Toxoplasmosis (yomwe imatchedwanso "toxo") mu matenda opatsirana omwe amachititsidwa ndi tizilombo toyambitsa matenda omwe amadziwika kuti Toxoplasma gondii. Nthawi zambiri, matenda a toxo adzakhala ofatsa ndi kuthetsa okha popanda mankhwala. Ngati chithandizo chikufunika, nthawi zambiri chimakhudza mankhwala amodzi kapena ambiri kapena mankhwala opatsirana pogonana omwe angathe kuthetsa matendawa.
Komabe, panthawi yomwe ali ndi mimba kapena anthu omwe ali ndi ma chitetezo a chitetezo cha m'thupi , akhoza kuthandizidwa kuti athetse kapena kuteteza matenda komanso kupewa mavuto aakulu a matenda. Izi ndizowona makamaka makamaka pakapita kachilombo ka HIV.
Kuchiza Kwambiri
Kwa anthu omwe ali ndi ma chitetezo oteteza thupi , pafupifupi 90 peresenti ya matenda a T. gondii sangakhale ndi zizindikiro konse. Omwe amachita nthawi zambiri amakhala ofatsa komanso ovuta chifukwa cha chimfine, ngakhale ndi dokotala. Pakati pa mwayi wa toxo amapezeka, dokotala nthawi zambiri amalimbikitsa kupuma kwa bedi komanso mwina kupweteka kwa OTC) ngati Tylenol (acetaminophen) kapena Advil (ibuprofen).
Chithandizo chachikulu chimalimbikitsidwa kwa anthu omwe ali ndi ma chitetezo a chitetezo chamthupi omwe alibe chitetezo cha mthupi kuti amenyane ndi matenda. Izi makamaka zikuphatikizapo anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi koma akhoza kuphatikizapo obwezera ziwalo komanso anthu omwe ali ndi matenda a khansa (omwe amamwa mankhwala osokoneza bongo).
Njira Zothandizira
Pofuna kuchiza matenda aakulu, madokotala amapereka mankhwala omwe amachititsa kuti matendawa asapitirire. Mankhwala omwe amagwiritsidwa ntchito kwambiri ndi awa:
- Pyrimethamine, mankhwala osokoneza bongo omwe amakhulupirira kuti ndi othandiza kwambiri pochiza matenda oopsa a toxo
- Sulfadiazine, mankhwala osokoneza bongo omwe amagwiritsidwa ntchito pamodzi ndi pyrimethamine
- Clindamycin, mankhwala ena omwe amagwiritsidwa ntchito pamodzi ndi pyrimethamine
- Minocycline, antibiotic yomwe imagwiritsidwa ntchito pokhapokha ngati munthu sagwirizana ndi sulfadiazine ndi clindamycin
- Asidi a folinic amagwiritsidwa ntchito monga chowonjezera pofuna kuchepetsa chiopsezo cha thrombocytopenia (mapiritsi otsika)
Thandizo la masabata asanu ndi limodzi lidzaphatikizapo mlingo wa tsiku ndi tsiku wa pyrimethamine, mlingo wa tsiku ndi tsiku wa mankhwala osankhidwa osankhidwa, ndi mlingo wa tsiku ndi tsiku wa folinic acid. Pofuna kuchepetsa kubwereza, mankhwala a antibiotic trimethoprim ndi sulfamethoxazole (TMP-SMX) amatengedwa kamodzi pa tsiku kwa milungu inayi.
Kuchiza mukutenga
Kutumiza kwa T. gondii kuchokera kwa mayi kupita kwa mwana sikopanda pokhapokha ngati mayi ali ndi kachilombo ka HIV ndipo ali ndi kachilombo koyambitsa matenda. Pakati pa amayiwa, mankhwala amalembedwa kuti asatenge HIV.
Asayansi akukhalabe otsimikiza kwambiri za amayi omwe ali ndi mphamvu zowonongeka. Ngakhale kuti matendawa amapezeka, pamakhalabe mkangano wokhudzana ndi momwe ma antibayotiki aliri othandizira kuteteza kufala kwa HIV, makamaka popeza zingakhale zovuta kupeza matenda a toxoplasmosis panthawi yoyembekezera.
Kuti izi zitheke, chisamaliro cha akatswiri chiyenera kufunidwa ngati muli ndi pakati ndipo muli ndi chiopsezo chowonjezeka cha toxoplasmosis.
Chithandizo chimaperekedwa motere:
- Ngati matenda opatsirana amapezeka m'kati mwa trimestre yoyamba, spiramycin idzaperekedwa kuchokera nthawi yomwe idzadziwitsidwe kufikira nthawi yobereka.
