Usuku Lomhlaba Lwesifo Sofuba 2026: Yebo! Singaqeda Isifo Sofuba

Umhla zingama-24 kuNdasa 2026 uphawula usuku lwama-31 lwesifo sofuba emhlabeni. I-World Health Organization (WHO) imemezele isihloko somhlaba wonke salo nyaka ngokuthi"Yebo! Singaqeda isifo sofuba!", egcizelela ukuthi ubuholi obuqinile bukahulumeni, ukuzibophezela okuqhubekayo kwezepolitiki, kanye nesenzo esihlanganisiwe semikhakha eminingi kubalulekile ekuqedeni ubhubhane lwesifo sofuba (TB).

Intuthuko Yomhlaba Wonke kanye Nezinselele Ezisele

Ngokusho koMbiko Wesifo Sofuba Womhlaba Wonke ka-2025, ukulawulwa kwesifo sofuba emhlabeni wonke kufinyelele ingqophamlando ebalulekile ngo-2024, kokubili iukwehla kwesimo nokufaokokuqala ngqa selokhu kwaqubuka ubhubhane lwe-COVID-19.

IsilinganisoAbantu abayizigidi eziyi-10.7bangenwe yi-TB ngo-2024, okuhlanganisa abesilisa abangu-54%, abesifazane abangu-35%, kanye nezingane nentsha engu-11%. Phakathi kwalezi zimo, cishe619,000 (5.8%)babenegciwane lesandulela ngculazi kanye kanye, futhi390,000 (3.6%)babeyi-TB engazweli emithini eminingi noma i-rifampicin engazweli TB (MDR/RR-TB).

I-TB ebangelwa cisheUkufa kwabantu abayizigidi ezingu-1.23ngo-2024, okusalokhu kuyimbangela ehamba phambili yokufa ethelelanayo emhlabeni jikelele, idlula i-COVID-19. Ngemva kweminyaka emithathu yokwanda phakathi kuka-2021 no-2023, izinga le-TB emhlabeni wonke lehle cishe ngo-2% ngo-2024, okubonisa ukubuya kancane kancane kwezinsizakalo ze-TB.[1]

Ngokwendawo,Amaphesenti angu-67 amacalazazigxile emazweni ayisishiyagalombili: i-India, i-Indonesia, iPhilippines, i-China, i-Pakistan, i-Nigeria, i-Democratic Republic of the Congo, kanye ne-Bangladesh.

Naphezu kwentuthuko, i-TB isalokhu iyimbangela ehamba phambili yokufa phakathi kwabantu abaphila ne-HIV futhi inegalelo elikhulu ekufeni okuhlobene nokumelana namagciwane. Uxhaso lomhlaba wonke luyaqhubeka nokuncipha, kuphelaAmaRandi ayizigidigidi ezingu-5.9kuyatholakala ngo-2024—ngaphansi kakhulu kwe-Umgomo wonyaka wamadola ayizigidigidi ezingama-US$22kuhlelwe u-2027.

Lezi zibalo ziqokomisa isidingo esiphuthumayo sokuqinisa izinhlelo zokulawula i-TB emhlabeni jikelele, kugxilwe ekwandiseni ukufinyelela ekuxilongweni, ekuthuthukiseni imiphumela yokwelashwa, kanye nokubhekana nezinto ezibangela ukusabalala kwe-TB. I-TB iyaqhubeka nokudinga ukubambisana okuqinile kwamazwe ngamazwe kanye nokuzibophezela kwezepolitiki ukuze kuhlangatshezwane nemigomo yeSu Lokuqeda I-TB​

Isifo sofuba se-Mycobacterium: I-Pathogenesis kanye nokuhlukaniswa

Isifo sofuba i-Mycobacterium (MTB/M. tuberculosis) yisifo esiyinhloko nesivame kakhulu esibangela isifo sofuba (TB). Singangena emzimbeni womuntu ngendlela yokuphefumula, indlela yokugaya ukudla, noma isikhumba esonakele kanye nolwelwesi lwamafinyila, sithelele izitho eziningi futhi sibangele izinhlobo ezahlukene zesifo sofuba. Isifo sofuba samaphaphu, esidluliselwa kakhulu ngamaconsi, sibangela amacala angaphezu kuka-80% esifo sofuba. Izimpawu ezivamile zifaka phakathi ukukhwehlela, ukukhiqizwa kwesikhwehlela, kanye ne-hemoptysis. Ngemva kokutheleleka emaphashini, amagciwane angasakazeka ngegazi aye ezinhlelweni eziningi, okungenzeka kuholele ku-TB yamathambo, yomchamo, noma yamathumbu.[2]

