Ukuhlolwa kwe-Dengue NS1 ukuhlolwa kwegazi okuthola i-NS1 antigen, iphrotheni ekhishwa yigciwane le-dengue ngesikhathi sokutheleleka okusebenzayo. I-NS1 antigen ivame ukutholakala kusukela osukwini loku-1 kuya cishe osukwini lwesi-5-7 lomkhuhlane, ngokuvamile ngaphambi kokuvela kwama-antibodies. Umphumela ongemuhle we-NS1 awuwukhiphi ngaphandle i-dengue.
Ukuthatha okhiye
- Ukuhlolwa kwe-Dengue NS1 kuthola amaprotheni egciwane, hhayi ama-antibodies, ngakho-ke ukuhlolwa kusebenza ngokushesha kakhulu kulesi sifo.
- I-antigen ye-NS1 ivame ukwehla ngemva kwezinsuku zokuqala ezinhlanu kuya kweziyisikhombisa zomkhuhlane, lapho ukuhlolwa kwe-NS1 kungasebenzi kahle.
- Umphumela we-NS1 ongemuhle awukuqedi udenga; ukuhlolwa kwe-IgM noma ukuhlolwa okuphindaphindiwe kungadingeka.
- Ukuhlolwa kwe-NS1 akulinganisi ubucayi bokugula, inani lama-platelet, i-hematocrit kanye nezimpawu zesixwayiso sezokwelapha kwenza lokho.
- Imiphumela kumele ichazwe udokotela ocele ukuhlolwa, kanye nezimpawu kanye nokunye ukuhlolwa kwegazi.
Nge-shazi
| Isici | Imininingwane |
|---|---|
| Yini kukalwa | I-antigen ye-Dengue NS1 (iprotheni 1 engeyona eyakhekile) egazini |
| Sample | Isampula yegazi lemithambo yegazi; isampula ye-capillary yama-kit athile asheshayo |
| Isikhathi esihle kakhulu | Usuku 1 kuya cishe osukwini 5-7 kusukela ekuqaleni komkhuhlane |
| izindlela | Ukuhlolwa kwe-ELISA noma ukuhlolwa okusheshayo kwe-immunochromatographic (ukugeleza kwe-lateral) |
| Ukuzila | akudingekile |
| Isikhathi sokukhipha igazi | Ngokuvamile kungaphansi kwemizuzu emihlanu |
| Uhlobo lomphumela | Okunekhwalithi, okuhle, okubi, noma okungaqondile |
| Ngokuvamile ku-odwa nge | Inani eliphelele legazi, i-dengue IgM/IgG, ukuhlolwa kwe-malaria |
Obeye aziwe njengo
- Ukuhlolwa kwe-antigen ye-NS1
- Ukuhlolwa kwe-antigen ye-dengue
- Ukuhlolwa kwekhadi le-dengue (elivame ukusetshenziswa eNdiya ngefomethi yekhithi esheshayo)
- I-Dengue NS1 ELISA
- "Ukuhlolwa kwe-Dengue", igama elingakahleleki elingasho i-NS1, i-IgM, i-IgG noma inhlanganisela, ngakho hlola ukuthi yini ngempela eyaliwe
Kuyini ukuhlolwa kwe-Dengue NS1
I-NS1 iyiprotheni ekhiqizwa yigciwane le-dengue njengoba igciwane liphindaphindeka. Iprotheni ikhishwa egazini ngobuningi obukhulu ngesikhathi somkhuhlane, ngokuvamile kusukela ngosuku lokuqala lomkhuhlane. Ukuhlolwa kwe-Dengue NS1 kusebenzisa ama-antibodies aboshwe ku-test strip noma ipuleti ukuze kubanjwe leyo protheni futhi kukhiqizwe isignali ebonakalayo noma elinganisekayo.
Ngenxa yokuthi i-NS1 ivela ngaphambi kokuba umzimba wenze ama-antibodies awo, ukuhlolwa kwe-Dengue NS1 kugcwalisa iwindi lokuqala lokuxilonga lapho ukuhlolwa kwe-IgM kuvame ukuba negative. Amalabhorethri amaningi abika ukuthi i-NS1 imane nje ilungile noma imbi. Amanye amapulatifomu e-ELISA aphrinta i-optical density noma inani le-index; lelo nani libonisa isignali yokuhlola kanye nokunqunywa, futhi akulona isilinganiso sokuthi umuntu ugula kangakanani.
Kungani kwenziwa ukuhlolwa kwe-Dengue NS1
- Ukuqinisekiswa kwasekuqaleni: ukusekela ukutholakala kwesifo sohudo kumuntu onomkhuhlane omkhulu ezinsukwini zokuqala zokugula.
