Ukutheleleka Okuvamile Kwama-parasitic Kungenzeka Ukuphila Kusongela Abantu abane-HIV
I-toxoplasmosis yisifo esiyingozi esibangelwa i-protozoan Toxoplasma gondii ( T. gondii ). Uma kuthinta ubuchopho (toxoplasmosis ye-cerebral), kuthathwa njengesimo esichazayo se- AIDS yizikhungo zokulawula nokuvimbela izifo.
Kulinganiselwa ukuthi cishe u-22% wabantu base-United States bane- T . gondii . Kubikwa amacala angaphezu kuka-200 000 unyaka ngamunye, okubangelwa ukufa kwabantu abangaba ngu-750-okwenza kube yimbangela yesibili evame kakhulu yezifo ezithwala ukudla okubulalayo ngemuva kokubulawa kwesifo se- Salmonella .
Izinga lezindleko e-Afrika, eningizimu-mpumalanga ye-Asia, e-Latin America, nasezingxenyeni ze-Central Central neMpumalanga Yurophu zingasebenzisa kahle ngaphezu kwama-50%.
Kusukela ngawo-1980, kuye kwaba nokunciphisa okukhulu kwezifo ezithathelwanayo eT. gondii e-US, ngokuyinhloko ngenxa yokuguqulwa okukhulu kwemishini yokulima nokuphathwa kokuphepha kokudla. Ukwengeza, ingozi ye-toxoplasmosis yehlile phakathi kwabantu abaphila negciwane lesandulela ngculazi ngenxa yendlela yokwelapha elwa namagciwane elwa ne- antiretroviral kanye nokusetshenziswa kwemithi ye- prophylactic engakwazi ukuvimbela kangcono ukuthuthukiswa kokutheleleka kwe- T. gondii .
Amamodeli wokuThunyelwa
U-T. gondii angakwazi ukuthelela izidalwa ezifudumele kakhulu, kodwa ikakhulukazi emakati. Ukudluliselwa kubangelwa njalo yi:
- Ukuthintana nomlomo ngezingqimba noma izinto eziye zonakaliswa ngendwangu yamathambo noma i-kitty litter
- Ukudla inyama ye- T. gondii- inesifo
- Ukudluliselwa kusuka kumama kuya kwengane ngesikhathi sokukhulelwa
Ukubeletha akubhekwa njengendlela yokudlulisela.
Izimpawu ze-Toxoplasmosis
Kubantu, iningi lezifo ezithathelwanayo zingenakulinganiswa noma zikhona ngezibonakaliso ezinomsoco, ezibhebhethekisa umkhuhlane, ngokuvamile zihambisana ne- lymphadenopathy (i- lymphadenopathy ). Kodwa-ke, kubantu abathinteka ekuzivikelweni-ikakhulukazi abanegciwane lesandulela ngculazi abanezibalo ze- CD4 ngaphansi kwamangqamuzana angu-100 / μL-ukutheleleka kungaba nzima kakhulu ekufeni.
Uma ishiywe ingalashwa, i-toxoplasmosis ingabangela i-encephalitis enamandla (ukuvuvukala kobuchopho) nomonakalo we-retinal. Izibonakaliso ezivame kakhulu zezinzwa kukhona ukukhuluma nokulimala. Ezifweni ezithuthukisiwe, ukugunjwa, i- meningitis , i-optic neramage, nokubonakaliswa kwengqondo ngokuvamile kubonakala.
I-toxoplasmosis ingabangela nomonakalo emaphashini, okwenza kube nokuvuvukala okunjenge-sepsis kanye nezimpawu ezingabonakali kakhulu kwi-PCP ( pneumocystis pneumonia ). Ezimweni ezimbi, i-toxoplasmosis ingasakazeka ngaphesheya kobuchopho namaphaphu ukuze kuthinte isibindi, umnkantsha wesifuba nenhliziyo.
I-Toxoplasmosis ekukhulelweni
I-T. gondii ingabangela umonakalo omkhulu ekuthuthukiseni izifunu, ngokuvamile okubangelwa ukukhubazeka okungokwengqondo nangokwenyama. Nakuba izinsana eziningi ezitholeleke uT. gondii zizobonakala zingenasifo, izimpawu zingase zithuthuke eminyakeni edlule.
Ucwaningo oluthile olwenziwe yi-Case Western Reserve University lubonise ukuthi, kulaba besifazane abanegciwane lesandulela ngculazi eliphakeme, kwaba nokwanda okuphindwe kathathu engozini yokudluliselwa kusuka kumama kuya kwengane.
Ukuxilongwa kwe-Toxoplasmosis
Ukuxilongwa kwe-toxoplasmosis kusekelwa ukubuyekezwa kwezici zempilo kanye nezimpawu, kanye nokuhlaziywa kwegazi noma izicubu zesisindo. Ukuhlola okulula kofuzo okuthiwa yi-PCR (polymerase chain reaction) kungasetshenziswa ukubona ukuthi kukhona amathrifu e- T. gondii egazini noma eminye imfucuza yomzimba.
