Ekupheleni konyaka ka-1995, i-World Health Organisation (WHO) yamisela umhla wama-24 kweyoKwindla njengoSuku lweHlabathi lweSifo sePhepha.
1 Ukuqonda isifo sephepha
Isifo sephepha (TB) sisifo esingapheliyo esidla abantu, esikwabizwa ngokuba "sisifo sokutya". Sisifo esosulelayo nesingapheliyo esidla abantu esibangelwa yi-mycobacterium tuberculosis ehlasela umzimba womntu. Asichaphazeleki bubudala, isini, uhlanga, umsebenzi kunye nommandla. Amalungu amaninzi kunye neenkqubo zomzimba womntu zinokugula sisifo sephepha, phakathi kwazo isifo sephepha sesona sixhaphakileyo.
Isifo sephepha sisifo esosulelayo esingapheliyo esibangelwa yiMycobacterium tuberculosis, esihlasela amalungu omzimba wonke. Ngenxa yokuba indawo eqhelekileyo yosulelo yimiphunga, sidla ngokubizwa ngokuba sisifo sephepha.
Ngaphezulu kwe-90% yosulelo lwesifo sephepha ludluliselwa ngendlela yokuphefumla. Izigulane zesifo sephepha zosulelwa kukukhwehlela, ukuthimla, ukwenza ingxolo enkulu, okubangela ukuba amathontsi anesifo sephepha (ngokwezonyango abizwa ngokuba ngama-microdroplets) akhutshwe emzimbeni aze aphefumlwe ngabantu abaphilileyo.
2 Unyango lwezigulane zesifo sofuba
Unyango ngamayeza lubaluleke kakhulu kunyango lwesifo sephepha. Xa kuthelekiswa nezinye iintlobo zosulelo lweentsholongwane, unyango lwesifo sephepha lunokuthatha ixesha elide. Kwisifo sephepha esisebenzayo semiphunga, amayeza okulwa nesifo sephepha kufuneka athathwe ubuncinane iinyanga ezi-6 ukuya kwezi-9. Amayeza athile kunye nexesha lonyango lixhomekeke kubudala besigulana, impilo iyonke kunye nokumelana namayeza.
Xa izigulana zinganyangeki kumayeza odidi lokuqala, kufuneka zitshintshwe ngamayeza odidi lwesibini. Amayeza asetyenziswa kakhulu kunyango lwesifo sephepha semiphunga esinganyangekiyo kumayeza aquka i-isoniazid (INH), i-rifampicin (RFP), i-ethambutol (EB), i-pyrazinamide (PZA) kunye ne-streptomycin (SM). La mayeza mahlanu abizwa ngokuba ngamayeza odidi lokuqala kwaye asebenza ngaphezu kwama-80% ezigulana ezisandula ukosuleleka sisifo semiphunga.
3 Umbuzo neempendulo zesifo sephepha
Umbuzo: Ngaba isifo sephepha singanyangeka?
A: Ama-90% ezigulana ezine-TB yemiphunga zinokunyangwa emva kokuba zinyanzelise amayeza aqhelekileyo kwaye zigqibe unyango olumiselweyo (iinyanga ezi-6-9). Naluphi na utshintsho kunyango kufuneka lugqitywe ngugqirha. Ukuba awuthathi amayeza ngexesha kwaye ugqibe unyango, kuya kukhokelela ekuchaseni amayeza e-TB. Nje ukuba ukuchasana namayeza kuvele, unyango luya kwandiswa kwaye luya kukhokelela ekusileleni konyango ngokulula.
Q: Yintoni ekufuneka izigulane ezine-TB ziyiqwalasele ngexesha lonyango?
A: Wakuba ufunyenwe unesifo sephepha, kufuneka ufumane unyango oluqhelekileyo lokulwa nesifo sephepha ngokukhawuleza, ulandele icebiso likagqirha, uthathe amayeza ngexesha, uhlole rhoqo kwaye wakhe ukuzithemba. 1. Nika ingqalelo ekuphumleni kwaye uqinise isondlo; 2. Nika ingqalelo kucoceko lomntu, kwaye uvale umlomo wakho nempumlo ngeetawuli zephepha xa ukhohlela okanye uthimla; 3. Nciphisa ukuphuma kwaye unxibe imaski xa kufuneka uphume.
Umbuzo: Ingaba isifo sephepha sisasuleleka na emva kokuba sinyangiwe?
A: Emva konyango oluqhelekileyo, ukosuleleka kwezigulane ezine-pulmonary tuberculosis kudla ngokuncipha ngokukhawuleza. Emva kweeveki ezininzi zonyango, inani leebhaktheriya ze-tuberculosis kwi-sputum liya kuncipha kakhulu. Uninzi lwezigulane ezine-pulmonary tuberculosis ezingosuleliyo zigqiba lonke unyango ngokwesicwangciso sonyango esimiselweyo. Emva kokufikelela kumgangatho wokunyanga, akukho bhaktheriya ye-tuberculosis inokufumaneka kwi-sputum, ngoko ke azisasuleli.
