Cutar Chagas

Cutar Chagas
Description (en)
Iri	trypanosomiasis (en) Yankin da ke cikin cuta (epidemiology)
Field of study (en)	Cututtukan cututtuka (ƙwarewar kiwon lafiya) parasitology (en)
Sanadi	Trypanosoma cruzi (mul)
Symptoms and signs (en)	chagoma (en) , Romana's sign (en) , lalacewar tsokar zuciya, myocarditis (en) , hepatomegaly (en) , Sifa, megacolon (en) , diarrhea, zazzaɓi amai
Disease transmission process (en)	insect borne transmission (en)
Physical examination (en)	physical examination (en) optical microscope (en)
Shekarar farawa	any age (en)
Suna saboda	Carlos Chagas (mul)
Therapy (en)
Magani	benznidazole (en) da nifurtimox (en)
Identifier (en)
ICD-10-CM	B57.3, B57.2, B57.0, B57, B57.1, B57.4 da B57.5
ICD-9-CM	086.2
DiseasesDB	13415
MedlinePlus	001372
eMedicine	001372
MeSH	D014355
Disease Ontology ID	DOID:12140

Cutar Chagas, wanda aka fi dangi da Tripanosomiasis na Amurka, cuta ce ta wurare masu zafi da Trypanosoma cruzi ke haifar. An yada shi galibi ta kwari a cikin subfamily Triatominae, wanda aka sani da "kissing bugs". Alamomin suna canzawa a duk lokacin kamuwa da cuta. A farkon matakin, alamun bayyanar cututtuka yawanci ba su kasance ba ko kuma masu sauƙi kuma suna iya haɗawa da zazzabi, kumburi na lymph, ciwon kai, ko kumburi a wurin ciwo.^[1] Bayan makonni huɗu zuwa takwas, mutanen da ba a kula da su ba sun shiga cikin cututtukan cututtuka, wanda a mafi yawan lokuta ba ya haifar da ƙarin alamomi.^[2][3] Har zuwa kashi 45% na mutanen da ke fama da cututtukan zuciya suna kamuwa da Cutar zuciya shekaru 10-30 bayan cutar ta farko, wanda zai iya haifar da gazawar zuciya. Matsalolin narkewar abinci, gami da karuwar esophagus ko karuwar colon, na iya faruwa a cikin har zuwa 21% na mutane, kuma har zuwa 10% na mutane na iya fuskantar lalacewar jijiyoyi.^[2]

T. cruzi yawanci yana yaduwa ga mutane da sauran dabbobi masu shayarwa ta hanyar raunin da kwari ya ci da kuma naman kwari.^[4] Hakanan ana iya yaduwar cutar ta hanyar ƙarin jini, transplantation na gabobin, cin abinci ko abin sha da aka gurɓata da kwayar cuta, da kuma watsawa a tsaye (daga uwa zuwa jaririnta). ^[1] Binciken cutar ta farko shine ta hanyar gano kwayar cutar a cikin jini ta amfani da microscope ko gano DNA ta hanyar polymerase chain reaction.^[3] Ana gano cutar ta yau da kullun ta hanyar gano magungunan rigakafi ga T. cruzi a cikin jini.^[5]

Rigakafin yana mai da hankali kan kawar da kwari masu sumba da guje wa cinyewar su.^[1] Wannan na iya haɗawa da amfani da Magungunan kashe kwari ko gado-nets.^[6] Sauran kokarin rigakafi sun hada da tantance jinin da aka yi amfani da shi don ƙarin jini. Ana iya magance cututtukan farko tare da magungunan benznidazole ko nifurtimox, wanda yawanci ke warkar da cutar idan aka ba shi jim kadan bayan an kamu da cutar, amma ya zama mara tasiri yayin da mutum ya sami cutar Chagas. Lokacin da aka yi amfani da shi a cikin cututtukan da ba su da tsanani, magani na iya jinkirta ko hana ci gaban alamun ƙarshe. Benznidazole da nifurtimox sau da yawa suna haifar da sakamako masu illa, gami da cututtukan fata, fushin tsarin narkewa, da alamun jijiyoyin jiki, wanda zai iya haifar da dakatar da magani.^[2][7] Sabbin magunguna don cutar Chagas suna ci gaba, kuma yayin da aka yi nazarin allurar rigakafi gwaji a cikin samfurin dabbobi, ba a samar da allurar rigar mutum ba.^[8][9][10]

