Chikungunya

Chikungunya bụ ọrịa nke Chikungunya virus (CHIKV) na-ebute.[1][2]  Mgbaàmà gụnyere ahụ ọkụ na mgbu mgbu.[3]  Ndị a na-emekarị ụbọchị abụọ ruo ụbọchị iri na abụọ mgbe ekpughere ya gasịrị.[2]  Mgbaàmà ndị ọzọ nwere ike ịgụnye isi ọwụwa, mgbu anụ ahụ, ọzịza nkwonkwo, na ọkụ ọkụ.[3]  Mgbaàmà na-akawanye mma n'ime otu izu;  Otú ọ dị, mgbe ụfọdụ, mgbu nkwonkwo nwere ike ịdịru ọnwa ma ọ bụ afọ.[3][4]  Ihe ize ndụ nke ọnwụ dị ihe dịka 1 n'ime 1,000.[5]  Ndị na-eto eto, ndị agadi, na ndị nwere nsogbu ahụ ike ndị ọzọ nọ n'ihe ize ndụ nke ọrịa ka njọ.[3] 

A na-agbasa nje a n'etiti ndị mmadụ site na ụdị anwụnta abụọ: Aedes albopictus na Aedes aegypti .  [1] Ha na-akakarị ata n'ụbọchị.  [2] Nje nwere ike ikiri n'ime anụ anụmanụ ekiri na òké .  [1] Nchọpụta bụ saịtị n'inyocha ike maka nje RNA ma ọ bụ ọgwụ nje.  [1] Enwere ike imehie ihe nke ahụ maka nke ahụ ọkụ dengue na ahụ ọkụ Zika .  [1] Ekwenyere na ọtụtụ ndị mmadụ na-alụso ọrịa ogụ mgbe otu ọrịa ahụ.

Ọ bụ ebe ahụ na ọrịa a na-emekarị n'Africa na Eshia, a kọwawo mmetụta na Europe na America nchebe afọ 2000. [1] Na 2014 ihe otu nde ndị a na-enyo enyo mere.  [1] Na 2014 ọ na-eme na Florida na kọntinent United States mana dịka nke 2016 akara ikpe enwetara mpaghara ọzọ.  [2] [3] Achọpụtara ọrịa a mbụ na 1952 na Tanzania .  [1] Okwu a sitere na asusu Kimakonde maputara "ime ka emekorita 

## Ihe ịrịba ama na mgbaàmà
11]dị ka okui 85 nke ndị na-ebu nje Chikungunya bu ọrịa na-enweta ihe, na-amalite site na nnukwu ahụ ọkụ na mgbakwunye 39 Celsius C (102 °F) .  [10] N'oge na-adịghị anya ahụ ọkụ na-esote oke ahụ ike na ego .  [11] MIhegbu na- adọta ọtụtụ ndị na ogwe aka na ụkwụ, ọ na-enwekwa symmetrical - ya bụ ma ọ bụrụ na ọ na-emetụta otu ike, nke ọzọ atụmatụ mma.  [11] Ndị nwere Chikungunya na-enwetakwa isi ihe, azụ, ọgbụgbọ, na ike mmụta .  [11] Ihe dị ka ọkara nke ndị ọ na-etolite ọkụ ọkụ, na -acha uhie na mgbe ụfọdụ obere mkpọ na ụbọ aka, ụbọ ụkwụ, ọkpụkpụ na ihu.  [11] Maka ụfọdụ, ihe ọkụ ọkụ na-pịa na-ejedebe na obere ahụ;  maka ndị ọzọ, ọkụ ọkụ ike ikike ukwuu, na-ekpuchi ihe ụmụaka 90% nke akpụkpọ ahụ.  [10] Ụfọdụ ndị mmadụ na-enwe nsogbu eriri afọ, na mgbu afọ na vomiting.  Ndị ọzọ na-enweta nsogbu anya, ya bụ uche na ìhè, conjunctivitis, na mgbu n'azụ anya.  [11] Ihe mbụ a - nke a na-akpọ "nnukwu oge" nke Chikungunya - na-adị ihe dị ka otu izu, mgbe nke ahụ nri, ọtụtụ nna na-edozi n'onwe 