(Uma kwenzeka ukutheleleka kwamuva, i-PCR ingase ingakwazi ukubona amasosha omzimba we- T. gondii amaviki ayisishiyagalombili. Phakathi nalokhu okuthiwa isikhathi sefasitela , uchungechunge lwe-PCR lungadingeka ukuqinisekisa ukutheleleka, okwenziwa okungenani amasonto amathathu ngaphandle.)
Ngenkathi i-biopsy yobuchopho ibhekwa njengokuxilongwa okucacile kwe-toxoplasmosis ye-cerebral, eminyakeni yamuva iye yenziwa ngokuyinhloko ngokuhlanganiswa kwe-MRI noma i-CT ukuskena ukuqinisekisa ukutholakala kwezilonda zobuchopho, kulandelwa ukuhlolwa kwe-PCR okungavamile.
Ukwelashwa kwe-Toxoplasmosis
Ukwelashwa Kunconywa abantu abane-HIV abanezibalo ze-CD4 ngaphansi kuka-200, lapho amasosha omzimba engakwazi ukulwa nokutheleleka.
Kulezi zimo, i-Trimethoprin / sulfamethoxale (i-co-trimoxazole) ngokuvamile iyisidakamizwa sokukhetha ukuvimbela i-prophylactic.
Ngezifo ezisebenzayo, izidakamizwa ezilandelayo zingase zibekwe:
- Inhlanganisela yeDaraprim (pyrimethamine) ne-sulfadiazine (i-antibiotic esekelwe i-sulfa), kanye ne-folinic acid
- I-Clindamycin (i-antibiotic esetshenziselwa ukwelapha izifo ze-bacterial and protozoan)
- I-Spiramycin (isacatshangelwa ukuhlolwa e-US, nakuba ingawuthola imvume ekhethekile ye-FDA ngesikhathi sokuqala kokukhulelwa)
- I-Mepron (atavaquone)
- Inhlanganisela yeClindamycin noMeprone
Ngo-2015, umkhiqizi wezidakamizwa uDaraprim (Turing Pharmaceuticals) waphelelwa ngxabano ngemuva kokuba i-CEO yayo, uMartin Shkreli, ezama ukuphakamisa intengo ngo-5000%, kusuka ku-$ 13.50 ngebhelethi ngayinye ibe yi-$ 750 per tablet.
Ukuvimbela ukutheleleka kwe- T. gondii
Ngomzimba omzimba omuntu ngamunye (izibalo ze-CD4 ezingaphansi kuka-100) noma abesifazane abakhulelwe abanesandulela ngculazi, ukuqapha okukhethekile kungacelwa ukuthi kuncishiswe ingozi yokutheleleka kwe- T. gondii . Lokhu kufaka:
- Ukuba nomunye umuntu ushintshe umshini we-kitty noma ugqoke igoli lamagilavu elahla uma wenza kanjalo. Geza izandla zakho emva kwalokho, futhi ungagcini ibhokisi lakho le-kitty noma eduze kwekhishi. Uma kunokwenzeka, gcina ikati lakho ngaphakathi.
- Ukupheka ukudla kuya emazingeni okushisa aphephile, kuyilapho uqinisekisa ukuthi inyama ayiyona i-pink futhi ama-juice asebenza kahle. Faka ikhasi bese ugeza izithelo nemifino lapho kunokwenzeka.
- Ukugqoka amagilavu noma nini lapho ulungisa khona noma usebenza nomhlabathi, ugeza kahle amagilavu nezandla uma usuqedile.
Ukubizwa ngegama: TOK-so-plas-MOE-sis
Imithombo:
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "I-toxoplasmosis (i-Toxoplasma Infection - i-Epidemiology ne-Fact Factors." I-Atlanta, i-Georgia; i-Global Health, i-Division of Parasitic Diseases kanye ne-Malaria; ngoJanuwari 10, 2012.
Oksenhendler, E .; I-Cadranel, J .; USarfati, C .; et al. "I-Toxoplasma gondii pneumonia kwiziguli ezine-immunodeficiency syndrome." I-American Journal of Medicine. May 1990; 88 (5): 18-21.
I-Rabaud, iC .; Kwangathi, T .; U-Amiel, uC .; et al. "I-toxoplasmosis ye-extracerebral kuneziguli ezithintekile nge-HIV." Imithi. Novemba 1994; 73 (6): 306-314.
Oksenhendler, E .; I-Cadranel, J .; USarfati, C .; et al. "I-Toxoplasma gondii pneumonia kwiziguli ezine-immunodeficiency syndrome." I-American Journal of Medicine. May 1990; 88 (5): 18-21.
I-Minkoff, i-H .; I-Remington, J .; Holman, S .; et al. "Ukudluliswa okuqondile kwe-toxoplasma ngamantombazane anegciwane lesandulela ngculazi." Journal American of Obstetrics and Gynecology. Mashi 1997; 176 (3): 555-9.