Ingabe unesilonda esikhumbeni sakho esingeke siphole? Ingabe kungaba yi-Leishmaniasis? Ake sixoxe ngaso!

Wake waphawula ukuthi abanye abantu banezilonda esikhumbeni sabo ezithatha isikhathi eside ukuphola, ngezinye izikhathi ezishiya izibazi ezimbi? Noma umkhuhlane ohlala izinsuku eziningi, ukwehla kwesisindo, kanye nesisu esivuvukile? Lokhu kungaba izimpawu zesifo esingasinaki kakhulu ngezinye izikhathi, njengesilwane esincane njengempukane. Esinye sezifo ezinjalo yi-Leishmaniasis. Namuhla, sizoxoxa ngalokhu ngokuningiliziwe, kalula.

Kuyini i-Leishmaniasis?

Kalula nje, i-Leishmaniasis iyiqembu lezifo ezibangelwa yi-parasite ebizwa ngokuthi i-Leishmania . Le parasite incane kakhulu kangangokuthi ayinakubonwa ngamehlo enyama ngaphandle kwesibonakhulu. Empeleni, ingeyeqembu lezinto eziphilayo ezibizwa ngokuthi i-protozoa, okuyizinto eziphilayo ezineseli elilodwa.

Lesi sifo sidluliselwa kithi uma uhlobo oluthile lwempukane yesihlabathi lusiluma. Lezi zimpukane zincane kakhulu, ngezinye izikhathi zincane kunomiyane. Lesi sifo singabangela izimo ezahlukahlukene, kusukela ezilondeni zesikhumba ezingabukeki kahle kuya ezinkingeni ezisongela ukuphila ezithinta izitho zangaphakathi.

Kunezindlela ezimbili eziyinhloko esivame ukubona ngazo lokhu:

1. I-leishmaniasis yesikhumba (`(i-leishmaniasis yesikhumba)`)

2. I-Visceral leishmaniasis ( ethinta izitho zangaphakathi )

Ubani okungenzeka kakhulu ukuthi athole lokhu?

I-Leishmaniasis ivame kakhulu ezindaweni zasemakhaya, ikakhulukazi ezindaweni ezingenazo indle ehlanzekile . Abantu abanamasosha omzimba abuthakathaka , njengalabo abangenwe yi-HIV noma labo abanezinye izinkinga zomzimba, banamathuba amaningi okuthola lesi sifo uma bengenwa yi-parasite ye-Leishmania.

I-Leishmaniasis ivame kangakanani? Ingabe ikhona eSri Lanka?

Emhlabeni jikelele, abanye abantu abangenwe yi-parasite ye-Leishmania ababi nezimpawu. Ngakho-ke kunzima ukusho ukuthi kuvame kangakanani. Kodwa-ke, ochwepheshe balinganisela ukuthi abantu abaphakathi kwezigidi ezingu-1.5 nezi-2 emhlabeni wonke bahlushwa yilesi sifo esinezimpawu minyaka yonke .

Yebo, ngokudabukisayo, i-Leishmaniasis ikhona naseSri Lanka. Ikakhulukazi uhlobo lwesikhumba (`(Cutaneous leishmaniasis)`) luye lwabikwa ezindaweni ezomile zezwe lethu, isibonelo ezifundeni ezifana ne-Anuradhapura, i-Polonnaruwa, i-Hambantota, ne-Matara. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

Kukuphi emhlabeni lapho lokhu kuvame kakhulu khona?

I-parasite ye-Leishmania itholakala emazweni angaphezu kuka-90 emhlabeni jikelele. Izinhlobo ezahlukene ze-Leishmania zingatholakala ezingxenyeni ezahlukene zomhlaba. Ochwepheshe bayihlukanisa ngezinhlobo ezimbili, i-"Old World leishmaniasis" kanye ne-"New World leishmaniasis," kuye ngokuthi itholakala kuphi.

• I-Old World leishmaniasis (`(I-Old World leishmaniasis)`) eMpumalanga Yenkabazwe, okungukuthi:
• Ezinye izingxenye zase-Asia
• E-Afrika, ikakhulukazi emazweni asezindaweni ezishisayo naseNyakatho Afrika
• INingizimu Yurophu
• Emaphakathi Mpumalanga
• I-New World leishmaniasis (`(New World leishmaniasis)`) eNtshonalanga Yenkabazwe, okungukuthi:
• IMelika Ephakathi
• i-South America
• Ezinye izindawo zaseMexico

Nakuba kungavamile e-United States, kuye kwabikwa amacala e-cutaneous leishmaniasis emazweni afana neTexas ne-Oklahoma.