[11]Ọtụtụ ndị mmadụ na-aga n'ihu na-enwe mmetụta mgbe "nnukwu ụdị", nke a na-akpọ "post-acute phase" maka maka na-adịru izu atọ ruo ụnwayọtọ, yana "ogbo oge" maka nlọ na  -adịru ogologo oge mgbochi ụgbụ.  [11] N' akara ngosi ahụ, akara na-adịgide adịgide na-egosi mgbu: ogbu na spa, tenosynovitis, na / ma ọ bụ bursitis .  [11] Ọ bụrụ na onye ahụ ahụ nwere nwere nsogbu ndị dị dịbu adị, ndị a na-akawanye njọ.  [11] Iji ike emebiga ihe ókè ike ime ka ọzịza na-egbu mgbu, isi ike, akwa akwa, na mgbu neuropathic .  [11] Na-emekarị mgbu na-akawanye mma ka oge na-aga;  Otú ọ dị nwere ike, ọnọdụ na-adịghị ala ala ike ikiri ebe ọ ALA site na ule ole na ole ruo ọtụtụ afọ.

. [11]Ndị nwere ike nwere Chikungunya na-enwekarị ike akwaa ozi, na-enwekarị ọzịrị ma ọ bụ ntọala nke ike, mbufụt ma ọ bụ isi nke sheaths myelin gburugburu neurons, ọrịa Guillain-Barré, nnukwu encephalomyelitis na-agbasa, hypotonia (n'ime ụmụ ,  ọhụrụ), na okwu gbasara anya.  [11] N'kaa ndị a na-ahụ ahụkebe, ndị nwe nwe ike izi-omume omume, odịdọ, mgbakasị nke cerebellum ma ọ bụ meninges, oculomotor nerve palsy, ma ọ bụ mkpọnwụ nke akwaa anya .  [11]

. [11]Na mgbakwunye na ụmụ ọhụrụ, ndị agadi, na ndị nwere ọrịa shuga, ọrịa obi, ọrịa imeju na pụtara, na ọrịa nje na-ahụ ahụkebe mmadụ na-enwekarị ọrịa Chikungunya ka njọ.  Ihe dị ka mmadụ 1 ruo 5 n'ime 1,000 ndị nwere ihe nkiri Chikungunya na-anwụ n'ihi ọrịa a

## Ihe kpatara ya

### Mbufe
Chikungunya ume anwụnta, gburugburu ha na omume.  Ntugharị nke anwụnta na egbochi ihu igwe nke North Africa ihe dị ka afọ 5,000 gara aga mere ka ha nso ebe ụmụ mmadụ na-echekwa mmiri.  Ebe obibi mmadụ na gburugburu anwụnta nwere njikọ chiri anya.  N'oge ọrịa na-efe efe, ụmụ mmadụ bụ ebe nchekwa nje.  N'ihi na nnukwu nje dị n' ịrịba na ngosi nke ọrịa dị oke njọ, nje nwere ike ike site na mmadụ viremic gaa anwụnta, ma kara na mmadụ.  [1] N'oge ndị ọzọ, enwe, ike na vertebrates ndị ọzọ na-eje ozi dị ka mmiri mmiri.  [2] A kọwawo ụdị genotype atọ nke nje a, nke ọ ble nwere ụdị genotype dị iche iche na agwa antigenic : West Africa, East/Central/South Africa, na genotypes Asia.  [3] Usoro mgbasa Eshia mgbasa na 1952 wee kewaa ụzọ - India (India Ocean Lineage) na South East Asia clades.  Ebu ụzọ mara nje a na America na 2014. ihe phylogenetic egosila na e nwere ụdị abụọ na Brazil - ụdị Eshia na East / Central / South Africa - na ụdị Asia rutere na Caribbean (yikarịrị site na Oceania) n'ihe dị ka March 2013  . [4] A na-eme ememe na evolushọn molekụla nwere ihe dị ka 5 × 10 -4 ngbanwe kwa saịtị kwa afụ (95% n ikpe nke puru omume dị elu 2.9-7.9 × 10 -4 ).  [4]

