journal of clinical investigation|date=2008 Apr|volume=118|issue=4|pages=1244-54|pmid=18382737|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276790/|accessdate=17 September 2012}}</ref> Kufikia mwaka [[2018]] walau watu wapatao 37,900,000 walikuwa wakiishi na VVU<ref>"Global HIV & AIDS statistics — 2019 fact sheet". www.unaids.org. UNAIDS. Archived from the original on December 4, 2019. Retrieved December 21, 2019.</ref> na kila mwaka watu milioni 2 wengine wanambukizwa<ref name=UNAIDS2015>{{cite web|title=Fact sheet 2015|url=http://www.unaids.org/sites/default/files/media_asset/20150901_FactSheet_2015_en.pdf|website=UNAIDS|accessdate=1 February 2016}}</ref><ref name=UN2013>{{cite web|title=UNAIDS reports a 52% reduction in new HIV infections among children and a combined 33% reduction among adults and children since 2001|url=http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/september/20130923prunga/|work=UNAIDS|accessdate=October 7, 2013|archivedate=2013-10-01|archiveurl=https://web.archive.org/web/20131001090619/http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/september/20130923prunga/}}</ref>. Zaidi ya nusu ni wanawake na milioni 2.6 ni watoto chini ya miaka 15.<ref name=UN2011Ten/> Hata hivyo watu wengi wenye VVU hawajui kuwa navyo<ref>{{cite journal|last=Centers for Disease Control and Prevention|first=(CDC)|title=HIV surveillance—United States, 1981–2008|journal=MMWR. Morbidity and mortality weekly report|date=June 3, 2011|volume=60|issue=21|pages=689–93|pmid=21637182}}</ref>. Kwa sababu hiyo, idadi halisi ya watu wanaoishi na VVU haijulikani. Hali hii ilisababisha karibu vifo milioni 1.8 mwaka 2010 ikilinganishwa na milioni 3.1 katika mwaka 2001.<ref name=UN2011Ten/> Kwa jumla watu 32,000,000 wameshakufa kwa ugonjwa huo<ref>"Global HIV & AIDS statistics — 2019 fact sheet". www.unaids.org. UNAIDS. Archived from the original on December 4, 2019. Retrieved December 21, 2019.</ref>. Wengi kati ya watu wenye VVU huishi Afrika kusini kwa Sahara (20,600,000). Wengi kati ya watoto ambao hufariki dunia kutokana na UKIMWI pia wanaishi barani Afrika. Katika mwaka wa 2010, kadirio la 68% (milioni 22.9&nbsp;) la visa vyote vya VVU na 66% ya vifo (milioni 1.2&nbsp;) vilitokea katika eneo hili.<ref name=UN2011Thirty>UNAIDS 2011 pg. 20–30</ref> Hii inamaanisha kuwa karibu 5% ya watu wazima wana virusi hivi<ref name=UN2011Fifty>UNAIDS 2011 pg. 40–50</ref> na vinaaminika kuwa kisababishi cha 10% ya vifo vyote vya watoto.<ref name=M117>Mandell, Bennett, and Dolan (2010). Sura ya 117.</ref> Wanawake wa eneo hili huchangia karibu 60% ya visa vyote tofauti na maeneo mengine.<ref name=UN2011Thirty/> [[Afrika Kusini]] ina idadi kubwa zaidi ya watu wenye VVU ulimwenguni kote, ikiwa ni watu milioni 5.9&nbsp;.<ref name=UN2011Thirty /> Kiwango cha [[matarajio ya urefu wa maisha]] kimepungua katika nchi zilizoathirika zaidi kutokana na VVU; kwa mfano, mwaka wa 2006, ilikadiriwa kuwa kiwango hiki kilipungua kutoka miaka 65 hadi 35 nchini [[Botswana]].<ref name=Kallings>{{Rejea jarida|journal= J Intern Med |year=2008|volume=263|issue=3|pages=218–43 |title= The first postmodern pandemic: Miaka 25 ya VVU |author= Kallings LO|doi=10.1111/j.1365-2796.2007.01910.x|pmid=18205765|url=http://doi.org/10.1111/j.1365-2796.2007.01910.x}}(subscription required)</ref> [[Asia Kusini]] na [[Asia Kusini Mashariki|Kusini Mashariki]] ni eneo la pili lililoathirika zaidi; mwaka wa 2010, eneo hili lilikuwa na kadirio la visa milioni 4&nbsp; au 12% ya watu wote wanaoishi na VVU, hivyo kupelekea vifo vya takriban watu 250,000.<ref name=UN2011Fifty/> Takriban milioni 2.4&nbsp; ya visa hivi viko India<ref name=UN2011Thirty/> Ukithiri wa VVU uko chini katika maeneo ya Uropa Magharibi na Kati ikifikia 0.2% na [[Mashariki mwa Asia]] ikiwa na 0.1%.<ref name=UN2011Fifty/> Mwaka wa 2008 nchini Marekani, takriban watu milioni 1.2 walikuwa wakiishi na VVU, hivyo kupelekea takriban vifo 17,500. Kituo cha Kudhibiti na Kuzuia Magonjwa kilikadiria kuwa, mwaka wa 2008, 20% ya Wamarekani waliokuwa na VVU hawakujua hali yao. <ref name=USAEPI2011>{{cite journal|last=Centers for Disease Control and Prevention|first=(CDC)|title=HIV surveillance—United States, 1981–2008|journal=MMWR. Morbidity and mortality weekly report|date=2011-06-03|volume=60|issue=21|pages=689–93|pmid=21637182}}</ref> Nchini Uingereza, kufikia 2009 kulikuwa na takriban visa 86,500 vilivyopelekea vifo 516.<ref>{{cite book|title=HIV in the United Kingdom: Ripoti ya 2010|year=2010|url=http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1287145367237|author=Health Protection Agency|access-date=2020-03-28|archive-date=2011-01-19|archive-url=https://web.archive.org/web/20110119155546/http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287145367237|dead-url=yes}}</ref> Nchini Kanada, kufikia 2008 kulikuwa na visa 65,000 vilivyopelekea vifo 53.<ref>{{cite book|last=Surveillance|title=HIV and AIDS in Canada : surveillance report to December 31, 2009|year=2010|publisher=Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Surveillance and Risk Assessment Division|location=Ottawa|isbn=978-1-100-52141-1|url=http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf|coauthors=riques, Risk Assessment Division = Le VIH et le sida au Canada : rapport de surveillance en date du 31 décembre 2009 / Division de la surveillance et de l'évaluation des|archiveurl=https://web.archive.org/web/20120119164919/http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf|archivedate=2012-01-19|access-date=2020-03-28|dead-url=yes|=https://web.archive.org/web/20120119164919/http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2009/dec/pdf/2009-Report-Rapport.pdf}}</ref> ==Jamii na utamaduni== === Unyanyapaa === [[File:Ryan White.jpg|thumb|alt=Mvulana baleghe akitabasamu akipigwa picha huku mkono wa mwingine ukiwa uemeegemeshwa begani mwake|[[Ryan White]] alipelekea kuwa [[mtoto wa uhamasisho]] wa VVU baada ya kufukuzwa shuleni kwa sababu alikuwa ameambukizwa.]] [[Unyanyapaa]] dhidi ya watu walio na UKIMWI zipo kote ulimwenguni kwa namna mbalimbali, zikiwemo kutengwa, kukataliwa na jamii, ubaguzi na kuepuka watu walioambukizwa VVU, kulazimishwa kupimwa VVU bila [[idhini]] au ulinzi wa [[usiri]], vurugu dhidi ya watu walioambukizwa au waliodhaniwa kuambukizwa VVU; na [[karantini]] ya watu waliombukizwa VVU.<ref name=UNAIDS2006Ch4>{{Rejea kitabu|publisher =[[Joint United Nations Programme on HIV/AIDS|UNAIDS]]| year = 2006| title = 2006 Report on the global AIDS epidemic| chapter = The impact of AIDS on people and societies| chapterurl =http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH04_en.pdf| accessdate =June 14, 2006| format= PDF| isbn =92-9173-479-9}}</ref> Vurugu zinazohusiana na unyanyapaa au hofu ya vurugu huzuia watu wengi kupima VVU, kurudia matokeo ya vipimo na kutotafuta matibabu. Hali hizi hugeuza ugonjwa wa muda mrefu unaoweza kudhibitiwa kuwa hukumu ya kifo na kuendeleza ueneaji wa VVU.<ref name=Ogden>{{cite web | author = Ogden J, Nyblade L | publisher = [[International Center for Research on Women]] | year = 2005 | title = Common at its core: HIV-related stigma across contexts | url = http://www.icrw.org/docs/2005_report_stigma_synthesis.pdf | format = PDF | accessdate = February 15, 2007 | archiveurl = https://www.webcitation.org/6FEwkK8ZU?url=http://www.icrw.org/publications/common-its-core-hiv-related-stigma-across-contexts | archivedate = 2013-03-19 | = https://www.webcitation.org/6FEwkK8ZU?url=http://www.icrw.org/publications/common-its-core-hiv-related-stigma-across-contexts }}</ref> Unyanyapaa dhidi ya watu wanaoishi na UKIMWI, umegawanywa zaidi katika vikundi vitatu kama ifuatavyo: * ''Unyanyapaa Mkuu wa UKIMWI ''-mawazo ya woga na wasiwasi unaoweza kuhusishwa na ugonjwa wowote aunaoua au kuambukiza.<ref name=Herek1999>{{Rejea jarida| author=Herek GM, Capitanio JP| journal=American Behavioral Scientist| year=1999| url=http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf| format=PDF| title=AIDS Stigma and sexual prejudice| accessdate=March 27, 2006| volume=42| issue=7| pages=1130–1147| doi=10.1177/0002764299042007006| archive-date=2006-04-09| archive-url=https://web.archive.org/web/20060409034211/http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf| dead-url=yes| =https://web.archive.org/web/20060409034211/http://psychology.ucdavis.edu/rainbow/html/abs99_sp.pdf}}</ref> * '' Unyanyapaa wa kiishara wa UKIMWI ''-kutumia VVU/UKIMWI kuonyesha mitazamo fulani dhidi ya vikundi vya jamii au mitindo ya maisha inayohusishwa na ugonjwa huu.<ref name=Herek1999 /> * Unyanyapaa wa kihisani wa UKIMWI''- Unyanyapaa dhidi ya watu wanaohusishwa na suala la VVU/UKIMWI au watu walio na VVU.<ref name=Snyder>{{Rejea jarida|author=Snyder M, Omoto AM, Crain AL |title=Punished for their good deeds: stigmatization for AIDS volunteers |url=https://archive.org/details/sim_american-behavioral-scientist_1999-04_42_7/page/1175 |journal=American Behavioral Scientist | year=1999 | pages=1175–1192 | volume=42 | issue=7|doi=10.1177/0002764299042007009}}</ref> Mara nyingi, unyanyapaa wa UKIMWI huonyeshwa pamoja na unyanyapaa wa aina moja au nyingine, hasa unyanyapaa unaohusiana na ushoga, [[uasherati]], ukahaba na kutumia dawa za kulevya.<ref>{{cite book|last=Sharma|first=A.K.|title=Population and society|publisher=Concept Pub. Co.|location=New Delhi|isbn=9788180698187|pages=242|url=http://books.google.ca/books?id=sE-VDhEuxmsC&pg=PA242}}</ref> Katika nchi nyingi zilizostawi, kuna uhusiano kati ya UKIMWI na ushoga.<ref name=Herek2002>{{cite journal|last=Herek|first=GM|coauthors=Capitanio, JP; Widaman, KF|title=HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999|url=https://archive.org/details/sim_american-journal-of-public-health_2002-03_92_3/page/371|journal=American journal of public health|date=2002 Mar|volume=92|issue=3|pages=371–7|pmid=11867313|pmc=1447082|doi=10.2105/AJPH.92.3.371}}</ref><ref name=Herek1999/>Hata hivyo, njia kuu ya kuenea kwa UKIMWI ulimwenguni kote inabakia kuwa maambukizi kati ya wanaume na wanawake, kwa kuwa ndio ngono ya kawaida. <ref>{{cite journal|last=De Cock|first=KM|coauthors=Jaffe, HW; Curran, JW|title=The evolving epidemiology of HIV/AIDS.|journal=AIDS (London, England)|date=2012 Jun 19|volume=26|issue=10|pages=1205-13|pmid=22706007}}</ref> === Athari za kiuchumi === [[File:Life expectancy in some Southern African countries 1958 to 2003.png|thumb|alt=Grafu inayoonyesha mistari kadhaa inayopanda ikifuatiwa na kushuka kwa ghafla kwa mistari hii kuanzia miaka ya katikati mwa 1980 hadi miaka ya 1990|Mabadiliko katika matarajio ya urefu wa maisha katika baadhi ya nchi za Afrika zilizoathiriwa zaidi. {{legend-line|red solid 2px|Botswana}}{{legend-line|darkgreen solid 2px|Zimbabwe}}{{legend-line|blue solid 2px|Kenya}}{{legend-line|black solid 2px|South Africa}}{{legend-line|grey solid 2px|Uganda}}]] VVU/UKIMWI huathiri [[uchumi]] wa watu na nchi.<ref name=M117/> [[Pato la ndani la uzalishaji]] la nchi zilizoathiriwa zaidi limepungua kufuatia ukosefu wa [[rasilimali ya kibinadamu]].<ref name=M117/><ref name="Bell-et-al-2003">{{Rejea jarida|author=Bell C, Devarajan S, Gersbach H|year=2003|url=http://econ.worldbank.org/external/default/main?pagePK=64165259&theSitePK=478060&piPK=64165421&menuPK=64166093&entityID=000160016_20031110113834|title=The long-run economic costs of AIDS: theory and an application to South Africa|accessdate=April 28, 2008|version=World Bank Policy Research Working Paper No. 3152|format=PDF|journal=|archive-date=2013-06-05|archive-url=https://web.archive.org/web/20130605151302/http://econ.worldbank.org/external/default/main?pagePK=64165259&theSitePK=478060&piPK=64165421&menuPK=64166093&entityID=000160016_20031110113834|dead-url=yes}}</ref>Bila [[lishe bora]], huduma za afya na dawa, watu wengi hufariki kutokana na matatizo yanayohusiana na UKIMWI. Kando ya kutoweza kufanya kazi, watu hao pia huhitaji kiwango kikubwa cha huduma za afya. UKIMWI hupunguza idadi ya watu wanaoweza kulipa [[ushuru]] Kwa kuwaathiri hasa vijana, hivyo kupunguza [[raslimali]] zilizopo za [[matumizi ya serikali|matumizi ya umma]] kama vile [[huduma za elimu]] na afya ambazo hazihusiki na UKIMWI. Hali hii husababisha upungufu wa [[pesa]] za nchi na wa ukuaji wa uchumi. Hali hii kisha hupelekea upungufu wa ukuaji wa msingi wa ushuru, athari ambayo huongezeka iwapo kuna matumizi zaidi katika matibabu, mafunzo (ili kuchukua nafasi ya [[wafanyakazi]] wanaougua), kuwalipa wafanyakazi wagonjwa na kuwatunza mayatima wa UKIMWI. Hali hii hutokea hasa iwapo ongezeko kubwa la vifo vya watu wazima litapelekea kubadilika kwa [[wajibu]] wa kuwatunza mayatima hawa kutoka kwa [[familia]] hadi kwa [[serikali]].<ref name=Greener /> Katika kiwango cha familia, UKIMWI husababisha upungufu wa mapato na pia ongezeko la matumizi katika huduma za afya. Utafiti katika nchi ya [[Côte d'Ivoire]] ulionyesha kuwa familia zilizo na mgonjwa aliye na VVU/UKIMWI zilitumia pesa mara mbili zaidi ya familia nyingine. Matumizi hayo ya ziada pia hupelekea kiwango kidogo zaidi cha mapato ya kutumia katika elimu au [[uwekezaji]] wa kibinafsi au wa kifamilia.<ref name="WBank">{{Rejea jarida| author=Over M| title=The macroeconomic impact of AIDS in Sub-Saharan Africa, Population and Human Resources Department| publisher=The World Bank| year=1992| url=http://www.worldbank.org/aidsecon/macro.pdf| format=PDF| accessdate=May 3, 2008| archiveurl=https://web.archive.org/web/20080527201655/http://www.worldbank.org/aidsecon/macro.pdf| archivedate=2008-05-27| deadurl=no| journal=}}</ref> === Mayatima === [[Picha: Africa HIV-AIDS 2002.png | haki | frame |Asilimia ya watu waliokuwa wanaishi na VVU katika Afrika miaka 1999-2001]] [[Picha:Ukimwi Afrika 2011.png|350px|thumb|Asilimia ya watu waliokuwa wanaishi na VVU Afrika mnamo mwaka 2011]] Watu wengi ambao wanakufa kutokana na UKIMWI, hasa katika [[Afrika]], huacha watoto ambao bado ni hai, na ambao wanaweza wanahitaji msaada na huduma. Inakadiriwa kuwa kufikia mwaka wa 2007, diadi ya watoto [[yatima kutokana na UKIMWI]] &nbsp;milioni 12.<ref name=M117/> Wengi wao hutunzwa na [[Bibi|nyanya]] na [[babu]] [[wazee]]. <ref name=Greener>{{Rejea kitabu| author = Greener R| year = 2002| title = State of The Art: UKIMWI na Uchumi| chapter = AIDS and macroeconomic impact| editor = S, Forsyth (ed.)| pages = 49–55| publisher = IAEN| url = http://pdf.usaid.gov/pdf_docs/PNACP969.pdf| access-date = 2020-03-28| archive-date = 2012-10-12| archive-url = https://web.archive.org/web/20121012090520/http://pdf.usaid.gov/pdf_docs/PNACP969.pdf| dead-url = yes}}</ref> === Dini na UKIMWI === Mada kuhusu dini na UKIMWI imekuwa ikikumbwa na utata mwingi katika miaka thelathini iliyopita, hasa kwa sababu baadhi ya viongozi wa dini wametangaza hadharani kwamba wanapinga utumiaji kondomu.<ref>{{cite web|url=http://www.news-medical.net/health/AIDS-Stigma.aspx |title=AIDS Stigma |publisher=News-medical.net|accessdate=November 1, 2011}}</ref> Mashirika mengine ya dini yamedai kuwa maombi yanatosha kutibu VVU/UKIMWI. Mwaka 2011, BBC iliripoti kuwa baadhi ya makanisa huko [[London]] yalikuwa yakidai kuwa maombi yanatibu UKIMWI. Kituo cha Utafiti wa Afya ya Kiuzazi na VVU cha [[Manispaa ya Hackney, London|Hackney]] kiliripoti kuwa watu wengi waliachma kutumia matibabu, wakati mwingine kwa kushauriwa na [[wachungaji]] wao. Jambo hili lilipelekea vifo vya watu wengi.<ref name=BBC18102011>{{cite news|url=http://www.bbc.co.uk/news/uk-england-london-14406818|title=Church HIV prayer cure claims 'cause three deaths'|date=October 18, 2011|accessdate=October 18, 2011|publisher=BBC News}}</ref> [[Synagogue Church Of All Nations]] ilitangaza ''maji ya upako'' ili kuwezesha [[uponyaji]] kutoka kwa [[Mungu]], ingawa ilikana kuwa iliwashauri watu kukoma kutumia matibabu.<ref name=BBC18102011 /> ===Katika vyombo vya habari=== Kimojawapo kati ya visa maarufu zaidi vya UKIMWI kilikuwa cha Mmarekani [[Rock Hudson]], [[muigizaji]] shoga aliyekuwa ameoa kisha kutalaki hapo awali. Hudson alifariki tarehe [[2 Oktoba]] [[1985]] baada ya kutangaza ana VVU tarehe [[25 Julai]] mwaka huohuo. Yeye alikuwa ametambuliwa kuwa na ugonjwa huo mwaka 1984.<ref>{{cite web|url=http://www.history.com/this-day-in-history/rock-hudson-announces-he-has-aids |title=Rock Hudson announces he has AIDS – History.com This Day in History – 7/25/1985 |publisher=History.com |accessdate=November 1, 2011}}</ref> Mgonjwa mashuhuri kutoka Uingereza mwaka huo alikuwa [[Nicholas Eden]] [[mwanasiasa]] shoga na [[mwana]] wa [[Waziri Mkuu]], [[marehemu]] [[Anthony Eden]].<ref>{{cite web|last=Coleman |first=Brian|url=http://www.newstatesman.com/blogs/brian-coleman/2007/06/lady-thatcher-gay-tory |title=Thatcher the gay icon|work=New Statesman |date=June 25, 2007 |accessdate=November 1, 2011}}</ref> Tarehe [[24 Novemba]] [[1991]], virusi hivi vilipelekea kifo cha mwanamuziki wa aina ya [[muziki wa rock]], Mwingereza [[Freddie Mercury]]. Mercury, aliyeongoza [[bendi]] iliyojulikana kama [[Queen (bendi)|Queen]] alifariki kutokana na magonjwa yanayohusiana na UKIMWI baada ya kujulikana kuwa na ugonjwa huo siku iliyopita tu.<ref>{{cite news|url=http://news.bbc.co.uk/onthisday/hi/dates/stories/november/24/newsid_2546000/2546945.stm |title=November 24, 1991: Giant of rock dies |work=BBC On This Day |publisher=BBC News |date= |accessdate=November 1, 2011}}</ref> Hata hivyo, Mercury alikuwa ametambuliwa kuwa na ugonjwa huo mwaka 1987.<ref>{{cite web|url=http://www.nndb.com/people/521/000044389/|title=Freddie Mercury |publisher=Nndb.com |accessdate=November 1, 2011}}</ref> Kimojawapo kati ya visa maarufu zaidi vilivyotokana na ngono kati ya watu wa jinsia tofauti ni kile cha [[Arthur Ashe]], [[mchezaji]] [[tenisi]] Mmarekani. Ashe alitambuliwa kuwa na VVU tarehe [[31 Agosti]] [[1988]]; baada ya kuambukizwa alipokuwa akiongezewa damu akifanyiwa [[upasuaji wa moyo]] awali [[miaka ya 1980]]. Vipimo zaidi katika saa 24 baada ya utambuzi wa kwanza vilionyesha kuwa Ashe alikuwa na UKIMWI, lakini hakuwambia watu kuhusu utambuzi huu hadi Aprili [[1992]].<ref>{{cite web |last=Bliss |first=Dominic |url=http://www.itennisstore.com/Tennis-Latest-News/FROZEN-IN-TIME--ARTHUR-ASHE-by-Dominic-Bliss.aspx |title=Frozen In Time: Arthur Ashe |work=iTENNISstore.com |accessdate=June 25, 2012 |archive-date=2013-07-30 |archive-url=https://web.archive.org/web/20130730170201/http://www.itennisstore.com/Tennis-Latest-News/FROZEN-IN-TIME--ARTHUR-ASHE-by-Dominic-Bliss.aspx |url-status=dead }}</ref> Ashe alifariki kutokana na UKIMWI akiwa na umri wa miaka 49 tarehe [[6 Februari]] [[1993]].<ref>{{cite news | url=http://www.independent.co.uk/news/tributes-to-arthur-ashe-1471622.html | title=Tributes to Arthur Ashe | location=London | work=The Independent | date=February 8, 1993 | accessdate=July 24, 2012 | archivedate=2013-03-19 | archiveurl=https://www.webcitation.org/6FEwqou9b?url=http://www.independent.co.uk/news/tributes-to-arthur-ashe-1471622.html }}</ref> Picha ya [[Therese Frare]] ikionyesha [[mwanaharakati]] wa ushoga [[David Kirby]] akifariki kutokana na UKIMWI huku akizungukwa na familia yake, ilipigwa Aprili mwaka wa 1990. ''[[LIFE magazine]]'' ilisema kuwa picha hiyo ilikuja kufahamika kama picha ''maarufu zaidi kuwahi kuhusishwa na janga la UKIMWI/VVU.'' Picha hiyo iliyochapishwa na [[gazeti]] hilo ilishinda [[tuzo]] la [[World Press Photo]], kisha kupata umaarufu ulimwenguni kote baada ya kutumiwa na [[Benetton Group|United Colors of Benetton]] katika kampeni ya utangazaji ya mwaka 1992.<ref>{{cite web|last=Cosgrove|first=Ben|title=Behind the Picture: Picha Iliyobadilisha Sura ya Ukimwi|url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|work=LIFE magazine|accessdate=16 August 2012|archivedate=2013-03-19|archiveurl=https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1|=https://www.webcitation.org/6FEws9aLJ?url=http://life.time.com/history/behind-the-picture-the-photo-that-changed-the-face-of-aids/#1}}</ref> === Ukanushaji, njama na hila === Kikundi kidogo cha watu kingali kinakana uhusiano wa VVU na UKIMWI, <ref name=Duesberg>{{cite journal|author=Duesberg, P. H.| title=HIV is not the cause of AIDS|url=https://archive.org/details/sim_science_1988-07-29_241_4865/page/n9| journal=Science | year=1988 | pages=514, 517 | volume=241 |issue=4865| pmid=3399880 | doi=10.1126/science.3399880|bibcode = 1988Sci...241..514D }}{{cite journal| author=Cohen, J.| title=The Controversy over HIV and AIDS| journal=Science | year=1994 | pages=1642–1649 | volume=266 | issue=5191|url=http://www.sciencemag.org/feature/data/cohen/266-5191-1642a.pdf| format = PDF| doi=10.1126/science.7992043|pmid=7992043| accessdate=2009-03-31 | bibcode=1994Sci...266.1642C}}</ref> uwepo wa VVU au ubora wa vipimo vya VVU na njia za matibabu.<ref name=Kalichman>{{cite book|author=Kalichman, Seth|authorlink=Seth Kalichman|title=Denying AIDS: Njama Nadhira, Itikadi na Msiba wa Mwanadamu|publisher=Copernicus Books ([[Springer Science+Business Media]])|location=New York|year=2009|pages=|isbn=978-0-387-79475-4| url =http://books.google.com/?id=_mtDBCDwxugC&printsec=frontcover&q=}}</ref><ref name=SmithNovella>{{cite journal|author=Smith TC, Novella SP|title=HIV Denial in the Internet Era|journal=PLoS Med.|volume=4|issue=8|pages=e256|year=2007|month=August|pmid=17713982|doi=10.1371/journal.pmed.0040256|url=http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040256&ct=1&SESSID=3d4baa1a64e57d8ff33e9d41eb2335a1|accessdate=2009-11-07|pmc=1949841|archive-date=2008-05-06|archive-url=https://web.archive.org/web/20080506012410/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040256&ct=1&SESSID=3d4baa1a64e57d8ff33e9d41eb2335a1|dead-url=yes}}</ref> Madai hayo, yanayojulikana kama [[ukanaji UKIMWI]], yamechunguzwa na kukataliwa na jamii ya kisayansi.<ref name=consensus>{{cite web| author=Various| publisher=[[National Institute of Allergy and Infectious Diseases]]|date=Last updated January 14, 2010|url=http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/howHIVCausesAIDS/Pages/HIVcausesAIDS.aspx| title= Resources and Links, HIV-AIDS Connection| accessdate = 2009-02-22}}</ref>Hata hivyo, madai hayo yana athari kuu kisiasa, hasa nchini [[Afrika Kusini]]. Hatua ya serikali ya nchi hiyo kukubali kirasmi ukanaji wa UKIMWI ilipelekea mwitikio usiofaa wa janga hili, na imelaumiwa kupelekea visa vingi vya maambukizi ya VVU na mamia ya maelfu ya vifo ambavyo vingeepukwa.<ref>{{cite journal |author=Watson J |title=Scientists, activists sue South Africa's AIDS 'denialists' |journal=Nat. Med. |volume=12 |issue=1 |page=6 |year=2006 |pmid=16397537|doi=10.1038/nm0106-6a}}</ref><ref>{{cite journal |author=Baleta A |title=S Africa's AIDS activists accuse government of murder |url=https://archive.org/details/sim_the-lancet_2003-03-29_361_9363/page/1104 |journal=Lancet |volume=361 |issue=9363 |page=1105 |year=2003 |pmid=12672319|doi=10.1016/S0140-6736(03)12909-1}}</ref><ref>{{cite journal |author=Cohen J |title=South Africa's new enemy|url=https://archive.org/details/sim_science_2000-06-23_288_5474/page/2168 |journal=Science |volume=288 |issue=5474 |pages=2168–70 |year=2000 |pmid=10896606|doi=10.1126/science.288.5474.2168}}</ref> [[Urusi]] ulianzisha [[Operesheni INFEKTION]], uhamasisho wa ulimwengu mzima kueneza habari kuwa VVU/UKIMWI ulitengenezwa na Marekani. Takwimu zinaonyesha kuwa idadi kubwa ya watu wanaamini na wanaendelea kuamini madai hayo. Kuna aina nyingi za [[dhana potovu kuhusu VVU na UKIMWI]]. Dhana tatu kuu ni kwamba UKIMWI unaweza kusambazwa kwa kumgusa mtu, kuwa ngono na [[bikira]] itatibu UKIMWI na kuwa VVU vinaweza tu kuambukiza mashoga na watumiaji wa madawa. Dhana nyingine potovu ni kuwa tendo lolote la ngono ya kinyeo kati ya mashoga wasioambukizwa linaweza kupelekea maambukizi.<ref>{{Rejea kitabu| author=Blechner MJ| title=Hope and mortality: psychodynamic approaches to AIDS and HIV| url=https://archive.org/details/hopemortalitypsy0000unse|publisher=Analytic Press| location=Hillsdale, NJ| year=1997| isbn=0-88163-223-6| unused_data=ISBN status=May be invalid– please double check}}</ref><ref>{{Rejea jarida|author=Kirby DB, Laris BA, Rolleri LA |title=Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world |journal=J Adolesc Health |volume=40|issue=3 |pages=206–17 |year=2007|month=March |pmid=17321420 |doi=10.1016/j.jadohealth.2006.11.143 |url=https://archive.org/details/sim_journal-of-adolescent-health_2007-03_40_3/page/206}}</ref> == Tanbihi == {{Reflist}} ==Marejeo== * {{cite book | editor1-last = Mandell | editor1-first = Gerald L. | editor2-last = Bennett | editor2-first =John E.| editor3-last = Dolin | editor3-first = Raphael |title=Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases | year=2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA|isbn=978-0-443-06839-3 | edition = 7th }} * {{cite book|author=[[Joint United Nations Programme on HIV/AIDS]] (UNAIDS) |title=Global HIV/AIDS Response, Epidemic update and health sector progress towards universal access|year=2011|publisher=Joint United Nations Programme on HIV/AIDS|url=http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20111130_UA_Report_en.pdf}} == Viungo vya nje == {{Commons category|AIDS}} * {{Dmoz|Health/Conditions_and_Diseases/Immune_Disorders/Immune_Deficiency/AIDS/|HIV/AIDS}} * [http://aidsinfo.nih.gov/ AIDSinfo] {{Wayback|url=http://aidsinfo.nih.gov/ |date=20110225133251 }} – HIV/AIDS Treatment Information, U.S. Department of Health and Human Services * [Http://www.who.int/3by5/en/ Shirika la Afya Duniani Mashirika 3 na 5 Initiative] * [Http://www.accessmed-msf.org/index.asp Médecins Sans Frontières: Kampeni ya upatikanaji wa madawa muhimu] {{Wayback|url=http://www.accessmed-msf.org/index.asp |date=20050812004522 }} * [Http://www.who.int/hiv/en/ WHO Mpango wa VVU / UKIMWI] * [Http://www.aegis.org/en/ Elimu UKIMWI Mfumo wa Taarifa za Global] * [Http://www.aidsinfo.nih.gov/ Kutoka Taasisi ya Taifa ya Marekani ya Afya] {{Wayback|url=http://www.aidsinfo.nih.gov/ |date=20210322035857 }} * [Http://content.nejm.org/cgi/content/full/353/8/749 New England Journal of Medicine Ibara "Ruhusu dhidi ya Wagonjwa? Kurefusha maisha Tiba katika India"] {{Wayback|url=http://content.nejm.org/cgi/content/full/353/8/749 |date=20090501234727 }} * [Http://www.aidsportal.org AIDSPortal maarifa mtandao] * [http://www.unaids.org/en/ Tovuti ya Shirika la Umoja wa Mataifa la Masuala ya Ukimwi, UNAIDS] {{Wayback|url=http://www.unaids.org/en/ |date=20130210215850 }} * [http://hivinsite.ucsf.edu HIV InSite] {{Wayback|url=http://hivinsite.ucsf.edu/ |date=20191213225029 }} * [http://www.sida.fr/ sida.fr • un centre pour les malades du SIDA • infos • tèmoignages • actualités] [[Jamii:Virusi]] [[Jamii:Ukimwi]] fmnbrc9ki5we94ddlzu2q164ojpbdpo 0 124454 1578063 1536577 2026-07-02T17:30:53Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578063 wikitext text/x-wiki [[image:houben.jpg|thumb|250px|Mt. Charles Houben akiwa amevaa [[kanzu]] ya shirika lake (1851).]] '''Karoli wa Mlima Argus, [[C.P.]]''' ([[jina]] la kuzaliwa: '''Joannes Andreas Houben'''; [[Munstergeleen]], [[Limburg, Uholanzi|Limburg]], [[Uholanzi]], [[11 Desemba]] [[1821]] &ndash; [[Harold's Cross]], [[Dublin]], [[Ireland]], [[5 Januari]] [[1893]]) alikuwa [[padri]] [[Mpasionisti]] aliyefanya kazi huko [[Ireland]]. Alipata sifa kubwa kutokana na [[huruma]] yake kwa [[wagonjwa]]<ref>His reputation for healings and miracles was so great at the time that a reference is made to him in the famous novel ''[[Ulysses (novel)|Ulysses]]'' by [[James Joyce]].</ref><ref>{{cite journal|journal=James Joyce Quarterly|first=Anne|last=Nolan|title=Father Charles of Mount Argus, 1821-1893|url=https://archive.org/details/sim_james-joyce-quarterly_summer-1992_29_4/page/841|date=Summer 1992|volume= 29|number=No. 4|pages=841–845|jstor = 25485327}}</ref> na wale waliohitaji [[ushauri nasaha]], hasa katika [[kitubio]]<ref>[[Martyrologium Romanum]]</ref>. [[Papa Yohane Paulo II]] alimtangaza [[mwenye heri]] [[tarehe]] [[16 Oktoba]] [[1988]], na [[Papa Benedikto XVI]] alimtangaza [[mtakatifu]] tarehe [[3 Juni]] [[2007]]. [[Sikukuu]] yake huadhimishwa tarehe ya [[kifo]] chake<ref>[[Martyrologium Romanum]]</ref>. [[File:Father Charles of Mount Argus.jpg|thumb|250px|Kaburi lake katika Mount Argus Church, Dublin.|right]] ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{Reflist}} ==Viungo vya nje== *[https://web.archive.org/web/20070624133742/http://www.catholic-forum.com/saints/saintc2p.htm Charles of Mount Argus] at Catholic Forum *[https://web.archive.org/web/20091209084606/https://www.vatican.va/news_services/liturgy/saints/ns_lit_doc_20070603_carlo-andrea_en.html Biography of Fr. Charles of St. Andrew (1821–1893)] {{mbegu-Mkristo}} {{BD|1821|1893}} [[Category:Mapadri]] [[Category:Wapasionisti]] [[Category:Watakatifu wa Uholanzi]] j5lp708uubq6eayywuo16lc1nrkf9qz 0 126060 1578221 1146276 2026-07-03T03:53:17Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578221 wikitext text/x-wiki [[File:Unload wheat by the combine Claas Lexion 584.jpg|thumb|upright=2.2|[[Mavuno]] ya [[ngano]] kwa [[vifaa]] vya kisasa yanawatimizia wengi mahitaji ya chakula.]] '''Uzalishaji''' (kutoka [[kitenzi]] ''kuzaa'', kilichonyambulishwa kuwa ''kuzalisha'') ni mchakato wa kutumia [[akili]], [[ujuzi]] n.k. ili kufanya [[mali]] na [[vitu]] kwa jumla viongezeke kulingana na mahitaji ya [[binadamu]], kuanzia [[chakula]]<ref>"Kotler", P., Armstrong, G., Brown, L., and Adam, S. (2006) ''Marketing'', 7th Ed. Pearson Education Australia/Prentice Hall.</ref> The area of economics that focuses on production is referred to as production theory, which in many respects is similar to the consumption (or consumer) theory in economics.<ref>[https://assets.cambridge.org/97811070/36161/frontmatter/9781107036161_frontmatter.pdf Sickles, R., & Zelenyuk, V. (2019). Measurement of Productivity and Efficiency: Theory and Practice. Cambridge: Cambridge University Press. doi:10.1017/9781139565981 ]</ref>, badala ya kutarajia viwatoshe daima kama ilivyo katika [[maisha]] ya [[wawindaji-wakusanyaji]] wanaoendeleza [[utamaduni]] wa watu wa kale hadi miaka 10,000 hivi iliyopita. Ndipo wengine walipoanza shughuli za [[ufugaji]] na [[kilimo]] zilizosababisha [[ustaarabu]] uliozidi kustawi na kuenea [[duniani]] kote pamoja na namna nyingi za [[uchumi]]. ==Tanbihi== {{reflist}} ==Marejeo== {{refbegin}} * {{cite book | last =Courbois | first =R. | authorlink = |author2=Temple, P. | title =La methode des "Comptes de surplus" et ses applications macroeconomiques | publisher =160 des Collect,INSEE,Serie C (35) | year =1975 | location = | pages =100 | url = | doi = | isbn = }} * {{cite journal | last =Craig | first =C. |author2=Harris, R. | title =Total Productivity Measurement at the Firm Level | journal =Sloan Management Review | volume = | issue =Spring 1973 | pages =13–28 | year =1973 | url = | doi =| ref =harv }} * {{cite journal | last =Genesca | first =G.E. |author2=Grifell, T. E. | title =Profits and Total Factor Productivity: A Comparative Analysis | journal =Omega. The International Journal of Management Science | volume = 20 | issue = 5/6 | pages =553–568 | year =1992 | url =https://archive.org/details/sim_omega_september-november-1992_20_5-6/page/553 | doi =10.1016/0305-0483(92)90002-O| ref =harv }} * {{cite journal | last =Gollop | first =F.M. | title = Accounting for Intermediate Input: The Link Between Sectoral and Aggregate Measures of Productivity Growth | journal =Measurement and Interpretation of Productivity | volume = | issue = | pages = | publisher =National Academy of Sciences | year =1979 | url = | doi =| ref =harv }} * {{cite journal | last =Hulten | first =C. R. | title =Total Factor Productivity: A Short Biography | journal = NBER Working Paper No. 7471 | date=January 2000 | doi =10.3386/w7471| ref =harv | doi-access =free }} * {{cite journal | last =Hulten | first =C. R. | title = Growth Accounting | date = September 2009 | journal = NBER Working Paper No. 15341 | doi =10.3386/w15341 | ref =harv | doi-access =free }} * {{cite conference | first =D.W. | last =Jorgenson | authorlink = |author2=Ho, M.S. |author3=Samuels, J.D. | title =Long-term Estimates of U.S. Productivity and Growth | booktitle = | pages = | publisher =Third World KLEMS Conference | year =2014 | location =Tokyo | url = http://www.worldklems.net/conferences/worldklems2014/worldklems2014_Ho.pdf | doi = | accessdate = }} * {{cite journal | last =Kurosawa | title =An aggregate index for the analysis of productivity | journal =Omega | volume =3 | issue =2 | pages =157–168 | year =1975 | url = | doi =10.1016/0305-0483(75)90115-2| authorlink = | first1 =K| ref =harv }} * {{cite journal | last =Loggerenberg van | first =B. |author2=Cucchiaro, S. | title =Productivity Measurement and the Bottom Line | journal =National Productivity Review | volume = 1 | issue = 1 | pages =87–99 | year =1982 | url = | doi =10.1002/npr.4040010111| ref =harv }} * {{cite book | last =Pineda | first =A. | authorlink = | title =A Multiple Case Study Research to Determine and respond to Management Information Need Using Total-Factor Productivity Measurement (TFPM). | publisher =Virginia Polytechnic Institute and State University | year =1990 | location = | pages = | url = | doi = | isbn = }} * {{cite book | last =Riistama | first =K. |author2=Jyrkkiö E. | title =Operatiivinen laskentatoimi (Operative accounting) | publisher = Weilin + Göös | year =1971 | location = | pages =335 | url = | doi = | isbn = }} * {{cite book | last =Saari | first =S. | authorlink = | title =Productivity. Theory and Measurement in Business. Productivity Handbook (In Finnish) | publisher = MIDO OY | year =2006a | location = | pages =272 | url = | doi = | isbn = }} * {{cite book | last =Saari | first =S. | authorlink = | title =Production and Productivity as Sources of Well-being | publisher = MIDO OY | year =2011 | location = | pages =25 | url = http://www.mido.fi/Index_tiedostot/Artikkeli%202011.htm | doi = | isbn = }} * {{cite conference | first =S. | last =Saari | authorlink = | title =Productivity. Theory and Measurement in Business | booktitle = | pages = | publisher =European Productivity Conference | year = 2006 | location =Espoo, Finland | url = http://www.mido.fi/Index_tiedostot/Productivity%202006.htm |format=PDF| doi = | accessdate = }} * Sickles, R., and Zelenyuk, V. (2019). Measurement of Productivity and Efficiency: Theory and Practice. Cambridge: Cambridge University Press. https://assets.cambridge.org/97811070/36161/frontmatter/9781107036161_frontmatter.pdf {{refend}} ==Marejeo mengine== *Moroney, J. R. (1967) Cobb-Douglass production functions and returns to scale in US manufacturing industry, ''Western Economic Journal'', vol 6, no 1, December 1967, pp 39–51. *Pearl, D. and Enos, J. ('''1975''') Engineering production functions and technological progress, ''The Journal of Industrial Economics'', vol 24, September 1975, pp 55–72. *Robinson, J. (1953) The production function and the theory of capital, ''Review of Economic Studies'', vol XXI, 1953, pp.&nbsp;81–106 *[[Anwar Shaikh (Economist)|Anwar Shaikh]], "Laws of Production and Laws of Algebra: The Humbug Production Function", in The Review of Economics and Statistics, Volume 56(1), February 1974, p.&nbsp;115-120. http://homepage.newschool.edu/~AShaikh/humbug.pdf {{Wayback|url=http://homepage.newschool.edu/~AShaikh/humbug.pdf |date=20050518113632 }} *[[Anwar Shaikh (Economist)|Anwar Shaikh]], "Laws of Production and Laws of Algebra—Humbug II", in Growth, Profits and Property ed. by Edward J. Nell. Cambridge, Cambridge University Press, 1980. http://homepage.newschool.edu/~AShaikh/humbug2.pdf {{Wayback|url=http://homepage.newschool.edu/~AShaikh/humbug2.pdf |date=20050518112119 }} *[[Anwar Shaikh (Economist)|Anwar Shaikh]], "Nonlinear Dynamics and Pseudo-Production Functions", published?, 2008. https://web.archive.org/web/20120603132106/http://homepage.newschool.edu/~AShaikh/Nonlinear%20Dynamics%20and%20Pseudo-Production%20Functions.pdf *Shephard, R (1970) ''Theory of cost and production functions'', Princeton University Press, Princeton NJ. *Sickles, R., and Zelenyuk, V. (2019). Measurement of Productivity and Efficiency: Theory and Practice. Cambridge: Cambridge University Press. doi:10.1017/9781139565981 https://assets.cambridge.org/97811070/36161/frontmatter/9781107036161_frontmatter.pdf *Thompson, A. (1981) ''Economics of the firm, Theory and practice'', 3rd edition, Prentice Hall, Englewood Cliffs. ISBN|0-13-231423-1 ==Viungo vya nje== *Elmer G. Wiens: [http://www.egwald.ca/economics/productionfunctions.php Production Functions] - Models of the Cobb-Douglas, C.E.S., Trans-Log, and Diewert Production Functions. {{mbegu-uchumi}} [[Category:Uchumi]] [[Category:Kazi]] 05azh1h8s73gmv2wooelbn1sxdvxeb8 0 126174 1578177 1572207 2026-07-02T23:52:27Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578177 wikitext text/x-wiki '''Utambuzi wa mpangilio wa DNA''' ([[ADN|Asidi Deoksiribo Nukleini]]) ni mchakato wa kung'amua mlolongo wa asidi deoksiribonukleini yaani mpangilio wa [[nukleotidi]] katika [[molekuli]] ya DNA. Hii inahusisha njia au [[teknolojia]] yoyote inayotumika kung'amua mpangilio wa nukleotidi nne za msingi: adenine, guanine, cytosine, na thymine. Kuvumbuliwa kwa njia za haraka za kubaini mpangilio wa DNA kumeongeza sana [[kasi]] ya [[utafiti]] na ugunduzi wa [[Biolojia|kibiolojia]] na [[afya]]<ref>{{cite web|url=https://theconversation.com/introducing-dark-dna-the-phenomenon-that-could-change-how-we-think-about-evolution-82867|title=Introducing 'dark DNA' – the phenomenon that could change how we think about evolution}}</ref><ref>{{cite journal | vauthors = Behjati S, Tarpey PS | title = What is next generation sequencing? | journal = Archives of Disease in Childhood. Education and Practice Edition | volume = 98 | issue = 6 | pages = 236–8 | date = December 2013 | pmid = 23986538 | pmc = 3841808 | doi = 10.1136/archdischild-2013-304340 }}</ref>. Maarifa ya mpangilio wa DNA yamekuwa muhimu kwenye maeneo mengi ya utafiti wa msingi wa kibaolojia, na katika nyanja nyingne zinazohusika kama vile utafiti wa kimatibabu, bioteknolojia, biolojia ya ujasusi, biolojia ya virusi na biolojia ya mifumo. Kulinganisha mlolongo wa DNA kunaweza kusaidia katika upimaji wa magonjwa mbalimbali ikijumuisha saratani kadhaa,<ref>{{cite journal | vauthors = Chmielecki J, Meyerson M | title = DNA sequencing of cancer: what have we learned? | journal = Annual Review of Medicine | volume = 65 | issue = 1 | pages = 63–79 | date = 2014-01-14 | pmid = 24274178 | doi = 10.1146/annurev-med-060712-200152 }}</ref> kutambua uwepo wa antibodi, na pia kutoa mwongozo wa matibabu ya mgonjwa.<ref>{{cite journal | vauthors = Pekin D, Skhiri Y, Baret JC, Le Corre D, Mazutis L, Salem CB, Millot F, El Harrak A, Hutchison JB, Larson JW, Link DR, Laurent-Puig P, Griffiths AD, Taly V | display-authors = 6 | title = Quantitative and sensitive detection of rare mutations using droplet-based microfluidics | journal = Lab on a Chip | volume = 11 | issue = 13 | pages = 2156–66 | date = July 2011 | pmid = 21594292 | doi = 10.1039/c1lc20128j}}</ref> Kuwepo kwa na njia ya haraka ya kutambua mpangilio wa DNA inaruhusu kupatikana kwa huduma za kiafya mahsusi kwa mtu mmoja mmoja na kutambua na kuorodhesha viumbehai wengi zaidi. ==Matumizi== Kutambua mpangilio wa [[DNA]] unaweza kutumiwa kutambua mlolongo wa [[jeni]] mojamoja, maeneo makubwa ya kijenetikia, [[kromosomu]] kamili au [[jenomu]] nzima ya [[kiumbehai]] yeyote. Mpangilio wa DNA pia ni njia bora zaidi, isiyo ya moja kwa moja, ya kutambua mpangilio wa [[RNA]] au [[protini]]. Mpangilio wa DNA imekuwa teknolojia muhimu katika maeneo mengi ya biolojia na [[sayansi]] nyingine kama afya, uchunguzi na [[anthropolojia]]. ===Biolojia ya masi=== Mpangilio wa DNA hutumiwa katika biolojia ya [[masi]] kusoma [[seti]] nzima ya jeni na protini ambazo huzalishwa. Taarifa inayopatikana kwa kutumia mpangilio wa DNA inawasaidia watafiti kutambua mabadiliko katika jeni, uhusiano wa [[magonjwa]] na [[fenotipu]], na kutambua eneo lengwa la [[dawa]]. ===Biolojia ya mageuko=== Kwa kuwa DNA ni [[makromolekuli]] ambayo hubeba taarifa kutoka [[kizazi]] kimoja kwenda kingine, mpangilio wa DNA hutumiwa katika biolojia ya uvumbuzi kuelewa jinsi viumbehai tofauti vinavyohusiana na jinsi vilivyotokea. ===Metagenomics=== Sehemu ya metagenomics inajumuisha utambulisho wa viumbe vilivyopo kwenye vyanzo vikubwa vya [[maji]], [[maji taka]], [[uchafu]], uchafu uliochujwa kutoka hewani, au sampuli za [[swabu]] kutoka kwa viumbe. Kufahamu ni viumbe gani vilivyopo katika mazingira fulani ni muhimu sana kutafiti katika [[ekolojia]], [[epidemolojia]], [[mikrobiolojia]], na [[fani]] nyingine. Mpangilio wa safu huwawezesha watafiti kutambua ni aina gani za vijidudu ambazo zinaweza kuwapo, kwa mfano kwenye [[mikrobiomu]]. ===Virolojia=== Kwa kuwa virusi vingi ni vidogo sana kuonekana na darubini nyepesi, mpangilio wa DNA ni moja ya zana kuu kwenye [[virolojia]] katika kutambua na kusoma virusi. Mpangilio wa DNA kwa njia ya Sanger na ya mlolongo wa kizazi kinachofuata hutumika kwenye mlolongo wa virusi katika utafiti wa kimsingi na wa [[kliniki]], na vilevile kwenye utambuzi wa [[maambukizo]] ya virusi yanayoibuka, epidemolojia, na upimaji wa usugu wa dawa. Kuna mlolongo wa pekee wa virusi zaidi ya [[milioni]] 2.3 katika [[benki ya jeni]]<ref name=":0c" />. Hivi karibuni, mlolongo wa kizazi kinachofuata NGS umeizidi njia ya Sanger na kuwa njia maarufu zaidi kutengeneza [[jenomu]] ya virusi <ref name=":0c">{{cite journal |last1=Castro |first1=Christina |last2=Marine |first2=Rachel |last3=Ramos |first3=Edward |last4=Ng |first4=Terry Fei Fan |title=The effect of variant interference on de novo assembly for viral deep sequencing |doi=10.1101/815480 |url=https://www.biorxiv.org/content/10.1101/815480v1|year=2019 |doi-access=free }}</ref>. ===Afya=== Wataalamu wa Afya wanaweza kufuata jeni (au, kinadharia, jenomu kamili) kutoka kwa [[wagonjwa]] ili kubaini ikiwa kuna hatari ya magonjwa ya jenetikia. Hii ni aina ya upimaji wa kijenetikia, ingawa uchunguzi fulani wa kijenetikia hauwezi kuhusisha mpangilio wa DNA. Pia, mpangilio wa DNA unaweza kuwa na maana katika kutambua bakteria fulani, kuruhusu [[matibabu]] sahihi ya viua [[vijasumu]], na hivyo kupunguza hatari ya usugu wa [[vimelea]] dhidi ya dawa <ref>{{cite journal| pmid=28425484 | doi=10.1038/srep46327 | volume=7 | title=''Mycobacterium tuberculosis'' resistance prediction and lineage classification from genome sequencing: comparison of automated analysis tools | year=2017 | journal=Sci Rep | page=46327 | vauthors=Schleusener V, Köser CU, Beckert P, Niemann S, Feuerriegel S}}</ref><ref>{{cite journal| pmid=31106066 | doi=10.7717/peerj.6857 | volume=7 | title=A large scale evaluation of TBProfiler and Mykrobe for antibiotic resistance prediction in ''Mycobacterium tuberculosis'' | pmc=6500375 | year=2019 | journal=PeerJ | page=e6857 | vauthors=Mahé P, El Azami M, Barlas P, Tournoud M}}</ref><ref>{{Rejea tovuti |url=https://innovation.ox.ac.uk/wp-content/uploads/2015/04/Mykrobe-predictor-Poster.pdf |title=Mykrobe predictor –Antibiotic resistance prediction for S. aureus and M. tuberculosis from whole genome sequence data |accessdate=2020-05-15 |archive-date=2020-11-25 |archive-url=https://web.archive.org/web/20201125230635/https://innovation.ox.ac.uk/wp-content/uploads/2015/04/Mykrobe-predictor-Poster.pdf |url-status=dead }}</ref><ref>[https://www.nature.com/articles/ncomms10063 Rapid antibiotic-resistance predictions from genome sequence data for ''Staphylococcus aureus'' and ''Mycobacterium tuberculosis'']</ref><ref>{{Rejea tovuti |url=https://www.tvo.org/transcript/115187X/michael-mosley-vs-the-superbugs |title=Michael Mosley vs the superbugs |accessdate=2020-05-15 |archivedate=2020-11-24 |archiveurl=https://web.archive.org/web/20201124174040/https://www.tvo.org/transcript/115187X/michael-mosley-vs-the-superbugs }}</ref><ref>[https://github.com/Mykrobe-tools/mykrobe Mykrobe Predictor github]</ref>. ===Biolojia ya ujasusi=== Mpangilio wa DNA unaweza kutumika pamoja na njia za utengenezaji wa DNA kutambua kama [[ujasusi]] umefanyika <ref>{{Rejea habari|url=https://theconversation.com/from-the-crime-scene-to-the-courtroom-the-journey-of-a-dna-sample-82250|title=From the crime scene to the courtroom: the journey of a DNA sample|last=Curtis|first=Caitlin|last2=Hereward|first2=James | name-list-format = vanc |date=29 August 2017|work=The Conversation }}</ref>, na uthibitisho wa ubaba. Upimaji wa DNA umetokea sana katika miongo michache iliyopita ili hatimaye kuonesha uhusiano kati ya chapisho la DNA na kile kilicho chini ya uchunguzi. Mifumo ya DNA katika [[alama]] za [[vidole]], mshono, vipande vya [[nywele]], n.k. Hutofautisha kila kiumbehai na mwingine. Upimaji wa DNA ni mbinu ambayo inaweza kugundua jenomu maalumu katika strandi ya DNA ili kutoa muundo wa pekee wa mtu mmojammoja. ==Nukleotidi nne za msingi== Muundo wa DNA una nukleotidi nne za msingi: thymine (T), adenine (A), cytosine (C), na guanine (G). Mpangilio wa DNA ni utambuzi wa nukleotidi kwenye molekuli ya DNA. Walakini, kuna nukleotidi nyingine ambayo inaweza kuwapo kwenye molekuli hiyo. Katika virusi vingine (haswa, vinavyokula bakteria), cytosine inaweza kubadilishwa na hydroxy methyl au hydroxy methyl glucose cytosine<ref>{{cite journal | vauthors = Moréra S, Larivière L, Kurzeck J, Aschke-Sonnenborn U, Freemont PS, Janin J, Rüger W | title = High resolution crystal structures of T4 phage beta-glucosyltransferase: induced fit and effect of substrate and metal binding | url = https://archive.org/details/journal-of-molecular-biology_2001-08-17_311_3/page/569 | journal = Journal of Molecular Biology | volume = 311 | issue = 3 | pages = 569–77 | date = August 2001 | pmid = 11493010 | doi = 10.1006/jmbi.2001.4905 }}</ref>.<ref>{{cite journal | vauthors = Ehrlich M, Gama-Sosa MA, Huang LH, Midgett RM, Kuo KC, McCune RA, Gehrke C | title = Amount and distribution of 5-methylcytosine in human DNA from different types of tissues of cells | journal = Nucleic Acids Research | volume = 10 | issue = 8 | pages = 2709–21 | date = April 1982 | pmid = 7079182 | pmc = 320645 | doi = 10.1093/nar/10.8.2709 }}</ref><ref>{{cite journal | vauthors = Ehrlich M, Wang RY | title = 5-Methylcytosine in eukaryotic DNA | url = https://archive.org/details/sim_science_1981-06-19_212_4501/page/n36 | journal = Science | volume = 212 | issue = 4501 | pages = 1350–7 | date = June 1981 | pmid = 6262918 | doi = 10.1126/science.6262918 | bibcode = 1981Sci...212.1350E }}</ref> .<ref>{{cite journal | vauthors = Song CX, Clark TA, Lu XY, Kislyuk A, Dai Q, Turner SW, He C, Korlach J | display-authors = 6 | title = Sensitive and specific single-molecule sequencing of 5-hydroxymethylcytosine | journal = Nature Methods | volume = 9 | issue = 1 | pages = 75–7 | date = November 2011 | pmid = 22101853 | pmc = 3646335 | doi = 10.1038/nmeth.1779 }}</ref>. Katika DNA ya [[mamalia]], nukleotidi tofauti na vikundi vya methyl au [[phosphosulfate]] zinaweza kupatikana. Kulingana na mbinu za mpangilio, muundo fulani, k.m. 5mC (methyl cytosine) ya kawaida kwa wanadamu, inaweza au haiwezi kugunduliwa. ==Historia== ===Uvumbuzi wa muundo wa DNA na kazi yake=== Awali, DNA (ADN) iligunduliwa na kutengwa kutoka kwenye seli na [[Friedrich Miescher]] mnamo mwaka [[1869]], lakini uchunguzi wake haukushika kasi kwa miongo mingi kwa sababu protini, na si DNA, zilidhaniwa kuwa ndizo zilizobeba chapa ya jenetikia kwa ajili ya uhai. Hali hiyo ilibadilika mwaka [[1944]] baada ya matokeo ya majaribio kadhaa yaliyofanywa na [[Oswald Avery]], [[Colin uMacLeod]] na [[Maclyn McCarty]] ambapo walionesha kwamba DNA iliyotakatishwa inaweza kubadilisha aina moja ya bakteria kuwa aina nyingine. Hii ilikuwa mara ya kwanza DNA kuoneshwa kuwa na uwezo wa kubadilisha [[tabia]] za seli. Mnamo mwaka [[1953]], [[James Watson]] na [[Francis Crick]] waliwasilisha kuwa DNA ina muundo wa misokoto miwili kwa kutumia mfumo wa [[kristalografia]] ya [[miali-X]] uliochunguzwa na [[Rosalind Franklin]]. Kulingana na muundo huo, DNA ni mfano wa [[ngazi]] iliyosokotwa, iliyotengenezwa kwa [[ncha]] mbili za nukleotidi zenye muelekeo tofauti zilizoshikiliwa na viunganishi vya [[hidrojeni]]. Kila ncha imeundwa na nukleotidi kikamilisho - adenine(A), cytosine(C), guanine(G) na thymine(T) - ambapo A katika ncha moja huunganishwa na T katika ncha nyingine wakati C huunganishwa na G. Walipendekeza kuwa muundo huo huruhusu kila ncha kutumika kuunda upya ncha kamilisho nyingine, hii ndio [[dhana]] kuu ya urithishaji wa [[taarifa]] katika [[vizazi]].<ref name="pmid13168976">{{cite journal | vauthors = Watson JD, Crick FH | title = The structure of DNA | journal = Cold Spring Harb. Symp. Quant. Biol. | volume = 18 | pages = 123–31 | year = 1953 | pmid = 13168976 | doi = 10.1101/SQB.1953.018.01.020 }}</ref> Msingi wa utambuzi mpangilio wa protini uliwekwa kwa mara ya kwanza kupitia kazi ya [[Frederick Sanger]] ambaye mwaka [[1955]] alikamilisha mlolongo wote wa [[asidi amino]] katika protini ndogo inayotolewa na [[kongosho]] iitwayo [[insulini]]. Hii ilipelekea kuwepo kwa ushahidi wa kwanza uliothibitisha kuwa protini ni [[dutu]] za [[kemikali]] zenye ruwaza mahususi ya kimolekuli, si mchanganyiko holela wa nyenzo mbalimbali katika kimiminika. Mafanikio ya Sanger katika utambuzi mpangilio wa insulini yalichochea zaidi wanakristalografia wa miali-X, wakiwemo Watson na Crick, ambao kwa muda huo walikua wakijaribu kufuatilia namna DNA inavyoelekeza utengenezwaji wa protini ndani ya seli. Baada ya kuhudhuria mihadhara kadhaa ya Frederick Sanger mfululizo mnamo Oktoba 1954, Crick alianzisha nadharia yake iliyohoji kwamba mpangilio wa nukleotidi katika DNA ndio unaoamua mpangilio wa asidi amino katika protini: hii ilisaidia kutambua kazi ya protini husika. Aliichapisha nadharia hiyo mnamo mwaka [[1958]].<ref>[http://www.whatisbiotechnology.org/exhibitions/sanger/path Marks, L, The path to DNA sequencing: The life and work of Frederick Sanger].</ref> ===Utambuzi mpangilio wa RNA=== [[Utambuzi mpangilio wa RNA]] ulikuwa moja ya aina za mwanzo za utambuzi mpangilio wa nukleotidi. [[Alama]] kuu ya mchakato wa utambuzi mpangilio wa RNA ni mlolongo kamili wa jeni na jenomu ya kwanza ya [[Bacteriophage MS2]], iliyotambuliwa na kuchapishwa na [[Walter Fiers]] na wafanyakazi wenzake katika [[Chuo Kikuu cha Ghent]] ([[Ghent]], [[Ubelgiji]]), mnamo mwaka [[1972]] <ref>{{cite journal | vauthors = Min Jou W, Haegeman G, Ysebaert M, Fiers W | title = Nucleotide sequence of the gene coding for the bacteriophage MS2 coat protein | url = https://archive.org/details/sim_nature-uk_1972-05-12_237_5350/page/82 | journal = Nature | volume = 237 | issue = 5350 | pages = 82–8 | date = May 1972 | pmid = 4555447 | doi = 10.1038/237082a0 | bibcode = 1972Natur.237...82J }}</ref> na 1976.<ref>{{cite journal | vauthors = Fiers W, Contreras R, Duerinck F, Haegeman G, Iserentant D, Merregaert J, Min Jou W, Molemans F, Raeymaekers A, Van den Berghe A, Volckaert G, Ysebaert M | title = Complete nucleotide sequence of bacteriophage MS2 RNA: primary and secondary structure of the replicase gene | url = https://archive.org/details/sim_nature-uk_1976-04-08_260_5551/page/n33 | journal = Nature | volume = 260 | issue = 5551 | pages = 500–7 | date = April 1976 | pmid = 1264203 | doi = 10.1038/260500a0 | bibcode = 1976Natur.260..500F }}</ref>. Njia za jadi za utambuzi mpangilio wa RNA zinahitaji uundaji wa molekuli ya [[cDNA]] ambayo lazima ifanyiwe utaratibu wa utambuzi mpangilio.<ref>{{cite journal | vauthors = Ozsolak F, Milos PM | title = RNA sequencing: advances, challenges and opportunities | journal = Nature Reviews Genetics | volume = 12 | issue = 2 | pages = 87–98 | date = February 2011 | pmid = 21191423 | pmc = 3031867 | doi = 10.1038/nrg2934 }}</ref> ==Tanbihi== {{reflist}} {{mbegu-biolojia}} [[Jamii:Jenetikia]] 22p3ogi0ohorbsnavbc784ja38kh15z 0 129275 1578147 1536496 2026-07-02T22:09:41Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578147 wikitext text/x-wiki {{Infobox saint |jina= Aristide wa Athens |tarehe ya kuzaliwa= karne ya 1 |death_date= |feast_day= |venerated_in= |picha=Aristides.jpg |imagesize= |maelezo ya picha=Picha takatifu ya Mt. Aristide. |birth_place= |death_place= |titles= |beatified_date= |beatified_place= |beatified_by= |canonized_date= |canonized_place= |canonized_by= |attributes= |patronage= |major_shrine= |suppressed_date= |issues= }} '''Aristide wa Athens''' (alizaliwa [[Athens]], [[Ugiriki]], [[karne ya 1]]) alikuwa [[mwanafalsafa]] mwenye [[imani]] na [[hekima]] ambaye, kisha kuongoka, alieneza na kutetea [[Ukristo]] hata kwa [[maandishi]] maarufu aliyomtumia [[Kaizari|kaisari]] [[Kaizari Hadrian|Hadriano]]<ref>https://www.santiebeati.it/dettaglio/68400</ref>. Anaheshimiwa na [[Kanisa Katoliki]] na [[Waorthodoksi]] kama [[mtakatifu]]. [[Sikukuu]] yake huadhimishwa [[tarehe]] [[31 Agosti]]<ref>[[Martyrologium Romanum]]</ref> au [[13 Septemba]]<ref>{{cite web|last1=Theodropolous|first1=Aristides|title=Dr.|url=http://www.johnsanidopoulos.com/2012/09/the-holy-martyr-aristides-philosopher.html|website=Mystagogy Resource Center}}</ref>. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] *[[Mababu wa Kanisa]] ==Tanbihi== {{reflist}} ==Vyanzo== {{Refbegin|2}} *{{cite book|last=Carrington|first=Philip|title=Christian Apologetics of the Second Century in their Relation to Medieval Thought|year=1921|location=New York|publisher=The Macmillan Company|url=https://books.google.com/books?id=l-FHAQAAIAAJ|ref=harv}} *{{cite book|last=Cayré|first=Fulbert|title=Manual of Patrology and History of Theology (Volume 1)|year=1936|location=Paris|publisher=Society of St. John the Evangelist, Desclée & Co.|url=https://books.google.com/books?id=QGrYAAAAMAAJ|ref=harv}} *{{cite journal|last=Fairweather|first=W.|title=The Greek Apologists of the Second Century|url=https://archive.org/details/sim_biblical-world_1905-08_26_2/page/132|journal=The Biblical World|volume=26|number=2|year=1905|pages=132–143|jstor=3141139|ref=harv|doi=10.1086/473625}} *{{cite journal|last=Grant|first=Robert M.|title=The Chronology of the Greek Apologists|journal=Vigiliae Christianae|volume=9|number=1|year=1955|pages=25–33|ref=harv|doi=10.1163/157007255x00035|jstor=1582007}} *{{cite book|last=Harris|first=J. Rendel|title=The Apology of Aristides on Behalf of the Christians|year=1891|location=Cambridge|publisher=Cambridge University Press|url=https://books.google.com/books?id=WytLAwAAQBAJ|ref=harv|isbn=9781592448470}} *{{cite book|last=Jurgens|first=William A.|title=The Faith of the Early Fathers|year=1970|location=Collegeville, MN|publisher=The Order of St. Benedict, Inc. (Liturgical Press)|isbn=978-0-81-460432-8|url=https://books.google.com/books?id=l62q-d4Wi20C|ref=harv}} *{{cite journal|last=Milne|first=H.J.M.|title=A New Fragment of the Apology of Aristides|url=https://archive.org/details/sim_journal-of-theological-studies_1923-10_25_97/page/73|journal=Journal of Theological Studies|volume=25|issue=97|year=1923|pages=73–77|ref=harv|doi=10.1093/jts/os-XXV.97.73}} *{{cite journal|last=O'Ceallaigh|first=G.C.|title="Marcianus" Aristides, On the Worship of God|url=https://archive.org/details/harvard-theological-review_1958-10_51_4/page/227|journal=The Harvard Theological Review|volume=51|number=4|year=October 1958|pages=227–254|ref=harv|doi=10.1017/s0017816000028674|jstor=1508704}} *{{cite journal|last=Palmer|first=D.W.|title=Atheism, Apologetic, and Negative Theology in the Greek Apologists of the Second Century|url=https://archive.org/details/vigiliae-christianae_1983-09_37_3/page/234|journal=Vigiliae Christianae|volume=37|number=3|year=September 1983|pages=234–259|ref=harv|doi=10.1163/157007283x00098|jstor=1583085}} *{{cite book|last=Quasten|first=Johannes|title=Patrology: Volume 1 – The Beginnings of Patristic Literature|year=1950|location=Utrecht|publisher=Spectrum Publishers|url=https://books.google.com/?id=6v8rAQAAMAAJ|ref=harv}} *{{cite journal|last=Shepherd|first=Massey Hamilton Jr.|title=The Early Apologists and Christian Worship|url=https://archive.org/details/sim_journal-of-religion_1938-01_18_1/page/60|journal=The Journal of Religion|volume=18|number=1|year=January 1938|pages=60–79|ref=harv|doi=10.1086/482092|jstor=1197201}} *{{cite journal|last=Wolff|first=Robert Lee|title=The Apology of Aristides: A Re-Examination|url=https://archive.org/details/harvard-theological-review_1937-10_30_4/page/233|journal=The Harvard Theological Review|volume=30|number=4|year=October 1937|pages=233–247|ref=harv|doi=10.1017/s0017816000021453|jstor=1508250}} {{Refend|2}} == Marejeo mengine == *{{cite book|last=Altaner|first=Berthold|title=Patrology|year=1960|location=New York|publisher=Herder and Herder|url=https://books.google.com/books?id=3NcNAQAAIAAJ|ref=harv}} == Viungo vya nje == *{{Commons category-inline}} *[http://www.tertullian.org/fathers/index.htm#Aristides Translation of 1891 Syriac version of the ''Apology'' of Aristides] {{mbegu-Mkristo}} [[Jamii:Waliozaliwa karne ya 1]] [[Jamii:Waliofariki karne ya 2]] [[Category:Wanafalsafa wa Ugiriki]] [[Jamii:waandishi wa Kigiriki]] [[Category:Mababu wa Kanisa]] [[Jamii:Watakatifu wa Ugiriki]] afh3qdch1hfro2b4eba6fkxxfft50se 0 135727 1578105 1466696 2026-07-02T20:05:28Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578105 wikitext text/x-wiki {{infobox | name = | logo = | logo_alt = | logo_size = | image = | image_alt = | image_size = | caption = [[Virginia Theatre (Champaign)|Virginia Theatre's]] Ebertfest ilipofanyika mwaka 2014 | status = Active | genre = [[Film festival]] | date = <!-- {{start date|YYYY|mm|dd}} "dates=" also works, but do not use both --> | begins = <!-- {{start date|YYYY|mm|dd}} --> | ends = <!-- {{start date|YYYY|mm|dd}} --> | frequency = Annually | venue = | location = [[Champaign, Illinois]] | coordinates = | country = United States | years_active = 1999–present | first = | founder_name = [[Roger Ebert]] | last = | prev = 21st Annual Ebertfest<br />April 10–13, 2019 | next = 22nd Annual Ebertfest<br />September 8–11, 2021 | participants = | attendance = | capacity = 1,463 (Virginia Theatre) | area = | budget = | activity = | leader_name = | patron = | organised = | filing = | people = [[Roger Ebert]]<br />[[Chaz Ebert]] | member = | sponsor = | website = {{URL|ebertfest.com}} | footnotes = }} '''Ebertfest''' ni [[tamasha]] la [[filamu]] la kila mwaka ambalo hufanyika mwezi Aprili huko [[Champaign, Illinois|Champaign]], [[Illinois]], [[Marekani]], ikiandaliwa na chuo cha habari cha UIUC College of Media<ref>{{cite web|url=https://media.illinois.edu/ebert|title=The Roger Ebert Center|author=<!--Staff writer(s); no by-line.-->|website=media.illinois.edu|publisher=University of Illinois College of Media|access-date=19 May 2016|accessdate=2021-05-16|archivedate=2018-05-12|archiveurl=https://web.archive.org/web/20180512055527/https://media.illinois.edu/ebert}}</ref> katika chuo kikuu cha Illinois huko Urbana–Champaign. Roger Ebert, mkosoaji wa filamu kwenye [[Televisheni|runinga]] na jarida la ''Chicago Sun-Times'', alikuwa mkazi wa [[mji]] wa Urbana, Illinois na ni mwanafunzi wa zamani wa chuo kikuu hicho.<ref name="milestones">{{cite news |author=<!--Staff writer(s); no by-line.--> |date=April 5, 2013 |title=Milestones in the life of Roger Ebert|url=http://www.news-gazette.com/news/local/2013-04-05/milestones-life-roger-ebert.html |newspaper=News-Gazette |location=Champaign, IL |access-date=19 May 2016 }}</ref> Ilianzishwa mnamo mwaka 1999 ikipewa jina la "Roger Ebert's Overlooked Film Festival", ambapo tukio hili limekuwa tamasha lakipekee kwa muda mrefu lililotokana na ukosoaji wa filamu.<ref name="milestones" /><ref>{{cite journal |last=Bordwell |first=David |date=May–June 2013 |title=The Fifth Estate: How Roger Ebert personified the critic as conversationalist |url=https://archive.org/details/sim_film-comment_may-june-2013_49_3/page/12 |journal=Film Comment |volume=49 |issue=3 |pages=12–13}}</ref> Ukiachana na kifo cha Ebert mwaka 2013,<ref name="milestones" /> tamasha lomekuwa likiendelea kufanyika kwakufuatia maelezo na maono ya Ebert kwa aina za filamu ambazo zimekuwa zikishindaniwa.<ref name="vision">{{cite web |url=http://www.ebertfest.com/PDFs/2015EbertProgram.pdf |title=Festival remains true to Ebert's vision |last1=Kohn |first1=Nate |date=April 2015 |website=ebertfest.com |page=11 |access-date=6 June 2016 |url-status=dead |archive-url=https://web.archive.org/web/20160509071842/http://ebertfest.com/PDFs/2015EbertProgram.pdf |archive-date=9 May 2016 |accessdate=2021-05-16 |archivedate=2016-05-09 |archiveurl=https://web.archive.org/web/20160509071842/http://ebertfest.com/PDFs/2015EbertProgram.pdf }}</ref><ref>{{cite news|last=Caro|first=Mark|url=http://www.chicagotribune.com/entertainment/chi-ebert-website-caro-20140110-column.html|title=Chaz Ebert's mission goes on|date=January 12, 2014|newspaper=Chicago Tribune|access-date=8 June 2016}}</ref> Tamasha la mwaka 2020 halikuweza kufanyika kutokana na janga kubwa la COVID-19. Toleo la 22 la tukio limepangwa kufanyika mwezi wa tisa mwaka huu(2021).<ref>{{cite web |url=https://www.rogerebert.com/festivals/ebertfest-2021-to-take-place-september-8-11 |title=Ebertfest Film Festival Announces Newly Revised Dates: September 8-11, 2021 |last=Ebert |first=Chaz |author-link=Chaz Ebert |date=August 12, 2020 |website=RogerEbert.com |access-date=February 5, 2021}}</ref> == Mabadiliko ya jina == Mwezi Aprili mwaka 2007 ilitangazwa kuwa kwanzia mwaka 2008 ikiizamwa kuwa awamu ya kumi ya tamasha jina litabadilishwa na kuitwa "Roger Ebert's Film Festival",<ref>{{cite news |last=Emerick |first=Laura|date=30 April 2007|title=’Overlooked’ becomes a lovefest … |newspaper= Chicago Sun-Times|edition=Final|page=Features, 53}}</ref> japo kawaida inajulikana kwa jina la Ebertfest. Hichi hakikubadili falsafa ya tukio zima <ref>{{cite web|url= https://news.illinois.edu/blog/view/6367/206513|title= Passes for 10th Ebert film fest, no longer ‘overlooked’, go on sale Nov.1|last1= Chamberlain|first1= Craig|date= 15 October 2007|website= news.illinois.edu|publisher= Illinois News Bureau|access-date= 21 May 2016|archive-date= 2017-05-05|archive-url= https://web.archive.org/web/20170505214211/https://news.illinois.edu/blog/view/6367/206513|url-status= dead}}</ref>imesaidia kuondoa adha ya kuelezea uwepo wa filamu za hivi karibuni na ambazo bado hazijatoka zinajumuishwa kwenye tamasha. Mara kwa mara imekuwa ikitaniwa kama "iliyotazamwa."<ref>{{cite news |last= Emerick|first=Laura |date= 25 April 2005|title=Ebert’s overlooked films get a shot |newspaper= Chicago Sun-Times|page=Features, 62}}</ref> == Ukumbi == Tangu ilipoanzishwa mwaka 1999, Ebertfest imefanyika kwenye tovuti ya <ref>http://thevirginia.org/history/ Virginia Theatre</ref>, sinema ya zamani huko Champaign iliyojengwa mwaka 1921 na iliyowekwa kwenye orodha ya kumbukumbu ya maeneo ya kihistoria.<ref>{{cite news |last=Emerick |first=Laura|date=May 1, 2006|title=A community for cinema: Ebert and fans give bypassed movies an avid audience |newspaper=Chicago Sun Times| edition=Final|page=39}}</ref><ref name="milestones"/> Sinema kwa sasa inamilikiwa na Champaign Park District. Ebert aliwahi kuongelea kuhudhuria filamu huko Virginia kipindi anakua huko Champaign-Urbana na pia aliwahi kuwa mwanafunzi chuoni hapo.<ref>{{cite web|url=http://www.ebertfest.com/PDFs/2011EbertProgram.pdf|title=Renovations bring local treasure back to life|last1=Silverberg|first1=Melissa|date=April 2011|website=ebertfest.com|page=15|url-status=dead|archive-url=https://web.archive.org/web/20160509063304/http://ebertfest.com/PDFs/2011EbertProgram.pdf|archive-date=9 May 2016|access-date=22 May 2016|accessdate=2021-05-17|archivedate=2016-05-09|archiveurl=https://web.archive.org/web/20160509063304/http://ebertfest.com/PDFs/2011EbertProgram.pdf}}</ref> Ilikuwa ni nia ya Ebert kwamba wahudhuriaji wote wa tamasha waweze kuangalia filamu zote kwenye sinema moja kwa ajili ya kujenga hisia ya jamii kwa wapenzi wa filamu.<ref name="show">{{cite news |url=http://www.news-gazette.com/news/local/2006-04-26/show.html |title=On with the show|last1=Merli |first1=Melissa |date=April 26, 2006|website=News-Gazette|location=Champaign, IL|access-date=10 July 2016}}</ref> Mwaka 2014, sanamu ya shaba ya Roger Ebert ilifunuliwa nje ya sinema ya Virginia kama ishara ya ushuru kwa Ebert na Ebertfest.<ref>{{cite web |url=http://www.ebertfest.com/PDFs/2014EbertProgram.pdf |title=Life-size statue commemorates Ebert |last1=Weber |first1=Ryan |date=April 2014 |website=ebertfest.com |page=17 |access-date=6 June 2016 |url-status=dead |archive-url=https://web.archive.org/web/20160509114015/http://ebertfest.com/PDFs/2014EbertProgram.pdf |archive-date=9 May 2016 |accessdate=2021-05-17 |archivedate=2016-05-09 |archiveurl=https://web.archive.org/web/20160509114015/http://ebertfest.com/PDFs/2014EbertProgram.pdf }}</ref> === Kukua === Kwa kupitia michango, sinema ya Virginia imekuwa na uwezo wakuwa na vifaa bora kwenye upande wa maonyesho na sauti yenye uwezo mkubwa ambayo ni toleo la hivi karibuni.<ref name="FAQ1">{{cite web|url=http://www.ebertfest.com/faq.html|title=FAQs/General Festival Questions|website=eberfest.com|access-date=22 May 2016|url-status=dead|archive-url=https://web.archive.org/web/20160527192426/http://www.ebertfest.com/faq.html|archive-date=27 May 2016|accessdate=2021-05-17|archivedate=2016-05-27|archiveurl=https://web.archive.org/web/20160527192426/http://www.ebertfest.com/faq.html}}</ref><ref>{{cite web|url=http://www.ebertfest.com/PDFs/2014EbertProgram.pdf|title=Sponsors|author=<!--Staff writer(s); no by-line.-->|date=April 2014|website=ebertfest.com|page=84|url-status=dead|archive-url=https://web.archive.org/web/20160509114015/http://ebertfest.com/PDFs/2014EbertProgram.pdf|archive-date=9 May 2016|access-date=22 May 2016|accessdate=2021-05-17|archivedate=2016-05-09|archiveurl=https://web.archive.org/web/20160509114015/http://ebertfest.com/PDFs/2014EbertProgram.pdf}}</ref> Pazia la sinema lina upana wa futi 56 na [[urefu]] wa futi 23 , ikiwa na eneo la picha inayoonekana hadi futi 50 upana na futi 21½ urefu. Wazungumzaji wakuu wanakaa nyuma ya pazia wakati wa maonyesho ya filamu na imeongezwa na vipaza sauti 36 kuwazunguka.<ref>{{cite web |url=http://thevirginia.org/venue-information/venue-rentals/#screen|title=Venue Rentals |author=<!--Staff writer(s); no by-line.--> |website=thevirginia.org |publisher=Champaign Park District |access-date=21 April 2017}}</ref> Ala kwenye hizi visasisho zimekuwa mashuhuri huko Chicago kulingana na mtabiri nguli James Bond ambaye anakuwa mtabiri wakati wa Tamasha .<ref>{{cite web |url=http://www.ebertfest.com/PDFs/2014EbertProgram.pdf |title=Welcome to Ebertfest! |last1=Ebert |first1=Chaz |date=April 2014 |website=ebertfest.com |page=7 |access-date=6 June 2016 |url-status=dead |archive-url=https://web.archive.org/web/20160509114015/http://ebertfest.com/PDFs/2014EbertProgram.pdf |archive-date=9 May 2016 |accessdate=2021-05-17 |archivedate=2016-05-09 |archiveurl=https://web.archive.org/web/20160509114015/http://ebertfest.com/PDFs/2014EbertProgram.pdf }}</ref> === Uwezo === Tangu mwaka 2013, sinema ya Virginia imekuwa na uwezo wa kupokea watu 1,463.<ref>{{cite web |url=http://thevirginia.org/history/|title=The Virginia Experience |author=<!--Staff writer(s); no by-line.--> |website=thevirginia.org |publisher=Champaign Park District |access-date=21 May 2016}}</ref> sinema ikafungwa tangu 2012 mpaka April 2013 kwa ajili ya ukarabati ikijumuisha kubadili viti vyote. Uwezo ukashuka kutoka 1,550 hadi kufikia 1,463 lakini viti vilivyowekwa vilikuwa vya starehe zaidi na sinema ikawa ikitoa viti vya walemavu na kuwezesha ufikiaji wa marafiki.<ref>{{cite news |last=Vorel |first=Jim|date=May 24, 2012 |title=Champaign’s Virginia Theatre begins final phase of renovation|url=http://herald-review.com/entertainment/local/champaign-s-virginia-theatre-begins-final-phase-of-renovation/article_28ab0c3a-a5cb-11e1-a916-0019bb2963f4.html |newspaper=Herald & Review |location=Decatur, IL |access-date=21 May 2016}}</ref> == Asili == Tamasha hili ni mjukuu wa moja kwa moja <ref>{{cite web |url=http://dailyillini.com/uncategorized/2013/04/08/the-history-of-roger-eberts-famed-film-festival/ |title=The history of Roger Ebert’s famed film festival |author=<!--Staff writer(s); no by-line.--> |date=April 8, 2013|website=Daily Illini|access-date= 20 May 2016}}</ref> wa mpango iliyowekwa kwenye chuo kikuu cha Illinois huko Urbana–Champaign miaka ya 1997 ikipewa jina la Cyberfest ambayo ilitumia siku ya kuzaliwa inayodhaniwa ya HAL 9000|HAL (kompyuta kwenye filamu ya ''2001: A Space Odyssey (film)|2001: A Space Odyssey'' ikiangazia ushiriki wa chuo hicho kikuu kwenye historia ya kompyuta.<ref>{{cite web |url=http://www.boraski.com/obelisk/cyberfest/s_1997hal.html |title= 1997: The Coming of HAL|last1=Wurth |first1= Julie|date=1997 |website=boraski.com |publisher=Obelisk: The Cyberfest Newssite|access-date=20 May 2016}}</ref> Filamu hiyo ikatakiwa kuonyenywa kama sehemu ya tamasha la Cyberfest, ambapo Roger Ebert alikubali kuwa mtayarishaji akishirikiana na muigizaji Gary Lockwood kama mgeni rasmi.<ref name=HAL>{{cite web |url=https://www.wired.com/1997/03/cyberfest-celebrates-hal-in-urbana/ |title=Cyberfest Celebrates HAL in Urbana |last1=Kestenbaum |first1= David S.|date=March 17, 1997|website=Wired |access-date=20 May 2016}}</ref> Lilitolewa wazo la kuonyesha filamu hiyo ambayo ilikuwa yenye uhalisia na yenye [[ubora]] wa hali ya juu. Mpango wa mwanzo ulikuwa kufanya uchunguzi kwenye chuo kikuu hicho kwenye kitengo cha sanaa ila swala la muda na changamoto zingine nyingi zilichangia kutokuwezekana kwa mpango huo . Mtu mmoja akapendekeza kuangalia uwezekano wa mpango huo kufanyikia kwenye sinema ya Virginia (Champaign), kutokana na uwezo wa eneo hilo wakuonyesha filamu yenye ubora wa hali ya juu kipindi cha nyuma. Katika nafasi hii sinema hiyo inamilikiwa na kikundi cha maonyesho ya nyumbani ambao wamekuwa wakiendeleza mchakato mzima wa filamu tangu iuzwe na mnyororo wa wamiliki. Wahusika wote walishangazwa na kuachwa kwa projekta kubwa ya maonyesho pamoja na spika.Vifaa vingine vimekuwa vikiletwa kwa maonyesho maalum na baada yakumaliza kuvitumia huondolewa. ==Tanbihi== {{reflist}} [[Jamii:Illinois]] 6o4lv6ewijcnnev8i1zrhq9tm4kbmyv 0 136688 1578179 1309710 2026-07-03T00:19:50Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578179 wikitext text/x-wiki '''Aïssa Khelladi''' ni [[raia]] kutokea nchini [[Algeria]], ni [[mwandishi wa habari]], [[riwaya]] na [[maigizo]], ambaye alichapisha [[vitabu]] vya misingi ya [[Kiislamu]], [[tamthilia]] na [[riwaya]] mbalimabali ikiwemo ''Peurs et Mensonges'' na ''Rose d'abime''. Riwaya hizi zote mbili zinajikita katika hali ya sasa ya [[Algeria]].<ref name=":0">[http://www.africultures.com/php/index.php?nav=personne&no=5106 Aïssa KHELLADI] Africultures.com </ref><ref name=":1">{{cite journal|last=Toler|first=Michael|author2=Aïssa Khelladi|author3=Marie Virolle|date=July 2006|title=Literature, Art, and a Country in Crisis|url=https://archive.org/details/sim_world-literature-today_july-august-2006_80_4/page/16|journal=World Literature Today|volume=80|issue=4|pages=16–20|doi=10.2307/40159128|jstor=40159128}}</ref> == Maisha== Aïssa Khelladi alizaliwa nchini [[Algeria]] mwaka[[1953]], kabla ya vita vya Algeria ya kupambania uhuru wake kati ya chama cha ukombozi cha ''National Liberation Front'' (F.L.N) ya [[Algeria]] na serikali ya [[Ufaransa]]. Alianza kuhudhuria masomo ya Kurani katika umri mdogo kabla ya kujiunga na shule ya msingi na Sekondari huko Algiers kabla ya kuachana na masuala ya elimu pale ambapo si ya ulazima na kuisaidia familia yake. Alifanya mtihani wa ''baccalaureate '' kabla ya kuendelea na elimu ya juu katika chuo kikuu cha Algiers na kutunikiwa shahada ya kwanza ya sanaa na DEA ambayo ni sawa na shahada ya uzamili ya saikolojia baada ya kupata mkopo kutoka wizara ya ulinzi ya Algeria. Baada ya kupata shahada ya kwanza, aliandika vitabu viwili kati ya mwaka [[1981]] na [[1984]], “Attende et Journal” na hadithi fupi.<ref>{{Cite book|title=Peurs et mensonges : roman|last=Khelladi, Aïssa, 1953-|date=1997|publisher=Seuil|isbn=2020312328|location=Paris|oclc=37244769}}</ref> Mwaka [[1988]], aliachana na jeshi baada ya kufikia cheo cha ukapteni na kuhamishia mitazamo yake katika uandishi. Kujitolea kwake katika uandishi wa habari na riwaya ilichangia kuundwa na kuanzishwa kwa habari za Hebdo mnamo mwaka [[1990]]. Baada ya hapo, alichapisha insha iitwayo “Les Islamistes Algeriens Face Au Pouvoir” ( Waislamu wa Algeria katika mamlaka), akichimbua ajenda za kidini za F.L.N na F.I.S. Insha hiyo ilipigwa marufuku na serikali ya Algeria na Khelladi alikimbia nchi baada ya majaribio ya kuuawa kwake kushindwa. Alipatiwa uhifadhi wa kisiasa na [[Ufaransa]] ambapo aliendelea na kazi yake. Akiwa Ufaransa, alichapisha riwaya nyingine iitwayo “Peurs et Mensonges” (“Fears and Lies”) mnamo mwaka [[1996]]. Ndani ya mwaka huo, Khelladi alianzisha jarida la ''Algérie Littérature/Action'' akiwa pamoja na Marie Virolle. Ilhali akiwa bado Ufaransa, alichapisha riwaya mbili mwaka [[1998]], Rose d’Abime” na “Spolaition”. ==Marejeo== {{reflist}} {{mbegu-mtu}} [[Jamii:Watu walio hai]] [[Jamii:Waandishi wa Algeria]] [[Jamii:Arusha Translation-a-thon]] kmbmsgjnkcecvrj5boxr6j0quubfvsp 14 138231 1577971 1172543 2026-07-02T13:14:04Z Riccardo Riccioni 452 1577971 wikitext text/x-wiki [[Jamii:Miji ya Burkina Faso]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Burkina Faso]] aesxv527akct8pvls4l3q64adms5m11 0 139619 1578064 1574186 2026-07-02T17:31:13Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578064 wikitext text/x-wiki [[Picha:Alexandre Cabanel - Napoleon III - Walters 37146.jpg|350px|thumb|Taswira ya Napoleon III mnamo 1865]] '''Napoleon III''' (Charles Louis Napoléon Bonaparte; 20 Aprili 1808{{Spaced ndash}}9 Januari 1873) alikuwa rais wa kwanza wa Ufaransa (kama Louis-Napoléon Bonaparte) kutoka 1848 hadi 1852 na Kaizari wa Ufaransa kutoka 1852 hadi 1870. Alikuwa mpwa wa [[Napoleon Bonaparte|Napoleon I]] na mfalme wa mwisho kutawala Ufaransa. ==Vyeo== Alichaguliwa kwa urais wa Jamhuri ya Pili ya Kifaransa mnamo 1848, alitwaa madaraka kwa nguvu mnamo 1851, wakati hakuweza kuchaguliwa tena kikatiba; baadaye alijitangaza kuwa Kaizari wa Ufaransa. Alitawala hadi kushindwa katika vita dhidi ya Ujerumani na kutekwa kwake na [[Prussia]] na washirika wake kwenye Mapigano ya Sedan mnamo 1870. ==Hitimisho== Napoleon III alikuwa mtawala maarufu aliyependwa na sehemu kubwa ya raia wake, ambaye alitumia [[Kura ya maoni|kura za maoni]] kuongoza siasa yake. Alisimamia mabadiliko ya uchumi wa Ufaransa. Aliwekeza sana katika miundombinu za nchi akaagiza kujengwa kwa idadi kubwa ya meli zabiashara na kivita. Alipanua [[Koloni za Ufaransa|maeneo ya koloni za Ufaransa]]. Alishiriki katika [[Vita ya Italia ya 1859]] akaamuru kuanzisha [[Vita ya Ufaransa dhidi ya Ujerumani ya 1870]] ambapo aliongoza wanajeshi wake wakati wa mapigano na akakamatwa. ==Siasa ya ndani na ya kiuchumi== Napoleon III aliagiza ujenzi mpya wa Paris uliotekelezwa na Georges-Eugène Haussmann, akienelea kupanusha mfumo mzuri wa bustani kubwa za starehe kwenye jiji. Alizindua miradi ya kazi za umma kama hiyo katika miji mingine yote mikubwa nchini Ufaransa. Alipanua na kuimarisha mfumo wa reli kwa taifa lote, na pia akafanya kazi ya kuboresha mfumo wa benki. Napoleon III aliendeleza ujenzi wa [[Mfereji wa Suez]] na kuanzisha kilimo cha kisasa, ambacho kilimaliza njaa nchini Ufaransa na kuifanya nchi kuwa muuzaji nje wa mazao. Alifanya mapatano na Uingereza kuhusu Mkataba wa Biashara Huria na makubaliano kama hayo na mataifa mengine ya Ulaya. Katika siasa ya kijamii alikubali kuwapa wafanyakazi wa Ufaransa haki ya kugoma na haki ya kuunda vyama vyao. Wanafunzi wa kwanza wa kike walidahiliwa huko Chuo Kikuu cha Sorbonne na fursa za elimu kwa wanawake ziliongezeka. Chini yake orodha ya masomo yanayotakiwa kufundishwa shuleni ilipanushwa vievie. ==Siasa ya Nje== Katika siasa ya nje, Napoleon III alilenga kurudisha athira ya Ufaransa huko Ulaya na ulimwenguni kote. Katika Ulaya, alijiunga na [[Uingereza]] na kuishinda [[Urusi]] katika [[Krim|Vita ya Krim]] (1853-1856). Siasa yake ilisaidia kuungana kwa Italia kwa kushinda Dola la Austria katika Vita ya Italia ya 1859. Baadaye alipata maeneo ya Savoy na [[Nice]] kama shukrani kwa msaada wake. Wakati huo huo, vikosi vyake vilitetea [[Dola la Papa]] dhidi ya kuunganishwa na Italia. Alisaidia pia maungano wa mikoa kwenye [[mto Danubi]] yaliyoendelea kuwa Temi za Moldavia na Wallachia. Napoleon III aliongeza [[koloni za Ufaransa]] mara mbili kwa upanuzi katika Asia, Pasifiki na Afrika. Kwa upande mwingine, alishindwa kabisa alipojaribu kuingilia kati ndani ya [[Mexiko|Meksiko]] alichotaka kufanya kuwa nchi chini ya ulinzi wa Ufaransa. ==Ugomvi na Prussia== Kuanzia 1866, Napoleon III alilazimika kukabili nguvu iliyoongezeka ya [[Prussia]] kwani waziri mkuu wake [[Otto von Bismarck]] alilenga kujenga umoja wa madola ya Kijerumani chini ya uongozi wa Prussia. Mnamo Julai 1870, Napoleon III alifuata wito wa wanasiasa na waanchi wengi akatangaza vita dhidi ya Prussia, ingawa alikuwa na wasiwasi. Bila washirika akiwa na jeshi dhaifu, Ufaransa ilishindwa haraka wakati Napoleon III alikamatwa katika mapigano ya Sedan. Aliondolewa cheo cha kifalme na Jamhuri ya Tatu ya Kifaransa ilitangazwa huko Paris. Alikwenda uhamishoni [[Uingereza]], ambapo alikufa mnamo 1873. ==Marejeo== {{Reflist}} == Maandiko ya Napoleon III == * [https://archive.org/details/napoleonicideasd00napoiala/page/n6 ''Des Idées Napoleoniennes''] – an outline of Napoleon III's opinion of the optimal course for France, written before he became Emperor. * [https://archive.org/details/historyofjuliusc01napoiala/page/n10 ''History of Julius Caesar''] – a historical work he wrote during his reign. He drew an analogy between the politics of [[Julius Caesar]] and his own, as well as those of his uncle. * Napoleon III wrote a number of articles on military matters (artillery), scientific issues ([[electromagnetism]], pros and cons of beet versus cane sugar), historical topics (the [[House of Stuart|Stuart]] kings of Scotland), and on the feasibility of the [[Nicaragua canal]]. His pamphlet ''The Extinction of Pauperism'' ({{OCLC|318651712}}, {{JSTOR|60201169}}) helped his political advancement. == Kujisomea == === Wasifu === * {{cite book |last=Baguley |first=David |date=2000 |title=Napoleon III and His Regime: An Extravaganza |url=https://archive.org/details/napoleoniiihisre0000bagu |publisher=Louisiana State University Press |isbn=9780807126240 }} * {{cite book |last=Bresler |first=Fenton |date=1999 |title=Napoleon III: a life (HarperCollins |url=https://archive.org/details/napoleoniiilife0000fent |isbn=9780002557870 }} * {{cite book|last=Corley|first = T. A. B. |title=Democratic Despot: A Life of Napoleon III |url=https://archive.org/details/democraticdespot00corl|year=1961| isbn=978-0837175874}} * {{cite book|last=Duff|first=David|title=Eugénie and Napoleon III|publisher=Collins|date=1978|isbn=978-0688033385|url=https://archive.org/details/eugenienapoleoni00duff}} * {{cite book|editor-last=Gooch|editor-first= Brison D.|title = Napoleon III – Man of Destiny: Enlightened Statesman or Proto-Fascist?| publisher = Holt, Rinehart and Winston |date= 1966 |url=https://www.amazon.com/Napoleon-III--Man-Destiny-Proto-Fascist/dp/B0000CLW4N/|isbn=978-0232070118}} * {{cite book|editor-last=Gooch|editor-first= Brison D.|title= The Reign of Napoleon III|url=https://archive.org/details/reignofnapoleoni0000gooc|publisher = Rand McNally & Company |date=1969 |isbn=978-0528665479}} * {{cite book|last = Guerard|first= Albert |title=Napoleon III A Great Life In Brief| publisher=Carroll & Graf Pub |date=1947 |url=https://archive.org/details/napoleoniiiagrea002678mbp|isbn=978-0786706600}} * {{cite book| last=McMillan|first= James F. |title=Napoleon III | url=https://archive.org/details/napoleoniii0000mcmi|publisher=Routledge|date= 1991|isbn=978-0582494831|series= Profiles In Power}} * {{cite book|last=Markham|first=Felix|title=The Bonapartes|publisher=Weidenfeld & Nicolson|location=London|date=1975|isbn=978-0-297-76928-6}} * {{cite book|last=Price|first= Roger|chapter= Napoleon III: 'hero' or 'grotesque mediocrity'?| editor1-last = Cowling|editor1-first=Mark|editor2-last =Martin |editor2-first=James| title=Marx's 'Eighteenth Brumaire': (Post)Modern Interpretations|url=https://archive.org/details/marxseighteenthb00cowl|url-access=limited|publisher = Pluto Press | date= 20 November 2002 |pages = [https://archive.org/details/marxseighteenthb00cowl/page/n150 145]–162 |isbn=978-0745318301}} * {{cite book|last= Ridley|first= Jasper|title=Napoleon III and Eugenie|year=1980|publisher = Viking|url= https://archive.org/details/napoleoniiieugen00ridl_0|isbn=978-0670504282 }} * {{cite journal |last=Spitzer |first=Alan B. |date=1962 |title=The Good Napoleon III |journal=French Historical Studies |volume=2 |issue=3 |pages=308–29 |doi=10.2307/285884 |jstor=285884 }} * {{cite book|last=Thompson|first=J. M.|title=Louis Napoleon and the Second Empire|url=https://archive.org/details/louisnapoleonand001713mbp|publisher=The Noonday Press|year=1955}} === Vyanzo vingine === {{refbegin|30em}} * {{cite book|last1=Briggs|first1=Asa|last2=Clavin|first2=Patricia|author-link1=Asa Briggs|author-link2=Patricia Clavin|title=Modern Europe, 1789-Present|url=https://archive.org/details/moderneurope17890000brig_z2o4|date=2003|publisher=Routledge|isbn=978-0582772601|edition=2}} * Campbell, Stuart L. ''The Second Empire Revisited: A Study in French Historiography'' (1978) * {{cite book |last=Case |first= Lynn M. |date=1954 |title=French Opinion on War and Diplomacy during the Second Empire |publisher=University of Pennsylvania Press |isbn=978-0374913021 |doi=10.2307/j.ctv5qdk0h |hdl= 2027/mdp.39015051389693 }} * {{cite book | last=Cobban |first=Alfred |author-link=Alfred Cobban |year=1965 |title=A History of Modern France |volume=Vol. 2: 1799–1871 |location=London |publisher=Penguin }} * {{cite book |last=Cunningham |first=Michele |year=2001 |title=Mexico and the Foreign Policy of Napoleon III |publisher=Palgrave | isbn=978-0333793022 |url=https://books.google.com/books?id=mpiXQgAACAAJ }} * Golicz, Roman. “Napoleon III, Lord Palmerston and the Entente Cordiale.” ''History Today'' 50#12 (December 2000): 10–17 * {{cite book |last=Guedalla|first= Philip|author-link = Philip Guedalla|title = The Second Empire |date=1923 |url=https://archive.org/details/in.ernet.dli.2015.95986/page/n11|asin=B00085CK6Y}} * {{cite journal|last=Pinkney|first= David H.|title=Napoleon III's Transformation of Paris: The Origins and Development of the Idea|url=https://archive.org/details/sim_journal-of-modern-history_1955-06_27_2/page/125|journal= Journal of Modern History|date= 1955|volume= 27|issue= 2 |pages=125–34 |jstor=1874987|doi= 10.1086/237781|s2cid= 144533244}} * {{cite book|last=Pinkney|first = David H. |title=Napoleon III and the Rebuilding of Paris |url=https://archive.org/details/napoleoniiirebui0000pink|publisher=Princeton University Press|year=1958|isbn=0-691-00768-3 }} * {{Rejea kitabu |last=Plessis |first=Alain |year=1988 |title=The Rise and Fall of the Second Empire 1852–1871 |publisher=Cambridge University Press |isbn=9780521358569 }} * {{cite book |last=Price |first=Roger |year=2001 |title=The French Second Empire: An Anatomy of Political Power |publisher=Cambridge Univ. Press |isbn=9781139430975 |url=https://books.google.com/books?id=l0LMNRvWaLIC }} * {{cite book |last=Wawro |first=Geoffrey |date=2005 |title=The Franco-Prussian War: The German Conquest of France in 1870–1871 |publisher=Cambridge University Press |isbn=9780521584364 |url=https://books.google.com/books?id=q1tPB20IMMoC }} * {{cite book |last=Wetzel |first=David |date=2012 |title=A Duel of Nations: Germany, France, and the Diplomacy of the War of 1870–1871 |publisher=University of Wisconsin Press |isbn=9780299291341 }} * Williams, Roger Lawrence. ''The Mortal Napoleon III'' (Princeton University Press, 2015). * {{cite book| last= Williams| first = Roger L. |title=Gaslight and shadow: The World of Napoleon III 1851-1870|publisher = Macmillan & Co Ltd| location = New York |date=1957| url= https://archive.org/details/gaslightshadowwo00will| asin = B001NHPZ72}} * {{cite book |last=Wolf |first=John B. |author-link=John Baptist Wolf |date=1963 |orig-date=1940 |title=France: 1815 to the Present |url=https://archive.org/details/france1815tothep007252mbp/page/n269/mode/2up }} * {{cite book |last=Zeldin |first=Theodore |date=1958a |title=The Political System of Napoleon III |location=New York |publisher=Macmillan |url=https://archive.org/stream/in.ernet.dli.2015.110509/2015.110509.The-Political-System-Of-Napoleon-Iii_djvu.txt }} * {{cite journal |last=Zeldin |first=Theodore |date=1958b |title=The Myth of Napoleon III |url=https://archive.org/details/sim_history-today_1958-02_8_2/page/103 |journal=History Today |volume=8 |issue=2 |pages=103–109 }} {{refend}} == Viungo vya nje == {{commons|Napoléon III}} {{Wikisource1911Enc|Napoleon III}} *{{gutenberg author | id=Napoleon_III | name=Napoleon III}} * [https://archive.org/details/napoleonicideasd00napouoft ''Napoleonic ideas. Des idées napoléniennes (1859)''] at the Internet Archive * [http://quod.lib.umich.edu/cgi/t/text/text-idx?c=moa&idno=AHJ8942.0001.001&view=toc ''History of Julius Caesar'' vol. 1 at MOA] * [http://quod.lib.umich.edu/cgi/t/text/text-idx?c=moa&idno=AHJ8942.0002.001&view=toc ''History of Julius Caesar'' vol. 2 at MOA] * [[iarchive:histoiredejulesc01napoiala|''Histoire de Jules César (Volume 1)'']] {{in lang|fr}} at the Internet Archive * [https://web.archive.org/web/20080111053727/http://caricaturesetcaricature.over-blog.com/article-6400408.html Editorial cartoons of the Second Empire] * [http://www.computours.co.uk/beziers/place_de_la_revolution/ Place de la Revolution, Béziers & Napoleon 111] {{Wayback|url=http://www.computours.co.uk/beziers/place_de_la_revolution/ |date=20191013102819 }} * [http://omniatlas.com/maps/europe/18481219/ Maps of Europe covering the reign of Napoleon III (omniatlas)] [[Jamii:Waliofariki 1873]] [[Jamii:Waliozaliwa 1808]] [[Jamii:Historia ya Ufaransa]] 6ysknvf3xs0saw5wozush0igwbozyhr 0 140880 1578096 1506797 2026-07-02T19:26:48Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578096 wikitext text/x-wiki '''Noma''' (pia inajulikana kama '''cancrum oris''') ni [[ugonjwa]] unaoenea kwa haraka, na mara nyingi huwa ni ugonjwa wa [[kinywa]] na [[uso]].<ref name=Enwonwu2006>{{cite journal |vauthors=Enwonwu CO, Falkler WA, Phillips RS |title=Noma (cancrum oris) |url=https://archive.org/details/sim_the-lancet_july-8-14-2006_368_9530/page/147 |journal=[[The Lancet]] |volume=368 |issue=9530 |pages=147–56 |date=July 8, 2006 |pmid=16829299 |doi=10.1016/S0140-6736(06)69004-1|s2cid=10647321 }}</ref> == Ishara na dalili == [[File:Noma (cropped).jpg|thumb|Noma.]] Ni [[utando wa kiwamboute]] kwenye kinywa na [[Kidonda cha kinywa]], na upungufu wa haraka wa tishu, za mifupa usoni.<ref name=AllRefer>{{cite web|url=http://health.allrefer.com/health/noma-info.html|title=AllRefer Health - Noma (Cancrum Oris, Gangrenous Stomatitis)|access-date=2007-07-12|archive-url=https://web.archive.org/web/20070528130856/http://health.allrefer.com/health/noma-info.html|archive-date=2007-05-28}}</ref> == Sababu == Noma huathiri [[watoto]] [[maskini]] sana na wenye [[utapiamlo]] katika nchi za [[Kusini kwa Sahara|Kusini mwa]] [[Jangwa]] la [[Sahara]] na maeneo mengine ya [[kitropiki]]; sababu za msingi za ugonjwa huo ni [[usafi]] duni wa [[mazingira]] na utapiamlo.<ref>{{cite journal | vauthors = Srour ML, Marck K, Baratti-Mayer D | title = Noma: Overview of a Neglected Disease and Human Rights Violation | journal = The American Journal of Tropical Medicine and Hygiene | volume = 96 | issue = 2 | pages = 268–274 | date = February 2017 | pmid = 28093536 | pmc = 5303022 | doi = 10.4269/ajtmh.16-0718 }}</ref><ref name=Enwonwu2006/> [[Fusobacterium necrophorum]] na [[Prevotella intermedia]] ni [[vimelea]] vya [[bakteria]] muhimu katika mchakato wa ugonjwa huu, wakishirikiana na kiini kimoja au zaidi vya bakteria (kama vile [[Borrelia vincentii]], [[Porphyromonas gingivalis]], [[Tannerella forsythia]], [[Treponema denticola]], [[Staphylococcus aureus]]'', na [[spishi]] nyingine za nonhemolytic [[Streptococcus]]).<ref name="ReferenceA">{{cite book|last=Neville|first=Brad|title=Oral and Maxillofacial Pathology|year=2007|url=https://archive.org/details/oralmaxillofacia0000brad|edition=3rd|publisher=Saunders Book Company|pages=062008. 5.11}}</ref> [[Matibabu]] ya [[Viumbehai|viumbe]] hao yanaweza kusaidia kuzuia [[maambukizo]], lakini hairejeshi [[tishu]] zilizokosekana au zilizoharibika. Sababu zinazowezesha kutabiri ni pamoja na:<ref name=Enwonwu2006/><ref name=Auluck2005>{{cite journal|vauthors=Auluck A, Pai KM|title=Noma: Life Cycle of a Devastating Sore - Case Report and Literature Review|journal=Journal of the Canadian Dental Association|volume=71|issue=10|pages=757–757c|year=2005|url=https://www.cda-adc.ca/jcda/vol-71/issue-10/757.pdf|pmid=16324228}}</ref><ref name=EnwonwuNEJM>{{cite journal|vauthors=Enwonwu CO|title=Noma--the ulcer of extreme poverty|url=https://archive.org/details/sim_new-england-journal-of-medicine_2006-01-19_354_3/page/220|journal=The New England Journal of Medicine|volume=354|issue=3|pages=221–4|year=2006|pmid=16421362|doi=10.1056/NEJMp058193}}</ref> * Utapiamlo (haswa [[Vitamini A]] na [[Vitamini B]]) au [[upungufu wa maji mwilini]] * Usafi duni, haswa [[mdomo]] * [[maji]] yasio salama ya kunywa * Ukaribu na [[mifugo]] isiyofaa * ugonjwa wa hivi karibuni * ugonjwa wa upungufu wa kinga mwilini, pamoja na [[UKIMWI]] * [[surua]] * kuvuta [[sigara]] ==Marejeo== {{reflist}} [[Jamii:Kinywa]] [[Jamii:Magonjwa ya bakteria]] [[Jamii:USLWA]] gis5m6w9ilbypqat8c7o29edarce1tg 0 145211 1578065 1506734 2026-07-02T17:33:27Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578065 wikitext text/x-wiki [[File:Vladimirskaya.jpg|thumb|Picha takatifu ilivyo leo.]] '''Mama wa Mungu wa Vladimir''' ni [[picha takatifu]] maarufu ya [[Mitindo|mtindo]] wa [[Eleusa]]; inamuonyesha [[Bikira Maria]] akimpakata [[mtoto Yesu]], [[uso|nyuso]] zao zikigusana.<ref name=Coomler >''The icon handbook: a guide to understanding icons and the liturgy'' by David Coomler 1995 ISBN 0-87243-210-6 page 203.