Umalaleveva

Umalaleveva yisifo esisongela ukuphila esisakazwa ngokulunywa umiyane. I-causative organism iyi-parasite ebizwa ngokuthi i-Plasmodium. Nakuba lesi sifo singavamile ezindaweni ezipholile, umalaleveva usadlangile emazweni ashisayo nashisayo. Lesi sifo sidluliselwa kubantu ngokulunywa umiyane i-Anopheles. Kunezinhlobo ezinhlanu ezahlukene umalaleveva-adala izimuncagazi ezingathinta abantu.

Lapho umiyane uluma, i-parasite idedelwa emgudwini wegazi. Ngaphakathi emzimbeni, izimuncagazi ziya esibindini, lapho zikhula khona futhi zivuthwe. Ngemva kwezinsuku ezimbalwa, izimuncagazi ezivuthiwe zingena emgudwini wegazi futhi ziqale ukuthelela ama-RBC. Emahoreni angama-48 kuya kwangama-72, izimuncagazi zikhula ngaphakathi kwama-RBC, okubangela ukuthi amangqamuzana anesifo aqhume avuleke. Amagciwane ayaqhubeka nokuthelela amanye ama-RBC, okuholela ezimpawu ezenzeka emijikelezweni ehlala izinsuku ezimbili kuya kwezintathu ngesikhathi. Lezi zimpawu zihlanganisa ukuhlaselwa okuphindaphindiwe kokubandayo & imfiva.

Ezimweni ezingavamile, umalaleveva uthathelwana usuka kumama uye enganeni engakazalwa lapho ekhulelwe, ngokumpontshelwa igazi, noma lapho abasebenzisa imijovo behlanganyela izinaliti.

Emhlabeni jikelele babalelwa ku-6,60,000 ababulawa umalaleveva unyaka ngamunye. Ukwanda kokuhamba kwamazwe ngamazwe kanye nokufuduka kwabantu, ingozi iye yanda ezindaweni lapho ingavamile ukwenzeka khona.

Kuvame kakhulu emazweni asathuthuka, ezindaweni ezinomswakama ophezulu kanye namazinga okushisa aphakathi nendawo. Lokhu kufaka phakathi izingxenye zeCentral & South America, Haiti, The Dominican Republic, Africa, Eastern Europe, and South & Southeast Asia. Izinhlobo ezibulala kakhulu zikamalaleveva zivame kakhulu e-Afrika. Ngokusho kwe-World Health Organization (WHO), unyaka ngamunye abantu abayizigidi ezingu-300-500 ze-malaria kwenzeka futhi abantu abangaphezu kwesigidi esisodwa babulawa umalaleveva, ikakhulukazi emazweni asathuthuka. Iningi labashonayo elezingane ezincane. E-Afrika, ingane ibulawa umalaleveva njalo ngemizuzwana engu-1. Ngenxa yokuthi umalaleveva udala ukugula okubi kakhulu nokufa, lesi sifo sidala ukuwohloka komnotho wezwe. Lesi sifo sigcina umjikelezo ononya wezifo nobumpofu emazweni ampofu.

Umalaleveva ubangelwa uhlobo lwesilokazane olwaziwa nge-Plasmodium. I-Plasmodium parasite isakazwa kakhulu omiyane besifazane i-Anopheles, abaluma kakhulu ebusuku nasebusuku.

Kunezinhlobo ezahlukene ze-Plasmodium parasite, kodwa yizinhlobo ezinhlanu kuphela ezibangela umalaleveva kubantu.

