Emarabi

**Emarabi** asifo lesitsatselanako lesibangela kugula kakhulu lokubitwa nge-encephalitis ebantfwini kanye naletinye tilwane letinengati leshisako. Timphawu letingasheshe tibonakale tingafaka ekhatsi ifiva nekunwayiswa emtimbeni.  Letimphawu tilandzelwa ngukunye noma ngetulu kwaletimphawu letilandzelako: kuhambahamba lokuneludlame, kujabula lokungalawuleki, kwesaba emanti, kanye nekungakhoni kusebentisa letinye tincenye temtimba, kudideka, kanye nekulahlekelwa ngumcondvo. Ngemuva kwekutsi timphawu tibonakale, emarabi avame kubulalana. Lesikhatsi lesisemkhatsini wekutsi utfole lesifo kanye nekucala kwetimphawu kuvamise kuba nguyinye yaletinyanga letintsatfu. Noma kunjalo, lesikhatsi singahluka kusukela kulesingaphansi kweliviki linye kuye ngetulu kwemnyaka munye.  Lesikhatsi lesicitfwako sitawuya ngebudze bekutsi leligciwane selihambe libanga lelingakanani kufika emcondvweni. 

## Imbangela nekutfolakala kwalesifo
Emarabi andluliselwa ebantfwini asuka kuletinye tilwane. Emarabi angandluliselwa uma ngabe silwane lesinalesifo sitinwaya noma siluma lesinye silwane noma umuntfu.  Ematse laphuma esilwaneni lesingenwe ngulesifo nawo angandlulisela emarabi uma ngabe lamatse atsintsana nemtsambo lomanti walesinye silwane noma umuntfu.   Emarabi lamanyenti langena bantfu avela ngekutsi balunywe tinja.  Emaphesenti langu 99% laphatselene neludzaba lwemarabi abangelwa kulunywa yinja.  Emaveni ase Amerika, kulunywangemalulwane yimitfombo leyetayelekile yekungenwa sifo semarabi ebantfwini, kantsi ngaphansi kwemaphesenti la 5% kuvela etinjeni.  Tilwanyana letilumako atikavami kutsi tibe nemarabi. Ligciwane lemarabi liya engcondvweni ngekulandzela lesemitsanjeni yeperipheral. Lesifo singatfolwa kuphela uma ngabe sekucale kubonakala timphawu. 

## Kusivikela nekusilapha
Tinhlelo tekulawulwa nekugonywa kwetilwane tiyabehlisa bungoti bemarabi etinjeni etigodzini letinyenti emhlabeni.  Kugoma bantfu ngembi kwekutsi bangenwe ngulesifo kubalulekile kulabo labasengotini ngekwelizinga leliphakeme. Laba labasengotini ngelizinga leliphakeme kufaka ekhatsi bantfu labasebenta ngemalulwane noma labacitsa sikhatsi lesidze etindzaweni tasemaveni lapho kuvame kutfolakala khona emarabi.   Kubantfu labangenwe ngemarabi, umjovo wemarabi nangalesinye sikhatsi emarabine-immunoglobulin tiyasebenta ekuvikeleni lesifo uma ngabe lomuntfu alashwa ngembi kwekubonakala kwetimphawu temarabi.  Kugeza lapho ulunywe khona nekuhwebheka imizuzu le-15 ngemanti nensipho, nge-povidone iodine , noma umutsi longahle ukhone kubulala leligciwane nako kubonakala njengalokuyimphumelelo ekuvikeleni kungenwa ngemarabi. Bambalwa bantfu labaphilile ngemuva kwekutsi balashelwe emarabi ngemuva kwekukhombisa timphawu talesifo. Loku bekuhambisana nekulashwa lokwendlulele lokubitwa nge Milwaukee protocol.
### Umjovo
Umjovo **wemarabi** ngumjovo losetjentiselwa kuvikela emarabi. Kunetindlela letitsite letikhona tekulapha letimbili tiphephile futsi tiba yimphumelelo. Tingasetjentiswa kuvikela emarabi ngembi futsi nangalesikhatsi sangemuva kwekungenwa nguleligciwane ngekulunywa yinja noma ulunywe lilulwane.  Lokuvikelwa lokwentiwako kutsatsa sikhatsi lesidze ngemuva kwekunatsa katsatfu umutsi.  Kuvamise kutsi lomutsi uniketwe ngemjovo esikhunjeni noma kumsipha.  Ngemuva kwekujovwa ngalomjovo uvamise kusetjentiswa kanye nalona  wemarabi lobitwa nge-immunoglobulin. Kuphakanyiswa kwekutsi labo labasengotini kakhulu yekungenwa ngulesifo bagonywe ngembi kwekutsi sibangene.  Kugonywa kuba yimphumelelo ebantfwini nakuletinye tilwane.  Kugoma tinja kuba yimphumelelo kakhulu ekuvikeleni tifo ebantfwini. 

#### Kuphepha
Tigidzi tebantfu mhlabawonkhe bagonyiwe kantsi kulinganiselwa ekutseni loko kuphephisa bantfu labandlula ku-250,000 ngemnyaka.  Kungasetjentiswa ngekuphepha kubo bonkhe bantfu beminyaka yonkhe. Bantfu labangemaphesenti lange-35 kuya 45 bayavuvuka kwesikhashane babe bovu futsi beve buhlungu lapho bajovwe khona.  Emaphesenti lalinganiselwa ku-5 kuya ku-15 ebantfu bangahle babe nefiva, kubandvwa yinhloko, noma kunyakuleka. Ngemuva kwekungenwa ngemarabi atikho tinkhomba tekutsi kungasetjentiswa umutsi ngoba utawuba yingoti nawusetjentiswa. Imijovo leminyenti ayinayo i-thimerosal. Imijovo leyentiwe ngemathishu emanevu isetjentiswe emaveni lambalwa, ikakhulukati e-Asia ne Latin Amerika, kodvwa ayisebenti kahle futsi inemitselela lemihle. Kusetjentiswa kwawo akusekelwa yiNhlangano Yetemphilo Velonkhe.

  

Uma uwutsenga embonini ubita emkhatsini wa 44 na 78 USD kutsi ulashwe kusukela nga 2014. E-United States umjovo wekulashelwa emarabi ubita ngetulu kwa 750 USD.

## i-Ephidemiyoloji
Emarabi ayimbangela yekufa kwebantfu labalinganiselwa ku 26,000 kuya ku 55,000 emhlabeni wonkhe ngemnyaka. Kundlula ku-95% wekushona kwenteke e-Asia kanye nase Afrika. Emarabi akhona kumave landlula ku-150 nakuwo onkhe emave kodvwa hhayi e-Antarctica. Bantfu labatigidzi leti-3 bahlala etigodzini takulomhlaba lapho kunemarabi khona.  Etindzaweni letinyenti e-Europe nase Australia, emarabi atfolakala kuphela kumalulwane.  Emave lamanyenti lasetichingini awanawo emarabi.

## Emareferensi