Umkhuhlane wodenga.. Lo bhubhane usakazeka kanjani, yiziphi izimbangela zawo, futhi sizivikela kanjani kuwo

I-Dengue fever yisifo esithathelwana ngomiyane esisabalale ngokushesha kuzo zonke izifunda ze-WHO eminyakeni yamuva nje. Igciwane lodenga lisakazwa omiyane besifazane, ikakhulukazi i-Aedes aegypti futhi, ngokwezinga elincane, i-Aedes albopictus. Lolu hlobo lomiyane ludlulisela i-chikungunya, i-yellow fever kanye namagciwane eZika. Umkhuhlane wodenga wande ezindaweni ezishisayo, futhi amazinga awo obunzima ayahlukahluka endaweni, ngokwezinkomba zezulu nezici zezenhlalo nezemvelo.

Imfiva yodenga ibangela izifo eziningi, ezingasukela ezifweni ezinezimpawu ezincane (abantu bangase bangazi nokuthi banalesi sifo) kuye kwezinzima, izimpawu ezinjengomkhuhlane kulabo abanaleli gciwane. Nakuba udenga olunzima lungavamile, abanye abantu bangangenwa yiwo futhi lungahlotshaniswa nenani lezinkinga ezihlobene nokopha kakhulu, ukwehluleka kwezitho kanye/noma ukuvuza kwe-plasma. Amathuba okufa ngenxa yokutheleleka ngalo mkhuhlane ayanda uma ungalawulwa ngendlela efanele. Yaqala ukubonakala eminyakeni yamashumi amahlanu ekhulwini elidlule ngesikhathi kuvela izifo eziwumshayabhuqe zomkhuhlane wodenga eThailand nasePhilippines. Namuhla, udenga olunzima luhlasela amazwe amaningi e-Asia naseLatin America, futhi seluyimbangela ehamba phambili yokulaliswa esibhedlela nokufa kwezingane nakubantu abadala kulezi zifunda ezimbili.

Udenga lubangelwa i-flavivirus.Kunezinhlobo ezine ezihlukene zegciwane ezibangela udenga, nakuba zihlobene eduze (DENV-1, DENV-2, DENV-3, neDENV-4). Kukholakala ukuthi ukwelulama kwesiguli ekuthelelekeni nge-HIV kusinika ukuzivikela impilo yonke ngokumelene nohlobo esatheleleka ngalo, nakuba ukuzivikela komzimba okutholakala ngemva kokululama ngokumelene nezinye izinhlobo kuhlala kuyingxenye futhi kuyisikhashana. Ukutheleleka okulandelayo nezinye izinhlobo zegciwane (ukutheleleka kwesibili) kwandisa ingozi yodenga olunzima.

Udenga lunamaphethini e-epidemiological ahlukile ahlotshaniswa nama-serotypes amagciwane amane. Lawa ma-serotypes angajikeleza ngokuhlanganyela endaweni, futhi empeleni kunamazwe amaningi atholakala kakhulu anawo wonke ama-virus serotypes amane. Umkhuhlane wodenga unemiphumela eshaqisayo empilweni yabantu nasemnothweni womhlaba wonke nokazwelonke ngokufanayo. Abahambi abangenwe udenga ngokuvamile bathwala igciwane lemfiva besuka endaweni ethile baye kwenye; Uma ama-vector asengozini ekhona kulezi zindawo ezintsha, kungenzeka ukuthi ukudluliselwa kwasendaweni kubambe.

umthwalo wembulunga yonke

Emashumini eminyaka amuva nje, izinga lomkhuhlane wodenga liye anda ngendlela emangalisayo emhlabeni wonke. Izimo eziningi azibonakali kahle noma zimnene futhi ziyazilawula, ngakho-ke inani langempela lamacala alibikwa kangako. Izimo eziningi nazo azihlonzwanga kahle njengezinye izifo ze-febrile [1].

