nkhani

M'mwezi uno, bungwe la World Health Organisation (WHO) lidalengeza kuti milandu ya nyani yakula ku Democratic Republic of Congo (DRC) ndi mayiko angapo aku Africa, zomwe zikupangitsa kuti pakhale vuto lazaumoyo padziko lonse lapansi.
Zaka ziwiri zapitazo, kachilombo ka monkeypox kamadziwika kuti ndi vuto ladzidzidzi lapadziko lonse lapansi chifukwa chakufalikira m'maiko angapo, kuphatikiza China, komwe kachilomboka sikanali kofala. Komabe, mu Meyi 2023, pomwe milandu yapadziko lonse lapansi ikucheperachepera, mkhalidwe wadzidzidziwu udathetsedwa.
Vuto la nyani lafikanso, ndipo ngakhale sipanakhalepo milandu ku China pano, zonena zomveka kuti kachilomboka kamafalikira kudzera kulumidwa ndi udzudzu zasefukira pamasamba aku China.
Kodi zifukwa zomwe WHO yachenjeza ndi ziti? Kodi zatsopano za mliriwu ndi zotani?
Kodi mtundu watsopano wa kachilombo ka monkeypox udzafalikira ndi madontho ndi udzudzu?

Kodi matenda a nyanipox ndi chiyani?
Kodi pali katemera woteteza nyani ndi mankhwala ochiza?
Kodi anthu ayenera kudziteteza bwanji?

N’chifukwa chiyani ukulandiranso chidwi?
Choyamba, pakhala kuwonjezeka kwakukulu komanso kofulumira kwa milandu ya nyani chaka chino. Ngakhale kuti milandu ya nyani yakhala ikupitirirabe ku DRC kwa zaka zambiri, chiwerengero cha milandu yomwe yanenedwa m'dzikoli chawonjezeka kwambiri mu 2023, ndipo chiwerengero cha milandu mpaka pano chaka chino chapitirira chaka chatha, ndipo chiwerengero cha milandu yoposa 15600, kuphatikizapo 537 imfa. Monkeypox virus ili ndi nthambi ziwiri za majini, I ndi II. Zomwe zilipo zikusonyeza kuti zizindikiro zachipatala zomwe zimayambitsidwa ndi kachilombo ka monkeypox ku DRC ndizovuta kwambiri kuposa zomwe zimayambitsidwa ndi mliri wa 2022. Pakali pano, pafupifupi mayiko 12 a mu Africa anenapo za matenda a nyani, ndipo Sweden ndi Thailand onse akufotokoza za nyani zomwe zatumizidwa kunja.

