Yakazara Nhungamiro yeTuberculosis Zvinokonzera, Zviratidzo & Kurapwa

Maonero eTB

Tuberculosis kana TB chirwere chinotapukira chinokonzerwa nebhakitiriya, Mycobacterium tuberculosis. Maererano neshumo yepasi rose yechirwere cherurindi yakapihwa neWorld Health Organisation kana WHO, TB ndiyo inonyanya kukonzera kufa kwezvirwere zvinotapukira pasi rose. Ndiyo yechipfumbamwe iri kukonzera rufu pasi rose. Muna 2016, pakanga paine vanofungidzirwa kuti miriyoni 1.3 vakafa neTB pakati HIV-negative vanhu (pasi kubva 1.7 miriyoni muna 2000). Mugore ra2016 pavanhu vese vakarwara neTB vanosvika zvikamu makumi mapfumbamwe kubva muzana vaive vanhu vakuru. 90% yevanhu vanogara munyika shanu (India, Indonesia, China, Philippines, nePakistan). Vanhu vanosvika mamiriyoni gumi nemazana mana vakabatwa neTB muna 56.

Utachiona hweTB hunowanzopararira kubva kumunhu kuenda kune mumwe kuburikidza netumadonhwe tudiki tunobuditswa mumhepo panguva yekukosora nekuhotsira. Hutachiona uhu hunowanzotapukira mumapapu, asi hunogonawo kubata dzimwe nhengo dzemuviri dzakaita sehuropi, itsvo kana musana. Kunobva TB muvanhu vane active pulmonary infection. Kana munhu ane chirwere cheTB chemapapu akakosora, kutaura, kuhotsira, kuimba kana kuseka, anoparadzira TB. Chirwere chinogona kurapika chinogona kurapwa nemishonga inorwisa mabhakitiriya.

Unogona kushanyira chiremba kana uine uremu husingatsananguriki, chikosoro chinoramba chiripo, kudikitira husiku uye zvisingatsananguriki. fever. Chiremba anogona kuona kuti une TB here kana kuti kwete nekuita ongororo chaiyo. Zviratidzo zvacho zvinogona kusiyana pamunhu nemunhu uye zvinopatsanurwa kuita TB yakarasika uye ichiri kushanda zvichienderana nezviratidzo zvinoratidzwa mumunhu.

Latent TB chirwere

• Mune vamwe vanhu, mushure mekupinda mumuviri, utachiona hweTB hunova husingaite, uye murwere haaone zviratidzo. Nekudaro, kana immune system yavo ikapera simba pane imwe nguva yehupenyu, saka vanogona kutanga chirwere chinoshanda.

Active TB

• Inogona kukura mukati memavhiki mashoma ekutanga kana kuti inogona kutora makore anosvika makore mushure mekunge utachiona hweTB hwapinda mumuviri. Ichi chirwere chinogona kupararira kubva kune mumwe munhu kuenda kune mumwe.
• Vanhu vakawanikwa vaine HIV kana AIDS uye vanhu vanoshandisa doro nevashandisi vezvinodhaka IV vari panjodzi huru yekutapurirwa TB. Zvimwe zvinhu zvine njodzi zvinosanganisira kupera-danho reitsvo chirwere, chirwere cheshuga, kushaya zvokudya zvinovaka muviri uye mamwe magomarara. Njodzi yeTB yakakwira kana uchienda kumatunhu (nyika dzakaita sesub-Saharan Africa, India, neMexico) uko huwandu hweTB hwakakwira.
• Mumakore achangopfuura, marudzi akawanda eTB asingaurayiwi nemishonga akatanga. Zvinoitika kana mushonga unorwisa mabhakitiriya ukatadza kuuraya mabhakitiriya ese uye utachiona hunenge huripo hunowedzera kusanzwa nemushonga. Mamwe mabhakitiriya eTB ave kusaita isoniazid nerifampin (mishonga inonyanya kushandiswa pakurapa tuberculosis).