Umbuzo: Ingaba isifo sephepha sisasuleleka na emva kokuba sinyangiwe?
A: Emva konyango oluqhelekileyo, ukosuleleka kwezigulane ezine-pulmonary tuberculosis kudla ngokuncipha ngokukhawuleza. Emva kweeveki ezininzi zonyango, inani leebhaktheriya ze-tuberculosis kwi-sputum liya kuncipha kakhulu. Uninzi lwezigulane ezine-pulmonary tuberculosis ezingosuleliyo zigqiba lonke unyango ngokwesicwangciso sonyango esimiselweyo. Emva kokufikelela kumgangatho wokunyanga, akukho bhaktheriya ye-tuberculosis inokufumaneka kwi-sputum, ngoko ke azisasuleli.
Isisombululo sesifo sephepha
I-Macro kunye ne-Micro-Test zibonelela ngezi mveliso zilandelayo:
Ukuchongwa kweI-MTB (iMycobacterium tuberculosis) i-nucleic acid
1. Ukuqaliswa kolawulo lomgangatho wesalathiso sangaphakathi kwinkqubo kunokubeka esweni ngokupheleleyo inkqubo yovavanyo nokuqinisekisa umgangatho wovavanyo.
2. Ukwandiswa kwe-PCR kunye ne-fluorescent probe zinokudityaniswa.
3. Uvakalelo oluphezulu: umda omncinci wokufunyanwa yibhaktheriya e-1 / mL.
Ukuchongwa kweukuxhathisa i-isoniazid kwi-MTB
1. Ukuqaliswa kolawulo lomgangatho wesalathiso sangaphakathi kwinkqubo kunokubeka esweni ngokupheleleyo inkqubo yovavanyo nokuqinisekisa umgangatho wovavanyo.
2. Kwamkelwe inkqubo yokuguqula i-amplification-blocking mutation ephuculiweyo ngokwayo, kwaye indlela yokudibanisa iteknoloji ye-ARMS kunye ne-fluorescent probe yamkelwe.
3. Uvakalelo oluphezulu: umda omncinci wokufunyanwa yi-1000 bacteria /mL, kwaye iintlobo ezingalinganiyo ezinganyangekiyo ngamayeza ezine-1% okanye ngaphezulu iintlobo eziguquliweyo zinokufunyanwa.
4. Ukuchaneka okuphezulu: Akukho mpendulo ihambelanayo notshintsho lwe-(511, 516, 526 kunye ne-531) kwiindawo ezine zokumelana namayeza ze-rpoB gene.
Ukufunyanwa koGuquguquko lwe-Ukumelana ne-MTB kunye ne-Rifampicin
1. Ukuqaliswa kolawulo lomgangatho wesalathiso sangaphakathi kwinkqubo kunokubeka esweni ngokupheleleyo inkqubo yovavanyo nokuqinisekisa umgangatho wovavanyo.
2. Indlela yokunyibilika kwe-melting curve edityaniswe ne-closed fluorescent probe equlethe iziseko ze-RNA isetyenzisiwe ekufumaneni i-in vitro amplification.
3. Uvakalelo oluphezulu: umda omncinci wokufunyanwa yi-50 bacteria /mL.
4. Ukuchaneka okuphezulu: akukho mpendulo ihambelanayo ne-genome yomntu, ezinye iintsholongwane ze-mycobacteria ezingezizo iintsholongwane kunye ne-pneumonia; Iindawo zotshintsho kwezinye iijini ze-mycobacterium tuberculosis ezinganyangekiyo ngamayeza, ezifana ne-katG 315G>C\A kunye ne-InhA -15 C>T, zifunyenwe, kwaye iziphumo azibonisanga mpendulo ihambelanayo.
Ukufunyanwa kwe-MTB nucleic acid (EPIA)
1. Ukuqaliswa kolawulo lomgangatho wesalathiso sangaphakathi kwinkqubo kunokubeka esweni ngokupheleleyo inkqubo yovavanyo nokuqinisekisa umgangatho wovavanyo.
2. Indlela yokukhulisa ubushushu obungaguqukiyo ye-enzyme digestion probe iyasetyenziswa, kwaye ixesha lokufumanisa lifutshane, kwaye iziphumo zokufumanisa zingafunyanwa kwimizuzu engama-30.
3. Idityaniswe ne-Macro & Micro-Test sample release agent kunye ne-Macro & Micro-Test constant temperature nucleic acid amplification analyzer, kulula ukuyisebenzisa kwaye ifanelekile kwiindawo ezahlukeneyo.
4. Uvakalelo oluphezulu: umda omncinci wokufunyanwa yi-1000Copies/mL.
5. Ukuchaneka okuphezulu: Akukho mpendulo ihambelanayo nezinye iintsholongwane ze-mycobacteria ezingezizo izifo zesifo sofuba (ezifana neMycobacterium kansas, Mycobacterium Sukarnica, Mycobacterium marinum, njl.njl.) kunye nezinye izifo (ezifana neStreptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, njl.njl.).
Ixesha leposi: Matshi-22-2024