Tsiku la Chifuwa Chapadziko Lonse 2026: Inde! Titha Kuthetsa Chifuwa Chapadziko Lonse

Pa 24 March, 2026, tsiku la 31 la Tsiku la Matenda a Chifuwa Padziko Lonse. Bungwe la World Health Organization (WHO) lalengeza mutu wa dziko lonse wa chaka chino kuti"Inde! Titha kuthetsa TB!", ndikugogomezera kuti utsogoleri wamphamvu wa boma, kudzipereka kwa ndale kosalekeza, ndi kuchitapo kanthu mogwirizana m'magawo osiyanasiyana ndikofunikira kwambiri kuti mliri wa chifuwa chachikulu (TB) uthe.

Kupita Patsogolo Padziko Lonse ndi Mavuto Otsala

Malinga ndi Global Tuberculosis Report 2025, kuchepetsa TB padziko lonse lapansi kudafika pachimake mu 2024, ndipo zonsezi ndiKuchepa kwa chiwerengero cha anthu ndi imfakwa nthawi yoyamba kuyambira mliri wa COVID-19.

Chiwerengero chaAnthu 10.7 miliyoniAnadwala TB mu 2024, kuphatikizapo 54% ya amuna, 35% ya akazi, ndi 11% ya ana ndi achinyamata. Pakati pa milandu iyi, pafupifupi619,000 (5.8%)anali ndi kachilombo ka HIV, ndipo390,000 (3.6%)anali ndi TB yosamva mankhwala ambiri kapena yosagwirizana ndi rifampicin (MDR/RR-TB).

TB yomwe imayamba pafupifupiImfa 1.23 miliyonimu 2024, yomwe ikupitilizabe kukhala chifukwa chachikulu cha imfa padziko lonse lapansi, ikuposa COVID-19. Pambuyo pa zaka zitatu za kuwonjezeka pakati pa 2021 ndi 2023, kuchuluka kwa TB padziko lonse lapansi kunachepa ndi pafupifupi 2% mu 2024, zomwe zikusonyeza kuti ntchito za TB zikuyambiranso pang'onopang'ono.[1]

Mwa malo,67% ya milanduZinali m'maiko asanu ndi atatu: India, Indonesia, Philippines, China, Pakistan, Nigeria, Democratic Republic of the Congo, ndi Bangladesh.

Ngakhale kuti kupita patsogolo kwapita patsogolo, TB ikadali chifukwa chachikulu cha imfa pakati pa anthu omwe ali ndi kachilombo ka HIV ndipo imayambitsa kwambiri imfa chifukwa cha kusamva mankhwala opha majeremusi. Ndalama zothandizira padziko lonse zikupitirirabe kuchepa, ndipo ndalama zokha ndi zomwe zaperekedwa.Madola aku US $5.9 biliyonilikupezeka mu 2024—lotsika kwambiri kuposaCholinga cha pachaka cha US$22 biliyoniyokonzekera chaka cha 2027.

Ziwerengerozi zikuwonetsa kufunika kolimbikitsa mapulogalamu oletsa TB padziko lonse lapansi, poganizira kwambiri kukulitsa mwayi wopeza matenda, kukonza zotsatira za chithandizo, komanso kuthana ndi zinthu zomwe zimayambitsa kufalikira kwa TB. TB ikupitilizabe kufunikira mgwirizano wamphamvu padziko lonse lapansi komanso kudzipereka kwandale kuti ikwaniritse zolinga za End TB Strategy​

Chifuwa chachikulu cha Mycobacterium: Pathogenesis ndi Kugawa

Matenda a Mycobacterium tuberculosis (MTB/M. tuberculosis) ndi matenda oyamba komanso ofala kwambiri omwe amayambitsa chifuwa chachikulu (TB). Amatha kulowa m'thupi la munthu kudzera m'njira yopumira, m'mimba, kapena pakhungu lowonongeka ndi mucous nembanemba, kufalikira m'ziwalo zosiyanasiyana ndikuyambitsa mitundu yosiyanasiyana ya chifuwa chachikulu. TB ya m'mapapo, yomwe imafalikira makamaka kudzera m'madontho, imayambitsa matenda opitilira 80% a TB. Zizindikiro zodziwika bwino zimaphatikizapo chifuwa, kupanga mafinya, ndi hemoptysis. Pambuyo pa matenda m'mapapo, mabakiteriya amatha kufalikira kudzera m'magazi kupita ku ziwalo zosiyanasiyana, zomwe zingayambitse chifuwa chachikulu cha mafupa, mkodzo, kapena m'mimba.[2]