Zvikonzero zveTB (Tuberculosis)

Tuberculosis chirwere chinotapuriranwa chinokonzerwa nebhakitiriya, Mycobacterium tuberculosis inonziwo tubercle bacilli. Inogona kupararira kubva kune mumwe munhu kuenda kune mumwe munhu kuburikidza nemadonhwe asingaoneki anobuditswa mumhepo kubva kumunhu ane utachiona (active TB). Aya mabhakitiriya ari intracellular aerobic, anononoka kukura tupukanana. Vane rusvingo rwakasiyana rwesero runoidzivirira kubva kunzira dzekudzivirira dzemuviri.

Utachiona hunonyanya kutapurira mapapu, asi hunogona kupararira kuburikidza neropa kana lymphatic system kune dzakawanda nhengo dzakadai seitsvo, uye mapfupa (kunyanya idzo nhengo dzine hupfumi hweokisijeni). Vanogona kuchengetedza mamwe madhayi senge fuchsin, dhayi tsvuku kunyangwe mushure mekusuka asidhi. Utachiona hunokanganisa tishu uye hunokonzera necrosis. Nzvimbo idzi dzine chitarisiko chakaoma, chakapfava uye chine cheesy.

Muvarwere vane hutachiwana hweHIV, immune system haina simba, izvo zvinoita kuti zviomerwe nemuviri kurwisa tubercle bacilli. Pane mikana mikuru yekufambira mberi kwechirwere chakavandika kusvika kuhutachiona hunoshanda muvanhu ava.

Tuberculosis isingaurayiwi nemishonga

Varwere vashoma vanoramba mishonga yeTB ine simba zvikuru (isoniazid nerifampin) uye vanozivikanwa kuti vane Multi-drug resistant tuberculosis. Uku kushorwa kwemycobacteria kunokura mumamiriro ezvinhu apo murwere haatore kurapwa kwakakodzera kana kukundikana kwekurapa kunoonekwa.

Muzviitiko zvisingawanzoitiki, varwere vashoma vanoramba rifampin neisoniazid, pamwe nechero fluoroquinolone pamwe chete nemishonga inokwana mitatu yemutsara wechipiri yakaita sekanamycin, amikacin, kana capreomycin. Varwere ava vanozivikanwa kuti vane XDR tuberculosis (Extensively-drug resistant)

Zviratidzo Nezviratidzo yeTB

Pulmonary Tuberculosis

Inokonzera 85% yezvirwere zveTB. Zviratidzo zvekiriniki zvekare uye zviratidzo zvepulmonary TB zvinogona kusanganisira zvinotevera

• Manheru Anodikitira
• Kupisa kusingatsananguriki, chikosoro chisingaperi
• Kuderera kana kurasikirwa kwechido, kurasikirwa kwehuremu kusingatsananguriki
• hemoptysis ( kukosora sputum ine ropa), kutadza kufema
• Chipfuva chepfu
• Akazvimba lymph node uye kuneta
• Mune varwere vakwegura, pneumonitis (utachiona hunopisa masaga emhepo mumapapu) hunogona kuonekwa

Kuwedzera Pulmonary Tuberculosis

Extra Pulmonary Tuberculosis zviratidzo zvinoitika kana tibhii inokanganisa nzvimbo dzisiri mapapu (nzvimbo dzisiri dzakananga)

• Pleural effusions (fluid mumapapu) uye empyema (kuunganidzwa kwepus mumapapu epleural) zvinoonekwa mupleural TB,
• Marwadzo mumusana, musana wakaoma uye kupora simba zvinogoneka muTB (inonziwo chirwere chePott).
• Musoro unoramba uripo, kuchinja kwepfungwa, uye coma zvinoonekwa muTB meningitis.
• TB chirwere chemumajoini: Kazhinji kazhinji inobatwa mahudyu nemabvi uye kazhinji inorwadza mujoini rimwe chete.
• Marwadzo epaflank, dysuria (kurwadziwa paunenge uchiita weti), kuwedzera kuwanda kweweti, kuwanda kana mapundu (granulomas) muitsvo zvinoonekwa mugenitourinary TB.
• Mapundu madiki akawanda aive akapararira munhengo dzakaita sembeu yemapfunde mumiliary tuberculosis.
• Kuomerwa nekumedza, kurwadziwa mudumbu, malabsorption, kusapora maronda, chirwere (ringava kana kuti risave neropa) rinoonekwa mugastrointestinal TB.
• Kashoma TB inogona kubata nzvimbo dzakatenderedza moyo wako. Inogona kukonzera kuungana kwemvura kutenderedza moyo uye kuzvimba. Ichi chirwere chinogona kuuraya uye chinogona kutungamirira kurufu. Iyo inozivikanwa se cardiac tamponade.

