Uburwayi bwo Kudahuka mu Tugo (Sleep Apnea): Ibimenyetso, Intandaro, n’Umuti

Uburwayi bwo kudahuka mu tugo (sleep apnea) ni uburwayi bwo mu buriri aho umwuka wawe uhagarara ukongera ugatangira kenshi nijoro. Ibi bihagarara bishobora kumara amasegonda make cyangwa iminota irenga umwe, kandi kenshi bibaho utamenye.

Tekereza ko umubiri wawe uhagaritse guhumeka mu gihe uri kuryama. Ubwonko bwawe bumenya ko umwuka muke, maze bugutera gukanguka gato kugira ngo wongere guhumeka. Uyu muzenguruko ushobora kwihuza inshuro nyinshi cyangwa amajana buri joro, bikagutera umunaniro nubwo waba wararyamye ijoro ryose.

Ibimenyetso by’Uburwayi bwo Kudahuka mu Tugo ni ibihe?

Ibimenyetso byerekana uburwayi bwo kudahuka mu tugo bikunze kugaragara kumanywa mu gihe uri maso. Ushobora kumva unaniwe nubwo wararyamye amasaha menshi, cyangwa ukabona uri kuryama mu bikorwa bikeye nko gusoma cyangwa kureba televiziyo.

Dore ibimenyetso bisanzwe ushobora kugira nijoro no kumanywa:

• Guhinda urusaku cyane, bikomeye bishobora kubyutsa abandi
• Guhumeka cyangwa guhumeka nabi mu gihe uri kuryama
• Guhagarika guhumeka byaboneka n’uwo muryamana
• Kanguka kenshi nijoro
• Kubabara umutwe mu gitondo bigashira uko umunsi ugenda
• Kumva unaniwe cyane kumanywa
• Kugorana kwibanda cyangwa ibibazo byo kwibuka
• Kwiheba cyangwa guhinduka kw’imitekerereze
• Kumva umunwa wumye cyangwa ijosi ryababaye uvuye kuryama

Bamwe bagira n’ibimenyetso bidafata kenshi nko gucana iminsi nijoro, gukora kenshi nijoro, cyangwa kugorana kuryama. Ibi bimenyetso bishobora gutandukana ukurikije umuntu, kandi ntabwo ukeneye kubigira byose kugira ngo ugire uburwayi bwo kudahuka mu tugo.

Ubwoko bw’Uburwayi bwo Kudahuka mu Tugo ni ubuhe?

Hari ubwoko butatu nyamukuru bw’uburwayi bwo kudahuka mu tugo, buri bwoko bufite intandaro zitandukanye. Gusobanukirwa ubwoko ushobora kuba ufite bifasha mu gupima uburyo bwiza bwo kuvura.

Uburwayi bwo kudahuka mu tugo buterwa no gufunga inzira y’umwuka (Obstructive sleep apnea - OSA) ni bwo bwoko busanzwe, bugira ingaruka ku bantu bagera kuri 90% bafite uburwayi bwo kudahuka mu tugo. Imitsi yo mu ijosi iruhuka cyane mu gihe cyo kuryama, bituma inzira y’umwuka igabanuka cyangwa ifunze burundu. Ibi bituma habaho guhinda urusaku no guhagarika guhumeka.

Uburwayi bwo kudahuka mu tugo buterwa n’ubwonko (Central sleep apnea - CSA) ni buke kandi buhaba igihe ubwonko bwawe budatanga amakuru akwiye ku mitsi igenzura guhumeka. Bitandukanye na OSA, ntabwo ukunze guhinda urusaku cyane, ariko uzakomeza guhagarika guhumeka no kunanirwa kumanywa.

Uburwayi bwo kudahuka mu tugo buhuriweho n’ubwoko bubiri (Complex sleep apnea syndrome) buhuza ubwoko bubiri. Utangira ufite ibibazo byo gufunga inzira y’umwuka, ariko nubwo inzira y’umwuka ifunzwe ivuwe, ibimenyetso bya central apnea bigaragara. Ubu bwoko buvangiye busaba uburyo bwihariye bwo kuvura.

Intandaro z’Uburwayi bwo Kudahuka mu Tugo ni izihe?

Uburwayi bwo kudahuka mu tugo buhaba igihe hari ikintu kibangamira uburyo bwawe busanzwe bwo guhumeka mu gihe cyo kuryama. Intandaro zitandukana bitewe n’ubwoko ufite, ariko ibintu byinshi bishobora gutera iyi ndwara.