I-MTB iyingxenye yohlobo lwe-Mycobacterium, oluhlanganisa:

• I-Mycobacterium tuberculosis complex (MTBC): Ihlanganisa i-M. tuberculosis, i-M. bovis, i-M. africanum, i-M. canettii, kanye ne-M. microti, phakathi kwezinye. Nakuba i-M. tuberculosis iyimbangela eyinhloko ye-TB, i-M. bovis kanye ne-M. africanum nazo zingadala lesi sifo.
• I-mycobacteria engeyona i-tuberculous (NTM).
• I-Mycobacterium leprae, imbangela yochoko.

Izindlela Zokuxilonga Zaselabhorethri

Ukuxilongwa okunembile nokufika ngesikhathi kubalulekile ekulawuleni i-TB ngempumelelo. I-World Health Organization igcizelela ukuthiUbuchwepheshe bokuxilonga ama-molecule ngokushesha bushintshe kakhulu ukutholwa kwe-TB ngokuvumela ukuhlonza izifo ezibangelwa amagciwane okubucayi kakhulu nokuqondile ngesikhathi esifanayo kuthola ukumelana nemithi.[1].

- I-Microscopy kanye namasikoe: Isiko lihlala liyindinganiso yegolide yokuxilongwa kwe-TB, njengoba livumela ukuhlonza okuqondile kwezinto eziphilayo futhi lisekela ukuhlolwa kokuzwela kwemithi kanye nokuhlaziywa kwe-genomic. Kodwa-ke, ngenxa yesilinganiso sokukhula kancane kwe-Mycobacterium tuberculosis, imiphumela ngokuvamile idinga amasonto ama-2-8, okunciphisa ukusetshenziswa kwayo kwezokwelapha ekwenzeni izinqumo eziphuthumayo.

-Ukuhlolwa Kwe-Immunological: Izindlela zokwelapha umzimba, okuhlanganisa ukuhlolwa kwesikhumba se-tuberculin (TST) kanye nokuhlolwa kokukhululwa kwe-interferon-gamma (IGRAs), zithola izimpendulo zomzimba zomuntu siqu ekuthelelekeni nge-TB. Nakuba ziwusizo ekuboneni ukutheleleka okufihliwe, lezi zindlela zokuhlola azikwazi ukuhlukanisa ngokuthembekile phakathi kokutheleleka okusebenzayo nokwangaphambilini futhi ngenxa yalokho zinokucaciswa okulinganiselwe kokuxilonga ezindaweni ezinomthwalo omkhulu.

-Ukuxilongwa Kwama-Molecular (NAAT): Ukuhlolwa okusekelwe ku-DNA okufana nokukhulisa i-nucleic acid (NAAT) kuyanconywa ngenxa yokuzwela kwayo okuphezulu kanye nokucacile.

-Ukulandelana Kwesizukulwane Esilandelayo Okuqondiwe (tNGS): Ubuchwepheshe bokulandelana okuqondiwe buhlinzeka ngokuhlonza okunesinqumo esiphezulu kwezinguquko ezihlobene nokumelana. Iziqondiso ze-WHO zincoma i-tNGS njengethuluzi elithuthukisiwe lokuthola ukumelana nemithi ngemva kokuxilongwa, lisekela amasu okwelapha ngokunemba [3].

-Ukulandelana Kwesizukulwane Esilandelayo se-Metagenomic (mNGS): Ukulandelana kwe-metagenomic kwenza kube lula ukuthola izinhlobo eziningi zezifo ezibangelwa amagciwane ngaphandle kokukhetha kusengaphambili. Le ndlela iwusizo kakhulu ezimweni zezokwelapha eziyinkimbinkimbi noma ezingacacile, okuhlanganisa izifo ezixubile kanye neziguli ezine-immune system ebuthakathaka, lapho ukuxilongwa okuvamile kungase kungabi ngokwanele.

