Matenda a Pasasitic Wowonjezereka Mwachidziwitso Moyo Uwopseza Anthu omwe ali ndi HIV
Toxoplasmosis ndi matenda a parasitic omwe amachititsidwa ndi protozoan Toxoplasma gondii ( T. gondii ). Pamene zimakhudza ubongo (ubongo wa toxoplasmosis), zimayesedwa ngati matenda a Edzi ndi Centers for Disease Control and Prevention.
Akuti pafupifupi 22 peresenti ya anthu a ku America ali ndi kachilombo ka T. gondii . Zaka 200,000 zimachitika chaka chilichonse, zomwe zimachititsa kuti anthu pafupifupi 750 azifa-zomwe zimachititsa kuti kachilombo ka HIV kasamveke chifukwa cha poizoni wa Salmonella .
Kuwonjezeka kwa chiwerengero ku Africa, Kumwera chakum'maŵa kwa Asia, Latin America, ndi mbali za Central ndi Eastern Europe zimatha kuyenda bwino kuposa 50%.
Kuyambira m'ma 1980, pakhala kuchepa kwakukulu kwa matenda a T. gondii ku US, makamaka chifukwa cha kusintha kwakukulu kwa kayendetsedwe kaulimi ndi kasamalidwe ka chitetezo cha zakudya. Kuwonjezera pamenepo, chiopsezo cha toxoplasmosis chagwera pakati pa anthu omwe ali ndi kachilombo ka HIV chifukwa cha mankhwala othandizira tizilombo toyambitsa matenda komanso kugwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala omwe angateteze chitukuko cha matenda a T. gondii .
Njira Zotumizira
T. gondii amatha kulandira zamoyo zamadzi ozizira, koma makamaka amapezeka m'mati. Kutumiza kumayambitsa kawirikawiri ndi:
- Kuyankhulana pamtima ndi malo kapena zinthu zomwe zaipitsidwa ndi nyansi zamatchi kapena zinyalala zamatenda
- Kudya nyama ya T. gondii- yodwala
- Kutumiza kuchokera kwa mayi kupita kwa mwana pamene ali ndi mimba
Kuyamwitsa sikungatengeke ngati njira yofalitsira.
Zizindikiro za Toxoplasmosis
Kwa anthu, matenda ambiri amachititsa kuti thupi likhale lopanda mphamvu kapena limakhala ndi zizindikiro zofatsa, zomwe zimawoneka ngati chimfine, nthawi zambiri zimakhala ndi zilonda zam'mimba zotupa ( lymphadenopathy ). Komabe, anthu omwe ali ndi kachilombo ka HIV omwe ali ndi kachilombo ka HIV / kachilombo ka HIV / μL amatha kukhala oopsa kwambiri.
Ngati sanatulitsidwe, toxoplasmosis ikhoza kuyambitsa encephalitis (kutupa kwa ubongo) ndi kuwonongeka kwa retina. Zizindikiro zodziwika kwambiri za ubongo ndizoyankhula ndi kuwonongeka kwa magalimoto. Matenda apamwamba, kugwidwa, kuthamanga kwa mimba , optic neramage, ndi mawonetseredwe a maganizo amapezeka nthawi zambiri.
Toxoplasmosis ingayambitsenso mapapu, ndipo izi zimapangitsa kuti ziphuphu ndi zizindikiro zomwe zimakhala zosiyana kwambiri ndi PCP ( pneumocystis pneumonia ). Pa milandu yoopsa, toxoplasmosis ikhoza kufalikira kupitirira ubongo ndi mapapo kuti zikhudze chiwindi, fupa la fupa ndi mtima.
Toxoplasmosis mu Mimba
T. gondii amatha kuwononga kwambiri kukulitsa fetus, ndipo nthawi zambiri zimakhala zofooka za thupi ndi thupi. Ngakhale kuti ana ambiri omwe amapezeka ndi kachilombo ka T. gondii adzawoneka ngati osadziwika bwino, zizindikiro zikhoza kukhala zaka zambiri.
Kafukufuku wina waposachedwapa wa University of Case Western Reserve anasonyeza kuti, mwa amayi omwe ali ndi kachilombo koyambitsa matenda a HIV, kuwonjezeka kwa katatu kwa amayi kupita kwa mwana.
Kuzindikira kwa Toxoplasmosis
Kusanthula kwa toxoplasmosis kumathandizidwa ndi kukambirana za zizindikiro ndi matenda, kuphatikizapo kusanthula magazi kapena minofu. Chinthu chosavuta kumva cha majeremusi chotchedwa PCR (polymerase chain reaction) chingagwiritsidwe ntchito pozindikira kupezeka kwa ma antibodies a T. gondii m'magazi kapena m'madzi ena.
