I-Dengue fever.. Usasazeka njani lo bhubhani, zithini izizathu zawo, kwaye sizikhusela njani kuwo?

Umkhuhlane weDengue sisifo esisasazwa ziingcongconi esisasazeke ngokukhawuleza kuyo yonke imimandla ye-WHO kwiminyaka yakutshanje. Intsholongwane yeDengue isasazwa ziingcongconi zamabhinqa, uninzi lwazo iAedes aegypti yaye, ukusa kumlinganiselo omncinane, iAedes albopictus. Olu hlobo lwengcongconi lusasaza i-chikungunya, i-yellow fever, kunye ne-Zika virus. I<em>Dengue fever ixhaphake kakhulu kwimimandla etshisayo, yaye amazinga omngcipheko ayo ahluka ngokwezalathi zemozulu nezentlalo nezendalo.

I-Dengue ibangela izifo ezininzi, ezinokusuka kwizifo ezineempawu ezingaphantsi (abantu basenokungazi nokuba bosulelekile) ukuya kwiimpawu eziqatha ezifana nomkhuhlane kwabo bosulelekileyo. Nangona i<em>dengue fever eqatha ingaxhaphakanga kangako, abanye abantu bangosuleleka kwaye inokunxulunyaniswa nenani leengxaki ezinxulumene nokopha kakhulu, ukungasebenzi kakuhle kwenkqubo, kunye/okanye ukuvuza kweplasma. Umngcipheko wokufa ngenxa yalo mkhuhlane uyanda ukuba awulawulwa kakuhle. Yaqala ukuchongwa ngeminyaka yee-1950s ngexesha lobhubhani we<em>dengue fever eThailand nakwiiPhilippines. Umkhuhlane wedengue omandundu namhlanje uchaphazela uninzi lwamazwe aseAsia naseLatin America, kwaye uye waba ngomnye woonobangela abaphambili bokulaliswa esibhedlele kunye nokufa kwabantwana kunye nabantu abadala kule mimandla mibini.

I-Dengue fever ibangelwa yintsholongwane evela kusapho lwe-Flavivirus, kwaye kukho iiserotypes ezine ezahlukeneyo zentsholongwane ebangela umkhuhlane wedengue, nangona zihlobene ngokusondeleyo enye kwenye (DENV-1, DENV-2, DENV-3, kunye neDENV- 4). Kukholelwa ukuba ukuchacha kwesigulana kusulelo lwentsholongwane kumnika ukhuseleko lobomi bonke ngokuchasene nohlobo awayesulelwe ngalo, nangona ukhuselo lomzimba olufunyenwe emva kokuchacha ngokuchasene nezinye iintlobo luhlala luyinxenye kwaye lwethutyana. Usulelo olulandelayo kunye nezinye iintlobo zentsholongwane (usulelo lwesibini) kwandisa umngcipheko wedengue enzima.

Umkhuhlane weDengue uneepatheni ezahlukeneyo ze-epidemiological ezinxulumene ne-virus serotypes ezine. Ezi ntlobo zinokujikeleza ngaphakathi kwingingqi, kwaye eneneni amazwe amaninzi axhaphake kakhulu kuzo zone iiserotypes zentsholongwane. Umkhuhlane weDengue uneziphumo ezothusayo kwimpilo yabantu nakuqoqosho lwehlabathi nolwelizwe ngokufanayo. Abahambi abanosulelo lwedengue badla ngokuyithwala intsholongwane yedengue ukusuka kwenye indawo ukuya kwenye; Xa ii-vectors ezisesichengeni zikhona kwezi ndawo zintsha, usulelo lwasekhaya lunokwanda kakhulu.

Umthwalo wehlabathi

Kumashumi eminyaka akutshanje, amazinga osulelo lwedengue aye anda ngendlela ephawulekayo ehlabathini lonke. Uninzi lweziganeko zosulelo azibonakalisi zimpawu okanye zithambile kwaye azinyange, kwaye ke elona nani lezehlo alixelwanga. Iimeko ezininzi zikwafunyaniswa ngendlela engeyiyo njengezinye izifo ze-febrile [1].

