Ukwazi Isikhathi Sokuvivinya Nalokho Okushiwo Imiphumela
I-virus ye-Zika yabangela ukwesaba emhlabeni wonke ngonyaka wezi-2015 lapho izifo ezithwala umiyane zithatha kakhulu eNingizimu neMelika Ephakathi kwaze kwaba sezingxenyeni eziseningizimu ye-United States. Nakuba lesi sifo sivame ukubangela ukugula okuncane, okubhebhetheka komkhuhlane, kungabhubhisa uma kwenzeka ngesikhathi sokukhulelwa, okuholela ezimweni ezingavamile ekubhekeni kwesifo sokuzalwa, okuthiwa i-microcephaly, lapho ingane izalwa khona nenhloko encane nobuchopho obungavamile.
Kungenxa yalesi sizathu ukuthi ukuxilongwa kubalulekile kubomama okungenzeka bavezwe ngegciwane lesandulela ngculazi ngenxa yokulunywa umiyane. Ngaphezu kwalokho, ngoba igciwane lingadluliselwa kusuka kumuntu kuya kwabesifazane ngesikhathi sezocansi, ukuhlolwa-okuhlanganisa inhlanganisela yokuhlolwa kwegazi kanye nomchamo-kungabona umlingani onegciwane futhi mhlawumbe kuvimbele ukudluliselwa.
Izinkomba zokuhlola
Ukulunywa ngumunyane, ngisho nasendaweni lapho igciwane lesandulela ngculazi likhona khona , akusho ukuthi usulelekile. Lesi sifo sidluliselwa uhlobo oluthile lwenyosi ebizwa ngokuthi i- Aedes aegypti , engabonakala ngamakhwala amhlophe emilenze yayo kanye nomumo we-lyre ukubeka phezu kwayo.
Ngisho noma une-HIV, ngeke ube nezimpawu . Uma wenza kanjalo, ngokuvamile beba mnene futhi bangabandakanya ukushisa, ukukhanda ikhanda, ubuhlungu obuhlangene, ubuhlungu be-muscle, izilonda ze-lymph ezivuvukalayo, mhlawumbe nokuphuza okuncane.
Uma ukholelwa ukuthi uye wadluliselwa ku-virus ye-Zika-noma ngenxa yokuthi unayo izimpawu noma uye endaweni eyingozi kakhulu-kunezivivinyo ezitholakalayo zokuthola ukutheleleka.
Iziphakamiso ze-CDC
Uma kuthiwa, ukuhlolwa kwe-Zika virus akuyona yonke into. Izinhloso eziyinhloko zokuhlola ukuvimbela ukudluliselwa kokutheleleka kusuka kumama kuya kwengane ngesikhathi sokukhulelwa nokuvimbela ukudluliselwa kwegciwane lesandulela ngculaza owesifazane okhulelwe noma ozokhulelwa.
Kuze kube sekugcineni, iCenters for Disease Control and Prevention (CDC) ikhuthaza ukuhlolwa kweZika kula maqembu alandelayo kuphela:
- Noma ubani, owesifazane noma owesilisa, enezibonakaliso okungenzeka ukuthi wayebhekene negciwane, noma ngenxa yokuthi bahlala endaweni engaphelele, baye bavakashela esifundeni esiphelele noma bahlanganyela ubulili obungavimbelwe nomuntu ohlala noma oye endaweni engaphelele
- Abesifazane abakhulelwe abanezibonakaliso zegciwane lesandulela ngculaza abaye bakwazi ukutholakala negciwane
- Abesifazane abakhulelwe bengenazo izimpawu abahlala endaweni lapho iZika ikhona khona noma ingozi yokuqhubeka nokuchayeka
- Abesifazane abakhulelwe abaye bahlaselwa isifo se-Zika futhi ingane yabo inezibonakaliso zokungazalwa okungavamile njenge- microcephaly kwi-ultrasound
Ukuhlolwa kungacatshangwa nabesifazane abakhulelwe abangenayo izimpawu okungenzeka ukuthi basanda kubonakala ukuthi banegciwane kodwa abangekho engozini eqhubekayo. Izifo ze-Zika ngokuvamile zibeka engozini enkulu emntwaneni ngesikhathi se-trimester yokuqala nasemasontweni ayisishiyagalombili ngaphambi kokukhulelwa.
Ngakolunye uhlangothi, ukuhlolwa akunconywa ngamadoda ngaphandle kwempawu, abesifazane abangakhulelwe abangenazo izimpawu, noma njengendlela yokuhlolwa kwangaphambi kwesikhathi.
Uma ungatholi ibhu yezohwebo eduze nawe okwazi ukwenza ukuhlolwa, shayela isendaweni noma isifunda sakho ongakunikeza ku-laboratory evunyelwe.
Izivivinyo ze-Lab
Kunezivivinyo ezimbili ezihlukene ezisetshenziselwa igciwane lesandulela ngculaza, elibhekene nesifo segciwane lesigciwane kanye nelinye elifuna ubufakazi bokutheleleka ngendlela yama-proteine avikelayo okuthiwa ama-antibodies .
