I-Toxoplasmosis (eyaziwa nangokuthi "toxo") kwisifo esithathelwanayo esibangelwa i-single-celled parasite ebizwa ngokuba yi- Toxoplasma gondii. Kwiimeko ezininzi, ukutheleleka kwe-toxo kuya kuba mnene kwaye kusombulule ngokwawo ngaphandle kokonyango. Ukuba unyango luyadingeka, ngokuqhelekileyo lubandakanya enye okanye ngaphezulu kwezilwanyana zokulwa nezidakamizwa ezikwazi ukucima intsholongwane.
Nangona kunjalo, ngexesha lokukhulelwa okanye kubantu abaneenkqubo zokuzivikela ezikhuselekileyo , kufuneka unyango olunzima lube lufuneka ukuba lulawulwe okanye luthintele usulelo kwaye lukhuphe iingxaki ezinzulu zentsholongwane. Oku kuyinyani ngokukodwa kwiimeko zokusuleleka kwe-HIV.
Uphuhliso oluchanekileyo
Kubantu abanamasosha omzimba aqhelekileyo, ukuya kuma-90 ekhulwini kwi- T. gondii izifo aziyi kuba nazo zonke iimpawu. Abo bakwenzayo baya kuba bumnene kwaye balahleke kalula ngenxa yomkhuhlane, kwanokuba ugqirha. Ngethuba le-toxo le-chanceslo lifunyenwe, ugqirha uya kuhlala ecetyiswa ukuphumla nokulala kunye nokuba mhlawumbi i-OTC) i-relenver like Tylenol (acetaminophen) okanye i-Advil (ibuprofen).
Unyango lujoliswe ngokuyinhloko kubantu abanamasosha omzimba athathaka abangenalo ukukhuselwa komzimba wokulwa nesifo. Oku kubandakanye abantu abanokusuleleka kosuleleko lwe-HIV kodwa banokubandakanya nabamkeli bezityalo kunye nabantu abaphethwe yi-chemotherapy yomhlaza (bobabini ngokuqhelekileyo bathabatha iziyobisi ezithintela umzimba).
Uphuhliso olukhuthaziweyo
Ukuphatha unyango olusisigxina (osebenzayo), oogqirha baya kunika imithi yokulwa neyeza kunye namanye amayeza anako ukususa intsholongwane nokukhusela eso sifo ukuba siphumelele. Amachiza aqhelekileyo aqhelekileyo aquka:
- I-Pyrimethamine, isichengululo se-malaria esicinga ukuba i-agent esebenzayo ekuphatheni i-toxo infection
- I-Sulfadiazine, isilwanyana esichaphazelekayo esetyenziselwa ukudibanisa ne-pyrimethamine
- I-Clindamycin, enye i-antibiotics esebenzisa kunye ne-pyrimethamine
- I-Minocycline, i-antibiotic esetyenziswa kuphela xa umntu enganyangekiyo kokubili sulfadiazine kunye ne-clindamycin
- I-folinic acid isetyenziswe njengesongezelelo ekunciphiseni umngcipheko we- thrombocytopenia (iiplatelet eziphantsi)
Unyango lweeveki ezintandathu luya kubandakanya i-dose yemihla ngemihla ye-pyrimethamine, iindleko ezine zemihla ngemihla ye-antibiotic ekhethiweyo, kunye ne-dose yansuku zonke ye-folinic acid. Ukuthintela ukuphindaphinda, i-antibiotic drug trimethoprim kunye ne-sulfamethoxazole (TMP-SMX) iya kuthathwa kanye ngeentsuku ezine.
Unyango lo ku khulelwa
Ukudluliselwa kwe- T. gondii ukusuka kumama ukuya kumntwana kunqabile ngaphandle kokuba unina unesifo se-HIV kwaye ukhuselwe ngamandla. Phakathi kwala baomama, unyango luvame ukumiselwa ukukhusela intsholongwane ka-fetal.
Oososayensi bahlala bengacinci malunga noomama abanomzimba omzimba. Nangona ukutheleleka kwe-toxo kwakufuneka kwenzeke, kukho impikiswano eninzi malunga nendlela amayeza asebenza ngayo ekukhuseleni ukuhanjiswa, ingakumbi kuba kunzima ukufumanisa i-toxoplasmosis ngexesha lokukhulelwa.
Kule nto, kufuneka unyanzeliswe ingcali xa ukhulelwe kwaye unobungozi obuninzi be-toxoplasmosis.
Utyando lujongwa ngokwemiqathango elandelayo:
- Ukuba usuleleko olunzima lwenzeka ngexesha lekota yokuqala, i-spiramycin iya kuba yanyulwa ukusuka ngexesha lokuxilongwa kwixesha lokunikezelwa.
- Emva kwe-trimester yokuqala (okanye ukuba isifo sofestile sagcinwe), i-pyrimethamine, i-sulfadiazine, kunye ne-acid folinic iya kusetyenziswa ekuxilongweni ukuya kwi-delivery.