Yiziphi izinhlobo eziyinhloko ze-Leishmaniasis?

I-Leishmaniasis ingahlukaniswa ngezinhlobo ezintathu eziyinhloko: isikhumba, ulwelwesi lwamafinyila kanye nesisu.

I-Leishmaniasis Yesikhumba (CL)

Lokhu ukutheleleka okwenzeka esikhumbeni lapho i-sand fly ilume khona . Kuqala njengeqhubu elincane bese kuba isilonda esikhulu. Lezi zilonda zithatha isikhathi eside ukuphola, futhi ngezinye izikhathi azipholi zodwa. Izimpawu zingaqala phakathi kwamasonto ambalwa kuya ezinyangeni ezimbalwa ngemva kokulunywa yi-sand fly.

Akuvamile kakhulu, abanye abantu bangase babe nalezi ziqhubu noma izilonda ezindaweni eziningi zesikhumba. Lokhu kubizwa ngokuthi `(i-diffuse cutaneous leishmaniasis)`. Lokhu kungaphinde kuvele ngisho nangemva kokwelashwa.

I-Mucosal/Mucocutaneous Leishmaniasis (ML)

Lokhu kuvame ukuvela njengenkinga ye-leishmaniasis yesikhumba . Kuthinta ulwelwesi lwamafinyila ngaphakathi kwekhala, emlonyeni, noma emphinjeni. Lesi simo asivamile ukuxazululeka sodwa futhi sivame ukubulala uma singelashwa . Singabangela nokonakala kobuso.

I-Visceral Leishmaniasis (VL) / Kala-azar

Lolu uhlobo olubi kakhulu lwalesi sifo . Lubangelwa uhlobo oluthile lwe-Leishmania. Luthinta izitho zakho zangaphakathi, ikakhulukazi ubende nesibindi sakho . Izimpawu zingathatha noma yikuphi kusukela ezinyangeni ezimbalwa kuya onyakeni noma ngaphezulu ukuze zivele ngemva kokuba ulunywe yimpukane ethelelekile. Lesi simo (VL) singaba sibi kakhulu ngokushesha futhi cishe njalo siyabulala uma singelashwa .

Ziyini izimpawu zalesi sifo?

Izimpawu ze-leishmaniasis ziyahlukahluka kuye ngohlobo onalo. Izinhlobo ezithinta isikhumba kanye nolwelwesi lwamafinyila zibangela izilonda ezinkulu, eziphola kancane. Izinhlobo ezithinta izitho zangaphakathi zibangela izimpawu ezijwayelekile njengomkhuhlane, ukwehla kwesisindo kanye nokuvuvukala kwesisu.

Izimpawu ze-Leishmaniasis yesikhumba

Kuvela iqhubu esikhumbeni lapho i-sandfly ilume khona. Kungase kube noqweqwe/uqweqwe phezulu. Ngokuhamba kwesikhathi, lokhu kungaba yisilonda,Kukhona unqenqema oluqinile oluzungezile, kanye nesikhungo esicwile (njengentaba-mlilo).

Izimpawu ze-Mucosal Leishmaniasis

Izilonda ezisemaqakaleni ngaphakathi kwekhala, emlonyeni, noma emphinjeni. Lezi zilonda zivame ukulandelwa noma zihambisane nezilonda zesikhumba esisodwa noma ngaphezulu.

Izimpawu ze-Visceral Leishmaniasis

Lezi zimpawu zifaka:

• Umkhuhlane: Lokhu kungase kuqale ngokuzumayo futhi kungase kufike kudlule amasonto.
• Ukuzizwa ubanda futhi ujuluka.
• Ama-lymph node avuvukele.
• Ukuvuvukala kwesisu ngenxa yokwanda kwe-spleen.
• Ukwehlisa isisindo.
• Ukukhathala ngokweqile, ukukhathala.
• Ubuthakathaka.
• Ukushintsha umbala noma ukuba mnyama kwezinye izindawo zesikhumba.

Yini ebangela i-Leishmaniasis? Idluliselwa kanjani?

I-Leishmaniasis ibangelwa yizinambuzane ezibizwa ngokuthi i-Leishmania. Lezi zinambuzane zihlala kubantu kanye nasezilwaneni ezifana nezinja, amakati, ama-opossum, amagundane kanye nezimpungushe.

