Lepera

Anter

• He aha nā hōʻailona o ka maʻi lēpera?
• Pehea ke ʻano o ka maʻi lēpera?
• Pehea ka laha ana o ka mai lepera?
• He aha nā ʻano lēpera?
• 1. Ka maʻi lepera tuberculoid vs. lepromatous leprosy vs. borderline leprosy
• 2.ʻO ka hoʻonohonoho ʻana o ka World Health Organization (WHO)
• 3. Hoʻonohonoho ridley-Jopling
• Pehea e ʻike ʻia ai ka maʻi lepera?
• Pehea e mālama ai i ka maʻi lepera?
• He aha nā pilikia kūpono o ka maʻi lēpera?
• Pehea e hiki ai iaʻu ke pale aku i ka maʻi lēpera?
• He aha ka manaʻo lōʻihi?
• Nā Kumuwaiwai ʻatikala

He aha ka maʻi lēpera?

ʻO ka maʻi lepera he maʻi maʻi maʻa mau ia e ka maʻi koʻohune Mycobacterium leprae. Hoʻopili mua ia i nā ʻalalā o nā ʻāʻī, ka ʻili, ka uhi ʻana o ka ihu, a me nā wahi hanu o luna. Ua ʻike ʻia ka maʻi lepera ʻo ka maʻi ʻo Hansen.

Hoʻopuka ka maʻi lepera i nā maʻi ʻili, nā ʻeha o ke aʻalolo, a me nā nāwaliwali o nā mākala. Inā mālama ʻole ʻia ia, hiki iā ia ke kumu i ka disfigurement nui a me ke kīnā nui.

ʻO ka maʻi lepera kekahi o nā maʻi kahiko loa i hoʻopaʻa ʻia i ka mōʻaukala. ʻO ka ʻōlelo i kākau ʻia i ʻike ʻia no ka maʻi lepera ma kahi o 600 B.C.

Maʻamau nā maʻi lepera ma nā ʻāina he nui, keu hoʻi me nā aniau tropical a subtropical paha. ʻAʻole maʻamau ia ma ʻAmelika Hui Pū ʻIa. ʻO nā hōʻike he 150 a 250 mau hihia hou wale nō i ʻike ʻia ma ʻAmelika Hui Pū ʻIa i kēlā me kēia makahiki.

He aha nā hōʻailona o ka maʻi lēpera?

ʻO nā ʻōuli nui o ka maʻi lepera:

• nāwaliwali o nā mākala
• ʻōlohelohe i nā lima, nā lima, nā wāwae, a me nā wāwae
• lesion ʻili

ʻO ka hopena o ka ʻili ka hopena o ka hoʻoliʻiliʻi o ka sensation e hoʻopā, mahana, a ʻeha paha. ʻAʻole lākou e hoʻōla, ʻoiai ma hope o kekahi mau pule. ʻOi aku ka māmā o lākou ma mua o kou kūleo o ka ʻili maʻamau a ʻulaʻula paha lākou mai ka mumū.

Pehea ke ʻano o ka maʻi lēpera?

Pehea ka laha ana o ka mai lepera?

ʻO ke koʻohune Mycobacterium leprae kumu lepera. Manaʻo ʻia e pālahalaha ka maʻi lepera ma o ka hoʻopili ʻana me nā huna mucosal o kahi kanaka me ka maʻi. Hana ʻia kēia i ka manawa e heʻe ai a ʻū paha ke kanaka lepera.

ʻAʻole maʻi nui ka maʻi. Eia nō naʻe, pili, ka launa hou ʻana me kahi kanaka i hoʻomaʻamaʻa ʻole ʻia no kahi manawa lōʻihi e hiki ai ke alakaʻi i ka maʻi lepera.

ʻO ke koʻohune nāna no ka maʻi lepera e hoʻonui lohi. Loaʻa ka maʻi i ka manawa incubation awelika (ka manawa ma waena o ka maʻi a me ke ʻano o nā ʻōuli mua) o, e like me ka World Health Organization (WHO).

ʻAʻole ʻike ʻia nā ʻōuli ma kahi o 20 mau makahiki.

Wahi a ka New England Journal of Medicine, hiki i kahi armadillo ʻōiwi i ka hema o ʻAmelika Hui Pū ʻIa a me Mexico ke halihali i ka maʻi a lawe i nā kānaka.

He aha nā ʻano lēpera?

ʻEkolu ʻōnaehana no ka hoʻokaʻawale ʻana i ka maʻi lēpera.