- Ukunciphisa umehluko: Umkhuhlane omkhulu eNdiya ungaba yi-dengue, umalaleveva, i-chikungunya, i-scrub typhus, i-leptospirosis, umkhuhlane wamathumbu, umkhuhlane, i-COVID-19 noma ukutheleleka ngomchamo. Umphumela omuhle we-NS1 ukhomba i-dengue kodwa awukukhiphi ukutheleleka okuhlangene.
- Ukuqapha okuqondisayo: Ukuxilongwa kwe-dengue okuqinisekisiwe kukhuthaza ukuqapha nokunakekela ama-platelet kanye ne-hematocrit alandelanayo ngesikhathi sesigaba esibucayi.
- Imibiko yezempilo yomphakathi: udenga oluqinisekiswe yilabhorethri ludluliselwa ekuqapheni kwesifunda kanye nesizwe.
Ubani okufanele athole lolu vivinyo
- Noma ubani onomkhuhlane ongaphansi kwezinsuku ezinhlanu kuya kweziyisikhombisa ngesikhathi noma ngemva kwemvula, noma endaweni evame ukuba khona noma enesifo sofuba.
- Abantu abanomkhuhlane kanye nekhanda elibuhlungu, ubuhlungu be-retro-orbital (ngemuva kweso), ubuhlungu obukhulu bomzimba namalunga, isicanucanu noma ukuqubuka.
- Abantu abanomkhuhlane abasanda kuya endaweni evame kakhulu udenga.
- Noma ubani onomkhuhlane kanye nokwehla kwenani lama-platelet noma ukwenyuka kwenani legazi.
- Abantu abanomkhuhlane kanye nengozi ephezulu yezinkinga, ukukhulelwa, ubuntwana, ukuguga, isifo sikashukela, isifo sezinso esingamahlalakhona, ukwehluleka kwenhliziyo, ukukhuluphala ngokweqile, noma labo abasebenzisa imithi yokunciphisa ukugabha kwegazi.
Ukuhlolwa akusizi njalo kumuntu ongenawo umkhuhlane noma izimpawu ezihambisanayo, futhi akusetshenziselwa ukuhlola abantu abaphilile.
Lokho ukuhlolwa kwe-Dengue NS1 okungenakukuthola noma okungakubandakanyi
- Awukwazi ukukhipha udenga. Umphumela we-NS1 ongemuhle usho ukuthi akukho antigen ye-NS1 etholakale ngaleso sikhathi kuleyo sampula. Ukuzwela kwe-NS1 kuphansi ngemva kosuku lwesihlanu lomkhuhlane futhi kuphansi ekuthelelekeni kwesibili kodenga, lapho ama-antibodies akhona kakade ebopha i-NS1 ejikelezayo.
- Akunabo ubunzima bebanga. Ukuhlolwa kwe-NS1 akukutsheli ukuthi i-dengue izohlala incane noma iqhubekele ekuvuthweni kwe-plasma, ukopha noma ukushaqeka. Ubunzima buhlolwa ngokwezokwelapha nangokwe-hematocrit elandelanayo, inani lama-platelet, i-albhamuin, ama-enzyme esibindi kanye ne-ultrasound ukuze kuqoqwe uketshezi lapho kuboniswe khona.
- Ayibonisi i-serotype. Ukuhlolwa okujwayelekile kwe-NS1 akuhlukanisi i-DENV-1 ne-DENV-4. I-Serotyping idinga i-RT-PCR.
- Akuhlukanisi ukutheleleka okuyinhloko nokwesibili. Leso siphetho sivela kuphethini ye-IgM/IgG, hhayi ku-NS1.
- Akukhiphi ezinye izifo. Umphumela omuhle we-NS1 awukhiphi ngaphandle umalaleveva ohambisanayo, i-scrub typhus, i-enteric fever noma i-leptospirosis, konke okuvamile eNdiya. Kuvela izifo ezimbili.
- Akubikezeli ukuzivikela komzimba. Ukuhlolwa kwe-NS1 akusho lutho ngokuvikelwa ekuthelelekeni nge-dengue esikhathini esizayo.
- Ayiqapheli ukululama. Ukuphinda i-NS1 ukuze "ubone ukuthi i-dengue isiphelile yini" akusizi ngokwezokwelapha.
Uma umkhuhlane noma izimpawu ziqhubeka naphezu komphumela ongemuhle we-NS1, buyela kudokotela wakho. Kungadingeka ukuhlolwa okwengeziwe noma ukuhlolwa kabusha.