Ukulinganisa okukodwa kokumodela ukuthi kunezigameko eziyizigidi ezingama-390 zokutheleleka ngegciwane lodenga ngonyaka (isikhathi sokuzethemba esingu-95% sezigameko eziyizigidi ezingama-284-528), kanti eziyizigidi ezingama-96 (izigameko eziyizigidi ezingama-67-136) zinezimpawu ezibalulekile zomtholampilo. isifo). Olunye ucwaningo, ekulinganisweni kwalo ngokudlanga komkhuhlane wodenga, lubonisa ukuthi ingozi yokungenwa amagciwane emfiva ilinganiselwa kubantu abayizigidi eziyizinkulungwane ezingu-3.9. Naphezu kwengozi enkulu yokutheleleka emazweni angu-129 [3], i-Asia ihlushwa u-70% womthwalo wayo wangempela [2].

Isibalo sabantu abaphethwe udenga olubikwe yi-WHO senyuke izikhathi ezingaphezu kweziyisi-8 kule minyaka engamashumi amabili edlule, sisuka ku-430 505 ngo-2000 saya ngaphezu kwezigidi ezingu-2.4 ngo-2010 safinyelela ezigidini ezingu-5.2 ngo-2019. Bangu-2000 abafayo kwabangu-2015, ikakhulukazi eqenjini elincane. Isibalo samacala sibonakala sehlile phakathi kuka-960 no-4032, njengoba kwenza nokufa okubikiwe. Kodwa-ke, le datha ayikaphelele, futhi ubhubhane lwe-COVID-2022 kungenzeka luvimbele amacala ukuthi abikwe emazweni amaningi.

Lokhu kwanda okwethusayo kwezibalo zamacala ewonke emashumini amabili eminyaka edlule ngokwengxenye kungenxa yokushintsha kwezinqubo zezwe zokurekhoda nokubika amacala odenga ezindlini zezempilo kanye ne-WHO. Kodwa futhi imele ukuqashelwa kohulumeni komthwalo we-dengue fever kanye nokubaluleka kokubika ngomthwalo wayo.

Ukusatshalaliswa komkhuhlane wodenga kanye namazinga okuqubuka kwawo

Ngaphambi kuka-1970, amazwe angu-9 kuphela aba nobhadane olunzima lodenga. Namuhla, lesi sifo sitholakala emazweni angaphezu kuka-100 ezifundeni ze-WHO zase-Afrika, emazweni aseMelika, eMpumalanga yeMedithera, eNingizimu-East Asia naseNtshonalanga Pacific. Izifunda zaseMelika, iNingizimu-mpumalanga ye-Asia kanye ne-Western Pacific yizona ezithinteka kakhulu, kanti i-Asia ithwele u-70% womthwalo womhlaba wonke.

Ngaphezu kokwanda kwesibalo samacala alesi sifo njengoba sibhebhetheka ezindaweni ezintsha, kuqubuka neziqhumane. Manje njengoba ukugqashuka komkhuhlane wodenga kungenzeka kuqubuke eYurophu; Ukudluliselwa kwalesi sifo endaweni kwabikwa okokuqala eFrance naseCroatia ngo-2010, kanti amacala angenisiwe atholakala kwamanye amazwe amathathu ase-Europe. Ngo-3, kwaqubuka ukuqubuka komkhuhlane wodenga eziqhingini zasePutukezi eMadeira, okwaholela ekungenweni izifo ezingaphezu kuka-2012, futhi kwatholakala amacala angenisiwe ezweni lasePortugal nakwamanye amazwe ayi-2000 eYurophu. Manje sekuqashelwa ukuthi kukhona amacala amsulwa njalo ngonyaka emazweni ambalwa aseYurophu.

Ngonyaka ka-2019 kwaba nenani elikhulu kunawo wonke lamacala odenga ake abikwa emhlabeni. Zonke izifunda ze-WHO ziyathinteka futhi ukudluliswa komkhuhlane wodenga kwaqoshwa okokuqala ngqa e-Afghanistan.

Isifunda Samazwe aseMelika sisodwa sibike izehlakalo eziyizigidi ezi-3.1, ezingaphezu kuka-25,000 zazo zichazwe njengezinzima. Naphezu kwalesi sibalo esishaqisayo samacala, ukufa okubangelwe yiwo bekumbalwa kunangonyaka odlule.