Olunye uqikelelo lwemodeli yi-390 yezigidi zeemeko zosulelo lwentsholongwane ye-dengue ngonyaka (95% CI 284-528 yezigidi zeemeko), apho iimeko ze-96 yezigidi (i-67-136 yezigidi zeemeko) zihamba kunye neempawu zekliniki ezicacileyo (Kungakhathaliseki ukuba isifo sinzima kangakanani. ). Olunye uhlolisiso, kuqikelelo lwayo lokuxhaphaka kwe<em>dengue, lubonisa ukuba ingozi yokosulelwa yintsholongwane ye<em>dengue isisisongelo kubantu abamalunga ne-3.9 lamawaka ezigidi. Nangona umngcipheko wosulelo uxhaphakile kumazwe angama-129 [3], iAsia ithwele i-70% yomthwalo wayo wokwenyani [2].

Inani lezifo zedengue ezixelwe kwi-WHO linyuke ngokuphindwe kasibhozo kule minyaka ingamashumi amabini idlulileyo, ukusuka kwi-8 yamatyala ngo-430 ukuya ngaphezulu kwe-505 yezigidi ngo-2000, kwaye ukuya kwi-2.4 yezigidi ngo-2010. , ukusuka kuma-5.2 ukuya kutsho kuma-2019 abantu ababhubhileyo, ingakumbi kwiqela eliselula. Inani lilonke lamatyala kubonakala ngathi lehlile ngo-2000 nango-2015, njengoko kuye kwaxelwa ukufa. Nangona kunjalo, le datha ayikagqitywa, kwaye ubhubhani we-COVID-960 usenokuba uthintele ukuxelwa kwengxelo kumazwe amaninzi.

Oku kunyuka kothusayo kwamanani amatyala ewonke kule minyaka ingamashumi amabini idlulileyo ngokuyinxenye kungenxa yokutshintsha kweendlela zelizwe zokurekhoda kunye nokuxela iimeko zedengue kubaphathiswa bezempilo kunye ne-WHO. Kodwa ikwamele ukuqondwa ngoorhulumente komthwalo wedengue kunye nokubaluleka kokuxela umthwalo wayo.

Amazinga okusasazwa kweDengue kunye nokuqhambuka

Ngaphambi kowe-1970, ngamazwe ali-9 kuphela aye ahlaselwa ngubhubhani we<em>dengue. Ngoku, esi sifo sixhaphake kumazwe angaphezu kwe-100 abekwe kwi-Afrika yoMbutho, eMelika, eMpuma yeMeditera, eMzantsi-mpuma Asia nakwimimandla yaseNtshona Pacific. Imimandla yaseMelika, i-Asia-mpuma ye-Asia, kunye ne-Western Pacific ithathwa njengeyona ichaphazeleka kakhulu sesi sifo, kwaye i-Asiya inomthwalo we-70% yomthwalo wayo kwihlabathi.

Ukongeza kwinani elandayo leemeko zesi sifo njengoko ukwanda kwaso kunwenwa kwiindawo ezintsha, kuqhambuke uqhushumbo. Ngoku uqhambuko lwedengue kusenokwenzeka ukuba luqhambuke eYurophu; Ukosulelwa kwesi sifo kwindawo yokuqala kwaxelwa eFransi naseCroatia ngo-2010, kwaye iimeko ezingeniswa kwamanye amazwe zafunyanwa kwamanye amazwe angama-3 aseYurophu. Ngo-2012, ukuqhambuka komkhuhlane wedengue ovele kwiziqithi zasePortugal zaseMadeira kubangele ukosuleleka okungaphezulu kwama-2000, kwaye amatyala angeniswa kumazwe angaphandle afunyenwe kwilizwe lasePortugal nakwamanye amazwe ali-10 aseYurophu. Ngoku kuqatshelwe ukuba kukho iimeko zokuqala minyaka le kumazwe ambalwa aseYurophu.

Unyaka ka-2019 wabona elona nani likhulu lamatyala e-dengue awakhe axelwa kwihlabathi. Yonke imimandla ye-WHO yachatshazelwa sesi sifo, kwaye usulelo lwedengue lwarekhodwa okokuqala ngqa e-Afghanistan.

Ummandla waseMelika kuphela uxele amatyala azizigidi ezi-3.1, apho ngaphezulu kwama-25,000 acalulwa njengaqatha. Ngaphandle kweli nani loyikekayo lamatyala, ukusweleka okubangelwe zizo bekungaphantsi kunonyaka ophelileyo.