Ukuhlolwa okuhlobene kodwa okuhlukile
Lezi zivivinyo ziphendula imibuzo ehlukene ezindaweni ezahlukene zokugula. Enye ayingcono kakhulu kunenye.
| test | Lokho elikutholayo | Isikhathi esihle kakhulu | Umkhawulo wokhiye |
|---|---|---|---|
| I-antigen ye-Dengue NS1 | Iprotheni yegciwane, ukutheleleka kwamanje | Usuku 1 kuya cishe osukwini 5-7 lomkhuhlane | Ukuzwela kwehla ngemva kosuku lwesi-5 kanye nasekuthelelekeni kwesibili; akukho serotype, akukho ubukhali |
| I-antibody ye-Dengue IgM | Impendulo yamuva nje yomzimba | Ngokuvamile kuyabonakala kusukela cishe osukwini lwesi-4 kuya ku-5 kuqhubeke | Ngokuvamile ayibi ezinsukwini ezimbalwa zokuqala; isabela kwamanye ama-flavivirus njenge-Japanese encephalitis kanye ne-Zika, kanye nokugonywa kwangaphambili kwamanye ama-flavivirus |
| I-antibody ye-Dengue IgG | Ukutheleleka kwangaphambilini noma kwesibili | Kuhunyushwe nge-IgM kanye namasampula abhangqiwe | Umphumela owodwa we-IgG awukwazi ukukhomba ukutheleleka; kuvamile kubantu abatholakala benesifo esithathelwanayo. |
| I-Dengue RT-PCR | I-RNA egciwane; kanye ne-serotype | Cishe izinsuku ezinhlanu zokuqala zomkhuhlane | Ukutholakala okulinganiselwe, izindleko eziphezulu, kudinga ilabhorethri ekhethekile |
| Isibalo segazi esiphelele (CBC) | Ama-platelet, i-hematocrit, amaseli amhlophe | Kuphindaphindwa phakathi nokugula | Akuyona into eqondile ku-dengue; ayikwazi ukuqinisekisa ukuxilongwa kuphela |
| Ikhadi le-combo elisheshayo (NS1 + IgM + IgG) | Zonke ezintathu kudivayisi eyodwa | Kulula ezindaweni zokulaliswa esibhedlela | Ama-Rapid kit ngokuvamile asebenza kahle kakhulu kune-ELISA; umphumela wekhadi ongemuhle ungadinga ukuqinisekiswa kwelabhorethri |
Okunye okuhlukile: ukuhlolwa kwekhadi okusheshayo kwe-NS1 kanye ne-NS1 ELISA akuzona izivivinyo ezifanayo. I-ELISA ivame ukwenziwa elabhorethri enokulawulwa kwekhwalithi futhi ngokuvamile inikeza ukuzwela okungcono kunamakhadi okunakekelwa, yize ukusebenza kuyahlukahluka kuye ngomkhiqizi nangosuku lokugula.
Ungalungiselela kanjani
- Ukuzila ukudla: Akudingeki ekuhlolweni kwe-Dengue NS1. Uma ukuvakasha okufanayo kufaka phakathi ukuhlolwa kwe-fasting lipid noma i-glucose, landela imiyalelo enikeziwe yalolo vivinyo.
- Tshela ithimba usuku umkhuhlane wakho owaqala ngalo. Usuku lokugula luyisici esibaluleke kakhulu ekuchazeni umphumela we-NS1.
- Letha uhlu lwakho lwemithi, ikakhulukazi imithi yokunciphisa igazi, imithi yokunciphisa ama-platelet, ama-steroids noma imithi engeyona i-steroidal yokulwa nokuvuvukala. Ungayeki noma ushintshe noma yimuphi umuthi owunikezwe ngudokotela wena, khuluma nodokotela.
- Khuluma ngohambo lwakamuva ngaphakathi eNdiya noma kwamanye amazwe, kanye nanoma yikuphi ukugonyelwa kwangaphambilini kwe-dengue, i-chikungunya noma i-flavivirus.
- Ukuhambisa amanzi: Ukuphuza uketshezi okuvamile kwenza kube lula ukufinyelela emthanjeni. Abantu abanokuvinjelwa koketshezi ngenxa yokwehluleka kwenhliziyo, isifo sezinso esingamahlalakhona esiqhubeke isikhathi eside noma i-dialysis kufanele bagcine umkhawulo woketshezi obekwe udokotela wabo okwelaphayo.
Ukulungiselela, izidingo zesampula, uhlobo lwekhithi kanye nomkhuba wokubika kuyahluka phakathi kwamalebhu. Imiyalelo ebhaliwe evela eyunithi eyenza ukuhlolwa kwakho iza kuqala kunesiqondiso esijwayelekile.
Uma ukhulelwe
Ukuthatha amasampula egazi kuyinto evamile ngesikhathi sokukhulelwa. Udenga ngesikhathi sokukhulelwa ludinga ukubhekwa ngokucophelela ngesikhathi sokubeletha, ikakhulukazi lapho sekuzozalwa, ngakho-ke tshela ilabhorethri kanye nodokotela wakho wezifo zabesifazane.
