Toxoplasmosis (sidoo kale loo yaqaano "toxo") ee cudurada faafa ee uu sababo halbeeg midi ah oo loo yaqaan ' Toxoplasma gondii'. Inta badan kiisaska, infekshanka kiimikada wuxuu noqon doonaa mid khafiif ah loona xaliyo daaweyn la'aan. Haddii loo baahdo daaweyn, waxay caadi ahaan ku lug leedahay hal ama dhowr daawo oo antibiyootiko ah ama daawooyinka antimusiyaanka ah oo awood u yeelan kara in la nadiifiyo cudurka.
Si kastaba ha noqotee, inta lagu jiro uurka ama dadka qaba nidaamyada difaaca jirka , daaweynta gardarrada ah waxaa looga baahan karaa inay xakameyso ama ka hortagto cudurka iyo ka fogaanshaha dhibaatooyinka halista ah ee cudurka. Tani waxay si gaar ah u hubineysaa kiisaska infekshanka HIV ee sareeya.
Daweyn Dheeraad ah
Dadka qaba nidaamyada difaaca jirka ee caadiga ah , ilaa 90 boqolkiiba infakshannada T. gondii wax calaamado ah ma lahan. Kuwa sameeya waxay badanaa noqon doonaan mid sahlan oo si sahlan u qaldana hargabka, xitaa dhakhtarku. Daaweynta sunta ah waxaa lagu ogaanayaa, dhakhtarku wuxuu inta badan ku talin karaa nasasho sariireed, waxaana laga yaabaa in laga yareeyo xanuunka 'Tylenol' (acetaminophen) ama Advil (Ibuprofen).
Daaweynta waxaa lagula talinayaa dadka difaacooda difaaca jirka ee aan haysan difaaca jirka si loola dagaalamo cudurka. Kuwani badiyaa waxaa ka mid ah dadka qaba infakshanka HIV-ga sareeya laakiin waxay sidoo kale ku lug yeelan karaan dadka qaata xubinta taranka iyo dadka qaada kiimiko ku daweynta kansarka (labadaba kuwaas oo sida caadiga ah qaata daawooyinka difaaca jirka).
Meelaha lagugula taliyay
Si loo daweeyo infakshanka ba'an (firfircoon), takhaatiirta ayaa qori doona antibiyootiko iyo daawooyin kale oo awood u leh inay iska nadiifiyaan caabuqa ayna ka hortagaan cudurku inuu sii socdo. Daawooyinka sida caadiga ah loo qoro waxaa ka mid ah:
- Pyrimethamine, daroogo liddi kufilan ayaa loo tixgeliyey wakiilka ugu wax ku oolka ah ee lagu daweynayo infekshinka ba'an ee ba'an
- Sulfadiazine, daawada antibiyootikada loo isticmaalo oo lagu daro pyrimethamine
- Clindamycin, antibiyootiko kale ayaa loo isticmaalaa dhinaca kale pyrimethamine
- Minocycline, antibiyootig loo isticmaalo keliya marka qofku u adkaysto sulfadiazin iyo clindamycin
- Folinic acid ayaa loo isticmaalay sidii loo kordhin lahaa khatarta trombocytopenia (trombelets hooseeya)
Daawaynta lix-todobaad ah waxay ku lug leedahay qiyaasta maalinlaha ah ee pyrimethamine, afar qiyaasood maalinle ah oo ah antibiotic la doortay, iyo qiyaasta maalinlaha ah ee folinic acid. Si looga hortago soo noqoshada, daawada antibiyootikada trimethoprim iyo sulfamethoxazole (TMP-SMX) ayaa la qaadayaa hal mar maalin afar toddobaad.
Daawaynta Uurka
Isku-gudbinta T. gondii hooyada ilaa ilmuhu waa mid dhif u ah haddii hooyadu leedahay HIV-ga iyo difaaca jirka oo aad u adag. Hooyooyinkaas waxaa ka mid ah daaweynta si looga hortago infekshanka uur-jiifka.
Cilmi-baadhayaashu weli way ka yara yareeyaan hooyooyinka leh habdhiska difaaca jirka caadiga ah. Xitaa haddii infekshanka jirku keeno, waxaa jira doodo badan oo la xidhiidha sida antibiyootigga waxtarka leh ee looga hortago gudbinta, gaar ahaan tan ay adkaan karto in lagu ogaado cudurka toxoplasmosis xilliga uurka.
Si loo dhammeeyo, daryeelka caafimaad ee takhasuska waa in la raadiyaa haddii aad uur leedahay oo aad khatar u tahay toxoplasmosmis.
Daaweynta waxaa caadi ahaan loo qoraa sida soo socota:
- Haddii infekshinka ba'an uu dhaco inta lagu jiro seddexda bilood ee ugu horreysa, spiramycin waa la soo qori doonaa waqtiga baaritaanka ilaa waqtiga dhalmada.