Lezi izi:

1. IPlasmodium falciparum – Itholakala kakhulu e-Afrika. Iwuhlobo oluyingozi kakhulu lwe-malaria futhi luyimbangela yokufa kwabantu abaningi umalaleveva emhlabeni jikelele.
2. I-Plasmodium vivax - Itholakala kakhulu e-Asia naseNingizimu Melika. I-parasite idala izimpawu ezithambile kune-Plasmodium falciparum. Lesi silokazane singahlala esibindini iminyaka efinyelela kwemithathu futhi sibangele ukuphindeka.
3. IPlasmodium i-ovale - Akuvamile futhi ivame ukutholakala eNtshonalanga Afrika. Ingahlala esibindini sakho iminyaka eminingana ngaphandle kokukhiqiza izimpawu.
4. IPlasmodium i-malaria - Lokhu kutholakala e-Afrika.
5. IPlasmodium knowlesi - Lokhu kutholakala ezingxenyeni eziseningizimu-mpumalanga ye-Asia

Izimpawu zikamalaleveva zingahlukaniswa zibe izigaba ezimbili: umalaleveva ongenzima noma oyinkimbinkimbi.

Umalaleveva ongaxakile

Kulesi simo izimpawu zikhona, kodwa azikho izimpawu zokutheleleka okukhulu noma ukungasebenzi kwezitho ezibalulekile. Leli fomu lingaba nzima uma lingelashwa, noma uma umsingathi unokutheleleka okuphansi noma kungenakho. Izimpawu zalolu hlobo lukamalaleveva ngokuvamile zihlala amahora angu-6 kuya kwayi-10 futhi zivela futhi njalo ngemva kwezinsuku ezimbili. Ezinye izinhlobo zalesi sitshalo zingaba nomjikelezo omude noma zibangele izimpawu ezixubile. Njengoba izimpawu zifana nalezo zomkhuhlane, zingase zingaxilongwa noma zihlonzwe ngokungeyikho ezindaweni lapho umalaleveva ungavamile khona.

Umalaleveva ongaxakile, izimpawu zihlanganisa:

• Ukuzwa amakhaza nokuqhaqhazela
• Imfiva, ikhanda, & oluhlanzayo
• ukuquleka kungenzeka kubantu abasha
• Ukujuluka kulandele ukululama ezingeni lokushisa elijwayelekile

Umalaleveva onzima

Umalaleveva onzima, ubufakazi bomtholampilo noma baselabhorethri bubonisa izimpawu zokungasebenzi kahle kwesitho esibalulekile.

Izimpawu zikamalaleveva onzima zihlanganisa:

• Umkhuhlane & amakhaza
• Ukulahlekelwa noma ukuphazamiseka kwengqondo
• Ukuqunjelwa nokukhathala
• Ukudlikizeka okuningi
• Ukuphefumula okujulile nokucindezeleka kokuphefumula
• Ukopha okungavamile nezimpawu i-anemia
• Imitholampilo jaundice kanye nobunye ubufakazi bokungasebenzi kahle kwesitho esibalulekile

Umalaleveva onzima kungaba yingozi ngaphandle kokwelashwa.

Isici esiyinhloko esiyingozi sokuthola umalaleveva ukuhlala noma ukuvakashela ezindaweni ezishisayo lapho isifo sivame khona. Kunezinhlobo ezingaphansi ezihlukahlukene zama-parasites zikamalaleveva. Izinhlobo ezibangela izinkinga ezibulala kakhulu ngokuvamile zitholakala ku:

• Amazwe ase-Afrika, eningizimu ye-Sahara Desert
• I-sub-continent yase-Asia
• Solomon Islands, Papua New Guinea naseHaiti

Ingozi yezifo ezinzima

Abantu abasengozini yokuthola izifo ezinzima bahlanganisa:

• Izingane ezincane nezinsana
• Abahambi abavela ezindaweni ezingenawo umalaleveva
• Abesifazane abakhulelwe kanye nezingane zabo ezingakazalwa

Ubumpofu, ukuntula ulwazi, kanye nokufinyelela okulinganiselwe noma okungekho ekunakekelweni kwezempilo kunomthelela ekufeni kukamalaleveva emhlabeni wonke.

Izakhamuzi zesifunda sikamalaleveva zingase zichayeke kulesi sifo kaningi kangangokuthi zithole ukuvikeleka ngokwengxenye, okunganciphisa ubukhali bezimpawu zikamalaleveva. Kodwa, lokhu kuvikeleka ngokwengxenye kungashabalala uma uthuthela ezweni lapho ungasachayeka khona njalo ezinambuzaneni.