</ref>. [[Mchoro]] asili ulifanywa na [[Wasanii|msanii]] asiyejulikana katika [[karne ya 12]], labda [[Konstantinopoli]] [[mwaka]] [[1131]]. Kutokana na vituko vya [[historia]] ulitengenezwa upya mara tano. Kwa sasa unatunzwa katika [[Tretyakov Gallery]], [[Moscow]], [[Urusi]]. ==Tanbihi== {{Reflist}} ==Marejeo== {{refbegin}} * {{cite news |url=https://pravoslavie.ru/7424.html |title=Vladimir Icon of the Mother of God |last1=Alekseyenko |first1=Anton |date=9 September 2008 |work=Orthodoxy and the World |access-date=12 August 2019 |language=en }} * {{cite journal |last1=Averintsev |first1=Sergej S. |title=The Image of the Virgin Mary in Russian Piety |journal=Gregorianum |date=1994 |volume=75 |issue=4 |pages=611–622 |jstor=23579744 |publisher=Gregorian Biblical Press |issn=0017-4114 |language=en}} * {{cite journal |last1=Beliaev |first1=Leonid A. |title=Mystery Monasteries |journal=Archaeology |date=July–August 1997 |volume=50 |issue=4 |pages=36–38 |jstor=41658720 |publisher=Archaeological Institute of America |issn=0003-8113 |language=en}} * {{cite book |last1=Forest |first1=Jim |title=Praying with Icons |year=2008 |publisher=Orbis Books |isbn=978-1-60833-077-5 |url=https://books.google.com/books?id=hUAh42qYnEsC |language=en }} * {{cite book |title=Funk & Wagnalls New World Encyclopedia |publisher=World Book, Inc. |year=2018 |location=Chicago |chapter=Byzantine Art and Architecture |id=[[EBSCO Information Services|EBSCOhost]] [http://search.ebscohost.com.mxcc.idm.oclc.org/login.aspx?direct=true&db=funk&AN=by218900&site=ehost-live by218900] |ref={{SfnRef|Funk & Wagnalls|2018}} |language=en}} * {{cite web |url=https://oca.org/saints/lives/2016/08/26/102402-commemoration-of-the-vladimir-icon-of-the-mother-of-god-and-the |title=Commemoration of the Vladimir Icon of the Mother of God and the deliverance of Moscow from the Invasion of Tamerlane |date=26 August 2016 |website=oca.org |publisher=The Orthodox Church in America |access-date=15 August 2019 |ref={{SfnRef|OCA|2016}} |language=en }} * {{cite journal |last1=Elkins |first1=James |title=From original to copy and back again |url=https://archive.org/details/sim_british-journal-of-aesthetics_1993-04_33_2/page/113 |journal=The British Journal of Aesthetics |date=1 April 1993 |volume=33 |issue=2 |pages=113–120 |publisher=Oxford University Press |issn=0007-0904 |id=[[Gale (publisher)|GALE]] [https://link.gale.com/apps/doc/A13772791/GPS?u=20300&sid=GPS&xid=8c0d7125 A13772791] |doi=10.1093/bjaesthetics/33.2.113 |language=en }} * {{cite book |title=Byzantium, Faith and Power (1261–1557) |date=2004 |publisher=Metropolitan Museum of Art/Yale University Press |isbn=978-1-58839-114-8 |editor1-last=Evans |editor1-first=Helen C. |oclc=893698628 |url-access=registration |url=https://archive.org/details/byzantiumfaithpo0000unse |language=en }} * {{cite book |last1=Hamilton |first1=George Heard |title=The art and architecture of Russia |url=https://archive.org/details/artarchitectureo0000hami |date=1983 |publisher=Yale University Press |location=New Haven |isbn=0-300-05327-4 |edition=3rd |language=en }} * {{cite journal |last1=Hoisington |first1=Sona |title=The Middle Period |journal=Dig into History |date=1 March 2019 |volume=21 |issue=3 |pages=20+ |publisher=Cricket Media |issn=1539-7130 |id=[[Gale (publisher)|GALE]] [http://link.galegroup.com/apps/doc/A581990256/GPS?u=20300&sid=GPS&xid=786d113d A581990256] |language=en}} * {{cite book |url=https://books.google.com/books?id=oRZ3DQAAQBAJ&pg=PT99 |title=Insight Guides Pocket Moscow (Travel Guide eBook) |date=2016 |publisher=Apa Publications (UK) Limited |isbn=978-1-78671-677-4 |access-date=9 August 2019 |ref={{SfnRef|Insight Guides|2016}} |language=en }} * {{cite journal |last1=Jackson |first1=David |title=The State Tretyakov Gallery. Moscow |url=https://archive.org/details/sim_burlington-magazine_1995-05_137_1106/page/342 |journal=The Burlington Magazine |date=May 1995 |volume=137 |issue=1106 |pages=342–344 |publisher=Burlington Magazine Publications |type=Review |issn=0007-6287 |jstor=886644 |language=en }} * {{cite book |title=State Tretyakov Gallery |date=1 January 2000 |publisher=Avant-Garde |isbn=978-5863941066 |editor1-last=Kirdina |editor1-first=N. |edition=2nd rev |location=Moscow |translator-last=Cook |translator-first=K. M. |type=Guidebook |oclc=54071928 |ol=9058828M |ref={{SfnRef|Tretyakov Guide|2000}} |language=fr}} * {{cite web |url=http://www.pravoslavie.ru/2753.html |title=Xрам Святого Николая Чудотворца В Толмачах |last1=Lebedeva |first1=Elena |date=18 December 2006 |website=pravoslavie.ru |language=ru |trans-title=Church of St. Nicholas the Wonderworker in Tolmachi |access-date=11 August 2019 }} * {{cite book |last1=Massie |first1=Suzanne |title=Land of the Firebird: the Beauty of Old Russia |date=1980 |publisher=Simon and Schuster |location=New York City |isbn=0-671-23051-4 |url=https://archive.org/details/landoffirebirdth00mass |url-access=limited |language=en }} * {{cite journal |last1=Miller |first1=David B. |date=October 1968 |title=Legends of the Icon of Our Lady of Vladimir: A Study of the Development of Muscovite National Consciousness |url=https://archive.org/details/sim_speculum_1968-10_43_4/page/657 |journal=Speculum |publisher=Medieval Academy of America |volume=43 |issue=4 |pages=657–670 |doi=10.2307/2855325 |issn=0038-7134 |jstor=2855325 |s2cid=154449436 |language=en }} * {{cite journal |last=Nouwen |first=Henri J. M. |date=11 May 1985 |title=The Icon of the Virgin of Vladimir: An Invitation to Belong to God |url=https://archive.org/details/sim_america_1985-05-11_152_18/page/387 |journal=America |publisher=America Media |volume=152 |issue=18 |pages=387–390 |issn=0002-7049 |id=[[EBSCO Information Services|EBSCOhost]] [http://search.ebscohost.com.mxcc.idm.oclc.org/login.aspx?direct=true&db=mfi&AN=35621166&site=ehost-live 35621166] |language=en }} * {{cite web |url=http://www.ap22.ru/paper/O-chem-molyatsya-Vladimirskoy-ikone-Bozhiey-Materi.html |title=О чем молятся Владимирской иконе Божией Матери |date=3 June 2019 |website=www.ap22.ru |publisher=Pravda |trans-title=About prayer for the Vladimir icon of the Mother of God |access-date=11 August 2019 |ref={{SfnRef|Pravda|2019}} |language=ru }} * {{cite journal |title=Our Lady at Rest |url=https://archive.org/details/sim_soviet-life_august-september-1999_42_5/page/8 |journal=Russian Life |date=August–September 1999 |volume=42 |issue=5 |page=8 |publisher=Russian Information Services, Inc. |location=Montpelier, VT |issn=1066-999X |id=[[Gale (publisher)|GALE]] [http://link.galegroup.com/apps/doc/A58065134/GPS?u=20300&sid=GPS&xid=b37e3956 A58065134] |ref={{SfnRef|Russian Life|1999}} |language=en}} * {{cite journal |last1=Phillips |first1=Peter |title=Band of gold: the historic towns north-east of Moscow give a beautiful glimpse into the dawn of Russian civilisation |journal=Spectator |date=25 June 2011 |volume=316 |issue=9539 |pages=59+ |publisher=The Spectator Ltd. |location=London |issn=0038-6952 |id=[[Gale (publisher)|GALE]] [http://link.galegroup.com/apps/doc/A259961864/GPS?u=20300&sid=GPS&xid=13486ff4 A259961864] |language=en}} * {{cite journal |last1=Rice |first1=D. Talbot |date=April 1946 |title=The Greek Exhibition at Burlington House |journal=The Burlington Magazine for Connoisseurs |volume=88 |issue=517 |pages=86–90 |issn=0951-0788 |jstor=869212 |language=en}} * {{cite book |title=Byzantine Style and Civilization |url=https://archive.org/details/byzantinestyleci00runc |last1=Runciman |first1=Steven |date=1975 |publisher=Penguin Books |isbn=978-0-14-013754-5 }} * {{cite news |url=http://e-vestnik.ru/interviews/tretyakovka_priglashaet_v_hram/ |title=Третьяковка приглашает... в храм/Интервью/ЖМПиЦВ |last1=Strelchik |first1=Evgeny |date=12 December 2012 |work=Tserkovny Vestnik |access-date=12 August 2019 |type=Interview |language=ru }} * {{cite news |title=The resurrection of holy Russia |work=The Economist |volume=329 |issue=7834 |publisher=Economist Intelligence Unit N.A. Incorporated |date=23 October 1993 |ref={{SfnRef|The Economist|1993}} |pages=109–110 |id=[[Gale (publisher)|GALE]] [http://link.galegroup.com/apps/doc/A14570055/GPS?u=20300&sid=GPS&xid=a5ae89f6 A14570055] |language=en}} * {{cite web |title=Что скрывает обратная сторона иконы Владимирской Божьей Матери? |url=http://tvkultura.ru/article/show/article_id/109585/ |website=TVkultura |access-date=24 August 2019 |ref={{SfnRef|TVkultura|2014}} |date=13 March 2014 |language=ru |accessdate=2021-12-29 |archivedate=2019-09-25 |archiveurl=https://web.archive.org/web/20190925005052/http://tvkultura.ru/article/show/article_id/109585 }} * {{cite book |title=The Icon |url=https://archive.org/details/icon0000unse_w3g2 |date=1982 |publisher=Evans Brothers Ltd |isbn=0-237-45645-1 |location=London |language=en |last1=Weitzmann |first1=Kurt }} * {{cite web |url=https://www.rbth.com/arts/329479-most-important-russian-icons |title=5 most famous and miraculous icons that Russians venerate |last=Yegorov |first=Oleg |date=12 November 2018 |website=[[Russia Beyond]] |access-date=9 August 2019 |language=en-US }} {{refend}} ==Marejeo mengine== {{refbegin}} * {{cite book |title=Early Christian and Byzantine Art |url=https://archive.org/details/earlychristianby0000beck_w2s1 |last1=Beckwith |first1=John |date=1970 |publisher=Penguin History of Art |isbn=978-0-14-056033-6 |edition=2nd |language=en}} * {{cite journal |url=https://projects.iq.harvard.edu/hdsjournal/wounded-presence-virgin-vlaidimir-icon |title=A Wounded Presence: The Virgin of Vlaidimir Icon |last1=Belz |first1=Elaine Elizabeth |journal=The Graduate Journal of Harvard Divinity School |date=2016 |publisher=Harvard College |access-date=12 August 2019 |language=en |archive-date=2021-12-29 |archive-url=https://web.archive.org/web/20211229100321/https://projects.iq.harvard.edu/hdsjournal/wounded-presence-virgin-vlaidimir-icon |url-status=dead }} {{refend}} == Viungo vya nje == * [http://www.pravenc.ru/text/178896.html Vladimir Icon of the Mother of God] at ''[[Orthodox Encyclopedia]]'' {{ru}} {{Bikira Maria}} [[Category:Bikira Maria| ]] [[Category:Sanaa]] dh6253i9se6gwp4lz0mukojr374rm9x 0 150679 1578050 1533328 2026-07-02T16:26:15Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578050 wikitext text/x-wiki [[Picha:Menologion of Basil 032.jpg|thumb|[[Mazishi]] ya Mt. Domisyano.]] '''Domisyano wa Melitene''' ([[550]] hivi - [[602]]) alikuwa [[askofu]] wa [[Melitene]], [[Armenia]] ya Kale, leo [[Malatya]], nchini [[Uturuki]], kuanzia [[mwaka]] [[580]] hivi hadi [[kifo]] chake<ref>http://www.santiebeati.it/dettaglio/36850</ref>. Alishughulikia sana [[uongofu]] wa [[Uajemi|Waajemi]]<ref>[[Martyrologium Romanum]]</ref>. Tangu kale anaheshimiwa na [[Wakatoliki]] na [[Waorthodoksi]] kama [[mtakatifu]]. [[Sikukuu]] yake ni [[tarehe]] [[10 Januari]]<ref>[[Martyrologium Romanum]]</ref>. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{reflist}} == Marejeo == {{refbegin|indent=yes|30em}} *{{cite journal |author-link=Pauline Allen |first=Pauline |last=Allen |title=Neo-Chalcedonism and the Patriarchs of the Late Sixth Century |journal=Byzantion |volume=50 |issue=1 |year=1980 |pages=5–17 |jstor=44170608}} *Phil Booth, The Ghost of Maurice at the Court of Heraclius, ,Byzantinische Zeitschrift, volume 112, issue 3, 2019, pages 781–826 * Charles-Louis Richard e Jean Joseph Giraud, [http://books.google.it/books?id=sQ1NAAAAcAAJ&pg=PA322 ''Biblioteca sacra''], tomo VII, Milano 1833, p.&nbsp;322 *{{cite journal |first=Matthew |last=Dal Santo |title=Imperial Power and Its Subversion in Eustratius of Constantinople's ''Life and Martyrdom of Golinduch'' (c. 602) |journal=Byzantion |volume=81 |year=2011 |pages=138–176 |jstor=44173231}} *{{cite book |editor-first1=Geoffrey |editor-last1=Greatrex |year=2002 |editor-first2=Samuel N. C. |editor-last2=Lieu |publisher=Routledge |title=The Roman Eastern Frontier and the Persian Wars: A Narrative Sourcebook |volume=Part II, AD 363–630}} *{{cite journal |author-link=William H. P. Hatch |last=Hatch |first=William H. P. |title=The Subscription in the Chester Beatty Manuscript of the Harclean Gospels |url=https://archive.org/details/harvard-theological-review_1937-07_30_3/page/141 |journal=Harvard Theological Review |volume=30 |issue=3 |year=1937 |pages=141–155 |doi=10.1017/S0017816000022203 |jstor=1507949}} *{{cite book |last=Honigmann |first=Ernest |year=1953 |chapter=Two Metropolitans, Relatives of the Emperor Maurice: Dometianus of Melitene (about 580 – January 12, 602) and Athenogenes of Petra |title=Patristic Studies |url=https://archive.org/details/patristicstudies0000honi |publisher=Biblioteca Apostolica Vaticana |location=Vatican City |pages=[https://archive.org/details/patristicstudies0000honi/page/217 217]–225 }} *{{cite journal |pages=99–106 |first=Doug |last=Lee |title=Episcopal Power and Perils in the Late Sixth Century: The Case of Gregory of Antioch |journal=Bulletin of the Institute of Classical Studies |volume=50 |issue=Supplement 91 |year=2007 |doi=10.1111/j.2041-5370.2007.tb02380.x}} *{{cite book |first=Andrew |last=Palmer |title=The Seventh Century in the West-Syrian Chronicles |url=https://archive.org/details/seventhcenturyin0015unse |publisher=Liverpool University Press |year=1993}} *{{cite journal |first=Roger |last=Paret |title=Dometianus de Mélitène et la politique religieuse de l'empereur Maurice |journal=Revue des études byzantines |year=1957 |volume=15 |pages=42–72 |doi=10.3406/rebyz.1957.1148 |url=https://www.persee.fr/doc/rebyz_0766-5598_1957_num_15_1_1148 }} *{{cite book |last=Watkins |first=Basil |title=The Book of Saints: A Comprehensive Biographical Dictionary |edition=8th rev. |publisher=Bloomsbury |year=2016}} *{{cite book |first=Michael |last=Whitby |author-link=Michael Whitby |title=The Emperor Maurice and His Historian: Theophylact Simocatta on Persian and Balkan Warfare |publisher=Clarendon Press |year=1988}} {{refend}} {{mbegu-Mkristo}} [[Jamii:Waliozaliwa 550]] [[Jamii:Waliofariki 602]] [[Jamii:Maaskofu Wakatoliki]] [[Jamii:Watakatifu wa Uturuki]] [[Jamii:Watakatifu wa Armenia]] nkqx8buxf733op1d0rjn33xiudys42k 14 152805 1577964 1232187 2026-07-02T13:05:39Z Riccardo Riccioni 452 1577964 wikitext text/x-wiki [[Jamii:Miji Mikuu Afrika]] [[Jamii:Shelisheli]] [[Jamii:miji ya Shelisheli]] 7vixscqtjj24ji6348ezc46w47rydia 0 159153 1578155 1536672 2026-07-02T22:38:32Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578155 wikitext text/x-wiki '''Konstantino wa Britania''' ([[Dumnonia]], [[Uingereza]], [[520]] hivi - [[Kintyre]], [[Uskoti]], [[9 Mei]] [[576]]) alikuwa [[mfalme]] mkatili na mzinzi wa [[Cornwall]]<ref>O'Sullivan, pp. 92–93.</ref> kuanzia [[mwaka]] [[537]]. Kisha kuongokea [[Ukristo]], aliacha [[utawala]] akawa [[mmonaki]] nchini [[Eire|Ireland]]. Miaka saba baadaye alipewa [[upadirisho]] akatumwa [[Uinjilishaji|kuinjilisha]] [[Uskoti]] chini ya [[Kolumba]]. Huko alianzisha [[monasteri]] ya Govon aliyoiongoza [[kama]] abati hadi [[kifodini|alipouawa]] na [[Dini za jadi|Wapagani]]<ref>http://www.santiebeati.it/dettaglio/44500</ref>. Tangu kale anaadhimishwa na [[Wakatoliki]] na [[Waorthodoksi]] kama [[mtakatifu]], hasa [[tarehe]] [[11 Machi]]<ref>[[Martyrologium Romanum]]</ref>. ==Tazama pia== * [[Watakatifu wa Agano la Kale]] * [[Orodha ya Watakatifu Wakristo]] * [[Orodha ya Watakatifu wa Afrika]] * [[Orodha ya Watakatifu Mabradha wa Shule za Kikristo]] * [[Orodha ya Watakatifu Waaugustino]] * [[Orodha ya Watakatifu Wabazili]] * [[Orodha ya Watakatifu Wabenedikto]] * [[Orodha ya Watakatifu Wadominiko]] * [[Orodha ya Watakatifu Wafransisko]] * [[Orodha ya Watakatifu Wajesuiti]] * [[Orodha ya Watakatifu Wakarmeli]] * [[Orodha ya Watakatifu Wakolumbani]] * [[Orodha ya Watakatifu Wamersedari]] * [[Orodha ya Watakatifu Waoratori]] * [[Orodha ya Watakatifu Wapasionisti]] * [[Orodha ya Watakatifu Wapremontree]] * [[Orodha ya Watakatifu Waredentori]] * [[Orodha ya Watakatifu Wasalesiani]] * [[Orodha ya Watakatifu Waskolopi]] * [[Orodha ya Watakatifu Wateatini]] * [[Orodha ya Watakatifu Watrinitari]] * [[Orodha ya Watakatifu Watumishi wa Maria]] * [[Orodha ya Watakatifu Wavinsenti]] ==Tanbihi== {{reflist}} ==Marejeo== *{{cite web |url= http://d.lib.rochester.edu/teams/text/alliterative-morte-arthur-part-iv |title= Alliterative Morte Arthure |editor-last1= Benson |editor-first1= Larry D.|editor-link1=Larry D. Benson| editor-last2= Foster |editor-first2= Edward E. |year= 1994 |website= d.lib.rochester.edu |publisher= University of Rochester: TEAMS Middle English Texts Series |access-date=20 February 2014}} *{{cite book|last= Benson|first= Larry D. |title= Malory's Morte D'Arthur|publisher= Harvard University Press|year= 1976|isbn= 0674543939|url= https://archive.org/details/malorysmortedart00larr}} *{{cite journal |last1= Blaess|first1= Madeleine |year= 1956 |title=Arthur's Sisters |journal= Bulletin Bibliographique de la Société Internationale Arthurienne|volume= 8|pages= 69–77}} *{{cite book |last= Bromwich|first= Rachel |author-link=Rachel Bromwich |title= Trioedd Ynys Prydein: The Triads of the Island of Britain |publisher= University of Wales Press|year= 2006 |isbn= 0-7083-1386-8}} *{{cite book |last= Bruce |first= Christopher W. |date= 1999 |title= The Arthurian Name Dictionary |url= https://books.google.com/books?id=XZFbczeMtYcC&pg=PA366 |publisher= Taylor & Francis |isbn= 0815328656 |access-date= 26 February 2014}} *{{cite journal|last= Clarkson|first= Tim|date= Winter 1999|title= Rhydderch Hael|journal= The Heroic Age|volume= 1|issue= 2|url= https://www.mun.ca/mst/heroicage/issues/2/ha2rh.htm|access-date= 15 September 2010|url-status= dead|archive-url= https://web.archive.org/web/20100426183445/http://www.mun.ca/mst/heroicage/issues/2/ha2rh.htm|archive-date= 26 April 2010}} *{{cite encyclopedia |last= Dichmann|first=Mary E. |editor-last= Lumiansky|editor-first=R. M. |encyclopedia= Malory's Originality: A Critical Study of Le Morte Darthur |title= The Tale of King Arthur and the Emperor Lucius |year= 1964 |publisher= Johns Hopkins University Press |isbn= 0801804035|pages= 67–90}} *{{cite book |last1= Finazzi-Agrò |first1= Ettore |year= 1978 |title= A novelística portuguesa do século XVI |url= http://cvc.instituto-camoes.pt/conhecer/biblioteca-digital-camoes/estudos-literarios-critica-literaria/30-30/file.html |format= PDF |language= pt |publisher= Instituto de Cultura e Língua Portuguesa |pages= 45–48 |asin= B000ZQ4P8M |access-date= 4 November 2014 |archive-date= 2014-10-10 |archive-url= https://web.archive.org/web/20141010050458/http://cvc.instituto-camoes.pt/conhecer/biblioteca-digital-camoes/estudos-literarios-critica-literaria/30-30/file.html |dead-url= yes }} *{{cite journal |last= Fisher, IV |first= Benjamin Franklin |year= 1990 |title= King Arthur Plays from the 1890s |url= https://archive.org/details/sim_victorian-poetry_autumn-winter-1990_28_3-4/page/153 |jstor= 40002298 |journal= Victorian Poetry |volume= 28 |issue= 3/4|pages= 153–176 }} *{{cite news |last= Grylls |first= David |date= 9 October 2011 |title= The play's the thing - or is it? - A new 'Shakespeare' provokes both scholarly dispute and a teasingly postmodern domestic drama|newspaper= [[The Sunday Times]] }} *{{cite web |url= http://d.lib.rochester.edu/camelot/text/geoffrey-of-monmouth-arthur-vita-merlini-translation |title= Arthur from the Vita Merlini |author= Geoffrey of Monmouth |editor1-last= Huber |editor1-first= Emily Rebekah |year= 2007 |website= d.lib.rochester.edu/camelot-project |publisher= The Camelot Project, University of Rochester |access-date= 8 July 2014 |archive-date= 2014-12-02 |archive-url= https://web.archive.org/web/20141202060926/http://d.lib.rochester.edu/camelot/text/geoffrey-of-monmouth-arthur-vita-merlini-translation |url-status= dead }} *{{cite encyclopedia |last= Hoburg |first= Tom |editor-last= Slocum |editor-first= Sally K. |encyclopedia= Popular Arthurian Traditions |title= In Her Own Right: The Guenevere of Parke Godwin |year= 1992 |publisher= Bowling Green State University Popular Press |isbn= 0879725621 |pages= 68–79 }} *{{cite book |title=The Medieval Cult of St Petroc|last= Jankulak|first= Karen|year= 2000 |publisher= Boydell & Brewer|isbn= 0-85115-777-7|url= https://books.google.com/books?id=zY-CBHHw-lIC&q=The+medieval+cult+of+St+Petroc|access-date=6 January 2010}} *{{cite book |last1= Lacy |first1= Norris J. |author-link1= Norris J. Lacy |last2= Ashe |first2= Geoffrey |author-link2= Geoffrey Ashe |last3= Mancoff |first3= Debra N. |date= 2014 |title= The Arthurian Handbook |url= https://books.google.com/books?id=v9isAgAAQBAJ |publisher= Routledge |isbn= 978-1317777441 |access-date= 14 July 2014}} *{{cite book |title=A History of Wales from the Earliest Times to the Edwardian Conquest|last= Lloyd|first= John Edward|author-link= John Edward Lloyd |year= 1912|publisher= Longmans, Green, and Co.|url= https://archive.org/details/bub_gb_NYwNAAAAIAAJ|quote=Lloyd history of Wales.|access-date=6 January 2010}} *{{cite book |last1= Lupack |first1= Alan |last2= Lupack |first2= Barbara Tepa |date= 1999 |title= Arthurian Literature by Women |url= https://books.google.com/books?id=Eki54h3V__YC&pg=PA381 |publisher= Psychology Press |isbn= 0815333056 |access-date= 3 March 2014}} *{{cite journal |last= Molchan |first= Greg|date= Spring 2014|title=Anna and the King(s): Marriage Alliances, Ethnicity, and Succession in the ''Historia Regum Britanniae'' |journal= [[Arthuriana]] |volume= 21|issue=1 |pages= 25–48|doi=10.1353/art.2014.0004|s2cid= 162393121}} *{{cite book|last= Moll|first= Richard James |title= Before Malory: Reading Arthur in Later Medieval England|publisher= University of Toronto Press|year= 2003 |isbn= 0802037224|url= https://books.google.com/books?id=ZUJ7Q2_0nEcC}} *{{cite book |last= Morris |first= Rosemary |date= 1982 |title= The Character of King Arthur in Medieval Literature |url= https://books.google.com/books?id=Tznkwnb6VaMC&pg=PA139 |publisher= Boydell & Brewer |isbn= 0815328656 |access-date= 26 February 2014}} *{{cite book |last= O'Sullivan |first= Thomas D. |date= 1978 |title= The De Excidio of Gildas: Its Authenticity and Date |url= https://books.google.com/books?id=q2U3i1X8B50C&q=damnonia |publisher= BRILL |isbn= 9004057935 |access-date= 4 February 2014}} *{{cite book |title= The Saints of Cornwall |last= Orme|first= Nicholas |year= 2000 |publisher= Oxford University Press|isbn= 0-19-820765-4|url= https://books.google.com/books?id=JxIjiMStTKIC|access-date=15 September 2010}} *{{cite book |last= Phillips |first= Arthur |author-link=Arthur Phillips |date= 2011 |title= [[The Tragedy of Arthur]] |publisher= Randon House |isbn=978-1400066476}} *{{cite encyclopedia |last= Simko |first=Jan |editor-last= Noguchi |editor-first= Shunʼichi |editor-last2= Suzuki|editor-first2= Takashi |editor-last3=Mukai |editor-first3=Tsuyoshi |encyclopedia= Arthurian and Other Studies: Presented to Shunichi Noguchi|title= Modernity of the Middle English Stanzaic Romance ''Le Morte Arthur'' |url= https://books.google.com/books?id=Bk0HUmtGlEsC&pg=PA167 |year= 1993|publisher=Boydell & Brewer |isbn= 0859913805|pages= 153–168}} *{{cite book |last=Spence |first= John |date= 2013 |title= Reimagining History in Anglo-Norman Prose Chronicles |url= https://books.google.com/books?id=VNHSsvRlLOwC&pg=PA84 |publisher= Boydell & Brewer |isbn= 978-1903153451|access-date= 11 March 2014}} *{{cite book |last1= Taylor |first1= Beverly |last2= Brewer |first2= Elisabeth |date= 1983 |title= The Return of King Arthur |url= https://books.google.com/books?id=72P7TBEl9gcC&pg=PA303 |publisher= Boydell & Brewer|page= 303 |isbn= 0859911365 |access-date= 7 July 2014 }} *{{cite encyclopedia |last1= Thompson|first1= Raymond H. |last2=Lacy |first2= Norris J. |editor-first= Norris K. |editor-last= Lacy |editor-link= Norris J. Lacy |encyclopedia= The New Arthurian Encyclopedia |title= Games |url= https://books.google.com/books?id=hf6zAAAAQBAJ&q=rht |access-date= 4 February 2013| year= 2013 |publisher= Routledge |isbn= 978-1136606335|page=590}} *{{cite encyclopedia |last1= Thompson|first1= Raymond H. |editor-first= Norris K. |editor-last= Lacy |editor-link= Norris J. Lacy |encyclopedia= The New Arthurian Encyclopedia |title= Darrell Schweitzer |url= https://books.google.com/books?id=hf6zAAAAQBAJ&q=rht |access-date= 22 September 2014| year= 2013 |publisher= Routledge |isbn= 978-1136606335|page=605}} *{{cite encyclopedia|last=Trachsler |first= Richard |editor-first= Carol |editor-last=Dover |encyclopedia= A Companion to the Lancelot-Grail |title= A Question of Time: Romance and History |url= https://books.google.com/books?id=KkBSujrlYRAC&pg=PA31|access-date= 28 February 2014 |year= 2003 |publisher= [[D.S. Brewer]] |isbn= 0859917835 |pages= 23–32}} *{{cite journal |last= Vargas Díaz-Toledo |first= Aurelio |year= 2006 |title= Os livros de cavalarias renascentistas nas histórias da literatura portuguesa |url= http://ler.letras.up.pt/uploads/ficheiros/3762.pdf | journal= Peninsula: Revista de Estudos Ibéricos |language= pt|volume= 3 |pages= 233–247 |access-date=4 November 2014}} *{{cite journal |last= Vargas Díaz-Toledo|first= Aurelio Vargas |year= 2013 |title= A Matéria Arturiana na literatura cavaleiresca portuguesa dos séculos XVI-XVII |url= http://e-spania.revues.org/22796?lang=en | journal= E-Spania |language= pt|volume= 3 |at= paragraphs 29–32 |access-date=4 November 2014}} *{{cite book |last= Wasyliw |first= Patricia Healy|title= Martyrdom, Murder, and Magic: Child Saints and Their Cults in Medieval Europe |publisher= Peter Lang |year= 2008 |isbn= 9780820427645}} *{{cite book |last= Whitaker |first= Muriel |title= Arthur's Kingdom of Adventure: The World of Malory's Morte Darthur |publisher= Boydell & Brewer |year= 1984 |isbn= 0859911659}} *{{cite encyclopedia |last=Wright |first= Neil |editor-first=Richard |editor-last= Barber |editor-link= Richard Barber |encyclopedia= Arthurian Literature|title= Geoffrey of Monmouth and Gildas|year=1982|publisher= Boydell & Brewer |volume= II|issn=0261-9946|pages= 1–40}} {{mbegu-Mkristo}} [[Category:Waliozaliwa 520]] [[Category:Waliofariki 576]] [[Jamii:wanasiasa wa Uingereza]] [[Category:Wamonaki]] [[Jamii:Wakolumbani]] [[Category:Mapadri]] [[Jamii:wamisionari]] [[Jamii:Watawa waanzilishi]] [[Jamii:wafiadini Wakristo]] [[Category:Watakatifu wa Uingereza]] [[Jamii:watakatifu wa Uskoti]] e0jg0ywlveayip1vl0niz47zia2m1o3 0 160418 1578158 1464403 2026-07-02T22:42:54Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578158 wikitext text/x-wiki {{Uainishaji | rangi = pink | jina = Mbu miguu-mirefu | picha = Female Tipula oleracea (10990569745).jpg | upana_wa_picha = 250px | maelezo_ya_picha = ''Tipula oleracea'' | himaya = [[Mnyama|Animalia]] (Wanyama) | faila = [[Arthropoda]] (Wanyama wenye miguu yenye viungo) | nusufaila = [[Hexapoda]] (Wanyama wenye miguu sita) | ngeli = [[Insecta]] (Wadudu) | ngeli_ya_chini = [[Pterygota]] (Wadudu wenye mabawa) | oda = [[Diptera]] (Wadudu wenye mabawa mawili tu) | nusuoda = [[Nematocera]] (Diptera wenye vipapasio kama nyuzi) | familia_ya_juu = [[Tipuloidea]] | bingwa_wa_familia_ya_juu = [[Pierre André Latreille|Latreille]], 1802 | subdivision = '''Familia 3''': * [[Cylindrotomidae]] <small>[[Ignaz Rudolph Schiner|Schiner]], 1863</small> * [[Pediciidae]] <small>[[Carl-Robert von Osten-Sacken|Osten-Sacken]], 1859</small> * [[Tipulidae]] <small>Latareille, 1802</small> }} '''Mbu miguu-mirefu''' (kutoka kwa [[Kiholanzi]] [[w:langpootmuggen|langpootmuggen]]) ni [[mbu]] wakubwa wa [[familia ya juu]] [[Tipuloidea]] katika [[nusuoda]] [[Nematocera]] wa [[oda]] [[Diptera]] walio na [[mguu|miguu]] mirefu. Kwa kawaida [[Bawa|mabawa]], yaliyo marefu pia, huwekwa kwa [[pembe]] ya kati ya 45º na 90º kwa [[mwili]] wakipumzika, lakini [[spishi]] za [[nusufamilia]] [[Limoniinae]] ([[Tipulidae]]) huyaweka pamoja juu ya [[fumbatio]]. Wanatokea kwa kawaida mahali pa unyevu mabarani kote isipokuwa [[Antakitiki]]. ==Maelezo== [[Picha:Tipulidae April 2008-2.jpg|thumb|left|150px|''Nephrotoma appendiculata'' mwenye rangi kali.]] [[Picha:Ctenophora elegans.jpg|thumb|left|150px|''Ctenophora elegans'' anaiga nyigu.]] Mbu miguu-mirefu hufanana na mbu wakubwa sana wenye mwili mwembamba na miguu mirefu sana hadi mara mbili ya urefu wa mwili wao. Wanapochukuliwa miguu huvunjika kwa urahisi ([[w:autotomy|autotomy]]). Urefu wa mwili kwa kawaida ni [[sm]] 1-3.5, lakini wanaweza kuwa wafupi kama [[mm]] 7 na warefu kama sm 5. Mabawa ni membamba na marefu, marefu kama au mafupi kidogo kuliko mwili. Kwa hivyo, upana wa mabawa ni sm 1-6.5 na upana mkubwa kabisa wa mabawa ni sm 11<ref>{{cite news |url=http://www.scmp.com/news/china/society/article/2143294/worlds-biggest-mosquito-found-southwest-china |title='World's biggest' mosquito with 11cm wing span found in southwest China |author=Louise Moon |newspaper=South China Morning Post |date=25 April 2018 |access-date=29 August 2019}}</ref>. Mabawa ni mangavu yakiwa na mabaka meusi au siyo. Rangi ya mwili mara nyingi huwa [[kijivu]], [[kahawia]] au [[njano]] ili wasiweze kugunduliwa kwa urahisi na [[mbuai]], haswa [[ndege (mnyama)|ndege]]. Hata hivyo, kuna spishi zilizo na rangi kali zaidi, kama zile za ''Nephrotona'' na ''Ctenophora'', ambazo zile za mwisho huiga [[nyigu]]. [[Kichwa]] kidogo kina [[pua ndefu]], ambayo mara nyingi ni ndefu kama kichwa yenyewe au hata kama kichwa na [[pronoto]] pamoja. [[Jicho|Macho]] ni madogo na kama [[ushanga|shanga]]. Sehemu za [[mdomo]] hupunguzika sana kwa kawaida, ingawa bado zinafanya kazi katika [[spishi]] fulani. [[Kipapasio|Vipapasio]] ni kama [[uzi|nyuzi]] na zina [[pingili]] hadi 19<ref name=delta>Watson, L. and M. J. Dallwitz. 2003 onwards. [http://delta-intkey.com/britin/dip/www/tipulida.htm Tipulidae.] {{Wayback|url=http://delta-intkey.com/britin/dip/www/tipulida.htm |date=20071013164646 }} British Insects: The Families of Diptera. Version: 1 January 2012.</ref>. Mabuu wamerefuka na wana umbo la [[mcheduara]] kwa kawaida. [[Theluthi]] mbili ya nyuma ya kifuniko cha kichwa kimefungika au kupunguzika ndani ya pingili ya [[prothoraksi]]. Kimeimarishika kwa mbele na kukatwa mbele. [[Mandibulo]] ni mkabala moja na nyingine na kusogea katika [[bapa]] ya usawa au [[mbetuko]]. Pingili za mwisho za [[fumbatio]] ni laini, mara nyingi zimeimarishika kwa sehemu na kubeba [[spirakulo]] nyuma. [[Sahani|Kisahani]] cha spirakulo huzungukwa kwa kawaida na [[papila]] au [[ndewe]]. ==Biolojia== Mbu miguu-mirefu hukiakia wakati wa usiku, jioni na alfajiri. Wanavutiwa na [[mwanga]]. Wakati wa mchana, wanajificha kwenye [[uoto]]. Wanaruka vibaya na kwa njia ya [[zigizaga]]. Spishi nyingi hazila, lakini wengi hujilisha kidogo kwa [[mbochi]] huku wachache wakila [[wadudu]] wadogo. Kinyume cha hiyo, mabuu ni walafi sana na wanaweza kula [[mwani|miani]], [[mikroflora]] na dutu ya [[mmea|mimea]] inayooza, pamoja na [[mbao]]. Wengine ni mbuai<ref name=pritch>{{cite journal |last1=Pritchard |first1=G |title=Biology of Tipulidae |journal=Annual Review of Entomology |date=1983 |volume=28 |issue=1 |pages=1–22 |doi=10.1146/annurev.en.28.010183.000245 |url=http://nlbif.eti.uva.nl/ccw/documents/Pritchard,_1983.pdf |access-date=2013-10-08 |archive-url=https://web.archive.org/web/20140112222236/http://nlbif.eti.uva.nl/ccw/documents/Pritchard,_1983.pdf |archive-date=2014-01-12 |url-status=dead }}</ref><ref name=oo>Oosterbroek, P., Superfamily Tipuloidea, Family Tipulidae. Chapter 2 In: Evenhuis, N. L. (Ed.) ''Catalog of the Diptera of the Australasian and Oceanian Regions'', Issue 86 of Bernice P. Bishop Museum Special Publication. Apollo Press. 1989.</ref>. Huishi katika [[udongo]], katika mbao zinazooza au ndani ya [[maji]]. ==Kama waharibifu== Mbu miguu-mirefu wa [[kinamasi|vinamasi]], ''Tipula paludosa'', na mbu miguu-mirefu wa [[mboga]], ''T. oleracea'', ni wadudu waharibifu wa [[kilimo]] huko [[Ulaya]]. Spishi nyingine haribifu hutokea sehemu nyingine za [[dunia]]. Mabuu ya mbu miguu-mirefu ya umuhimu wa ki[[uchumi]] huishi kwenye [[tabaka]] za juu za udongo ambapo hujilisha kwa [[mzizi|mizizi]], [[nywele]] za mizizi na pengine [[jani|majani]] ya mazao na kudumaza ukuaji wao au kuua mimea hiyo. Ni wadudu waharibifu kwenye bidhaa mbalimbali. Tangu mwishoni mwa [[mwaka|miaka]] ya [[1900]], ''T. paludosa'' na ''T. oleracea'' zimekuwa vamizi nchini [[Marekani]]<ref>{{cite journal |first1=Sujaya |last1=Rao |first2=Aaron |last2=Listona |first3=Lora |last3=Cramptonb |first4=Joyce |last4=Takeyasu |year=2006 |title=Identification of Larvae of Exotic ''Tipula paludosa'' (Diptera: Tipulidae) and ''T. oleracea'' in North America Using Mitochondrial ''cytB'' Sequences |url=https://archive.org/details/sim_entomological-society-of-america-annals_2006-01_99_1/page/33 |journal=Annals of the Entomological Society of America |volume=99 |issue=1 |pages=33–40 |doi=10.1603/0013-8746(2006)099[0033:IOLOET]2.0.CO;2|s2cid=85635147 }}</ref><ref>{{cite journal |last1=Blackshaw |first1=R.P. |last2=Coll |first2=C. |title=Economically important leatherjackets of grassland and cereals: biology, impact and control |journal=Integrated Pest Management Reviews |date=1999 |volume=4 |issue=2 |pages=145–162 |doi=10.1023/A:1009625724013 |s2cid=80918734 |url=http://nlbif.eti.uva.nl/ccw/documents/Blackshaw_and_Coll,_1999.pdf |access-date=2019-08-29 |archive-url=https://web.archive.org/web/20140115062323/http://nlbif.eti.uva.nl/ccw/documents/Blackshaw_and_Coll,_1999.pdf |archive-date=2014-01-15 |url-status=dead }}</ref>. Mabuu yameonwa kwenye mazao mengi, pamoja na mboga, [[tunda|matunda]], [[nafaka]], [[malishoni]], nyanja za [[nyasi]] na [[mmea wa mapambo|mimea ya mapambo]]. Wanaweza kuharibu sehemu kubwa za nyanja za nyasi, k.m. kwenye [[kigoe|vigoe]]. ==Spishi kadhaa za Afrika ya Mashariki== {{columns | width = 30em | col1 = * ''Afrolimnophila unijuga'' * ''Antocha longicornis'' * ''Antocha multispina'' * ''Austrolimnophila cladoneura'' * ''Austrolimnophila diffusa'' * ''Dicranomyia nairobii'' * ''Dicranomyia tipulipes'' * ''Dicranoptyga kenyana'' * ''Dicranoptyga matengoensis'' * ''Dolichopeza distigma'' * ''Elephantomyia satura'' * ''Erioptera cristata'' * ''Erioptera euzona'' * ''Geranomyia alberticola'' * ''Geranomyia obsolescens'' * ''Gonomyia flavonotata'' * ''Helius brevisector'' * ''Helius capensis'' * ''Libnotes oresitropha'' * ''Libnotes rhizosema'' * ''Limnophila allosoma'' * ''Limnophila obscura'' * ''Medleromyia tanzanica'' | col2 = * ''Metalimnobia congoensis'' * ''Metalimnobia zernyana'' * ''Molophilus africanus'' * ''Molophilus nannopterus'' * ''Nephrotoma capensis'' * ''Nephrotoma elgonica'' * ''Nephrotoma ruwenzoriana'' * ''Paradelphomyia ugandae'' * ''Pilaria morogoroensis'' * ''Rhipidia afra'' * ''Styringomyia clandestina'' * ''Styringomyia vittata'' * ''Symplecta brevifurcata'' * ''Tasiocera probosa'' * ''Tipula elgonensis'' * ''Tipula flagellicurta'' * ''Tipula kenia'' * ''Tipula masai'' * ''Tipula uluguruensis'' * ''Trentepohlia curtipennis'' * ''Trentepohlia msingiensis'' * ''Trichotrimicra mbeya'' * ''Trichotrimicra subnuda'' }} ==Picha== <gallery> Dicranomyia.modesta.-.lindsey.jpg|''Dicranomyia modesta'' Limnophila pictipennis.jpg|''Limnophila pictipennis'' Tipula paludosa - European crane fly (7076589381).jpg|''Tipula paludosa'' </gallery> ==Marejeo== {{reflist}} [[Jamii:Nzi na jamaa]] lfl0mrt4ykfmj7l42rk9xb160sn6bv3 0 161709 1578048 1528839 2026-07-02T16:24:18Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578048 wikitext text/x-wiki '''Vijana nchini [[Uganda]]''' ni muhimu sana kwa sababu Uganda ndiyo nchi ambayo wakazi wake wana [[umri]] mdogo zaidi duniani, huku 77% wakiwa chini ya umri wa miaka 25.<ref name="Population Action">{{cite web|title=The Effects of a Very Young Age Structure in Uganda|url=http://www.populationaction.org/oldmedia/SOTC_Uganda.pdf|publisher=Population Action International|access-date=May 1, 2013|archive-url=https://web.archive.org/web/20130124120235/http://www.populationaction.org/oldmedia/SOTC_Uganda.pdf|archive-date=2013-01-24|url-status=dead|accessdate=2022-12-08|archivedate=2013-01-24|archiveurl=https://web.archive.org/web/20130124120235/http://www.populationaction.org/oldmedia/SOTC_Uganda.pdf}}</ref> Kuna vijana 7,310,386 kutoka umri wa miaka 15-24 wanaoishi [[Uganda]]. <ref name="Urban Ministry">{{cite web|title=Ugandan Youth Statistics|url=http://www.urbanministry.org/wiki/ugandan-youth-statistics|access-date=May 12, 2013|archive-date=2018-02-16|archive-url=https://web.archive.org/web/20180216200535/http://www.urbanministry.org/wiki/ugandan-youth-statistics|url-status=dead}}</ref> [[File:Ug-map.png|thumb|350px|Ramani ya Uganda.]] == Ufafanuzi wa vijana == [[Ujana]] ni hatua ya kati iliyojengwa kijamii ambayo inasimama kati ya utoto na utu uzima.<ref>Furlong, Andy (2013). ''Youth Studies: An Introduction''. Routledge: New York.</ref> [[UNICEF]] kwa ujumla inafafanua vijana ni kuwa kati ya umri wa miaka 15 na 24. [https://www.youthpolicy.org/ Sera ya vijana] inafafanua vijana kama [[vijana]] wote, wa kike na wa kiume, ni wenye umri wa miaka 12 hadi 30. <ref>{{Rejea tovuti|title=Uganda {{!}} Factsheets {{!}} Youthpolicy.org|url=https://www.youthpolicy.org/factsheets/country/uganda/#definition-of-youth|website=www.youthpolicy.org|access-date=2020-05-29|accessdate=2022-12-08|archivedate=2022-12-08|archiveurl=https://web.archive.org/web/20221208211017/https://www.youthpolicy.org/factsheets/country/uganda/#definition-of-youth}}</ref> == Idadi ya watu == Nchini [[Uganda]] uwiano wa wanaume kwa wanawake ni wanaume 100.2 kwa wanawake 100.<ref name="urbanministry1">{{cite web |url=http://www.urbanministry.org/wiki/ugandan-youth-statistics |title=Ugandan Youth Statistics: Encyclopedia of Urban Ministry UYWI :: Urban Youth Workers Institute |publisher=Urbanministry.org |access-date=2013-05-23 |archive-date=2013-06-01 |archive-url=https://web.archive.org/web/20130601232204/http://www.urbanministry.org/wiki/ugandan-youth-statistics |url-status=dead }}</ref> Matarajio ya maisha wakati wa kuzaliwa kwa wanaume ni miaka 42.59 na miaka 44.49 kwa wanawake.<ref name="urbanministry1"/> Vijana wa Uganda hupitia maisha tofauti kulingana na kama wanaishi kijijini au mijini. Vijana wengi huamua kuhama kutoka maeneo ya mashambani hadi mijini kwa kuzingatia mambo ambayo ni pamoja na uhusiano wa kindugu na uhusiano wa kirafiki, mapato ya vijijini, jukumu la elimu ya vijijini, na mfumo wa kijamii wa vijijini.<ref>{{cite journal|last=Byerlee|first=Derek|title=Rural-Urban Migration in Africa: Theory, Policy and Research Implications|url=https://archive.org/details/sim_international-migration-review_winter-1974_8_4/page/543|journal=International Migration Review|date=Winter 1974|volume=8|issue=4|pages=543–566|jstor=3002204|doi=10.2307/3002204}}</ref> == Elimu == [[File:Uganda students.jpg|thumb|300px|Wanafunzi katika Unyama Primary School, Unyama IDP Camp.]] [[Uganda]] ilianzisha [[Chuo Kikuu cha Makerere]], chuo kikuu cha kwanza cha umma mnamo [[1922]] na chuo kikuu cha pili cha umma mnamo [[1989]]. Mapema [[miaka ya 1990]], [[Uganda]] ilianzisha ufadhili wa kibinafsi katika vyuo vikuu vya umma. <ref>{{cite journal|last=Bisaso|first=Ronald|title=Organisational responses to public sector reforms in higher education in Uganda: a case study of Makerere University|journal=Journal of Higher Education Policy and Management|date=8 July 2010|volume=32|issue=4|pages=343–351|doi=10.1080/1360080X.2010.491108|s2cid=154981703 }}</ref> Kufikia [[2005]], kulikuwa na vyuo vikuu 27 nchini [[Uganda]] na ambavyo 80% vilikuwa taasisi za binafsi. Viwango vya elimu ya vijana kati ya [[2005]] na [[2010]] vilikuwa 90% kwa wanaume na 85% kwa wanawake. <ref name="unicef1">{{cite web |url=http://www.unicef.org/infobycountry/uganda_statistics.html |title=Uganda - Statistics |publisher=UNICEF |access-date=2013-05-23 |accessdate=2022-12-08 |archivedate=2016-10-24 |archiveurl=https://web.archive.org/web/20161024172118/http://www.unicef.org/infobycountry/uganda_statistics.html }}</ref> [[Wanafunzi]] ambao wamefanikiwa kumaliza sekondari ya upili na kufaulu Uthibitisho wa elimu ya Juu [[Uganda]] ndio pekee wanaostahiki kujiunga na vyuo vya baada ya sekondari.<ref name="schoolguideuganda1">{{cite web |author=Musoke, Herbert |url=http://www.schoolguideuganda.com/education-information/higher-education-in-uganda.php |title=Higher Education in Uganda |publisher=School Guide Uganda |access-date=2013-05-23 |accessdate=2022-12-08 |archivedate=2022-12-08 |archiveurl=https://web.archive.org/web/20221208214651/http://www.schoolguideuganda.com/education-information/higher-education-in-uganda.php }}</ref> Kuna aina tatu za taasisi zinazoungwa mkono za umma nchini [[Uganda]]. Zinajumuisha taasisi zinazojitegemea, taasisi zinazoendeshwa na [[Wizara ya Elimu]], na taasisi zinazosimamiwa na Tume ya Utumishi wa Umma. Kufikia [[1998]], uandikishaji wa [[Uganda]] katika vyuo vikuu na taasisi za elimu ya juu ulikuwa hadi wanafunzi 34,773. <ref name="schoolguideuganda1"/> Hii ni mara mbili ya kiwango cha mwaka 1991 wakati Uganda ilikuwa na wanafunzi 17,585 pekee walioandikishwa. Kiwango cha wanawake waliojiandikisha mwaka wa [[1998]] kilikuwa asilimia 33 ya idadi ya wanafunzi ambayo ilikuwa ongezeko kutoka 28% mwaka wa 1991. [[Wanafunzi]] ambao ni raia na ni wasaidizi wa serikali hawalipi chochote kwa ajili ya masomo yao, gharama za hela ya matumizi, gharama za usafiri na gharama za bweni. <ref name="schoolguideuganda1"/> Wizara ya Elimu inawashughulikia wanafunzi wote hawa katika bajeti yao kubwa ya mwaka ambayo wanapokea kutoka [[Wizara ya Fedha na Uchumi|Wizara ya Fedha]]. Wanakadiria kuwa wanalipa takriban shilingi 6,000,000 za [[Uganda]] au dola 3,000 za Kimarekani kwa kila mwanafunzi wanazomsaidia. Kulingana na [[UNFPA]] (2014), 78% ya vijana wenye umri wa miaka 13-18 kwa sasa wanahudhuria shule. 10% ya wale kati ya 10% miaka 6-12 hawajawahi kwenda shule. 22% ya [[vijana]] walio na umri wa miaka 13-18 wameacha shule.<ref>{{Rejea tovuti|title=Young People Fact Sheet|url=https://uganda.unfpa.org/sites/default/files/pub-pdf/YoungPeople_FactSheet%20%2811%29_0.pdf}}</ref> Zaidi ya hayo, [[vijana]] milioni 8.8 wenye umri wa miaka 15-24 hawajishughulishi na [[elimu]], [[ajira]] au chini ya mafunzo yoyote.<ref>{{Rejea tovuti|title=Young People Fact Sheet|url=https://uganda.unfpa.org/sites/default/files/pub-pdf/YoungPeople_FactSheet%20%2811%29_0.pdf}}</ref> == Ajira == Kiwango cha ukosefu wa [[ajira]] kwa vijana nchini [[Uganda]] wenye umri wa miaka 15-24 ni 83%. Kiwango hiki ni cha juu zaidi kwa wale walio na digrii rasmi na wanaoishi katika eneo la mijini. Hii ni kutokana na kukatika kati ya shahada iliyopatikana na ujuzi wa ufundi unaohitajika kwa kazi ambazo zinahitajika kwa wafanyakazi. Wale wasio na shahada pia hawawezi kupata kazi kwa sababu hawana ujuzi unaohitajika kwa nafasi hiyo au hawana rasilimali kama vile ardhi au mtaji. Vijana wengine pia wana maoni hasi juu ya kazi fulani kwa hivyo hawako tayari kuzichukua ikiwa watapewa nafasi. Ukosefu wa ajira kwa vijana huleta changamoto kubwa ya kisiasa, kiuchumi na kijamii kwa nchi na uongozi wake. Mzunguko huo unafanya kuwa vigumu zaidi kwa [[Uganda]] kuondokana na umaskini. Wanawake wachanga pia mara nyingi zaidi hulazimika kukaa nyumbani katika jukumu la uzazi tangu umri mdogo jambo ambalo huzuia uwezo wao wa kufanya kazi. Kazi ya sekta isiyo rasmi inachangia wengi wa wafanyakazi [[vijana]] nchini [[Uganda]]. <ref name="autogenerated2">Garcia, Marito. 2008. Directions in Development- Human Development. World Bank</ref> 3.2% ya vijana wanafanya kazi za kuajiriwa, 90.9% wanafanya kazi kwa ajira isiyo rasmi, na 5.8% ya vijana wa Uganda wamejiajiri. <ref name="autogenerated2"/> Kulingana na Amamukirori B. na Mubiru A.([[2018]]), katika ripoti ya idadi ya watu, zinaonyesha kuwa kuna tofauti za mishahara kulingana na jinsia zinazopendelea mwanamume miongoni mwa vijana walioajiriwa. Vijana katika sekta ya umma wanapata zaidi kuliko wale wa sekta ya kibinafsi wakati wale wa Kaskazini na Mashariki ndio wanaolipwa kidogo zaidi. Zaidi ya hayo, wanaangazia sekta ya kilimo kuwa ndiyo inayoajiri idadi kubwa ya vijana, ikifuatiwa na biashara, viwanda na kisha sekta ya uchukuzi. Kiwango cha ukosefu wa ajira kwa vijana ambacho sasa kinafikia 6.5%, kinahusishwa na kutolingana kati ya ujuzi unaopatikana kupitia mfumo wa elimu na mahitaji ya soko la ajira.<ref>{{Rejea tovuti|title=1.2million Ugandan youth idle- population report|url=http://www.newvision.co.ug/new_vision/news/1488782/12million-ugandan-youth-idle-population-report|website=www.newvision.co.ug|access-date=2020-05-29}}</ref> == Afya == Umri wa kuanza ngono katika jumuiya hii mwaka wa [[2000]] uliripotiwa kuwa miaka 16.7 kwa wasichana na miaka 18.2 kwa wanaume vijana, wakati umri wa wastani wa kuolewa ulikuwa miaka 19.5 kwa wasichana na miaka 24 kwa wanaume. Taarifa za afya ya uzazi na ujinsia kwa vijana zinatoka katika vyanzo mbalimbali wakiwemo wazazi, shangazi wa baba (ssenga), wajomba (kojja), kaka na dada wakubwa, rika, redio na magazeti. Walipoulizwa kama walikuwa na ujuzi kuhusu [[VVU]], 38% ya wanaume wenye umri wa miaka 15-19 walisema ndiyo na 31% ya wanawake walio katika umri sawa walisema ndiyo. <ref name="unicef1"/> Vijana ambao walihojiwa kuhusu umri ambao watu wanapaswa kuanza kufanya ngono, washiriki wote katika mbinu zote za kukusanya data walisema kwamba umri unaofaa ni kati ya miaka 18 na 20. Washiriki pia walisema kwamba watu walianza kujamiiana mahali popote kutoka miaka 4 hadi 16, lakini vijana wote waliamini kuwa hii ilikuwa mapema sana. <ref name="unicef1"/> Matumizi ya [[kondomu]] ni ya juu zaidi miongoni mwa vijana walio shuleni kuliko vijana ambao hawajaenda shule.<ref name="autogenerated2004">{{cite journal|last=Ndyanabangi|first=Bannet|author2=Kipp, W|author3=Diesfeld, HJ|title=Reproductive Health Behavior Among In-School and Out-Of-School Youth in Kabarole District, Uganda.|journal=African Journal of Reproductive Health|date=December 2004|volume=8|issue=3|pages=55–67|pmid=17348325|doi=10.2307/3583393|jstor=3583393|url=http://www.bioline.org.br/abstract?id=rh04042|archive-date=2022-12-08|access-date=2022-12-08|archive-url=https://web.archive.org/web/20221208221317/http://www.bioline.org.br/abstract?id=rh04042|url-status=dead}}</ref> Vijana walio shuleni pia walikuwa na wapenzi wachache kwa jumla kuliko wale walio nje ya shule na pia wana uwezekano mkubwa wa kuhusika katika kupanga uzazi kuliko vijana wasio shule.<ref name="autogenerated2004"/> == Marejeo == {{reflist}} == Kusoma zaidi == * {{Rejea jarida|title=Youth Policy Briefs: Youth and Public Policy in Uganda|url=http://www.youthpolicypress.com/pdfs/Uganda_20150914.pdf|journal=Youth Policy Briefs: Youth and Public Policy in Uganda|pages=246}} Muhtasari wa Sera ya Vijana: Sera ya Vijana na Umma nchini Uganda * {{Rejea jarida|title=Assessing Alternative Care for Children in Uganda 2018|url=https://bettercarenetwork.org/sites/default/files/Assessing%20Alternative%20Care%20for%20Children%20in%20Uganda_FINAL_tr-18-250.pdf|journal=Assessing Alternative Care for Children in Uganda 2018|pages=92|access-date=2022-12-08|archive-date=2022-12-08|archive-url=https://web.archive.org/web/20221208221721/https://bettercarenetwork.org/sites/default/files/Assessing%20Alternative%20Care%20for%20Children%20in%20Uganda_FINAL_tr-18-250.pdf|url-status=dead}} Kutathmini Utunzaji Mbadala kwa Watoto nchini [[Uganda]] [[Jamii:Uganda]] [[Jamii:African Youth Month 2022]] 03s5whnvfiy101dnqzady56gdnjc17l 0 163367 1578228 1513312 2026-07-03T04:24:48Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578228 wikitext text/x-wiki {{tafsiri kompyuta}} '''Haki ya Afya ya Uzazi na Jinsia''' ([[Kiingereza]] ''Sexual and reproductive health and rights'') kwa kifupi ni ''SRHR'' ni dhana inayohusu [[haki za binadamu]] hasa katika [[Afya ya Uzazi]] ,ni muunganiko wa maneno manne yaliyopo katika sehemu moja na wakati mwingine maneno matatu,ambayo ni Afya ya [[Uzazi]], wakati mwingine neno hili wakati mwingine linatengenishwa kawa sababu kadhaa..<ref>{{Rejea tovuti|url=https://inspire-partnership.org/we-love-srhr.html|title=SRHR|accessdate=2023-01-16|archivedate=2019-05-02|archiveurl=https://web.archive.org/web/20190502051537/https://inspire-partnership.org/we-love-srhr.html}}</ref> Haki ya uzazi wakati mwingine pia hujumuishwa kama haki ya Afya ua Uzazi na Ngono ama kinyume chakea.<ref>{{cite web| url=http://ippf.org/resource/IPPF-Charter-Sexual-and-Reproductive-Rights| title=IPPF Charter on Sexual and Reproductive Rights Guidelines| date=22 November 2011| publisher=IPPF| accessdate=2023-01-16| archivedate=2018-12-23| archiveurl=https://web.archive.org/web/20181223155448/https://www.ippf.org/resource/IPPF-Charter-Sexual-and-Reproductive-Rights}}</ref> tofauti hiyo ni kama tofauti kati ya asasi isiyo ya kiserikali pamoja na asasi ya kiserikali lakini neno hilo hufanya kazi kwa pamoja kama asasi. Baadhi ya Mashirika yanatetea haki ya Uzazi na ngono salama yanakiwemo [[International Planned Parenthood Federation|IPPF]] (International Planned Parenthood Federation), [[International Lesbian, Gay, Bisexual, Trans and Intersex Association|ILGA]] (International Lesbian and Gay Alliance), ''WAS'' ([[World Association for Sexual Health]] ambalo zamani lilikuwa likijulikana kama ''World Association for Sexology'',pamoja na shirika jingine liitwalo ''International HIV/AIDS Alliance''.<ref>{{cite web | url = http://www.aidsalliance.org/TechnicalThemeDetails.aspx?Id=10 | archive-url = https://web.archive.org/web/20131206105333/http://www.aidsalliance.org/TechnicalThemeDetails.aspx?Id=10 | archive-date = 6 December 2013 | url-status = dead | title = SRHR and HIV | publisher = International HIV/AIDS Alliance | accessdate = 2023-01-16 | archivedate = 2013-12-06 | archiveurl = https://web.archive.org/web/20131206105333/http://www.aidsalliance.org/TechnicalThemeDetails.aspx?Id=10 }}</ref><ref>{{cite web | url = http://www.eurongos.org/Default.aspx?ID=1495 | archive-url = https://web.archive.org/web/20110616041715/http://www.eurongos.org/Default.aspx?ID=1495 | archive-date = 16 June 2011 | url-status = dead | title = Members of EuroNGOs | publisher = EuroNGOs | accessdate = 2023-01-16 | archivedate = 2011-06-16 | archiveurl = https://web.archive.org/web/20110616041715/http://www.eurongos.org/Default.aspx?ID=1495 }}</ref> == Historia == Programu za Afya ya Uzazi wa mpango zilianza mwaka [[1950]]<ref name="Visaria_1999">{{cite journal | last1 = Visaria | first1 = Leela | last2 = Jejeebhoy | first2 = Shireen | last3 = Merrick | first3 = Tom | name-list-style = vanc | date = 1999 | title = From Family Planning to Reproductive Health: Challenges Facing India | jstor = 2991871 | journal = International Family Planning Perspectives | volume = 25 | pages = S44–S49 | doi=10.2307/2991871 }}</ref> na lengo kubwa la orogramu hizi ilikuwa kuonguza idadi ya watu duniani kwa sababu za kimaendeleo na kiuchumi.<ref name="Ledbetter_1984">{{cite journal | vauthors = Ledbetter R | title = Thirty years of family planning in India | url = https://archive.org/details/sim_asian-survey_1984-07_24_7/page/736 | journal = Asian Survey | volume = 24 | issue = 7 | pages = 736–58 | date = 1984 | pmid = 11616645 | doi = 10.2307/2644186 | jstor = 2644186 }}</ref> mwaka [[1994]] katika mkutano mkuu wa kimataifa wa ongezeko la watu duniani uliofanyika katika mjini wa [[Cairo]] nchini [[Misri]] ulichukulia kwa uzito kuhusu uzazi wa mpango hali iliyopelekea kuanzishwa kwa harakati za Afya ya Uzazi na Ngono salama.<ref name="Glasier_2006">{{cite journal | vauthors = Glasier A, Gülmezoglu AM, Schmid GP, Moreno CG, Van Look PF | title = Sexual and reproductive health: a matter of life and death | url = https://archive.org/details/sim_the-lancet_november-4-10-2006_368_9547/page/1595 | journal = Lancet | volume = 368 | issue = 9547 | pages = 1595–607 | date = November 2006 | pmid = 17084760 | doi = 10.1016/S0140-6736(06)69478-6 | s2cid = 24712226 }}</ref> Mkutano huu ulitazamia na kujadili juu ya uzazi wa mpango na familia,kuanzia uchumi pamoja na haki za [[Binadamu]] .<ref name="Fincher_1994">{{cite journal | vauthors = Fincher RA | title = International Conference on Population and Development | url = https://heinonline.org/HOL/LandingPage?handle=hein.journals/envpola24&id=309 | journal = Environmental Policy and Law | volume = 24 | issue = 6 | date = 1994 }}</ref> Programu ijulikanayo kama ''Program of Action'' (POA) ilianzishwa na kukubaliwa na nchi zaidi ya 179 katika mkutano huo .<ref name="ICPD">{{cite web | title = Programme of Action | url = https://www.unfpa.org/sites/default/files/pub-pdf/programme_of_action_Web%20ENGLISH.pdf | work = International Conference on Population and Development | location = Cairo | date = September 1994 }}</ref> Program ya POA ilikubali kwamba, haki ya Uzazi na ngono salama ni suala la haki za binadamu ulimwenguni,likihusisha kuwawezesha wanawake,uzazi pamoja na afya ya njema,mipango ya POA ilikuwa ni kutimiza [[Malengo]] yaki kufikia mwaka wa [[2015]].<ref name="Abrejo_2008">{{cite journal | vauthors = Abrejo FG, Shaikh BT, Saleem S | title = ICPD to MDGs: Missing links and common grounds | journal = Reproductive Health | volume = 5 | pages = 4 | date = September 2008 | pmid = 18783600 | pmc = 2546384 | doi = 10.1186/1742-4755-5-4 }}</ref> ,Mnamo mwaka [[2000]], mpango wa maendeleo ya Milenium ulizinduliwa lakini afya ua zazi na ngono salama haikuwepo katika mpango huo na kufikia mwaka [[2010]] programu ya POA ilifanyiwa marekebisho na Afya ua uzazi na ngono Salama ikapewa kipaumbele In 2000 ==Marejeo== {{Reflist}} {{Mbegu}} [[Jamii:Wiki in Activism]] [[Jamii:Haki]] 8g0q2jz4ga915f3oht1125brkgivwaw 0 166426 1578232 1307628 2026-07-03T04:46:56Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578232 wikitext text/x-wiki '''''Commonitorium'''''<ref>Available at http://www.ccel.org/ccel/schaff/npnf211.iii.html</ref> ([[jina]] hilo la [[Kilatini]] lilitumiwa naye kudokeza kwamba aliandika aweze ''kujikumbusha'': ndiyo maana ya [[kichwa]] jicho) ni [[kitabu]] maarufu kilichoandikwa na [[Vincent wa Lerins|Vinsenti wa Lerins]] [[mwaka]] [[434]] hivi, yaani miaka 3 baada ya [[Mtaguso wa Efeso]]. Huyo [[mmonaki]] [[Upadri|padri]] wa [[Galia]] (leo [[Ufaransa]]), akitaka kufanya [[imani]] ya [[Ukristo|Wakristo]] istawi ndani mwao, alikiandika akiwa katika [[monasteri]] ya [[Lérins]] kwenye [[kisiwa]] [[Saint-Honorat]], na akitumia [[jina bandia]] la [[Peregrinus]] alibainisha [[vigezo]] vya kutofautisha [[ukweli]] wa [[imani sahihi]] [[uongo]] uliofichama katika [[uzushi]]. Sawa na [[mtaguso mkuu]] huo, Vincent alitetea matumizi ya [[jina]] [[Mama wa Mungu]] kwa [[Bikira Maria]], akipinga [[hoja]] za [[Nestori wa Konstantinopoli]]. ==Tazama pia== *[[Watakatifu wa Agano la Kale]] *[[Orodha ya Watakatifu Wakristo]] *[[Orodha ya Watakatifu wa Afrika]] *[[Orodha ya Watakatifu Wafransisko]] *[[Mababu wa Kanisa]] ==Tanbihi== {{reflist}} == Marejeo == * Thomas G. Guarino, ''Vincent of Lerins and the Devolopment of Doctrine.'' Grand Rapids: Baker Academic, 2013. *{{cite journal|location=Leiden|publisher=Brill|journal=Vigiliae Christianae|issn=0042-6032|volume=49|issue=2|year=1995|pages=180&ndash;188|last=Ferreiro|first=Alberto|title=Simon Magus and Priscillian in the ''Commonitorium'' of Vincent of Lérins|url=https://archive.org/details/vigiliae-christianae_1995-05_49_2/page/180|doi=10.2307/1584394|jstor=1584394}} *{{cite journal|location=Rome|publisher=Gregorian & Biblical Press|journal=Gregorianum|issn=0017-4114|volume=75|issue=3|year=1994|last=Guarino|first=Thomas|title=Vincent of Lerins and the hermeneutical question: historical and theological reflections|url=https://books.google.com/books?id=RqzxB99MleMC&pg=PA491|jstor=23579794}} ==Viungo vya nje== * [http://www.documentacatholicaomnia.eu/30_10_0380-0450-_Vincentius_Lerinus.html Opera Omnia by Migne Patristica Latina] * [http://www.fordham.edu/halsall/ancient/434lerins-canon.asp Vincent of Lerins, ''The "Vincentian Canon"''] {{Wayback|url=http://www.fordham.edu/halsall/ancient/434lerins-canon.asp |date=20140814163829 }} * [http://www.newadvent.org/fathers/3506.htm ''Commonitory''] {{mbegu-kitabu}} [[Category:Mababu wa Kanisa]] [[Category:Teolojia]] dym1lnge8hsv2i6m7alnkv30n5ha3i6 0 170868 1578051 1381798 2026-07-02T16:31:24Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578051 wikitext text/x-wiki '''Cynthia E. Rosenzweig''' ( ''née'' Ropes <ref>{{Cite web|url=http://www.earth.columbia.edu/eidirectory/view/710|title=Dr. Cynthia Ropes Rosenzweig - Directory - The Earth Institute - Columbia University|work=www.earth.columbia.edu|language=en|accessdate=2018-10-17}}</ref> ) (alizaliwa mnamo mwaka 1958) ni mtaalamu wa elimu ya [[tabianchi]] kutoka [[Marekani]] katika Taasisi ya [[NASA]] Goddard ya Mafunzo ya Anga, iliyoko katika [[Chuo Kikuu cha Columbia]], "Alisaidia kuanzishwa kwa utafiti wa mabadiliko ya hali ya hewa na kilimo." <ref name="gillis">Justin Gillis, [https://www.nytimes.com/2011/06/05/science/earth/05harvest.html "A Warming Planet Struggles to Feed Itself"], ''[[The New York Times]]'', June 5, 2011.</ref> <ref>{{Cite journal|last=Brumfiel|first=G.|last2=Tollefson|first2=J.|last3=Hand|first3=E.|last4=Baker|first4=M.|last5=Cyranoski|first5=D.|last6=Shen|first6=H.|last7=Van Noorden|first7=R.|last8=Nosengo|first8=N.|last9=Butler|first9=D.|displayauthors=8|year=2012|title=366 days: ''Nature''{{'}}s 10|url=https://archive.org/details/sim_nature-uk_december-20-27-2012_492_7429/page/335|journal=Nature|volume=492|issue=7429|pages=335–343|bibcode=2012Natur.492..335.|doi=10.1038/492335a|pmid=23257862|doi-access=free}}</ref> Ni mwanasayansi mwandamizi wa utafiti katika Shule ya Hali ya Hewa iliyopo nchini [[Columbia, South Carolina|Columbia]] na ana zaidi ya machapisho 300, <ref>{{Cite web|url=https://www.researchgate.net/scientific-contributions/54074194_Cynthia_Rosenzweig|title=Cynthia Rosenzweig's research works {{!}} Columbia University, NY (CU) and other places|work=ResearchGate|language=en|accessdate=2018-10-17}}</ref> zaidi ya nakala 80 zilizopitiwa na kuhaririwa, pia ameandika na kuhariri vitabu vinane. <ref>{{Cite web|url=http://heymancenter.org/people/cynthia-rosenzweig/|title=People {{!}} Cynthia Rosenzweig {{!}} The Heyman Center for the Humanities at Columbia University|work=heymancenter.org|language=en|accessdate=2018-10-17|archivedate=2020-10-09|archiveurl=https://web.archive.org/web/20201009205542/http://heymancenter.org/people/cynthia-rosenzweig//}}</ref> Na amehudumu katika mashirika mengi tofauti yanayofanya kazi za kuandaa mipango ya kudhibiti mabadiliko ya hali ya hewa, katika ngazi ya kimataifa na vile vile katika Jiji la [[New York]] baada ya Kimbunga Sandy . == Elimu na taaluma == Rosenzweig alihudhuria na kusoma katika ndaki ya Cook iliyopo ndani ya [[Chuo Kikuu cha Rutgers]] na kupata shahada ya kwanza ya Sanaa katika [[sayansi ya kilimo]] mnamo mwaka 1980. Mtazamo wa Rosenzweig katika kilimo ulianza mwaka wa 1969, wakati yeye na mume wake mtarajiwa walipokodisha na kuendesha shamba huko Toscany, [[Italia]], wakichuma zabibu na mizeituni na kufuga wanyama kama mbuzi, nguruwe, bata na bata bukini. <ref name=":0">{{Cite journal|last=Heuer|first=R. D.|last2=Rosenzweig|first2=C.|last3=Steltzner|first3=A.|last4=Blanpain|first4=C.|last5=Iorns|first5=E.|last6=Wang|first6=J.|last7=Handelsman|first7=J.|last8=Gowers|first8=T.|last9=De Bernardinis|first9=B.|date=2012-12-19|title=366 days: Nature's 10|url=https://www.nature.com/news/366-days-nature-s-10-1.11997|journal=Nature|language=en|volume=492|issue=7429|pages=335–343|bibcode=2012Natur.492..335.|doi=10.1038/492335a|issn=0028-0836|pmid=23257862|doi-access=free}}</ref> Aliamua kurudi chuo kikuu kusomea kilimo, na kupata Shahada ya Uzamili ya Sayansi katika Udongo na Mazao kutoka Chuo Kikuu cha Rutgers mwaka wa 1983. <ref name="nasaprofile">[http://www.giss.nasa.gov/staff/crosenzweig.html "Cynthia Rosenzweig"] (profile), [[NASA GISS]] (last visited Aug. 15, 2012).</ref> Wakati wa Shahada yake ya Uzamili, aliajiriwa na Taasisi ya [[NASA]] Goddard ya Mafunzo ya Anga na kuanza kusomea ardhi ya kilimo kwa kutumia data ya setilaiti. Kisha alipata Ph.D. kutoka Chuo Kikuu cha Massachusetts Amherst katika Sayansi ya Mimea, Udongo na Mazingira mwaka wa 1991. <ref name="nasaprofile" /> Ameendelea kufanya kazi NASA, ambapo amekuwa mkuu wa Kundi la Athari za Hali ya Hewa tangu 1993. <ref name=":1">{{Cite web|url=https://www.giss.nasa.gov/staff/crosenzweig.html|title=NASA GISS: Cynthia Rosenzweig|work=GISS Personnel Directory|accessdate=October 16, 2018}}</ref> <ref name="interview-2008">[https://web.archive.org/web/20111106182026/http://www.takeabite.cc/interview-with-dr-cynthia-rosenzweig/ "An Interview with Dr. Cynthia Rosenzweig of NASA – Q&A with Anna Lappé"], ''Take a Bite Out of Climate Change'', Sept. 2008</ref> Kazi yake na Kikosi Kazi cha IPCC kwenye Data ilitambuliwa wakati Tuzo ya Amani ya Nobel ya 2007 ilipotolewa kwa pamoja kwa [[Al Gore]] na IPCC . <ref>[http://www.giss.nasa.gov/research/news/20071217/ "NASA Climate Change 'Peacemakers' Aided Nobel Effort"], NASA Press Release, Dec. 17, 2007.</ref> Pia kwa sasa anatumika kama profesa msaidizi katika Chuo cha Barnard na pia ni mwanasayansi mwandamizi wa utafiti katika Shule ya Hali ya Hewa ya Columbia katika Chuo Kikuu cha Columbia. <ref name=":1">{{Cite web|url=https://www.giss.nasa.gov/staff/crosenzweig.html|title=NASA GISS: Cynthia Rosenzweig|work=GISS Personnel Directory|accessdate=October 16, 2018}}</ref> <ref>{{Cite web|url=https://barnard.edu/profiles/cynthia-rosenzweig|title=Cynthia Rosenzweig {{!}} Barnard College|work=barnard.edu|language=en|accessdate=2018-10-17}}</ref> <ref>{{Cite web|url=http://uccrn.org/who-we-are/people/|title=Global Management Team – Urban Climate Change Research Network|work=uccrn.org|language=en-US|accessdate=2018-10-17|archivedate=2020-10-09|archiveurl=https://web.archive.org/web/20201009205555/https://uccrn.ei.columbia.edu/who-we-are/people//}}</ref> == Ushiriki katika jamii na kujitolea == Akiwa katika Taasisi ya NASA na Columbia ya Goddard inayohusika Mafunzo ya Anga, Rosenzweig ameanzisha utafiti wa athari za mabadiliko ya hali ya hewa katika kilimo na miji ya binadamu. <ref name="gillis">Justin Gillis, [https://www.nytimes.com/2011/06/05/science/earth/05harvest.html "A Warming Planet Struggles to Feed Itself"], ''[[The New York Times]]'', June 5, 2011.</ref> Amehusika katika vikundi vingi vya kazi vinavyojaribu kutathmini na kuanzisha mipango ya kudhibiti mabadiliko ya hali ya hewa, pamoja na: * Mwenyekiti Mwenza, Jopo la Jiji la New York kuhusu Mabadiliko ya Tabianchi * Kiongozi Mwenza, Tathmini ya Kanda ya Pwani ya Mashariki ya Metropolitan ya Tathmini ya Kitaifa ya Marekani ya Madhara Yanayowezekana ya Kubadilika kwa Tabianchi na Mabadiliko, iliyofadhiliwa na Mpango wa Utafiti wa Mabadiliko ya Dunia wa Marekani. * Kuratibu Mwandishi Kiongozi wa Ripoti ya Tathmini ya Nne ya Kikundi Kazi cha IPCC (sura ya "Mabadiliko Yaliyozingatiwa") * Kuratibu Mwandishi Kiongozi wa Ripoti Maalum ya IPCC kuhusu Mabadiliko ya Tabianchi na Ardhi * Mwanachama, Kikundi Kazi cha IPCC kuhusu Data na Matukio ya Athari na Tathmini ya Hali ya Hewa * Mhariri-Mwenza, Ripoti ya Tathmini ya Kwanza [[UCCRN|ya UCCRN]] kuhusu Mabadiliko ya Tabianchi na Miji (ARC3). * Mjumbe wa Jopo la Jopo la Jiji la New York kuhusu Mabadiliko ya Tabianchi . * Mwanzilishi mwenza na mjumbe wa Kamati Tendaji ya Mradi wa Kulinganisha na Uboreshaji wa Mfano wa Kilimo (AgMIP) * Mnamo Oktoba 20, 2022 Rosenzweig alitunukiwa Tuzo ya Chakula Duniani. <ref name="WFP">{{Cite web|url=https://www.worldfoodprize.org/index.cfm/87428/48752/2022_world_food_prize_awarded_to_nasa_climate_scientist|work=World Food Prize Organization|title=2022 World Food Prize Awarded to NASA Climate Scientist|date=May 5, 2022|accessdate=February 18, 2023}}</ref> * Rosenzweig alianzisha Mradi wa Kulinganisha na Uboreshaji wa Mfano wa Kilimo mnamo 2010. == Machapisho == Muhtasari wa utafiti wa Rosenzweig unaweza kupatikana katika wasifu wake [https://scholar.google.com/citations?user=eBnigv0AAAAJ&hl=en kwenye Google Scholar] . Orodha kamili ya machapisho yake yanaweza pia kupatikana kwenye [https://pubs.giss.nasa.gov/authors/crosenzweig.html tovuti ya NASA Goodard Institute for Space Studies] . * {{Cite journal|last=Rosenzweig|first=C.|last2=Parry|first2=M. L.|year=1994|title=Potential impact of climate change on world food supply|url=https://zenodo.org/record/1233153|journal=Nature|volume=367|issue=6459|pages=133|bibcode=1994Natur.367..133R|doi=10.1038/367133a0}} * C.L. Rosenzweig & M.L. Parry, [http://pure.iiasa.ac.at/id/eprint/3350/1/XB-90-705.pdf "Climate Change and Agriculture"], 1990 * {{Cite journal|last=Rosenzweig|first=C.|last2=Karoly|first2=D.|last3=Vicarelli|first3=M.|last4=Neofotis|first4=P.|last5=Wu|first5=Q.|last6=Casassa|first6=G.|last7=Menzel|first7=A.|last8=Root|first8=T. L.|last9=Estrella|first9=N.|year=2008|title=Attributing physical and biological impacts to anthropogenic climate change|url=https://archive.org/details/sim_nature-uk_2008-05-15_453_7193/page/n117|journal=Nature|volume=453|issue=7193|pages=353–357|bibcode=2008Natur.453..353R|doi=10.1038/nature06937|pmid=18480817}} * [https://web.archive.org/web/20170501101544/https://science.house.gov/sites/republicans.science.house.gov/files/documents/hearings/041707_rosenzweig.pdf Testimony before Congress], April 17, 2007. == Tuzo == * Mshirika wa Guggenheim <ref name="nasaprofile">[http://www.giss.nasa.gov/staff/crosenzweig.html "Cynthia Rosenzweig"] (profile), [[NASA GISS]] (last visited Aug. 15, 2012).</ref> * Tuzo ya Heshima ya GSFC - Sayansi (2011) <ref name="GISSAwards">{{Cite web|title=Fellow, American Association for the Advancement of Science|url=http://science.gsfc.nasa.gov/earth/giss/awardswon|author=NASA (GISS)|year=2011}}</ref> * Tuzo Bora ya Uchapishaji ya GISS (2009) <ref name="GISSAwards" /> * Tuzo ya Heshima ya GSFC - Mafanikio ya Sayansi ya Dunia (2007) <ref name="GISSAwards" /> * Chama cha Marekani cha Kuendeleza Sayansi (2006) <ref>{{Cite web|url=https://www.aaas.org/fellows/listing|title=Elected Fellows|publisher=American Association for the Advancement of Science}}</ref> * Imetajwa kama mojawapo ya 10 ya Nature : Watu Kumi Walio umuhimu katika 2012" na jarida Nature <ref name=":0">{{Cite journal|last=Heuer|first=R. D.|last2=Rosenzweig|first2=C.|last3=Steltzner|first3=A.|last4=Blanpain|first4=C.|last5=Iorns|first5=E.|last6=Wang|first6=J.|last7=Handelsman|first7=J.|last8=Gowers|first8=T.|last9=De Bernardinis|first9=B.|date=2012-12-19|title=366 days: Nature's 10|url=https://www.nature.com/news/366-days-nature-s-10-1.11997|journal=Nature|language=en|volume=492|issue=7429|pages=335–343|bibcode=2012Natur.492..335.|doi=10.1038/492335a|issn=0028-0836|pmid=23257862|doi-access=free}}</ref> * Tuzo ya Chakula Duniani (2022) <ref name="WFP">{{Cite web|url=https://www.worldfoodprize.org/index.cfm/87428/48752/2022_world_food_prize_awarded_to_nasa_climate_scientist|work=World Food Prize Organization|title=2022 World Food Prize Awarded to NASA Climate Scientist|date=May 5, 2022|accessdate=February 18, 2023}}</ref> <ref>{{Cite news|title=Nasa climate research scientist awarded World Food prize|url=https://www.theguardian.com/environment/2022/may/05/world-food-prize-2022-winner-cynthia-rosenzweig-nasa}}</ref> == Marejeo == <references group="" responsive="0"></references> [[Jamii:Watu walio hai]] 1g416utwzs4fevuqv4fvesobmw4n0y3 0 175204 1578128 1306320 2026-07-02T21:18:55Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578128 wikitext text/x-wiki {{Uainishaji | rangi = pink | jina = Bungo-fyatuo | picha = Giant Acacia Click Beetle (Tetralobus flabellicornis) (52765072734).jpg | upana_wa_picha = 250px | maelezo_ya_picha = Bungo-fyatuo mkubwa wa migunga (''Tetralobus flabellicornis'') | himaya = [[Mnyama|Animalia]] (Wanyama) | faila = [[Arthropodi|Arthropoda]] (Wanyama wenye miguu yenye viungo) | nusufaila = [[Hexapoda]] (Wanyama wenye miguu sita) | ngeli = [[Insecta]] (Wadudu) | ngeli_ya_chini = [[Pterygota]] (Wadudu wenye mabawa) | oda = [[Coleoptera]] (Wadudu wenye mabawa magumu) | nusuoda = [[Polyphaga]] | familia_ya_juu = [[Elateroidea]] | familia = [[Elateridae]] | bingwa_wa_familia = [[William Elford Leach|Leach]], 1815 | subdivision = '''Nusufamilia 19, 4 katika Afrika ya Mashariki:''' * [[Agrypninae]] <small>[[Ernest Candèze|Candèze]], 1857</small> * [[Dendrometrinae]] <small>[[Johannes von Nepomuk Franz Xaver Gistel|Gistel]], 1848</small> * [[Elaterinae]] <small>Leach, 1815</small> * [[Tetralobinae]] <small>Latreille, 1802</small> }} '''Bungo-fyatuko''' ni [[mbawakawa]] wa [[familia (biolojia)|familia]] [[Elateridae]] katika [[nusuoda]] [[Polyphaga]] ya [[oda]] [[Coleoptera]] walio na [[njia]] ya kurudi kwa [[mguu|miguu]] yao baada ya kutua [[chali]] kwa kujisukuma [[anga]]ni ambapo hujaribu kugeuka na kutua kwa miguu yao. [[Lava]] wao huishi [[ardhi]]ni na kuitwa [[nyunguwaya]] ([[w:wireworm|wireworms) kwa sababu ya umbo lao jembamba na refu na ushupavu wao kulinganisha na lava wa bungo wengine. Kuna [[spishi]] 9300 [[dunia]]ni kote<ref>{{cite journal |author=Schneider, M. C. |year=2006 |title=Evolutionary chromosomal differentiation among four species of ''Conoderus'' Eschscholtz, 1829 (Coleoptera, Elateridae, Agrypninae, Conoderini) detected by standard staining, C-banding, silver nitrate impregnation, and CMA₃/DA/DAPI staining |url=https://archive.org/details/sim_genetica_september-november-2006_128_1-3/page/333 |journal=[[Genetica]] |volume=128 |issue=1–3 |pages=333–346 |pmid=17028962 |doi=10.1007/s10709-006-7101-5|s2cid=1901849 |display-authors=etal}}</ref>; idadi ya spishi za [[Afrika ya Mashariki]] haijahesabiwa. ==Maelezo== [[Picha:Schnellkaefer ruecken.jpg|thumb|left|200px|Picha ya upande wa chini wa kichwa na toraksi za bungo-fyatuo ambayo inaoyesha kulabu na tundu ya mfumo wa ufyataji. Inaonyesha pia vipapasio na miguu ndani ya mifuo yao.]] Bungo hao wana urefu wa sm 0.2-7 lakini wengi sana ni chini ya sm 2. Baadhi yao wana rangi kali lakini wengine ni weusi au kahawia bila mabaka. Kwa kawaida urefu wa vipapasio ni nusu ya ule wa mwili na vinaweza kukunjwa katika mifuo kwenye upande wa chini wa kichwa. Mifuo ingine iko kwenye pronoto ili kupokea miguu. Kulabu inatokeza upande wa chini wa pingili ya kwanza ya pronoto ambaye inawafikia tundu kwenye pingili ya pili. Ikiwa bungo anapolala chali au kutishwa na adui, anaingiza kulabu katika tundu hili kwa kupinda pronoto. Kisha bungo huvuta kulabu hadi inafyatua nje huku ikitokeza kidoko kinachosikika. Kwa sababu ya hii pingili ya kwanza inapiga chini kwa nguvu sana kwamba bungo husukumwa angani ambapo anajaribu kugeuka na kutua kwa miguu yake<ref>{{cite AV media |year=2015 |title=How the click beetle jumps from the back !|url=https://www.youtube.com/watch?v=Vew2nzaLerY |archive-url=https://ghostarchive.org/varchive/youtube/20211221/Vew2nzaLerY |archive-date=2021-12-21 |url-status=live|access-date=3 December 2015 |publisher=Myrmecofourmis.fr on Youtube}}{{cbignore}}</ref>. Bungo-fyatuo wanaweza kuruka angani, lakini hawawezi kuruka kutoka ardhi au sehemu nyingine bapa. Lazima wapande juu ya kitu wima, kama mti, kikingi n.k., kabla ya kufungua mabawa. Lava ni warefu na wembamba wenye kutikulo ngumu kiasi. Kwa hivyo mwili umeshupaa kama waya na kwa sababu ya hii huitwa nyunguwaya. Kwa kawaida wana rangi ya manjano au ya machungwa isiyokolea. ==Biolojia na ekolojia== Kwa kawaida bungo-fyatuo hukiakia usiku na kwa hivyo hawaonekani mara nyingi, ingawa, usiku wa joto, huvutiwa na mwanga na wanaweza kuingia ndani ya nyumba. Wanakula sehemu za mimea, lakini spishi kadhaa tu zina umuhimu wa kiuchumi. Ingawa nyunguwaya wa spishi fulani hukamilisha ukuaji wao katika mwaka mmoja (k.m. Monocrepidius), wengi wao hutumia miaka mitatu au minne kwenye udongo. Nyunguwaya kawaida hula viumbe waliokufa, lakini spishi kadhaa hula mizizi ya mimea na wanaweza kuwa wadudu waharibifu wa kilimo. Wengine ni mbuai wamilifu wa lava wa wadudu wengine. ===Usumbivu=== Kwa kula mizizi ya mimea, nyunguwaya mara nyingi husababisha uharibifu wa mazao ya kilimo kama vile viazi, sitroberi, mahindi na ngano<ref>{{cite journal |author1=R. S. Vernon |author2=W. van Herk |author3=J. Tolman |author4=H. Ortiz Saavedra |author5=M. Clodius |author6=B. Gage |year=2008 |title=Transitional sublethal and lethal effects of insecticides after dermal exposures to five economic species of wireworms (Coleoptera: Elateridae) |url=https://archive.org/details/sim_journal-of-economic-entomology_2008-04_101_2/page/365 |journal=[[Journal of Economic Entomology]] |volume=101 |issue=2 |pages=365–374 |pmid=18459400 |doi=10.1603/0022-0493(2008)101[365:TSALEO]2.0.CO;2}}</ref><ref>{{cite journal |author1=William E. Parker |author2=Julia J. Howard |year=2001 |title=The biology and management of wireworms (''Agriotes'' spp.) on potato with particular reference to the U.K. |journal=[[Agricultural and Forest Entomology]] |volume=3 |issue=2 |pages=85–98 |doi=10.1046/j.1461-9563.2001.00094.x|doi-access=free }}</ref>, lakini pia kwa nyasi, kama vile katika viwanja vya gofu. Tabia za chini ya ardhi za nyunguwaya, kama uwezo wao wa kupata chakula kwa haraka kwa kufuata viwango vya juu vya kaboni dioksidi zinazozalishwa na dutu za mimea kwenye udongo<ref>{{cite journal |author1=J. F. Doane |author2=Y. W. Lee |author3=N. D. Westcott |author4=J. Klingler |year=1975 |title=The orientation response of ''Ctenicera destructor'' and other wireworms (Coleoptera: Elateridae) to germinating grain and to carbon dioxide |url=https://archive.org/details/sim_canadian-entomologist_1975-12_107_12/page/1233 |journal=[[Canadian Entomologist]] |volume=107 |issue=12 |pages=1233–1252 |doi=10.4039/Ent1071233-12}}</ref>, na uwezo wao wa ajabu wa kupona kutokana na magonjwa yanayosababishwa na kuathiriwa na viuawadudu (wakati mwingine baada ya miezi mingi)<ref>{{cite journal |author1=W. G. van Herk |author2=R. S. Vernon |author3=J. H. Tolman |author4=H. Ortiz Saavedra |year=2008 |title=Mortality of a wireworm, ''Agriotes obscurus'' (Coleoptera: Elateridae), after topical application of various insecticides |url=https://archive.org/details/sim_journal-of-economic-entomology_2008-04_101_2/page/375 |journal=[[Journal of Economic Entomology]] |volume=101 |issue=2 |pages=375–383 |pmid=18459401 |doi=10.1603/0022-0493(2008)101[375:moawao]2.0.co;2}}</ref>, zinaifanya ngumu kuwaangamiza mara tu wameanza kushambulia mazao. Nyunguwaya wanaweza kupita kwa urahisi kwenye udongo kwa sababu ya umbo lao na mwelekeo wao wa kufuata mashimo yaliyokuwepo awali<ref>{{cite journal |author1=Willem G. van Herk |author2=Robert S. Vernon |year=2007 |title=Soil bioassay for studying behavioral responses of wireworms (Coleoptera: Elateridae) to inecticide-treated wheat seed |url=https://archive.org/details/sim_environmental-entomology_2007-12_36_6/page/1441 |journal=[[Environmental Entomology]] |volume=36 |issue=6 |pages=1441–1449 |pmid=18284772 |doi=10.1603/0046-225X(2007)36[1441:SBFSBR]2.0.CO;2|doi-access=free }}</ref>, na wanaweza kusafiri kutoka mmea hadi mmea, hivyo basi kuumiza mizizi ya mimea mingi ndani ya muda mfupi. Mbinu za kudhibiti waharibifu ni pamoja na mzunguko wa mazao na kusafisha ardhi ya wadudu kabla ya kupanda. ==Spishi zilizochaguliwa za Afrika ya Mashariki== * ''Cryptalaus'' sp. * ''Euphemus funerarius'' * ''Hemicrepidius nemnonius'' * ''Melanotus'' sp. * ''Orthostethus'' sp. * ''Tetralobus flabellicornis'' ==Picha== <gallery> Cryptalaus larvatus in Kaisho Forest - 1.jpg|''Cryptalaus lacteus'' Elateridae - Hemicrepidius hirtus.jpg|''Hemicrepidius hirtus'' Melanotus brunnipes 02.JPG|''Melanotus brunnipes'' Animalia Arthropoda Insecta Coleoptera Polyphaga Elateroidea Elateridae Elaterinae Elaterini Orthostethus Orthostethus infuscatus (5652441231).jpg|''Orthostethus infuscatus'' </gallery> ==Marejeo== {{reflist}} [[Jamii:Mbawakawa]] mvv5a3ac7c44njiu2eqxd897g5t0yn3 0 175216 1578143 1306646 2026-07-02T21:53:08Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578143 wikitext text/x-wiki '''Christopher B. Field''' ni [[mwanasayansi]] na mtafiti kutoka [[Marekani]], ambaye amechangia katika nyanja ya [[Kupanda kwa halijoto duniani|mabadiliko ya hali ya hewa]]. Mwandishi wa zaidi ya machapisho 200 ya kisayansi, Utafiti wa Field unasisitiza [[athari za mabadiliko ya hali ya hewa]], kutoka kwa [[molekuli]] hadi kiwango cha kimataifa. Kazi yake inajumuisha majaribio makubwa ya nyanjani juu ya majibu ya nyika ya [[California]] kwa mabadiliko ya ulimwengu ya mambo mengi, tafiti shirikishi juu ya mzunguko wa [[kaboni]] duniani,<ref>{{Cite journal | last = Ostrom | first = Elinor | authorlink = |author2=Joanna Burger |author3=Christopher B. Field |author4=Richard B. Norgaard |author5=David Policansky | title = Revisiting the Commons: Local Lessons, Global Challenges | url = https://archive.org/details/sim_science_1999-04-09_284_5412/page/278 | journal = [[Science (journal)|Science]] | volume = 284 | issue = 5412 | pages = 278–282 | date = 1999-04-09 | issn = | doi = 10.1126/science.284.5412.278 | id = | pmid=10195886| citeseerx = 10.1.1.510.4369 | bibcode = 1999Sci...284..278. }}</ref> na tathmini ya athari za mabadiliko ya hali ya hewa kwenye [[kilimo]].<ref>{{Cite journal |last = Field |first = Christopher |authorlink = |author2 = Michael J. Behrenfeld |author3 = James T. Randerson |author4 = Paul Falkowski |title = Primary Production of the Biosphere: Integrating Terrestrial and Oceanic Components |journal = Science Magazine |volume = 281 |issue = 5374 |pages = 237–240 |date = 1998-07-10 |issn = |doi = 10.1126/science.281.5374.237 |id = |pmid = 9657713 |url = http://www.escholarship.org/uc/item/9gm7074q |bibcode = 1998Sci...281..237F |access-date = 2020-07-14 |archive-url = https://web.archive.org/web/20180925215921/https://escholarship.org/uc/item/9gm7074q |archive-date = 2018-09-25 |url-status = live }}</ref> Kazi ya Field na miundo inajumuisha tafiti juu ya usambazaji wa kimataifa wa vyanzo vya kaboni na sinki, na tafiti kuhusu madhara ya [[mazingira]] ya kupanua [[nishati]] ya [[biomasi]].<ref name=stanford /> == Vyeo na sifa == Field ndiye mkurugenzi mwanzilishi wa Idara ya Ekolojia ya Kimataifa ya Taasisi ya Carnegie.<ref>{{cite web | last = | first = | authorlink = | title = Christopher "Chris" Field | website = | publisher = Woods Institute for the Environment | url = http://woods.stanford.edu/cgi-bin/facultydb.pl?profile=cfield | format = | doi = | accessdate = 2010-12-04 | archive-url = https://web.archive.org/web/20100709120317/https://woods.stanford.edu/cgi-bin/facultydb.pl?profile=cfield | archive-date = 2010-07-09 | url-status = live | archivedate = 2010-07-09 | archiveurl = https://web.archive.org/web/20100709120317/https://woods.stanford.edu/cgi-bin/facultydb.pl?profile=cfield }}</ref> Field alipokea [[Uzamivu|PhD]] yake kutoka [[Chuo Kikuu cha Stanford]] mnamo mwaka [[1981]] na amekuwa katika Taasisi ya Carnegie ya Sayansi tangu [[1984]]. Field pia ni Profesa wa [[Biolojia]] na Sayansi ya Mfumo wa Mazingira katika [[Chuo Kikuu cha Stanford]],<ref name=stanford>{{cite web | last = | first = | authorlink = | title = Christopher Field, PhD | website = | publisher = The Freeman Spogli Institute for International Studies at Stanford University | url = http://fsi.stanford.edu/people/christopherfield/ | format = | doi = | accessdate = 2010-12-04 | archive-url = https://web.archive.org/web/20140705211831/http://fsi.stanford.edu/people/christopherfield/ | archive-date = 2014-07-05 | url-status = live }}</ref> Mkurugenzi wa Kitivo cha Hifadhi ya Biolojia ya Jasper Ridge ya Stanford, na mwanachama wa Chuo cha Kitaifa cha Sayansi cha Marekani . Alikuwa mwandishi mkuu anayeratibu kwa ripoti ya nne ya tathmini ya Jopo la Serikali Mbalimbali kuhusu Mabadiliko ya Tabianchi . Field ametoa ushahidi mbele ya kamati za Bunge na Seneti na amejitokeza kwenye vyombo vya habari kuanzia “Science Friday” ya NPR hadi “Your World Today.” ya [[BBC]]. Mnamo [[Septemba]] [[2008]], Field alichaguliwa kuwa mwenyekiti mwenza wa Kikundi Kazi cha 2 cha IPCC, pamoja na Vicente Barros.<ref>{{cite web | last = | first = | authorlink = | title = Carnegie's Chris Field Elected Co-chair of IPCC Working Group 2 | website = | publisher = Carnegie Institution for Science | date = 2008-09-04 | url = http://carnegiescience.edu/news/carnegie_s_chris_field_elected_co_chair_ipcc_working_group_2 | format = | doi = | accessdate = 2010-12-04 | archive-url = https://web.archive.org/web/20100808101105/http://carnegiescience.edu/news/carnegie_s_chris_field_elected_co_chair_ipcc_working_group_2 | archive-date = 2010-08-08 | url-status = live | archivedate = 2010-08-08 | archiveurl = https://web.archive.org/web/20100808101105/http://carnegiescience.edu/news/carnegie_s_chris_field_elected_co_chair_ipcc_working_group_2 }}</ref> Mnamo mwaka [[2009]], Field alikuwa mmoja wa wapokeaji kumi wa Tuzo ya 15 ya Mwaka ya Heinz kwa kuangazia maalumu kwenye mazingira.<ref>{{cite web | last = | first = | authorlink = | title = Carnegie's Christopher Field To Receive Heinz Award | website = | publisher = Carnegie Institution for Science | date = 2009-09-15 | url = http://carnegiescience.edu/news/carnegie_s_christopher_field_receive_heinz_award | format = | doi = | accessdate = 2010-12-04 | archive-url = https://web.archive.org/web/20100815064946/http://carnegiescience.edu/news/carnegie_s_christopher_field_receive_heinz_award | archive-date = 2010-08-15 | url-status = live | archivedate = 2010-08-15 | archiveurl = https://web.archive.org/web/20100815064946/http://carnegiescience.edu/news/carnegie_s_christopher_field_receive_heinz_award }}</ref><ref>{{Cite web|last=|first=|date=|title=Heinz Awards - Christopher Field|url=http://www.heinzawards.net/recipients/christopher-field|url-status=live|archive-url=https://web.archive.org/web/20091215083616/http://www.heinzawards.net:80/recipients/christopher-field |archive-date=2009-12-15 |access-date=|website=}}</ref> == Marejeo == {{Reflist}} {{mbegu-mwanasayansi}} [[Jamii:Watu walio hai]] [[Jamii:Wanaume wa Marekani]] [[Jamii:wanaharakati wa Marekani]] [[Jamii:Wanabiolojia wa Marekani]] [[Jamii:Swahili climate voices]] 7jci18m4q7qpeaq430462p6t33n84ud 0 176840 1578112 1575031 2026-07-02T20:23:30Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578112 wikitext text/x-wiki [[Faili:Guanine-3D-balls.png|thumb|Guanine]] '''Guanine''' ni mojawapo ya nukleotidi inayopatikana katika [[DNA]] na [[RNA]], ambazo ni molekuli za kubeba habari jenetiki. Kwa maneno rahisi, guanine ni sehemu muhimu ya vifaa vya jenetiki vinavyounda maisha. Inafanya kazi kama mojawapo ya "code" (herufi) katika lugha inayojulikana kama msimbo wa genetic. Molekuli ya guanine ni mojawapo ya nukleotidi nne inayounda vifaa vya jenetiki, pamoja na adenine, [[thymine]] (kwa DNA), cytosine, na uracil (kwa RNA). Mfululizo wa hizi nukleotidi katika [[DNA]] na [[RNA]] unaunda maagizo ya kibiolojia ambayo yanahusika na ukuaji, maendeleo, na kazi ya kila seli na kiumbe. Guanine inaunganishwa na cytosine katika muundo wa helix wa DNA na inachangia kwenye msimbo wa maisha<ref>{{cite journal | last = Miyakawa | first = S |author2=Murasawa, K. |author3=Kobayashi, K. |author4=Sawaoka, AB. | title = Abiotic synthesis of guanine with high-temperature plasma | url = https://archive.org/details/sim_origins-of-life-and-evolution-of-biospheres_2000-12_30_2-6/page/557 | journal = Orig Life Evol Biosph | volume = 30 | issue = 6 | pages = 557–66 |date=December 2000 | doi = 10.1023/A:1026587607264 | pmid = 11196576| bibcode = 2000OLEB...30..557M | s2cid = 25417484 }}</ref> . == Marejeo == {{reflist}} {{mbegu-sayansi}} [[Jamii:Sayansi]] 8onln9ataeqbzh4t9ntec1ticl9g3ks 0 177423 1578191 1522470 2026-07-03T02:09:44Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578191 wikitext text/x-wiki [[Faili:Artist's impression of a blue quasar.jpg|thumb|300x300px|Picha ya sanaa ya kisahani cha uongezekaji cha nusuranyota.]] '''Nusuranyota''' (kwa kiingereza: ''quasar'') ni [[Kiini cha majarra hai|kiini angavu sana cha majarra hai]]. Nguvu ya [[mnururisho]] wake inatokana na [[shimo jeusi lenye tungamomno|shimo jeusi la tungamomno]], lenye [[tungamo]] kutoka [[tungamo ya Jua]] milioni kumi hadi bilioni kumi, na huzingirwa na [[kisahani cha uongezekaji]]. Kuanguka kwa [[gesi]] ya kisahani hupasha [[joto]] na hutoa [[nishati]] yenye jinsi ya [[mnururisho sumakuumeme]]. Nishati ng’avu ya nusuranyota ni kubwa mno; nusuranyota zenye nguvu zaidi zina mng’aro maelfu ya mara mkubwa kuliko [[majarra]] kama [[Njia Nyeupe]].<ref>{{cite journal |last1=Wu |first1=Xue-Bing |display-authors=etal |title=An ultraluminous quasar with a twelve-billion-solar-mass black hole at redshift 6.30 |url=https://archive.org/details/sim_nature-uk_nature_2015-02-26_518_7540/page/512 |journal=Nature |date=2015 |volume=518 |issue=7540 |pages=512–515 |doi=10.1038/nature14241 |pmid=25719667 |arxiv = 1502.07418 |bibcode = 2015Natur.518..512W |s2cid=4455954 }}</ref><ref>{{Rejea kitabu |last1=Frank |first1=Juhan |last2=King |first2=Andrew |last3=Raine |first3=Derek J. |title=Accretion Power in Astrophysics |edition=Third |bibcode=2002apa..book.....F |isbn=0521620538 |location=Cambridge, UK |publisher=Cambridge University Press |date=February 2002}}</ref> Nusuranyota huainizishwa kama kijamii cha jamii kubwa zaidi ya kiini cha majarra hai. [[Msogeo mwekundu|Misogeo miekundu]] ya nusuranyota inatokana na [[kuvimba kwa Ulimwengu]].<ref>{{Rejea tovuti |title=Quasars and Active Galactic Nuclei |url=https://ned.ipac.caltech.edu/level5/Kembhavi/Kem1_5.html |access-date=2020-08-31 |website=ned.ipac.caltech.edu}}</ref> Istilahi ''nusuranyota'' ni ambatani ya ''nusura'' na ''[[nyota]]''. Kwa kiingereza, ''quasar'' ni mkato wa “quasi-stellar radio source”—kwa sababu zilitambuliwa kwanza wakati wa miaka ya 1950 kama violwa vya asili isiyojulikana ambavyo hutokeza [[Wimbiredio|mawimbiredio]]—na zilipochunguzwa kwa masafa wa mawimbi yanayoonekena, zilifanana na nukta dhaifu ya nuru kama nyota. Taswira za [[Mwonekano picha|mwonekano]] wa juu za nyota, hasa kutoka [[Hubble (darubini)|Darubini ya Angani ya Hubble]], zimeonyesha kwamba nusuranyota ziko katika vitovu vya majarra, na majarra nyingine [[Majarra zinazoingiliana|zinaingiliana]] sana au [[Majarra zinazochanganyana|zinachanganyana]].<ref>{{cite journal |last1=Bahcall |first1=J. N. |display-authors=etal |title=Hubble Space Telescope Images of a Sample of 20 Nearby Luminous Quasars |url=https://archive.org/details/sim_astrophysical-journal_1997-04-20_479_2/page/n127 |journal=The Astrophysical Journal |date=1997 |volume=479 |issue=2 |pages=642–658 |doi=10.1086/303926 |arxiv = astro-ph/9611163 |bibcode = 1997ApJ...479..642B|s2cid=15318893 }}</ref> == Marejeo == {{marejeo}} {{mbegu-sayansi}} [[Jamii:Majarra]] [[Jamii:Nyota]] [[Jamii:Mashimo meusi]] isibpcc0117wge7nonl9faxz0csstb0 0 181681 1578061 1522419 2026-07-02T17:22:37Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578061 wikitext text/x-wiki [[File:Duccio di Buoninsegna 018.jpg|thumb|alt=A typical Western image of the Pentecost. [[Duccio di Buoninsegna]] (1308) [[Tempera]] on wood.|Bikira Maria na [[Mitume wa Yesu|Mitume]] walivyojazwa Roho Mtakatifu mwishoni mwa siku tisa za sala [[ghorofa|ghorofani]]. [[Mchoro]] wa [[Duccio di Buoninsegna]] ([[1308]]).]] [[File:A neuvaine immaculee conception, novena, Christian devotionalism in France.jpg|thumb|Mchoro wa [[Kifaransa]] unaomuonyesha Bikira Maria akimuuliza muumini: "Unataka nimuombe nini [[Mwana wa Mungu|Mwanangu wa Kimungu]]?"]] '''Novena''' (kutoka [[neno]] la [[Kiitalia]] "novena" lenye [[asili]] katika [[Kilatini]]: ''novem'', "tisa") ni mfululizo wa [[sala]] au [[ibada]] ambazo zinazunguka maombi maalumu ambayo kwa kawaida yanafanywa na [[Wakristo]] kwa [[siku]] [[Kenda|tisa]] mfululizo<ref>{{cite book|author=Schnurr, Dennis|title=Novena for Justice and Peace|url=https://books.google.com/books?id=17pdZ0b951AC |year=1998|publisher=US Catholic Conference Publishers|isbn=978-1-57455-237-9|pages=1–2}}; Quote: "Novenas are devotional prayers repeated nine successive times for special intentions."