I-Oral and Injectable Formulations Iyatholakala
Umkhuhlane we-typhoid (obizwa nje ngokuthi i-typhoid) akuyona ukugula esikubona konke okuvamile e-United States. Nokho, kusukela kumbono womhlaba wonke, kubhekwa njengokukhathazeka okukhulu kwezempilo emphakathini ngezifo ezintsha ezingaba ngu-21 million kanye nokufa kuka-150 000 ngonyaka.
Ngisho lapha e-United States, abantu abaningi abangu-5 700 bakholelwa ukuthi banegciwane lesandulela ngculaza minyaka yonke, ngokusho kombiko ovela kwi-Centers for Disease Control and Prevention (CDC).
Iningi liwumphumela wokuhamba ngamazwe ngamazwe omhlaba lapho isifo se-typhoid sisakazeke khona.
Lesi sifo, esivame ukuhambisana nemikhuba engcolile yokuhlanzeka nemibandela yomphakathi, ingavinjelwa ngomlomo noma ngomuthi wokugoma.
Yeka ukuthi isifo se-typhoid sithunyelwa kanjani
Umkhuhlane we-typhoid uyisifo esongela ukuphila esabangelwa amagciwane eSalmonella typhi . Ama-bacterium kuphela ekhona kubantu futhi aphila ngokuyinhloko egazini noma emathunjini.
Uma umuntu ene-typhoid, uzokhipha ama-bacteria ngendwangu (izitokisi). Noma yikuphi ukungcola kwamanzi, ukudla, noma okunye kungenza kube lula ukusakazeka kwesifo. Ukudluliselwa komuntu nomuntu, njengokungena ngesandla, kuvamile.
Ezindaweni ezikhulayo ezikhulayo zomhlaba, ukungabi namasu okuthuthwa kwamanzi okugcoba kuyingxenye enkulu ekutheleleni kwegciwane lesandulela ngculazi.
Izimpawu Zesifo Se-typhoid Fever
Uma usulelekile, ama-bacterium ngokushesha aphindaphindela futhi asakaze ngegazi, okwenza uhla lwezimpawu kuzo zonke izigaba ezintathu ezihlukene:
- Phakathi nesonto elilodwa, umuntu angase azwe nomkhuhlane, ikhanda, ukukhwehlela, ukukhathala, ukwehlisa izinga lenhliziyo ( bradycardia ), ubuhlungu besisu, kanye ne-nosebleeds.
- Ngesonto elibili, ukukhathala kuzobe kuthuthukile lapho umuntu angase akwazi ukuvuka khona. Njengoba imfiva iqhubeka ikhula, i- delirium ivamile. Amabala anemibala e-rose angase athuthuke nesisu, kuyilapho lo muntu engase ahlangane noma ukuvota okuvame ukwanda kwesifo sohudo noma ukuqothulwa.
- Ngeviki ezintathu, izinkinga zingaba nzima futhi zingabandakanya ukukhulelwa kwamathumbu emathunjini, ukuvuvukala kwengqondo ( encephalitis ), i-perforation yamathumbu, ukuvuvukala kwenhliziyo ( myocarditis ) kanye nezifo zokuphefumula ezifana ne-pneumonia kanye ne-bronchitis enamandla.
Kuphela ekupheleni kweviki ezintathu ukuthi izinga lokushisa eliphakeme lizoqala ukwehlisa. Ukwelashwa ngokuvamile kuhilela inkambo yama- antibiotics (njenge-amoxicillin noma i-trimethoprim-sulfamethoxazole) kanye nezikhukhula ezivamile ukuvimbela ukungcola.
Uma uphathwa ngendlela esifike ngesikhathi, i-typhoid ayikho neze ebangela ukufa. Kodwa-ke, uma kushiywe kungalashwa ngesonto lesithathu, ingozi yokufa ingakhula ngamaphesenti angama-20.