MTB ndi gawo la mtundu wa Mycobacterium, womwe umaphatikizapo:

• Mycobacterium tuberculosis complex (MTBC): Imakhala ndi M. tuberculosis, M. bovis, M. africanum, M. canettii, ndi M. microti, pakati pa ena. Ngakhale M. tuberculosis ndiye chifukwa chachikulu cha TB, M. bovis ndi M. africanum zimathanso kuyambitsa matendawa.
• Mycobacteria yosakhala ndi chifuwa chachikulu (NTM).
• Mycobacterium leprae, chomwe chimayambitsa khate.

Njira Zodziwira Matenda a M'ma laboratories

Kuzindikira matenda molondola komanso panthawi yake n'kofunika kwambiri kuti munthu azitha kulamulira bwino chifuwa chachikulu. Bungwe la World Health Organization likugogomezera kutiUkadaulo wofulumira wofufuza matenda a TB wasintha kwambiri kuzindikira matenda a TB mwa kulola kuzindikira matenda opatsirana mwachangu komanso mwachindunji komanso nthawi yomweyo kuzindikira kukana mankhwala.[1].

- Microscopy ndi Chikhalidwee: Chikhalidwe chikadali muyezo wabwino kwambiri wodziwira matenda a TB, chifukwa chimalola kuzindikira bwino zamoyo zomwe zimagwira ntchito bwino komanso chimathandizira kuyezetsa mankhwala ndi kusanthula majini. Komabe, chifukwa cha kukula pang'onopang'ono kwa Mycobacterium TB, zotsatira zake nthawi zambiri zimatenga milungu 2-8, zomwe zimapangitsa kuti zisamagwire ntchito mwachangu popanga zisankho.

-Kuyesa kwa Chitetezo cha Mthupi: Njira zodzitetezera ku matenda, kuphatikizapo mayeso a khungu la tuberculin (TST) ndi mayeso otulutsa interferon-gamma (IGRAs), zimazindikira momwe chitetezo cha mthupi chimayankhira ku matenda a TB. Ngakhale kuti ndi zothandiza pozindikira matenda obisika, mayesowa sangasiyanitse bwino pakati pa matenda omwe alipo ndi omwe adachitika kale ndipo motero ali ndi chidziwitso chochepa chodziwira matenda m'malo omwe ali ndi mavuto ambiri.

-Kuzindikira Mamolekyulu (NAAT): Mayeso ozikidwa pa DNA monga nucleic acid amplification (NAAT) amalimbikitsidwa chifukwa cha kuthekera kwawo kozindikira bwino komanso kulondola.

-Kutsatana kwa Mibadwo Yotsatira (tNGS): Ukadaulo wotsatira njira zowunikira umathandiza kuzindikira bwino kusintha kwa majini komwe kumakhudzana ndi kukana mankhwala. Malangizo a WHO amalimbikitsa kuti tNGS ikhale chida chapamwamba chodziwira kukana mankhwala pambuyo pozindikira, kuthandizira njira zochizira molondola [3].

-Kutsatana kwa Metagenomic Next-Genuation (mNGS): Kusanthula kwa metagenomic kumathandiza kuzindikira mitundu yosiyanasiyana ya tizilombo toyambitsa matenda popanda kusankha komwe tikufuna. Njira imeneyi ndi yofunika kwambiri pazochitika zovuta kapena zosamveka bwino zachipatala, kuphatikizapo matenda osiyanasiyana ndi odwala omwe ali ndi chitetezo chamthupi chofooka, komwe kuzindikira matenda mwachizolowezi kungakhale kosakwanira.