</ref>. Ingawa kuna aina mbalimbali za novena, lengo lake kuu ni kukuza [[imani]], kujitolea, na kuomba msaada wa kutoka [[mbinguni]] katika shida au kwa maombi maalumu kama vile [[toba]] na [[msamaha]] au kwa ajili ya [[amani]]<ref name="Anatolios2009p140">{{cite book|author1=Stephen F. Brown|author2=Khaled Anatolios|author3=Martin Palmer|title=Catholicism & Orthodox Christianity|url=https://books.google.com/books?id=3KePZKSVUgwC&pg=PA140|year=2009|publisher=Infobase Publishing|isbn=978-1-60413-106-2|page=140}}, Quote: Novena, Roman Catholic devotions consisting of prayers or services held on nine consecutive days or weeks honoring Mary, the mother of Jesus, or the saints</ref><ref>{{cite book|author=Thomas Carson|title=New Catholic Encyclopedia: Mos-Pat |url=https://books.google.com/books?id=tQ4KAQAAMAAJ |edition=2nd|year=2003| publisher=Thomson/Gale|isbn=978-0-7876-4004-0|pages=465–468}}</ref><ref>{{cite journal | last=Sosa | first=Juan J. | title=Illness and Healing in Hispanic Communities | url=https://archive.org/details/liturgy_1982_2_2/page/64 | journal=Liturgy | publisher=Routledge | volume=2 | issue=2 | year=1982 | pages=64–67 | doi=10.1080/04580638209408609 }}</ref> . Asili ya [[desturi]] hiyo ni siku tisa za sala zilizoshikwa na wafuasi wa [[Yesu]] huko [[Yerusalemu]] kati ya [[Kupaa Bwana|kupaa kwake]] [[mbinguni]](siku ya 40 baada ya [[Pasaka]]) na [[Pentekoste]] (siku ya 50) kama walivyoagizwa naye ili wajiandae kujazwa [[Roho Mtakatifu]] waweze kumshuhudia [[ulimwengu|ulimwenguni]] kote<ref>[[Mdo]] 1:14</ref><ref name=ncr>{{Rejea tovuti|date=2020-05-21|title=Novena for Pentecost: Feast of the Ascension|url=https://www.ncronline.org/news/spirituality/novena-pentecost-feast-ascension|access-date=2020-06-18|website=National Catholic Reporter|language=en}}</ref>. Katika [[Kanisa Katoliki]]<ref name="Nadeau2011p350">{{cite book|author1=Jonathan H. X. Lee|author2=Kathleen M. Nadeau|title=Encyclopedia of Asian American Folklore and Folklife |url=https://books.google.com/books?id=9BrfLWdeISoC |year=2011|publisher=ABC-CLIO|isbn=978-0-313-35066-5|pages=350–351}}</ref>, novena mara nyingi hufanywa kwa [[heshima]] ya [[nafsi]] [[Utatu|mojawapo]] ya [[Mungu]], [[Bikira Maria]], [[malaika]] au [[mtakatifu]] fulani<ref name=hilger>[http://www.newadvent.org/cathen/11141b.htm Hilgers, Joseph. "Novena." The Catholic Encyclopedia] Vol. 11. New York: Robert Appleton Company, 1911</ref>, lakini maarufu sana ni novena ya [[Huruma ya Mungu]] ambayo inaanzia [[Ijumaa Kuu]], yaani siku tisa kabla ya [[Sikukuu]] ya Huruma ya Mungu, inayofanyika [[Jumapili]] ya Pili ya [[Pasaka]]. Wakatoliki wengi hushiriki katika novena hiyo kwa kufanya sala maalumu kila siku kwa siku hizo tisa, wakilenga kukuza [[huruma]] na [[upendo]] wa Mungu kwa njia ya [[Maombezi ya watakatifu|maombezi]] ya Bikira Maria. ==Tanbihi== {{reflist}} ==Marejeo== * Barbara Calamari & Sandra DiPasqua, ''Novena'', Penguin Studio, 1999. {{ISBN|0-670-88444-8}}. * Right Reverend Monsignor [[Joseph F. Stedman]], ''The New Revised 'Triple' Novena Manual'', Confraternity of the Precious Blood, 1975. ==Marejeo mengine== * {{cite book|author=William G. Storey|title=Novenas: Prayers of Intercession and Devotion|url=https://books.google.com/books?id=EYT77Z4SRgYC|year=2005|publisher=Loyola University Press|isbn=978-0-8294-2161-3}} ==Viungo vya nje== * [https://www.praymorenovenas.com/novenas List of Novenas at PrayMoreNovenas] * [http://www.usccb.org/liturgy/novena.pdf "Novena for the repose of the soul of John Paul II"] {{Webarchive|url=https://web.archive.org/web/20051219023153/http://www.usccb.org/liturgy/novena.pdf |date=2005-12-19 }}, United States Conference of Catholic Bishops (USCCB) {{Mbegu-Ukristo}} [[Jamii:Sala]] [[Jamii:Ukristo]] ow1uuyv6gdes4o0hiznva3lmd8ro8xb 0 184101 1578104 1346172 2026-07-02T20:01:46Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578104 wikitext text/x-wiki '''Unafiki''' ni utovu wa [[ukweli]] katika mwenendo wa [[binadamu]] hasa kwa lengo la kujipatia [[sifa]], k. mf. kama mwanadini [[maadili|mwadilifu]]. Tofauti na [[mkosefu]], mnafiki anatenda vema kwa nje, lakini nia yake si kufuata [[dhamiri]] yake na maadili anayojua ni mazuri, bali ni kupendeza watu wengine ili kupata [[faida]] fulani kutoka kwao. Ni jambo linalolaumiwa sana katika [[dini]] zote, hasa [[Ukristo]], kutokana na lawama za [[Yesu]] dhidi ya [[Kiongozi|viongozi]] wengi wa [[Uyahudi]]. [[Injili]] zinasisitiza hasa lawama zake dhidi ya baadhi ya [[Mafarisayo]]. == Marejeo == * {{cite journal |last1=Caviola |first1=Lucius |last2=Faulmüller |first2=Nadira |date=August 2014 |title=Moral hypocrisy in economic games – how prosocial behavior is shaped by social expectations |journal=Frontiers in Psychology |volume=5 |page=897 |doi=10.3389/fpsyg.2014.00897 |doi-access=free |pmid=25177307 |pmc=4132261}} * {{cite journal |last1=la Cour |first1=Anders |first2=Joakim |last2=Kromann |date=July 2011 |title=Euphemisms and hypocrisy in corporate philanthropy |url=https://archive.org/details/sim_business-ethics_2011-07_20_3/page/267 |journal=Business Ethics: A European Review |volume=20 |issue=3 |pages=267–279 |doi=10.1111/j.1467-8608.2011.01627.x |s2cid=153773218}} * {{cite book |last=Davidson |first=Jenny |date=2004 |title=Hypocrisy & the Politics of Politeness: Manners & Morals from Locke to Austen |url=https://archive.org/details/hypocrisypolitic0000davi |publisher=Cambridge University Press}} * {{cite journal |last=Fernández |first=Jordi |year=2013 |title=Self-deception and self-knowledge |journal=Philosophical Studies |volume=162 |issue=2 |pages=379–400 |doi=10.1007/s11098-011-9771-9 |s2cid=170896976}} * {{cite journal |last=Furia |first=Peter A. |date=January 2009 |title=Democratic citizenship and the hypocrisy of leaders |url=https://archive.org/details/sim_polity_2009-01_41_1/page/113 |journal=Polity |volume=41 |issue=1 |pages=113–133 |doi=10.1057/pol.2008.24 |s2cid=145561665}} * {{cite journal |last1=Greene |first1=Meredith |last2=Low |first2=Kathryn |date=April 2014 |title=Public integrity, private hypocrisy, and the moral licensing effect |journal=Social Behavior and Personality |volume=42 |issue=3 |pages=391–400 |doi=10.2224/sbp.2014.42.3.391}} * {{cite journal |last1=Lammers |first1=Joris |last2=Stapel |first2=Diederik A. |last3=Galinsky |first3=Adam D. |date=May 2010 |title=Power increases hypocrisy moralizing in reasoning, immorality in behavior |url=https://www8.gsb.columbia.edu/researcharchive/articles/11633 |journal=Psychological Science |volume=21 |issue=5 |pages=737–744 |doi=10.1177/0956797610368810 |pmid=20483854 |s2cid=206585150 |jstor=41062277}} * {{cite journal |last1=Laurent |first1=Sean M. |last2=Clark |first2=Brian A. M. |last3=Walker |first3=Stephannie |last4=Wiseman |first4=Kimberly D. |year=2014 |title=Punishing hypocrisy: The roles of hypocrisy and moral emotions in deciding culpability and punishment of criminal and civil moral transgressors |journal=Cognition & Emotion |volume=28 |issue=1 |pages=59–83 |doi=10.1080/02699931.2013.801339 |pmid=23725235 |s2cid=1644336}} * {{cite journal |last=Porcher |first=José Eduardo |date=July–December 2014 |title=Is self-deception pretense? |journal=Manuscrito |volume=37 |issue=2 |pages=291–332 |doi=10.1590/S0100-60452015005000002 |doi-access=free}} * {{cite journal |last=Renzo |first=Massimo |date=July 2014 |title=Fairness, self-deception and political obligation |journal=Philosophical Studies |volume=169 |issue=3 |pages=467–488 |doi=10.1007/s11098-013-0203-x |s2cid=143769845 |jstor=42920430|hdl=1885/23939 |hdl-access=free }} * {{cite book |last1=Ross |first1=Lee |last2=Ward |first2=Andrew |date=1996 |chapter=Naive realism in everyday life: Implications for social conflict and misunderstanding |title=Values and Knowledge |editor-first=Edward S. |editor-last=Reed |editor-first2=Elliot |editor-last2=Turiel |editor-first3=Terrance |editor-last3=Brown |publisher=Lawrence Erlbaum Associates |place=Hillsdale, NJ |pages=103–135 |series=The Jean Piaget Symposium Series |chapter-url=https://web.mit.edu/curhan/www/docs/Articles/15341_Readings/Negotiation_and_Conflict_Management/Ross_Ward_Naive_Realism.pdf}} * {{cite journal |last1=Rustichini |first1=Aldo |first2=Marie Claire |last2=Villeval |date=November 2014 |title=Moral hypocrisy, power and social preferences |journal=Journal of Economic Behavior & Organization |volume=107 |issue=Part A |pages=10–24 |doi=10.1016/j.jebo.2014.08.002|hdl=10419/58984 |hdl-access=free }} * {{cite journal |last=Sommervoll |first=Dag Einar |year=2013 |title=Sweet self-deception |journal=Journal of Economics |volume=109 |issue=1 |pages=73–88 |doi=10.1007/s00712-012-0308-2 |hdl=11250/93930 |hdl-access=free |s2cid=154041122 }} * {{cite journal |last=Stone |first=Rebecca |year=2014 |title=Unconscionability, exploitation, and hypocrisy |journal=Journal of Political Philosophy |volume=22 |issue=1 |pages=27–47 |doi=10.1111/jopp.12009}} * {{cite book |last1=Szabados |first1=Béla |first2=Eldon |last2=Soifer |year=2004 |title=Hypocrisy: Ethical Investigations |url=https://archive.org/details/hypocrisyethical0000szab |isbn=978-1551115573 |publisher=Broadview Press}} * {{cite journal |first=Eero |last=Vaara |date=June 2003 |title=Post‐acquisition integration as sensemaking: Glimpses of ambiguity, confusion, hypocrisy, and politicization |url=https://archive.org/details/sim_journal-of-management-studies_2003-06_40_4/page/859 |journal=Journal of Management Studies |volume=40 |issue=4 |pages=859–94 |doi=10.1111/1467-6486.00363 |hdl=10138/26465 |hdl-access=free}} * {{cite journal |first1=Piercarlo |last1=Valdesolo |first2=David |last2=DeSteno |date=August 2007 |title=Moral hypocrisy: Social groups and the flexibility of virtue |url=https://archive.org/details/sim_psychological-science_2007-08_18_8/page/689 |journal=Psychological Science |volume=18 |issue=8 |pages=689–90 |doi=10.1111/j.1467-9280.2007.01961.x |pmid=17680939 |s2cid=41023171}} * {{cite journal |last1=Wagner |first1=Tillmann |last2=Lutz |first2=Richard J. |last3=Weitz |first3=Barton A. |date=December 2009 |title=Corporate hypocrisy: Overcoming the threat of inconsistent corporate social responsibility perceptions |journal=Journal of Marketing |volume=73 |issue=6 | pages = 77–91 | doi=10.1509/jmkg.73.6.77| citeseerx = 10.1.1.463.1501 | s2cid = 51790683 }} * {{cite book |last=Wieting |first=Stephen G. |date=2016 |title=The Sociology of Hypocrisy: An Analysis of Sport and Religion |publisher=Routledge|isbn=9781317015345 |url=https://books.google.com/books?id=3nu1CwAAQBAJ}} {{mbegu}} [[Jamii:Maadili]] [[Jamii:Saikolojia]] pg1med60ujoi8lpy8ta9oro3sts2s3k 0 185122 1578230 1575693 2026-07-03T04:41:27Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578230 wikitext text/x-wiki [[Faili:Annex - Stewart, James (Call Northside 777) 01.jpg|thumb|Taswira ya James Stewart.]] '''James Maitland Stewart''' (20 Mei 1908 - 2 Julai 1997) alikuwa mwigizaji maarufu wa filamu kutoka nchini [[Marekani]]. James Stewart, anayejulikana pia kama Jimmy Stewart, alizaliwa [[Indiana]], [[Pennsylvania]]. Jimmy ni uzao uliuotokana na familia ya wafanyabiashara. Aliitwa bingwa wa kila uhusika. Stewart alishinda [[Tuzo ya Academy]] kama Mwigizaji Bora kwa kazi yake katika filamu ya The Philadelphia Story (1940). Filamu zake nyingine maarufu ni pamoja na Mr. Smith Goes to Washington (1939), It’s a Wonderful Life (1946), Rear Window (1954), Vertigo (1958), na The Man Who Shot Liberty Valance (1962). ==Bibliografia== {{Refbegin}} *{{cite journal |last1=Adams |first1=Iain |title=James Curran : l'athlète écossais aérien et la légende américaine du coaching |journal=STAPS |date=2017 |volume=1 |issue=115 |url=https://www.cairn.info/article.php?ID_ARTICLE=STA_115_0073# |access-date=June 6, 2019 |archive-date=June 19, 2020 |archive-url=https://web.archive.org/web/20200619204058/https://www.cairn.info/article.php?ID_ARTICLE=STA_115_0073 |url-status=live }} *{{cite journal |last1=Ayres |first1=Brenda A. |title=Reconciliation in Civil War Movies |journal=Faculty Publications and Presentations |date=2009 |url=https://digitalcommons.liberty.edu/cgi/viewcontent.cgi?article=1015&context=eml_fac_pubs |access-date=June 12, 2019 |publisher=Liberty University |archive-date=June 19, 2020 |archive-url=https://web.archive.org/web/20200619185439/https://digitalcommons.liberty.edu/cgi/viewcontent.cgi?article=1015&context=eml_fac_pubs |url-status=live }} *{{cite journal |last1=Barr |first1=Alan P. |title=The Man Who Shot Liberty Valance Inhabits Film Noir |url=https://archive.org/details/sim_western-american-literature_summer-2011_46_2/page/162 |journal=Western American Literature |date=Summer 2011 |volume=46 |issue=2 |pages=162–179 |doi=10.1353/wal.2011.0051 |s2cid=163037778 }} * {{cite book |last1=Basinger |first1=Jeanine |title=Anthony Mann: New and Expanded Edition |date=2007 |publisher=Wesleyan University Press |location=Middletown, Connecticut |isbn=9780819568458 |url=https://archive.org/details/anthonymann00basi |url-access=registration }} * [[Jim Beaver|Beaver, Jim]]. "James Stewart." ''Films in Review'', October 1980. *{{cite book |last1=Belton |first1=John |title=American Cinema/American Culture |date=1994 |publisher=McGraw-Hill |location=New York |isbn=007004466X |url-access=registration |url=https://archive.org/details/americancinemaam00belt }} *{{cite book |last1=Bingham |first1=Dennis |title=Acting Male: Masculinities in the films of James Stewart, Jack Nicholson, and Clint Eastwood |date=1994 |publisher=Rutgers University Press |location=New Brunswick, NJ |isbn=0813520738 |url-access=registration |url=https://archive.org/details/actingmalemascul00bing }} *{{cite book |last1=Booker |first1=M. Keith |title=Historical Dictionary American Cinema |url=https://archive.org/details/historicaldictio0000book_w4d8 |date=2011 |publisher=The Scarecrow Press |location=Lanham |isbn=9780810871922}} *{{cite book |last1=Bowman |first1=Martin |title=B-24 Liberator 1939–1945 |date=1979 |publisher=Patrick Stephens Ltd. |location=London |isbn=9780528815386}} *{{cite book |last1=Britton |first1=Andrew |title=Katharine Hepburn: The Thirties and After |date=1984 |publisher=Tyneside Cinema |location=Newcastle |isbn=0946493014}} *{{cite book |last1=Chandler |first1=Charlotte |title=It's Only a Movie: Alfred Hitchcock, A Personal Biography |date=2006 |publisher=Applause Theatre & Cinema Books |location=New York |isbn=9781476849409 |chapter-url=https://books.google.com/books?id=p0RMAgAAQBAJ&q=james+stewart&pg=PT115 |access-date=August 27, 2019 |chapter=Transatlantic Interlude |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174341/https://books.google.com/books?id=p0RMAgAAQBAJ&q=james+stewart&pg=PT115 |url-status=live }} *{{cite book |last1=Coe |first1=Jonathan |title=Jimmy Stewart: A Wonderful Life |date=1994 |publisher=Arcade Publishing |location=New York |isbn=1559702575 |url=https://archive.org/details/jimmystewartwond00coej }} * Collins, Thomas W. Jr.[http://www.anb.org/articles/18/18-03481.html "Stewart, James"]{{Wayback|url=http://www.anb.org/articles/18/18-03481.html |date=20160303181959 }}. ''American National Biography Online''. Retrieved February 18, 2007. *{{cite book |last1=Day |first1=Kirsten |title=Cowboy Classics: The Roots of the American Western in the Epic Tradition |url=https://archive.org/details/cowboyclassicsro0000dayk |date=2016 |publisher=Edinburgh University Press |location=Edinburgh |isbn=9781474402460}} *{{cite book |last1=Dewey |first1=Donald |title=James Stewart: A Biography |url=https://archive.org/details/jamesstewartbiog0000dewe |date=1996 |publisher=Turner Publishing |location=Atlanta |isbn=1570362270}} *{{cite journal |last1=Dienstag |first1=Joshua Foa |title=A Storied Shooting: Liberty Valance and the Paradox of Sovereignty |url=https://archive.org/details/sim_political-theory_2012-06_40_3/page/290 |journal=Political Theory |date=June 2012 |volume=40 |issue=3 |pages=290–318 |jstor=41703027 |doi=10.1177/0090591712439303 |s2cid=159881731 }} *{{cite book |last1=Dunning |first1=John |title=On the Air: The Encyclopedia of Old-Time Radio |date=1998 |publisher=Oxford University Press |location=New York |isbn=9780195076783 |url=https://archive.org/details/onairencyclop00dunn |url-access=registration |page=[https://archive.org/details/onairencyclop00dunn/page/419 419] |quote=james stewart lux radio theater no highways in the sky. |access-date=June 3, 2019 }} *{{cite book |last1=Eliot |first1=Mark |title=Jimmy Stewart: A Biography |url=https://archive.org/details/jimmystewartbiog00elio |date=2006 |publisher=Random House |location=New York |isbn=9781400052226}} *{{cite book |last1=Eyman |first1=Scott |title=Hank and Jim: The Fifty-Year Friendship of Henry Fonda and James Stewart |date=2017 |publisher=Simon & Schuster Paperbacks |location=New York |isbn=9781501102196 |url=https://books.google.com/books?id=Ka-uDgAAQBAJ&q=james+stewart+%22journey+by+night%22+april+1935&pg=PA56 |access-date=June 4, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174339/https://books.google.com/books?id=Ka-uDgAAQBAJ&q=james+stewart+%22journey+by+night%22+april+1935&pg=PA56 |url-status=live }} *{{cite book |last1=Fishgall |first1=Gary |title=Pieces of Time: The Life of James Stewart |date=1997 |publisher=Scribner |location=New York |isbn=068482454X |url=https://archive.org/details/piecesoftimelife00fish }} *{{cite book |author=Fonda, Henry as told to [[Howard Teichmann]] |title=Fonda: My Life |location=New York |publisher=A Signet Book, New American Library |date=1981 |isbn=0-451-11858-8 |ref={{harvid|Fonda|Teichmann|1981|p=74}} |url=https://archive.org/details/fondamylife00fond }} *{{cite book |editor1-last=Gevinson |editor1-first=Alan |title=American Film Institute Catalog: Within Our Gates: Ethnicity in American Feature Films, 1911–1960 |date=1997 |publisher=University of California Press |location=Berkeley |isbn=0520209648 |url=https://books.google.com/books?id=bsoUXGZSxZcC&q=james+stewart+lux+radio+theater+winchester+%2773&pg=PA1144 |access-date=June 3, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174335/https://books.google.com/books?id=bsoUXGZSxZcC&q=james+stewart+lux+radio+theater+winchester+%2773&pg=PA1144 |url-status=live }} *{{cite book |last1=Grams |first1=Martin Jr. |title=Radio Drama: A Comprehensive Chronicle of American Network Programs, 1932–1962 |url=https://archive.org/details/radiodramacompre0000gram_d2n9 |date=2000 |publisher=McFarland & Company, Inc. |location=Jefferson, North Carolina |isbn=078640051X }} *{{cite book |last1=Gregg |first1=Jill A. |title=St. James Encyclopedia of Popular Culture |date=2000 |publisher=St. James Press |editor1-last=Pendergast |editor1-first=Tom |editor2-last=Pendergast |editor2-first=Sara |location=Detroit |isbn=1558624007}} *{{cite book |last1=Hannan |first1=Brian |title=Coming Back to a Theater Near You |date=2016 |publisher=McFarland & Company |location=Jefferson, North Carolina |isbn=9781476623894 |url=https://books.google.com/books?id=Ug3MDAAAQBAJ&q=re-release+of+hitchcock+films+brought+critical+acclaim+to+rear+window+and+vertigo&pg=PA281 |access-date=August 1, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174345/https://books.google.com/books?id=Ug3MDAAAQBAJ&q=re-release+of+hitchcock+films+brought+critical+acclaim+to+rear+window+and+vertigo&pg=PA281 |url-status=live }} *{{cite book |editor1-last=Hanson |editor1-first=Patricia King |title=American Film Institute Catalog of Motion Pictures in the United States: Feature Films, 1941–1950, Film Entries, A-L |date=1999 |publisher=University of California Press |location=Berkeley |isbn=0520215214 |url=https://books.google.com/books?id=fRY0QiacQccC&q=james+stewart+lux+radio+theater+june+bride&pg=PA1246 |access-date=October 18, 2020 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174337/https://books.google.com/books?id=fRY0QiacQccC&q=james+stewart+lux+radio+theater+june+bride&pg=PA1246 |url-status=live }} *{{cite book |last1=Hischak |first1=Thomas S. |title=Broadway Plays and Musicals: Descriptions and Essential Facts of More than 14,000 Shows through 2007 |date=2009 |publisher=McFarland & Company, Inc. |location=Jefferson, North Carolina |isbn=9780786434480 |url=https://books.google.com/books?id=GzeiySJZXF4C&q=james+stewart++%22harvey%22+%22broadway%22+february-may+1970+helen+hayes&pg=PA189 |access-date=June 4, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174337/https://books.google.com/books?id=GzeiySJZXF4C&q=james+stewart++%22harvey%22+%22broadway%22+february-may+1970+helen+hayes&pg=PA189 |url-status=live }} *{{cite book |last1=Holston |first1=Kim R. |title=Movie Roadshows: A History and Filmography of Reserved-Seat Limited Showings, 1911–1973 |date=2013 |publisher=McFarland & Company Publishers |location=Jefferson, North Carolina |isbn=9780786460625 |page=156 |url=https://books.google.com/books?id=kwq69QWWFPYC&q=%22how+the+west+was+won%22+box+office+hit&pg=PA337 |access-date=June 12, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174346/https://books.google.com/books?id=kwq69QWWFPYC&q=%22how+the+west+was+won%22+box+office+hit&pg=PA337 |url-status=live }} * [[Norris Houghton|Houghton, Norris]]. ''But Not Forgotten: The Adventure of the University Players''. New York: William Sloane Associates, 1951. *{{cite book |last1=Hyatt |first1=Wesley |title=Short-Lived Television Series 1948–1978 |date=2003 |publisher=McFarland & Company |location=Jefferson, North Carolina |isbn=0786414200 |url=https://books.google.com/books?id=ty21CgAAQBAJ&q=hawkins+james+stewart+shaft&pg=PA222 |access-date=June 12, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174348/https://books.google.com/books?id=ty21CgAAQBAJ&q=hawkins+james+stewart+shaft&pg=PA222 |url-status=live }} *{{cite thesis |last1=Huzera |first1=Jennifer |title=(A)Typical Jimmy: James Stewart and Hollywood Studio Era Acting |date=May 2011 |pages=53–54 |url=https://curve.carleton.ca/system/files/etd/38c89d8e-3991-4043-aa18-ddf8029a45f5/etd_pdf/327c92df03da7040c8673ed147cc7d88/huzera-atypicaljimmyjamesstewartandhollywoodstudio.pdf |access-date=June 13, 2019 |archive-date=May 1, 2019 |archive-url=https://web.archive.org/web/20190501181915/https://curve.carleton.ca/system/files/etd/38c89d8e-3991-4043-aa18-ddf8029a45f5/etd_pdf/327c92df03da7040c8673ed147cc7d88/huzera-atypicaljimmyjamesstewartandhollywoodstudio.pdf |url-status=live }} * Jackson, Kenneth T., Karen Markoe and Arnie Markoe. ''The Scribner Encyclopedia of American Lives'' (5). New York: Simon and Schuster, 1998. {{ISBN|0-684-80663-0}}. *{{cite book |last1=Jones |first1=Ken D. |first2=Arthur F. |last2=McClure |first3=Alfred E. |last3=Twomey |title=The Films of James Stewart |location=New York |publisher=Castle Books |date=1970 }} *{{cite journal |last1=Lawrence |first1=Amy |title=Jimmy Stewart is being beaten: Rope and the postwar crisis in American masculinity |journal=Quarterly Review of Film & Video |date=1997 |volume=16 |issue=1 |pages=41–58 |doi=10.1080/10509209709361452 }} *{{cite book |editor1-last=Lloyd |editor1-first=Ann |editor2-last=Fuller |editor2-first=Graham |editor3-last=Desser |editor3-first=Arnold |title=The Illustrated Who's Who of the Cinema |url=https://archive.org/details/illustratedwhosw0000unse |date=1983 |publisher=Macmillan |location=New York |isbn=0029234506}} *{{cite book |editor1-last=Magill |editor1-first=Frank N. |title=The 20th Century O-Z: Dictionary of World Biography |date=1999 |publisher=Routledge |location=London |isbn=0893563234 |url=https://books.google.com/books?id=eE_ZjR1dKB4C&pg=PA3530 |access-date=March 19, 2020 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174357/https://books.google.com/books?id=eE_ZjR1dKB4C&pg=PA3530 |url-status=live }} *{{cite book |last1=Mann |first1=Denise |title=Hollywood Independents: The Postwar Talent Takeover |date=2008 |publisher=University of Minnesota Press |location=Minneapolis |isbn=9780816645404 |url=https://archive.org/details/hollywoodindepen0000mann |url-access=registration |page=[https://archive.org/details/hollywoodindepen0000mann/page/50 50] |quote=winchester '73 box office success. |access-date=June 17, 2019 }} *{{cite book |last1=McBride |first1=Joseph |title=Frank Capra: The Catastrophe of Success |date=2011 |publisher=University Press of Mississippi}} *{{cite book |last1=McGowan |first1=Helene |title=James Stewart |url=https://archive.org/details/jamesstewart0000mcgo_i1m8 |date=1992 |publisher=Crescent |location=New York |isbn=0517067080 }} *{{cite book |last1=Molyneaux |first1=Gerard |title=James Stewart: A Bio-Bibliography |url=https://archive.org/details/jamesstewartbiob0000moly |date=1992 |publisher=Greenwood Press |location=New York |isbn=0313273529}} *{{cite book |last1=Munn |first1=Michael |title=Jimmy Stewart: The Truth Behind the Legend |url=https://archive.org/details/jimmystewarttrut0000munn_v5e4 |date=2005 |publisher=Robson Books |location=London |isbn=1861059612}} *{{cite book |last1=Naremore |first1=James |title=Acting in the Cinema |url=https://archive.org/details/actingincinema0000nare |date=1988 |publisher=University of California Press |location=Berkeley |isbn=0520062280}} *{{cite journal |last1=O'Neill |first1=Timothy P. |title=Two Concepts of Liberty Valance: John Ford, Isaiah Berlin, and Tragic Choice on the Frontier |journal=The John Marshall Institutional Repository |date=2004 |url=https://repository.jmls.edu/cgi/viewcontent.cgi?article=1123&context=facpubs |access-date=June 13, 2019 |publisher=John Marshall Law School |archive-date=June 19, 2020 |archive-url=https://web.archive.org/web/20200619145209/https://repository.jmls.edu/cgi/viewcontent.cgi?article=1123&context=facpubs |url-status=live }} *{{cite book |last1=Palmer |first1=Tim |editor1-last=Hart |editor1-first=Kylo-Patrick R. |title=Film and Television Stardom |date=2009 |publisher=Cambridge Scholars Publishing |location=Newcastle |isbn=978-1847186287 |chapter=Star, Interrupted: The Reinvention of James Stewart}} * {{cite book |last1=Pickard |first1=Roy |title=Jimmy Stewart: A Life in Film |url=https://archive.org/details/jimmystewartlife0000pick |url-access=registration |date=1992 |publisher=St. Martin's Press |location=New York |isbn=0312088280 }} * {{cite book |last= Pomerance |first= Murray |editor1-last= Palmer |editor1-first= R. Barton |chapter= James Stewart and James Dean: The Darkness Within |title= Larger Than Life: Movie Stars of the 1950s |url= https://archive.org/details/largerthanlifemo0000rbar |year= 2010 |publisher= Rutgers University Press }} * Prendergast, Tom and Sara, eds. "Stewart, James." ''International Dictionary of Films and Filmmakers, 4th edition''. London: St. James Press, 2000. {{ISBN|1-55862-450-3}}. * Prendergast, Tom and Sara, eds. "Stewart, James." ''St. James Encyclopedia of Popular Culture, 5th edition''. London: St. James Press, 2000. {{ISBN|1-55862-529-1}}. *{{cite book |last1=Quirk |first1=Lawrence J. |title=Margaret Sullavan: Child of Fate |url=https://archive.org/details/margaretsullavan00quir |url-access=registration |date=1986 |publisher=St. Martin's Press |location=New York |isbn=0312514425 }} *{{cite book |last1=Quirk |first1=Lawrence J. |title=James Stewart: Behind the Scenes of a Wonderful Life |date=1997 |publisher=Applause |location=New York |isbn=155783329X |url=https://books.google.com/books?id=3BMMfHkHZs4C&q=james+stewart+lux+radio+theater+madame+X&pg=PA76 |access-date=June 3, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174358/https://books.google.com/books?id=3BMMfHkHZs4C&q=james+stewart+lux+radio+theater+madame+X&pg=PA76 |url-status=live }} *{{cite book |last1=Resch |first1=John Phillips |title=Americans at war: Society, culture, and the homefront |date=2005 |publisher=Macmillan Reference |location=Detroit |isbn=002865806X |url=https://archive.org/details/americansatwarso0000unse |access-date=July 15, 2019 }} *{{cite book |last1=Rinella |first1=Michael D. |title=Margaret Sullavan: The Life and Career of a Reluctant Star |date=2019 |publisher=McFarland & Company, Inc. |location=Jefferson, North Carolina |isbn=9781476636054 |url=https://books.google.com/books?id=t7ylDwAAQBAJ&q=%22Next+Time+We+Love%22+box+office&pg=PA77 |access-date=November 5, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174338/https://books.google.com/books?id=t7ylDwAAQBAJ&q=%22Next+Time+We+Love%22+box+office&pg=PA77 |url-status=live }} *{{cite book |last1=Robbins |first1=Jhan |title=Everybody's Man: A Biography of Jimmy Stewart |date=1985 |publisher=Putnam |location=New York |isbn=0399129731 |url=https://archive.org/details/everybodysmanbio00robb }} *{{cite book |last1=Sanello |first1=Frank |title=Jimmy Stewart: A Wonderful Life |url=https://archive.org/details/jimmystewartwond0000sane |date=1997 |publisher=Kensington Publishing Corp |location=New York |isbn=9780786005062}} *{{cite book |last1=Sarris |first1=Andrew |title="You Ain't Heard Nothing Yet": The American Talking Film History & Memory, 1927–1949 |date=1998 |publisher=Oxford University Press |location=New York |isbn=0195038835 |url=https://archive.org/details/youaintheardnoth00sarr }} *{{cite book |last1=Shepherd |first1=Donald |last2=Slatzer |first2=Robert F. |last3=Grayson |first3=Dave |title=Duke, the life and times of John Wayne |url=https://archive.org/details/dukelifetimesof00shep |url-access=registration |date=1985 |publisher=Doubleday |location=Garden City, New York |isbn=038517893X }} *{{cite book |last1=Smith |first1=Starr |title=Jimmy Stewart: Bomber Pilot |date=2005 |publisher=Zenith Press |location=St. Paul, Minnesota |isbn=076032199X |url=https://archive.org/details/jimmystewart00star }} *{{cite book |first=Jimmy |last=Stewart |title=Jimmy Stewart and His Poems |publisher=[[Crown Publishing Group|Crown]] |isbn=978-0517573822 |date=August 19, 1989 |url=https://archive.org/details/jimmystewarthisp00stew }} *{{cite book |last1=Sweeney |first1=Kevin |title=Henry Fonda: A Bio-Bibliography |url=https://archive.org/details/henryfondabiobib0000swee_x3p1 |date=1992 |publisher=Greenwood Press |location=New York |isbn=0313265712}} *{{cite magazine|url=https://archive.org/details/Screen_Volume_32_Issue_3/page/n17|magazine=Screen|volume=32|issue=3|date=August 1991|title=The popular cash and culture in the postwar British cinema industry|first=Janet|last=Thumim}} *{{cite book |last1=Thomas |first1=Tony |title=A Wonderful Life: The Films and Career of James Stewart |date=1988 |publisher=Citadel Press |location=Secaucus, New Jersey |isbn=0806510811 |url=https://books.google.com/books?id=rE_CgD4pk2wC&q=james+stewart+%22journey+by+night%22+%22carl%22&pg=PA13 |access-date=June 4, 2019 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174338/https://books.google.com/books?id=rE_CgD4pk2wC&q=james+stewart+%22journey+by+night%22+%22carl%22&pg=PA13 |url-status=live }} *{{cite book |last1=Truffaut |first1=François |last2=Hitchcock |first2=Alfred |last3=Scott |first3=Helen G. |title=Hitchcock |date=1983 |publisher=Simon & Schuster Paperbacks |location=New York |isbn=9780671604295 |url=https://books.google.com/books?id=NnE_sPb3XBQC&pg=PA94 |access-date=March 19, 2020 |archive-date=April 23, 2021 |archive-url=https://web.archive.org/web/20210423174338/https://books.google.com/books?id=NnE_sPb3XBQC&pg=PA94 |url-status=live }} *{{cite book |last1=Turk |first1=Edward Baron |title=Hollywood Diva: A Biography of Jeanette MacDonald |url=https://archive.org/details/hollywooddivabio0000turk |url-access=registration |date=1998 |publisher=University of California Press }} *{{cite book |last1=Urwand |first1=Ben |title=The Collaboration: Hollywood's Pact with Hitler |url=https://archive.org/details/collaborationhol0000urwa |date=2013 |publisher=The Belknap Press of Harvard University Press}} * Wright, Stuart J. ''An Emotional Gauntlet: From Life in Peacetime America to the War in European Skies—A History of 453rd Bomb Group Crews''. Milwaukee, Wisconsin: University of Wisconsin Press, 2004. {{ISBN|0-299-20520-7}}. {{Refend}} ==Viungo vya nje== {{Commons category}} {{Wikiquote}} * {{IBDB name}} * {{IMDb name|71|James Stewart}} * {{Tcmdb name|name=Jimmy Stewart}} * [http://jimmy.org/ Jimmy Stewart Museum] * [http://www.bbc.co.uk/programmes/p009mhx7 James Stewart] interview on [[BBC Radio 4]]'s ''[[Desert Island Discs]]'', December 23, 1983 * [http://archives.lib.byu.edu/agents/people/2879?&filter_fields%5B%5D=primary_type&filter_values%5B%5D=resource Collections related to James Stewart] at the [[L. Tom Perry Special Collections]], [[Harold B. Lee Library]], [[Brigham Young University]] {{BD|1908|1997}} {{KWW}} [[Jamii:Waigizaji filamu wa Marekani]] qlwlicl7q44hd29skltwv8skpxi4o99 0 185593 1578192 1465900 2026-07-03T02:14:00Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578192 wikitext text/x-wiki [[picha:Margaret Murray 1928c.jpg|thumb|Margaret Murray]] '''Margaret Murray''' ([[13 Julai]] [[1863]] - [[13 Novemba]] [[1963]]) alikuwa mtaalamu maarufu wa masuala ya [[Historia|kihistoria]] na [[anthropolojia]] kutoka [[Uingereza]]. Murray ni maarufu kwa tafiti zake kuhusu [[dini]] za kale na ushirikina, hasa katika kazi yake kuhusu Dini ya Wakati wa Kale na maandiko yake kuhusu ma[[hekalu]] ya Kipagani. <ref>https://england.prm.ox.ac.uk/englishness-Margaret-Murray.html</ref>. ==Tanbihi== {{reflist}} === Tafsiri ya Vitabu na Vyanzo === {{Refbegin|30em|indent=yes}} * {{cite journal |author=Anonymous |year=1963 |title=Siku ya Mia ya Kuzaliwa ya Dr. Margaret Murray |journal=Man |volume=63 |pages=106 |jstor=2796898}} * {{cite journal |last=Bonser |first=Wilfrid |year=1961 |title=Orodha ya Vitabu Vilivyoandikwa na Dr. Murray |journal=Folklore |volume=72 |issue=3 |pages=560–566 |doi=10.1080/0015587X.1961.9717300}} * {{cite news|last=Burr|first=George L.|title=Mapitio ya Kitabu cha Margaret Murray, ''The Witch-Cult in Western Europe''|url=https://archive.org/details/sim_american-historical-review_1922-07_27_4/page/780|journal=American Historical Review|volume=27|number=4|year=1922|pages=780–783|jstor=1837549}} * {{cite news|last=Burr|first=George L.|author-mask=2|title=Mapitio ya Kitabu cha Margaret Murray, ''The God of the Witches''|url=https://archive.org/details/sim_american-historical-review_1935-04_40_3/page/490|journal=American Historical Review|volume=40|number=3|year=1935|pages=491–492|jstor=1838913}} * {{cite book|title=Demoni wa Ndani wa Ulaya: Utafiti Uliosukumwa na Ujio Mkubwa wa Uchawi|last=Cohn|first=Norman|publisher=Sussex University Press na Heinemann Educational Books|year=1975|isbn=978-0-435-82183-8|location=Sussex na London}} * {{cite journal |last=Daniel |first=Glyn |year=1964 |title=Mhariri |journal=Antiquity |volume=38 |issue=149 |pages=1–6 |doi=10.1017/S0003598X00068708 |doi-access=free}} * {{cite journal |last=Davidson |first=Hilda Ellis |year=1987 |title=Mabadiliko katika Folklore Society, 1949–1986 |journal=Folklore |volume=98 |issue=2 |pages=123–130 |doi=10.1080/0015587X.1987.9716407}} * {{cite book|title=Wicca: Historia, Imani, na Jamii katika Uchawi wa Kisasa|last=Doyle White|first=Ethan|publisher=Sussex Academic Press|year=2016|isbn=978-1-84519-754-4|location=Brighton, Chicago, na Toronto}} * {{cite journal |last=Doyle White |first=Ethan |author-mask=2 |year=2016b |title=Mapitio ya Kitabu cha Kathleen L. Sheppard, ''The Life of Margaret Alice Murray: A Woman's Work in Archaeology'' |journal=Aries: Journal for the Study of Western Esotericism |volume=16 |pages=154–156 |doi=10.1163/15700593-01501015 |number=1}} * {{cite encyclopedia|last=Drower|first=Margaret S.|contribution=Margaret Alice Murray|title=Breaking Ground: Wanawake Waliokuwa Wa Kwanza Katika Uarchaeology|editor1=Getzel M. Cohen|editor2=Martha Joukowsky|year=2004|pages=[https://archive.org/details/breakinggroundpi0000unse/page/109 109–141]|location=Ann Arbor|publisher=University of Michigan Press|isbn=978-0-472-11372-9|url=https://archive.org/details/breakinggroundpi0000unse/page/109}} * {{cite journal |last=Eliade |first=Mircea |year=1975 |title=Maoni Machache Kuhusu Uchawi wa Ulaya |url=https://archive.org/details/sim_history-of-religions_1975-02_14_3/page/148 |journal=History of Religions |volume=14 |pages=149–172 |doi=10.1086/462721 |s2cid=161503454 |number=3}} * {{cite book|title=Satanic Feminism: Lucifer kama Mkombozi wa Mwanamke katika Utamaduni wa Karne ya 19|last=Faxneld|first=Per|publisher=Molin & Sorgenfrei|year=2014|isbn=978-91-87515-04-0|location=Stockholm}} * {{cite journal |last=Finneran |first=Niall |year=2003 |title=Urithi wa T.C. Lethbridge |journal=Folklore |volume=114 |pages=107–114 |doi=10.1080/0015587032000059915 |jstor=30035070 |s2cid=216644161 |doi-access=free |number=1}} * {{cite book|title=Kufikiria Zamani kwa Watu wa Kiasili: Miungu na Miungu wa Kike Katika Fasihi na Historia Tangu Nyakati za Giza|last=Gibson|first=Marion|publisher=Routledge|year=2013|isbn=978-0-415-67419-5|location=London na New York}} * {{cite book|title=Mapambano ya Usiku: Uchawi na Dini za Kilimo katika Karne ya 16 na 17|last=Ginzburg|first=Carlo|publisher=Johns Hopkins Press|year=1983|isbn=978-0-8018-4386-0|location=Baltimore|translator=John Tedeschi|author-link=Carlo Ginzburg|orig-year=1966|translator2=Anne Tedeschi}} * {{cite news|last=Halliday|first=W.R.|title=Mapitio ya Kitabu cha Margaret Murray, ''The Witch-Cult in Western Europe''|journal=Folklore|volume=33|year=1922|pages=224–230}} * {{cite book|url=https://archive.org/details/triumphofmoonhis00hutt|title=Ushindi wa Mwezi: Historia ya Uchawi wa Kisasa|last=Hutton|first=Ronald|publisher=Oxford University Press|year=1999|isbn=978-0-19-820744-3|location=New York}} * {{cite journal |last=James |first=E. O. |year=1963 |title=Dr. Margaret Murray |journal=Folklore |volume=74 |pages=568–569 |doi=10.1080/0015587x.1963.9716934 |jstor=1258738 |doi-access=free |number=4}} * {{cite book|title=Miaka Mia ya Kwanza: Utaalamu wa Misri katika University College London, 1892–1992|url=https://archive.org/details/firsthundredyear0000jans|last=Janssen|first=Rosalind M.|publisher=University College London|year=1992|isbn=978-0-902137-33-2|location=London}} * {{cite journal |last=Loeb |first=E. M. |year=1922 |title=Mapitio ya ''The Witch-Cult in Western Europe'' |url=https://archive.org/details/sim_american-anthropologist_october-december-1922_24_4/page/476 |journal=American Anthropologist |volume=24 |pages=476–78 |doi=10.1525/aa.1922.24.4.02a00150 |doi-access=free |number=4}} * {{cite journal |last=Merrifield |first=Ralph |date=June 1993 |title=G.B. Gardner na 'Wahawa' wa Karne ya 20 |journal=Folklore Society News |volume=17 |page=10}} * {{cite book|title=Uchawi wa Wajane Ulaya|last=Murray|first=Margaret A.|publisher=Clarendon Press|year=1962|location=Oxford|orig-year=1921}} * {{cite book|url=https://archive.org/details/godofwitches00murr|title=Mungu wa Wahawa|last=Murray|first=Margaret A.|publisher=Faber and Faber|year=1952|location=London|author-mask=2|orig-year=1931|url-access=registration}} * {{cite book|title=Miaka Yangu Mia ya Kwanza|last=Murray|first=Margaret|publisher=William Kimber|year=1963|location=London|author-mask=2}} * {{cite journal |last=Noble |first=Catherine |year=2005 |title=Kutoka Ukweli Hadi Uwongo: Mageuzi ya Nadharia ya Uchawi ya Margaret Alice Murray |journal=The Pomegranate: The International Journal of Pagan Studies |volume=7 |pages=5–26 |doi=10.1558/pome.v7i1.5 |number=1}} * {{cite book|title=Kundi la Watafiti: Margaret Murray na Mbinu Zake za Kazi|last1=Oates|first1=Caroline|last2=Wood|first2=Juliette|publisher=The Folklore Society|year=1998|isbn=978-0-903515-16-0|series=Archive Series 1|location=London}} * {{cite book|title=Uchawi katika Historia: Maonyesho ya Awali na ya Karne ya Ishirini|last=Purkiss|first=Diane|publisher=Routledge|year=1996|isbn=978-0-415-08762-9|location=Abingdon}} * {{cite book|title=Razor kwa Mbuzi: Majadiliano Kuhusu Changamoto Fulani katika Uchawi na Shirikina|last=Rose|first=Elliot|publisher=Toronto University Press|year=1962|location=Toronto}} * {{cite book|title=Uchawi wa Wajane Ulaya|last=Runciman|first=Steven|publisher=Clarendon Press|year=1962|editor=Margaret Murray|location=Oxford|chapter=Utangulizi}} * {{cite book|title=Historia Mpya ya Uchawi: Wachawi, Wapinga Dini na Wapagani|url=https://archive.org/details/historyofwitchcr0000russ_t8u9|last1=Russell|first1=Jeffrey B.|last2=Alexander|first2=Brooks|publisher=Thames and Hudson|year=2007|isbn=978-0-500-28634-0|location=London}} * {{cite journal |last=Sheppard |first=Kathleen L. |year=2012 |title=Kati ya Maonyesho na Sayansi: Margaret Murray na Kaburi la Wanaume Wawili |journal=Science in Context |volume=25 |pages=525–549 |doi=10.1017/S0269889712000221 |s2cid=144547116 |number=4}} * {{cite book|title=Maisha ya Margaret Alice Murray: Kazi ya Mwanamke Katika Archaeology|last=Sheppard|first=Kathleen L.|publisher=Lexington Books|year=2013|isbn=978-0-7391-7417-3|location=New York|author-mask=2}} * {{cite news|title=Margaret Murray: Nani Aliyeamini Yeye na Kwa Nini?|url=https://archive.org/details/sim_folklore_1994_105/page/88|last=Simpson|first=Jacqueline|year=1994|journal=Folklore|volume=105|pages=89–96|jstor=1260633}} * {{cite journal |last=Thornton |first=Amara |year=2014 |title=Currya ya Nyama ya Margaret Murray |journal=Present Pasts |volume=6 |issue=1 |pages=1–7 |doi=10.5334/pp.59 |doi-access=free}} * {{cite book|title=Dini na Upungufu wa Uchawi: Masomo Kuhusu Imani za Umma katika Karne ya 16 na 17 England|last=Thomas|first=Keith|publisher=Weidenfeld & Nicolson|year=1971|location=London}} * {{cite book|title=Kuzaliwa Upya kwa Uchawi|last=Valiente|first=Doreen|publisher=Robert Hale|year=1989|isbn=978-0-7090-3715-6|location=London}} * {{cite book|title=T.C. Lethbridge: Mwanaume Aliyeona Maisha ya Baadaye|last=Welbourn|first=Terry|publisher=O-Books|year=2011|isbn=978-1-84694-500-7|location=Winchester na Washington}} * {{cite journal |last=Whitehouse |first=Ruth |date=2013 |title=Margaret Murray (1863–1963): Mwandishi wa Kwanza wa Misri, Mwanaharakati wa Haki za Wanawake na Mhadhiri wa Kwanza wa Archaeology |journal=Archaeology International |volume=16 |issue=2012–2013 |pages=120–127 |doi=10.5334/ai.1608 |doi-access=free}} * {{cite journal |last=Williams |first=Mary |year=1961 |title=Miaka Tisini na Nane na Sita za Ukombozi |journal=Folklore |volume=72 |pages=433–437 |doi=10.1080/0015587X.1961.9717291 |number=3}} * {{cite journal |last=Winick |first=Mimi |year=2015 |title=Uchawi wa Kisasa wa Mwanamke Mwandamizi: Utafiti wa Ajabu wa Margaret Murray na Fantasy Halisi ya Sylvia Townsend Warner |journal=Modernism/Modernity |volume=22 |pages=565–592 |doi=10.1353/mod.2015.0051 |s2cid=143216129 |number=3}} * {{cite journal |title=Margaret Murray na Kuibuka kwa Wicca |last=Wood |first=Juliette |year=2001 |journal=The {{mbegu-mtu}} [[Jamii:Waliozaliwa 1863]] [[Jamii:Waliofariki 1963]] [[Jamii:Wanawake wa Uingereza]] [[Jamii:wanahistoria wa Uingereza]] [[Jamii:WikiMonthly Edit-a-thon Kilimanjaro]] 942bcuzery3cf0jzzeg8cj9otm5mef7 0 186128 1578166 1448175 2026-07-02T23:03:10Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578166 wikitext text/x-wiki '''Rhodococcus opacus''' ni [[spishi]] ya [[bakteria]] katika [[jenasi]] Rhodococcus anayepata nishati yake kwa kutumia michakato ya kikemia inayohusisha oksidi ya madini (chemolithotrophic). <ref name="KlatteKroppenstedt1994">{{cite journal|last1=Klatte|first1=Stefan|last2=Kroppenstedt|first2=Reiner Michael|last3=Rainey|first3=Frederick A.|title=Rhodococcus opacus sp.nov., An Unusual Nutritionally Versatile Rhodococcus-species|url=https://archive.org/details/systematic-and-applied-microbiology_1994-11_17_3/page/355|journal=Systematic and Applied Microbiology|volume=17|issue=3|year=1994|pages=355–360|issn=0723-2020|doi=10.1016/S0723-2020(11)80051-2}}</ref><ref name="PathakGreen2013">{{cite journal|last1=Pathak|first1=A.|last2=Green|first2=S. J.|last3=Ogram|first3=A.|last4=Chauhan|first4=A.|title=Draft Genome Sequence of Rhodococcus opacus Strain M213 Shows a Diverse Catabolic Potential|journal=Genome Announcements|volume=1|issue=1|year=2013|pages=e00144-12–e00144-12|issn=2169-8287|doi=10.1128/genomeA.00144-12|pmid=23409266|pmc=3569331}}</ref> ==Marejeo== {{reflist}} ==Usomaji zaidi== * {{cite journal|vauthors=Alvarez HM, Mayer F, Fabritius D, Steinbüchel A | title=Uundaji wa mafuta ya ndani ya seli ya Rhodococcus opacus strain PD630 |url=https://archive.org/details/archives-of-microbiology_1996-06_165_6/page/377 | journal=Arch Microbiol | year=1996 | volume=165 | issue=6 | pages=377–386 | pmid=8661931 | doi=10.1007/s002030050341 | s2cid=27581767 }} * Alvarez, Héctor M. ''Biolojia ya Rhodococcus''. Vol. 16. Springer, 2010. * {{cite journal | last1=Wältermann | first1=Marc | display-authors=etal | year=2000 | title=Rhodococcus opacus strain PD630 kama chanzo kipya cha mafuta ya seli moja yenye thamani kubwa? Utengenezaji na sifa za triacylglycerols na lipidi nyingine za hifadhi | journal=Microbiology | volume=146 | issue=5 | pages=1143–1149 | doi=10.1099/00221287-146-5-1143 | pmid=10832641 | doi-access=free }} * {{cite journal|last1=Chen|first1=Y.|last2=Ding|first2=Y.|last3=Yang|first3=L.|last4=Yu|first4=J.|last5=Liu|first5=G.|last6=Wang|first6=X.|last7=Zhang|first7=S.|last8=Yu|first8=D.|last9=Song|first9=L.|last10=Zhang|first10=H.|last11=Zhang|first11=C.|last12=Huo|first12=L.|last13=Huo|first13=C.|last14=Wang|first14=Y.|last15=Du|first15=Y.|last16=Zhang|first16=H.|last17=Zhang|first17=P.|last18=Na|first18=H.|last19=Xu|first19=S.|last20=Zhu|first20=Y.|last21=Xie|first21=Z.|last22=He|first22=T.|last23=Zhang|first23=Y.|last24=Wang|first24=G.|last25=Fan|first25=Z.|last26=Yang|first26=F.|last27=Liu|first27=H.|last28=Wang|first28=X.|last29=Zhang|first29=X.|last30=Zhang|first30=M. Q.|last31=Li|first31=Y.|last32=Steinbuchel|first32=A.|last33=Fujimoto|first33=T.|last34=Cichello|first34=S.|last35=Yu|first35=J.|last36=Liu|first36=P.|title=Utafiti wa Omics uliounganishwa unaoonyesha mabadiliko ya lipidi droplets katika Rhodococcus opacus PD630 | journal=Nucleic Acids Research | volume=42 | issue=2 | year=2013 | pages=1052–1064 | issn=0305-1048 | doi=10.1093/nar/gkt932 | pmid=24150943 | pmc=3902926 }} * {{cite journal|last1=Richardson|first1=Paul M.|last2=Holder|first2=Jason W.|last3=Ulrich|first3=Jil C.|last4=DeBono|first4=Anthony C.|last5=Godfrey|first5=Paul A.|last6=Desjardins|first6=Christopher A.|last7=Zucker|first7=Jeremy|last8=Zeng|first8=Qiandong|last9=Leach|first9=Alex L. B.|last10=Ghiviriga|first10=Ion|last11=Dancel|first11=Christine|last12=Abeel|first12=Thomas|last13=Gevers|first13=Dirk|last14=Kodira|first14=Chinnappa D.|last15=Desany|first15=Brian|last16=Affourtit|first16=Jason P.|last17=Birren|first17=Bruce W.|last18=Sinskey|first18=Anthony J.|title=Ulinganifu na Genomiki ya Kazi ya Rhodococcus opacus PD630 kwa Maendeleo ya Biofuel | journal=PLOS Genetics | volume=7 | issue=9 | year=2011 | pages=e1002219 | issn=1553-7404 | doi=10.1371/journal.pgen.1002219 | pmid=21931557 | pmc=3169528 | doi-access=free }} {{mbegu-biolojia}} [[Jamii:Bakteria]] [[jamii:WikiMonthly Edit-a-thon Kilimanjaro]] 5n7dqmcuh9grxb11iu5yu2wbg55odgk 0 190073 1578234 1361836 2026-07-03T08:06:38Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578234 wikitext text/x-wiki [[picha:Greta Christina at SASHAcon.jpg|thumb| Greta Christina]] '''Greta Christina''' (alizaliwa [[1961]]) ni [[mwanamke]] mfuasi wa [[Ukanamungu]], [[mwandishi]] wa blogu, mzungumzaji, na mwandishi kutoka [[Marekani]].<ref>{{cite web|url=http://gretachristina.typepad.com/greta_christinas_weblog/2008/06/the-screwed-up-teachings-of-jesus.html#comment-6a00d8341bf68b53ef01156ff8d5e9970b|title=Greta Christina's Blog: The Messed-Up Teachings of Jesus|website=Gretachristina.typepad.com|date=2008-06-30|access-date=2013-01-04|archive-date=2013-01-14|archive-url=https://web.archive.org/web/20130114133630/http://gretachristina.typepad.com/greta_christinas_weblog/2008/06/the-screwed-up-teachings-of-jesus.html#comment-6a00d8341bf68b53ef01156ff8d5e9970b|url-status=dead}}</ref> == Marejeo == {{Reflist|2}} {{Mbegu-mwandishi}} [[Jamii:Waliozaliwa 1961]] [[Jamii:Watu walio hai]] [[Jamii:Wanawake wa Marekani]] rlfweytymgg019l66vs2rbgy0qoy3yp 0 190079 1578153 1361869 2026-07-02T22:26:20Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578153 wikitext text/x-wiki '''Anne Koedt''' (alizaliwa [[1941]]) ni mtetezi wa [[haki za wanawake]] mwenye [[Itikadi kali|msimamo mkali]] na [[mwandishi]] wa ''The Myth of the Vaginal Orgasm'', kazi maarufu ya kike ya mwaka 1970 kuhusu ujinsia wa [[Mwanamke|wanawake]]. Alikuwa na uhusiano na kundi la New York Radical Women na alikuwa mjumbe mwanzilishi wa New York Radical Feminists.<ref name="Gerhard 449–476">{{cite journal|last=Gerhard|first=Jane|date=Summer 2000|title=Revisiting "''The Myth of the Vaginal Orgasm''": the female orgasm in American sexual thought and second wave feminism|url=https://archive.org/details/sim_feminist-studies_summer-2000_26_2/page/449|journal=[[Feminist Studies]]|volume=26|issue=2|pages=449–476|doi=10.2307/3178545|jstor=3178545|pmid=16856271|hdl-access=free|hdl=2027/spo.0499697.0026.216}}</ref> == Marejeo == {{Reflist}} {{Mbegu-mtu}} [[Jamii:Waliozaliwa 1941]] [[Jamii:Watu walio hai]] [[Jamii:Wanaharakati wa Marekani]] qbw1j75gpv07xgcckh58dduws3npihq 0 192009 1578180 1510755 2026-07-03T00:54:17Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578180 wikitext text/x-wiki '''Deanna Syme Tewari''' ([[1939]]–[[2024]]) alikuwa [[mwanariadha]] wa [[India]] kutoka [[Bangalore]] katika miaka ya [[1950]] na mapema miaka ya [[1960]]. Alikuwa mkimbiza mwenge wa India katika [[Michezo]] ya [[Asia]] ya mwaka [[1982]] huko [[New Delhi]]. <ref>{{Rejea tovuti |last=Thyagarajan |first=Roshan |title=Deanna Syme Tewari: Athlete, teacher, coach, legend |url=https://www.deccanherald.com/sports/other-sports/deanna-syme-tewari-athlete-teacher-coach-legend-2959483 |access-date=2024-04-04 |website=Deccan Herald |language=en}}</ref><ref>{{Rejea tovuti |last=The Hindu Archives |date=1963-05-22 |title=Image ID: 158048548 |url=https://thehinduimages.com/details-page.php?id=158048548 |access-date=2024-04-04 |website=www.thehinduimages.com |archive-date=2024-04-04 |archive-url=https://web.archive.org/web/20240404092546/https://thehinduimages.com/details-page.php?id=158048548 |url-status=dead }}</ref> == Marejeo == {{reflist}} <references /> {{mbegu-mtu}} {{BD|1939|2024}} [[Jamii:Wanariadha wa India]] 9y9njqjsvt63atc41bdwsk7s2idf96m 0 195333 1578087 1515903 2026-07-02T19:07:53Z Dee Soulza 66446 /* */ Typo on the second name. 1578087 wikitext text/x-wiki {{Sanduku la Habari la Mhusika|tbl-class=Infobox|tbl-style=width: 40% !important; background color: #f5f5f5; padding: 5px; border: 2px solid black; float: right|color=#ffff00|picha= |jina la utani=Big Joe, Joe, Boss Joe, Biggy|jina lingine=Joseph Mkama Kusaga, Joseph Kusaga|umri=Miaka 58|amezaliwa=9 Juni, 1966, Musoma, Tanzania.|mtaalam wa=Uhandisi|kazi yake=Mwekezaji, mjasiriamali.|ndoa=Mke mmoja|utaifa=Mtanzania|colour text=#f9f9f9|color text=#000000|maelezo ya picha=Joseph M. Kusaga}} '''Joseph Mkama Kusaga''' (maarufu kwa majina ya Big Joe, Biggy na Boss Joe; alizaliwa [[Mkoa wa Mara|mkoani Mara]], [[Tanzania]], 9 Juni 1966) ni mwekezaji wa Tanzania mwenye maono ya kupigiwa mfano ya [[ujasiriamali]] wa kikampuni, anayefahamika kwa uasisi wake wa Clouds Entertainment Limited (sasa Clouds Media Group) kwa kushirikiana na aliyekuwa mbia na rafiki yake mkubwa, hyt. [[Ruge Mutahaba]]. <ref>https://www.jamiiforums.com/threads/historia-ya-joseph-kusaga.1748466/</ref> <ref>{{Rejea tovuti |url=https://www.jifunzeujasiriamali.co.tz/2019/03/siri-kubwa-2-za-mafanikio-ya-ruge.html |title=Nakala iliyohifadhiwa |accessdate=2024-12-14 |archive-date=2025-01-25 |archive-url=https://web.archive.org/web/20250125200239/https://www.jifunzeujasiriamali.co.tz/2019/03/siri-kubwa-2-za-mafanikio-ya-ruge.html |url-status=dead }}</ref> == Maisha ya udogoni na elimu == Katika familia ya watoto 9 wa mzee Kusaga (wa kabila la [[Wakurya]]), Joe ni wa nne. Aliondoka [[Musoma]] na kuhamia [[Dar Es Salaam]] akiwa na umri wa miaka mitano kufuatia kuhamishwa kwa baba yake ambaye alikuwa mtumishi wa umma.<ref> https://www.jamiiforums.com/threads/historia-ya-joseph-kusaga.1748466/</ref> Aliendelea na masomo akiwa Dar katika shule za [msingi na sekondari] [[Muhimbili]], [[Forodhani]] na [[Mzizima]]. Katika ngazi ya elimu ya juu, alisomea uhandisi wa umeme.<ref>https://tanzania.mom-gmr.org/en/owners/individual-owners/detail/owner/owner/show/joseph-m-kusaga/</ref> Kabla ya kuibuka na kuwa Joe anayefahamika hivi sasa, kichocheo cha awali kilikuwa kupenda kwake sana [[muziki]] na burudani wakati akisoma shule. Hali hiyo ilitanabaisha ukweli kuwa Joe alikuwa "upande wa mwenge wa shilingi" na baba yake alikuwa upande wa "kichwa" (Baba yake alipenda muziki na burudani sawa na Joe). Kuanza kwake kuendesha shughuli za muziki na burudani katika umri mdogo huku akiwa chuoni, kulikubaliwa na wazazi wake japo kwa tahadhari. Walikuwa ni aina ya wazazi wasaidiao kufanikisha ndoto za mtoto.<Ref>https://tanzania.mom-gmr.org/en/owners/companies/detail/company/company/show/clouds-entertainment-co-limited-1/</Ref> Katika jitihada zake za mwanzo kabisa za kuendesha discotheques na boogies (matamasha ya muziki ya muda wa mchana), Joe alifuga kuku kujipati mtaji na aliazima vifaa vya kielektroniki vya familia. Kutokana na kipaji na kukubalika kwake kama Dj na mpanga matamasha, Joe alipata mafanikio makubwa. Alifanya matamasha kwenye kumbi zote maarufu za Dar na mashabiki walimpachika majina kuashiria kuwa yeye ni [[mfalme]] wa [[tasnia]]. Baada ya mafanikio hayo, akajiwa na wazo la kufanya ziara [[Marekani|nchini Marekani]]. Huko ndiko alikopata wazo la kuanzisha kituo cha [[redio]] kadhalika alikutana na rafikiye wa kuliana yamini, Ruge Mutahaba.<ref> https://www.jamiiforums.com/threads/historia-ya-joseph-kusaga.1748466/</ref> <ref>https://tanzania.mom-gmr.org/en/owners/companies/detail/company/company/show/clouds-entertainment-co-limited-1/</ref> === Kampuni na miradi === [[Kampuni]] ya kwanza kufunguliwa na Joe katika ubia na Ruge, ni [[w:en:Clouds Media Group|Clouds Entertainment Limited]] mwaka 1998.<ref>{{Rejea tovuti |url=https://www.jifunzeujasiriamali.co.tz/2019/03/siri-kubwa-2-za-mafanikio-ya-ruge.html |title=Nakala iliyohifadhiwa |accessdate=2024-12-14 |archive-date=2025-01-25 |archive-url=https://web.archive.org/web/20250125200239/https://www.jifunzeujasiriamali.co.tz/2019/03/siri-kubwa-2-za-mafanikio-ya-ruge.html |url-status=dead }}</ref> Miradi iliyokuwa chini ya kampuni hiyo ni pamoja na Clouds Disco na ule wa uratibu wa matamasha. Joe wa wakati huo ni yule Dj Emperor, pia 'Kinta Kinte'. Mwaka huohuo [[w:en:Clouds FM|CloudsFm Radio]] (The peoples' station - Redio ya watu) ilianzishwa. "CLOUDS" ni finyanzo la "Cool, Lovable, Outrageous, Dynamic Sound." Joe anafunguka kwenye mahojiano na CloudsFm (Desemba 4, 2024); <blockquote>Uanzishwaji wake ulikuwa mgumu kulingana na mazingira yale ambapo mamlaka zilizoea ukiritimba wa redio mbili nchini ([[TBC|RTD]] na iliyokuwa Radio One Stereo, sasa Radio One, ya IPP Media). Kufanikiwa kuisajili kulikuja kutokana na maono ya mbali ya uliokuwa uongozi wa TCC (sasa TCRA). Tulianza na frequency ya chini ya 90 (88.5 Dar Es Salaam) na ndani ya wiki 2 tuliwateka mashabiki wa Dar ''en masse''.</blockquote> Mwaka 2013 Joe alilifanyia ukarabati jina la kampuni na kuwa [[w:en:Clouds Media Group|Clouds Media Group]] (sasa inavuma kama "Gen C" ) , (kutoka Clouds Entertainment Ltd). Kwa sasa kampuni hiyo ina takriban wafanyakazi 400, ina stesheni za redio 3 Tz na zingine zipo nje, stesheni za Tv 9, chaneli za kidijitali, chombo cha uchapishaji, mkongo wa Tv wenye chaneli 50, ushauri wa kitaalam kuhusu utangazaji, nk.<ref> https://tz.linkedin.com/company/clouds-media-group</ref> Kama ilivyo kwa CloudsFm upande wa redio, Clouds Tv iliyoanza rasmi 2010 inasikika zaidi. == [[Falsafa]]== Joseph Makama Kusaga ameweka wazi falsafa yake ambayo ndiyo msingi wa mafanikio yake. Inajengwa kwa nguzo kuu tatu: Kufanya anachokipenda, Kumakinika na anachokifanya na Nidhamu kwenye utendaji. Nguzo hizo hujengwa na [[w:en: material|makunzi]] (materials) yafuatayo: kuifuata jamii na si kulazimisha jamii imfuate, kwenda na wakati kiteknolojia na ufundi, elimu na ujuzi bila ukomo, mipango na mikakati bora, azma ya mafanikio zaidi, kuwa wa mfano, kurejesha kwa jamii, kukua, kazi kitaalamu, upendo, heshima na kukataa fitina na rushwa <ref>https://www.slideshare.net/slideshow/clouds-media-profile/70251617?searchfrom=header&q=Clouds+Media+</ref> ==Kurejesha kwa jamii== Chini ya uongozi wa Joe, [[w:en: Clouds Media Group|CMG]] imerejesha kwa namna mbalimbali kwa jamii: * [[Fursa]]: ni mradi ulobuniwa na hyt. Ruge Mutahaba na kubarikiwa na Joe. Kuanzia mwanzoni mwa 2010, CMG imefanya kazi kubwa sana kuuelimisha umma wa Watanzania jinsi wanavyoweza kuzitumia fursa zinazowazunguka kujikwamua [[Uchumi|kiuchumi]]. Chini ya kaulimbiu za "tunakufungulia dunia," "kuwa unachotaka, "wewe ni mpanbanaji" na kadhalika, CMG imerejesha kwa jamii kupitia elimu ya bure ya ujasiriamali.<ref>https://www.instagram.com/cloudsfmtz/reel/DDSbiVRM6Pg/</ref> * Malkia wa nguvu: ni programu maarufu ya CMG ya Joe inayojielekeza katika kuwawezesha wanawake.<ref>https://www.instagram.com/cloudsfmtz/p/C4Xf6yPNKmI/</ref> Huchechemua juhudi za wanawake katika uzalilishaji na ubunifu. Programu hii ni uso mpya wa iliyokuwa Mwanamakuka. * Ajira: Jumla kuu ya walioajiriwa CMG (wakati wote) inapindukia 400. Wengi waliajiriwa, wakawa maarufu na weledi na kuhamia kwingine. * Kuibua vipaji: Sifa kuu za kuajiriwa CMG ni akili, kipaji na uwezo wa kazi kivitendo. Watu kadhaa wasio [[Mtangazaji|watangazaji]] kwa kusomea wameibuka kuwa wabeba kampuni huku wakipata [[taaluma]] zaidi kazini. Hali kadhalika matamasha ya Fiesta na kazi za Prime time promotions vimechangia pakubwa tasnia ya sanaa na wasanii.<ref>https://www.thecitizen.co.tz/tanzania/magazines/the-beat/fredwaa-radio-is-all-about-creativity-2520846</ref> * Elimu kwa umma: Kila siku ni ya kozi za kielimu kupitia CMG: afya, amali, siasa, uchumi, lugha, muziki, biashara, jamii, nk. Yote yanajiri chini ya uongozi wa Joe Kusaga. ==Mafanikio== Kutoka kuwa Dj na mwandazi wa matamasha hadi [[Mkurugenzi]] wa kampuni ya kimataifa iliyo mbioni kuweka hisa zake kibiashara kwenye [[soko la hisa]], ni hatua kubwa. CMG ya Joe sasa imetapakaza nyayo zake maeneo mbalimbali duniani kama vile [[Jamaica]], [[Abu Dhabi]], [[Burundi]], [[Rwanda]], [[Kenya]], [[Uganda]] na kwingine<ref>https://www.slideshare.net/slideshow/clouds-media-profile/70251617?searchfrom=header&q=Clouds+Media+</ref> Muziki wa [[Bongo Flava]] ulikubalika katika hatua zake za awali kwa juhudi za Joe na CMG. Umashuhuri wa Joe uligonga kwenye anga za kimataifa zaidi ya miaka 15 iliyopita. [[Jarida]] maarufu duniani la [[w:en:Forbes|Forbes]] lilimtafuta na kufanya nae mahojiano akiwa ni mwafrika wa kwanza kuhojiwa nao kadhalika kupamba jalada la jarida hilo kwa picha yake. Pia Joe aliweza kuwaleta [[wasanii]] wafuatao Tz na kuishangaza Afrika: [[Eve]], [[Fat Joe]], P Square, [[Shaggy]], [[50 Cent]], Kevin Lyttle, [[Koffi Olomide|Koffi]], [[Jay Z]] - kwa kuishirikisha MTV Base, [[Ja Rule]], Hugh Masekela, Mya, [[Miriam Makeba]], Youssou N’Dour na wengine.<ref>https://www.forbesafrica.com/entrepreneurs/2011/10/01/ear-for-profits/</ref> Mafanikio yake yanaakisiwa pia kwa kuwaibua nguli wengi wa utangazaji kama: Reuben Ndege, Sebastian Maganga, Paul James, hyt. Gardner G. Habash, hyt. Ephraim Kibonde, hyt. [[Amina Chifupa]], hyt. Fred Fidelis (Fredwaa), Ibrahim Masoud, Phina Mango, [[Masoud Kipanya]], Ray C., Barbara Hassan, Dina Marios, B. Dozen, Gerald Hando, Regina Mwalekwa, [[Millard Ayo]], Geah Habib, Husna Abdul, Jose Mara, Fatma Ahmed (fettylicious), Caesar, Mussa Hussein, George Bantu, Adam Mchomvu, Alex Luambano, Masta Tindwa, Mbwiga Mbwiguke, Prisca Kishamba, Amri Kiemba, Loveness Diva, Zamaradi Mketema, Sofia Kessy, Mahija Zayumba, Mo Jay, [[Mamy Baby]], Vido Vidox, [[Meena Ally]], Kennedy The Remedy, John Jackson, [[Frida Amani]] ... Wote ''wanam-verify'' Joe<ref>https://www.thecitizen.co.tz/tanzania/magazines/the-beat/fredwaa-radio-is-all-about-creativity-2520846</ref> <ref>https://www.wikiwand.com/en/articles/Clouds_FM</ref> <ref>https://www.mwananchi.co.tz/mw/habari/kitaifa/clouds-wagoma-kulihamisha-tamasha-la-fiesta-2941132</ref> ==Maisha binafsi== Joe ana mke (mama watoto wake) na watoto.<ref>https://www.mwananchi.co.tz/mw/habari/kitaifa/mke-wa-kusaga-na-diamond-wamiliki-wasafi-televisheni-2941498</ref> Maisha yake ni ya Kitanzania na ''anamudu kuweka mboga saba mezani''. == Viungo vya nje == {{marejeo}} {{BD|1966|}} [[Jamii:wajasiriamali wa Tanzania]] qh659e593knk8j9a8dmxt1ju8gbaf8f 0 195697 1578160 1512376 2026-07-02T22:45:17Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578160 wikitext text/x-wiki {{Infobox Person |jina = Flower Ezekiel Msuya |picha = Flower Msuya.png |maelezo_ya_picha = Picha ya Dr.Flower Msuya |tarehe_ya_kuzaliwa = 1959 |mahala_pa_kuzaliwa = Kilimanjaro |tarehe_ya_kufariki = |mahala_alipofia = |majina_mengine = |anafahamika kwa = |kazi_yake = Mtaalamu wa kilimobahari |nchi = Tanzania }} '''Flower Ezekiel Msuya''' (alizaliwa [[Kifula]]<ref name="ALLAFRICA" />, Ugweno, sehemu ya [[Wilaya ya Mwanga]], [[Mkoa wa Kilimanjaro]], [[Tanzania]], [[1959]]<ref name="WIOMSA">{{cite news |last=Msuya |first=Flower |url=https://www.wiomsa.org/wp-content/uploads/2019/12/WIOMSA-Magazine-Issue-9_Web-version.pdf |title=At first it was not easy |work=People and the Environment |publisher=Western Indian Ocean Marine Science Association |date= |pages=13–15 |access-date=2021-02-27 |archive-date=2020-12-04 |archive-url=https://web.archive.org/web/20201204140156/https://www.wiomsa.org/wp-content/uploads/2019/12/WIOMSA-Magazine-Issue-9_Web-version.pdf |url-status=live }}</ref>) ni mtaalamu wa magugumaji (stadi za [[mwani]]) kutoka nchini [[Tanzania]]. Ana utaalamu katika [[kilimo]] cha mwani wa [[Bahari|baharini]] na aquaculture (kilimobahari).<ref name=AQUA>{{Rejea tovuti|first=Emmanuel |last=Rubagumya|url=https://aquaculturemag.com/2020/04/15/tanzania-flower-msuya-a-scientist-fighting-tirelessly-to-promote-seaweed-farming/|title=Tanzania: Flower Msuya. A scientist fighting tirelessly to promote seaweed farming |work=Aquaculture Magazine |date=15 April 2020}}</ref> ==Maisha ya awali na elimu== Flower Ezekiel Msuya alipata [[Shahada ya Awali|Shahada ya kwanza]] (BSc) katika [[Botania|botani]] na [[takwimu]] kutoka [[Chuo Kikuu cha Dar es Salaam]].<ref name="WIOMSA" /> Alipata [[Uzamili|Shahada ya Uzamili]] (MSc) katika [[uvuvi]] na aquaculture kutoka Chuo Kikuu cha Kuopio nchini [[Finland]].<ref name="ALLAFRICA" /> Kwa msingi wa kozi ya phycology (masomo ya algae na seaweed),<ref name="WIOMSA" /> alijenga shauku kuhusu kilimo cha magugmaji. Alipata PhD katika aquaculture iliyounganishwa na seaweed kutoka Chuo Kikuu cha Tel Aviv mwaka 2004.<ref name="AQUA" /> Utafiti wake, "The Influence of Culture Regimes on the Performance of Seaweed Biofilters in Integrated Mariculture", ulijikita katika kutumia magugumaji kama chujioasili kwa maji ya taka kutoka kwa [[samaki]].<ref>{{cite web |first=Flower|last=Msuya |date=2004|title=The Influence of Culture Regimes on the Performance of Seaweed Biofilters in Integrated Mariculture|url=https://www.researchgate.net/publication/237148717}}</ref> ==Kazi== Kuanzia mwaka [[1993]] hadi [[1996]], Msuya alifanya utafiti kuhusu athari za kijamii na [[mazingira]] za kilimo cha mwani.<ref name="ALLAFRICA" /><ref name=GLOBALSHAKERS>{{Rejea tovuti|url=https://globalshakers.com/world-shakers/flower-ezekiel-msuya/|title=Flower Ezekiel Msuya|website=Global Shakers|accessdate=2024-12-22|archive-date=2023-12-10|archive-url=https://web.archive.org/web/20231210101511/https://globalshakers.com/world-shakers/flower-ezekiel-msuya/|url-status=dead}}</ref> Aliongoza kuanzishwa kwa kilimo cha magugumaji kusini mwa Tanzania mwaka [[1995]] na 1996.<ref name="ALLAFRICA" /><ref name="GLOBALSHAKERS" /> Kuanzia mwaka [[2005]] amekuwa akifanya utafiti kuhusu teknolojia za kuongeza thamani ya magugumaji (kwa mfano, kutengeneza mitandao ya tubuli).<ref name="ALLAFRICA" /> Tangu mwaka [[2017]], Msuya amekuwa sehemu ya timu inayotekeleza [[mradi]] wa GlobalSeaweedSTAR ili kulinda mustakabali wa aquaculture ya magugumajji dhidi ya athari za [[mabadiliko ya tabianchi]] katika nchi kama [[Tanzania]], [[Ufilipino]] na [[Malaysia]]. Mradi huu unashirikisha Scottish Association of Marine Science (SAMS) na unafadhiliwa na UK Research and Innovation Global Challenges Research Fund.<ref>{{cite news |title=How seaweed farming can help tackle global poverty |url=https://thefishsite.com/articles/how-seaweed-farming-can-help-tackle-global-poverty |work=The Fish Site |date=24 September 2020 |language=en}}</ref> Msuya amefanya kazi kama afisa utafiti katika Taasisi ya Utafiti wa Uvuvi ya Tanzania (TAFIRI) huko [[Kigoma-Ujiji|Kigoma]], Tanzania. Yeye ni mtaalamu mstaafu na mchunguzi mkuu katika Biolojia ya Baharini katika Taasisi ya Sayansi ya Baharini ya [[Chuo Kikuu cha Dar es Salaam]] kilichopo [[Zanzibar]].<ref>{{cite journal |last1=Brugere |first1=Cecile |last2=Msuya |first2=Flower E. |last3=Jiddawi |first3=Narriman |last4=Nyonje |first4=Betty |last5=Maly |first5=Ritha |title=Can innovation empower? Reflections on introducing tubular nets to women seaweed farmers in Zanzibar |journal=Gender, Technology and Development |date=2 January 2020 |volume=24 |issue=1 |pages=89–109 |doi=10.1080/09718524.2019.1695307|s2cid=213899411 }}</ref> Mahitaji ya kukuza sekta ya Tanzania ili kuhimili athari za mazingira ni kipengele muhimu cha kazi yake.<ref>{{cite book|last=Msuya |first=Flower |date=January 2012 |title=A Study of Working Conditions in the Zanzibar Seaweed Farming Industry |isbn=978-92-95095-40-3 |publisher=Women in Informal Employment: Globalizing and Organizing|url=https://www.researchgate.net/publication/239259708}}</ref> Msuya ni mmoja wa wakufunzi watano wa kimataifa katika Innovation na Cluster Facilitation. Anafundisha kuhusu [[teknolojia]] za kilimo cha magugumaji, kuongeza thamani na kuunganisha magugumaji na bidhaa zingine za baharini kama matango bahari, majumba ya samaki na samaki wa baharini.<ref name=FISH>{{Rejea tovuti|first=Bonnie|last=Waycott|url=https://thefishsite.com/articles/women-in-aquaculture-dr-flower-msuya|title=Women in aquaculture: Dr Flower Msuya|publisher=The Fish Site|date=6 August 2018|access-date=14 February 2021|archive-date=27 October 2020|archive-url=https://web.archive.org/web/20201027215418/https://thefishsite.com/articles/women-in-aquaculture-dr-flower-msuya|url-status=live}}</ref> Msuya amefanya kazi na [[FAO]], WIEGO, [[UNIDO]] na WWF. Amechangia kuanzishwa kwa kilimo cha seaweed katika [[Mauritius]], Rodrigues na [[Mayotte]].<ref name="ALLAFRICA">{{Rejea tovuti|url=https://allafrica.com/stories/202004030195.html|title=Tanzania: Flower Msuya - Fighting Tirelessly to Promote Seaweed Farming, Products|first=Emmanuel|last=Rubagumya|date=2 April 2020|work=[[Daily News (Tanzania)|Daily News]]|via=[[AllAfrica]]|access-date=14 February 2021|archive-date=6 April 2020|archive-url=https://web.archive.org/web/20200406021605/https://allafrica.com/stories/202004030195.html|url-status=live}}</ref> Yeye ni mwanachama wa Tropical Agriculture Association (TAA), Royal Society of Biology (RSB),<ref name="ALLAFRICA" /> World Aquaculture Society (WAS),<ref>{{cite news |title=Feed firm backs African aquaculture |url=https://thefishsite.com/articles/feed-firm-backs-african-aquaculture |work=The Fish Site |date=12 November 2018 |language=en |access-date=28 February 2021 |archive-date=17 January 2021 |archive-url=https://web.archive.org/web/20210117012132/https://thefishsite.com/articles/feed-firm-backs-african-aquaculture |url-status=live }}</ref> International Seaweed Association (ISA), Western Indian Ocean Marine Science Association (WIOMSA) na Pan African Competitiveness Forum (PACF).<ref name="ALLAFRICA" /> Msuya ni mwasisi na [[mwenyekiti]] wa Zanzibar Seaweed Cluster Initiative (ZaSCI). Kama sehemu ya mpango huu, amechangia kutengeneza bidhaa za seaweed<ref>{{cite journal |last=Msuya |first=F.E. |date=2006 |title=The Seaweed Cluster Initiative in Zanzibar, Tanzania. In Mwamila B.L.M. and A.K. Temu, Proceedings of the 3rd Regional Conference on Innovation Systems and Innovative Clusters in Africa, Dar es Salaam, Tanzania, September 3-7, 2006 |journal=Proceedings of the 3Rd Regional Conference On... |pages=246–260 |url=https://www.academia.edu/1839070 |access-date=2021-02-28 |archive-date=2016-06-23 |archive-url=https://web.archive.org/web/20160623232440/http://www.academia.edu/1839070/The_Seaweed_Cluster_Initiative_in_Zanzibar_Tanzania |url-status=live }}</ref> ikiwemo poda, vipodozi na vyakula.<ref>{{cite news |last1=Coates |first1=Karen J. |title=Warming waters hurt Zanzibar's seaweed. But women farmers have a plan. |url=https://www.csmonitor.com/World/Africa/2018/0521/Warming-waters-hurt-Zanzibar-s-seaweed.-But-women-farmers-have-a-plan |work=Christian Science Monitor |date=21 May 2018 |access-date=28 February 2021 |archive-date=9 November 2020 |archive-url=https://web.archive.org/web/20201109031214/https://www.csmonitor.com/World/Africa/2018/0521/Warming-waters-hurt-Zanzibar-s-seaweed.-But-women-farmers-have-a-plan |url-status=live }}</ref><ref name="FISH" /> ZaSCI pia inasaidia [[Zanzibar]] kupanua uchakataji wa seaweed kwa kutekeleza mimea ya uchakataji ya seaweed kwa semi-refined carrageenan (geli inayopima ubora wa seaweeds nyekundu zinazolimwa visiwani).<ref name="ALLAFRICA" /> ==Machapisho aliyoandika== *{{cite journal |last1=Msuya |first1=Flower E. |last2=Neori |first2=Amir |title=Effect of water aeration and nutrient load level on biomass yield, N uptake and protein content of the seaweed Ulva lactuca cultured in seawater tanks |journal=Journal of Applied Phycology |date=December 2008 |volume=20 |issue=6 |pages=1021–1031 |doi=10.1007/s10811-007-9300-6|s2cid=20524645 }} *{{cite journal |last1=Neori |first1=Amir |last2=Msuya |first2=Flower E. |last3=Shauli |first3=Lilach |last4=Schuenhoff |first4=Andreas |last5=Kopel |first5=Fidi |last6=Shpigel |first6=Muki |title=A novel three-stage seaweed ( Ulva lactuca ) biofilter design for integrated mariculture |url=https://archive.org/details/journal-of-applied-phycology_2003-11_15_6/page/543 |journal=Journal of Applied Phycology |date=November 2003 |volume=15 |issue=6 |pages=543–553 |doi=10.1023/B:JAPH.0000004382.89142.2d|s2cid=22870531 }} *{{cite journal |last1=Schuenhoff |first1=Andreas |last2=Shpigel |first2=Muki |last3=Lupatsch |first3=Ingrid |last4=Ashkenazi |first4=Arik |last5=Msuya |first5=Flower E |last6=Neori |first6=Amir |title=A semi-recirculating, integrated system for the culture of fish and seaweed |url=https://archive.org/details/sim_aquaculture_2003-05-01_221_1-4/page/167 |journal=Aquaculture |date=May 2003 |volume=221 |issue=1–4 |pages=167–181 |doi=10.1016/S0044-8486(02)00527-6}} *{{cite book |last1=Msuya |first1=Flower |title=The influence of culture regimes on the performance of seaweed biofilters in integrated mariculture |date=2011 |isbn=978-3-8454-3642-5}} ==Marejeo== <references /> {{mbegu-mwanasayansi}} {{BD|1959|}} {{WAST KRM}} {{DEFAULTSORT:Msuya, Flower Ezekiel}} [[Jamii:Waliozaliwa 1959]] [[Category:Wanasayansi wa Tanzania]] [[Jamii:Wanawake wa Tanzania]] [[Jamii:WikiGap JWK 2026]] azks2zr0rk73puxz5v39bcj0onupnz4 3 195840 1578045 1390618 2026-07-02T16:05:28Z CeylonChingu 77364 /* Congratulations from Wiki Project Med ⭐ */ mjadala mpya 1578045 wikitext text/x-wiki {{karibu}} == Thank you for being a medical translator! == <div lang="en" dir="ltr" class="mw-content-ltr"> {| style="background-color: #fdffe7; border: 1px solid #fceb92;" |rowspan="2" style="vertical-align: middle; padding: 5px;" | [[File:Wiki Project Med Foundation logo.svg|100px]] |style="font-size: x-large; padding: 3px 3px 0 3px; height: 1.5em;" |'''The 2024 Cure Translators Award''' |- | style="vertical-align: middle; padding: 3px;" |In 2024 you [https://mdwiki.toolforge.org/Translation_Dashboard/leaderboard.php?camp=all&project=all&year=2024&start=Filter joined us as a medical translator]. Thank you from [[m:WikiProject_Med|Wiki Project Med]] for helping bring free, complete, accurate, up-to-date health information to the public. We look forwards to working together in 2025. |} Thanks again :-) -- [https://mdwiki.org/wiki/User:Doc_James <span style="color:#0000f1">'''Doc James'''</span>] along with the rest of the team at '''[[m:WikiProject_Med|Wiki Project Med Foundation]]''' 06:54, 26 Januari 2025 (UTC) </div> <!-- Message sent by User:Doc James@metawiki using the list at https://meta.wikimedia.org/w/index.php?title=Global_message_delivery/Targets/Top_Translators_2024&oldid=28173086 --> == Congratulations from Wiki Project Med ⭐ == {| class="barnstar" style="border: 1px solid gray; background-color: #fdffe7;" | rowspan="2" valign="middle" |[[Faili:Translation_Barnstar.svg|120x120px]] | rowspan="1" | | style="font-size: x-large; padding: 0; text-align:left; border-bottom:1px solid #aaa;" |'''The [https://mdwiki.toolforge.org/Translation_Dashboard/index.php Health Translation] Barnstar!''' |- | rowspan="1" | | style="vertical-align:middle; " |Congratulations on translating more than [https://mdwiki.toolforge.org/Translation_Dashboard/leaderboard.php 100 health articles into Sw Wikipedia]. Thank you for making the world a better place and keep up the good work! -- '''[[m:WikiProject_Med|Wiki Project Med Foundation]]''' Team |} '''[[Mtumiaji:CeylonChingu|CeylonChingu]] ([[Majadiliano ya mtumiaji:CeylonChingu|majadiliano]])''' 16:05, 2 Julai 2026 (UTC) 07lx1lo4zyapfhw3zaj1rh35k3voefl 0 201239 1578077 1399661 2026-07-02T18:33:13Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578077 wikitext text/x-wiki '''Karl Rahner''' [[Shirika la Yesu|S.J.]] ([[5 Machi]] [[1904]] – [[30 Machi]] [[1984]]) alikuwa [[Upadri|padre]] na [[mwanateolojia]] wa [[Ujerumani]] wa Shirika la Yesu. Pamoja na [[Henri de Lubac]], [[Hans Urs von Balthasar]], na [[Yves Congar]], anachukuliwa kama mmoja wa wanateolojia wa Kikatoliki wenye ushawishi mkubwa katika [[karne ya 20]]. Alikuwa ndugu wa [[Hugo Rahner]], pia mwanateolojia wa Shirika la Yesu.<ref>{{cite news|last1=Sheehan|first1=Thomas|title=The Dream of Karl Rahner|url=https://www.nybooks.com/articles/1982/02/04/the-dream-of-karl-rahner/|work=The New York Review|date=4 February 1982}}</ref> Kabla ya [[Mtaguso wa pili wa Vatikani]], Rahner alifanya kazi kwa karibu na Yves Congar, Henri de Lubac, na [[Marie-Dominique Chenu]], wanateolojia walioungana na shule inayojitokeza ya mawazo ya kitekolojia iitwayo Nouvelle Théologie. [[Mtaguso Mkuu]] huo uliathiriwa na teolojia ya Rahner na uelewa wake wa imani ya Kikatoliki.<ref>{{cite journal|last1=Marmion|first1=Declan|date=March 2017|title=Karl Rahner, Vatican II, and the Shape of the Church|url=https://archive.org/details/theological-studies_2017_78_1-2/page/25|journal=Theological Studies|volume=78|issue=1|pages=25–48|doi=10.1177/0040563916681992}}</ref> == Marejeo == {{reflist}}{{Mbegu-Mkristo}} [[Jamii:Waliozaliwa 1904]] [[Jamii:Waliofariki 1984]] [[Jamii:Wajesuiti]] [[Jamii:Mapadri]] [[Jamii:wanateolojia wa Ujerumani]] 56gvk863bussrrbjhpn1jpsh2d42j27 0 201251 1578233 1512391 2026-07-03T05:39:49Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578233 wikitext text/x-wiki '''Folorunso Alakija''' (alizaliwa [[15 Julai]], 1951) ni [[mfanyabiashara]] na mwanahisani wa nchini [[Nigeria]].<ref>{{citeweb|URL=https://www.vanguardngr.com/2017/10/collectively-can-build-thriving-economy-folorunso-alakija/amp/|website=vanguardngr.com|title=Collectively, we can build a thriving economy - Folorunsho Alakija|accessdate=September 17, 2024}}</ref><ref>{{cite magazine|last1=Iyengar|first1=Rishi|title=Here's She is the World's Richest Black woman in the world|url=https://time.com/3649223/richest-black-woman-folorunsho-alakija-oprah-winfrey-nigeria/|archive-url=https://web.archive.org/web/20180503025255/http://time.com/3649223/richest-black-woman-folorunso-alakija-oprah-winfrey-nigeria/|url-status=live|archive-date=3 May 2018|magazine=[[Time (magazine)|Time]]|access-date=30 December 2014|date=30 December 2014}}</ref><ref name="fa">{{Rejea tovuti|title=Folorunso Alakija|url=https://africa.harvard.edu/people/folorunso-alakija|access-date=20 May 2021|website=africa.harvard.edu|language=en|archive-date=2022-07-01|archive-url=https://web.archive.org/web/20220701070503/https://africa.harvard.edu/people/folorunso-alakija|url-status=dead}}</ref> Kwa sasa ni [[mkurugenzi]] mkuu wa kampuni ya ''The Rose of Sharon Group'' na pia anahudumu kama makamu mwenyekiti mtendaji wa kampuni ya Famfa Oil Limited.<ref>{{cite web|title=Folorunso Alakija|url=https://folorunsoalakija.com/about-me/|publisher=Folorunsho Alakija|access-date=27 April 2021|archive-date=27 April 2021|archive-url=https://web.archive.org/web/20210427025749/https://folorunsoalakija.com/about-me/|url-status=dead}}</ref> == Maisha ya awali == Alakija alizaliwa katika familia yenye maisha ya kawaida mnamo 15 Julai 1951<ref>{{citeweb|URL=https://nairametrics.com/2021/09/17/folorunsho-alakija-from-a-middle-class-home-to-becoming-nigerias-richest-woman/|title=Folorunsho Alakija: From a Middle Class Home to becoming Nigeria's richest woman|website=Nairametrics.com|accessdate=September 17, 2024}}</ref>. Baba yake chifu L.A. Ogbara, alikua na wake 8 na watoto 52,<ref>{{Rejea tovuti|title=FOLORUNSHO ALAKIJA - A Pathway For Very Female Entrepreneur|url=https://www.arabellastarmagazine.com/the-biography-of-folorunsho-alakija/|access-date=24 April 2024|publisher=Alamin Abdulhadi|archive-date=2024-11-26|archive-url=https://web.archive.org/web/20241126210155/https://www.arabellastarmagazine.com/the-biography-of-folorunsho-alakija/|url-status=dead}}</ref> na Folorunso akiwa ndio mtoto wa kwanza.<ref>{{Rejea tovuti|date=2021-07-18|title=Covenant I made with God at age 40 — Folorunso's Alakija|url=https://punchng.com/covenant-i-made-with-god-at-age-40-folorunsho-alakija/|access-date=2023-01-20|website=Punch Newspapers|language=en-US}}</ref> Anatoka katika kabila la Yoruba kusini-magharibi mwa Nigeria.<ref>{{Rejea tovuti|last=Sadiq|first=Mobola|date=2021-07-18|title=Covenant I made with God at age 40 — Folorunsho Alakija|url=https://punchng.com/covenant-i-made-with-god-at-age-40-folorunsho-alakija/|access-date=2024-02-10|website=Punch Newspapers|language=en-US}}</ref> Akiwa na umri wa miaka kumi, Alakija alisafiri hadi [[Uingereza]] kwa ajili ya elimu yake. Alakija alisoma [[shule ya upili]] ya kiislamu huko Shagamu, Nigeria. Kisha na kurudi Uingereza kwa masomo yake ya ukatibu katika Chuo Kikuu cha Pitman, [[London]]. == Marejeo == <references /> {{mbegu-mtu}} [[Jamii:Watu walio hai]] [[Jamii:Waliozaliwa 1951]] [[Jamii: Wanawake Katika Sanaa]] ljttvr5sqklolckmnt0lmnk7sybu1hp 0 203426 1578086 1483443 2026-07-02T19:07:27Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578086 wikitext text/x-wiki [[File:The Levite and the concubine (89398076).jpg|thumb|''[[Kabila la Lawi|Mlawi]] akikuta [[mlango|mlangoni]] suria wake amefariki kwa [[Ubakaji|kubakwa]] na [[kabila la Benyamini|Wabenyamini]] wengi ([[Waamuzi (Biblia)|Amu]] 19-21); [[mchoro]] wa [[Gustave Doré]].]] {{Mapendo}} '''Usuria''' (kutoka [[Kiarabu]]; kwa [[Kiingereza]] na [[Kifaransa]]: ''concubinage'') ni [[uhusiano]] wa kimapenzi na wa karibu kati ya watu wawili ambao hawawezi au hawataki kufunga [[ndoa]] kamili. Mahusiano hayo mara nyingine hufananishwa na [[ndoa]], lakini yanatofautiana kwa namna fulani.[[Haki]] za suria zinategemea [[sheria]] na [[desturi]] za wahusika. Katika hatua za awali za ukoloni wa Ulaya, watawala wa kikoloni waliwahimiza [[Mwanaume|wanaume]] wa Kizungu kushiriki katika mahusiano haya ili kuwazuia kulipa makahaba kwa ajili ya ngono (ambayo ingeweza kusababisha maambukizi ya magonjwa ya zinaa) na pia ili kuwazuia kuingia katika mahusiano ya [[ushoga]]. Aidha, watawala wa kikoloni waliamini kuwa kuwa na uhusiano wa karibu na wanawake wa [[jamii]] za wenyeji kungeweza kusaidia wanaume wa Kizungu kuelewa [[utamaduni]] wa wenyeji na pia kupata msaada wa kazi za nyumbani. Hii ilikuwa muhimu kwa mradi wa ukoloni kwa sababu ilimaanisha kuwa wanaume wa Kizungu hawakuhitaji wake kutoka kwao Ulaya, hivyo basi hawakuhitaji mshahara wa kifamilia.<ref>Ann L. Stoler, 1989, "Making Empire Respectable: The Politics of Race and Sexual Morality in 20th-Century Colonial Cultures., ''American Ethnologist, 16(2): 634-660.''</ref> Hata hivyo, mahusiano haya yalipoanza kuzaa [[watoto]], ilizuka changamoto ya kisiasa kwani kizazi hiki mchanganyiko kilihofiwa kuwa kingeweza kupinga utawala wa wazungu. Hofu hii iliwafanya watawala wa kikoloni kubadili msimamo na kuanza kuhimiza wanawake wa Kizungu kusafiri kwenda makoloni. Wanawake hawa walichangia mradi wa kikoloni kwa manufaa yao ya kibaguzi, huku pia wakihimizwa kuendeleza dhana ya mgawanyo wa majukumu kati ya maeneo ya umma na binafsi, jambo lililochangia pia kudumisha mfumo dume dhidi yao wenyewe.<ref>{{cite book|author=Peter Jackson|title=The Mongols and the West 1221–1410|date=May 2014|url=https://books.google.com/books?id=kMCCBAAAQBAJ&pg=PT64|publisher=[[Taylor & Francis]]|isbn=9781317878988}}</ref><ref>{{cite encyclopedia|title=The Greenwood Encyclopedia of International Relations: S-Z|entry=slave labor/slavery|page=1530}}</ref> Katika China, hadi karne ya [[20]], mahusiano ya wake wa mitala bila ndoa yalikuwa yamehalalishwa kisheria na yalikuwa na mfumo rasmi wa haki na wajibu kwa wake wa mitala. Mwanamke aliyekuwa wake wa mitala angeweza kuwa mtu huru au mtumwa, na hali yake ilitegemea [[mapenzi]] ya [[bwana]] wake. Wakati wa uvamizi wa Wamongolia, familia za kifalme za kigeni na wanawake waliotekwa walichukuliwa kama wake wa mitala.<ref>{{cite encyclopedia |title = Concubinage |encyclopedia = Encyclopædia Britannica |url = https://www.britannica.com/topic/concubinage |access-date = 2021-10-25 }}</ref> Katika [[Japani]] ya enzi ya Meiji, mahusiano haya yalikuwa ishara ya heshima ya kijamii. Katika jamii nyingi za [[Kiarabu]], wake wa mitala walihusishwa na suala la uzazi. [[Sheria]] za Hammurabi zinaeleza jinsi ambavyo mke tasa angeweza kumpa mumewe mjakazi wake kama wake wa mitala, na watoto waliotokana na uhusiano huo walihesabika kuwa wa halali. Mfumo huu pia ulikuwa maarufu katika ulimwengu wa Kiislamu wa zama za kale, ambapo watawala wengi wa [[Dola]] ya Abbasid na Milki ya [[Ottoman]] walizaliwa kutokana na mahusiano ya wake wa mitala bila ndoa. Katika bara la Afrika, kuanzia Misri hadi [[Afrika]] Kusini, wake wa [[Mitalojia|mitala]] wa asili ya watumwa walichangia kuzaliwa kwa [[jamii]] zenye mchanganyiko wa rangi. Hata hivyo, desturi hii ilipungua kwa kiasi kikubwa baada ya utumwa kupigwa marufuku. Katika Dola la [[Roma]] la kale, mfumo wa ''concubinatus'' ulikuwa uhusiano wa mke wa mitala wa mtu mmoja, kama mbadala wa ndoa, mara nyingi kutokana na hali ya kijamii ya chini ya [[mwanamke]]. [[Wanaume]] waliokuwa wajane au waliotalikiana mara nyingi walichukua wake wa mitala badala ya kuoa tena ili kuepuka matatizo ya mirathi. Baada ya [[Ukristo]] kushika mizizi katika [[Dola]] la [[Roma]], watawala wa [[Ukristo|Kikristo]] waliboresha hadhi ya wake wa mitala kwa kuwapa haki za umiliki wa mali na urithi ambazo hapo awali zilihifadhiwa kwa wake wa ndoa pekee.<ref>{{cite book |last1=Long |first1=Scott |title=Family, unvalued : discrimination, denial, and the fate of binational same-sex couples under U.S. law. |date=2006 |publisher=Human Rights Watch |location=New York |isbn=9781564323361 |url=https://www.hrw.org/reports/2006/us0506/10.htm#_Toc132691986 |access-date=29 November 2021}}</ref><ref>{{cite journal |last1=Halho |first1=H.R. |title=The Law of Concubinage |journal=South African Law Journal |date=1972 |volume=89 |pages=321–332}}</ref><ref>{{cite journal |last1=Soles III |first1=Donald E. |title=Truisms & Tautologies: Ambivalent Conclusions regarding Same-Sex Marriage in Chapin v. France |journal=Global Justice & Public Policy |date=2016 |volume=3 |page=149}}</ref> Katika [[Koloni|makoloni]] ya [[Ulaya]] na mashamba ya watumwa ya [[Marekani]], [[Mwanaume|wanaume]] wasio na wake na hata waliooa waliingia katika mahusiano ya muda mrefu. == Tanbihi == <references /> ==Marejeo== {{refbegin}} *{{cite journal |last=Andreeva |first=Elena |date=2007 |title=Russia and Iran in the great game: travelogues and Orientalism |journal=Routledge Studies in Middle Eastern History |volume=8 |publisher=Psychology Press |pages=162–63 |isbn=978-0415771535}} *{{cite book |last1=Bloom |first1=Jonathan |last2=Blair |first2=Sheila |title=Islam: A Thousand Years of Faith and Power |publisher=Yale University Press |year=2002 |isbn=0-300-09422-1 |url=https://archive.org/details/isbn_9780300094220}} *{{cite book |last=Broadbridge |first=Anne F. |url=https://books.google.com/books?id=RHOFDwAAQBAJ |title=Women and the Making of the Mongol Empire |year=2018 |publisher=Cambridge University Press |isbn=978-1-108-63662-9}} *{{cite encyclopedia |last=Cortese |first=Delia |editor=Natana J. DeLong-Bas |title=The Oxford Encyclopedia of Islam and Women |entry=Concubinage |publisher=[[Oxford University Press]] |year=2013}} *{{cite journal |last= Gellérfi |first= Gergő |date= 2020 |title=''Nubit amicus'': Same-Sex Weddings in Imperial Rome|journal=Graeco-Latina Brunensia |volume=25 |issue=1|pages=89–100}} * {{cite book |last=Gibbon |first=Edward |author-link=Edward Gibbon |year=1994 |title=The History of the Decline and Fall of the Roman Empire | title-link=The History of the Decline and Fall of the Roman Empire |chapter=Fall in the East | orig-date=1781 |editor=David Womersley |publisher=Penguin |isbn=978-0140433937 |chapter-url=http://www.ccel.org/ccel/gibbon/decline/files/volume2/chap46.htm#Heraclius}} *{{cite book |first1=Karen |last1=Hagemann |first2=Sonya O. |last2=Rose |first3=Stefan |last3=Dudink |editor-first1=Karen |editor-first2=Stefan |editor-first3=Sonya O. |editor-last1=Hagemann |editor-last2=Dudink |editor-last3=Rose |title=The Oxford Handbook of Gender, War, and the Western World since 1600 |publisher=[[Oxford University Press]] |year=2020 |isbn=9780199948710 |doi=10.1093/oxfordhb/9780199948710.001.0001}} *{{cite book |first=Ross |last=Hassig |date=2016 |title=Polygamy and the Rise and Demise of the Aztec Empire |url=https://archive.org/details/polygamyrisedemi0000hass |publisher=[[University of New Mexico Press]]}} *{{cite book |last=İlkkaracan |first=Pınar |title=Deconstructing sexuality in the Middle East: challenges and discourses |url=https://books.google.com/books?id=pnGwP9-FhxYC&pg=PA36 |publisher=Ashgate Publishing |year=2008 |isbn=978-0-7546-7235-7 |url-status=live |archive-url=https://web.archive.org/web/20151030194344/https://books.google.com/books?id=pnGwP9-FhxYC&pg=PA36&dq |archive-date=2015-10-30}} *{{cite book |first1=Leigh K. |last1=Jenco |first2=Murad |last2=Idris |first3=Megan C. |last3=Thomas |editor-first1=Leigh K. |editor-first2=Murad |editor-first3=Megan C. |editor-last1=Jenco |editor-last2=Idris |editor-last3=Thomas |title=The Oxford Handbook of Comparative Political Theory |pages=291–292 |publisher=[[Oxford University Press]] |date=2019 |isbn=9780190253752 |doi=10.1093/oxfordhb/9780190253752.001.0001}} * {{cite book| last = Kiefer | first= O.| title = Sexual Life in Ancient Rome | url = https://books.google.com/books?id=XXksBgAAQBAJ | date = 2012 | publisher = [[Routledge]]| isbn = 978-1-136-18198-6}} *{{cite encyclopedia |title=Historical Dictionary of Slavery and Abolition |entry=Concubines and Concubinage |first1=Martin A. |last1=Klein |page=122 |publisher=[[Rowman & Littlefield]] |year=2014 |ref={{sfnRef|Historical Dictionary of Slavery and Abolition|2014}}}} *{{cite book |title=Concubines and Courtesans: Women and slavery in Islamic history |editor=Matthew S. Gordon and Kathryn A. Hain |publisher=[[Oxford University Press]] |year=2017 |ref={{sfnRef|Concubines and Courtesans|2017}}}} *{{cite journal |title=Women and slavery |first=Gerda |last=Lerner |journal=Slavery & Abolition |volume=4 |issue=3 |date=2008 |pages=173–198 |doi=10.1080/01440398308574858}} *{{cite book |first=Michael |last=Lieb |title=Milton and the culture of violence |url=https://archive.org/details/miltoncultureofv00lieb_1 |publisher=Cornell University Press |date=1994}} * {{cite journal| last = McGinn | first = Thomas A.&nbsp;J. | date = 1991 | title = Concubinage and the ''Lex Iulia'' on Adultery| journal = [[Transactions of the American Philological Association]]| volume = 121| pages = 335–375 | doi = 10.2307/284457|jstor =284457}} *{{cite book |title=The Imperial Harem Women and Sovereignty in the Ottoman Empire |publisher=[[Oxford University Press]] |first=Leslie P. |last=Peirce |year=1993}} *{{cite encyclopedia |author-last=Nina |author-first=Kushner |editor-last=Smith |editor-first=Bonnie G. |editor-link=Bonnie G. Smith |year=2008 |title=The Oxford Encyclopedia of Women in World History |entry=Concubinage |entry-url=https://books.google.com/books?id=EFI7tr9XK6EC&pg=PA468 |url=https://books.google.com/books?id=EFI7tr9XK6EC |publisher=[[Oxford University Press|OUP]] |pages=467–72 |isbn=9780195337860 |doi=10.1093/acref/9780195148909.001.0001 |access-date=2020-09-15 |ref={{sfnRef|The Oxford Encyclopedia of Women in World History|2008}}|url-access=subscription }} *{{cite journal |last=Rawson |first=Beryl |date=1974 |title=Roman Concubinage and Other ''De Facto'' Marriages |journal=[[Transactions of the American Philological Association]] |volume=104 |pages=279–305 |doi=10.2307/2936094 |publisher=[[Johns Hopkins University Press|JHUP]] |jstor=2936094}} *{{cite encyclopedia |title=Slavery in the Modern World: A History of Political, Social, and Economic Oppression |entry=Concubines |editor-first1=Junius P. |editor-last1=Rodriguez |page=203 |publisher=[[ABC-CLIO]] |year=2011}} * {{cite journal|author1-last= Sandon | author1-first = Tatjana|author2-last= Scalso|author2-first=Luca| year = 2020| title = More Than Mistresses, Less Than Wives: The Role of Roman ''Concubinae'' in Light of Their Funerary Monuments| journal = Papers of the British School at Rome| volume = 88| pages = 151–184}} *{{cite book |last1=Sikainga |first1=Ahmad A. |title=Slaves into Workers: Emancipation and Labor in Colonial Sudan |publisher=University of Texas Press |year=1996 |isbn=0-292-77694-2 |url=https://archive.org/details/slavesintoworker0000sika}} *{{cite journal |last=Stocquart |first=Emile |translator-last=Bierkan |translator-first=Andrew T. |editor-last=Sherman |editor-first=Charles Phineas |date=March 1907 |title=Marriage in Roman law |journal=[[Yale Law Journal]] |volume=16 |issue=5 |pages=303–27 |doi=10.2307/785389 |jstor=785389 |url=https://digitalcommons.law.yale.edu/cgi/viewcontent.cgi?article=1887&context=ylj |access-date=2020-09-15}} *{{cite encyclopedia |author-last=Tran |author-first=Lisa |editor-last=Callan |editor-first=Hillary |year=2018 |title=The International Encyclopedia of Anthropology |entry=Concubinage |publisher=[[Wiley (publisher)|Wiley]] |doi=10.1002/9781118924396.wbiea1331 |s2cid=240237467 |ref={{sfnRef|The International Encyclopedia of Anthropology|1999}}}} *{{cite encyclopedia |editor-last=Tierny |editor-first=Helen |year=1999 |title=Women's Studies Encyclopedia |entry=Concubinage |url=https://books.google.com/books?id=DkPFL6XcKeQC |publisher=[[Greenwood Press]] |pages=290–91 |isbn=9780313296208 |ref={{sfnRef|Women's Studies Encyclopedia|1999}}}} *{{cite journal |last=Treggiari |first=Susan |author-link=Susan Treggiari |year=1981 |title=Contubernales |journal=[[Phoenix (classics journal)|Phoenix]] |volume=35 |issue=1 |pages=42–69 |doi=10.2307/1087137 |publisher=CAC |jstor=1087137}} * {{cite journal | last = Treggiari | first = Susan | year = 1981b | title = ''Concubinae'' | journal = [[Papers of the British School at Rome]] | volume = 49 | pages = 59–81 | doi = 10.1017/S0068246200008473 }} *{{cite book |last=Walthall |first=Annue |title=Servants of the Dynasty Palace Women in World History |publisher=[[University of California Press]] |year=2008}} *{{cite journal |last=Williams |first= Kathryn F.|year=2006 |title=Pliny and the Murder of Larcius Macedo |url=https://archive.org/details/sim_classical-journal_april-may-2006_101_4/page/409 |journal=Classical Journal |volume=101 |issue=4 |pages=409–424 }} {{refend}} {{mbegu-sheria}} [[Jamii:Jinsia]] [[Jamii:Ndoa]] [[Jamii:Feminism and Folklore 2021 in Tanzania]] 4052knwfu0t4yp6behfy8ejxvn7tlif 0 203537 1578085 1521709 2026-07-02T19:05:29Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578085 wikitext text/x-wiki {{tafsiri kompyuta}} '''Nadharia ya filamu ya kifeministi''' ni ukosoaji wa kinadharia wa filamu unaotokana na [[siasa]] za [[kifeministi]] na nadharia ya kifeministi iliyoathiriwa na wimbi la pili la ufeministi na kuletwa karibu na miaka ya [[1970]] huko Marekani. Pamoja na [[Maendeleo (Mbeya mjini)|maendeleo]] katika [[filamu]] kwa miaka mingi, nadharia ya filamu ya kifeministi imekua na kubadilika ili kuchanganua njia za sasa za [[filamu]] na pia kurudi nyuma kuchanganua filamu za [[zamani]]. Wafeministi wana mbinu nyingi za uchanganuzi wa sinema, kuhusu vipengele vya filamu vinavyochanganuliwa na misingi yao ya kinadharia.<ref>{{Rejea tovuti|url=http://www.uh.edu/~cfreelan/courses/femfilm.html|title=Feminist Film Theory|last=Freeland|first=Cynthia|date=3 October 1996|access-date=10 October 2019}}</ref><ref>Smelik, Anneke. "And The Mirror Cracked: Feminist Cinema and Film Theory."New York: St. Martin's Press, 1998. Page 7-8.</ref> == Historia == Maendeleo ya nadharia ya filamu ya kifeministi yaliathiriwa na wimbi la pili la ufeministi na masomo ya [[wanawake]] katika miaka ya [[1960]] na [[1970]]. Hapo awali, huko Marekani katika miaka ya mapema ya [[1970]], nadharia ya filamu ya [[kifeministi]] iliegemezwa zaidi kwenye nadharia ya kijamii na iliangazia kazi ya wahusika wa kike katika simulizi za filamu au aina za filamu. Nadharia ya filamu ya kifeministi, kama vile Popcorn [[Venus]]: Women, Movies, and the American Dream ya Marjorie Rosen ([[1973]]) na From Reverence to Rape: ''The Treatment of Women in Movies ya Molly Haskell'' ([[1974]]), zinachanganua njia ambazo wanawake wanaonyeshwa katika filamu, na jinsi hii inavyohusiana na muktadha wa kihistoria wa upana zaidi. Aidha, ukosoaji wa kifeministi pia unachunguza [[mitindo]] ya kawaida inayoonyeshwa katika filamu, kiwango ambacho wanawake walionyeshwa kama watendaji au wategemezi tu, na kiasi cha muda wa skrini waliopewa wanawake.<ref>{{Rejea jarida|last=Mizejewski|first=Linda|date=2019-05-14|title=Specters of Slapstick and Silent Film Comediennes by Maggie Hennefeld, and: Comic Venus: Women and Comedy in American Silent Film by Kristen Anderson Wagner (review)|journal=Journal of Cinema and Media Studies|volume=58|issue=3|pages=177–184|doi=10.1353/cj.2019.0035|s2cid=194306243 |issn=2578-4919}}</ref><ref name=":1">{{Rejea jarida|last=Schaff|first=Rachel|date=2019-08-07|title=Jane Gaines, Pink-Slipped: What Happened to Women in the Silent Film Industries?|journal=Nineteenth Century Theatre and Film|volume=46|issue=2|pages=231–233|doi=10.1177/1748372719863945|s2cid=202465564|issn=1748-3727}}</ref><ref name="0:">{{cite journal |author=Laura Mulvey |title=Visual Pleasure and Narrative Cinema |url=https://archive.org/details/sim_screen_autumn-1975_16_3/page/6 |journal=Screen |date=Autumn 1975 |volume=16 |issue=3 |pages=6–18 |doi=10.1093/screen/16.3.6}}</ref> Kinyume chake, wananadharia wa filamu huko Uingereza walijihusisha na nadharia ya ukosoaji, uchanganuzi wa kisaikolojia, semiotiki, na Marxisma. Hatimaye, mawazo haya yalipata nguvu ndani ya jumuiya ya wasomi wa Marekani katika miaka ya 1980. Uchanganuzi kwa ujumla uliangazia maana ndani ya maandishi ya filamu na jinsi maandishi hayo yanavyounda mtu anayeiangalia. Pia ulichunguza jinsi mchakato wa utengenezaji wa [[sinema]] unavyoathiri jinsi [[wanawake]] wanavyowakilishwa na kuimarisha ubaguzi wa kijinsia.<ref>{{Rejea kitabu|title=Issues in feminist film criticism|date=1990|publisher=Indiana University Press|others=Erens, Patricia, 1938-|isbn=978-0253206107|location=Bloomington|oclc=21118050|url-access=registration|url=https://archive.org/details/issuesinfeminist00eren}}</ref> Mwanadharia wa filamu ya kifeministi wa Uingereza, Laura Mulvey, anayejulikana zaidi kwa insha yake, "Visual Pleasure and Narrative Cinema", iliyoandikwa mwaka [[1973]] na kuchapishwa mwaka [[1975]] katika jarida la nadharia ya filamu la Uingereza lenye ushawishi, Screen, aliathiriwa na nadharia za Sigmund Freud na Jacques Lacan. "Visual Pleasure" ni moja ya insha za kwanza za msingi ambazo zilisaidia kubadilisha mwelekeo wa nadharia ya filamu kuelekea mfumo wa uchanganuzi wa kisaikolojia. Kabla ya Mulvey, wananadharia wa filamu kama Jean-Louis Baudry na Christian Metz walitumia mawazo ya uchanganuzi wa kisaikolojia katika maelezo yao ya kinadharia ya sinema. Hata hivyo, mchango wa Mulvey ulianzisha makutano ya nadharia ya filamu, uchanganuzi wa kisaikolojia na ufeministi.<ref>{{Citation|last1=Hastie|first1=Amelie|title=(Re)Inventing Camera Obscura|date=2015|work=Feminisms|pages=169–184|editor-last=Mulvey|editor-first=Laura|series=Diversity, Difference and Multiplicity in Contemporary Film Cultures|publisher=Amsterdam University Press|isbn=9789089646767|last2=Joyrich|first2=Lynne|last3=White|first3=Patricia|last4=Willis|first4=Sharon|editor2-last=Rogers|editor2-first=Anna Backman|jstor=j.ctt16d6996.19}}</ref> Mnamo [[1976]], jarida la Camera Obscura lilichapishwa na wanafunzi wa kwanza wa shahada ya uzamili Janet Bergstrom, Sandy Flitterman, Elisabeth Lyon, na Constance Penley. Walijadili jinsi wanawake walivyonyeshwa katika [[filamu]], lakini waliotengwa katika mchakato wa maendeleo. Camera Obscura bado linachapishwa hadi leo na Duke University Press na limehamia kutoka nadharia ya filamu tu hadi masomo ya [[Vyombo vya habari|vyombo vya habari.]] Ushawishi mwingine muhimu unatoka kwenye insha ya Metz The Imaginary Signifier, "Identification, Mirror," ambapo anasema kuwa kutazama filamu kunawezekana tu kupitia scopophilia (raha ya kutazama, inayohusiana na voyeurism), ambayo inaonyeshwa vyema katika filamu za kimya. Pia, kulingana na Cynthia A.<ref>Griselda Pollock, ''Encounters in the Virtual Feminist Museum: Time, Space and the Archive''. Rutledge, 2007.</ref> Freeland katika "''Feminist Frameworks for Horror Films,''" masomo ya [[kifeministi]] ya filamu za kutisha yameangazia saikodinamikia ambapo maslahi ya msingi ni "juu ya nia na maslahi ya watazamaji katika kutazama filamu za kutisha".<ref>Braudy and Cohen, ''Film Theory and Criticism'', Sixth Edition, Oxford University Press, 2004, page 827</ref><ref>Bracha L. Ettinger, ''The Matrixial Borderspace'', University of Minnesota Press, 2006</ref> Kuanzia mwanzoni mwa miaka ya [[1980]], nadharia ya filamu ya kifeministi ilianza kuangalia filamu kupitia lenzi ya makutano zaidi. Jarida la filamu Jump Cut lilichapisha toleo maalum lililopewa jina "''Lesbians and Film''" mwaka [[1981]] ambalo lilichunguza ukosefu wa utambulisho wa wasagaji katika filamu. Insha ya Jane Gaines "''White Privilege and Looking Relations: Race and Gender in Feminist Film Theory''" ilichunguza kufutwa kwa wanawake weusi katika sinema na watengenezaji filamu wanaume weupe. Wakati Lola Young anasema kuwa watengenezaji filamu wa rangi zote wanashindwa kuvunja mbali na matumizi ya mitindo iliyochoka wakati wa kuonyesha wanawake weusi. Wanadharia wengine waliounda kuhusu nadharia ya filamu ya kifeministi na rangi ni pamoja na bell hooks na Michele Wallace.<ref>Braudy and Cohen, ''Film Theory and Criticism'', Sixth Edition, Oxford University Press, 2004</ref><ref>James Batcho, ''Terrence Malick's Unseeing Cinema. Memory, Time and Audibility''. Palgrave Macmillan.