I-Toxoplasmosis (eyaziwa nangokuthi "toxo") esifo esithathelwanayo esibangelwa i-one-celled parasite eyaziwa ngokuthi i- Toxoplasma gondii. Ezimweni eziningi, ukutheleleka kwe-toxo kuyoba mnene futhi kuxazululwe ngaphandle kokwelashwa. Uma ukwelashwa kuyadingeka, ngokuvamile kubandakanya i-antibiotic eyodwa noma ngaphezulu noma izidakamizwa ze-antimalarial ezikwazi ukusula ukutheleleka.
Kodwa-ke, ngesikhathi sokukhulelwa noma kubantu abanamasosha omzimba , ukuphathwa okunomsoco kungadingeka ukuba kulawulwe noma kuvimbele ukutheleleka futhi ugweme izinkinga ezinkulu zokutheleleka. Lokhu kuyiqiniso ikakhulukazi ezimweni zokutheleleka okuphezulu kwegciwane lesandulela ngculaza.
Ukwelapha Okunamandla
Kubantu abanamasosha omzimba avamile, amaphesenti angaba ngu-90 ama- T. gondii angeke abe nezimpawu nakancane. Labo abakwenzayo ngokuvamile bayoba mnene futhi kalula ngephutha ngenxa yesifo, ngisho nodokotela. Ngaphandle kwe-toxo ye-chance, kutholakala ukuthi udokotela uyaphakamisa ukuphumula kombhede futhi mhlawumbe ubuhlungu obukhulu kakhulu (OTC) bubuyisa njengo-Tylenol (acetaminophen) noma i-Advil (ibuprofen).
Ukwelashwa ngokuyinhloko kunconywa kubantu abanamasosha omzimba akhungethwe abangenayo izivikelo zokuvikela omzimba ukulwa nesifo. Lokhu kubandakanya abantu abanesandulela-ngculazi esithuthukisiwe kodwa bangabandakanya nabamukeli be-organ transplant kanye nabantu abaphethwe yi-chemotherapy yomdlavuza (bobabili abavame ukuthatha izidakamizwa ezithintekayo zokuzivikela).
Izindlela zokwelapha eziphakanyisiwe
Ukwelapha ukutheleleka okusheshayo (okusebenzayo), odokotela bazohlinzeka ngama-antibiotics kanye neminye imithi ekwazi ukusula ukutheleleka nokuvimbela lesi sifo ukuba singaqhubeki. Imithi ejwayelekile kakhulu ehlanganisiwe ihlanganisa:
- I-Pyrimethamine, izidakamizwa ze-antimalaria zazibhekwa njenge-agent esebenzayo kakhulu ekuphatheni i-toxo ekhuthele kakhulu
- I-Sulfadiazine, umuthi we-antibiotic osetshenziselwa ukuhlanganiswa ne-pyrimethamine
- I-Clindamycin, i-antibiotic ehlukile esetshenziswa eceleni kwe-pyrimethamine
- I-Minocycline, i-antibiotic esetshenziselwa kuphela uma umuntu emelana kokubili i-sulfadiazine ne-clindamycin
- I-folinic acid isetshenziselwa ukwesekwa ukunciphisa ingozi ye- thrombocytopenia ( amapleletthi aphansi)
Ukwelashwa kwamasonto ayisithupha kuzobandakanya umthamo wansuku zonke we-pyrimethamine, ukulinganisa kwezinsuku ezine zemithi ekhethiwe, kanye nomthamo wansuku zonke we-folinic acid. Ukuvimbela ukuphindaphinda, isidakamizwa se-antibiotic trimethoprim ne-sulfamethoxazole (TMP-SMX) singathathwa kanye ngosuku nsuku zonke amaviki amane.
Ukwelashwa kokukhulelwa
Ukudluliselwa kwe- T. gondii kusuka kumama kuya kwengane akuvamile uma umama enesandulela ngculaza futhi ekhunjulwa kakhulu. Phakathi kwalaba omama, ukwelashwa kuvame ukushiwo ukuvimbela ukutheleleka kwesisu.
Ososayensi bahlala bengacacile ngokuphathelene nomama abanomzimba omzimba ojwayelekile. Ngisho noma ngabe ukutheleleka kwe-toxo kwakuzokwenzeka, kuqhubeka ingxabano enkulu mayelana nokuthi ama-antibiotics asebenza kanjani ekuvimbeleni ukudluliselwa, ikakhulukazi ngoba kungaba nzima ukuxilonga i-toxoplasmosis ngesikhathi sokukhulelwa.
Kuze kube sekugcineni, ukunakekelwa kochwepheshe kumele kudingeke uma ukhulelwe futhi kukhona engozini yokwanda kwe-toxoplasmosis.
Ukwelashwa ngokuvamile kunqunywe kanje:
- Uma ukutheleleka okunzima kwenzeka ngesikhathi se-trimester yokuqala, i-spiramycin izobe ishiwo kusukela ngesikhathi sokuxilongwa ngesikhathi sokubeletha.
