Ukugonywa ukulwa nezifo yingxenye ebalulekile yocwaningo jikelele lokunakekelwa kwezempilo kubantu abanesifo sofuba (IBD) . Ukuhlala usesikhathini ekugonyeni kubalulekile ngezizathu eziningi, kepha ikakhulu uma imithi ye-biologic ingasetshenziswa esikhathini esizayo. Ngokuvamile, isikhathi esiwusizo kakhulu sokunikeza amagciwane ngaphambi kokuba kuqalwa i-biologic, kodwa ezinye zingase zinikezwe ngemuva uma zidingeka.
Abantu abane-IBD kufanele bahlole odokotela babo ngesimo sabo sokugoma. Abantu abadala, ikakhulukazi, bangadinga uhlelo lokungena kuzo zonke izinconywa eziphakanyisiwe abazidingayo. Ukuzibandakanya ngokugoma kuyoba ukuzivikela okungcono kunazo zonke izifo ezithintekayo esikhathini esizayo.
Ngokuvamile, kunconywa imigomo ngaphambi kokuba isiguli siqale ukwelashwa kwe-biologic. Ukugonywa ngokumelene nezifo ezivamile kuyadingeka ngoba ukwelashwa kwe-biologic kuthintela isimiso somzimba sokuzivikela. Lokhu kusho ukuthi umuntu othola isidakamizwa se-biologic angase abe nethuba lokuthola isifo. Izifo zingabangela umonakalo omkhulu futhi zisho nokuthi i-biologic kufanele imiswe okwesikhashana ngenkathi ukutheleleka kuxazululwa. Akuwona umphumela ozozuzisa ukwelapha i-IBD engaphansi, yingakho imigomo ivame ukunikezwa ngaphambi kokuqala izidakamizwa ze-biologic, noma ngezinye izikhathi emva kwalokho.
Ingabe I-Biologic Therapy Kufanele Ihlehliselwe Imithi?
Udokotela uzoba yisisetshenziswa esihle kakhulu sokuphendula lo mbuzo, kodwa ezimweni eziningi, mhlawumbe hhayi.
Imithi eminingi ingasetshenziswa ngemuva kokuqala ukwelashwa kwe-biologic. Uhlobo oluvame ukugwetshwa yizigciwane ezilondolozwe bukhoma , noma ama-LAIV, anemigomo equkethe igciwane bukhoma. Ngokushesha nje lapho i-biologics ixoxwa njengendlela yokwelapha, imithi kufanele iyingxenye yengxoxo.
Imishanguzo Kunconywe kulabo abathola ukwelashwa kwe-Biologic
Wonke uhlelo lokugoma lomuthi luzohluka, ngokusekelwe emigodweni abayitholile futhi engozini yokuthuthukisa izifo ezithile. Udokotela ophethe imishanguzo kufanele asebenze nesiguli se-IBD ukuthuthukisa uhlelo oluqinisekisa ukugcwala okuphelele. Kuneziqondiso ezithile zokugoma ezikhona kulabo abathola kakade ukwelapha nge-agent ye-biologic.
- Ukugonywa kweHib . I- Haemophilus influenzae hlobo b (Hib) igciwane lingabangela i-meningitis, i-pneumonia, nezinye izifo. Lo mgomo uvame ukunikezwa ezinganeni futhi kunconywa kubantu abadala abangazange bawuthole, kuhlanganise nanoma ubani othola i-biologic.
I-HPV yokugoma . Umuthi wokugoma womuntu we-papillomavirus (HPV) ucezu lwezingqimba ezintathu ezinikezwa ukuvimbela ukutheleleka nge-HPV. I-HPV ixhunywe ekuthuthukiseni izinhlobo eziningi ezihlukene zomdlavuza wesimiso sokuzala kanye nomdlavuza we-throat kanye nomdlavuza. I-HPV inconywa kuze kube yilapho ineminyaka engama-26 kubantu abangenakuzivikela (okufaka iziguli ze-IBD ezithola ukwelashwa kwe-biologic).
