Bayanin gabaɗaya
Leptospirosis cuta ce da ƙwayar Leptospira ke haifarwa. Tana yaduwa ta hanyar fitsarin dabbobi da ke gurɓata ruwa. Tana iya shafar hanta da koda.
Alamomi
Alamomi | Yawan faruwa | Tsanani | Farawa |
|---|---|---|---|
| Jan ido | 40% | Dan kadan | Farkon cuta |
| Sanyi | 70% | Dan kadan | Farkon cuta |
| Zazzabi | 97% | Matsakaici | Farkon cuta |
| Ciwon kai | 98% | Matsakaici | Farkon cuta |
| Zazzabi mai tsanani | 75% | Matsakaici | Farkon cuta |
| Ciwon tsoka | 90% | Matsakaici | Farkon cuta |
| Ciwon baya | 50% | Dan kadan | Farkon cuta |
| Rashin son ci | 65% | Dan kadan | Farkon cuta |
| Rashin jin daɗi | 65% | Dan kadan | Farkon cuta |
| Tashin zuciya | 60% | Dan kadan | Farkon cuta |
| Ciwo a bayan ido | 35% | Dan kadan | Farkon cuta |
| Amai | 50% | Dan kadan | Farkon cuta |
| Ƙurji | 10% | Dan kadan | Farkon cuta |
| Shanƙe | 10% | Mai tsanani | Kololuwar cuta |
| Ƙarancin fitsari | 15% | Mai tsanani | Kololuwar cuta |
| Duhuwar fitsari | 12% | Matsakaici | Kololuwar cuta |
| Fitar da jini ta tari | 3% | Hadari | Kololuwar cuta |
| Zubar jini | 5% | Mai tsanani | Kololuwar cuta |
| Kumburin hanta | 25% | Dan kadan | Kololuwar cuta |
| Raguwar matsin jini | 8% | Mai tsanani | Kololuwar cuta |
| Ƙarancin numfashi | 8% | Mai tsanani | Kololuwar cuta |
| Ƙananan ɗigon jini | 8% | Dan kadan | Kololuwar cuta |
| Kumburin saifa | 15% | Dan kadan | Kololuwar cuta |
| Ciwon ciki | 40% | Dan kadan | Kowane lokaci |
| Tari | 25% | Dan kadan | Kowane lokaci |
| Zawo | 30% | Dan kadan | Kowane lokaci |
| Saurin bugun zuciya | 30% | Dan kadan | Kowane lokaci |
Hanyoyin yaduwa
Bayanin gabaɗaya
Leptospirosis cuta ce ta zoonotic ta ƙwayar cuta da spirochete masu cutarwa na dangin Leptospira (>300 serovars) suke haifarwa. Ana ɗaukarta a matsayin cutar zoonotic da ta fi yaɗuwa a duniya. Wurin ajiyewa: beraye, karnuka, shanu, alade. Yaɗuwa ta hanyar taɓar fata/jijiyoyi da ruwa/ƙasa mai gurbata. 5–15% suna samun cutar Weil (rawaya, gazawar koda, zubar jini; CFR 5–15%). ~cututtuka miliyan 1 da mutuwa 58,900/shekara.
Bayanin gabaɗaya
Leptospirosis cutar da kwayoyin cuta Leptospira ke haifarwa. Yaduwa: hulda da ruwa ko kasa da fitsarin beraye/dabbobi ya gurbata — musamman a lokacin ambaliyar ruwa. A Najeriya: ambaliyar ruwa a lokacin damina (musamman a yankunan karkarar Arewaci da jihohin kudu) tana kara hadarin kamuwa. Ba a yawan gano cutar a Najeriya saboda alamominta sun yi kama da malaria da leptospirosis ba ta cikin gwaje-gwajen da ake yi a yau da kullum. Cutar Weil (Weil's disease): rawaya + gazawar koda + zubar jini — mutuwa kashi 10-50%.
Alamomin gaggawa
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Tofi jini (zubar jini na huhu) — na iya nuna SPHS (CFR >50%)
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Rawaya — hanta ta shiga, cutar Weil
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Ƙarancin fitsari/babu fitsari — gazawar koda
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Zubar jini daga hakori, hanci; ƙananan tabo, kashin baki mai jini
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Ciwon ƙirji/bugun zuciya mara daidaituwa — myocarditis
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Taurin wuya da ciwon kai mai tsanani — meningitis
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Ƙasƙantar hawan jini duk da ruwan sha — girgiza Musamman da tarihin taɓa ruwan ambaliya ko dabbobi a yankunan zafi.
Cikakkun alamomi
Alamomi da alamu mafi yawa
Leptospirosis ba tare da rawaya ba (85–90%): Mataki na 1: Zazzaɓi mai tsanani na kwatsam, ciwon kai mai tsanani, ciwon tsokokin ƙafa da kugu (mai nuni sosai), jajayen ido (30–40%, mai nuni), tashin zuciya. Mataki na 2: Zazzaɓin da ya dawo, meningitis. Cutar Weil (5–15%): Rawaya mai zurfi, AKI (hypokalemic), zubar jini, thrombocytopenia, myocarditis. SPHS: Zubar jini na alveolar, tofi jini; CFR >50%.
Sanin alamomi shine mataki na farko don amsa cikin sauri.
