Ekupheleni kuka-1995, i-World Health Organization (WHO) yaqoka umhla zingama-24 kuNdasa njengoSuku Lomhlaba Lwesifo Sofuba.
1 Ukuqonda isifo sofuba
Isifo sofuba (TB) yisifo esingapheli esidla abantu, esibizwa nangokuthi "isifo sokudla". Yisifo esithathelwanayo kakhulu esidla abantu esibangelwa yisifo sofuba se-mycobacterium esihlasela umzimba womuntu. Asithinteki ngokweminyaka, ubulili, uhlanga, umsebenzi kanye nendawo. Izitho eziningi zomzimba womuntu zingahlushwa isifo sofuba, phakathi kwaso isifo sofuba sivame kakhulu.
Isifo sofuba yisifo esithathelwanayo esingamahlalakhona esibangelwa yisifo sofuba i-Mycobacterium, esihlasela izitho zomzimba wonke. Ngenxa yokuthi indawo evamile yokutheleleka yiphaphu, sivame ukubizwa ngokuthi isifo sofuba.
Ngaphezu kwama-90% okutheleleka kwesifo sofuba kudluliswa ngomgudu wokuphefumula. Iziguli zesifo sofuba zitheleleka ngokukhwehlela, ukuthimula, ukwenza umsindo omkhulu, okubangela ukuba amaconsi anesifo sofuba (okubizwa ngokuthi ama-microdroplets ngokwezokwelapha) akhishwe emzimbeni bese ehogelwa abantu abaphilile.
2 Ukwelashwa kweziguli ezinesifo sofuba
Ukwelashwa ngemithi kuyisisekelo sokwelashwa kwesifo sofuba. Uma kuqhathaniswa nezinye izinhlobo zokutheleleka ngamagciwane, ukwelashwa ngemithi kungathatha isikhathi eside. Ngesifo sofuba esisebenzayo emaphashini, imithi yokulwa nesifo sofuba kumele ithathwe okungenani izinyanga eziyi-6 kuya kweziyi-9. Imithi ethile kanye nesikhathi sokwelashwa kuncike eminyakeni yesiguli, impilo iyonke kanye nokumelana nemithi.
Uma iziguli zingayithandi imithi yomugqa wokuqala, kumele zithathelwe indawo imithi yomugqa wesibili. Imithi evame ukusetshenziswa kakhulu ekwelapheni isifo sofuba samaphaphu esingamelani nemithi ihlanganisa i-isoniazid (INH), i-rifampicin (RFP), i-ethambutol (EB), i-pyrazinamide (PZA) kanye ne-streptomycin (SM). Le mithi emihlanu ibizwa ngokuthi imithi yomugqa wokuqala futhi isebenza kahle kubantu abangaphezu kuka-80% abanesifo sofuba samaphaphu abasanda kutheleleka.
3 Umbuzo nempendulo yesifo sofuba
Umbuzo: Ingabe isifo sofuba singelapheka?
A: Iziguli ezingama-90% ezinesifo sofuba semiphunga zingelapheka ngemva kokuphikelela emithini ejwayelekile futhi ziqede inkambo yokwelashwa enqunyiwe (izinyanga eziyi-6-9). Noma yiluphi ushintsho ekwelashweni kufanele lunqunywe udokotela. Uma ungawuthathi umuthi ngesikhathi futhi uqede inkambo yokwelashwa, kuzoholela kalula ekumelaneni nesifo sofuba ngemithi. Uma ukumelana nemithi sekwenzekile, inkambo yokwelashwa izothatha isikhathi eside futhi kuzoholela kalula ekwehlulekeni kokwelashwa.
U: Yini okufanele iziguli ezinesifo sofuba ziyiqaphele ngesikhathi sokwelashwa?
A: Uma usutholakale unesifo sofuba, kufanele uthole ukwelashwa okuvamile kwesifo sofuba ngokushesha okukhulu, ulandele iseluleko sikadokotela, uthathe imithi ngesikhathi, uhlole njalo futhi wakhe ukuzethemba. 1. Naka ukuphumula futhi uqinise ukudla okunomsoco; 2. Naka inhlanzeko yomuntu siqu, bese umboza umlomo nekhala lakho ngamathawula ephepha uma ukhwehlela noma uthimula; 3. Nciphisa ukuphuma futhi ugqoke imaski uma kufanele uphume.
U: Ingabe isifo sofuba sisathelelana ngemva kokwelashwa?
A: Ngemva kokwelashwa okujwayelekile, ukutheleleka kweziguli ezinesifo sofuba samaphaphu kuvame ukwehla ngokushesha. Ngemva kwamasonto amaningana okwelashwa, inani lamagciwane ofuba esikhwehleni lizoncishiswa kakhulu. Iningi leziguli ezinesifo sofuba samaphaphu esingatheleleki ziqeda yonke inkambo yokwelashwa ngokwecebo lokwelashwa elinqunyiwe. Ngemva kokufinyelela izinga lokwelashwa, awekho amagciwane ofuba angatholakala esikhwehleni, ngakho-ke awasathelelani.