</ref> Kuanzia [[1985]] na kuendelea, nadharia ya Matrixial ya [[msanii]] na mchanganuzi wa kisaikolojia Bracha L. Ettinger ilileta mapinduzi katika nadharia ya [[filamu]] ya [[kifeministi]]. Dhana yake, kutoka kitabu chake, The Matrixial Gaze, imeanzisha mtazamo wa kike na imeelezea tofauti zake na mtazamo wa kifaliki na uhusiano wake na sifa za kike na za [[kimama]] na uwezekano wa "''kuibuka pamoja''", ikitoa ukosoaji wa uchanganuzi wa kisaikolojia wa Sigmund Freud na Jacques Lacan, unatumika sana katika uchanganuzi wa [[filamu]], na wakurugenzi wa kike, kama Chantal Akerman, pamoja na wakurugenzi wanaume, kama Pedro Almodovar. Mtazamo wa matrixial unampa mwanamke nafasi ya kuwa [[Mhusika (fasihi)|mhusika]], sio kitu, cha mtazamo, huku ukivunja [[muundo]] wa mhusika yenyewe, na unatoa muda wa mpaka, nafasi ya mpaka na uwezekano wa huruma na ushuhuda. Mawazo ya Ettinger yanaelezea uhusiano kati ya aesthetics, [[maadili]] na [[Kiwewe sugu cha ubongo cha Encephalopathy|kiwewe]].<ref>Smelik, Anneke. "And The Mirror Cracked: Feminist Cinema and Film Theory."New York: St. Martin's Press, 1998. Page 20-23.</ref><ref>Griselda Pollock, ''After-effects - After-images''. Manchester University Press, 2013</ref><ref>Maggie Humm, ''Feminism and Film''. Edinburgh University Press, 1997</ref><ref>Lucia Nagib and Anne Jerslev (ends.), ''Impure Cinema''. London: I.B.Tauris.</ref> == Marejeo == {{marejeo}} [[Jamii:Feminism and Folklore 2025 in Tanzania]] 7o9c9s0qqq4ly3z3j0a7nvivitc08of 0 204651 1578114 1523853 2026-07-02T20:24:40Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578114 wikitext text/x-wiki {{tafsiri kompyuta}} '''Uhusiano wa Kimapenzi wa Kimapenzi''' ni tabia ya kushiriki katika shughuli za ngono mara kwa mara na wapenzi tofauti au kuwa na uchaguzi usio na upendeleo wa wapenzi wa kimapenzi. Neno hili linaweza kubeba hukumu ya maadili. Mfano wa kawaida wa tabia inayochukuliwa kama ya promisiki na tamaduni nyingi ni "usiku mmoja," na mara nyingi hutumika na watafiti kama kipimo cha promisiki.<ref>{{cite web|title=Promiscuous - definition of promiscuous by the Free Online Dictionary|url=http://www.thefreedictionary.com/promiscuous|publisher=The Free Dictionary|access-date=21 September 2013}}</ref> Tabia za ngono zinazochukuliwa kama promisiki hutofautiana kati ya tamaduni, kama vile ni kiwango cha promisiki. Viwango tofauti mara nyingi hutumika kwa jinsia tofauti na sheria za kiraia. Wanaharakati wa haki za wanawake wamekuwa wakihoji kwa muda mrefu kuwa kuna utofauti mkubwa kati ya jinsi wanaume na wanawake wanavyohukumiwa kwa promisiki. Kihistoria, michoro ya wanawake promisiki mara nyingi imekuwa ya dhihaka, kama vile "kahaba" au "malaya", wakati michoro ya wanaume imekuwa ya aina mbalimbali, wengine wakionyesha idhini, kama vile "mwanaume mvulana" au "mchezaji", wakati wengine wanadhihirisha upotovu wa kijamii, kama vile "mwanaume mzinzi" au "mtaka mke wa nje". Utafiti wa kisayansi uliochapishwa mwaka wa 2005 uligundua kwamba wanaume na wanawake promisiki wote wanakutana na hukumu ya kudhalilishwa.<ref>{{cite web|title=UK's most promiscuous city in 'one night stand' poll revealed|url=http://metro.co.uk/2014/01/08/liverpool-named-uks-most-promiscuous-city-in-one-night-stand-poll-4254176/|website=Metro.co.uk|publisher=Associated Newspapers Limited|date=2014-01-08}}</ref> Promisiki ni kawaida katika spishi nyingi za wanyama. Baadhi ya spishi zina mifumo ya kuzaliana ya promisiki, kuanzia polyandry na polygyny hadi mifumo ya kuzaliana bila uhusiano thabiti ambapo kuzaliana kati ya binafsi wawili ni tukio la mara moja. Spishi nyingi huunda viungo thabiti vya kushirikiana, lakini bado huzaa na wanyama wengine nje ya wenzi wao. Katika biolojia, matukio ya promisiki katika spishi zinazounda viungo thabiti vya kushirikiana kwa kawaida huitwa "mapenzi ya nje ya wenzi".<ref>{{cite journal|last1=Marks|first1=Michael|last2=Fraley|first2=R.|year=2005|title=The Sexual Double Standard: Fact or Fiction?|url=https://archive.org/details/sim_sex-roles_2005-02_52_3-4/page/175|journal=[[Sex Roles (journal)|Sex Roles]]|volume=52|issue=3–4|pages=175–186|doi=10.1007/s11199-005-1293-5|s2cid=13018834}}</ref> == Motisha == Kukadiria kwa usahihi tabia za ngono za watu ni vigumu, kwani kuna motisha kubwa za kijamii na kibinafsi zinazoathiri, kulingana na adhabu za kijamii na makatazo, ili ama kupunguza au kupanua shughuli za ngono zinazoripotiwa. Majaribio ya Marekani ya mwaka 1978 na 1982 yaligundua kuwa idadi kubwa ya wanaume walikuwa tayari kufanya ngono na wanawake wasio wajua, ambao walikuwa na mvuto wa wastani, waliowalenga. Kwa upande mwingine, hakuna mwanamke aliyeafiki mapendekezo kama hayo kutoka kwa wanaume wa mvuto wa wastani. Wakati wanaume kwa ujumla walikuwa na raha na maombi hayo, bila kujali ni jeuri yao, wanawake walijibu kwa mshangao na kudharauliwa.<ref>{{cite journal|last1=Hull|first1=J. W.|last2=Clarkin|first2=J. F.|last3=Yeomans|first3=F.|year=1993|title=Borderline personality disorder and impulsive sexual behavior|url=https://archive.org/details/sim_psychiatric-services_1993-10_44_10/page/1000|journal=Psychiatric Services|volume=44|issue=10|pages=1000–1001|doi=10.1176/ps.44.10.1000|pmid=8225264}}</ref> [[Faili:Grand_Duchess_Catherine_Alexeevna_by_anonymous_after_Rotari_(18th_c,_Russian_museum).jpg|thumb|Empress Catherine the Great, mtu muhimu wakati wa Mwangaza, anakumbukwa kwa upotovu wake wa ngono.]] Idadi ya wapenzi wa kimapenzi ambao watu wamekuwa nao katika maisha yao hutofautiana sana ndani ya jamii. Tunaona idadi kubwa ya watu ambao wanajivunia na jinsia zao katika ulimwengu wa kisasa. Utafiti wa kitaifa wa mwaka 2007 nchini Marekani uligundua kuwa idadi ya wapenzi wa kimapenzi wa wanawake inaripotiwa kuwa saba na idadi ya wapenzi wa wanaume inaripotiwa kuwa wanne. Wanaume huenda waliongeza idadi ya wapenzi wao waliyoripotiwa, wanawake waliripoti idadi ndogo kuliko idadi halisi, au wachache kati ya wanawake walikuwa na idadi kubwa ya wapenzi kuliko wanawake wengi wengine, hivyo kutoa wastani ambao ulikuwa juu ya wastani wa idadi. Karibu 29% ya wanaume na 9% ya wanawake waliripoti kuwa na zaidi ya wapenzi 15 katika maisha yao. Utafiti wa kusambaa kwa maambukizi ya zinaa umeonyesha kuwa asilimia ndogo ya watu waliofanyiwa utafiti wana wapenzi wengi zaidi kuliko mwanaume au mwanamke wa wastani, na idadi ndogo ya watu wana wapenzi wachache kuliko wastani wa takwimu. Swali muhimu katika utafiti wa epidemiolojia ya maambukizi ya zinaa ni ikiwa vikundi hivi huvua kwa utaratibu na wapenzi wa kimapenzi kutoka kwa watu wa jamii nzima au ndani ya vikundi vya kijamii.<ref>{{cite web|title=Liverpool named UK's most promiscuous city|url=http://metro.co.uk/2014/01/08/liverpool-named-uks-most-promiscuous-city-in-one-night-stand-poll-4254176/|website=themetro.co.uk|publisher=Mark Molloy|date=2014-01-08}}</ref> Uchunguzi wa kimataifa wa mwaka 2006 ulioangalia data kutoka nchi 59 duniani kote, uligundua kuwa hakuna uhusiano kati ya tabia za ngono za kanda, kama vile idadi ya wapenzi, na hali ya afya ya ngono. Mambo muhimu zaidi yanayohusiana na hali ya afya ya ngono ni mambo ya kiuchumi kama vile umaskini na uhamaji. Utafiti mwingine umeonyesha kuwa watu wanaoweka wapenzi wa kimapenzi wengi wa kawaida wana uwezekano mkubwa wa kugundulika kuwa na maambukizi ya zinaa.<ref name="Waite">{{cite news|url=http://women.timesonline.co.uk/tol/life_and_style/women/relationships/article5257166.ece|archive-url=https://web.archive.org/web/20091008003832/http://women.timesonline.co.uk/tol/life_and_style/women/relationships/article5257166.ece|url-status=dead|archive-date=October 8, 2009|work=The Times|location=London|title=Britain on top in casual sex league|first=Roger|last=Waite|date=2008-11-30|access-date=2010-05-22}}</ref><ref name="telegraph.co.uk">{{cite news|url=https://www.telegraph.co.uk/health/healthnews/3536598/Britain-is-among-casual-sex-capitals-of-the-Western-world-research-claims.html|archive-url=https://web.archive.org/web/20081204030604/http://www.telegraph.co.uk/health/healthnews/3536598/Britain-is-among-casual-sex-capitals-of-the-Western-world-research-claims.html|url-status=dead|archive-date=2008-12-04|work=[[The Daily Telegraph]]|location=London|title=Britain is among casual sex capitals of the Western world, research claims|first1=Martin|last1=Beckford|first2=Alastair|last2=Jamieson|date=2008-11-30|access-date=2010-05-22}}</ref><ref name="upi.com">{{cite web|url=http://www.upi.com/Health_News/2008/11/30/British_top_promiscuity_study/UPI-98281228072500/|title=British top promiscuity study|work=UPI}}</ref> Promisiki kali na ya ghafla, pamoja na hamu ya kushiriki ngono kwa siri na watu walio katika uhusiano, ni dalili za kawaida za tatizo la utu wa mpakani, tatizo la utu wa kihisia, tatizo la utu wa kijivuno, na tatizo la utu wa kupinga sheria, lakini watu wengi wanaofanya promisiki hawana matatizo haya. '''Utafiti wa Kimataifa''' Katika mwaka 2008, utafiti wa chuo kikuu cha Marekani kuhusu promisiki ya kimataifa ulipata kwamba Wafinlandi walikuwa na idadi kubwa zaidi ya wapenzi wa ngono katika ulimwengu wa viwanda, na Wabritania walikuwa na idadi kubwa zaidi kati ya mataifa makubwa ya viwanda vya magharibi. Utafiti huo ulipima "usiku mmoja", mitazamo ya ngono ya kawaida, na idadi ya wapenzi wa ngono. Utafiti wa mwaka 2014 wa kitaifa nchini Uingereza ulitaja Liverpool kama mji wa kimapenzi zaidi nchini humo.<ref>{{Rejea tovuti|url=https://onlinedoctor.superdrug.com/whats-your-number/|title=What's Your Number?|website=Onlinedoctor.superdrug.com}}</ref><ref>{{Rejea tovuti|url=https://www.mindbodygreen.com/articles/the-ideal-number-of-sexual-partners-for-men-women|title=The verdict is in: This is the ideal number of sexual partners to have in your lifetime|website=Mindbodygreen.com|date=2 September 2017}}</ref> Nafasi ya Uingereza kwenye orodha ya kimataifa "inaweza kuhusishwa na kukubalika kwa kijamii kwa promisiki kati ya wanawake na wanaume". Nafasi ya Uingereza ilielezewa na mambo kama vile kupungua kwa wasiwasi wa kidini kuhusu ngono za nje ya ndoa, ukuaji wa mishahara sawa na haki sawa kwa wanawake, na utamaduni maarufu wa ngono. Nchi kumi bora za OECD zenye idadi ya watu zaidi ya milioni 10 kwenye orodha ya promisiki, kwa mpangilio wa kushuka, zilikuwa Uingereza, Ujerumani, Uholanzi, Czechia, Australia, Marekani, Ufaransa, Uturuki, Mexico, na Kanada. Utafiti wa mwaka 2017 na Superdrug ulionyesha kwamba Uingereza ilikuwa nchi na wapenzi wengi zaidi wa ngono, kwa wastani wa 7, wakati Austria ilikuwa na wastani wa 6.5. Utafiti wa Trojan Sex Life Survey wa mwaka 2012 uligundua kuwa wanaume wa Kiafrika-Amerika waliripoti wastani wa wapenzi 38 wa ngono katika maisha yao. Utafiti wa Durex uliofadhiliwa na mtengenezaji wa kondomu, uliofanywa mwaka 2006 na kuchapishwa mwaka 2009, ulipima promisiki kwa jumla ya idadi ya wapenzi wa ngono. Utafiti huo ulionyesha kuwa wanaume wa Austria walikuwa na idadi kubwa zaidi ya wapenzi wa ngono duniani, kwa wastani wa wapenzi 29.3. Wanawake wa New Zealand walikuwa na idadi kubwa zaidi ya wapenzi wa ngono duniani, kwa wastani wa wapenzi 20.4. Katika nchi zote zilizochunguzwa, isipokuwa New Zealand, wanaume waliripoti wapenzi zaidi wa ngono kuliko wanawake. Moja ya hakiki ilionyesha kuwa watu kutoka nchi zilizoendelea za Magharibi walikuwa na wapenzi wengi zaidi wa ngono kuliko watu kutoka nchi zinazoendelea kwa jumla, huku kiwango cha maambukizi ya zinaa kikikuwa juu katika nchi zinazoendelea.<ref name=":6">{{Rejea kitabu|url=https://www.researchgate.net/publication/281747420|title=The Man Who Would Be Queen|last=Bailey|first=J. Michael|publisher=Joseph Henry Press|year=2003|isbn=978-0-309-08418-5|pages=87|format=PDF}}</ref> == Marejeo == {{Reflist|30em}} [[Jamii:Feminism and Folklore 2025 in Tanzania]] 7p0w43j7de75v8azf9hcje45x9v3sod 0 204699 1578231 1464681 2026-07-03T04:46:18Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578231 wikitext text/x-wiki {{tafsiri kompyuta}} '''Harriet Martineau''' ([[12 Juni]] [[1802]] – [[27 Juni]] [[1876]]) alikuwa mwananadharia wa kijamii wa Kiingereza. Aliandika kutoka kwa mtazamo wa kisosholojia, wa kina, wa kidini na wa kike, alitafsiri [[kazi]] za Auguste Comte, na, jambo la nadra kwa mwandishi mwanamke wa wakati huo, alipata mapato ya kutosha kujikimu. Malkia Victoria [[mchanga]] alifurahia kazi yake na akamwalika kwenye taji lake la [[1838]]. Martineau alishauri kuzingatia mambo yote ya [[jamii]], ikiwa ni pamoja na jukumu la nyumba katika maisha ya nyumbani pamoja na taasisi za msingi za kisiasa, kidini, na kijamii. Mwandishi wa riwaya Margaret Oliphant alimuita "mhadhiri wa kuzaliwa na mwanasiasa... asiyeathiriwa sana na jinsia yake kuliko labda mwingine yeyote, mwanamume au mwanamke, wa kizazi chake."<ref>{{cite web |title=Harriet Martineau |url=https://www.npg.org.uk/collections/search/portraitExtended/mw04251/Harriet-Martineau |website=National Portrait Gallery, London |publisher=NPG (London) |access-date=19 April 2023 |quote=This portrait appeared on the art market in 1885 from an unknown source (it had not come from the family). According to family letters, it was painted by Evans during 1833 and 1834, 'as a labour of love', so it may have been kept by the artist. It was first offered, as a work by Lawrence, to Sir Thomas Martineau}}</ref> Kujitolea kwake kwa maisha yote kwa [[harakati]] ya kumudu futa ukoloni kumesababisha umaarufu na mafanikio ya Martineau kusomwa ulimwenguni kote, hasa katika [[taasisi]] za elimu ya juu za Marekani kama Chuo Kikuu cha Northwestern. Wakati wa kufunua sanamu ya Martineau mnamo Desemba [[1883]] katika Old South Meeting House huko [[Boston, Massachusetts|Boston]], Wendell Phillips alimtaja kama "mudu futa ukoloni mkuu wa Marekani." Sanamu ya Martineau ilitolewa kwa Chuo cha Wellesley mnamo [[1886]].<ref name="BirminghamLive">{{cite news |last1=Perrin |first1=B. |title=Kate Middleton 'is a Brummie' claims history teacher ahead of Royal visit to city |url=https://www.birminghammail.co.uk/news/midlands-news/kate-middleton-is-brummie-claims-26722953 |access-date=24 April 2023 |publisher=BirminghamLive |date=18 April 2023 |quote=Mr Reed told BirminghamLive: "Kate's great great great great great aunt Harriet Martineau who died in 1876 – who is famous as the 'greatest American abolitionist' – is buried in the Jewellery Quarter at Key Hill cemetery. ...Kate and William will be visiting the Jewellery Quarter this Thursday, April 20.}}</ref> Alizaliwa Norwich, England, Harriet Martineau alikuwa wa sita kati ya watoto wanane wa Thomas, mtengenezaji wa nguo. Alihudumu kama shemasi wa Octagon Chapel, Norwich kutoka [[1797]]. [[Mama]] yake, Elizabeth (née Rankin), alikuwa binti wa mmudu fua sukari na mbuni. Ndugu zake watano waliomudu zidi Harriet walijumuisha dada wawili na kaka watatu. Kwa mpangilio wa umri majina yao yalikuwa, Elizabeth, Thomas, Henry, Robert na Rachel Ann. Ndugu zake wawili wadogo wa Harriet walikuwa James na wa mwisho kati ya wale wanane, Ellen. Familia ya Martineau ilikuwa ya asili ya Kihugenoti ya [[Kifaransa]] na ilikiri maoni ya Kiunitariani. Wajomba zake walijumuisha daktari wa upasuaji Philip Meadows Martineau ([[1752]]–[[1829]]), ambaye alikuwa amefurahia kumtembelea katika mali yake ya karibu, Bracondale Lodge, na mfanyabiashara na msaidizi Peter Finch Martineau. Martineau alikuwa wa karibu zaidi na kaka yake James, ambaye alikua mwanafalsafa na kasisi katika mila ya Wapingaji wa Kiingereza. Kulingana na mwandishi Diana Postlethwaite, uhusiano wa Harriet na mama yake ulikuwa wa mkazo na ukosefu wa upendo, ambao ulichangia maoni yaliyoelezwa katika maandishi yake ya baadaye. Martineau alidai mama yake alimudu acha kwa mlezi wa maziwa.<ref name="Postlethwaite 1989">{{cite journal |last=Postlethwaite |first=Diana |title=Mothering and Mesmerism in the Life of Harriet Martineau |url=https://archive.org/details/sim_signs_spring-1989_14_3/page/583 |journal=Signs |volume=14 |issue=3 |date=Spring 1989 |pages=583–609 |publisher=University of Chicago Press |jstor=3174403|doi=10.1086/494525 |s2cid=143910920}}</ref> Utoto wa Harriet ulikuwa tofauti kabisa ikilinganishwa na mtoto yeyote wa kawaida. Familia yake ilikuwa na hali ya kifedha ya starehe na walikuwa [[marafiki]] wa karibu na familia ya Gurney ya Earlham Hall, Norfolk. Baba ya Harriet, Thomas, alimiliki ukodishaji wa nyumba ya Gurney, Gurney Court, mahali pa kuzaliwa kwa Harriet. Utajiri wa familia ulibaki hadi karibu [[1825]]–26 wakati soko la hisa na mfumo wa [[benki]] ulipoporomoka. Kama ilivyotajwa hapo awali uhusiano wa Harriet na mama yake ulikuwa wa uhasama tangu mapema. Ilikuwa ni ishara ya jadi kwa mama kuajiri walezi wa maziwa kwa watoto wao, hasa ikiwa hawangeweza kuwanyonyesha watoto wao wenyewe. Hata hivyo mlezi wa maziwa mahususi ambaye mama ya Harriet alikuwa ameajiri hakuweza kutoa kiasi cha kutosha cha [[maziwa]] kwa [[mtoto]] mchanga. Hili lilimudu acha Harriet akiwa na njaa kwa wiki chache za kwanza za maisha yake, ambayo ndiyo Bi. Martineau alihusisha magonjwa yote ya baadaye ya Harriet.<ref>{{cite book |last=Martineau |first=Harriet |title=Harriet Martineau's Autobiography |url=https://books.google.com/books?id=z3_fRgeg_-UC&pg=PA81 |volume=3 |year=1877 |publisher=Cambridge University Press |access-date=10 February 2013 |quote=How delighted the Princess Victoria was with my 'Series' |pages=79–80 |isbn=9781108022583}}</ref><ref>{{cite news |last=Wilson |first=Christopher |title=The benefits of a feminist in the family |url=https://www.telegraph.co.uk/news/uknews/kate-middleton/8374204/The-benefits-of-a-feminist-in-the-family.html |newspaper=[[Daily Telegraph|The Telegraph]] |date=6 March 2011 |access-date=10 February 2013}}</ref> Mawazo ya Harriet juu ya maisha ya nyumbani na "''ufakulti wa asili wa ukaazi wa nyumbani,''" kama ilivyoelezwa katika kitabu chake "''Household Education''" ([[1848]]), yalitokana na ukosefu wake wa malezi alipokuwa akikua. Iligundulika kuwa upendo ulioonyeshwa kwa Harriet na mama yake ulikuwa wa nadra sana. Kwa hakika, kumekuwa na matokeo ambayo yalipendekeza kwamba Harriet alikuwa amewazia malaika wakimudu chukua, ambayo ilifikiriwa kuashiria tamaa yake ya kupata njia ya kutoroka kutoka kwa utawala wa [[mama]] yake kupitia kujiua.<ref>{{cite book |last1=Voelkner |first1=K. |title=Introduction to Harriet Martineau: A Global Anthology of Women's Resistance from 600 B.C.E. to the Present |year=1997 |pages=385–386 |publisher=Northwestern University |url=https://www.scholars.northwestern.edu/en/publications/introduction-to-harriet-martineau-a-global-anthology-of-womens-re |access-date=3 February 2021}}</ref><ref>{{cite news |last1=McCrum |first1=R.|author-link=Robert McCrum |title=The 100 best nonfiction books: No 67 – Household Education by Harriet Martineau (1848) |url=https://www.theguardian.com/books/2017/may/15/100-best-nonfiction-books-67-household-education-harriet-martineau |access-date=3 February 2020 |date=15 May 2017 |work=The Guardian |quote=...contemporary success, and short-term celebrity...she is a pioneer sociologist both in her own right as the author of books such as Society in America (1837)...}}</ref><ref>{{cite book |last1=Cosgrove |first1=C. |title=Fortune and Faith in Old Chicago: A Dual Biography of Mayor |year=2020 |page=179 |publisher=SIU Press |isbn=9780809337941 |url=https://books.google.com/books?id=X6nSDwAAQBAJ&pg=PA179 |access-date=7 February 2021 |quote=Other antislavery activists belonging to the circle of Chicago and Evanston Methodists included Northwestern University founder John Evans. Evans was an organizer of the Republican Party in Illinois, an opponent of the Fugitive Slave ...}}</ref><ref>{{cite book |last1=Phillips |first1=W. |title=Speeches, Lectures, and Letters of Wendell Phillips – Volume 2 |year=1891 |publisher=Lee and Shepherd |page=476 |url=https://books.google.com/books?id=1A9OAQAAMAAJ&pg=PA475 |access-date=19 April 2023 |quote=[December 26, 1883 – Old South Meeting House in Boston]: Americans, I ask you to welcome to Boston this statue of Harriet Martineau, because she was the greatest American abolitionist.}}</ref><ref>{{cite web |title=Harriet Martineau Statue, Wellesley College |year=1883 |url=http://omeka.wellesley.edu/annewhitney/items/show/63 |publisher=Wellesley College |access-date=19 April 2023 |archive-date=2024-07-24 |archive-url=https://web.archive.org/web/20240724065930/http://omeka.wellesley.edu/annewhitney/items/show/63 |url-status=dead }}</ref><ref name="spartacus-educational.com">{{cite web |title=Harriet Martineau |url=https://spartacus-educational.com/Wmartineau.htm |access-date=7 August 2019 |website=Spartacus Educational}}</ref><ref>{{cite book |last1=Martineau |first1=Harriet |title=Autobiography |url=https://archive.org/details/autobiography0000mart |url-access=registration |publisher=Broadview Press |year=2007 |page=[https://archive.org/details/autobiography0000mart/page/49 49]|isbn=9781551115559 |editor-first=Linda&nbsp;H. |editor-last=Peterson |access-date=29 September 2013}}</ref><ref>{{cite journal |last=Ronalds |first=B.&nbsp;F. |date=February 2018 |title=Peter Finch Martineau and his Son|journal=The Martineau Society Newsletter |volume=41 |pages=10–19}}</ref><ref>{{cite book |last1=Hanna |first1=W. |title=Memoirs of the Life and Writings of Thomas Chalmers |date=1852 |page=407 |url=https://books.google.com/books?id=V9s5AAAAcAAJ&dq=thomas+Martineau+Gurney+family+norfolk&pg=PA407 |access-date=21 July 2023 |quote=MY DEAR GRACE, -Rode to Norwich with Mr. Gurney and Mr. F. Cunningham. Called on Mrs. Martineau, mother to the celebrated authoress.}}</ref><ref>{{cite web |last1=Farrant |first1=A. |title=Amelia Opie and the Martineaus |url=https://martineausociety.co.uk/wp-content/uploads/2018/09/MS-Newsletter-37-Sept-2015-Final.pdf |publisher=Martineau Society |access-date=21 July 2023 |quote=Harriet was born in Gurney Court in Magdalen Street, Norwich, in June 1802. It has a central block with two side wings and it takes its name from John Gurney, a wool merchant, who bought the property in 1754.}}</ref><ref>{{cite web |last1=O'Malley |first1=I. |title=Florence Nightingale, 1820–1856 : a study of her life down to the end of the Crimean war |url=https://archive.org/stream/florencenighting00omal/florencenighting00omal_djvu.txt |access-date=10 September 2019 |quote=Hilary was at a school kept by Miss Rachael Martineau, sister of Harriet.}}</ref><ref>{{cite book |last1=Cromwell |first1=J. |title=Florence Nightingale – Feminist |date=15 March 2013 |url=https://books.google.com/books?id=7SEiqxGoxmMC&q=hilary+bonham+carter++++academy&pg=PA37 |publisher=McFarland, 25 February 2013 |access-date=10 September 2019 |page=37 |isbn=9780786470921 |quote=....Unitarian Academy....}}</ref> == Marejeo == <references />{{Mbegu-mwandishi}} [[Jamii:Waliozaliwa 1802]] [[Jamii:Waliofariki 1876]] [[Jamii:waandishi wa Uingereza]] [[Jamii:Feminism and Folklore 2025 in Tanzania]] 8j0yfk0ktwjjz1b7op7x1c1k6b73swg 0 204832 1578140 1526931 2026-07-02T21:46:23Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578140 wikitext text/x-wiki {{tafsiri kompyuta}} '''Teresa de Lauretis''' (Kiitalia: [teˈrɛːza de lauˈrɛːtis]; alizaliwa [[1938]] huko Bologna) ni [[mwandishi]] wa Italia na Profesa Mashuhuri Emerita wa Historia ya Fahamu katika Chuo Kikuu cha California, Santa Cruz. Maeneo yake ya kupendeza ni pamoja na semiotiki, uchanganuzi wa kisaikolojia, nadharia ya [[filamu]], nadharia ya fasihi, ufeministi, masomo ya [[wanawake]], masomo ya wasagaji na queer. Pia ameandika juu ya hadithi za sayansi. Anaweza kuzungumza Kiingereza na Kiitaliano kwa ufasaha, na anaandika katika lugha zote mbili. Zaidi ya hayo, [[kazi]] yake imetafsiriwa katika lugha nyingine kumi na sita.<ref>{{cite journal|last=Halperin|first=David |title=The normalizing of queer theory|url=https://archive.org/details/journal-of-homosexuality_2003_45_2-4/page/343|journal=Journal of Homosexuality|volume=45|year=2003|issue=2–4 |page=343|location=Binghamton, N.Y.|publisher=Haworth Press|issn=0091-8369|oclc=948835311|doi=10.1300/j082v45n02_17 |pmid=14651188 |s2cid=37469852 }}</ref><ref name=":0">{{Rejea jarida |last=Miller |first=Jennifer |title=Chapter 1: Thirty Years of Queer Theory |url=https://milnepublishing.geneseo.edu/introlgbtqstudies/chapter/thirty-years-of-queer-theory/ |language=en}}</ref><ref name=honors>{{cite web | title = Teresa De Lauretis | url = https://humanities.ucsc.edu/about/singleton.php?&singleton=true&cruz_id=tdl | publisher = Regents of the University of California | accessdate = 2017-06-05 | archive-date = 2016-12-12 | archive-url = https://web.archive.org/web/20161212223928/http://humanities.ucsc.edu/about/singleton.php?&singleton=true&cruz_id=tdl | url-status = dead }}</ref><ref name=choicemag>{{cite book| title = Awards|publisher=WorldCat| oclc = 474185039}}</ref> De Lauretis alipokea udaktari wake katika Lugha za Kisasa na Fasihi kutoka Chuo Kikuu cha Bocconi huko Milan kabla ya kuja [[Marekani]]. Alijiunga na Historia ya Fahamu na Hayden White, Donna Haraway, Fredric Jameson na Angela Davis. Ameshikilia Uprofesa wa Kutembelea katika vyuo vikuu duniani kote ikiwa ni pamoja na zile za [[Kanada]], [[Ujerumani]], [[Italia]], [[Uswidi]], [[Austria]], [[Argentina]], [[Chile]], [[Ufaransa]], [[Uhispania]], [[Hungaria]], [[Kroatia]], [[Mexico]] na [[Uholanzi]]. Kwa sasa anaishi San Francisco, CA, lakini mara nyingi hutumia muda huko Italia na Uholanzi.<ref>{{cite book | title = Freud's drive : psychoanalysis, literature and film | url = https://archive.org/details/freudsdrivepsych0000dela |location=Basingstoke|publisher=Palgrave Macmillan|year=2008|series=Language, discourse, society|isbn=9780230524781|oclc=474185039}}</ref><ref>{{cite book | title = Figures of resistance : essays in feminist theory |editor-last=De Lauretis|editor-first=Teresa|others=Patricia White (introduction)|location=Urbana |publisher=University of Illinois Press|isbn=9780252031977|oclc=174099974| year=2007}}</ref><ref>{{cite book| title = Technologies of gender : essays on theory, film and fiction | url = https://archive.org/details/technologiesofge0000dela |year=1987|location=Bloomington|publisher=Indiana University Press |isbn=9780253358530|oclc=801874505 }}</ref><ref>{{cite book|title=The practice of love : lesbian sexuality and perverse desire|year=1994|url=https://archive.org/details/practiceoflovele00dela|location=Bloomington|publisher=Indiana University Press|isbn=9780253208781|oclc=422843489|access-date=2017-06-06|url-access=registration}}</ref> == Nadharia == Akaunti ya De Lauretis ya utambulisho kama bidhaa ya "kuwa chini ya semiosis" (yaani, kufanya maana na kufanywa na hizo) inasaidia kutatua na kushinda mvutano wa kinadharia kati ya hatua ya [[binadamu]] (wakala) na muundo. Anatumia usomaji wa Umberto Eco wa C.S. Peirce ili kuanzisha dhana yake ya semiotiki ya uzoefu. Anarudisha umudu wa mwili katika mazungumzo juu ya uundaji wa utambulisho ambao umechukuliwa zaidi kwa maneno ya lugha. Semiotiki yake sio tu semiotiki ya lugha lakini pia semiotiki ya picha za kuona na mazoea yasiyo ya maneno. "Tabia" yake ya (Peircean) au "mabadiliko ya tabia" mara nyingi hulinganishwa na dhana ya Bourdieu ya habitus. Uchambuzi wa Michel Foucault wa mwili haukujumuisha uzingatiaji wa umudu wa mwili wa kike ambao wafeministi wengi wamekosoa. Ili kumudu ongeza kushindwa huko, jinsia inapaswa kuwa moja ya athari za [[teknolojia]] ambayo inatoa ufahamu wa msingi wa mwili na hiyo inageukia "teknolojia ya jinsia" ya de Lauretis. De Lauretis aliunda neno "nadharia ya queer" ingawa njia ambayo linatumika leo inatofautiana na kile alichopendekeza awali na neno hilo. Alibuni neno hilo mnamo [[Februari]] [[1990]] katika mkutano katika Chuo Kikuu cha [[California]], Santa Cruz. Baada ya mkutano, "michakato" ilikusanywa katika toleo la pekee la [[1991]] la "Differences: A Journal of Feminist Cultural Studies." De Lauretis alijadili mawazo ya msingi ya nadharia ya queer katika toleo hilo, akiacha athari katika uwanja wa masomo ya queer. Alipendekeza kuwa masomo ya queer yanapaswa kusomwa tofauti na [[Masomo ya Jinsia|masomo]] ya wasagaji na [[mashoga]]. De Lauretis anasema kwamba "nadharia ya queer ilipinga kanuni" zinazotekeleza ukosefu wa usawa kuhusu "utambulisho wa kijamii" kama jinsia, ujinsia, tabaka, na rangi. Ingawa aliunda neno hilo aliliacha tu miaka mitatu baadaye, kwa misingi kwamba lilikuwa limechukuliwa na [[nguvu]] za kawaida na taasisi ambazo lilibuniwa kupinga.<ref>{{cite book| title = Alice Doesn't... Anywhere, Anymore! 1975 Women's Strike|year=1975|author=Archives for Research on Women and Gender|publisher=Georgia State University Library|oclc=927316153}}</ref><ref>{{cite book|title=Feminist studies : critical studies|series=Theories of contemporary culture|volume=8|year=1986|location=Bloomington|publisher=Indiana University Press|url=https://archive.org/details/feministstudiesc00gres|isbn=9780253203861|oclc=441855325|access-date=2017-06-06|url-access=registration}}</ref><ref>Papers and discussions from a conference held Feb. 22-24, 1978 by the Center for Twentieth Century Studies, University of Wisconsin--Milwaukee.{{cite book| title = The Cinematic apparatus|editor-last1=De Lauretis|editor-first1=Teresa|editor-last2=Heath|editor-first2=Stephen|year=1980|location=London|publisher=MacMillan|oclc=988211947}}</ref><ref>{{cite book| title = The Technological imagination : theories and fictions |editor-last1=De Lauretis|editor-first1=Teresa |editor-last2=Huyssen|editor-first2=Andreas|editor-last3=Woodward|editor-first3=Kathleen|year=1980| location=Madison, Wisconsin|publisher=Coda Press|series=Theories of contemporary culture|volume=3 |isbn=9780930956110|oclc=300392644}}</ref> == Heshima, Tuzo na Ruzuku == * Mgeni wa Heshima, Universidad Nacional del Litoral, Argentina ([[2014]]) * Daktari honoris causa, Universidad Nacional de Córdoba, Argentina ([[2014]]) * Tuzo ya Kazi ya Kipekee, Jumuiya ya Sinema na Masomo ya Vyombo vya Habari ([[2010]]) * Mshindi, Tuzo ya Jarida la Choice la Kitabu cha Marejeleo/Kitaaluma cha Kipekee ([[2009]]) * Ushirika wa Utafiti wa Binadamu wa IHR ([[2007]]) * Daktari wa Falsafa honoris causa, Chuo Kikuu cha Lund, Uswidi (2005) * Ushirika wa Kitivo cha Wakaazi wa UCHRI, Chuo Kikuu cha California, Irvine ([[2003]]-[[2004]]) * Ushirika wa Guggenheim ([[1993]]) * Ushirika wa NEH kwa Walimu wa Chuo Kikuu ([[1992]]) * Ruzuku ya Mkutano, Idara ya Binadamu, Chuo Kikuu cha California, Santa Cruz ([[1990]]) * Ruzuku ya Mkutano, Baraza la Utafiti la Kanada ([[1884]]) * Ushirika wa Utafiti, Kituo cha Masomo ya Karne ya Ishirini, Chuo Kikuu cha Wisconsin—Milwaukee ([[1982]]–83) * Ruzuku katika Masomo ya Vyombo vya Habari, National Endowment for the Arts ([[1977]]–78) == Marejeo == <references />{{Mbegu-mtu}} [[Jamii:Feminism and Folklore 2025 in Tanzania]] [[Jamii:Waliozaliwa 1938]] [[Jamii:Waandishi wa Italia]] 4yzfb3k90b0vel99wfkqk3yv5vti9e4 0 204934 1578196 1525164 2026-07-03T02:35:34Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578196 wikitext text/x-wiki {{tafsiri kompyuta}} '''Sandra Florence Schwartz Tangri''' ([[Agosti 27]], [[1936]] - [[11 Juni]] [[2003]]) <ref>{{Rejea jarida |last=Mednick |first=Martha T. |date=2004 |title=Sandra Schwartz Tangri (1937–2003). |url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0003-066X.59.4.265 |journal=American Psychologist |language=en |volume=59 |issue=4 |pages=265 |doi=10.1037/0003-066X.59.4.265 |issn=1935-990X}}</ref> alikuwa [[mwanasaikolojia]] wa wanawake na [[profesa]] mashuhuri wa chuo kikuu wa saikolojia ya kijamii na saikolojia ya wanawake. Tangri alifanya utafiti wa upainia juu ya maisha ya wanawake ambao walihitimu kutoka [[chuo kikuu]] na kuanza kazi zinazotawaliwa na wanaume. Alisoma motisha za wanawake katika kuchagua kazi na uzoefu wao wa unyanyasaji wa kijinsia. Tangri inajulikana kwa kufanya Utafiti wa Njia za Maisha za Wanawake, utafiti wa muda mrefu uliochukua muda wa miaka 25<ref name=":3">{{Rejea jarida |last1=Stewart |first1=Abigail J. |last2=Vandewater |first2=Elizabeth A. |date=1999 |title="If I had it to do over again...": Midlife review, midcourse corrections, and women's well-being in midlife. |url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-3514.76.2.270 |journal=Journal of Personality and Social Psychology |language=en |volume=76 |issue=2 |pages=270–283 |doi=10.1037/0022-3514.76.2.270 |pmid=10074709 |issn=1939-1315}}</ref> ambao ulichunguza njia za maisha na uzoefu wa wahitimu wa kike wa Darasa la Chuo Kikuu cha Michigan cha [[1967]].<ref>{{Rejea jarida |last=Tangri |first=Sandra Schwartz |date=1972 |title=Determinants of Occupational Role Innovation Among College Women |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1540-4560.1972.tb00024.x |journal=Journal of Social Issues |language=en |volume=28 |issue=2 |pages=177–199 |doi=10.1111/j.1540-4560.1972.tb00024.x}}</ref><ref>{{Rejea tovuti |last=Tangri, S. S., & Jenkins, S. R. |date=1993 |title=The University of Michigan class of 1967: The Women's Life Paths Study. In K. D. Hulbert & D. T. Schuster (Eds.), Women's lives through time: Educated American women of the twentieth century (pp. 259–281). Jossey-Bass/Wiley. |url=https://psycnet.apa.org/record/1993-97348-010 |access-date=2022-11-24 |website=psycnet.apa.org |language=en}}</ref> Kando na kazi yake ya kitaaluma, Tangri alikuwa mwanaharakati wa kisiasa na kijamii aliyehusika katika harakati za usawa wa kijinsia katika miaka ya 1990. == Wasifu == Sandra Schwartz alizaliwa huko St. Louis na kukulia [[Los Angeles]] katika familia ya wahamiaji wa Kiyahudi ya darasa la kufanya kazi. Baba yake, Haim Schwartz, alikuwa mshairi aliyechapishwa wa Yiddish kutoka mji wa Belarus. <ref name=":0">{{Rejea tovuti |title=Feminist Voices – Sandra Schwartz Tangri |url=https://feministvoices.com/profiles/sandra-schwartz-tangri |access-date=2022-10-27 |website=Feminist Voices |language=en}}</ref> Tangri alikiri utambulisho wake wa ufeministi, na msingi wa siasa zake kwa kujitolea kwa nguvu kwa baba yake kwa haki ya kijamii na uzoefu wake wa kukua katika familia ya Kiyahudi ya tabaka la wafanyikazi.<ref name=":0" /><ref>{{Rejea tovuti |title=Psychology in the United States |url=https://jwa.org/encyclopedia/article/psychology-in-united-states |access-date=2022-11-24 |website=Jewish Women's Archive |language=en}}</ref> Tangri alihudhuria Chuo cha Jiji la Los Angeles na Chuo cha Reed. Aliendelea kupokea B.A. katika saikolojia na heshima kutoka Chuo Kikuu cha [[California]], Berkeley. Aliendeleza elimu yake kwa kupokea M.A katika saikolojia katika Chuo Kikuu cha Wayne State mnamo [[1964]], na Ph.D. katika Saikolojia ya Kijamii katika Chuo Kikuu cha Michigan mnamo [[1969]]. <ref name=":1">{{Rejea tovuti |title=Sandra Schwartz Tangri '62 |url=https://www.reed.edu/reed-magazine/in-memoriam/obituaries/november2003/sandra-schwartz-tangri-1962.html}}</ref> Jina lake la tasnifu "Ubunifu wa jukumu katika uchaguzi wa kazi miongoni mwa wanawake wa chuo" lilikuwa utafiti wa muda mrefu uliohusisha wanawake 200 kutoka Darasa la Chuo Kikuu cha Michigan cha [[1967]]. <ref>{{Cite thesis |title=Role-innovation In Occupational Choice Among College Women. |url=http://deepblue.lib.umich.edu/handle/2027.42/127313 |date=1969 |degree=Thesis |language=EN |first=Sandra Florence Schwartz |last=Tangri|hdl=2027.42/127313 }}</ref> Tangri alifundisha katika Chuo cha Douglass, Chuo Kikuu cha Rutgers, na katika Chuo cha Richmond ambacho baadaye kiliunganishwa na kuunda Chuo cha Staten Island. Tangri aliacha masomo mwaka wa 1974 na kuwa Mkurugenzi wa Ofisi ya Utafiti katika Tume ya Haki za Kiraia ya Marekani, ambako alikaa kwa miaka mitano. Tangri alikuwa mtafiti mwandamizi katika Taasisi ya Mjini kuanzia [[1982]] hadi [[1985]]. Kuanzia 1980 hadi alipostaafu mwaka wa 1998, Tangri alikuwa profesa wa saikolojia ya kijamii katika Chuo Kikuu cha Howard. Katika Chuo Kikuu cha Howard, utafiti wa Tangri ulilenga uzoefu wa kielimu na kazi wa wanawake wasomi wa Kiafrika. Utafiti wa Tangri ulifadhiliwa na Taasisi ya Kitaifa ya Afya ya Akili, Wakfu wa MacArthur, Taasisi ya Kitaifa ya Elimu, na Idara ya Kazi. Tangri alikuwa Fulbright mwenzake huko [[New Zealand]] mwaka wa [[1991]]. <ref>{{Rejea tovuti |title=Sandra Tangri {{!}} Fulbright Scholar Program |url=https://fulbrightscholars.org/grantee/sandra-tangri |access-date=2022-11-24 |website=fulbrightscholars.org}}</ref> Alikuwa Mshiriki aliyechaguliwa wa Chama cha Kisaikolojia cha Marekani na alihudumu katika Baraza la Jumuiya ya Saikolojia ya Wanawake. <ref name=":2">{{Rejea habari |title=Sandra S. Tangri Dies – The Washington Post |newspaper=[[The Washington Post]] |url=https://www.washingtonpost.com/archive/local/2003/06/21/sandra-s-tangri-dies/d6dcbdfc-e062-4164-8998-6f7402c45799/}}</ref> Ndoa ya Tangri na Shanti Tangri iliisha kwa talaka. Tangri alikufa mnamo Juni 11, 2003, huko Bethesda, Maryland kutokana na saratani ya mapafu. == Tuzo == Tangri alipokea Tuzo la Carolyn Wood Sherif kwa mchango kwa Saikolojia ya Wanawake na Jinsia kutoka Kitengo cha 35 cha Muungano wa Kisaikolojia wa [[Marekani]] (Society for the Psychology of Women) mwaka wa 1999. <ref>{{Rejea tovuti |title=Carolyn Wood Sherif Award |url=https://www.apadivisions.org/division-35/awards/sherif |access-date=2022-11-24 |website=www.apadivisions.org |language=en}}</ref> Tangri alipokea [[Tuzo]] Lililotukuka la Uchapishaji kutoka kwa Chama cha Wanawake katika Saikolojia kwa makala yake ya [[1976]] "Mtazamo wa kifeministi kuhusu masuala ya kimaadili katika programu za idadi ya watu".<ref>{{Rejea tovuti |title=Distinguished Publication – Association for Women in Psychology |url=https://www.awpsych.org/distinguished_publication.php |access-date=2022-11-24 |website=www.awpsych.org |language=en |archive-date=2020-06-19 |archive-url=https://web.archive.org/web/20200619150950/https://www.awpsych.org/distinguished_publication.php |url-status=dead }}</ref><ref>{{cite journal |id={{ProQuest|1300108031}} |last1=Tangri |first1=Sandra Schwartz |title=A Feminist Perspective on Some Ethical Issues in Population Programs |url=https://archive.org/details/sim_signs_summer-1976_1_4/page/895 |journal=Signs |location=Chicago |volume=1 |issue=4 |date=Summer 1976 |pages=895–904 |doi=10.1086/493307 |s2cid=143656456 }}</ref> Kitengo cha 35 cha APA ''(Society for the Psychology of Women)'' hapo awali kilitoa Tuzo ya Ukumbusho ya Sandra Schwartz Tangri kwa Utafiti wa Wanafunzi Waliohitimu ikilenga masuala kama vile "unyanyasaji wa kijinsia, ubaguzi, haki za uzazi, wasiwasi wa wanawake wa kabila na kijinsia na ushauri wa wanafunzi wa chuo cha kizazi cha kwanza." <ref>{{Rejea tovuti |title=Grants and Awards: $500 for Social Justice Research |url=https://www.apa.org/gradpsych/2012/01/bulletin-board |access-date=2022-11-24 |website=www.apa.org}}</ref> == Marejeo == {{Reflist}}{{Mbegu-mwanasayansi}} [[Jamii:Waliozaliwa 1936]] [[Jamii:Waliofariki 2003]] [[Jamii:Wanasaikolojia wa Marekani]] [[Jamii:Feminism and Folklore 2025 in Tanzania]] qqmz3t8a68wxxqf6lq1n3k3e0g8mb2z 0 205106 1578229 1564496 2026-07-03T04:33:42Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578229 wikitext text/x-wiki {{tafsiri kompyuta}} '''Dora Marsden''' ([[5 Machi]] [[1882]] – [[13 Desemba]] [[1960]]) alikuwa [[mwanaharakati]] wa haki za wanawake wa [[Uingereza]], mhariri wa majarida ya fasihi, na [[mwanafalsafa]] wa lugha. Akianza kazi yake kama mwanaharakati katika [[Jumuiya]] ya [[Wanawake]] ya Kijamii na Kisiasa (WSPU), Marsden hatimaye alijitenga na shirika la wapigania haki za wanawake ili kuanzisha [[jarida]] ambalo lingetoa nafasi kwa sauti za kimudu pinga zaidi katika harakati hiyo. Umuhimu wake wa msingi upo katika michango yake kwa harakati ya haki za wanawake, ukosoaji wake wa WSPU ya Pankhursts, na ufeministi wake wa kimudu pinga, kupitia "''The Freewoman''." Wapo wanaodai pia ana umuhimu katika kuibuka kwa usasa wa kifasihi, wakati wengine wanathamini mchango wake katika uelewa wa Egoism.<ref>{{Rejea tovuti|url=https://www.unionofegoists.com/authors/marsden/|title=Dora Marsden (1882–1960)|last=Blake|first=Trevor|date=7 February 2016|website=Union Of Egoists|issn=2639-5339|oclc=1055555533|language=en-US|access-date=31 January 2020}}</ref> == Maisha == Dora Marsden alizaliwa tarehe [[5 Machi]] [[1882]] kwa wazazi wa tabaka la wafanyakazi, Fred na Hannah, huko Marsden, Yorkshire. Matatizo ya kiuchumi katika Biashara ya Fred yalimlazimisha kuhamia [[Marekani]] mnamo [[1890]], akikaa [[Philadelphia]] na mtoto wake wa kwanza. Hannah alifanya kazi kama mshonaji ili kusaidia watoto wake waliobaki, ambayo iliacha familia ikiishi katika umaskini wakati Marsden alipokuwa mtoto. Miongoni mwa moja ya vizazi vya kwanza kufaidika na Sheria ya Elimu ya Msingi ya 1870 (33 & 34 Vict. c. 75), Marsden aliweza kuhudhuria shule akiwa mtoto licha ya hali yake ya umaskini. Alithibitisha kuwa mwanafunzi aliyefanikiwa, akifanya kazi kama mwalimu akiwa na umri wa miaka kumi na tatu kabla ya kupokea Scholarship ya Malkia akiwa na miaka kumi na nane, ambayo ilimudu wezesha kuhudhuria Chuo cha Owens huko Manchester (baadaye Chuo Kikuu cha Victoria cha [[Manchester]]). Mnamo [[1903]], Marsden alihitimu kutoka chuo na kufundisha shule kwa miaka kadhaa, hatimaye akawa mwalimu mkuu wa Kituo cha Mwalimu-Mwanafunzi cha Altrincham mnamo [[1908]].<ref name=ondb>{{cite encyclopedia | last = Garner | first = Les | title = Marsden, Dora (1882–1960) | encyclopedia = [[Dictionary of National Biography]] | publisher = [[Oxford University Press]] | date = 23 September 2004 | doi = 10.1093/ref:odnb/39090 | isbn = 9780198614128 | oclc = 4916064756 | url = https://www.oxforddnb.com/view/10.1093/ref:odnb/9780198614128.001.0001/odnb-9780198614128-e-39090 | access-date =18 October 2022}}</ref> Mnamo Oktoba [[1909]], Marsden alikamatwa pamoja na wanachama wengine kadhaa wa Jumuiya ya [[Wanawake]] ya Kijamii na Kisiasa (WSPU) kwa kuvaa jezi kamili za kitaaluma na kukatiza hotuba ya chansela wa alma mater yao, wakidai amudu onge dhidi ya kulishwa kwa nguvu kwa wahitimu wa suffragist waliokuwa [[gerezani]] waliokuwa kwenye mgomo wa njaa. Miezi michache baadaye, aliingia kwa nguvu katika Southport Empire Theatre na akajinyanyua hadi kwenye kuba, ambapo alingoja kwa masaa 15 ili amudu kejeli [[Winston Churchill]], ambaye hivi karibuni angekuwa Waziri wa Mambo ya Ndani, alipokuwa akizungumza kwenye mkutano wa uchaguzi. Marsden alikamatwa pamoja na ujumbe kwa [[Bunge]] ambao uliripotiwa sana wakati huo.<ref name="spartacus">{{Cite encyclopedia|url=https://spartacus-educational.com/WmarsdenD.htm |last=Simkin |first=John |date=September 1997 |title=Dora Marsden |encyclopedia=[[Spartacus Educational]] |access-date=18 October 2022 |oclc=855163194}}</ref><ref name="Clarke, Bruce 1992">{{cite journal|last=Clarke|first=Bruce|title=Dora Marsden and Ezra Pound: "The New Freewoman" and "The Serious Artist"|url=https://archive.org/details/sim_contemporary-literature_spring-1992_33_1/page/n98|journal=Contemporary Literature|issn=0010-7484|oclc=5361332857|jstor=1208375|publisher=[[University of Wisconsin Press]]|volume=33|issue=1|year=1992|pages=91–112|doi=10.2307/1208375 }}</ref> Kujitolea kwa Marsden kwa sababu hiyo kulimpatia nafasi ya kiutawala katika WSPU ya Christabel na Emmeline Pankhurst, ambayo aliacha nafasi yake ya ualimu mnamo 1909. Ingawa alikuwa amejitolea kwa harakati ya kifeministi ya mapema, kanuni za kinadharia za Marsden na tabia yake ya kujitegemea mara nyingi zilimletea mgogoro na uongozi wa WSPU, ambao walimudu ona kuwa mgumu kumudu simamia. Mnamo [[1911]], Marsden alikubaliana kwa pande zote na Pankhursts kujiuzulu wadhifa wake na WSPU. Akiwa amechukizwa na shirika hilo, lakini bado amejitolea kwa harakati ya wanawake, aliazimia kutafuta njia za kusaidia sauti mbadala zinazohusiana na sababu hiyo.<ref>{{Rejea tovuti|url=https://www.unionofegoists.com/2018/08/01/in-front-of-the-party-was-miss-dora-marsden/|title=In Front of the Party was Miss Dora Marsden|last=Blake|first=Trevor|date=1 August 2018|website=Union Of Egoists|issn=2639-5339|oclc=1055555533|language=en-US|access-date=31 January 2020}}</ref><ref name="Cary Franklin 2002">{{cite journal|last=Franklin|first=Cary|year=2002|title=Marketing edwardian feminism: Dora Marsden, votes for women and the freewoman|journal=[[Women's History Review]]|volume=11|issue=4|pages=631–642|doi=10.1080/09612020200200341|s2cid=144243378 |issn=0961-2025|oclc=4901613189|doi-access=free}}</ref><ref>{{cite web|last=Scholes|first=Robert|year=2011|title=General Introduction to the Marsden Magazines|url=https://modjourn.org/general-introduction-to-the-marsden-magazines/|work=The Modernist Journals Project|publisher=[[Brown University]]|access-date=18 October 2022|oclc=52063516|quote=Given all these changes, it is not easy to sort out the relationships among these three journals. It is apparent, though, that Marsden wished the second to be clearly distinguished from the first [...] On the other hand, for the first three years of ''The Egoist'', the masthead of the third journal carried this statement about its connection to the second: "Formerly the ''NEW FREEWOMAN''." Thus it is clear that the editor wished to emphasize the break between the first two incarnations of the journal and the connection between the last two. Following this lead, we should be aware that these connections are real.}}</ref><ref>{{cite journal|last=Delap|first=Lucy|title='Philosophical vacuity and political ineptitude': ''The Freewoman's'' critique of the suffrage movement|journal=[[Women's History Review]]|year=2002|volume=11|issue=4|pages=615|issn=0961-2025|oclc=4649354003|quote=This unease over the content of suffragist politics was combined with a dislike of the autocratic organisation of the suffrage societies, in particular the Women’s Social and Political Union (WSPU). ''Freewoman'' contributors believed that militant suffrage organisations demanded an obedience from their members that amounted to ‘servility’ and was fundamentally antagonistic to the ends of feminism.|doi=10.1080/09612020200200340|s2cid=143873959 |doi-access=}}</ref><ref>{{cite book|last=Williams|first=Raymond|title=The Politics of Modernism|url=https://archive.org/details/politicsofmodern0000will|url-access=registration|year=1989|publisher=Verso|location=London|isbn=0-86091-241-8|oclc=1289901764|pages=[https://archive.org/details/politicsofmodern0000will/page/54 54]–57}}</ref> <ref>{{cite book|last=Clarke|first=Bruce|title=Dora Marsden and Early Modernism|url=https://books.google.com/books?id=07mk2Lx6Y-gC|year=1996|publisher=[[University of Michigan Press]]|location=[[Ann Arbor]]|isbn=9780472106462|oclc=33101850|page=3|quote=Her ''Freewoman'' leaders already traced two doctrinal shifts—transitions from feminist to anarchist and from socialist to individualist idioms—directly connected to her support in the ''New Freewoman'' for literary innovation within a psychological practice of ‘egoistic investigation’}}</ref><ref>{{cite journal|last=Joannou|first=Maroula|title=The Angel of Freedom: Dora Marsden and the transformation of The Freewoman into The Egoist|journal=[[Women's History Review]]|issn=0961-2025|oclc=8314960056|year=2002|volume=11|issue=4|pages=595–612|quote=The key stages in her personal development, from New Woman to suffragette, from feminist to anarchist, taking in philosophical individualism and literary modernism en route, can only be understood in relation to the influential intellectual currents of her day.|doi=10.1080/09612020200200339|doi-access=free}}</ref><ref name="Storch, Margret 1998">{{cite journal|last=Storch|first=Margaret|year=1998|title=Dora Marsden & Early Modernism|url=https://archive.org/details/sim_english-literature-in-transition-1880-1920_1998_41_1/page/91|journal=English Literature in Transition|volume=41|issue=1|issn=0013-8339|oclc=4586279980|pages=91–94}}</ref><ref>{{cite book|last=Clarke|first=Bruce|title=Dora Marsden and Early Modernism|url=https://books.google.com/books?id=07mk2Lx6Y-gC|year=1996|publisher=[[University of Michigan Press]]|location=[[Ann Arbor]]|isbn=9780472106462|oclc=33101850}}</ref><ref>{{cite book|url=https://books.google.com/books?id=zGjfOC8Y3sEC&q=Dora+Marsden+biography&pg=PA64|first=Gabriele|last=Griffin|title=Difference in View: Women and Modernism|publisher=[[Taylor & Francis]]|year=1994|isbn=0748401342|oclc=29314327|access-date=25 February 2013}}</ref> == Marejeo == <references />{{Mbegu-mwandishi}} [[Jamii:Waliozaliwa 1882]] [[Jamii:Waliofariki 1960]] [[Jamii:Feminism and Folklore 2025 in Tanzania]] [[Jamii:Waandishi wa Uingereza]] hb3kddpa42e6i711syepmqv8wonvsr3 0 205225 1578172 1519821 2026-07-02T23:30:43Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578172 wikitext text/x-wiki {{tafsiri kompyuta}} '''Mary Daly''' ([[Oktoba 16]], [[1928]] – [[Januari 3]], [[2010]]) alikuwa mwanafalsafa na mwana-theolojia wa Kifeministi mwenye msimamo mkali kutoka Marekani. Daly, ambaye alijitambulisha kama ''"mwanaharakati msagaji wa Kifeministi mwenye msimamo mkali"'', alifundisha katika Chuo cha [[Boston, Massachusetts|Boston]] kinachoendeshwa na Wajesuiti kwa miaka 33.<ref>{{cite journal |last1=Pinn |first1=Anthony B. |title=Religion and ''America's Problem Child'': Notes on Pauli Murray's Theological Development |url=https://archive.org/details/sim_journal-of-feminist-studies-in-religion_spring-1999_15_1/page/20 |journal=Journal of Feminist Studies in Religion |date=1999 |volume=15 |issue=1 |pages=21–39 |jstor=25002350 }}</ref><ref name="fox">{{cite news |last1=Fox |first1=Margalit |title=Mary Daly, a Leader in Feminist Theology, Dies at 81 |url=https://www.nytimes.com/2010/01/07/education/07daly.html |work=The New York Times |date=7 January 2010 }}</ref> Awali akiwa Mkatoliki anayefuata imani, aliachana rasmi na Ukristo kufikia miaka ya [[1970]]. Daly alistaafu kutoka Chuo cha [[Boston, Massachusetts|Boston]] mwaka [[1999]] baada ya kukiuka sera ya chuo kwa kukataa kuruhusu wanafunzi wa kiume katika madarasa yake ya juu ya masomo ya [[wanawake]]. Hata hivyo, aliwaruhusu [[wanaume]] kuhudhuria darasa lake la utangulizi na pia aliwapa mafunzo ya kibinafsi wale waliotaka kusoma katika ngazi ya juu. == Maisha na Elimu == Mary Daly alizaliwa Schenectady, New York, mnamo [[Oktoba 16]], [[1928]]. Alikuwa mtoto wa pekee. Mama yake alikuwa mama wa nyumbani, huku baba yake akiwa mfanyabiashara wa [[safari]]. Daly alilelewa katika mazingira ya Kikatoliki, kwani wazazi wake wote walikuwa Wakatoliki wa asili ya Kiayalandi, na alisoma katika shule za Kikatoliki alipokuwa msichana. Katika utoto wake, Daly alipata uzoefu wa kiroho ambapo alihisi uwepo wa uungu katika mazingira ya asili.<ref>{{cite news | url=http://www.bostonherald.com/news/regional/view/20100106feminist_bc_theology_professor_mary_daly_dies/srvc=home&position=recent | title=Feminist BC theology professor Mary Daly dies | date=6 January 2010 | work=Boston Herald | agency=Associated Press | access-date=13 January 2010}}</ref><ref>{{cite web |url=http://www.crosscurrents.org/madsenf00.htm |title=The Thin Thread of Conversation: An Interview with Mary Daly |first=Catherine |last=Madsen |work=Cross Currents |date=Fall 2000 |access-date=January 13, 2010 }}</ref> Alipata Shahada ya Kwanza ya Sanaa (BA) katika Lugha ya Kiingereza kutoka Chuo cha Saint Rose mwaka [[1950]], na Shahada ya Uzamili (MA) katika Kiingereza kutoka Chuo Kikuu cha Kikatoliki cha [[Amerika]]. Mwaka [[1953]], alipata shahada ya Uzamivu (PhD) katika Dini kutoka Chuo cha Saint Mary. Pia alipata shahada mbili za ziada za uzamivu katika Theolojia Takatifu na Falsafa kutoka Chuo Kikuu cha [[Fribourg]], Uswisi. == Kazi == Daly alifundisha katika Chuo cha [[Boston, Massachusetts|Boston]] kuanzia [[1967]] hadi [[1999]], akifundisha masomo ya theolojia, maadili ya Kifeministi, na mfumo dume.<ref>{{cite news | last=Bindel | first=Julie | url=https://www.theguardian.com/world/2010/jan/27/mary-daly-obituary | title=Mary Daly obituary: Radical US theologian and the world's first feminist philosopher | work=The Guardian | date=27 January 2010 |access-date=2021-02-10}}</ref> Alitishiwa mara ya kwanza kufukuzwa kazi baada ya kuchapishwa kwa kitabu chake cha kwanza, ''The Church and the Second Sex'' ([[1968]]), ambapo alipewa mkataba wa muda maalum. Hata hivyo, kutokana na uungwaji mkono kutoka kwa wanafunzi (waliokuwa wote wa kiume wakati huo) pamoja na [[jamii]] kwa ujumla, hatimaye alipewa nafasi ya kudumu kazini.<ref name="Smith">{{Rejea tovuti| title = Collection: Mary Daly papers {{!}} Smith College Finding Aids| access-date = 2020-05-12| url = https://findingaids.smith.edu/repositories/2/resources/1163}} {{Cc-notice|cc=by3|from this source=yes}}</ref> Uamuzi wa Daly wa kutowaruhusu [[wanafunzi]] wa kiume kuhudhuria baadhi ya madarasa yake katika Chuo cha [[Boston, Massachusetts|Boston]] pia ulisababisha hatua za kinidhamu kuchukuliwa dhidi yake. Daly alitetea msimamo wake kwa kusema kuwa uwepo wa wanaume ulidhoofisha mijadala ya darasani, lakini Chuo cha [[Boston, Massachusetts|Boston]] kiliona kuwa hatua yake ilikuwa kinyume na ''Title IX'', sheria ya shirikisho inayokataza taasisi yoyote ya elimu kuwabagua watu kwa misingi ya jinsia, pamoja na sera ya chuo yenyewe ya kutobagua, inayotaka masomo yote yawe wazi kwa wanafunzi wa jinsia zote.<ref name=":0">{{Rejea habari |date=2010-01-07 |title=Mary Daly, a Leader in Feminist Theology, Dies at 81 (Published 2010) |url=https://www.nytimes.com/2010/01/07/education/07daly.html |archive-url=https://web.archive.org/web/20241208095608/https://www.nytimes.com/2010/01/07/education/07daly.html |archive-date=2024-12-08 |access-date=2024-12-15 |language=en |url-status=live }}</ref> Mwaka [[1989]], Daly alijiunga na ''Women's Institute for Freedom of the Press'', taasisi inayotetea uhuru wa vyombo vya habari kwa wanawake.<ref>{{Rejea tovuti |date=2024-12-04 |title=Mary Daly {{!}} Feminist Theology, Radical Feminism, Gender Equality {{!}} Britannica |url=https://www.britannica.com/biography/Mary-Daly |access-date=2024-12-15 |website=www.britannica.com |language=en}}</ref><ref>{{Rejea tovuti | url=http://www.wifp.org/who-we-are/associates/ | title=Who we are: Associates | publisher=The Women's Institute for Freedom of the Press | language=en-US | access-date=2017-06-21}}<!-- Not present in earliest archive: https://web.archive.org/web/20170810090955/https://www.wifp.org/who-we-are/associates/ --></ref> Mwaka [[1998]], wanafunzi wawili wa kiume waliwasilisha shtaka dhidi ya chuo kwa madai ya kubaguliwa, na walipata uungwaji mkono kutoka ''Center for Individual Rights'', shirika la utetezi wa sera za libertarian. Daly alikabiliwa na onyo zaidi, na badala ya kuwaruhusu wanafunzi wa kiume kuhudhuria darasa lake, aliamua kutohudhuria kabisa.<ref>{{Rejea habari | last = Seele| first = Michael| title = Daly's Absence Prompts Cancellations| work = The Boston College Chronicle | date = March 4, 1999 | issn=2637-3696 | volume=7 | issue=12 | publication-place=Chestnut Hill, MA | publisher=Boston College | url = http://www.bc.edu/bc_org/rvp/pubaf/chronicle/v7/mr4/daly.html| archive-url = https://web.archive.org/web/20141119141749/http://www.bc.edu/bc_org/rvp/pubaf/chronicle/v7/mr4/daly.html| archive-date = November 19, 2014}}</ref><ref>{{Rejea habari | last = Sullivan| first = Mark| title = Judge Denies Daly's Bid for Injunction| work = The Boston College Chronicle | date = May 28, 1999 | issn=2637-3696 | volume=7 | issue=18 | publication-place=Chestnut Hill, MA | publisher=Boston College | url = http://www.bc.edu/bc_org/rvp/pubaf/chronicle/v7/my28/daly.html| archive-url = https://web.archive.org/web/20141119141754/http://www.bc.edu/bc_org/rvp/pubaf/chronicle/v7/my28/daly.html| archive-date = November 19, 2014}}</ref><ref>{{Rejea habari | author=Boston College Office of Public Affairs | date=February 15, 2001 | title=Mary Daly Ends Suit, Agrees to Retire | work=The Boston College Chronicle | issn=2637-3696 | volume=9 | number=11 | publication-place=Chestnut Hill, MA | publisher=Boston College | url=http://www.bc.edu/bc_org/rvp/pubaf/chronicle/v9/f15/daly.html | archive-url=https://web.archive.org/web/20150306024643/http://www.bc.edu/bc_org/rvp/pubaf/chronicle/v9/f15/daly.html | archive-date=March 6, 2015 }}</ref> Chuo cha [[Boston, Massachusetts|Boston]] kilimwondolea haki yake ya kudumu kazini, kikidai kuwa alikuwa amekubaliana kwa maneno kustaafu. Daly alifungua kesi dhidi ya chuo akidai kuwa haki zake za kudumu kazini zilivunjwa na kwamba alilazimishwa kuacha kazi bila hiari yake, lakini ombi lake la kuwekewa zuio la kisheria lilikataliwa na Jaji Martha Sosman wa Mahakama Kuu ya Middlesex.<ref>{{cite encyclopedia |last=Pippin |first=Tina |editor1-first=Edward L. |editor1-last=Queen II |editor2-first=Stephen R. |editor2-last=Prothero |editor3-first=Gardiner H. |editor3-last=Shattuck, Jr. |encyclopedia=Encyclopedia of American Religious History |title=Mary Daley |url=https://books.google.com/books?id=u-_6P2rMy2wC&pg=PA326 |access-date=August 25, 2011 |edition=3d |year=2009 |publisher=Facts on File |volume=3 |location=New York |isbn=978-0-8160-6660-5 |page=326 }}</ref><ref>{{cite news |url=http://newsweek.washingtonpost.com/onfaith/panelists/susan_brooks_thistlethwaite/2010/01/the_courage_to_sin_big_the_life_of_mary_daly.html |archive-url=https://web.archive.org/web/20100120090014/http://newsweek.washingtonpost.com/onfaith/panelists/susan_brooks_thistlethwaite/2010/01/the_courage_to_sin_big_the_life_of_mary_daly.html |archive-date=January 20, 2010 |title=Mary Daly's 'Courage to Sin Big' |last=Thistlethwaite |first=Susan Brooks |date=January 5, 2010 |newspaper=The Washington Post |access-date=August 25, 2011 }}</ref><ref>{{cite magazine | author=<!--none--> |url=https://www.smith.edu/libraries/sites/default/files/fa2009.pdf |title=Noteworthy Acquisitions |date=1 October 2009 |page=2 |magazine=Friends of the Smith Libraries Newsletter | publication-place=Northampton, Massachusetts | publisher=Friends of the Smith Libraries |archive-url=https://web.archive.org/web/20160830231023/http://www.smith.edu/libraries/sites/default/files/fa2009.pdf |archive-date=August 30, 2016 |access-date=June 6, 2017 }}</ref><ref>{{cite journal |last1=Culpepper |first1=Emily Erwin |title=Introduction [to section on Mary Daly] |url=https://archive.org/details/journal-of-feminist-studies-in-religion_fall-2012_28_2/page/89 |journal=Journal of Feminist Studies in Religion |date=2012 |volume=28 |issue=2 |pages=89–90 |id={{Project MUSE|490248}} |doi=10.2979/jfemistudreli.28.2.89 }}</ref><ref>{{cite book |title=The Mary Daly Reader |editor1-first=Jennifer |editor1-last=Rycenga |editor2-first=Linda |editor2-last=Barufaldi |year=2017 |publisher=New York University Press |location=New York |isbn=978-1-4798-7776-8 |chapter=Acknowledgements |page=xxi |chapter-url=https://books.google.com/books?id=yAbvCwAAQBAJ&pg=PR21 }}</ref><ref>{{cite book |last=Sargisson |first=Lucy |url=https://books.google.com/books?id=Tq2XYE9xgdQC&pg=PA184 |title=Contemporary feminist utopianism |publisher=Routledge |year=1996 |page=184 |isbn=978-0-41-514175-8}}</ref><ref>{{Rejea habari | last = Kettle| first = Martin| title = Unholy row as feminist lecturer bars men| work = The Guardian| date = February 27, 1999| url = https://www.theguardian.com/world/1999/feb/27/martinkettle}}</ref><ref name=Riswold>{{Rejea kitabu| last = Riswold| first = Caryn D.| title = Two Reformers| publisher = Wipf & Stock Publishers| year = 2007| location = Eugene, OR| page = 33| isbn = 978-1-59752-826-9}}</ref><ref>{{cite book|last1=Daly|first1=Mary|title=Pure Lust: Elemental Feminist Philosophy|url=https://archive.org/details/purelustelementa00dalyrich|date=1984|lccn=83071944|isbn=978-0-8070-1504-9|publisher=Beacon Press}}</ref><ref name=Ruether>{{Rejea kitabu| last = Ruether| first = Rosemary Radford| title = Women and Redemption: A Theological History| publisher = Fortress Press| year = 1998| location = Minneapolis| pages = [https://archive.org/details/womenredemptiont0000ruet/page/218 218–9]| url = https://archive.org/details/womenredemptiont0000ruet/page/218| isbn = 0-8006-2947-7}}</ref><ref>{{cite journal |last1=Echols |first1=Alice |title=Cultural Feminism: Feminist Capitalism and the Anti-Pornography Movement |journal=Social Text |date=1983 |issue=7 |pages=34–53 |doi=10.2307/466453 |jstor=466453 |url=https://www.jstor.org/stable/466453 |issn=0164-2472}}</ref><ref>{{cite journal |last1=Alcoff |first1=Linda |title=Cultural Feminism versus Post-Structuralism: The Identity Crisis in Feminist Theory |journal=Signs: Journal of Women in Culture and Society |date=April 1988 |volume=13 |issue=3 |pages=405–436 |doi=10.1086/494426 |url=https://www.journals.uchicago.edu/doi/abs/10.1086/494426 |language=en |issn=0097-9740}}</ref><ref>{{cite journal |last1=Spelman |first1=Elizabeth V. |title=Inessential Woman: Problems of Exclusion in Feminist Thought |website=philpapers.org |date=1988 |url=https://philpapers.org/rec/SPEIWP |language=en}}</ref> == Marejeo == <references /> {{Mbegu-mtu}} [[Jamii:wanafalsafa wa Marekani]] [[Jamii:Waliozaliwa 1928]] [[Jamii:Waliofariki 2010]] [[Jamii:Feminism and Folklore 2025 in Tanzania]] n4sktgv9xfdbidzwfqktsbugz9trxsj 0 205433 1578199 1472793 2026-07-03T02:44:49Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578199 wikitext text/x-wiki '''Hawaa''' (kwa [[Kiarabu]] maana yake ni ''[[Eva]]'') ni majarida ya kila wiki ya [[Mwanamke|wanawake]] yanayochapishwa huko [[Kairo]], [[Misri]]. Jarida hili limeigwa na majarida mengine ya wanawake katika nchi za Kiarabu.<ref name=adel/> Lilikuwa jarida la kwanza la wanawake nchini Misri, lililoanzishwa mnamo mwaka [[1954]].<ref>{{cite book|author=Mervat F. Hatem|title=Gender and Citizenship in the Middle East|date=2005|publisher=[[Syracuse University Press]]|location=Syracuse, NY|isbn=978-0-8156-2864-4|page=46|edition=1st|url=https://books.google.com/books?id=dAnkIJfXrD4C&pg=PA46}}</ref><ref name=janet>{{cite book|author1=Janet K. Boles |author2=Diane Long Hoeveler|title=Historical Dictionary of Feminism|page=282|url=https://books.google.com/books?id=tOVlvvrMJhUC&pg=PA282 |year=2004|publisher=Scarecrow Press|isbn=978-0-8108-4946-4|edition=2nd|location=Lanham, MD}}</ref> == Historia na wasifu == ''Hawaa'' lilichapishwa kwa mara ya kwanza mnamo mwaka 1954.<ref name=son>{{cite web|author=Sonia Aly Dabbous|title=Women in the Media Past - Present - Future... |url=http://www.ayamm.org/english/Conference%202002%20e%202.htm|work=Ayamm|access-date=6 October 2014|date=October 2002|url-status=dead|archive-date=11 August 2014|df=dmy-all|archive-url=https://web.archive.org/web/20140811065517/http://www.ayamm.org/english/Conference%202002%20e%202.htm}}</ref><ref name=ob/> Mwanzilishi alikuwa Amina Al Said, mwandishi wa habari na [[Ufeministi|mfeministi]] kutoka nchi ya Misri.<ref name=adel/><ref name=bec>{{cite encyclopedia|title=Amīnah al-Saʿīd|encyclopedia=[[Encyclopædia Britannica]]|url=http://global.britannica.com/EBchecked/topic/516537/Aminah-al-Said#ref794928}}</ref> Mchapishaji ni Dar Al Hilal.<ref>{{cite book|editor=Suad Joseph|title=Gender and Citizenship in the Middle East|location=Syracuse, NY|author-link=Suad Joseph|chapter-url=https://books.google.com/books?id=dAnkIJfXrD4C&pg=PA46|year=2000|publisher=Syracuse University Press|page=46 |isbn=978-0-8156-2864-4|author=Mervat F. Hatem|chapter=The Pitfalls of the Nationalist Discourses on Citizenship in Egypt}}</ref> ''Hawaa'' huchapishwa kila wiki <ref name=shmk/> na huangazia habari kuhusu afya na urembo, masuala ya familia, mitindo, <ref name=son/> urembo na usimamizi wa nyumbani kwa kutumia [[Harakati za utetezi wa wanawake|mtazamo wa kifeministi]].<ref>{{cite journal|author=Marilyn Booth|author-link=Marilyn Booth|title=Woman in Islam: Men and the "Women's Press" in Turn-of-the-20th-Century Egypt|url=https://archive.org/details/sim_international-journal-of-middle-east-studies_2001-04_33_2/page/171|jstor=259561|journal=[[International Journal of Middle East Studies]] |date=May 2001|volume=33|issue=2|pages=171–201|doi=10.1017/S002074380100201X|s2cid=161301527 }}</ref> Katika miaka ya [[1970]] iliangazia hadithi fupi zilizoandikwa na waandishi wa Misri na [[Magharibi]].<ref>{{cite journal|author=Michael W. Suleiman|title=Changing Attitudes Toward Women in Egypt: The Role of Fiction in Women's Magazines|journal=[[Middle Eastern Studies (journal)|Middle Eastern Studies]]|date=October 1978|doi=10.1080/00263207808700386|page=352 |volume=14|issue=3}}</ref> Jarida hili haliwalengi wanawake pekee bali hata wanaume.<ref>{{cite journal|author=Mohamed Younis|title=Daughters of the Nile: The Evolution of Feminism in Egypt|journal=Washington and Lee Journal of Civil Rights and Social Justice|year=2007|volume=13|issue=2 |url=https://scholarlycommons.law.wlu.edu/crsj/vol13/iss2/9}}</ref> Amina Al Said, ambaye ni mwanzilishi, alikuwa mhariri mkuu wa kwanza wa jarida hili la kila wiki na alihudumu katika wadhifa huo tangu kuanzishwa kwake mwaka wa 1954 hadi [[1969]].<ref name=bec/> Yeye alikuwa mhariri mkuu wa kwanza mwanamke<ref name=adel>{{cite news|author=Adel Darwish|title=Obituary: Amina al-Said |url=https://www.independent.co.uk/news/people/obituary-amina-alsaid-1599537.html|access-date=6 October 2014|work=[[The Independent]]|date=5 September 1995}}</ref> na mwenyekiti wa kwanza mwanamke wa shirika la uchapishaji, linaloitwa, Dar Al Hilal, nchini Misri. Alitoa machapisho ya wiki katika jarida la ''Hawaa'' hadi kifo chake mnamo mwaka [[1995]].<ref name=ob>{{cite news|title=Amina el-Saeed; Egyptian Feminist, 81|work=[[The New York Times]]|access-date=26 October 2014|date=15 August 1995 |url=https://www.nytimes.com/1995/08/15/obituaries/amina-el-saeed-egyptian-feminist-81.html}}</ref> [[Iqbal Baraka]] alikuwa mhariri mkuu wa muda mrefu wa jarida hili<ref>{{cite web|title=Feminists in Egypt|publisher=International Quranic Center|url=http://www.ahl-alquran.com/English/show_article.php?main_id=626|access-date=6 October 2014}}</ref> ambaye aliteuliwa kushika wadhifa huo Julai, 1993.<ref>{{cite news|title=All about Eve: Egyptian feminist and journalist Iqbal...|url=https://www.chicagotribune.com/1993/07/25/all-about-eve-egyptian-feminist-and-journalist/|access-date=26 October 2014|work=[[Chicago Tribune]]|date=25 July 1993}}</ref> Mnano tarehe 28 Juni 2014 Magda Mahmoud akawa mhariri mkuu wa jarida hili.<ref>{{cite web|title=Media Situation in Egypt: Thirteenth report for the period June and August 2014|url=http://asahnetwork.org/wp-content/uploads/2014/09/MM-13-En-2014-A1.pdf|work=Al Sawt Al Hurr|access-date=6 October 2014|format=Report|archive-date=2014-10-09|archive-url=https://web.archive.org/web/20141009211924/http://asahnetwork.org/wp-content/uploads/2014/09/MM-13-En-2014-A1.pdf|url-status=dead}}</ref> Msomi wa Kimisri Latifa al-Zayyat alikuwa mchangiaji wa jarida la ''Hawaa'' kuanzia [[1965]] hadi [[1968]].<ref>{{cite journal|author=Amal Amireh|volume=2 |title=Remembering Latifa al-Zayyat|journal=Al Jadid|date=October 1996|issue=12|url=http://www.aljadid.com/content/remembering-latifa-al-zayyat}}</ref> == Mzunguko == ''Hawaa'' iliuza nakala 175,000 mnamo mwaka 1954.<ref name=son/> Usambazaji wake ilikuwa nakala 200,000 kabla ya mwaka [[1967]] na ilikuwa takribani nakala 175,000 katika kipindi cha kati ya mwaka 1967 na [[1970]].<ref name=son/> Mnamo mwaka [[2000]], usambazaji wa jarida hili ilikuwa nakala 150,000.<ref name=shmk>{{cite journal|author1=Sahar Hegazi|author2=Mona Khalifa|title=Increasing the Coverage of Reproductive Health Issues in Egyptian Press Project|journal=FRONTIERS/Population Council|access-date=6 October 2014|url=https://knowledgecommons.popcouncil.org/departments_sbsr-rh/392/|date=October 2000|doi=10.31899/rh4.1139|doi-access=free}}</ref> Pia, jarida hili lilifurahia viwango vya juu vya usambazaji nje ya nchi<ref name=janet/><ref>{{cite book|author=Karen L. Kinnear|title=Women in Developing Countries: A Reference Handbook|year=2011|location=Santa Barbara, CA|publisher=ABC-CLIO|isbn=978-1-59884-426-9|page=141 |url=https://books.google.com/books?id=oIjxVimxO_wC&pg=PA141}}</ref> na lilikuwa na usambazaji mkubwa zaidi wa kigeni katika mwaka [[1989]].<ref>{{cite book |editor1=Jennifer Uglow|editor2=Frances Hinton|title=Macmillan Dictionary of Women's Biography|year=1989|publisher=[[Palgrave Macmillan]] |location=London|isbn=978-1-349-12704-7|page=14|chapter-url=https://doi.org/10.1007/978-1-349-12704-7|chapter=AI-Sa'id 'Aminah}}</ref> == Marejeo == {{marejeo}} [[Jamii:Feminism and Folklore 2025 in Tanzania]] [[Jamii:Magazeti ya Misri]] 0jmid7qrod37g9awuve235awx4apuoo 0 205607 1578223 1412079 2026-07-03T04:00:20Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578223 wikitext text/x-wiki {{tafsiri kompyuta}} '''Christina Marie Hoff Sommers''' (alizaliwa [[28 Septemba]] [[1950]]) ni mtaalamu wa falsafa na [[mwandishi]] kutoka [[Marekani]], maarufu kwa mchango wake katika masuala ya haki za wanawake na usawa wa kijinsia. Sommers ni mwandishi wa vitabu maarufu kama "Who Stole Feminism?" na "The War Against Boys," ambapo anahoji baadhi ya mitindo na masuala ya kisasa katika harakati za haki za wanawake. Alijulikana kwa msimamo wake wa kupinga baadhi ya matendo ya kisasa ya uanaharakati wa wanawake, akizingatia umuhimu wa usawa katika mazingira ya kijamii, kisiasa na kisheria.<ref name="AEI">{{Cite web |title=Christina Hoff Sommers |url=https://www.aei.org/profile/christina-hoff-sommers/ |access-date=2023-04-08 |website=American Enterprise Institute - AEI |language=en-US}}</ref><ref>{{cite book |last1=Gordon |first1=Dane R. |last2=Niżnik |first2=Józef |title=Criticism and Defense of Rationality in Contemporary Philosophy |date=1998 |publisher=Rodopi |isbn=90-420-0368-5 |pages=56 |url=https://books.google.com/books?id=j34ARAWhd1cC&pg=PA56 |language=en}}</ref><ref>{{cite book |last1=Nussbaum |first1=Martha C. |title=Sex and Social Justice |date=1999 |publisher=Oxford University Press |isbn=978-0-19-535501-7 |pages=130 |url=https://books.google.com/books?id=7zoaKIolT9oC&pg=PA130 |language=en}}</ref><ref>{{cite book |url=https://archive.org/details/feministwriters00shel |url-access=registration |title=Feminist Writers |editor1-first=Pamela |editor1-last=Kester-Shelton |editor2-first=Ashley A. |editor2-last=Shelton |editor3-first=Margaret |editor3-last=Mazurkiewicz |location=Detroit |publisher=St. James Press |date=September 17, 1996 |chapter=Christina Hoff Sommers |quote=Philosopher and educator Christina Hoff Sommers's principal work, Who Stole Feminism?, is an edgy invective against contemporary feminism as the author perceives it. |pages=[https://archive.org/details/feministwriters00shel/page/444 444]–446 |isbn=978-1-55862-217-3}}</ref><ref>{{cite web |url-access=subscription |work=Contemporary Authors Online |publisher=Detroit: Gale |date=2005 |title=Biography in Context |access-date=February 29, 2016 |quote=Christina Hoff Sommers attracted wide attention for her controversial 1994 book, Who Stole Feminism?: How Women Have Betrayed Women, an indictment of the contemporary feminist movement. |url=https://www.gale.com/}}</ref><ref>{{cite magazine |url=https://newrepublic.com/article/118430/independent-womens-forum-challenges-one-five-statistic |title=Independent Women's Forum Challenges One In Five Statistic |author=Taylor Malmsheimer |date=June 27, 2014 |magazine=New Republic |quote="Christina Hoff Sommers, a former philosophy professor best known for her critiques of late-twentieth-century feminism."}}</ref> == Maisha ya Awali na Elimu == Sommers alizaliwa mwaka 1950 kwa Kenneth na Dolores Hoff.<ref>{{Cite book |url=https://books.google.com/books?id=uuDh7j7Ruo0C |title=Contemporary Authors: A Biobibliographical Guide to Current Writers in Fiction, General Nonfiction, Poetry, Journalism, Drama, Motion Pictures, Television, and Other Fields. New revision series |isbn=978-0-7876-4604-2 |last1=Peacock |first1=Scot |year=2001 |publisher=Gale Group Publishers}}</ref>Alisoma katika Chuo Kikuu cha Paris, alipata shahada ya Bachelor of Arts kutoka Chuo Kikuu cha New York mwaka 1971, na alipata Doctor of Philosophy katika falsafa kutoka Chuo Kikuu cha Brandeis mwaka 1979.<ref name="CAO">"Christina Hoff Sommers." Contemporary Authors Online. Detroit: Gale, 2005. Biography in Context. Web. February 29, 2016.</ref><ref>{{Cite book |url=https://archive.org/details/feministwriters00shel/page/444 |isbn=978-1-55862-217-3 |title=Feminist writers |year=1996 |last1=Shelton |first1=Pamela L. |last2=Kester-Shelton |first2=Pamela |publisher=St. James Press}}</ref> ==Kazi== ===Mawazo na Mitazamo=== Sommers amejitambulisha kama feministi wa usawa,<ref name="Scatamburlo 1998">{{cite book |last=Scatamburlo |first=Valerie L. |title=Soldiers of Misfortune: The New Right's Culture War and the Politics of Political Correctness |date=1998 |publisher=Lang |location=New York |isbn=0-8204-3012-9 |page=129 |url=https://books.google.com/books?id=TVzuAAAAMAAJ&q=%22sommers%22+%22equity+feminist%22}}</ref><ref name="Nussbaum 1999">{{cite book |last=Nussbaum |first=Martha |date=1999 |title=Sex and Social Justice |chapter=American Women: Preferences, Feminism, Democracy |chapter-url=https://books.google.com/books?id=7zoaKIolT9oC&q=%22equity+feminist%22+sommers |page=[https://archive.org/details/sexsocialjustice00nuss/page/132 132] |publisher=Oxford University Press |location=New York |isbn=0-19-511032-3 |url=https://archive.org/details/sexsocialjustice00nuss/page/132}}</ref><ref name="Gring-Pemble 2000">{{cite journal |last1=Gring-Pemble |first1=Lisa M. |last2=Blair |first2=Diane M. |title=Best-selling feminisms: The rhetorical production of popular press feminists' romantic quest |url=https://archive.org/details/sim_communication-quarterly_fall-2000_48_4/page/360 |journal=Communication Quarterly |date=1 September 2000 |volume=48 |issue=4 |pages=360–379 |doi=10.1080/01463370009385604 |s2cid=143536256 |issn=0146-3373}}</ref><ref>[https://ideas.time.com/contributor/christina-hoff-sommers/ Contributions] to ''Time''</ref> <ref>[https://www.theatlantic.com/author/christina-hoff-sommers/ Contributions] to ''The Atlantic''</ref> <ref>[https://opinionator.blogs.nytimes.com/author/christina-hoff-sommers/ Contributions] to ''The New York Times''</ref> <ref>[https://www.youtube.com/watch?v=cYpELqKZ02Q&list=PLytTJqkSQqtr7BqC1Jf4nv3g2yDfu7Xmd The Factual Feminist] on YouTube</ref> == Marejeo == {{marejeo}} {{Mbegu-mwandishi}} {{BD|1950|}} [[Jamii:Waandishi wa Marekani]] [[Jamii:Feminism and Folklore 2025 in Tanzania]] df2cm3epocv7o3tkcqiuz5876raqp92 0 205742 1578059 1412965 2026-07-02T17:17:12Z InternetArchiveBot 41439 Add 5 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578059 wikitext text/x-wiki {{tafsiri kompyuta}} '''Susan Leigh Star''' ([[1954]] – [[2010]]) alikuwa mwanasosholojia kutoka [[Marekani]]. Alijikita katika utafiti wa [[taarifa]] katika jamii za kisasa; dunia za taarifa; miundombinu ya taarifa; [[lugha]] ya kuainisha|uainishaji na kulinganisha; sosholojia ya sayansi; sosholojia ya kazi; na historia ya sayansi, historia ya tiba, historia ya teknolojia, na mifumo ya mawasiliano/taarifa. Alikuwa akitumia mara nyingi mbinu za mbinu za ubora na nadharia ya kike. Alijulikana pia kwa kuanzisha dhana ya kipengele cha mpaka na michango yake kwa kazi ya ushirikiano inayosaidiwa na kompyuta. ==Maisha== ==Maisha na Elimu== Star alikulia katika eneo la kijijini la tabaka la wafanyakazi huko [[Rhode Island]].<ref name="Balka">{{cite journal |last=Balka |first=Ellen |title=Susan Leigh Star (1954-2010) |url=https://archive.org/details/social-studies-science_2010-08_40_4/page/647 |journal=Social Studies of Science |volume=40 | issue = 4 |date=July 2010 |page=647 |doi=10.1177/0306312710376010|s2cid=145294632 }}</ref>Familia yake ilikuwa ya asili ya Kiyahudi, Kiingereza, na Kil Scotland, na alijielezea kama "nusu-Kiyahudi.".<ref>{{cite web|url=https://www.ics.uci.edu/~gbowker/classification/ |title=SORTING THINGS OUT: CLASSIFICATION AND ITS CONSEQUENCES |publisher=[[University of California, San Diego]] |accessdate=2019-10-23}}</ref>Alikuwa na hamu kubwa ya [[falsafa]], alifanya urafiki na mtawa aliyejiondoa wakati wa shule ya upili na hatimaye alipata ufadhili wa masomo katika Radcliffe College, ambapo alianza kuchukua masomo ya falsafa. Alijisikia kama hakuwa anafaa katika Radcliffe na alikata tamaa ya kupata shahada ya [[dini]], hivyo Star aliacha masomo, akaoa, na kuhamia [[Venezuela]], ambapo alianzisha commune ya kikaboni. Huko, Star alianza kuuliza maswali mengi ambayo yalikuwa msingi wa utafiti wake wa baadaye. Kazi yake inaongozwa na maslahi katika teknolojia na feminism, na ilikuwa wakati huu ambapo [[Harakati ya Wanawake Marekani (1963-1982) na kitabu cha Kate Millett ''Kazi yake inaongozwa na maslahi katika teknolojia na feminism, na ilikuwa wakati huu ambapo Harakati ya Wanawake Marekani (1963-1982) na kitabu cha Kate Millett ''Sexual Politics'' kilimhamasisha kuchunguza na kufanya utafiti juu ya teknolojia na athari ambazo teknolojia nzuri na mbaya zinaweza kuwa nazo kwa watumiaji binafsi na kwa dunia kwa ujumla. Baadaye Star alirudi shuleni na alihitimu magna cum laude kutoka Radcliffe mwaka 1976 akiwa na shahada ya saikolojia na uhusiano wa kijamii. Kisha alihamia [[California]] na alianza masomo ya shahada ya uzamili katika falsafa ya elimu katika Stanford University. Programu hiyo haikufaa, hivyo aliendelea na masomo yake ya uzamili katika sayansi ya jamii katika Chuo Kikuu cha California..<ref name="Balka b">{{cite journal |last=Balka |first=Ellen |title=Susan Leigh Star (1954-2010) |url=https://archive.org/details/social-studies-science_2010-08_40_4/page/648 |journal=Social Studies of Science |volume=40 | issue = 4 |date=July 2010 |page=648 |doi=10.1177/0306312710376010|s2cid=145294632 }}</ref>Wakati akifanya utafiti pamoja na Carl Hewitt kuhusu mchakato wa uamuzi wa jamii ya kisayansi kama mfano wa akili bandia, aliguswa na masuala ya sayansi ya kompyuta. Kuanzia 2004 hadi 2009 alishikilia nafasi ya profesa katika Kituo cha Sayansi, Teknolojia, na Jamii katika Chuo Kikuu cha Santa Clara.<ref name="Clarke">{{cite journal |last1=Clarke |first1=Adele E. |title=In Memoriam: Susan Leigh Star (1954-2010) |url=https://archive.org/details/sim_science-technology-human-values_2010-09_35_5/page/n9 |journal=Science, Technology, & Human Values |date=10 August 2010 |volume=35 |issue=5 |page=584 |doi=10.1177/0162243910378096|s2cid=144471766 }}</ref> ===Kazi ya Kitaaluma=== Kuanzia 1987 hadi 1990, Star alikuwa profesa msaidizi katika Idara ya Sayansi ya Habari na Kompyuta ya UC Irvine. Alihadhiri masomo mbalimbali ikiwemo: uchambuzi wa kijamii wa teknolojia na mashirika, kompyuta na jamii, mbinu za utafiti, na jinsia na teknolojia. Mnamo 1987-1988, Star alishikilia ufadhili katika Centre de Sociologie de l’Innovation huko Paris na alifanya kazi na Bruno Latour na Michel Callon. Walifanya kazi kuhusu mbinu za Kifaransa/Ki-Amerika kuhusu teknolojia na sayansi. Baada ya Irvine, Star alishikilia nafasi ya Mhadhiri Mkuu na Idara ya Isimu na Antropolojia ya Jamii katika Chuo Kikuu cha Keele. Mnamo 1992, Star na mpenzi wake Geoff Bowker walikwenda Shule ya Graduati ya Masomo ya Maktaba na Sayansi ya Habari katika Chuo Kikuu cha Illinois hadi mwaka 1999. Baada ya kuondoka Chuo Kikuu cha Illinois, walirudi California na kuhamia Idara ya Mawasiliano katika Chuo Kikuu cha California San Diego ambapo walikaa hadi 2004. Star na Bowker walihamia kaskazini mnamo 2004 na kufanya kazi katika Kituo cha Sayansi, Teknolojia na Jamii cha Chuo Kikuu cha Santa Clara. Mnamo 2009 walihamia Shule ya Sayansi ya Habari ya Chuo Kikuu cha Pittsburgh, ambapo Star alipewa kiti cha Doreen Boyce. Zaidi ya hayo, amekuwa mzungumzaji mualiko katika vyuo vikuu vingi na kampuni za viwanda, kama vile: Harvard, MIT, na Xerox PARC.<ref name="Zachry">{{cite journal |last=Zachry |first=Mark |title=An Interview with Susan Leigh Star |url=https://archive.org/details/sim_technical-communication-quarterly_october-december-2008_17_4/page/437 |journal=Technical Communication Quarterly |volume=17 | issue = 4 |date=October 2008 |page=437 |doi=10.1080/10572250802329563|s2cid=144431192 }}</ref>Alikuwa pia Mhariri Mkuu wa *Science, Technology, and Human Values* na alikuwa rais wa *Society for the Social Studies of Science* kuanzia 2005 hadi 2007. Star amekuwa na mshawishi mkubwa hasa katika eneo la miundombinu ya taarifa, akisisitiza mara kwa mara kwamba ingawa masomo ya miundombinu mara nyingi yanahusisha uchunguzi wa vitu vinavyoonekana kuwa vya kawaida, vitu hivyo vya kila siku vina athari kubwa kwa wanadamu na mwingiliano wa kibinadamu. Star amefanya kazi kuendeleza njia za kuelewa jinsi watu wanavyowasiliana kuhusu miundombinu, na ameisaidia kuendeleza mbinu za utafiti zinazolenga kuchunguza jukumu la miundombinu katika shughuli za kibinadamu zinazojumuisha mawasiliano. Lakini kazi yake inazidi mipaka ya miundombinu ya taarifa. Hamu ya Star kuhusu uhusiano kati ya teknolojia na uzoefu wa maisha ilisababisha kufanya kazi katika nyanja mbalimbali, ikiwa ni pamoja na sayansi za maktaba, sayansi za kompyuta, neuroscience, falsafa na masomo ya wanawake. ====Vitu vya Mpaka==== Katika makala ""Ecology ya Taasisi, 'Masilahi' na Vitu vya Mpaka: Wapenzi na Wataalamu katika Jumba la Makumbusho la Zoolojia ya Vertebrate la Berkeley, 1907-39", Star na mwandishi mwenzake Griesemer wanatambulisha dhana ya vitu vya mpaka. Katika makala hii, Star na Griesemer wanachambua miaka ya awali ya *Museum of Vertebrate Zoology* kwa kupanua mfano wa interessement ulioendelezwa na Latour na Callon, ili kuunda dhana yao ya vitu vya mpaka.<ref name="Star; Griesemer">{{cite journal|last=Star|first=Susan|author2=Griesemer, James |title=Institutional Ecology, 'Translations' and Boundary Objects: Amateurs and Professionals in Berkeley's Museum of Vertebrate Zoology, 1907-39|journal=Social Studies of Science|year=1989|volume=19|issue=3|pages=387|doi=10.1177/030631289019003001|s2cid=112710658}}</ref>Star na Griesmer awali walifafanua vitu vya mpaka kama "vitu ambavyo ni vya kubadilika vya kutosha ili kuendana na mahitaji ya eneo husika na vikwazo vya pande mbalimbali zinazovitumia, lakini pia vya imara vya kutosha kudumisha utambulisho wa kawaida katika maeneo mbalimbali... Vitu hivi vinaweza kuwa vya kifasili au vya kimwili."Kwa lengo la makala hii, Star na Griesmer walifafanua aina nne za vitu vya mpaka: “hifadhi, aina za kimaadili, mipaka inayolingana na fomu zilizothibitishwa,” hata hivyo Star baadaye alieleza kuwa hakukusudia hii kuwa orodha kamili; badala yake aliona makala hii kama mwanzo wa "orodha ya baadhi ya sifa za vitu vya mpaka."<ref name="Zachry b">{{cite journal |last=Zachry |first=Mark |title=An Interview with Susan Leigh Star |url=https://archive.org/details/sim_technical-communication-quarterly_october-december-2008_17_4/page/440 |journal=Technical Communication Quarterly |volume=17 | issue = 4 |date=October 2008 |page=440 |doi=10.1080/10572250802329563|s2cid=144431192 }}</ref> == Marejeo == {{marejeo}} {{Mbegu-mwandishi}} {{BD|1954|2010}} [[Jamii:Wanahistoria wa Marekani]] [[Jamii:Feminism and Folklore 2025 in Tanzania]] agfekej7q6nnikay0gxurtmzmcek28k 0 205766 1577972 1479407 2026-07-02T13:22:49Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1577972 wikitext text/x-wiki '''Agda Georgina Dorothea Alexandra Montelius''' ([[23 Aprili]] [[1850]] – [[27 Oktoba]] [[1920]]) alikuwa mfadhili na [[mwanaharakati]] wa haki za wanawake kutoka [[Uswidi]]. Alikuwa kiongozi mashuhuri katika harakati za misaada ya kijamii na kampeni za usawa wa kijinsia, hasa katika kupigania haki ya wanawake kupiga kura. Aliongoza Chama cha Fredrika Bremer kutoka mwaka [[1903]] hadi [[1920]].<ref>{{Rejea tovuti|url=http://www.ub.gu.se/kvinn/portaler/arbete/biografier/montelius.xml|title=Agda Montelius|publisher=Göteborgs universitetsbibliotek|accessdate=1 Desemba 2018|archive-date=2019-03-22|archive-url=https://web.archive.org/web/20190322092055/http://www.ub.gu.se/kvinn/portaler/arbete/biografier/montelius.xml|url-status=dead}}</ref> == Wasifu == Montelius alizaliwa mwaka 1850 katika mji wa [[Köping]], akiwa mtoto wa [[Luteni jenerali|Luteni Jenerali]] Alexander Reuterskiöld, waziri wa ulinzi na ofisa wa jeshi la kifalme, na Anna Schenström. Alipata elimu yake katika shule ya wasichana ya Hammarstedtska flickskolan mjini Stockholm. Mnamo tarehe [[20 Septemba]] [[1871]], aliolewa na [[Mwanaakiolojia|mwanakiolojia]] na profesa wa Kiswidi, Oscar Montelius (1843–1921). Montelius alielezewa kama mwanamke mdogo kwa umbo, mtulivu, mwenye huruma, maadili imara na mawazo ya kina. Alijitolea sana katika shughuli mbalimbali za kijamii, licha ya changamoto ya kupoteza uwezo wa kuona katika jicho moja kadiri alivyozeeka. Maisha yake binafsi yaliakisi maadili ya unyenyekevu na nidhamu ya hali ya juu. Alitambuliwa kama kielelezo miongoni mwa wanawake wa tabaka la kati la juu jijini [[Stockholm]]. Lydia Wahlström alimualika mara kwa mara kushuhudia mitihani ya wanafunzi katika shule ya wasichana Åhlinska skolan.<ref>{{Rejea tovuti|url=https://runeberg.org/nfcc/0036.html|title=Reuterskiöld|publisher=Nordisk familjebok|date=1916|access-date=1 Desemba 2018}}</ref><ref>{{Rejea tovuti|url=https://sok.riksarkivet.se/Sbl/Mobil/Artikel/9458|title=Agda G D A Montelius|publisher=Svenskt biografiskt lexikon|author=Ann-Katrin Hatje|accessdate=1 Desemba 2018|archive-date=2018-12-05|archive-url=https://web.archive.org/web/20181205103301/https://sok.riksarkivet.se/Sbl/Mobil/Artikel/9458|url-status=dead}}</ref> == Kazi ya Kijamii na Misaada == Montelius alikuwa mmoja wa viongozi wakuu wa misaada ya kijamii nchini Uswidi mwanzoni mwa karne ya 20. Kauli mbiu yake kuu ilikuwa: "Kuwasaidia watu ili wajisaidie wenyewe." Alikuwa mwanachama wa Nya Idun (Idun Mpya) kuanzia mwaka 1885 hadi 1901, na aliwahi kuwa mwenyekiti wake mwaka 1900–1901. Vilevile, alihudumu katika Maria skyddsförening (Chama cha Ulinzi wa Maria) kati ya 1879 na 1892. Mwaka 1889, alishirikiana kuanzisha Föreningen för välgörenhetens ordnande (Chama cha Kupanga Misaada ya Kijamii), ambacho alikiongoza hadi mwaka 1911, na kisha kuwa mkurugenzi wa kamati yake kuu hadi kifo chake mwaka 1920. Alikuwa pia mwanachama wa kamati kuu ya Sällskapet för uppmuntran av öm och sedlig modersvård (Chama cha Kuhamasisha Malezi ya Maadili kwa Akina Mama) kuanzia 1901 hadi 1920. Alisaidia kuanzisha Centralförbundet för socialt arbete (CSA) (Shirikisho Kuu la Kazi za Kijamii) na Svenska fattigvårdsförbundet (Chama cha Huduma kwa Maskini cha Uswidi), ambapo alihudumu katika nafasi mbalimbali kati ya 1903 na 1920. == Uanaharakati wa Haki za Wanawake == [[File:Rösträttspetitionen.jpg|thumb|Agda Montelius na [[Gertrud Adelborg]] wakimkabidhi Waziri Mkuu [[Erik Gustaf Boström]] ombi la haki ya wanawake kupiga kura, mwaka 1899]] Kupitia shughuli zake za misaada ya kijamii, Montelius alihusika kikamilifu katika harakati za kupigania haki za wanawake. Alifuata mtazamo wa feminismu ya utofauti (difference feminism), akisisitiza umuhimu wa ushiriki wa wanawake katika siasa na uundaji wa jamii kwa ajili ya kuwalinda wagonjwa, wanyonge, na wahitaji kwa lengo la kuifanya jamii kuwa "kama nyumbani kwa wote." Mwaka 1886, alijiunga rasmi na Chama cha Fredrika Bremer (Fredrika Bremer Association, FBF), shirika lililoanzishwa na Sophie Adlersparre. Hata hivyo, alihusika tangu mwaka 1884 kama mmoja wa waanzilishi. Kitaasisi, chama kilikuwa chini ya uongozi wa mwanaume, Hans Hildebrand, ili kupata heshima zaidi kijamii ingawa kwa uhalisia Adlersparre ndiye aliyekuwa akiongoza kwa vitendo. Baada ya kifo cha Adlersparre mnamo 1895, Montelius alichukua uongozi. Awali alikuwa makamu wa mwenyekiti, lakini mnamo mwaka 1903 aliteuliwa rasmi kuwa mwenyekiti, na kuwa mwanamke wa kwanza kuliongoza chama hicho kwa cheo rasmi. == Marejeo == {{marejeo}} {{Mbegu-mwandishi}} {{BD|1850|1920}} [[Jamii:Wanaharakati wa Uswidi]] [[Jamii:Feminism and Folklore 2025 in Tanzania]] 37p3oeu3q1jve87gw0lasy7exvzadq6 0 207820 1578204 1569234 2026-07-03T03:01:23Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578204 wikitext text/x-wiki '''Ubaguzi dhidi ya Wayahudi''' (kwa [[Kiingereza]]: '''Antisemitism''') ni [[chuki]], [[ubaguzi]] au [[upendeleo]] wa aina yoyote dhidi ya [[Wayahudi]].<br>'''Maelezo ya IHRA kuhusu ubaguzi dhidi ya Wayahudi''': * Kuita au kusaidia kuua au kuumiza Wayahudi kwa jina la [[itikadi kali]] au [[dini]]. * Kutunga hadithi za uongo, chuki au kejeli kuhusu Wayahudi au nguvu zao, kama vile kusema Wayahudi wanadhibiti dunia, vyombo vya habari au serikali. * Kuwalaumu Wayahudi wote kwa kosa la mtu mmoja au kundi dogo, au hata kosa lililofanywa na mtu asiye Myahudi. * Kukana mauaji ya [[Maangamizi makuu dhidi ya Wayahudi wa Ulaya]], kama vile kusema hayakutokea, au kupunguza ukubwa wake. * Kusema Wayahudi au Israeli walitunga au walikithirisha hadithi ya [[Maangamizi makuu dhidi ya Wayahudi wa Ulaya]]. * Kusema raia Wayahudi ni waaminifu zaidi kwa Israeli kuliko kwa nchi zao. * Kukataa haki ya Wayahudi ya kuwa na taifa lao wenyewe, mfano kusema kuwa [[Israeli]] ni mradi wa kibaguzi. * Kuitaka Israeli kufuata viwango ambavyo mataifa mengine ya [[demokrasia]] hayatakiwi. * Kutumia picha au maneno ya zamani ya chuki dhidi ya Wayahudi kuelezea Israeli au Waisraeli. * Kufananisha sera za Israeli na zile za Wanazi. * Kuwalaumu Wayahudi wote kwa matendo ya serikali ya [[Israeli]].<ref name="Analyses">*{{cite web |website=American Jewish Committee |title=AJC's glossary of antisemitic terms, phrases, conspiracies, cartoons, themes, and memes. |url=https://www.ajc.org/sites/default/files/pdf/2021-02/AJC_Translate-Hate-Glossary-2021.pdf |year=2021 |access-date=December 3, 2024}} *{{cite web |website=World Jewish Congress |url=https://www.worldjewishcongress.org/en/ihra-misconceptions |title=Magnifying glass<br>Debunking Misconceptions About the Definition of Antisemitism |access-date=October 23, 2024 |quote=Those who hate Jews can no longer hide behind empty rhetoric}} *{{cite web |website=[[Holocaust Encyclopedia]] |title=500 years of antisemitic propaganda |url=https://www.ushmm.org/collections/the-museums-collections/collections-highlights/500-years-of-antisemitic-propaganda |access-date=December 4, 2024}} *{{cite magazine |magazine=Fathom Journal |url=https://fathomjournal.org/holocaust-inversion-and-contemporary-antisemitism |title=Holocaust Inversion and contemporary antisemitism |last=Klaff |first=Lesley |year=2014 |access-date=October 24, 2024}} *{{cite journal |journal=The Christian Century |title=From hateful murmurs to blood libel |url=https://www.christiancentury.org/review/books/hateful-murmurs-blood-libel |last=Sweeney |first=Jon |year=2023 |access-date=December 4, 2024 |quote=Heather Blurton explains the origins and legacy of an outrageous antisemitic lie: the fable of William of Norwich.}} *{{cite news |work=[[Jewish News Syndicate]] |url=https://www.jns.org/holocaust-inversion-is-going-mainstream |title=Holocaust inversion is going mainstream |date=August 15, 2024 |access-date=October 24, 2024 |quote=The point, of course, is to legitimize violence against Jews.}}</ref> Neno lingine linalotumika badala ya "antisemitism" ni '''Judeophobia'''.<ref name="J"> * {{cite book |title=Judeophobia: Attitudes toward the Jews in the Ancient World |url=https://www.hup.harvard.edu/books/9780674487789 |last=Schäfer |first=Peter |publisher=[[Harvard University]] Press |date=October 1, 1998 |isbn=9780674487789 |access-date=November 3, 2024 }} * {{cite journal |journal=Jewish Studies Quarterly |title=Judeophobia: Peter Schäfer on the Origins of Anti-Semitism |url=https://www.jstor.org/stable/40753239 |last=Hayes |first=Christine |volume=6 |issue=3 |year=1999 |pages=261–273 |publisher=Mohr Siebeck GmbH & Co. KG |jstor=stable/40753239 |access-date=November 3, 2024 }} * {{cite book |title=Demonizing the other: Antisemitism, racism and xenophobia |last=Wistrich |first=Robert S. |publisher=Routledge |url=https://www.routledge.com/Demonizing-the-Other-Antisemitism-Racism-and-Xenophobia/Wistrich/p/book/9780415516198?srsltid=AfmBOorY99Ri7050fJeXI_aVojJOJ6Cgs9H9BzucjIJaNJ0g1VHmWr2v |isbn=978-0-415-51619-8 |year=1999 |access-date=December 7, 2024 }} * {{cite news |work=Haaretz |title=Opinion {{!}} Antisemitism? Better Call It Judeophobia |url=https://www.haaretz.com/opinion/2020-11-24/ty-article-opinion/.premium/antisemitism-better-call-it-judeophobia/0000017f-e187-d75c-a7ff-fd8fb67f0000 |last=Sand |first=Shlomo |date=November 24, 2020 |access-date=November 3, 2024 }} * {{cite magazine |magazine=Israel Today |title=It’s Not Antisemitism, It’s Judeophobia. What’s the Difference and Why You Should Know |url=https://www.israeltoday.co.il/read/its-not-antisemitism-its-judeophobia-whats-the-difference-and-why-you-should-know |date=July 1, 2021 |last=Sadan |first=Tsvi |access-date=December 3, 2024 }}</ref> Baadhi ya watu hupendelea jina hili kwa sababu "antisemitism" linaweza kueleweka kwa njia tofauti.