Sekungamashumi amabili eminyaka, i-albendazole inikelwe ohlelweni olukhulu lokwelapha i-lymphatic filariasis. Ukubuyekezwa kwakamuva kwe-Cochrane kuhlole ukusebenza kwe-albendazole ekwelapheni i-lymphatic filariasis.
I-Lymphatic filariasis isifo esivamile ezindaweni ezishisayo nezishisayo, esisakazwa omiyane futhi sibangelwa ukutheleleka kwe-parasitic filariasis. Ngemuva kokutheleleka, izibungu zikhula zibe abantu abadala futhi zihlangane zenze i-microfilariae (MF). Umiyane ube usucosha i-MF ngenkathi udla igazi, futhi isifo singadlulela komunye umuntu.
Ukutheleleka kungatholwa ngokuhlolelwa i-MF (microfilamentemia) ejikelezayo noma ama-antigen ezinambuzane (i-antigenemia) noma ngokuthola izikelemu zabantu abadala abaphilayo nge-ultrasonography.
I-World Health Organization (WHO) incoma ukwelashwa kwabantu abaningi ngonyaka okungenani iminyaka emihlanu. Isisekelo sokwelashwa siyinhlanganisela yezidakamizwa ezimbili: i-albendazole ne-microfilaricidal (i-antifilariasis) yesidakamizwa i-diethylcarmazine (DEC) noma i-ivermectin.
I-Albendazole iyodwa inconywa ukuthi isetshenziswe isigamu sonyaka ezindaweni lapho isifo se-Roa sihlala khona, lapho i-DEC noma i-ivermectin akufanele isetshenziswe ngenxa yengozi yemiphumela emibi kakhulu.
Kokubili i-ivermectin ne-DEC kusule ngokushesha ukutheleleka kwe-MF futhi kwacindezela ukuphindeka kwayo. Nokho, ukukhiqizwa kwe-MF kuzoqala kabusha ngenxa yokuchayeka okulinganiselwe kubantu abadala. I-Albendazole yacatshangelwa ukwelapha i-lymphatic filariasis ngemuva kocwaningo lwabonisa ukuthi imithamo ephezulu enikezwe emasontweni ambalwa yaholela emiphumeleni emibi kakhulu ephakamisa ukufa kwezikelemu ezindala.
Ukubonisana okungakahleleki kwe-WHO kamuva kwabonisa ukuthi i-albendazole inomsebenzi wokubulala noma wokuvala inzalo ngokumelene nezikelemu zabantu abadala. Ngo-2000, i-GlaxoSmithKline yaqala ukunikela nge-albendazole kumaphrojekthi wokwelapha i-lymphatic filariasis.
Izivivinyo zemitholampilo ezingahleliwe (RCTs) zihlole ukusebenza kahle nokuphepha kwe-albendazole yedwa noma kuhlanganiswe ne-ivermectin noma i-DEC. Kamuva, kube nokubuyekezwa okuhlelekile okuningana kokuhlolwa okulawulwa ngokungahleliwe kanye nedatha yokubuka, kodwa akucaci ukuthi i-albendazole inenzuzo yini ku-lymphatic filariasis.
Ngenxa yalokhu, ukubuyekezwa kwe-Cochrane okushicilelwe ku-2005 kuye kwabuyekezwa ukuze kuhlolwe umthelela we-albendazole ezigulini nasemiphakathini ene-lymphatic filariasis.
Ukubuyekezwa kwe-Cochrane kuwukubuyekezwa okuhlelekile okuhlose ukuhlonza, ukuhlola, kanye nokufingqa bonke ubufakazi obunamandla obuhlangabezana nenqubo enqunyiwe yokuphendula umbuzo wocwaningo. Izibuyekezo ze-Cochrane ziyabuyekezwa njengoba idatha entsha itholakala.
Indlela ye-Cochrane inciphisa ukuchema enqubweni yokubuyekeza. Lokhu kuhlanganisa ukusebenzisa amathuluzi ukuhlola ubungozi bokuchema esivivinyweni ngasinye kanye nokuhlola ukuqiniseka (noma ikhwalithi) yobufakazi bomphumela ngamunye.
I-Cochrane Commentary ebuyekeziwe ethi "Albendazole iyodwa noma ihlanganiswe nama-microfilaricidal agents ku-lymphatic filariasis" yashicilelwa ngoJanuwari 2019 yi-Cochrane Infectious Diseases Group kanye ne-COUNTDOWN Consortium.
