Izindlela Zokuvimbela Nokwelapha Umalaleveva
I-Pendahuluan
Umalaleveva yisifo esithathelwanayo esibangelwa yi-Plasmodium parasite, esidluliselwa ngokulunywa umiyane wesifazane i-Anopheles. Lesi sifo besilokhu sikhona kusukela ezikhathini zasendulo futhi siseyinkinga enkulu yezempilo emazweni amaningi asezindaweni ezishisayo nezishisayo. Amacala angaphezu kwezigidi ezingu-200 kamalaleveva ayenzeka minyaka yonke emhlabeni jikelele, okuholela ekufeni kwabantu ababalelwa ku-400.000. Kulesi sihloko, sizoxoxa ngezindlela ezahlukene zokuvimbela nomalaleveva kanye nokwelapha ezingasiza ekunciphiseni ukwanda kanye nomthelela walesi sifo.
Ukuvimbela Umalaleveva
Ukuvimbela umalaleveva kungenziwa ngezindlela eziningana, okuhlanganisa ukusetshenziswa kwemithi yokuvimbela, ukulawulwa kwezifo ezibangelwa yigciwane, kanye nokwandisa ulwazi lomphakathi kanye nemfundo.
1. Imithi Yokuvimbela
Kunconywa ukusetshenziswa kwemithi yokulwa nomalaleveva njengendlela yokuvimbela kubantu abaya ezindaweni ezivame ukuba khona umalaleveva. Le mithi yokuvimbela isebenza ngokubulala amagciwane egazini noma ukuvimbela ukutheleleka ukuthi kungaqhubekeli esifweni. Eminye imithi evame ukusetshenziswa ifaka phakathi i-chloroquine, i-mefloquine, i-doxycycline, kanye ne-atovaquone-proguanil. Ukukhetha umuthi kuncike endaweni, uhlobo lwegciwane, ukumelana nemithi, kanye nomlando wezokwelapha womuntu ngamunye.
2. Ukulawulwa Kwevektha
Ukulawula inani lomiyane be-Anopheles kuyisici esibalulekile sokuvimbela umalaleveva. Amanye amasu asetshenziswa kakhulu okulawula izinambuzane ahlanganisa:
a. Isibulala-zinambuzane
Ukusetshenziswa kwezibulala-zinambuzane ezindaweni zokuphumula nokuzalela omiyane kusiza ekunciphiseni inani lomiyane abadala. Izibulala-zinambuzane ezivame ukusetshenziswa zifaka phakathi i-DDT, i-pyrethroids, kanye ne-organophosphates. Kodwa-ke, ukumelana nezibulala-zinambuzane kuyinkinga ekhulayo futhi kudinga amasu okuphatha okusimeme.
b. Amanethi omiyane aphathwe ngezibulala-zinambuzane
Amanethi omiyane alashwe ngezibulala-zinambuzane ayisinyathelo esisebenza kahle kakhulu sokuvimbela, ikakhulukazi ekuvikeleni abantu lapho belele. Ahlinzeka kokubili ngokuvikelwa ngokomzimba nangokwekhemikhali ekulunyweni omiyane.
c. I-Larvivora kanye ne-Genetics
Ukusetshenziswa kwezinhlanzi ezidla ezinye izilwane ezidla ezinye izilwane (ama-larvivora) kanye nokulawulwa kwezakhi zofuzo kwenani lomiyane, njengokukhishwa komiyane besilisa abahlanzekile noma omiyane abaguqulwe izakhi zofuzo, kungasiza ekunciphiseni inani lomiyane.
3. Imfundo Yomphakathi Nokuqwashisa
Imfundo yomphakathi ngokuvimbela umalaleveva kanye nokubaluleka kokusebenzisa imishini yokuzivikela njengemanethi ombhede, izingubo zokuzivikela, kanye nemithi yokuxosha omiyane kuyisinyathelo esibalulekile ekunciphiseni ukwanda kokutheleleka. Ukusabalalisa ulwazi ngemikhankaso, amaphosta, kanye nezinkundla zokuxhumana kungandisa ulwazi lomphakathi kanye nokuqapha mayelana nezingozi zomalaleveva.
Ukwelashwa Komalaleveva
Ukwelashwa komalaleveva kugxile ekususeni amagciwane emzimbeni wesiguli kanye nokuvimbela izinkinga ezisongela ukuphila. Ukwelashwa okusheshayo nokufanelekile kubalulekile ukuvimbela ukufa kanye nezinkinga ezinkulu.
1. Ukuxilongwa
Ukuxilongwa okusheshayo nokunembile kuyisinyathelo sokuqala sokwelashwa komalaleveva. Umalaleveva ungatholakala ngokuhlolwa kwegazi, kungaba ngokuhlola ama-microscope ukuthola amagciwane noma ukuhlolwa okusheshayo kokuxilongwa (ama-RDT) okuthola ama-antigen kamalaleveva egazini.