Izinketho Zomkhuhlane We-Typhoid
Njengoba kunikezwe imiphumela yokutheleleka kwe-typhoid, abantu abasengozini enkulu banganikezwa ukuvikelwa noma umuthi wokugoma umjovo owodwa noma umuthi wokugoma ngomlomo owodwa.
Kunemigomo emibili okwamanje evunyelwe yi-US Food and Drug Administration:
- U-Typhim Vi uyisitofu somjovo we-typhoid engenayo eyenziwe nge-bacterium engasebenzi (engabulawa ngokugcwele) engeke ibangele isifo. It is delivered intramuscularly (ngokuvamile ibe muscle deltoid ingalo engenhla) futhi idinga kuphela umthamo owodwa. Umgomo kufanele unikezwe okungenani amasonto amabili ngaphambi kohambo futhi ungasetshenziswa kunoma ubani oneminyaka engaphezu kwengu-2. Ama-shot shoot angathunyelwa njalo eminyakeni emibili kubantu abasengozini yokuqhubeka.
- I-Vivotif ngumuthi wokugoma we-typhoid owenziwa nge-livetentenated (live but weakened) bacteria. Ihlinzekwa ngepakethe lama-capsules amane, ngasinye esithathwa nsuku zonke ngesisu esingenalutho. I-Vivotif ingasetshenziswa kunoma ubani oneminyaka engaphezu kwengu-6, kuyilapho ama-booster doses kuphela adinga ukuthathwa minyaka yonke emihlanu. Njengomuthi wokugoma ophilayo, kudinga ukuba kube yisiqandisiso futhi akufanele unikezwe ngabanye abantu abathintekayo ngokuzivikela ( njengalabo abane-HIV ).
Ngaphandle kokuhlukana kokuphatha (umjovo nomlomo) kanye nemingcele yomsebenzisi (yobudala nesimo somzimba wokuzivikela), zombili imishanguzo inikeza ukuvikeleka okuvela kuma-70% we-typhoid.
Lokhu kusho ukuthi uzobe usadingeka ukubukela lokho okudlayo noma okuphuzayo uma uke waya e-hotspot ye-typhoid.
Imiphumela emibi nokuphambene
Imiphumela emibi ibonakala ngokujwayelekile nge-Typhim Vi enezingxenye ezingaphezulu kwezingu-10 zabantu ababhekene nomkhuhlane, ukukhathala, ikhanda, izinhlungu zomzimba, kanye nobuhlungu besayithi. Nge-Vivotif, ingozi iphansi (ngaphansi kwamaphesenti ayisikhombisa) futhi ingafaka phakathi ikhanda, isicanucanu, nesilonda esiswini. Kuzo zombili izimo, izimpawu ziba nomusa futhi zixazululwe ngaphandle kokwelashwa.
Ehlangothini lwe-flip, kunezidakamizwa eziningi zokuphikisana ne-Vivotif kunokuba noTyphim Vi. Ukukhathazeka okubili kokubili ukusebenzisana kwezidakamizwa okungenza ukuthi umuthi wokugoma ungasebenzi.
Kwezinye izimo, kungenxa yokuthi izidakamizwa ziyisidumbu sokuzivikela esivimbela ukukhiqizwa kwama-antibodies okuzivikela. Lokhu kufaka phakathi izidakamizwa ezisetshenziselwa ukuphatha izifo ezizenzekelayo njenge-lupus, i-rheumatoid arthritis, ne-psoriasis. Kwezinye izimo, kuzodingeka umise umuthi isikhathi eside izinsuku ezingama-30 ngaphambi kokuthi udutshulwa u-typhoid.