Umgomo wokugoma i-pneumococcal. Lokhu kugonywa ngama-bacterial Streptococcus pneumoniae , okungabangela izinhlobo eziningi zokugula. Kubalulekile ukuthi zonke iziguli zithole lokhu kugonywa, ngokuzama konke okwenzelwe ukunikeza ngaphambi kokuqala ukwelashwa kwe-biologic. Lokhu kugonywa kuyinkimbinkimbi ngoba ihlukile kulabo abayitholile ngaphambili nalabo abangakaze bayithole. Labo abaye bathola umgomo esikhathini esidlule bangadinga ukugoma ezimbili, ngokuvamile (kodwa hhayi njalo) enikezwa cishe ngonyaka ngaphandle. Kwabagulayo be-IBD abangakaze bathole umgomo wokugoma, kungase kube khona ukugoma ezintathu okudingekayo. I-booster njalo eminyakeni emihlanu nayo iphonyiswa.
Ukushona komkhuhlane wonyaka . Kunconywa umkhuhlane wezinkathi wonyaka kubantu abane-IBD, ngisho nalabo abathola ukwelashwa kwe-biologic noma bathatha ezinye izidakamizwa ezivimbela isimiso somzimba. Ukuguquka komkhuhlane akuqukethe igciwane lesifo sofuba. Inkungu ye-spray yangasese (engatholakali kwenkathi yesifo se-2017-2018) ayikhuthazwa ngoba i-LAIV.
I-Tetanus . Kubantu abano-IBD, ukudubula kwe-tetanus kunconywa okufanayo njengabantu abaningi. Izibhamu zeTetanus kufanele zinikezwe okungenani njalo eminyakeni eyishumi, futhi kaningi lapho kwenzeka ingozi, njengokungena esikhwameni esinomvutha. Umuthi wokugoma we-tetanus uhlanganiswe neminye imithi, okuyi-diphtheria kanye ne-tetanus toxoids kanye nomuthi wokugoma we-acellular pertussis (DTaP). Lo mgomo uvikela isifo sofuba, i-pertussis (ukukhwehlela okukhwehlelayo), ne-diphtheria. Abantu abadala abangakaze bathole umgomo wokugoma i-pertussis bangadinga i-DTaP, enganikezwa ochungechungeni lwemigomo emithathu.
Imishanguzo Inconywe Ngezinye Izimo
- Umuthi wokugoma we-Hepatitis A. I-virus ye-hepatitis A ingabangela isibindi se-hepatitis yesifo sesibindi. Lo mgomo unconywa kubantu abangaphezu kweminyaka engama-1 abasengozini enkulu yokuthola igciwane, ngisho nalabo abamukela i-biologic.
- Ukugonywa kwe-Hepatitis B. I-virus ye-hepatitis B ingabangela ukutheleleka esibindi, okungenzeka ukuthi singapheli. Lo mgomo uphakanyiswa nalabo abathinteka ukuthi bangengozini yokuthola igciwane lesifo sofuba.
- Ukugonywa kwe-Meningococcal. Umgomo wokuvikela imithi uvikela ukutheleleka ngohlobo lwamabhaktheriya okuthiwa i- Neisseria meningitidis . Lo mgomo ungadingeka kubantu abasengozini enkulu yezifo ze-meningococcal, ezihlanganisa izinsana, izingane, kanye nabantu abadala (ikakhulu labo abaya ekolishi).
- Ukugonywa kwepholi. Umgomo wokugoma ipholio awusatholakali njalo e-United States. Ngokuvamile kunconywa kuphela kubantu abasengozini yokuthola igciwane elidala i-polio ngenxa yokuya endaweni yezwe lapho isifo sofuba sisasajwayelekile.
Imishanguzo Ebukhoma Ayinconywanga Ngenkathi Ethola Ukwelashwa Kwezinto Eziphilayo
Uhlobo lwemigomo engavunyelwe iziguli ze-IBD ezithola imithi ye-biologic yizo eziqukethe amagciwane aphilayo. Okufanelekile, uma le migomo iyadingeka, kufanele inikezwe ngaphambi kokuqala ukwelashwa nge-biologic. Lokhu kudinga ukucabanga okuqhubeka phambili: odokotela kanye neziguli ze-IBD kufanele zibheke isimo sokugoma lapho zixilongwa noma ngokushesha ngangokunokwenzeka emva kokuxilongwa futhi zilungiselele usuku lapho isiguli singadinga khona i-biologic.