Izingane
Kusetshenziswa amasampula amancane. Izinsana nezingane ezincane zingawohloka ngokushesha ngesikhathi sesigaba esibucayi, ngakho-ke ukubuyekezwa kwezingane kubaluleke kakhulu kunomphumela wokuhlolwa wodwa.
Abantu abadala kanye nabantu abanezinkinga zesikhathi eside
I-dengue ingase ivele ngendlela engavamile kubantu abadala nakubantu abanesifo sikashukela, isifo sezinso esingamahlalakhona noma ukwehluleka kwenhliziyo. Ukuphathwa koketshezi kula maqembu kubucayi futhi kufanele kuqashwe udokotela.
Abantu abasebenzisa imithi yokunciphisa igazi noma abanezinkinga zokopha
Tshela udokotela we-phlebotomist ngaphambi kokudonsa. Kufakwa ingcindezi eqinile futhi ende ngemuva kwalokho.
Kwenzekani ngesikhathi sokuhlolwa
- Ukubhaliswa kanye nokuqoqwa kwamasampula: Kufakwa i-tourniquet, isikhumba siyahlanzwa, bese igazi likhishwa emthanjeni osengalweni, ngokuvamile lifakwe epayipini elilula noma lejeli. Kwamanye ama-kit asheshayo, isampula yokuhlatshwa ngomunwe inganele.
- Isikhathi esithathiwe: ukudonswa kwezithombe ngokwako kuvame ukuthatha imizuzu emibili kuya kwemihlanu; lonke uhambo, okuhlanganisa nokubhalisa, kuvame ukuthatha imizuzu eyi-15 kuya kwengama-30 kuye ngokuthi isikhungo sokuqoqa simatasa kangakanani.
- Iyacubungula: umphumela wekhadi osheshayo uvela cishe emizuzwini eyi-15 kuya kwengama-20. I-ELISA ivame ukuhlanganiswa futhi ibikwe ngosuku olufanayo noma ngosuku olulandelayo lokusebenza, kuye ngesheduli yokusebenza yelabhorethri.
- Ngemva kwalokho: Akukho sikhathi sokululama esidingekayo. Ubuhlungu obuncane noma ukuphuka okuncane endaweni yokubhoboza kuvamile futhi kuziphelela ngokwako.
Ukuqonda umbiko wakho
Ukuhlolwa kwe-Dengue NS1 kubikwe ngokwekhwalithi.
- I-NS1 enhle / esabelayo: Kutholakale i-antigen ye-NS1, esekela ukutheleleka kwe-dengue okunamandla kumuntu onomkhuhlane ohambisanayo. Umphumela awubonisi ukuthi lesi sifo sizoba sibi kangakanani.
- I-NS1 engemihle / engaphenduli: I-antigen ye-NS1 ayitholakalanga kulesi sampula. I-dengue isangenzeka, ikakhulukazi uma isampula ithathwe kusenesikhathi kakhulu, ngemva kosuku lwesihlanu, noma ekuthelelekeni kwesibili. Umkhuhlane oqhubekayo udinga ukubuyekezwa futhi ngokuvamile ukuhlolwa kwe-IgM ngemva kosuku lwesihlanu.
- Okungalingani / umngcele: isignali iwele eduze komkhawulo wokuhlola. Ukuhlolwa okuphindaphindiwe noma enye indlela kuvame ukwelulekwa.
Eminye imibiko ye-ELISA ikhombisa inani le-index noma le-optical density. Lelo nani lihlobene nesignali yokuhlola, hhayi ubukhali besifo noma umthwalo wegciwane nganoma iyiphi indlela engasetshenziswa ngokwezokwelapha. Sicela ungalifundi i-index ephezulu ngokuthi "i-dengue enzima". Ubunzima buhlolwa ngezibonakaliso zesexwayiso zezokwelapha kanye nokubalwa kwegazi okulandelanayo, futhi umphumela kumele uhunyushwe ngudokotela ocele ukuhlolwa.
Uma imiphumela ingadukisa
Kuyiphutha ngokungeyikho (umkhuhlane we-dengue ukhona, i-NS1 ayitholakali)
- Isampula ithathwe ngemva kosuku lwesihlanu kuya kwelesikhombisa lomkhuhlane, lapho i-NS1 isiphelile ngokuphelele.
- Ukutheleleka kwesibili kwe-dengue, lapho i-IgG ekhona ibopha khona i-NS1 kuma-immune complexes.
- Ukuthatha amasampula kusenesikhathi kakhulu emahoreni ambalwa okuqala komkhuhlane.
- Ama-rapid kit aphansi uma kuqhathaniswa ne-ELISA.
- Ukwehluka okuhlobene ne-serotype ekutholakaleni kokuhlolwa.
- Izinkinga zokuphatha amasampula, ukubambezeleka, ukugcinwa okungafanele noma i-hemolysis.
