Mu mpera za 1995, Umuryango Mpuzamahanga wita ku Buzima (OMS) wagennye ko itariki ya 24 Werurwe ari yo yizihizwa ku Isi ku Munsi w’Igituntu.
1 Gusobanukirwa igituntu
Igituntu (TB) ni indwara idakira yo kwandura, yitwa kandi "indwara yo kwandura". Ni indwara idakira yo kwandura cyane iterwa n'igituntu cya mycobacterium cyibasiye umubiri w'umuntu. Ntikibasirwa n'imyaka, igitsina, ubwoko, akazi n'akarere. Ingingo nyinshi z'umubiri w'umuntu zishobora kurwara igituntu, muri zo igituntu kikaba ari cyo gikunze kugaragara cyane.
Igituntu ni indwara idakira yandura iterwa na Mycobacterium tuberculosis, yinjira mu ngingo z'umubiri wose. Kubera ko ahantu hakunze kwandurira ari mu bihaha, akenshi yitwa igituntu.
Abarenga 90% by'ubwandu bw'igituntu bandurira mu nzira z'ubuhumekero. Abarwayi b'igituntu bandura mu gukorora, kwitsamura, no gusakuza cyane, bigatuma uduce duto tw'igituntu (bita microdroplets) dusohoka mu mubiri tugahumekwa n'abantu bazima.
2 Kuvura abarwayi b'igituntu
Kuvura igituntu ni inkingi ikomeye mu kuvura igituntu. Ugereranyije n'ubundi bwoko bw'indwara zandura ziterwa na bagiteri, kuvura igituntu bishobora gufata igihe kirekire. Ku gituntu cy'ibihaha, imiti irwanya igituntu igomba gufatwa nibura mu mezi 6 kugeza kuri 9. Imiti yihariye n'igihe cyo kuvura biterwa n'imyaka y'umurwayi, ubuzima bwe muri rusange n'uburyo imiti idakira.
Iyo abarwayi badakunze imiti yo mu cyiciro cya mbere, bagomba kuyisimbuza imiti yo mu cyiciro cya kabiri. Imiti ikoreshwa cyane mu kuvura igituntu cy’ibihaha kidakunze imiti irimo isoniazid (INH), rifampicin (RFP), ethambutol (EB), pyrazinamide (PZA) na streptomycin (SM). Iyi miti itanu yitwa imiti yo mu cyiciro cya mbere kandi igira akamaro ku barwayi barenga 80% bashya banduye igituntu cy’ibihaha.
3 Ikibazo n'igisubizo cy'indwara y'igituntu
Q: Ese igituntu gishobora gukira?
A: 90% by'abarwayi barwaye igituntu cy'ibihaha bashobora gukira nyuma yo gutinda ku miti isanzwe no kurangiza gahunda y'ubuvuzi (amezi 6-9). Impinduka iyo ari yo yose mu buvuzi igomba gufatwa na muganga. Iyo udafashe umuti ku gihe ngo urangize gahunda y'ubuvuzi, bizatuma igituntu kidakira ku miti. Iyo imiti imaze kunanirwa, gahunda y'ubuvuzi izaramba kandi bizatera kunanirwa kuvura.
Q: Ni iki abarwayi ba igituntu bagomba kwitondera mu gihe cyo kuvurwa?
A: Iyo umaze gufatwa n'igituntu, ugomba guhabwa imiti igabanya igituntu vuba bishoboka, gukurikiza inama za muganga, gufata imiti ku gihe, kwisuzumisha buri gihe no kwiyubakamo icyizere. 1. Kwita ku kuruhuka no kongera imirire; 2. Kwita ku isuku y'umubiri, no gupfuka umunwa n'amazuru n'impapuro zo kwambara mu gihe ukorora cyangwa witsamuye; 3. Kugabanya gusohoka no kwambara agapfukamunwa iyo ugomba gusohoka.
Q: Ese igituntu kiracyandura nyuma yo gukira?
A: Nyuma yo kuvurwa mu buryo busanzwe, kwanduza abarwayi ba igituntu cy’ibihaha bikunze kugabanuka vuba. Nyuma y’ibyumweru byinshi bavurwa, umubare wa bagiteri z’igituntu mu mavuta uzagabanuka cyane. Abarwayi benshi barwaye igituntu cy’ibihaha kitandura barangiza gahunda yose y’ubuvuzi hakurikijwe gahunda yagenwe yo kuvura. Nyuma yo kugera ku gipimo cyo gukira, nta bagiteri z’igituntu zishobora kuboneka mu mavuta, bityo ntiziba zikindura.
Q: Ese igituntu kiracyandura nyuma yo gukira?