Ukwanda kwezibalo zalesi sifo kubikwe e-Bangladesh (izigameko ezingu-000 101), ePhilippines (izigameko ezingu-000 420), i-Viet Nam (izigameko ezingu-000 320) naseMalaysia (izigameko ezingu-000 131) e-Asia.

Ngo-2020, udenga lwahlasela amazwe amaningana, amanani andayo abikwa e-Ecuador, Indonesia, Brazil, Bangladesh, Thailand, Timor-Leste, Cook Islands, Sri Lanka, Singapore, Sudan, Mayotte (French), Maldives, Mauritania, Nepal, India kanye Yemen. Ngo-2021, i-dengue fever iyaqhubeka nokuthinta iParaguay, iBrazil, iPeru, i-Cook Islands, i-Reunion Island, i-Philippines, i-Viet Nam, i-Fiji, i-Colombia, i-Kenya ne-India.

Ubhubhane lwe-COVID-19 lubeka ingcindezi enkulu ezinhlelweni zokunakekelwa kwezempilo kanye nokuphatha. I-WHO igcizelele ukubaluleka kokugcina imizamo yokuvikela, ukuthola, kanye nokwelapha izifo ezithwalwa yizilwane ezifana nodenga nezinye izifo ezithwalwa yi-arthropod phakathi nalolu bhubhane, olubona ukwanda kwenani lamacala emazweni amaningana, okwenza izakhamizi zasemadolobheni zibe sengozini enkulu. kulezi zifo.. Inhlanganisela yemithelela yobhubhane lwe-COVID-19 kanye nomkhuhlane wodenga kungaholela emiphumeleni emibi kubantu abasengozini.

ukudluliswa kwezifo

Sisakazwa ngokuchayeka ekulunyweni omiyane

Leli gciwane lidluliselwa kubantu ngokulunywa omiyane besifazane abanaleli gciwane, ikakhulukazi uhlobo lwe-Aedes aegypti. Ezinye izinhlobo zomiyane i-Aedes nazo zingaba amagciwane alesi sifo, kodwa igalelo labo ekusakazeni lincane uma liqhathaniswa ne-Aedes aegypti.

Ngemva kokuba umiyane usudle igazi lomuntu ongenwe igciwane lodenga, leli gciwane liyaphindaphindeka phakathi kwawo ngaphambi kokuba lingene ezicutshini zalo zesibili, kuhlanganise nezindlala zamathe. Isikhathi umiyane asithatha kusukela ekudleni igciwane kuya ekulidluliseleni kumuntu omusha sibizwa ngokuthi inkathi yokufukamela yangaphandle. Lesi sikhathi sithatha cishe phakathi kwezinsuku eziyi-8 neziyi-12 uma izinga lokushisa lendawo liphakathi kuka-25 no-28 degrees Celsius [4-6]. Ukwehluka kwenkathi yokufukamela yangaphandle akuthintwa nje kuphela izinga lokushisa elizungezile; Kunalokho, inani lezici ezifana nobukhulu bokushintshashintsha kwezinga lokushisa kwansuku zonke [7, 8], i-genotype yegciwane [9] kanye nokugxila kwegciwane lokuqala [10] nakho kungashintsha isikhathi esisithathayo ukuze umiyane uwudlulise. Uma umiyane usuthathelanayo, uyakwazi ukudlulisela leli gciwane impilo yalo yonke.

Ukudluliselwa kusuka kumuntu kuya emiyane

Omiyane bangangenwa i-dengue fever kubantu abanaleli gciwane egazini labo. Lokhu kungaba umuntu ongenwe yizimpawu zomkhuhlane wodenga, umuntu ongakazibonisi izimpawu zokutheleleka, noma ngisho nomuntu ongenazo nhlobo izimpawu [11].

Ukutheleleka kungadluliselwa kusuka kubantu kuya omiyane ezinsukwini ezimbili ngaphambi kokuba umuntu abe nezimpawu [5, 11], kanye nezinsuku ezimbili ngemva kokuba umkhuhlane usuphelile [12].