- Ngemuva kwe-trimester yokuqala (noma uma ukutheleleka kwe-fetus kuqinisekisiwe), i-pyrimethamine, i-sulfadiazine, ne-folinic acid ingasetshenziswa kusukela ekuxilongweni kuya kwezidingo.
Izincomo zezingane
Ukwelashwa kunconywa kakhulu kubantwana abasanda kuzalwa abane-HIV abathola ukuthi baneT. gondii ngesikhathi sokukhulelwa. Lokhu kuyiqiniso noma ngabe unina wayenayo izimpawu noma wanikwa ukwelashwa okuvimbela. Isikhathi sokwelashwa (pyrimethamine, sulfadiazine, ne-folinic acid) singashintsha kodwa singase siphelele izinyanga ezingu-12.
Uma ngabe usana noma ingane ithola ukuthi i-toxoplasmosis ne-HIV, i-TMP-SMX izobekwa eceleni kanye ne- HIV yokwelapha . I-TMP-SMX izosetshenziselwa ukuvimbela i-encephalitis ye-toxoplasmic (isifo esibuhlungu kunazo zonke se-toxoplasmosis yokuzalwa) futhi yaqhubeka kuze kube isikhathi lapho izidakamizwa ze-HIV zikwazi ukuvuselela isimiso somzimba samasosha omntwana.
Uma kwenzeka i-encephalitis ye-toxoplasmic, ama- corticosteroids ayomelwe ukunciphisa ukuvuvukala kobuchopho. Imithi ye-anticonvulsive ingase isetshenziselwe ukuvimbela ukuwa .
Ukwelapha Kwabantu abane-HIV
I-Toxoplasmosis kubantu abanesandulela ngculaza ingabangela ukonakala okukhulu, futhi okungenzeka kube yingozi, izifo ezithinta ubuchopho, amehlo namaphaphu. Ezimweni eziningi, lesi sifo sizobangelwa ukuvuselelwa kwesandulela-ngculazi esedlule kunesinye esisha.
Ngaphandle kokuvikeleka kwamagciwane okulawula ukutheleleka, umuntu angakwazi ukuwela ngokushesha ekuguleni ngaphandle kokuba kuthathwe izinyathelo ngokushesha ukuze kubuyiselwe umsebenzi wokuzivikela omzimba, kucacise ukutheleleka kwe- T. gondii , futhi uphathe ukucindezeleka kwesifo.
I-Antiretroviral Therapy
I-toxoplasmosis kubantu abane-HIV ibhekwa njengenhle ngoba ingabangela izifo kuphela uma isimiso somzimba samasosha omzimba sibuthakathaka kakhulu ukuyiyeka.
Kuze kube sekugcineni, indlela yodwa yokuthola i-toxoplasmosis ukubuyisela izivikelo zomzimba zomzimba. Imithi ye-antiretroviral yenza lokhu ngokuphazamisa ikhono le-HIV lokuphindaphinda. Ngenkathi bengakwazi ukuphulukisa lesi sifo, bagcina inani le-viral liphansi ngangokunokwenzeka ukuze lingasakwazi ukutheleleka futhi libulale amangqamuzana omzimba omzimba ahloselwe ukusivikela.
Ngokuvamile okunqunywe ngokuhlanganiswa kwezidakamizwa ezintathu , ukwelashwa kwama-antiretroviral kungabuyisa ukusebenza komzimba ngisho nabantu abagulayo kakhulu, ngokuvamile phakathi nezinyanga ezimbalwa. Ukwelashwa kuzoqhubeka nokuphila konke futhi kufaka ukuvakashelwa odokotela njalo ukuze uqaphe isimo sakho somzimba wokuzivikela omzimba futhi uhlole imiphumela emibi.
I-Antibiotic Therapy
Ukwelashwa kwesifo sofuba esenziwe kabusha se- T. gondii kufana nesifo sofuba futhi singabandakanya:
- Pyrimethamine, i-sulfadiazine, ne-folinic acid
- I-Pyrimethamine, i-clindamycin, ne-folinic acid
- I-Atovaquone (i-antifungal enamandla) esetshenziswa ngokuhlanganiswa ne-pyrimethamine ne-folinic acid
- I-Azithromycin (enye i-antibiotic evamile), i-pyrimethamine, ne-folinic acid
- I-Atovaquone ne-sulfadiazine
Lapho ukutheleleka kusuliwe, i-TMP-SMX izobekwa ukuba ivinjelwe ukuphindaphinda futhi iqhubeke kuze kube isikhathi lapho imithi ye - antiretroviral ingabuyisa ukusebenza komzimba.
Ukwelapha Izifo Zokugula
Izinkinga ezintathu ezivame kakhulu ze-toxoplasmosis kubantu abane-HIV yi-toxoplasmosis ebonakalayo (ethinta amehlo), i-CNS toxoplasmosis (ethinta ubuchopho nesistimu yezinzwa), ne-toxoplasmosis yamapulmoni. Ukwelashwa ngamunye kuzoqondiswa ubukhulu bezimpawu kanye nesimo sezempilo sabathintekayo.