<ref name="J" /> ==Muhtasari== [[Historia ya binadamu]] imejawa na chuki dhidi ya Wayahudi (antisemitism),<ref name="J" /> ambapo mfano mbaya zaidi ni [[Maangamizi Makuu (Holocaust)]],<ref name="Holocaust introductions">* {{cite book |chapter=Faith, murder, resurrection: The Iron Guard and the Romanian Orthodox Church |title=Antisemitism, Christian Ambivalence, and the Holocaust |last=Shapiro |first=P.A. |url=https://muse.jhu.edu/pub/3/monograph/book/4016 |publisher=[[Indiana University]] Press |year=2007 |isbn=9780253116741 |oclc=191071016 |access-date=November 4, 2024 }} * {{cite book |chapter=Towards the Holocaust |title=The Changing Face of Antisemitism: From Ancient Times to the Present Day |url=https://global.oup.com/academic/product/the-changing-face-of-anti-semitism-9780195341218?cc=gb&lang=en& |last=Laqueur |first=Walter |date=July 30, 2009 |publisher=[[University of Oxford|Oxford University]] Press, USA |isbn=9780195341218 |access-date=November 3, 2024 }} * {{cite web |title=Deportation of Hungarian Jews |url=https://www.ushmm.org/learn/timeline-of-events/1942-1945/deportation-of-hungarian-jews |work=Timeline of Events |publisher=United States Holocaust Memorial Museum |access-date=October 6, 2017 |archive-url=https://web.archive.org/web/20171125004028/https://www.ushmm.org/learn/timeline-of-events/1942-1945/deportation-of-hungarian-jews |archive-date=25 November 2017 |url-status=live }} * {{cite web |last1=Brosnan |first1=Matt |title=What Was The Holocaust? |url=https://www.iwm.org.uk/history/what-was-the-holocaust |publisher=Imperial War Museum |date=June 12, 2018 |archiveurl=https://archive.today/20190302062958/https://www.iwm.org.uk/history/what-was-the-holocaust |archive-date=March 2, 2019 |access-date=2 March 2019 |url-status=live |df=dmy-all }} * {{Rejea tovuti|title=36 Questions About the Holocaust|url=https://www.museumoftolerance.com/education/teacher-resources/holocaust-resources/36-questions-about-the-holocaust.html|access-date=2024-10-14|website=Museum of Tolerance, [[Los Angeles]]}}{{Dead link|date=June 2026 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> huku aina ya kawaida ya chuki dhidi ya Wayahudi ikiwa ni [[Nadharia ya njama|nadharia za njama]].<ref> * {{cite web |website=University of Edinburgh Research Archive |title=Metaphysical conspiracism: UFOs as discursive object between popular millennial and conspiracist fields |url=https://era.ed.ac.uk/handle/1842/10586 |last=Robertson |first=David George |date=November 25, 2014 |access-date=December 14, 2024}} * {{cite journal |journal=Antisemitism Studies |title=Conspiracy Fetishism, Community, and the Antisemitic Imaginary |url=https://muse.jhu.edu/article/767680 |last=Bronner |first=Stephen Eric |pages=371–387 |volume=4 |issue=2 |publisher=[[Indiana University]] Press |year=2020 |doi=10.2979/antistud.4.2.06 |access-date=December 14, 2024}} * {{cite journal |journal=Journal of Personality and Social Psychology |title=What breeds conspiracy antisemitism? The role of political uncontrollability and uncertainty in the belief in Jewish conspiracy |url=https://psycnet.apa.org/record/2020-00767-001 |last1=Kofta |first1=Mirosław |last2=Soral |first2=Wiktor |last3=Bilewicz |first3=Michał |pages=900–918 |volume=118 |issue=5 |doi=10.1037/pspa0000183 |year=2020 |access-date=December 14, 2024}} * {{cite book |title=Handbook of UFO Religions |chapter=Chapter 7 They Knew Too Much: The Entangled History of Conspiracy Theories, UFOs and New Religions |url=https://brill.com/display/book/9789004435537/BP000017.xml |last=Robertson |first=David G. |pages=178–196 |doi=10.1163/9789004435537_009 |year=2021 |access-date=December 14, 2024}} * {{cite book |title=The Routledge Handbook of Religion and Secrecy |chapter=Conspiracy Theories about Secret Religions: Imagining the Other |url=https://www.taylorfrancis.com/chapters/edit/10.4324/9781003014751-33/conspiracy-teories-secret-religions-imagining-david-robertson |last=Robertson |first=David G. |edition=1 |publisher=Routledge |isbn=9781003014751 |year=2022 |access-date=December 14, 2024}}</ref><ref>* {{cite journal |journal=New German Critique |title=Outrageous Conspiracy Theories: Popular and Official Responses to 9/11 in Germany and the United States |url=https://www.jstor.org/stable/27669225 |last=Knight |first=Peter |issue=103 |pages=165–193 |publisher=[[Duke University]] Press |year=2008 |access-date=December 14, 2024 }} * {{cite journal |journal=Journal of Contemporary Antisemitism |title=Antisemitic Conspiracy Theories and Violent Extremism on the Far Right: a Public Health Approach to Counter-Radicalization |url=https://www.degruyter.com/document/doi/10.26613/jca/2.1.19/pdf |last=Byington |first=Bradley |doi=10.26613/jca/2.1.19 |date=December 19, 2020 |access-date=December 14, 2024 }} * {{cite journal |journal=Language and Literature: International Journal of Stylistics |title=Antisemitic conspiracy fantasy in the age of digital media: Three ‘conspiracy theorists’ and their YouTube audiences |url=https://journals.sagepub.com/doi/full/10.1177/0963947020971997 |last1=Allington |first1=Daniel |last2=Buarque |first2=Beatriz L |last3=Flores |first3=Daniel Barker |volume=30 |issue=1 |doi=10.1177/0963947020971997 |date=December 27, 2020 |access-date=December 14, 2024 }} * {{cite journal |journal=Polyphony |title=Does Antisemitism Provide the Blueprint for Nearly All Conspiracy Theories? |url=https://www.polyphonyjournal.com/_files/ugd/110a40_815d58f1316344cb8a302a1e972e483d.pdf#page=35 |last=Dye |first=Isobel |volume=5 |issue=2 |publisher=American Studies Press |date=June 24, 2023 |access-date=December 14, 2024 |archive-date=2024-03-29 |archive-url=https://web.archive.org/web/20240329155155/https://www.polyphonyjournal.com/_files/ugd/110a40_815d58f1316344cb8a302a1e972e483d.pdf#page=35 |url-status=dead }} * {{cite book |title=Handbook of Prejudice, Stereotyping, and Discrimination |chapter=The Psychology of Contemporary Antisemitism |url=https://www.taylorfrancis.com/chapters/edit/10.4324/9781003399162-14/psychology-contemporary-antisemitism-neil-kressel |last=Kressel |first=Neil J. |edition=3 |publisher=Routledge |isbn=9781003399162 |year=2024 |access-date=December 14, 2024}}</ref> [[Kivumishi]] cha chuki dhidi ya Wayahudi ni '''-enye chuki dhidi ya Wayahudi'''. Wale wenye maoni ya chuki dhidi ya Wayahudi wanaitwa '''wachukia Wayahudi'''.<ref> * {{cite magazine |magazine=Tablet magazine |title=Intersectional Antisemitism in America |url=https://www.tabletmag.com/sections/news/articles/intersectional-antisemitism-america |last=Vidino |first=Lorenzo |date=February 8, 2023 |access-date=December 16, 2024 |quote=More often, left-wing antisemites claim to be acting in the name of [[Progressivism|progressive]] principles while espousing the same [[#Lies about Jews|trite tropes]] that depict [[#Modern|Jews as embodiments of soulless capitalism]], [[colonialism]] (Israel is cast as the last colonial state), and white privilege.}} * {{cite journal |journal=Fathom Journal |title=Anti-Zionism’ has become the new Antisemitism in Ireland |url=https://fathomjournal.org/anti-zionism-has-become-the-new-antisemitism-in-ireland |last=Sears |first=Oliver |year=2024 |access-date=December 16, 2024 |quote=The language I hear denouncing Zionism is identical to the language deployed by antisemites, historical and current.}} * {{cite magazine |magazine=Spiked |title=Who is the Guardian to call spiked ‘hard right’? |url=https://www.spiked-online.com/2024/12/09/who-is-the-guardian-to-call-spiked-hard-right |last=Slater |first=Tom |date=December 9, 2024 |access-date=December 16, 2024 |quote=While it [[Smear campaign|smears]] us as [[Far-right politics|right-wing extremists]], it stands accused of harbouring [[Misogyny|misogynists]] and anti-Semites.}} * {{cite news |work=The Free Press |title=The Explosion of Jew-Hate in Trudeau’s Canada |url=https://www.thefp.com/p/explosion-of-jew-hate-in-canada-trudeau-israel-palestine |last=Glavin |first=Terry |date=December 11, 2024 |access-date=December 16, 2024 |quote=Almost none of these verbal or physical assaults are coming from [[White supremacy|white supremacists]] or antisemites of the [[Right-wing politics|right-wing variety]]. They are being carried out by self-described [[Progressivism|progressives]], Arabs [... .]}} * {{cite journal |journal=Jewish Journal |title=Pity the Poor Antisemite |url=https://jewishjournal.com/commentary/opinion/377749/pity-the-poor-antisemite |last=Socken |first=Paul |date=December 13, 2024 |access-date=December 16, 2024 |quote=The antisemite is the most extreme and enduring symptom of a society in crisis.}}</ref> ===Mwenendo wa hivi karibuni=== [[File:This is the Devil Black Jesus sign protest by Black Hebrew Israelites at San Diego.jpg|thumb|[[Black Hebrew Israelites]], ambao wanakataa kuamini kwamba [[Yesu]] alikuwa [[Myahudi|Myahudi]], walipinga huko [[San Diego, California]] dhidi ya [[Uchoraji|taswira]] ya muda mrefu ya Yesu kama "[[Wazungu|Mzungu]]" badala ya [[Watu weusi|Mweusi]].]][[File:12 Lost Tribes of Israel.jpg|thumb|[[Bango]] la [[propaganda]] lililotengenezwa na Black Hebrew Israelites (BHI) likimaanisha kuwa [[Waamerika Weusi|Weusi]] na [[Wenyeji wa Amerika]] ndio "warithi halisi" wa [[Makabila ya Israeli|Makabila Kumi Yaliyopotea]] ya [[Waisraeli|Israeli]]. BHI wanadai kwamba watu hao wameainishwa "kimakosa" na [[Ubeberu|waheberu]] weupe katika makundi tofauti ya kikabila kote katika Dunia ya Magharibi.]] Mnamo Januari 14, 2025, kikundi cha [[haki za kiraia]] cha Marekani [[Anti-Defamation League]] (ADL) kilitangaza matokeo ya utafiti wao mpya wa kimataifa (washiriki 58,000) kwamba 46% ya watu wazima duniani (takriban watu 2,200,000,000) walikuwa na maoni yaliyokita mizizi ya chuki dhidi ya Wayahudi.<ref name="Jan2025I">{{cite news |work=Algemeiner |title=Nearly Half of World’s Adults Hold Antisemitic Views, ADL Survey Finds |url=https://www.algemeiner.com/2025/01/14/nearly-half-worlds-adults-hold-antisemitic-views-adl-survey-finds |last=Pierre |first=Dion J. |date=January 14, 2025 |access-date=January 15, 2025}}</ref> Miongoni mwa washiriki, 56% walifikiri kwamba Wayahudi walikuwa "waaminifu kwa Israeli pekee" huku 46% wakiamini kwamba "Wayahudi walikuwa na nguvu nyingi juu ya masuala ya kimataifa".<ref name="Jan2025I" /> 76% ya wale walio katika [[Mashariki ya Kati]] na [[Afrika Kaskazini]] (MENA) walionekana kukubaliana na [[Kasumba|dhana potofu]] 11 hasi kuhusu Wayahudi,<ref name="Jan2025I" /> asilimia ya juu zaidi kuliko maeneo mengine yote.<ref name="Jan2025I" /> Wakati huo huo, [[Kuwait]] na [[Indonesia]] zilipatikana kuwa na asilimia kubwa zaidi ya dhana hizo.<ref name="Jan2025II">{{cite news |work=Haaretz |title='Deeply Alarming' {{!}} Kuwait and Indonesia Top List of World's Most Antisemitic Countries, Global Survey Shows |url=https://www.haaretz.com/jewish/2025-01-14/ty-article/.premium/kuwait-and-indonesia-top-list-of-worlds-most-antisemitic-countries-global-survey-shows/00000194-5f7d-df8d-abbd-dfffe5250000 |last=Maltz |first=Judy |date=January 14, 2025 |access-date=January 15, 2025}}</ref> Kuhusu [[Maangamizi Makuu (Holocaust)]], ni 48% tu ya washiriki walitambua usahihi wake wa kihistoria, huku asilimia ikiwa ya chini kabisa (39%) miongoni mwa kundi la umri wa miaka 18–34,<ref name="Jan2025II" /> kinyume na imani ya kawaida ya wasomi wa kushoto kwamba vijana wana uwezekano mdogo wa kuelewa juu ya [[Ubaguzi wa rangi|wabaguzi wa rangi]].<ref>{{cite news |work=[[Wall Street Journal]] (WSJ) |title=Nearly Half of Adults Worldwide Hold Antisemitic Views, Survey Finds |url=https://www.wsj.com/world/nearly-half-of-adults-worldwide-hold-antisemitic-views-survey-finds-574a1766 |last=Pancevski |first=Bojan |date=January 14, 2025 |access-date=January 15, 2025 |quote=Antisemitism has surged, especially among the young, as the Holocaust fades from collective memory}}</ref> ==Asili ya jina== [[Mwanahistoria]] wa Marekani [[Deborah Lipstadt]] na wataalamu kadhaa wa chuki dhidi ya Wayahudi walisema kwamba neno ''antisemitism'' lilibuniwa na mwanaharakati wa [[Ujerumani|Kijerumani]] mwenye chuki dhidi ya Wayahudi [https://www.britannica.com/biography/Wilhelm-Marr Wilhelm Marr] katika [[kitabu]] chake ''Path to Victory of Germanism Over Judaism'' kurejelea [[chuki]] dhidi ya Wayahudi, ambayo aliona ni muhimu kwa [[Jamii (sosholojia)|mbari]] ya Kijerumani kuwazuia Wayahudi (kikundi kikuu cha ''[[Wasemiti]]'' Ulaya wakati huo) kuharibu [[Ujerumani#Utamaduni|utamaduni wa Kijerumani]].<ref name="O">{{cite web |website=[[Jewish Virtual Library]] |title=Anti-Semitism or Antisemitism? |last=Bard |first=Mitchell |url=https://www.jewishvirtuallibrary.org/anti-semitism-or-antisemitism |access-date=November 4, 2024}}</ref> Licha ya ''Wasemiti'' kujumuisha makundi mengine ya kikabila ya [[Mashariki ya Kati]],<ref name="Semite"> * {{cite web |website=American Jewish Committee |title=Semite {{!}} #TranslateHate {{!}} AJC |url=https://www.ajc.org/translatehate/Semite |access-date=January 16, 2025 |quote=Given the term’s [[Linguistics|linguistic]] origins [...] some Arabic speakers say they cannot be antisemitic because they are “Semites” too [...] these claims are actually a [[Example|manifestation]] of turn of the [[Roman Catholics and antisemitism in the 21st century|century European]] [[racism]] [. ...] the [[Black Hebrew Israelites]], have said they cannot be antisemitic because they “are the Semitic people.” [[Celebrity]] [[Kanye West|Kanye (Ye) West]] echoed this [[Delusion|belief]] [. ...which] is an example of the [[#Lies about Jews|antisemitic claim]] that [[Jewish diaspora|today’s Jews]] are not [[Descendant|descended]] from the [[Israelites|Jews of the Bible]].}} * {{cite news |work=The Jerusalem Post |title=Encyclopedia Britannica: Arab, Semitic people can't be called antisemitic |url=https://jpost.com/diaspora/antisemitism/article-695378 |last=Starr |first=Michael |date=February 4, 2022 |access-date=January 16, 2025 |quote=Excluding Arabs and Semitic people from being labeled antisemitic because of their "Semitism" is what is called a "etymological fallacy" -- When the archaic root words or original meaning of a term are used to make an argument about the current meaning or even the generally accepted definition.}} * {{cite web |website=[[Britannica]] |title=Origins and concept of anti-Semitism |url=https://www.britannica.com/summary/anti-Semitism |access-date=January 16, 2025}}</ref> wanaharakati wa Ujerumani kama Wilhelm Marr waliwarejelea Wayahudi kama ''Wasemiti'' hasa.<ref name="O" /><ref name="Semite" /> Kutokana na [[Semantiki|maana]], ''antisemitism'' haiwezi kuchukuliwa kama chuki dhidi ya makundi yote ya ''Kisemitiki'', au ingesababisha makosa ya kiisimu (kutumia maana ya zamani ya neno kufanya hoja kuhusu maana yake ya sasa).<ref name="Semite" /> Zaidi ya hayo, neno hilo linajumuisha Wayahudi wanaofanya [[Uyahudi]], Wayahudi walio badili dini na kuwa [[Ukristo]] na wale wenye [[asili]] ya Kiyahudi inayoweza kufuatiliwa,<ref name="O" /><ref name="Semite" /> ambao wote wanaweza kuwa waathirika wa chuki dhidi ya Wayahudi.<ref name="O" /><ref name="Semite" /> ===Tahajia=== Neno hili huandikwa na wengine kama ''anti-Semitism'', lakini [[tahajia]] kama hiyo ina utata. Wanahistoria wameeleza kuwa ''anti-Semitism'' inapotosha kwani hakuna [[itikadi]] kama "Semitism" inayoweza kupingwa,<ref name="O" /><ref name="Semite" /> huku [[dhana]] ya ''[[Wasemiti]]'' [[Kinasaba|ikichimbuka]] kutoka sayansi-bandia ya karne ya 19 ubaguzi wa rangi wa kisayansi.<ref name="O" /><ref name="Semite" /> ==Uongo kuhusu Wayahudi== ===Kale=== # Wayahudi walimuua Yesu # Wayahudi waliwasaliti [[Nabii|manabii]] wao<ref name="A1" /><ref name="A2">* {{cite journal|journal=HAU: Journal of Ethnographic Theory|title=The Roman Catholic Church, the Holocaust, and the demonization of the Jews. Response to “Benjamin and us: Christanity, its Jews, and history” by Jeanne Favret-Saada|url=https://www.journals.uchicago.edu/doi/pdfplus/10.14318/hau4.3.020|last=Kertzer|first=David I.|pages=329–333|volume=4|issue=3|publisher=The [[University of Chicago]] Press|location=[[Brown University]], [[Providence, Rhode Island]], [[United States]]|access-date=December 23, 2024|quote=OPEN ACCESS}} * {{cite web|website=[[United States Holocaust Memorial Museum]]|title=Antisemitism in History: From the Early Church to 1400|url=https://encyclopedia.ushmm.org/content/en/article/antisemitism-in-history-from-the-early-church-to-1400|access-date=December 23, 2024}} * {{cite news|work=The Jerusalem Post|url=https://www.jpost.com/jerusalem-report/the-resurrection-of-christian-antisemitism-631109|title=The resurrection of Christian antisemitism|date=18 June 2020|access-date=6 October 2024}} * {{cite news|work=The Telegraph|url=https://www.telegraph.co.uk/politics/2024/02/15/tory-mayor-salisbury-atiqul-hoque-expelled-antisemitism|title=Expelled Tory mayor 'said Jews were responsible for Jesus's death'|date=February 15, 2024|access-date=October 15, 2024}} * {{cite web|website=[[Southern Poverty Law Center]]|url=https://www.splcenter.org/fighting-hate/extremist-files/ideology/radical-traditional-catholicism|title=Radical Traditional Catholicism|access-date=December 23, 2024}}</ref> # Wayahudi wanapanga njama dhidi ya Ukristo<ref name="A3">{{cite book |url=http://archive.adl.org/presrele/asus_12/the_talmud.pdf |title=The Talmud in Anti-Semitic Polemics |publisher=[[Anti-Defamation League]] |year=2003 |access-date=15 August 2014 |page=11 |archive-url=https://web.archive.org/web/20140815143023/http://archive.adl.org/presrele/asus_12/the_talmud.pdf |archive-date=15 August 2014}}</ref> ===Zama za Kati=== # Wayahudi huchukua [[damu]] kutoka kwa [[Mtoto|watoto wachanga]] Wakristo kwa ajili ya [[Uyahudi|ibada]] ('''mashtaka ya damu''')<ref name="A3" /><ref> * {{cite book |first=Gane S. |last=Gerber |date=1986 |title=History and hate: the dimensions of anti-Semitism |url=https://archive.org/details/historyhatedimen0000unse |publisher=Jewish Publication Society of America |isbn=0827602677 |page=88}} * {{cite book |first=John |last=Kelly |date=2005 |title=The Great Mortality: An Intimate History of the Black Death, the Most Devastating Plague of All Time |url=https://archive.org/details/greatmortality00kell |publisher=HarperCollins |isbn=978-0060006921 |page=[https://archive.org/details/greatmortality00kell/page/242 242]}} * {{cite web |url=http://www.memri.org/report/en/0/0/0/0/0/177/1561.htm |title=Iranian TV Blood Libel: Jewish Rabbis Killed Hundreds of European Children to use Their Blood for Passover Holiday & Discussion on Holocaust Denial |archive-url=https://web.archive.org/web/20110604135837/http://www.memri.org/report/en/0/0/0/0/0/177/1561.htm |archive-date=4 June 2011 |date=22 December 2005}}</ref> # Wayahudi kuabudu [[Shetani]]<ref name="A1" /><ref name="A2" /> # Wayahudi hutia [[sumu]] [[Kisima|visima]] kusababisha [[Mlipuko wa ugonjwa|milipuko ya magonjwa]], ikiwemo [[karne ya 14]] Kifo Cheusi<ref name="A3" /><ref> * Etinger, Iakov (1995). "The Doctors' Plot: Stalin's Solution to the Jewish Question". In Yaacov Ro'i, ''Jews and Jewish Life in Russia and the Soviet Union''. London: Frank Cass. {{ISBN|0-7146-4619-9}}, pp. 103–6. * {{cite web |website=World Jewish Congress |url=https://www.worldjewishcongress.org/en/news/this-week-in-jewish-history--six-jewish-doctor-arrested-jumpstarting-doctors-plot-1-4-2021 |title=Six Jewish doctors arrested, jumpstarting 'Doctors Plot'}} * {{cite news |work=[[The Forward]] |url=https://forward.com/culture/575235/zionist-doctors-plot-soviet-antisemitic-conspiracy |title=A viral post demonizing Zionist doctors sounds eerily like a Soviet antisemitic conspiracy theory}} * {{cite news |work=Jewish News |url=https://www.jewishnews.co.uk/american-anti-racism-activist-condemned-over-terrified-about-zionist-doctors-claim |title=American 'anti-racism' activist condemned over 'terrified about Zionist doctors' claim}}</ref> ===Siku hizi=== # Wayahudi wanadhibiti vyombo vya habari<ref name="A3" /><ref>{{cite book |last1=Láníček |first1=Jan |title=Czechs, Slovaks and the Jews, 1938–48: Beyond Idealisation and Condemnation |date=2013 |publisher=Springer |location=New York |isbn=978-1-137-31747-6 |language=en}}</ref> # Wayahudi wanadhibiti [[Benki|benki]]<ref name="A3" /><ref>{{cite web |title=Jewish 'Control' of the Federal Reserve: A Classic Anti-Semitic Myth |url=http://archive.adl.org/special_reports/control_of_fed/print.html |website=[[Anti-Defamation League]] |access-date=25 January 2014 |archive-url=https://web.archive.org/web/20140112040544/http://archive.adl.org/special_reports/control_of_fed/print.html |archive-date=12 January 2014}}</ref> # Wayahudi wanadhibiti serikali duniani kote<ref> * {{cite journal |first=Svetlana |last=Boym |title=Conspiracy theories and literary ethics: Umberto Eco, Danilo Kis and ''The Protocols of Zion'' |url=https://archive.org/details/sim_comparative-literature_spring-1999_51_2/page/n2 |journal=Comparative Literature |date=Spring 1999 |volume=51 |issue=2 |pages=97–122 |doi=10.2307/1771244 |jstor=1771244}} * {{cite web |website=World Jewish Congress |url=https://www.worldjewishcongress.org/en/conspiracy-myths/the-myth-that-jews-control-the-world |title=The Myth that Jews Control the World |access-date=October 26, 2024}} * {{cite journal |journal=Center on Terrorism, Extremism, and Counterterrorism |title=The Violent Impact of Anti-Semitic Conspiracy Theories: Examining the Jewish World Domination Narratives and History |url=https://www.middlebury.edu/institute/academics/centers-initiatives/ctec/ctec-publications/violent-impact-anti-semitic-conspiracy |last=S. Broschowitz |first=Michael |publisher=Middlebury Institute of International Studies at Monterey |date=May 6, 2022 |access-date=October 26, 2024}} * {{cite book |last1=Alderman |first1=G. |title=The Jewish Community in British Politics |url=https://archive.org/details/jewishcommunityi0000alde |date=1983 |publisher=Clarendon Press |location=[[Oxford]] |page=102}}</ref><ref> * {{cite journal |last1=Herf |first1=Jeffrey |title=The 'Jewish War': Goebbels and the Antisemitic Campaigns of the Nazi Propaganda Ministry |journal=Holocaust and Genocide Studies |year=2005 |volume=19 |issue=1 |pages=51–80 |doi=10.1093/hgs/dci003 |s2cid=143944355}} * {{cite web |website=domino.un.org |url=http://domino.un.org/UNISPAL.NSF/0/4eb2f5f2a5956cfb85256e59006dd050?OpenDocument |publisher=[[United Nations Economic and Social Council]] |title=Dissemination of racist and antisemitic hate material on television programs |access-date=30 September 2005 |archive-url=https://archive.today/20121228183944/http://domino.un.org/UNISPAL.NSF/0/4eb2f5f2a5956cfb85256e59006dd050?OpenDocument |archive-date=28 December 2012}} * {{cite book |first=Sidney |last=Schwarz |year=2006 |title=Judaism and Justice: The Jewish Passion to Repair the World |publisher=Jewish Lights Publishing |isbn=1-58023-312-0 |page=[https://archive.org/details/judaismjusticeje00schw/page/96 96] |url=https://archive.org/details/judaismjusticeje00schw}} * {{cite book |last1=Mendes |first1=Philip |title=Debunking the myth of Jewish communism |date=2010}}</ref> # Wayahudi wanazua [[Vita|vita]] na mapinduzi duniani [[dunia]]<ref name="A3" /><ref>{{cite journal |last1=Karsh |first1=Efraim |date=July 2012 |title=The war against the Jews |url=https://www.researchgate.net/publication/241713271 |journal=Israel Affairs |volume=18 |issue=3 |pages=319–343 |doi=10.1080/13537121.2012.689514 |s2cid=144144725}}</ref> ===Sasa hivi=== # Wayahudi ni walimwengu wasio na asili<ref> * {{cite book |title=The Changing Face of Anti-Semitism: From Ancient Times to the Present Day |chapter=Contemporary Antisemitism |url=https://global.oup.com/academic/product/the-changing-face-of-anti-semitism-9780195304299?cc=gb&lang=en& |last=Laqueur |first=Walter |isbn=9780195304299 |date=September 21, 2006 |access-date=February 9, 2025}} * {{cite book |last=Figes |first=Orlando |title=The Whisperers: Private Life in Stalin's Russia |year=2007 |publisher=Metropolitan Books |location=New York City |isbn=978-0-8050-7461-1 |url=https://archive.org/details/whisperersprivat00fige |url-access=registration |page=[https://archive.org/details/whisperersprivat00fige/page/494 494]}} * Etinger, Iakov (1995). "The Doctors' Plot: Stalin's Solution to the Jewish Question". In Yaacov Ro'i, ''Jews and Jewish Life in Russia and the Soviet Union''. London: Frank Cass. {{ISBN|0-7146-4619-9}}, pp. 103–6. * {{cite web |website=World Jewish Congress |url=https://www.worldjewishcongress.org/en/news/this-week-in-jewish-history--six-jewish-doctor-arrested-jumpstarting-doctors-plot-1-4-2021 |title=Six Jewish doctors arrested, jumpstarting 'Doctors Plot' |year=2021}} * {{cite news |work=Jewish News |url=https://www.jewishnews.co.uk/american-anti-racism-activist-condemned-over-terrified-about-zionist-doctors-claim |title=American 'anti-racism' activist condemned over 'terrified about Zionist doctors' claim |date=January 3, 2024 |access-date=February 8, 2025}} * {{cite news |work=[[The Forward]] |url=https://forward.com/culture/575235/zionist-doctors-plot-soviet-antisemitic-conspiracy |title=A viral post demonizing Zionist doctors sounds eerily like a Soviet antisemitic conspiracy theory |date=January 4, 2024 |access-date=February 8, 2025}}</ref><ref> * {{cite book |last=Brook |first=Vincent |year=2006 |title=You Should See Yourself: Jewish Identity in Postmodern American Culture |url=https://archive.org/details/youshouldseeyour0000unse_e5i8 |location=New Brunswick, NJ |publisher=Rutgers University Press |page=[https://archive.org/details/youshouldseeyour0000unse_e5i8/page/n179 166] |isbn=0813538440 |quote=This outlook can be viewed positively as a condition that enhances Jews' and adaptability and empathy for others, or it can have a negative connotation, as in the recurring trope of the rootless cosmopolitan}} * {{cite web |url=https://www.newstatesman.com/politics/uk/2019/05/no-direction-home-tragedy-jewish-left| title=No direction home: the tragedy of the Jewish left |last=Glasman |first=Maurice |date=22 May 2019 |website=New Statesman |quote=I knew that the phrase "rootless cosmopolitan" was minted by Stalin and his executioners in the show trials to exterminate Jews, particularly [[Trotskyism|Trotskyists]], for whom this became the standard expression. I cannot hear it without the dread fear of the knock on the door by the [[Cheka]] in the early hours.}} * {{cite hansard |jurisdiction=Parliament of the United Kingdom |title=Anti-Semitism |url=https://hansard.parliament.uk/Commons/2018-04-17/debates/9D70B2B4-39D7-4241-ACF8-13F7DFD8AEB2/Anti-Semitism |house=House of Commons |date=16 April 2014 |column=255 |speaker=Andrew Gwynne}} * {{cite news |work=Jewish News |title=Union official told to ‘cease’ social media after ‘rootless cosmopolitans’ tweet |url=https://www.jewishnews.co.uk/union-official-told-to-cease-social-media-after-rootless-cosmopolitans-tweet |date=April 8, 2019 |access-date=February 8, 2025}} * {{cite magazine |magazine=Slate |title=Fox News Analyst Recently Said “Rootless Cosmopolitans”—Also Known as Jews—Are the Cause of America’s Problems |url=https://slate.com/news-and-politics/2022/03/fox-news-analyst-rootless-cosmopolitans-jews-russia.html |last=Mathis-Lilley |first=Ben |date=March 17, 2022 |access-date=February 8, 2025}} * {{cite news |work=The Jewish Chronicle |title=Anti-Zionist speaker uses Stalinist slogan about Jews at Holocaust Memorial Day event |url=https://www.thejc.com/news/uk/anti-zionist-speaker-uses-stalinist-slogan-about-jews-at-holocaust-memorial-day-event-jh72eci7 |date=January 26, 2024 |access-date=February 8, 2025}}</ref> # Wayahudi ni waongofu wa Ulaya wa [[Uyahudi]] [[Kizazi|waliozaliwa]] kutoka kwa [[Khazars]]<ref>* {{Rejea kitabu |chapter= Contemporary Arab Anti-Semitism: its Causes and Roots |title= The Persisting Question: Sociological Perspectives and Social Contexts of Modern Antisemitism |last= Harkabi |first= Yehoshafat |editor-last= Fein |editor-first= Helen |publisher= Walter de Gruyter |year= 1987 |orig-year= 1968 |pages= 412–427 |isbn= 978-3-11-010170-6 |chapter-url= https://books.google.com/books?id=uHWG1pDCtNgC&pg=PA424 }} * {{cite encyclopedia |title = The story of a euphemism: The Khazars in Russian Nationalist Literature 353-372 |last = Schnirelmann |first = Victor A. |editor1-last = Golden |editor1-first = Peter B. |editor2-last = Ben-Shammai |editor2-first = Haggai |editor3-last = Róna-Tas |editor3-first = András |encyclopedia = The World of the Khazars: New Perspectives |series = Handbook of Oriental Studies |volume = 17 |publisher = [[Brill Publishers|Brill]] |year = 2007a |pages = 353–372 |isbn = 978-90-04-16042-2 |url = https://books.google.com/books?id=yO-vCQAAQBAJ }} * {{cite news |title= Contemporary Racist and Judeophobic Ideology Discovers the Khazars, or, Who Really Are the Jews? |last= Singerman |first= Robert |newspaper= Rosaline and Myer Feinstein Lecture Series 2004 |year= 2004 |url= https://www.academia.edu/5289705 |access-date= 1 March 2014 |archive-date= 23 November 2023 |archive-url= https://web.archive.org/web/20231123064422/https://www.academia.edu/5289705 |url-status= dead }} * {{cite book |chapter = Anti-Semitism in Eurasian Historiography: The Case of Lev Gumilev |last = Rossman |first = Vadim Joseph |title = Russia Between East and West: Scholarly Debates on Eurasianism |editor-last = Shlapentokh |editor-first = Dmitry |publisher = [[Brill Publishers|Brill]] |year = 2007 |isbn = 978-9-004-15415-5 |chapter-url = https://books.google.com/books?id=EnsHyxPZfOIC&pg=PA134 }} * Rory Miller(2020) [https://www.taylorfrancis.com/chapters/edit/10.4324/9780429026034-2/anti-zionist-jewish-khazar-syndrome-official-british-mind-rory-miller The anti-Zionist ‘Jewish Khazar’ syndrome in the official British mind]</ref><ref name="BHI"> * {{cite book |title=Jews, Slaves, and the Slave Trade: Setting the Record Straight |url=https://www.jstor.org/stable/j.ctt9qg5gs |last=Faber |first=Eli |year=1998 |publisher=[[New York University|NYU]] Press |edition=1 |jstor=j.ctt9qg5gs |isbn=978-0814726396 |access-date=December 2, 2024}} * {{cite web |website=Simon Wiesenthal Center |url=https://www.wiesenthal.com/assets/pdf/black_hebrew_israelite_movement-12-2022.pdf |title=Extreme Black Hebrew Israelite Movement |date=December 2022}} * {{cite web |website=[[UC Davis]] |url=https://www.ucdavis.edu/blog/curiosity/what-are-myths-facts-about-hebrew-israelites |title=What are the Myths, Facts, About Hebrew Israelites? Two Experts Discuss Jews of African Descent |date=4 January 2023}} * {{cite web |website=Campaign Against Antisemitism |url=https://antisemitism.org/caa-launches-four-part-debunked-black-hebrew-israelites-instagram-series |title=CAA Launched Four-part "Debunked: Black Hebrew Israelites" Instagram Series |date=14 March 2023}}</ref> # Wayahudi waliendesha [[Biashara ya utumwa kupitia Atlantiki|Biashara ya utumwa ya Atlantiki]]<ref name="BHI" /><ref> * {{cite web |website=[[Southern Poverty Law Center]] |url=https://www.splcenter.org/fighting-hate/extremist-files/individual/louis-farrakhan |title=Louis Farrakhan |access-date=October 27, 2024}} * {{cite magazine |magazine=Tablet Magazine |title=Is Jewish Control Over the Slave Trade a Nation of Islam Lie or Scholarly Truth? |url=https://www.tabletmag.com/sections/arts-letters/articles/slave-trade-black-muslim |last=Ungar-Sargon |first=Batya |date=August 5, 2013 |access-date=December 2, 2024}} * {{cite magazine |magazine=Workers’ Liberty |title=Scapegoating Jews for the slave trade? |url=https://workersliberty.org/story/2017-07-26/scapegoating-jews-slave-trade |last=Katz |first=Dan |date=September 11, 2016 |access-date=December 2, 2024}} * {{cite journal |journal=SAPIR Journal |url=https://sapirjournal.org/friends-and-foes/2024/03/black-radicalism |title=Black Radicalism |last=Hughes |first=Coleman |year=2024 |access-date=October 27, 2024 |quote=Antisemitism runs deeper in the black radical tradition than many realize}} * {{cite news |work=Jewish Insider |title=Paul Coates, father of journalist Ta-Nehisi Coates, republishing antisemitic screed 'The Jewish Onslaught' |url=https://jewishinsider.com/2024/09/paul-coates-antisemitic-conspiracy-theory-slave-trade-the-jewish-onslaught |date=September 27, 2024 |access-date=December 5, 2024}}</ref> # Wayahudi walisababisha [[UKIMWI]] na [[COVID-19]]<ref> * {{cite web |website=Fathom Journal |url=https://fathomjournal.org/covid-19-blaming-the-jews-for-the-plague-again |title=COVID-19: Blaming the Jews for the Plague, Again |last=Topor |first=Lev |year=2020 |access-date=13 October 2024}} * {{cite web |website=Begin-Sadat Center for Strategic Studies |url=https://besacenter.org/coronavirus-conspiracy-theories-jews |title=Anti-Jewish Coronavirus Conspiracy Theories in Historical Context |author=Dr. Manfred Gerstenfeld |date=31 March 2020 |access-date=13 October 2024}} * {{cite news |work=[[The Jerusalem Post]] |url=https://www.jpost.com/diaspora/antisemitism/article-771415 |title='Jewish Space Lasers': Rothschild antisemitic canards that refuse to die - review |date=3 November 2023 |access-date=13 October 2024}} * {{cite journal |journal=Scientific Reports |title=Correlation between coronavirus conspiracism and antisemitism: a cross-sectional study in the United Kingdom |url=https://www.nature.com/articles/s41598-023-41794-y |last1=Allington |first1=Daniel |last2=Hirsh |first2=David |last3=Katz |first3=Louise |volume=13 |issue=21104 |date=December 5, 2023 |access-date=December 15, 2024}} * {{cite web |website=[[Anti-Defamation League]] |title=How Antisemites, Extremists and Conspiracy Theorists are Exploiting the Anti-Vax Movement |url=https://www.adl.org/resources/article/how-antisemites-extremists-and-conspiracy-theorists-are-exploiting-anti-vax |date=June 11, 2024 |access-date=December 15, 2024}}</ref> ==Mashariki ya Kati na Afrika ya Kaskazini (MENA)== ===Historia=== [[File:Banu Qurayza.png|thumb|[[Mauaji ya halaiki|Mauaji]] ya Banu Qurayza, [[kabila]] la Kiyahudi huko [[Madina]], 627 [[Baada ya Kristo|BK]].]] Wayahudi walianza kuishi katika [[Rasi ya Uarabuni]] katika karne ya 6 [[Kabla ya Kristo|KK]], wakati uvamizi wa [[Babilonia|Ufalme wa Babeli]] wa [[Yuda|Ufalme wa Yuda]] ulipowalazimisha Wayahudi kuondoka [[Yudea]]. [[Uhamiaji|Mawimbi]] mfululizo ya kuhamisha Wayahudi – yaliyosababishwa na uvamizi wa Yudea kwa vipindi tofauti – yaliwafanya Wayahudi kuwa kundi kuu la kikabila-kidini<ref>{{cite web |website=American Jewish Committee |title=Who Are the Jews? {{!}} AJC - American Jewish Committee |url=https://www.ajc.org/news/who-are-the-jews |access-date=January 13, 2025}}</ref> katika Rasi ya Uarabuni, ambapo [[Uyahudi]] ulikuwa tofauti na dini ya miungu mingi ya [[Upagani|upagani]] wa Waarabu wa kale,<ref name="A">{{cite book |title=The origin of the Jews of Yathrib |url=https://books.google.com/books?id=8vTTCwG0nKIC&pg=PA4 |last=Gil |first=Moshe |pages=4–5 |year=1997 |publisher=Brill |isbn=9789004138827}}</ref> wengi wao walikuwa wamefika baadaye kuliko Wayahudi kutokana na asili yao ya kuhamahama.<ref name="A" /> ===Zama za Kati=== Wayahudi walifanikiwa katika Rasi ya Uarabuni hadi Waislamu [[Uvamizi wa Kiislamu|waliposhinda Rasi hiyo]], ambapo wao, pamoja na watu wa asili wengine waliotekwa, walitakiwa kulipa ''[[Kodi ya kichwa|jizya]]'' (kodi ya kichwa) kwa kubadilishana na uwepo wao uvumiliwe.<ref name="A" /><ref> * {{cite book |title=Jewish Life under Islam: Jerusalem in the Sixteenth Century |url=https://www.degruyter.com/document/doi/10.4159/harvard.9780674283589/html |last=Cohen |first=Amnon |publisher=Harvard University Press |doi=10.4159/harvard.9780674283589 |year=1984 |isbn=9780674283572 |access-date=January 11, 2025}} * {{cite book |title=Islam: State And Society |chapter=Administration In The Islamic State: An Interpretation Of The Terms “Dhimma” And “Jizya” |url=https://www.taylorfrancis.com/chapters/edit/10.4324/9780203060957-9/administration-islamic-state-interpretation-terms-dhimma-jizya-j%C3%B8rgen-b%C3%A6k-simonsen |last=Simonsen |first=Jørgen Bæk |edition=1 |publisher=Routledge |isbn=9780203060957 |year=2004 |access-date=January 11, 2025}} * {{cite web |website=Katz Center for Advanced Judaic Studies |title=What Do You Know? Dhimmi, Jewish Legal Status under Muslim Rule |url=https://katz.sas.upenn.edu/resources/blog/what-do-you-know-dhimmi-jewish-legal-status-under-muslim-rule |last=Wagner |first=Mark |date=November 30, 2018 |access-date=January 11, 2025}}</ref> Malipo ya ''jizya'' yaliwapa Wayahudi hadhi ya ''dhimmi'' ambapo walikatazwa – chini ya tishio la [[Mauaji|kunyongwa]] – kukosoa nyanja yoyote ya Uislamu, kushiriki mawazo ya [[Uyahudi#Imani za msingi|Kiyahudi]] kwa Waislamu au kumgusa mwanamke wa Kiislamu.<ref name="B"> * {{cite book |title=La Cité Musulmane. Vie Sociale et Politique |url=https://www.abebooks.co.uk/Cit%C3%A9-Musulmane-Vie-Sociale-Politique-Gardet/14971474082/bd |last=Gardet |first=Louis |page=348 |publisher=Librairie Philosophique J. Vrin |edition=2 |year=1954 |access-date=January 11, 2025 |location=[[Paris]], [[Ufaransa]] |lang=fr}} * {{cite book |title=The Dhimmi: Jews and Christians Under Islam |url=https://www.abebooks.co.uk/book-search/title/the-dhimmi-jews-christians-under-islam/author/ye%27or-bat |last=Ye'or |first=Bat |pages=43–44; 56–57 |publisher=Fairleigh Dickinson University Press |isbn=9781611470796 |year=1985 |access-date=January 11, 2025 |lang=en-us}} * {{cite journal |journal=Middle East Quarterly |title=The Qur’an: Israel Is Not for the Jews |url=https://www.meforum.org/middle-east-quarterly/the-quran-israel-not-for-jews#_ftn9 |last=Spencer |first=Robert |volume=16 |issue=4 |year=2009 |access-date=January 11, 2025}} * {{cite web |website=San Diego Jewish World |title=Israeli Scholar Explains Religious Conflicts Between Jews and Muslims |url=https://www.sdjewishworld.com/2024/11/21/israeli-scholar-explains-religious-conflicts-between-jews-and-muslims |last=Gershenson |first=Miriam |date=November 21, 2024 |access-date=January 11, 2025}} * {{cite web |website=[[Jewish Virtual Library]] |title=Jews in Islamic Countries: The Treatment of Jews |url=https://www.jewishvirtuallibrary.org/the-treatment-of-jews-in-arab-islamic-countries#N_4_ |access-date=January 11, 2025}}</ref> Wayahudi pia hawakuruhusiwa<ref name="B" /> * kunywa divai hadharani * kupanda [[Farasi|farasi]] au [[Ngamia|ngamia]] * [[Sala|kusali]] au kuomboleza kwa sauti kubwa * kujenga [[Sinagogi|masinagogi]] marefu kuliko misikiti * kujenga [[Nyumba|nyumba]] ndefu kuliko nyumba za Kiislamu ===Karne ya 21=== ====Miaka ya 2010==== Chuki dhidi ya Wayahudi ni jambo la kawaida sana Mashariki ya Kati na Afrika Kaskazini (MENA).<ref name="Analyses" /> Mnamo mwaka 2011, [[Pew Research Center]] ilifanya utafiti kwa idadi kubwa ya wananchi wa nchi za [[Mashariki ya Kati]], ambapo [[Waislamu]] ndio wengi. Wengi wa waliohojiwa walikuwa na chuki dhidi ya Wayahudi. Ni 2% tu ya [[Wamisri]], 3% ya Waislamu wa [[Lebanon]] na 2% ya [[Jordan|Wajordan]] waliripoti kujisikia vizuri kuhusu Wayahudi.<ref>{{cite web|date=21 July 2011|title=Muslim-Western Tensions Persist - Pew Research Center|url=http://www.pewglobal.org/2011/07/21/muslim-western-tensions-persist|location=Washington, DC}}</ref> Baadhi ya [[Chuo kikuu|wanazuoni]] wanaamini kwamba [[vyombo vya habari]] vimecheza jukumu muhimu katika jambo hilo.<ref> * {{cite web |website=Washington Institute |url=https://www.washingtoninstitute.org/policy-analysis/western-media-misguided-narrative-about-al-jazeera |title=The Western Media Misguided Narrative about Al Jazeera |date=March 22, 2018 |access-date=November 1, 2024}} * {{cite news |work=[[The Daily Telegraph|The Telegraph]] |url=https://www.telegraph.co.uk/news/2019/05/20/qatari-funded-al-jazeera-arabic-channel-fires-journalists-holocaust |title=Qatari-funded Al Jazeera Arabic channel suspends journalists over 'Holocaust denial' video |date=May 20, 2019 |access-date=November 1, 2024}} * {{cite news |work=[[BBC News (TV channel)|BBC News]] |url=https://www.bbc.co.uk/news/world-middle-east-48335169 |title=Al Jazeera suspends journalists for Holocaust denial video |date=May 20, 2019 |access-date=November 1, 2024}} * {{cite web |website=Foundation for Defense of Democracies |url=https://www.fdd.org/analysis/2023/11/24/al-jazeera-must-register-as-a-foreign-agent-of-qatar |title=Al Jazeera Must Register as a Foreign Agent |date=November 24, 2023 |access-date=November 1, 2024}} * {{cite news |work=The Jerusalem Post |url=https://m.jpost.com/middle-east/al-jazeeras-holocaust-legacy-justification-alongside-outright-denial-800079 |title=Al-Jazeera’s Holocaust legacy: Justification alongside outright denial |date=May 6, 2024 |access-date=November 1, 2024}} * {{cite web |work=[[Britannica]] |url=https://www.britannica.com/topic/Al-Jazeera |title=Al Jazeera {{!}} News Channel, History, & Qatar {{!}} Britannica |date=October 25, 2024 |access-date=November 1, 2024}}</ref><ref> * {{cite web |website=Media Bias / Fact Check |title=Al Jazeera – Bias and Credibility |url=https://mediabiasfactcheck.com/al-jazeera |access-date=November 9, 2024}} * {{cite web |website=Honest Reporting |url=https://honestreporting.com/tag/middle-east-eye |title=Middle East Eye |access-date=November 3, 2024}} * {{cite web |website=Ad Fontes Media |title=Al Jazeera Website Bias and Reliability |url=https://adfontesmedia.com/al-jazeera-bias-and-reliability |access-date=November 9, 2024}} * {{cite web |website=American Enterprise Institute |url=https://www.aei.org/foreign-and-defense-policy/middle-east/qatars-other-covert-media-arm |title=Qatar’s Other Covert Media Arm |date=July 25, 2017 |access-date=November 3, 2024}} * {{cite news |work=Scottish Daily Express |url=https://www.scottishdailyexpress.co.uk/comment/what-middle-east-eye-shadowy-32241918 |title=What is 'Middle East Eye' - the shadowy Qatar-linked news outlet that interviewed Humza Yousaf |date=February 29, 2024 |access-date=November 3, 2024}}</ref> Data zaidi yamewasilishwa kama ifuatavyo. {|class="wikitable sortable" font-size:80%;" |+style="font-size:100%" | Chuki dhidi ya Wayahudi katika MENA (Shirika la Utafiti: [[Anti-Defamation League|ADL]])<ref name="S(A)" /> |- ! Nchi ! colspan="2"|% ya idadi ya watu wenye [[Upendeleo|chuki]] dhidi ya Wayahudi<br />(kiwango cha uhakika 95%)<ref name="S(A)" /> |- |'''Palestina''' |align=right| {{bartable|93||2||background:#7B3F00}} |- | '''Iraq''' |align=right| {{bartable|92||2||background:#7B3F00}} |- | '''Yemen''' |align=right| {{bartable|88||2||background:#7B3F00}} |- | '''Algeria''' |align=right| {{bartable|87||2||background:#7B3F00}} |- | '''Libya''' |align=right| {{bartable|87||2||background:#7B3F00}} |- | '''Tunisia''' |align=right| {{bartable|86||2||background:#7B3F00}} |- | '''Kuwait''' |align=right| {{bartable|82||2||background:#7B3F00}} |- | '''Jordan''' |align=right| {{bartable|81||2||background:#7B3F00}} |- | '''Bahrain''' |align=right| {{bartable|81||2||background:#7B3F00}} |- | '''Qatar''' |align=right| {{bartable|80||2||background:#7B3F00}} |- | '''Moroko''' |align=right| {{bartable|80||2||background:#7B3F00}} |- | '''Falme za Kiarabu''' |align=right| {{bartable|80||2||background:#7B3F00}} |- | '''Lebanon''' |align=right| {{bartable|78||2||background:#7B3F00}} |- | '''Oman''' |align=right| {{bartable|76||2||background:#7B3F00}} |- | '''Misri''' |align=right| {{bartable|75||2||background:#7B3F00}} |- | '''Saudi Arabia''' |align=right| {{bartable|74||2||background:#7B3F00}} |} ==Afrika Kusini mwa Sahara== {|class="wikitable sortable" font-size:80%;" |+style="font-size:100%" | Chuki dhidi ya Wayahudi Kusini mwa Jangwa la Sahara (Shirika la Utafiti: [[Anti-Defamation League|ADL]])<ref name="S(A)" /> |- ! Nchi ! colspan="2"|% ya idadi ya watu wenye [[Upendeleo|chuki]] dhidi ya Wayahudi<br />(kiwango cha uhakika 95%)<ref name="S(A)" /> |- | '''Senegal''' |align=right| {{bartable|53||2||background:#7FFF00}} |- | '''Mauritius''' |align=right| {{bartable|44||2||background:#7FFF00}} |- | '''Afrika Kusini''' |align=right| {{bartable|38||2||background:#7FFF00}} |- | '''Kamerun''' |align=right| {{bartable|35||2||background:#7FFF00}} |- | '''Kenya''' |align=right| {{bartable|35||2||background:#7FFF00}} |- | '''Botswana''' |align=right| {{bartable|33||2||background:#7FFF00}} |- | '''Côte D'Ivoire''' |align=right| {{bartable|22||2||background:#7FFF00}} |- | '''Nigeria''' |align=right| {{bartable|16||2||background:#7FFF00}} |- | '''Uganda''' |align=right| {{bartable|16||2||background:#7FFF00}} |- | '''Ghana''' |align=right| {{bartable|15||2||background:#7FFF00}} |- | '''Tanzania''' |align=right| {{bartable|12||2||background:#7FFF00}} |} Asilimia ya wakazi wa [[Afrika Kusini]] wenye chuki dhidi ya Wayahudi iliongezeka hadi 47% mwaka 2019 kutoka 38% mwaka 2014.<ref>{{cite web |website=[[Anti-Defamation League]] |title=The ADL GLOBAL 100: An Index of Antisemitism – South Africa |url=https://global100.adl.org/country/south-africa/2019 |access-date=December 23, 2024 |archive-date=2025-02-18 |archive-url=https://web.archive.org/web/20250218120116/https://global100.adl.org/country/south-africa/2019 |url-status=dead }}</ref> Tangu [[Vita vya Israeli na Hamas]] vilipoanza Oktoba 7, 2023, kumekuwa na ongezeko kubwa la unyanyasaji na vurugu dhidi ya Wayahudi nchini Afrika Kusini.<ref> * {{cite news |work=[[Jewish News Syndicate]] |title=South Africa’s antisemitic firestorm |url=https://www.jns.org/south-africas-antisemitic-firestorm |last=Mascarini |first=Saadia |date=January 11, 2024 |access-date=December 23, 2024}} * {{cite news |work=[[Financial Times]] (FT) |title=South African Jewish community unnerved by Israel genocide case |url=https://www.ft.com/content/59acd176-1034-43c6-ac8a-ba9959520057 |date=January 24, 2024 |access-date=December 23, 2024 |quote=Row over young [[cricket]] captain exposes social rift as [[Pretoria]] pursues landmark International Court of Justice lawsuit}} * {{cite web |website=World Jewish Congress |title=In Washington Mission, WJC and South African Jewish Board of Deputies Highlight Surge in Antisemitism |url=https://www.worldjewishcongress.org/en/news/wjc-and-sajbd-highlight-antisemitism-in-washington-dc |date=April 26, 2024 |access-date=December 23, 2024}} * {{cite magazine |magazine=New Lines Magazine |title=South Africa’s Stance on Palestine Opens Questions About Apartheid and History |url=https://newlinesmag.com/argument/south-africas-stance-on-palestine-opens-questions-about-apartheid-and-history |last=Dana |first=Joseph |date=September 30, 2024 |access-date=December 23, 2024}} * {{cite web |website=HonestReporting |title=Exposing the Corruption Behind South Africa’s ICJ Case: An Interview With ISGAP Executive Director, Dr. Charles Asher Small |url=https://honestreporting.com/exposing-the-corruption-behind-south-africas-icj-case-an-interview-with-isgap-executive-director-dr-charles-asher-small |date=December 12, 2024 |access-date=December 23, 2024}}</ref><ref> * {{cite news |work=Daily Express |title=South Africa accused of 'plain antisemitism' after 'sacking' Jewish cricket captain |url=https://www.express.co.uk/sport/cricket/1856730/South-Africa-antisemitism-David-Teeger-cricket-news |date=January 17, 2024 |access-date=December 23, 2024}} * {{cite news |work=The Jewish Chronicle |title=South African politician accuses rivals of selling Cape Town to Jews |url=https://www.thejc.com/news/world/south-african-politician-accuses-rivals-of-selling-cape-town-to-jews-b12rnl0m |date=February 20, 2024 |access-date=December 23, 2024 |quote=National Freedom Party figure says 'we will not allow you to [[The Protocols of the Elders of Zion|make this a Jewish state]]'}} * {{cite news |work=South African Jewish Report (SAJR) |title=UCT prof targeted for exam depicting antisemitism |url=https://www.sajr.co.za/uct-prof-targeted-for-exam-depicting-antisemitism |date=May 30, 2024 |access-date=December 23, 2024}} * {{cite news |work=South African Jewish Report (SAJR) |title=Nothing to be gained from silence about antisemitism |url=https://www.sajr.co.za/nothing-to-be-gained-from-silence-about-antisemitism |date=October 31, 2024 |access-date=December 23, 2024}} * {{cite news |work=The Jerusalem Post |title=South African Jewish community condemns president for silence after explosive thrown at JCC |url=https://www.jpost.com/diaspora/antisemitism/article-833971 |date=December 18, 2024 |access-date=December 23, 2024}}</ref> Kati ya Oktoba 7 na Desemba 31, 2023, mashambulizi dhidi ya Wayahudi yaliongezeka kwa 631% nchini Afrika Kusini ikilinganishwa na kipindi kama hicho mwaka 2022.<ref>{{cite news |work=Algemeiner |title=‘There is No Antisemitism Here,’ South African Justice Minister Claims, Despite 631 Percent Increase in Attacks on Jews |url=https://www.algemeiner.com/2024/01/31/there-is-no-antisemitism-here-south-african-justice-minister-claims-despite-631-percent-increase-in-attacks-on-jews |date=January 31, 2024 |access-date=December 23, 2024}}</ref> ==Ulaya== [[File:Expulsion judios-en selection.svg|thumb|[[Ramani]] ya kufukuzwa kwa [[Myahudi#Zama za Kati|Wayahudi]] kutoka mikoa mbalimbali ya Ulaya, [[Takriban|takriban.]] [[Karne ya 12|1100]]–[[Karne ya 16|1600]] [[Baada ya Kristo|BK]].]] ===Kabla ya Karne ya 20=== ===Karne ya 20=== {{Main|Pogrom|Ujerumani ya Nazi}} [[Image:Haus der Deutschen Kunst, Nazi Germany Grundsteinlegung 15.10.1933 House of German Art foundation stone. Hilter, Esser, Nuntius Vasallo di Torregrossa. Heute versteh ich Sie. NSDAP Propaganda Reichstagswahl 12 Nov Election poster xx1990.tif|thumb|[[Adolf Hitler]] (1889–1945) akisalimiana na Alberto Vassallo-Torregrossa (1865–1959), [[makasisi]] wa cheo cha juu wa [[Vatikani]] huko [[Bavaria]], [[Ujerumani ya Nazi]].]] ====Maangamizi Makuu (Holokausti)==== {{Main|Maangamizi Makuu (Holokausti)|Orodha ya kambi za mateso za Nazi|Ustaše|Dola Huru ya Kroatia|Jamhuri ya Kislovakia (1939–1945)}}{{Further|Kristallnacht|Babi Yar|Ante Pavelić|Kanisa Katoliki na Dola Huru ya Kroatia}} [[File:"Nebuď služobníkom žida"—Slovak propaganda poster.jpg|thumb|Bango kutoka [[Ujerumani ya Nazi|dola bandia]] ya [[Jamhuri ya Kislovakia (1939–1945)]] ya Wanazi: ''"Usiwe [[mtumishi]] wa Myahudi: yeye ajiunganaye na Myahudi atazama hadi kiwango chake."'']][[File:Jože Beranek - V usodnem trenutku nož v hrbet.jpeg|thumb|Bango la kupinga Wayahudi huko Slovenia iliyokaliwa na Wanazi likisema "Kisu mgongoni wakati muhimu", likirejelea hadithi ya kuchomwa kisu mgongoni iliyokuwa maarufu miongoni mwa Wajerumani wakati huo.]] Maangamizi Makuu yalikuwa mauaji ya halaiki<ref> * {{cite web |website=[[United States Holocaust Memorial Museum]] |title=What is Genocide? |url=https://www.ushmm.org/genocide-prevention/learn-about-genocide-and-other-mass-atrocities/what-is-genocide |access-date=December 18, 2024}} * {{cite web |website=Holocaust Memorial Day Trust |title=The ten stages of genocide |url=https://hmd.org.uk/learn-about-the-holocaust-and-genocides/what-is-genocide/the-ten-stages-of-genocide |access-date=December 18, 2024}} * {{cite web |website=[[Holocaust Encyclopedia]] |title=What is Genocide? {{!}} Holocaust Encyclopedia |url=https://encyclopedia.ushmm.org/content/en/article/what-is-genocide |date=September 25, 2024 |access-date=December 18, 2024}} * {{cite web |website=American Jewish Committee |title=5 Reasons Why the Events in Gaza Are Not “Genocide” |url=https://www.ajc.org/news/5-reasons-why-the-events-in-gaza-are-not-genocide |date=December 5, 2024 |access-date=December 18, 2024}} * {{cite web |website=[[Britannica]] |title=Genocide {{!}} Definition, Examples, & Facts |url=https://www.britannica.com/topic/genocide |date=December 16, 2024 |access-date=December 18, 2024}}</ref> yaliyofanywa na [[Ujerumani ya Nazi]] kuanzia 1933 hadi 1945 wakati wa [[Vita Kuu ya Pili ya Dunia]]. Yalijulikana kama ''[[Suluhisho la Mwisho]]''. Mpango wa [[Chama cha Nazi|Wanazi]] ulikuwa kuwaondoa Wayahudi wote Ulaya. Walifanikiwa kuwaua angalau Wayahudi 6,000,000 – 67% ya Wayahudi wa Ulaya wakati huo.<ref name="Holocaust introductions" /> [[Mein Kampf|Mpango wa Maangamizi Makuu ulikuwa na mizizi katika chuki dhidi ya Wayahudi]].<ref name="Holocaust introductions" /><ref> * {{cite web |website=Anne Frank House |title=Adolf Hitler publishes ‘Mein Kampf’ |url=https://www.annefrank.org/en/timeline/6/adolf-hitler-publishes-mein-kampf |date=July 18, 1925 |access-date=December 3, 2024}} * {{cite web |website=[[Holocaust Encyclopedia]] |title=Mein Kampf: Hitler's Manifesto {{!}} Holocaust Encyclopedia |url=https://encyclopedia.ushmm.org/content/en/article/mein-kampf |access-date=December 3, 2024}} * {{cite news |work=[[The Washington Post]] |title='Mein Kampf': A historical tool, or Hitler's voice from beyond the grave? |url=https://www.washingtonpost.com/world/europe/mein-kampf-a-historical-tool-or-hitlers-voice-from-beyond-the-grave/2015/02/24/f7a3110e-b950-11e4-bc30-a4e75503948a_story.html |last=Faiola |first=Anthony |date=February 24, 2015}} * {{cite journal |journal=Fascism |title=Latvia’s ''Pērkonkrusts'': Anti-German National Socialism in a Fascistogenic Milieu |url=https://www.sciencedirect.com/org/science/article/pii/S2211624915000066#fn8 |last=Kott |first=Matthew |volume=4 |issue=2 |pages=169–193 |date=November 23, 2015 |doi=10.1163/22116257-00402007 |access-date=October 28, 2024}} * {{cite journal |journal=German History |title=Hitler’s Mein Kampf and the Holocaust: A Prelude to Genocide |url=https://academic.oup.com/gh/article-abstract/41/1/134/6847778?redirectedFrom=fulltext |last1=Michalczyk |first1=John J. |last2=Michalczyk |first2=Susan A. |last3=Bryant |first3=Michael S. |date=November 26, 2022 |volume=41 |issue=1 |pages=134–137 |access-date=December 3, 2024}}</ref> ===Karne ya 21=== Katika utafiti wa mwaka 2013 wa Wayahudi 5,847 huko [[Ulaya]], 76% walifikiri kwamba chuki dhidi ya Wayahudi iliongezeka katika miaka mitano iliyopita, huku 29% walikuwa wamefikiria [[Uhamiaji|kuhamia]] nchi nyingine kwa sababu [[Hisia|walijisikia]] [[Hatari|kutokuwa salama]].<ref>{{cite web |website=[[European Union]] Agency for Fundamental [[Haki za binadamu|Haki]] |title=Discrimination and hate crime against Jews in EU Member States: experiences and perceptions of antisemitism |url=http://fra.europa.eu/sites/default/files/fra-2013-discrimination-hate-crime-against-jews-eu-member-states_en.pdf |year=2013 |access-date=December 2, 2024}}</ref> Utafiti wa [[Anti-Defamation League|ADL]] wa mwaka 2023 uligundua kuwa theluthi moja ya [[Ulaya Magharibi|Wazungu wa Magharibi]] waliamini [[#Uongo Kuhusu Wayahudi|chuki dhidi ya Wayahudi]]. Hali hii iliripotiwa kuwa mbaya zaidi katika nchi zingine za Ulaya Mashariki, hasa [[Hungary]] (37%), Poland (35%) na Urusi (26%).<ref>{{cite web |website=[[Anti-Defamation League]] |title=ADL Survey Finds Harmful Antisemitic Stereotypes Remain Deeply Entrenched Across Europe |url=https://www.adl.org/resources/press-release/adl-survey-finds-harmful-antisemitic-stereotypes-remain-deeply-entrenched |date=May 31, 2023 |access-date=December 3, 2024}}</ref> Katika [[Ulaya Mashariki]], kiwango cha chuki dhidi ya Wayahudi kimeonekana kuwa kikubwa.<ref> * {{cite web |website=American Jewish Committee |title=The State of Antisemitism in Eastern Europe |url=https://www.ajc.org/news/the-state-of-antisemitism-in-eastern-europe |date=December 17, 2020 |access-date=December 2, 2024}} * {{cite news |work=The Times of Israel |title=Jewish group’s report finds rise in antisemitic incidents in Poland |url=https://www.timesofisrael.com/jewish-groups-report-finds-rise-in-antisemitic-incidents-in-poland |date=April 25, 2023 |access-date=December 2, 2024 |quote=First survey of its kind counts 488 anti-Jewish [[Uhalifu wa chuki|matendo]] nchini [[Ubaguzi wa rangi nchini Poland#Wayahudi|Poland]] mwaka 2022, zaidi ya mara 4 ya jumla [[Takwimu|iliyotajwa]] na [[European Union]] [[2021|mwaka uliopita]]}} * {{cite news |work=Balkan Insight |title=Middle-East Conflict Sparks Uptick in Anti-Semitic Incidents in South-East Europe |url=https://balkaninsight.com/2023/10/23/middle-east-conflict-sparks-uptick-in-anti-semitic-incidents-in-south-east-europe |date=October 23, 2023 |access-date=December 2, 2024 |quote=[[Vita vya Israeli na Hamas|Ghasia zinazoendelea]] nchini [[Mzozo wa Israeli na Palestina|Israeli-Palestina]] [[Uhusiano|zinaunganishwa]] na ongezeko la matukio ya kupinga Wayahudi [...] [[Uharibifu wa mali|uharibifu]] wa [[Maangamizi Makuu|maeneo ya ukumbusho wa Maangamizi Makuu]] katika [[Ulaya Mashariki|Ulaya Mashariki]] na [[Balkan|Kusini-Mashariki mwa Ulaya]].}} * {{cite news |work=[[The Guardian]] |title=Antisemitism is deeply ingrained in European society, says EU official |url=https://theguardian.com/news/2023/oct/30/antisemitism-deeply-ingrained-in-european-society-says-eu-official |date=October 30, 2023 |access-date=December 2, 2024 |quote=[[Maoni|Maelezo]] ya mkuu wa haki yanakuja wakati makundi ya kiraia [[Utetezi|yakionya kuhusu]] ongezeko la chuki dhidi ya Wayahudi huku [[Vita vya Israeli na Hamas]]}} * {{cite web |website=[[European Union]] Agency for Fundamental [[Haki za binadamu|Haki]] (FRA) |title=Jews in Europe still face high levels of antisemitism |url=https://fra.europa.eu/en/news/2024/jews-europe-still-face-high-levels-antisemitism |date=July 11, 2024 |access-date=December 2, 2024}}</ref> Chanzo cha kuendelea kwa chuki dhidi ya Wayahudi Ulaya kinajadiliwa.<ref> * {{cite news |work=Jewish Telegraphic Agency |title=How Jewish journalist Ruth Elkrief wound up in the middle of France’s debate over antisemitism and Islamophobia |url=https://www.jta.org/2024/02/21/global/how-jewish-journalist-ruth-elkrief-wound-up-in-the-middle-of-frances-debate-over-antisemitism-and-islamophobia |date=February 21, 2024 |access-date=December 26, 2024}} * {{cite magazine |magazine=Tablet Magazine |title=An Inconvenient Truth |url=https://www.tabletmag.com/sections/news/articles/inconvenient-truth-germany-antisemitism-august-hanning |last=Hanning |first=August |date=March 19, 2024 |access-date=December 26, 2024}} * {{cite news |work=The Jewish Chronicle |title=Former German Intelligence head blames far-left and Muslim migrants for growing antisemitism |url=https://www.thejc.com/news/former-german-intelligence-head-blames-muslim-migrants-for-growing-antisemitism-dzram88h |date=March 26, 2024 |access-date=December 26, 2024}} * {{cite news |work=[[Jewish News Syndicate]] |title=German MPs to name Muslim Jew-hatred as antisemitism vector |url=https://www.jns.org/german-mps-to-name-muslim-jew-hatred-as-antisemitism-vector |date=November 3, 2024 |access-date=December 26, 2024}} * {{cite news |work=Ynetnews |title=From Nazis to Jihadists: Antisemitism, the cancer of the West |url=https://www.ynetnews.com/article/hkbkamcz1x |last=Yemini |first=Ben-Dror |access-date=December 26, 2024}}</ref><ref> * {{cite web |website=American Jewish Committee |title=Antisemitism Among Migrant Populations in Europe |url=https://www.ajc.org/antisemitism-among-migrant-populations-in-europe |access-date=December 26, 2024}} * {{cite book |title=European Muslim Antisemitism: Why Young Urban Males Say They Don't Like Jews |url=https://www.jstor.org/stable/j.ctt16gzdvm |last=Jikeli |first=Günther |publisher=[[Indiana University]] Press |jstor=j.ctt16gzdvm |year=2015 |access-date=December 26, 2024}} * {{cite journal |journal=Fathom Journal |title=Pop Islam: How Germany is tackling the new Islamic antisemitism |url=https://fathomjournal.org/pop-islam-how-germany-is-tackling-the-new-islamic-antisemitism |last=Rickenbacher |first=Daniel |year=2018 |access-date=December 26, 2024}} * {{cite news |work=Wall Street Journal (WSJ) |title=Antisemitism Among Muslim Migrants Unsettles a Germany Haunted by the Holocaust |url=https://www.wsj.com/world/europe/antisemitism-among-muslim-migrants-unsettles-a-germany-haunted-by-the-holocaust-ff359e73 |last=Pancevski |first=Bojan |date=October 18, 2023 |access-date=December 26, 2024}} * {{cite magazine |magazine=National Review |title=How Mass Immigration Makes Antisemitism Worse |url=https://www.nationalreview.com/magazine/2023/12/how-mass-immigration-makes-antisemitism-worse |last=Murray |first=Douglas |date=November 9, 2023 |access-date=December 26, 2024}}</ref> {|class="wikitable sortable" font-size:80%;" |+style="font-size:100%" | Chuki dhidi ya Wayahudi huko Ulaya (Shirika la Utafiti: [[Anti-Defamation League|ADL]])<ref name="S(A)" /> |- ! Nchi ! colspan="2"|% ya idadi ya watu wenye [[Upendeleo|chuki]] dhidi ya Wayahudi<br />(kiwango cha uhakika 95%)<ref name="S(A)" /> |- | '''Ugiriki''' |align=right| {{bartable|69||2||background:#8000FF}} |- | '''Armenia''' |align=right| {{bartable|58||2||background:#8000FF}} |- | '''Poland''' |align=right| {{bartable|45||2||background:#8000FF}} |- | '''Bulgaria''' |align=right| {{bartable|44||2||background:#8000FF}} |- | '''Serbia''' |align=right| {{bartable|42||2||background:#8000FF}} |- | '''Hungary''' |align=right| {{bartable|41||2||background:#8000FF}} |- | '''Belarus''' |align=right| {{bartable|38||2||background:#8000FF}} |- | '''Ufaransa''' |align=right| {{bartable|37||2||background:#8000FF}} |- | '''Azerbaijan''' |align=right| {{bartable|37||2||background:#8000FF}} |- | '''Lithuania''' |align=right| {{bartable|36||2||background:#8000FF}} |- | '''Romania''' |align=right| {{bartable|35||2||background:#8000FF}} |- | '''Kroatia''' |align=right| {{bartable|33||2||background:#8000FF}} |- | '''Bosnia na Herzegovina''' |align=right| {{bartable|32||2||background:#8000FF}} |- | '''Georgia''' |align=right| {{bartable|32||2||background:#8000FF}} |- | '''Urusi''' |align=right| {{bartable|30||2||background:#8000FF}} |- | '''Moldova''' |align=right| {{bartable|30||2||background:#8000FF}} |- | '''Hispania''' |align=right| {{bartable|29||2||background:#8000FF}} |- | '''Montenegro''' |align=right| {{bartable|29||2||background:#8000FF}} |- | '''Latvia''' |align=right| {{bartable|28||2||background:#8000FF}} |- | '''Austria''' |align=right| {{bartable|28||2||background:#8000FF}} |- | '''Slovenia''' |align=right| {{bartable|27||2||background:#8000FF}} |- | '''Ubelgiji''' |align=right| {{bartable|27||2||background:#8000FF}} |- | '''Ujerumani''' |align=right| {{bartable|27||2||background:#8000FF}} |- | '''Uswisi''' |align=right| {{bartable|26||2||background:#8000FF}} |- | '''Estonia''' |align=right| {{bartable|22||2||background:#8000FF}} |- | '''Ureno''' |align=right| {{bartable|21||2||background:#8000FF}} |- | '''Ireland''' |align=right| {{bartable|20||2||background:#8000FF}} |- | '''Italia''' |align=right| {{bartable|20||2||background:#8000FF}} |- | '''Iceland''' |align=right| {{bartable|16||2||background:#8000FF}} |- | '''Norway''' |align=right| {{bartable|15||2||background:#8000FF}} |- | '''Finland''' |align=right| {{bartable|15||2||background:#8000FF}} |- | '''Jamhuri ya Czech''' |align=right| {{bartable|13||2||background:#8000FF}} |- | '''Denmark''' |align=right| {{bartable|9||2||background:#8000FF}} |- | '''Ufalme wa Muungano''' |align=right| {{bartable|8||2||background:#8000FF}} |- | '''Uholanzi''' |align=right| {{bartable|5||2||background:#8000FF}} |- | '''Uswidi''' |align=right| {{bartable|4||2||background:#8000FF}} |} ===Ireland=== {{Main|Chuki dhidi ya Wayahudi nchini Ireland}} [[File:Banner of the Blueshirts.svg|thumb|Bendera ya kikundi cha Wakatoliki wa Ireland waliokuwa wakipendelea Wanazi na kupinga Wayahudi<ref name="IRB"> * {{cite news |work=The Irish Times |title=Eoin O'Duffy, the Blueshirts and fascism |url=https://www.irishtimes.com/opinion/letters/eoin-o-duffy-the-blueshirts-and-fascism-1.413587 |date=February 9, 2005 |access-date=December 7, 2024}} * {{cite news |work=The Jewish Chronicle |title=The Jew at the centre of Irish nationalism |url=https://www.thejc.com/life-and-culture/books/the-jew-at-the-centre-of-irish-nationalism-cfdvxcyw |last=Shindler |first=Colin |date=March 31, 2016 |access-date=December 7, 2024}} * {{cite web |website=Ireland Israel Alliance |title=Anti-Semitism in Ireland along the history |url=https://www.irelandisrael.ie/blog/anti-semitism-in-ireland |date=November 5, 2018 |access-date=December 7, 2024}} * {{cite magazine |magazine=Tablet Magazine |title=Fascist Lit and Hungary’s Future |url=https://www.tabletmag.com/sections/arts-letters/articles/hungary-viktor-orban-anti-semitism |last=Goldman |first=David P. |date=April 17, 2020 |access-date=December 7, 2024}} * {{cite web |website=TPQ |title=Fine Gael's Historical Flirtations With Fascism |url=https://www.thepensivequill.com/2021/09/fine-gaels-historical-flirtations-with.html |date=September 23, 2021 |access-date=December 7, 2024}}</ref> iitwayo ''Blueshirts''.]][[File:Blueshirts leadership, circa 1934.jpg|thumb|Wakatoliki wa Ireland waliokuwa wakipendelea Wanazi na kupinga Wayahudi<ref name="IRB" /> wa kikundi cha ''Blueshirts'' wakiandamana barabarani.]] ==Marejeo== {{marejeo}} [[Jamii:Historia ya Wayahudi]] [[Jamii:Uyahudi]] [[Jamii:Ubaguzi]] 8ijkx0pd9i38qrrvae25ah1k2u5jsv7 0 208467 1578236 1576808 2026-07-03T08:43:50Z Riccardo Riccioni 452 /* Tazama pia */ 1578236 wikitext text/x-wiki [[File:Merian's Daniel 7 engraving.jpg|alt=Woodcut image of Daniel, sleeping, while four beasts watch.|thumb|265x265px|Danieli akiwa amelala [[usingizi]] na kupata njozi ya [[Mnyama|wanyama]] wanne.]] '''Mtindo wa kiapokalipti''' ulikuwa [[mtindo wa uandishi]] ulioanza kati ya [[Wayahudi]] wa [[Uhamisho wa Babeli]], hasa [[nabii Ezekieli]], na kuendelea hata kwa [[Ukristo|Wakristo]] wa kwanza. [[Kitabu cha Danieli]] ni kilele cha mtindo huo katika [[Biblia ya Kiebrania]]. Katika [[Biblia ya Kikristo]] [[kitabu]] maarufu zaidi cha namna hiyo ni [[Ufunuo wa Yohane]]. [[Jina]] la mtindo huo linatokana na lile la [[Kigiriki]] la kitabu hicho, ἀποκάλυψις, linalotamkwa: apokálupsis. Kwa jumla, [[Mitindo|mtindo]] huo unasimulia [[njozi]] au [[ndoto]] za [[Mungu|Kimungu]] zilizodaiwa kumfunulia [[mwandishi]] [[siri]] kuhusu [[mwisho wa nyakati]] unaotarajiwa kuleta [[ukombozi]] na kuhusu mambo ya [[ahera]]. Mara nyingi [[ujumbe]] uliletwa na [[malaika]]. Lengo ni kuwapa [[tumaini]] waamini walio katika [[dhuluma]]. Mtindo huo ulitumia mifano mingi ya [[fumbo|kifumbo]] ([[namba]], [[Kiumbehai|viumbehai]] pengine wa kutisha n.k.) ukionyesha [[vita]] kati ya [[Mwenyezi Mungu]] na [[shetani]] Vitabu vingi vya mtindo huo havikukubaliwa kama [[Neno la Mungu]] vikabaki nje ya [[Biblia]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] == Tanbihi == {{reflist}} ==Marejeo== * {{EB1911|wstitle=Apocalyptic Literature|volume=2|pages=169–175|first=Robert Henry|last=Charles|author-link=Robert Charles (scholar)}} * Charlesworth, James H. ed., ''The Old Testament Pseudepigrapha'', Vol. 1: ''Apocalyptic Literature and Testaments'', Gsrden City, New York: Doubleday & Co., 1983. * Collins, John Joseph ''The Apocalyptic Imagination: An Introduction to Jewish Apocalyptic Literature'', (The Biblical Resource Series), Grand Rapids: Eerdman, 1998 (second edition). * Coogan, Michael ''A Brief Introduction to the Old Testament'', Oxford: Oxford University Press 2009. * Cook, David, ''Contemporary Muslim Apocalyptic Literature'' (Religion and Politics), Syracure, NY: Syracuse University Press, 2005. * Cook, Stephen L., ''The Apocalyptic Literature: Interpreting Biblical Texts'', Nashville: Abingdon Press, 2003. * [[Northrop Frye|Frye, Northrop]], 1957. ''Anatomy of Criticism: Four Essays'', Princeton, Princeton University Press, 1957. * Goswiller, Richard, ''Revelation'', Pacific Study Series, Melbourne, 1987. * Reddish, Mitchell G. ''Apocalyptic Literature: A Reader'', Peabody, Massachusetts: Hendrickson Publishers, 1998. ==Viungo vya nje== * {{cite web | author1 = L. Michael White | url = https://www.pbs.org/wgbh/pages/frontline/shows/apocalypse/primary/white.html | title = Apocalyptic literature in Judaism and early Christianity | website = [[PBS]] | archive-url = https://web.archive.org/web/20000304005402/https://www.pbs.org/wgbh/pages/frontline/shows/apocalypse/primary/white.html | language = en | archive-date = March 4, 2000 | url-status = live}} (Thorough historical introduction). *{{cite web | author1 = David M. Williams | url = http://www.geocities.com/davidmwilliams/ntb519c.html | title = The Book of Revelation as Jewish apocalyptic literature | archive-url = https://web.archive.org/web/20091003072014/http://www.geocities.com/davidmwilliams/ntb519c.html | language = en | archive-date = October 3, 2009 | url-status = live | access-date = April 28, 2019 | df = mdy-all }} (A coincise introduction to the Apocalypse of John) * {{cite web | url = http://www.iranicaonline.org/articles/apocalyptic-that-which-has-been-rcvealed | archive-url = https://web.archive.org/web/20180517004553/http://www.iranicaonline.org/articles/apocalyptic-that-which-has-been-rcvealed | archive-date = May 17, 2018 | title = "Apocalyptic" lemma | website = iranicaonline.org | access-date = Aug 19, 2018 | url-status = live}} * {{cite journal| author1 = David L. Barr (Wright State University) | title = Using Plot to Discern Structure in John's Apocalypse | journal = Proceedings of the Eastern Great Lakes and Mid-West Biblical Societies | language = en | year = 1995 | pages = 23–33}} (sourced in {{cite web| url = http://www.ntgateway.com/book-of-revelation/articles-and-chapters-in-books| title = Articles & Reviews on the Boom of Revelation| website = ntgateway.com| access-date = 2018-08-19| archive-date = 2018-08-20| archive-url = https://web.archive.org/web/20180820005639/http://www.ntgateway.com/book-of-revelation/articles-and-chapters-in-books/| url-status = dead}} {{mbegu-Biblia}} [[Jamii:Biblia]] [[Jamii:fasihi]] 80zh9ec73u3psg47wjukiw8i2zfv6ux 0 208468 1578226 1435673 2026-07-03T04:18:38Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578226 wikitext text/x-wiki '''Umarsioni''' ulikuwa aina ya [[Ukristo]]<ref name="Ehrman 2005">{{cite book |last=Ehrman |first=Bart D. |author-link=Bart D. Ehrman |year=2005 |orig-year=2003 |title=Lost Christianities: The Battles for Scripture and the Faiths We Never Knew |chapter=At Polar Ends of the Spectrum: Early Christian Ebionites and Marcionites |chapter-url=https://books.google.com/books?id=URdACxKubDIC&pg=PA95 |location=[[Oxford]] |publisher=[[Oxford University Press]] |pages=95–112 |doi=10.1017/s0009640700110273 |isbn=978-0-19-518249-1 |lccn=2003053097 |s2cid=152458823}}</ref> iliyoenea sana katika [[karne]] za kwanza za [[Kanisa]]<ref name="Dunn 2016">{{cite book |last=Dunn |first=James D. G. |author-link=James Dunn (theologian) |year=2016 |chapter=“The Apostle of the Heretics”: Paul, Valentinus, and Marcion |chapter-url=https://books.google.com/books?id=Cc0JDAAAQBAJ&pg=PA105 |editor1-last=Porter |editor1-first=Stanley E. |editor1-link=Stanley E. Porter |editor2-last=Yoon |editor2-first=David |title=Paul and Gnosis |location=[[Leiden]] and [[Boston]] |publisher=[[Brill Publishers]] |series=Pauline Studies |volume=9 |pages=105–118 |doi=10.1163/9789004316690_008 |isbn=978-90-04-31668-3 |lccn=2016009435 |s2cid=171394481}}</ref> ikifundisha uwepo wa [[miungu]] wawili, mmoja mwema na wa kweli (yule wa [[Injili]]), mwingine mbaya (yule [[Muumba]] wa [[Agano la Kale]])<ref name="Ehrman 2005"/><ref name="Dunn 2016"/><ref>{{cite journal |last1=BeDuhn |first1=Jason |author-link1=Jason BeDuhn |title=The New Marcion |journal=Forum |volume=3 |issue=Fall 2015 |page=165 |year=2015 |url=http://www.westarinstitute.org/wp-content/uploads/2015/10/Forum-42-Challenging-Common-Conceptions-of-Early-Christianity.pdf |access-date=2023-12-23 |archive-date=2019-05-25 |archive-url=https://web.archive.org/web/20190525073815/http://www.westarinstitute.org/wp-content/uploads/2015/10/Forum-42-Challenging-Common-Conceptions-of-Early-Christianity.pdf |url-status=dead }}</ref>. [[Jina]] lilitokana na lile la [[mwanzilishi]] wake, [[Marsioni]], [[mtoto]] wa [[askofu]] wa [[Sinop (Uturuki)|Sinope]], [[Ponto]], leo nchini [[Uturuki]]. Alipohamia [[Roma]] katikati ya [[karne ya 2]], alifundisha na kuandika hayo<ref>''History of the Christian Church'', Volume II: Ante-Nicene Christianity. A.D. 100–325. Marcion and his School by PHILIP SCHAFF [http://www.ccel.org/ccel/schaff/hcc2.v.xiii.xvi.html]</ref>, akikataa [[vitabu]] vyote vya [[Biblia]] isipokuwa [[Injili ya Luka]] aliyoifupisha na [[Nyaraka za Paulo|barua]] 10 za [[Mtakatifu Paulo|Mtume Paulo]]<ref>{{cite book |last=Ehrman |first=Bart D. |date=2005 |title=Misquoting Jesus: The Story Behind Who Changed the Bible and Why |location=New York |publisher=HarperOne |page=[https://archive.org/details/misquotingjesus00bart/page/33 33] |isbn=978-0-06-085951-0 |url-access=registration |url=https://archive.org/details/misquotingjesus00bart/page/33 }}</ref><ref>{{cite web|url=http://www.ccel.org/ccel/schaff/hcc2.v.xiii.xvi.html |title=Eusebius' Church History |publisher=Ccel.org |date=2005-06-01 |access-date=2013-01-25}}</ref><ref name="Ehrman">{{cite book |last=Ehrman |first=Bart D. |title= Misquoting Jesus |url=https://archive.org/details/texts_201807 |pages=33–34}}</ref>. [[Maandishi]] yake yamepotea, lakini yanajulikana kupitia yale ya [[Tertuliani]] na [[Babu wa Kanisa|Mababu wa Kanisa]] waliompinga mapema<ref>{{cite book |last=Ehrman |first=Bart D. |title= Misquoting Jesus |url=https://archive.org/details/texts_201807 |pages=163}}</ref>. ==Tanbihi== {{Reflist}} ==Marejeo== * Baker, David L., ''Two Testaments, One Bible'' (second edn; Leicester: Inter-Varsity, 1991): pp.&nbsp;35, 48–52. * Legge, Francis, ''Forerunners and Rivals of Christianity, From 330 B.C. to 330 A.D. '' (1914), reprinted in two volumes bound as one, University Books New York, 1964. LC Catalog 64-24125. *{{cite journal |doi=10.1353/earl.2001.0045 |title=Marcion's Love of Creation |url=https://archive.org/details/journal-of-early-christian-studies_fall-2001_9_3/page/295 |journal=Journal of Early Christian Studies |volume=9 |issue=3 |pages=295–311 |year=2001 |last1=McGowan |first1=Andrew Brian |s2cid=170522717 }} * Mead, G.R.S., [http://www.gnosis.org/library/marcion/Mead.htm ''Gospel of Marcion Fragments of a Faith Forgotten''], London and Benares, 1900; 3rd Edition 1931. * Price, Robert M. [https://web.archive.org/web/20070613153625/http://depts.drew.edu/jhc/Rpcanon.html ''The Evolution of the Pauline Canon'']. *Riparelli, Enrico, ''Il volto del Cristo dualista. Da Marcione ai catari'', Peter Lang, Bern – Berlin – Bruxelles – Frankfurt am Main – New York – Oxford – Wien 2008, 368 pp.&nbsp;{{ISBN|978-3-03911-490-0}} *{{cite journal |doi=10.1086/482828 |title=Pseudepigraphic Refutations of Marcionism |url=https://archive.org/details/sim_journal-of-religion_1942-01_22_1/page/n49 |journal=The Journal of Religion |volume=22 |issue=1 |pages=39–62 |year=1942 |last1=Rist |first1=Martin |s2cid=171058612 }} *{{cite journal |doi=10.1353/jqr.2012.0020 |title=On the Road to Marcionism: Franz Rosenzweig's Early Theology |url=https://archive.org/details/jewish-quarterly-review_spring-2012_102_2/page/224 |journal=Jewish Quarterly Review |volume=102 |issue=2 |pages=224–55 |year=2012 |last1=Pollock |first1=Benjamin |s2cid=170094655 }} *{{cite journal |doi=10.1080/08913818808459542 |title=From Marcionism to Marxism |url=https://archive.org/details/sim_critical-review_fall-1988_2_4/page/n102 |journal=Critical Review |volume=2 |issue=4 |pages=101–13 |year=1988 |last1=Merquior |first1=J. G }} *{{cite book |last1=Sciglitano |first1=Anthony Charles |title=Hans Urs von Balthasar's theology of Judaism: Trinitarian anti -Marcionism and the surprising nature of grace |year=2003 |series=ETD Collection for Fordham University |pages=1–230 |url=https://fordham.bepress.com/dissertations/AAI3078612 }} ==Viungo vya nje== {{Commons category|Marcion}} * {{Cite EB1911|wstitle=Marcion|author=von Harnack, Adolf|author-link=Adolf von Harnack|volume=17|pages=691–693|short=x}} *[http://www.marcionite-scripture.info/ The Marcionite Research Library] *{{CathEncy|wstitle=Marcionites}} {{mbegu-Ukristo}} [[Jamii:Historia ya Kanisa]] cuqsxkiw1xra78y1f2qxb3chsrsfje4 4 208508 1577988 1577895 2026-07-02T14:13:32Z Gayle-Bot 78697 #2.0 CAQI Bot updated with page views column 1577988 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-02) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-02)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 651 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 741 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2898 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 327 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1304 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 968 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 588 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 246 |- | [[Irani]] | 7.62 | style="background-color:#90EE90; color:black" | 442 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 278 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 783 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 419 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 155 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 230 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 602 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 186 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 233 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 511 |- | [[Italia]] | 6.23 | style="background-color:#C8E6C9; color:black" | 270 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 161 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 43 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 471 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 416 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 197 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 137 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 186 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 138 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 251 |- | [[Israeli]] | 5.15 | style="background-color:#90EE90; color:black" | 411 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1824 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 172 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 417 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 55 |- | [[Misri]] | 4.78 | style="background-color:#90EE90; color:black" | 308 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 381 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 64 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 316 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 347 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 31 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 66 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 174 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 84 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 257 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 22 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 243 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 96 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 141 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 459 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 563 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 31 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 258 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 237 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 216 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 63 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 318 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 67 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 75 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 170 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 95 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 72 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 373 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 58 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 234 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 53 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 41 |- | [[Indonesia]] | 3.64 | style="background-color:#FFA500; color:black" | 106 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 382 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 482 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 82 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 56 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 99 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 83 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 27 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 117 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 189 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 112 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 117 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 53 |- | [[Myanmar]] | 3.23 | style="background-color:#FF4444; color:white" | 52 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 93 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 121 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 124 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 75 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 80 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 85 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 150 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 133 |- | [[Kosovo]] | 2.99 | style="background-color:#FF4444; color:white" | 50 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 46 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 86 |- | [[Qatar]] | 2.91 | style="background-color:#FFA500; color:black" | 155 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 139 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 111 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 34 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 88 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 154 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 59 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 70 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 38 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#FF4444; color:white" | 80 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 170 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 77 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 90 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 148 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 79 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 28 |- | [[Bahrain]] | 2.51 | style="background-color:#FF4444; color:white" | 50 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 208 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 68 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 116 |- | [[Mongolia]] | 2.42 | style="background-color:#FFA500; color:black" | 127 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 58 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 47 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 141 |- | [[Nepal]] | 2.37 | style="background-color:#FF4444; color:white" | 51 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 35 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 53 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 60 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 63 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 73 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 62 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 115 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 47 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 45 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 154 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 68 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 55 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 78 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 67 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 36 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 25 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 62 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 22 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 75 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 10 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 30 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 8 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 31 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 29 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 19 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#FF4444; color:white" | 51 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 30222 || ↑ +1.7% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 175.7 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2827 || ↓ -1.0% |- | 2 || [[Cabo Verde]] || 1824 || ↑ +1670.9% |- | 3 || [[Marekani]] || 1271 || ↑ +14.4% |- | 4 || [[Urusi]] || 783 || ↑ +58.5% |- | 5 || [[Kenya]] || 708 || ↓ -5.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 617 || ↓ -10.6% |- | 7 || [[Australia]] || 602 || ↑ +56.4% |- | 8 || [[Afrika Kusini]] || 588 || ↑ +16.7% |- | 9 || [[Kanada]] || 563 || ↑ +202.7% |- | 10 || [[Ufaransa]] || 511 || ↓ -33.7% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} f0wpoaucu4ogam3lafdm50vz0kwm44s 1577998 1577988 2026-07-02T14:17:55Z Gayle-Bot 78697 Sasisha Takwimu za mradi 1577998 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-02) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-02)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 651 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 741 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2898 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 327 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1304 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 968 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 588 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 246 |- | [[Irani]] | 7.62 | style="background-color:#90EE90; color:black" | 442 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 278 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 783 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 419 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 155 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 230 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 602 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 186 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 233 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 511 |- | [[Italia]] | 6.23 | style="background-color:#C8E6C9; color:black" | 270 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 161 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 43 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 471 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 416 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 197 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 137 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 186 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 138 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 251 |- | [[Israeli]] | 5.15 | style="background-color:#90EE90; color:black" | 411 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1824 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 172 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 417 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 55 |- | [[Misri]] | 4.78 | style="background-color:#90EE90; color:black" | 308 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 381 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 64 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 316 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 347 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 31 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 66 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 174 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 84 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 257 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 22 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 243 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 96 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 141 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 459 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 563 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 31 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 258 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 237 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 216 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 63 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 318 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 67 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 75 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 170 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 95 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 72 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 373 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 58 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 234 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 53 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 41 |- | [[Indonesia]] | 3.64 | style="background-color:#FFA500; color:black" | 106 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 382 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 482 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 82 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 56 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 99 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 83 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 27 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 117 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 189 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 112 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 117 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 53 |- | [[Myanmar]] | 3.23 | style="background-color:#FF4444; color:white" | 52 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 93 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 121 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 124 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 75 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 80 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 85 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 150 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 133 |- | [[Kosovo]] | 2.99 | style="background-color:#FF4444; color:white" | 50 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 46 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 86 |- | [[Qatar]] | 2.91 | style="background-color:#FFA500; color:black" | 155 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 139 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 111 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 34 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 88 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 154 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 59 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 70 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 38 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#FF4444; color:white" | 80 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 170 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 77 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 90 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 148 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 79 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 28 |- | [[Bahrain]] | 2.51 | style="background-color:#FF4444; color:white" | 50 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 208 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 68 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 116 |- | [[Mongolia]] | 2.42 | style="background-color:#FFA500; color:black" | 127 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 58 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 47 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 141 |- | [[Nepal]] | 2.37 | style="background-color:#FF4444; color:white" | 51 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 35 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 53 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 60 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 63 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 73 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 62 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 115 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 47 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 45 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 154 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 68 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 55 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 78 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 67 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 36 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 25 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 62 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 22 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 75 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 10 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 30 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 8 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 31 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 29 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 19 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#FF4444; color:white" | 51 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 30218 || ↑ +1.7% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 175.7 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2827 || ↓ -1.0% |- | 2 || [[Cabo Verde]] || 1824 || ↑ +1670.9% |- | 3 || [[Marekani]] || 1271 || ↑ +14.4% |- | 4 || [[Urusi]] || 783 || ↑ +58.5% |- | 5 || [[Kenya]] || 708 || ↓ -5.