Tafiyar cuta
Leptospira suna shiga fata/jijiyoyi → Shiryawa kwanaki 7–12 → Mataki na 1 (kwanaki 3–7): Zazzaɓi na kwatsam, ciwon ƙafa, jajayen ido; leptospira a cikin jini/CSF. Gajeren lokacin da zazzaɓi ta rage (kwanaki 1–3). Mataki na 2 (kwanaki 7–14): Zazzaɓin da ya dawo, meningitis, uveitis. Cutar Weil: Ba tare da rabuwar biphasic ba — rawaya mai ci gaba, gazawar koda, zubar jini (kwanaki 4–7). SPHS (kwanaki 4–10): Zubar jini na alveolar na kwatsam.
Binciken cuta
Yadda ake gano wannan cutar
MAT (Microscopic Agglutination) — ma'aunin zinare; ƙaruwar ninka 4 tana tabbatarwa; tana gano serogroup; a dakunan gwaje na musamman kawai. IgM-ELISA — daga rana 5–7, inganci 52–97%. PCR — a cikin jini (kwanaki 7–10 na farko) da fitsari (bayan mako 1). Noma — a hankali (makonni 1–13). Alamomin asibiti: Zazzaɓi + ciwon ƙafa + jajayen ido + tarihin ruwa/dabba = mai nuna sosai.
Magani
Hanyoyin magani da ake da su
Sauƙi: Doxycycline 100mg sau 2/rana kwanaki 7 (na farko), azithromycin (madadin, lafiyayye ga masu juna biyu), amoxicillin. Guji NSAID. Mai tsanani: IV Penicillin G 1.5M IU kowane sa'o'i 6 ko IV Ceftriaxone 1g/rana; aƙalla kwanaki 7. Jarisch-Herxheimer na iya faruwa. Tallafawa: Dialysis (AKI yawanci ana iya gyarawa), injin numfashi ga SPHS, kayan jini. Rigakafi: Doxycycline 200mg sau 1/mako ga haɗarin girma.
Yawancin lokuta ana magance su yadda ya kamata tare da gano cutar da wuri.
Cikakkun bayanin rigakafi
Yadda za ka kare kanka
Babu allurar rigakafi da ake samu ko'ina (a wasu ƙasashe na musamman ga serovar). Kariyar kai: Guji ruwan da ya iya gurbata, bandeji masu hana ruwa akan raunuka, takalmin roba, safar hannu lokacin taɓa dabbobi. Kariyar aiki: Yaƙi da beraye, PPE ga ma'aikatan magudanar ruwa/manoma. Muhalli: Yaƙi da beraye, kula da ambaliya. Rigakafi: Doxycycline 200mg/mako ga haɗarin girma.
Shirye-shirye shine mafi kyawun kariya.
Shawarar tafiya
Yankunan haɗari mai girma: Kudu-Gabashin Asiya (Thailand, Philippines, Indonesia), Kudancin Asiya (India, Sri Lanka), Tsakiya/Kudancin Amurka (Brazil, Peru), Tsibiran Pacific, Caribbean. Ayyukan haɗari: Rafting, kayak, iyo a cikin ruwan daci, tafiya a cikin daji. Shawarwari: Bandeji masu hana ruwa, takalmin roba. Bayan dawowa: Nemi likita da zazzaɓi, ciwon ƙafa ko rawaya cikin kwanaki 2–30 — ambaci leptospirosis!
Yaya yawancinta?
Ƙididdiga da bayanan yanki
~cututtuka miliyan 1.03 da mutuwa 58,900/shekara (GBD 2015). Mafi girman adadi a yankunan zafi (10–100+/100,000). Ba a gane ta isa ba. Muhimman annoba: Philippines (kowace shekara, guguwa), Brazil (annoba na birane, >3,000/shekara), India (monsoon, Mumbai/Kerala). Yanayi: Lokacin damina/monsoon. Maza:Mata 3–4:1. Sauyin yanayi zai ƙara nauyin duniya.
Dalilan haɗari
Wanene ke cikin haɗarin mafi girma
Haɗarin fallasa: Ambaliya (mafi muhimmancin dalili a duniya), ruwan daci, gonar shinkafa, magudanar ruwa, soja, taɓa beraye, wasannin kasaɗa, ƙauyukan birane marasa kyau. Cutar mai tsanani: Jinkirtar magani >kwanaki 4, shekaru >40, jinsin namiji, wasu serovars (Icterohaemorrhagiae), cutar hanta da ta rigaya, raunin garkuwar jiki.
Cikakkun bayanan matsaloli
Rikitarwa da za ta iya faruwa
Koda: AKI a 40–60% na cutar Weil — yawanci ba oliguria ba kuma hypokalemic (bambanci da sauran AKI); yawanci ana iya gyarawa. Hanta: Rawaya na cholestatic (bilirubin galibi >15 mg/dL, AST/ALT yawanci <200 — bambanci da hepatitis na kwayar cuta). Huhu: SPHS — zubar jini na alveolar; CFR >50%. Zuciya: Myocarditis, arrhythmia. Ido: Uveitis na leptospiral (makonni 2 zuwa shekaru 2 bayan kamuwa, na iya dawowa).
Murmurewa da hasashe
Sakamakon da ake tsammani da murmurewa
Ba tare da rawaya ba: Kyakkyawan hasashe, yana warwarewa kansa makonni 1–3. Cutar Weil: CFR 5–15% tare da magani (20–40% ba tare da ICU ba). AKI yawanci ana iya gyarawa. SPHS: CFR >50%, mutuwa galibi cikin sa'o'i 72. Alamomin sakamakon da ba shi da kyau: Rashin hankali, ƙarancin fitsari, zubar jini na huhu, creatinine >3 mg/dL, bilirubin >10 mg/dL, shekaru >40, jinkirtar antibiotics >kwanaki 4.