Ku burwayi bwo kudahuka mu tugo buterwa no gufunga inzira y’umwuka, ibintu by’umubiri bigabanya inzira y’umwuka ni byo bigira uruhare runini:

• Urubura rw’umubiri, cyane cyane mu ijosi no mu kanwa
• Amatonsille cyangwa adenoids manini
• Ijosi rikomeye (irenga santimetero 43 ku bagabo, santimetero 40 ku bagore)
• Ururimi runini rushobora gufunga inzira y’umwuka
• Ibibazo byo mu mazuru cyangwa ibibazo by’imiterere
• Ijosi ridafite ubushobozi bwo gufungura

Uburwayi bwo kudahuka mu tugo buterwa n’ubwonko bufite intandaro zitandukanye, kenshi zifitanye isano n’uburwayi cyangwa imiti:

• Gucika intege kw’umutima cyangwa ibindi bibazo by’umutima
• Stroke cyangwa uburibwe bw’ubwonko
• Kuryama ahantu hari hejuru
• Imiti imwe n’imwe ihagarika ububabare, cyane cyane imiti y’ibyago
• Gucika intege kw’impyiko
• Kuzalirwa imburagihe (ku bana)

Rimwe na rimwe, uburwayi bwo kudahuka mu tugo buterwa n’ubwonko buhaba nta ntandaro isobanutse. Muganga wawe ashobora kugufasha kumenya icyaba gitera ikibazo cyawe.

Ibyago byo Kurwara Uburwayi bwo Kudahuka mu Tugo ni ibihe?

Ibintu bimwe na bimwe bikongera ibyago byo kurwara uburwayi bwo kudahuka mu tugo, nubwo ufite ibyago ntibibuza ko uzabirwara. Gusobanukirwa ibi bishobora kugufasha wowe na muganga wawe gusuzuma ibyago byawe byo kurwara uburwayi bwo kudahuka mu tugo.

Imyaka n’igitsina bigira uruhare runini mu byago byo kurwara uburwayi bwo kudahuka mu tugo:

• Kuba umugabo (abagabo bafite ibyago byinshi inshuro 2-3 kurusha abagore)
• Kuba ufite imyaka irenga 40
• Kuba umaze guhita mu gihe cyo kubyara (ku bagore)
• Kugira amateka yo mu muryango y’uburwayi bwo kudahuka mu tugo

Ubuzima n’imiterere y’ubuzima bikongera ibyago byawe:

• Kuba ufite umubyibuho ukabije
• Kunywesha itabi
• Kunywesha inzoga buri gihe, cyane cyane mbere yo kuryama
• Kunywa imiti ihagarika uburibwe cyangwa ituza
• Kugira diabete
• Kugira umuvuduko w’amaraso muriki
• Amwe mu moko (Abanyamerika b’Abirabura, Abahispanike, Abatuye mu birwa bya Pasifika)

Nubwo ufite ibyago byinshi, uburwayi bwo kudahuka mu tugo si uko buzabaho. Ibyinshi muri ibi bintu, nko kuba ufite umubyibuho ukabije no kunywesha itabi, bishobora guhinduka kugira ngo ugabanye ibyago byawe.

Ni ryari ukwiye kujya kwa muganga kubera uburwayi bwo kudahuka mu tugo?

Ukwiye gutekereza kujya kwa muganga niba ufite umunaniro ukomeye kumanywa ubangamira ibikorwa byawe bya buri munsi. Ibi ni ingenzi cyane niba uri kuryama mu biganiro, mu gihe uri gutwara imodoka, cyangwa mu kazi.

Ibindi bimenyetso bikomeye bisaba ubuvuzi harimo guhinda urusaku cyane hamwe no guhumeka nabi cyangwa guhumeka nabi mu gihe cyo kuryama. Niba uwo muryamana abona uhagaritse guhumeka mu gihe cyo kuryama, ibi ni ikimenyetso gikomeye cy’uko ukeneye isuzuma ry’umwuga.

Ntugatege amatwi niba ufite ububabare bw’umutwe mu gitondo, kugorana kwibanda, cyangwa guhinduka kw’imitekerereze hamwe n’ibimenyetso byo kuryama. Ibi bimenyetso bigaragaza ko ireme ry’uburyo bwawe bwo kuryama ryagize ingaruka zikomeye, ibyo bishobora kugira ingaruka ku buzima bwawe rusange n’umutekano.

