Okuqukethwe
Iyini i-bacterial meningitis?
I-Meningitis ukuvuvukala nokutheleleka kwe-meninges, ulwelwesi oluncane oluzungeze ubuchopho nomgogodla (uhlelo lwezinzwa olumaphakathi). Ukutheleleka kungabangelwa igciwane (i-viral meningitis), amagciwane (i-bacterial meningitis), noma isikhunta noma i-parasite.
Endabeni ye-bacterial meningitis, imindeni ehlukene kanye nezinhlobo zamabhaktheriya zingabandakanyeka. Kuzo zonke izimo, Ukwelashwa kusekelwe ekunikeni ama-antibiotics, ngokuvamile ngomthambo.
I-Pneumococcal meningitis
I-pneumococcus, yegama layo lesiLatini Streptococcus pneumoniae, iwumndeni wamabhaktheriya akwazi ukubangela izifo eziningana noma ezibucayi kakhulu, kusuka ku-sinusitis kuya ku-pneumonia, kuhlanganise ne-meningitis noma i-otitis.
I-pneumococcus iyibhaktheriya engase ibe khona ngokwemvelo ku-nasopharyngeal sphere (ikhala, i-pharynx kanye mhlawumbe nomlomo) "yezithwali ezinempilo" ngaphandle kokubangela izimpawu. Kodwa-ke, uma idluliselwa kumuntu ongenalo futhi / noma ukuzivikela kwakhe komzimba kunganele, kungaholela ku-otitis, sinusitis, noma i-pneumonia noma i-meningitis uma Streptococcus pneumoniae ingena emgudwini wegazi futhi ifinyelele kuma-meninges.
Inani lokufa kwe-pneumococcal meningitis liphezulu kubantu asebekhulile kanye nasezinganeni ezincane nasezinsaneni. Nokho, lolu hlobo lwe-meningitis aluholeli ezifweni eziwumshayabhuqe njengoba kungabonakala endabeni ye-bacterial meningococcal meningitis.
I-Neisseria Meningitidis : Icala le-meningococcal meningitis
Njengoba igama layo libonisa, amagciwane I-Neisseria meningitidis, emndenini we-meningococcal, ngokuyinhloko ibangela i-meningitis. Kunezinhlobo eziyi-13, noma ama-serogroups alo mndeni webhaktheriya. Lokhu kuhlanganisa i-meningococcal meningitis yohlobo B nohlobo C, oluvame kakhulu eYurophu, kanye nohlobo A, W, X kanye no-Y.
E-France ngo-2018, ngokusho kwedatha evela ku-National Reference Center ye-Meningococci kanye I-Haemophilus influenzae kusukela ku-Institut Pasteur, phakathi kwezimo ezingama-416 ze-meningococcal meningitis okwakwaziwa ngazo i-serogroup, Amaphesenti angama-51 kwakungu-serogroup B, u-13% kwaba u-C, 21% ka-W, 13% ka-Y kanye no-2% wama-serogroups angavamile noma angewona ama-serogroupable.
Qaphela ukuthi amagciwane I-Neisseria meningitidis ikhona ngokwemvelo ku-ENT sphere (umphimbo, ikhala) kusukela ku-1 kuya ku-10% wabantu (ngaphandle kwesikhathi sobhubhane), ngokusho kwe-World Health Organization (WHO). Kodwa kuyenzeka ukuthi leli gciwane leqa amasosha omzimba futhi libangele i-meningitis, ikakhulukazi ezinsaneni, izingane ezincane, intsha noma abantu abadala, kanye neziguli ezingenawo amandla omzimba.
I-Listeria, i-Haemophilus influenzae et Escherichia coli, amanye amagciwane ahilelekile
Kwaziwa kakhulu kwabesifazane abakhulelwe, the Listeria iyi-ejenti ethathelwanayo ebangela i-listeriosis ezifundweni ezibuthakathaka, kodwa futhi engabangela i-meningitis. Ngakho ukubaluleka landela izincomo zokudla kanye nenhlanzeko ngesikhathi sokukhulelwa nasebuntwaneni, phakathi kwabanye ukugwema ushizi nemikhiqizo yobisi eyenziwe ngobisi olungaphekiwe, inyama eluhlaza, ebhemayo noma engaphekwa kahle, njll. I-Listeria monocytogenes idluliselwa ngomgudu wokugaya ukudla lapho kusetshenziswa imikhiqizo yobisi engcolile noma inyama ebandayo.
Ezinye izinhlobo ze-bacterial meningitis zikhona, ikakhulukazi leyo kuhlanganiswe nama-bacteria I-Haemophilus influenzae (Hib), okwakusavame kakhulu eFrance emashumini ambalwa eminyaka adlule. Umuthi wokugomelaI-Haemophilus influenzae, kwaqala kwelulekwa kwase kwenziwa impoqo, kuye kwanciphisa ukwenzeka kwalolu hlobo lwe-meningitis nenyumoniya ebangelwa yileli gciwane.
