Uchoko

-Delile

• Ziyini izimpawu zochoko?
• Ubulephero bubukeka kanjani?
• Uchoko lusakazeka kanjani?
• Ziyini izinhlobo zochoko?
• 1. Uchoko lwesifo sofuba luqhathaniswa nochoko loqhaqho oluqhathaniswa nochoko lomngcele
• 2.Ukwahlukaniswa kweWorld Health Organisation (WHO)
• 3. Ukwahlukaniswa kwe-Ridley-Jopling
• Utholakala kanjani uchoko?
• Welashwa kanjani uchoko?
• Yiziphi izinkinga ezingaba khona zochoko?
• Ngingaluvikela kanjani uchoko?
• Uyini umbono wesikhathi eside?
• Imithombo ye-athikili

Luyini uchoko?

Uchoko kuyisifo esingelapheki, esiqhubekayo esivela kubhaktheriya esibangelwa yigciwane I-Mycobacterium leprae. Ngokuyinhloko kuthinta izinzwa zemikhawulo, isikhumba, ulwelwesi lwekhala, nomgudu wokuphefumula ongaphezulu. Uchoko lwaziwa nangokuthi isifo sikaHansen.

Uchoko lukhiqiza izilonda zesikhumba, ukulimala kwezinzwa nobuthakathaka bemisipha. Uma ingalashwa, ingadala ukonakala kakhulu nokukhubazeka okukhulu.

Uchoko lungesinye sezifo ezindala kakhulu emlandweni orekhodiwe. Inkomba yokuqala ebhaliwe yochoko ivela cishe ngo-600 B.C.

Uchoko luvamile emazweni amaningi, ikakhulukazi lawo anezimo ezishisayo noma ezishisayo. Akuvamile kakhulu e-United States. Imibiko yokuthi bangu-150 kuya ku-250 kuphela abatholakala e-United States minyaka yonke.

Ziyini izimpawu zochoko?

Izimpawu eziyinhloko zochoko zihlanganisa:

• ubuthakathaka bemisipha
• ukuba ndikindiki ezandleni, ezingalweni, ezinyaweni nasemilenzeni
• izilonda zesikhumba

Izilonda zesikhumba ziholela ekunciphiseni ukuzwa kokuthinta, ukushisa, noma ubuhlungu. Azipholi, nangemva kwamasonto ambalwa. Zilula ukwedlula ithoni yakho ejwayelekile yesikhumba noma zingabomvu ngokuvuvukala.

Ubulephero bubukeka kanjani?

Uchoko lusakazeka kanjani?

Igciwane I-Mycobacterium leprae kubangela uchoko. Kucatshangwa ukuthi uchoko lusakazeka ngokuxhumana nezimfihlo ze-mucosal zomuntu onesifo. Lokhu kuvame ukwenzeka lapho umuntu onochoko ethimula noma ekhwehlela.

Lesi sifo asithelelani kakhulu. Kodwa-ke, ukusondelana, ukuphindaphinda okuphindaphindiwe nomuntu ongelashwa isikhathi eside kungaholela ekungenweni yisifo sochoko.

Igciwane elibangela uchoko landa kancane kakhulu. Lesi sifo sinesikhathi esimaphakathi sokufukamela (isikhathi esiphakathi kokutheleleka nokuvela kwezimpawu zokuqala), ngokusho kweWorld Health Organisation (WHO).

Izimpawu zingahle zivele isikhathi esingangeminyaka engama-20.

Ngokwe-New England Journal of Medicine, i-armadillo edabuka eningizimu ye-United States naseMexico nayo ingasithwala lesi sifo futhi isidlulisele kubantu.

Ziyini izinhlobo zochoko?

Kunezinhlelo ezintathu zokuhlukanisa uchoko.