Idluliselwa kakhulu ngokulunywa uhlobo lwempukane ebizwa ngokuthi i-phlebotomine sand fly . Uma le mpukane iluma umuntu noma isilwane esinalesi sifo, bese iluma omunye umuntu, ifaka i-parasite ye-Leishmania emzimbeni womunye umuntu.

Ngaphandle kwalokhu, ezinye izindlela ongatheleleka ngazo yi-Leishmania, okuyinto engavamile kakhulu, yilezi:

• Ngokwabelana ngezinaliti.
• Ngokumpontshelwa igazi.
• Kusukela kumama okhulelwe kuya enganeni esibelethweni.

Okubalulekile: Awukwazi ukuthola i-leishmaniasis ngqo enjeni noma kunoma yisiphi esinye isilwane. Kodwa-ke, kunobufakazi bokuthi izinja zingayidlulisela kwezinye izinja. Njengoba izinja zingayidlulisela nakubantu ngezimpukane zesihlabathi, kubalulekile ukuvimbela izinja ekuyitholeni.

Wazi kanjani ukuthi une-Leishmaniasis?

Udokotela uhlola lesi sifo ngokuthatha amasampula ezicubu emzimbeni wakho bese ewahlola ukuze athole i-parasite ye-Leishmania. Lawa masampula angathathwa emanxebeni, e-spleen, kuma-lymph node, noma emangqamuzaneni ethambo. Emazweni lapho i-leishmaniasis ivame khona, odokotela bavame ukuxilonga lesi sifo ngokulalela izimpawu noma ukuhlola isikhumba.

Yiziphi izivivinyo ezenziwayo?

• I-biopsy yenaliti: Udokotela usebenzisa inaliti ukuthatha isampula yezicubu kusuka ku-spleen yakho, i-lymph node, noma umnkantsha. Uchwepheshe welebhu uyibheka ngaphansi kwe-microscope ukuze abone ukuthi ikhona yini i-Leishmania. Lena yindlela engcono kakhulu yokuxilonga i-visceral leishmaniasis.
• I-biopsy yesikhumba: Udokotela uthatha isampula yezicubu esilondeni esikhumbeni sakho, ekhaleni, noma emlonyeni. Kuhlolwa i-Leishmania. Lokhu kusiza ekuxilongeni i-leishmaniasis yesikhumba noma ye-mucosal.
• Ukuhlolwa kwegazi (i-Serology) : Ngezinye izikhathi udokotela angahlola igazi lakho ukuze abone izimpawu zokutheleleka kwe-Leishmania. Kodwa-ke, ukuhlolwa kwegazi ngokuvamile akusizi kakhulu ekutholeni ukutheleleka okukhona. Ngenxa yokuthi abanye abantu bangaba nakho ngaphandle kwezimpawu, ukuhlolwa kwegazi kungaba nomthelela omuhle noma ngabe awunalo ukutheleleka okwamanje.

Yiziphi izindlela zokwelapha lokhu?

Kunezinhlobo eziningana zemithi yokulwa nezibungu ezingasetshenziswa ukwelapha i-Leishmaniasis. Imithi udokotela wakho ayinikezayo izoncika ohlotsheni lwe-Leishmaniasis onayo. Le mithi ingaba ngezindlela ezahlukene:

• Ukugwinya amaphilisi.
• Okhilimu noma ama-lotion aduduza isikhumba.
• Uketshezi olunikezwa udokotela ngepayipi le-saline (i-IV catheter) olufakwe emthanjeni.

Uma une-leishmaniasis yesikhumba, udokotela wakho angase asebenzise ukwelashwa ngokushisa (i-thermotherapy), ukwelashwa ngokushisa (i-cryotherapy), noma ukwelashwa nge-laser ngqo ezilondeni. Lokhu kungabulala i-parasite futhi kusize izilonda ziphole.

Imithi ye-Leishmaniasis:

• I-Amphotericin
• I-Miltefosine
• Ama-antimonials e-Pentavalent, isibonelo i-sodium stibogluconate
• I-Paromomycin

Ngezinye izikhathi kunikezwa ezinye izindlela zokwelapha i-leishmaniasis yesikhumba. Lokhu kufaka phakathi:

• Ukwelashwa Nge-Thermotherapy : Udokotela ufaka ukushisa enxebeni nasezindaweni ezizungezile.
• Ukwelashwa nge-Cryotherapy : Udokotela upholisa inxeba nendawo ezungezile cishe imizuzwana eyi-10-30.
• Ukwelashwa nge-laser : Udokotela usebenzisa idivayisi ephathwayo ukuqondisa imisebe ye-laser enxebeni nasendaweni ezungezile.