Uhlu lwezidakamizwa eziphikisanayo ukuze kusetshenziswe ne- Vivotif yilokhu:
- UBenlysta (belimumab) , isidakamizwa sokucindezela amagciwane
- I-Cimzia (certolizumab pegol) , isidakamizwa sokucindezela amagciwane
- I-Cosentix (secukinumab), izidakamizwa ezithinta umzimba
- I-Hydrea (hydroxyurea), umuthi we-chemotherapy yomdlavuza
- I-Methotrexate esetshenziselwa ukwelapha umdlavuza, i-psoriasis, nesifo se-rheumatoid arthritis
- I-Taltz (ixekizumab), izidakamizwa ezicindezelayo
- I-Teflaro (i-ceftaroline), i-antibiotic
Uhlu lwezidakamizwa eziphikisanayo ukuze zisebenzise noTyphim Vi yizi:
- UBenlysta (belimumab) , ukusetshenziswa komuthi okudambisa umzimba
- I-Cosentix (secukinumab), izidakamizwa ezithinta umzimba
- I-Taltz (ixekizumab), izidakamizwa ezicindezelayo
Uma udinga ukugonywa kwe-typhoid, qiniseka ukuthi uneluleka udokotela wakho nganoma yimiphi imithi ongayithatha nayo noma yimuphi umuthi wezokwelapha ohambisana nokucindezelwa kwamagciwane noma isimiso somzimba sokuzivikela.
Uma Udinga Ukugoma
Ngokusho kweKomidi Elilulekayo Emigodini (ACIP), ukugoma okujwayelekile kungavunyelwe e-United States. Kodwa-ke, kukhona amacala aqondile lapho ukugoma kuneluleka kakhulu:
- Abahambi baya ezindaweni lapho kukhona ingozi ehlonishwayo ye- Salmonella typhi
- Abantu abahlala nabo noma abathintana naye obesebenza noma abaphathwa nge-feverid fever
- Amacrobiologists noma abasebenzi belebhu abahlangana noSalmonella typhi amasiko noma izibonelo
Uma uhlela uhambo lwangaphandle, ungabheka izidingo zamanje zokugoma kanye nezincomo ngokuvakashela iwebhusayithi yezeluleko zezempilo ezihamba nge-CDC.
Izwi elivela
Nakuba ukugoma kwe-typhoid kunganciphisa kakhulu ingozi ye-typhoid fever, akuyona into ewubuwula. Ukuze uqinisekise ukuthi uhlala uphephile ngenkathi uhamba phesheya, kunezinhlobo ezi-10 ezijwayelekile zomqondo okufanele uzilandele:
- Geza izandla zakho njalo nge-sese namanzi ashisayo.
- Thatha isiphuzo se-santizer esekelwe utshwala ngezikhathi lapho amanzi engekho.
- Gwema ukuphuza amanzi angaphathwa kabi.
- Ngesikhathi ukuphuza ibhodlela noma iziphuzo ezisemathinini kuhle, cela isiphuzo ukuba sikhululwe uphawu.
- Njalo ucele iziphuzo ngaphandle kweqhwa.
- Gwema izithelo nemifino eluhlaza ngisho noma zihanjiswe.
- Khetha ukudla okushisayo; ukudla okugcinwe noma okukhishwa ekamelweni lokushisa kufanele kugwenywe.
- Gwema abathengisi bokudla emigwaqweni.
- Sebenzisa amanzi asemabhodleleni ukuze uphonsa amazinyo akho.
- Zama ukugwinya amanzi eshaweni.
> Imithombo:
> Izikhungo Zokulawulwa Nokuvimbela Izifo (CDC) "Umkhuhlane Wesivunguvungu." I-Atlanta, Georgia: ibuyekezwe ngoJulayi 18, 2016.
> Ukuphathwa Kwezokudla Nezidakamizwa (FDA). "UThiphim Vi." I-Silver Spring, e-Maryland; ibuyekeziwe ngo-Okthoba 10, 2017.
> FDA. "Vivotif." Kubuyekezwe ngo-Septhemba 12, 2016.
> Jackson, B .; Iqbal, uS .; Mahon, B. et al. "Izincomo Ezibuyekeziwe Zokusetshenziswa Kwesifo Se-Typhoid - Ikomidi Elilulekayo Emisebenzini Yokugoma, e-United States, 2015." I-MMWR. 2015; 64 (11) 305-8.