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 617 || ↓ -10.6% |- | 7 || [[Australia]] || 602 || ↑ +56.4% |- | 8 || [[Afrika Kusini]] || 588 || ↑ +16.7% |- | 9 || [[Kanada]] || 563 || ↑ +202.7% |- | 10 || [[Ufaransa]] || 511 || ↓ -33.7% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} lu54lrkjtopnlta3zkihkfl6jederlc 1578098 1577998 2026-07-02T19:38:59Z Gayle-Bot 78697 #2.0 CAQI Bot updated with page views column 1578098 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-02) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-02)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 617 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 708 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2827 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 327 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1271 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 952 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 588 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 246 |- | [[Irani]] | 7.62 | style="background-color:#90EE90; color:black" | 442 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 278 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 783 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 419 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 149 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 230 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 602 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 186 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 233 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 511 |- | [[Italia]] | 6.23 | style="background-color:#C8E6C9; color:black" | 270 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 161 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 43 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 471 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 405 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 195 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 137 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 186 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 138 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 251 |- | [[Israeli]] | 5.15 | style="background-color:#90EE90; color:black" | 411 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1824 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 168 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 417 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 55 |- | [[Misri]] | 4.78 | style="background-color:#90EE90; color:black" | 308 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 381 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 64 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 316 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 347 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 31 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 66 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 174 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 84 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 257 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 22 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 243 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 96 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 141 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 454 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 563 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 31 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 258 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 237 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 216 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 63 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 318 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 67 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 75 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 170 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 95 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 72 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 373 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 58 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 234 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 53 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 41 |- | [[Indonesia]] | 3.64 | style="background-color:#FFA500; color:black" | 106 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 382 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 482 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 82 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 56 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 99 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 83 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 27 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 117 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 186 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 112 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 117 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 53 |- | [[Myanmar]] | 3.23 | style="background-color:#FF4444; color:white" | 52 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 93 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 121 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 124 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 75 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 80 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 85 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 150 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 133 |- | [[Kosovo]] | 2.99 | style="background-color:#FF4444; color:white" | 50 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 46 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 86 |- | [[Qatar]] | 2.91 | style="background-color:#FFA500; color:black" | 155 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 139 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 111 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 34 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 88 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 154 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 59 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 70 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 38 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#FF4444; color:white" | 80 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 168 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 77 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 90 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 148 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 79 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 28 |- | [[Bahrain]] | 2.51 | style="background-color:#FF4444; color:white" | 50 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 208 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 68 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 116 |- | [[Mongolia]] | 2.42 | style="background-color:#FFA500; color:black" | 127 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 58 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 47 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 141 |- | [[Nepal]] | 2.37 | style="background-color:#FF4444; color:white" | 51 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 35 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 53 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 60 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 63 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 73 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 62 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 115 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 47 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 45 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 154 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 68 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 55 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 78 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 67 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 36 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 25 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 62 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 22 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 75 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 10 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 30 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 8 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 31 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 29 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 19 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#FF4444; color:white" | 51 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 30218 || ↑ +1.7% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 175.7 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2827 || ↓ -1.0% |- | 2 || [[Cabo Verde]] || 1824 || ↑ +1670.9% |- | 3 || [[Marekani]] || 1271 || ↑ +14.4% |- | 4 || [[Urusi]] || 783 || ↑ +58.5% |- | 5 || [[Kenya]] || 708 || ↓ -5.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 617 || ↓ -10.6% |- | 7 || [[Australia]] || 602 || ↑ +56.4% |- | 8 || [[Afrika Kusini]] || 588 || ↑ +16.7% |- | 9 || [[Kanada]] || 563 || ↑ +202.7% |- | 10 || [[Ufaransa]] || 511 || ↓ -33.7% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} shcsbd5gp705w18mawyzrvwljz5pw4h 1578101 1578098 2026-07-02T19:42:06Z Gayle-Bot 78697 Sasisha Takwimu za mradi 1578101 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-02) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-02)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 617 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 708 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2827 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 327 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1271 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 952 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 588 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 246 |- | [[Irani]] | 7.62 | style="background-color:#90EE90; color:black" | 442 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 278 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 783 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 419 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 149 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 230 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 602 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 186 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 233 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 511 |- | [[Italia]] | 6.23 | style="background-color:#C8E6C9; color:black" | 270 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 161 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 43 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 471 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 405 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 195 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 137 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 186 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 138 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 251 |- | [[Israeli]] | 5.15 | style="background-color:#90EE90; color:black" | 411 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1824 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 168 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 417 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 55 |- | [[Misri]] | 4.78 | style="background-color:#90EE90; color:black" | 308 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 381 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 64 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 316 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 347 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 31 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 66 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 174 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 84 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 257 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 22 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 243 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 96 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 141 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 454 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 563 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 31 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 258 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 237 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 216 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 63 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 318 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 67 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 75 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 170 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 95 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 72 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 373 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 58 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 234 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 53 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 41 |- | [[Indonesia]] | 3.64 | style="background-color:#FFA500; color:black" | 106 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 382 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 482 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 82 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 56 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 99 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 83 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 27 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 117 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 186 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 112 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 117 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 53 |- | [[Myanmar]] | 3.23 | style="background-color:#FF4444; color:white" | 52 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 93 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 121 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 124 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 75 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 80 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 85 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 150 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 133 |- | [[Kosovo]] | 2.99 | style="background-color:#FF4444; color:white" | 50 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 46 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 86 |- | [[Qatar]] | 2.91 | style="background-color:#FFA500; color:black" | 155 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 139 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 111 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 34 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 88 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 154 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 59 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 70 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 38 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#FF4444; color:white" | 80 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 168 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 77 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 90 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 148 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 79 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 28 |- | [[Bahrain]] | 2.51 | style="background-color:#FF4444; color:white" | 50 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 208 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 68 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 116 |- | [[Mongolia]] | 2.42 | style="background-color:#FFA500; color:black" | 127 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 58 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 47 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 141 |- | [[Nepal]] | 2.37 | style="background-color:#FF4444; color:white" | 51 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 35 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 53 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 60 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 63 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 73 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 62 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 115 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 47 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 45 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 154 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 68 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 55 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 78 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 67 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 36 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 25 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 62 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 22 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 75 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 10 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 30 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 8 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 31 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 29 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 19 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#FF4444; color:white" | 51 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 30222 || ↑ +1.7% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 175.7 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2827 || ↓ -1.0% |- | 2 || [[Cabo Verde]] || 1824 || ↑ +1670.9% |- | 3 || [[Marekani]] || 1271 || ↑ +14.4% |- | 4 || [[Urusi]] || 783 || ↑ +58.5% |- | 5 || [[Kenya]] || 708 || ↓ -5.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 617 || ↓ -10.6% |- | 7 || [[Australia]] || 602 || ↑ +56.4% |- | 8 || [[Afrika Kusini]] || 588 || ↑ +16.7% |- | 9 || [[Kanada]] || 563 || ↑ +202.7% |- | 10 || [[Ufaransa]] || 511 || ↓ -33.7% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} 7r4vzrludzyrxz7zcc3m8olyboxy9d5 1578216 1578101 2026-07-03T03:40:19Z Gayle-Bot 78697 #2.0 CAQI Bot updated with page views column 1578216 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-03) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-03)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 632 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 720 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2785 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 322 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1265 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 918 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 568 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 244 |- | [[Irani]] | 7.62 | style="background-color:#90EE90; color:black" | 432 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 268 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 738 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 405 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 150 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 223 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 601 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 184 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 211 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 504 |- | [[Italia]] | 6.23 | style="background-color:#C8E6C9; color:black" | 265 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 155 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 42 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 457 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 407 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 231 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 192 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 128 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 183 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 136 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Israeli]] | 5.15 | style="background-color:#90EE90; color:black" | 393 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1822 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 169 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 407 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 54 |- | [[Misri]] | 4.78 | style="background-color:#C8E6C9; color:black" | 299 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 373 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 63 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 312 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 340 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 29 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 62 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 170 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 81 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 254 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 21 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 91 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 131 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 451 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 554 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 29 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 239 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 227 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 210 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 62 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 315 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 66 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 73 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 163 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 91 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 71 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 357 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 57 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 226 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 52 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 40 |- | [[Indonesia]] | 3.64 | style="background-color:#FFA500; color:black" | 101 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 378 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 459 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 77 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 51 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 95 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 80 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 26 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 110 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 188 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 107 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 113 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 52 |- | [[Myanmar]] | 3.23 | style="background-color:#8B0000; color:white" | 49 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 91 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 110 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 123 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 74 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 79 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 83 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 148 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 131 |- | [[Kosovo]] | 2.99 | style="background-color:#8B0000; color:white" | 49 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 45 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 81 |- | [[Qatar]] | 2.91 | style="background-color:#FFA500; color:black" | 153 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 131 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 108 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 33 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 83 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 153 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 58 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 66 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 37 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#FF4444; color:white" | 80 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 169 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 76 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 84 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 146 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 77 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 26 |- | [[Bahrain]] | 2.51 | style="background-color:#8B0000; color:white" | 49 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 206 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 67 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 110 |- | [[Mongolia]] | 2.42 | style="background-color:#FFA500; color:black" | 124 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 54 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 45 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 139 |- | [[Nepal]] | 2.37 | style="background-color:#8B0000; color:white" | 48 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 34 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 51 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 56 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 60 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 72 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 60 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 241 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 113 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 46 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 36 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 152 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 65 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 236 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 51 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 75 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 65 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 35 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 24 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 61 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 0 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 73 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 9 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 29 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 7 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 29 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 29 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 18 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#8B0000; color:white" | 49 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 30222 || ↑ +1.7% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 175.7 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2827 || ↓ -1.0% |- | 2 || [[Cabo Verde]] || 1824 || ↑ +1670.9% |- | 3 || [[Marekani]] || 1271 || ↑ +14.4% |- | 4 || [[Urusi]] || 783 || ↑ +58.5% |- | 5 || [[Kenya]] || 708 || ↓ -5.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 617 || ↓ -10.6% |- | 7 || [[Australia]] || 602 || ↑ +56.4% |- | 8 || [[Afrika Kusini]] || 588 || ↑ +16.7% |- | 9 || [[Kanada]] || 563 || ↑ +202.7% |- | 10 || [[Ufaransa]] || 511 || ↓ -33.7% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} apubjj0d2hl77fxnw2kn2lpimhrn5b0 1578220 1578216 2026-07-03T03:51:50Z Gayle-Bot 78697 Sasisha Takwimu za mradi 1578220 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-03) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-03)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 632 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 720 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2785 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 322 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1265 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 918 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 568 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 244 |- | [[Irani]] | 7.62 | style="background-color:#90EE90; color:black" | 432 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 268 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 738 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 405 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 150 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 223 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 601 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 184 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 211 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 504 |- | [[Italia]] | 6.23 | style="background-color:#C8E6C9; color:black" | 265 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 155 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 42 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 457 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 407 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 231 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 192 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 128 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 183 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 136 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Israeli]] | 5.15 | style="background-color:#90EE90; color:black" | 393 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1822 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 169 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 407 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 54 |- | [[Misri]] | 4.78 | style="background-color:#C8E6C9; color:black" | 299 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 373 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 63 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 312 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 340 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 29 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 62 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 170 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 81 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 254 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 21 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 91 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 131 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 451 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 554 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 29 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 239 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 227 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 210 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 62 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 315 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 66 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 73 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 163 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 91 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 71 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 357 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 57 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 226 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 52 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 40 |- | [[Indonesia]] | 3.64 | style="background-color:#FFA500; color:black" | 101 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 378 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 459 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 77 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 51 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 95 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 80 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 26 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 110 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 188 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 107 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 113 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 52 |- | [[Myanmar]] | 3.23 | style="background-color:#8B0000; color:white" | 49 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 91 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 110 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 123 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 74 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 79 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 83 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 148 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 131 |- | [[Kosovo]] | 2.99 | style="background-color:#8B0000; color:white" | 49 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 45 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 81 |- | [[Qatar]] | 2.91 | style="background-color:#FFA500; color:black" | 153 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 131 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 108 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 33 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 83 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 153 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 58 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 66 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 37 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#FF4444; color:white" | 80 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 169 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 76 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 84 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 146 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 77 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 26 |- | [[Bahrain]] | 2.51 | style="background-color:#8B0000; color:white" | 49 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 206 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 67 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 110 |- | [[Mongolia]] | 2.42 | style="background-color:#FFA500; color:black" | 124 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 54 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 45 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 139 |- | [[Nepal]] | 2.37 | style="background-color:#8B0000; color:white" | 48 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 34 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 51 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 56 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 60 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 72 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 60 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 241 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 113 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 46 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 36 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 152 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 65 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 236 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 51 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 75 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 65 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 35 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 24 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 61 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 0 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 73 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 9 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 29 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 7 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 29 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 29 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 18 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#8B0000; color:white" | 49 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 29565 || ↑ +0.1% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 171.9 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2785 || ↓ -3.1% |- | 2 || [[Cabo Verde]] || 1822 || ↑ +1740.4% |- | 3 || [[Marekani]] || 1265 || ↑ +11.9% |- | 4 || [[Urusi]] || 738 || ↑ +39.0% |- | 5 || [[Kenya]] || 720 || ↓ -4.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 632 || ↓ -7.5% |- | 7 || [[Australia]] || 601 || ↑ +62.0% |- | 8 || [[Afrika Kusini]] || 568 || ↑ +11.2% |- | 9 || [[Kanada]] || 554 || ↑ +199.5% |- | 10 || [[Ufaransa]] || 504 || ↓ -34.4% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} 7e6kh6bpd3tt54v7ang0w4iayn0hxnl 1578243 1578220 2026-07-03T09:27:22Z Gayle-Bot 78697 #2.0 CAQI Bot updated with page views column 1578243 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-03) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-03)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 632 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 720 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2785 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 322 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1265 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 918 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 568 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 244 |- | [[Irani]] | 7.62 | style="background-color:#8B0000; color:white" | 0 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 268 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 738 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 405 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 150 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 223 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 601 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 184 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 211 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 504 |- | [[Italia]] | 6.23 | style="background-color:#8B0000; color:white" | 0 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 155 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 42 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 457 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 407 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 231 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 192 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 128 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 183 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 136 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Israeli]] | 5.15 | style="background-color:#8B0000; color:white" | 0 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1822 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 169 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 407 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 54 |- | [[Misri]] | 4.78 | style="background-color:#C8E6C9; color:black" | 299 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 373 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 63 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 312 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 340 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 29 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 62 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 170 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 81 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 254 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 21 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 91 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 131 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 451 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 554 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 29 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 239 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 227 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 210 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 62 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 315 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 66 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 73 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 163 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 91 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 71 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 357 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 57 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 226 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 52 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 40 |- | [[Indonesia]] | 3.64 | style="background-color:#8B0000; color:white" | 0 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 378 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 459 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 77 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 51 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 95 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 80 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 26 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 110 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 188 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 107 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 113 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 52 |- | [[Myanmar]] | 3.23 | style="background-color:#8B0000; color:white" | 49 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 91 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 110 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 123 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 74 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 79 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 83 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 148 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 131 |- | [[Kosovo]] | 2.99 | style="background-color:#8B0000; color:white" | 49 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 45 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 81 |- | [[Qatar]] | 2.91 | style="background-color:#8B0000; color:white" | 0 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 131 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 108 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 33 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 83 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 153 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 58 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 66 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 37 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#8B0000; color:white" | 0 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 169 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 76 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 84 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 146 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 77 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 26 |- | [[Bahrain]] | 2.51 | style="background-color:#8B0000; color:white" | 49 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 206 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 67 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 110 |- | [[Mongolia]] | 2.42 | style="background-color:#8B0000; color:white" | 0 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 54 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 45 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 139 |- | [[Nepal]] | 2.37 | style="background-color:#8B0000; color:white" | 48 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 34 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 51 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 56 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 60 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 72 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 60 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 241 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 113 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 46 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 36 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 152 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 65 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 236 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 51 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 75 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 65 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 35 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 24 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 61 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 22 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 73 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 9 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 29 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 7 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 29 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 0 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 18 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#8B0000; color:white" | 49 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 29565 || ↑ +0.1% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 171.9 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2785 || ↓ -3.1% |- | 2 || [[Cabo Verde]] || 1822 || ↑ +1740.4% |- | 3 || [[Marekani]] || 1265 || ↑ +11.9% |- | 4 || [[Urusi]] || 738 || ↑ +39.0% |- | 5 || [[Kenya]] || 720 || ↓ -4.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 632 || ↓ -7.5% |- | 7 || [[Australia]] || 601 || ↑ +62.0% |- | 8 || [[Afrika Kusini]] || 568 || ↑ +11.2% |- | 9 || [[Kanada]] || 554 || ↑ +199.5% |- | 10 || [[Ufaransa]] || 504 || ↓ -34.4% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} 0pubc0wlnskpjbbqa8itr07af4q66jy 1578246 1578243 2026-07-03T09:29:22Z Gayle-Bot 78697 Sasisha Takwimu za mradi 1578246 wikitext text/x-wiki {{Redirect|WP:Mradi/Nchi|maelezo kuhusu nchi|nchi}} {{Kigezo:Mradi/Nchi}} == Yaliyomo == <div style="margin: 1em 0; background-color:#E0F8E0; border: 1px solid #a2a9b1; padding: 12px 16px; border-radius: 2px; border-left: 5px solid #a2a9b1; line-height: 1.6;"> Kuna mradi mpya wa kujadili majina ya makala za nchi katika Kiswahili. Ili kushiriki, angalia [[WP:Mradi wa Nchi/Majina ya Nchi]]. [[Mtumiaji:Gayle157|<div style="display: inline; font-family: 'Georgia', serif; color: #4A90E2;">'''<i>Gayle157^2.0</i>'''</div>]] ([[Mtumiaji:Gayle157|Mtumiaji]]) 13:46, 14 Mei 2026 (UTC) </div> == Mwongozo == ===Sanduku/Jedwali la taarifa=== '''Sanduku la taarifa''' kwa kawaida huonekana kando ya makala katika mwonekano wa [[kompyuta]], ilhali katika mwonekano wa simu huenda likaonekana baada ya aya ya kwanza ya utangulizi. Hutoa muhtasari mfupi wa mambo muhimu kuhusu nchi na husaidia wasomaji kuelewa kwa haraka taarifa muhimu zaidi. Katika [[Wikipedia ya Kiswahili]], sanduku la taarifa la kawaida linalotumiwa kwa makala za nchi ni '''<nowiki>{{Jedwali la nchi}}</nowiki>'''. Ni muhimu kujumuisha [[tarehe]] na marejeo kwa data zote za kihalisi ili masasisho yaweze kufanywa kwa urahisi na kwa usahihi. Sanduku la taarifa linapaswa kuwa na angalau vigezo 20 pale inapowezekana. ===Utangulizi=== {{Main|Wikipedia:Sehemu ya Utangulizi}} Sehemu hii hutoa muhtasari wa jumla wa nchi na kufupisha mambo makuu yanayoshughulikiwa katika makala. Kwa kawaida hugawanywa katika sehemu zifuatazo: ====Aya ya Utangulizi==== Hii ndiyo aya ya kwanza ya makala. Inapaswa kuwa na maelezo muhimu zaidi, kama vile [[jina rasmi]], nchi jirani, idadi ya watu, ukubwa wa eneo la [[jiografia|kijiografia]], jiji kubwa zaidi, [[mji mkuu]], na [[lugha rasmi]]. Huenda pia ikajumuisha maelezo mafupi kuhusu kile ambacho nchi hiyo inajulikana nacho. Aya ya mwanzo inapaswa kuwa wazi, rahisi, na iliyoandikwa vizuri, na kwa kawaida inapaswa kuwa na ukubwa wa takribani baiti 500 hadi 800. Mfano: </br> {{Blockquote| '''Kanada''', ni [[nchi]] iliyoko katika [[Amerika ya Kaskazini]]. Inapakana na [[Bahari ya Atlantiki]] mashariki, [[Bahari ya Pasifiki]] magharibi, [[Bahari ya Aktiki]] kaskazini, na [[Marekani]] bara kusini. Kanada ina idadi ya wakazi takriban milioni 41 mwaka 2025 na kuwa ya 37 duniani kwa idadi ya watu, huku ikiwa na eneo la pili kubwa zaidi duniani baada ya [[Urusi]]. Mji mkuu ni [[Ottawa]], na jiji kubwa zaidi ni [[Toronto]], likifuatiwa na [[Montreal]] na [[Vancouver]]. Lugha rasmi ni [[Kiingereza]] na [[Kifaransa]], na Kanada inajulikana kwa msitu na maziwa yake mengi, mfumo wa [[siasa|kisiasa]] wa [[demokrasia|kidemokrasia]] wa kifederali, utofauti wa [[Utamaduni|kitamaduni]], viwango vya juu vya maisha, na kuwa miongoni mwa mataifa tajiri na yenye ushawishi mkubwa duniani.}} ====Aya zinazofuata==== Aya hizi zinapaswa kuendelea kufupisha nchi kwa kuzungumzia kwa ufupi mada kama [[historia]], [[jiografia]], [[uchumi]], [[siasa]], na maendeleo ya sasa. Zinapaswa kubaki fupi na zenye taarifa muhimu, bila kuwa ndefu kupita kiasi. Kwa hakika, kunapaswa kuwa na angalau aya mbili na zisizozidi nne katika sehemu ya utangulizi ili kudumisha usomaji rahisi na kuboresha urambazaji. Hakuna picha zinazopaswa kuwekwa katika sehemu hii. ===Mwili=== Hii ndiyo sehemu kuu ya makala na ina taarifa za kina kuhusu nchi. Kwa kawaida hugawanywa katika sehemu kuu zilizopangwa kwa mpangilio wa kimantiki. Mwili unapaswa kuwa na maudhui ya kutosha ili kuwa na manufaa, lakini haupaswi kuwa mrefu kupita kiasi au kumchosha msomaji. Picha zinazohusiana zinaweza kuongezwa katika kila sehemu ili kuboresha uwazi na uwasilishaji. ====Asili ya jina==== Sehemu hii inaeleza chanzo na maana ya jina la nchi. ====Historia==== Hii kwa kawaida ndiyo sehemu kuu ya kwanza ya mwili na inashughulikia matukio makuu ya kihistoria ya nchi. Inaweza kugawanywa katika sehemu ndogo kama vile historia ya awali, historia ya mwanzo, kipindi cha ukoloni, uhuru, na kuundwa kwa taifa la kisasa. ====Jiografia==== Sehemu hii ina taarifa kuhusu sifa za kijiografia za nchi, ikiwa ni pamoja na [[topografia]], [[hali ya hewa]], mifumo ya maji, maeneo asilia, na sifa nyingine za kijiografia. Husaidia wasomaji kuelewa mahali nchi ilipo na mazingira yake ya asili. ====Demografia==== Sehemu hii inawasilisha taarifa za kitakwimu kuhusu idadi ya watu. Huenda ikajumuisha [[Kabila]], [[dini]], [[lugha]], usambazaji wa watu, miji, na data nyingine zinazohusiana. ====Uchumi==== Sehemu hii inaeleza hali ya kiuchumi ya nchi, katika historia na wakati wa sasa. Huenda ikahusu [[Pato la taifa]] (GDP), ukuaji wa uchumi, ajira, [[umaskini]], [[viwanda]], [[biashara]], na vyanzo vikuu vya mapato. ====Serikali na siasa==== Sehemu hii inaeleza mfumo wa sasa wa kisiasa na muundo wa serikali ya nchi. Huenda pia ikajadili aina za awali za serikali, historia ya kisiasa, na changamoto kuu za kisiasa. ====Utamaduni==== Sehemu hii inashughulikia maisha ya kitamaduni ya nchi, ikijumuisha [[mila]], [[chakula|vyakula]], [[muziki]], [[fasihi]], [[sanaa]], [[dini]], na alama za kitaifa. ====Tazama pia==== Sehemu hii ina viungo vya makala zinazohusiana na mada husika. ====Marejeo==== Sehemu hii inaorodhesha vyanzo vilivyotumiwa katika makala. Huenda ikajumuisha nukuu za marejeo, bibliografia, na usomaji zaidi inapofaa. ====Viungo vya nje==== Sehemu hii hutoa viungo vya tovuti rasmi na nyenzo nyingine za nje zilizoaminika zinazohusiana na nchi hiyo. == Makala == {{Chati ya duara | caption= CAQI (2026-07-03) | label1 = Makala Bora | value1 = 7 | color1= green | label2 = Makala Nzuri | value2 = 9 | color2= yellow | label3 = Makala Msingi | value3 = 60 | color3= orange | label4 = Makala ya Chini | value4 = 73 | color4= lightblue | label5 = Mbegu | value5 = 26 | color5= red }} {| class="wikitable sortable" ! Nchi ! CAQI (2026-07-03)<br /> ! Mitazamo (siku 30)<br /> |- | colspan="3" style="background-color:green" | Makala Bora |- | [[Jamhuri ya Kidemokrasia ya Kongo]] | 9.56 | style="background-color:#3CB371; color:white" | 632 |- | [[Kenya]] | 9.44 | style="background-color:#228B22; color:white" | 720 |- | [[Tanzania]] | 9.17 | style="background-color:#006400; color:white" | 2785 |- | [[Ghana]] | 8.93 | style="background-color:#90EE90; color:black" | 322 |- | [[Marekani]] | 8.76 | style="background-color:#006400; color:white" | 1265 |- | [[Jumuiya ya Afrika Mashariki|EAC]] | 8.25 | style="background-color:#228B22; color:white" | 918 |- | [[Afrika Kusini]] | 8.09 | style="background-color:#3CB371; color:white" | 568 |- | colspan="3" style="background-color:yellow" | Makala Nzuri |- | [[Hispania]] | 7.84 | style="background-color:#C8E6C9; color:black" | 244 |- | [[Irani]] | 7.62 | style="background-color:#8B0000; color:white" | 0 |- | [[Ethiopia]] | 7.58 | style="background-color:#C8E6C9; color:black" | 268 |- | [[Urusi]] | 7.54 | style="background-color:#228B22; color:white" | 738 |- | [[Burundi]] | 7.36 | style="background-color:#90EE90; color:black" | 405 |- | [[Sudan Kusini]] | 7.28 | style="background-color:#FFA500; color:black" | 150 |- | [[Nigeria]] | 7.26 | style="background-color:#C8E6C9; color:black" | 223 |- | [[Australia]] | 7.15 | style="background-color:#3CB371; color:white" | 601 |- | [[Somalia]] | 7.09 | style="background-color:#FFA500; color:black" | 184 |- | colspan="3" style="background-color:orange" | Makala Msingi |- | [[Senegal]] | 6.90 | style="background-color:#C8E6C9; color:black" | 211 |- | [[Ufaransa]] | 6.68 | style="background-color:#3CB371; color:white" | 504 |- | [[Italia]] | 6.23 | style="background-color:#8B0000; color:white" | 0 |- | [[Falme za Kiarabu]] | 6.08 | style="background-color:#FFA500; color:black" | 155 |- | [[Laos]] | 5.95 | style="background-color:#8B0000; color:white" | 42 |- | [[Uingereza]] | 5.93 | style="background-color:#90EE90; color:black" | 457 |- | [[Jamhuri ya Watu wa China]] | 5.59 | style="background-color:#90EE90; color:black" | 407 |- | [[Rwanda]] | 5.49 | style="background-color:#C8E6C9; color:black" | 231 |- | [[Korea Kaskazini]] | 5.44 | style="background-color:#FFA500; color:black" | 192 |- | [[Mali]] | 5.42 | style="background-color:#FFA500; color:black" | 128 |- | [[Korea Kusini]] | 5.34 | style="background-color:#FFA500; color:black" | 183 |- | [[Ufini]] | 5.20 | style="background-color:#FFA500; color:black" | 136 |- | [[Uswisi]] | 5.17 | style="background-color:#C8E6C9; color:black" | 242 |- | [[Israeli]] | 5.15 | style="background-color:#8B0000; color:white" | 0 |- | [[Ufalme wa Muungano]] | 5.05 | style="background-color:#FFA500; color:black" | 169 |- | [[Cabo Verde]] | 4.89 | style="background-color:#006400; color:white" | 1822 |- | [[Zambia]] | 4.89 | style="background-color:#FFA500; color:black" | 169 |- | [[Ujerumani]] | 4.83 | style="background-color:#90EE90; color:black" | 407 |- | [[Niger]] | 4.79 | style="background-color:#FF4444; color:white" | 54 |- | [[Misri]] | 4.78 | style="background-color:#C8E6C9; color:black" | 299 |- | [[Uganda]] | 4.78 | style="background-color:#90EE90; color:black" | 373 |- | [[Afghanistan]] | 4.70 | style="background-color:#FF4444; color:white" | 63 |- | [[Shelisheli]] | 4.68 | style="background-color:#90EE90; color:black" | 312 |- | [[Japani]] | 4.66 | style="background-color:#90EE90; color:black" | 340 |- | [[San Marino]] | 4.63 | style="background-color:#8B0000; color:white" | 29 |- | [[Chad]] | 4.59 | style="background-color:#FF4444; color:white" | 62 |- | [[Austria]] | 4.49 | style="background-color:#FFA500; color:black" | 170 |- | [[Kamerun]] | 4.47 | style="background-color:#FF4444; color:white" | 81 |- | [[Vatikani]] | 4.43 | style="background-color:#C8E6C9; color:black" | 254 |- | [[Gine Bisau]] | 4.41 | style="background-color:#8B0000; color:white" | 21 |- | [[Ukraini]] | 4.41 | style="background-color:#C8E6C9; color:black" | 240 |- | [[Sudan]] | 4.39 | style="background-color:#FF4444; color:white" | 91 |- | [[Uswidi]] | 4.30 | style="background-color:#FFA500; color:black" | 131 |- | [[Uholanzi]] | 4.26 | style="background-color:#90EE90; color:black" | 451 |- | [[Kanada]] | 4.17 | style="background-color:#3CB371; color:white" | 554 |- | [[Kamboja]] | 4.14 | style="background-color:#8B0000; color:white" | 29 |- | [[Moroko]] | 4.13 | style="background-color:#C8E6C9; color:black" | 239 |- | [[Uhindi]] | 4.08 | style="background-color:#C8E6C9; color:black" | 227 |- | [[Malawi]] | 4.05 | style="background-color:#C8E6C9; color:black" | 210 |- | [[Pakistani]] | 3.98 | style="background-color:#FF4444; color:white" | 62 |- | [[Ubelgiji]] | 3.92 | style="background-color:#90EE90; color:black" | 315 |- | [[Udeni]] | 3.88 | style="background-color:#FF4444; color:white" | 66 |- | [[Burkina Faso]] | 3.84 | style="background-color:#FF4444; color:white" | 73 |- | [[Ugiriki]] | 3.84 | style="background-color:#FFA500; color:black" | 163 |- | [[Vietnam]] | 3.84 | style="background-color:#FF4444; color:white" | 91 |- | [[Bulgaria]] | 3.82 | style="background-color:#FF4444; color:white" | 71 |- | [[Ureno]] | 3.79 | style="background-color:#90EE90; color:black" | 357 |- | [[Isilandi]] | 3.77 | style="background-color:#FF4444; color:white" | 57 |- | [[Msumbiji]] | 3.76 | style="background-color:#C8E6C9; color:black" | 226 |- | [[Aljeria]] | 3.73 | style="background-color:#FF4444; color:white" | 52 |- | [[Kazakhstan]] | 3.65 | style="background-color:#FF4444; color:white" | 52 |- | [[Malta]] | 3.65 | style="background-color:#8B0000; color:white" | 40 |- | [[Indonesia]] | 3.64 | style="background-color:#8B0000; color:white" | 0 |- | [[Singapuri]] | 3.63 | style="background-color:#90EE90; color:black" | 378 |- | [[Uturuki]] | 3.62 | style="background-color:#90EE90; color:black" | 459 |- | [[Papua Guinea Mpya]] | 3.61 | style="background-color:#8B0000; color:white" | 34 |- | [[Eritrea]] | 3.60 | style="background-color:#FF4444; color:white" | 77 |- | [[Uthai]] | 3.58 | style="background-color:#FF4444; color:white" | 51 |- | [[Angola]] | 3.52 | style="background-color:#FF4444; color:white" | 95 |- | [[Hong Kong]] | 3.52 | style="background-color:#FF4444; color:white" | 80 |- | colspan="3" style="background-color:lightblue" | Makala ya Chini |- | [[Bhutan]] | 3.46 | style="background-color:#8B0000; color:white" | 26 |- | [[Fiji]] | 3.46 | style="background-color:#FF4444; color:white" | 53 |- | [[Madagaska]] | 3.45 | style="background-color:#FFA500; color:black" | 110 |- | [[Ufalme wa Udeni]] | 3.44 | style="background-color:#8B0000; color:white" | 16 |- | [[Palestina]] | 3.43 | style="background-color:#FFA500; color:black" | 188 |- | [[Jamhuri ya Afrika ya Kati]] | 3.38 | style="background-color:#FFA500; color:black" | 107 |- | [[Syria]] | 3.35 | style="background-color:#FFA500; color:black" | 113 |- | [[Latvia]] | 3.30 | style="background-color:#FF4444; color:white" | 52 |- | [[Myanmar]] | 3.23 | style="background-color:#8B0000; color:white" | 49 |- | [[Botswana]] | 3.22 | style="background-color:#FF4444; color:white" | 91 |- | [[Komori]] | 3.20 | style="background-color:#FFA500; color:black" | 110 |- | [[Liberia]] | 3.16 | style="background-color:#FF4444; color:white" | 64 |- | [[Eswatini]] | 3.11 | style="background-color:#FFA500; color:black" | 123 |- | [[Morisi]] | 3.11 | style="background-color:#FF4444; color:white" | 74 |- | [[Jibuti]] | 3.09 | style="background-color:#FF4444; color:white" | 79 |- | [[Omani]] | 3.04 | style="background-color:#FF4444; color:white" | 83 |- | [[Polandi]] | 3.03 | style="background-color:#FFA500; color:black" | 148 |- | [[Zimbabwe]] | 3.02 | style="background-color:#FFA500; color:black" | 131 |- | [[Kosovo]] | 2.99 | style="background-color:#8B0000; color:white" | 49 |- | [[Benin]] | 2.93 | style="background-color:#8B0000; color:white" | 45 |- | [[Brunei]] | 2.92 | style="background-color:#FF4444; color:white" | 81 |- | [[Qatar]] | 2.91 | style="background-color:#8B0000; color:white" | 0 |- | [[Jamhuri ya Kongo]] | 2.90 | style="background-color:#FFA500; color:black" | 131 |- | [[Saudia]] | 2.90 | style="background-color:#FFA500; color:black" | 108 |- | [[Gine ya Ikweta]] | 2.89 | style="background-color:#8B0000; color:white" | 33 |- | [[Lesotho]] | 2.88 | style="background-color:#FF4444; color:white" | 83 |- | [[Nyuzilandi]] | 2.86 | style="background-color:#FFA500; color:black" | 153 |- | [[Hungaria]] | 2.84 | style="background-color:#FF4444; color:white" | 56 |- | [[Sierra Leone]] | 2.82 | style="background-color:#FF4444; color:white" | 51 |- | [[Eire]] | 2.80 | style="background-color:#FF4444; color:white" | 58 |- | [[Liechtenstein]] | 2.78 | style="background-color:#8B0000; color:white" | 42 |- | [[Gabon]] | 2.74 | style="background-color:#FF4444; color:white" | 66 |- | [[Azerbaijan]] | 2.69 | style="background-color:#8B0000; color:white" | 37 |- | [[Kroatia]] | 2.68 | style="background-color:#FFA500; color:black" | 107 |- | [[Slovenia]] | 2.66 | style="background-color:#8B0000; color:white" | 0 |- | [[Namibia]] | 2.65 | style="background-color:#FFA500; color:black" | 169 |- | [[Tunisia]] | 2.64 | style="background-color:#FF4444; color:white" | 76 |- | [[Ufilipino]] | 2.64 | style="background-color:#FF4444; color:white" | 84 |- | [[Kodivaa]] | 2.60 | style="background-color:#FFA500; color:black" | 146 |- | [[Jamhuri ya China]] | 2.54 | style="background-color:#FF4444; color:white" | 77 |- | [[Moldova]] | 2.52 | style="background-color:#8B0000; color:white" | 26 |- | [[Bahrain]] | 2.51 | style="background-color:#8B0000; color:white" | 49 |- | [[Norwei]] | 2.51 | style="background-color:#C8E6C9; color:black" | 206 |- | [[Luxemburg]] | 2.49 | style="background-color:#FF4444; color:white" | 67 |- | [[Masedonia Kaskazini]] | 2.48 | style="background-color:#8B0000; color:white" | 26 |- | [[Yordani]] | 2.48 | style="background-color:#FFA500; color:black" | 110 |- | [[Mongolia]] | 2.42 | style="background-color:#8B0000; color:white" | 0 |- | [[Belarus]] | 2.41 | style="background-color:#FF4444; color:white" | 54 |- | [[Serbia]] | 2.41 | style="background-color:#FF4444; color:white" | 66 |- | [[Turkmenistan]] | 2.41 | style="background-color:#8B0000; color:white" | 31 |- | [[Gambia]] | 2.39 | style="background-color:#8B0000; color:white" | 45 |- | [[Iraki]] | 2.37 | style="background-color:#FFA500; color:black" | 139 |- | [[Nepal]] | 2.37 | style="background-color:#8B0000; color:white" | 48 |- | [[Timor ya Mashariki]] | 2.34 | style="background-color:#8B0000; color:white" | 24 |- | [[Tuvalu]] | 2.33 | style="background-color:#8B0000; color:white" | 34 |- | [[Sri Lanka]] | 2.32 | style="background-color:#FF4444; color:white" | 51 |- | [[Yemen]] | 2.32 | style="background-color:#FF4444; color:white" | 56 |- | [[Andorra]] | 2.30 | style="background-color:#8B0000; color:white" | 28 |- | [[Kirgizia]] | 2.26 | style="background-color:#FF4444; color:white" | 51 |- | [[Romania]] | 2.25 | style="background-color:#FF4444; color:white" | 60 |- | [[Sao Tome na Principe]] | 2.23 | style="background-color:#FF4444; color:white" | 72 |- | [[Bangladesh]] | 2.22 | style="background-color:#FF4444; color:white" | 60 |- | [[Bosnia na Herzegovina]] | 2.22 | style="background-color:#C8E6C9; color:black" | 241 |- | [[Libya]] | 2.22 | style="background-color:#FFA500; color:black" | 113 |- | [[Armenia]] | 2.19 | style="background-color:#8B0000; color:white" | 46 |- | [[Welisi]] | 2.14 | style="background-color:#8B0000; color:white" | 36 |- | [[Ucheki]] | 2.11 | style="background-color:#FFA500; color:black" | 152 |- | [[Sahara ya Magharibi]] | 2.10 | style="background-color:#FF4444; color:white" | 65 |- | [[Uzbekistan]] | 2.09 | style="background-color:#C8E6C9; color:black" | 236 |- | [[Kuwait]] | 2.07 | style="background-color:#FF4444; color:white" | 51 |- | [[Malaysia]] | 2.06 | style="background-color:#FF4444; color:white" | 75 |- | [[Kupro]] | 2.04 | style="background-color:#FF4444; color:white" | 65 |- | [[Maldivi]] | 2.02 | style="background-color:#8B0000; color:white" | 28 |- | colspan="3" style="background-color:red" | Mbegu |- | [[Visiwa vya Cook]] | 1.99 | style="background-color:#8B0000; color:white" | 23 |- | [[Montenegro]] | 1.99 | style="background-color:#8B0000; color:white" | 35 |- | [[Nauru]] | 1.98 | style="background-color:#8B0000; color:white" | 30 |- | [[Ossetia Kusini]] | 1.97 | style="background-color:#8B0000; color:white" | 5 |- | [[Vanuatu]] | 1.96 | style="background-color:#8B0000; color:white" | 24 |- | [[Togo]] | 1.95 | style="background-color:#FF4444; color:white" | 61 |- | [[Albania]] | 1.92 | style="background-color:#8B0000; color:white" | 37 |- | [[Mauritania]] | 1.91 | style="background-color:#FF4444; color:white" | 61 |- | [[Samoa]] | 1.82 | style="background-color:#8B0000; color:white" | 22 |- | [[Georgia]] | 1.72 | style="background-color:#FF4444; color:white" | 73 |- | [[Polynesia ya Kifaransa]] | 1.71 | style="background-color:#8B0000; color:white" | 9 |- | [[Lituanya]] | 1.69 | style="background-color:#8B0000; color:white" | 29 |- | [[Gine]] | 1.67 | style="background-color:#8B0000; color:white" | 32 |- | [[Niue]] | 1.66 | style="background-color:#8B0000; color:white" | 16 |- | [[Abkhazia]] | 1.58 | style="background-color:#8B0000; color:white" | 7 |- | [[Tajikistan]] | 1.55 | style="background-color:#8B0000; color:white" | 29 |- | [[Palau]] | 1.53 | style="background-color:#8B0000; color:white" | 22 |- | [[Visiwa vya Solomon]] | 1.51 | style="background-color:#8B0000; color:white" | 41 |- | [[Gibraltar]] | 1.41 | style="background-color:#8B0000; color:white" | 34 |- | [[Estonia]] | 1.40 | style="background-color:#8B0000; color:white" | 29 |- | [[Kiribati]] | 1.38 | style="background-color:#8B0000; color:white" | 0 |- | [[Visiwa vya Mariana ya Kaskazini]] | 1.38 | style="background-color:#8B0000; color:white" | 18 |- | [[Samoa ya Marekani]] | 1.36 | style="background-color:#8B0000; color:white" | 27 |- | [[Slovakia]] | 1.33 | style="background-color:#8B0000; color:white" | 49 |- | [[Visiwa vya Mariana]] | 1.25 | style="background-color:#8B0000; color:white" | 5 |- | [[Tonga]] | 1.11 | style="background-color:#8B0000; color:white" | 33 |} ==Takwimu== ===Takwimu za Jumla=== {| class="wikitable" ! Vipimo !! Jumla !! Mabadiliko |- | Jumla ya Makala || 172 || — |- | Jumla ya Hariri (siku zote) || 34950 || — |- | Jumla ya Mitazamo (siku 30) || 29587 || ↓ -0.0% |- | Wastani wa Hariri kwa Makala || 203.2 || — |- | Wastani wa Mitazamo kwa Makala || 172.0 || — |} ===Makala 10 Zilizotazamwa Zaidi (siku 30)=== {| class="wikitable sortable" ! Nafasi !! Makala !! Mitazamo !! Mabadiliko |- | 1 || [[Tanzania]] || 2785 || ↓ -3.1% |- | 2 || [[Cabo Verde]] || 1822 || ↑ +1740.4% |- | 3 || [[Marekani]] || 1265 || ↑ +11.9% |- | 4 || [[Urusi]] || 738 || ↑ +39.0% |- | 5 || [[Kenya]] || 720 || ↓ -4.5% |- | 6 || [[Jamhuri ya Kidemokrasia ya Kongo]] || 632 || ↓ -7.5% |- | 7 || [[Australia]] || 601 || ↑ +62.0% |- | 8 || [[Afrika Kusini]] || 568 || ↑ +11.2% |- | 9 || [[Kanada]] || 554 || ↑ +199.5% |- | 10 || [[Ufaransa]] || 504 || ↓ -34.4% |- |} ====Wahariri==== Wahariri kuu wa Mradi wa Nchi wa Wikipedia (siku 365) {| class="wikitable sortable" ! Namba !! Jina !! Hariri !! Asilimia |- | 1 || [[User:Gayle157|Gayle157]] || 629 || 44.3% |- | 2 || [[User:Gayle-Bot|Gayle-Bot]] || 358 || 25.2% |- | 3 || [[User:Riccardo Riccioni|Riccardo Riccioni]] || 127 || 8.9% |- | 4 || [[User:InternetArchiveBot|InternetArchiveBot]] || 127 || 8.9% |- | 5 || [[User:~2025-60637-6|~2025-60637-6]] || 12 || 0.8% |- | 6 || [[User:~2025-61248-5|~2025-61248-5]] || 12 || 0.8% |- | 7 || [[User:That Js Not Dead|That Js Not Dead]] || 8 || 0.6% |- | 8 || [[User:CommonsDelinker|CommonsDelinker]] || 7 || 0.5% |- | 9 || [[User:Kisare|Kisare]] || 5 || 0.4% |- | 10 || [[User:Jojaruba|Jojaruba]] || 5 || 0.4% |- |} b5kadimfipwofjogwz3qgnaxy4nlm61 0 212195 1577933 1521625 2026-07-02T12:37:09Z Riccardo Riccioni 452 /* Marejeo */ 1577933 wikitext text/x-wiki '''My Love''' ni filamu ya kimapenzi ya [[1970]] ya [[lugha ya Kihindi]] iliyoongozwa na [[Sukhdev Thapar|S. Sukhdev.]] Filamu hiyo imeigizwa na Shashi Kapoor na Sharmila Tagore. Hii ilikuwa ni filamu ya kwanza ya [[Uhindi]] iliyoigizwa nchini [[Kenya]] na [[Tanzania]]<ref>{{Rejea tovuti|title=Memorabilia of Foreign Theatrical Movies Filmed In The East Africa Region (1931–1975) – AwaaZ Magazine|url=https://www.awaazmagazine.com/volume-20/issue-2-volume-20/memorabilia-of-foreign-theatrical-movies-filmed-in-the-east-africa-region-1931-1975|accessdate=2025-08-22|language=en-US|author=Fuko Uchi}}</ref>. == Hadithi == Hadithi hii inahusu maisha ya mwanamuziki Raj Kumar Rai anayeishi [[Nairobi]]. Anakutana na Sangeeta kwenye sherehe na anampenda. Wakati huohuo, Rani Mehta naye anampenda Raj Kumar.<ref>{{Rejea tovuti|title=My Love Movie Trailer, Star Cast, Release Date, Box Office, Movie Review {{!}} My Love Movie budget and Collection {{!}} My Love|url=https://www.indianfilmhistory.com/movie/my-love|work=www.indianfilmhistory.com|accessdate=2025-08-22|language=en}}</ref> == Wahusika == * Shashi Kapoor as Raj Kumar Rai * Sharmila Tagore as Sangeeta Thakur * Nirupa Roy as Durga * Madan Puri as Pran Mehra * Rajendra Nath as Tom Genda * Azra as Rani Mehta * Laxmi Chhaya as Laxmi * Raj Mehra as Mr. Mehta * Jayant as Mr. Rai * Iftekhar as Doctor * Sulochana Chatterjee as Sangeeta's Mother * Manorama as Tom's Mother * Pinchoo Kapoor as Tom's Father == Nyimbo za filamu == Maneno ya nyimbo zote yaliandikwa na Anand Bakshi. {| class="wikitable" !Song !Singer |- |"Woh Tere Pyar Ka Gham" |Mukesh |- |"Zikr Hota Hai Jab Qayamat Ka" |Mukesh |- |"Tum Mera Pyar Ho, My Love" |Mohammed Rafi |- |"Sunate Hai Sitare" (Happy) |Asha Bhosle |- |"Sunate Hai Sitare" (Sad) |Asha Bhosle |- |"Bheegi Bheegi Raat Mein" |Asha Bhosle |- |"Guzar Gaye Jo Haseen" |Asha Bhosle |} == Mapokezi == Mkaguzi wa gazeti la ''The Indian Express'' aliita filamu hiyo ‘kazi ya uvuguvugu, isiyo na uhai, ambayo haingeweza kuokolewa hata na uchezaji bora wa Shashi Kapoor'<ref>{{Rejea tovuti|title=The Indian Express - Google News Archive Search|url=https://news.google.com/newspapers?id=D35lAAAAIBAJ&sjid=wp0NAAAAIBAJ&pg=1085,2017337|work=news.google.com|accessdate=2025-08-22}}</ref> == Marejeo == <references /> [[Jamii:ACWP + film in Tanzania]] [[Jamii:filamu za 1970]] [[Jamii:Filamu za India]] qvz6x4sdmck58q1exv70f83utjnsb7d 0 212645 1578079 1464213 2026-07-02T18:43:52Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578079 wikitext text/x-wiki '''Bina Agarwal''' ni [[mchumi]] wa [[maendeleo]] kutoka [[Uhindi|India]] na [[Profesa]] wa Uchumi wa Maendeleo na Mazingira katika Taasisi ya Maendeleo ya Ulimwengu (Global Development Institute) ya Chuo Kikuu cha [[Manchester]]. Ameandika kwa kina kuhusu ardhi, riziki na haki za umiliki; mazingira na maendeleo; siasa ya uchumi wa kijinsia; umaskini na usawa; mabadiliko ya kisheria; pamoja na [[kilimo]] na mabadiliko ya kiteknolojia.<ref name="Contributors">{{Cite journal |date=2003 |title=Notes on contributors |url=https://archive.org/details/feminist-economics_july-november-2003_9_2-3/page/334 |journal=Feminist Economics |volume=9 |issue=2–3 |pages=333–335 |doi=10.1080/1354570032000114554 |s2cid=216645024}}</ref> Yeye ndiye [[mwandishi]] wa [[kitabu]] kilichoshinda [[tuzo]] kiitwacho ''A Field of One's Own: Gender and Land Rights in South Asia'', ambacho kimekuwa na athari kubwa kwa serikali, mashirika yasiyo ya kiserikali (NGOs), na mashirika ya kimataifa katika kukuza [[haki]] za [[wanawake]] kwenye ardhi na mali. Kazi hii pia imechochea utafiti katika [[Amerika]] ya Kusini na kote duniani.<ref>{{cite web|last=Staff writer|title=SEED's Bina Agarwal launches book prize|archive-url=https://web.archive.org/web/20180123192711/http://www.humanities.manchester.ac.uk/humnet/news-events/recent-news/headline-603371-en.htm|archive-date=23 January 2018|url=http://www.humanities.manchester.ac.uk/humnet/news-events/recent-news/headline-603371-en.htm|date=9 November 2017|access-date=23 January 2018}}</ref> == Marejeo == {{Reflist}}{{Mbegu-mtu}} [[Jamii:Waliozaliwa 1951]] [[Jamii:Watu walio hai]] [[Jamii:Wanawake wa Uhindi]] [[Jamii:WikiMonthly Edit-a-thon Kilimanjaro]] 9fcy5hekq5d4mvgy7u79y124h7tzswu 2 214456 1577950 1576313 2026-07-02T12:53:47Z Elizabeth Samwel 75873 /* */ 1577950 wikitext text/x-wiki {{#babel:sw-N|en-4}} [[File:Elizabeth Samwel.jpg|thumb|Elizabeth Samwel]] Habari! Naitwa Elizabeth Samwel ni mwanawikipedia kutoka Tanzania mwenye uzoefu katika kuhariri na kuchangia katika miradi ya Wikimedia Foundation kama [[Wikipedia]] ya [[Kiingereza]] na ya [[Kiswahili]], Wikamusi, Wikidata na Wikimedia Commons. Mimi ni mshiriki wa programu ya ''[[m:Event:Wiki_AfroDemics_Project/Mentorship_Programme_Fellows/2026|Wiki Afrodemics Mentorship Program]].'' Unaweza kusoma makala yangu kwenye jukwaa la diff ikielezea jinsi programu hii ilivyokuza ujuzi wangu katika Wikipedia ''(''[[diffblog:2026/07/01/how-wiki-afrodemics-mentorship-program-wamp-improved-my-wikipedia-skills/|How Wiki Afrodemics Mentorship Program improved my Wikipedia Skills]]) cdwtu8jyj4hky5ezuvryql66eyxj4db 1577952 1577950 2026-07-02T12:54:37Z Elizabeth Samwel 75873 /* */ 1577952 wikitext text/x-wiki {{#babel:sw-N|en-4}} [[File:Elizabeth Samwel.jpg|thumb|Elizabeth Samwel]] Habari! Naitwa Elizabeth Samwel ni mwanawikipedia kutoka Tanzania mwenye uzoefu katika kuhariri na kuchangia katika miradi ya Wikimedia Foundation kama [[Wikipedia]] ya [[Kiingereza]] na ya [[Kiswahili]], Wikamusi, Wikidata na Wikimedia Commons. Mimi ni mshiriki wa programu ya ''[[m:Event:Wiki_AfroDemics_Project/Mentorship_Programme_Fellows/2026|Wiki Afrodemics Mentorship Program]].'' Unaweza kusoma makala yangu kwenye jukwaa la diff ikielezea jinsi programu hii ilivyokuza ujuzi wangu katika masuala ya Wikipedia ''(''[[diffblog:2026/07/01/how-wiki-afrodemics-mentorship-program-wamp-improved-my-wikipedia-skills/|How Wiki Afrodemics Mentorship Program improved my Wikipedia Skills]]) 7a4ejigyekzx216jer23bblvk13p9an 1577956 1577952 2026-07-02T12:56:34Z Elizabeth Samwel 75873 1577956 wikitext text/x-wiki {{#babel:sw-N|en-4}} [[File:Elizabeth Samwel.jpg|thumb|Elizabeth Samwel]] Habari! Naitwa Elizabeth Samwel ni mwanawikipedia kutoka Tanzania mwenye uzoefu katika kuhariri na kuchangia katika miradi ya Wikimedia Foundation kama [[Wikipedia]] ya [[Kiingereza]] na ya [[Kiswahili]], Wikamusi, Wikidata na Wikimedia Commons. Mimi ni mshiriki wa programu ya ''[[m:Event:Wiki_AfroDemics_Project/Mentorship_Programme_Fellows/2026|Wiki Afrodemics Mentorship Program]].'' Unaweza kusoma makala yangu kwenye jukwaa la diff ikielezea jinsi programu hii ilivyokuza ujuzi wangu katika masuala ya Wikipedia ''(''[[diffblog:2026/07/01/how-wiki-afrodemics-mentorship-program-wamp-improved-my-wikipedia-skills/|How Wiki Afrodemics Mentorship Program improved my Wikipedia Skills]]) [[File:Wiki Afrodemics Mentorship Programme Cohort 1 Participants 01.png|thumb]] 6davbby5agra8oiab7u87x0k8tdckzy 0 215133 1578169 1492628 2026-07-02T23:25:23Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578169 wikitext text/x-wiki '''Chuo Kikuu cha Pwani''' ni [[Chuo Kikuu|chuo kikuu]] cha umma <ref>{{Rejea tovuti|title=Commission for University Education - Status Of Universities (Universities Authorized to Operate in Kenya) - Status Of Universities (Universities Authorized to Operate in Kenya)|url=http://www.cue.or.ke/index.php/status-of-universities-universities-authorized-to-operate-in-kenya-1|work=www.cue.or.ke|accessdate=2020-05-25}}</ref> katika [[Kaunti ya Kilifi]], [[Kenya]], katika mji wa mapumziko wa [[Kilifi]], kilomita 60 kaskazini mwa [[Mombasa]]. Kabla ya tuzo ya hati ya chuo kikuu, kilikuwa tawi la [[Chuo Kikuu cha Kenyatta]]. Chuo hicho, kilichokuwa Taasisi ya Kilimo ya Kilifi, ilianzishwa tarehe 23 Agosti 2007 kwa agizo lililotiwa saini na Rais [[Mwai Kibaki]]. <ref>{{Rejea kitabu|url=https://www.pu.ac.ke/forms/Pwani%20University%20Strategic%20Plan%202014-2024.pdf|title=Strategic Plan 2014-2024|last=PU|first=Pwani University|publisher=Pwani University|pages=5}}</ref> == Mahali == Chuo kikuu cha Pwani kinapatikana kwenye barabara kuu ya Mombasa-Malindi. Ni makazi katika takriban 239&nbsp;hekta za ardhi, kweka nafasi ya upanuzi wa siku zijazo. Kundi la kwanza la wanafunzi katibia 200 lilisajiliwa tarehe 20 Oktoba 2007, hasa katika nyanja ya Elimu ya Sayansi na ya Sanaa. <ref>{{Rejea kitabu|url=https://www.pu.ac.ke/forms/Pwani%20University%20Strategic%20Plan%202014-2024.pdf|title=Strategic Plan 2014-2024|last=PU|first=Pwani University|publisher=Pwani University|pages=1}}</ref> == Shule zake== * Shule ya Elimu <ref>{{Rejea tovuti|title=Home|url=http://soe.pu.ac.ke/|work=soe.pu.ac.ke|accessdate=2020-05-30|archive-date=2020-06-11|archive-url=https://web.archive.org/web/20200611230746/http://soe.pu.ac.ke/|url-status=dead}}</ref> * Shule ya Binadamu na Sayansi ya Jamii <ref>{{Rejea tovuti|title=SHHS|url=http://shhs.pu.ac.ke/|work=shhs.pu.ac.ke|accessdate=2020-05-30}}</ref> * Shule ya Biashara na Uchumi <ref>{{Rejea tovuti|title=School of Business and Economics|url=https://www.pu.ac.ke/index.php/academics/schools-at-pu/sbe|work=www.pu.ac.ke|accessdate=2020-05-30|archive-date=2024-06-22|archive-url=https://web.archive.org/web/20240622102328/https://www.pu.ac.ke/index.php/academics/schools-at-pu/sbe|url-status=dead}}</ref> * Shule ya Sayansi Safi na Inayotumika (SPAS) <ref>{{Rejea tovuti|title=SPAS|url=http://spas.pu.ac.ke/|work=spas.pu.ac.ke|accessdate=2020-05-30}}</ref> * Shule ya Sayansi ya Kilimo na Masomo ya Biashara ya Kilimo <ref>{{Rejea tovuti|title=SASA|url=http://sasa.pu.ac.ke/|work=sasa.pu.ac.ke|accessdate=2020-05-30}}</ref> * Shule ya Sayansi ya Mazingira na Dunia <ref>{{Rejea tovuti|title=SEES|url=http://sees.pu.ac.ke/|work=sees.pu.ac.ke|accessdate=2020-05-30}}</ref> * Shule ya Mafunzo ya Wahitimu (SGS) <ref>{{Rejea tovuti|title=School of Graduate Studies|url=https://www.pu.ac.ke/index.php/academics/schools-at-pu/sgs|work=www.pu.ac.ke|accessdate=2020-05-30|archive-date=2024-06-22|archive-url=https://web.archive.org/web/20240622102318/https://www.pu.ac.ke/index.php/academics/schools-at-pu/sgs|url-status=dead}}</ref> * Shule ya Afya na Sayansi ya Binadamu <ref name=":0">{{Rejea tovuti|title=Pwani University|url=https://www.pu.ac.ke/|work=www.pu.ac.ke|accessdate=2020-05-15}}</ref> == Utafiti == Chuo Kikuu cha Pwani kimetia saini Hati ya Maelewano, yanayogusa maeneo mbalimbali ya maslahi kama njia ya kuimarisha mwingiliano wa manufaa. <ref>{{Rejea tovuti|title=Strategic plan|url=https://www.pu.ac.ke/forms/Strategic%20Plan%202014%20-%202024%20(RE2020).pdf|accessdate=20 February 2024|work=Pwani University|archive-date=2024-11-15|archive-url=https://web.archive.org/web/20241115214207/http://mailto:j.chege@pu.ac.ke/forms/Strategic%20Plan%202014%20-%202024%20(RE2020).pdf|url-status=dead}}</ref> Chuo Kikuu kinashirikiana na taasisi za utafiti nchini Kenya na duniani kote. <ref>{{Rejea tovuti|title=Collaborations|url=https://www.pu.ac.ke/index.php/research/others/collaborations|accessdate=2023-05-15|work=www.pu.ac.ke|archive-date=2024-06-20|archive-url=https://web.archive.org/web/20240620231920/https://www.pu.ac.ke/index.php/research/others/collaborations|url-status=dead}}</ref> Baadhi yao ni: * [https://www.kari.org Taasisi ya Utafiti wa Kilimo ya Kenya] , * [https://www.kemri.org Taasisi ya Utafiti wa Matibabu ya Kenya] {{Wayback|url=https://www.kemri.org/ |date=20221118052206 }} , * [https://www.nacosti.go.ke Baraza la Taifa la Sayansi na Teknolojia] , * [https://www.fsu.edu Chuo Kikuu cha Jimbo la Florida] , * Technische Universitat Dortmund <ref>{{Rejea tovuti|date=20 September 2023|title=Collaborations|url=https://www.pu.ac.ke/index.php/research/others/collaborations/technische-universitat-dortmund|accessdate=20 September 2023|work=Pwani University|archive-date=2024-06-22|archive-url=https://web.archive.org/web/20240622102317/https://www.pu.ac.ke/index.php/research/others/collaborations/technische-universitat-dortmund|url-status=dead}}</ref> * Chuo Kikuu cha Anglia Mashariki, * Kituo cha John Innes nchini Uingereza, * [https://www.gla.ac.uk/ Chuo Kikuu cha Glasgow] , * Taasisi ya Kimataifa ya Utafiti wa Mifugo * Huduma ya Ukaguzi wa Afya ya Mimea Kenya. * [[Chuo Kikuu cha Eldoret]] <ref>{{Rejea tovuti|date=20 September 2023|title=Collaborations|url=https://www.pu.ac.ke/index.php/research/others/collaborations/university-of-eldoret|accessdate=20 September 2023|work=Pwani University|archive-date=2024-06-22|archive-url=https://web.archive.org/web/20240622102326/https://www.pu.ac.ke/index.php/research/others/collaborations/university-of-eldoret|url-status=dead}}</ref> * Chuo Kikuu cha Sun Yet Sen <ref>{{Rejea tovuti|date=20 September 2023|title=Collaboration|url=https://www.pu.ac.ke/index.php/research/others/collaborations/sun-yet-sen-university|accessdate=20 September 2023|work=Pwani University|archive-date=2024-06-24|archive-url=https://web.archive.org/web/20240624112804/https://www.pu.ac.ke/index.php/research/others/collaborations/sun-yet-sen-university|url-status=dead}}</ref> Kwa ushirikiano na Baraza la Kitaifa la Sayansi na Teknolojia, chuo kikuu kilifanya kongamano la washikadau kushughulikia shida la utendaji duni katika masomo ya sayansi kwenye mitihani ya KSCE na viwango vya chini vya ubadilishaji kiwango kutoka ngazi yaawali ya shule ya msingi kuenda shule ya upili na Chuo Kikuu. <ref>{{Rejea jarida |last=Pederson |first=Olivia |date=2025-05-17 |title=Beyond the Exam Score: An Examination of the Kenyan Education System, Its Reforms, Inefficiencies, and Impact on Individuals and Society at Large |url=https://digitalcommons.spu.edu/honorsprojects/238 |journal=Honors Projects}}</ref> Ili kufikia watu zaidi na ujumbe wa maendeleo katika kanda hili, chuo kikuu kimekuwa kikishiriki katika Maonyesho ya Kimataifa ya Kilimo ya Mombasa kutoka mwakwa wa 2008. Katika maonyesho haya ya biashara, chuo kikuu ina maonyesho ya matokeo ya utafiti wa kisayansi na ya teknolojia zilizotumika ambazo zinaweza kutumika na wakulima kutatua changamoto za uzalishaji wa kilimo, uhaba wa chakula na biashara za kilimo. <ref>{{Rejea tovuti|title=Pwani University|url=https://www.pu.ac.ke/|work=www.pu.ac.ke|accessdate=2020-05-24}}</ref> == Programu maalum == Ukanda wa pwani, kama sehemu nyingine nyingi za nchi ina changamoto ya [[Ukimwi|VVU/UKIMWI]] na [[utumiaji mbaya wa Pombe]] na madawa ya kulevya. Wanafunzi wengi katika chuo kikuu ni vijana, katika umri hatari ya kuambukizwa [[Virusi vya UKIMWI|VVU]] au kuangukia mtego wa matumizi ya madawa ya kulevya. Kwa kufahamu hatari hii, chuo kikuu kimeanzisha kitengo cha kudhibiti Ukimwi ambacho huratibu programu na shughuli za kupigana na changamoto za Ukimwi. kitengo hicho cha kudhibiti [[Ukimwi|UKIMWI]] inaungwa mkono na kamati ya matumizi ya pombe na dawa za kulevya katika Chuo Kikuu. Kitengo hicho cha kudhibiti Ukimwi inapeana mafunzo kwa waelimishaji/washauri wanaotolewa kutoka kwa wanafunzi na kusambazwa katika kumbi za makazi na programu za masomo. Wanatambua kesi zinazoibuka na kutoa usaidizi kabla ya kupeleka kesi kwa washauri wa kitaalamu. Kila muhula kitengo cha kudhibiti Ukimwi hupanga wiki za VVU/UKIMWI kutoa huduma za ushauri nasaha na upimaji. Idara ya Sayansi ya Kibayolojia inapeana mafunzo kwa wanafunzi kuhusu ujuzi ili kuwasaidia wanafunzi katika miradi yao ya utafiti wa mwaka wa mwisho kama sehemu ya mtaala. Mafunzo haya ni ya ujifunzaji rika kwa wanafunzi na ni ushirikiano kati ya Chuo Kikuu cha Pwani na Kituo cha The John Innes. <ref name=":0"/> == Marejeo == {{Reflist}} == Viungo vya nje == * [http://www.pu.ac.ke/ Ukurasa wavuti wa Chuo Kikuu cha Pwani] {{mbegu-elimu}} <templatestyles src="Module:Coordinates/styles.css"></templatestyles>{{Majiranukta|03|36|59|S|39|50|38|E}} [[Jamii:Kaunti ya Kilifi]] [[Jamii:vyuo vikuu vya Kenya]] d65ebr14896pg02y245osfoa9jij0pd 0 215686 1578203 1529936 2026-07-03T02:56:39Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578203 wikitext text/x-wiki [[Faili:Investiturewoodcut.png|thumb|[[Mfalme]] wa [[Enzi ya kati|karne za kati]] akisimika askofu kwa kumkabidhi [[Kifaa|vifaa]] vya [[cheo]] chake, [[kazi]] ya Philip Van Ness Myers, [[1905]].]] '''Mgogoro wa Usimikaji''' (kwa [[Kiingereza]]: ''Investiture Controversy'' or ''Contest'') ulikuwa mgongano wa [[mamlaka|kimamlaka]] wa miaka 50 ([[1076]]-[[1122]]) kati ya [[Kiongozi|viongozi]] wa [[Kanisa Katoliki]] na wa [[Dola Takatifu la Kiroma]] kuhusu nani awe na [[haki]] ya kuchagua na kusimika [[Askofu|maaskofu]], [[abati|maabati]] na hata [[Papa|Mapapa]]. Wahusika wakuu walikuwa [[Papa Gregori VII]] na [[Heinrich IV wa Ujerumani|Henri IV wa Ujerumani]]. Katikati, miaka [[1103]]-[[1107]] mgongano kama huo ulitokea pia kati ya [[Papa Paskali II]] na mfalme [[Henri I wa Uingereza]]. Hatimaye ilikubalika kwamba uteuzi ufanywe na [[Kanisa]], ila askofu atapaswa kula [[kiapo]] cha [[uaminifu]] kwa mfalme. ==Upande wa Papa== Gregori VII, baada ya kuishi kama [[mmonaki]] wa [[Wabenedikto|Kibenedikto]] na kuchangia sana [[urekebisho]] wa Kanisa kama [[kardinali]] na [[balozi wa Papa]], alipochaguliwa mwenyewe kuwa Papa alipigania kwa [[nguvu]] zote [[utakatifu]] wa [[Kuhani|ukuhani]] na [[uhuru]] wa Kanisa Katoliki dhidi ya mamlaka ya [[serikali]], akifungua njia kwa Mapapa waliofuata. Ni kwamba wakati huohuo Henri IV aliwahi kumsimika askofu mmoja nchini [[Ujerumani]] kufuatana na [[desturi]] ya huko. Kumbe Papa aliona haki yake ya kuteua maaskofu imeingiliwa, hivyo akatafuta na kupata tamko la wakubwa wa Kanisa huko [[Italia]], kuwa washauri wa mfalme watengwe na Kanisa. Mfalme alikasirika akaita maaskofu wa Ujerumani waliamua Papa huyo asiwe Papa tena. <ref>{{Rejea tovuti |url=http://www.fordham.edu/halsall/source/henry4-to-g7a.html |title=Nakala iliyohifadhiwa |accessdate=2021-10-22 |archivedate=2014-11-12 |archiveurl=https://web.archive.org/web/20141112003454/http://www.fordham.edu/halsall/source/henry4-to-g7a.html }}</ref> Wakati Gregori VII aliposikia hayo alimtenga Heinrich IV na Kanisa, alitangaza kuwa hakuwa mfalme tena akafuta viapo ambavyo watu walikuwa wamemwapia mfalme. Kutengwa kwa mfalme kulisababisha [[hisia]] kali huko Ujerumani na Italia. [[Baba]] wa mfalme, [[Heinrich III wa Ujerumani|Henri III]] aliwahi kuwaondoa [[madaraka|madarakani]] Mapapa watatu, lakini wakati Heinrich IV alipojaribu kuiga mfano huo, hakuungwa mkono na watu. Hali ikawa mbaya sana kwa mfalme. Papa alipiga marufuku askofu au [[Upadri|padre]] yeyote kumruhusu katika [[ibada]] au kumhudumia kwa namna yoyote. Ilibainika kuwa ilibidi apate [[msamaha]] kutoka kwa Papa. Mwanzoni alijaribu kufanya hivyo kwa kutuma [[balozi]]. Baada ya Papa kumkataa balozi huyo, mfalme alikwenda Italia mwenyewe. [[File:Hugo-v-cluny_heinrich-iv_mathilde-v-tuszien_cod-vat-lat-4922_1115ad.jpg|thumb|Henri IV akiwaomba [[Hugo wa Cluny]] na [[Matilde wa Canossa]] kumtetea kwa Papa.]] Alimkuta Papa huko Canossa akapiga [[goti|magoti]] mbele ya [[ngome]] Papa alipokuwa amepata ulinzi akaomba msamaha. Kwa kuonyesha [[unyenyekevu]] vile alimfanya Papa kumsamehe na kumrudisha katika [[jumuiya]] ya Kanisa. Wakubwa huko Ujerumani waliwahi kutumia nafasi ya kutengwa kwa mfalme kanisani ili kumtangaza mfalme mpinzani. Papa aliamua kumuunga mkono huyo mfalme wa upinzani akamtenga Heinrich upya mwaka [[1080]]. Lakini baada ya miezi michache yule mfalme mpinzani alifariki [[dunia]], hivyo Henri IV alianza kupigania upya kuwa mfalme. Mnamo [[1081]] alianzisha [[vita]] dhidi ya Papa Gregori VII nchini Italia. Aliitisha mkutano wa maaskofu waliomwunga mkono na mkutano huo ulitangaza kufukuzwa kwa Papa Gregori wakamchagua [[Antipapa]]. [[Jeshi]] la mfalme Heinrich liliingia [[Roma]] mnamo mwaka [[1084]], kumtangaza papa mpya aliyeweka [[taji]] la ukaizari penye [[kichwa]] cha mfalme. Hatimaye mfalme alipaswa kuondoka Roma tena, ila Papa Gregori aliaga dunia uhamishoni [[Salerno]] <ref>https://www.santiebeati.it/dettaglio/27400</ref>. == Upande wa mfalme == Henri IV alikuwa mfalme wa tatu wa [[nasaba ya Wasali]] waliotawala Ujerumani kutoka mwaka [[1024]] hadi [[1125]]. Wafalme hao wa Ujerumani katika [[karne ya 11]] walitawala pia [[Italia]]. Vilevile waliweza kupokea [[cheo]] cha Kaizari wa Dola Takatifu la Roma. Cheo hicho kilitolewa na Papa, hivyo mfalme Mjerumani alipaswa kufanya [[safari]] ya kwenda Roma. Wafalme hao waliamini kwamba cheo cha Kaizari kiliwafanya kuwa wakuu wa [[Ukristo|Wakristo]] wote na pia kusimamia [[uchaguzi]] wa Papa mpya. [[Imani]] hiyo iliwaingiza mara kwa mara katika fitina za ndani za Italia, maana Roma yenyewe ilikuwa mikononi mwa makundi ya [[Ukabaila|makabaila]] waliotumia ushawishi wao kupelekea wagombea kwa nafasi ya Papa mbele. Matokeo ya fitina zao yalikuwa uchaguzi wa Mapapa tofauti kwa wakati mmoja; mwaka [[1045]] uliona Mapapa watatu: [[Papa Benedikto IX|Benedikto IX]], [[Papa Silvester III|Silvester III]] na [[Papa Gregori VI]]. Ili kumaliza mgawanyiko, mfalme Henri III alivuka [[milima] ya [[Alpi]] kwenda Italia akaitia [[sinodi]] ya kanisa huko [[Sutri]] mnamo 20 Desemba 1046. Sinodi iliwandoa mapapa wote watatu na kumchagua askofu Mjerumani, Suidger wa Bamberg, ambaye alichukua jina la kipapa [[Papa Klementi II|Klementi II]]. Heinrich IV alirithi imani ya baba yake kuwa mfalme aliyebarikiwa kwa [[mafuta]] matakatifu ni [[mlinzi]] wa Kanisa lote, ilhali Mapapa waliona umuhimu kutetea [[madaraka]] yao juu ya Kanisa lote. Ugomvi ulikuwa wa lazima katika suala la kuteua na kusimika maaskofu waliokuwa pia [[Ofisa|maafisa]] wa utawala katika ufalme. Wafalme walitaka kuteua maaskofu waliosimama upande wao, ilhali Mapapa walisisitiza askofu kuwa cheo cha kidini, kwa hiyo walidai haki ya kuwateua na kuwasimika. Wakati Heinrich III alipokufa ghafla mnamo [[1056]], Heinrich IV alikuwa na [[umri]] wa miaka sita tu akatangazwa kuwa mfalme bila shida. Mama yake, [[malkia]] Agnes, alishika utawala kwa niaba yake na [[Papa Viktor II]] aliyekuwa Mjerumani aliteuliwa kama mshauri wake. Alipotimiza umri wa miaka 15, Henri alihesabika kuwa [[Watu wazima|mtu mzima]]. Aliona wakati alipokuwa mfalme mtoto, wakubwa wengine walinyanganya mali ya kifalme, hivyo alijitahidi kutawala tena yale yote yaliyowahi kuwa mali ya baba yake. Hatua alizochukua, zilisababisha upinzani kutoka kwa [[Kabila|makabila]] mbalimbali katika Ujerumani, hasa wa [[Wasaksoni]]. Katika vita vya ndani baina ya miaka 1073 hadi 1075 aliwashinda Wasaksoni. Hatimaye alijikuta katika mapambano na Papa Gregori VII. [[Papa]] huyo alichaguliwa mnamo [[1073]]. Kutokana na ugomvi wake na Kanisa mfalme alidhoofishwa na wapinzani wake katika Ujerumani na Italia walimshambulia mara kwa mara, na makundi ya maaskofu yalikutana na kutangaza tena na tena kuwa mfalme si [[Ukristo|Mkristo]] halali anayetengwa katika Kanisa, Hata hivyo, sehemu kubwa ya maaskofu wa Ujerumani walisimama upande wake wakamtetea. Mwishoni mtoto wake aliasi na kumlazimisha Henri IV kujiuzulu. Mwanawe alipanda kiti cha kifalme kwenye mwaka 1104 kwa [[jina]] la [[Heinrich V wa Ujerumani|Henri V]]. ==Tanbihi== {{marejeo}} ==Vyanzo== ===Vikuu=== {{Refbegin|35em|indent=yes}} * {{cite book |author=Henry IV, Holy Roman Emperor |author-link=Henry IV, Holy Roman Emperor |year=1076 |chapter=Henry IV.'s Answer to Gregory VII., Jan. 24, 1076 |editor-last=Henderson |editor-first=Ernest F. |title=Select Historical Documents of the Middle Ages |chapter-url=https://archive.org/details/selecthistorical00hendiala |translator-last=Henderson |translator-first=Ernest F. |location=London |publisher=George Bell and Sons |publication-date=1903 |pages=372–373 |access-date=13 October 2017 |ref={{sfnref|Henry IV|1076}} }} * {{cite book |author=Pope Gregory VII |author-link=Pope Gregory VII |year=1076 |chapter=First Deposition and Banning of Henry IV. by Gregory VII., February 22, 1076 |editor-last=Henderson |editor-first=Ernest F. |title=Select Historical Documents of the Middle Ages |chapter-url=https://archive.org/details/selecthistorical00hendiala |translator-last=Henderson |translator-first=Ernest F. |location=London |publisher=George Bell and Sons |publication-date=1903 |pages=376–377 |access-date=13 October 2017 }} *{{cite book |last1=Kohn |first1=George Childs |title=Dictionary of Wars |url=https://archive.org/details/dictionaryofwars0000kohn |date=1999 |publisher=Facts On File, Inc. |location=New York |isbn=0-8160-3928-3 |edition=Revised }} *{{cite book |last1=Robinson |first1=I.S. |title=Henry IV of Germany 1056-1106 |date=2003 |publisher=Cambridge University Press |location=Cambridge |isbn=0521545900 |url=https://books.google.com/books?id=QP8fNo5UNIYC |access-date=18 March 2020 }} * {{cite book |year=2010 |chapter=The Investiture Controversy |editor-last=Slocum |editor-first=Kenneth |title=Sources in Medieval Culture and History |location=Boston |publisher=Prentice Hall |pages=170–175 |isbn=978-0-13-615726-7 }} * Bettenson, Henry, and Chris Maunder, eds. (2011). ''Documents of the Christian Church''. Oxford University Press. {{Refend}} * Slocum, Kenneth, ed. (2010). ''Sources in Medieval Culture and History''. pp.