Ungakugwema kanjani i-Leishmaniasis?

Indlela engcono kakhulu yokugwema zonke izinhlobo ze-Leishmaniasis ukugwema ukulunywa yizimpukane zesihlabathi , ikakhulukazi ezindaweni lapho i-Leishmania ivame khona. Nazi ezinye izindlela zokugwema ukulunywa yizimpukane zesihlabathi:

• Gqoka izingubo ezimboza umzimba wakho kahle: amabhulukwe amade, amahembe anemikhono emide, amasokisi, njll.
• Sebenzisa isixoshi sezinambuzane esivunyelwe yi-EPA. Izixoshi zezinambuzane eziphumelela kakhulu ngokuvamile ziqukethe i-DEET.
• Futha isibulala-zinambuzane ukuze ubulale izimpukane zesihlabathi ngaphakathi emakhaya, njengamakamelo okulala kanye namakamelo okuhlala.
• Lala ekamelweni elinamafasitela avaliwe noma elinezikrini emafasiteleni.
• Lala ngaphansi kwenethi yombhede womiyane. Amanye amanethi aphathwa kusengaphambili ngesibulali zinambuzane ukuze avikeleke kakhulu. Izimpukane zesihlabathi zincane kakhulu kunomiyane. Ngakho-ke imigodi enetheni kufanele ibe mincane kakhulu ukuvimba izimpukane ukuthi zingangeni.

Kwenzekani uma uthola i-Leishmaniasis? Ingabe ingelapheka?

Uma uhlaselwa yilesi sifo, ukubikezela kwakho kuncike ohlotsheni onalo kanye nempilo yesimiso sakho somzimba sokuzivikela. Uhlobo oluthinta izitho zangaphakathi (VL) kanye nohlobo oluthinta ulwelwesi lwamafinyila (ML) kudingeka lwelashwe ngokushesha. Zombili cishe njalo ziyabulala uma zingelashwa.

I-leishmaniasis yesikhumba ingaphela ngokuzenzekelayo noma ngokwelashwa. Kodwa-ke, kungathatha izinyanga ukuphola ngokuphelele, futhi kungaba nezibazi ezihlala njalo.

Kungase kudingeke uqhubeke uthatha imithi amasonto noma izinyanga ukuqinisekisa ukuthi ukutheleleka sekuphelile ngokuphelele. Buza udokotela wakho mayelana nokwelashwa kanye nesikhathi sokululama.

I-Leishmaniasis ivame ukwelapheka uma udokotela ethola lesi sifo kusenesikhathi futhi eselaphe ngemithi. Ngokwelashwa kusenesikhathi, izinga lokuphulukiswa kwe-visceral leishmaniasis lingaphezu kuka-90%, kanti kwi-mucosal leishmaniasis, lingaphezu kuka-75%. Abanye abantu bangagula futhi ezinyangeni ezimbalwa ngemva kokuba sebeluleme futhi bengasaguli (lokhu kubizwa ngokuthi ukubuyela emuva).

I-leishmaniasis ye-visceral kanye ne-mucosal kunzima ukuyiphatha uma ingelashwa. Kunzima futhi ukuyiphatha kubantu abanezivikeli mzimba ezibuthakathaka.

Yiziphi izinkinga zalesi sifo?

Izinkinga ze-leishmaniasis zingaba zimbi kakhulu noma zisongele impilo, ikakhulukazi ezinhlotsheni zesisu kanye ne-mucosal. Zihlanganisa:

• Ukutheleleka ngamagciwane: Lokhu kubizwa nangokuthi ukutheleleka kwesibili. Lokhu kungenza amanxeba abe mabi kakhulu. Amagciwane angangena ajule emzimbeni futhi abangele izifo ezinkulu.
• Izibazi: I-leishmaniasis yesikhumba kanye ne-mucosal ingabangela umonakalo ohlala njalo kanye nezibazi ezinkulu zesikhumba, umlomo kanye nekhala.
• Ukubuyela emuva: Abanye abantu banezimpawu eziphela ngokwelashwa bese zibuya. Izilonda zesikhumba ezibuyayo zibizwa ngokuthi "i-leishmaniasis recidivans." Uma lokhu kwenzeka, kungadingeka ukwelashwa okwengeziwe.
• Ukubhoboza noma ukudilika kwe-Septal:I-mucosal leishmaniasis ingabangela imbobo esicutshini phakathi kwemigudu emibili yamakhala (udonga oluphakathi kwamakhala - ``(septum)``). Isakhiwo sekhala singawa. Lokhu kungabangela ukukhubazeka, izifo, kanye nobunzima bokuphefumula.
• Ukutheleleka kwe-pneumonia noma kwesisu (ukutheleleka kwe-GI (kwesisu): I-Mucosal kanye ne-visceral leishmaniasis kungabangela ukutheleleka kwezinye izingxenye zomzimba.