Shaka ubuvuzi bw’ihutirwa niba ufite umunaniro ukabije kumanywa ukugiraho ingaruka mu gihe uri gutwara imodoka cyangwa uri gukora imashini. Impanuka ziterwa n’uburwayi bwo kudahuka mu tugo zishobora kwirindwa hakoreshejwe uburyo bukwiye bwo kuvura.

Ingaruka zishoboka z’Uburwayi bwo Kudahuka mu Tugo ni izihe?

Uburwayi bwo kudahuka mu tugo butaravuwe bushobora gutera ibibazo bikomeye by’ubuzima mu gihe kirekire. Kugabanuka kenshi kw’umwuka no kubangamirwa kuryama bigira ingaruka ku migendekere y’umubiri, cyane cyane umutima n’ubwonko.

Ingaruka ku mutima ni zimwe mu zikomeye cyane:

• Umuvuduko w’amaraso muriki ugora kuvura
• Ibibazo by’umutima (arrhythmias)
• Gucika intege kw’umutima
• Ibyago byiyongereye byo kurwara indwara y’umutima
• Stroke
• Umuvuduko w’amaraso muriki mu mitsi y’ibihaha (pulmonary hypertension)

Uburwayi bwo kudahuka mu tugo bugira kandi ingaruka ku miterere y’umubiri n’ubuzima bwo mu mutwe:

• Diabete yo mu bwoko bwa 2 cyangwa kudakora neza kwa insulin
• Kubyibuha no kugorana kugabanya ibiro
• Kwiheba no guhangayika
• Ibibazo byo kwibuka no kugabanuka kw’ubushobozi bwo gutekereza
• Kugabanuka kw’ubudahangarwa bw’umubiri
• Ibyago byiyongereye by’impanuka kubera umunaniro kumanywa

Inkuru nziza ni uko kuvura uburwayi bwo kudahuka mu tugo bishobora kugabanya cyane ibyo byago kandi bikunze kunoza ubuzima bumaze kubaho. Abantu benshi babona kunoza umuvuduko w’amaraso, ingufu, n’imitekerereze mu byumweru bike nyuma yo gutangira kuvurwa.

Uburwayi bwo Kudahuka mu Tugo bushobora kwirindwa gute?

Nubwo udashobora kwirinda ubwoko bwose bw’uburwayi bwo kudahuka mu tugo, ushobora kugabanya ibyago byawe ukora amahitamo y’ubuzima bwiza. Uburyo bwinshi bwiza bwo kwirinda bugendera ku kugumana ubuzima bwiza rusange n’imyitwarire myiza yo kuryama.

Kugabanya ibiro ni kimwe mu bintu bikomeye cyane byo kwirinda ushobora gukora. Kugabanya ibiro bike bya kilogaramu 4.5-6.8 bishobora kugabanya cyane ibyago byo kurwara uburwayi bwo kudahuka mu tugo niba ufite umubyibuho ukabije. Gukora siporo si ukugabanya ibiro gusa ahubwo binonosora ireme ry’uburyo bwo kuryama kandi bigabanya kubyimba.

Aho uryama n’imyitwarire yawe yo kuryama na byo ni ingenzi:

• Ryama ku ruhande aho kuryama ugaramye
• Komeza inzira z’amazuru zifunguye ukoresheje amazi asukuye cyangwa imiti igabanya umuvuduko
• Irinde inzoga n’imiti ituza, cyane cyane mbere yo kuryama
• Reka kunywesha itabi, kuko byongera kubyimba mu nzira y’umwuka
• Komeza gahunda isanzwe yo kuryama
• Vura allergie zituma amazuru afunga

Niba ufite ibyago udashobora guhindura, nko kugira amateka yo mu muryango cyangwa imyaka, shyira imbaraga mu byo ushobora guhindura. Kusuzuma buri gihe kwa muganga wawe bishobora kugufasha kubona uburwayi bwo kudahuka mu tugo hakiri kare igihe bworoshye kuvura.

Uburwayi bwo Kudahuka mu Tugo bupimwa gute?

