Bayanin gabaɗaya
Leishmaniasis cuta ce da parasites na Leishmania ke haifarwa, ƙudan yashi (sandfly) ke yaɗa ta. Tana da nau'i uku: na fata, na ciki (visceral/kala-azar), da na ƙwayar mucosa.
Alamomi
Alamomi | Yawan faruwa | Tsanani | Farawa |
|---|---|---|---|
| Gajiya | 85% | Dan kadan | Farkon cuta |
| Zazzabi | 95% | Matsakaici | Farkon cuta |
| Toshewar hanci | 90% | Matsakaici | Farkon cuta |
| Rashin son ci | 70% | Dan kadan | Farkon cuta |
| Rashin jin daɗi | 80% | Dan kadan | Farkon cuta |
| Kumburin ƙwayoyin lymph | 30% | Dan kadan | Farkon cuta |
| Kumburin jiki | 20% | Dan kadan | Farkon cuta |
| Gyambon fata | 85% | Matsakaici | Kololuwar cuta |
| Kumburin saifa | 95% | Mai tsanani | Kololuwar cuta |
| Kumburin hanta | 80% | Matsakaici | Kololuwar cuta |
| Raguwar nauyi | 90% | Matsakaici | Kololuwar cuta |
| Wahalar haɗiya | 30% | Matsakaici | Kololuwar cuta |
| Zubar jini | 60% | Matsakaici | Kololuwar cuta |
| Gumi da dare | 40% | Dan kadan | Kololuwar cuta |
| Tari | 15% | Dan kadan | Kololuwar cuta |
| Zawo | 20% | Dan kadan | Kololuwar cuta |
| Ƙaiƙayi | 15% | Dan kadan | Kololuwar cuta |
| Ƙananan ɗigon jini | 25% | Matsakaici | Kololuwar cuta |
| Raguwar matsin jini | 5% | Matsakaici | Ƙarshen cuta |
| Shanƙe | 10% | Matsakaici | Ƙarshen cuta |
Hanyoyin yaduwa
Bayanin gabaɗaya
Leishmaniasis cuta ce ta parasitic da ƙudaje irin sandfly mace masu ɗauke da cutar (Phlebotomus/Lutzomyia) ke yaɗawa, da protozoa na dangin Leishmania suke haifarwa. Nau'oi uku: visceral (kala-azar, kusan koyaushe tana kashewa ba tare da magani ba), cutaneous (mafi yawa), da mucocutaneous. Sabbin cututtuka 700,000–miliyan 1/shekara a ƙasashe 98, mutuwa 26,000–65,000/shekara.
Bayanin gabaɗaya
Leishmaniasis cutar da kwayoyin cuta Leishmania ke haifarwa. Yaduwa: cizon kudan yashi (sandfly, nau'in Phlebotomus) — ƙananan kwari ne da ke cizo musamman da yamma da daddare. A Najeriya: cutar fata ta leishmaniasis (cutaneous leishmaniasis, CL) tana yaduwa ne a jihohin Arewa maso gabas — Borno, Yobe, da Adamawa — inda kudan yashi ke da yawa a yankunan hamada da sahel. An samu rahotannin barkewar cutar a sansanonin 'yan gudun hijira a Borno (rikicin Boko Haram ya kara yaduwar cutar). Cutar cikin gida ta leishmaniasis (visceral leishmaniasis, VL — kala-azar): ba ta yawaita a Najeriya ba amma tana yaduwa a kasashen gabashin Afirka (Sudan, South Sudan, Ethiopia, Kenya). Ba tare da magani ba, mutuwar VL kusan kashi 90%. Babu allurar rigakafi.
Alamomin gaggawa
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Zazzaɓi mai tsayi da hepatosplenomegaly mai girma — ana zargin VL
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Ƙarancin ƙwayoyin jini mai tsanani (anemia, neutropenia, thrombocytopenia) — haɗarin kamuwa/zubar jini
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Zubar jini marar iko — thrombocytopenia a cikin VL
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Wahalar numfashi (anemia mai tsanani, ciwon huhu na biyu)
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Saurin lalacewar fuska/hanci — mucocutaneous VL tana kashewa >95% ba tare da magani ba — fara magani cikin gaggawa.
Cikakkun alamomi
Alamomi da alamu mafi yawa
Cutar fata (CL): gyambo/miki maras ciwon da ke da gefen da ya tashi (ulcer with raised border) — galibi a fuska, hannaye, ko kafafu; yana bayyana ne makonni zuwa watanni bayan cizon kudan yashi; zai iya warkewa da kansa amma yana barin tabo. Cutar cikin gida (VL/kala-azar): zazzabi mai tsawo da ba ya sauka da magani, kumburi na saifa mai girma (massive splenomegaly), kumburi na hanta, raguwar nauyi mai tsanani, karancin dukkan jini (pancytopaenia — karancin farin jini, jajayen jini, da platelets).
Sanin alamomi shine mataki na farko don amsa cikin sauri.