. A na-agbasa Chikungunya site na aru sitere na anwụnta Aedes, na ụdị A. aegypti ka a na-dị ka ihe na-emekarị vector, ọ bụ ebe na nje na nso a na-ere na ọtụtụ ụdị ndị ọzọ, A.  albopictus .  [1] ihe nke ụlọ ọrụ Pasteur dị na Paris bụ aro ka nje virus Chikungunya na ndakpọ nke Reunion Island 2005-2006 butere ngbanwe nke mere ka anwụnta agụ Asia ( A. albopictus ) bute ya ngwa ngwa.  [2] Ụdị ndị ọzọ nwere ike ibunye nje Chikungunya akpọ Ae.  furcifer-taylori, Ae.  africanus, na Ae.  luteocephalus

## Mechanism
 Chikungunya na-ebufe mmadụ ma ọ bụrụ anwụnta bu ọrịa na-agbaji akpụkpọ ahụ wee bute nje ahụ n'ime ahụ.  Ihe na-akpata ọrịa chikungunya n'ime mmadụ ka nsogbu nke ọma, n'agbanyeghị ihe nke nso a.  Ọ dị ka na in vitro, nje Chikungunya nwere ike nwere ikeghachi na ndụ epithelial na endothelial mmadụ, fibroblasts isi na macrophages sitere na monocyte.  Mmụgharị nke nje virus bụ cytopathic nke ukwuu, mana ọ nwere ike ime ụdị-I na -II interferon .  [1] Na vivo, na igbu ihe na-eji mmetụta ndụ dị ndụ, nje chikungunya yiri ka ọ na- ike na fibroblasts, skeletal muscle progenitor cell, na myofibers.

### Ntugharị nje virus

## Nchọpụta nchọpụta
. A na-azụ Chikungunya na-adabere n'usoro ụlọọgwụ, ọrịa na-efe efe na ụlọ nyọkọ.  N' ọgwụ ọgwụ, nnukwu ihe ngosi nnukwu ahụ ọkụ na oke mgbu na-egosi ga-eduga na enyo chikungunya.  Usoro ọrịa na-efe efe ma onye ahụ agaala ma ọ bụ ihe oge na mpaghara ebe chikungunya dị n'ime ụbọchị iri na abụọ gara aga (ya bụ) oge nwere ike.  Usoro nkọwa ụlọ ọhụrụ mmetụta ọnụ lymphocyte na viremia .  muhim, ike nke ezigbo ezinụlọ ụlọ site na nje virus, RT-PCR, ma ọ bụ serological .

. Kewapụ nje virus na-enye nchoputa mgbasa, mana ọ na-ewe otu izu ma ọ bụ abụọ maka mmecha ma a ga-eme ngwaahịa ya na ụlọ ụlọ biosafety Andrew III .  [1] Usoro a kpọgidere ahịrị sel kpọmkwem na- sitere na ọkụ dum yana nje Chikungunya - isi ndị ike.  A na-eji RT-PCR na-eji ụzọ abụọ agbụ akwuamụbawanye ọtụtụ ndị ji ndụ ihe nketa chikungunya sitere na ọkụ dum, na- puku kwuru nde ndị agha ihe nketa iji mata ha.  Iji RT-PCR iji mgbochi ibu nje dị n'ibu.  Iji RT-PCR, ndị ntakiri nwere ike ikike n'ime otu ụbọchị ma ọ bụ abụọ.  [1] Nchọpụta serological elele buru ụzọ ụzọ ndị ọzọ, ma na-eji nyọkọ ELISA iji ụda ọkwa IgM kpọmkwem chikungunya n'ime ọkụ ọkụ.  Otu uru nke serological nchoputa na-enye bụ na a na- mgbasa ozi IgM site na ụbọchị 5 ruo ụnwanwa nta nke nta nke anụ ahụ, ma ihe ndọghachi azụ bụ na-ahụ ahụ nwere ike ụbọchị ma ọ bụ atọ, na njedebe,  nwere ike ime na ọrịa n'ihi nje ndị ọzọ mgbasa ya, dị ka.  nje virus o'nyong'nyong na nje Semliki Forest