Kutholakale ukuthi kunegciwane elingelona iqiniso (kutholakale ukuthi i-NS1 ayiyona imbangela)
- Ukusabela okuhlangene namanye ama-flavivirus asakazeka ezingxenyeni ezithile zaseNdiya, njenge-encephalitis yaseJapan noma i-Zika, kuye kwachazwa ngokuhlolwa okuthile.
- Ukuphazamiseka okuvela ku-rheumatoid factor noma amazinga aphezulu ama-antibodies athile ngama-kit athile.
- Ukufunda kabi umugqa ongabonakali ekhadini elisheshayo, noma ukufunda ikhadi ngaphandle kwesikhathi somkhiqizi.
- Ukuhlolwa kumuntu onethuba eliphansi lokuhlolwa, isibonelo, ongenawo umkhuhlane, okwandisa isilinganiso semiphumela emihle engamanga.
Ngenxa yale miphumela, umphumela we-NS1 ufundwa kanye nosuku lokugula, izimpawu, umsebenzi wokuqubuka kwendawo kanye nenani eliphelele legazi.
Izingozi nokuphepha
Isampula yegazi lemithambo yegazi (i-ELISA noma ukuhlolwa kwelebhu)
Izingozi zincane futhi ikakhulukazi zendawo: ubuhlungu obufushane, ukudumba, ikhanda elikhanyayo, kanye nokuqoqwa kwegazi okuncane ngaphansi kwesikhumba noma ukutheleleka endaweni yokubhoboza. Ukudumba kungenzeka kakhulu ku-dengue uqobo ngoba inani lama-platelet liyehla, nakubantu abathatha imithi yokunciphisa igazi.
Isampula yomunwe (ikhadi elisheshayo)
Ukungakhululeki kufushane futhi ukopha kuncane, yize inani eliphansi lama-platelet lingase lihlale isikhathi eside likhipha amanzi kancane.
Ingozi yokwenza okuthile ngomphumela wodwa
Ingozi ebaluleke kakhulu iwukuchaza, hhayi inqubo: ukuphatha umphumela we-NS1 ongemuhle njengobufakazi bokuthi udenga alukho kanye nokuyeka ukuqapha. Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye.
Amafulegi abomvu: nini ukufuna usizo
Isimo esiphuthumayo manje
- Ukopha okungayeki, okuvela ezinsinini, ekhaleni, ekuhlanzeni okufana nokugcotshwa kwekhofi, indle emnyama, noma ukopha okukhulu kwesitho sangasese sowesifazane.
- Isikhumba esibandayo, esinomswakama noma esinamabala, ukushaya kwenhliziyo okusheshayo okubuthakathaka, ukuquleka, noma ukuwa.
- Ukuphefumula kanzima noma ubunzima bokuphefumula.
- Ukudideka, ukozela, ukuxhuzula, noma ukuba nzima ukukuvusa.
- Ezinganeni: ukwenqaba ukuncelisa, ukungachami amahora amaningi, ukudinwa, noma ukuhlanza okuqhubekayo.
Ngosuku olufanayo
- Ubuhlungu besisu obukhulu noma obuqhubekayo, noma ukuhlanza okuqhubekayo.
- Uma umkhuhlane uphela kodwa umuntu ezizwa kabi, lokhu kuvame ukuphawula isigaba esibucayi, ngokuvamile cishe ezinsukwini ezintathu kuya kweziyisikhombisa.
- Ukwehla kokukhishwa komchamo, ukoma okuphawulekayo, noma ukungakwazi ukugcina uketshezi luphansi.
- Ukuminyana okusha, i-petechiae (ukubonisa amabala abomvu), noma izinsini eziphuma igazi.
- Umkhuhlane ngesikhathi sokukhulelwa, kusana, noma kumuntu onesifo sikashukela, isifo sezinso esingamahlalakhona, ukwehluleka kwenhliziyo noma osebenzisa imithi yokunciphisa ukugabha kwegazi.
I-aphoyintimenti ejwayelekile
- Umkhuhlane uyaphela ngaphandle kwezimpawu zokuxwayisa, ukuze kubalwe igazi eliphindaphindwayo njengoba kuceliwe.
- Ukukhathala okuqhubekayo, isimo sengqondo esiphansi noma ubuhlungu bamalunga emasontweni alandela udenga.
- Ukulahlekelwa izinwele noma ukungakuthandi ukudla ngesikhathi sokululama.
Izimo ezikhethekile
ukukhulelwa
Umkhuhlane we-dengue ngesikhathi sokukhulelwa uhlotshaniswa nezingozi ezengeziwe ezihlanganisa ukopha ngesikhathi sokubeletha kanye nokubeletha ngaphambi kwesikhathi. Ukuhlolwa kwe-NS1 kwenziwa ngendlela efanayo. Ukunakekelwa kuvame ukwabelwana phakathi kwababelethisi nodokotela.