Risk Factors cheTB (Tuberculosis)

Ngozi yeTB inowedzera kana murwere aine immune system isina kusimba. Zvikonzero zvakawanda zvinosangana neTB zvakaita se

• Vana nevakwegura vane immune system isina simba (kunyanya avo vane TB yeganda test)
• Varwere vane HIV nechirwere cheshuga
• Vashandisi vezvinodhaka (zvikurukuru IV kushandisa zvinodhaka avo vane immune system isina simba vane njodzi huru kana vakasangana nehutachiona hweTB)
• Vashanyi nevatorwa vanobva kunzvimbo dzinozivikanwa kuti dzine TB yakakura (Africa, Russia, Eastern Europe, Asia, Latin America neCaribbean Islands)
• Transplant varwere
• Varwere vane zvirwere zveitsvo
• Vanhu vari kuita immunosuppressive therapy senge CHEMOTHERAPY
• Kushaya zvokudya zvinovaka muviri uye silicosis
• Kushandisa fodya
• Mimwe mishonga inoshandiswa kurapa rheumatoid arthritis, psoriasis uye, chirwere cheCrohn.
• Munyika dzine urombo uye kuwandisa kwevanhu kwakakwirira

kuongorora chirwere yeTB

Tuberculosis inogona kuonekwa nemiedzo inotevera

Ganda Bvunzo

Muedzo weganda unozivikanwa seMantoux tuberculin skin test (kana) iyo tuberculin skin test (kana) TST. Iyi bvunzo yeganda inogona kuitwa kuti uone kana iwe wakatakura tubercle bacteria. Mumuedzo uyu, 0.1 mL yePPD (yakacheneswa protein inotorwa kana tuberculin - inotorwa kubva kukuuraya mycobacteria) inobaiwa pasi pepamusoro peganda rako. Kana pane welt kana induration yakaonekwa mushure memazuva 2-3 paganda rako, unogona kunge uine hutano. Ongororo iyi hairatidze kuti une utachiona huchiri kushanda asi kuti inokwanisa kuona kuti wakambobatwa neTB kare here kana kuti kwete.

Zvisinei, muedzo wacho hausi wakarurama nguva dzose. Vanhu vachangowana nhomba yeBCG vanogona kuongororwa kuti vane utachiona. Vamwe varwere vanoenda kunovhenekwa kunyangwe vasina TB uye vamwe havapindure pakuongororwa kunyangwe vaine TB.

Chest X-ray: Kana chiremba wako akawana kuti PPD test yako yakanaka, saka anogona kukukurudzira kuti uve nebhokisi x-ray yakaitwa. Kana makwapa madiki akaonekwa mumapapu ako mu x-ray yechipfuva, zvino zvinogona kuratidza hutachiona hweTB hunoshanda. Kana muviri wako uchiedza kutsaura tubercle mabhakitiriya, aya mavara mumapapu anogona kuoneka pa x-ray.

Kuongororwa kweSputum

Sputum inotorwa mukati memukati memapapu ako kuti uone kana utachiona hweTB. Kana sputum yako ichiongororwa kuti uri positive, zvinoreva kuti une utachiona hweTB uye mushonga unofanirwa kutangwa nekukasika. Matanho ekungwarira sekupfeka mask yakakosha, kudzivirira nzvimbo dzeveruzhinji kunofanirwa kutorwa kudzivirira kupararira kweutachiona hweTB kune vamwe.

Tsika

Kukura kwe mycobacteria kubva ku sputum tsika kana tishu biopsy tsika ndiyo yechokwadi kuongororwa kwechirwere chetibhii. Iwo mycobacteria ari kunonoka kukura mabhakitiriya, saka zvinogona kutora mavhiki kuti vakure pane nyanzvi midhiya.