WHO ikugogomezeranso kuti kutsimikizira za tizilombo toyambitsa matenda ndikofunikira kwambiri poyambitsa chithandizo choyenera ndikukweza zotsatira za odwala, zomwe zikugogomezera kufunika kophatikiza njira zamakono zodziwira matenda a TB mu mapulogalamu oletsa TB [1].

Mayankho Okwanira Ofufuza za Ma Molecular kuchokera ku Macro & Micro-Test

1.Kuzindikira Multiplex PCR kuti mudziwe chifuwa chachikulu komanso kukana mankhwalaTB

Ngati pali chikayikiro chachikulu cha matenda a chifuwa chachikulu (TB),HWTS-RT147Kuyezetsa uku kumalimbikitsidwa kuti kuzindikire matenda a MTB ndi chifuwa chachikulu chosamva mankhwala ambiri (MDR-TB). Kuyezetsa uku kumazindikira kusintha kwa majini mujini ya rpoBzomwe zimapangitsa kuti rifampicin (RIF) isagwire bwino ntchito, komanso kusintha kwa masinthidwe m'thupi.majini a katG ndi InhA, zomwe zimagwirizana ndi kukana kwa isoniazid (INH). Imapereka mayeso ogwira mtima, kamodzi kokha a MTB ndi MDR-TB, kuphatikiza kuwongolera kwamkati kuti muchepetse zotsatira zabodza, ndikutsimikizira zotsatira mwachangu komanso zolondola.

2.Kutsata kwa PTNseq kwa Matenda Oyambitsa Kupuma ndi Kutsutsa Kufufuza

Pankhani ya matenda osiyanasiyana okhudza kupuma (kuphatikizapo matenda a m'mapapo apamwamba ndi otsika, chifuwa chachikulu, ndi matenda osatha a kupuma), kapena ngati pakufunika kusanthula majini okana mankhwala (monga chifuwa chachikulu chomwe chikuganiziridwa kuti sichinalandire mankhwala),Mndandanda wa PTNseq wa kuzindikira majini ochulukirapoingagwiritsidwe ntchito. Kutengera ukadaulo wapamwamba wotsata njira zowunikira, PTNseq imagwiritsa ntchito PCR ya ultra-multiplex kuti iwonjezere njira zinazake zowunikira, kuphatikiza njira zowunikira njira zapamwamba komanso ukadaulo wa nanopore wa m'badwo wachitatu kuti izindikire bwino tizilombo toyambitsa matenda komanso kusanthula momwe mankhwala amagwirira ntchito.

Dongosololi limagwiritsa ntchito ma primer okhala ndi patent komanso apadera kwambiri kuti awonjezere ma gene omwe akufuna. Mothandizidwa ndi database yake komanso ma algorithms anzeru a bioinformatics, limapereka chidziwitso cholondola cha tizilombo toyambitsa matenda pamodzi ndi kukana mankhwala komanso kusanthula majini omwe ali ndi kachilomboka. Kuchulukitsa komwe kumayang'aniridwa kumachepetsa kusokoneza kwa DNA ya munthu, kukulitsa kukhudzidwa kwa zitsanzo zomwe zili ndi mbiri yayikulu ya anthu ndikuthandiza kuzindikira bwino ma gene ovuta mongaChifuwa chachikulu cha Mycobacterium, bowa, mabakiteriya amkati mwa maselo, mavairasi a RNA, ndi majini okana kapena owononga.

PTNseq imakwaniritsa malire opezekampaka makope 100 pa mLndi zophimbaMatenda 175 ofala kwambiri okhudza kupuma, kuphatikizapo mabakiteriya 76, mavairasi 73, bowa 19, ma mycoplasmas 7, komansoChlamydia, Rickettsia, ndi majini 54 osagwiritsa ntchito mankhwalaGululi likuphatikizapoChifuwa chachikulu cha Mycobacteriummycobacteria yovuta komanso yayikulu yopanda chifuwa chachikulu.