Izingane
Izingane zingase zibukeke kahle ngokukhohlisa zisencane bese ziwohloka ngokushesha ngesikhathi esibucayi. Ibhalansi yoketshezi kanye nokukhishwa komchamo kubaluleke kakhulu njenganoma yimuphi umphumela welabhorethri.
Abantu abadala abadala
Umkhuhlane ungase ungabonakali kakhulu futhi ukudideka noma ukuwa kungase kuqhubeke. Isifo senhliziyo noma sezinso esikhona kanye kanye sinciphisa ithuba eliphephile lokwelashwa ngoketshezi.
Isifo sikashukela ekwelashweni kokwehlisa ushukela
Ukuphuza kabi ngesikhathi somkhuhlane kungabangela ushukela wegazi ophansi kubantu abasebenzisa i-insulin noma i-sulfonylureas. Ungazishintshi izilinganiso ngokwakho, xhumana nodokotela ukuze uthole iseluleko futhi uqaphe i-glucose kaningi.
Isifo sezinso esingamahlalakhona kanye nokwehluleka kwenhliziyo
Kokubili ukuphelelwa amanzi emzimbeni kanye noketshezi oluningi kuyingozi kula maqembu. Iseluleko soketshezi esinikezwa umuntu omdala onempilo one-dengue singase singaphephile lapha, ngakho landela imiyalelo yomuntu ngamunye.
Izinkinga zokopha ezaziwayo noma ukwelashwa kwe-anticoagulant
Lokhu kukhulisa ingozi yokopha uma ama-platelet ehla. Ukubuyekezwa kwezokwelapha kusenesikhathi kufanelekile.
Ukuhlolwa kwe-Dengue NS1 kumongo waseNdiya
- Isikhathi sonyaka: Ukusabalala kodenga eNdiya kuyanda ngesikhathi nangemva kwemvula, yize amacala enzeka unyaka wonke ezingxenyeni eziseningizimu nasentshonalanga.
- Ukusabalala kanye nokutheleleka kwesibili: Zonke izinhlobo ezine ze-DENV serotypes zijikeleza eNdiya. Ukutheleleka okuphindaphindiwe nge-serotype ehlukile kuvamile, futhi ukutheleleka kwesibili kunciphisa ukuzwela kwe-NS1, okuyisizathu esibalulekile sokungaphathi umphumela we-NS1 ongemuhle njengokuqinisekisa.
- Imfiva ejikeleza igazi kanyekanye: Umalaleveva, i-chikungunya, i-scrub typhus, i-leptospirosis kanye nomkhuhlane wamathumbu kuyafana ngokwezokwelapha ne-dengue. Odokotela bavame ukuhlola eziningana ngesikhathi esisodwa.
- Ukubhekwa: I-National Center for Vector Borne Diseases Control (NCVBDC, eyayiyi-NVBDCP) iqoqa idatha yamacala odenga kanye nokufa eNdiya, kanti i-National Guidelines for Clinical Management of Dengue Fever inika ulwazi ngesibhedlela.
- Isexwayiso sokuzelapha: I-aspirin kanye nama-NSAID afana ne-ibuprofen kanye ne-diclofenac ngokuvamile ayagwenywa uma kusolwa ukuthi udenga lubangelwa ingozi yokopha. Ungayiqali noma uyeke imithi ngaphandle kweseluleko sikadokotela.
- Itemu: Iziguli kanye nemitholampilo bavame ukuthi "ukuhlolwa kwamakhadi e-dengue" kwekhithi ye-NS1 esheshayo kanye "nenani lama-platelet" le-CBC, kokubili kuyingxenye yokuhlolwa okufanayo kodwa kulinganisa izinto ezihlukile.
Izindleko kanye nomshuwalense eNdiya
Izindleko zokuhlolwa kwe-Dengue NS1 ziyahlukahluka kakhulu phakathi kwamadolobha, phakathi kwezikhungo zikahulumeni nezizimele, kanye naphakathi kwefomethi yekhadi esheshayo kanye ne-ELISA. Izindleko ezicashunwe ku-inthanethi ziyizinkomba kuphela; qinisekisa intengo yamanje nelabhorethri ngaphambi kokuhlola.
Izici ezithinta izindleko:
- Indlela esetshenzisiwe, ikhadi le-immunochromatographic elisheshayo uma liqhathaniswa ne-ELISA yelabhorethri.
- Kungakhathaliseki ukuthi i-NS1 i-odwa yodwa noma njengephaneli ene-IgM, i-IgG kanye nokubalwa kwegazi okuphelele.
- Ukucutshungulwa okuphuthumayo, izibalo noma ngemva kwamahora kuvame ukubiza kakhulu.
