ÖZET
"Tek Sağlık" konsepti, insanların, hayvanların ve ekosistemlerin sağlığını sürdürülebilir bir şekilde dengelemeyi ve optimize etmeyi esas alan üniversal bir yaklaşımdır. Bu yaklaşım entegresyon, birleştirici ve holostik temel karakteristikleri ile insanların, evcil ve vahşi hayvanların, bitkilerin ve içerisinde kendi kendini yenileyebilir ekosistemlerin bulunduğu daha geniş bir çevrenin sağlığını esas alır. Dünyada hem karasal hem de okyanus ekosistemlerinde en yaygın zoonotik karakterli enfeksiyonlardan birisi olan Toxoplasmosis, "Tek Sağlık" konsepti için ideal model bir hastalıktır. Toxoplasmosis, zoonotik karakterli, zorunlu hücre içi patojen protozoon Toxoplasma gondii’nin meydana getirdiği bir hastalıktır. Hastalık etkeni T. gondii’nin hayat siklusunda son konağı evcil kedi ve kedigiller, ara konakları ise insan dahil tüm memeliler, kanatlı hayvanlar ve reptillerdir. Hastalık etkeni patojen T. gondii’nin hayat siklusunda kediler hem son konak hem de ara konak vazifesi gördükleri için, ekosistemin kontaminasyonundan da primer öneme sahiptirler. Dolayısıyla evcil kedilerin ve serbest dolaşan kedilerin bulunduğu ekosistemler, T. gondii oocytleriyle enfekte kedi dışkılarıyla kontamine olurlar. Toxoplasma gondii pozitifliği, karasal ve sucul habitatlarda tüm sıcakkanlılarda bilimsel çalışmalarla gösterilmiştir. Hastalık çiftlik hayvanlarında ölümlere ve abortlara yol açarak büyük ekonomik kayıplar oluşturur. Bununla beraber hastalık, insanlarda özellikle hamile kadınlarda büyük problemlere neden olmaktadır. Gebelikte T. gondii konjenital enfeksiyonları, fetüsün göz ve beyninde lezyonlar, prematüre doğum, intrauterin büyüme geriliği, ateş, pnömoni, trombositopeni, oküler lezyonlar, ensefalit ve abort gibi patolojik bozukluklara yol açar. Toxoplasma gondii ile enfekte bir gebede ölüm ve abort, maternal bağışıklık mekanizmasının tamamen bozulması sonucu şekillenmektedir. Toxoplasmosis’e karşı mücadele, üniversal boyutta Dünya Hayvan Sağlığı Teşkilatı, Dünya Sağlık Teşkilatı ve Dünya Gıda Teşkilatı’nın "Tek Sağlık" konseptinde koordinasyonunu ve tüm paydaş ülkelerde ulusal düzeyde ilgili tüm disiplinlerin bütünleştirici yaklaşımlarını gerektirir. Bu bağlamda özellikle hastalıktan korunma ve kontrolde, tekniğine uygun olarak çevre güvenliği için kedi dışkısının imhası, kedilerde pozitifliğin izlenmesi ve tedavisi, kontamine gıda ve malzemelerle temastan kaçınmak, modern tedavi ve aşı seçeneklerinin geliştirilmesi ve insan ve hayvanlarda hastalığın zorunlu izlenmesi/taraması gerekmektedir. Özellikle insanlarda hastalığın izlenmesinde Fransa modeline geçilmesinde yarar vardır. Bu makalede, "Tek Sağlık" konseptinde toxoplasmosis’in ekolojisi incelenmiştir.
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