Kachiwiri, milandu yatsopanoyi ikuwoneka kuti ndi yovuta kwambiri. Pali malipoti kuti chiwerengero cha imfa ya nyanipox HIV nthambi I matenda ndi mkulu monga 10%, koma katswiri ku Belgian Institute of Tropical Medicine amakhulupirira kuti zochulukira mlandu deta pa zaka 10 zapitazi zikusonyeza kuti mlingo wa imfa ya nthambi I ndi 3% yokha, yomwe ndi yofanana ndi chiwerengero cha imfa ya nthambi II matenda. Ngakhale kuti kachilombo ka nyani komwe kamene kamapezeka kumene ku nthambi ya Ib ili ndi kachilombo koyambitsa matenda kwa anthu ndipo imafalikira mofulumira m'madera ena, deta ya epidemiological panthambiyi ndi yochepa kwambiri, ndipo DRC sangathe kuyang'anitsitsa kufalitsa kachilombo ka HIV ndikuwongolera mliri chifukwa cha zaka za nkhondo ndi umphawi. Anthu samamvetsabe zambiri zofunika kachilombo, monga kusiyana pathogenicity pakati osiyana HIV nthambi.
Atalengezanso kuti kachilombo ka monkeypox ndi vuto ladzidzidzi lomwe likufunika padziko lonse lapansi, WHO ikhoza kulimbikitsa ndikugwirizanitsa mgwirizano wapadziko lonse, makamaka kulimbikitsa mwayi wopeza katemera, zida zowunikira matenda, komanso kulimbikitsa chuma kuti agwiritse ntchito bwino kupewa ndi kuwongolera miliri.
Makhalidwe atsopano a mliri
Monkeypox virus ili ndi nthambi ziwiri za majini, I ndi II. Chaka cha 2023 chisanafike, IIb ndiye kachilombo kamene kamafala padziko lonse lapansi. Pakadali pano, zapha pafupifupi 96000 ndipo anthu osachepera 184 afa m'maiko 116. Kuyambira 2023, miliri yayikulu ku DRC yakhala munthambi ya Ia, ndipo pafupifupi 20000 omwe akukayikira kuti ali ndi nyani; Pakati pawo, milandu 975 yomwe akuganiziridwa kuti yapha nyani inachitika, makamaka mwa ana azaka 15 kapena kuchepera. Komabe, kachilombo kumene nyanipox HIV Ⅰ b nthambi tsopano kufalikira ku mayiko anayi Africa, kuphatikizapo Uganda, Kenya, Burundi ndi Rwanda, komanso Sweden ndi Thailand, mayiko awiri kunja kwa Africa.
Chiwonetsero chachipatala
Monkeypox imatha kupatsira ana ndi akulu, nthawi zambiri m'magawo atatu: nthawi yobisika, nthawi ya prodromal, ndi nthawi yotupa. Avereji ya nthawi imene nyani wangobadwa kumene ndi incubation ndi masiku 13 (kusiyana, masiku 3-34). Gawo la prodromal limatenga masiku 1-4 ndipo nthawi zambiri limadziwika ndi kutentha thupi kwambiri, mutu, kutopa, komanso kukulitsa ma lymph node, makamaka khosi ndi nsagwada zakumtunda. Kukula kwa ma lymph node ndi chikhalidwe cha nyanipox chomwe chimasiyanitsa ndi nkhuku. Panthawi ya kuphulika kwa masiku 14-28, zotupa zapakhungu zimagawidwa m'njira ya centrifugal ndipo zimagawidwa m'magulu angapo: macules, papules, matuza, ndipo potsiriza pustules. Chotupa cha khungu ndi cholimba komanso cholimba, chokhala ndi malire omveka bwino komanso kukhumudwa pakati.
Zilonda zapakhungu zimayamba nkhanambo ndi kukhetsedwa, zomwe zimapangitsa kuti malo ofananirako asakhale ndi utoto wokwanira pambuyo pokhetsa, kenako ndikuthira mitundu yambiri. Zilonda zapakhungu za wodwalayo zimayambira pang'ono mpaka zikwi zingapo, makamaka zomwe zimakhala pankhope, thunthu, mikono, ndi miyendo. Zilonda zapakhungu nthawi zambiri zimachitika m'manja ndi m'mapazi, zomwe zimawonetsa nyani mosiyana ndi nkhuku. Nthawi zambiri, zotupa zonse zapakhungu zimakhala pamlingo womwewo, womwe ndi chikhalidwe china chomwe chimasiyanitsa nyani ndi matenda ena owonetsa pakhungu monga nkhuku. Odwala nthawi zambiri amamva kuyabwa ndi kupweteka kwa minofu. The kuopsa kwa zizindikiro ndi nthawi ya matenda mwachindunji mogwirizana ndi kachulukidwe zotupa pakhungu. Matendawa ndi ovuta kwambiri kwa ana ndi amayi apakati. Monkeypox nthawi zambiri imakhala ndi njira yodziletsa, koma nthawi zambiri imasiya mawonekedwe oyipa monga zipsera kumaso.