## Mgbochi
thumb| ''A. aegypti'' anwụnta na-ata mmadụ
Yiri ogologo aka uwe na uwe ogologo ọkpa na-makà ihe ahụ na- mkpa, na uwe nwere ike iji pyrethroids, otu klas nke ụmụ na-enwe ihe ndị na-awụ oyi.  Pyrethroid vaporized (kaka ọmụmaatụ na eriri anwụnta) bụkwa ihe na-ahụ ụmụ anụmanụ.  Dị ka anwụnta ndị butere ọrịa na-eri nri ma na-ezu ike n'ime ụlọ, ichekwa enyo na windo na ọnụ ụzọ ga-enyere aka enyemaka anwụnta n' ilo.  N'ihe ndị na-arụ ọrụ A. aegypti na A. albopictus, Otú ọ dị, nke a ga-enwe nanị ike dị nta, ebe ọ bụ na ọtụtụ ndị n'etiti anwụnta na ụmụ mmadụ na-eme n'ahụ.  

### Ọgwụ mgbochi ọrịa
, no approved vaccines are available. A phase-II vaccine trial used a live, attenuated virus, to develop viral resistance in 98% of those tested after 28 days and 85% still showed resistance after one year. However, 8% of people reported transient joint pain, and attenuation was found to be due to only two mutations in the E2 glycoprotein. Alternative vaccine strategies have been developed, and show efficacy in mouse models. In August 2014 researchers at the National Institute of Allergy and Infectious Diseases in the USA were testing an experimental vaccine which uses virus-like particles (VLPs) instead of attenuated virus.  All the 25 people participated in this phase 1 trial developed strong immune responses. As of 2015, a phase 2 trial was planned, using 400 adults aged 18 to 60 and to take place at 6 locations in the Caribbean. Even with a vaccine, mosquito population control and bite prevention will be necessary to control chikungunya disease. In 2021, two vaccine manufacturers, one in France, the other in the United States, reported successful completion of Phase II clinical trials.

## Ọgwụgwọ
Ugbu a, ọnweghị nsogbu maka chikungunya dị.  [1] A na-atụ aro nkwado, na-akụ nke ahụ ọkụ na ọkụ na ọzịza na-enye iji ọgwụ na-ahụ steroidal anti-inflammatory drugs dị ka naproxen, ndị na-eso aspirin analgesics dị ka paracetamol (acetaminophen) na mmiri mmiri.  .  [1] A naghị atụ aro aspirin n'ihi nnukwu ihe ize ndụ nke nyocha.  [2] N'agbanyeghị ọdịiche mkpali, a na-adịghị atụ aro corticosteroids n'oge nnukwu ọrịa nke ọrịa, n'ihi na ha nwere ike ịhụta immunosuppression na ọrịa na-akawanye njọ.

### Ọrịa ogbu na nkwonkwo na-adịghị ala ala
. N'ime ndị nwere ihe akụkọ izu abụọ nke ọrịa ogbu na nchekwa, ribavirin nwere ike ịba uru.  [1] chloroquine pụtara akara.  [1] O yighị ka ọ na-enyere nnukwu ọrịa aka, mana ihe mgbaàmà na-egosi na ọ nwere ike inyere ndị nwere ọrịa ogbu na-egosi aka.  [1] Steroid gosiri na ọ bụ nha dị irẹ.  [1] Enwere ike iji NSAIDs na analgesics dị mfe iji nyea mgbakasị ahụ n'ọtụtụ ọnọdụ.  Methotrexate, ọgwụ a na-eji na- ọrịa ogbu na-egosi, egosila na ọ ga-erite uru n'ịgwọrọ ọrịa polyarthritis na- pre nke sitere na chikungunya.

## Amụma
Apọọgụ nke chikungunya dị iche iche ihe na- mgbochi 1 n'ime 1000. [1] Ndị Passala afọ 65, ụmụ ọhụrụ, na ndị nwere nsogbu ngwaọrụ na- ala ala nwere ike inwe nnukwu nsogbu.  [2] Ụmụ ọhụrụ na-adị mfe n'ihi na ọ ga-ekwe omume ibunye chikungunya site na nne gaa na nwa ọhụrụ n'oge a na-amụ nwa, nke na-ebute ọnụ dị elu nke ọrịa, n'ihi  na ụmụ ngwaọrụ mkpa zuru oke.  [2] O bra ka ọ bụrụ na-adịte aka ma ọ bụ echekwa na-enweghị ala ala na-arị na awụ na-eme na ọrịa rheumatological tupu.

