Ukuxhaphazwa ngokuqhelekileyo kwePasasitic Ubomi obungasongela kubantu abane-HIV
I-Toxoplasmosis isifo esibangelwa yi-protozoan Toxoplasma gondii ( T. gondii ). Xa ichaphazela ingqondo (i-toxoplasmosis ye-cerebral), ithathwa njenge- AIDS-defining condition by Centers for Disease Control and Prevention.
Kulinganiselwa ukuba malunga ne-22% yabantu base-United States banesifo sikaT . gondii . Amacala angaphezu kwama-200 000 anikwa ingxelo ngonyaka, okwenza kube malunga nokufa kwabangama-750-okwenza kube yimbangela yesibini yezidlo ezibulalayo ngenxa yesifo se- Salmonella .
Amanani entengo e-Afrika, kwi-mpuma ye-Asia, i-Latin American, kunye neengingqi ze-Central kunye neMpuma Yurophu zingakwazi ukuqhuba kakuhle ngaphezu kwama-50%.
Ukususela kuma-1980, kubekho ukuhla kwehla kwe- T. gondii e-US, ngenxa yokuguqulwa kwamashishini okufama kunye nokulawulwa kokutya kokutya. Ukongezelela, umngcipheko we-toxoplasmosis wehlile phakathi kwabantu abaphila ne-HIV ngenxa ye- antiretroviral therapy kunye nokusetyenziswa kweyeza zeprolactic ezinokuthintela ngakumbi ukuphuhliswa kwe- T. gondii .
Iimodeli zoTshintshelo
I-T. gondii inokuchaphazela izidalwa ezininzi ezifudumalayo, kodwa ikhetheke kakhulu kwiikati. Ukuhanjiswa kubangelwa rhoqo:
- Ukuqhagamshelana ngomlomo kunye neendawo okanye izinto eziye zonakaliswa ngetekisi okanye i-kitty litter
- Ukutya inyama ye- T. gondii-
- Ukuhanjiswa komama kumntwana ngexesha lokukhulelwa
Ukuxiliswa akuthathwa njengesimo sokudluliselwa.
Iimpawu zeToxoplasmosis
Kubantu, uninzi lwasuleleko lunokuba lukhuni okanye lunokubonakaliswa ngeempawu ezinjengobunzima, obukhuhlane-mkhuhlane, ngokuqhelekileyo zihamba kunye nezilonda ze-lymph (i- lymphadenopathy ). Nangona kunjalo, abantu abaxhatshazwe ngamagciwane-ngokukodwa abantu abanesifo se-HIV abaneengxelo ze- CD4 ngaphantsi kweeseli ezili-100 / μL-ukusuleleka kungabangela ukubulala.
Ukuba ishiywe ingaphathwa, i-toxoplasmosis ingabangela i-encephalitis enamandla (ukuvuvukala kwengqondo) kunye nomonakalo wokubuyisela. Iimpawu eziqhelekileyo zeengxaki zomzimba zithetha intetho kunye nokuphazamiseka kwemoto. Kwizifo eziphambili, ukuxhonywa, ukuthatha i- meningitis , i-optic neramage, kunye nokubonakaliswa kwengqondo kubonakala kubonakala.
I-Toxoplasmosis ingabangela umonakalo emiphakeni, okubangelwa ukuvuvukala okufana ne-sepsis kunye neempawu ezingabonakaliyo kwi-PCP ( pneumocystis pneumonia ). Kwiimeko ezinzima, i-toxoplasmosis inokusasazeka ngaphaya kweengqondo kunye nemiphunga ukuze ithintele isibindi, umongo kunye nentliziyo.
I-Toxoplasmosis ekukhulelweni
I-T. gondii inokubangela umonakalo owonakalisayo ekuphuhliseni iintsholongwane, ngokuqhelekileyo kubangele ukukhubazeka kwengqondo kunye nokukhubazeka komzimba. Nangona ininzi abantwana abasandul 'ulwasulelekileyo abane- T. gondii baya kubonakala bengabonakali, iimpawu ziyakhula kwiminyaka kamva.
Olunye uphando olutshanje lwe-Case Western Reserve University lubonise ukuba, kwabasetyhini abanentsholongwane ephezulu ye-HIV, kukho ukunyuka okuphindwe kathathu kwengozi yokusasazeka kumama ukuya kumntwana.
Ukuxilongwa kwe-Toxoplasmosis
Ukuxilongwa kwe-toxoplasmosis kuxhaswa ngokuphononongwa kweempawu zeklinikhi kunye neempawu, kunye nohlalutyo lwegazi okanye iisampuli zamathambo. Uvavanyo oluthile lofuzo olubizwa ngokuba yi-PCR (i-polymerase chain reaction) lingasetyenziselwa ukufumanisa ubukho be- antibodies T. gondii egazini okanye kwezinye izifo zomzimba.
