Kuongororwa kwechirwere cheChagas kunobva pakuti chirwere chacho chakaoma, chisingaperi, kana congenital.
Kuongororodza Chirwere Chagas Chirwere
Nguva yakanakisisa yekuongorora chirwere cheChagas iri munguva yechikamu chechirwere chechirwere, apo mukana wekubvisa chirwere cheTerpanosoma cruzi (T. cruzi) nemishonga ye antitrypanosomal ndiyo yakakwirira.
Zvinosuruvarisa, mukana uyu unowanzosiyiwa.
Izvi ndezvokuti zviratidzo zvinokonzerwa nechirwere chakanyanya cheChagas kazhinji chinonyoro uye kwete kunyanya kunetsa, saka vanhu vane chirwere chakanyanya havakwanisi kutsvaga kurapwa.
Vanhu vanogara munzvimbo dzakaoma vanofanira kubhadhara kune zviratidzo zvingangova nechirwere chinonzi Chagas , kunyanya kana vakaona zvipembenene zvezvipembenene zvinonyanya kuzivikanwa kana zvisingagumi, kana kuti vanoziva kubuda kwechirwere chaChagas munharaunda yavo. Kana vari kukanganisa vanofanira kuona chiremba.
Kana vari vanachiremba, zvakakosha kuti ivowo varambe vachifungira kuti chirwere cheChagas chinogona kunge chichiripo uye zvinoita kuongororwa kuongororwa kuongororwa. Mune tsika chaiyo, izvi zvinowanzoitika chete panguva yainozivikanwa kubuda kwepanyika, apo kuongorora kwepakati pevanhu kunotanga.
Kuita Kuziva
Munguva yechirwere chakaoma chechichi chirwere, nhamba yezvipembenene zveT. cruzi muropa rinowanzokwirira. Izvi zvinobvumira kufungidzirwa kweChagas kuitwa kuburikidza nekuongororai sampuli yeropa-yakagadzirirwa pasi pe microscope.
Zvisinei, nhamba yeT. cruzi muropa inowira nokukurumidza mushure mekutanga kwemazuva 90, kunyange kana pasina kurapwa kunopiwa. Kuongororwa kweropa rekare hakusi nzira yakatendeseka yekuongorora chirwere cheChagas mushure menguva iyo. Chiyero chekusimba microscope hachina kumbobvira chachishandiswa panguva yechikamu chisingaperi cheChagas.
Mukuwedzera pane kuongorora kwechidiki, kuongorora kwekuongorora ropa kunogonawo kuva yakarurama pakuongorora chirwere chakakura cheChagas. Izvi zvinoitwa ne polymerase chain reaction (PCR) test , iyo inoona DNA yaT. cruzi muropa samples. A positive PCR test, semuenzaniso wekuongorora microscope, inoratidza kuti zvipenyu zveT. cruzi zviripo muropa.
Zviratidzo zvinosangana nechirwere chakaipa cheChagas-sekushaya simba, fivha, maronda, kupisa, uye maronda-zvinogona nyore nyore kuvhiringidzika nezviratidzo zvepachivande mononucleosis , kana kuti nehutachiona hweHIV . Saka kana munhu anogara mune imwe nzvimbo yakazara nechirwere cheChagas chiri kuedzwa kune chimwe chezviitiko izvi, kazhinji chinangwa chakanaka chekuedza kutapurirwa kweT. cruzi zvakare.
Kuongorora Hupenyu Husingaperi
Mune chirwere chisingagumi chechigas, mhuka yeT. cruzi kazhinji haisati iripo muropa, saka kuongorora kukura kwemazipa eropa kunowanzova kusina kunaka, sezvinoitwa kuongorora kwePCR.
Kuongorora chirwere chisingagumi chechigas kazhinji kunotsamira pakucherechedza zvirwere zvinoshandiswa nemuviri kurwisa utachiona. Mune miedzo yakawanda yakagadzirwa kuti iongorore zvirwere zvekare kune T. cruzi, kusanganisira enzyme-yakabatana immunosorbent assay (ELISA) uye inoridzivirira immunofluorescent antibody (IFA).
Hapana chimwe chezviongorori izvi zvinopesana kuti zvishandiswe pachazvo, kuitira kuti uongorore chirwere chisingagumi cheChagas, zvinenge zviviri zvakasiyana zvakasiyana-siyana zvinoshandiswa nehutachiona hunowanzoitwa-uye kana mhinduro yacho yakasiyana pakati pavo, chechitatu chekuedzwa zvino inoshandiswa kushanda se tie-breaker.
Panguva imwe chete, kuedza kunofanirwa kuitwawo kutarisa chero chimwe chezvimwe zvinokonzera kukanganisa kwematambudziko emwoyo uye emakumbo anokonzerwa nechirwere chisingaperi chechigas . Nhamba yemamiriro ezvinhu anokwanisa kuita izvi zvinosuruvarisa kwenguva refu, uye vanachiremba vanoshandisa kurapa kukuru kwechirongwa chekuita mukusarudza kuti chii chinoedzwa kuti chiite, uye mune zvakarongeka.
Kuongororwa Congenital Chagas
Kusvikira 10 muzana yevana vanoberekwa naamai vanotapukirwa naT. cruzi vachava nechirwere chakanyanya cheChagas-chirwere chinonzi congenital Chagas chirwere. Zvakakosha kune mwana ane chirwere che congenital Chagas chekubatwa ne antitrypanosomal therapy kuitira kudzivirira zvinetso zvisingagumi.
Chirwere chekuzvarwa chechigas chirwere chinofanirwa kuonekwa mumwana chero upi zvake achangoberekwa ane amai vanobva kunzvimbo iyo chirwere chacho chiripo. Kuongororwa kwepabonde kunowanzoitwa kuvakadzi vane pamuviri vanogara munzvimbo dzakadaro, uye vacheche vemadzimai vanoedza zviratidzo vanogona kuongororwa chirwere chacho.
Kuongorora kwevana pachavo nokuda kwechirwere che congenital Chagas chinowanzoitwa pakuberekwa neCPR kuongorora kwetambo yeropa, kana kuenzanisa neropa rawanikwa mumazuva mashomanana ekuberekwa mushure mokuberekwa. Kana amai vachizivikanwa kuti vane hutano hwechirwere cheChagas uye kuongorora kwekutanga kwecheche hakuna kunaka, kudzokorora kuongororwa kwomwana kunofanira kuitwa mushure memwedzi kana maviri.
> Sources:
> Bern C, Martin DL, Gilman RH. Acute uye Congenital Chagas Disease. Adv Parasitol 2011; 75:19.
> Mutumwa LA, Gilman RH, Verastegui M, et al. Kutarisa Kuvandudza Kuziva Kwokutanga KwechiKristu Chagas Chirwere Mukugadzirisa Kwekupedzisira. Clin Infect Dis 2017; 65: 268.