Mankhwala Odziwika ndi Omwe Amapangidwira Opezeka
Kutentha kwa chiwombankhanga (kumangotchedwa typhoid) si matenda amene timawawona nthawi zambiri ku United States. Komabe, kuchokera kudziko lonse lapansi, zikuwoneka kuti ndizofunikira kwambiri pa umoyo wa anthu odwala matenda okwana 21 miliyoni ndi oposa 150,000 akufa chaka chilichonse.
Ngakhale pano ku United States, anthu 5,700 amakhulupirira kuti ali ndi kachilombo chaka ndi chaka, malinga ndi lipoti la Centers for Disease Control and Prevention (CDC).
Ambiri amachokera ku mayiko osiyanasiyana kupita ku zigawo zadziko kumene typhoid yakula.
Matendawa, omwe amagwirizanitsidwa ndi kachitidwe ka ukhondo kaukhondo komanso malo oyeretsera ukhondo, akhoza kutetezedwa ndi katemera kapena pakamwa.
Mmene Mphepo Yachiwopseyi Imatulutsira
Kutentha kwa chiwombankhanga ndi matenda omwe angawopsyeze chifukwa cha Salmonella typhi bacteria. Mabakiteriya amangokhalapo mwa anthu ndipo amakhala makamaka m'magazi kapena matumbo.
Ngati munthu ali ndi typhoid, iye adzakhetsa mabakiteriya kupyolera mu zinyansi. Kusokonezeka kulikonse kwa madzi, chakudya, kapena malo omwe angapangidwe kungathandize kufalitsa matendawa. Kutumizirana kwa munthu ndi munthu, monga kupyolera m'manja, kumakhalanso kofala.
M'madera osauka omwe akutukuka padziko lonse lapansi, kusowa kwa kayendedwe kabwino ka madzi osokoneza bongo ndikowopangitsa kuti matenda ambiri afalikire.
Zizindikiro za Mliri wamkuntho
Kamodzi kachilomboka, mabakiteriya amakula mofulumira ndikufalikira kudzera m'magazi, kuchititsa zizindikiro zosiyanasiyana pamadera atatu osiyana:
- Pa sabata imodzi, munthu akhoza kukhala ndi malungo, mutu, chifuwa, kutopa, kuchepetsa mtima wamtima ( bradycardia ), ululu m'mimba, ndi nosebleeds.
- Pa sabata iwiri, kutopa kwapita patsogolo komwe munthu sangathe kudzuka. Pamene malungo akupitirira kukula, delirium ndizofala. Mabala a Rose angathenso kukula pamimba, pomwe munthuyo angakhale ndi nthenda yotsekula m'mimba kapena kutsekemera.
- Pambuyo pa sabata itatu, mavutowa amatha kupweteka kwambiri ndipo amatha kuphatikiza m'mimba, kutupa kwa ubongo ( encephalitis ), kupweteka m'mimba, kutupa mtima ( myocarditis ) ndi matenda opuma monga chibayo komanso bronchitis.
Ndikumapeto kwa sabata zitatu kuti kutentha kwapamwamba kudzayamba kugonjetsa. Chithandizochi chimaphatikizapo mankhwala enaake (monga amoxicillin kapena trimethoprim-sulfamethoxazole) komanso nthawi zambiri madzi oteteza madzi kuti asafe.
Ngati mankhwalawa amatha nthawi yake, typhoid sichimayambitsa imfa. Komabe, ngati sanasamalidwe pakadutsa sabata itatu, chiopsezo cha imfa chikhoza kuwonjezeka ndi 20 peresenti.
Mliri wamatenda
Chifukwa cha matenda a typhoid, anthu omwe ali pa chiopsezo chachikulu angathe kupatsidwa chitetezo ndi katemera umodzi wodwala kapena katemera wodwala wa mankhwala amodzi.
Pali katemera awiri omwe akuvomerezedwa ndi US Food and Drug Administration:
- Chithunzithunzi Vi ndi katemera wa tizilombo omwe amachitidwa ndi mabakiteriya osatetezeka omwe sangayambitse matenda. Amaperekedwa mwatsatanetsatane (kawirikawiri amakhala mu minofu yapamwamba pamanja) ndipo imafuna mlingo umodzi. Katemera ayenera kuperekedwa masabata awiri pasanapite ulendo ndipo angagwiritsidwe ntchito kwa aliyense woposa zaka ziwiri. Ziwombankhanga zikhoza kuperekedwa zaka ziwiri zilizonse kwa anthu omwe ali pangozi.
- Vivotif ndi katemera wa typhoid wamtundu wokhala ndi mabakiteriya omwe amakhala attenuated (amoyo koma ofooka). Amaperekedwa mu paketi ya ma makuloni anayi, omwe amachotsedwa tsiku lililonse m'mimba yopanda kanthu. Vivotif ikhoza kugwiritsidwa ntchito kwa aliyense ali ndi zaka zoposa sikisi, pamene zofunikira zowonjezera zimangotengedwa zaka zisanu zilizonse. Monga katemera wamoyo, amafunika kukhala firiji ndipo sayenera kuperekedwa kwa anthu omwe ali ndi HIV (monga omwe ali ndi HIV ).
Pambuyo pa kusiyana kwa mautumiki (jekeseni vs. pamlomo) ndi zoletsedwa ndi ogwiritsira ntchito (zaka ndi chidziwitso cha mthupi), katemera onse amapereka pafupifupi 70 peresenti kutetezedwa ndi typhoid.
Izi zikutanthauza kuti mufunikira kuyang'anitsitsa zomwe mumadya kapena kumwa ngati mukupita ku typhoid hotspot.