2. Ukwelashwa Ngemithi Yokulwa Nomalaleveva
Ukwelashwa komalaleveva kuyahlukahluka kuye ngohlobo lwezinambuzane ezibangela lesi sifo kanye nobunzima besifo. Ezinye izinhlobo zemithi yokulwa nomalaleveva esetshenziswayo zifaka:
a. Ukwelashwa Okuhlanganisiwe Okusekelwe ku-Artemisinin (ACTs)
I-ACTs iyindlela ejwayelekile yokwelapha umalaleveva obangelwa yiPlasmodium falciparum, i-parasite ebulalayo kakhulu. I-ACTs ihlanganisa inhlanganisela ye-artemisinin derivative (njenge-artemether noma i-artesunate) nomunye umuthi, njenge-lumefantrine noma i-amodiaquine. Le nhlanganisela ikhulisa ukusebenza kahle kokwelashwa futhi ivimbela ukumelana nemithi.
b. I-Chloroquine ne-Primaquine
Umalaleveva obangelwa yiPlasmodium vivax noma iPlasmodium ovale, i-chloroquine ivame ukusetshenziswa njengokwelashwa kokuqala. I-Primaquine inikezwa futhi ukubulala izinhlobo ezifihliwe ze-parasite esibindini nokuvimbela ukuphindaphinda.
c. I-Quinine nama-Antibiotic
Ezimweni zomalaleveva noma izinkinga ezinkulu, iziguli zingadinga ukulaliswa esibhedlela kanye nokwelashwa ngemithi yokulwa nomaleveva efakwa ngemithambo efana ne-quinine noma i-artesunate. Ama-antibiotic afana ne-doxycycline noma i-clindamycin nawo angangezwa ukuze kuthuthukiswe ukusebenza kahle kokwelashwa.
3. Ukuphathwa Kwezinkinga
Umalaleveva ungabangela izinkinga ezinkulu ezahlukahlukene, njengokuntuleka kwegazi okukhulu, ukwehluleka kwezinso, ukuvuvukala kwamaphaphu, kanye nomalaleveva wobuchopho. Ukuphathwa kwalezi zinkinga kuvame ukudinga ukunakekelwa okujulile, okuhlanganisa ukumpontshelwa igazi, ukwelashwa nge-oxygen, noma i-dialysis.
4. Ukwelashwa Ngezimpawu
Ngaphezu kwemithi yokulwa nomalaleveva, ukwelashwa okusekelayo ukulawula izimpawu ezifana nomkhuhlane, ubuhlungu, kanye nokuphelelwa amanzi emzimbeni kubalulekile. Ukusetshenziswa kwemithi yokulwa namagciwane njenge-paracetamol, ukuphinda uphuze amanzi ngoketshezi lomlomo noma ngemithambo yegazi, kanye nokulawula ubuhlungu kungasiza ekunciphiseni ukungakhululeki kwesiguli.
5. Ukuvimbela Ukuphinda Kubuye
Ngemva kokwelashwa komalaleveva, ukuvimbela ukubuyela emuva kubalulekile, ikakhulukazi ezifweni ezibangelwa yiPlasmodium vivax kanye nePlasmodium ovale. Ukusebenzisa i-primaquine ngemuva kwesigaba sokwelashwa esiphuthumayo kusiza ukuvimbela izimuncagazi ezifihliwe esibindini ezingaholela ekuthelelekeni kabusha.
Ucwaningo nentuthuko
Ucwaningo luyaqhubeka nokuthola umuthi wokugomela umalaleveva osebenzayo kanye namasu amasha okuvimbela nokwelapha umalaleveva. Umuthi wokugomela i-RTS,S/AS01 (Mosquirix) ubonise ukusebenza kahle ekunciphiseni amacala kamalaleveva ezinganeni e-Afrika. Ngaphezu kwalokho, ucwaningo ngamathuluzi okuxilonga asheshayo, imithi emisha, kanye namasu okulawula ama-vector amasha luyaqhubeka nokuthuthuka.
Isiphetho
Umalaleveva usalokhu uyinselele yomhlaba wonke edinga indlela ebanzi yokuvimbela nokwelapha. Ukusetshenziswa kwezidakamizwa zokuvimbela, ukulawulwa kwezifo ezibangelwa amagciwane, imfundo yomphakathi, ukuxilongwa okusheshayo, kanye nokwelashwa okufanele kubalulekile ekunciphiseni umthwalo walesi sifo. Ngokubambisana phakathi kohulumeni, izinhlangano zezempilo, kanye nemiphakathi, kunethemba lokuthi umalaleveva ungancishiswa futhi ekugcineni uqedwe njengenkinga yezempilo yomphakathi esikhathini esizayo.