Cutar Chagas tana faruwa a matakai biyu: hanci mataki mai tsanani, wanda ke tasowa mako daya zuwa biyu bayan cin kwari, da kuma mataki mai tsanani. ^{[2] [3]} Mataki mai tsanani sau da yawa ba shi da alamomi.^[2] Lokacin da yake, alamun yawanci ƙananan ne kuma ba takamaiman wani cuta ba.^[3] Alamomi da alamun sun haɗa da zazzabi, Rashin lafiya, ciwon kai, da fadada hanta, ƙashin jini, da Ƙwayoyin lymph.^[1][2][3] Wani lokaci, mutane suna samun kumburi a wurin kamuwa da cuta, wanda ake kira "alamu na Romaña" idan yana kan ido, ko kuma "chagoma" idan yana wani wuri a kan fata.^[3][11] A lokuta masu wuya (kasa da 1-5%), mutanen da suka kamu da cutar suna kamuwa da mummunar cuta, wanda zai iya haɗawa da kumburi na tsokoki na zuciya, tara ruwa a kusa da zuciya, da kumburi a kwakwalwa da kyallen da ke kewaye da su, kuma yana iya zama barazana ga rayuwa. Mataki mai tsanani yawanci yana ɗaukar makonni huɗu zuwa takwas kuma yana ƙuduri ba tare da magani ba.^[2]

Sai dai idan an yi musu magani da magungunan rigakafi, mutane suna ci gaba da kamuwa da T. cruzi bayan sun warke daga mummunan lokaci. Yawancin cututtukan cututtukani ba su da alamomi, wanda ake kira cutar Chagas mai tsanani. Koyaya, sama da shekarun da suka gabata tare da cutar, kusan 30-40% na mutane suna fama da rashin aiki na gabobin jiki (ƙayyadadden cutar Chagas mai tsanani), wanda galibi yana shafar zuciya ko Tsarin narkewa.^[2][3]

Mafi yawan bayyanar na dogon lokaci shine Cutar zuciya, wanda ke faɗuwa a cikin 14-45% na mutanen da ke fama da cutar Chagas mai tsanani.^[2] Mutanen da ke fama da cutar zuciya ta Chagas galibi suna fuskantar bugun zuciya, kuma wani lokacin suna raunana, saboda aikin zuciya mara kyau. Ta hanyar electrocardiogram, mutanen da ke fama da cutar zuciya ta Chagas galibi suna da arrhythmias. Yayin da cutar ke ci gaba, ventricles na zuciya ya karu (dilated cardiomyopathy), wanda ke rage ikonsa na famfo jini. A lokuta da yawa, alamar farko ta cutar zuciya ta Chagas ita ce gazawar zuciya, thromboembolism, ko ciwon kirji da ke da alaƙa da abnormalities a cikin microvasculature.^[12]

Har ila yau, ya zama ruwan dare a cikin cutar Chagas mai tsanani shine lalacewar tsarin narkewa, wanda ke shafar 10-21% na mutane.^[2] Girman esophagus ko colon sune batutuwan narkewa na yau da kullun. Wadanda ke da ƙaruwa mai girma sau da yawa suna fuskantar ciwo (odynophagia) ko matsala ta haɗiyewa (dysphagia), ƙuƙwalwar acid, tari, da asarar nauyi. Mutanen da ke fama da karuwar hanji sau da yawa suna fuskantar ƙuntatawa, kuma suna iya haifar da mummunar toshewar hanji ko jininsa. Har zuwa kashi 10% na mutanen da suka kamu da cutar ta ci gaba suna haifar da lalacewar jijiyoyi wanda zai iya haifar da rashin ƙarfi da canzawa ko motsi.^[2] Duk da yake cututtukan da ba su da tsanani yawanci suna tasowa sama da shekaru da yawa, wasu mutane da ke fama da cutar Chagas (kasa da 10%) suna ci gaba zuwa lalacewar zuciya kai tsaye bayan mummunar cuta.^[12]