Ukwanda kwenani leemeko zesifo kuye kwabikwa eBangladesh (i-000 iimeko), iiPhilippines (iimeko ze-101), i-Viet Nam (i-000 iimeko) kunye ne-Malaysia (i-420 iimeko) e-Asia.

Umkhuhlane weDengue ngo-2020 uchaphazele amazwe aliqela, ngeengxelo zokunyuka kwamanani osulelo e-Ecuador, e-Indonesia, eBrazil, eBangladesh, eThailand, eTimor-Leste, kwiZiqithi zaseCook, eSri Lanka, eSingapore, eSudan, eMayotte (eFransi), eMaldives, eMauritania, eNepal. , eIndiya naseYemen. Ngo-2021, i<em>dengue iyaqhubeka nokuchaphazela iParaguay, iBrazil, iPeru, iCook Islands, iReunion Island, iPhilippines, iViet Nam, iFiji, iColombia, iKenya neIndiya.

Ubhubhani we-COVID-19 ubeka uxinzelelo olukhulu kukhathalelo lwempilo kunye neenkqubo zolawulo. Umbutho ugxininise ukubaluleka kokugcina iinzame ezijolise ekuthinteleni izifo ezithwalwa ziintsholongwane, ezifana ne-dengue fever kunye nezinye izifo ezithwalwa yi-arthropod, kunye nokufumanisa kunye nokunyanga ezi zifo ngexesha lo bhubhani, ongqina ukwanda kwenani lamatyala kumazwe aliqela. , nto leyo eyenza ukuba abemi basezixekweni babe sesichengeni ngakumbi sokwasulelwa zezi zifo. Iziphumo ezidityanisiweyo ze-COVID-19 kunye nobhubhani wedengue zinokuba neziphumo ezimandundu kubantu abasesichengeni.

Ukudluliselwa kwezifo

Usulelo ngokuchanabeka ekulunyweni ziingcongconi

Le ntsholongwane idluliselwa ebantwini ngokulunywa ziingcongconi ezizimazi ezosulelekileyo, ingakumbi kwiintlobo ze-Aedes aegypti. Kukho ezinye iintlobo zeengcongconi ze-Aedes ezinokuthi zibe ngabathwali besi sifo, kodwa igalelo labo ekusaseni likwinqanaba lesibini xa lithelekiswa ne-Aedes aegypti.

Emva kokuba ingcongconi itya igazi lomntu osulelwe yintsholongwane yedengue, le ntsholongwane iphindaphindeka kumbindi wesisu ngaphambi kokuba ingene kwizihlunu zayo zesibini, kuquka namadlala amathe. Ixesha elithathayo ukuze ingcongconi iyiginye le ntsholongwane ide iyigqithisele kumntu omtsha ibizwa ngokuba lixesha lokufukamela kwangaphandle. Eli xesha lithatha malunga neentsuku ezisi-8 ukuya kwezili-12 ukuba iqondo lobushushu kwindawo liphakathi kwama-25 nama-28 ngokukaCelsius [4-6]. Umahluko kwi-incubation yangaphandle ayichatshazelwa kuphela ngubushushu be-ambient; Endaweni yoko, kukho inani lezinto, ezinje ngobungakanani bokuguquguquka kobushushu bemihla ngemihla [7, 8], i-genotype yentsholongwane [9], kunye noxinzelelo lokuqala lwentsholongwane [10] enokutshintsha kwakhona ixesha elithatha ingcongconi ukuba uyigqithisele. Yakube ingcongconi yosulela, iyakwazi ukosulela intsholongwane ubomi bayo bonke.

Usulelo olusuka ebantwini lusiya kwiingcongconi

Iingcongconi zisenokwasulelwa yidengue kubantu abanale ntsholongwane egazini labo. Lo isenokuba ngumntu onosulelo lwedengue oluneempawu, umntu ongekabonakalisi zimpawu zosulelo, okanye abantu abangazange babonise zimpawu zosulelo [11].

Usulelo lunokosulelwa lusuka ebantwini lusiya kwiingcongconi iintsuku ezimbini phambi kokuba umntu abonise iimpawu zokugula [5, 11], kunye neentsuku ezimbini emva kokuba umkhuhlane wakhe wehlile [12].