Iziphakamiso zezilwanyana
Unyango lukhuthazwa kakhulu kubantwana abatsha abane-HIV abanesifo se-HIV abafumene i- T. gondii ngexesha lokukhulelwa. Oku kuyinyaniso ukuba ingaba unina wayenayo impawu okanye wanikwa unyango lokukhusela. Ubude bonyango (pyrimethamine, sulfadiazine, kunye ne-folinic acid) bunokuhluka kodwa buhlala ixesha elide kwiinyanga ezili-12.
Ukuba umntwana okanye umntwana ufumaneka ukuba ene-toxoplasmosis ne-HIV, i-TMP-SMX iya kumiselwa kunye ne- HIV yonyango . I-TMP-SMX iya kusetyenziselwa ukukhusela i-encephalitis ye-toxoplasmic (ingxaki enzima kakhulu ye-toxoplasmosis yokuzalwa) kwaye yaqhubeka de kubekho ixesha elifana neziyobisi ze-HIV ziyakwazi ukulungelelanisa inkqubo yomzimba womntwana.
Xa kwenzeka i-encephalitis ye-toxoplasmic, i- corticosteroids iya kunqunyulwa ukunciphisa ubuchopho buchopho. Iziyobisi ze-anticonvulous zingasetyenziselwa ukukhusela ukuthintela .
Unyango kubantu abane-HIV
I-Toxoplasmosis kubantu abanentsholongwane kaGawulayo ingabangela ingxaki enkulu, kwaye isenokusongela ubomi, izifo ezichaphazela ingqondo, amehlo kunye nemiphunga. Kwiimeko ezininzi, eso sifo siza kubangelwa ukusetyenziswa kwakhona kosulelo lwangaphambili kunokuba lutsha.
Ngaphandle kokukhusela umkhuhlane ukukhusela isifo, umntu unokukhawuleza angqubuzana nesifo ngaphandle kokuba kuthathwa amanyathelo amanyathelo okubuyisela ukukhusela umzimba, acacise intsholongwane kaT. gondii , kwaye ayiphathe ingxaki yesifo.
Unyango lwe-antiretroviral
I-Toxoplasmosis kubantu abanentsholongwane kaGawulayo ithathwa njengengenelelo kuba inokubangelwa zizifo kuphela xa isistim somzimba siphelile.
Kule ndlela, indlela yodwa yokubuyisela kwi-toxoplasmosis kukubuyisela ukukhusela umzimba. Izidakamizwa ze-antiretroviral zenza oku ngokuphazamisa ukukwazi ukwenza i-HIV. Ngoxa bengenako ukuphilisa eso sifo, bahlala bephantsi kwintsholongwane ukuze bangakwazi ukuthelela kwaye babulale amaseli omzimba okumele asisindise.
Ngokuqhelekileyo emiselweyo ngokudibeneyo kwezidakamizwa ezintathu , unyango lwe-antiretroviral lungakwazi ukubuyisela umsebenzi wokuzivikela omzimba nakubantu abagula kakhulu, kaninzi phakathi kweenyanga ezimbalwa. Unyango luya kuqhutyelwa ubomi bonke kwaye uquka ukutyelela rhoqo ugqirha ukujonga imeko yakho yokuzikhusela komzimba kwaye uhlolisise imiphumo emibi.
Unyango lwe-antibiotics
Unyango lwe- T. gondii evuselelwe isifo sifana nesifo sosuleleko kwaye singabandakanya:
- I-Pyrimethamine, i-sulfadiyazine, kunye ne-acid folinic
- Pyrimethamine, clindamycin, kunye ne-folinic acid
- I-Atovaquone (i-antifungal enamandla) isetyenziswe ngokudibanisa ne-pyrimethamine kunye ne-folinic acid
- I-Azithromycin (enye i-antibiotic eqhelekileyo), i-pyrimethamine kunye ne-acid folinic
- Atovaquone kunye ne-sulfadiazine
Emva kokuba usulelo lukhutshwe, i-TMP-SMX iya kumiselwa ukukhusela ukuphindaphinda kwaye iqhubeke de kubekho ixesha elifanelekileyo njengoko izidakamizwa ze-antiretroviral ziyakwazi ukubuyisela ukusebenza komzimba.
Ukunyangwa kwezifo
Iingxaki ezintathu eziqhelekileyo ze-toxoplasmosis kubantu abanentsholongwane ka-HIV banesifo se-toxoplasmosis (echaphazela amehlo), i-CNS toxoplasmosis (echaphazela ingqondo kunye nenkqubo ye-nervous), kunye ne-toxoplasmosis ye-pulmonary. Unyango lwalunye luya kubhekiswa ubunzima beempawu kunye nesimo sempilo yabantu abachaphazelekayo.