&nbsp;170–175. ===Vingine=== {{Refbegin|35em|indent=yes}} * {{cite book |last=Blumenthal |first=Uta-Renate |year=1988 |title=The Investiture Controversy: Church and Monarchy from the Ninth to the Twelfth Century |publisher=University of Pennsylvania Press |url=https://www.degruyter.com/document/doi/10.9783/9780812200164/html |isbn=978-0-8122-8112-5 |doi=10.9783/9780812200164 }} *{{cite journal |last=Browne |first=P.&nbsp;W. |year=1922 |title=The Pactum Callixtinum: an innovation in Papal diplomacy |journal=The Catholic Historical Review |volume=8 |issue=2 |pages=180–190 |jstor=25011853 }} * {{cite book |last=Cantor |first=Norman F. |author-link=Norman Cantor |year=1958 |title=Church, Kingship, and Lay Investiture in England, 1089–1135 |url=https://archive.org/details/churchkingshipla0000cant |publisher=Princeton University Press }} * {{cite book |last=Cantor |first=Norman F. |author-link=Norman Cantor |year=1993 |title=The Civilization of the Middle Ages |url=https://archive.org/details/civilizationofmi0000cant_y5v2 |publisher=HarperCollins <!--pp. 265–76, 284–88--> }} * {{cite book |last=Cantor |first=Norman F. |year=1969 |title=Medieval History: The Life and Death of a Civilization |url=https://archive.org/details/medievalhistoryl00cant |url-access=registration |publisher=Macmilllan |isbn=9780023190704 }} * {{cite book |last=Cowdrey |first=H. E. J. |author-link=Herbert Edward John Cowdrey |year=1998 |title=Pope Gregory VII, 1073–1085 |publisher=Oxford University Press }} *{{cite book |last=Dahmus |first=Joseph |year=1969 |title=The Middle Ages, A Popular History |publisher=Doubleday and Company |location=Garden City, NY }} *{{cite book |last=Davis |first=R. H. C. |year=1966 |title=A History of Medieval Europe: From Constantine to Saint Louis |url=https://archive.org/details/bwb_W8-BLU-503 |publisher=Longmans }} *{{cite book |last=Fawtier |first=Robert |year=1964 |title=The Capetian Kings of France: Monarch and Nation 987–1328 |url=https://archive.org/details/capetiankingsoff0000unse/page/n3/mode/2up |url-access=registration |translator=Lionel Butter and R. J. Adam |location=London |publisher=Macmillan }} * {{cite encyclopedia |last=Floto |year=1891 |title=Gregory VII |editor-last=Schaff |editor-first=Philip |editor-link=Philip Schaff |encyclopedia=Religious Encyclopedia: or Dictionary of Biblical, Historical, Doctrinal, and Practical Theology |url=https://archive.org/details/religiousencyclo02herz |volume=2 |edition=3rd |location=New York |publisher=Funk & Wagnalls Company |pages=910–912 |access-date=13 October 2017 }} * {{cite book |last=Fuhrmann |first=Horst |year=1986 |title=Germany in the High Middle Ages c. 1050–1200 |url=https://archive.org/details/germanyinhighmid0000fuhr |translator-last=Reuter |translator-first=Timothy |translator-link=Timothy Reuter |location=Cambridge, England |publisher=Cambridge University Press |publication-date=2001 |isbn=978-0-521-31980-5 }} * {{cite book |editor1-last=Hearder |editor1-first=H. |editor2-last=Waley |editor2-first=D. P. |year=1963 |title=A Short History of Italy: From Classical Times to the Present Day |url=https://archive.org/details/bwb_UH-619-473 }} * {{cite book |last=Jolly |first=Karen Louise |year=1997 |title=Tradition & Diversity: Christianity in a World Context to 1500 |url=https://archive.org/details/traditiondiversi0000joll |publisher=ME Sharpe }} *{{cite journal |last=Joranson |first=Einar |year=1948 |title=The inception of the career of the Normans in Italy – legend and history |url=https://archive.org/details/sim_speculum_1948-07_23_3/page/n5 |journal=[[Speculum (journal)|Speculum]] |volume=23 |issue=3 |pages=353–396 |jstor=2848427 |doi=10.2307/2848427|s2cid=162331593 }} *{{cite book |last=Jordan |first=William Chester |year=2003 |title=Europe in the High Middle Ages |url=https://archive.org/details/europeinhighmidd00jord |url-access=registration |series=Penguin History of Europe |publisher=Viking |isbn=9780670032020 }} *{{cite book |last=Le Goff |first=Jacques |year=1964 |title=Medieval Civilization 400–1500 }} * {{cite Catholic Encyclopedia |last=Löffler |first=Klemens |wstitle=Conflict of Investitures |volume=8 |pages=84–89 |noicon=yes }} * {{cite book |last=McCarthy |first=T. J. H. |year=2014 |title=Chronicles of the Investiture Contest: Frutolf of Michelsberg and His Continuators |location=Manchester |publisher=Manchester Medieval Sources |isbn=978-0-7190-8470-6 |url-access=registration |url=https://archive.org/details/chroniclesofinve00unse }} * {{cite book |last=Metz |first=René |year=1960 |title=What Is Canon Law? |series=[[Twentieth Century Encyclopedia of Catholicism|The Twentieth Century Encyclopedia of Catholicism]] |volume=80 |translator-last=Derrick |translator-first=Michael |location=New York |publisher=Hawthorn Books }} * {{cite book |year=1971 |editor-last=Morrison |editor-first=Karl F. |editor-link=Karl F. Morrison |title=The Investiture Controversy: Issues, Ideas, and Results |url=https://archive.org/details/investiturecontr00morr |publisher=Holt McDougal }} *{{cite journal |last=de Mesquita |first=Bruce Bueno |year=2000 |title=Popes, kings, and endogenous institutions: the Concordat of Worms and the origins of sovereignty |url=https://archive.org/details/sim_international-studies-review_summer-2000_2_2/page/93 |journal=International Studies Review |volume=2 |issue=2: Continuity and Change in the Westphalian Order |pages=93–118 |doi=10.1111/1521-9488.00206 |jstor=3186429 }} *{{cite book |last=Reynolds |first=Susan |year=1994 |title=Fiefs and Vassals, The Medieval Evidence Reinterpreted |publisher=Oxford University Press }} * {{cite book |last=Rubenstein |first=Jay |author-link=Jay Rubenstein |year=2011 |title=Armies of Heaven: The First Crusade and the Quest for Apocalypse |url=https://archive.org/details/armiesofheavenfi00jayr |location=New York |publisher=Basic Books |isbn=978-0-465-01929-8 }} *{{cite book |last=Strayer |first=Joseph R. |year=1959 |title=The Middle Ages, 395–1500 |url=https://archive.org/details/middleages3951500000stra |edition=4th |publisher=Appleton-Century-Crofts }} *{{cite book |last=Stroll |first=Mary |year=2004 |title=Calixtus II (1119–1124): A Pope Born to Rule |publisher=Brill }} * {{cite book |last=Tellenbach |first=Gerd |author-link=Gerd Tellenbach |year=1993 |title=The Western Church from the Tenth to the Early Twelfth Century |publisher=Cambridge University Press }} * {{cite book |last1=Thompson |first1=James Westfall |author1-link=James Westfall Thompson |last2=Johnson |first2=Edgar Nathaniel |year=1937 |title=An Introduction to Medieval Europe, 300–1500|url=https://archive.org/details/in.ernet.dli.2015.157348 <!-- pp. 380–90 --> }} *{{cite book |last=Thorndike |first=Lynn |year=1956 |title=The History of Medieval Europe |url=https://archive.org/details/historyofmedieva00thor_2 |edition=3rd |publisher=Houghton Mifflin }} *{{cite journal |last=Zanichelli |first=Giusi |year=2006 |title=Una donna al potere |journal=Alumina |url=https://www.scrinium.org/it-it/Rassegna-Stampa |volume=15 |pages=47–51 |archive-date=2025-08-21 |access-date=2025-10-10 |archive-url=https://web.archive.org/web/20250821112517/https://www.scrinium.org/it-it/Rassegna-Stampa |url-status=dead }} {{Refend}} ==Marejeo mengine== ===Muhimu zaidi=== {{Refbegin|35em|indent=yes}} * {{cite book |year=2007 |chapter=Selected Sources: Empire and Papacy |chapter-url=https://sourcebooks.fordham.edu/halsall/sbook1l.asp |editor-last=Halsall |editor-first=Paul |title=Internet Medieval Sourcebook |location=New York |publisher=Fordham University |access-date=13 October 2017 }} * {{cite book |year=1122 |chapter=Concordat of Worms, Sept. 23, 1122 |editor-last=Henderson |editor-first=Ernest F. |title=Select Historical Documents of the Middle Ages |chapter-url=https://archive.org/details/selecthistorical00hendiala |translator-last=Henderson |translator-first=Ernest F. |location=London |publisher=George Bell and Sons |publication-date=1903 |pages=408–409 |access-date=13 October 2017 }} * {{cite book |author=Pope Gregory VII |author-link=Pope Gregory VII |year=1078 |chapter=Decree of Nov. 19th, 1078, Forbidding Lay Investiture |editor-last=Henderson |editor-first=Ernest F. |title=Select Historical Documents of the Middle Ages |chapter-url=https://archive.org/details/selecthistorical00hendiala |translator-last=Henderson |translator-first=Ernest F. |location=London |publisher=George Bell and Sons |publication-date=1903 |page=365 |access-date=13 October 2017 }} * {{cite book |author=Pope Gregory VII |author-link=Pope Gregory VII |author-mask={{long dash}} |year=1080 |chapter=Second Banning and Dethronement of Henry IV., through Gregory VII., March 7th, 1080 |editor-last=Henderson |editor-first=Ernest F. |title=Select Historical Documents of the Middle Ages |chapter-url=https://archive.org/details/selecthistorical00hendiala |translator-last=Henderson |translator-first=Ernest F. |location=London |publisher=George Bell and Sons |publication-date=1903 |pages=388–391 |access-date=13 October 2017 }} * {{cite book |author=Pope Gregory VII |author-link=Pope Gregory VII |author-mask={{long dash}} |year=1903 |chapter=The Dictate of the Pope |editor-last=Henderson |editor-first=Ernest F. |title=Select Historical Documents of the Middle Ages |chapter-url=https://archive.org/details/selecthistorical00hendiala |translator-last=Henderson |translator-first=Ernest F. |location=London |publisher=George Bell and Sons |publication-date=1903 |pages=366–367 |access-date=13 October 2017 }} {{Refend}} ===Mengine=== {{Refbegin|35em|indent=yes}} * {{cite encyclopedia |last=Blumenthal |first=Uta-Renate |year=2016 |title=Investiture Controversy |url=https://www.britannica.com/event/Investiture-Controversy |encyclopedia=[[Encyclopædia Britannica]] |access-date=13 October 2017 }} * {{cite encyclopedia |year=2007 |title=Investiture |url=http://www.bartleby.com/65/in/investit.html |encyclopedia=[[Columbia Encyclopedia|The Columbia Encyclopedia]] |edition=6th |location=New York |publisher=Columbia University Press |archive-url=https://web.archive.org/web/20090221005510/http://www.bartleby.com/65/in/investit.html |archive-date=21 February 2009 |access-date=13 October 2017 }} * {{cite web |last=Nelson |first=Lynn H. |title=The Owl, the Cat, and the Investiture Controversy |url=http://the-orb.net/textbooks/nelson/investiture.html |work=Lectures for a Medieval Survey |publisher=On-line Reference Book for Medieval Studies |archive-url=https://web.archive.org/web/20150215144418/http://the-orb.net/textbooks/nelson/investiture.html |archive-date=15 February 2015 |access-date=13 October 2017 }} * {{cite book |last=Schroeder |first=H. J. |year=1937 |chapter=The Ninth General Council (1123) |title=Disciplinary Decrees of the General Councils: Text, Translation, and Commentary |chapter-url=https://archive.org/details/DisciplinaryCouncils |location=St. Louis, Missouri |publisher=B. Herder Book Co. |pages=177–194 |access-date=13 October 2017 }} * {{cite Catholic Encyclopedia |last=Van Hove |first=Alphonse |wstitle=Canonical Investiture |volume=8 |page=84 |noicon=yes }} {{Refend}} ==Viungo vya nje== * [https://www.bbc.co.uk/programmes/b0184v2j "The Concordat of Worms"], ''[[In Our Time (radio series)|In Our Time]]'', [[BBC Radio 4]] {{mbegu-historia}} [[Jamii:Historia ya Ulaya]] [[Jamii:Historia ya Ujerumani]] [[Jamii:Historia ya Kanisa]] jnu3m3mam2tma0mgca05l9xwedlx31i 0 217548 1578070 1481955 2026-07-02T17:57:28Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578070 wikitext text/x-wiki [[picha:Mummy LadyRai Smith.JPG|thumb|Lady Rai]] '''Bibi Rai''' ([[1570 KK]]/[[1560 KK]] – [[1530 KK]]) alikuwa [[mwanamke]] wa [[Misri ya Kale|Misri ya kale]] aliyekuwa anamlea [[Malkia]] Ahmose-Nefertari alipokuwa mtoto. Mwili wake ulihifadhiwa na kaburi lake liligundulika mwaka [[1881]]. Wanasema alipokufa alikuwa na miaka 30–40. Mwaka [[1909]], mtaalamu mmoja aliufungua mwili wake na akasema ulikuwa umehifadhiwa vizuri sana kuliko miili mingi ya kipindi hicho. Pia alisema Lady Rai alikuwa mwembamba, mfupi (urefu mita 1.510), na alikuwa na mikono midogo kama ya mtoto. Mwaka [[2009]], kipimo cha CAT scan kilicho­fanywa na wataalamu wa afya kilionyesha kuwa Lady Rai alikuwa na tatizo kwenye mshipa mkubwa wa damu (aortic arch). Hii imeifanya mwili wake kua mwaili uliohifadhiwa zamani zaidi, alijulikana kuwa na ugonjwa wa atherosclerosis (mishipa ya damu kuziba). Mwili wa Ahmose Inhapy, ambaye alikuwa binti wa kifalme na pia malkia katika mwisho wa nasaba ya 17 ya Misri, na ambaye alikuwa shangazi wa Ahmose-Nefertari, ulipatikana ndani ya jeneza la nje la Lady Rai.<ref>{{Cite journal |last1=Allam |first1=Adel H. |last2=Nureldin |first2=Abdelhalium |last3=Adelmaksoub |first3=Gomma |last4=Badr |first4=Ibrahem |last5=Amer |first5=Hany Abdel |last6=Soliman |first6=Muhamed Al Tohamy |last7=Thomas |first7=Gregory S. |last8=Thompson |first8=Randall C. |last9=Miyamoto |first9=Michael I. |last10=Thomas |first10=Ian G. |last11=Thompson |first11=Adam |last12=Wann |first12=Samuel |date=2010-06-01 |title=Something old, something new-Computed tomography studies of the cardiovascular system in ancient egyptian mummies |url=http://www.scopus.com/inward/record.url?scp=79954623029&partnerID=8YFLogxK |journal=American Heart Hospital Journal |volume=8 |issue=1 |pages=10–13 |doi=10.15420/ahhj.2010.8.1.10 |issn=1541-9215 |doi-access=free}}</ref><ref>{{Cite book|url=https://books.google.com/books?id=4InwCgAAQBAJ&dq=Rai+nursemaid+ahmose-nefertari&pg=PA360|title=The Oxford Handbook of the Valley of the Kings|last1=Wilkinson|first1=Richard H.|last2=Weeks|first2=Kent|date=2015-12-18|publisher=Oxford University Press|isbn=978-0-19-993164-4|language=en}}</ref><ref>{{cite journal |last1=Allam |first1=Adel H. |display-authors=etal |date=November 18, 2009 |title=Computed tomographic assessment of atherosclerosis in ancient Egyptian mummies |url=https://archive.org/details/sim_jama_2009-11-18_302_19/page/2091 |journal=JAMA: The Journal of the American Medical Association |volume=302 |issue=19 |pages=2091–2094 |doi=10.1001/jama.2009.1641 |pmid=19920233 |doi-access=}}</ref><ref>{{Cite book|url=https://books.google.com/books?id=BYrwCgAAQBAJ&dq=Rai+nursemaid+ahmose-nefertari&pg=PA335|title=The Oxford Handbook of the Valley of the Kings|last1=Wilkinson|first1=Richard H.|last2=Weeks|first2=Kent R.|date=2016|publisher=Oxford University Press|isbn=978-0-19-993163-7|language=en}}</ref> == Marejeo == {{reflist}} {{Mbegu-mtu}} [[Jamii:Watu wa Misri ya Kale]] [[Jamii:Wikimalkia 2025-26 campaign in Tanzania]] [[Jamii:Waliozaliwa 1570 KK]] [[Jamii:Waliofariki 1530 KK]] g3v8x4v79qxddv5n1v7bjd8omnqfy37 0 218183 1578094 1574242 2026-07-02T19:23:48Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578094 wikitext text/x-wiki [[Faili:Brooklyn Museum 82.154.2 Housepost One of Pair.jpg|thumb|Nguzo ya baraza ya Yoruba, Makumbusho ya [[Brooklyn]].]] '''Aṣẹ''', '''àṣẹ''',<ref>{{cite web|url=http://www.aseire.com/meaning.php|title=What Is Ase Ire?|publisher=Ase Ire.com|access-date=29 November 2016|archive-url=https://web.archive.org/web/20180307075108/http://aseire.com/meaning.php|archive-date=7 March 2018|url-status=dead}}</ref> '''aṣe''',<ref name=":03">{{Cite book |last=Salamone |first=Frank A. |title=Encyclopedia of Religious Rites, Rituals, and Festivals |url=https://archive.org/details/encyclopediaofre00sala |publisher=[[Routledge]] |year=2004 |isbn=0-415-94180-6 |editor-last=Levinson |editor-first=David |location=New York |pages=[https://archive.org/details/encyclopediaofre00sala/page/23 24]}}</ref> '''ase''' au '''ashe''' katika [[dini]] ya jadi ya [[Wayoruba]], ni nguvu ya kiasili inayodhaniwa kuwa ndiyo inayoumba, kuchochea au kuwezesha mabadiliko katika dunia ya asili kulingana na tafsiri. Inaaminika kwamba hutolewa na ''Olódùmarè'' kwa kila kitu miungu, roho, wanadamu, wanyama, mimea, mawe, mito na hata maneno yanayotamkwa kama vile nyimbo, sala, sifa, laana au mazungumzo ya kawaida ya kila siku. Kwa mujibu wa fikra za [[Wayoruba]], uwepo wa kila kitu unategemea aṣẹ.<ref name=Drewal>{{cite book|last=Drewal|first=H. J., and J. Pemberton III with Rowland Abiodun|title=Yoruba: Nine Centuries of African Art and Thought|url=https://archive.org/details/yorubaninecentur0000drew|year=1989|publisher=The Center for African Art|location=New York City|editor=Allen Wardwell}}</ref> Mbali na sifa zake za kiutakatifu, àṣẹ pia ina athari muhimu katika jamii, jambo linaloonekana katika tafsiri yake kama ''nguvu, mamlaka, amri''. Mtu ambaye, hupitia mafunzo, uzoefu na uanzishwaji wa kimila, anajifunza jinsi ya kutumia nguvu msingi ya uhai ya vitu ili kuleta mabadiliko kwa makusudi huitwa ''aláàṣẹ''.<ref name="Drewal 1987">{{cite journal|last=Drewal|first=M. T., and H. J. Drewal|title=Composing Time and Space in Yoruba Art|url=https://archive.org/details/word-image_july-september-1987_3_3/page/225|journal=Word and Image: A Journal of Verbal/Visual Enquiry|year=1987|volume=3|issue=3|pages=225–251|doi=10.1080/02666286.1987.10435383}}</ref><ref>{{Cite web|title=Black Catholic History Month Installment 1. "The Gift-Àsè"|url=https://www.facebook.com/events/d41d8cd9/black-catholic-history-month-installment-1-the-gift-ashe/394422095261531/|access-date=2020-12-17|website=www.facebook.com|language=en}}</ref> ==Marejeo== <references /> {{Mbegu-utamaduni}} [[Jamii:Sanaa ya Afrika]] [[Jamii:utamaduni wa Nigeria]] kuvi7d1a2h7osyrxrfxo1aj3iyesvfd 0 218708 1578208 1479408 2026-07-03T03:11:31Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578208 wikitext text/x-wiki '''Philip Langstaffe Ord Guy''' ([[23 Januari]] [[1885]] – [[7 Desemba]] [[1952]]) alikuwa mchunguzi wa kale, msimamizi, na afisa wa [[Jeshi]] la [[Uingereza]].<ref name="WWW">{{cite web |title=Guy, Lt-Col Philip Langstaffe Ord, (23 Jan. 1885–7 Dec. 1952) |website=[[Who Was Who]] |publisher=Oxford University Press |doi=10.1093/ww/9780199540884.013.U238067 | url= http://www.ukwhoswho.com/view/10.1093/ww/9780199540891.001.0001/ww-9780199540884-e-238067 |date=1 December 2007 |isbn=978-0-19-954089-1 }}</ref><ref name="bio PEF">{{cite web |last1=Green |first1=Jack |title=Lt. Col. Philip Langstaffe Ord Guy, 1885-1952 |url=https://www.pef.org.uk/profiles/lt-col-philip-langstaffe-ord-guy-1885-1952 |website=The Palestine Exploration Fund |accessdate=8 August 2018 |date=2008}}</ref><ref name="Green">{{cite journal |last1=Green |first1=John D. M. |title=Archaeology and Politics in the Holy Land: The Life and Career of P. L. O. Guy |url=https://archive.org/details/palestine-exploration-quarterly_2009-10_141_3/page/167 |journal=[[Palestine Exploration Quarterly]] |date=November 2009 |volume=141 |issue=3 |pages=167–187 |doi=10.1179/003103209x12483454548086|s2cid=154945484 }}</ref><ref name="MEMORIAM">{{cite journal |journal=[[Israel Exploration Journal]] |date=1953 |volume=3 |issue=1 |pages=1–3 |jstor=27924500 |title=P.l.o. Guy 1885-1952: In Memoriam |url=https://archive.org/details/sim_israel-exploration-journal_1953_3_1/page/n11 }}</ref> ==Tanbihi== {{reflist}} {{mbegu-mtu}} [[Jamii:Waliozaliwa 1885]] [[Jamii:Waliofariki 1952]] [[Jamii:watu wa Uingereza]] [[Jamii:WikiMonthly Edit-a-thon Kilimanjaro]] 4xu8v83a8bgb6kcdzgqurye567toltq 0 220205 1577960 1480477 2026-07-02T13:02:11Z InternetArchiveBot 41439 Rescuing 0 sources and tagging 1 as dead.) #IABot (v2.0.9.5 1577960 wikitext text/x-wiki '''Adetunwase Adenle''' ni mwalimu wa sanaa kutoka [[Nigeria]], [[msanii]] na mmiliki wa zamani wa Rekodi za Dunia za Guinness. Yeye ndiye mwanzilishi mwenza wa Slum Art Foundation, na Ecole de Dessin School of Art. <ref>{{Cite web |date=2020-07-18 |title=Slum Art Foundation marks world skills day with art exhibition |url=https://m.guardian.ng/saturday-magazine/slum-art-foundation-marks-world-skills-day-with-art-exhibition/ |access-date=2022-05-18 |website=The Guardian Nigeria News - Nigeria and World News |language=en-US}}</ref><ref>{{Cite web |date=2019-07-15 |title=Slum Art Foundation starts construction of school using pet bottles |url=https://businessday.ng/life-arts/article/slum-art-foundation-starts-construction-of-school-using-pet-bottles/ |access-date=2022-05-18 |website=Businessday NG |language=en-US}}</ref><ref>{{Cite web |last=Alawode |first=Abisola |date=2020-06-10 |title=Meet Adetunwase Adenle, the Nigerian teacher with 4 Guinness World Records |url=https://www.legit.ng/1153963-nigerian-teacher-adetunwase-adenle-4-guinness-world-records.html |access-date=2022-05-18 |website=Legit.ng - Nigeria news. |language=en }}{{Dead link|date=July 2026 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> == Marejeo == {{Reflist}} [[Jamii:Waliozaliwa mwaka usiojulikana]] [[Jamii:Watu walio hai]] [[Jamii:Wasanii wa Nigeria]] [[Jamii:Watu wa Nigeria]] 6g1qolx4v3ztfi7eeha26g7oeubxr2y 0 220398 1578080 1481016 2026-07-02T18:45:38Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578080 wikitext text/x-wiki '''Anta Germaine Gaye''' (alizaliwa [[1953]]) ni [[mchoraji]] na [[mchongaji]] kutoka [[Senegal]].<ref>{{Cite book|last=Harney, Elizabeth.|url=http://worldcat.org/oclc/1055247530|title=In Senghor's shadow : art, politics, and the avant-garde in Senegal, 1960-1995|date=2004|publisher=Duke University Press|isbn=978-0-8223-8605-6|oclc=1055247530}}</ref><ref>{{Cite journal|last=Grabski|first=Joanna|date=March 2008|title=Trajectoires: Art Contemporain du Sénégal|url=https://archive.org/details/sim_african-arts_spring-2008_41_1/page/88|journal=African Arts|volume=41|issue=1|pages=88–91|doi=10.1162/afar.2008.41.1.88|issn=0001-9933}}</ref> ==Marejeo== {{reflist}} {{mbegu-mtu}} [[Jamii:Waliozaliwa 1953]] [[Jamii:wachoraji wa Senegal]] [[Jamii:Watu walio hai]] [[Jamii:Wachongaji wa Senegal]] iv4afi4n2y7ewvyptia2orsr78t78bc 0 221377 1577975 1501164 2026-07-02T13:25:48Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1577975 wikitext text/x-wiki {{Mtu |rangi = |jina = Agnes Jebet Ngetich |picha = Agnes Ngetich.jpg |maelezo_ya_picha = |jina la kuzaliwa = |alizaliwa = {{birth date and age|2001|1|23|df=yes}} |alikufa = |nchi = Kenya |kazi yake = Mkimbiaji wa masafa marefu |ndoa = |wazazi = |watoto = |tovuti rasmi = }} '''Agnes Jebet Ngetich''' (alizaliwa tarehe [[23 Januari]] [[2001]]) ni [[Riadha|mwanariadha]] wa masafa marefu kutoka [[Kenya]]. Kwa sasa ndiye bingwa mtetezi wa dunia wa mbio za kuvuka nchi (World Cross Country), baada ya kushinda taji hilo katika Mashindano ya Dunia ya Cross Country mwaka [[2026]].<ref>{{Cite web|title=Agnes Jebet Ngetich|access-date=February 19, 2023|url=https://worldathletics.org/athletes/kenya/agnes-jebet-ngetich-14758189|website=[[World Athletics]]}}</ref> Awali, alishinda medali mbili za dhahabu akiwa na timu ya Kenya katika mashindano ya timu ya World Cross Country mwaka 2023 na 2024, pamoja na medali ya shaba katika mbio za wanawake wakubwa mwaka 2023. Mwezi Januari 2024, akiwa Valencia, aliweka rekodi mpya ya dunia ya mbio za kilomita 10 kwa muda wa dakika 28 na sekunde 46, akiivunja rekodi ya awali kwa tofauti ya sekunde 28. Katika mbio hizo hizo, Ngetich pia alivunja rekodi ya dunia ya kilomita 5, akipita umbali huo kwa muda wa dakika 14 na sekunde 13, ikiwa ni sekunde 6 haraka zaidi kuliko rekodi ya awali. Aidha, anashikilia muda wa pili kwa kasi zaidi katika historia ya mbio za nusu marathon, kwa saa 1, dakika 3 na sekunde 4.<ref>{{Cite web|date=2024-01-14|title=Agnes Ngetich Kicks Off 2024 Season With 10K Road World Record In Valencia|url=https://marathonhandbook.com/agnes-ngetich-10k-road-wr/|access-date=2024-01-31|language=en-US}}</ref><ref name="auto">{{Cite web|url=https://worldathletics.org/competitions/world-athletics-label-road-races/news/agnes-ngetich-world-10km-record-2846-valencia|title=Ngetich smashes world 10km record with 28:46 in Valencia &#124; REPORTS &#124; World Athletics|website=worldathletics.org}}</ref> == Kazi == Akiwa na umri wa miaka 16, Ngetich alishika nafasi ya nane katika Mashindano ya Taifa ya Mbio za Kuvuka Nchi za Kenya kwa vijana chini ya umri wa miaka 20 mwaka 2017. Mwaka huo huo, alimaliza wa sita katika majaribio ya Dunia ya Vijana, akitumia muda wa dakika 9:13.0 katika mbio za mita 3000.<ref>{{Cite web |url=https://worldathletics.org/athletes/kenya/agnes-jebet-ngetich-14758189 |title=Agnes Jebet Ngetich Profile |publisher=World Athletics }}</ref> Mnamo Februari 2018, Ngetich alipanda hadi nafasi ya nne katika mashindano ya taifa ya vijana chini ya miaka 20 ya mbio za kuvuka nchi nchini Kenya. Muda mfupi baadaye, alipata nafasi ya nne katika Mashindano ya Afrika ya Mbio za Kuvuka Nchi kwa vijana chini ya miaka 20 yaliyofanyika Algeria, na kuchangia ushindi wa dhahabu wa timu ya Kenya.<ref>{{Cite web |url=https://www.citizen.digital/sports/commanding-kenya-top-of-africa-once-again-194029 |title=Commanding Kenya top of Africa once again |date=2018-03-18 |publisher=Citizen Digital |accessdate=2026-03-30 |archive-date=2024-11-29 |archive-url=https://web.archive.org/web/20241129011543/https://www.citizen.digital/sports/commanding-kenya-top-of-africa-once-again-194029 |url-status=dead }}</ref> Mwezi Machi 2019, akiwa na umri wa miaka 18, Ngetich alishinda mbio za mita 5000 katika majaribio ya Afrika ya vijana chini ya miaka 20 nchini Kenya.<ref>{{Cite web |url=https://worldathletics.org/athletes/kenya/agnes-jebet-ngetich-14758189 |title=Agnes Jebet Ngetich Profile |publisher=World Athletics }}</ref> Mnamo Septemba 2022, Ngetich alimaliza katika nafasi ya pili katika mbio za kilomita 10 za barabarani za Tamasha la Mbio la Brasov nchini Romania.<ref>{{Cite web |url=https://sportslumo.com/amp/athletics/brasov-running-festival-10km-2022-world-athletics-elite-label-road-race-find-out-the-full-results |title=Brasov Running Festival 10km 2022 Results |date=2022-09-28 |publisher=Sportslumo |accessdate=2026-03-30 |archive-date=2023-02-19 |archive-url=https://web.archive.org/web/20230219121304/https://sportslumo.com/amp/athletics/brasov-running-festival-10km-2022-world-athletics-elite-label-road-race-find-out-the-full-results/ |url-status=dead }}</ref> === 2023 === Tarehe 18 Februari 2023, akiwa na umri wa miaka 22, Ngetich alishinda medali ya shaba katika mbio binafsi na dhahabu katika mashindano ya timu kwenye Mashindano ya Dunia ya Mbio za Kuvuka Nchi yaliyofanyika Bathurst, Australia.<ref>{{Cite web |url=https://worldathletics.org/competitions/world-athletics-cross-country-championships/bathurst23/news/report/report-2023-senior-women-chebet |title=Senior women's race report Bathurst 2023 |date=2023-02-18 |publisher=World Athletics }}</ref> Mnamo Septemba 2023, Ngetich alivunja rekodi ya dunia ya wanawake pekee katika mbio za kilomita 10 mjini Brasov, Romania, kwa muda wa dakika 29:24. Hata hivyo, baadaye ilibainika kuwa umbali wa mbio ulikuwa mfupi kwa mita 25, hivyo rekodi hiyo haikutambuliwa rasmi.<ref>{{Cite web |url=https://www.tag24.de/sport/der-grund-ist-absurd-zehn-kilometer-strassenlauf-weltrekord-von-agnes-ngetich-aberkennt-2969703 |title=Zehn Kilometer Straßenlauf Weltrekord aberkannt |date=2023-09-30 |publisher=TAG24 |accessdate=2026-03-30 |archive-date=2024-12-07 |archive-url=https://web.archive.org/web/20241207092231/https://www.tag24.de/sport/der-grund-ist-absurd-zehn-kilometer-strassenlauf-weltrekord-von-agnes-ngetich-aberkennt-2969703 |url-status=dead }}</ref> === 2024 === Tarehe 14 Januari 2024, Ngetich aliweka rekodi ya dunia ya mbio za kilomita 10 kwa wanawake katika mbio za mchanganyiko wa jinsia huko Valencia, Hispania, akitumia muda wa dakika 28:46 na kuwa mwanamke wa kwanza kukimbia chini ya dakika 29.<ref>{{Cite web |url=https://worldathletics.org/athletes/kenya/agnes-jebet-ngetich-14758189 |title=Agnes Jebet Ngetich Profile |publisher=World Athletics }}</ref> Katika Mashindano ya Dunia ya Mbio za Kuvuka Nchi 2024 yaliyofanyika Serbia, alimaliza katika nafasi ya tano huku Kenya ikishinda dhahabu ya timu.<ref>{{Cite web |url=https://athleticsweekly.com/event-reports/chebet-supreme-as-gb-captain-donnelly-leads-by-example-1039976987/ |title=Chebet reigns supreme in Bathurst |date=2024-03-30 |publisher=Athletics Weekly }}</ref> Tarehe 27 Oktoba 2024, Ngetich alishinda nusu marathon ya Valencia kwa muda wa saa 1:03:04.<ref>{{Cite web |url=https://worldathletics.org/competitions/world-athletics-label-road-races/news/valencia-half-marathon-2025-ngetich-kejelcha |title=Valencia Half Marathon 2025 |date=2025-10-26 |publisher=World Athletics }}</ref> === 2025 === Tarehe 22 Februari 2025, alishinda mashindano ya Sirikwa Classic yaliyofanyika Eldoret.<ref>{{Cite web |url=https://worldathletics.org/competitions/world-athletics-cross-country-tour/news/ngetich-ebenyo-sirikwa-classic-eldoret |title=Ngetich and Ebenyo victorious at Sirikwa Classic |date=2025-02-22 |publisher=World Athletics }}</ref> Mwezi Aprili 2025, alishika nafasi ya pili katika mashindano ya Grand Slam Track yaliyofanyika Kingston, Jamaica.<ref>{{Cite web |url=https://athleticsweekly.com/featured/grand-slam-track-gets-off-and-running-1039998816/ |title=Grand Slam Track gets off and running |date=2025-04-05 |publisher=Athletics Weekly }}</ref> Tarehe 2 Mei 2025, alishinda mbio za mita 5000 katika mashindano ya Miami.<ref>{{Cite web |url=https://www.letsrun.com/news/2025/05/grand-slam-track-miami-day-1-masai-russell-breaks-american-record-in-100m-hurdles-as-josh-kerr-makes-1500-statement/ |title=Grand Slam Track Miami Day 1 |date=2025-05-02 |publisher=LetsRun }}</ref> Aliendelea kufanya vizuri katika mashindano mbalimbali ikiwa ni pamoja na Prefontaine Classic.<ref>{{Cite web |url=https://worldathletics.org/competitions/diamond-league/news/chebet-world-5000m-record-eugene-sub-14-prefontaine-classic |title=Prefontaine Classic 2025 results |date=2025-07-05 |publisher=World Athletics }}</ref> Alishika nafasi ya nne katika mbio za mita 10,000 kwenye Mashindano ya Dunia 2025.<ref>{{Cite web |url=https://worldathletics.org/competition/calendar-results/results/7190593?eventId=10229521 |title=World Athletics Championships 10000m results |date=2025-09-18 |publisher=World Athletics |language=en}}</ref> Tarehe 26 Oktoba 2025, alishinda tena nusu marathon ya Valencia.<ref>{{Cite web |url=https://worldathletics.org/competitions/world-athletics-label-road-races/news/valencia-half-marathon-2025-ngetich-kejelcha |title=Valencia Half Marathon 2025 |date=2025-10-26 |publisher=World Athletics }}</ref> === 2026 === Ngetich alishinda medali ya dhahabu katika Mashindano ya Dunia ya Mbio za Kuvuka Nchi 2026 yaliyofanyika Tallahassee.<ref>{{Cite web |url=https://worldathletics.org/women-in-athletics/news/agnes-ngetich-kenya-cross-country |title=Agnes Ngetich wins world cross country 2026 |date=2026-01-19 |publisher=World Athletics }}</ref> Pia alishinda medali ya fedha katika mashindano ya timu.<ref>{{Cite web |url=https://worldathletics.org/competitions/world-athletics-cross-country-championships/tallahassee26/news/report/world-cross-tallahassee-26-senior-women |title=World Cross Country Championships 2026 results |date=2026-01-10 |publisher=World Athletics }}</ref> == Marejeo == {{Reflist}}{{Mbegu-mtu}} [[Jamii:Waliozaliwa 2001]] [[Jamii:Watu walio hai]] [[Jamii:Wanawake wa Kenya]] o8bu0cf7mt8dqnnd6945z26hdtw2v55 0 222730 1578092 1499607 2026-07-02T19:21:53Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578092 wikitext text/x-wiki '''Birtukan Ayano Dadi''' (alizaliwa [[12 Novemba]] [[1975]]) ni jaji na [[mwanadiplomasia]] wa [[Ethiopia]]. Kuanzia mwaka 2013 hadi 2017 aliwahi kuwa Balozi wa Ethiopia nchini Kanada. Tangu mwaka 2018, amehudumu kama Naibu Waziri katika Wizara ya Mambo ya Nje.<ref name="Mekasa">Ambo Mekasa, [http://tuckmagazine.com/2018/11/23/double-success-story-ambassador-birtukan-ayano/ A woman with a double success story: Ambassador Birtukan Ayano], ''Tuck Magazine'', November 23, 2018. Accessed January 2, 2021.</ref> == Maisha == [[Faili:Michael Martin with Birtukan Ayano.jpg|thumb|Naibu Waziri Mkuu Michael Martin akiwa na Waziri wa Mambo ya Nje wa Nchi Birtukan Ayano]] Birtukan Ayano Dadi (alizaliwa 12 Novemba 1975, Mkoa wa Arsi, Ethiopia) ni mwanasheria na mwanadiplomasia wa Ethiopia. Alisomea katika Shule ya Upili ya Bale Robe na alifundishwa kuwa mwalimu katika Taasisi ya Mafunzo ya Walimu ya Bale, akifanya kazi kama mwalimu wa shule ya msingi na shule ya upili ya junior. Mnamo 2003, alipata shahada ya LL.B. kutoka Chuo Kikuu cha Huduma za Umma cha Ethiopia. Kuanzia 2003 hadi 2006, alihudumu kama jaji wa Mahakama Kuu ya Marekani. Mnamo Januari 2006, alijiunga na Wizara ya Mambo ya Nje ya Ethiopia, akishika nafasi za katibu na mshauri katika Ubalozi wa Ethiopia Ottawa na Ubalozi Mkuu wa Ethiopia Toronto. Kuanzia Julai 2011 hadi Mei 2013, aliteuliwa kuwa Mshauri Mkuu wa Kurugenzi Kuu ya Mikataba ya Kimataifa na Masuala ya Kisheria. Kuanzia Mei 2013 hadi Novemba 2017, alihudumu kama Balozi wa Ethiopia nchini Kanada. Mnamo Novemba 2014, alipokea Tuzo ya Peace Dreamers kutoka Wakfu wa Sri Chinmoy. Mnamo Desemba 2017, aliteuliwa Mkurugenzi Mkuu wa Masuala ya Marekani. Mnamo Mei 2018, aliteuliwa kuwa Waziri wa Nchi wa Mambo ya Nje, Rasilimali Watu na Masuala ya Utawala.<ref name=":0">{{Cite web|date=2021-08-30|title=Waziri wa Nchi wa Rasilimali Watu na Masuala ya Utawala - Wizara ya Mambo ya Nje ya Ethiopia|url=https://mfa.gov.et/state-minister-for-human-resource-and-administrative-affairs/|access-date=2024-11-05|website=mfa.gov.et|language=one-GB|archive-date=2024-11-19|archive-url=https://web.archive.org/web/20241119092032/https://mfa.gov.et/state-minister-for-human-resource-and-administrative-affairs/|url-status=dead}}</ref> == Marejeo == {{reflist}}{{Mbegu-mtu}} [[Jamii:Waliozaliwa 1975]] [[Jamii:Watu walio hai]] [[Jamii:Wanawake wa Ethiopia]] 1djj5wb9iax833b3tggck1yc1uz8it0 0 223868 1578139 1492324 2026-07-02T21:45:08Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578139 wikitext text/x-wiki '''Ahmadou Babatoura Ahidjo''' ([[24 Agosti]] [[1924]] – [[30 Novemba]] [[1989]]) alikuwa mwanasiasa kutoka [[Kamerun]] na rais wa kwanza wa nchi hiyo kuanzia mwaka 1960 hadi 1982. Awali, alikuwa Waziri Mkuu wa kwanza wa nchi hiyo tangu uhuru wake mwezi Januari 1960 hadi Mei ya mwaka huo huo, baada ya kuanzishwa kwa wadhifa wa urais.<ref name=":10">{{Cite journal |last=Stark |first=Frank M. |date=1976 |title=Federalism in Cameroon: The Shadow and the Reality |url=https://archive.org/details/canadian-journal-of-african-studies_1976_10_3/page/n24 |journal=Canadian Journal of African Studies |volume=10 |issue=3 |pages=423–442 |doi=10.2307/483799 |jstor=483799}}</ref> == Marejeo == {{reflist}} {{Mbegu-mwanasiasa}} [[Jamii:Waliozaliwa 1924]] [[Jamii:Waliofariki 1989]] [[Jamii:Marais wa Kamerun]] kdd5oyrft7cr6v10jyao4j5yhbi4e7j 0 224109 1578154 1492698 2026-07-02T22:28:41Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578154 wikitext text/x-wiki '''Charles Pecher''' ([[26 Novemba]] [[1913]] – [[28 Agosti]] [[1941]]) alikuwa mwanzilishi wa mapema wa [[Ubelgiji]] katika tiba ya kinyuklia. Charles aligundua na kuanzisha matumizi ya strontium-89 katika taratibu za matibabu mnamo mwaka 1939.<ref name=":0">{{Cite journal|last=Lawrence|first=John H.|date=1941-12-05|title=Charles Pecher|url=https://archive.org/details/sim_science_1941-12-05_94_2449/page/533|journal=Science|language=en|volume=94|issue=2449|pages=533|doi=10.1126/science.94.2449.533|issn=0036-8075|pmid=17756655|bibcode=1941Sci....94..533L}}</ref> ==Marejeo== {{reflist}} {{mbegu-mwanasayansi}} [[jamii:waliozaliwa 1913]] [[jamii:waliofariki 1941]] [[jamii:wanasayansi wa Ubelgiji]] rrogydlmk4ypjm9lg7gkd7udkltt84x 0 224831 1578210 1493822 2026-07-03T03:16:50Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578210 wikitext text/x-wiki '''Ellen 'Maposholi Molapo''' alikuwa [[mwanasiasa]] wa [[Lesotho]]. Mwanamke wa kwanza kucheza nafasi muhimu katika [[siasa]] za Lesotho, alikua [[mwanamke]] wa kwanza kuingia katika Parliament of Lesotho alipoteuliwa kujiunga na Senate (Lesotho) mwaka 1965. ==Wasifu== Katika miaka ya 1950, Molapo aliishi katika eneo la Newclare, ambapo alikuwa mwanachama wa Southern African Clothing and Textile Workers Union (Garment Workers Union) na kuwa mwanaharakati kwa niaba ya African National Congress.<ref>Gail M. Gerhart (1977) ''From Protest to Challenge a Documentary History of African Politics in South Africa 1882-1964: Challenge and Violence 1953-1964'', p372</ref><ref name=ME2>Marc Epprecht (1992) ''[https://dalspace.library.dal.ca/bitstream/handle/10222/55320/NN80122.PDF?sequence=1&isAllowed=y Women, Class and Politics in Colonial Lesotho, 1930-1965] {{Wayback|url=https://dalspace.library.dal.ca/bitstream/handle/10222/55320/NN80122.PDF?sequence=1&isAllowed=y |date=20240427005058 }}'', pp345–346</ref> == Marejeo == {{Reflist}} {{mbegu-mwanasiasa}} {{BD||}} [[Jamii:Wanasiasa wa Liberia]] ajc4g7o9h6trrk3fvxk1gp055hev9us 0 226939 1578071 1502425 2026-07-02T17:58:38Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578071 wikitext text/x-wiki '''Nana Buluku''' (pia hujulikana kama '''Nana Buruku''', '''Nana Buku''' au '''Nanan-bouclou''') ni kiumbe wa juu kabisa wa kike katika [[dini za jadi]] za [[Afrika ya Magharibi|Afrika Magharibi]] za [[Wafon]] ([[Benin]]) na [[Waewe]] ([[Togo]]).<ref name="Washington2005p63">{{cite book|author=Teresa N. Washington|title=Our Mothers, Our Powers, Our Texts: Manifestations of Àjé in Africana Literature|url=https://books.google.com/books?id=q_WoU41r8I4C&pg=PA63|year=2005|publisher=Indiana University Press|isbn=0-253-00319-9|pages=63–64}}</ref><ref>{{cite journal | last=Greene | first=Sandra E. | title=Religion, History and the Supreme Gods of Africa: a Contribution To the Debate | journal=Journal of Religion in Africa | publisher=Brill Academic Publishers | volume=26 | issue=2 | year=1996 | pages=122–138 | doi=10.1163/157006696x00037 }}</ref><ref>{{cite book|author1=Toyin Falola|author2=Nana Akua Amponsah|title=Women's Roles in Sub-Saharan Africa|url=https://books.google.com/books?id=hVxtIRV1a5kC |year=2012|publisher=ABC-CLIO|isbn=978-0-313-38545-2|page=70}}</ref> Ni miongoni mwa miungu wenye ushawishi mkubwa katika theolojia ya Afrika Magharibi, na pia hupatikana katika makabila mengine tofauti na Wafon, ingawa kwa namna na tafsiri tofauti. Kwa mfano, hujulikana kama ''Nana Bukuu'' miongoni mwa [[Wayoruba]] na ''Olisabuluwa'' miongoni mwa [[Waigbo]], ambapo baadhi ya jamii humwabudu moja kwa moja na nyingine humchukulia kama chanzo cha miungu wengine badala ya kumwabudu yeye moja kwa moja.<ref name="Washington2005p63"/><ref>{{cite book|author=Geoffrey Parrinder|title=West African Religion: A Study of the Beliefs and Practices of Akan, Ewe, Yoruba, Ibo, and Kindred Peoples|url=https://books.google.com/books?id=UAOQBAAAQBAJ&pg=PA28 |year=2014|publisher=Wipf & Stock |isbn=978-1-4982-0492-7|pages=28–29}}</ref> Katika mytholojia ya Dahomey, Nana Buluku ndiye muumbaji mkuu wa kike ambaye alimzaa roho ya mwezi [[Mawu]], roho ya jua Lisa, na pia ulimwengu wote. Baada ya kuzaa viumbe hawa, alijitenga na akaacha masuala ya dunia chini ya Mawu-Lisa. Yeye anachukuliwa kama muumbaji wa awali, wakati Mawu-Lisa ni wa pili, na theolojia inayotokana na imani hii inajulikana kama Vodun, Voodoo au Vodoun.<ref name="Asante2009p270">{{cite book|author1=Molefi Kete Asante|author2=Ama Mazama|title=Encyclopedia of African Religion|url=https://books.google.com/books?id=B667ATiedQkC |year=2009|publisher=SAGE Publications|isbn=978-1-4129-3636-1|pages=270–273}}</ref> Kulingana na Maya Deren, baadhi ya waumini wa Vodou wanaamini kwamba Nanan-bouclou ni kiumbe mwenye jinsia mbili, yaani wa kike na wa kiume kwa pamoja.<ref>Divine Horsemen: The Living Gods of Haiti by Maya Deren, page 55</ref> ==Ibada== ===Afrika=== Dini ya Vodoun ya Wafon ina vipengele vinne vinavyohusiana: miungu ya umma, miungu binafsi au ya faragha, roho za mababu, na uchawi au hirizi.<ref name="Asante2009p270"/> Katika dini hii ya jadi ya Afrika Magharibi, uumbaji huanza na kiumbe wa juu kabisa wa kike aitwaye Nana Buluku, ambaye alizaa Mawu na Lisa na kuumba ulimwengu. Baada ya kuumba, muumbaji huyo alijitenga na akaacha uendeshaji wa dunia kwa Mawu-Lisa (Mwezi-Jua, kike-kiume), pamoja na miungu, roho na ulimwengu usio na uhai. Mawu-Lisa waliendelea kuumba miungu midogo isiyo kamilifu. Katika imani ya Wafon, mungu wa kike Mawu alihitaji kushirikiana na mdanganyifu Legba pamoja na nyoka wa uumbaji Aido Hwedo ili kuumba viumbe hai, mfumo ambao uliingiza mema, mabaya na hatima ya kila kiumbe ikiwemo binadamu. Kwa mujibu wa theolojia ya Wafon, ni kwa kupatanisha miungu midogo na Legba pekee ndipo hatima ya mtu inaweza kubadilishwa. Upatanisho huu huhitaji ibada, sadaka na matoleo kwa miungu wadogo na roho za mababu, ambao wanaaminika kuwa na uwezo wa kusaidia wanadamu kupata baraka.<ref name="Asante2009p270"/><ref>Sara A. Rich (2009), [https://www.jstor.org/stable/41715164 The Face of "Lafwa": Vodou & Ancient Figurines Defy Human Destiny], Journal of Haitian Studies, Vol. 15, No. 1/2 (Spring/Fall 2009), pages 262-278</ref><ref>{{cite journal | last=Cosentino | first=Donald | title=Who Is That Fellow in the Many-Colored Cap? Transformations of Eshu in Old and New World Mythologies | url=https://archive.org/details/sim_journal-of-american-folklore_july-september-1987_100_397/page/n6 | journal=The Journal of American Folklore | volume=100 | issue=397 | year=1987 | pages=261–275 | doi=10.2307/540323 | jstor=540323 }}</ref> ===Amerika=== Wakati wa biashara ya utumwa ya Atlantiki, mamilioni ya Waafrika Magharibi walitekwa na kupelekwa kufanya kazi katika mashamba ya miwa, pamba na tumbaku. Walibeba pia imani zao za kidini, ikiwemo zile za Nana Buluku. Leo hii, Nana Buluku huabudiwa kama ''Nanã'' katika Candomblé Jejé na Tambor de Mina, na kama ''Nana Burukú'' katika Candomblé Ketu, ambapo huwakilishwa kama mzee wa kike sana, aliyezeeka kuliko uumbaji wenyewe. Anaendelea kuabudiwa katika maeneo mbalimbali ya Diaspora ya Afrika ikiwemo Guyana ya Ufaransa, Suriname, Guyana, Brazil, Trinidad, Martinique, Haiti na visiwa vingine vya Karibiani.<ref name="TaylorCase2013p742">{{cite book|author1=Patrick Taylor|author2=Frederick I. Case|title=The Encyclopedia of Caribbean Religions|url=https://books.google.com/books?id=XOyYCgAAQBAJ |year=2013|publisher=University of Illinois Press|isbn=978-0-252-09433-0|pages=742–746, 1134–1139}}</ref><ref>{{cite journal | last=Miller | first=N. L. | title=Haitian Ethnomedical Systems and Biomedical Practitioners: Directions for Clinicians | journal=Journal of Transcultural Nursing | volume=11 | issue=3 | year=2000 | pages=204–211 | doi=10.1177/104365960001100307 | pmid=11982109 | s2cid=33589193 }}</ref> ==Marejeo== {{reflist}} [[Jamii:utamaduni wa Benin]] [[Jamii:utamaduni wa Togo]] bs586nd6f77fddtc66s09gua64xzjgs 0 227870 1578052 1509776 2026-07-02T16:33:44Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578052 wikitext text/x-wiki '''Charry Ada Onwu-Otuyelu''' ni [[mwandishi]] wa fasihi kutoka [[Nigeria]] anayejulikana hasa kwa kazi zake za [[fasihi]] ya watoto.<ref>{{Cite book|url=https://books.google.com/books?id=kf7_x8yz430C&dq=Charry+Ada+Onwu&pg=PR11|title=Bearing Witness: Readers, Writers, and the Novel in Nigeria|last=Griswold|first=Wendy|year=2000|publisher=Princeton University Press|isbn=0691058296|language=en}}</ref><ref>{{Cite book|url=https://books.google.com/books?id=0YspAQAAIAAJ&q=Charry+Ada+Onwu|title=ALA Bulletin: A Publication of the African Literature Association|date=1988-01-01|publisher=African Literature Association|language=en}}</ref> Alikuwa mwanamke wa kwanza kuwa Mkurugenzi wa Baraza la Sanaa na Utamaduni la Jimbo la Imo. Anatoka katika mji wa Amaigbo uliopo Imo State.<ref name=":0" /> Ni mwandishi wa hadithi za kubuni, hasa katika fasihi ya watoto.<ref name=":0">{{Cite web|url=http://dinfa.studiesonafrica.com/directory/children/2|title=DINFA | Directory | Children|website=dinfa.studiesonafrica.com|access-date=2017-03-27|archive-date=2017-03-29|archive-url=https://web.archive.org/web/20170329050528/http://dinfa.studiesonafrica.com/directory/children/2|url-status=dead}} </ref><ref>{{Cite web|url=http://www.worldcat.org/search?q=au:Onwu,+Charry+Ada.&qt=hot_author|title=Results for 'au:Onwu, Charry Ada.'|website=WorldCat|access-date=2017-03-27}}</ref> Pia aliwahi kuwa mwanajeshi, akihudumu katika kitengo cha huduma za afya cha Nigerian Armed Forces wakati wa Nigerian Civil War.<ref name=":0" /> == Wasifu == Charry Ada Onwu-Otuyelu alikuwa na shauku kubwa katika hadithi za jadi na historia, jambo lililoathiri sana mwelekeo wa utafiti na uandishi wake. Kazi zake nyingi zinahusiana na historia, jamii na masimulizi ya jadi. Aliingia katika uandishi wa fasihi bunifu mwanzoni mwa miaka ya 1980, akiwa miongoni mwa wanawake wa kwanza nchini Nigeria kuchukua kwa uzito fasihi ya watoto. Moja ya kazi zake za awali, ''Ifeanyi and Obi'', ilishinda tuzo ya fasihi ya watoto mwaka 1988. Baadaye aliendelea kupata tuzo nyingine kutokana na mchango wake katika fasihi ya watoto. Kwa taaluma, alikuwa muuguzi aliyepata mafunzo katika Hospitali ya Mafunzo ya Chuo Kikuu cha Ibadan na Hospitali ya Wazazi ya Lagos. Pia aliendesha kliniki au kituo cha uzazi katika eneo la Obinze karibu na Owerri, mji mkuu wa Jimbo la Imo. Aidha, alikuwa mkongwe wa vita vya wenyewe kwa wenyewe vya Nigeria (Vita vya Biafra), ambako alihudumu katika huduma za afya za jeshi. Uandishi wake ndio uliompa umaarufu mkubwa, kama ilivyokuwa kwa waandishi wengine wenye taaluma ya udaktari kama Cyprian Ekwensi na Anezi Okoro. == Kazi zake == Baadhi ya kazi zake ni pamoja na: *''Good Morning Mr. Kolanut!'' (2006; kwa ushirikiano na waandishi wengine) *''Triumph of Destiny'' (2003) *''Amaigbo Kwenu: History, Legend & Myth of Amaigbo'' (1988) *''Catastrophe: A Novel'' (1982)<ref name=":1">{{Cite journal|last1=Griswold|first1=Wendy|last2=Bastian|first2=Misty|date=1990|title=A Bibliographic Listing of Nigerian Novels: 1952–1990|url=https://archive.org/details/journal-of-commonwealth-literature_1990_25_2/page/225|journal=The Journal of Commonwealth Literature|volume=25|issue=2|pages=225|doi=10.1177/002198949002500211}}</ref> *''One Bad Turn'' (1982)<ref name=":1" /> *''Ifeanyi and Obi'' (1982) == Marejeo == {{marejeo}} {{Mbegu-mwandishi}} [[Jamii:Waandishi wa Nigeria]] [[Jamii:Wanawake wa Nigeria]] 4xxbqndpsa20euiirisatkuu9yokw32 0 228830 1578102 1529948 2026-07-02T19:52:12Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578102 wikitext text/x-wiki '''Johanna Alida Coetzee''' (1921 – 2007), anayejulikana pia kama '''Joey Coetzee''', alikuwa mtafiti katika taaluma ya Palynology (sayansi ya chavua za mimea) katika University of the Free State na mmoja wa waanzilishi wa uchambuzi wa chavua za visukuku. Tasnifu yake ya DSc ilipata kutambuliwa kimataifa na kusifiwa na mwanajiolojia mashuhuri wa barafu Richard Foster Flint, na ilisaidia kubainisha umuhimu wa mabadiliko ya joto katika kudhibiti mabadiliko ya maeneo ya uoto duniani na ndani ya maeneo maalum. == Elimu na kazi == Coetzee alizaliwa mwaka 1921 mjini [[Johannesburg]] na alisoma katika Jeppe High School for Girls. Alipata shahada ya uzamili (Master’s) katika [[Botany]] kutoka [[University of the Witwatersrand]]. Baadaye alifanya masomo ya juu zaidi katika chuo hicho pamoja na University of Natal kabla ya kuhamia University of the Free State ambako aliajiriwa mwaka 1946 kama msaidizi wa mtaalamu wa mimea katika Idara ya Botania. Alisafiri mara kadhaa nje ya nchi kwa ajili ya masomo na tafiti, akijifunza kutoka kwa wataalamu mbalimbali wa botania, wakiwemo Gunnar Erdtman, mmoja wa waanzilishi wa taaluma ya palinolojia. Mwishoni mwa miaka ya 1950 na 1960, Coetzee alisafiri pamoja na mshauri wake Eduard Meine van Zinderen-Bakker kutafuta maziwa na maeneo ya vinamasi yanayofaa kwa uchunguzi wa chavua za visukuku. Maeneo hayo yalijumuisha Mlima Kenya katika Afrika Mashariki na Lesotho Highlands kusini mwa Afrika. Alihudumu katika kamati mbalimbali zinazohusiana na tafiti za kipindi cha Quaternary na palinolojia, na kati ya mwaka 1978 hadi 1988 alikuwa mhariri wa jarida la kisayansi ''Palaeoecology of Africa''. == Utafiti == Kilele cha kazi yake kilikuwa kukamilisha mfuatano wa chavua za miaka 33,000 kutoka Ziwa Sacred katika Mount Kenya. Kazi hii ilikuwa sehemu ya tasnifu yake ya DSc yenye kichwa ''Pollen analytical studies in east and southern Africa'' na ilichapishwa katika juzuu ya 3 ya ''Palaeoecology of Africa and the Surrounding Islands and Antarctica''. Utafiti wake ulionyesha kuwa vipindi vya barafu (glacial episodes) havikuishia tu katika Northern Hemisphere. Wazo lililokubalika wakati huo lilikuwa kwamba vipindi vya unyevunyevu mkubwa Pluvial Afrika Mashariki vilikuwa sambamba na vipindi vya barafu katika maeneo ya latitudo ya juu. Hata hivyo, utafiti wa Coetzee pamoja na van Zinderen-Bakker ulisaidia kubadili mtazamo huu kwa kuonyesha umuhimu wa mabadiliko ya joto katika kusababisha mabadiliko ya uoto. Katika miaka ya 1970 na 1980, utafiti wake uliweka wazi umuhimu wa mabadiliko ya joto katika historia ya uoto wa Afrika katika kipindi cha Quaternary na kuonyesha kuwa vipindi vya barafu havikuwa na mvua nyingi zaidi katika maeneo hayo. Pia alifafanua historia ya mfumo wa ikolojia wa fynbos nchini Afrika Kusini kwa kufuatilia asili ya mimea hiyo kupitia chavua za visukuku, ikijumuisha familia kama Palmae, Winteraceae, Casuarinaceae, Chloranthaceae na Sarcolaenaceae katika mabaki ya kipindi cha Cenozoic. Utafiti huo pia ulionyesha kuwa katika kipindi cha [[Neogene]], kupoa kwa hali ya hewa duniani na kuundwa kwa barafu Antarctica kulisababisha misitu ya kitropiki kubadilishwa na uoto wa fynbos. Coetzee alipandishwa cheo kuwa mhadhiri mwandamizi wa botania katika University of the Free State na baadaye kuwa profesa. Alistaafu mwaka 1988. == Machapisho teule == * {{cite journal | last=Coetzee | first=J. A. | title=Evidence for a Considerable Depression of the Vegetation Belts during the Upper Pleistocene on the East African Mountains | url=https://archive.org/details/sim_nature-uk_1964-11-07_204_4958/page/564 | journal=Nature | publisher=Springer Science and Business Media LLC | volume=204 | issue=4958 | year=1964 | pages=564–566| doi=10.1038/204564a0 }} * {{cite journal |last1=Coetzee |first1=J.A. |title=Pollen analytical studies in east and southern Africa |journal=Palaeoecology of Africa |date=1967 |volume=3 |pages=1–146}} * {{cite journal |last1=Coetzee |first1=J.A. |title=Climatic and biological changes in South-Western Africa during the Late Cainozoic |journal=Palaeoecology of Africa |date=1978 |volume=10 |pages=13–29}} * {{cite book |last1=Coetzee |first1=J.A. |title=Antarctic glacial history and world palaeoenvironments |date=1978 |pages=115–127 |chapter=Late Cainozoic palaeoenvironments of Southern Africa}} * {{cite journal |last1=Coetzee |first1=J.A. |last2=Muller |first2=J. |title=The phytogeographic significance of some extinct Gondwana pollen types from the Tertiary of the southwestern Cape (South Africa) |journal=Annals of the Missouri Botanical Garden |date=1984 |volume=71 |issue=4 |pages=1088–1099}} * {{cite journal | last1=Coetzee | first1=J. A. | last2=Praglowski | first2=J. | title=Winteraceae pollen from the miocene of the southwestern cape (south africa) | url=https://archive.org/details/grana_1988_27_1/page/27 | journal=Grana | volume=27 | issue=1 | year=1988 | pages=27–37}} == Maisha binafsi == Baada ya kustaafu kutoka Idara ya Botania katika University of the Free State mwaka 1988, Coetzee alihamia [[Somerset West]] katika [[Western Cape]]. Alifariki tarehe 28 Aprili 2007. == Marejeo == {{Reflist}} {{Mbegu-mwanasayansi}} {{BD|1921|2007}} [[Jamii:Wanawake wa Afrika Kusini]] [[Jamii:Wanabiolojia wa Afrika Kusini]] ocpwya63s8ga8i6c2fvkfo0m1jgmdjj 0 228950 1578084 1507033 2026-07-02T19:02:11Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578084 wikitext text/x-wiki '''Ethel Mary Doidge''' (1887–1965) alikuwa mtaalamu wa kuvu (mycology) na bakteriolojia aliyezaliwa [[Uingereza]] lakini kufanya kazi [[Afrika Kusini]]. Doidge alizaliwa tarehe 31 Mei 1887 katika [[Nottingham]], Uingereza, na alisomea nchini Afrika Kusini katika Epworth School huko [[Pietermaritzburg]] na Huguenot College huko Wellington, Western Cape. Mwaka 1908 alijiunga na Idara ya Kilimo ya Transvaal kama msaidizi wa Dkt. I.B. Pole Evans. Mwaka 1909 alipata shahada ya uzamili (M.A.) kutoka University of the Cape of Good Hope, na mwaka 1914 alipata shahada ya uzamivu (D.Sc.), akiwa mwanamke wa kwanza kupata shahada ya uzamivu nchini Afrika Kusini. Tasnifu yake iliitwa ''A bacterial disease of mango, Bacillus mangiferae n. sp.''{{sfn|Doidge|1915}}{{sfn|HSRC|2000|p=226}} Ugonjwa huu ulikuwa haujulikani hapo awali nje ya Afrika Kusini na ulisababisha hasara kubwa kwa wakulima wa maembe kwa muda fulani. Mwaka 1912 alichaguliwa kuwa mwanachama wa Linnean Society of London (F.L.S). Mwaka 1919 aliteuliwa kuwa Naibu Mkuu wa Idara ya Botania na Patholojia ya Mimea, na mwaka 1929 akawa Mkuu wa Patholojia ya Mimea, nafasi aliyoshikilia hadi alipostaafu mwaka 1942. Baada ya hapo aliendelea kufanya kazi kwa miaka minne zaidi, akimalizia kitabu chake ''The South African fungi and lichens''.{{sfn|Doidge|1950}} Kupitia utaalamu wake katika bakteriolojia na mycology, aliweza kutatua matatizo muhimu katika sekta ya kilimo. Doidge pia aliteuliwa kuwa mwanachama wa baraza la kwanza la University of South Africa. Alikuwa mmoja wa waanzilishi wa South African Biological Society, na mwaka 1922 alitunukiwa tuzo kuu ya shirika hilo, Senior Captain Scott Memorial Medal, kwa mchango wake katika utafiti wa magonjwa ya mimea nchini Afrika Kusini. == Machapisho == {{refbegin}} * {{cite journal|type=PhD|last1=Doidge|first1=Ethel|title=A Bacterial Disease of the Mango. Bacillus Mangiferae N.sp |journal=Annals of Applied Biology|volume=2|issue=1|year=1915|pages=1–45|doi=10.1111/j.1744-7348.1915.tb05424.x}} * {{cite book|last=Doidge|first=Ethel Mary|title=The South African Fungi and Lichens to the End of 1945|year=1950|publisher=Government Printer, South Africa}} * {{cite journal|last1=Doidge|first1=Ethel M.|title=A TOMATO CANKER|url=https://archive.org/details/annals-of-applied-biology_1921-02_7_4/page/407|journal=Annals of Applied Biology|volume=7|issue=4|year=1921|pages=407–430|doi=10.1111/j.1744-7348.1921.tb05528.x}} * {{cite journal|last1=Doidge|first1=Ethel M.|title=A Bacterial Blight of Pear Blossoms Occurring in South Africa|url=https://archive.org/details/annals-of-applied-biology_1917-09_4_1-2/page/50|journal=Annals of Applied Biology|volume=4|issue=1–2|year=1917|pages=50–74|doi=10.1111/j.1744-7348.1917.tb05904.x}} * {{cite journal|last1=Doidge|first1=Ethel M.|title=South African Microthyriaceae|journal=Transactions of the Royal Society of South Africa|volume=8|issue=1|year=1919|pages=235–282|doi=10.1080/00359191909520002}} {{refend}} == Marejeo == {{Reflist}} {{Mbegu-mwanasayansi}} {{BD|1887|1965}} [[Jamii:Wanawake wa Uingereza]] [[Jamii:Wanasayansi wa Uingereza]] [[Jamii:Wanawake wa Afrika Kusini]] [[Jamii:Wanasayansi wa Afrika Kusini]] 9k2ax134bkso2hmpogn9zqqn5watk2p 0 229239 1578189 1530205 2026-07-03T02:03:22Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578189 wikitext text/x-wiki '''''Homo habilis''''' (maana ya [[Kilatini]] ni "mtu mwenye uwezo wa kutengeneza [[vifaa]]") katika [[uainishaji wa kisayansi]] ni [[spishi]] iliyokoma ya [[zamadamu]] wa kwanzakwanza<ref>{{cite book|title= The Cambridge Encyclopedia of Human Evolution |last=Stringer |first=C.B. |author-link=Chris Stringer |chapter=Evolution of early humans |editor-last1=Jones |editor-first1=S. |editor-last2=Martin |editor-first2=R. |editor-last3=Pilbeam |editor-first3=D. |year=1994 |publisher=[[Cambridge University Press]] |location=Cambridge |page=242}}</ref><ref>{{cite book |last1=Schrenk |first1=F. |last2=Kullmer |first2=O. |last3=Bromage |first3=T. |chapter=Chapter 9: The Earliest Putative ''Homo'' Fossils |editor-last1=Henke |editor-first1=W. |editor-last2=Tattersall |editor-first2=I. |title=Handbook of Paleoanthropology |date=2007 |pages=1611–1631 |doi=10.1007/978-3-540-33761-4_52}}</ref>. Mabaki yake yalipatikana huko [[Oltupai]] ([[Tanzania]]). Huyo anafikiriwa kutokana na ''[[Australopithecus garhi]]'' ambaye kabla yake alikuwa ameanza kutengeneza vifaa kwa [[mawe]]. Pia kwa sababu hiyo, kwamba hakuwa [[kiumbehai]] wa kwanza kutengeneza vifaa, baadhi ya [[wanasayansi]] wamependekeza [[jina]] lake liwe "Australopithecus habilis"<ref>{{cite journal|first1=B.|last1=Wood|first2=M.|last2=Collard|year=1999|title=The Human Genus|journal=Science|volume=284|issue=5411|pages=65–71|doi=10.1126/science.284.5411.65|pmid=10102822|bibcode=1999Sci...284...65.|s2cid=7018418|url=https://pdfs.semanticscholar.org/5cbf/24153dbb801176e3089052060a9d92b5082b.pdf|archive-url=https://web.archive.org/web/20201123192921/https://pdfs.semanticscholar.org/5cbf/24153dbb801176e3089052060a9d92b5082b.pdf|archive-date=2020-11-23}}</ref><ref>{{cite journal | author = Miller J. M. A. | year = 2000 | title = Craniofacial variation in ''Homo habilis'': an analysis of the evidence for multiple species | url = https://archive.org/details/sim_american-journal-of-physical-anthropology_2000-05_112_1/page/102 | journal = American Journal of Physical Anthropology | volume = 112 | issue = 1| pages = 103–128 | doi=10.1002/(SICI)1096-8644(200005)112:1<103::AID-AJPA10>3.0.CO;2-6 | pmid=10766947}}</ref><ref>{{cite journal|first=P. V.|last=Tobias|year=1991|title=The species ''Homo habilis'': example of a premature discovery|url=https://archive.org/details/annales-zoologici-fennici_1991_28_3-4/page/371|journal=Annales Zoologici Fennici|volume=28|issue=3–4|pages=371–380|jstor=23735461}}</ref><ref>{{Rejea kitabu | doi=10.1007/978-3-642-39979-4_51|chapter = Defining the Genus Homo|title = Handbook of Paleoanthropology| pages=2107–2144|year = 2015|last1 = Collard|first1 = Mark| last2=Wood| first2=Bernard| isbn=978-3-642-39978-7}}</ref>. Tena mnamo Mei [[2010]] huko [[Afrika Kusini]] yalipatikana mabaki ya ''[[Homo gautengensis]]'', spishi inayofikiriwa na wengine kuwa ya kale kuliko Homo habilis<ref name="toothy">{{Rejea tovuti |url=http://news.discovery.com/human/human-ancestor-tree-swinger.html |title="Toothy Tree-Swinger May Be Earliest Human" |accessdate=2012-04-28 |archivedate=2012-05-02 |archiveurl=https://web.archive.org/web/20120502102146/http://news.discovery.com/human/human-ancestor-tree-swinger.html }}</ref>, lakini wengine wanaijumlisha katika jina Homo habilis. Kumbe wataalamu wengine wanaona spishi hizo mbili hazistahili kuitwa Homo, ila [[Australopithecus]]. ==Historia ya awali== [[File:Homo_lineage_2017update.svg|thumb|200px|Uenezi wa jenasi ''Homo'' kwa wakati na mahali kuanzia miaka 2,000,000 iliyopita.]] Spishi hiyo <ref name=Johanson1986>{{cite journal|first1=D. C.|last1=Johanson|author1-link=Donald Johanson|first2=F.|last2=Masao|first3=G. G.|last3=Eck|first4=T. D.|last4=White|author4-link=Tim D. White|display-authors=et al.|year=1987|title=New partial skeleton of ''Homo habilis'' from Olduvai Gorge, Tanzania|url=https://archive.org/details/sim_nature-uk_1987-05-21_327_6119/page/204|journal=Nature|volume=327|issue=6119|pages=205–209|doi=10.1038/327205a0|pmid=3106831|bibcode=1987Natur.327..205J|s2cid=4321698}}</ref> imekadiriwa kuanza kuwepo miaka [[milioni]] 2.4 iliyopita<ref name="encylopediahumanevolution">{{cite book|title= The Cambridge Encyclopedia of Human Evolution | author=Stringer, C.B. | chapter=Evolution of early humans | editors=Steve Jones, Robert Martin & David Pilbeam (eds.)| year=1994 | publisher= Cambridge University Press | location= Cambridge |isbn= 0-521-32370-3 | page=242}} Also ISBN 0-521-46786-1 (paperback)</ref><ref name="evolutionthe1st4billionyears">{{cite book|title= Evolution: The First Four Billion Years|url= https://archive.org/details/evolutionfirstfo00mich| author=McHenry, H.M | chapter=Human Evolution | editors=Michael Ruse & Joseph Travis | year=2009 | publisher= The Belknap Press of Harvard University Press | location = Cambridge, Massachusetts |isbn=978-0-674-03175-3 | page=[https://archive.org/details/evolutionfirstfo00mich/page/265 265]}}</ref> kutokana na spishi mojawapo ya nusukabila [[Australopithecina]] (siku hizi linatumika pia jina [[Hominina]]) iliyokuwepo kuanzia miaka milioni 5.6 hadi 1.2 iliyopita. Homo habilis alikoma miaka milioni 1.65 iliyopita. Kutokana naye alipatikana miaka milioni 2 iliyopita ''[[Homo erectus]]'' aliyekuwa wa kwanza kusimama daima juu ya [[miguu]] yake miwili, [[Wawindaji-wakusanyaji|kuwinda]] na kumudu [[moto]], na ambaye alienea kote [[Asia]] na [[Ulaya]] (aliyebaki [[Afrika]] anaitwa pia ''[[Homo ergaster]]'') kabla ya kugawanyika katika nususpishi au spishi mpya mbalimbali kama ''[[Homo georgicus]]'', ''[[Homo antecessor]]'', ''[[Homo heidelbergensis]]'', wa kwanza kujenga makazi ya kudumu na [[Mazishi|kuzika]] wafu, n.k. Kwa jumla Homo erectus alidumu zaidi ya miaka milioni moja. Wengi wanaona spishi nyingi zilizopendekezwa awali kuwa nususpishi tu za Homo erectus. Miaka 800,000–200,000 iliyopita, wakati wa mabadiliko makubwa ya [[hali ya hewa]], [[ubongo]] wa jenasi hiyo ulikua sana na kupata uwezo wa kufanya mambo mengi mapya katika mahusiano na katika kukabili [[mazingira]] ambayo yalizidi kubadilika na kudai maitikio tofauti ili kudumisha [[uhai]] wa jenasi yenyewe. Kwamba [[Binadamu|homo sapiens]] ametokana na Homo erectus moja kwa moja ni dhana inayozidi kupingwa. ==Picha== <gallery> Homo habilis - forensic facial reconstruction.png|''Homo habilis'' mwanamume Homo naledi facial reconstruction.jpg|''Homo naledi'' mwanamume Homo rudolfensis.png|''Homo rudolfensis'' mwanamume Homo.erectus.adult.female.smithsonian.timevanson.flickr.jpg|''Homo erectus'' mwanamke Recente reconstrução de corpo inteiro do indivíduo LB1, Homo floresiensis.jpg|''Homo floresiensis'' mwanamke Homo heidelbergensis - forensic facial reconstruction-crop.png|''Homo heidelbergensis'' mwanamume Homo longi NT.jpg|''Homo longi'' mwanamume HomoLuzonensisRestoration.jpg|''Homo luzonensis'' mwanamume </gallery> ==Tanbihi== {{Marejeo}} ==Viungo vya nje== {{Commons category|Homo habilis}} {{Wikispecies|Homo habilis}} * [http://gurche.com/homo-floresiensis-1 Reconstructions of ''H. habilis''] by [[John Gurche]] * [http://www.archaeologyinfo.com/homohabilis.htm Archaeology Info] {{Webarchive|url=https://web.archive.org/web/20110526073252/http://www.archaeologyinfo.com/homohabilis.htm |date=2011-05-26 }} * [https://humanorigins.si.edu/evidence/human-fossils/species/homo-habilis ''Homo habilis''] – The Smithsonian Institution's Human Origins Program * [http://humanorigins.si.edu/evidence/human-evolution-timeline-interactive Human Timeline (Interactive)] – [[Smithsonian Institution|Smithsonian]], [[National Museum of Natural History]] (August 2016). {{mbegu-biolojia}} [[Jamii:Hominini]] [[Jamii:Historia]] c8njh6qq1c9dj0cp5wh8hd7gv2amww3 0 229248 1578074 1558598 2026-07-02T18:20:53Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578074 wikitext text/x-wiki [[Picha:Homo.erectus.adult.female.smithsonian.timevanson.flickr.jpg|thumb|Homo erectus wa [[jinsia]] ya kike.]] [[File:Homo_lineage_2017update.svg|thumb|200px|Uenezi wa jenasi ''Homo'' kwa wakati na mahali kuanzia miaka 2,000,000 iliyopita.]] '''''Homo erectus''''' (maana ya [[Kilatini]] ni "mtu aliyesimama") katika [[uainishaji wa kisayansi]] ni [[spishi]] iliyokoma ya [[zamadamu]]. Spishi hiyo imekadiriwa kuanza kuwepo takriban miaka [[milioni]] 2 iliyopita kutokana na [[Homo habilis]] (anayeitwa pia Australopithecus habilis). [[Mageuko ya spishi|Mageuko]] yaliyotokea kati ya spishi hizo mbili ni hatua muhimu katika maendeleo ya [[Homo]], kwa sababu [[ubongo]] ukawa mkubwa zaidi sana (hadi [[Sentimita ya ujazo|sentimeta za ujazo]] 1100 katika baadhi ya nusushipi zake), na Homo erectus alitengeneza [[Kifaa|vifaa]] vinavyoonyesha [[teknolojia]] ya juu zaidi. Kwa miaka 500,000 hivi spishi hizo mbili ziliishi pamoja katika [[Bonde Kuu la Ufa]]<ref>{{cite journal|first1=F.|last1=Spoor|first2=M. G.|last2=Leakey|first3=P. N.|last3=Gathogo|first4=F. H.|last4=Brown|title=Implications of new early ''Homo'' fossils from Ileret, east of Lake Turkana, Kenya|url=https://archive.org/details/sim_nature-uk_2007-08-09_448_7154/page/688|journal=Nature|year=2007|issn=0028-0836|page=689|volume=448|issue=7154|doi=10.1038/nature05986|first5=S. C.|last5=Antón|first6=I.|last6=McDougall|first7=C.|last7=Kiarie|first8=F. K.|last8=Manthi|first9=L. N.|last9=Leakey |pmid=17687323 |bibcode=2007Natur.448..688S }}</ref>. Homo erectus alikuwa wa kwanza kusimama daima juu ya [[miguu]] yake miwili, [[Wawindaji-wakusanyaji|kuwinda]], kumudu [[moto]], na kutoka [[bara]] la [[Afrika]] hata akaenea kote [[Asia]] na [[Ulaya]] (aliyebaki [[Afrika]] anaitwa pia ''[[Homo ergaster]]''). Kwa jumla Homo erectus alidumu zaidi ya miaka milioni moja ikagawanyika katika nususpishi au spishi mpya mbalimbali, ingawa [[Mtaalamu|wataalamu]] hawajakubaliana juu ya hizo. Wanatajwa ''[[Homo georgicus]]'', ''[[Homo antecessor]]'', na hasa ''[[Homo heidelbergensis]]'', wa kwanza kujenga makazi ya kudumu na [[Mazishi|kuzika]] wafu, n.k. Wengi wanaona spishi nyingi zilizopendekezwa awali kuwa nususpishi tu za Homo erectus<ref name=Anton2002>{{cite journal |first=S. C. |last=Antón |year=2002 |title=Evolutionary significance of cranial variation in Asian ''Homo erectus'' |url=https://archive.org/details/sim_american-journal-of-physical-anthropology_2002-08_118_4/page/302 |journal=American Journal of Physical Anthropology |volume=118 |issue=4 |page=302 |doi=10.1002/ajpa.10091|pmid=12124912 |bibcode=2002AJPA..118..301A }}</ref><ref>{{cite journal |first=I. |last=Tattersall |author-link=Ian Tattersall |year=1986 |title=Species recognition in human paleontology |url=https://archive.org/details/journal-of-human-evolution_1986-03_15_3/page/168 |journal=Journal of Human Evolution |volume=15 |issue=3 |page=168 |doi=10.1016/S0047-2484(86)80043-4|bibcode=1986JHumE..15..165T }}</ref>. Utata huo mkubwa kuhusu zamadamu gani walikuwa wa spishi hiyo, unafanya iwe vigumu kueleza sifa zake halisi. Kwa hakika, miaka 800,000–200,000 iliyopita, wakati wa mabadiliko makubwa ya [[hali ya hewa]], ubongo wa baadhi ya [[Kiumbehai|viumbehai]] wa [[jenasi]] Homo ulikua sana na kupata uwezo wa kufanya mambo mengi mapya katika mahusiano na katika kukabili [[mazingira]] ambayo yalizidi kubadilika na kudai maitikio tofauti ili kudumisha [[uhai]] wa jenasi yenyewe. Hata hivyo kwamba [[Binadamu|Homo sapiens]] ametokana na Homo erectus moja kwa moja ni [[dhana]] inayozidi kupingwa. Wengi wanakubali Homo sapiens alitokana na Homo ergaster kupitia Homo heidelbergensis, kama ilivyokuwa kwa [[Homo neanderthalensis]] na [[Homo longi]]. ==Tanbihi== {{Marejeo}} ==Marejeo== * {{cite book |last1=Boaz |first1=N. T. |last2=Ciochon |first2=R. |author2-link=Russell Ciochon |year=2004 |title=Dragon Bone Hill: An Ice-Age Saga of Homo erectus |url=https://archive.org/details/dragonbonehillic00boaz |publisher=Oxford University Press |isbn=978-0-19-803488-9}} * {{cite journal |first=S. C. |last=Antón |year=2003 |title=Natural history of ''Homo erectus''^† |journal=American Journal of Biological Anthropology |volume=122 |issue=S37 |pages=126–170 |doi=10.1002/ajpa.10399 |doi-access=free|pmid=14666536 |bibcode=2003AJPA..122S.126A }} * {{cite book |last=Theunissen |first=B. |year=1989 |title=Eugène Dubois and the Ape-Man from Java |url=https://archive.org/details/eugeneduboisapem0000theu |publisher=Kluwer Academic Publishers |isbn=978-1-55608-081-4}} ==Viungo vya nje== {{Commons category|Homo erectus}} {{Wikispecies|Homo erectus|''Homo erectus''}} * [http://www.bradshawfoundation.com/origins/homo_erectus.php Homo erectus] Origins – Exploring the Fossil Record – Bradshaw Foundation * [http://www.archaeologyinfo.com/homoerectus.htm Archaeology Info] {{Webarchive|url=https://web.archive.org/web/20110516125629/http://www.archaeologyinfo.com/homoerectus.htm |date=16 May 2011 }} * [http://humanorigins.si.edu/evidence/human-fossils/species/homo-erectus Homo erectus] – The Smithsonian Institution's Human Origins Program * [http://news.bbc.co.uk/1/hi/sci/tech/6937476.stm Possible co-existence with Homo Habilis] – BBC News * [[John D. Hawks|John Hawks]]'s [http://johnhawks.net/weblog/fossils/middle/kocabas/kappelman_2007_kocabas_tuberculosis.html discussion of the Kocabas fossil] * [https://web.archive.org/web/20080511210522/http://www-personal.une.edu.au/~pbrown3/palaeo.html Peter Brown's Australian and Asian Palaeoanthropology] * [http://atlasofhumanevolution.com/HomoErectus.asp The Age of Homo erectus] – Interactive Map of the Journey of Homo erectus out of Africa * [http://humanorigins.si.edu/evidence/human-evolution-timeline-interactive Human Timeline (Interactive)] – [[Smithsonian Institution|Smithsonian]], [[National Museum of Natural History]] (August 2016). {{mbegu-biolojia}} [[Jamii:Hominini]] [[Jamii:Historia]] dxmnyj5sxzd4vf2tv0irsb8b3qzrjop 0 229921 1578141 1529950 2026-07-02T21:48:45Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578141 wikitext text/x-wiki '''Obioma Nwaorgu''' (alizaliwa [[1948]]) ni mtaalamu wa vimelea na magonjwa ya mlipuko kutoka [[Nigeria]], anayejulikana kwa mchango wake mkubwa katika utafiti wa magonjwa ya [[kitropiki]] na afya ya jamii. Alikuwa Profesa mstaafu katika Nnamdi Azikiwe University, taasisi ambayo hapo awali ilijulikana kama Chuo Kikuu cha Teknolojia cha [[Jimbo la Anambra]] kabla ya mageuzi ya kitaasisi. Alipata elimu yake ya juu katika [[Chuo Kikuu cha Nigeria, Nsukka|University of Nigeria]] na baadaye katika [[University of Cambridge]], mojawapo ya vyuo vikuu vinavyoongoza duniani. Obioma Nwaorgu anakumbukwa kwa utafiti wake na juhudi za kutokomeza magonjwa ya kitropiki kama vile Guinea Worm Disease, Malaria, River Blindness (upofu wa mto), na Schistosomiasis (homa ya konokono). Aliongoza au kushiriki kama mtafiti mkuu katika miradi 12 ya utafiti wa magonjwa haya iliyofadhiliwa na World Health Organization (WHO). Mbali na utafiti, alikuwa mwanzilishi na rais wa Global Health and Awareness Research Foundation (GHARF), shirika lisilo la kiserikali lililojikita katika utoaji wa elimu ya afya na mafunzo ya uwezeshaji kwa wanawake na vijana. Kwa kutambua mchango wake wa kisayansi, Obioma Nwaorgu alichaguliwa kuwa mwanachama wa Nigerian Academy of Science mwaka [[2011]], na pia ni mwanachama wa Royal Society of Tropical Medicine and Hygiene ya [[London]].{{sfn|World Health Organization|2015}} == Maisha ya awali, elimu na familia == Obioma Nwaorgu (aliyezaliwa Obioma Chebechi Okolo mwaka [[1948]] nchini Nigeria) alipata elimu yake ya awali katika sayansi ya maisha kabla ya kujikita katika utafiti wa vimelea na magonjwa ya mlipuko.{{sfn|Langlois|1999|p=269}} Alipata Shahada ya Sayansi katika [[Zoolojia]] kutoka Chuo Kikuu cha Nigeria, Nsukka, mwaka [[1973]]. Baadaye aliendelea na masomo ya juu katika zoolojia katika University of Cambridge nchini Uingereza, ambapo alibobea zaidi katika taaluma ya sayansi ya viumbe.{{sfn|''NLNG Magazine''|2016|p=46}}{{sfn|Nigerian Academy of Science|2021}} Mnamo mwaka [[1976]], katika Kanisa la St Mark huko Cambridge, aliolewa na mwanafunzi mwenzake wa Nigeria, Joseph Goziem Nwaorgu, ambaye alikuwa akisomea usimamizi wa mali. Wawili hao walipata watoto wanne pamoja. Obioma Nwaorgu alipata Shahada ya Uzamivu (PhD) katika vimelea vya mimea mwaka 1979, hatua iliyomuwezesha kuanza safari yake ya kitaaluma kama mtafiti na mtaalamu wa magonjwa ya kitropiki. == Kazi zilizochaguliwa == * {{cite journal |last1=Albertson |first1=Donna G. |last2=Nwaorgu |first2=Obioma C. |last3=Sulston |first3=John E. |date=October 1979 |title=Chromatin Diminution and a Chromosomal Mechanism of Sexual Differentiation in ''Strongyloides Papillosus'' |url=https://link.springer.com/article/10.1007/bf00330626 |journal=Chromosoma |location=Vienna, Austria |publisher=[[Springer Science+Business Media|Springer-Verlag]] |volume=75 |pages=75–87 |doi=10.1007/bf00330626 |issn=0009-5915 |oclc=112576514 |pmid=533664 |s2cid=24522348 |url-access=subscription |ref=none}} * {{cite journal |last1=Nwaorgu |first1=O. C. |date=September 1991 |title=The Effectiveness of Combined Control Measures on the Prevalence of Guinea Worm Disease in Anambra State, Nigeria |url=https://archive.org/details/journal-of-helminthology_1991-09_65_3/page/226 |journal=[[Journal of Helminthology]] |location=London, UK |publisher=[[London School of Hygiene and Tropical Medicine]] |volume=65 |issue=3 |pages=226–231 |doi=10.1017/S0022149X00010750 |issn=0022-149X |oclc=116942380 |s2cid=34302664 |ref=none}} * {{cite journal |last1=Nwaorgu |first1=O. C. |last2=Okeibunor |first2=J. |last3=Madu |first3=E. |last4=Amazigo |first4=U. |last5=Onyegegbu |first5=N. |last6=Evans |first6=D. |date=October 1998 |title=A School-Based Schistosomiasis and Intestinal Helminthiasis Control Programme in Nigeria: Acceptability to Community Members |url=https://archive.org/details/sim_tropical-medicine-and-international-health_1998-10_3_10/page/842 |journal=[[Tropical Medicine & International Health]] |location=Oxford, UK |publisher=[[Wiley-Blackwell|Blackwell Science Ltd]] |volume=3 |issue=10 |pages=842–849 |doi=10.1046/j.1365-3156.1998.00313.x |issn=1360-2276 |oclc=5153516561 |pmid=9809919 |ref=none}} * {{cite journal |last1=Aribodor |first1=Dennis N. |last2=Nwaorgu |first2=Obioma C. |last3=Eneanya |first3=Christine I. |last4=Okoli |first4=Ikechukwu |last5=Pukkila-Worley |first5=Reed |last6=Etaga |first6=Harrison O. |date=September 2009 |title=Association of Low Birth Weight and Placental Malarial Infection in Nigeria |journal=[[Journal of Infection in Developing Countries]] |location=Sassari, Italy |publisher=Open Learning on Enteric Pathogens, [[University of Sassari]] |volume=3 |issue=8 |pages=264–281 |doi=10.3855/jidc.554 |issn=1972-2680 |oclc=449974346 |pmid=19801805 |ref=none |doi-access=free}} * {{cite journal |last1=Nwaorgu |first1=O. C. |last2=Orajaka |first2=B. N. |date=October 2011 |title=Prevalence of Malaria among Children 1–10 Years Old in Communities in Awka North Local Government Area, Anambra State South East Nigeria |journal=African Research Review |location=Dire Dawa, Ethiopia |publisher=International Association of African Researchers and Reviewers |volume=5 |issue=22 |pages=264–281 |doi=10.4314/afrrev.v5i5.21 |issn=1994-9057 |oclc=4807749411 |ref=none |doi-access=free}} * {{cite book|url=https://www.hsph.harvard.edu/wp-content/uploads/sites/114/2013/05/GoverningHealthSystems_Cover-front-matter.pdf|title=Governing Health Systems: For Nations and Communities Around the World|last1=Okeibunor|first1=Joseph|last2=Njepuome|first2=A. Ngozi|last3=Nwaorgu|first3=Obioma C.|last4=Onyeneho|first4=Nkechi G.|last5=Amazigo|first5=Uche V.|date=2015|publisher=Lamprey & Lee|isbn=978-1-942108-00-9|editor1-last=Reich|editor1-first=Michael R.|editor1-link=Michael R. Reich|edition=1st|location=Brookline, Massachusetts|pages=138–176|chapter=6. Community Perception of Health Services in South East Nigeria: A Reflection of Health System Governance in Nigeria|ref=none|editor2-last=Takemi|editor2-first=Keizō|editor2-link=Keizō Takemi|archive-url=https://web.archive.org/web/20240229151457/https://www.hsph.harvard.edu/wp-content/uploads/sites/114/2013/05/GoverningHealthSystems_Cover-front-matter.pdf|archive-date=29 February 2024|url-status=live}} ==Tanbihi== {{reflist}} {{mbegu-mtu}} [[Jamii: Waliozaliwa 1948]] [[Jamii: Watu walio hai]] [[Jamii: Wanasayansi wa Nigeria]] [[Jamii: Wanawake wa Nigeria]] j7eqdkuovbp8rh1ne9kpv9w8tcetgc1 0 230020 1577938 1508680 2026-07-02T12:39:52Z Riccardo Riccioni 452 1577938 wikitext text/x-wiki '''''Sabriya''''' ni filamu ya mwaka 1997. Sabriya ni sehemu ya mradi wa ''"Africa Dreaming"'', [[historia ya Afrika]] katika vitendo sita, hadithi sita za kisasa ambazo zinashirikiana katika dhamira ya upendo.<ref>[[imdbtitle:0192560|"Africa Dreaming" Sabriya (TV Episode 1997) - IMDb]]</ref> Ni saikolojia ya tamthilia za kijamii zinazowasilishwa katika miktadha mahususi ya [[Utamaduni|kitamaduni]] na kimapokeo ya kila moja ya nchi sita zinazowakilishwa: [[Afrika Kusini]], [[Zimbabwe]], [[Namibia]], [[Msumbiji]], [[Mauritania]] na [[Senegal|Senegali]]. == Muhtasari == Filamu inachunguza athari za ulimwengu wa kisasa kwa jamii ya wanaume wa jadi wa upande wa [[Maghrib]]. Ni filamu inayohusu wanaume wanaopendelea kuishi maisha kama mchezo wa kufikirika na mwanamke mwenye roho huru ambaye hubadilisha hayo yote. == Marejeo == <references /> [[Jamii:Filamu za 1997]] [[Jamii:filamu za Mali]] [[Jamii:filamu za Tunisia]] [[Jamii:Africa Film Cinema Tanzania 2026]] g0lfy0jw1qyuic1s8vgwta2wdjxoj32 0 230121 1578068 1545001 2026-07-02T17:40:15Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578068 wikitext text/x-wiki [[File:Homo_lineage_2017update.svg|thumb|300px|Uenezi wa jenasi ''Homo'' kwa wakati na mahali kuanzia miaka 2,000,000 iliyopita.]] [[File:Homo sapiens lineage.svg|thumb|300px|''Homo'' katika miaka 600,000 ya mwisho (kutoka chini kwenda juu). <ref>The horizontal axis represents geographic location; the vertical axis represents time in [[Year#Abbreviations yr and ya|thousands of years ago]]. Based on Schlebusch et al., "Southern African ancient genomes estimate modern human divergence to 350,000 to 260,000 years ago" ''Science'', 28 September 2017, [http://science.sciencemag.org/content/early/2017/09/27/science.aao6266.full DOI: 10.1126/science.aao6266], [https://d2ufo47lrtsv5s.cloudfront.net/content/sci/early/2017/09/27/science.aao6266/F3.large.jpg Fig. 3] {{Wayback|url=https://d2ufo47lrtsv5s.cloudfront.net/content/sci/early/2017/09/27/science.aao6266/F3.large.jpg |date=20180114130711 }} (''H. sapiens'' divergence times) and {{cite journal | last=Stringer | first=C. | title=What makes a modern human | url=https://archive.org/details/sim_nature-uk_2012-05-03_485_7396/page/32 | journal=Nature | year=2012 | volume=485 | issue=7396 | pages=33–35 | doi=10.1038/485033a | pmid=22552077| bibcode=2012Natur.485...33S }} (archaic admixture).</ref> ''Homo heidelbergensis'' anaonyeshwa akigawanyika kati ya Waneanderthal, Wadenisova na ''H. sapiens''. Baada ya ''H. sapiens sapiens'' kuenea kuanzia miaka 300,000 iliyopita, Waneanderthal na Wadenisova (na wengineo wasiojulikana bado) wanaonyeshwa kuchanganyikana na ''H. sapiens''. Pia inaonyeshwa michanganyiko mingine iliyoweza ikawatokea Waafrika wa kisasa.]] '''''Homo heidelbergensis''''' (maana ya [[Kilatini]] ni "mtu wa [[Heidelberg]]", [[jina]] la [[mji]] wa [[Ujerumani]] yalipopatikana kwa mara ya kwanza mabaki yake<ref name=Schoetensack1908>{{cite journal|first1=Otto|last1=Schoetensack|title=Der Unterkiefer des ''Homo Heidelbergensis'' aus den Sanden von Mauer bei Heidelberg. Ein Beitrag zur Paläontologie des Menschen|url=https://archive.org/details/molecular-genetics-and-genomics_1908-1909_1/page/408|language=German|trans-title=The lower jaw of ''Homo Heidelbergensis'' from the sands of Mauer near Heidelberg. A contribution to human paleontology|journal=Zeitschrift für induktive Abstammungs- und Vererbungslehre|year=1908|issn=1432-1874|pages=408–410|volume=1|issue=1|doi=10.1007/BF01990624|doi-access=free}}</ref>) katika [[uainishaji wa kisayansi]] ni [[spishi]] au [[nususpishi]] ya [[jenasi]] [[Homo]] ambayo imekadiriwa kuanza kuwepo huko [[Afrika]]<ref name=Profico2016>{{cite journal|first1=A. |last1=Profico |first2=F. |last2=di Vincenzo |display-authors=et al. |year=2016 |title=Filling the gap. Human cranial remains from Gombore II (Melka Kunture, Ethiopia; ca. 850 ka) and the origin of ''Homo heidelbergensis'' |journal=[[Journal of Anthropological Sciences]] |volume=94 |issue=94 |pages=1–24 |pmid=26583275 |url= http://www.isita-org.com/jass/Contents/2016vol94/Profico/26583275.pdf |doi=10.4436/JASS.94019}} ([https://www.researchgate.net/publication/284184973_Filling_the_gap_Human_cranial_remains_from_Gombore_II_Melka_Kunture_Ethiopia_ca_850_ka_and_the_origin_of_Homo_heidelbergensis Convenience link])</ref> kutokana na [[Homo ergaster]] ([[Homo erectus]] wa [[bara]] hilo), labda baada ya huyo kupungua sana hata karibu kutoweka kabisa miaka [[laki]] 8-9 hivi iliyopita<ref>{{Rejea jarida |last1=Hu |first1=Wangjie |last2=Hao |first2=Ziqian |last3=Du |first3=Pengyuan |last4=Di Vincenzo |first4=Fabio |last5=Manzi |first5=Giorgio |last6=Cui |first6=Jialong |last7=Fu |first7=Yun-Xin |last8=Pan |first8=Yi-Hsuan |last9=Li |first9=Haipeng |year= 2023 |title=Genomic inference of a severe human bottleneck during the Early to Middle Pleistocene transition |journal=Science |volume=381 |issue=6661 |pages=979–984 |doi=10.1126/science.abq7487 |pmid=37651513 |bibcode=2023Sci...381..979H |s2cid=261396309 |issn=0036-8075}}</ref>. Inafikiriwa kwamba Homo heidelbergensis alikuwa wa kwanza kujenga makazi ya kudumu, [[Mazishi|kuzika]] wafu, n.k. Miaka 700,000 hivi iliyopita alienea [[Ulaya]]<ref name=McBrearty2000>{{cite journal|first=S.|last=McBrearty|author1-link=Sally McBrearty|first2=A. S.|last2=Brooks|author2-link=Alison S. Brooks|year=2000|title=The revolution that wasn't: a new interpretation of the origin of modern human behavior|journal=Journal of Human Evolution|volume=39|pages=480–481|doi=10.1006/jhev.2000.0435}}</ref><ref>{{cite journal|title=''Homo cepranensis'' sp. nov. and the evolution of African-European Middle Pleistocene hominids|journal=Comptes Rendus Palevol|year=2003 |pages=153–159|volume=2|issue=2|doi=10.1016/s1631-0683(03)00015-0}}</ref><ref>{{cite journal|first1=R. |last1=Hosfield |first2=J. |last2=Cole |year=2018 |title=Early hominins in north-west Europe: A punctuated long chronology? |journal=Quaternary Science Reviews |volume=190 |pages=148–160 |doi=10.1016/j.quascirev.2018.04.026 |bibcode=2018QSRv..190..148H |doi-access=free}}</ref>. Wengi, si wote<ref name=meyer2016>{{cite journal|first1=M. |last1=Meyer |first2=J. |last2=Arsuaga |first3=C. |last3=de Filippo |first4=S. |last4=Nagel |title=Nuclear DNA sequences from the Middle Pleistocene Sima de los Huesos hominins |url=https://archive.org/details/nature-uk_2016-03-24_531_7595/page/504 |journal=[[Nature (journal)|Nature]] |volume=531 |issue=7595 |pages=504–507 |year=2016 |doi=10.1038/nature17405 |pmid=26976447 |bibcode=2016Natur.531..504M |s2cid=4467094}}</ref>, wanakubali Homo sapiens alitokana na Homo ergaster kupitia Homo heidelbergensis, kama ilivyotokea kwa [[Homo neanderthalensis]] na [[Homo longi]], ambao wote walikuwa na [[chembeuzi]] 46 kama [[binadamu]] wa leo, tofauti na [[Sokwe (Hominidae)|sokwe]] ambao wanazo 48. Ni kwamba miaka 800,000–200,000 iliyopita, wakati wa mabadiliko makubwa ya [[hali ya hewa]], [[ubongo]] wa jenasi Homo ulikua sana na kupata uwezo wa kufanya mambo mengi mapya katika mahusiano na katika kukabili [[mazingira]] ambayo yalizidi kubadilika na kudai maitikio tofauti ili kudumisha [[uhai]] wa jenasi yenyewe. ==Tanbihi== {{Marejeo}} ==Viungo vya nje== {{Commons category|Homo heidelbergensis}} {{Wikispecies|Homo heidelbergensis}} * ''[http://humanorigins.si.edu/evidence/human-fossils/species/homo-heidelbergensis Homo heidelbergensis]'' – The Smithsonian Institution's Human Origins Program * [http://www.homoheidelbergensis.de/ Homepage of Mauer 1 Club] {{In lang|de}} * [https://whc.unesco.org/en/list/989 UNESCO World Heritage Centre - Archaeological Site of Atapuerca] * [http://humanorigins.si.edu/evidence/human-evolution-timeline-interactive Human Timeline (Interactive)] – [[Smithsonian Institution|Smithsonian]], [[National Museum of Natural History]] (August 2016). {{mbegu-biolojia}} [[Jamii:Hominini]] [[Jamii:Historia]] fm83ecjqfeajuf9akadaj4uc86s0xi0 0 230218 1578142 1509618 2026-07-02T21:49:44Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578142 wikitext text/x-wiki '''Robert Van Norden Hine Jr.''' (26 Aprili 1921, Los Angeles – 27 Machi 2015, [[Irvine, California]]) alikuwa mwandishi wa kumbukumbu binafsi, mwandishi wa riwaya za kihistoria, na profesa wa historia kutoka [[Marekani]] aliyeandika vitabu kadhaa. Kumbukumbu yake ya mwaka 1993 iitwayo ''Second Sight'' inaelezea uzoefu wake wa kupoteza uwezo wa kuona alipokuwa na umri wa miaka 50, na baadaye kurejesha sehemu ya uwezo huo wa kuona miaka 15 baadaye kwa msaada wa upasuaji wenye hatari kubwa.<ref name=ObitLA>{{cite news|author=Woo, Elaine|url=[https://www.latimes.com/local/obituaries/la-me-robert-hine-20150420-story.html|title=Robert](https://www.latimes.com/local/obituaries/la-me-robert-hine-20150420-story.html|title=Robert) V. Hine dies at 93; historian wrote of losing, regaining sight|date=19 Aprili 2015|newspaper=LA Times}}</ref><ref>{{cite journal|doi=10.1177/0145482X9508900218|title=Book Review: ''Second Sight''|url=https://archive.org/details/sim_journal-of-visual-impairment-blindness_march-april-1995_89_2/page/184|year=1995|last1=Kent|first1=D.|journal=Journal of Visual Impairment & Blindness|volume=89|issue=2|pages=184–186|s2cid=220537763 }}</ref><ref>{{cite web|url=[https://www.publishersweekly.com/978-0-520-08195-6|title=Nonfiction](https://www.publishersweekly.com/978-0-520-08195-6|title=Nonfiction) Book Review: ''Second Sight'' by Robert V. Hine|date=2 Agosti 1993|website=Publishers Weekly}}</ref> == Marejeo == {{Reflist}} {{Mbegu-mwandishi}} {{BD|1921|2015}} [[Jamii:Waandishi wa Marekani]] 4v51u9nqg2c30xiiu65zs4hoi20i2n2 0 230434 1578078 1509892 2026-07-02T18:33:42Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578078 wikitext text/x-wiki '''Barthold Georg Niebuhr''' (27 Agosti 1776 – 2 Januari 1831) alikuwa mwanasiasa, benki na mwanahistoria wa asili ya Kidenmaki na Kijerumani, aliyekuwa mmoja wa wanahistoria mashuhuri wa [[Ujerumani]] kuhusu Roma ya kale na mmoja wa waanzilishi wa uandishi wa kisayansi wa historia wa kisasa. Kufikia mwaka 1810, Niebuhr alikuwa akichochea uzalendo wa Kijerumani miongoni mwa wanafunzi katika Chuo ki Kuu cha Berlin kupitia uchambuzi wake wa uchumi na serikali ya Roma. Alikuwa kiongozi wa kipindi cha Uromantiki na ishara ya roho ya utaifa wa Kijerumani iliyojitokeza baada ya kushindwa katika Vita vya Jena. Hata hivyo, pia alikuwa ameathiriwa sana na fikra za [[Age of Enlightenment|Enzi ya Mwangaza]] katika misingi yake ya kiakili, matumizi yake ya uchambuzi wa filolojia, na msisitizo wake juu ya vipengele vya jumla na mahususi katika historia.<ref>{{Cite journal|last=Reill|first=Peter Hanns|date=1980|title=Barthold Georg Niebuhr and the Enlightenment Tradition|url=https://archive.org/details/german-studies-review_1980-02_3_1/page/9|journal=German Studies Review|volume=3|issue=1|pages=9–26|doi=10.2307/1429481|jstor=1429481}}</ref> == Marejeo == {{Reflist}} {{Mbegu-mtu}} {{BD|1776|1831}} [[Jamii:Wanahistoria wa Ujerumani]] 2tzn445i2z8vw6das5krcbzizpthq8c 0 232379 1578202 1545801 2026-07-03T02:55:43Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578202 wikitext text/x-wiki '''Camara Phyllis Jones''' (amezaliwa Agosti 16, 1955)<ref>{{cite web|last=Nielsen|first=Euell A.|url=[https://www.blackpast.org/african-american-history/camara-phyllis-jones-1955/|title=Camara](https://www.blackpast.org/african-american-history/camara-phyllis-jones-1955/|title=Camara) Phyllis Jones (1955- )|work=[[BlackPast.org]]|date=August 23, 2020|access-date=2020-09-19}}</ref> ni daktari wa [[Marekani]], mtaalamu wa epidemiolojia, na mwanaharakati dhidi ya ubaguzi wa rangi ambaye amebobea katika kuchunguza athari za ubaguzi wa rangi na ukosefu wa usawa wa kijamii katika afya za watu. Anajulikana kwa kazi yake ya kufafanua ubaguzi wa rangi wa kitaasisi, ubaguzi wa rangi wa moja kwa moja baina ya watu, na ubaguzi wa rangi uliojengeka ndani ya nafsi katika muktadha wa mahusiano ya kisasa ya rangi nchini Marekani.<ref>{{Cite journal|last=Jones|first=Camara Phyllis|date=2002|title=Confronting Institutionalized Racism|url=https://archive.org/details/sim_phylon_2002_50_1-2/page/7|journal=[[Phylon]] |volume=50|issue=1/2|pages=7–22|doi=10.2307/4149999|jstor=4149999}}</ref> Wakati wa janga la COVID-19, Jones alipendekeza kwamba ubaguzi wa rangi ulikuwa ukiweka makundi ya wachache nchini Marekani katika hatari kubwa zaidi ya kuambukizwa COVID-19 na kupata madhara makubwa kutokana na maambukizi hayo.<ref>{{Cite web|last=Wallis|first=Claudia|title=Why Racism, Not Race, Is a Risk Factor for Dying of COVID-19|url=[https://www.scientificamerican.com/article/why-racism-not-race-is-a-risk-factor-for-dying-of-covid-191/|website=[[Scientific](https://www.scientificamerican.com/article/why-racism-not-race-is-a-risk-factor-for-dying-of-covid-191/|website=[[Scientific) American]]|date=2021-12-21|orig-date=Originally published July 12, 2020|access-date=2025-10-08}}{{Dead link|date=May 2026 |bot=InternetArchiveBot |fix-attempted=yes }}</ref><ref name=levenson2020>{{Cite news|last=Levenson|first=Eric|title=Why Black Americans are at higher risk for coronavirus|url=[https://www.phillytrib.com/news/health/coronavirus/why-black-americans-are-at-higher-risk-for-coronavirus/article_5663224b-d19c-5478-a2eb-9456d0d8fc86.html|date=2020-04-07|work=[[The](https://www.phillytrib.com/news/health/coronavirus/why-black-americans-are-at-higher-risk-for-coronavirus/article_5663224b-d19c-5478-a2eb-9456d0d8fc86.html|date=2020-04-07|work=[[The) Philadelphia Tribune]]|access-date=2025-10-08}}</ref> Pia alitoa wito wa kuchukuliwa hatua za kupambana na ubaguzi wa rangi wa kimuundo.<ref name=levenson2020/><ref>{{Cite news|last=Simon|first=Clea |title=Facing the denial of American racism|url=[https://news.harvard.edu/gazette/story/2020/06/facing-the-denial-of-american-racism/|date=June](https://news.harvard.edu/gazette/story/2020/06/facing-the-denial-of-american-racism/|date=June) 5, 2020|work=[[The Harvard Gazette]]|access-date=2020-07-12}}</ref> == Marejeo == {{Reflist}} {{Mbegu-mtu}} [[Jamii:Watu wa Marekani]] [[Jamii:Wanawake wa Marekani]] [[Jamii:Watu walio hai]] 0p9mat1bv27c0ys442ixxwdkh1fxnab 0 232915 1578201 1538744 2026-07-03T02:54:49Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578201 wikitext text/x-wiki '''Mary Griffith''' (1772–1846) alikuwa mwandishi, mtaalamu wa bustani, na mwanasayansi kutoka [[Marekani]]. Alichapisha matokeo ya tafiti zake katika majarida ya kisayansi na ya fasihi, pamoja na magazeti.<ref name=":0">{{cite journal|last=Cox|first=Robt S.|title=A Spontaneous Flow: The Geological Contributions of Mary Griffith, 1772-1846|url=https://archive.org/details/earth-sciences-history_1993_12_2/page/187|year=1993|journal=Earth Sciences History|volume=12|issue=2|pages=187–195|doi=10.17704/eshi.12.2.0110m7w273027w67|jstor=24138608|bibcode=1993ESHis..12..187C}}</ref> Pia alichapisha riwaya na hadithi kadhaa, zikiwemo ''Camperdown, or News from Our Neighborhood'' (1836), pamoja na ''Three Hundred Years Hence'', ambayo inachukuliwa kuwa [riwaya ya kwanza ya jamii bora iliyoandikwa na mwanamke kutoka Marekani inayojulikana hadi sasa.