Amathuba okutheleleka omiyane ngalesi sifo ayanda ngokuba khona okuphezulu kwamagciwane egazini egazini lesiguli kanye nokushisa komzimba okuphezulu komzimba wakhe. Ngokuphambene, amazinga aphezulu egazi amasosha omzimba aqondene negciwane lodenga ahlotshaniswa namathuba amancane okutheleleka komiyane (Nguyen et al. 2013 PNAS). Igciwane lihlala egazini labantu abaningi phakathi kwezinsuku ezi-4 neziyi-5, kodwa ukusinda kwalo kungase kuqhubeke izinsuku eziyi-12 [13].

Ukudluliselwa kokutheleleka kusuka kumama kuya ku-fetus

Indlela eyinhloko yokudluliselwa kwegciwane lodenga phakathi kwabantu ngokusebenzisa ama-vectors omiyane. Kodwa-ke, kunobufakazi obubonisa ukuthi kungenzeka ukuthi igciwane lidluliselwe kumama (okhulelwe) liye embungwini wakhe, nakuba amazinga okudluliselwa kwegciwane kusuka kumama kuya ku-fetus ebonakala ephansi, uma kubhekwa ukuthi ingozi yokudluliselwa ngale ndlela. kubonakala kuhlotshaniswa nesikhathi sokutheleleka kodenga ngesikhathi sokukhulelwa [14-17]. Uma umama esevele etheleleke ngegciwane lodenga ngesikhathi ekhulelwe, ingane yakhe ingase izalwe ngaphambi kwesikhathi futhi ingase ibe nesisindo sokuzalwa esiphansi kanye nokucindezeleka kombungu [18].

ezinye izindlela zokudlulisa

Kuye kwabikwa izehlakalo ezingavamile zokutheleleka ngemikhiqizo yegazi, ukunikelwa kwezitho zomzimba kanye nokumpontshelwa igazi. Ngokufanayo, amacala okudluliselwa kwe-ovarian kwegciwane komiyane nawo aqoshiwe.

I-Vector ecology

Umiyane i-Aedes aegypti iwumthombo oyinhloko we-dengue fever. Ingazalela ezitsheni zemvelo ezifana nezimbobo zezihlahla kanye nezitshalo ze-bromeliad, kodwa isijwayele izindawo zokuhlala zasemadolobheni futhi izalanisa ikakhulukazi ezitsheni ezenziwe abantu, okuhlanganisa amabhakede, izimbiza zobumba, izitsha ezilahliwe, amathayi asetshenzisiwe, amathangi okuqoqa amanzi, njll., okuyinto kwenza udenga lube isifo esicashile ezindaweni zasemadolobheni eziminyene. Umiyane udla emini; Izikhathi zokuluma kwayo zisezingeni eliphezulu ekuseni nakusihlwa ngaphambi kokushona kwelanga [19]. Umiyane wesifazane i-Aedes aegypti iluma izikhathi eziningana phakathi njalo nezinkathi ezimbili lapho izalela khona amaqanda, okuholela emaqenjini abantu abanaleli gciwane [20]. Uma esezalelwe, la maqanda angaphila izinyanga ezimbalwa ezimeni ezomile futhi achanyuselwe lapho ethintana namanzi.