• Izimpawu zikamalaleveva zingalingisa ezinye izifo eziningi, kuhlanganise Umkhuhlane noma i-viral syndrome. Ngakho-ke kubalulekile ukubuza ngomlando wohambo lwakamuva oluya endaweni ewugwadule noma okunye ukuchayeka okungaba khona.
• Kumelwe ufune usizo lwezokwelapha ngokushesha uma ugula ngenkathi uhamba endaweni lapho kutholakala khona umalaleveva, noma ngemva kokubuya ohambweni, ngisho noma ubudla amaphilisi okulwa nomalaleveva.
• Umalaleveva ungakhula ngokushesha okukhulu, ngakho kuyadingeka ukuthi uxilongwe futhi welashwe ngokushesha ngangokunokwenzeka.
• Uma ubona izimpawu zikamalaleveva ngenkathi uphuza amaphilisi e-antimalarial, kungaba ngenkathi usohambweni noma ezinsukwini nasemavikini ngemva kokubuya, khumbula ukutshela udokotela ukuthi yiluphi uhlobo obuluphuza. Uhlobo olufanayo lwe-antimalarial akufanele lusetshenziselwe ukwelapha nawe.
• Uma ubona izimpawu ngemva kokubuyela ekhaya, vakashela udokotela wakho jikelele noma udokotela wasesibhedlela futhi ubatshele ukuthi yimaphi amazwe ohambe kuwo ezinyangeni eziyi-12 ezidlule.
• Ukuxilongwa okulungile kwenziwa ngokubheka igazi lesiguli esinegciwane ngaphansi kwesibonakhulu (blood smear) nokuhlonza ubukhona be-parasite. Igazi lesiguli lilungiswa ngaphansi kwesilayidi esinebala elithile ukuze lisize ekuboneni i-parasite. Lokhu ukuhlola okwenziwa kakhulu futhi okwamukelwe.
• Izivivinyo zokuxilonga ngokushesha (ukuhlolwa kwe-antigen) ziyatholakala ezinganikeza ukuxilongwa emizuzwini embalwa. Kuyelulekwa ukuthi ukuhlolwa kulandelwe ukuhlolwa kwegazi.

Uma umalaleveva utholwa futhi welashwa ngokushesha, kungalindelwa ukululama okuphelele. Ukwelashwa kufanele kuqale ngokushesha lapho ukuhlolwa kwegazi kuqinisekisa umalaleveva.

Imithi eminingana ye-antimalarial isetshenziselwa ukwelapha lesi sifo. Zingasetshenziswa futhi ukuvimbela umalaleveva.

Uhlobo lomuthi we-antimalarial nokuthi kufanele uwuphuze isikhathi esingakanani kuzoncika kuwo

• Uhlobo lwe-malaria
• Lapho uthola khona umalaleveva
• Ubukhulu bezimpawu
• Ukuthi ngabe usebenzise amaphilisi e-antimalarial okuvimbelayo
• Ubudala
• Ukuthi ukhulelwe

Udokotela wakho angase asikisele ukusebenzisa inhlanganisela yemithi ehlukene yokulwa nomalaleveva ukwelapha izinhlobo zezimuncagazi zikamalaleveva esezikwazi ukumelana nezinhlobo ezithile zemithi.

Imithi ye-antimalarial ngokuvamile inikezwa njengamaphilisi noma amaphilisi. Uma othile egula kakhulu, uzonikezwa njengomjovo noma ukumnika engalweni esibhedlela. Ukwelashwa umalaleveva kungakwenza uzizwe ukhathele kakhulu futhi ubuthakathaka amasonto amaningi.

Imithi elwa nomalaleveva evame kakhulu ihlanganisa

• I-Chloroquine (Aralen)
• I-Hydroxychloroquine (i-Plaquenil)
• I-quinine sulfate (i-Qualaquin)
• I-Mefloquine
• Inhlanganisela ye-atovaquone ne-proguanil (Malarone)

Ukwelashwa kokuvimbela

Ezimweni ezimbalwa, ungase unikezwe imithi ye-malaria ngaphambi kokuba uhambe. Lokhu kwenziwa uma kunobungozi bokuthi ungenwe umalaleveva ngenkathi uya endaweni enabantu abaningi abanesifo sikamalaleveva kanye nokufinyelela okulinganiselwe ekunakekelweni kwezempilo.