- Imali yokuqoqa amasampula ekhaya.
- Uhlobo lwesikhungo kanye nesimo sokugunyazwa kwelabhorethri.
- Idolobha kanye nesifundazwe; ohulumeni bezifundazwe abathile banciphisa izindleko zokuhlolwa kwe-dengue ngesikhathi sokuqubuka kwalesi sifo.
Umshwalense: izivivinyo zelebhu ezingalaliswa esibhedlela ngokuvamile azikhokhelwa ngaphandle kokuthi inqubomgomo ifaka ikhava ye-OPD noma inzuzo yokuxilonga. Uma udenga luholela ekungenisweni esibhedlela, uphenyo ngesikhathi sokwamukelwa luvame ukumbozwa ngokuya ngemigomo yenqubomgomo, izikhathi zokulinda kanye nemikhawulo engaphansi. Izinhlelo zikahulumeni kanye nomshwalense wezempilo kahulumeni zingamboza ukuhlolwa ezindaweni ezihlanganisiwe. Hlola nomshwalense noma ideski lokukhokhisa esibhedlela.
Izinganekwane namaqiniso
| Inganekwane | Iqiniso |
|---|---|
| Umphumela we-NS1 ongemuhle usho ukuthi awunayo i-dengue. | I-NS1 ingaba negative ku-dengue yangempela, ikakhulukazi ngemva kosuku lwesihlanu kanye nasekuthelelekeni kwesibili. Ukubuyekezwa kwezokwelapha kanye nokuhlolwa kwe-IgM kungase kusadingeka. |
| I-NS1 enhle kakhulu isho udenga olubi kakhulu. | Ukuhlolwa kwe-NS1 empeleni kungokomgangatho. Ubunzima buhlulelwa ngezibonakaliso zesixwayiso, i-hematocrit kanye nokuthambekela kwama-platelet, hhayi ngamandla esignali ye-NS1. |
| Uma i-NS1 isithole ukuthi inegciwane, akusadingeki ukuhlolwa okwengeziwe. | Ukubalwa kwegazi okuphelele okulandelanayo phakathi nesigaba esibucayi ngokuvamile kuyithuluzi lokuqapha elibaluleke kakhulu. |
| I-Papaya leaf extract, kiwi noma ubisi lwembuzi luphatha i-dengue. | Lokhu akuzona izindlela zokwelapha ezisekelwe. Ubufakazi bokushintsha kwemiphumela yezokwelapha abwanele, futhi ukubambezeleka kokubuyekezwa kwezokwelapha kuyingozi. |
| Ukumpontshelwa ama-platelet kuyadingeka noma nini lapho ama-platelet ewa. | Ukufakwa kwegazi kugcinelwe izimo ezithile ezifana nokopha okukhulu, okunqunywa yithimba elilaphayo, hhayi inombolo yama-platelet kuphela. |
| Ukuba nodenga kanye kusho isivikelo sokuphila konke. | Ukungavikeleki komzimba kuncike ku-serotype. Ukutheleleka nge-serotype ehlukile kungenzeka futhi kungaba nengozi enkulu yesifo esibi. |
| Ukuhlolwa kwe-NS1 kungenziwa noma nini ngesikhathi sokugula. | Isikhathi sibalulekile. I-NS1 inolwazi kakhulu ezinsukwini zokuqala zomkhuhlane. |
Imibuzo ejwayelekile ukubuzwa
Iluphi usuku olungcono kakhulu lokwenza isivivinyo se-Dengue NS1?
Ukuhlolwa kwe-Dengue NS1 kusebenza kahle kakhulu kusukela osukwini lokuqala lomkhuhlane kuya cishe osukwini lwesihlanu. Ngemva kwalokho, amazinga e-antigen e-NS1 avame ukwehla futhi ukuhlolwa kuvame ukubuya ku-negative ngisho naku-dengue yangempela. Uma umkhuhlane wakho usuvele udlule izinsuku ezinhlanu noma ngaphezulu, udokotela wakho angase angeze noma akhethe ukuhlolwa kwe-dengue IgM.
I-NS1 yami ayinayo i-HIV kodwa ngisenomkhuhlane. Kuzokwenzekani ngokulandelayo?
Buyela kudokotela wakho. Umphumela we-NS1 ongemuhle uchaza lokho okungatholakalanga, hhayi okungekho. Kuye ngosuku lokugula, udokotela angaphinda ukuhlolwa, acele i-dengue IgM ngemva kosuku lwesihlanu, ahlele ukubalwa kwegazi okuphelele, noma aphenye ezinye izimbangela ezifana nomalaleveva, i-scrub typhus noma i-enteric fever.
Ingabe ukuhlolwa kwekhadi le-NS1 kuthembekile njenge-NS1 ELISA?