Ithuba lokuba i-mosquito ichaphazele isifo iyanda kunye nobukho obuphezulu bentsholongwane egazini lomguli kunye nobushushu bomzimba obuphezulu. Kungenjalo, amanqanaba aphezulu amajoni omzimba kwintsholongwane yedengue ngokukodwa egazini anxulunyaniswa nokuba nokwenzeka okusezantsi kwengcongconi ukuba yosulelwe sisifo (Nguyen et al. PNAS 2013). Intsholongwane ihlala egazini labantu abaninzi phakathi kweentsuku ezi-4 kunye ne-5, kodwa ukusinda kwayo kunokuhlala kwiintsuku ezili-12 [13].

Usulelo olusuka kumama luye kwi-fetus

Eyona ndlela iphambili yosulelo lwentsholongwane yedengue phakathi kwabantu kukusebenzisa iingcongconi zayo. Nangona kunjalo, kukho ubungqina bokuba intsholongwane inokudluliselwa ukusuka kumama (umfazi okhulelweyo ukuya kumntwana ongekazalwa), nangona amazinga okudluliselwa kwentsholongwane evela kumama ukuya kwi-fetus ibonakala ephantsi, ngenxa yokuba umngcipheko wokudluliselwa kule ntsholongwane. indlela ibonakala inxulunyaniswe nexesha losulelo lwedengue ngexesha lokukhulelwa [14-17]. Ukuba umama sele esulelwe yintsholongwane yedengue ngexesha lokukhulelwa, usana lwakhe lunokuzalwa ngaphambi kwexesha kwaye lunokuba nobunzima bokuzala obuphantsi kunye noxinzelelo lomntwana [18].

Ezinye iindlela zosulelo

Iimeko ezinqabileyo zokudluliselwa ngeemveliso zegazi, ukunikezelwa kwamalungu kunye nokumpontshelwa igazi kuye kwabikwa. Ngokufanayo, iimeko zokusasazwa kwentsholongwane ngendlela ye-ovarian kwiingcongconi nazo zirekhodwe.

I-ecology yeVector

Ingcongconi i-Aedes aegypti yeyona nto ithwala intsholongwane yedengue. Iyakwazi ukuzalela kwizikhongozelo zendalo ezifana nemingxuma yemithi kunye ne-bromeliads, kodwa iye yaqhelana neendawo zokuhlala zasezidolophini kwaye izalanisa ikakhulu kwizikhongozeli ezenziwe ngabantu, kubandakanywa iibhakethi, iimbiza zodongwe, izitya ezilahliweyo, amatayara asele esetyenzisiwe, iitanki zokuqokelela amanzi, njl. Idengue sisifo esifihlakeleyo ehlabathini Amaziko asezidolophini axineneyo. Ingcongconi itya emini; Amaxesha alo ahlabayo akwincopho yalo kusasa nangokuhlwa phambi kokutshona kwelanga [19]. Iingcongconi eziziimazi ze-Aedes aegypti ziluma izihlandlo ezininzi phakathi kwexesha ngalinye lokubeka iqanda, nto leyo ekhokelela kumaqela abantu abosulelekileyo [20]. Xa sele zibeke amaqanda azo, zingaphila iinyanga ezininzi kwiimeko zemozulu ezomileyo kwaye ziqandusele xa zidibene namanzi.

I-Aedes albopictus, i-second vector ye-dengue fever, isasazwa kumazwe angaphezu kwama-32 e-United States of America nakwamanye amazwe angaphezu kwama-25 kummandla waseYurophu, ngenxa yorhwebo lwamazwe ngamazwe lwamatayara asele esetyenzisiwe (indawo yokuzalela iingcongconi) kunye nezinye izinto ezithengiswayo. ezifana nethamsanqa bamboo). Ikhetha ukuzalela kwiindawo ezikufutshane nezityalo ezixineneyo, kubandakanywa iifama, kwaye inxulunyaniswa nomngcipheko owongezelelweyo wosulelo phakathi kwabasebenzi basemaphandleni, njengabo basebenza kumasimi erabha kunye neoli yesundu, kodwa ikwabonakaliswe ukuba izalela kwiindawo zasezidolophini. I-Aedes albopictus ibonakaliswa ngamandla ayo aphezulu okuziqhelanisa, kwaye ukusasazeka kwayo kuluhlu olubanzi lwejografi kubalelwa kubuchule bayo bokumelana namaqondo obushushu aphantsi, nokuba liqanda okanye ingcongconi endala [21, 22]. Ngokufana ne-Aedes aegypti, i-Aedes albopictus izulazula emini kwaye iye yabangelwa inani elilinganiselweyo lokuqhambuka njenge-vector ephambili ye-virus ye-dengue, kwiimeko apho i-Aedes aegypti ingekho okanye ikhona ngamanani aphantsi [23, 24].