I-Aedes albopictus, igciwane lesibili lomkhuhlane wodenga, litholakala ezifundazweni ezingaphezu kuka-32 e-United States of America nasemazweni angaphezu kuka-25 esifundeni saseYurophu, ngenxa yohwebo lwamazwe ngamazwe ngamathayi asetshenzisiwe (indawo yokuzalela komiyane) nezinye. izinto ezisetshenziswayo (njenge-clematis). Incamela ukuzalanisa ezindaweni eziseduze nezimila eziminyene, okuhlanganisa namasimu, futhi ihlotshaniswa nengozi eyengeziwe yokutheleleka phakathi kwezisebenzi zasemaphandleni, njengalezo ezisemasimini enjoloba namasundu kawoyela, kodwa futhi kuboniswe ukuthi izalela ezindaweni zasemadolobheni. I-Aedes albopictus ibonakala ngekhono layo eliphezulu lokuzivumelanisa nezimo, futhi ukusabalala kwayo okubanzi kwendawo kubangelwa ikhono layo lokumelana nezinga lokushisa eliphansi, kungakhathaliseki ukuthi iqanda noma umiyane omdala [21, 22]. Ngokufana ne-Aedes aegypti, i-Aedes albopictus indiza phakathi nosuku futhi inani elilinganiselwe lokuqubuka kuye kwashiwo ukuthi liyi-vector eyinhloko yegciwane lodenga kuyo, ezimeni lapho i-Aedes aegypti ingekho noma ikhona ngezinombolo eziphansi [23, 24] .

Izimpawu zesifo (izimpawu nezimpawu)

Nakuba izimo eziningi zomkhuhlane wodenga zingenazimpawu noma zingase zihambisane nezimpawu ezithambile, ziveza njengesifo esinzima, esifana nomkhuhlane esihlasela izinsana, izingane ezincane kanye nabantu abadala, kodwa akuvamile ukuba sibulale. Izimpawu zalesi sifo ngokuvamile zihlala izinsuku ezingu-7-4 ngemva kokufukamela izinsuku ezingu-10-25 nangemva kokuba umuntu elunywe umiyane onaleli gciwane. I-World Health Organization ihlukanisa i-dengue fever ngezigaba ezimbili eziyinhloko: udenga (olunezimpawu/ezingenazo izimpawu eziyisixwayiso) kanye nodenga olunzima. Ukuhlukaniswa kwe-dengue njengezimpawu eziyisixwayiso noma ngaphandle kuhloswe ukusiza abasebenzi bezempilo ukuthi bahlole iziguli ezidinga ukulaliswa esibhedlela, ukuqinisekisa ukunakekelwa kanye nokunciphisa ingozi yodenga olubi kakhulu [25].

umkhuhlane wodenga

Udenga kufanele kusolwelwe lapho umuntu enomkhuhlane ophezulu (40°C/104°F) onezimpawu ezimbili kwezilandelayo phakathi nesigaba se-febrile (izinsuku ezingu-7-XNUMX):

• ikhanda elibuhlungu kakhulu
• Ubuhlungu ngemuva kwamehlo
• Ubuhlungu bemisipha namalunga
• isicanucanu
• ukuhlanza
• izindlala ezivuvukele
• Ukuqubuka kwesikhumba

Udenga olunzima

Isiguli ngokuvamile singena esigabeni esibucayi phakathi kwezinsuku ezingu-3 kuya kwezingu-7 ngemva kokuqala kwezimpawu zesifo. Phakathi namahora angu-24 kuya kwangu-48 esigaba esibucayi, ingxenye encane yeziguli ingase ibonise ukuwohloka kwezimpawu okungazelelwe. Lesi yisigaba lapho izinga lokushisa lesiguli lehla (ngaphansi kuka-38°C/100°F) futhi lingabonisa izimpawu eziyisixwayiso ezihlobene nodenga olunzima. Umkhuhlane wodenga onzima ungabangela izinkinga ezibulalayo ngenxa yokuvuza kwe-plasma, ukunqwabelana koketshezi, ukuphelelwa umoya, ukopha kakhulu, noma ukwehluleka kwezitho.

Nazi izimpawu eziyisixwayiso odokotela okufanele baziqaphele:

• ubuhlungu obukhulu esiswini
• ukuhlanza okungapheli
• ukuphefumula ngokushesha
• Izinsini zokopha noma ikhala
• ukucindezeleka
• ukudlikiza
• I-Hepatomegaly
• Ukuba khona kwegazi emhlanzweni noma esithweni.