- Pambuyo pa trimester yoyamba (kapena ngati kachilombo ka fetus kanatsimikiziridwa), pyrimethamine, sulfadiazine, ndi folinic asidi angagwiritsidwe ntchito kuchokera ku matenda mpaka kufika.
Malingaliro a ana
Chithandizo chikulimbikitsidwa kwambiri kwa ana omwe ali ndi kachilombo ka HIV omwe amapezeka ndi T. gondii pa nthawi ya mimba. Izi ndi zoona ngati mayiyo anali ndi zizindikiro kapena ayi. Kutalika kwa mankhwala (pyrimethamine, sulfadiazine, ndi folinic acid) kungakhale kosiyana koma kumatha kwa miyezi 12.
Ngati khanda kapena mwanayo atapezeka kuti ali ndi toxoplasmosis ndi HIV, TMP-SMX idzalamulidwa limodzi ndi kachilombo ka HIV . TMP-SMX idzagwiritsidwa ntchito popewera toxoplasmic encephalitis (vuto lalikulu kwambiri la congenital toxoplasmosis) ndipo anapitiriza mpaka nthawi yomwe mankhwala omwe ali ndi kachilombo ka HIV amatha kuonetsetsa kuti chitetezo cha mwana chimasintha.
Zikakhala kuti inxoplasmic encephalitis, corticosteroids iyenera kulamulidwa kuti kuchepetsa ubongo kutupa. Mankhwala osokoneza bongo angagwiritsidwenso ntchito kuti asatope .
Kuchiza kwa Anthu Amene Ali ndi HIV
Toxoplasmosis kwa anthu omwe ali ndi kachilombo ka HIV angayambitse matenda aakulu, omwe angathe kupha moyo, matenda, komanso mapapo. Kawirikawiri, matendawa amayamba chifukwa cha kubwezeretsa kachilombo koyambitsa matenda osati kale.
Pokhapokha chitetezo cha mthupi chiteteze matendawa, munthu akhoza kuthana ndi matenda mwamsanga pokhapokha ngati atayesetsedwanso kuti ateteze chitetezo cha mthupi, athetse matenda a T. gondii , ndi kuchiza matendawa.
Antiretroviral Therapy
Toxoplasmosis kwa anthu omwe ali ndi kachirombo ka HIV amaonedwa kuti ndi othandiza chifukwa amatha kuyambitsa matenda pamene chitetezo cha mthupi sichifooka.
Kuti izi zitheke, njira yokhayo yobweretsera ku toxoplasmosis ndiyo kubwezeretsa chitetezo cha mthupi. Mankhwala opatsirana pogonana amachititsa zimenezi polepheretsa kuti HIV ikhale yovuta. Ngakhale kuti sangathe kuchiza matendawa, amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda kuti tisateteze.
Kawirikawiri amapatsidwa mankhwala osokoneza bongo atatu , mankhwala opatsirana pogonana akhoza kubwezeretsa chitetezo cha mthupi ngakhale anthu odwala kwambiri, kawirikawiri mkati mwa miyezi ingapo. Chithandizo chikhoza kupitilizidwa kwa moyo wanu wonse ndipo muzipitanso kuchipatala nthawi zonse kuti muwone momwe thupi lanu limatetezera .
Thandizo la antibiotic
Chithandizo cha matenda opatsirana a T. gondii ndi ofanana ndi omwe ali ndi matenda aakulu ndipo angaphatikizepo:
- Pyrimethamine, sulfadiyazine, ndi folinic acid
- Pyrimethamine, clindamycin, ndi folinic acid
- Atovaquone (antifungal wamphamvu) yogwiritsidwa ntchito pamodzi ndi pyrimethamine ndi folinic asidi
- Azithromycin (mankhwala ena omwe amagwiritsidwa ntchito masiku onse), pyrimethamine, ndi folinic acid
- Atovaquone ndi sulfadiazine
Nthendayi ikatha, TMP-SMX idzalamulidwa kuti iteteze kubwereza ndikupitirira mpaka nthawi yomwe mankhwala ochepetsa kachilombo ka HIV amatha kubwezeretsanso ntchito.
Kuchiza Matenda Ovuta
Matenda atatu omwe amafala kwambiri a toxoplasmosis kwa anthu omwe ali ndi kachilombo ka HIV ali ndi toxoplasmosis (omwe amachititsa maso), CNS toxoplasmosis (yomwe imakhudza ubongo ndi njira zamanjenje), ndi pulmonary toxoplasmosis. Chithandizo cha aliyense chidzalimbikitsidwa ndi kuopsa kwa chizindikiro komanso umoyo wa munthu wokhudzidwayo.