## Epidemiology
thumb| Akwụkwọ ndụ akwụkwọ ndụ gbara ọchịchịrị na-egosi mba nwere mgbasa ozi mpaghara ugbu a ma ọ bụ nke gara aga nke CHIKV, kwa CDC ruo Septemba 17, 2019.
. Pọọgụ ọrịa chikungunya zuru ụwa ọnụ na-agbanwe agbanwe, dabere na ihe.  Mgbe mbụ a mụrụ chikungunya n'afọ 1952, ọ na-ekesa n'ọkwa dị ala na West Africa, yana ọrịa mgbaàmà ya na mmiri ozuzo.  Malite n'afọ ndị 1960, a na-edekọ ọrịa na-efe efe nke oge n'Eshia na Africa.  Otú ọ dị, ụdị 2005, na-esochi ọtụtụ iri afọ nke ọrụ, chikungunya apụtala ọzọ wee bute nnukwu ime na Africa, Eshia na America.  N'India, dịka ọmụmaatụ, chikungunya nọmba ọzọ mgbe afọ 32 ọrụ nje.  [1] na-efe efe emeela na Europe, Caribbean, na South America, ebe a na-ebunyeghị chikungunya na mbụ.  Mbufe mpaghara emewokwa na United States na Australia, mba ndị a na-amabughị nje a.  [2] N'afọ 2005, njọ n'etiti Réunion bụ nke kachasi n' akwụkwọ mgbe ahụ, na-eme akwụkwọ na ikpe 266,000 n'akwụkwọetiti nwere ihe dị ka 770,000.  [3] Na ihe nke 2006, India kọrọ nde mmadụ 1.25 a na-enyo enyo.  [4] Ewebatara Chikungunya na America na 2013, nke izizi izira n'agwaetiti France nke Saint Martin, [5] na afọ abụọ sochirinụ na America, 1,118,763 a na-enyo enyo na 24,682 enwetara ikpe sitere na PAHO.

Nyocha nke ndị agha ndụ ihe nketa nje Chikungunya na-atụ aro na nwa nke ihe nke 2005-ugbu a nwere ike ịbụ n'ihi ihe n'usoro n'usoro ndụ ihe nketa nke ụzọ E1 nke nje virus 'protein' mmetụta nje,  ụdị dị iche iche a na-akpọ E1-A226V.  Mgbanwe a nwere ike inye ọhọrọ ka nje na-amụba ngwa ngwa n'ime ndụ anwụnta.  [1] Mgbanwe ahụ na-enye nhọrọ nje ahụ iji anwụnta tiger Asia (ụdị na-enweta ahụ ) dị ka vector na mgbakwunye na vector bụ isi nke akwụkwọ, Aedes aegypti .  [2] Mgbasawanye nje virus Chikungunya site na A. albopictus nwere ike ịpụta nnukwu ihe ize ndụ maka mpaghara ndị ọzọ ebe anwụnta nke Asia dị.  [3] Albopictus bụ ụdị na-akpa ike na Europe, America, Caribbean, Africa na Middle East.  

## Akụkọ ihe mere eme
>Marion Robinson [1] na WHR Lumsden [2] akara ngosi ahụ na akwụkwọ akụkọ nke 1955, na-esote eke na 1952 na Makonde Plateau, n'ụdị egwu Mozambique na Tanganyika (maka ala nke Tanzania nke oge a. ).  ahụ ahụ, ahụ na-eme mgbe ụfọdụ na Africa, South Asia, nada Ebe Ọwụwa Ndị agha Eshia;  mmetụta na nso aagbasala ọrịa a n'ọtụtụ ebe.  
* Chikungunya: Ọrụ bụ isi nke "mgbochi ebumpụta ụwa"
Òtù:Pages with unreviewed translations