Futhi uma isiguli sibonisa lezi zimpawu ngesikhathi sesigaba esibucayi sesifo, kuyadingeka ukuthi siqashwe ngokucophelela kungakapheli amahora angama-24 kuye kwangama-48 ukuze sinikezwe usizo lwezokwelapha oludingekayo ukuze kugwenywe izinkinga kanye nethuba lokufa. . Ukuqapha eduze kufanele futhi kuqhubeke phakathi nesigaba sokululama.

Ukuxilonga

Ziningi izindlela ezingasetshenziswa ukuxilonga igciwane lodenga. Ukusetshenziswa kwezindlela zokuxilonga ezahlukene kuncike esikhathini sokuqala kwezimpawu zesifo. Amasampula aqoqwe ezigulini phakathi nesonto lokuqala lokuqala kwesifo kufanele ahlolwe kusetshenziswa izindlela ezichazwe ngezansi.

Izindlela zokuhlukanisa amagciwane

Igciwane lingahlukaniswa negazi phakathi nezinsuku ezimbalwa zokuqala zokutheleleka. Izindlela ezahlukahlukene zokwenza i-reverse transcriptase-PCR assay ziyatholakala futhi izindlela zokuhlola ireferensi. Nokho, kudinga amathuluzi akhethekile nokuqeqeshwa kwabasebenzi ukwenza lezi zivivinyo.

Leli gciwane lingatholwa futhi ngokuhlola amaprotheni eliwakhiqizayo, abizwa ngokuthi ama-nonstructural proteins 1. Kukhona ukuhlola okukhiqizwa ngokushesha okukhiqizwa ngokudayiswa okutholakalayo ngale njongo okuthatha imizuzu engu-20 kuphela ukugijima ukuze kutholwe umphumela futhi akudingi amasu akhethekile aselabhorethri noma imishini.

Izindlela ze-serological

Izindlela ze-serological ezifana ne-enzyme-linked immunoassay zingase ziqinisekise ukuba khona kokutheleleka kwakamuva noma okwedlule ngokuthola amasosha omzimba alwa nodenga. Amasosha omzimba e-IgM angatholwa ngesonto ngemva kokutheleleka, futhi asengabonakala cishe izinyanga ezintathu, futhi ukuba khona kwawo kubonisa ukutheleleka kwamuva ngegciwane lodenga. Amasosha omzimba e-IgG athatha isikhathi eside ukwakha emazingeni athile futhi ahlale emzimbeni iminyaka eminingi. Ukuba khona kwamasosha omzimba e-IgG kubonisa ukutheleleka kwangaphambilini ngegciwane lodenga.

ukwelashwa

Akukho ukwelashwa okuqondile kodenga. Iziguli kufanele ziphumule, ziphuze amanzi anele futhi zifune izeluleko zodokotela. Ngokuya ngezimpawu zomtholampilo nezinye izimo, iziguli zingathunyelwa ekhaya noma zidluliselwe esibhedlela ukuze ziphathwe noma zingadinga ukwelashwa okuphuthumayo noma ukudluliselwa okuphuthumayo [25].

Ukunakekelwa okusekelayo okunjengama-antipyretics kanye nezidambisi zobuhlungu kunganikezwa ukulawula izimpawu zokuqaqamba kwemisipha, izinhlungu nomkhuhlane.

• I-acetaminophen noma i-paracetamol yizindlela ezingcono kakhulu ezitholakalayo zokwelapha lezi zimpawu.
• Kufanele ugweme ukuthatha izidakamizwa ezingezona ukuvuvukala, njenge-ibuprofen ne-aspirin. Le mithi elwa nokuvuvukala isebenza ngokunciphisa ama-platelet egazini futhi ingase ibe yimbi kakhulu ukubikezela esimweni salesi sifo ngamandla ako okopha.

Ngodenga olunzima, izimpilo zingasindiswa ngenxa yosizo lwezokwelapha olunikezwa odokotela nabahlengikazi abanolwazi ngemiphumela nezigaba zesifo - ukunakekelwa okunjalo okwehlisa izinga lokufa libe ngaphansi kuka-1% emazweni amaningi.