Izinketho zokwelapha ze- toxoplasmosis ochungechunge zingabandakanya:
- I-corticosteroids yesistimu ukusiza ekunciphiseni ukuvuvukala
- Izifo ze-corticosteroids ne-clindamycin ezweni
- Ukufakelwa kokuhlinzwa kwe-clindamycin pellets emehlweni
Izinketho zokwelashwa ze- CNS toxoplasmosis zingafaka:
- I-corticosteroids esebenzayo yokunciphisa ukuvuvukala kobuchopho nesistimu enkulu yezinzwa (i-CNS)
- Imithi yama-anticonvulsive yokwelashwa
Izinketho zokwelashwa kwe -toxoplasmosis yamaphalenda zingabandakanya:
- I-corticosteroids yesistimu yokunciphisa ukuvuvukala
- I-TMX-SMP ukuphatha ukutheleleka kwe- pneumocystis esebenzayo yamaphaphu
I-Prophylactic Therapies
Uma unesandulela ngculaza, imithi ye-prophylactic (yokuvimbela) ingahle ibekwe uma isistimu yakho yomzimba igxiliswa.
Lokhu kunganqunywa inani lakho le- CD4 elenza inani lamaseli e-CD4 avikela igazi lakho. Ngomuntu onempilo, inani le-CD4 liyoba phakathi kuka-800 no-1,500. Kubantu abanesimiso se-immune esonakele, lelo nani lalizowela ngaphansi kwezingu-200.
Ukuze uvimbele i-toxoplasmosis, i-TMP-SMX izobekwa ezinyangeni zansuku zonke njengoba isibalo sakho se-CD4 sisondela "endaweni engozini" yezingu-100. Kanye nemithi yakho ye-antiretroviral, uzoqhubeka uthatha i-TMP-SMX kuze kube isikhathi sokuthi inani lakho le-CD4 lihle ngaphezu 200 futhi uyakwazi ukuhlala lapho. Ungabeka u-antibiotic bese uqhubeka uthatha imithi yakho ye-HIV.
Amathuluzi Okuvimbela
Uma ukhulelwe noma unesivikelo somzimba sokuzivikela, uzodinga ukuthatha izinyathelo zokugwema ukuvezwa ku- T. gondii empilweni yakho yansuku zonke. Lezi zivikelo zingakuvikela kusuka kwi-toxoplasmosis kakhulu kakhulu kunezo zonke izindlela zokwelashwa emhlabeni.
Ezinye zezinyathelo zokuzivikela eziphumelela zihlanganisa:
- Ukugqoka iiglavu ezilahlayo lapho uhlanza ibhokisi lensimbi yesikhumba noma, kungcono okwamanje, ukuba nomunye umuntu akwenze
- Ukugqoka amagilavu uma ugadile ngaphandle
- Ukupheka inyama yakho, izinkukhu nezinhlanzi
- Ukubheka nokuhlanza noma yimiphi imifino noma izithelo ezivela emasimini noma emakethe yomlimi
- Ukuhlanza amabhodi, ama-knives, noma ukubeka inyama eluhlaza kungase kuhlangane nakho
- Gwema amanzi angacacisiwe nganoma yiluphi uhlobo
- Ukugcina ikati lakho ngaphakathi
- Ukondla ikati lakho kuphela ukudla okusemathinini noma okomisiwe nokugwema inyama eluhlaza noma engaphekiwe
- Ukumboza i-sandbox yengane yakho
- Ukugeza izandla zakho kahle ngamanzi ashisayo nasensiphu ngemuva kokulima, udlala nekati yakho, ulungiselela ukudla, noma uhlanza ibhokisi le-sandbox
- Ukufundisa izingane zakho amakhono afanele wokuwazisa izandla
> Imithombo:
> Amakilasi Ukulawulwa Nokuvimbela Izifo. "Izinambuzane - I-Toxoplasmosis (I-Toxoplasma Disease): Ukuvimbela Nokulawula." E-Atlanta, eGeorgia; ibuyekezwe ngoJanuwari 10, 2013.
> Lee, S. no-Lee. T. "Encephalitis Toxoplasmic in Patient nge Acquired Immunodeficiency Syndrome . 2017; 5 (1): 34-36. I-DOI: 10.1479 / btrt.2017.5.1.34.
> Park, Y. kanye noNam. H. "Izici Zemitholampilo Nokunakekelwa Kwe-Toxoplasmosis Ye-Ocula." I- Korean J Parasitol. 2013; 51 (4): 393-399. I-DOI: 10.3357 / kjp.2013.51.4.393.
> UMnyango wezeMpilo waseMelika kanye nezinsizakalo zabasebenzi. "Imihlahlandlela Yokuvimbela Nokunakekelwa Kwezifo Ezingavamile Ezinganeni Ezikhulelwe Ne- Adolescent" . I-Rockville, e-Maryland; ibuyekeziwe ngo-Okthoba 28, 2015.