Ama-Antimalari ngesikhathi sokukhulelwa

Uma ukhulelwe, kuphakanyiswa ukuthi ugweme ukuya ezindaweni lapho kunobungozi khona umalaleveva.

Abesifazane abakhulelwe banengozi eyengeziwe yokuthola umalaleveva onzima, futhi bobabili ingane nomama bangase bahlangabezane nezinkinga ezinzima. Kubalulekile ukuphuza imithi efanele ye-antimalarial uma ukhulelwe futhi ungakwazi ukuhlehlisa/ukukhansela ukuvakasha kwakho endaweni lapho kunobungozi khona umalaleveva. Eminye yemithi esetshenziselwa ukuvikela nokwelapha umalaleveva ayibafanele abesifazane abakhulelwe ngoba ingabangela imiphumela engemihle kubo bobabili umama nengane.

Lokhu kufaka phakathi

• I-Mefloquine - okungajwayelekile ukunqunywa ku-trimester yokuqala yokukhulelwa. Ukukhulelwa kufanele kugwenywe phakathi nezinyanga ezintathu zokuqala ngemva kokumiswa kwemithi yokuvimbela umalaleveva.
• I-Doxycycline - akakaze alulekwe kwabesifazane abakhulelwe noma abancelisa ibele ngoba lokho kungalimaza ingane.
• I-Atovaquone plus proguanil – akukhuthazwa ngesikhathi sokukhulelwa noma encelisa. Noma kunjalo, uma ingozi yokuba umalaleveva iphezulu, bangase belulekwe uma ingekho enye indlela efanelekile.
• I-Chloroquine kanye ne-proguanil ifanelekile ngesikhathi sokukhulelwa, kodwa ayisetshenziswa ngaso sonke isikhathi njengoba ingasebenzi ngokumelene nohlobo oluvame kakhulu noluyingozi lwe-malaria.

Kukhona ingozi yokuthola umalaleveva uma uya endaweni ethintekile. Kubalulekile ukunakekela ukuvikela lesi sifo. Umalaleveva ngokuvamile ungagwenywa ngokusebenzisa indlela ye-ABCD yokuvimbela:

• Ukuqwashisa ngengozi – hlola ingozi yokuthola umalaleveva.
• Ukuvimbela ukuluma – gwema ukulunywa omiyane ngokusebenzisa into exosha izinambuzane, ukumboza izingalo nemilenze yakho, noma ngokusebenzisa inetha lomiyane.
• Hlola ukuthi uyawadinga yini amaphilisi okuvimbela umalaleveva – uma wenza kanjalo, qiniseka ukuthi uphuza amaphilisi e-antimalarial afanele ngethamo elifanele futhi uqedele isifundo.
• Sifo - cela izeluleko zezempilo ngokushesha uma unezimpawu zikamalaleveva kuze kube unyaka ubuyile ohambweni.

Ukuqwashisa ngengozi

Hlola ukuthi ingabe udinga ukuthatha imithi yokuvimbela umalaleveva emazweni owavakashelayo. Kuyadingeka futhi ukuthi uvakashele udokotela wakho jikelele noma umtholampilo wezokuvakasha wendawo ukuze uthole ulwazi lukamalaleveva ngokushesha nje lapho wazi ukuthi uzohambelaphi. Kusadingeka uthathe izinyathelo zokuphepha ukuze uzivikele ekungenweni izifo uma uya endaweni esengozini, ngisho noma wakhulela ezweni elivame kakhulu umalaleveva. Akekho umuntu ongagonywa ngokuphelele umalaleveva futhi noma yiliphi izinga lokuvikelwa kwemvelo okungenzeka ukuthi ube nalo liyalahleka ngokushesha lapho uphuma endaweni esengozini.