Gupima uburwayi bwo kudahuka mu tugo bisanzwe bitangira hagamijwe kuganira byimbitse ku bimenyetso byawe n’imyitwarire yo kuryama. Muganga wawe azakubaza ibyerekeye guhinda urusaku, umunaniro kumanywa, nibyo uwo muryamana yabonye ku bijyanye no guhumeka kwawe mu gihe cyo kuryama.

Isuzuma ry’umubiri rigendera ku nzira y’umwuka n’ijosi. Muganga wawe azapima ingano y’ijosi ryawe, azasuzume ijosi ryawe kugira ngo arebe niba hari imyanya yagutse, kandi arebe ibimenyetso byo mu mazuru cyangwa ibibazo by’imiterere bishobora gutera ibibazo byo guhumeka.

Uburyo bwiza bwo gupima uburwayi bwo kudahuka mu tugo ni ubushakashatsi bwo kuryama, bwitwa polysomnography. Ibi bishobora gukorwa mu bitaro byo kuryama cyangwa rimwe na rimwe mu rugo hakoreshejwe ibikoresho byoroheje. Mu gihe cy’ubushakashatsi, ibikoresho bipima guhumeka kwawe, umuvuduko w’umutima, imikorere y’ubwonko, n’umwuka mu gihe cyo kuryama.

Ibizamini byo kuryama byo murugo biriyongera ku bantu bafite ibimenyetso bigaragara kandi badafite ibindi bibazo byo kuryama. Ibi bizamini byoroshye bigendera ku buryo bwo guhumeka n’umwuka. Ariko, ubushakashatsi bwo mu bitaro butanga amakuru arambuye kandi bukenewe mu gihe cy’ibibazo bikomeye cyangwa igihe hari ibindi bibazo byo kuryama bikekwa.

Umuti w’Uburwayi bwo Kudahuka mu Tugo ni uwuhe?

Kuvura uburwayi bwo kudahuka mu tugo biterwa n’ubwoko n’uburemere bw’uburwayi bwawe. Intego ni ukomeza inzira y’umwuka ifunguye mu gihe cyo kuryama kandi ukabona ijoro ryiza ridasanzwe.

Uburyo bwo guhumeka buhoraho bufite umuvuduko (Continuous Positive Airway Pressure - CPAP) ni bwo buryo busanzwe kandi bukoreshwa cyane mu kuvura uburwayi bwo kudahuka mu tugo buterwa no gufunga inzira y’umwuka buri hagati n’ubukomeye. Iyi mashini itanga umwuka ufite umuvuduko binyuze mu gikoresho cyo mu maso kugira ngo ikomeze inzira y’umwuka ifunguye. Nubwo bisaba igihe kugira ngo umenye, abantu benshi babona kunoza cyane ibimenyetso byabo mu minsi mike.

Ubundi buryo bwo guhumeka bufite umuvuduko burimo imashini za BiPAP, zitanga umuvuduko utandukanye wo guhumeka no guhemba, n’imashini za Auto-PAP zihita zihinduranya umuvuduko nijoro. Ibi bikorwa bikora neza ku bantu bagorana kwihanganira kuvurwa kwa CPAP.

Ibikoresho byo mu kanwa bitanga uburyo buke cyane bwo kuvura uburwayi bwo kudahuka mu tugo buke cyangwa buri hagati. Ibi bikoresho byakozwe ku giti cyawe bihindura aho umunwa cyangwa ururimi biherereye kugira ngo bikomeze inzira y’umwuka ifunguye. Bikora neza cyane ku bantu badashobora kwihanganira imashini za CPAP.

Uburyo bwo kubaga buhari igihe ubundi buryo butarakoze:

• Gukuraho imyanya y’umubiri mu ijosi (UPPP)
• Guhindura aho amagufwa y’umunwa aherereye (maxillomandibular advancement)
• Ibikoresho byashyizwe mu mubiri bisakuza imitsi yo mu nzira y’umwuka
• Kubaga mu mazuru kugira ngo kunoze guhumeka
• Gukuraho amatonsille cyangwa adenoids yagutse

Ku burwayi bwo kudahuka mu tugo buterwa n’ubwonko, kuvura kenshi bigendera ku kuvura ibibazo by’uburwayi nko gucika intege kw’umutima. Bamwe bagira akamaro k’ibikoresho bya adaptive servo-ventilation (ASV) cyangwa imiti isakuza guhumeka.