Iimpawu zesi sifo (imiqondiso kunye neempawu)

Nangona iimeko ezininzi zomkhuhlane wedengue zingenazimpawu okanye zinokukhatshwa ziimpawu ezingephi, kubonakala ngathi sisifo esiqatha, esifana nomkhuhlane esichaphazela iintsana, abantwana abancinci, kunye nabantu abadala, kodwa akufane kwenzeke ukuba simbulale umntu owosulelweyo. Iimpawu zesi sifo zihlala phakathi kweentsuku ezi-7 ukuya kwezi-4 emva kokufukanyelwa kweentsuku ezi-10 ukuya kwezili-25 nasemva kokuba umntu elunywe yingcongconi eyosulelekileyo [25]. IWorld Health Organization ihlela i<em>dengue fever ibe ziindidi ezimbini eziphambili zilandelayo: i<em>dengue (ine/ngaphandle kweempawu ezilumkisayo) kunye ne<em>dengue eyingozi. I-subclassification ye-dengue fever njengempawu okanye ngaphandle kwesilumkiso yenzelwe ukunceda abasebenzi bezempilo bahlole izigulane ukuba zingeniswe esibhedlele, ukuqinisekisa ukuba imeko yabo iyakhathalelwa, kwaye inciphise umngcipheko we-dengue enzima kakhulu [XNUMX].

umkhuhlane wedengue

I<em>dengue ifanele irhanelwe xa umntu esiba nomkhuhlane omkhulu (40°C/104°F) ehamba nezi mpawu zimbini zilandelayo ebudeni benqanaba lefiva (iintsuku ezi-7-XNUMX):

• intloko ebuhlungu kakhulu
• Iintlungu emva kwamehlo
• Iintlungu zemisipha kunye namalungu
• Isicaphucaphu
• ukugabha
• Ukudumba kwamadlala
• Irhashalala eluswini

Umkhuhlane omkhulu wedengue

Isigulane sihlala singena kwisigaba esibizwa ngokuba yisigaba esibalulekileyo phakathi kweentsuku ezi-3 ukuya kwezi-7 emva kokuvela kweempawu zesifo. Ngaphakathi kwe-24 kwiiyure ze-48 zesigaba esibalulekileyo, inxalenye encinci yezigulane ingabonisa ukuhla ngokukhawuleza kweempawu. Eli linqanaba apho ubushushu bomguli buyehla (ngaphantsi kwama-38°C/100°F), yaye usenokubonakalisa iimpawu ezilumkisayo ezinxulumene ne<em>dengue fever. Umkhuhlane wedengue oqatha unokubangela iingxaki ezibulalayo ezibangelwa kukuvuza kweplasma, ukufumba kolwelo, ukuphefumla nzima, ukopha kakhulu, okanye ukusilela kwamalungu.

Nazi iimpawu ezilumkiso oogqirha ekufuneka bazijonge:

• Iintlungu ezibuhlungu zesisu
• Ukugabha rhoqo
• ukuphefumla ngokukhawuleza
• Ukopha iintsini okanye impumlo
• uxinzelelo
• ukuphutha-phutha
• Hepatomegaly
• Ubukho begazi emhlanzweni okanye kwisitulo.

Ukuba umguli ubonisa ezi mpawu ebudeni benqanaba eliyingozi lesi sifo, kuyimfuneko ukuba abekwe esweni ngokusondeleyo kwiiyure ezingama-24 ukusa kwezingama-48 ukuze afumane unyango oluyimfuneko ukuze aphephe iingxaki nokufa okunokwenzeka. Ukubeka iliso olusondeleyo kufuneka kwakhona kuqhubeke ngexesha lesigaba sokubuyisela.