Mimwe Miedzo

IGRA (interferon-gamma release assays): Iyi miedzo inogona kuyera maitiro ekudzivirira zvirwere kune Mycobacterium tuberculosis.

Vanhu vane zviratidzo zvakanaka, sputum smear, kana tsika dzakanaka vanonzi vane TB uye vanotapukira (active TB).

mabatiro yeTB

Kana ukaonekwa uine TB unogona kunwa mushonga mumwe chete kana kupfuura kwemwedzi mitanhatu kusvika mipfumbamwe zvichienderana nerudzi rweutachiona. Kurapwa kweTB kunoenderana nekuti,

• Mhando yeutachiona hweTB uye
• Zvinodhaka senitivity ye mycobacteria

Mishonga yekutanga inoshandiswa isoniazid (INH), rifampin (RIF), ethambutol (EMB), nepyrazinamide. Uchange uchitapurirana kwemavhiki maviri kusvika matatu munguva yako yekurapwa kana ukawanikwa uine pulmonary TB. CDC inopa gwara remarongero ekutanga ekurapa TB inoshanda (drug-susceptible TB organisms) sezvinotevera:

a) Muchikamu chekutanga

Rejisheni inodikanwa ndeyezuva nezuva isoniazid, rifampin, pyrazinamide uye ethambutol kwemakumi mashanu nematanhatu (masvondo masere).

Mamwe marejisheni ezuva nezuva isoniazid, rifampin, pyrazinamide uye ethambutol kwegumi nemana (masvondo maviri), kozoti kaviri pasvondo pamadhora gumi nemaviri (masvondo matanhatu).

b) Muchikamu chekuenderera mberi

Risingaurayiwi Nezvinodhaka Uye Multidrug-Resistant Tuberculosis

Kurapwa kweasingaurayiwi nemishonga uye MDR TB kunogona kunetsa. Nzira dzakasiyana-siyana dzinokurudzirwa neCDC muvarwere vane MDR neXDR TB dzinosanganisira zvirongwa zvakasiyana-siyana zvekurapa nemimwe mishonga inorwisa TB. Kurapwa nemishonga mitanhatu kana kupfuura yakasiyana kunogona kudiwa, kana uine TB isingarapike nemushonga.

Mishonga mitsva & marongero ekurapa anotenderwa neFDA ndizvo

• Bedaquiline (Sirturo) yakatenderwa kurapwa MDR TB, uye
• Tsvagiridzo pa iclipusavza (nemushonga unorwisa utachiona), inoratidza kuti inogona kubatsira mukurapwa.

Zvirwere zvekuvhiya

Kuvhiya kubviswa kwechirwere chemapapu kunoitwa mune vamwe varwere kana kuparadzwa kwemapapu kungave kwakanyanya.

Migumisiro Yechiri

Kushaya kudya, jaundice, kuda kusvotwa kana kurutsa, kuita mavanga (kubuda ropa) uye kuchinja kwekuona zvishoma zvinokonzerwa nekurapa TB.

Vanhu vari kunwa mishonga yeTB vanofanira kuzvidzivirira pamishonga inorwisa mabhakitiriya inogona kukuvadza chiropa uye vanofanira kuziva zviratidzo zvakaita seweti yakasviba, kutadza kudya, zvisingatsananguriki. Nausea kana kurutsa, jaundice, kana kutsvuka kweganda kana kuti fivha inotora nguva yakareba kupfuura mazuva matatu.

dziviriro yeTB

1) Nzira yose yemishonga: Muvarwere vane TB inoshanda, danho rinokosha nderekupedza nguva yose yemishonga. Utachiona hweTB hunogona kutanga kusanzwa nemishonga ine simba zvakanyanya (Ex: rifampin neisoniazid) kana ukakurumidza kumisa mushonga kana kusvetuka madosi. Marudzi asingaurayiwi nemishonga anonetsa kurapa uye anogona kuuraya murwere.