- Umuthi wokugoma we-Chickenpox. Umuthi wokugoma we-chickenpox usiza ukuvimbela ukutheleleka nge-varicella-zoster virus. Lo mgomo uvame ukunikezwa izingane, ngamazinga amabili. Lona yi-LAIV, ngakho-ke ezimweni eziningi, ngeke kunconywe kunoma ubani okwamanje othatha i-biologic. Ucwaningo olusha luveza ukuthi lo mgomo kungenzeka ungaphephile kakhulu ezigulini ezithola ukwelashwa kwe-biologic, kodwa okwamanje, izincomo zizoqhubeka ziwugwema.
- I-Herpes zoster vaccine . I-herpes zoster virus ibangela inkukhu kanye nesinye isimo esibizwa ngokuthi ama- shingles . Abantu abaye baba ne-chickenpox bangase bahlakulele ama-shingles, ngokuvamile uma beneminyaka engaphezu kwengu-60. Umuthi wokugoma we-herpes zoster ungavimbela ama-shingles cishe uhhafu futhi uvimbele izinkinga ezihlala isikhathi eside ezibangelwa i-herpes zoster virus. Kodwa-ke, lo mgomo yi-LAIV futhi ngokuvamile awukhuthazwa abantu abamukela i-biologic. Olunye ucwaningo lwamuva lubonisa ukuthi lungase luphephile, kodwa izincomo zamanje kufanele ziqhubeke ukuzigwema.
- Umuthi wokugoma we-measles-mumps-rubella . Imithi yokugoma, izimpumpi, kanye ne-rubella (umjovo waseJalimane) ihlinzeka njalo ezinganeni. Akunconywa kubantu abamukela i-biologic ngoba yi-LAIV.
Izwi elivela
I-Immunology iyisayensi eyinkimbinkimbi futhi iba nakakhulu nakakhulu kubantu abanesifo esingapheli njengo-IBD. Ngenkathi kunemihlahlandlela yokuthi yimiphi imishanguzo enconywa kubantu abane-IBD abamukela i-biologic, kukhona okunye okuhlukile. Kubalulekile ukuthi noma ubani onesifo se-IBD ahlale esesimweni ngemithi, ngaphambi kokuba aqale ukwelashwa kwe-biologic, ngoba lezi zidakamizwa zivimbela isimiso somzimba sokuzivikela.
Kodwa-ke, imishanguzo eminingi isenganikwa isiguli esithatha i-biologic. Isihluthulelo kuzo zonke lokhu ukuthi kube nenkhulumomphendvulwano evulekile mayelana nokugoma nabaqeqeshi bezempilo ngaphambi kokuba izidakamizwa ezivimbela amasosha omzimba adingekayo.
> Imithombo:
> Uhlu lwe-Hepatitis Viral. "I-Hepatitis A Imibuzo Nezimpendulo Zomsebenzi WezeMpilo." Amasevisi Okulawula Nokuvimbela Izifo. 13 Jul 2016.
> Ferreira I, Isenberg D. "Imishanguzo kanye ne-biologics." I-Ann Rheum Dis. 2014 Aug; 73: 1446-1454.
> Isikhungo Sikazwelonke Sokulungiswa, Ukutholakala Nokulawulwa Kwezifo Ezifolasayo. "I-HPV Vaccines: Ukugoma I-Your Preteen or Teen". Isikhungo Sokulawulwa Nokuvimbela Izifo. 26 Jan 2015.
> Isikhungo Sikazwelonke Sokugoma Nezifo Zokuphefumula. "I-Meningococcal: Obani Abadinge Ukugonywa?" Amasevisi Okulawula Nokuvimbela Izifo. 26 Aug 2016.
> Isikhungo Sikazwelonke Sokugoma Nezifo Zokuphefumula. I-Tetanus (Lockjaw) Ukugonywa: Okufanele Wonke Umuntu Akwazi. " Amasevisi Okulawula Nokuvimbela Izifo. 9 Jan 2013.