Mndandanda wa PTNseq umaphatikiza kukhudzidwa kwakukulu ndi kugwiritsa ntchito bwino ndalama, kukweza kuchuluka kwa matenda opatsirana komanso kuthandizira chithandizo chamankhwala chothana ndi majeremusi payekhapayekha komanso kuthandizira kuchepetsa kukana majeremusi. Kuphatikiza ndi dongosolo lokonzekera laibulale yodziyimira payokha ya majini (AIOS), imapereka yankho losavuta, lokhazikika m'chipatala komanso nthawi yobwerera mwachangu ngati maola 6.5 kuchokera pa chitsanzo kupita ku zotsatira.

3. Kutsata kwa Metagenomic kwa Kuzindikira Matenda a Broad-Spectrum

Ngati matenda a matenda sakudziwika bwino,Kuzindikira majini opangidwa ndi tizilombo toyambitsa matenda a mNGSKungachitike pa zitsanzo zosiyanasiyana kuchokera kwa wodwala, kuphatikizapo madzi otsukira a bronchoalveolar, sputum, pakhosi, magazi, pleural effusion, mafinya, ndi zitsanzo za minofu. Njirayi imagwiritsa ntchito ukadaulo wa metagenomic sequencing, pomwe zitsanzo zosiyanasiyana zimachitidwa chithandizo choyambirira chotsatiridwa ndi nucleic acid extraction pogwiritsa ntchito mikanda yagalasi ndi ma enzymes ogaya makoma, zomwe zimapangitsa kuti ntchito yochotsa igwire bwino ntchito. Sequencing imasinthidwa kukhala nsanja zingapo, kuonetsetsa kuti deta yambiri ikupezeka kuti ikhale yolondola komanso yokhazikika. Deta imasanthulidwa pogwiritsa ntchito database yodzipangira yokha komanso ma algorithms anzeru kuti azindikirematenda opatsirana oposa 20,000, kuphatikizapo mabakiteriya, bowa, mavairasi, ndi tizilombo toyambitsa matenda, kupereka chidziwitso pa tizilombo toyambitsa matenda tomwe tikukayikiridwa kuti ndi toyambitsa matenda. Njirayi ndi yoyenera kwa odwala omwe ali ovuta kuwazindikira, odwala kwambiri, kapena omwe ali ndi chitetezo chamthupi chofooka, kuphatikizapo kuzindikiraMTBzovutandiNTM, komanso matenda osiyanasiyana. Zimathandiza kwambiri kuzindikira matenda ndipo zimathandiza kutsogolera kugwiritsa ntchito maantibayotiki kuchipatala, zomwe zimathandiza kuzindikira matenda molondola.

Mapeto

Ngakhale kuti pakhala kupita patsogolo kwakukulu, chifuwa chachikulu chikupitirirabe kukhala vuto lalikulu padziko lonse la thanzi, makamaka pankhani ya kusamva mankhwala, kusowa ndalama, komanso mwayi wofanana wopeza matenda.

WHO ikugogomezera kuti kukulitsa mwayi wopeza njira zodziwira matenda mwachangu komanso ukadaulo wapamwamba wotsatizana ndikofunikira kuti tikwaniritse zolinga za End TB Strategy. Ndi kupitilizabe kupanga zinthu zatsopano, ndalama, komanso mgwirizano wapadziko lonse lapansi, kuthetsa TB sikulinso cholinga, koma cholinga chomwe chingatheke.

Zolemba:

1. Bungwe la Zaumoyo Padziko Lonse. Lipoti la Padziko Lonse la Matenda a Chifuwa 2024/2025: Kuyesa ndi Kuchiza Matenda.
2. Bungwe la Zaumoyo Padziko Lonse. Buku la WHO Losankha Mayeso Ofulumira Ozindikira Matenda a Chifuwa Omwe Amalimbikitsidwa ndi WHO Kuti Azindikire Chifuwa Chachikulu ndi Chifuwa Chosagwiritsa Ntchito Mankhwala.
3. Bungwe la Zaumoyo Padziko Lonse. Malangizo Ogwirizana a WHO pa Matenda a Chifuwa Chachikulu: Gawo 3 - Kuzindikira Matenda (Zosintha za 2024).