Iindlela zokuxilonga

Zininzi iindlela ezinokusetyenziswa ukuxilonga usulelo lwentsholongwane yedengue. Ukusetyenziswa kweendlela ezahlukeneyo zokuxilonga kuxhomekeke xa kuvela iimpawu zesifo. Iisampulu eziqokelelwe kwizigulane kufuneka zihlolwe ngeveki yokuqala yokuqala kwesi sifo ngokusebenzisa iindlela ezichazwe ngezantsi.

Iindlela zokwahlula iintsholongwane

Intsholongwane inokuhlukaniswa negazi ngexesha leentsuku zokuqala zosulelo. Iindlela ezahlukeneyo zokwenza uvavanyo lwe-reverse transcriptase-PCR ziyafumaneka kwaye zijongwa njengeendlela zokuvavanya ireferensi. Nangona kunjalo, kufuna izixhobo ezikhethekileyo kunye noqeqesho lwabasebenzi ukwenza olu mvavanyo.

Kwakhona le ntsholongwane inokubonwa ngokuvavanya iiproteni ezivelisayo, ezibizwa ngokuba ziiproteni ezingezona izakhiwo 1. Kukho iimvavanyo zokuxilonga ezikhawulezayo ezithengiswayo ezithatha imizuzu engama-20 kuphela ukumisela umphumo yaye azifuni buchule bukhethekileyo baselabhoratri okanye izixhobo.

Iindlela zeSerological

Iindlela ze-serological ezifana ne-enzyme-linked immunosorbent assays zinokuqinisekisa usulelo lwamva nje okanye oludlulileyo ngokubona izilwa-anti-dengue antibodies. Izilwa-buhlungu ze-IgM zinokubonwa kwiveki enye emva kosulelo, kwaye zihlale zibonakala kangangeenyanga ezi-3, kwaye ubukho bazo bubonisa ukosuleleka kwamva nje yintsholongwane yedengue. Ngokumalunga ne-IgG antibodies, zithatha ixesha elide ukwenza kumanqanaba athile kwaye zihlala emzimbeni iminyaka emininzi. Ubukho be-IgG antibodies bubonisa ukosuleleka kwangaphambili kwintsholongwane yedengue.

unyango

Alukho unyango olukhethekileyo lomkhuhlane wedengue. Izigulana kufuneka ziphumle, zisele amanzi aneleyo, kwaye zifune iingcebiso kugqirha. Ngokuxhomekeke kwiimpawu zeklinikhi kunye nezinye iimeko, izigulane zingathunyelwa ekhaya, zithunyelwe esibhedlele ukuze zilawule imeko yazo, okanye zinokufuna unyango olungxamisekileyo okanye ukuthunyelwa ngokukhawuleza [25].

Ukhathalelo oluxhasayo olunje nge-antipyretics kunye neentlungu zokuphelisa iintlungu zinokunikwa ukulwa neempawu zokuqaqamba kwemisipha, iintlungu kunye nomkhuhlane.

• I-acetaminophen okanye i-paracetamol zezona zikhetho zikhoyo zokunyanga ezi mpawu.
• Kufuneka ugweme ukuthatha amayeza achasene ne-steroidal anti-inflammatory, njenge-ibuprofen kunye ne-aspirin. Ezi ziyobisi ezichasayo zisebenza ngokunciphisa iiplatelets zegazi kwaye zinokuthi zibe mbi ngakumbi i-prognosis kumxholo wesi sifo, esihambelana nokuba nokwenzeka ukopha.

Ngokubhekiselele kwi-dengue fever enzima, ubomi bunokusindiswa kwintshabalalo yayo ngenxa yokhathalelo lwezonyango olubonelelwa ngoogqirha kunye nabongikazi abanamava kwiziphumo zesifo kunye nezigaba zophuhliso lwaso - olo khathalelo lunciphisa izinga lokufa libe ngaphantsi kwe-1% kumazwe amaninzi. .