1. Ka maʻi lepera tuberculoid vs. lepromatous leprosy vs. borderline leprosy

Hoʻomaopopo ka ʻōnaehana mua ʻekolu mau ʻano lepera: tuberculoid, lepromatous, a me borderline. ʻO ka pane pale a ke kanaka i ka maʻi e hoʻoholo ai i kahi o nā ʻano maʻi lēpera iā lākou:

• I ka maʻi lepera tuberculoid, maikaʻi ka pane pale ʻana. ʻO kahi kanaka me kēia ʻano maʻi e hōʻike wale i kekahi mau leona. Mālie ka maʻi a maʻi wale hoʻi.
• I ka maʻi lepera, ʻilihune ka pane pale ʻana. Hoʻopili pū kēia ʻano i ka ʻili, nā aʻalolo, a me nā mea ʻē aʻe. Aia nā liona ākea, e like me nā nodule (nā puʻupuʻu nui a me nā puʻupuʻu). ʻOi aku ka maʻi lele o kēia ʻano maʻi.
• I ka lepera palena, aia kekahi mau hiʻohiʻona o ka maʻi lepera tuberculoid a me ka maʻi lēpera. Manaʻo ʻia kēia ʻano ma waena o nā ʻano ʻelua ʻē aʻe.

2.ʻO ka hoʻonohonoho ʻana o ka World Health Organization (WHO)

ka maʻi e pili ana i ke ʻano a me ka helu o nā ʻili i hoʻopili ʻia.

• ʻO ka mahele mua paucibacillary. ʻElima a ʻoi aku paha nā liona a ʻaʻohe bacteria i ʻike ʻia ma nā laʻana o ka ʻili.
• ʻO ka mahele ʻelua multibacillary. Aia ma mua o ʻelima mau leona, ʻike ʻia ke koʻohuna i ka ʻili, a i ʻole ʻelua paha.

3. Hoʻonohonoho ridley-Jopling

Hoʻohana nā noiʻi lapaʻau i ka ʻōnaehana Ridley-Jopling. ʻElima mau hoʻohālikelike e pili ana i ke koʻikoʻi o nā ʻōuli.

Aia kekahi ʻano lepera i kapa ʻia he lepera paʻa ʻole i hoʻokomo ʻole ʻia i loko o ka ʻōnaehana hoʻokaʻawale ʻo Ridley-Jopling. Manaʻo ʻia he ʻano lepera mua loa ia ma kahi e loaʻa ai i kahi kanaka hoʻokahi wale nō ʻili leona e nū wale i ka hoʻopā.

Hiki i ka lepera paʻa ʻole ke hoʻonā a holomua hou i kekahi o nā ʻano ʻelima o ka maʻi lepera ma loko o ka ʻōnaehana ʻo Ridley-Jopling.

Pehea e ʻike ʻia ai ka maʻi lepera?

E alakaʻi ana kāu kauka i kahi hoʻokolohua kino e nānā i nā hōʻailona Telltale a me nā ʻōuli o ka maʻi. E hana pū lākou i kahi biopsy kahi a lākou e hemo ai i kahi ʻili liʻiliʻi o ka ʻili a i ʻole ke aʻalolo a hoʻouna iā ia i kahi keʻena hoʻokolohua no ka hoʻāʻo ʻana.

Hiki paha i kāu kauka ke hana i kahi hōʻoia lepera ʻili e hoʻoholo i ke ʻano o ka maʻi lepera. E hoʻopili lākou i kahi liʻiliʻi o ka maʻi lepera-i hoʻokumu ʻia i ka maʻi lepera, i hana ʻole ʻia, i loko o ka ʻili, ma ka maʻamau o ka forearm o luna.

ʻO ka poʻe i loaʻa ka maʻi tuberculoid a i ʻole borderline tuberculoid lepera e ʻike i kahi hopena maikaʻi ma ka pūnaewele injection.

Pehea e mālama ai i ka maʻi lepera?

Ua hoʻomohala ʻo WHO ma 1995 e hoʻōla i nā ʻano maʻi lēpera āpau. Loaʻa iā ia me ka uku ʻole ma ka honua holoʻokoʻa.

Hoʻohui ʻia, mālama kekahi mau antibiotic i ka maʻi lepera ma ka luku ʻana i nā koʻohune nāna i kumu. Hoʻopili kēia mau antibiotics:

• dapsone (Aczone)
• rifampin (Rifadin)
• clofazimine (Lamprene)
• minocycline (Minocin)
• ofloxacin (Ocuflux)

E kuhikuhi paha kāu kauka i ka mea ʻoi aku ma mua o hoʻokahi antibiotic i ka manawa like.

Makemake paha lākou iā ʻoe e lawe i kahi lāʻau anti-inflammatory e like me aspirin (Bayer), prednisone (Rayos), a i ʻole thalidomide (Thalomid). E mālama ka mālama ʻana i mau mahina a hiki a i ka 1 a i ka 2 mau makahiki.