U: Ingabe isifo sofuba sisathelelana ngemva kokwelashwa?
A: Ngemva kokwelashwa okujwayelekile, ukutheleleka kweziguli ezinesifo sofuba samaphaphu kuvame ukwehla ngokushesha. Ngemva kwamasonto amaningana okwelashwa, inani lamagciwane ofuba esikhwehleni lizoncishiswa kakhulu. Iningi leziguli ezinesifo sofuba samaphaphu esingatheleleki ziqeda yonke inkambo yokwelashwa ngokwecebo lokwelashwa elinqunyiwe. Ngemva kokufinyelela izinga lokwelashwa, awekho amagciwane ofuba angatholakala esikhwehleni, ngakho-ke awasathelelani.
Isixazululo sesifo sofuba
I-Macro & Micro-Test inikeza imikhiqizo elandelayo:
Ukutholwa kweI-MTB (i-Mycobacterium tuberculosis) i-nucleic acid
1. Ukwethulwa kokulawulwa kwekhwalithi yokubhekisela kwangaphakathi ohlelweni kungaqapha ngokuphelele inqubo yokuhlola nokuqinisekisa ikhwalithi yokuhlola.
2. Ukukhulisa i-PCR kanye ne-fluorescent probe kungahlanganiswa.
3. Ukuzwela okuphezulu: umkhawulo omncane wokutholwa yi-bacteria eyi-1/mL.
Ukutholwa kweukumelana ne-isoniazid ku-MTB
1. Ukwethulwa kokulawulwa kwekhwalithi yokubhekisela kwangaphakathi ohlelweni kungaqapha ngokuphelele inqubo yokuhlola nokuqinisekisa ikhwalithi yokuhlola.
2. Kwasetshenziswa uhlelo lokuguqula ukwakheka kwezakhi zokukhulisa oluzithuthukisile, kwathi indlela yokuhlanganisa ubuchwepheshe be-ARMS ne-fluorescent probe yasetshenziswa.
3. Ukuzwela okuphezulu: umkhawulo omncane wokutholwa ungama-bacteria ayi-1000 /mL, futhi izinhlobo ezingalingani ezingamelani nemithi ezinezinhlobo eziguquliwe ezingu-1% noma ngaphezulu zingatholakala.
4. Ukucaciswa okuphezulu: Akukho ukusabela okuhlangene nokuguqulwa kwezakhi zofuzo ezine ze-rpoB gene (511, 516, 526 kanye no-531).
Ukutholwa Kwezinguquko Ze-MutationsUkumelana ne-MTB kanye ne-Rifampicin
1. Ukwethulwa kokulawulwa kwekhwalithi yokubhekisela kwangaphakathi ohlelweni kungaqapha ngokuphelele inqubo yokuhlola nokuqinisekisa ikhwalithi yokuhlola.
2. Indlela yokuncibilikisa ijika ehlanganiswe neprobe ekhanyayo evaliwe equkethe izisekelo ze-RNA yasetshenziselwa ukuthola ukukhulisa kwe-in vitro.
3. Ukuzwela okuphezulu: umkhawulo omncane wokutholwa ungama-bacteria angu-50/mL.
4. Ukucaciswa okuphezulu: akukho ukusabela okuhlangene ne-genome yomuntu, ezinye izifo ze-mycobacteria ezingezona i-tuberculous kanye ne-pneumonia; Izindawo zokuguqulwa kwezakhi zofuzo ze-mycobacterium tuberculosis ezingamelani nemithi, njenge-katG 315G>C\A kanye ne-InhA -15 C>T, zitholiwe, futhi imiphumela ayibonisanga ukusabela okuhlangene.
Ukutholwa kwe-MTB nucleic acid (EPIA)
1. Ukwethulwa kokulawulwa kwekhwalithi yokubhekisela kwangaphakathi ohlelweni kungaqapha ngokuphelele inqubo yokuhlola nokuqinisekisa ikhwalithi yokuhlola.
2. Indlela yokukhulisa izinga lokushisa eliqhubekayo ye-enzyme digestion probe iyasetshenziswa, futhi isikhathi sokuthola sifushane, futhi umphumela wokuthola ungatholakala ngemizuzu engama-30.
3. Ihlanganiswe ne-ejenti yokukhipha isampula ye-Macro & Micro-Test kanye ne-Macro & Micro-Test constant temperature nucleic acid amplification analyzer, kulula ukuyisebenzisa futhi ifanelekela izigcawu ezahlukahlukene.
4. Ukuzwela okuphezulu: umkhawulo omncane wokutholwa ungamakhophi ayi-1000/mL.
5. Ukucaciswa okuphezulu: Akukho ukusabela okuhlangene namanye ama-mycobacteria e-non-tuberculosis mycobacteria complex (njenge-Mycobacterium kansas, i-Mycobacterium Sukarnica, i-Mycobacterium marinum, njll.) kanye namanye ama-pathogen (njenge-Streptococcus pneumoniae, i-Haemophilus influenzae, i-Escherichia coli, njll.).
Isikhathi sokuthunyelwe: Mashi-22-2024