Ugonyo lokuthintela umkhuhlane wedengue

I-vaccine yokuqala ye-dengue, i-Dengvaxia® (CYD-TDV), elungiselelwe yi-Sanofi Pasteur Vaccine Laboratory, inikwe ilayisenisi yokusetyenziswa ngoDisemba 2015 kwaye ngoku ivunyiwe ngabasemagunyeni abalawulayo ukuba isetyenziswe kumazwe angama-20. NgoNovemba 2017, iziphumo zolunye uhlalutyo lokujonga i-serostatus yesitofu sokugonya ngexesha lokugonywa kwapapashwa. Uhlalutyo lubonise ukuba i-subgroup yabathathi-nxaxheba bolingo abafunyenwe be-seronegative ngexesha lokugonywa kwabo kokuqala kunye ne-vaccine babesengozini enkulu yokuphuhlisa i-dengue enzima kunye nokulaliswa esibhedlele ngenxa ye-dengue kunabathathi-nxaxheba abangagonywanga. Ke ngoko, ugonyo lwe-cyd-tdv lwenzelwe ukuba lisetyenziswe kubantu abahlala kwiindawo eziphezulu eziphakathi kweminyaka eli-9 ne-45 kwaye obenalo isiqendu sentsholongwane sangaphambili se-dengue virus. Izitofu ezininzi zokuthintela umkhuhlane wedengue ziyavavanywa.

Isikhundla se-WHO kwisitofu sokugonya iCYD-TDV [26]

Iphepha lesikhundla se-WHO (ngoSeptemba 2018) kwisitofu sokugonya i-Dengvaxia [26] yachaza ukuba isitofu sokugonya se-CYD-TDV se-dengue se-CYD-TDV sibonakaliswe sisebenza kwaye sikhuselekile kwiimvavanyo zeklinikhi ezenziwe kubantu ababekade benesifo se-dengue virus (abantu abane-seropositive). Amazwe athathela ingqalelo ugonyo njengenxalenye yeenkqubo zawo zokulawula idengue ayacetyiswa ukuba alandele isicwangciso sovavanyo lwangaphambi kokugonywa. Ngokwesi sicwangciso-qhinga, ugonyo ngesi sitofu sokugonya luya kuthintelwa kuphela abantu abanobungqina bosulelo lwedengue lwangaphambili (ngokusekwe kuvavanyo lwe-antibody okanye amaxwebhu osulelo lwe-dengue olungqinwe elabhoratri kwixesha elidlulileyo). Izigqibo malunga nokuphunyezwa kwesicwangciso sovavanyo lwangaphambi kokugonywa luya kubandakanya uvavanyo lwenqanaba lelizwe ngononophelo, kubandakanywa ukuqwalaselwa kobuntununtunu kunye nokuchaneka kweemvavanyo ezikhoyo, izinto eziphambili zendawo, i-dengue epidemiology, amazinga okulaliswa esibhedlele kwizigulane ezine-febrile kwilizwe ngalinye, kunye nokufikeleleka konyango. Isitofu sokugonya se-CYD -TDV kunye ne-case triage tests zombini.

Ugonyo kufuneka luthathelwe ingqalelo njengenxalenye yesicwangciso esihlanganisiweyo sothintelo nolawulo lwedengue. Kukho imfuneko engxamisekileyo yokubambelela kwamanye amanyathelo okuthintela izifo, njengamanyathelo aphunyezwe kakuhle kwaye agcinwe elawula i-vector. Abantu, kungakhathaliseki ukuba ugonyiwe okanye akunjalo, bafanele bafune unyango ngokukhawuleza ukuba baneempawu ezifanayo nezo zibonisa umkhuhlane wedengue.

izinto eziyingozi

Usulelo lwangaphambili yidengue kwandisa umngcipheko wokuba abantu bosuleleke kakhulu yidengue.

Ukufudukela ezidolophini (ngokukodwa okungalawulwayo) kuhambelana nokusasazeka kwedengue ngeendlela ezininzi zentlalo kunye nokusingqongileyo: ukuxinana kwabantu, ukuhamba kwabantu, ukufikelela kumanzi athembekileyo, ukugcinwa kwamanzi, njl njl.

Umngcipheko woluntu wokuba sesichengeni somkhuhlane wedengue kwakhona uxhomekeke kulwazi lwabahlali, isimo sengqondo kunye nezenzo ngokubhekiselele kumkhuhlane wedengue, kunye nokuphunyezwa kwemisebenzi ezinzileyo yolawulo lwezifo kuluntu.

