Izinhlobo Zemizamo Yokuxilongwa Nalokho Abazokutshela
Kunezinhlobo ezimbili zokuhlola ezihlukahlukene ezitholakala ukutholakala kwamabhaktheriya e-TB (i-Mantoux test skin) kanye nama-interferon gamma release release), uhlobo lokuhlolwa kwegazi. Uma ukuhlolwa kwesikhumba sakho kulungile, kusho ukuthi unegciwane lesifo se-TB kepha akudingeki ukuthi ube nesimo esisebenzayo nesithathelwanayo sesifo; lokhu kubizwa ngokuthi i-TB evulekile.
Udokotela wakho uzophishekela ukuhlolwa okungeziwe, kufaka phakathi i-X-ray yesifuba nesikhukhula se-sputum ukuze uthole ukuthi une-TB esebenzayo.
Umhlinzeki wakho wezempilo uzokutusa ukuhlolwa kwe-TB okungcono kakhulu kuwe ngokususelwa kusizathu sokuhlola, ukutholakala kokuhlolwa, nezindleko. Ngokuvamile, akukhuthazwa ukuba uthole kokubili ukuhlolwa kwesikhumba nokuhlolwa kwegazi.
Ngaphezu kwalokho, udokotela wakho uzokwenza ukuhlola ngokomzimba futhi ahambe nomlando wakho wezokwelapha. Izifo ezithile, ezifana ne-HIV nesifo sikashukela, zingakubeka engozini ephakeme ye-TB.
Ukuhlolwa Kwesikhumba
Isivivinyo sesikhumba se-Mantoux sisebenzisa i-tuberculin ehlanjululwe ngamaprotheni asetshenzisiwe (PPD), isisombululo esinezici ezithile ze-bacterium ye-TB. I-syringe enealiti encane ye-gauge igcwele isisombululo se-PPD, esishaywa phansi ngaphansi kwesikhumba esihlokweni sakho.
I-PPD idala amangqamuzana akhethekile omzimba omzimba, awaziwa ngokuthi ama-T-cells, ukuze aqaphele i-derivative ejojwe njengesihlaseli esisongelayo, okwenza ukuphendula kwesikhumba.
Izinga lempendulo lihunyushwa ukuze lihlolwe ukuthi ngabe umuntu unomqondo omuhle noma omuhle we-TB.
Ngokungafani nokugoma okunikezwa nge-intramuscularly, umjovo we-PPD umane nje ushiya indawo encane, ephukile, ephakanyisiwe yesikhumba ebizwa ngokuthi "wheal" endaweni yomjovo. I-wheal ekugcineni izonyamalalala phakathi kwamahora amaningana, kepha uma ingabonakali, ukuhlolwa kumele kuphindiwe.
Imiphumela
Ukusabela kwesikhumba kufinyelele ekuphakameni kwayo emahoreni ama-48 kuya kwangu-72 ngemuva kokufakwa kwe-PPD. Kumele ubuyele kumhlinzeki wakho wezokunakekelwa kwezempilo phakathi naleso sikhathi ukuze impendulo yakho ihumushe kahle. Ukulinda isikhathi eside noma kungekudala kungabangela imiphumela engalungile.
Udokotela wakho uzobheka indawo ephakanyisiwe, eqinile yesikhumba ebizwa ngokuthi i-induration. Ubukhulu bayo buzonquma ukuthi unomthelela noma unomthelela omubi we-TB, nokuthi yisiphi isayizi esibonisa i-TB kuwe kuxhomeke kwezinye izinkinga ongase ube nazo.
Isibonelo, ngaphandle kwalokho abantu abanempilo kumele babe nokukhushulwa okukhudlwana (15 mm) ukuthi labo abavikelekile ngegciwane lesandulela ngculaza, bathi ngenxa ye-HIV, noma abaye bakuthintana nomuntu onesifo sofuba esisebenzayo (5 mm). I-induration encane kunaleyo ayikhombisi ukutheleleka kwe-TB.
Uhlolo oluhle luzoholela ekubomvu nasekutheni.
Amaphutha amanga kanye namaqiniso amanga avame ukuhlolwa ngesikhumba kunokuhlola igazi. Lezi zivame zibangelwa ukuphathwa okungalungile kokuhlolwa kwesikhumba noma ukungahunyushwa kahle kwemiphumela yayo. Umphumela wamanga ongahle nawo ungenzeka uma usanda kubonakala ku-TB; impendulo ye-immune ebonakalayo ingase ingabi namaviki ayisishiyagalombili kuya kwangu-10 ngemuva kokuxhumana nama-bacteria.
AmaLabhu nezivivinyo zegazi
Ukuhlolwa kwegazi okungakwazi ukubona amabhaktheriya e-TB kungenye indlela yokuhlola isikhumba-okuvame ukukhethwa ngezizathu eziningana. Uma ukuhlolwa kwegazi kwakho kulungile, udokotela wakho angase futhi aqoqe isampula se-sputum futhi akhulume ukuze anqume ukuthi unesifo sofuba.