Ukugonywa komkhuhlane wodenga

Umuthi wokuqala wokugomela udenga, i-Dengvaxia® (CYD-TDV) othuthukiswe yi-Sanofi Pasteur Vaccine Laboratory, unikezwe ilayisense ngoZibandlela wezi-2015 futhi manje usuthole ukugunyazwa okulawulwayo ukuze usetshenziswe emazweni angu-20. NgoNovemba 2017, imiphumela yolunye uhlaziyo lwe-retrospective yesimo se-serostatus somgomo ngesikhathi sokugoma yashicilelwa. Ukuhlaziywa kubonise ukuthi iqembu elincane labahlanganyeli bocwaningo abatholakala bengenayo i-sero-negative ngesikhathi sokugoma kwabo kokuqala babesengozini enkulu yodenga olunzima kanye nokulaliswa esibhedlela ngenxa yodenga kunabahlanganyeli abangagonyiwe. Ngakho-ke, ukusetshenziswa komgomo we-CYD-TDV kuhloselwe abantu abahlala ezindaweni ezihlala njalo phakathi kweminyaka eyi-9 nengama-45 abaye baba nesiqephu okungenani esisodwa sokutheleleka ngegciwane lodenga esikhathini esidlule. Abantu abambalwa abazogomela i-dengue fever bayahlolwa.

Isimo se-WHO ngomgomo we-CYD-TDV [26]

Iphepha le-WHO (September 2018) ku-Dengvaxia [26] lithi umuthi wokugomela udenga we-CYD-TDV owancishisiwe ufakazele ukusebenza kahle nokuphepha ezivivinyweni zomtholampilo ezenziwa kubantu ababengenwe yigciwane lodenga (abantu abane-sero-positive). Amazwe acabangela ukugoma njengengxenye yezinhlelo zawo zodenga ayanconywa ukuba asebenzise isu lokuhlola ngaphambi kokugonywa. Ngokwaleli su, ukugoma ngalo mgomo kuzokhawulelwa kubantu abanobufakazi bokutheleleka kwangaphambilini kodenga (okusekelwe ekuhlolweni kwe-antibody noma imibhalo yokutheleleka okuqinisekiswe ilabhorethri esikhathini esedlule). Izinqumo ezimayelana nokuqaliswa kwesu lokuphinda ligonywe ngaphambi kokugoma zizobandakanya ukuhlolwa okuqinile kwezinga lezwe, okuhlanganisa ukucabangela ukuzwela nokucaciswa kokuhlolwa okutholakalayo, izinto ezibalulekile endaweni, isifo somkhuhlane we-dengue esiqondene nezwe elithile, amazinga okulaliswa esibhedlela nge-febrile kanye nokufinyeleleka komgomo we-CYD. - I-TDV kanye nokuhlolwa kwecala kokubili.

Ukugoma kufanele kuthathwe njengengxenye yesu elididiyelwe lokuvimbela nokulawula udenga. Kunesidingo esiphuthumayo sokubambelela kuzo zonke ezinye izindlela zokuvimbela izifo, njengezinyathelo ezimiswe kahle nezinakekelwe kahle zokulawula ama-vector. Abantu ngabanye, kungakhathaliseki ukuthi ugonyiwe noma cha, kufanele bafune usizo lwezokwelapha ngokushesha uma beba nezimpawu ezifana nalezo zodenga.

izici eziyingozi

Ukutheleleka kwangaphambilini ngodenga kwandisa amathuba okuba abantu bathole ukutheleleka okunzima kodenga.

Ukuhlala kwabantu emadolobheni (ikakhulukazi okungalawulwa) kuhlotshaniswa nokudluliswa kokutheleleka kodenga ngokusebenzisa izici eziningana zezenhlalo nezemvelo: ukuminyana kwabantu, ukuhamba kwabantu, ukufinyelela emthonjeni wamanzi onokwethenjelwa, umkhuba wokugcina amanzi, njalonjalo.

Ukuchayeka emphakathini ngodenga nakho kuncike olwazini lwabantu, izimo zengqondo kanye nemikhuba mayelana nodenga, kanye nokuqaliswa kwemisebenzi evamile, eqhubekayo yokulawula ama-vector emphakathini.