Ngokufanelekileyo, imingcipheko yezifo inokutshintsha kwaye itshintshe phantsi kokutshintsha kwemozulu kwiindawo ezishushu kunye neendawo ezitshisayo, kwaye ii-vectors zinokuqhelana nokusingqongileyo kunye neemeko zemozulu entsha.

Uthintelo nolawulo lwezifo

Ukuba uyazi ukuba unomkhuhlane wedengue, qiniseka ukuba uyakuphepha ukulunywa yingcongconi ngakumbi kwiveki yokuqala yesigulo sakho. Intsholongwane isenokuba ijikeleza egazini lakho ngelo xesha, yaye ngaloo ndlela iyindlela yokudlulisela le ntsholongwane kwiingcongconi ezintsha ezingenalo usulelo, nto leyo enokudluliselwa kwabanye abantu.

Ukuba kufutshane kweendawo ezizalela kuzo iingcongconi ezisasaza esi sifo kwindawo ehlala abantu ngomnye weyona miba iyingozi nebalulekileyo yokosulelwa yidengue fever. Ngoku kukho indlela ephambili yokulawula okanye yokuthintela usulelo lwentsholongwane yedengue: ukulawula iingcongconi ezisasaza esi sifo. Nantsi indlela yokufikelela oku:

• Ukuthintela ukuzala kweengcongconi ngoku:
  • Ukuthintela iingcongconi ekufikeleleni kwindawo ezizalela amaqanda ngokuthatha amanyathelo olawulo lokusingqongileyo kunye nohlengahlengiso;
  • Lahla inkunkuma eqinileyo ngokufanelekileyo kwaye ususe iindawo zokuhlala ezenziwe ngabantu apho amanzi anokuqokelelana khona;
  • Gquma, ungenanto, kwaye ucoce izikhongozeli zokugcina amanzi kwikhaya rhoqo ngeveki;
  • Sebenzisa izibulali-zinambuzane ezifanelekileyo kwizikhongozeli zangaphandle zokugcina amanzi;

• Nanga amanyathelo okuzikhusela ekulunyweni ziingcongconi:
  • Indawo ekuchithelwa kuyo iiholide kumanyathelo okukhusela asekhaya afana nezikrini zefestile, izinto ezigxothayo, iikhoyili, kunye neziqhumiso. La manyathelo kufuneka aqwalaselwe emini ngaphakathi nangaphandle kwekhaya (umzekelo, xa usemsebenzini/esikolweni), kuba iingcongconi, abona bantu bathwala esi sifo baluma emini;
  • Kucetyiswa ukuba unxibe iimpahla ezinciphisa ukubonakala kwesikhumba kwiingcongconi;

• Ukubandakanyeka koluntu:
  • Ukufundisa uluntu lwasekuhlaleni malunga nobungozi bezifo ezisasazwa ziingcongconi;
  • Ukuthatha inxaxheba ekusebenzisaneni noluntu lwasekuhlaleni ukuze kuphuculwe ukuthatha inxaxheba kwabantu kunye nokudibanisa amandla abo okulawula i-vector ezinzileyo;

• Ifumanisa ngokufanelekileyo iingcongconi kunye neentsholongwane:
  • Ubungakanani bezifo ezithwala izifo kufuneka bubekwe esweni kwaye bubekw' esweni ngenkuthalo ukufumanisa impumelelo yongenelelo lolawulo.
  • Ukubekwa esweni okulindelweyo kokusasazeka kwale ntsholongwane phakathi kwamabhulu eengcongconi ngokubambisana nokuhlolwa okusebenzayo kweqela labo abalindileyo.
  • Ukuhlolwa kweVector kunokudityaniswa nokuhlolwa kweklinikhi kunye nokusingqongileyo.

Ukongeza, uphando luqhubeka ngokukhawuleza phakathi kwamaqela amaninzi abadibanisi bamazwe ngamazwe ukufumana izixhobo ezitsha kunye nezicwangciso ezitsha zokufaka isandla kwiinzame zehlabathi zokunqanda usulelo lwedengue. I-WHO ikhuthaza ukudityaniswa kweendlela zokulawula i-vector ukuphumeza ungenelelo oluzinzileyo, olusebenzayo nolulungelelanisiweyo lwasekhaya.