1. Uchoko lwesifo sofuba luqhathaniswa nochoko loqhaqho oluqhathaniswa nochoko lomngcele

Uhlelo lokuqala lubona izinhlobo ezintathu zochoko: i-tuberculoid, i-lepromatous, ne-borderline. Impendulo yomuntu yokuzivikela kulesi sifo inquma ukuthi yiluphi kulezi zinhlobo zochoko abanalo:

• Ochokweni lwe-tuberculoid, ukusabela komzimba kuhle. Umuntu onolu hlobo lokutheleleka ukhombisa izilonda ezimbalwa kuphela. Lesi sifo simnene futhi siyathelelana kancane.
• Kuchoko lopromatous, ukusabela komzimba akunampilo. Lolu hlobo luthinta nesikhumba, izinzwa nezinye izitho zomzimba. Kunezilonda ezisabalele, kufaka phakathi amaqhubu (izigaxa ezinkulu namaqhubu). Leli fomu lesifo liyathathelana ngokwengeziwe.
• Kuchoko lomngcele, kunezici zomtholampilo zochoko lwesifo sofuba kanye nochoko. Lolu hlobo lubhekwa ukuthi luphakathi kwezinye izinhlobo ezimbili.

2.Ukwahlukaniswa kweWorld Health Organisation (WHO)

lesi sifo ngokuya ngohlobo nenombolo yezindawo ezithintekile zesikhumba:

• Isigaba sokuqala sithi paucibacillary. Kunezilonda ezinhlanu noma ezimbalwa futhi alikho igciwane elitholakele kumasampula esikhumba.
• Isigaba sesibili sithi multibacillary. Kunezilonda ezingaphezu kweziyisihlanu, igciwane litholwa esikhunjeni smear, noma zombili.

3. Ukwahlukaniswa kwe-Ridley-Jopling

Izifundo zemitholampilo zisebenzisa uhlelo lweRidley-Jopling. Iqukethe izigaba ezinhlanu ngokuya ngobukhulu bezimpawu.

Kukhona nefomu lochoko olubizwa ngochoko olungapheli olungafakwanga ohlelweni lokuhlukanisa iRidley-Jopling. Kuthathwa njengohlobo lokuqala kakhulu lochoko lapho umuntu ezoba nesilonda sesikhumba esisodwa kuphela esikindiki ukuthintwa.

Uchoko olungapheli lungasombulula noma luqhubekele phambili luye kolunye lwezinhlobo ezinhlanu zochoko ngaphakathi kohlelo lwe-Ridley-Jopling.

Utholakala kanjani uchoko?

Udokotela wakho uzokwenza ukuhlolwa komzimba ukuze afune izimpawu nezimpawu zesifo. Bazophinda futhi benze i-biopsy lapho besusa khona isiqeshana esincane sesikhumba noma sezinzwa bese besithumela elabhorethri ukuze ihlolwe.

Udokotela wakho angenza nokuhlolwa kwesikhumba kochoko ukuthola uhlobo lochoko. Bazofaka inani elincane lebhaktheriya elibangela uchoko, ebelingasebenzi, esikhunjeni, imvamisa engalweni ephezulu.

Abantu abanochoko lwesifo sofuba noma semingcele besifo sofuba bazothola imiphumela emihle endaweni yomjovo.

Welashwa kanjani uchoko?

I-WHO yasungula ngo-1995 ukwelapha zonke izinhlobo zochoko. Itholakala mahhala emhlabeni wonke.

Ngokwengeziwe, ama-antibiotic amaningana alapha uchoko ngokubulala amabhaktheriya ayimbambayo. Lawa ma-antibiotic ahlanganisa:

• i-dapsone (Aczone)
• i-rifampin (Rifadin)
• i-clofazimine (i-Lamprene)
• i-minocycline (Minocin)
• I-ofloxacin (Ocuflux)

Udokotela wakho kungenzeka anikeze ama-antibiotic angaphezu kweyodwa ngasikhathi sinye.

Bangase futhi bafune ukuthi uthathe umuthi olwa nokuvuvukala njenge-aspirin (Bayer), i-prednisone (i-Rayos), noma i-thalidomide (i-Thalomid). Ukwelashwa kuzohlala izinyanga futhi kuze kube unyaka owodwa kuya kwemibili.

Akufanele uthathe i-thalidomide uma ukhulelwe noma ungakhulelwa. Ingakhiqiza ukukhubazeka okukhulu kokuzalwa.