(Kwiimeko zentsholongwane yakutsha nje, i-PCR iyakwazi ukufumanisa iintsholongwane zeT. gondii ukuya kwiiveki ezisibhozo. Ngethuba elibizwa ngokuba yiwindow , kukho uluhlu lwe-PCR luyafuneka ukuba luqinisekise ukusulelwa kwintsholongwane, lwenziwa ubuncinane kwiiveki ezintathu ngaphandle.)
Nangona i-biopsy yengqondo ibonwa njengento ecacileyo yokuxilongwa kwe-toxoplasmosis ye-cerebral, kwiminyaka yakutshanje iye yatshintshwa ngokubanzi ngokudibanisa kwe-MRI okanye i-CT ukuskena ukuqinisekisa ubungqina beengxaki zeengqondo, zilandelwa ukuhlolwa kwe-PCR engapheliyo.
Unyango lwe-toxoplasmosis
Unyango lukhuthazwa ngabantu abane-HIV abaneengxelo ze-CD4 ngaphantsi kwe-200, xa isistim somzimba sokulwa nesifo singakwazi ukulwa nesifo.
Kule meko, i-Trimethoprin / sulfamethoxale (i-co-trimoxazole) ngokuqhelekileyo isichengululo sokhetho lokuthintela iprophylactic.
Ngenxa yesifo esisebenzayo, ezi ziyobisi ziyakunikwa:
- Inhlanganisela yeDaraprim (pyrimethamine) kunye ne-sulfadiazine (i-antibiotics esekelwe kwi-sulfa), kunye ne-folinic acid
- I-Clindamycin (i-antibiotics esetyenziselwa ukuphatha unyango lwe-bacterial and protozoan)
- I-Spiramycin (isacinga ukuhlola e-US, nangona ingafumaneka ngeemfuno ezikhethekileyo ze-FDA ngethuba lokuqala lokukhulelwa)
- IMepron (atavaquone)
- Inhlanganisela yeClindamycin neMeprone
Ngo-2015, umenzi weziyobisi i-Daraprim (iTuring Pharmaceuticals) wayexutywe emva kwengxabano emva kokuba i-CEO yayo, uMartin Shkreli, ezama ukuphakamisa intengo nge-5000%, ukusuka kwi-13.50 nganye kwipilisi ye-tablet engama-$ 750 nganye.
Uthintelo lweT. gondii Infection
Ngamaxhoba omzimba omzimba (abantu abangama-CD4 abangaphantsi kwe-100) okanye abafazi abakhulelweyo abanesifo se-HIV, ukucwangciswa okukhethekileyo kunokucetyiswa ukunciphisa ingozi yeT. gondii . Ezi ziquka:
- Ukuba nomnye umntu utshintshe i-kitty litter okanye ugqoke iiglavu ezilahlayo xa wenza njalo. Phinda uhlambe izandla zakho emva koko, kwaye ungagcini ibhokisi lakho lekiti okanye kufuphi nekhitshi. Ukuba kunokwenzeka, gcina ikati lakho ngaphakathi.
- Ukutya okupheka kwiindawo ezifudumeleyo, ngelixa uqinisekisa ukuba inyama ayinayo iphinki kwaye ijezi zihamba kakuhle. I-Peel uze uhlambe izithelo kunye nemifuno xa kunokwenzeka.
- Ukugqoka iiglavu xa udibanisa okanye usebenza nomhlaba, uhlambe kakuhle iiglavu kunye nezandla xa ugqibe.
Ukubizwa: I- TOK-so-plas-MOE-sis
Imithombo:
Amaziko e-US for Control and Prevention (CDC) yeZifo. "I-Toxoplasmosis (i-Toxoplasma Infection - i-Epidemiology ne-Fact Factors." I-Atlanta, iGeorgia; iMpilo yeSizwe, iSahlulo seZifo eziMnyama kunye neMalariya; ngoJanuwari 10, 2012.
Oksenhendler, E .; Cadranel, J; Sarfati, C .; okqhubekayo. "I-Toxoplasma gondii pneumonia kwizigulane ezine-immunodeficiency syndrome." I-American Journal of Medicine. Meyi 1990; 88 (5): 18-21.
Rabaud, C .; NgoMeyi, iT .; Amiel, C; okqhubekayo. "I-toxoplasmosis ye-extracebrbral kwizigulane ezitheleleke nge-HIV. Mayeza. Novemba 1994; 73 (6): 306-314.
Oksenhendler, E .; Cadranel, J; Sarfati, C .; okqhubekayo. "I-Toxoplasma gondii pneumonia kwizigulane ezine-immunodeficiency syndrome." I-American Journal of Medicine. Meyi 1990; 88 (5): 18-21.
Minkoff, H .; Remington, J .; Holman, S; okqhubekayo. "Ukutshintshela ngokuthe ngqo kwe-toxoplasma ngamabhinqa anetyholongwane ka-HIV." I-American Journal ye-Obstetrics ne-Gynecology. Matshi 1997; 176 (3): 555-9.