Kukhona futhi i-meningitis exhunywe nayo ibhaktheriya Escherichia coli, kungaba ngubani ukudla, phakathi ukuzalwa kwesitho sangasese sowesifazane, ngenxa yokuthintana nesitho sangasese sikamama. Izingane ezizalwa ezinesisindo esiphansi kanye nezizalwa ngaphambi kwesikhathi zisengozini enkulu.
I-ejenti ethathelwanayo yesifo sofuba nayo ingabangela i-meningitis kubantu abangenawo amandla omzimba.
I-Contagion: uyibamba kanjani i-meningitis yebhaktheriya?
Ukudluliswa kwe-bacterial meningitis, kungakhathaliseki ukuthi kungenxa ye-pneumococcus noma i-meningococcus, kwenzeka ngokuthintana eduze, okuqondile noma okungaqondile kanye nesikhathi eside. ukukhishwa kwe-nasopharyngeal, ngamanye amazwi ngamaconsi amathe, ukukhwehlela, ama-postillions. Ukusetshenziswa kwezinto ezingcolile (amathoyizi, izinto zokusika) zingaphinde zidlulisele amagciwane, azovalelwa ku-ENT sphere noma afinyelele kuma-meninges, ikakhulukazi ezigulini ezingenawo amandla omzimba, izinsana kanye nezingane ezincane.
Qaphela ukuthi i-pneumococcal meningitis ingenzeka ngemva kokulimala ekhanda, okuzodala ukuphulwa kwe-meninges. Lokhu kubizwa nge-post-traumatic meningitis. I-pneumococcal meningitis ingase ivele ngemva kokutheleleka kwe-ENT yakudala (i-otitis, amakhaza, i-bronchiolitis, umkhuhlane ...).
Izimpawu ze-bacterial meningitis
I-bacterial meningitis ihlanganisa izinhlobo ezimbili eziyinhloko zezimpawu, okuyilezi:
- un isifo esithathelwanayo, ukuhlanganisa ndawonye izimpawu zokutheleleka njengokushisa okuphezulu, ikhanda elibuhlungu, ukuhlanza (ikakhulukazi kumajethi);
- futhi i-meningeal syndrome, isibonakaliso sokuvuvukala kwama-meninges, okuholela ekuqineni kwentamo, ukudideka, ukuphazamiseka kokuqaphela, ukukhathala, ukuzwela ekukhanyeni (photophobia), ngisho ne-coma noma ukubanjwa.
Izimpawu okunzima ngezinye izikhathi ukuzibona enganeni
Qaphela ukuthi ezinganeni ezincane, futhi ikakhulukazi ezinsaneni, izimpawu ze-meningitis zingaba ezingaqondile futhi kube nzima ukuzibona.
Abanye abakhona i-pallor noma ibala elimpunga, ukuquleka noma ukunyakazisa kwemisipha. Ingane encane ingakwazi yenqaba ukudla, ukuba sesimweni soku ukozela okungajwayelekile, noma okujwayele ukukhala njalo, noma ukucasuka. a ukuqhuqha kwefontineli kusukela phezulu kogebhezi futhi i-hypersensitivity to touch nayo ingabonwa, nakuba lokhu kungenalo uhlelo.
Kuzo zonke izimo, umkhuhlane omkhulu ongazelelwe kufanele uholele ekubonisaneni okuphuthumayo.
Le i-purpura fulminans, isimo esiphuthumayo esibalulekile
Ukuba khona kwamabala abomvu noma a-purplish, abizwa ngokuthi i-purpura fulminans, EMpumalanga umbandela wamandla adonsela phansi ngokwedlulele i-bacterial meningitis. Ukubonakala kwamabala anjalo esikhumbeni kufanele kuholele ekunakekelweni okuphuthumayo, ngombono wokulaliswa esibhedlela ngokushesha. Uma i-purpura ivele futhi ihlotshaniswa nezimpawu ze-meningitis, ukuphathwa kokwelashwa kwama-antibiotic kuqalwa ngokushesha ngangokunokwenzeka. Ukuqala kwe-purpura ngenxa ye-meningitis yi-a ukuphuthuma ngokuphelele, ngoba i ubungozi bokushaqeka kwe-septic, esongela ukuphila (sivame ukukhuluma nge-meningitis yombani).
Njengoba izimpawu zomtholampilo zisondelene kakhulu phakathi kwe-meningitis ngenxa yegciwane noma amagciwane, kunjalo ukuhlaziywa kwe-cerebrospinal fluid, othathwe emgogodleni ngesikhathi a ukubhoboza okungekho emthethweni, okuzokwenza kube nokwenzeka ukwazi ukuthi i-meningitis imvelaphi yebhaktheriya noma cha. Uma ukubonakala koketshezi oluthathiwe kungase kunikeze umbono wohlobo lwe-meningitis okukhulunywa ngayo (kunalokho i-purulent phambi kwamagciwane), ukuhlaziywa okuningiliziwe kwesampula kuzokwenza kube nokwenzeka ukwazi ukuthi iyiphi igciwane eliyimbangela futhi ngenxa yalokho. ukulungisa ukwelashwa kwama-antibiotic ngendlela efanele.