ʻAʻole pono ʻoe e lawe i ka thalidomide inā hāpai a hāpai paha ʻoe. Hiki iā ia ke hana i nā kīnā hānau koʻikoʻi.

He aha nā pilikia kūpono o ka maʻi lēpera?

ʻO ka lohi a me ka lāʻau lapaʻau hiki ke alakaʻi i nā pilikia koʻikoʻi. Hiki i kēia mau mea ke:

• hoʻomāinoino
• ka lauoho lauoho, keu hoʻi i nā kuʻemaka a me nā maka maka
• nāwaliwali o nā mākala
• pōʻino nerve paʻa mau i nā lima a me nā wāwae
• hiki ʻole ke hoʻohana i nā lima a me nā wāwae
• ka ihu paʻa, nā ihu, a me ka hāʻule ʻana o ka ihu septum
• iritis, kahi pehu o ka iris o ka maka
• glaucoma, kahi maʻi maka e hoʻopōʻino ai i ke aʻalolo optic
• makapō
• hana erectile (ED)
• infertility
• hakuʻala ʻole

Pehea e hiki ai iaʻu ke pale aku i ka maʻi lēpera?

ʻO ke ala ʻoi loa e pale aku ai i ka maʻi lepera, ʻo ia ke pale i ka wā lōʻihi, pili pili loa me kahi kanaka i hoʻomaʻemaʻe ʻole ʻia i loaʻa i ka maʻi.

He aha ka manaʻo lōʻihi?

ʻOi aku ka maikaʻi o ka nānā ākea inā ʻike koke kāu kauka i ka maʻi lepera ma mua o ka lilo ʻana i mea koʻikoʻi. Pale ka mālama mua ʻana i ka hōʻino hou ʻana o nā mea, hoʻopau i ka hoʻolaha ʻana o ka maʻi, a pale i nā pilikia olakino koʻikoʻi.

ʻOi aku ka maikaʻi ʻole o ka nānā ke kū ʻia kahi hōʻailona ma kahi wā i ʻoi aku ka holomua, ma hope o ka hōʻeha nui a kīnā ʻole o ke kanaka. Eia nō naʻe, pono mau ka lāʻau kūpono e pale ai i nā hōʻino kino hou a pale i ka hoʻolaha ʻana o ka maʻi i nā poʻe ʻē aʻe.

Aia paha he pilikia olakino paʻa ma muli o ke kūleʻa o nā lāʻau ʻalopika, akā hiki i kāu kauka ke hana pū me ʻoe e hāʻawi i ka mālama kūpono i mea e kōkua ai iā ʻoe e kūleʻa a mālama i nā koena i koe.

Nā Kumuwaiwai ʻatikala

• Anand PP, et al. (2014). Lepera nani: ʻO kekahi helehelena o ka maʻi o Hansen! He loiloi. DOI: 10.1016 / j.ejcdt.2014.04.005
• Ka hoʻākāka ʻana o ka maʻi lepera. (n.d.).
• ʻO Gaschignard J, et al. (2016). ʻO ka lepera Pauci- a me multibacillary: ʻElua mau maʻi ʻokoʻa, mālama ʻole ʻia i nā genetically.
• Lepera. (2018).
• Lepera. (n.d.). https://rarediseases.org/rare-diseases/leprosy/
• Leprosy (maʻi ʻo Hansen). (n.d.). https://medicalguidelines.msf.org/viewport/CG/english/leprosy-hansens-disease-16689690.html
• Leperosy: lapaʻau (n.d.). http://www.searo.who.int/entity/leprosy/topics/the_treatment
• Pardillo FEF, et al. (2007). Nā kiʻina no ka hoʻokaʻawale ʻana o ka maʻi lēpera no nā kumu lapaʻau. https://academic.oup.com/cid/article/44/8/1096/298106
• Scollard D, et al. (2018). Leprosy: Epidemiology, microbiology, hōʻike pilikino, a me ka hōʻailona. https://www.uptodate.com/contents/leprosy-epidemiology-microbiology-clinical-manifestations-and-diagnosis
• Tierney D, et al. (2018). Lepera. https://www.merckmanuals.com/professional/infectious-diseases/mycobacteria/leprosy
• Truman RW, et al. (2011). ʻO ka maʻi lepera zoonotic paha ma ka hema o ʻAmelika Hui Pū ʻIa. DOI: 10.1056 / NEJMoa1010536
• He aha ka maʻi o Hansen? (2017).
• ʻO WHO multidrug therapy. (n.d.).