Ngenxa yalokho, izingozi zezifo zingashintsha futhi zishintshe ngokushintsha kwesimo sezulu ezindaweni ezishisayo nasezindaweni ezishisayo, futhi amagciwane angase azivumelanise nezimo ezintsha zemvelo nesimo sezulu.

Ukuvimbela nokulawula izifo

Uma wazi ukuthi unodenga, qaphela ukuthi ugweme okunye ukulunywa omiyane phakathi nesonto lokuqala lokugula kwakho. Igciwane lingase lijikeleze egazini lakho ngaleso sikhathi, futhi ngaleyo ndlela libe yindlela yokudlulisela igciwane ezinambuzaneni ezintsha ezivela omiyane abangathwali isifo salo, ukuze lidlulisele kwabanye abantu.

Ukuba seduze kwezindawo ezizalela kuzo omiyane abadlulisela lesi sifo endaweni okuhlala abantu kungenye yezinto eziyingozi nezibalulekile ekuthelelekeni kodenga. Njengamanje, kunendlela eyodwa kuphela eyinhloko yokulawula noma yokuvimbela ukusakazeka kwegciwane lodenga, futhi leyo iwukulawula omiyane abasakaza lesi sifo. Nansi indlela yokufeza lokhu:

• Ukuvimbela ukuzalanisa omiyane ngokulandelayo:
  • ukuvimbela omiyane ekufinyeleleni ezindaweni zabo zokubekela amaqanda ngokuthatha izinyathelo zokulawula imvelo kanye nokuguqula;
  • ukulahlwa kahle kwemfucuza eqinile kanye nokususwa kwezindawo zokuhlala ezenziwe abantu lapho amanzi engaqoqa khona;
  • Izitsha zokugcina amanzi zasekhaya ziyambozwa, zithululwe futhi zihlanzwe masonto onke;
  • ukusetshenziswa kwezibulala-zinambuzane ezifanele ezitsheni zokugcina amanzi ngaphandle;

• Okulandelayo yizinyathelo zokuzivikela ekulunyweni omiyane:
  • Sebenzisa izindlela zokuvikela ikhaya lomuntu siqu njengezikrini zamafasitela, izinto ezixoshayo, amakhoyili, namafumigators. Lezi zinyathelo kufanele zibhekwe phakathi nosuku ngaphakathi nangaphandle (isb. ngenkathi usemsebenzini/esikoleni), ngoba umiyane oyinhloko uyaluma emini;
  • Kunconywa ukuthi ugqoke izingubo ezinciphisa ukuchayeka esikhumbeni omiyane;

• Ukuzibandakanya komphakathi:
  • ukufundisa umphakathi ngobungozi bezifo ezithwalwa omiyane;
  • Ukuxhumana nomphakathi ukwenza ngcono ukubamba iqhaza komuntu ngamunye kanye nokuhlanganisa ukulawulwa kwe-vector esimeme;

• Qaphela ngempumelelo omiyane namagciwane:
  • Ukuqapha ukusabalala kwe-vector kanye nokugadwa ngempumelelo kufanele kwenziwe ukuze kutholwe ukuphumelela kokungenelela kokulawula ama-vector.
  • Ukuqapha okulindelwe amazinga okusabalala kwegciwane phakathi komiyane omiyane ngokuhambisana nokuhlolwa okusebenzayo kweziswebezane zabalindi;
  • Ukubhekwa kweVector kungahlanganiswa nokubhekwa komtholampilo kanye nemvelo.

Ngaphezu kwalokho, ucwaningo luqhubeka ngokushesha phakathi kwamaqembu amaningi ababambisene namazwe ngamazwe ekutholeni amathuluzi amasha namasu amasha okufaka isandla emzamweni womhlaba wonke wokumisa ukusakazeka kodenga. I-WHO ikhuthaza ukuhlanganiswa kwezindlela zokuphatha ama-vector ukuze kuqaliswe ukungenelela kokulawula ama-vector okusimeme, okuphumelelayo nokuguquguquka kwendawo.