Uburyo bwo kuvura uburwayi bwo kudahuka mu tugo murugo

Kuvura murugo bigira uruhare runini mu kuvura uburwayi bwo kudahuka mu tugo, bifatanije n’uburyo bwo kuvura bwa muganga kunoza ireme ry’uburyo bwawe bwo kuryama. Guhindura imyifatire yoroshye bishobora kugira ingaruka zikomeye ku bimenyetso byawe n’ubuzima bwawe rusange.

Aho uryama ni ingenzi kurusha uko ushobora kubitekereza. Kuryama ku ruhande birinda ururimi rwawe n’imiterere yoroheje kugwa inyuma no gufunga inzira y’umwuka. Urashobora gukoresha umusego w’umubiri cyangwa ibikoresho byihariye byo kuryama kugira ngo bikufashe kuguma ku ruhande rwawe nijoro.

Kugabanya ibiro bikomeza kuba kimwe mu bintu bikomeye cyane byo kuvura murugo. Kugabanya ibiro ku kigero cya 10% bishobora kunoza cyane ibimenyetso by’uburwayi bwo kudahuka mu tugo. Shyira imbaraga mu mirire yuzuye ifite imbuto, imboga, na poroteyine zoroheje mugihe ugabanya ibiryo byakozwe n’ibindi byinshi by’ibiryo.

Kora ahantu heza ho kuryama n’amahame:

• Komeza ibitanda byawe bikonje, byijimye kandi bituje
• Shyiraho igihe cyo kuryama no kubyuka buri gihe
• Irinde ibiryo byinshi, kafeyin, n’inzoga mbere yo kuryama
• Koresha humidifier niba umwuka wumye utera ibibazo mu nzira y’umwuka
• Komeza isuku nziza y’amazuru ukoresheje amazi asukuye
• Kora imyitozo y’ijosi n’ururimi nkuko muganga wawe abikubwiye

Niba ukoresha kuvurwa kwa CPAP, kubungabunga neza ni ingenzi. Suzuma igikoresho cyawe cyo mu maso n’imigozi buri gihe, hindura ibyuma nkuko bikenewe, kandi komeza igikoresho cyawe cyo mu maso gikora neza. Abantu benshi basanga kongera igihe cyo gukoresha buhoro buhoro bibafasha kumenyera kuvurwa kwa CPAP neza.

Uko wakwitegura gusura muganga wawe

Kwitunganya mbere yo gusura muganga wawe kubera uburwayi bwo kudahuka mu tugo bifasha guhamya ko ubona isuzuma ryiza kandi uburyo bwiza bwo kuvura. Tangira ukoresheje igihe cyo kuryama mu byumweru byibuze kimwe mbere yo gusura, ugaragaza igihe cyo kuryama, igihe cyo kubyuka, n’uko wumva waruhuye buri gitondo.

Saha uwo muryamana wawe kuza nawe cyangwa atange ibitekerezo byanditse ku myitwarire yawe yo kuryama. Bashobora kuvuga ibyerekeye guhinda urusaku rwawe, igihe cyose bahagaritse guhumeka, n’uburyo ukunze kubyuka nijoro. Aya makuru ni ingenzi cyane mu isuzuma rya muganga wawe.

Kora amakuru y’ingenzi uzazana mu gihe cyo gusura:

• Urutonde rwuzuye rw’imiti n’ibindi ukomeza kunywa
• Amateka y’ubuzima, harimo ibibazo by’umutima, diabete, cyangwa ibyabaga byabanje
• Amateka yo mu muryango y’uburwayi bwo kuryama
• Ibimenyetso byawe, harimo igihe byatangiye n’uburyo bigira ingaruka ku buzima bwawe bwa buri munsi
• Amakuru yerekeye kunywa inzoga na kafeyin
• Ibizamini byo kuryama byabanje cyangwa uburyo bwo kuvura wari wagerageje

Andika ibibazo ushaka kubaza, nko kumenya ubwoko bw’ibizamini byo kuryama ushobora kuba ukeneye, uburyo bwo kuvura buhari, n’igihe bisanzwe bitwara kugira ngo ubone kunoza. Ntugire ikibazo cyo gusaba ibisobanuro ku kintu udasobanukiwe.