Cutar Chagas ta samo asali ne daga kamuwa da cuta tare da kwayar cutar protozoan T. cruzi, wanda yawanci ake gabatar da shi cikin mutane ta hanyar cin kwari na triatomine, wanda kuma ake kira "kissing bugs".[1] Lokacin da kwari ya lalace a wurin cinyewa, nau'ikan T. cruzi da ake kira trypomastigotes sun shiga cikin jini kuma sun mamaye ƙwayoyin halitta daban-daban.[2] A cikin tantanin halitta, kwayar cutar ta canza zuwa wani nau'i mai kama da ake kira amastigote, wanda ke fuskantar zagaye da yawa na maimaitawa.[2] Kwayoyin da aka sake maimaitawa sun canza zuwa trypomastigotes, wanda ke fashewar tantanin halitta kuma ana sake su cikin jini.[3] Trypomastigotes sa'an nan kuma suna yadawa a cikin jiki zuwa kyallen takarda daban-daban, inda suke mamaye sel kuma suna maimaitawa.[3] A cikin shekaru da yawa, sake zagayowar kwayar cuta da amsawar rigakafi na iya lalata waɗannan ƙwayoyin, musamman zuciya da hanyar narkewa.[3]

Rarraba

[gyara sashe | gyara masomin]

T. cruzi na iya yaduwa ta hanyar kwari daban-daban na triatomine a cikin jinsunan Triatoma, Panstrongylus, da Rhodnius.[1] Abubuwan da ke haifar da kamuwa da cuta na mutum sune nau'in kwari na triatomine waɗanda ke zaune a gidajen mutane, wato Triatoma infestans, Rhodnius prolixus, Triatoma dimidiata da Panstrongylus megistus.[2] Wadannan kwari an san su da sunayen gida da yawa, gami da vinchuca a Argentina, Bolivia, Chile da Paraguay, barbeiro (mai aski) a Brazil, pito a Colombia, chinche a Amurka ta tsakiya, da Chipo a Venezuela.[3] Kwayoyin suna cin abinci da dare, sun fi son wurare masu laushi kusa da idanu ko baki.[4][2] Kwayar cutar triatomine na iya kamuwa da T. cruzi lokacin da take cin abinci a kan mai kamuwa da cutar.[4] T. cruzi ya sake maimaitawa a cikin hanji na kwari kuma an zubar da shi a cikin datti na kwari.[4] Lokacin da triatomine mai kamuwa da cuta ya ci abinci, sai ya shiga fata kuma ya shiga abinci na jini, yana zubar da ciki a lokaci guda don samar da wuri don sabon abinci.[4] Yawanci ba shi da zafi, amma yana haifar da ƙishirwa.[4] Gishiri a cinyewar yana gabatar da T. cruzi-laden feces a cikin raunin cinyewa, yana fara kamuwa da cuta.

Baya ga yaduwar cututtukan gargajiya, ana iya yaduwar cutar Chagas ta hanyar cin abinci ko abin sha da aka gurɓata da kwari na triatomine ko datti.[1] Tun da yake dumama ko bushewa yana kashe kwayar cuta, abin sha kuma musamman ruwan 'ya'yan itace sune mafi yawan tushen kamuwa da cuta.[1] Wannan hanyar yaduwar baki an haɗa ta da barkewar cututtuka da yawa, inda ya haifar da alamun bayyanar cututtuka masu tsanani, mai yiwuwa saboda kamuwa da cuta tare da nauyin kwayar cuta mafi girma fiye da daga cin kwari na triatomine - [1] triatomine guda ɗaya a cikin abinci ko abin sha mai dauke da T cruzi na iya ƙunshe da kusan 600,000 metacyclic trypomastigotes, yayin da triatomine fecal matter ya ƙunshi 3,000-4,000 a kowace μL.[2][3]