Lezi zivivinyo ezimbili zenziwa ngesikhathi esifanayo ukuze zihlolwe. Lokhu kungenxa yokuthi ukuhlolwa kofuzo, okwaziwa ngokuthi i- RNA nucleic acid ukuqinisekiswa kokukhulisa (NAT) , kukhulunywa ngokucacile ekukwazi ukutholakala negciwane kepha kungacabangi okungenani (okusho ukuthi kutholakala emiphumeleni engalungile ).
Ngokuphambene nalokho, ukuvivinywa kwe- immunoglobulin (IgM) ye-antibody kunesibindi kakhulu kodwa kungacacile (okusho ukuthi ayikwazi ukuhlukanisa iZika kusuka kumagciwane afanayo).
Uma isetshenziselwa ndawonye, ukuhlolwa kwe-RNA NAT ne-IgM kunikeza izinga eliphakeme lokunemba uma uhlola iZika.
Ukuhlolwa kwe-RNA NAT
Ukuhlolwa kwe-RNA NAT ubuchwepheshe obusheshayo ukukhulisa inani lezinhlayiya zofuzo egazini, umchamo, nezinye izifo zomzimba ezivela ezinkulungwaneni ezimbalwa kuya kwezigidi eziyinkulungwane.
Ngokwenza kanjalo, lebhu ingabona i-close-close uma kunomabuphi ubufakazi bofuzo bokutheleleka kweZika. Uma usolwa ukuthi unesifo se-Zika, ukuhlolwa kwe-NAT kufanele kwenziwe kwenzelwa isampula yegazi neyomchamo ethathwe ngesikhathi esifanayo.
Inzuzo yokuhlolwa kwe-NAT yilapho ingenziwa ngemuva nje kokuthi izimpawu zivele. Uma kuthiwa, izinga le-RNA egazini lizokwehla ngokushesha njengoba amasosha omzimba aqala ukulawula ukutheleleka. Ngenxa yalokho, ukuhlola kwe-NAT kubhekwa njengelusizo kuphela uma kuhlolwe ezinsukwini ezingu-14 zokuqala izimpawu. (Okuwukuphela kokukodwa kulaba besifazane abakhulelwe abanomzimba lapho i-RNA enegciwane ingaphikelela kuze kube amasonto angu-12.)
Ngenxa yokulinganiselwa kokuhlolwa, umphumela we-NAT omubi awufaki ukutheleleka kwegciwane le-Zika.
Ukuhlolwa kwe-IgM
Ukuhlola kwe-IgM yisilingo esisekelwe egazini esithola ama-antibodies akhiqizwa ngumzimba ukulwa negciwane leZika. Kungathatha umzimba kuze kube amasonto amabili emva kokuvezwa ukukhiqiza ama-antibodies anele ukuletha umphumela onembile. Ukuhlola kusenesikhathi kungabangela umphumela omubi .
Izinga lama-anti-zika liye landa ukwanda ngokuncipha kwe-RNA egazini. Njengoba kunjalo, ukuhlolwa kwe-IgM kuyasiza kakhulu emavikini angu-12 okuqala okutheleleka futhi ngezinye izikhathi isikhathi eside. Kungasetshenziswa futhi ukuhlola uketshezi lwe-cerebrospinal ezimweni lapho ukutheleleka kwe-Zika kubangele ukuvuvukala kobuchopho.
Lapho ukuvivinya kwe-IgM kungase kungabi khona kuyinkinga yayo kwigciwane leZika. I-Zika virus igxile emndenini waseFlaviviridae futhi ihlobene eduze ne-virus edala i-dengue fever , i- yellow fever , ne- encephalitis yaseJapane . Ngenxa yalokhu, ukuhlolwa kungase kubuyele ngokuphindaphindiwe imiphumela engalungile. Lokhu kungenye yezizathu zokuthi ukuhlolwa kokuqinisekisa kubaluleke kangakanani.
Ngenxa yobuzwe bayo obuphezulu, ukuhlolwa okungalungile kwe-IgM kungabhekwa njengokucacile.
Ukuhlolwa kokunciphisa kwe-Plaque Ukunciphisa I-Plaque
Ukuhlolwa kokunciphisa i-Plaque (PRNT) kuyisimo esilinganisa izinga lokulwa ne- antibodies egazini. Ama-antibodies we-neutralizing yi-subset yama-immunoglobins ayingxenye yokubulala igciwane. Ngokungafani nama-antibodies angenayo i-neutralizing etholakalayo ekuhlolweni kwe-IgM, izinkinga zokulwa ne-neutralizing zingase zihlale emzimbeni iminyaka, zilungele ukuhlasela uma igciwane livele livele.
I-PRNT igcinwe ukuqinisekisa ukuhlolwa okungaqondile, okungaqondakaliyo, noma okweqisayo.