- Saddexda bilood ee ugu horreeya (ama haddii infakshanka fetaal-ka la xaqiijiyay), pyrimethamine, sulfadiazine, iyo folinic acid ayaa loo isticmaali doonaa baadhitaan si loo keeno.
Talooyinka Carruurta
Daaweynta waxaa si weyn loogu talinayaa dhalaanka ay hooyada qabta HIV-ga laga helay T. gondii inta uurka lagu jiro. Taasi waa run in hooyadu leedahay calaamado ama la siiyo daaweyn ka hortag ah. Muddada daaweynta (pyrimethamine, sulfadiazine, iyo folinic acid) way kala duwanaan kartaa laakiin waxay socon kartaa illaa 12 bilood.
Haddii ilmaha ama ilmaha laga helo cudurka toxoplasmosis iyo HIV, TMP-SMX ayaa lagu qori doonaa daaweynta HIV . TMP-SMX waxaa loo isticmaali doonaa in looga hortago xanuunka 'toxoplasmic encephalitis' (dhibaatada ugu ba'an ee keena toxoplasmosis) iyo sii wado illaa waqtigaa sida daawooyinka HIV ay awood u leeyihiin inay caadi u noqdaan nidaamka difaaca ilmaha.
Haddii ay dhacdo ensenflasmic encephalitis, corticosteroids ayaa loo qori karaa si loo yareeyo bararka maskaxda. Dawooyinka anticonvulsive ayaa sidoo kale loo isticmaali karaa si looga hortago qallalka .
Daweynta Dadka qaba HIV
Toxoplasmosis ee dadka qaba HIV waxay sababi kartaa mid halis ah, iyo khatarta nafta halis galisa, cudurada saameynaya maskaxda, indhaha, iyo sanbabada. Xaaladaha badankood, cudurku wuxuu keenayaa dib u soo noqoshada infakshii hore oo aan ahayn mid cusub.
Iyadoo aan laheyn difaaca difaaca si loo xakameeyo jeermiska, qofku si deg deg ah ayuu u fuuli karaa cudurka illaa aan laga qaadin tallaabooyin degdeg ah si loo soo celiyo hawlaha difaaca jirka, in la nadiifiyo infekshanka T. gondii , oo daaweyn kara dhibaatada cudurka.
Daaweynta Antiretroviral
Toxoplasmosis ee dadka qaba HIV waxaa loo tixgeliyaa fursado fursad ah maxaa yeelay waxay kaliya u keeni kartaa cudur marka nidaamka difaaca jirka uu aad u daciifo si uu u joojiyo.
Si loo dhamaystiro, habka kaliya ee looga soo kabasho toxoplasmosis waa in la soo celiyo difaaca difaaca jidhka. Daawooyinka Antiretrovoviral ayaa tan sameeya iyada oo faragelinta awoodda HIV-ga ee soo-celinta. Inkastoo aysan daaweyn karin cudurka, waxay ku hayaan dadka fayraska ah sida ugu hooseeya ee suurtogalka ah si aysan mar dambe u qaadsiin karin uguna dilaan unugyada difaaca ee loola jeedo inay naga difaacaan.
Caadi ahaan daawooyinka loo isticmaalo daawooyinka antiretroviral ayaa dib u soo celin kara hawlaha difaaca xataa xitaa dadka xanuunsan, inta badan mudo dhawr bilood ah. Daaweyntu waxay sii wadi doontaa noloshooda oo waxay ku jirtaa booqashooyin dhakhtar joogta ah si loo kormeero xaaladdaada jirka iyo hubinta saameynaha suurtogalka ah.
Daaweynta Antibiyootigga
Daaweynta infekshanka T. gondii waa mid la mid ah mid ka mid ah infakshanka ba'an waxaana ka mid noqon kara:
- Pyrimethamine, sulfadiazine, iyo folinic acid
- Pyrimethamine, clindamycin, iyo folinic acid
- Atovaquone (antifungal xoog leh) ayaa loo adeegsadaa iyadoo lagu darayo pyrimethamine iyo folinic acid
- Azithromycin (antibiyootig kale oo caadi ah), pyrimethamine, iyo folinic acid
- Atovaquone iyo sulfadiazine
Marka infekshanka la nadiifiyo, TMP-SMX ayaa loo qori doonaa si looga hortago soo noqoshada oo sii socdo illaa waqtigaas oo daawooyinka antiretrovoviral ay soo celin karto hawlaha difaaca.
Daweynta Dhibaatooyinka Cudurada
Saddexda dhibaatooyinka ugu badan ee sunta toxoplasmosis ee dadka qaba HIV waa indhaha toxoplasmosis (indhaha oo saameeya), CNS toxoplasmosis (saameynta maskaxda iyo habdhiska dareenka), iyo sambabada toxoplasmosis. Daaweynta mid kasta waxaa lagu tilmaami karaa darnaanta calaamadaha iyo xaaladda caafimaad ee qofka ay dhibaatadu saameysey.