(Ngati matenda aposachedwa, PCR sichikhoza kuyang'ana ma antibodies a T. gondii kwa milungu isanu ndi itatu. Pa nthawi yotchedwa zenera , ma PCR angathenso kutsimikizira matenda, opitirira milungu itatu padera.)
Ngakhale kuti ubongo umagwiritsidwa ntchito kuti uzindikire kuti uli ndi ubongo wa toxoplasmosis, m'zaka zaposachedwa wakhala m'malo mwa kuphatikiza MRI kapena CT kusinkhasinkha kuti zitsimikizire kukhalapo kwa zilonda za ubongo, zotsatiridwa ndi kuyesera kwa PCR.
Kuchiza kwa Toxoplasmosis
Chithandizo chilimbikitsidwa kwa anthu omwe ali ndi kachirombo ka HIV omwe ali ndi CD4 pansi pa 200, pamene chitetezo cha mthupi sichitha kulimbana ndi matenda.
Muzochitika izi, Trimethoprin / sulfamethoxale (co-trimoxazole) kawirikawiri ndi mankhwala osankhidwa kuti asatetezedwe ndi prophylactic.
Kwa matenda opatsirana, mankhwalawa amatha kulembedwa:
- Kuphatikiza kwa Daraprim (pyrimethamine) ndi sulfadiazine (mankhwala ophera sulfa), kuphatikizapo folinic acid
- Clindamycin (antibiotic yogwiritsidwa ntchito pochiza matenda a bakiteriya ndi a protozoa)
- Spiramycin (idakali kuyesedwa kuyesera ku US, ngakhale kuti ikhoza kupezedwa ndi chipani chapadera cha FDA pa nthawi yoyamba ya mimba)
- Mepron (atavaquone)
- Kuphatikiza kwa Clindamycin ndi Meprone
Mchaka cha 2015, wopanga mankhwala a Daraprim (Turing Pharmaceuticals) adatsutsidwa potsutsana ndi Chief CEO, Martin Shkreli, akuyesera kukweza mtengo wa 5000%, kuchokera pa $ 13.50 pa piritsi kufika $ 750 pa piritsi.
Kuteteza matenda a T. gondii
Ngati munthu ali ndi kachilombo koyambitsa matenda a m'thupi (ma CD4 osachepera 100) kapena amayi apakati omwe ali ndi kachilombo ka HIV, akhoza kulangizidwa kuti athe kuchepetsa chiopsezo cha matenda a T. gondii . Izi zikuphatikizapo:
- Kukhala ndi wina wina akusintha malonda a kitty kapena kuvala magolovesi osayera pamene mukuchita nokha. Sambani m'manja mwanu, musasunge bokosi lanu mkati kapena pafupi ndi khitchini. Ngati n'kotheka, sungani mkaka wanu m'nyumba.
- Kuphika zakudya kumadera otentha, pamene kuonetsetsa kuti nyama si pinki ndipo timadzi timathamanga bwino. Peel ndi kusamba zipatso ndi ndiwo zamasamba nthawi iliyonse.
- Kuvala magolovesi nthawi iliyonse yobzala kapena kugwira ntchito ndi nthaka, kutsuka bwino magolovesi ndi manja mutatha.
Kutchulidwa: TOK-so-plas-MOE-sis
Zotsatira:
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "Toxoplasmosis (Toxoplasma Infection - Epidemiology ndi Zoopsa." Atlanta, Georgia; Global Health, Division of Parasitic Diseases ndi Malaria; January 10, 2012.
Oksenhendler, E .; Cadranel, J .; Sarfati, C .; et al. "Toxoplasma gondii chibayo kwa odwala omwe ali ndi matenda a immunodeficiency." American Journal of Medicine. May 1990; 88 (5): 18-21.
Rabaud, C .; May, T .; Amiel, C .; et al. "Kuchuluka kwa toxoplasmosis kwa odwala omwe ali ndi kachirombo ka HIV." Mankhwala. November 1994; 73 (6): 306-314.
Oksenhendler, E .; Cadranel, J .; Sarfati, C .; et al. "Toxoplasma gondii chibayo kwa odwala omwe ali ndi matenda a immunodeficiency." American Journal of Medicine. May 1990; 88 (5): 18-21.
Minkoff, H ;; Remington, J ;; Holman, S .; et al. "Kupatsirana moyenera kwa toxoplasma ndi amayi omwe ali ndi kachirombo ka HIV." Journal American Obstetrics ndi Gynecology. March 1997; 176 (3): 555-9.