Ukuvimbela ukuluma

Ukuze ugweme ukulunywa omiyane:

• Hlala ezindaweni ezine-air conditioning esebenza kahle futhi zihlola iminyango namafasitela. Uma lokhu kungenzeki, qiniseka ukuthi iminyango namafasitela kuvaleka kahle.
• Sebenzisa isixosha izinambuzane esikhumbeni sakho nasezindaweni zokulala. Khumbula ukuphinda usifake njalo. Izixosha ezisebenza kahle kakhulu ziqukethe i-diethyltoluamide (DEET) futhi zitholakala kuzifutho, ama-roll-ons, izinti namakhilimu.
• Gqoka ibhulukwe elilula, elixegayo kunezikhindi, namahembe anemikhono emide. Lokhu kubaluleke kakhulu kusihlwa nasebusuku lapho omiyane bethanda ukudla.

Hlola ukuthi uyawadinga yini amaphilisi okuvimbela umalaleveva

Okwamanje awukho umuthi wokugoma otholakala kalula onikeza isivikelo kumalaleveva, ngakho-ke kuyadingeka ukuthi uphuze imithi elwa nomalaleveva ukuze unciphise amathuba akho okuthola lesi sifo.

Imithi elwa nomalaleveva inciphisa kuphela ingozi yokutheleleka cishe ngama-90%. Ngakho-ke ukuthatha izinyathelo zokugwema ukulunywa nakho kubalulekile.

Izinhlobo zemithi ye-antimalarial esetshenziselwa ukuvimbela umalaleveva

Imithi ye-antimalarial isetshenziselwa ukuvimbela umalaleveva. Izinhlobo zemithi elwa nomalaleveva esetshenziselwa ukwelapha noma ukuvimbela umalaleveva zinikezwe ngezansi.

I-Atovaquone + proguanil

• Isikali – Umthamo omdala ithebhulethi eyodwa yamandla abantu abadala ngosuku. Umthamo wezingane uncike esisindweni somntwana. Kufanele iqalwe usuku olulodwa noma ezimbili ngaphambi kohambo lwakho futhi ithathwe nsuku zonke usendaweni engcuphe. Amaphilisi kufanele aqhutshekwe izinsuku eziyisikhombisa ngemva kokubuya.
• Izincomo - akukhuthazwa kwabesifazane abakhulelwe noma abancelisa ibele. Ayelulekwa futhi kubantu abanenkinga enkulu yezinso.
• Imiphumela emibi engaba khona - ukuphazamiseka kwesisu, ubuhlungu bekhanda, ukuqubuka kwesikhumba kanye nezilonda emlonyeni.

I-Doxycycline

• Isikali – umthamo ngu-100mg nsuku zonke njengethebhulethi/i-capsule. Kufanele uqale imithi ezinsukwini ezimbili ngaphambi kokuba uhambe futhi uyiphuze usuku ngalunye usendaweni esengozini, futhi amasonto amane ngemva kokubuya.
• Izincomo – akubafanele abesifazane abakhulelwe noma abancelisa ibele, izingane ezingaphansi kweminyaka engu-12 (ngenxa yengozi yokushintsha kombala wamazinyo unomphela), abantu abazwelayo kuma-antibiotic e-tetracycline, noma abantu abanezinkinga zesibindi.
• Imiphumela emibi engaba khona - isisu esibuhlungu, ukushaya kwenhliziyo, i-thrush kanye nokushiswa yilanga ngenxa yokuzwela ukukhanya.