I-Interferon Gamma Release Assays (IGRAs)
Ukuhlolwa kwegazi okusetshenziselwa ukukhomba ukutholakala kwamabhaktheriya e-TB kubizwa ngokuthi i-interferon gamma release assays (IGRAs). Ngalokhu, igazi liqoqwe emathinini akhethekile besebenzisa inaliti, bese ithunyelwa ebhokisatri yokuhlola. Asikho isidingo sokulandelwa kwesiguli futhi imiphumela iyatholakala emahoreni angu-24 azungezile.
Kunezivivinyo ezimbili ze-IGRA ezivunywe yi-Food and Drug Administration (FDA):
- Ukuhlola kwe-QuantiFERON-TB ye-Gold In-Tube (QFT-GIT)
- Ukuhlolwa kwe-T-SPOT.TB (T-Spot)
Lezi zivivinyo zegazi zivame ukukhethwa ngoba zivame ukuba zinembile kunesivivinyo sesikhumba. Okungukuthi, ngokwengxenye, ngenxa yokuthi kungavamile ukuba abantu baphuthelwe isikhathi esiyimfuneko sokwenza amahora angu-48 kuya kwangu-72 isikhathi sokuhlolwa okulungile kwemiphumela yabo yokuhlolwa kwesikhumba.
Ukuhlolwa kwegazi kubuye kunembile kunokuhlolwa kwesikhumba kubantu abathola i-bacille Calmette-Guerin (BCG), umgomo wokugula kwesifo sofuba esisetshenziswa emazweni amaningi anesifo sofuba esiphakeme.
Ukuhlolwa okuhle kwe-TB kusho ukuthi, ngesikhathi esithile empilweni yakho, watholwa futhi unesifo se-TB. Kulesi simo, ezinye izivivinyo ziyadingeka ukuze unqume ukuthi unayo yini i-TB evulekile, engabonakali izimpawu futhi engenasifo, noma i-TB esebenzayo.
Amasiko eSiputum
Uma isikhumba sakho noma ukuhlolwa kwegazi kuyingozi kuma-bacteria e-TB, udokotela wakho uzokwenza ukuhlolwa okulandelwayo, kufaka phakathi isiko lesampula se-sputum (phlegm). I-sputum yi-fluid ebanzi ekhiqizwa emaphashini ngenxa yokugula. Isampula izobekwa ebhodini lokuhlola noma petri dish ukuze ubone ukuthi amabhaktheriya akhula. Isifo sofuba se-Mycobacterium sivame ukukhula kancane, ngakho-ke kungathatha izinsuku ezingu-21 ukuthola imiphumela enembile.
Ukucabanga
Ukuvivinya ama-bacterium wesifo sofuba kuyothuthukisa nokuhleleka kwe-X-ray esifubeni. Uma une-TB esebenzayo, umphumela walesi sivivinyo ngokuvamile uvame ukungajwayelekile, mhlawumbe ubonisa indawo emnyama.
Ngezinye izikhathi, i-TB ivela ezingxenyeni ezingaphandle kwamaphaphu; kulezi zimo, ukuhlolwa kwe-CT, kanye nama-MRIs angasetshenziswa futhi.
Ukuhlonza okuhlukile
Ezinye zezimpawu ze-TB-ukugula, ukuphelelwa yindlala, ukulahlekelwa ukudla, ukuncipha kwesisindo kanye nokuthunga ebusuku-yizibonakaliso ezivamile zezifo eziningi, kuhlanganise nalabo abathinta amaphaphu. Lokhu kufaka:
- I-bacterial lung abscess (empyema)
- Isifo se-Chronic obstructive pulmonary (COPD)
- I-pneumonia
- Ukutheleleka kwegciwane lesandulela ngculaza (i-HIV)
- Ukwelashwa nge-fungus, njenge-histoplasmosis
- Ukuthelelwa kwesinye i-mycobacterium
- Umdlavuza we-Lung
Ibhethri egcwele yokuhlolwa kwe-TB, kanye nokuhlolwa okuqondile kwezifo ezingenhla, kuzoholela ekuxilongweni okunembile.
> Imithombo:
> I-Merck Manual, I-Consumer Version. Isifo sofuba (i-TB). https://www.merckmanuals.com/home/infections/tuberculosis-and-leprosy/tuberculosis-tb#v785596
> University of Michigan. I-Medicine Health Medicine Library. Ezinye izimo ezinezimpawu ezifanayo zesifo sofuba (TB).
> Amasevisi aseMelika okuLawula nokuVimbela (CDC). I-Fact Sheets: I-BCG Vaccine. Kubuyekezwe ngo-Septhemba 12, 2016
> Amasevisi aseMelika okuLawula nokuVimbela (CDC). Itheksthi leqiniso: Ukuhlolwa kwesifo se-Tuberculin. Kubuyekezwe ngo-Septhemba 8, 2016.