Ukuhlola ekukhulelweni
Imihlahlandlela yokuhlola ekukhulelweni ihlukahluka ngokuthi ngabe wena, njengomama, unayo izimpawu futhi usengozini yokuqhubeka nokutheleleka. I-CCD njengamanje iyancoma:
- Uma ukhulelwe futhi unezibonakaliso zokuhlolwa kukaZika, i-NAT kanye ne-IgM kungenziwa ngesikhathi esifanayo phakathi kwamasonto angu-12 wokubonakala kwezimpawu.
- Uma ungenayo izimpawu kodwa usolwa ukuthi uye wadalulwa, kufanele uhlolwe phakathi kwamasonto amabili kuya kwangu-12 ukubuyela endaweni yesifunda noma ukulala nomuntu otholakala ngegciwane leZika.
- Uma ukhulelwe futhi uhlala esifundeni lapho kukhona ingozi eqhubekayo yokuchayeka, kufanele ube nokuhlolwa kwe-IgM ngesikhathi sokuvakasha kwakho kokuqala kokubeletha nokuvakashelwa okubili kokunye.
- Uma i-ultrasound yembula izimpawu zokukhubazeka okuzalwa okuhambisana ne-Zika virus, uzonikezwa kokubili ukuhlolwa kwe-NAT no-IgM. Ukuhlolwa kwe-NAT kwe-amniotic fluid nakho kungenziwa.
Ukuhlonza okuhlukile
Ngenxa yokuthi igciwane leZika lifana nesakhiwo se-molecular kanye / noma izimpawu kwezinye izifo ezithwala izinambuzane nezinambuzane, ezinye izimbangela zingadingeka ukuba zikhishwe ngaphandle uma imiphumela yakho yokuhlola ingaphansi kwezingqikithi. Bangase bahlanganise:
- I-Chikungunya virus
- I-Dengue
- Leptospirosis
- I-Malaria
- I-Parvovirus
- I-Rubella
- Ukutheleleka kukaRickettsial
- I-Yellow Fever
Uma Uhlola Okuhle
Imiphumela emihle ye-Zika izoqinisekisa ukuthi unegciwane. Ukuze ugweme ukudlulisa igciwane kumlingani ozocansi, kungadingeka ukuthi ubaleke ucansi noma usebenzise amakhondomu njalo ngezinyanga ezingaphansi kwezinyanga eziyisithupha. Lokhu kuyiqiniso ikakhulukazi uma umlingani wakho ekhulelwe noma eminyakeni yakhe ethwele ingane.
Uma uthola umphumela omuhle ngesikhathi ukhulelwe, akusho ukuthi ingane yakho izothola ukukhubazeka kokuzalwa noma ukuthi uzokhipha isisu. Iningi lalezi zifo azitholakali kulezi zinkinga. Esikhundleni salokho, ukuqhutshwa komshini wengane yakho kuzokwenziwa ukuze kuqaphe intuthuko yengane yakho futhi uhlole noma yiziphi izimpawu zenkathazo.
Uma ingane yakho izalwa engenamaphutha, kuzotholakala ukuhlolwa okuningi ukuze kuqinisekiswe ukuthi konke kulungile, kufaka phakathi:
- Ukuhlolwa kwe-Zika virus ngesikhathi sokuzalwa
- Ukuhlolwa kokuzwa ngaphambi kokukhipha esibhedlela
- I-head ultrasound engakapheli inyanga eyodwa yokuzalwa
- Ukuhlolisisa amehlo okuphelele ngaphakathi kwenyanga eyodwa yokuzalwa
- Isivivinyo esiphezulu se-brainory response (ABR) ngaphakathi kwenyanga eyodwa yokuzalwa ukuhlola izinzwa zomntwana zokuzwa
Uma ingane yakho izalwa enephutha lanoma yiluphi uhlobo, kungakhathaliseki ukuthi luyingcosana noma lukhulu, ukuhanjelwa kuzokwenzelwa izazi ze-neurologists, i-ophthalmologists, nezinye izazi ezikwazi ukuphatha nokuphatha isimo somntanakho. Ukuthuthukiswa kanye nezinye izinsiza zokungenelela zizofunwa ngaphezu kwemisebenzi yokwesekwa komndeni.
> Imithombo:
> Amasevisi Okulawula Nokuvimbela Izifo (CDC). "I-Zika nokukhulelwa: Ukuhlola nokuhlola | Isifo Sosandulela Ngculaza Sase-Congenital." I-Atlanta, Georgia; ibuyekezwe ngo-Ephreli 16, 2018.
> CDC. "I-Virus Zika: Izivivinyo Zokuxilongwa Ze-Virus Zika." Kubuyekezwe i-Disemba 12, 2017.
> Petersen, E .; I-Polen, K .; UMeaney-Delman, uDana; et al. "Ukuvuselela: Isiqondiso Sesikhashana Sezinhlinzeko Zokunakekelwa KwezeMpilo Ukunakekela Abesifazane Besikhathi Sokukhiqiza Ngendlela Ebonakala Ngayo Ye-Virus Zika- > United > States, 2016." I- MMWR. 2016; 65 (12): 315-22. I-DOI: 10.15585 / mmwr.mm6512e2.