Lepera

ʻO ka maʻi lepera he maʻi lele ia e ka maʻi koʻohune Mycobacterium leprae. Mālama kēia maʻi i nā ʻeha o ka ʻili, nā ʻino o ke aʻalolo, a me nā nāwaliwali o nā mākala e ʻoi aku ana ka maikaʻi ma mua o ka manawa.

ʻAʻole hiki i ka maʻi lepera ke lele loa a lōʻihi kona manawa hoʻopulapula (manawa ma mua o ka hōʻike ʻia ʻana o nā ʻōuli), paʻakikī e ʻike ma hea a i ʻole i loaʻa i kekahi ka maʻi. ʻOi aku ka nui o nā keiki ma mua o ka loaʻa ʻana o ka maʻi i nā mākua.

ʻO ka hapa nui o ka poʻe i launa pū me nā bacteria ʻaʻole hoʻomohala i ka maʻi. ʻO kēia no ka mea hiki i kā lākou ʻōnaehana pale pale ke pale aku i nā bacteria. Manaʻo ka poʻe loea ua pāhola ka bacteria i ka hanu ʻana o ke kanaka i loko o nā kulu ʻāpana ea i hoʻokuʻu ʻia i ka wā e ʻeha ai ka maʻi lepera a i ʻole ka ʻū ʻana. Hoʻohui pū ʻia nā koʻohune e ka hui ʻana me nā wai ihu o ke kanaka me ka maʻi lēpera. He ʻelua ʻano maʻamau ka lepera: tuberculoid a me lepromatous. Hana nā ʻano ʻelua i nā ʻeha ma ka ʻili. Eia naʻe, ʻoi aku ke koʻikoʻi o ka lepromatous form. Hoʻokumu ia i nā puʻupuʻu nui a me nā puʻupuʻu (nodule).

Maʻalahi ka maʻi lepera ma nā ʻāina he nui ma ka honua holoʻokoʻa, a me nā aniau, aniau, a me nā ʻano subtropical. Ma kahi o 100 mau hihia i kēlā me kēia makahiki e ʻike ʻia ma ʻAmelika Hui Pū ʻIa. ʻO ka hapa nui o nā hihia ma ka Hema, Kaleponi, Hawaii, a me nā mokupuni ʻo US, a me Guam.

Kūpaʻa lāʻau Mycobacterium leprae a me ka hoʻonui ʻia o nā hihia ma ka honua holoʻokoʻa i alakaʻi i ka hopohopo honua no kēia maʻi.

ʻO nā hōʻailona me:

• ʻOi aku ka māmā o nā ʻili o ka ʻili ma mua o kou kala ʻili maʻamau
• ʻO nā leona i hoʻemi i ke ʻano e hoʻopā, wela, a ʻeha paha
• ʻO nā leona e hōʻola ʻole ma hope o kekahi mau pule i mau mahina
• Nāwaliwali ka ʻiʻo
• Pōpō a nele paha i ka manaʻo ʻole i nā lima, nā lima, nā wāwae, a me nā wāwae

Hana ʻia nā hoʻāʻo e:

• ʻO ka biopsy lesion ʻili
• ʻImi ʻili ʻili

Hiki ke hoʻohana ʻia ka hoʻāʻo ʻili lepera e haʻi i nā ʻano ʻokoʻa ʻelua o ka maʻi lēpera, akā ʻaʻole hoʻohana ʻia ka hōʻike e hōʻike i ka maʻi.

Hoʻohana ʻia kekahi mau lāʻau antibiotic e pepehi i nā koʻohune ke kumu o ka maʻi. Hoʻopili kēia i ka dapsone, rifampin, clofazamine, fluoroquinolones, macrolides, a me minocycline. Hāʻawi pinepine ʻia ma kahi o hoʻokahi antibiotic, a maʻa mau no nā mahina.

Hoʻohana ʻia ʻo Aspirin, prednisone, a i ʻole thalidomide e kāohi ai i ka mumū.

ʻImi ka ʻike ʻana i ka maʻi ma mua. Kākoʻo ka mālama mua ʻana i ka pohō, pale i ke kanaka mai ka hoʻolaha ʻana i ka maʻi, a hoʻemi i nā pilikia lōʻihi.

ʻO nā pilikia olakino i hopena ʻia mai ka maʻi lepera e komo pū:

• Hoʻonohonoho kino
• Nāwaliwali ka ʻiʻo
• Poino nā nerve paʻa mau i nā lima a me nā wāwae
• Lilo o ka naʻau

Hiki i nā poʻe me ka maʻi lepera lōʻihi ke lilo i ka hoʻohana ʻana i ko lākou mau lima a i ʻole nā ​​wāwae ma muli o ka hōʻeha pinepine ʻana no ka mea ʻaʻohe o lākou manaʻo i kēlā mau wahi.

Kāhea i kāu kauka mālama inā loaʻa nā ʻōuli o ka maʻi lepera iā ʻoe, keu hoʻi inā ua launa ʻoe me kekahi mea maʻi. Ua hōʻike ʻia nā hihia lepera ma ʻAmelika Hui Pū ʻIa i nā Kikowaena no ka mālama ʻana i ka maʻi a me ka pale ʻana.

ʻO ka poʻe i ka lā lōʻihi e lilo i mea noninfectious. ʻO ke kumu ʻaʻole lākou e hoʻoili i ka meaola e kumu ai ka maʻi.

Maʻi ʻo Hansen

Dupnik K. Leprosy (Mycobacterium leprae). I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 250.

Ernst JD. Leprosy (maʻi ʻo Hansen). I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 310.