I-WHO igcizelela futhi ukuthi ukuqinisekiswa kwe-microbiological kubalulekile ekuqaliseni ukwelashwa okufanele kanye nokuthuthukisa imiphumela yesiguli, okuqinisa ukubaluleka kokuhlanganisa ukuxilongwa kwama-molecule okuthuthukile ezinhlelweni zokulawula i-TB [1].

Izixazululo Eziphelele Zokuxilonga Ama-Molecular ezivela ku-Macro & Micro-Test

1.Ukutholwa kwe-Multiplex PCR kwe-TB kanye nokungamelani nemithiI-TB

Uma kukhona ukusola okukhulu kwezokwelapha ngesifo sofuba (TB),I-HWTS-RT147Kunconywa ukuhlolwa ukuze kutholakale ukutheleleka kwe-MTB kanye nesifo sofuba esingamelana nemithi eminingi (i-MDR-TB). Lokhu kuhlolwa kukhomba izinguquko ku-i-gene ye-rpoB, okuholela ekumelaneni ne-rifampicin (RIF), kanye nokuguquka kwezakhi zofuzoizakhi zofuzo ze-katG kanye ne-InhA, ezihlotshaniswa nokumelana ne-isoniazid (INH). Ihlinzeka ngokuhlolwa okusebenzayo, okwenziwa kanye kuphela kwe-MTB kanye ne-MDR-TB, okuhlanganisa ukulawulwa kwekhwalithi yangaphakathi ukunciphisa imiphumela emibi engamanga, ukuqinisekisa imiphumela esheshayo nenembile.

2.Ukulandelana Okuqondiwe kwe-PTNseq Kwamagciwane Okuphefumulayo kanye Nephrofayili Yokumelana

Ezimweni zezifo zokuphefumula ezixubile (kufaka phakathi izifo zokuphefumula eziphezulu nezingezansi, isifo sofuba, kanye nezifo zokuphefumula ezingamahlalakhona), noma lapho kudingeka ukuhlaziywa kwezakhi zofuzo ezimelana nemithi (isb., isifo sofuba esisolwayo esingamelana nemithi),Uchungechunge lwe-PTNseq lokutholwa kwezakhi zofuzo ezisebenzisa i-high-throughputingasetshenziswa. Ngokusekelwe kubuchwepheshe obuthuthukisiwe bokulandelana okuqondiwe, i-PTNseq isebenzisa i-ultra-multiplex PCR ukuze ithuthukise ukulandelana okuqondiwe okuthile, kuhlanganiswe nokulandelana okuphezulu kanye nobuchwepheshe be-nanopore besizukulwane sesithathu ukuze kutholakale ngokuphelele i-pathogen kanye nokuphrofayili yokumelana nemithi.

Lolu hlelo lusebenzisa ama-primer anelungelo lobunikazi, acacile kakhulu ukuze kukhuliswe izakhi zofuzo eziqondiwe kakhulu. Isekelwa yisizindalwazi esizimele kanye nama-algorithms ahlakaniphile e-bioinformatics, inikeza ukuhlonza okunembile kwe-pathogen kanye nokumelana nemithi kanye nokuhlaziywa kwezakhi zofuzo eziyingozi. Ukucebisa okuqondiwe kunciphisa ukuphazamiseka okuvela ku-DNA yomnikazi, kuthuthukisa ukuzwela kumasampula anesizinda esiphakeme somuntu futhi kuvumela ukutholakala okuphumelelayo kwezinhloso ezinzima ezifanaIsifo sofuba se-Mycobacterium, isikhunta, amabhaktheriya angaphakathi kwamangqamuzana, amagciwane e-RNA, kanye nezakhi zofuzo zokumelana noma ukutheleleka.

I-PTNseq ifinyelela umkhawulo wokutholwangaphansi kwamakhophi ayi-100/mLkanye nezimbozoIzifo ezivamile zokuphefumula eziyi-175, okuhlanganisa amabhaktheriya angu-76, amagciwane angu-73, isikhunta esingu-19, ama-mycoplasmas angu-7, kanyeI-Chlamydia, I-Rickettsia, kanye nezakhi zofuzo ezingama-54 zokumelana nemithiIphaneli ihlanganisaIsifo sofuba se-Mycobacteriumi-mycobacteria eyinkimbinkimbi futhi enkulu engenazo izifo ezibangelwa yi-tuberculous.

