I-Elephantiasis ibonakala ngokuvuvukala kwezitho, ngokuvamile imilenze, ngezinye izikhathi futhi ithinta izitho zangasese. Kusuka kulokhu okungavamile, ukunikeza izitho ezingezansi zomuntu othintekayo ukubonakala okufana nemilenze yendlovu, ukuthi i-elephantiasis ithola igama layo. Le pathology ingaba nemvelaphi emibili ehluke kakhulu. Okuvame kakhulu yisifo se-parasitic, esikhona ikakhulukazi e-Afrika nase-Asia: esibangelwa i-filiform parasite, ibizwa nangokuthi i-lymphatic filariasis. Elinye ifomu, i-elephantiasis yethu warts, kuyisimo esingavamile kakhulu esihlobene nokuvinjelwa kwemithambo ye-lymphatic.

Incazelo ye-elephantiasis

I-Elephantiasis ibonakala ngokuvuvukala kwezitho ezingezansi ezibukeka njengemilenze yendlovu. Iminonjana yakudala yale pathology eye yatholakala isukela eminyakeni engaphezu kuka-2000 BC Ngakho-ke, isifanekiso sikaFaro Mentuhotep II sasimelwe umlenze ovuvukalayo, isici se-elephantiasis, okuyinto eqinisweni uphawu lokutheleleka okubi kakhulu okubizwa nangokuthi. i-lymphatic filariasis. Lesi sifo esitholakala e-Asia nase-Afrika, asikho nhlobo eYurophu.

Olunye uhlobo lwe-elephantiasis, olubizwa ngokuthi I-warty elephantiasis yethu, engatholakala eFrance, ngenxa yokuvinjelwa kwemikhumbi ye-lymphatic, ngenxa noma cha ukutheleleka kwebhaktheriya. Ihlala ingavamile kakhulu.

Izinkinga ze-elephantiasis

I-Elephantiasis iyisici esiyingozi kakhulu se-lymphatic filariasis: isifo esibangelwa ama-parasites amancane, noma i-filaria, ehlala egazini lomuntu nezicubu, futhi idluliselwa ngomiyane, i-vector yabo. Lezi zikelemu zingama-90% Wuchereria Bancrofti, ezinye izinhlobo ngokuyinhloko Brugia Malayi et UBrugia uyesaba. Izibungu ziyi-microfilariae, ezihlala egazini. Lapho sezikhulile, lezi zinambuzane zitholakala ohlelweni lwe-lymphatic, okuyizo zonke izakhiwo nemikhumbi edlala indima ebalulekile emasosheni omzimba. Le filaria ehlala emithanjeni ye-lymphatic iyanwebeka futhi iyivimbe, ibangele ukuvuvukala kwesitho esisodwa noma ngaphezulu. Lokhu ikakhulukazi kuthinta imikhumbi ye-lymphatic engxenyeni engezansi yomzimba, isibonelo ku-groin, izitho zangasese namathanga.

Ngokuphathelene i-verrucous elephantiasis yethu, ngakho-ke akubangelwa yi-parasite, imvelaphi ye-lymphedemas ixhunywe ekuvinjweni kwemikhumbi ye-lymphatic, okungenzeka noma ingabi yimvelaphi yebhaktheriya. I-Lymphedema izobe isixhunyaniswa nesimo esingapheli sokuvuvukala.

Ezinye izimo zisengabangela i-elephantiasis: izifo ezibizwa ngokuthi i-leishmaniasis, izifo eziphindaphindiwe ze-streptococcal, zingaba futhi imiphumela yokukhishwa kwama-lymph nodes (ngokuvamile ngenjongo yokuvimbela ukukhula komdlavuza), noma zisaxhunyaniswa nenkinga yokuzalwa ezuzwe njengefa.

kwesifo

Ukuxilongwa komtholampilo kufanele kwenziwe uma kukhona isitho esingezansi esivuvukele, noma uma ukuvuvukala kubonakala kakhulu esithweni esisodwa kunesinye. Isinyathelo sokuqala sokuxilonga se-lymphatic filiarosis ukusungula umlando wokuchayeka ku-parasite ezindaweni ezihlala njalo. Khona-ke ukuhlolwa kwaselabhorethri kungaqinisekisa ukuxilongwa.