A: Nyuma yo kuvurwa mu buryo busanzwe, kwanduza abarwayi ba igituntu cy’ibihaha bikunze kugabanuka vuba. Nyuma y’ibyumweru byinshi bavurwa, umubare wa bagiteri z’igituntu mu mavuta uzagabanuka cyane. Abarwayi benshi barwaye igituntu cy’ibihaha kitandura barangiza gahunda yose y’ubuvuzi hakurikijwe gahunda yagenwe yo kuvura. Nyuma yo kugera ku gipimo cyo gukira, nta bagiteri z’igituntu zishobora kuboneka mu mavuta, bityo ntiziba zikindura.
Umuti w'igituntu
Macro & Micro-Test itanga ibicuruzwa bikurikira:
Gutahuraaside nucleic ya MTB (Mycobacterium tuberculosis)
1. Gushyiraho uburyo bwo kugenzura ubuziranenge bw'imbere muri sisitemu bishobora gukurikirana mu buryo bwuzuye inzira y'igerageza no kwemeza ubuziranenge bw'igerageza.
2. Gutera imbaraga za PCR n'icyuma gipima urumuri bishobora guhuzwa.
3. Ubushobozi bwo kuvura indwara cyane: ntarengwa yo kuyibona ni bagiteri 1/mL.
GutahuraUbudahangarwa bwa isoniazid muri MTB
1. Gushyiraho uburyo bwo kugenzura ubuziranenge bw'imbere muri sisitemu bishobora gukurikirana mu buryo bwuzuye inzira y'igerageza no kwemeza ubuziranenge bw'igerageza.
2. Hashyizweho uburyo bwo kwihutisha iterambere ry’ingufu zo mu kirere, kandi hashyizweho uburyo bwo guhuza ikoranabuhanga rya ARMS na probe ya fluorescent.
3. Ubushobozi bwo kumenya indwara cyane: ntarengwa yo kuyimenya ni bagiteri 1000 /mL, kandi ubwoko butangana budashobora kwihanganira imiti bufite ubwoko bwa 1% cyangwa burenze bwa mutant bushobora kugaragara.
4. Ubwinshi buhanitse: Nta buryo bwo guhuza imiterere y’ibinyabuzima (511, 516, 526 na 531) ahantu hane harwanya imiti ya gene ya rpoB.
Gutahura impinduka mu miterere y'umubiriUbudahangarwa bwa MTB na Rifampicin
1. Gushyiraho uburyo bwo kugenzura ubuziranenge bw'imbere muri sisitemu bishobora gukurikirana mu buryo bwuzuye inzira y'igerageza no kwemeza ubuziranenge bw'igerageza.
2. Uburyo bwo gushonga buhujwe n'icyuma gifunganye gifite RNA bases bwakoreshejwe mu gupima amplification muri vitro.
3. Ububasha bwo kumenya indwara cyane: ntarengwa yo kuyimenya ni bagiteri 50 / mL.
4. Uburyo bworoshye bwo kumenya: nta buryo bwo guhuza imiterere y’uturemangingo tw’umubiri w’umuntu, izindi ndwara za mycobacteria zitari iz’ibicurane n’iziterwa n’umusonga; Ahantu habayeho impinduka mu miterere y’utundi turemangingo tw’igituntu cy’ubwoko bwa mycobacterium, nka katG 315G>C\A na InhA -15 C>T, hagaragaye, kandi ibisubizo nta buryo bwo guhuza imiterere y’uturemangingo.
Gupima aside nucleike ya MTB (EPIA)
1. Gushyiraho uburyo bwo kugenzura ubuziranenge bw'imbere muri sisitemu bishobora gukurikirana mu buryo bwuzuye inzira y'igerageza no kwemeza ubuziranenge bw'igerageza.
2. Uburyo bwo kongera ubushyuhe buhoraho bwo gupima enzymes bukoreshwa, kandi igihe cyo kubitahura ni gito, kandi ibisubizo byo kubitahura bishobora kuboneka mu minota 30.
3. Iyo ihujwe n'ikintu gitanga ingero za Macro & Micro-Test hamwe n'icyuma gipima ubushyuhe buhoraho cya Macro & Micro-Test, biroroshye kuyikoresha kandi ikwiriye ahantu hatandukanye.
4. Ububasha bwo kumenya ibintu cyane: ntarengwa yo kubitahura ni kopi 1000/mL.
5. Ubwinshi bw'indwara: Nta buryo bwo guhuza izindi ndwara za mycobacteria zitari iz'igituntu (nka Mycobacterium kansas, Mycobacterium Sukarnica, Mycobacterium marinum, n'izindi) n'izindi ndwara (nka Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, n'izindi).
Igihe cyo kohereza: Werurwe-22-2024