<ref>{{cite web |last=Suksang |first=Duangrudi |title=Mary Griffith's Pioneering Vision: Three Hundred Years Hence |date=1 Januari 2000 |url=[http://www.encyclopedia.com/doc/1G1-66454600.html](http://www.encyclopedia.com/doc/1G1-66454600.html) |accessdate=15 Aprili 2008}}</ref> == Marejeo == {{Reflist}} {{Mbegu-mtu}} [[Jamii:Watu wa Marekani]] 0imzvuw67crb8z8bdfz3gvj7ov40hbf 0 233173 1578095 1539210 2026-07-02T19:25:48Z InternetArchiveBot 41439 Add 2 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578095 wikitext text/x-wiki '''Constance Virginia Kies''' (13 Desemba 1934 – 30 Novemba 1993) alikuwa mwanasayansi wa nutrition na mtaalamu wa lishe (dietitian) kutoka [[Marekani]]. Alifundisha kama mwalimu wa shule za umma kwa miaka mitatu kabla ya kuingia katika masomo ya juu ya kitaaluma, hatua iliyompelekea kuvunja baadhi ya kanuni za kijinsia za wakati wake na kuhitimu shahada za M.S. na Ph.D. katika University of Wisconsin–Madison. Katika kazi yake ya zaidi ya miaka 30 katika University of Nebraska–Lincoln, Kies alifanya utafiti katika biokemia ya lishe, akionyesha uhusiano kati ya madini, protini, na nyuzinyuzi za chakula kupitia tafiti za kibinadamu za awali (human subject research). Utafiti wake ulichangia maendeleo ya uelewa wa kisayansi kuhusu metaboli ya Shaba na protini. Alitunukiwa Borden Award na alikuwa mshirika wa American College of Nutrition. Pia alikuwa mtetezi wa haki za wanawake na mwanachama wa National Organization for Women pamoja na Women's Equity Action League. Alifariki dunia kutokana na uterine cancer miezi mitatu baada ya kugundulika na ugonjwa huo. == Maisha ya awali na elimu == Kies alizaliwa 13 Desemba 1934 huko Blue River, Wisconsin.<ref>{{cite book|title=Who's Who in the Midwest, Volume 20|url=[https://books.google.com/books?id=FZ5mAAAAMAAJ&q=%22kies+constance+virginia%22+1934|publisher=A.N](https://books.google.com/books?id=FZ5mAAAAMAAJ&q=%22kies+constance+virginia%22+1934|publisher=A.N). Marquis|year=1986|page=310}}</ref> Baba yake alikuwa msimamizi wa shule (superintendent), na mama yake alikuwa mwalimu. Akiwa mtoto, familia yake ilihamia shamba huko Platteville, Wisconsin, pamoja na dada zake watatu. Alisoma katika Platteville High School ambapo alikuwa mwanafunzi bora (valedictorian). Baadaye alisoma katika Wisconsin State College, Platteville na kupata shahada ya B.S. mwaka 1955 katika English pamoja na masomo ya historia, jiografia, sayansi ya maktaba na sayansi ya nyumbani.<ref name=":1">{{Cite journal|date=1994|title=Deaths|url=https://archive.org/details/chemical-engineering-news_1994-01-17_72_3/page/39|journal=Chemical & Engineering News Archive|volume=72|issue=3|pages=39|doi=10.1021/cen-v072n003.p039|issn=0009-2347}}</ref> Baada ya kuhitimu, alifundisha shule kwa miaka mitatu kabla ya kuanza masomo ya uzamili. Alipata M.S. katika foods and nutrition mwaka 1960, na Ph.D. katika Lishe ya binadamu na Fiziolojia ya tiba mwaka 1963 kutoka University of Wisconsin–Madison.<ref name=":0">{{Cite journal|date=1994|title=Deaths|url=https://archive.org/details/chemical-engineering-news_1994-01-17_72_3/page/39|journal=Chemical & Engineering News Archive|volume=72|issue=3|pages=39|doi=10.1021/cen-v072n003.p039|issn=0009-2347}}</ref> Tasnifu yake ya uzamili ilihusu "Studies in Urinary Nitrogen Excretion", na dissertation yake ilichunguza uhusiano wa amino asidi muhimu na zisizo muhimu kwa binadamu na panya. == Marejeo == {{Reflist}} {{Mbegu-mtu}} [[Jamii:Watu wa Marekani]] ot8azqdgpcekgq16gh4fmpvdvg9ppix 0 236681 1578138 1574203 2026-07-02T21:44:45Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578138 wikitext text/x-wiki '''Alice Eastwood''' ([[Januari 19]], [[1859]] – [[Oktoba 30]], [[1953]]) alikuwa [[mwanabotania]] mwenye asili ya [[Kanada]] na uraia wa [[Marekani]]. Alihesabiwa kwa kujenga mkusanyiko wa [[botania]] katika Chuo cha Sayansi cha [[California]] (California Academy of Sciences) huko [[San Francisco]]. Alichapisha zaidi ya makala 310 za kisayansi na aliandika majina ya spishi za mimea ya nchi kavu 395, nambari ya nne kwa idadi ya majina kama hayo yaliyoandikwa na mwanasayansi wa kike.<ref>{{cite journal|last1=Lindon|first1=Heather L.|last2=Gardiner|first2=Lauren M.|last3=Brady|first3=Abigail|last4=Vorontsova|first4=Maria S.|title=Fewer than three percent of land plant species named by women: Author gender over 260 years|url=https://archive.org/details/taxon_2015-04_64_2/page/209|journal=Taxon|date=5 May 2015|volume=64|issue=2|pages=209–215|doi=10.12705/642.4|bibcode=2015Taxon..64..209L |df=dmy-all}}</ref><ref name=":0">{{Cite book|last=Bonta|first=Marcia|title=Women in the field : America's pioneering women naturalists|url=https://archive.org/details/womeninfieldamer0000bont|date=1991|publisher=Texas A & M University Press|isbn=0-89096-467-X|edition=1|location=College Station|pages=[https://archive.org/details/womeninfieldamer0000bont/page/93 93]–102|oclc=22623848}}</ref> == Marejeo == {{reflist}} {{Mbegu-mtu}} [[Jamii:Wanasayansi wa Marekani]] [[Jamii:Waliozaliwa 1859]] [[Jamii:Waliofariki 1953]] 9xprwxleeejgt953yivyqc0gvw7747n 0 237402 1578056 1547964 2026-07-02T16:59:51Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578056 wikitext text/x-wiki '''Frank Caplan''' (10 Juni 1911 – 28 Septemba 1988) alikuwa Frank Caplan mfanyakazi wa vijana, mwalimu, mkusanyaji wa vifaa vya kuchezea vya jadi, na mmoja wa waanzilishi wa maendeleo na utengenezaji wa vifaa vya kuchezea vya kielimu kwa watoto. Alianzisha kampuni ya Creative Playthings] mwaka 1945 pamoja na mke wake Theresa Caplan. Caplan alifanya kazi na wasanii, wasanifu majengo, na wabunifu mbalimbali kama Isamu Noguchi, Louis Kahn, Henry Moore, Robert Winston, pamoja na mtengenezaji wa vifaa vya kuchezea kutoka Uswisi, Antonio Vitali, ili kubuni vifaa vya ubunifu vya michezo ya kielimu na miundo ya viwanja vya michezo kwa watoto.<ref name=Ogata>{{cite journal|last=Ogata|first=Amy F.|title=Creative Playthings: Educational Toys and Postwar American Culture|url=https://archive.org/details/sim_winterthur-portfolio_summer-autumn-2004_39_2-3/page/129|journal=[[Winterthur Portfolio]]|date=Summer–Autumn 2004|volume=39|issue=2/3|pages=129–156|doi=10.1086/433197|s2cid=151517793}}</ref> == Marejeo == {{Reflist}} {{Mbegu-mtu}} {{BD|1911|1988}} [[Jamii:Watu wa Marekani]] 1ewzx4bb7rjsycqzcuxbdm1vxpxo0n8 0 240042 1578214 1558980 2026-07-03T03:31:19Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578214 wikitext text/x-wiki '''Caroline Kathryn Allen''' (7 Aprili 1904 – 6 Aprili 1975) alikuwa mtaalamu wa mimea, mchoraji wa vielelezo vya mimea na mtaalamu wa taksonomia kutoka [[Marekani]], aliyefahamika kwa tafiti zake kuhusu miti ya familia ya mikarafuu (Lauraceae). Alikuwa mfanyakazi katika Arnold Arboretum na pia New York Botanical Garden.<ref name=":0">{{cite journal |last1=Howard |first1=Richard A. |title=Caroline Kathryn Allen (1904-1975): A Remembrance Long Overdue |url=https://archive.org/details/taxon_1994-08_43_3/page/501 |journal=Taxon |date=Aug 1994 |volume=43 |issue=3 |pages=501–504 |jstor=1222741 }}</ref> Allen alielezea kisayansi zaidi ya spishi 275 za mimea na alitoa mchango mkubwa katika machapisho ya kitaaluma ya botania.<ref name=":1">{{cite web |title=Caroline Kathryn Allen Papers |url=[https://sciweb.nybg.org/science2/libr/finding_guide/allpap.asp.html](https://sciweb.nybg.org/science2/libr/finding_guide/allpap.asp.html) |website=sciweb.nybg.org |accessdate=7 January 2019}}</ref><ref>{{cite web |title=Tropicos {{!}} Person - Allen, Caroline Kathryn |url=[http://www.tropicos.org/Person/2477](http://www.tropicos.org/Person/2477) |website=[www.tropicos.org](http://www.tropicos.org) |accessdate=7 January 2019}}</ref> == Marejeo == {{Reflist}} {{Mbegu-mtu}} {{BD|1904|1975}} [[Jamii:Watu wa Marekani]] b53t3grvk60y8mb4lbwyfqr7dknr418 0 240901 1578103 1574289 2026-07-02T19:54:45Z InternetArchiveBot 41439 Add 1 book for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578103 wikitext text/x-wiki [[File:St_Polycarp-ApollinareNuovoRavenna.JPG|thumb|Mt. Polikarpo katika [[mozaiki]] za [[Ravenna]], [[Italia]].]] '''''Kifodini cha Polikarpo''''' ni [[kitabu]] cha [[karne ya 2]] kinachosimulia tukio hilo ambapo [[Polikarpo Mtakatifu|Polikarpo]], [[askofu]] wa [[İzmir|Smirna]], alichomwa [[moto]] akiwa hai mbele ya [[umati]] uliokusanyika katika [[uwanja wa michezo]] wa [[mji]] huo [[mwaka]] [[155]] [[Baada ya Kristo|BK]]. Upande mmoja kina mtindo wa [[barua]], upande mwingine wa [[kumbukumbu]] za [[mahakama]]. Ni [[ushahidi]] wa kwanza kuandikwa nje ya [[Agano Jipya]] kuhusu [[Mfiadini|kifodini]] cha [[Ukristo|Kikristo]]{{sfn|Encyclopaedia Britannica|2018|ref=EBMartPol}}. ==Tazama pia== * [[Mababu wa Kitume]] * [[Babu wa Kanisa|Mababu wa Kanisa]] ==Tanbihi== {{Reflist}} ==Marejeo== * {{citation |url=https://www.britannica.com/topic/Martyrdom-of-Polycarp |title=Martyrdom of Polycarp |publisher=Encyclopaedia Britannica |year=2018 |access-date=23 November 2018 |ref=EBMartPol}} * Bobichon, Philippe, ''La plus ancienne littérature martyriale'' in ''Histoire de la littérature grecque chrétienne, t. II/5 : De Paul apôtre à Irénée de Lyon'', B. Pouderon and E. Norelli (dir.), Paris, Cerf, 2013, pp.&nbsp;619–647 [https://www.academia.edu/7280302/_La_plus_ancienne_litt%C3%A9rature_martyriale_ online] * {{cite book |last1=Foster |first1=Paul |first2=Sara |last2=Parvis |author2-link=Sara Parvis |title=Writings of the Apostolic Fathers |location=London |publisher=Continuum International |date=2007}} * Hartog, Paul, ''Polycarp's Epistle to the Philippians and the Martyrdom of Polycarp. Introduction, Text, and Commentary'', New York, Oxford University Press, 2013. * {{cite book |last1=Jefford |first1=Clayton |first2=Kenneth |last2=Harder |first3=Louis |last3=Amezaga |title=Reading the Apostolic Fathers: An Introduction |url=https://archive.org/details/readingapostolic0000jeff |location=Peabody, Massachusetts |publisher=Hendrickson Publishers |date=1996 |isbn=9781565631540}} * {{cite journal |last=Moss |first=Candida R. |title=On the Dating of Polycarp: Rethinking the Place of the Martyrdom of Polycarp in the History of Christianity |url=https://archive.org/details/early-christianity_2010_1_4/page/539 |journal=Early Christianity |volume=1 |number=4 |date=2010 |pages=539–574|doi=10.1628/186870310793597051 }} * {{cite journal |last=Moss |first=Candida R. |title=Nailing Down and Tying Up: Lessons in Intertextual Impossibility from the Martyrdom of Polycarp |journal=Vigiliae Christianae |volume=66 |date=2012 |pages=1–20}} * {{cite book |last=Pratscher |first=Wilhelm |title=The Apostolic Fathers: An Introduction |location=New York |publisher=T&T Clark |date=2007}} * Sailors, Timothy B. {{citation |title=Bryn Mawr Classical Review: Review of ''The Apostolic Fathers: Greek Texts and English Translations'' |work=Bryn Mawr Classical Review |url=http://bmcr.brynmawr.edu/2009/2009-07-08.html |accessdate=21 May 2023}} * {{Rejea jarida |title=An Early Church Slavonic Translation of the Martyrdom of St Polycarp": Three Decades Later |journal=Analecta Bollandiana |url=https://www.researchgate.net/publication/288067126 |last=Khomych |first=Taras |issue=2 |volume=130 |pages=294–302 |doi=10.1484/J.ABOL.5.101802 |year=2012}} ==Viungo vya nje== * [http://early.xpian.info/eng/martyrdomofpolycarp.html An extensive catalogue of English translations of The Martyrdom of Polycarp] * [http://www.biblicalaudio.com/polycarp.htm Letter & Martyrdom of Polycarp: 2012 Translation with Audio Drama] at biblicalaudio {{mbegu-kitabu}} [[Jamii:vitabu]] [[Jamii:Fasihi ya Kigiriki]] [[Jamii:Mababu wa Kanisa]] fe1sxzw24szuaimjhwbuugb0z5dmsu7 0 240991 1578072 1573198 2026-07-02T18:01:22Z InternetArchiveBot 41439 Rescuing 0 sources and tagging 1 as dead.) #IABot (v2.0.9.5 1578072 wikitext text/x-wiki '''Battle of the Sacred Tree''' (Mapambano ya Mti Mtakatifu) ni filamu ya nchini [[Kenya]] ya mwaka 1995 iliyoandikwa na kuongozwa na Wanjiru Kinyanjui.<ref>{{Citation|title=The BATTLE OF THE SACRED TREE (1995)|url=https://www.bfi.org.uk/films-tv-people/4ce2b7e8a048e|work=BFI|language=en|access-date=2026-06-15}}</ref><ref>{{Cite web|title=The Battle of the Sacred Tree|url=https://variety.com/1995/film/reviews/the-battle-of-the-sacred-tree-1200443299/|work=Variety|date=1995-10-23|accessdate=2026-06-15|language=en-US|author=Dennis Harvey}}</ref> Katika kijiji kidogo cha [[Wakikuyu]], imani za kitamaduni za Kiafrika zinapingana na ari ya kidini ya [[Mmisionari|wamisionari]]. Hapo, mti mtakatifu ambao una ushawishi wa ajabu kwa kila mtu aliye karibu nao na ndio kiini cha maisha ya jamii hiyo. Kwa wanawake wa Kikristo, ni wazi kwamba mti huo ni ukumbusho tu wa zamani za kipagani. Mumbi, binti wa mganga wa jadi ambaye amerejea kutoka mjini akiwa na mume mnyanyasaji, anapinga uamuzi wao wa kuukata mti huo. Alinasa 'tukio lenye msisimko mkubwa zaidi la Hisia za Mti Mtakatifu' katika picha za Polaroid ambazo zilileta jamii hiyo pamoja katika furaha ya kurejesha matumaini na uponyaji. == Kisa == Filamu hii inatupa picha ya jinsi watu wa jamii fulani bado wanavyoweza kutaka kuendelea kuabudu sanamu au miungu midogo badala ya kuongoka kuwa Wakristo.<ref>{{Cite web|title=Battle Of The Sacred Tree {{!}} African Film Festival, Inc.|url=https://africanfilmny.org/films/battle-of-the-sacred-tree/|accessdate=2026-06-15|language=en-US}}</ref><ref>{{Cite web|title=SPLA {{!}} Battle of sacred tree (The)|url=https://www.spla.pro/ficha.filme.battle-of-sacred-tree-the.225.html|work=Spla|accessdate=2026-06-15|language=en}}{{Dead link|date=July 2026 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> Wambui anamrudisha binti yake kijijini kwao ili kumkimbia mume wake mnyanyasaji na asiye mwaminifu. Huko, shirika la wanawake wa Kikristo limeanzisha vita dhidi ya dawa za mitishamba za Mzee, ambapo Wambui anapata kazi, miongoni mwa mambo mengine. Lakini mti huo mtakatifu unaendelea kuwa chanzo kikuu cha migogoro. Kinyanjui anaelezea uhasama uliopo kati ya utamaduni wa Kiafrika na usasa kwa kutumia ucheshi mwingi na kejeli.<ref>{{Cite web|url=https://www.imdb.com/title/tt0110234/|work=www.imdb.com|accessdate=2026-06-15}}</ref> == Waigizaji == * Margaret Nyacheo kama Mumbi * Catherine Kariuki * Roslynn Kimani * Titi Wainaina == Marejeo == <references /> [[Jamii:Africa Film Cinema Tanzania 2026]] [[Jamii:Filamu za 1995]] [[Jamii:Filamu za Kenya]] bjjlm2xwawn10vkivziczhz1ip5z0fz 0 241096 1578235 1576818 2026-07-03T08:41:28Z Riccardo Riccioni 452 1578235 wikitext text/x-wiki [[File:Merian's_Daniel_7_engraving.jpg|thumb|[[Danieli]] akipata [[njozi]] ya [[wanyama]] wanne.]] '''Maandiko ya kiapokalipti''' ni yale ambayo katika [[Kitabu|vitabu]] vya [[Biblia]] na nje yake yalifuata [[mtindo wa uandishi]] wa pekee wa [[nabii|kinabii]] ulioanza na [[nabii Ezekieli|Ezekieli]] wakati wa [[uhamisho wa Babeli]] ([[karne ya 6 KK]]) na kufikia kilele chake kwa [[Ufunuo wa Yohane]] mwishoni mwa [[karne ya 1]] [[Baada ya Kristo|BK]], kisha ukafifia taratibu, lakini uliendelea kuathiri [[Uyahudi]] na [[Ukristo]]. [[Kitabu cha Danieli]] ndicho maarufu zaidi kati ya maandiko ya aina hiyo ya [[Agano la Kale]]{{sfn|Charles|1911|p=169}}. Badala ya kukabili hali ya wakati ule yalipotolewa {{sfn|Charles|1911|p=170}}, maandiko hayo yalikusudia kujulisha matukio ya mbele sana, hasa [[Mwisho wa nyakati|mwisho wa nyakati]], kadiri ya [[njozi]] au [[ujumbe]] wa [[malaika]] <ref>Coogan 2009 p 424</ref>. [[Jina]] linatokana na [[neno]] la [[Kiyunani|Kigiriki]] ἀποκάλυψις, ''apokalyupsis'', yaani [[Ufunuo]].<ref>Goswiller 1987 p.3</ref> ==Orodha== Kati ya maandiko ya namna hiyo, ya awali ni: * [[Kitabu cha Isaya]] 24–27; 33; 34–35; 65–66 * [[Kitabu cha Yeremia]] 33:14–26 * [[Kitabu cha Ezekieli]] 38–39 * [[Kitabu cha Yoeli]] 3:9–17 * [[Kitabu cha Zekaria]] 12–14 Maarufu zaidi kati ya maandiko ya aina hiyo ya [[Agano la Kale]]{{sfn|Charles|1911|p=169}} ni: * [[Kitabu cha Danieli]] 7–12 Yaliyobaki nje ya [[Biblia ya Kiebrania]] ni: * [[1 Henoko]] * [[2 Henoko]] * [[3 Henoko]] * [[2 Baruku]] * [[3 Baruku]] * [[Genesis Apocryphon]] * [[Gombo la Vita]] * [[Kupalizwa kwa Musa]] * [[Sefer Elijah]] * [[Ufunuo wa Abrahamu]] * [[Ufunuo wa Adamu]] * [[Ufunuo wa Gabrieli]] * [[Ufunuo wa Musa]] * [[Ufunuo wa Sefania]] * [[Ufunuo wa Shadraka]] * [[Ufunuo wa Zerubabeli]] * [[Ufunuo wa Kiaramu]] * [[Ufunuo wa Kigiriki wa Danieli]] * [[Ufunuo wa Kigiriki wa Ezra]] Katika [[Agano Jipya]] kuna: *[[Injili ya Mathayo]] 24; 25:31-46 *[[Injili ya Marko]] 13 *[[Waraka wa pili kwa Wathesaloniki]] 2 *[[Waraka wa kwanza kwa Timotheo]] 4 *[[Waraka wa pili wa Petro]] 3 *[[waraka wa Yuda|Yuda]] 14-15 *[[Ufunuo wa Yohane]] Yaliyobaki nje ya [[Biblia ya Kikristo]] ni: * [[Ufunuo wa Elia]] * [[Ufunuo wa Goliathi]] * [[Ufunuo wa Paulo]] * [[Ufunuo wa Petro]] * [[Ufunuo wa Pseudo-Methodi]] * [[Ufunuo wa Samueli wa Kalamoun]] * [[Ufunuo wa Stefano]] * [[Ufunuo wa Thoma]] Hatimaye yaliyofuata [[Ujuzilio]] ni: * [[Ufunuo wa Kignosi wa Petro]] * [[Ufunuo wa Kikopti wa Paulo]] * [[Ufunuo wa kwanza wa Yakobo]] * [[Ufunuo wa pili wa Yakobo]] ==Tazama pia== * [[Mtindo wa kiapokalipti]] ==Tanbihi== {{reflist}} ==Marejeo== * {{EB1911|wstitle=Apocalyptic Literature|volume=2|pages=169–175|first=Robert Henry|last=Charles|author-link=Robert Charles (scholar)}} * {{Rejea kitabu |title=The Old Testament Pseudepigrapha, Vol. 1: Apocalyptic Literature and Testaments |publisher=Doubleday & Co. |year=1983 |editor-last=Charlesworth |editor-first=James H. |location=Garden City, New York}} * {{Rejea kitabu |last=Collins |first=John Joseph |title=The Apocalyptic Imagination: An Introduction to Jewish Apocalyptic Literature, (The Biblical Resource Series) |publisher=Eerdman |year=1998 |edition=2nd |location=Grand Rapids}} * {{Rejea kitabu |last=Coogan |first=Michael |title=A Brief Introduction to the Old Testament |publisher=Oxford University Press |year=2009 |location=Oxford}} * {{Rejea kitabu |last=Cook |first=David |title=Contemporary Muslim Apocalyptic Literature (Religion and Politics) |publisher=Syracuse University Press |year=2005 |location=Syracure, NY}} * {{Citebook |last=Cook |first=Stephen L. |title=The Apocalyptic Literature: Interpreting Biblical Texts |publisher=Abingdon Press |year=2003 |location=Nashville}} * {{Rejea kitabu |last=Frye |first=Northrop |title=Anatomy of Criticism: Four Essays |publisher=Princeton University Press |year=1957 |location=Princeton}} * {{Rejea kitabu |last=Goswiller |first=Richard |title=Revelation |publisher=Pacific Study Series |year=1987 |location=Melbourne}} * {{Rejea kitabu |last=Reddish |first=Mitchell G. |title=Apocalyptic Literature: A Reader |publisher=Hendrickson |year=1998 |location=Peabody : Massachusetts}} ==Viungo vya nje== * {{cite web | author1 = L. Michael White | url = https://www.pbs.org/wgbh/pages/frontline/shows/apocalypse/primary/white.html | title = Apocalyptic literature in Judaism and early Christianity | website = [[PBS]] | archive-url = https://web.archive.org/web/20000304005402/https://www.pbs.org/wgbh/pages/frontline/shows/apocalypse/primary/white.html | language = en | archive-date = March 4, 2000 | url-status = live}} (Thorough historical introduction). *{{cite web | author1 = David M. Williams | url = http://www.geocities.com/davidmwilliams/ntb519c.html | title = The Book of Revelation as Jewish apocalyptic literature | archive-url = https://web.archive.org/web/20091003072014/http://www.geocities.com/davidmwilliams/ntb519c.html | language = en | archive-date = October 3, 2009 | url-status = live | access-date = April 28, 2019 | df = mdy-all }} (A coincise introduction to the Apocalypse of John) * {{cite web | url = http://www.iranicaonline.org/articles/apocalyptic-that-which-has-been-rcvealed | archive-url = https://web.archive.org/web/20180517004553/http://www.iranicaonline.org/articles/apocalyptic-that-which-has-been-rcvealed | archive-date = May 17, 2018 | title = "Apocalyptic" lemma | website = iranicaonline.org | access-date = Aug 19, 2018 | url-status = live}} * {{cite journal| author1 = David L. Barr (Wright State University) | title = Using Plot to Discern Structure in John's Apocalypse | journal = Proceedings of the Eastern Great Lakes and Mid-West Biblical Societies | language = en | year = 1995 | pages = 23–33}} (sourced in {{cite web| url = http://www.ntgateway.com/book-of-revelation/articles-and-chapters-in-books| title = Articles & Reviews on the Boom of Revelation| website = ntgateway.com| access-date = 2018-08-19| archive-date = 2018-08-20| archive-url = https://web.archive.org/web/20180820005639/http://www.ntgateway.com/book-of-revelation/articles-and-chapters-in-books/| url-status = dead}} {{mbegu-Biblia}} [[Jamii:Biblia]] 57wmqgstpzx1vl0u8lyo0kdwb4cume4 0 241296 1578244 1575995 2026-07-03T09:27:45Z Riccardo Riccioni 452 1578244 wikitext text/x-wiki [[File:BL_Or_485_f._102r.png|thumb|Mwanzo wa kitabu katika toleo la [[Kige'ez]] la [[karne ya 16]].]] '''{{PAGENAME}}''' ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]]. Ingawa sentensi yake moja imenakiliwa katika Waraka wa Yuda (14-15), kitabu kizima [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]] isipokuwa na [[Ukristo|Wakristo]] [[Waorthodoksi wa Mashariki]] wa [[Kanisa la Kiorthodoksi la Ethiopia]] na wa [[Kanisa la Kiorthodoksi la Eritrea]]. Kiliandikwa kwa [[Kiaramu]] au kwa [[Kiebrania]] katika [[karne ya 3 KK]] hadi [[karne ya 1 KK]]<ref>Fahlbusch, E.; Bromiley, G.W. ''The Encyclopedia of Christianity: P–Sh'' page 411, {{ISBN|0-8028-2416-1}} (2004)</ref>, ingawa kilijidai kutungwa na [[Henoko]]<ref name="Barker Lost Prophet">Barker, Margaret. (2005) [1998]. ''The Lost Prophet: The Book of Enoch and Its Influence on Christianity''. London: SPCK; Sheffield Phoenix Press. {{ISBN|978-1-905048-18-2}}</ref>. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] ==Tanbihi== {{Reflist}} ==Marejeo== {{refbegin|25em|small=yes}} * {{cite book |first=Margaret |last=Barker |chapter=The Book of Enoch |title=The Older Testament: The survival of themes from the ancient royal cult in sectarian Judaism and early Christianity |orig-year=1987 |publisher=Sheffield Phoenix Press |year=2005 |isbn=978-1-905048-19-9}} * {{cite book |first=Gabriele |last=Boccaccini |title=Beyond the Essene Hypothesis: The Parting of the Ways between Qumran and Enochic Judaism |place=Grand Rapids |publisher=Eerdmans |year=1998 |isbn=0-8028-4360-3}} * {{Cite journal |last=Brock |first=Sebastian P. |author-link=Sebastian P. Brock |year=1968 |title=A fragment of Enoch in Syriac |journal=The Journal of Theological Studies |volume=19 |number=2 |pages=626–633 |doi=10.1093/jts/XIX.2.626 |jstor=23958598}} * {{cite book |first=John J. |last=Collins |title=The Apocalyptic Imagination |edition=2nd |place=Grand Rapids |publisher=Eermans |year=1998 |isbn=0-8028-4371-9}} * {{cite book |first=A. |last=Dillmann |author-link=August Dillmann |year=1853 |title=Das Buch Henoch |language=de |trans-title=The Book of Enoch |place=Leipzig, DE |publisher=Vogel }} * {{cite book |first=Philip F. |last=Esler |year=2017 |title=God's Court and Courtiers in the Book of the Watchers: Re-interpreting heaven in {{nobr|1 Enoch 1-36}} |place=Eugene, OR |publisher=Cascade |isbn=978-1-62564-908-9}} * {{cite book |first=Florentino |last=Garcia-Martinez |year=1992 |title=Qumran & Apocalyptic: Studies on the Aramaic texts from Qumran |place=Leiden, NL |publisher=Brill |isbn=90-04-09586-1}} * {{cite book |editor-last1=Milik |editor-first1=Josef T. |title=The Books of Enoch: Aramaic Fragments of Qumrân Cave 4 |others=With the collaboration of Matthew Black |date=1976 |publisher=Clarendon Press |isbn=978-0-19-826161-2 |url=https://archive.org/download/MILIKEnochInAramaicQumranCave4/MILIK_Enoch-in-Aramaic-Qumran-Cave-4.pdf |language=en}} * {{cite book |first=Annette Yoshiko |last=Reed |title=Fallen Angels and the History of Judaism and Christianity: The reception of Enochic literature |place=Cambridge |publisher=Cambridge University Press |year=2005 |isbn=0-521-85378-8}} {{refend}} ==Marejeo mengine== {{refbegin|25em|small=yes}} * {{cite EB1911 |wstitle=Enoch, Book of |volume=9 |pages=650–652 |first=Robert Henry |last=Charles |ref=none}} * {{cite book |editor1-first=Gabriele |editor1-last=Boccaccini |editor2-first=John J. |editor2-last=Collins |title=The Early Enoch Literature |place=Leiden |publisher=Brill |year=2007 |isbn=978-90-04-16154-2 |ref=none}} * {{cite book |last=Dugan |first=Elena |year=2023 |title=The Apocalypse of the Birds: 1&nbsp;Enoch and the Jewish revolt against Rome |publisher=Edinburgh University Press |location=Edinburgh |isbn=978-1-3995-0865-0 |ref=none}} * {{cite book |first1=Florentino |last1=Garcia-Martinez |last2=Tigchelaar |year=1999 |title=The Dead Sea Scrolls Study Edition |publisher=Brill |url=http://www.filbluz.ca/resources/_The.Dead.Sea.Scrolls.Study.Edition_Martinez-Tigchelaar.pdf |url-status=dead |archive-url=https://web.archive.org/web/20160615144741/http://www.filbluz.ca/resources/_The.Dead.Sea.Scrolls.Study.Edition_Martinez-Tigchelaar.pdf |archive-date=2016-06-15 |df=dmy-all |ref=none}} * {{cite book |first=Helge S. |last=Kvanvig |title=Roots of Apocalyptic: The Mesopotamian background of the Enoch figure and of the Son of Man |place=Neukirchen-Vluyn |publisher=Neukirchener |year=1988 |isbn=3-7887-1248-1 |ref=none}} * {{cite Catholic Encyclopedia |wstitle=The Book of Henoch (Ethiopic) |volume= |ref=none}} * {{cite journal |last=Hernández Valencia |first=Juan S. |title=Influence of the Enochic tradition on Qumran: reception and adaptation of the Watchers and Giants as a case study |journal=Perseitas |volume=12 |date=2024 |pages=34–71 |doi=10.21501/23461780.4671 |ref=none |doi-access=free}} * {{cite book |first=Andrei A. |last=Orlov |title=The Enoch-Metatron Tradition |place=Tuebingen |publisher=Mohr Siebeck |year=2005 |isbn=3-16-148544-0 |ref=none}} * {{cite book |first1=Paolo |last1=Sacchi |first2=William J. |last2=Short |year=1996 |title=Jewish Apocalyptic and its History |place=Sheffield, UK |publisher=Academic |isbn=1-85075-585-X |ref=none}} * {{cite book |first=D. A. De |last=Sola |year=1852 |title=[[iarchive:significationofp00sola|Signification of the Proper Names occurring in the Book of Enoch: from the Hebrew and Chaldee languages]] |place=London |publisher=Isaac Frost |ref=none}} * {{cite book |first=James C. |last=Van der Kam |title=Enoch and the Growth of an Apocalyptic Tradition |place=Washington, DC |publisher=Catholic Biblical Association of America |year=1984 |isbn=0-915170-15-9 |ref=none}} * {{cite book |first=James C. |last=Van der Kam |title=Enoch: A man for all generations |place=Columbia |publisher=University of South Carolina |year=1995 |isbn=1-57003-060-X |ref=none}} {{refend}} ==Viungo vya nje== {{Wikisource|1 Enoch|Book of Enoch|has=an incomplete translation of|nocat=yes}} * [http://www.marquette.edu/maqom/ Jewish Roots of Eastern Christian Mysticism: An interdisciplinary seminar at Marquette University] * [http://www.tau.ac.il/~hacohen/Henoch/Henoch%201.html Ethiopic text online] (all 108 chapters) * [https://web.archive.org/web/20181006021949/http://enoksbok.se/ Book of Enoch Interlinear] (''Including three English and two Swedish translations'') * [http://www.biblicalaudio.com/enoch.htm Book of Enoch New 2012 Translation with Audio Drama] * August Dillmann (1893). ''The Book of Enoch'' ([https://web.archive.org/web/20160811142032/http://www.filbluz.ca/resources/1Enoch_Dillmann.pdf 1Enoch]) translated from Geez, መጽሐፈ ፡ ሄኖክ ።. * [https://www.patrologia-lib.ru/apocryph/vetus/index.htm Apocryphi testamenti veteris], access to the Ethiopic Greek, a Latin translation * [https://www.ccel.org/c/charles/otpseudepig/enoch/ENOCH_1.HTM BOOK OF ENOCH From-The Apocrypha and Pseudepigrapha of the Old Testament R.H. Charles Oxford: The Clarendon Press] {{mbegu-Biblia}} [[Jamii:Biblia]] [[Jamii:maandiko ya kiapokalipti]] [[jamii:Apokrifa]] 9svglbonmctfizt4cnx1qiw7ej3ms07 1578245 1578244 2026-07-03T09:28:51Z Riccardo Riccioni 452 1578245 wikitext text/x-wiki [[File:BL_Or_485_f._102r.png|thumb|Mwanzo wa kitabu katika toleo la [[Kige'ez]] la [[karne ya 16]].]] '''{{PAGENAME}}''' ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]]. Ingawa [[sentensi]] yake moja imenakiliwa katika [[Waraka wa Yuda]] (14-15), kitabu kizima [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]] isipokuwa na [[Ukristo|Wakristo]] [[Waorthodoksi wa Mashariki]] wa [[Kanisa la Kiorthodoksi la Ethiopia]] na wa [[Kanisa la Kiorthodoksi la Eritrea]]. Kiliandikwa kwa [[Kiaramu]] au kwa [[Kiebrania]] katika [[karne ya 3 KK]] hadi [[karne ya 1 KK]]<ref>Fahlbusch, E.; Bromiley, G.W. ''The Encyclopedia of Christianity: P–Sh'' page 411, {{ISBN|0-8028-2416-1}} (2004)</ref>, ingawa kilijidai kutungwa na [[Henoko]]<ref name="Barker Lost Prophet">Barker, Margaret. (2005) [1998]. ''The Lost Prophet: The Book of Enoch and Its Influence on Christianity''. London: SPCK; Sheffield Phoenix Press. {{ISBN|978-1-905048-18-2}}</ref>. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] ==Tanbihi== {{Reflist}} ==Marejeo== {{refbegin|25em|small=yes}} * {{cite book |first=Margaret |last=Barker |chapter=The Book of Enoch |title=The Older Testament: The survival of themes from the ancient royal cult in sectarian Judaism and early Christianity |orig-year=1987 |publisher=Sheffield Phoenix Press |year=2005 |isbn=978-1-905048-19-9}} * {{cite book |first=Gabriele |last=Boccaccini |title=Beyond the Essene Hypothesis: The Parting of the Ways between Qumran and Enochic Judaism |place=Grand Rapids |publisher=Eerdmans |year=1998 |isbn=0-8028-4360-3}} * {{Cite journal |last=Brock |first=Sebastian P. |author-link=Sebastian P. Brock |year=1968 |title=A fragment of Enoch in Syriac |journal=The Journal of Theological Studies |volume=19 |number=2 |pages=626–633 |doi=10.1093/jts/XIX.2.626 |jstor=23958598}} * {{cite book |first=John J. |last=Collins |title=The Apocalyptic Imagination |edition=2nd |place=Grand Rapids |publisher=Eermans |year=1998 |isbn=0-8028-4371-9}} * {{cite book |first=A. |last=Dillmann |author-link=August Dillmann |year=1853 |title=Das Buch Henoch |language=de |trans-title=The Book of Enoch |place=Leipzig, DE |publisher=Vogel }} * {{cite book |first=Philip F. |last=Esler |year=2017 |title=God's Court and Courtiers in the Book of the Watchers: Re-interpreting heaven in {{nobr|1 Enoch 1-36}} |place=Eugene, OR |publisher=Cascade |isbn=978-1-62564-908-9}} * {{cite book |first=Florentino |last=Garcia-Martinez |year=1992 |title=Qumran & Apocalyptic: Studies on the Aramaic texts from Qumran |place=Leiden, NL |publisher=Brill |isbn=90-04-09586-1}} * {{cite book |editor-last1=Milik |editor-first1=Josef T. |title=The Books of Enoch: Aramaic Fragments of Qumrân Cave 4 |others=With the collaboration of Matthew Black |date=1976 |publisher=Clarendon Press |isbn=978-0-19-826161-2 |url=https://archive.org/download/MILIKEnochInAramaicQumranCave4/MILIK_Enoch-in-Aramaic-Qumran-Cave-4.pdf |language=en}} * {{cite book |first=Annette Yoshiko |last=Reed |title=Fallen Angels and the History of Judaism and Christianity: The reception of Enochic literature |place=Cambridge |publisher=Cambridge University Press |year=2005 |isbn=0-521-85378-8}} {{refend}} ==Marejeo mengine== {{refbegin|25em|small=yes}} * {{cite EB1911 |wstitle=Enoch, Book of |volume=9 |pages=650–652 |first=Robert Henry |last=Charles |ref=none}} * {{cite book |editor1-first=Gabriele |editor1-last=Boccaccini |editor2-first=John J. |editor2-last=Collins |title=The Early Enoch Literature |place=Leiden |publisher=Brill |year=2007 |isbn=978-90-04-16154-2 |ref=none}} * {{cite book |last=Dugan |first=Elena |year=2023 |title=The Apocalypse of the Birds: 1&nbsp;Enoch and the Jewish revolt against Rome |publisher=Edinburgh University Press |location=Edinburgh |isbn=978-1-3995-0865-0 |ref=none}} * {{cite book |first1=Florentino |last1=Garcia-Martinez |last2=Tigchelaar |year=1999 |title=The Dead Sea Scrolls Study Edition |publisher=Brill |url=http://www.filbluz.ca/resources/_The.Dead.Sea.Scrolls.Study.Edition_Martinez-Tigchelaar.pdf |url-status=dead |archive-url=https://web.archive.org/web/20160615144741/http://www.filbluz.ca/resources/_The.Dead.Sea.Scrolls.Study.Edition_Martinez-Tigchelaar.pdf |archive-date=2016-06-15 |df=dmy-all |ref=none}} * {{cite book |first=Helge S. |last=Kvanvig |title=Roots of Apocalyptic: The Mesopotamian background of the Enoch figure and of the Son of Man |place=Neukirchen-Vluyn |publisher=Neukirchener |year=1988 |isbn=3-7887-1248-1 |ref=none}} * {{cite Catholic Encyclopedia |wstitle=The Book of Henoch (Ethiopic) |volume= |ref=none}} * {{cite journal |last=Hernández Valencia |first=Juan S. |title=Influence of the Enochic tradition on Qumran: reception and adaptation of the Watchers and Giants as a case study |journal=Perseitas |volume=12 |date=2024 |pages=34–71 |doi=10.21501/23461780.4671 |ref=none |doi-access=free}} * {{cite book |first=Andrei A. |last=Orlov |title=The Enoch-Metatron Tradition |place=Tuebingen |publisher=Mohr Siebeck |year=2005 |isbn=3-16-148544-0 |ref=none}} * {{cite book |first1=Paolo |last1=Sacchi |first2=William J. |last2=Short |year=1996 |title=Jewish Apocalyptic and its History |place=Sheffield, UK |publisher=Academic |isbn=1-85075-585-X |ref=none}} * {{cite book |first=D. A. De |last=Sola |year=1852 |title=[[iarchive:significationofp00sola|Signification of the Proper Names occurring in the Book of Enoch: from the Hebrew and Chaldee languages]] |place=London |publisher=Isaac Frost |ref=none}} * {{cite book |first=James C. |last=Van der Kam |title=Enoch and the Growth of an Apocalyptic Tradition |place=Washington, DC |publisher=Catholic Biblical Association of America |year=1984 |isbn=0-915170-15-9 |ref=none}} * {{cite book |first=James C. |last=Van der Kam |title=Enoch: A man for all generations |place=Columbia |publisher=University of South Carolina |year=1995 |isbn=1-57003-060-X |ref=none}} {{refend}} ==Viungo vya nje== {{Wikisource|1 Enoch|Book of Enoch|has=an incomplete translation of|nocat=yes}} * [http://www.marquette.edu/maqom/ Jewish Roots of Eastern Christian Mysticism: An interdisciplinary seminar at Marquette University] * [http://www.tau.ac.il/~hacohen/Henoch/Henoch%201.html Ethiopic text online] (all 108 chapters) * [https://web.archive.org/web/20181006021949/http://enoksbok.se/ Book of Enoch Interlinear] (''Including three English and two Swedish translations'') * [http://www.biblicalaudio.com/enoch.htm Book of Enoch New 2012 Translation with Audio Drama] * August Dillmann (1893). ''The Book of Enoch'' ([https://web.archive.org/web/20160811142032/http://www.filbluz.ca/resources/1Enoch_Dillmann.pdf 1Enoch]) translated from Geez, መጽሐፈ ፡ ሄኖክ ።. * [https://www.patrologia-lib.ru/apocryph/vetus/index.htm Apocryphi testamenti veteris], access to the Ethiopic Greek, a Latin translation * [https://www.ccel.org/c/charles/otpseudepig/enoch/ENOCH_1.HTM BOOK OF ENOCH From-The Apocrypha and Pseudepigrapha of the Old Testament R.H. Charles Oxford: The Clarendon Press] {{mbegu-Biblia}} [[Jamii:Biblia]] [[Jamii:maandiko ya kiapokalipti]] [[jamii:Apokrifa]] t8sxk6ukld0h47bwutwjkrn8fkb88dm 0 241302 1578247 1575996 2026-07-03T09:32:06Z Riccardo Riccioni 452 1578247 wikitext text/x-wiki '''{{PAGENAME}}''' ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]] lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]<ref>{{Cite web |title=Second Book of Enoch {{!}} Jewish Mysticism, Apocalyptic Texts, Fallen Angels {{!}} Britannica |url=https://www.britannica.com/topic/Second-Book-of-Enoch |access-date=2025-08-25 |website=www.britannica.com |language=en}}</ref>. Kiliandikwa katika [[karne ya 1 KK]] au [[karne ya 1]] [[BK]]<ref>{{Cite web |title=Second Book of Enoch {{!}} religious literature {{!}} Britannica |url=https://www.britannica.com/topic/Second-Book-of-Enoch |access-date=2022-05-09 |website=www.britannica.com |language=en}}</ref>, ingawa kilijidai kutungwa na [[Henoko]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] == Viungo vya nje == === Tafsiri za Kiingereza === *[http://www.sacred-texts.com/bib/fbe/index.htm#section_002 The Book of the Secrets of Enoch – without 2EM] *{{cite book|editor-last1=Charles|editor-first1=Robert Henry|editor-link1=Robert Charles (scholar)|translator-last=Morfill|translator-first=William Richard|title=The Book Of The Secrets Of Enoch|publisher=Clarendon Press|location=Oxford|year=1896|url=https://archive.org/details/booksecretsenoc00morfgoog/page/n7/mode/2up}}, with the "Melkizedekian Fragment" as an appendix === Kuhusu 2 Henoko === *[http://www.jewishencyclopedia.com/view.jsp?letter=E&artid=384 Jewish Encyclopedia: Enoch, Books of (Ethiopic and Slavonic)] *[https://web.archive.org/web/20060220071408/http://www.st-andrews.ac.uk/~www_sd/enoch.html Enoch Literature] *[http://www.marquette.edu/maqom/slavonic.html Bibliography on 2 Enoch] *[http://www.marquette.edu/maqom/enochic.html Secrets of Creation in 2 Enoch] *[http://www.marquette.edu/maqom/melchizedek.html Melchizedek Legend of 2 (Slavonic) Enoch] *[http://www.marquette.edu/maqom/metatron.html Titles of Enoch in 2 Enoch] *[http://www.marquette.edu/maqom/noah.html Patriarch Noah in 2 Enoch] *[http://www.marquette.edu/maqom/polemika.html On the Polemical Nature of 2 Enoch] {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] [[Jamii:Apokrifa]] gatv35xgxhv13r5tqopl0rgzyn4hfko 1578248 1578247 2026-07-03T09:32:33Z Riccardo Riccioni 452 /* Tazama pia */ 1578248 wikitext text/x-wiki '''{{PAGENAME}}''' ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]] lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]<ref>{{Cite web |title=Second Book of Enoch {{!}} Jewish Mysticism, Apocalyptic Texts, Fallen Angels {{!}} Britannica |url=https://www.britannica.com/topic/Second-Book-of-Enoch |access-date=2025-08-25 |website=www.britannica.com |language=en}}</ref>. Kiliandikwa katika [[karne ya 1 KK]] au [[karne ya 1]] [[BK]]<ref>{{Cite web |title=Second Book of Enoch {{!}} religious literature {{!}} Britannica |url=https://www.britannica.com/topic/Second-Book-of-Enoch |access-date=2022-05-09 |website=www.britannica.com |language=en}}</ref>, ingawa kilijidai kutungwa na [[Henoko]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] ==Tanbihi== {{marejeo}} == Viungo vya nje == === Tafsiri za Kiingereza === *[http://www.sacred-texts.com/bib/fbe/index.htm#section_002 The Book of the Secrets of Enoch – without 2EM] *{{cite book|editor-last1=Charles|editor-first1=Robert Henry|editor-link1=Robert Charles (scholar)|translator-last=Morfill|translator-first=William Richard|title=The Book Of The Secrets Of Enoch|publisher=Clarendon Press|location=Oxford|year=1896|url=https://archive.org/details/booksecretsenoc00morfgoog/page/n7/mode/2up}}, with the "Melkizedekian Fragment" as an appendix === Kuhusu 2 Henoko === *[http://www.jewishencyclopedia.com/view.jsp?letter=E&artid=384 Jewish Encyclopedia: Enoch, Books of (Ethiopic and Slavonic)] *[https://web.archive.org/web/20060220071408/http://www.st-andrews.ac.uk/~www_sd/enoch.html Enoch Literature] *[http://www.marquette.edu/maqom/slavonic.html Bibliography on 2 Enoch] *[http://www.marquette.edu/maqom/enochic.html Secrets of Creation in 2 Enoch] *[http://www.marquette.edu/maqom/melchizedek.html Melchizedek Legend of 2 (Slavonic) Enoch] *[http://www.marquette.edu/maqom/metatron.html Titles of Enoch in 2 Enoch] *[http://www.marquette.edu/maqom/noah.html Patriarch Noah in 2 Enoch] *[http://www.marquette.edu/maqom/polemika.html On the Polemical Nature of 2 Enoch] {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] [[Jamii:Apokrifa]] c0gxju7yuhar4cs1mtyraowa26bhhuu 0 241303 1578249 1575997 2026-07-03T09:43:27Z Riccardo Riccioni 452 1578249 wikitext text/x-wiki '''{{PAGENAME}}''' ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]] lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]. Kiliandikwa kwa [[Kiebrania]] katika [[karne ya 2]] hadi [[karne ya 6]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] ==Tanbihi== {{Reflist}} ==Marejeo== *{{cite book|translator-last=Alexander|translator-first=Philip S.|translator-link=Philip S. Alexander|editor-last=Charlesworth|editor-first=James H.|editor-link=James H. Charlesworth|title=The Old Testament Pseudepigrapha|volume=1: Apocalyptic Literature and Testaments|chapter=(Hebrew Apocalypse of) Enoch (Fifth to Sixth Century A.D.)|pages=223–316|publisher=Hendrickson Publishers|location=Peabody, Massachusetts|year=1983|isbn=978-1598564914|url=https://books.google.com/books?id=Z8cyt_SM7voC&q=Old+Testament+Pseudepigrapha,+Vol.+1+-+Apocalyptic+Literature+and+Testaments+%233}} *{{cite book|editor-last=Evans|editor-first=Craig A.|title=Noncanonical writings and New Testament Interpretation|publisher=Hendrickson Publishers|location=Peabody, Massachusetts|year=1992|isbn=0-943575-95-8 |url=https://archive.org/details/noncanonicalwrit0000evan/page/n5/mode/2up}} ==Viungo vya nje== *{{cite book|editor-last=Odeberg|editor-first=Hugo|title=3 Enoch or The Hebrew Book of Enoch|publisher=Cambridge University Press|location=London|year=1928|url=https://archive.org/details/pdfy-lFh2SRV-tLJq15wg/page/n5/mode/2up}} {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] [[Jamii:Apokrifa]] oi492gs05dut3m0urt66xhzbnhr2fnl 0 241307 1578239 1576000 2026-07-03T09:13:58Z Riccardo Riccioni 452 1578239 wikitext text/x-wiki [[File:Angel zbejsi Adama pa Evo z paradizoma (Mala biblia z-kejpami, 1897).JPG|thumb|"Adamu na Eva wakifukuzwa paradisini" kadiri ya [[Péter Kollár]] (1897).]] '''{{PAGENAME}}''' (pia: '''Maisha ya Adamu na Eva''') ni [[kitabu]] cha [[Uyahudi|Kiyahudi]]<ref name="sparks" /> au cha [[Ukristo|Kikristo]]<ref name="lmw05">{{cite book |author1=L. Michael White |title=From Jesus to Christianity: How Four Generations of Visionaries & Storytellers Created the New Testament and Christian Faith |date=October 25, 2005 |publisher=HarperOne |isbn=0060816104 |chapter=Chapter Fifteen: Literary Trajectories and Regional Trends}}</ref> kilichoandikwa kwa [[mtindo wa kiapokalipti]] katika [[karne ya 1]]<ref name="Johnson" />{{rp|252}} lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] == Tanbihi == {{reflist|30em}} == Marejeo == {{refbegin}} * [[Brian O. Murdoch]], ''The Apocryphal Adam and Eve in Medieval Europe: Vernacular Translations and Adaptations of the Vita Adae et Evae'', Oxford (OUP), 2009. {{ISBN|978-0-19-956414-9}}. * Marinus de Jonge, Johannes Tromp ''The Life of Adam and Eve and Related Literature'' {{ISBN|1-85075-764-X}} (1997) * Gary A. Anderson, Michael E. Stone, Johannes Tromp ''Literature on Adam and Eve: Collected Essays'' {{ISBN|90-04-11600-1}} (2000) * [[H.F.D. Sparks]] ''The Apocryphal Old Testament'' {{ISBN|0-19-826177-2}} (1984) * M.D. Johnson ''Life of Adam and Eve, a new translation and introduction'' in ed. J.H. Charlesworth ''the Old Testament Pseudepigrapha Vol 2'' {{ISBN|0-385-18813-7}} (1985) * L. Rosso Ubigli in ed. P.Sacchi ''Apocrifi dell'Antico Testamento 2'' {{ISBN|978-88-02-07606-5}} (1989) * English Translations by L.S.A. Wells from ''The Apocrypha and Pseudepigrapha of the Old Testament in English, Volume II Pseudepigrapha'' edited by [[R. H. Charles]], Clarendon Press, 1913. * Stone, Michael E. "The fall of Satan and Adam's penance: three notes on the 'Books of Adam and Eve.'." The Journal of Theological Studies 44, no. 1 (1993): 143+. Religion and Philosophy Collection (accessed 15 December 2017). http://link.galegroup.com.ezproxy.tntech.edu/apps/doc/A13749296/PPRP?u=tel_a_ttul&sid=PPRP&xid=1042769b. {{refend}} ===Marejeo mengine=== * {{cite book |last=de Jonge |first=Marinus |date=1997 |title=Life of Adam and Eve and Related Literature |location=Sheffield |publisher=[[Sheffield Academic Press]] |series=Guides to Apocrypha and Pseudepigrapha |isbn=9781850757641}} == Viungo vya nje == * [http://www2.iath.virginia.edu/anderson/ Adam and Eve Archive Project] * ''Apocalypse of Moses'' (Greek version of the ''Life of Adam and Eve'') ** [http://www.pseudepigrapha.com/pseudepigrapha/apcmose.htm Pseudepigrapha] ** [http://www.ccel.org/c/charles/otpseudepig/apcmose.htm Christian Classics Ethereal Library: Apocalypse of Moses] ** [https://www.newadvent.org/fathers/0828.htm Revelation of Moses] **[http://users.sch.gr/aiasgr/Biblos/Apokrufa_biblia_Palaias_Diathikhs/Apokalupsis_Mwusews.htm Greek text] {{Webarchive|url=https://web.archive.org/web/20200224013951/http://users.sch.gr/aiasgr/Biblos/Apokrufa_biblia_Palaias_Diathikhs/Apokalupsis_Mwusews.htm |date=24 February 2020 }} * ''Latin Life of Adam and Eve'' ** [http://www.pseudepigrapha.com/pseudepigrapha/adamnev.htm Pseudepigrapha] ** [http://www.ccel.org/c/charles/otpseudepig/adamnev.htm Christian Classics Ethereal Library: POT] ** [http://www.sacred-texts.com/chr/apo/adamnev.htm Sacred Texts: Christianity: Apocrypha] * ''Slavonic Life of Adam and Eve'' ** [http://www.pseudepigrapha.com/pseudepigrapha/slanev.htm Pseudepigrapha] ** [http://www.ccel.org/c/charles/otpseudepig/slanev.htm Christian Classics Ethereal Library: POT] ** [http://www.sacred-texts.com/chr/apo/slanev.htm Sacred Texts: Christianity: Apocrypha] * ''The Georgian Book of Adam'' ** [http://www.pseudepigrapha.com/pseudepigrapha/TheBookOfAdam.htm Pseudepigrapha] * ''The Armenian Penitence of Adam'' ** [http://micro5.mscc.huji.ac.il/~armenia/website The Penitence of Adam] {{Webarchive|url=https://web.archive.org/web/20230110134700/http://micro5.mscc.huji.ac.il/~armenia/website/ |date=10 January 2023 }}, the original Armenian text in graphic form and edited and translated into English from ''M.E. Stone, Texts and Concordances of the Armenian Adam Literature'' (Society of Biblical Literature: Early Judaism and its Literature, 12; Atlanta: Scholars Press, 1996) ({{ISBN|0-7885-0278-6}}). {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] [[Jamii:Uyahudi]] ec1wb2fvi88r0ht52w1t8p1om3oyljt 1578240 1578239 2026-07-03T09:14:56Z Riccardo Riccioni 452 1578240 wikitext text/x-wiki [[File:Angel zbejsi Adama pa Evo z paradizoma (Mala biblia z-kejpami, 1897).JPG|thumb|"Adamu na Eva wakifukuzwa paradisini" kadiri ya [[Péter Kollár]] (1897).]] '''{{PAGENAME}}''' (pia: '''Maisha ya Adamu na Eva''') ni [[kitabu]] cha [[Uyahudi|Kiyahudi]] au cha [[Ukristo|Kikristo]]<ref name="lmw05">{{cite book |author1=L. Michael White |title=From Jesus to Christianity: How Four Generations of Visionaries & Storytellers Created the New Testament and Christian Faith |date=October 25, 2005 |publisher=HarperOne |isbn=0060816104 |chapter=Chapter Fifteen: Literary Trajectories and Regional Trends}}</ref> kilichoandikwa kwa [[mtindo wa kiapokalipti]] katika [[karne ya 1]] lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] == Tanbihi == {{reflist|30em}} == Marejeo == {{refbegin}} * [[Brian O. Murdoch]], ''The Apocryphal Adam and Eve in Medieval Europe: Vernacular Translations and Adaptations of the Vita Adae et Evae'', Oxford (OUP), 2009. {{ISBN|978-0-19-956414-9}}. * Marinus de Jonge, Johannes Tromp ''The Life of Adam and Eve and Related Literature'' {{ISBN|1-85075-764-X}} (1997) * Gary A. Anderson, Michael E. Stone, Johannes Tromp ''Literature on Adam and Eve: Collected Essays'' {{ISBN|90-04-11600-1}} (2000) * [[H.F.D. Sparks]] ''The Apocryphal Old Testament'' {{ISBN|0-19-826177-2}} (1984) * M.D. Johnson ''Life of Adam and Eve, a new translation and introduction'' in ed. J.H. Charlesworth ''the Old Testament Pseudepigrapha Vol 2'' {{ISBN|0-385-18813-7}} (1985) * L. Rosso Ubigli in ed. P.Sacchi ''Apocrifi dell'Antico Testamento 2'' {{ISBN|978-88-02-07606-5}} (1989) * English Translations by L.S.A. Wells from ''The Apocrypha and Pseudepigrapha of the Old Testament in English, Volume II Pseudepigrapha'' edited by [[R. H. Charles]], Clarendon Press, 1913. * Stone, Michael E. "The fall of Satan and Adam's penance: three notes on the 'Books of Adam and Eve.'." The Journal of Theological Studies 44, no. 1 (1993): 143+. Religion and Philosophy Collection (accessed 15 December 2017). http://link.galegroup.com.ezproxy.tntech.edu/apps/doc/A13749296/PPRP?u=tel_a_ttul&sid=PPRP&xid=1042769b. {{refend}} ===Marejeo mengine=== * {{cite book |last=de Jonge |first=Marinus |date=1997 |title=Life of Adam and Eve and Related Literature |location=Sheffield |publisher=[[Sheffield Academic Press]] |series=Guides to Apocrypha and Pseudepigrapha |isbn=9781850757641}} == Viungo vya nje == * [http://www2.iath.virginia.edu/anderson/ Adam and Eve Archive Project] * ''Apocalypse of Moses'' (Greek version of the ''Life of Adam and Eve'') ** [http://www.pseudepigrapha.com/pseudepigrapha/apcmose.htm Pseudepigrapha] ** [http://www.ccel.org/c/charles/otpseudepig/apcmose.htm Christian Classics Ethereal Library: Apocalypse of Moses] ** [https://www.newadvent.org/fathers/0828.htm Revelation of Moses] **[http://users.sch.gr/aiasgr/Biblos/Apokrufa_biblia_Palaias_Diathikhs/Apokalupsis_Mwusews.htm Greek text] {{Webarchive|url=https://web.archive.org/web/20200224013951/http://users.sch.gr/aiasgr/Biblos/Apokrufa_biblia_Palaias_Diathikhs/Apokalupsis_Mwusews.htm |date=24 February 2020 }} * ''Latin Life of Adam and Eve'' ** [http://www.pseudepigrapha.com/pseudepigrapha/adamnev.htm Pseudepigrapha] ** [http://www.ccel.org/c/charles/otpseudepig/adamnev.htm Christian Classics Ethereal Library: POT] ** [http://www.sacred-texts.com/chr/apo/adamnev.htm Sacred Texts: Christianity: Apocrypha] * ''Slavonic Life of Adam and Eve'' ** [http://www.pseudepigrapha.com/pseudepigrapha/slanev.htm Pseudepigrapha] ** [http://www.ccel.org/c/charles/otpseudepig/slanev.htm Christian Classics Ethereal Library: POT] ** [http://www.sacred-texts.com/chr/apo/slanev.htm Sacred Texts: Christianity: Apocrypha] * ''The Georgian Book of Adam'' ** [http://www.pseudepigrapha.com/pseudepigrapha/TheBookOfAdam.htm Pseudepigrapha] * ''The Armenian Penitence of Adam'' ** [http://micro5.mscc.huji.ac.il/~armenia/website The Penitence of Adam] {{Webarchive|url=https://web.archive.org/web/20230110134700/http://micro5.mscc.huji.ac.il/~armenia/website/ |date=10 January 2023 }}, the original Armenian text in graphic form and edited and translated into English from ''M.E. Stone, Texts and Concordances of the Armenian Adam Literature'' (Society of Biblical Literature: Early Judaism and its Literature, 12; Atlanta: Scholars Press, 1996) ({{ISBN|0-7885-0278-6}}). {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] [[Jamii:Uyahudi]] [[Jamii:Apokrifa]] 7uzlt6jbu6pufpo3kpzdnik4rhw0m7d 0 241315 1578271 1576809 2026-07-03T10:13:18Z Riccardo Riccioni 452 1578271 wikitext text/x-wiki '''{{PAGENAME}}''' (au '''Ufunuo wa Kigiriki wa Baruku''') ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]] lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]. Kiliandikwa kati ya [[mwaka]] [[70]] na [[karne ya 3]]<ref>{{cite book |editor-last=Charlesworth |editor-first=James H. |editor-link=James H. Charlesworth |date=2007 |title=The Old Testament Pseudepigrapha, Volume 1: Apocalyptic Literature and Testaments |location=New Haven, Conn. |publisher=Yale University Press |isbn=978-0300140194}}</ref>, ingawa kinajidai kuandikwa na [[nabii Baruku]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] == Tanbihi == {{reflist}} == Marejeo == {{Refbegin}} * {{cite book |last=Lee |first=Pilchan |title=The New Jerusalem in the Book of Revelation: A Study of Revelation 21–22 in the Light of Its Background in Jewish Tradition |publisher=Mohr Siebeck |year=2001 |isbn=978-3-16-147477-4 |url=https://books.google.com/books?id=PN8RdHFLIQ4C&pg=PA158 }} {{Refend}} == Viungo vya nje== *[https://earlyjewishwritings.com/3baruch.html 3 Baruch at earlyjewishwritings.com] *[https://www.marquette.edu/maqom/pseudepigrapha.html Bibliography and Slavonic Manuscripts of 3 Baruch] * [https://web.archive.org/web/20030421102137/http://wesley.nnu.edu/noncanon/ot/pseudo/3baruch.htm Text of 3 Baruch] {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] [[Jamii:Apokrifa]] tdmmz7o8sbqr4iep7t9jpjwq3u8jqm0 0 241319 1578267 1576011 2026-07-03T09:55:50Z Riccardo Riccioni 452 1578267 wikitext text/x-wiki '''{{PAGENAME}}''' (pia: '''Ufunuo wa Kisiria wa Baruku''') ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]] lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]. Kiliandikwa labda kwa [[Kiebrania]] kati ya [[mwaka]] [[70]] na mwanzo wa [[karne ya 1]], ingawa kinajidai kuandikwa na [[nabii Baruku]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] * [[Apokrifa]] == Marejeo == * P. Bettiolo ''Apocalisse Siriana di Baruc'' in ed. P.Sacchi ''Apocrifi dell'Antico Testamento Vol 2'' {{ISBN|978-88-02-07606-5}} (2006) * A. F. J. Klijn ''Syriac Apocalypse of) Baruch, a new Translation and Introduction'' in James Charlesworth (ed.), ''The Old Testament Pseudepigrapha, Vol 1'' {{ISBN|0-385-09630-5}} (1983) * F. Leemhuis, A. F. J. Klijn, G. J. H. van Gelder ''The Arabic Text of the Apocalypse of Baruch: Edited and Translated with a Parallel Translation of the Syriac Text'' {{ISBN|90-04-07608-5}} (1986) * {{CathEncy|wstitle=Baruch}} ==Viungo vya nje== {{Wikisource1911Enc|Baruch}} * [https://web.archive.org/web/20090914163320/http://ocp.acadiau.ca/?2Bar Text of 2 Baruch in its ancient versions: Syriac, Greek, and Latin] * [http://www.pseudepigrapha.com/pseudepigrapha/2Baruch.html Translation from "Pseudepigrapha, Apocrypha and Sacred Writings"], by [[R. H. Charles]] *[http://jewishencyclopedia.com/view.jsp?artid=330&letter=B&search=2%20baruch Jewish Encyclopedia: BARUCH, APOCALYPSE OF (Syriac)] * [http://www.biblicalaudio.com/baruch2.htm 2 Baruch: 2012 Critical Translation with Audio Drama] at biblicalaudio {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] [[jamii:Apokrifa]] 4vyk6bgme3nw4wh0u7vmg4gwnu7luhg 0 241323 1578049 1576045 2026-07-02T16:25:54Z InternetArchiveBot 41439 Add 3 books for verifiability (20260702sim)) #IABot (v2.0.9.5) ([[User:GreenC bot|GreenC bot]] 1578049 wikitext text/x-wiki '''{{PAGENAME}}''' ni [[kitabu]] cha kale kilichoandikwa kwa [[mtindo wa kiapokalipti]] lakini [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]]. Kwanza kiliandikwa kwa [[Kiaramu]] katika [[karne ya 7]], ingawa kinajidai kuwa kazi ya [[Metodi wa Olimpo|Metodi wa Olimpo]]. ==Tazama pia== * [[Maandiko ya kiapokalipti]] ==Vyanzo== *{{cite book|last=Alexander|first=P. J.|title=Byzantine Apocalyptic Traditions|year=1985|publisher=University of California Press|location=Berkeley}} *{{cite book|last=Ballard|first=Martin|title=End-timers: Three-thousand Years of Waiting for Judgment Day|url=https://archive.org/details/endtimersthreeth0000ball|url-access=registration|year=2011|publisher=Praeger|location=Santa Barbara}} *{{cite book|last=Bonura|first=Christopher|year=2016|chapter=A Forgotten Translation of Pseudo-Methodius in Eighth-Century Constantinople: New Evidence for the Dispersal of the Greek ''Apocalypse of Pseudo-Methodius'' during the Dark Age Crisis|title=From Constantinople to the Frontier: The City and the Cities|publisher=Brill|doi=10.1163/9789004307742_018|pages=260–276|isbn=9789004307742 |editor1=Nicholas S.M. Matheou|editor2=Theofili Kampianaki|editor3=Lorenzo M. Bondioli}} *{{cite book |first=Sebastian |last=Brock |author-link=Sebastian P. Brock |year=1997 |title=A Brief Outline of Syriac Literature |location=Kottyam |publisher=St Ephrem's Ecumenical Research Institute |url=https://archive.org/details/ABriefOutlineOfSyriacLiterature_267}} *{{cite journal|title=The Earliest Allusion in Slavic Literature to the Revelations of Pseudo-Methodius|url=https://archive.org/details/sim_speculum_1929-07_4_3/page/329|first=Samuel H.|last=Cross|journal=Speculum|volume=4|issue=3|year=1929|pages=329–339|doi=10.2307/2849558 |jstor=2849558 |s2cid=162384162 }} *{{cite book|last=Debié|first=Muriel|title=Muslim-Christian Controversy in an Unedited Syriac Text: ''Revelations and Testimonies about Our Lord's Dispensation''|chapter=Muslim-Christian Controversy in an Unedited Syriac Text Revelations and Testimonies About Our Lord's Dispensation |journal=History of Christian-Muslim Relations|year=2005|volume=5|pages=225–236 |doi=10.1163/ej.9789004149380.i-338.40|isbn=9789047408826}} *{{cite book|last=Garstad|first=Benjamin ed. and trans.|title=Apocalypse of Pseudo-Methodius. An Alexandrian World Chronicle|isbn=978-0674053076|year=2012|publisher=Harvard University Press|location=Cambridge}} *{{cite book|last=Griffith|first=Sidney Harrison|title=The Church in the Shadow of the Mosque: Christians and Muslims in the World of Islam|url=https://books.google.com/books?id=jn-tiP0b-PYC|year=2008|publisher=Princeton University Press|location=Princeton|isbn=9780691130156}} *{{cite book|last=Griffith|first=Sidney Harrison|title=''"Christians Under Muslim Rule" in'' The Cambridge History of Christianity, Volume 3|year=2010|publisher=Cambridge University Press|location=Cambridge}} *{{cite book|title=Cultures of Eschatology|volume=1: Empires and Scriptural Authorities in Medieval Christian, Islamic and Buddhist Communities|editor1=Veronika Wieser|editor2=Vincent Eltschinger|editor3=Johann Heiss|first1=Cinzia|last1=Grifoni|first2=Clemens|last2=Gantner|chapter=The Third Latin Recension of the Revelationes of Pseudo-Methodius|pages=194–232|publisher=DeGruyter|year=2020}} *{{cite journal|last=Guenther|first=Alan M.|title=The Christian experience and interpretation of the early Muslim conquest and rule|journal=Islam and Christian-Muslim Relations|date=May 2007}} *{{cite journal|last=Jackson|first=Peter|title=Medieval Christendom's Encounter with the Alien|url=https://archive.org/details/sim_historical-research_2001-11_74_186/page/347|journal=Historical Research|date=November 2001|volume=74|issue=186|pages=347–369 |doi=10.1111/1468-2281.00132|s2cid=159860524 }} *{{cite book|last=Louth|first=Andrew|title=''"Byzantium Transforming (600-700)" in'' The Cambridge History of the Byzantine Empire c.500-1492|year=2010|url=http://universitypublishingonline.org/cambridge/histories/chapter.jsf?bid=CBO9781139055994&cid=CBO9781139055994A015|publisher=Cambridge University Press|location=Cambridge}} *{{cite journal|last=Pelle|first=Stephen|title=The Revelationes of Pseudo-Methodius and 'Concerning the Coming of Antichrist' in British Library MS Cotton Vespasian D.XIV|url=https://archive.org/details/sim_notes-and-queries_2009-09_56_3/page/324|journal=Notes and Queries|date=September 2009|volume=56|issue=3|pages=324–330 |doi=10.1093/notesj/gjp125}} *{{cite book|first=Michael Philip |last=Penn |title=When Christians First Met Muslims: A Sourcebook of the Earliest Syriac Writings on Islam |publisher=University of California Press|year=2015}} *{{cite book|last=Pollard|first=Richard M.|title=''"One Other on Another" in'' Difference and Identity in Francia and Medieval France|year=2010|publisher=Ashgate Publishing|location=Burlington, VT}} *{{cite book|last=Shepard|first=Jonathan|chapter=Introduction to 'Approaching Byzantium'|title=The Cambridge History of the Byzantine Empire c.500-1492|year=2010|publisher=Cambridge University Press|location=Cambridge}} *{{Rejea kitabu |last=Bonura |first=Christopher J. |url=https://www.jstor.org/stable/jj.35139482 |title=A Prophecy of Empire: The Apocalypse of Pseudo-Methodius from Late Antique Mesopotamia to the Global Medieval Imagination |date=2025 |publisher=University of California Press |isbn=9780520418257 |edition=1 |volume=15 |language=en}} {{mbegu-kitabu}} [[Jamii:maandiko ya kiapokalipti]] exp0jesp7x8xuxg5ayau3xlrdjxzs4i 0 241391 1578117 1576266 2026-07-02T20:31:57Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578117 wikitext text/x-wiki '''Bwawa la Weija''' ni bwawa lililojengwa kwenye Mto Densu nchini [[Ghana]], ambalo linatumika kutoa maji katika kituo kikuu cha kutibu maji kwa ajili ya Jiji la Accra. Bwawa hili linaendeshwa na mamlaka ya maji ya Ghana.<ref>{{Cite web|title=NADMO - Weija Dam Spillage Ongoing ... Nadmo Success Story|url=http://www.nadmo.gov.gh/index.php/archives/5-main-article/main-article/124-weija-dam-spillage-is-ongoing-nadmo-success-story|work=www.nadmo.gov.gh|accessdate=2026-06-23|language=en-gb|author=Amoani Emmanuel Ofori}}</ref><ref>{{Cite web|title=Spillage of Weija dam causes 'severe' flooding at Glefe, Opetekwei - MyJoyOnline.com|url=https://www.myjoyonline.com/news/2014/june-10th/spillage-of-weija-dam-causes-severe-flooding-at-glefe-opetekwei.php|work=www.myjoyonline.com|accessdate=2026-06-23|archive-date=2017-08-21|archive-url=https://web.archive.org/web/20170821083906/https://www.myjoyonline.com/news/2014/june-10th/spillage-of-weija-dam-causes-severe-flooding-at-glefe-opetekwei.php|url-status=dead}}</ref> Bwawa la Weija linauwezo wa kutoa maji takribani asilimia 80 ya maji safi kwa matumizi kwa wakazi wa [[Accra]] na maeneo ya jirani. Ujenzi wake ulianza mwaka 1974 na kukamilika mwaka 1978 na kampuni ya Kiitaliano iliyojulikana kama Messrs Tahi. == Kumwagwa kwa maji ya bwawa == Mnamo Juni 2014, maji yalifunguliwa kutoka bwawani na kusababisha mafuriko katika eneo la Glefe. Baadhi ya waathirika walidai kuwa mafuriko hayo yalichangiwa na kutofanyika kwa uchimbaji wa mkondo wa mto unaoelekea baharini kutokana na kusubiri kumalizika kwa tamasha la Homowo. Mwezi Machi 2017, Ghana Water Company ilianza kumwaga maji kutoka bwawani ili kuzuia kiwango cha [[maji]] kisizidi kiwango cha juu kinachoruhusiwa. Hatua hiyo ilihitajika kutokana na msimu wa mvua na ilisababisha mafuriko katika maeneo ya Tetegu na Oblogo. Mwezi Machi 2021, malango ya bwawa yalifunguliwa baada ya kiwango cha maji kuongezeka ghafla kwa futi 1.9 ndani ya saa 24. Kiwango cha maji kiliongezeka kutoka futi 46.2 hadi futi 48.1, ambacho kilikuwa futi 1.1 juu ya kiwango salama cha uendeshaji cha futi 47. Kufunguliwa kwa malango kulifanyika ili kupunguza hatari ya bwawa kuharibika au kupasuka. Mwezi Oktoba 2022, bwawa lilimwaga maji mara mbili kutokana na mvua kubwa. Kiwango cha maji kilikuwa [[futi]] 49.5 wakati wa kumwagwa kwa kwanza mwanzoni mwa mwezi huo, na futi 47.9 wakati wa kumwagwa kwa pili baadaye mwezi huo. Bwawa la Weija ni mojawapo ya miundombinu muhimu zaidi ya maji nchini Ghana kutokana na mchango wake mkubwa katika usambazaji wa maji kwa mji mkuu wa Accra na maeneo yanayouzunguka.<ref>{{Cite web|title=Weija dam spillage causes flooding downstream|url=https://www.graphic.com.gh/news/general-news/weija-dam-spillage-causes-flooding-downstream.html|work=Graphic Online|date=2022-10-04|accessdate=2026-06-23|language=en-gb}}</ref> == Marejeo == <references /> {{Mbegu-jio-Ghana}} [[Jamii:Jiografia ya Ghana]] [[Jamii:AWC 2026]] [[Jamii:Maji]] 0iw0zs7tdw5jzd9yqwswok1b2vniwto 0 241421 1578116 1576510 2026-07-02T20:30:02Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578116 wikitext text/x-wiki '''Bwawa la Wadi Wishka''' ni bwawa la kujazwa kwa mawe lenye uso wa saruji lililojengwa kwenye Wadi Wishka, takribani [[kilomita]] 29 kusini-magharibi mwa mji wa Sokna katika eneo la Fezzan nchini [[Libya]].<ref>{{Cite web|title=Projects {{!}} Jacobs|url=https://www.ane-ly.net/projects.html|work=www.ane-ly.net|accessdate=2026-06-23}}</ref>Lengo kuu la ujenzi wa bwawa hili ni kudhibiti mafuriko na kuhifadhi maji kwa matumizi mbalimbali.<ref>{{Cite web|title=Home|url=https://www.zutari.com/|work=Zutari|accessdate=2026-06-23|language=en-US|archive-date=2026-03-06|archive-url=https://web.archive.org/web/20260306010053/https://www.zutari.com/|url-status=dead}}</ref> Ujenzi wa Bwawa la Wadi Wishka ulianza mwaka [[2004]] na kukamilika mwaka 2006 kwa gharama ya takribani dola za [[Marekani]] milioni 5. Bwawa hili ni sehemu ya miundombinu muhimu ya usimamizi wa rasilimali za maji katika eneo la Fezzan, ambalo linakabiliwa na hali ya [[ukame]] na hutegemea mifumo ya kuhifadhi maji na kudhibiti [[mafuriko]] ya ghafla yanayotokea katika mabonde ya mito ya msimu. == Marejeo == <references /> {{Mbegu-jio-Afrika}} [[Jamii:Maziwa ya Libya]] [[Jamii:AWC 2026]] gxiaxw6j9oscpnu6sw02rj5b52e24q1 0 241430 1578115 1577518 2026-07-02T20:26:14Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578115 wikitext text/x-wiki '''Bwawa la Ndakaini''' ni bwawa la udongo lenye urefu wa [[mita]] 63 na urefu wa taji (crest) wa mita 458, lililojengwa kwenye Mto Thika karibu na mji mdogo wa Ndakaini, takribani kilomita 50 kaskazini mwa Nairobi, [[Kenya]].<ref>{{Cite web|title=Thika Dam|url=http://www.howardhumphreys.com/project_pages/we_3.htm|work=www.howardhumphreys.com|accessdate=2026-06-24|archive-date=2011-08-23|archive-url=https://web.archive.org/web/20110823094058/http://www.howardhumphreys.com/project_pages/we_3.htm|url-status=dead}}</ref><ref>{{Cite web|title=Nairobi City Water and Sewerage Company Limited - Improving Reliability|url=http://www.nairobiwater.co.ke/water_quality/?ContentID=8|work=www.nairobiwater.co.ke|accessdate=2026-06-24|archive-date=2011-12-03|archive-url=https://web.archive.org/web/20111203213145/http://www.nairobiwater.co.ke/water_quality/?ContentID=8|url-status=dead}}</ref> Hifadhi ya maji ya bwawa hili ina uwezo wa kuhifadhi mita za ujazo milioni 70 za maji na hutumika kwa [[usambazaji]] wa maji ya kunywa. Maji kutoka bwawani hutibiwa katika Kituo cha Kusafisha Maji cha Ngethu kabla ya kusambazwa kwa watumiaji. Bwawa la Ndakaini limeongeza kwa kiasi kikubwa uhakika wa upatikanaji wa maji katika jiji la [[Nairobi]], ambalo lilikuwa likikabiliwa na upungufu wa maji wakati wa misimu ya ukame kabla ya kukamilika kwa ujenzi wa bwawa mwaka 1994. Mradi wa ujenzi wa bwawa hili ulifadhiliwa na Benki ya Maendeleo ya Afrika, [[Benki ya Dunia]], Benki ya Uwekezaji ya Ulaya pamoja na Serikali ya Kenya.<ref>{{Cite journal |date=1999-12-01 |title=The problems of project implementation:: a post-mortem study of Thika Dam project, Kenya |url=https://www.sciencedirect.com/science/article/abs/pii/S0197397599000211 |journal=Habitat International |language=en-US |volume=23 |issue=4 |pages=467–479 |doi=10.1016/S0197-3975(99)00021-1 |issn=0197-3975}}</ref> Ujenzi wa bwawa ulicheleweshwa kutokana na changamoto za upatikanaji wa ardhi, jambo lililosababisha ongezeko la gharama za mradi. Wakati wa [[ujenzi]], muundo wa bwawa ulifanyiwa marekebisho ili uweze kuhimili mafuriko makubwa yanayoweza kutokea mara moja katika kipindi cha miaka 10,000 na kuimarisha usalama wake. ==Tazama pia== * [[Orodha ya maziwa ya Kenya]] == Marejeo == <references /> {{Mbegu-jio-Kenya}} [[Jamii:Maziwa ya Kenya]] [[Jamii:AWC 2026]] pdpr39pnjik0x5j349jooajps3jgh37 0 241452 1578113 1576532 2026-07-02T20:24:34Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578113 wikitext text/x-wiki '''Bwawa la Swakoppoort''' ni bwawa lililopo kilomita 50 kutoka mji wa Okahandja katika Mkoa wa Otjozondjupa nchini [[Namibia]]. Limejengwa kwenye Mto Swakop na wakati mwingine hupokea maji kutoka Bwawa la Omatako lililopo kwenye Mto Omatako, ambao ni tawimto la [[Mto]] Swakop.<ref>{{Cite web|title=NamWater|url=https://www.namwater.com.na/index.php?option=com_content&view=article&id=71&Itemid=68|work=www.namwater.com.na|accessdate=2026-06-24|language=en-gb|author=Super User|archive-date=2016-03-06|archive-url=https://web.archive.org/web/20160306100445/https://www.namwater.com.na/index.php?option=com_content&view=article&id=71&Itemid=68|url-status=dead}}</ref> Bwawa hili lina uwezo wa kuhifadhi maji kiasi cha mita za ujazo milioni 63.489. Lilikamilishwa mwaka 1978 na ni mojawapo ya mabwawa matatu makuu yanayosambaza [[maji]] kwa mji mkuu wa Namibia, Windhoek. Mbali na Windhoek, [[bwawa]] hili pia husambaza maji kwa Mgodi wa Navachab Mine na mji wa Karibib. Bwawa la Swakoppoort lina mchango muhimu katika kuhakikisha upatikanaji wa maji kwa matumizi ya nyumbani, viwandani na shughuli za uchimbaji madini katika maeneo ya kati ya Namibia == Marejeo == <references /> {{Mbegu-jio-Namibia}} [[Jamii:AWC 2026]] [[Jamii:Maziwa ya Namibia]] sj6trxda4kqpgsragre3j03loflujz5 0 241455 1578110 1576534 2026-07-02T20:18:38Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578110 wikitext text/x-wiki '''Bwawa la Sidi Salem''' ni bwawa kubwa zaidi la [[udongo]] na mawe nchini [[Tunisia]]. Lipo takribani [[kilomita]] 6 kaskazini-magharibi mwa mji wa Testour kwenye Mto Medjerda katika Mkoa wa Béja. Bwawa hili lilijengwa kati ya mwaka 1977 na 1981. Kazi zake kuu ni kusambaza [[maji]] kwa ajili ya umwagiliaji na kusaidia uzalishaji wa umeme kupitia kituo cha kuzalisha umeme chenye uwezo wa megawati 12. Bwawa la Sidi Salem lina umuhimu mkubwa katika maendeleo ya kilimo nchini [[Tunisia]] kwa kusaidia upatikanaji wa maji ya [[umwagiliaji]], pamoja na kuchangia katika uzalishaji wa nishati ya umeme.<ref>{{Cite web|title=Sidi Salem (1977-1981)|url=https://hidrotehnika.rs/brane/tunis/sidi-salem/|work=Hidrotehnika-Hidroenergetika|accessdate=2026-06-24|language=en|archive-date=2026-06-08|archive-url=https://web.archive.org/web/20260608185934/https://hidrotehnika.rs/brane/tunis/sidi-salem/|url-status=dead}}</ref> == Marejeo == <references /> {{Mbegu-jio-Tunisia}} [[Jamii:AWC 2026]] [[Jamii:Maziwa ya Tunisia]] 8t0fbo4oc1of0vzvxpis5sayv63sy1l 0 241456 1578111 1576535 2026-07-02T20:22:46Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578111 wikitext text/x-wiki '''Bwawa la Sidi El Barrak''' ni bwawa la [[udongo]] na mawe lililopo takribani kilomita 18 kaskazini-mashariki mwa [[mji]] wa Tabarka na kilomita 2 kutoka Bahari ya Mediterania, kwenye Mto Oued Zouara katika Mkoa wa Béja nchini Tunisia. Bwawa hili lilijengwa kati ya mwaka 1994 na 2000, na lengo lake kuu ni kuhifadhi na kusambaza [[maji]].<ref>{{Cite web|title=Sidi el Barrak (1994-2000)|url=https://hidrotehnika.rs/brane/tunis/sidi-el-barrak/|work=Hidrotehnika-Hidroenergetika|accessdate=2026-06-24|language=en|archive-date=2026-04-10|archive-url=https://web.archive.org/web/20260410164047/https://hidrotehnika.rs/brane/tunis/sidi-el-barrak/|url-status=dead}}</ref> Kama sehemu ya Mradi wa [[Maendeleo]] wa Sidi El Barrak, maji yanayohifadhiwa kwenye bwawa husafirishwa kwa kusukumwa hadi Bwawa la Sejnane kwa kiwango cha takribani mita za ujazo [[milioni]] 265 kwa mwaka. Maji hayo husambazwa kwa matumizi ya mijini na kilimo katika mji wa Tunis, eneo la Cap Bon, eneo la Sahel pamoja na Sfax. Mradi mzima wa Sidi El Barrak ulikamilika mwaka [[2002]] na una umuhimu mkubwa katika kuhakikisha upatikanaji wa maji kwa matumizi ya nyumbani na shughuli za kilimo nchini Tunisia. == Marejeo == <references /> {{Mbegu-jio-Tunisia}} [[Jamii:AWC 2026]] [[Jamii:Maziwa ya Tunisia]] ibdk5adcxe84qxa2uryx3szox9jye4n 0 241467 1578106 1576701 2026-07-02T20:05:52Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578106 wikitext text/x-wiki '''Bwawa la Avis''' ni bwawa lililopo nje ya mji wa [[Windhoek]] nchini [[Namibia]]. Bwawa hili lilijengwa mwaka 1933 na mamlaka ya kikoloni ya [[Afrika Kusini]], ambayo ilikuwa ikitawala Namibia wakati huo.<ref>{{Cite web|title=LATはスピーキング力強化に特化した英会話プログラム|url=https://www.avisdam.org/index.html|work=www.avisdam.org|accessdate=2026-06-25|language=ja|archive-date=2019-12-09|archive-url=https://web.archive.org/web/20191209124009/https://www.avisdam.org/index.html|url-status=dead}}</ref> Kwa mara ya kwanza, bwawa hili lilijaa maji na kufurika mwezi Aprili mwaka 1934. Baada ya hapo, kiwango cha maji katika bwawa hakikuzidi asilimia 75 ya uwezo wake hadi mwaka 2007. Bwawa la Avis ni mojawapo ya mabwawa ya zamani nchini Namibia na lina umuhimu katika historia ya maendeleo ya rasilimali za maji nchini humo. == Marejeo == <references /> {{Mbegu-jio-Namibia}} [[Jamii:AWC 2026]] [[Jamii:maziwa ya Namibia]] bk2qcbo35ipadlx8x7do5mx6umhjfie 0 241474 1578108 1576708 2026-07-02T20:09:30Z InternetArchiveBot 41439 Rescuing 1 sources and tagging 0 as dead.) #IABot (v2.0.9.5 1578108 wikitext text/x-wiki '''Bwawa la Bongolo''' ni bwawa lililopo kwenye [[Mto Louetsi]] katika kusini-magharibi mwa [[Gabon]], karibu na eneo la [[Bongolo]]. Bwawa hili lilijengwa mwanzoni mwa miaka ya 1990 kwa msaada wa uwekezaji kutoka nchini [[Kanada|Canada]]. Mwaka 2020, ilitangazwa kuwa bwawa hilo litakarabatiwa na shirika la nishati na maji la Gabon, Société d’énergie et d’eau du Gabon. Marekebisho hayo yalihusisha kubadilisha mitambo mitano yenye hitilafu pamoja na kuboresha mifumo ya usalama na uendeshaji wa bwawa.<ref>{{Cite web|title=afrik21.africa|url=https://www.afrik21.africa/en/gabon-the-seeg-allocates-e10-7m-to-electricity-and-drinking-water-projects/|work=www.afrik21.africa|accessdate=2026-06-25|language=en|archive-date=2025-10-18|archive-url=https://web.archive.org/web/20251018023354/https://www.afrik21.africa/en/gabon-the-seeg-allocates-e10-7m-to-electricity-and-drinking-water-projects/|url-status=dead}}</ref> Bwawa la Bongolo lina umuhimu katika uzalishaji wa umeme na usambazaji wa huduma za maji katika eneo hilo la Gabon.<ref>{{Cite web|title=Gabon starts rehabilitating the Bongolo hydroelectric power station|url=https://constructionreviewonline.com/gabon-starts-rehabilitating-the-bongolo-hydroelectric-power-station/|work=Construction Review|date=2020-11-10|accessdate=2026-06-25|language=en-US|author=patrick mulyungi}}</ref> == Marejeo == <references /> {{Mbegu-jio-Gabon}} [[Jamii:AWC 2026]] [[Jamii:maziwa ya Gabon]] 5wb9tb0ot6800rq9tnr9ymp731daz4y 0 241752 1577934 1577910 2026-07-02T12:37:15Z InternetArchiveBot 41439 Rescuing 0 sources and tagging 1 as dead.) #IABot (v2.0.9.5 1577934 wikitext text/x-wiki {{Infobox_Person | jina = Abdirahman Ahmed Ali Tuur | jina_asili = عبد الرحمن أحمد علي الطور | picha = Abdirahman Ahmed Ali Tuur.jpg | ukubwawapicha = 220px | maelezo_ya_picha = | cheo1 = Rais wa kwanza wa Somaliland | makamu1 = Hassan Isse Jama | kipindi_cha_kuanza1= 7 Juni 1991<ref>{{Cite book | url=https://uca.edu/politicalscience/dadm-project/sub-saharan-africa-region/somaliasomaliland-1960-present/|title = 37. Somalia/Somaliland (1960-present)}}</ref> | kipindi_cha_kwisha1= 16 Mei 1993 | mtangulizi1 = Nafasi ilianzishwa | mrithi1 = Muhammad Haji Ibrahim Egal | cheo2 = Mwenyekiti wa Harakati ya Kitaifa ya Somalia (SNM)<ref>{{cite web|url=http://www.alnef.org.za/conf/2010/presentantions/somalia.pdf |title=Civil Society & their role in Africa's struggle to deepen democracy: Experiences of Somaliland in the Horn by Cde. Iqbal Jhazbhay |website=www.alnef.org.za |access-date=2019-09-12}}</ref> | kipindi_cha_kuanza2= Aprili 1990 | kipindi_cha_kwisha2= Mei 1991 | mtangulizi2 = Ahmed Mohamed Mohamoud | mrithi2 = Nafasi ilifutwa | tarehe_ya_kuzaliwa = {{Birth date|1931|11|6}} | mahala_pa_kuzaliwa = Burao, Somaliland ya Kiingereza (sasa Somalia) | tarehe_ya_kifo = {{Death date and age|2003|11|8|1931|11|6}} | mahala_pa_kifo = Hargeisa, Somaliland<ref>{{Cite book |url=https://uca.edu/politicalscience/dadm-project/sub-saharan-africa-region/somaliasomaliland-1960-present/ |title=37. Somalia/Somaliland (1960-present)}}</ref> | elimu = Chuo Kikuu cha Exeter | chama = | mwenzi = Kinsi Ibrahim Osman Basbas<ref>{{Cite web|last=Somalilandsun.com|date=31 May 2015|title=Somaliland: A Tribute to Abdirahman Ahmed Ali "Tuur" Father of Re-independence|url=https://www.somalilandsun.com/somaliland-a-tribute-to-abdirahman-ahmed-ali-tuur-father-of-re-independence/|url-status=live|archive-url=https://web.archive.org/web/20210207115054/https://www.somalilandsun.com/somaliland-a-tribute-to-abdirahman-ahmed-ali-tuur-father-of-re-independence/ |archive-date=2021-02-07}}</ref> | watoto = }} '''Abdirahman Ahmed Ali Tuur''' (6 Novemba 1931 - 8 Novemba 2003) alikuwa [[Siasa|mwanasiasa]] wa [[Somalia]] aliyetumikia kama [[Rais]] wa kwanza wa [[Somaliland]] kuanzia mwaka 1991 hadi 1993. Kabla ya hapo, Tuur alikuwa Mwenyekiti wa chama cha harakati ya kitaifa ya Kisomali kuanzia mwaka 1990 hadi 1991. == Marejeo == {{marejeo}} ==Viungo vya nje== * [http://www.irb-cisr.gc.ca/en/research/ndp/ref/index_e.htm?docid=233&cid=0&version=printable&disclaimer=show Issue Paper: SOMALIA, UPDATE ON THE SITUATION IN THE NORTH (SOMALILAND)]{{Dead link|date=July 2026 |bot=InternetArchiveBot |fix-attempted=yes }}, Research Directorate of the Immigration and Refugee Board of Canada, January 1995</ref> {{WFR}} [[Jamii:Waliozaliwa 1931]] [[Jamii:Waliofariki 2003]] [[Jamii:Wanasiasa wa Somalia]] [[Jamii:Wiki for Refugees 2026]] q69q85cmetb3kiz0sq4mreyg400h5hs 14 241767 1577917 2026-07-02T12:28:34Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|L]] [[Jamii:Liberia|F]]' 1577917 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|L]] [[Jamii:Liberia|F]] pwf944n28j675vt8gaqhrv5y07otqlr 14 241768 1577918 2026-07-02T12:29:33Z Riccardo Riccioni 452 Ukurasa 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2026-07-02T12:32:26Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|E]] [[Jamii:Eswatini|F]]' 1577922 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|E]] [[Jamii:Eswatini|F]] si3f4gixueer9qt3y9nmmsb3bjg0a6j 14 241773 1577923 2026-07-02T12:32:45Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|G]] [[Jamii:Gambia|F]]' 1577923 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|G]] [[Jamii:Gambia|F]] e0be4rufed49tzahezjygxii41hdl3o 14 241774 1577924 2026-07-02T12:33:02Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|G]] [[Jamii:Ghana|F]]' 1577924 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|G]] [[Jamii:Ghana|F]] 3jbc9d5dlfoxxfkunxwgl60cnfsg0fa 14 241775 1577925 2026-07-02T12:33:19Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|G]] [[Jamii:Guinea|F]]' 1577925 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|G]] [[Jamii:Guinea|F]] 9dqy6sirpnmray51fv2tbnx5dpbmao6 14 241776 1577926 2026-07-02T12:33:36Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|H]] [[Jamii:Hong Kong|F]]' 1577926 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|H]] [[Jamii:Hong Kong|F]] 6iyrjstcsyql146mzpftrpwrs5d5ix2 14 241777 1577927 2026-07-02T12:34:24Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|M]] [[Jamii:Meksiko|F]]' 1577927 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|M]] [[Jamii:Meksiko|F]] jbtn71ddsa1xvetwof8iup2d9qjbal4 1577929 1577927 2026-07-02T12:35:40Z Riccardo Riccioni 452 1577929 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|M]] [[Jamii:Mexiko|F]] nqdybkac9a55fxjssqom9gn3i2e5q8w 14 241778 1577928 2026-07-02T12:34:51Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Sao Tome na Principe|F]]' 1577928 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Sao Tome na Principe|F]] qysdi3o1cpht8ty1h1nah4ahkvgal66 14 241779 1577930 2026-07-02T12:36:01Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Shelisheli|F]]' 1577930 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Shelisheli|F]] j7qw1f1poxcwfcuu4kn5u91erjlmslm 14 241780 1577931 2026-07-02T12:36:23Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Sierra Leone|F]]' 1577931 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Sierra Leone|F]] bte2stflunos98eyf3mzxq6vj1k9yld 14 241781 1577932 2026-07-02T12:36:42Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Somalia|F]]' 1577932 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|S]] [[Jamii:Somalia|F]] feyte4elm2m8nynjh1kjtxd6zj1802r 14 241782 1577935 2026-07-02T12:37:27Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|U]] [[Jamii:Uholanzi|F]]' 1577935 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|U]] [[Jamii:Uholanzi|F]] pp93u2qr9oysx1m46pmux1j7cmvy99g 14 241783 1577936 2026-07-02T12:37:46Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|U]] [[Jamii:Ureno|F]]' 1577936 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|U]] [[Jamii:Ureno|F]] movll3ucvcvcrs463dvd3c4czv9agif 14 241784 1577937 2026-07-02T12:38:11Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Filamu nchi kwa nchi|U]] [[Jamii:Urusi|F]]' 1577937 wikitext text/x-wiki [[Jamii:Filamu nchi kwa nchi|U]] [[Jamii:Urusi|F]] hywxq6gevcz202cnohpeygybywtfwdl 14 241785 1577939 2026-07-02T12:40:34Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:miji ya Botswana]] [[Jamii:Miji Mikuu Afrika]]' 1577939 wikitext text/x-wiki [[Jamii:miji ya Botswana]] [[Jamii:Miji Mikuu Afrika]] p82pepp6p0y4wqcybe0n63jgzuc03xp 14 241786 1577953 2026-07-02T12:54:45Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Eswatini]] [[Jamii:Eswatini]]' 1577953 wikitext text/x-wiki [[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Eswatini]] [[Jamii:Eswatini]] 28zejm9ch5lhs7stunzxa9tmcojv5gr 14 241787 1577958 2026-07-02T12:59:36Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Jibuti]] [[Jamii:Jibuti]]' 1577958 wikitext text/x-wiki [[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Jibuti]] [[Jamii:Jibuti]] 0o8r9hva51pb69uxboot6536tianlls 14 241788 1577966 2026-07-02T13:07:28Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:miji ya Komori]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Komori]]' 1577966 wikitext text/x-wiki [[Jamii:miji ya Komori]] [[Jamii:Miji Mikuu Afrika]] [[Jamii:Komori]] d8tegxmrvgjsc7fo4z174f3yvidzvx5 14 241789 1577969 2026-07-02T13:10:36Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Sao Tome na Principe]] [[Jamii:Sao Tome na Principe]]' 1577969 wikitext text/x-wiki [[Jamii:Miji Mikuu Afrika]] [[Jamii:miji ya Sao Tome na Principe]] [[Jamii:Sao Tome na Principe]] 5065nlhlwuqr8m6dwsqx7q8pthlf9l0 0 241790 1578237 2026-07-03T09:02:58Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika ''''Mtindo wa uandishi''' ni [[istilahi]] ya [[fasihi]] inayolenga kuainisha namna ya kuandika iliyotumika<ref>{{Cite book|last=David|first=Mikics|title=A New Handbook of Literary Term|publisher=[[Yale University Press]]|year=2010|isbn=9780300164312|pages=132–133}}</ref> ili kufikisha [[ujumbe]], kwa mfano [[nathari]], [[tamthilia]] au [[shairi]]<ref name=":0">{{Cite journal|last=Pavel|first=Thomas|date=2003|title=Literary Genres as Norms and Good Habits|...' 1578237 wikitext text/x-wiki '''Mtindo wa uandishi''' ni [[istilahi]] ya [[fasihi]] inayolenga kuainisha namna ya kuandika iliyotumika<ref>{{Cite book|last=David|first=Mikics|title=A New Handbook of Literary Term|publisher=[[Yale University Press]]|year=2010|isbn=9780300164312|pages=132–133}}</ref> ili kufikisha [[ujumbe]], kwa mfano [[nathari]], [[tamthilia]] au [[shairi]]<ref name=":0">{{Cite journal|last=Pavel|first=Thomas|date=2003|title=Literary Genres as Norms and Good Habits|journal=New Literary History|publisher=[[The Johns Hopkins University Press]]|volume=34|issue=2|pages=201–210|doi=10.1353/nlh.2003.0021 |jstor=20057776|s2cid=144429849}}</ref>. Kutofautisha mitindo ni msaada muhimu kwa kuelewa ujumbe uliokusudiwa, kwa mfano katika [[Biblia]] ambayo ni mkusanyo wa [[Kitabu|vitabu]] vingi vilivyoandikwa kwa [[muda]] wa zaidi ya [[karne]] 10 na kwa kutumia [[lugha]] tatu tofauti. Humo tunakuta habari za [[historia]], [[hadithi]], [[sheria]], taratibu za [[ibada]], [[Wimbo|nyimbo]], [[Methali|mithali]], [[utabiri|matabiri]], [[barua]] n.k. Hivyo [[ukweli]] uliosadikika [[ufunuo|umefunuliwa]] na [[Mungu]] umetolewa kwa namna mbalimbali ambazo ni lazima kuzitofautisha ili ujumbe usipotoshwe. <ref>https://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_const_19651118_dei-verbum_en.html, cfr. n. 12.</ref><ref>https://uscatholic.org/articles/202407/what-does-the-bible-mean-dei-verbum-has-the-answer/</ref> ==Tanbihi== <references /> {{mbegu-lugha}} [[Jamii:Fasihi]] [[Jamii:Biblia]] 7wo56s70d7wtnhkg3knpbttru1xlw6l 1578268 1578237 2026-07-03T09:59:03Z Gayle-Bot 78697 #2.0 Boti Replaced Cite web->Rejea tovuti, Cite journal->Rejea jarida, Cite book->Rejea kitabu, Cite news->Rejea habari; 2 template(s) replaced. 1578268 wikitext text/x-wiki '''Mtindo wa uandishi''' ni [[istilahi]] ya [[fasihi]] inayolenga kuainisha namna ya kuandika iliyotumika<ref>{{Rejea kitabu|last=David|first=Mikics|title=A New Handbook of Literary Term|publisher=[[Yale University Press]]|year=2010|isbn=9780300164312|pages=132–133}}</ref> ili kufikisha [[ujumbe]], kwa mfano [[nathari]], [[tamthilia]] au [[shairi]]<ref name=":0">{{Rejea jarida|last=Pavel|first=Thomas|date=2003|title=Literary Genres as Norms and Good Habits|journal=New Literary History|publisher=[[The Johns Hopkins University Press]]|volume=34|issue=2|pages=201–210|doi=10.1353/nlh.2003.0021 |jstor=20057776|s2cid=144429849}}</ref>. Kutofautisha mitindo ni msaada muhimu kwa kuelewa ujumbe uliokusudiwa, kwa mfano katika [[Biblia]] ambayo ni mkusanyo wa [[Kitabu|vitabu]] vingi vilivyoandikwa kwa [[muda]] wa zaidi ya [[karne]] 10 na kwa kutumia [[lugha]] tatu tofauti. Humo tunakuta habari za [[historia]], [[hadithi]], [[sheria]], taratibu za [[ibada]], [[Wimbo|nyimbo]], [[Methali|mithali]], [[utabiri|matabiri]], [[barua]] n.k. Hivyo [[ukweli]] uliosadikika [[ufunuo|umefunuliwa]] na [[Mungu]] umetolewa kwa namna mbalimbali ambazo ni lazima kuzitofautisha ili ujumbe usipotoshwe. <ref>https://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_const_19651118_dei-verbum_en.html, cfr. n. 12.</ref><ref>https://uscatholic.org/articles/202407/what-does-the-bible-mean-dei-verbum-has-the-answer/</ref> ==Tanbihi== <references /> {{mbegu-lugha}} [[Jamii:Fasihi]] [[Jamii:Biblia]] 5emfai6co4yxn7xbbepyhsiia1r0xgr 0 241791 1578238 2026-07-03T09:06:10Z Riccardo Riccioni 452 Ukurasa umeelekezwa kwenda [[Ufunuo wa Musa]] 1578238 wikitext text/x-wiki #REDIRECT[[Ufunuo wa Musa]] ms9wr5mlqpzigdba2n7andqwa3d5td8 14 241792 1578241 2026-07-03T09:15:29Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika '[[Jamii:Uyahudi]] [[Jamii:Ukristo]]' 1578241 wikitext text/x-wiki [[Jamii:Uyahudi]] [[Jamii:Ukristo]] hdhf4hkvu9bloi82pu8e0b8s6941a2d 3 241793 1578250 2026-07-03T09:48:14Z AmmarBot 81277 Karibu 1578250 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:48, 3 Julai 2026 (UTC) 7r3ysxt0b1e9el2vcx89cbilzimhw6a 3 241794 1578251 2026-07-03T09:48:24Z AmmarBot 81277 Karibu 1578251 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:48, 3 Julai 2026 (UTC) 7r3ysxt0b1e9el2vcx89cbilzimhw6a 3 241795 1578252 2026-07-03T09:48:34Z AmmarBot 81277 Karibu 1578252 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:48, 3 Julai 2026 (UTC) 7r3ysxt0b1e9el2vcx89cbilzimhw6a 3 241796 1578253 2026-07-03T09:48:44Z AmmarBot 81277 Karibu 1578253 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:48, 3 Julai 2026 (UTC) 7r3ysxt0b1e9el2vcx89cbilzimhw6a 3 241797 1578254 2026-07-03T09:48:54Z AmmarBot 81277 Karibu 1578254 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:48, 3 Julai 2026 (UTC) 7r3ysxt0b1e9el2vcx89cbilzimhw6a 3 241798 1578255 2026-07-03T09:49:04Z AmmarBot 81277 Karibu 1578255 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:49, 3 Julai 2026 (UTC) ic8oqg266kbhrxd1rvb7gcuvdlut9co 1578266 1578255 2026-07-03T09:54:45Z Queen Chloe ug 90658 /* */ Jibu 1578266 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:49, 3 Julai 2026 (UTC) :Asante sana bwana. I wish I knew more Swahili words it would be better. Buh what I know is that am welcomed on this planet. Am really humbled 🙏lets keep the spirit '''[[Mtumiaji:Queen Chloe ug|Queen Chloe ug]] ([[Majadiliano ya mtumiaji:Queen Chloe ug#top|majadiliano]])''' 09:54, 3 Julai 2026 (UTC) 4sdqrstfdzkzip7ad8sl61znzlbodhb 3 241799 1578256 2026-07-03T09:49:14Z AmmarBot 81277 Karibu 1578256 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:49, 3 Julai 2026 (UTC) ic8oqg266kbhrxd1rvb7gcuvdlut9co 3 241800 1578257 2026-07-03T09:49:24Z AmmarBot 81277 Karibu 1578257 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:49, 3 Julai 2026 (UTC) ic8oqg266kbhrxd1rvb7gcuvdlut9co 3 241801 1578258 2026-07-03T09:49:34Z AmmarBot 81277 Karibu 1578258 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:49, 3 Julai 2026 (UTC) ic8oqg266kbhrxd1rvb7gcuvdlut9co 3 241802 1578259 2026-07-03T09:49:44Z AmmarBot 81277 Karibu 1578259 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:49, 3 Julai 2026 (UTC) ic8oqg266kbhrxd1rvb7gcuvdlut9co 3 241803 1578260 2026-07-03T09:49:54Z AmmarBot 81277 Karibu 1578260 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:49, 3 Julai 2026 (UTC) ic8oqg266kbhrxd1rvb7gcuvdlut9co 3 241804 1578261 2026-07-03T09:50:04Z AmmarBot 81277 Karibu 1578261 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:50, 3 Julai 2026 (UTC) brwjtgfxk2qhdu421fklcx7o3v535zq 3 241805 1578262 2026-07-03T09:50:14Z AmmarBot 81277 Karibu 1578262 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:50, 3 Julai 2026 (UTC) brwjtgfxk2qhdu421fklcx7o3v535zq 3 241806 1578263 2026-07-03T09:50:24Z AmmarBot 81277 Karibu 1578263 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:50, 3 Julai 2026 (UTC) brwjtgfxk2qhdu421fklcx7o3v535zq 3 241807 1578264 2026-07-03T09:50:34Z AmmarBot 81277 Karibu 1578264 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:50, 3 Julai 2026 (UTC) brwjtgfxk2qhdu421fklcx7o3v535zq 3 241808 1578265 2026-07-03T09:50:44Z AmmarBot 81277 Karibu 1578265 wikitext text/x-wiki <div style="background-color: #EEEEFF; border: solid 1px #eaa5ff; padding: 6pt; margin: 1em auto; width: 85%"> <p style="margin-left: 5em;">'''<big>Karibu kwenye Wikipedia kwa Kiswahili!</big>'''</p> Tunamfurahia kila mmoja anayeingia na kuungana nasi. Hii ni kamusi elezo ya maandishi huru. Unaweza kuandika makala uipendayo ama kuitafsiri kutoka Wikipedia ya lugha nyingine. Ukipenda kutumia '''kurasa zetu za mwongozo na msaada''', a) ukitumia simu bofya kwa "'''Dawati'''" chini kwenye dirisha lako na b) ubadilishe mwonekano wa Wikipedia kwa kubofya "'''Switch to old look'''" kwenye menyu upande wa kushoto. Kwa mawili matatu labda tazama:<br> * [[Wikipedia:Ukurasa wangu na kurasa za kamusi|Kuhusu ukurasa wako wa mtumiaji na kurasa nyingine]] * [[Wikipedia:Mwongozo|Ukurasa wa mwongozo]] * [https://sw.wikipedia.org/wiki/Jamii:Msaada Jamii:Msaada] <small>(makala zilizomo humo zinaweza kusaidia mara nyingi)</small> * [[Wikipedia:Jumuia|Ukurasa wa jumuia]] <small>(pamoja na '''[[Wikipedia:Wakabidhi]]''', penye majina walio tayari kukusaidia)</small> * [[Wikipedia:Makala za msingi za kamusi elezo|Makala za msingi za Wikipedia]] Jisikie huru kuuliza swali lolote lihusianalo na Wikipedia hii. Karibu kujitambulisha kwenye "Ukurasa wa mtumiaji". Ukitaka kupata kwanza uzoefu wa kuweza kuhariri Wikipedia, tafadhali tumia '''[[Msaada:Jaribio#2._Jaribio_katika_nafasi_yako_ya_mtumiaji| ukurasa wako kwa majaribio]]'''. Humo unaruhusiwa kujipatia uzoefu wa uundaji wa makala za Wikipedia! Juu yako mwenyewe uandike tu kwenye '''[[Special:Mypage|ukurasa wako wa mtumiaji]]'''. Humo uko huru kutangaza chochote upendacho, kama si biashara au matusi. <big>'''Ujue miiko:'''</big> * usilete kamwe matini wala [[Msaada:Picha|picha kutoka tovuti za nje]]. * usiingize matangazo ya kibiashara (pamoja na kuelekeza kwa kurasa zenye matangazo). * usimwage kamwe matini kutoka [[Msaada:Tafsiri ya kompyuta‎|google-translate]] au [[Msaada:Tafsiri|programu za kutafsiri]]. * usitumie kama vyanzo vya taarifa au tanbihi <nowiki><ref>Wikipedia (au mradi mwingine wa Wikimedia)</ref></nowiki>, ila unaweza kutumia vyanzo vyake kwa kuvitaja vyenyewe moja kwa moja. Tunakushauri pia [[Wikipedia:Email|kuandikisha email]] yako; haitaonekana na wengine lakini wataweza kukuandikia kupitia mfumo wa Wikipedia. Karibu sana! <p style="margin-left: 5em;">'''Welcome to Kiswahili Wikipedia!'''</p> We welcome you even if you don't speak Kiswahili. For a bot flag go to [[Wikipedia:Bots|this site]]. If you try to edit entries as a non-speaker, it is better to first communicate with one of our admins who can advise you. You may find them at [[Wikipedia:Wakabidhi]]. And, please: * '''do not''' post computer translated texts (like Google Translate, [[Special:ContentTranslation|Content Translation]], etc. all do not work for Swahili) * nor copied texts/images from other webs to this site! * do not use links to commercial pages, never post anything that looks like advertising. * do not use as references <nowiki><ref>Wikipedia (or another project of Wikimedia)</ref></nowiki>, though you can use their references by writing them themselves. As a newcomer we advise that you [[:en:Wikipedia:Emailing_users|register your email]]. This will not be visible to others but it allows us to notify you, which often is helpful in case of problems. </div> '''[[Mtumiaji:AmmarBot|AmmarBot]] ([[Majadiliano ya mtumiaji:AmmarBot|majadiliano]])''' 09:50, 3 Julai 2026 (UTC) brwjtgfxk2qhdu421fklcx7o3v535zq 0 241809 1578270 2026-07-03T10:10:29Z Riccardo Riccioni 452 Ukurasa ulianzishwa kwa kuandika ''''{{PAGENAME}}''' (au '''Maandishi yaliyobaki ya [[Nabii Yeremia|Yeremia]]'''<ref>{{Cite web|url=http://ccat.sas.upenn.edu/rs/rak/publics/pseudepig/ParJer-Eng.html|title=Paraleipomena Jeremiah English}}</ref>) ni [[kitabu]] cha kale ambacho [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]], isipokuwa na [[Ukristo|Wakristo]] [[Waorthodoksi wa Mashariki]] wa [[Kanisa la Kiorthodoksi la Ethiopia|Ethiopia]] na Kanisa la Kiorthodoksi la Eritrea|Erit...' 1578270 wikitext text/x-wiki '''{{PAGENAME}}''' (au '''Maandishi yaliyobaki ya [[Nabii Yeremia|Yeremia]]'''<ref>{{Cite web|url=http://ccat.sas.upenn.edu/rs/rak/publics/pseudepig/ParJer-Eng.html|title=Paraleipomena Jeremiah English}}</ref>) ni [[kitabu]] cha kale ambacho [[Kanuni ya Biblia|hakikukubaliwa]] kama [[Neno la Mungu]], isipokuwa na [[Ukristo|Wakristo]] [[Waorthodoksi wa Mashariki]] wa [[Kanisa la Kiorthodoksi la Ethiopia|Ethiopia]] na [[Kanisa la Kiorthodoksi la Eritrea|Eritrea]]. Kiliandikwa [[mwaka]] [[136]] hivi, ingawa kinajidai kuandikwa na [[nabii Baruku]]. ==Tazama pia== * [[Apokrifa]] == Tanbihi == {{Reflist}} ==Viungo vya nje== * [https://ccat.sas.upenn.edu/rak//publics/pseudepig/ParJer-Eng.html English translation] * [https://web.archive.org/web/20081001042651/http://ocp.acadiau.ca/ Greek text] * [http://www.earlyjewishwritings.com/4baruch.html Early Jewish Writings] * [https://web.archive.org/web/20070128151732/http://wesley.nnu.edu/biblical_studies/noncanon/summaries/4baruch-notes.htm Notes on 4 Baruch] {{mbegu-Biblia}} [[Jamii:apokrifa]] [[Jamii:Biblia]] bphm4s7ys0aeoqdjoty3j4jlrx3gf0b