Akuvamile. Amakhadi asheshayo ayashesha futhi alula kodwa ngokuvamile awazweli kakhulu kune-ELISA yelabhorethri, futhi ukusebenza kuyahluka phakathi kwabakhiqizi. Umphumela wekhadi omuhle uvame ukwamukelwa ngokwezokwelapha, kanti umphumela wekhadi omubi esimweni esisolwa kakhulu ungalandelwa yi-ELISA noma ukuhlolwa okwengeziwe.
Ingabe ukuhlolwa kwe-NS1 kungitshela ukuthi nginawo yini ama-platelet?
Cha. Ukuhlolwa kwe-Dengue NS1 kuthola kuphela i-antigen yegciwane. Inani lama-platelet, i-hematocrit kanye nenani lamaseli amhlophe livela ekubalweni kwegazi okuphelele, okuwukuhlolwa okuhlukile futhi kuvame ukuphindwa izinsuku eziningana ngesikhathi se-dengue ukuze kulandelwe isigaba esibucayi.
Inqubo yonke ithatha isikhathi esingakanani?
Ukukhishwa kwegazi ngokwako kuthatha cishe imizuzu emibili kuya kwemihlanu, kanti ukuvakasha kuvame ukuba yimizuzu eyi-15 kuya kwengama-30. Umphumela wekhadi osheshayo uvela cishe ngemizuzu eyi-15 kuya kwengama-20. I-ELISA yelabhorethri ivame ukuhlanganiswa futhi ibikwe ngosuku olufanayo noma ngosuku olulandelayo lokusebenza, kuye ngesheduli yelabhorethri.
Ingabe i-NS1 ne-IgM zombili zingaba ne-positive ngesikhathi esisodwa?
Yebo. Kukhona isikhathi sokuhlangana, ngokuvamile cishe ezinsukwini ezine kuya kweziyisithupha zomkhuhlane, lapho i-antigen ye-NS1 isatholakala futhi ama-antibodies e-IgM eseqalile ukuvela. Le nhlanganisela isekela udenga olunamandla. Udokotela wakho uchaza iphethini kanye nosuku lokugula kanye nokubalwa kwegazi.
Ingabe kudingeka ngizile ukudla ngaphambi kokuhlolwa kwe-Dengue NS1?
Akukho ukuzila ukudla okudingekayo ekuhlolweni kwe-Dengue NS1. Yidla futhi uphuze ngokujwayelekile ngaphandle kokuthi unemikhawulo yoketshezi lwesifo senhliziyo noma sezinso, noma ngaphandle kokuthi olunye ukuhlolwa okwenziwa ngesikhathi esifanayo kudinga ukuzila ukudla. Landela imiyalelo ethile enikezwe yisikhungo sakho sokuqoqa ukudla.
Ingabe ukuhlolwa kwe-NS1 kungasho ukuthi nginaluphi uhlobo lwe-dengue?
Cha. Ukuhlolwa okujwayelekile kwe-NS1 kuthola i-antigen evamile ku-DENV-1 kuya ku-DENV-4 kodwa akubonisi ukuthi iyiphi i-serotype ebangela. Ukuhlonza i-serotype kudinga i-RT-PCR, esetshenziswa kakhulu emalabhorethri okudlulisela, ocwaningweni kanye nophenyo lokuqubuka kwesifo kunokunakekelwa kwesiguli okuvamile.
Ingabe kufanele ngiphinde ukuhlolwa kwe-NS1 ukuze ngihlole ukululama?
Ukuphinda i-NS1 ukuqinisekisa ukululama akusizi, ngoba i-antigen iyaphela ngokwemvelo kungakhathaliseki ukuthi ukugula kuqhubeka kanjani. Ukululama kwahlulelwa ngokwezokwelapha kanye nangokuthambekela kokubalwa kwama-platelet kanye ne-hematocrit. Xoxa nganoma yikuphi ukuhlolwa okulandelayo nodokotela ophethe ukunakekelwa kwakho.
Imithombo
- I-World Health Organization, i-Dengue kanye nephepha lamaqiniso kanye neziqondiso zokuxilonga, ukwelashwa, ukuvimbela kanye nokulawula.
- Isikhungo Sikazwelonke Sokulawulwa Kwezifo Ezithwalwa Yizilokazane (i-NCVBDC), uMnyango Wezempilo kanye Nenhlalakahle Yomndeni, uHulumeni waseNdiya, imibiko yesimo se-dengue kanye Neziqondiso Zikazwelonke Zokuphathwa Kwezokwelapha Komkhuhlane We-dengue.
- I-Indian Council of Medical Research, izeluleko mayelana nokuxilongwa kwelabhorethri ye-dengue.
- I-WHO/TDR, UDengue: Iziqondiso Zokuxilongwa, Ukwelashwa, Ukuvimbela Nokulawula.