I-bacterial meningitis: ukuvikela kudinga umgomo
Ukuvinjelwa kwe-bacterial meningitis kuncike kakhulu ekusetshenzisweni kwezincomo zeshejuli yokugoma. Eqinisweni, ukugoma kuvikela kumagciwane ahlukahlukene angabangela i-meningitis, ikakhulukazi I-Streptococcus pneumonia, ama-serogroups athile amagciwane I-Neisseria meningitidis, et I-Haemophilus influenzae.
Umuthi wokugomela i-meningococcal
Ukugonyelwa i-meningococcal serogroup C okuphoqelekile ezinganeni ezizalwe kusukela ngomhlaka-1 Januwari 2018, futhi kunconyelwe izingane ezizalwe ngaphambi kwalolu suku ngokwalolu hlelo olulandelayo:
- ezinsaneni, ukugoma ezinyangeni ezi-5, kulandele umthamo we booster ezinyangeni ezingu-12 ubudala (ngomuthi wokugoma ofanayo uma kungenzeka), ngokwazi ukuthi umthamo wezinyanga eziyi-12 unganikezwa kanye nomgomo we-MMR (measles-mumps-rubella);
- Kusukela ezinyangeni ezingu-12 kuze kufike eminyakeni engu-24, kulabo abangazange bathole ukugoma okuyinhloko kwangaphambilini, uhlelo luqukethe umthamo owodwa.
Umuthi wokugomela uhlobo B lwe-meningococcal, obizwa I-Bexsero, etuswayo futhi ibuyiselwe kuphela ezimeni ezithile, ikakhulukazi kubantu ababuthaka abasengozini noma abasesimweni esiwumqedazwe. ;
Umuthi wokugomela i-meningococcal conjugate tetravalent ngokumelene nama-serogroups A, C, Y, W135, nawo unconyiwe ezimeni ezithile.
Ukugoma ngokumelene nezifo ze-pneumococcal
Ukugoma ngokumelene nezifo ze-pneumococcal okuphoqelekile ezinsaneni ezizalwe kusuka ngoJanuwari 1, 2018, ngokwalolu hlelo olulandelayo:
- imijovo emibili ngokwehlukana kwezinyanga ezimbili (izinyanga ezimbili nezine);
- i-booster eneminyaka engu-11 ubudala.
Ngemuva kweminyaka engu-2 ubudala, ukugoma kunconywa ezinganeni nakubantu abadala abasengozini yokuzivikela komzimba noma isifo esingelapheki esiholela ekuveleni kokutheleleka kwe-pneumococcal (ikakhulukazi isifo sikashukela). Bese ihlanganisa imijovo emibili ehlukaniswe ngezinyanga ezi-2, ilandelwe i-booster ezinyangeni eziyisikhombisa kamuva.
Umuthi wokugomela i-Haemophilus influenzae wohlobo B
Ukugoma amagciwane I-Hemophilus influenzae yohlobo B is okuphoqelekile ezinsaneni ezizalwe ngomhlaka-1 Januwari 2018 noma ngemva kwalokho, futhi kunconyelwe izingane ezizalwe ngaphambi kwalolo suku, kuhlanganiswe nemithi yokugomela i-diphtheria, i-tetanus kanye uvendle (i-DTP):
- umjovo ezinyangeni ezimbili bese kuthi ezinyangeni ezine;
- ukukhumbula ezinyangeni eziyi-11.
Un ukugoma ukubamba kungenziwa kuze kufike eminyakeni engu-5. Bese ihlanganisa imithamo emibili kanye ne-booster uma ingane iphakathi kwezinyanga eziyisi-6 neziyi-12 ubudala, kanye nomthamo owodwa ongaphezu kwezinyanga eziyi-12 futhi ifike eminyakeni eyi-5.
Kufanele kuqashelwe ukuthi le mithi yokugoma yenze kwaba nokwenzeka ukunciphisa inani lezifo ze-bacterial meningitis ezinsaneni nasezinganeni ezincane, kanye nokufa okuhlobene nalezi zifo ezimbi.
Ukugoma akuvumeli kuphela ukuvikelwa komuntu ngamunye, kunciphisa ukusabalala kwalawa mabhaktheriya ngakho-ke vikela labo abangakwazi ukuthola umgomo, ikakhulukazi izingane ezisanda kuzalwa kanye neziguli ezingenawo amandla omzimba.
imithombo:
- https://www.pasteur.fr/fr/centre-medical/fiches-maladies/meningites-meningocoques
- https://www.ameli.fr/assure/sante/themes/meningite-aigue/definition-causes-facteurs-favorisants
- https://www.associationpetitange.com/meningites-bacteriennes.html
- https://www.meningitis.ca/fr/Overview
- https://www.who.int/immunization/monitoring_surveillance/burden/vpd/WHO_SurveillanceVaccinePreventable_17_Pneumococcus_French_R1.pdf