Kokarin hana cutar Chagas ya fi mayar da hankali kan kula da vector don iyakance bayyanar kwari na triatomine. Shirye-shiryen yaduwar ƙwayoyin cuta sun kasance babban abin da ke tattare da kula da ƙwayoyin ƙwayoyin, wanda ya ƙunshi gidajen yaduwar da ke kewaye da su tare da magungunan ƙwayoyin.^[13] An fara yin wannan ne da organochlorine, organophosphate, da carbamate insecticides, waɗanda aka maye gurbinsu a cikin 1980s tare da pyrethroids.^[13] Wadannan shirye-shiryen sun rage yaduwa sosai a Brazil da Chile, kuma sun kawar da manyan cututtuka daga wasu yankuna: Triatoma infestans daga Brazil, Chile, Uruguay, da sassa na Peru da Paraguay, da kuma Rhodnius prolixus daga Amurka ta tsakiya. ^[12] Kula da kwayoyin cuta a wasu yankuna an hana su ta hanyar ci gaban juriya ta maganin kwari tsakanin kwari na triatomine.^[13] A mayar da martani, shirye-shiryen kula da kwayoyin sun aiwatar da madadin magungunan kwari (misali fenitrothion da bendiocarb a Argentina da Bolivia), maganin dabbobin gida (wanda kuma kwari na triatomine ke ciyar da su) tare da magungunan kashe kwari, fentin da aka yi da magunguna, da sauran hanyoyin gwaji.^[13] A yankunan da ke da kwari na triatomine, ana iya hana yaduwar T. cruzi ta hanyar barci a ƙarƙashin raga da kuma inganta gidaje waɗanda ke hana kwari na Triatomine daga mulkin mallaka gidaje.^[14]

Jinin jini a baya shine yanayin yaduwar cutar Chagas na biyu.^[15] T. cruzi na iya rayuwa a cikin jinin da aka adana a firiji, kuma yana iya tsira daga daskarewa da narkewa, yana ba shi damar ci gaba a cikin jini gaba ɗaya, jajayen ƙwayoyin jini, granulocytes, cryoprecipitate, da platelets.^[15] Ci gaba da aiwatar da gwaje-gwaje na binciken bankin jini sun rage haɗarin kamuwa da cuta yayin ƙarin jini.^[15] Kusan dukkanin gudummawar jini a cikin ƙasashen Latin Amurka suna fuskantar gwajin Chagas.^[15] Ana kuma nunawa a ko'ina a cikin ƙasashe da ba na musamman ba tare da yawan baƙi daga yankunan da ba su da yawa, gami da Ingila (wanda aka aiwatar a 1999), Spain (2005), Amurka (2007), faranti da Sweden (2009), Switzerland (2012), da Belgium (2013). ^[16] Ana amfani da gwaje-gwaje na serological, yawanci ELISAs, don gano magungunan rigakafi akan sunadarai na T. cruzi a cikin jinin mai ba da gudummawa.^[15]