Yiziphi izinkinga ezingaba khona zochoko?

Ukuxilongwa okulindelekile nokwelashwa kungaholela ezinkingeni ezinkulu. Lokhu kungafaka:

• ukukhinyabezeka komzimba
• ukulahleka kwezinwele, ikakhulukazi kumashiya nakuzinkophe
• ubuthakathaka bemisipha
• ukulimala okungapheli kwemizwa ezingalweni nasemilenzeni
• ukungakwazi ukusebenzisa izandla nezinyawo
• isiminyaminya esingamahlalakhona, ukuphuma kwamakhala, kanye nokuwa kwempumulo yamakhala
• I-iritis, okuwukuvuvukala kwe-iris yeso
• i-glaucoma, isifo samehlo esidala ukulimala kwe-optic nerve
• ubumpumputhe
• ukungasebenzi kahle kwe-erectile (ED)
• ukungazali
• ukwehluleka kwezinso

Ngingaluvikela kanjani uchoko?

Indlela engcono yokuvikela uchoko ukugwema ukuthintana isikhathi eside nokusondelana nomuntu ongelashwa onalesi sifo.

Uyini umbono wesikhathi eside?

Umbono jikelele ungcono uma udokotela wakho ehlonza uchoko ngokushesha ngaphambi kokuba lube nzima. Ukwelashwa kusenesikhathi kuvimbela ukulimala okwengeziwe kwezicubu, kumisa ukusakazeka kwalesi sifo, futhi kuvimbela nezinkinga ezinkulu zempilo.

Umbono uvame ukuba mubi kakhulu uma ukuxilongwa kwenzeka esigabeni esithuthuke kakhulu, ngemuva kokuthi umuntu enokukhubazeka okukhulu noma ukukhubazeka. Kodwa-ke, ukwelashwa okufanele kusadingeka ukuvimbela noma yikuphi ukulimala komzimba okuqhubekayo nokuvimbela ukusakazeka kwesifo kwabanye.

Kungahle kube nezinkinga zokwelashwa unomphela naphezu kwenkambo ephumelelayo yama-antibiotic, kepha udokotela wakho uzokwazi ukusebenza nawe ukuhlinzeka ngokunakekelwa okufanele ukuze akusize ubhekane nakho futhi uphathe noma yiziphi izimo ezisalile.

Imithombo ye-athikili

• U-Anand PP, et al. (2014). Ubulephero obuhle: Obunye ubuso besifo sikaHansen! Ukubuyekeza. INGXENYE: 10.1016 / j.ejcdt.2014.04.005
• Ukuhlukaniswa kochoko. (ng).
• UGaschignard J, et al. (2016). Uchoko lwe-Pauci- kanye ne-multibacillary: Izifo ezimbili ezihlukile, ezinganakiwe zofuzo.
• Uchoko. (2018).
• Uchoko. (ng). https://rarediseases.org/rare-diseases/leprosy/
• Uchoko (isifo sikaHansen). (ng). https://medicalguidelines.msf.org/viewport/CG/english/leprosy-hansens-disease-16689690.html
• Uchoko: Ukwelashwa. (ng). http://www.searo.who.int/entity/leprosy/topics/the_treatment
• UPardillo FEF, et al. (2007). Izindlela zokuhlukaniswa kochoko ngezinhloso zokwelashwa. https://academic.oup.com/cid/article/44/8/1096/298106
• UScollard D, et al. (2018). Uchoko: I-Epidemiology, microbiology, ukubonakaliswa kwemitholampilo, kanye nokuxilongwa. https://www.uptodate.com/contents/leprosy-epidemiology-microbiology-clinical-manifestations-and-diagnosis
• UTierney D, et al. (2018). Uchoko. https://www.merckmanuals.com/professional/infectious-diseases/mycobacteria/leprosy
• UTruman RW, et al. (2011). Uchoko lwe-zoonotic oluseningizimu ye-United States. INGXENYE: 10.1056 / NEJMoa1010536
• Siyini isifo sikaHansen? (2017).
• Ukwelashwa kwemithi eminingi ye-WHO. (ng).