Zotsatira Zotsatira ndi Zosiyana
Zotsatira zake zimawonekera kwambiri ndi Typhim Vi oposa 10 peresenti ya anthu omwe ali ndi malungo, kutopa, kupweteka kwa mutu, thupi, ndi kupweteka kwa tsamba. Ndi Vivotif, chiopsezochi n'chochepa (pansi pa zisanu ndi ziwiri peresenti) ndipo chimaphatikizansopo kupweteka mutu, kusungunuka, ndi zowawa m'mimba. Pazochitika zonsezi, zizindikiro zimakhala zofatsa ndikudzipangira okha popanda kuchiritsidwa.
Pazithunzi, pali zotsutsana kwambiri ndi Vivotif kusiyana ndi Typhim Vi. Chofunika kwambiri pa zonsezi ndizogwirizanitsa mankhwala omwe angathe kuchepetsa zotsatira za katemera.
Nthawi zina, chifukwa mankhwalawa amateteza thupi kuti lisatetezedwe. Izi zikuphatikizapo mankhwala omwe amagwiritsidwa ntchito pofuna kuthana ndi matenda omwe amabwera chifukwa cha matendawa monga lupus, rheumatoid arthritis, ndi psoriasis. Nthawi zina, mufunika kuimitsa mankhwalawa kwa masiku 30 asanayambe kuwombera typhoid.
Mndandanda wa mankhwala omwe amatsutsana kuti agwiritsidwe ntchito ndi Vivotif ndi awa:
- Benlysta (belimumab) , mankhwala osokoneza chitetezo cha mthupi
- Cimzia (certolizumab pegol) , mankhwala osokoneza thupi oteteza thupi
- Cosentix (secukinumab), mankhwala osokoneza thupi oteteza thupi
- Hydrea (hydroxyurea), mankhwala osokoneza bongo
- Methotrexate amagwiritsidwa ntchito pochiza khansa, psoriasis, ndi nyamakazi ya nyamakazi
- Taltz (ixekizumab), mankhwala osokoneza thupi oteteza thupi
- Teflaro (ceftaroline), antibiotic
Mndandanda wa mankhwala omwe amatsutsana kuti agwiritsidwe ntchito ndi Tiphim Vi ndi awa:
- Benlysta (belimumab) , ntchito yogwiritsira ntchito mankhwala osokoneza bongo
- Cosentix (secukinumab), mankhwala osokoneza thupi oteteza thupi
- Taltz (ixekizumab), mankhwala osokoneza thupi oteteza thupi
Ngati mukufunika katemera wa typhoid, onetsetsani kuti mukumupatsa dokotala mankhwala aliwonse amene mungakhale nawo komanso matenda alionse omwe amachititsa kuti thupi lanu lizipewa kuteteza thupi kapena kuteteza thupi lawo.
Pamene Mufunika Kudwala
Malinga ndi Komiti Yowunikira za Vaccinations (ACIP), katemera wosagwiritsidwa ntchito nthawi zonse sali woyenera ku United States. Komabe, pali zochitika zenizeni pamene katemera akulangizidwa bwino:
- Oyendayenda kupita kumadera omwe amadziwika kuti ali ndi vuto la Salmonella typhi
- Anthu omwe amakhala ndi chibwenzi ndi munthu amene wakhala akuchitidwa kapena akuchiritsidwa ndi matenda a typhoid fever
- Madokotala a microbiologist kapena antchito a laboratory omwe amakumana ndi zikhalidwe za Salmonella kapena typhi
Pokonzekera ulendo wopita kunja kwa nyanja, mukhoza kufufuza zofunikira zomwe zilipo panopa ndi maulendo poyendera webusaiti ya uphungu wathanzi woyendetsedwa ndi CDC.
Mawu Ochokera
Ngakhale katemera wa typhoid akhoza kuchepetsa kwambiri chiopsezo cha chiwindi cha typhoid, sizitsimikiziranso. Pofuna kuti mukhale otetezeka mukakhala kunja, pali malamulo khumi omwe mukuyenera kutsatira:
- Sambani manja anu nthawi zambiri ndi sopo ndi madzi otentha.
- Gwiritsani ntchito mankhwala osokoneza bongo opangira mowa nthawi yomwe madzi sapezeka.
- Pewani kumwa madzi osatetezedwa.
- Pamene mukumwa zakumwa zamabotolo kapena zamzitini, funsani zakumwa kuti mubweretse chisindikizo.
- Nthawi zonse funsani zakumwa popanda ayezi.
- Pewani zipatso zobiriwira ndi masamba ngakhale atapulidwa.
- Sankhani zakudya zotentha; zakudya zomwe zasungidwa kapena zomwe zimagwiritsidwa ntchito pamtentha kutentha.
- Pewani ogulitsa chakudya cha pamsewu.
- Gwiritsani ntchito madzi otsekemera kuti muzitsuka mano.
- Yesetsani kumeza madzi osamba.
> Zotsatira:
> Zomwe Zidzasintha Kudziteteza ndi Kupewa Matenda (CDC) "Chiwindi cha Mkuntho." Atlanta, Georgia: yasinthidwa pa July 18, 2016.
> Chakudya ndi Drug Administration (FDA). "Chipiliro Vi." Silver Spring, Maryland; zasinthidwa pa October 10, 2017.
> FDA. "Vivotif." Idasinthidwa pa September 12, 2016.
> Jackson, B ;; Iqbal, S .; Mahon, B. et al. "Zowonjezereka Zomwe Zigwiritsidwe Ntchito za Tizilombo Katemera - Komiti Yopereka Malangizo Okhudza Kuteteza Katemera, United States, 2015." MMWR. 2015; 64 (11) 305-8.