• Magunguna don Cututtukan da aka yi watsi da su
• Chagas: Lokaci don Magana

1. 1 2 3 4 "Chagas disease (American trypanosomiasis)". World Health Organization. 17 April 2019. Archived from the original on 20 January 2020. Retrieved 9 March 2020. Cite error: Invalid <ref> tag; name "WHO2019" defined multiple times with different content.
2. 1 2 3 4 5 6 7 8 9 10 11 Pérez-Molina JA, Molina I (2018). "Chagas disease". The Lancet. 391 (10115): 82–94. doi:10.1016/S0140-6736(17)31612-4. ISSN 0140-6736. PMID 28673423. S2CID 4514617. Cite error: Invalid <ref> tag; name "Molina2018" defined multiple times with different content.
3. 1 2 3 4 5 6 7 Bern C (July 2015). "Chagas' disease". N. Engl. J. Med. (Review). 373 (5): 456–66. doi:10.1056/NEJMra1410150. PMID 26222561. Cite error: Invalid <ref> tag; name "Bern2015" defined multiple times with different content.
4. ↑ "DPDx – Trypanosomiasis, American. Fact Sheet". Centers for Disease Control (CDC). 30 April 2019. Archived from the original on 5 September 2019. Retrieved 10 March 2020.
5. ↑ Guarner J (May 2019). "Chagas disease as example of a reemerging parasite". Seminars in Diagnostic Pathology. 36 (3): 164–9. doi:10.1053/j.semdp.2019.04.008. PMID 31006555.
6. ↑ "Prevention of Chagas disease". World Health Organization. Archived from the original on 11 February 2018. Retrieved 24 February 2018.
7. ↑ Santi AM, Murta SM (2022). "Antioxidant defence system as a rational target for Chagas disease and Leishmaniasis chemotherapy". Memórias do Instituto Oswaldo Cruz. 117. doi:10.1590/0074-02760210401. PMC 8896756 Check |pmc= value (help). PMID 35239945 Check |pmid= value (help).
8. ↑ Porta EO, Kalesh K, Steel PG (2023). "Navigating drug repurposing for Chagas disease: advances, challenges, and opportunities". Front Pharmacol. 14. doi:10.3389/fphar.2023.1233253. PMC 10416112 Check |pmc= value (help). PMID 37576826 Check |pmid= value (help).
9. ↑ Rios LE, Vázquez-Chagoyán JC, Pacheco AO, Zago MP, Garg NJ (2019). "Immunity and vaccine development efforts against Trypanosoma cruzi". Acta Tropica. 200. doi:10.1016/j.actatropica.2019.105168. ISSN 0001-706X. PMC 7409534. PMID 31513763.
10. ↑ Vermelho AB, Rodrigues GC, Supuran CT (2019). "Why hasn't there been more progress in new Chagas disease drug discovery?". Expert Opinion on Drug Discovery. 15 (2): 145–158. doi:10.1080/17460441.2020.1681394. ISSN 1746-0441. PMID 31670987. S2CID 207815975.
11. ↑ "Chagas Disease – Detailed Fact Sheet". www.cdc.gov. CDC-Centers for Disease Control and Prevention. Archived from the original on 16 August 2019. Retrieved 15 April 2020.
12. 1 2 3 Nunes MC, Beaton A, Acquatella H, et al. (September 2018). "Chagas cardiomyopathy: an update of current clinical knowledge and management: a scientific statement from the American Heart Association". Circulation (Review). 138 (12): e169–e209. doi:10.1161/CIR.0000000000000599. PMID 30354432. Cite error: Invalid <ref> tag; name "Nunes2018" defined multiple times with different content.
13. 1 2 3 4 Mougabure-Cueto G, Picollo MI (September 2015). "Insecticide resistance in vector Chagas disease: Evolution, machanisms, and management". Acta Tropica. 149: 70–85. doi:10.1016/j.actatropica.2015.05.014. PMID 26003952. |hdl-access= requires |hdl= (help)
14. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named "PD7".
15. 1 2 3 4 5 Angheben A, Boix L, Buonfrate D, et al. (October 2015). "Chagas disease and transfusion medicine: a perspective from non-endemic countries". Blood Transfusion. 13 (4): 540–50. doi:10.2450/2015.0040-15. PMC 4624528. PMID 26513769.
16. ↑ Lidani KC, Andrade FA, Bavia L, et al. (July 2019). "Chagas disease: from discovery to a worldwide health problem". Frontiers in Public Health. 7. Bibcode:2019FrPH....7..166L. doi:10.3389/fpubh.2019.00166. PMC 6614205. PMID 31312626.