Njira zothandizira odwala toxoplasmosis angaphatikizepo:
- Corticosteroids zothandiza kuthetsa kutupa
- Mankhwala a corticosteroids ndi clindamycin m'maso
- Kuika opaleshoni ya clindamycin pellets m'diso
Njira zochiritsira za CNS toxoplasmosis zingakhalepo:
- Corticosteroids zowononga kuchepa kwa ubongo ndi pakatikati zamanjenje (CNS)
- Mankhwala osokoneza bongo kuti asamalidwe
Njira zothandizira ma pulmonary toxoplasmosis zingaphatikizepo:
- Corticosteroids zowononga kuchepa
- TMX-SMP kuti athane ndi matenda opatsirana a pneumocystis m'mapapo
Mankhwala Opatsirana
Ngati muli ndi kachilombo koyambitsa matenda a HIV, mankhwalawa angapangidwe ngati chitetezo chanu cha mthupi chimasokonekera.
Izi zikhoza kudziwika ndi chiwerengero chanu cha CD4 chomwe chimayeza kuchuluka kwa CD4 T-maselo anu magazi anu. Munthu wathanzi, CD4 chiwerengero chidzakhala pakati pa 800 ndi 1,500. Kwa anthu okhala ndi chitetezo cha m'thupi, chiwerengero chimenecho chidzagwa pansi pa 200.
Pofuna kupewa tizilombo toxoplasmosis, TMP-SMX idzayankhidwa tsiku lililonse ngati CD4 yanu ikuyandikira "malo oopsa" a 100. Pamodzi ndi mankhwala anu ochepetsa kachilombo ka HIV, mupitirize kutenga TMP-SMX mpaka nthawi yomwe CD4 yanu ili pamwamba 200 ndipo amatha kukhala kumeneko. Mutha kuimitsa mankhwalawa ndikupitiriza kutenga mankhwala anu.
Zida za Kupewa
Ngati muli ndi pakati kapena muli ndi chitetezo cha m'thupi, muyenera kutengapo mbali kuti musapezeke ku T. gondii pamoyo wanu wa tsiku ndi tsiku. Zitetezo izi zingakuteteze ku toxoplasmosis bwino koposa mankhwala onse padziko lapansi.
Zina mwa njira zothandizira kwambiri ndi izi:
- Kuvala magolovesi owonongeka mukamayeretsa bokosi la katchi kapena, bwinobe, kuti wina achite zimenezo
- Kuvala magolovesi mukakhala kunja kwa munda
- Kuphika nyama, nkhuku, ndi nsomba bwino
- Kujambula ndi kusamba masamba kapena zipatso zomwe zimachokera kumunda kapena msika wa mlimi
- Kukonza matabwa, mipeni, kapena malo opangidwa ndi nyama yaiwisi angakhale akukumana nawo
- Kupewa madzi osayeretsedwa a mtundu uliwonse
- Kusunga mphaka wanu m'nyumba
- Kudyetsa kathi wanu kokha basi kapena zakudya zouma ndikupewa nyama zakuda kapena zosaphika
- Kuphimba sandbox ya mwana wanu
- Kusamba m'manja mwako ndi madzi otentha ndi sopo mutatha kulima, kusewera ndi kamba, kukonzekera chakudya, kapena kuyeretsa sandbox
- Phunzitsani ana anu maluso abwino othandizira manja
> Zotsatira:
> Magulu a Kuletsa ndi Kuteteza Matenda. "Mafinya - Toxoplasmosis (Toxoplasma Matenda): Kupewa ndi Kulamulira." Atlanta, Georgia; zasinthidwa pa January 10, 2013.
> Lee, S. ndi Lee. T. "Encephalitis ya Toxoplasmic Patient ndi Acquired Immunodeficiency Syndrome . 2017; 5 (1): 34-36. DOI: 10.1479 / btrt.2017.5.1.34.
> Park, Y. ndi Nam. H. "Zochitika Pachipatala ndi Chithandizo cha Ocular Toxoplasmosis." Korea J Parasitol. 2013; 51 (4): 393-399. DOI: 10.3357 / kjp.2013.51.4.393.
> US Department of Health and Human Services. "Malangizo Othandizira Kupewa ndi Kuchiza Matenda Oponderezedwa Aakulu Achikulire omwe ali ndi kachirombo ka HIV ndi Achinyamata." AIDSInfo. Rockville, Maryland; zasinthidwa pa October 28, 2015.