Imiphumela ethakaselwayo ihlanganisa amandla okudlulisela (i-MF prevalence and density), izimpawu zokutheleleka kwezikelemu zabadala (i-antigenemia prevalence and density, kanye nokutholwa kwe-ultrasound kwezikelemu zabantu abadala), kanye nezilinganiso zezehlakalo ezimbi.
Ababhali bazame ukusebenzisa usesho lwe-elekthronikhi ukuze bathole zonke izilingo ezifanele kuze kube nguJanuwari 2018, ngokunganaki ulimi noma isimo sokushicilelwa. Ababhali ababili bahlola ngokuzimela izifundo zokufakwa, ubungozi obuhloliwe bokuchema, kanye nedatha yesilingo ekhishwe.
Ukubuyekezwa kufaka phakathi izivivinyo eziyi-13 nenani labahlanganyeli abangama-8713. Ukuhlaziywa kwe-meta kokusabalala kwama-parasite nemiphumela emibi kwenziwa ukuze kulinganiswe imiphumela yokwelashwa. Lungiselela amathebula ukuze uhlaziye imiphumela yokuminyana kwezinambuzane, njengoba ukubika okubi kusho ukuthi idatha ayikwazi ukuhlanganiswa.
Ababhali bathola ukuthi i-albendazole yodwa noma ihlanganiswe ne-microfilaricides yayingenawo umthelela omncane ekusakazekeni kwe-MF phakathi kwamasonto amabili nezinyanga ze-12 ngemuva kokwelashwa (ubufakazi bekhwalithi ephezulu).
Abazange bazi ukuthi ngabe kunomphumela ku-mf density ezinyangeni ezingu-1-6 (ubufakazi bekhwalithi ephansi kakhulu) noma ezinyangeni ezingu-12 (ubufakazi bekhwalithi ephansi kakhulu).
I-Albendazole yodwa noma ihlangene nama-microfilaricides yayingenawo umthelela omncane ekusakazekeni kwe-antigenemia phakathi nezinyanga ezingu-6-12 (ubufakazi obuphezulu).
Ababhali babengazi ukuthi ngabe kukhona yini umphumela ku-antigen density phakathi kwe-6 nezinyanga ze-12 ubudala (ubufakazi obuphansi kakhulu). I-Albendazole yengezwe kuma-microfilaricides cishe yayingenawo umthelela omncane ekwandeni kwezibungu zabantu abadala ezitholwe yi-ultrasound ezinyangeni eziyi-12 (ubufakazi obuncane obuqinisekile).
Lapho isetshenziswa iyodwa noma ihlangene, i-albendazole yayingenawo umthelela omncane enanini labantu ababika izehlakalo ezimbi (ubufakazi bekhwalithi ephezulu).
Ukubuyekezwa kuthole ubufakazi obanele bokuthi i-albendazole, iyodwa noma ihlanganiswe ne-microfilaricides, inomphumela omncane noma ongekho ekuqothulweni okuphelele kwe-microfilariae noma i-helminths yabantu abadala phakathi nezinyanga ezingu-12 zokwelashwa.
Njengoba kunikezwe ukuthi lesi sidakamizwa siyingxenye yenqubomgomo evamile, nokuthi i-World Health Organization manje futhi incoma uhlobo lwezidakamizwa ezintathu, akunakwenzeka ukuthi abacwaningi bazoqhubeka nokuhlola i-albendazole ngokuhambisana ne-DEC noma i-ivermectin.
Kodwa-ke, ezindaweni ezivame kakhulu i-Roa, kunconywa i-albendazole kuphela. Ngakho-ke, ukuqonda ukuthi ingabe umuthi uyasebenza yini kule miphakathi kuhlala kuseqhulwini ocwaningweni.
Ama-insecticide amakhulu e-filariatic anezinhlelo zokufaka isicelo zesikhashana angaba nomthelela omkhulu ezinhlelweni zokuqeda i-filariasis. Enye yale mithi okwamanje isathuthukiswa ngaphambi kokwelashwa futhi yashicilelwa kubhulogi yakamuva ye-BugBitten.
Ngokuqhubeka nokusebenzisa le sayithi, uyavumelana neMigomo yethu Yokusebenzisa, Izinkombandlela Zomphakathi, Isitatimende Sobumfihlo kanye Nenqubomgomo Yekhukhi.