• Lokhu kuhlola kusekelwe ekutholeni amasosha omzimba.
• I-biopsy yesikhumba ingasiza futhi ukukhomba ama-microfilariae. 
• Kukhona futhi indlela esekelwe ku-ultrasound, uhlobo lwe-vascular ultrasound engakwazi ukuthola futhi ikubone ngeso lengqondo ukunyakaza kwe-parasite yabantu abadala.
• Izindlela zokubona ezifana nokuhlolwa kwe-PCR zenza kube nokwenzeka ukukhombisa ubukhona be-DNA yesilokazane, kubantu kanye nakomiyane.
• I-Lymphoscintigraphy, indlela yokuhlola imikhumbi ye-lymphatic, ibonise ukuthi ngisho nasezigabeni zokuqala nezingenayo izimpawu zomtholampilo, ukungahambi kahle kwe-lymphatic kungatholwa emaphashini abantu abanaleli gciwane.
• Ukuhlolwa kwe-Immunochromatographic kuzwela kakhulu futhi kuqondile ekuhlonzweni kokutheleleka kwe-W. Bancrofti.

Ngokuphathelene ne-elephantiasis nostras verrucosa engavamile kakhulu, ukuxilongwa kungenziwa yi-phlebologist. Uzichaza emtholampilo wakhe.

Abantu abathintekayo

• Abantu abayizigidi ezingu-120 emhlabeni wonke bayathinteka, abayizigidi ezingu-40 kubo abahlushwa amafomu anzima anezibonakaliso ezibalulekile zomtholampilo ze-lymphatic filariasis: i-lymphedemas, i-elephantiasis kanye ne-hydrocele.
• Lesi sifo sithinta ikakhulukazi abantu base-Afrika nase-Asia, nasentshonalanga yePacific. I-pathology ikhona kodwa ayivamile emazweni aseMelika nasempumalanga yeMedithera, futhi ayikho nhlobo eYurophu.
• Abantu abadala, ikakhulukazi phakathi kweminyaka engu-30 no-40 ubudala, bakhathazeke kakhulu kunezingane, ngoba nakuba lesi sifo sivame ukuqala ebuntwaneni, kubantu abadala ukuthi i-filariasis iba yinto ebalulekile, ngenxa yokuvimbela okuqhubekayo. imikhumbi ye-lymphatic.
• Izigameko ze-elephantiasis eFrance zingaba yimiphumela engemihle kulandela ukususwa kwama-lymph nodes, isibonelo kulandela umdlavuza.

Izici zengozi

Ukusulelana kwamagciwane emphakathini kusengozini enkulu uma izimo zenhlanzeko zingezinhle.

Uphawu olubaluleke kakhulu lwe-elephantiasis ukuvuvukala, okuhlangene noma okuhlangene, kwezitho ezingezansi. Lokhu kuvuvukala kuyathambile futhi kuyancishiswa ekuqaleni, kodwa kuba nzima, noma kuqine lapho kuthintwa, ezilonda ezindala.

Ezigulini zesilisa, i-lymphatic filiariasis ingase futhi ibonakale njengokuvuvukala kwe-scrotum noma i-hydrocele (isikhwama esigcwele uketshezi ku-scrotum). Kwabesifazane, kungase kube nokuvuvukala kwe-vulva, hhayi ithenda ngaphandle kwalapho umuntu efinyelela kakhulu.

Kungase futhi kube nama-ozes, anuka.

Ezinye izimpawu phakathi nesigaba esibuhlungu

• Imfiva.
• Ubuhlungu esithweni esithelelekile.
• Izindlela ezibomvu nezibucayi.
• Ukungaphatheki kahle.

Izimpawu zikai-warty elephantiasis yethu ziseduze, ngokuba khona njalo kwelungu lomzimba elivuvukele, ngaphezu kwalokho zibonakala ngezinsumpa esikhumbeni.

Kunezinhlobo eziningana zokwelapha ezikhona zokwelapha i-elephantiasis exhunywe nama-parasite:

• Ukwelashwa kwezidakamizwa: ivermectin ne-suuramin, i-mebendazole ne-flubendazole, noma ngisho ne-diethylcarmazine, ne-albendazole.
• Ukwelashwa ngokuhlinzwa: I-Hydrocele ingelashwa ngezinqubo zokuhlinzwa, njengokusikwa. Isitho esinegciwane singelashwa futhi ngokuhlinzwa, ngokukhipha amanzi noma ngokuhlinza.
• Ukwelashwa kokushisa: AmaShayina ahlole ngempumelelo indlela entsha yokwelapha i-lymphedema, eshintsha ukushisa nokubanda.
• Umuthi we-Herbal: amakhambi amaningana abekwe amakhulu eminyaka ekwelapheni i-elephantiasis: Vitex negundo L. (izimpande), Butea monosperma L. (izimpande namaqabunga), U-Ricinus communis L. (amashidi), Ama-marmellos amahle (amashidi), I-Canthium manii (ama-rubiacées), Boerhaavia diffusa L. (sonke isitshalo).