Tafiyar cuta
Cizon ƙudaje masu cutar → Promastigotes suna shiga macrophage → Canzawa zuwa amastigotes → Haɓakawa a cikin ƙwayoyin → VL: Yaɗuwa zuwa safara, hanta, ƙashi cikin makonni-watanni → Zazzaɓi, hepatosplenomegaly, pancytopenia mai ci gaba → Mutuwa cikin shekaru 2 ba tare da magani ba. CL: Parasites suna tsayawa a fata → Tabo → Ƙurje → Warkewa da tabo. MCL: Yaɗuwa zuwa jijiyoyin hanci/maƙogwaro watanni-shekaru daga baya.
Binciken cuta
Yadda ake gano wannan cutar
VL: Gwajin gaggawa na rK39 (inganci 90–97%, musamman 92–100%) — ma'aunin zinaren filin; microscopy/noma na ƙashi/safara/ƙwayoyin lymph. PCR: Mafi girman inganci. CL: Microscopy da noma na biopsy na ƙurje; PCR. DAT (Direct Agglutination Test): Inganci mai girma ga VL. Eosinophilia BABU — bambanci da yawancin cututtukan parasitic.
Magani
Hanyoyin magani da ake da su
CL: sodium stibogluconate (Pentostam) ko meglumine antimoniate (Glucantime) — allura tsawon kwanaki 20. Amphotericin B ga cututtukan da ba su amsa magani ba. A wasu lokutan CL yana warkewa da kansa cikin watanni 6-12. VL: Liposomal amphotericin B (AmBisome) — maganin farko na WHO ga VL; allura guda daya ko kadan tana iya warkar da cutar. Miltefosine (magani na baki) — madadin. Combination therapy (sodium stibogluconate + paromomycin) a gabashin Afirka.
Yawancin lokuta ana magance su yadda ya kamata tare da gano cutar da wuri.
Cikakkun bayanin rigakafi
Yadda za ka kare kanka
Kariya daga cizon kudan yashi: gidan sauro mai rami mai kankaninta (fine-mesh net — kudan yashi ya fi sauro kankaninta), DEET a fata da yamma/daddare, permethrin a tufafi da gidan sauro. Sauya yanayin gida: toshe ramukan gida inda kudan yashi ke shiga, fesa maganin kwari a dakuna. Babu allurar rigakafi. A yankunan rikici (Borno): UNHCR/WHO suna rarraba gidan sauro da magungunan fesa.
Shirye-shirye shine mafi kyawun kariya.
Shawarar tafiya
Haɗari: Kudancin Asiya (India, Bangladesh, Nepal ga VL), Gabas ta Tsakiya (CL), Gabashin Afirka (VL), Kudanci da Tsakiyar Amurka (CL/MCL). Mafi yawan masu tafiya suna samun CL bayan ziyartar yankunan daji. Yi amfani da maganin sauro, gidajen sauro na gado (<0.6mm), tufafin rufe da dare. Bayan dawowa: Ƙuraje na fata da ba su warke cikin makonni 2 ba — nemi likita ka ambaci yankin tafiya.
Yaya yawancinta?
Ƙididdiga da bayanan yanki
VL: Sabbin cututtuka 50,000–90,000/shekara; >90% a India, Bangladesh, Sudan, Kudancin Sudan, Ethiopia, Brazil. CL: Cututtuka 600,000–1M/shekara; galibi a Afghanistan, Brazil, Iran, Peru, Saudi Arabia, Syria. MCL: Galibi Kudancin Amurka (L. braziliensis). Yanayi: VL tana raguwa India/Bangladesh (burin kawarwa); CL tana ƙaruwa saboda rikici (Syria, Afghanistan).
Dalilan haɗari
Wanene ke cikin haɗarin mafi girma
Haɗarin fallasa: Zama/tafiya yankunan cutar, ayyuka a waje da dare (lokacin da ƙudaje suka fi aiki), gidaje marasa kyau (gidajen laka/ciyawa), rashin abinci mai gina jiki, cunkoson jama'a. Cutar mai tsanani (VL): Kamuwa tare da HIV (haɗari 100–2,300× na VL), raunin garkuwar jiki, rashin abinci mai gina jiki, shekaru <5 ko >50, hijira/gudun hijira.
Cikakkun bayanan matsaloli
Rikitarwa da za ta iya faruwa
VL: Kamuwa na biyu (ciwon huhu, TB — babbar sanadin mutuwa), zubar jini mai tsanani, PKDL (5–20%, ƙuraje na fata bayan magani, wurin ajiye cutar), VL-HIV (sakamakon da ba shi da kyau, dawowa akai-akai). CL: Manyan tabo na fuska, kyama ta zamantakewa. MCL: Rushewar septum na hanci, lalacewar fuska, wahalar numfashi/haɗiya. Magani: Gubar antimonials (zuciya, pancreas).
Murmurewa da hasashe
Sakamakon da ake tsammani da murmurewa
VL ba tare da magani ba: CFR >95% cikin shekaru 2, galibi saboda kamuwar biyu ko zubar jini. VL tare da magani: Adadin warwarewa 90–95%. Dawowa 1–10% (har 60% a VL-HIV). PKDL yana faruwa 5–20% bayan magani. Cutaneous: Yana warkewa kansa watanni 2–18, amma da tabo. Mucocutaneous: Cutar da ke ci gaba da lalacewa; ba ta warkewa kanta ba.