Fursadaha daaweynta ee daaweynta sunta toxoplasmosis waxaa ka mid ah:
- Corticosteroids nidaamsan si ay u caawiso yaraynta barar
- Talaalka corticosteroids iyo clindamycin isha
- Qalitaanka ilmagaleenka ee pellets ee clindamycin isha
Fursadaha daaweynta ee CNS toxoplasmosis waxaa ka mid ah:
- Corticosteroids nidaamka si loo yareeyo bararka maskaxda iyo habka dhexe ee dareenka (CNS)
- Daawooyinka Anticonvulsive ee lagu daweeyo qalalka
Kala-duwanaanta daaweynta sunta toxoplasmosis waxaa ka mid ah:
- Corticosteroids nidaam ah si loo yareeyo bararka
- TMX-SMP si loo daaweeyo infekshanka pneumocystis firfircoon ee sanbabada
Daaweynta Nabdoonaanta
Haddii aad qabtid HIV, daawooyinka prophylactic (ka hortagga) ayaa laga yaabaa in la qoro haddii nidaamka difaaca jirkaagu uu khalkhal galo.
Tan waxaa lagu go'aamin karaa xisaabtaada CD4 kaas oo cabbiraya tirada difaaca CD4 T-duubayaasha dhiigaaga. Qofka caafimaadka qaba, tirada CD4 waxay noqon doontaa inta u dhaxaysa 800 ilaa 1,500. Dadka qaba habdhiska difaaca jirka, tiradaasi waxay hoos u dhici doontaa 200.
Si looga hortago toxoplasmosis, TMP-SMX ayaa lagu qori doonaa qiyaasta maalinlaha ah iyada oo xisaabtaada CD4 ay la xiriirto "aagga halista" ee 100. Marka lagu daro dawada daawada antiretroviral, waxaad sii wadi doontaa qaadashada TMP-SMX illaa wakhtiga tirada xisaabtaada CD4 200 oo awood u leh inay halkaas joogaan. Waxaad joojin kartaa antibiyootikada oo aad sii wadi kartaa qaadashada daawooyinkaaga HIV.
Qalabka Ka-hortagga
Haddii aad uur leedahay ama aad leedahay habdhiska difaaca jirka, waxaad u baahan doontaa inaad qaaddo tallaabooyin aad kaga hortageyso in lagaa qaado T. gondii nolol maalmeedkaaga. Badbaadadani waxay kaa ilaalin karaan toxoplasmosis si aad uga fiican dhammaan daaweynta adduunka.
Qaar ka mid ah tallaabooyinka kahortagga ugu waxtarka leh waxaa ka mid ah:
- Xiro galoofis la tuuri karo marka la nadiifinayo sanduuqa boodhka ama hagaagsanaan, qof kale ayaa sameeya
- Gashashada gacmo gashiga marka aad banaan baxayso
- Cunto hilibka, digaaga, iyo kalluunka si fiican loo qabto
- Diirinta iyo dhaqashada khudaarta ama miraha ka yimaada beerta ama suuqa beerta
- Nadiifinta kuraasta jarista, mindiyaha, ama dusha sare ee hilibka cayriin ayaa laga yaabaa inay la xiriiraan
- Ka fogaanshaha biyaha aan loo baahneyn ee nooc kasta
- Ku ilaalinta kalluunkaaga gudaha
- Quudinta kalluunkaaga oo kaliya qasacadeysan ama qalajiyey cunto iyo ka fogaanshaha hilibka cayriin ama aan la karin
- Ku daboolida sanduuqa sanduuqa ee ilmahaaga
- Gacmahaaga si fiican ugu dhaq biyo kulul iyo saabuun ka dib beerta, ku ciyaarida bugaaga, diyaarinta cuntada, ama nadiifinta sanduuqa
- Barida caruurtaada xirfadaha gacmo-dhaqashada habboon
> Ilo:
> Xarumaha Xakamaynta iyo Ka Hortagga Cudurrada. "Parasites - Toxoplasmosis (Cudurka Toxoplasma): Ka Hortagga iyo Xakamaynta" Atlanta, Georgia; updated January 10, 2013.
> Lee, S. iyo Lee. T. "Xanuunka Toxoplasmic Encephalitis ee Bukaanka qaba Xanuun Dhibaato Immunodeficiency Syndrome" . 2017; 5 (1): 34-36. DOI: 10.1479 / btrt.2017.5.1.34.
> Park, Y. iyo Nam. H. "Qaababka Daaweynta iyo Daaweynta Cudurka Toxoplasmosis." Korean J Parasitol. 2013; 51 (4): 393-399. DOI: 10.3357 / kjp.2013.51.4.393.
> Waaxda Caafimaadka ee Mareykanka iyo Adeegyada Aadanaha. "Tilmaamayaasha Ka Hortagga iyo Daaweynta Cudurrada Fursadaha ee Dadka Qaangaarka ah ee Dadka qaba HIV iyo Dhalinyarada." AIDSInfo. Rockville, Maryland; updated October 28, 2015.