Kukhona amasu amaningana okwelapha i-elephantiasis ye-non-parasitic imbangela, okusenzima kakhulu ukuyelapha:

• Amamasaji, amabhandeshi, ukucindezela.
• Ukuhlanzeka kwesikhumba.
• Ukususwa kwezicubu ngokuhlinzwa.
• I-Ablative carbon dioxide laser, indlela entsha esanda kuhlolwa ngempumelelo.

Ukuvimbela izidakamizwa ze-filariasis

Izinhlelo ezinkulu zokulawulwa kwezidakamizwa kule minyaka eyishumi nantathu edlule, ngokusho kweNhlangano Yezempilo Yomhlaba (i-WHO), zivimbele noma zelapha izehlakalo ezingaphezu kwezigidi ezingama-96. Ukuqeda le filariasis ye-lymphatic kungenzeka ngokuphazamisa umjikelezo wokudluliselwa kwe-parasite.

• Eqinisweni, ukuhlinzeka ngokwelashwa ngezinga elikhulu kuyo yonke imiphakathi lapho ukutheleleka kwezinambuzane kukhona kungasiza ekunqandeni ukusabalala kokutheleleka. Leli su, eliwukwelapha kwezidakamizwa okuvimbelayo, lihlanganisa ukunikeza umthamo ohlanganisiwe wezidakamizwa ezimbili minyaka yonke kubantu abasengozini.
• Ngakho-ke, i-albendazole (400 mg) inikezwa kanyekanye ne-invermectin (150 kuya ku-200 mg / kg) noma nge-diethylcarbamazine citrate (6 mg / kg). Le mithi, enemiphumela elinganiselwe kuma-parasite abantu abadala, inciphisa ngempumelelo inani le-microfilariae egazini, noma izibungu ze-parasite. Bavimbela ukusabalala kanye nentuthuko maqondana omiyane. Izinhlobo zabantu abadala ze-parasite zingahlala ziphila iminyaka.
• Emazweni lapho kukhona esinye isilokazane esibizwa ngokuthi i-Loa loa, lelisu lokuvimbela kungcono ukuthi linikezwe kabili ngonyaka.

I-Egypt iyizwe lokuqala emhlabeni ukumemezela ukuqedwa ngokuphelele kwe-lymphatic filariasis, ngokusho kwe-WHO.

Ukulawula omiyane be-vector

Ukulawulwa kwe-vector yesifo, umiyane, kungakhuphula imizamo yokuqeda, kunciphise ukuminyana komiyane, nokuvimbela ukuthintana kwabantu nomiyane. Ukungenelela ekulawuleni umalaleveva, ngama-aerosol kanye nezibulala-zinambuzane, kunemiphumela ezuzisayo yokubambisa ngokunciphisa nokudluliswa kwe-lymphatic filariasis.

Ukuvimbelai-warty elephantiasis yethu

Ngokuphathelene ne-elephantiasis engahlobene ne-parasite, kufanele kuqashelwe, ngokuvamile, ukuvimbela ngokumelene nokukhuluphala, okungenye yezinto eziyingozi.

Ekuphethweni

Kusukela ngo-1997 zonke lezi zinyathelo zaqalwa ukuze kuqedwe i-lymphatic filariasis njengenkinga enkulu yezempilo yomphakathi. Futhi ngo-2000, i-WHO yethula uhlelo lomhlaba wonke lwalokhu kuqedwa, olunezingxenye ezimbili:

• ukumisa ukusabalala kokutheleleka (ngokuphazamisa ukudluliswa).
• ukukhulula ukuhlupheka kwabantu abathintekile (ngokulawula ukugula), ngenqubo yokwelashwa, okuhlanganisa ukuhlinzwa, inhlanzeko enhle nokunakekelwa kwesikhumba, ukuze kugwenywe ukungenwa yigciwane.