Izinyango zokwelapha kwi- toxoplasmosis ye- ocular zingabandakanya:
- I-corticosteroids yenkqubo yokunciphisa ukuvuvukala
- Izigulane ze-corticosteroids kunye ne-clindamycin kwiso
- Ukufakelwa kokugqitywa kwama-clindamycin epellets kwiso
Izinyango zokwelapha kwi- CNS toxoplasmosis zingaquka:
- I-corticosteroids echanekileyo yokunciphisa ukuvuvukala kwengqondo kunye nenkqubo ye-nervous central (CNS)
- Izidakamizwa ze-Anticonvulous zokunyanga
Izinyango zokwelapha ze -toxoplasmosis yepulmonary zingabandakanya:
- I-corticosteroids yenkqubo yokunciphisa ukuvuvukala
- I-TMX-SMP ukuphatha i- pneumocystis esebenzayo yokusuleleka kwemiphunga
Prophylactic Therapies
Ukuba unesifo se-HIV, iprophylactic (inqandezelo) unokumiselwa ukuba umzimba wakho we-immune unganyaniseki.
Oku kunokumiselwa ngumlinganiselo wakho we- CD4 olinganisa inani le- CD4 T-cell ekhuselayo igazi lakho. Ngomntu onempilo, inani le-CD4 liya kuba phakathi kuka-800 no-1,500. Kubantu abanesistim somzimba sokuzikhusela, loo nombolo iya kulahla ngaphantsi kwe-200.
Ukuthintela i-toxoplasmosis, i-TMP-SMX iya kumiselwa kwidaysi yansuku zonke njengoko isibalo sakho se-CD4 sisondela "kwindawo yengozi" ye-100. Kanye kunye neyeza lakho le-antiretroviral, uya kuqhubeka uthabatha i-TMP-SMX kude kube nexesha elifanelekileyo ukuba inani lakho le-CD4 liphezulu ngaphezulu 200 kwaye uyakwazi ukuhlala apho. Unokumisa i-antibiotic kwaye uqhubeke nokuthatha iziyobisi zakho ze-HIV.
Zixhobo zo Khuselo
Ukuba ukhulelwe okanye unesistim somzimba esichengileyo, kufuneka uthabathe amanyathelo okuphepha ukufikelela kwiT. gondii ebomini bakho bemihla ngemihla. Ezi khuselo zingakukhusela kwi-toxoplasmosis bhetele kunezona zonke zonyango kwihlabathi.
Amanye amanyathelo okukhusela asebenzayo aquka:
- Ukugqoka iiglavu zeglavu ezilahlayo xa uhlamba ibhokisi yecatter okanye, kungcono kunjalo, ukuba omnye umntu akwenze
- Ukugqoka iiglavu xa ugadi lwangaphandle
- Ukupheka inyama yakho, inkukhu kunye nentlanzi eyenziwe kakuhle
- Ukujongana nokuhlamba nayiphi na imifuno okanye iziqhamo ezivela kumyezo okanye umfama weemarike
- Ukucoca iiplanga, ukukhwela, okanye izambatho zenyama ekhutshiweyo zingabonisana nazo
- Ukuphepha amanzi angabonakaliyo naluphi na uhlobo
- Ukugcina ikati lakho lingena
- Ukondla ikati yakho kuphela ukutya okomityiweyo okanye okomileyo kunye nokuphepha ukutya okudakileyo okanye okungadliyo
- Ukumboza i-sandbox yomntwana wakho
- Ukuhlamba izandla kakuhle ngamanzi ashushu kunye nesepha emva kokulima, udlala nekati yakho, ulungiselela ukutya, okanye uhlambulule i-sandbox
- Ukufundisa abantwana bakho abanezakhono zokulungisa izandla
> Imithombo:
> Amacandelo okuLawula nokuLawula izifo. "Izidumbu - I-Toxoplasmosis (i-Toxoplasma Disease): Ukuthintela nokuLawula." E-Atlanta, eGeorgia; hlaziywa ngoJanuwari 10, 2013.
> Lee, S. noLee. T. "I-Encephalitis ye-Toxoplasmic kwi-Patient nge-Acunired Immunodeficiency Syndrome." I- Brain Tumor Res Treat. 2017; 5 (1): 34-36. INGXELO: 10.1479 / btrt.2017.5.1.34.
> Ipaki, Y. kunye noNam. H. "Iimpawu zeCliniki kunye nokuPhathwa kwe-Ox toxoplasmosis." IsiKorea J Parasitol. 2013; 51 (4): 393-399. INGXELO: 10.3357 / kjp.2013.51.4.393.
> Isebe lezeMpilo laseMzantsi Afrika kunye neNkonzo zoLuntu. "Izikhokelo Zokuthintela Nokunyangwa Kwezonyango Ezichaphazelekayo Kwi-HIV-Abathintekayo Abantwana Neengxaki Zomntwana. " I- AIDSInfo. Rockville, Maryland; hlaziywa ngoOktobha 28, 2015.