Icyingenzi cyo kumenya ku bijyanye n’uburwayi bwo kudahuka mu tugo

Uburwayi bwo kudahuka mu tugo ni uburwayi bukomeye ariko buvurwa cyane bugira ingaruka kuri miliyoni z’abantu. Ikintu cy’ingenzi cyo gusobanukirwa ni uko kumva unaniwe nubwo wararyamye bihagije atari ibisanzwe, kandi ntabwo ugomba kubikomeza.

Gupima hakiri kare no kuvura bishobora kwirinda ibibazo bikomeye by’ubuzima no kunoza cyane ireme ry’ubuzima bwawe. Abantu benshi bafite uburwayi bwo kudahuka mu tugo babona kunoza cyane ingufu zabo, imitekerereze, n’ubuzima bwabo rusange mu byumweru bike nyuma yo gutangira kuvurwa.

Wibuke ko kuvura uburwayi bwo kudahuka mu tugo bihuzwa n’umuntu ku giti cye. Icyakora neza kuri umwe gishobora kuba atari cyo gikwiye kuri undi. Korera hamwe n’itsinda ryawe ry’abaganga kugira ngo mushake uburyo bwo kuvura buhuye n’ubuzima bwawe n’ibikenewe mu buzima.

Urugendo rwo kuryama neza rutangira ukoresheje kumenya ibimenyetso no gutera intambwe ya mbere yo gushaka ubufasha. Hamwe no kuvura neza no guhindura imyifatire, ushobora kwitega ijoro ryiza n’iminsi yuzuye imbaraga.

Ibibazo bikunze kubaho ku bijyanye n’uburwayi bwo kudahuka mu tugo

Uburwayi bwo kudahuka mu tugo bushobora gukira ubwarwo?

Uburwayi bwo kudahuka mu tugo ntabwo bukira ubwarwo, cyane cyane ubwoko buri hagati n’ubukomeye. Ariko, uburwayi bwo kudahuka mu tugo buke bushobora kunoza hakoreshejwe kugabanya ibiro, guhindura imyifatire, cyangwa kuvura ibibazo by’uburwayi nka allergie. Abantu benshi bakeneye uburyo bwo kuvura buhoraho kugira ngo bakomeze ibimenyetso byabo bigengwa kandi birinde ibibazo by’ubuzima.

Uburwayi bwo kudahuka mu tugo ni bibi niba butaravuwe?

Yego, uburwayi bwo kudahuka mu tugo butaravuwe bushobora gutera ibibazo bikomeye by’ubuzima harimo umuvuduko w’amaraso muriki, indwara y’umutima, stroke, na diabete. Byongera kandi ibyago by’impanuka kubera umunaniro kumanywa. Inkuru nziza ni uko ibyo byago bigabanuka cyane hakoreshejwe uburyo bukwiye bwo kuvura.

Bitwara igihe kingana iki kumenyera kuvurwa kwa CPAP?

Abantu benshi bakeneye ibyumweru 2-4 kugira ngo bamenyere kuvurwa kwa CPAP, nubwo bamwe babona kunoza ireme ry’uburyo bwabo bwo kuryama mu gihe cy’imbere.

Abana bashobora kurwara uburwayi bwo kudahuka mu tugo?

Yego, abana bashobora kurwara uburwayi bwo kudahuka mu tugo, cyane cyane kubera amatonsille na adenoids yagutse. Ibimenyetso ku bana harimo guhinda urusaku cyane, kuryama nabi, kunyara mu buriri, n’ibibazo by’imyitwarire kumanywa cyangwa kugorana kwibanda. Kuvura kenshi bigizwe no gukuraho amatonsille na adenoids yagutse, ibyo bishobora gukemura burundu ikibazo.

Kugabanya ibiro bikuraho uburwayi bwo kudahuka mu tugo?

Kugabanya ibiro bishobora kunoza cyangwa no gukuraho uburwayi bwo kudahuka mu tugo kuri bamwe, cyane cyane niba umubyibuho ukabije ari wo ntandaro nyamukuru. Ariko, si buri wese ufite uburwayi bwo kudahuka mu tugo ufite umubyibuho ukabije, kandi ibintu by’imiterere nko kuba ufite umunwa muto cyangwa imyanya yagutse bishobora gusaba ubundi buryo bwo kuvura. Nubwo kugabanya ibiro bitakuraho burundu uburwayi bwawe bwo kudahuka mu tugo, kenshi bituma ubundi buryo bwo kuvura bugira akamaro kurushaho.