Izinkinga ezengeziwe ze-visceral leishmaniasis:

• I-Post kala-azar dermal leishmaniasis (PKDL): I-PKDL yisimo esibangela izilonda ezinkulu, ezinamaqhubu ebusweni noma kwezinye izingxenye zomzimba. Kungenzeka ngesikhathi noma ngemva kwe-visceral leishmaniasis. Ingahlala isikhathi eside futhi ingabangela izibazi ezinkulu.
• Ukopha kakhulu: Ukopha ngokweqile kungaba yingozi.
• I-Hemophagocytic lymphohistiocytosis: Lesi yisimo esisongela impilo, esilimaza izitho zomzimba.
• I-Sepsis: I-Sepsis yindlela umzimba osabela ngayo engozini yokutheleleka okukhulu.

Kufanele ngizinakekele kanjani?

Buza udokotela wakho ukuthi ungazinakekela kanjani uze ululame. Uma une-leishmaniasis yesikhumba, udokotela wakho uzokutshela ukuthi ungazihlanza kanjani futhi uzinakekele kanjani izilonda zize ziphole. Kuzo zonke izinhlobo ze-leishmaniasis, qaphela izimpawu ezibuyayo ngisho nangemva kokuba ucabanga ukuthi usululame.

Kufanele ngimbone nini udokotela?

Bona udokotela wakho kulezi zimo:

• Uma uhlala endaweni lapho i-Leishmania ivame khona noma uke wahamba futhi unezimpawu.
• Uma isilonda esikhumbeni sakho sithatha isikhathi eside ukuphola.
• Uma amasosha omzimba wakho ebuthakathaka noma unezimpawu zokutheleleka, bona udokotela.

Uma ungenazo izimpawu ngemva kokulunywa yi-sand fly, awudingi ukubona udokotela. Akuzona zonke izimpukane zesand fly ezisakaza izifo. Ngezinye izikhathi imizimba yethu ingalwa nokutheleleka kwe-Leishmania ngaphandle kokubangela ukugula. Ngaphandle kokuthi amasosha omzimba wakho abuthakathaka noma usuvele ugula, odokotela ngokuvamile ngeke bakwelaphe.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Uma unalezi zimpawu ezinzima, iya ekamelweni lezimo eziphuthumayo eliseduze:

• Uma unomkhuhlane ophezulu (ongaphezu kuka-103 Fahrenheit / 40 Celsius) lokho akwehli.
• Ubunzima bokuphefumula.
• Ukuvuvukala okubonakalayo kwesisu.
• Ukuphuzi kwesikhumba noma amehlo (i-jaundice).
• Umbala oluhlaza okwesibhakabhaka wesikhumba, izindebe, noma izinzipho (i-cyanosis, uphawu lomoya-mpilo ophansi egazini).

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Kungaba usizo ukubuza udokotela wakho le mibuzo:

• Yiziphi izindlela zokwelapha enginazo?
• Kufanele nginakekele kanjani amanxeba ami?
• Ngizolulama nini/ingabe ukulimala kwami ​​kuzophola?
• Isifo sami sibi kangakanani?
• Ngingawuthatha kanjani umuthi wami?
• Kufanele ngiye nini egumbini lezimo eziphuthumayo?
• Kufanele ngiphinde ngikubone nini futhi?

Khumbula njengesifinyezo

I-Leishmaniasis yisifo esibangelwa yizinambuzane esingabangela izimo ezibuhlungu nezisongela ukuphila. Uma uhlala noma uya endaweni lapho i-Leishmania ivame khona, thatha izinyathelo zokuzivikela. Uma unezimpawu ze-Leishmaniasis, noma uma unesilonda esingapholi noma esiba sibi kakhulu, qiniseka ukuthi ufuna usizo lwezokwelapha. Iningi labantu abathola ukwelashwa ngaphambi kokuba kube kubi kakhulu bangalulama ngokuphelele. Ngakho-ke, kubalulekile ukuqaphela lezi zimpawu futhi ufune ukwelashwa ngokushesha.

i- leishmaniasis, i-kala-azar, i-sand fly, isilonda sesikhumba, i-parasite