I-Mefloquine

• Isikali – umthamo wabadala ithebhulethi eyodwa ngesonto. Isilinganiso sengane siphinde sibe kanye ngesonto, kodwa inani lizoxhomeka esisindweni sabo. Kufanele iqalwe amasonto amathathu ngaphambi kokuthi uhambe futhi ithathwe ngaso sonke isikhathi usendaweni esengozini, futhi iqhubeke amaviki amane ngemva kokubuya.
• Izincomo – akunconywa uma umuntu ehlushwa isithuthwane, ukuquleka, ukudangala noma ezinye izinkinga zempilo yengqondo, noma uma isihlobo esiseduze sinanoma iyiphi yalezi zimo. Akuvamile ukululekwa kubantu abanezinkinga ezinzima zenhliziyo noma zesibindi.
• Imiphumela emibi engaba khona - isiyezi, ikhanda elibuhlungu, ukuphazamiseka kokulala (ukuqwasha & namaphupho acacile) & ukusabela kwengqondo (ukukhathazeka, ukudangala, ukuhlaselwa ukwethuka kanye nokubona izinto ezingekho). Kubalulekile ukutshela udokotela nganoma yiziphi izinkinga zempilo yengqondo zangaphambilini, kuhlanganise nokucindezeleka okuncane. Ungawuphuzi lo muthi uma unesifo sokuwa.

I-Chloroquine ne-proguanil

Inhlanganisela yemithi elwa nomalaleveva ebizwa ngokuthi i-chloroquine & proguanil nayo iyatholakala kodwa ngokuvamile ayisebenzi ngokumelene ne-Plasmodium falciparum.

Uhlale welulekwa ukuthi uphuze umuthi we-antimalarial uma uya ezindaweni lapho kunobungozi khona umalaleveva. Vakashela udokotela wakho ojwayelekile noma umtholampilo wezokuvakasha wendawo ukuze uthole iseluleko sikamalaleveva ngokushesha nje lapho wazi ukuthi uzohamba nini nalapho uzohamba khona.

Kudingeka ukuthatha umthamo ofanele futhi uqedele inkambo yemithi elwa nomalaleveva. Uma ungabaza, buza udokotela wakho jikelele noma udokotela wezidakamizwa ukuthi kufanele uphuze isikhathi esingakanani imithi yakho.

I-DEET exosha izinambuzane

Ikhemikhali i-DEET ivamise ukusetjenziswa ezinto ezixosha izinambuzane. Ayelulekwa ezinganeni ezingaphansi kwezinyanga ezimbili ubudala. I-DEET iphephile ezinganeni ezindala, abantu abadala nabesifazane abakhulelwe.

• Sebenzisa esikhumbeni esiveziwe
• Ungafutha ngqo ebusweni bakho – fafaza ezandleni zakho bese umbambatha ebusweni bakho
• Gwema ukuthintana ngezindebe namehlo
• Geza izandla ngemuva kokusebenzisa
• Ungayifaki esikhumbeni esilimele noma esicasuliwe
• Qinisekisa ukuthi usebenzisa i-DEET ngemva kokufaka i-sunscreen, hhayi ngaphambili

1. Umuntu uwuthola kanjani umalaleveva?

Lapho umiyane othwele i-parasite ye-malaria uluma, lesi silwane siphuma singene egazini futhi sibangele umalaleveva

1. Usakazwa kanjani umalaleveva?

Umalaleveva usakazwa ukulunywa wumiyane.

1. Yiziphi izimpawu zikamalaleveva onzima?

Umalaleveva onzima

Umalaleveva onzima, ubufakazi bomtholampilo noma baselabhorethri bubonisa izimpawu zokungasebenzi kahle kwesitho esibalulekile.

Uphawums umalaleveva onzima zihlanganisa:

• umkhuhlane & amakhaza
• ukwazi kahle
• ukukhothama, noma ukuthatha indawo ethambekele
• ukudlikizeka okuningi
• ukuphefumula okujulile nokucindezeleka kokuphefumula
• ukopha okungavamile kanye nezimpawu ze-anemia
• i-jaundice yomtholampilo nobufakazi bokungasebenzi kahle kwesitho esibalulekile

1. Yiziphi ezivame kakhulu i-antimi-alarial izidakamizwa ezisetshenzisiwe?

• I-Chloroquine (Aralen)
• I-Hydroxychloroquine (i-Plaquenil)
• I-quinine sulfate (i-Qualaquin)
• I-Mefloquine
• Inhlanganisela ye-atovaquone ne-proguanil (Malarone)

Izinkinga zikamalaleveva

Izimpawu zikamalaleveva

Ukuxilonga Umalaleveva

Ukwelapha Umalaleveva

Ukuvimbela Umalaleveva