Uchungechunge lwe-PTNseq luhlanganisa ukuzwela okuphezulu nokusebenza kahle kwezindleko, luthuthukisa amazinga okutholakala kwamagciwane futhi lusekele ukwelashwa ngamagciwane komuntu ngamunye ngenkathi kusiza ekunciphiseni ukumelana namagciwane. Ihlanganiswe nohlelo lokulungiselela umtapo wolwazi wokulandelela izakhi zofuzo oluzenzakalelayo ngokuphelele (AIOS), lunikeza ikhambi elilula, elisesibhedlela elinesikhathi sokushintsha ngokushesha esingamahora angu-6.5 kusukela kusampula kuya kumphumela.

3. Ukulandelana kwe-Metagenomic kokutholwa kwe-Broad-Spectrum Pathogen

Uma ukuxilongwa kwezokwelapha kungacacile,Ukutholwa kwezakhi zofuzo ezisebenzisa i-mNGS pathogen high-throughputkungenziwa kumasampula ahlukahlukene avela esigulini, okuhlanganisa uketshezi lokuhlanza i-bronchoalveolar, i-sputum, ama-throat swabs, igazi, i-pleural effusion, i-pus, kanye namasampula ezicubu. Le ndlela isebenzisa ubuchwepheshe bokulandelana kwe-metagenomic, lapho amasampula ahlukene ephathwa khona ngaphambi kokwelashwa okuqondisiwe kulandelwa ukukhishwa kwe-nucleic acid kusetshenziswa ubuhlalu beglasi kanye nama-enzyme okugaya udonga, okuthuthukisa ukusebenza kahle kokukhipha. Ukulandelelana kulungiswa kumapulatifomu amaningi, kuqinisekisa ivolumu ephezulu yedatha ukuze kuthuthukiswe ukuzwela kwe-mNGS kanye nobuqotho bokuhlangana. Idatha ihlaziywa kusetshenziswa isizindalwazi esakhelwe sona kanye nama-algorithms ahlakaniphile ukutholaizifo ezingaphezu kuka-20,000, okuhlanganisa amabhaktheriya, isikhunta, amagciwane, kanye nezinambuzane, okunikeza ulwazi ngama-microorganism abangela izifo okusolwayo. Le ndlela ifanele iziguli okunzima ukuzixilonga, ezigula kakhulu, noma ezinamasosha omzimba abuthakathaka, okuhlanganisa nokuhlonzaI-MTBokuyinkimbinkimbifuthiI-NTMkanye nokutheleleka okuxubile. Kuthuthukisa kakhulu amazinga okutholakala kwezifo futhi kusiza ekuqondiseni ukusetshenziswa kwama-antibiotic okuhlosiwe emitholampilo, okuvumela ukuhlonza ukutheleleka okunembile.

Isiphetho

Nakuba sekufezwe intuthuko enkulu, isifo sofuba sisalokhu siyinselele enkulu yezempilo emhlabeni wonke, ikakhulukazi esimweni sokumelana nemithi, izikhala zezimali, kanye nokufinyelela okungalingani ekuxilongweni.

I-WHO igcizelela ukuthi ukwandisa ukufinyelela ekuxilongweni okusheshayo kwama-molecule kanye nobuchwepheshe obuthuthukisiwe bokulandelana kubalulekile ekufezeni imigomo yeSu Lokuqeda I-TB. Ngokuqhubeka nokusungula izinto ezintsha, ukutshalwa kwezimali, kanye nokubambisana komhlaba wonke, ukuqeda i-TB akuseyona isifiso, kodwa kuwumgomo ofinyelelekayo.

Izinkomba:

1. Inhlangano Yezempilo Yomhlaba. Umbiko Wesifo Sofuba Womhlaba Wonke 2024/2025: Ukuhlolwa Nokwelashwa Kokuxilongwa.
2. Inhlangano Yezempilo Yomhlaba. Incwadi Ye-WHO Yokukhetha Ukuhlolwa Okusheshayo Kokuxilongwa Okunconywe yi-WHO Kokuthola Isifo Sofuba kanye Nesifo Sofuba Esimelana Nemithi.
3. Inhlangano Yezempilo Yomhlaba. Iziqondiso Ezihlanganisiwe Ze-WHO Ngesifo Sofuba: Isigaba 3 – Ukuxilongwa (Isibuyekezo sika-2024).