Njira yotumizira
Monkeypox ndi matenda a zoonotic, koma mliri wapanowu umafala makamaka pakati pa anthu polumikizana kwambiri ndi odwala anyani. Kukhudzana kwambiri kumaphatikizapo kukhudza khungu ndi khungu (monga kukhudza kapena kuchita zogonana) ndi pakamwa ndi pakamwa kapena pakamwa ndi khungu (monga kupsopsonana), komanso kuyang'ana maso ndi maso ndi odwala anyanipox (monga kuyankhulana kapena kupuma pafupi wina ndi mzake, zomwe zingabweretse tizilombo toyambitsa matenda opatsirana). Pakalipano, palibe kafukufuku wosonyeza kuti kulumidwa ndi udzudzu kungathe kufalitsa kachilombo ka monkeypox, ndipo poganizira kuti kachilombo ka nyani ndi nthomba zimakhala zamtundu womwewo wa orthopoxvirus, ndipo kachilombo ka nthomba sikungafalikire kudzera mu udzudzu, mwayi wofalitsa kachilombo ka monkeypox kudzera mu udzudzu ndi wotsika kwambiri. Kachilombo ka nyani kamakhalabe kwa nthawi yayitali pa zovala, zogona, zopukutira, zinthu, zida zamagetsi, ndi malo omwe odwala anyani akumana nawo. Ena amatha kutenga kachilomboka akakumana ndi zinthu zimenezi, makamaka ngati ali ndi mabala kapena mikwingwirima, kapena atagwira m’maso, m’mphuno, m’kamwa, kapena m’mitsempha ina asanasambe m’manja. Mukakumana ndi zinthu zomwe zili ndi kachilombo, kuzitsuka ndikuzipha tizilombo toyambitsa matenda, komanso kuyeretsa m'manja, kungathandize kupewa kufala kumeneku. Kachilomboka amathanso kufalikira kwa mwana wosabadwayo pa nthawi yomwe ali ndi pakati, kapena kufalikira kudzera pakhungu pakubadwa kapena kubadwa. Anthu omwe amakumana ndi nyama zomwe zili ndi kachilomboka, monga agologolo, amathanso kutenga kachilombo ka nyani. Kuwonekera chifukwa chokhudzana ndi nyama kapena nyama kumatha kuchitika mwa kulumidwa kapena kukanda, kapena pazochitika monga kusaka, kusenda, kutchera misampha, kapena kukonza chakudya. Kudya nyama yowonongeka yomwe sinaphikidwa bwino kungayambitsenso matenda.
Ndani ali pachiwopsezo?
Aliyense amene amalumikizana kwambiri ndi odwala omwe ali ndi zizindikiro za nyani amatha kutenga kachilombo ka nyanipox, kuphatikiza ogwira ntchito zachipatala ndi achibale. Chitetezo cha ana cha mthupi chikukulabe, ndipo amaseweretsa ndi kucheza kwambiri. Kuonjezera apo, alibe mwayi wolandira katemera wa nthomba, womwe unathetsedwa zaka zoposa 40 zapitazo, choncho chiopsezo cha matenda ndi chachikulu. Kuonjezera apo, anthu omwe ali ndi chitetezo chochepa cha chitetezo cha mthupi, kuphatikizapo amayi apakati, amaonedwa kuti ali pachiopsezo chachikulu.
Chithandizo ndi Katemera
Pakali pano palibe mankhwala ochizira kachilombo ka monkeypox, kotero njira yaikulu yothandizira ndi chithandizo chothandizira, chomwe chimaphatikizapo chisamaliro cha zidzolo, kuchepetsa ululu, ndi kupewa zovuta. Makatemera awiri a nyani avomerezedwa ndi WHO koma sanayambitsidwe ku China. Onsewa ndi a m'badwo wachitatu opumira katemera wa nthomba. Katemera awiriwa pakalibe, WHO idavomerezanso kugwiritsa ntchito katemera wa nthomba wa ACAM2000. Gao Fu, katswiri wa maphunziro a Institute of Microbiology of the Chinese Academy of Sciences, adafalitsa buku mu Nature Immunology koyambirira kwa 2024, kutanthauza kuti katemera wa "awiri mwa m'modzi" wophatikizananso ndi kachilombo ka monkeypox wopangidwa ndi njira zambiri zama epitope chimerism motsogozedwa ndi kapangidwe ka antigen amatha kuteteza ma virus awiri opatsirana omwe ali ndi kachilombo ka HIV kamene kamayambitsa kachilombo ka HIV. Kachilombo ka nyani ndi kuwirikiza ka 28 kuposa katemera wanthawi zonse wocheperako, yemwe angapereke njira yotetezeka komanso yowopsa ya katemera wina wopewera ndi kuwongolera kachilombo ka nyani. Gululi likugwirizana ndi Kampani ya Shanghai Junshi Biotechnology kuti ipititse patsogolo kafukufuku wa katemera ndi chitukuko.