2) Muedzo weTB: Kana uchigara munzvimbo dzine hutachiwana hweTB kana kuti uine fungidziro yekuti unogona kubatwa neutachiona hweTB, unofanira kuongororwa TB. Kana ukaonekwa uine hutachiwana, unogona kurairwa nanachiremba wako kuti utore mishonga.

3) Zvidzivirire iwe nemhuri yako: TB inoshanda chete ndiyo inotapuriranwa zvakanyanya. Panyaya yechirwere cherurindi chinoshanda, unogona kutora matanho ekudzivirira kupararira kweTB kumhuri yako neshamwari.

• Vhara muromo wako nemucheka kana napkin paunenge uchikosora kana kutaura nevamwe vanhu (kudzivirira kupararira kwebhakitiriya mumhepo),
• Iwe unogona kupfeka mask kuti uderedze njodzi yekutapurirana mukati memavhiki matatu ekutanga ekurapa.
• Kufefetedza kwakakodzera kwemakamuri kunodiwa. Utachiona hweTB hunogona kupararira zviri nyore mumakamuri akavharwa uye munzvimbo diki.
• Mumavhiki mashoma ekutanga ehutachiona hwechirwere cherurindi, dzivisa kugara kana kurara mukamuri rimwechete nevamwe vanhu. Regedza kuenda kunzvimbo dzeveruzhinji senzvimbo dzebasa, chikoro, mapaki nezvimwe.
• Multi-drug resistant TB uye TB yakakura isingaurayiwi nemishonga inogona kudzivirirwa nekukasika kuongorora vanhu vanofungidzirwa kuti vari munzvimbo dzine TB. Kukurumidza kutariswa kwevarwere, kutevera nhungamiro yekurapa inokurudzirwa, kutarisa mhinduro yevarwere pakurapwa uye kuona kuti kurapwa kwapera kunogona kudzivirira MDR neXDR TB.
• Vanoongorora hutachiona uye nyanzvi dzehutano hwehutano dzinofanirwa kubvunzurudzwa kuti vatore matanho ekudzivirira kupararira kweTB (kunyanya munzvimbo dzine vanhu vakawanda semajeri, misha inochengeterwa vakwegura, nzvimbo dzekugara dzisina pekugara).
• Nzira dzinodiwa dzezvakatipoteredza uye dzekutonga dzinofanirwa kutorwa kudzivirira kupararira kweTB. Njodzi yekusangana neTB inodzikira kana zvidziviriro izvi kana nzira dzaitwa. Mamwe matanho emunhu anogona zvakare kutorwa anosanganisira kushandisa midziyo yekudzivirira yekufema.
• Mushonga weBacillus Calmette-Guerin (BCG) unopihwa kuvacheche kudzivirira mhando dzakakomba dzerurindi munzvimbo dzine huwandu hweTB.

FAQ's yeTB

1)Ndingazvidzivirira sei kuti ndisabatwa nechirwere cherurindi?

Dzivisa kushamwaridzana nevarwere veTB vanozivikanwa munzvimbo dzakatsvikinyidzana uye dzakakomberedzwa sezvipatara, makiriniki, majeri, kana pekugara.

2)Ndingaitei kana ndichifunga kuti ndakasangana nemunhu ane chirwere cheTB?

Kana uchifunga kuti wakambosangana nemunhu ane chirwere cheTB, unofanira kuonana nachiremba wako wovazivisa nezvekufuga kwako uye woongororwa ganda reTB kana kuongororwa ropa reTB.

3) Mushonga weTB (BCG) ungabatsira here kudzivirira XDR TB?

Mushonga weTB unonzi Bacille Calmette-Guérin (BCG), uye unoshandiswa munyika dzakawanda kudzivirira mhando dzakakomba dzeTB muvana. Zvakadaro, hazviratidzike kudzivirira TB zvachose mumunhu akatora mushonga weBCG.

Apollo Hospitals ine vana chiremba veTuberculosis vakanyanya muIndia. Kuti uwane vanachiremba veTuberculosis vakanyanya muguta rako riri padyo, shanyira zvinongedzo pazasi:
https://www.askapollo.com/book-health-check