Izivivinyo zokuhlolwa kwezempilo ziyingxenye ebalulekile yokunakekelwa kwezokwelapha. Ukuhlola kungathatha uhlobo lwemibuzo elula, izivivinyo zamalebhu, izivivinyo zama-radiology (isib. I- ultrasound , i-X-ray) noma izinqubo (isib. Ukuhlolwa kokucindezeleka). Kodwa ngenxa yokuthi ukuhlolwa kuhlinzekwa ngezinhloso zokuhlola, akusho ukuthi ukuhlolwa okuhle kokuhlola. Ukunemba kwezobuchwepheshe kuyadingeka kepha akulutholi ukuhlolwa kokuhlola.
Ukuhlanganiswa kokuhlolwa okulungile, isifo, uhlelo lokugula kanye nesiphakamiso kudala uhlelo lokuhlola impilo.
Ukuhlola nokuhlola i-Screening
Ukuhlolwa kwezokwelapha kungenziwa ngezinhloso zokuxilonga noma ukuhlolwa, kuye ngokuthi ngabe isiguli sinempawu noma izimpawu ezihlobene nesifo esibucayi.
Inhloso yokuhlolwa kwezokwelapha ukuxilongwa ukuthola ukutholakala noma ukungabikho kwezifo kumuntu onezibonakaliso noma izimpawu zesifo. Isivivinyo sokuxilonga singenziwa futhi ukulandela ukuhlolwa kokuhlola okuhle. Okulandelayo yizibonelo zokuhlolwa kokuxilongwa:
- Ukuhlolwa kokucindezeleka kwe-cardiac ukuhlola isifo senhliziyo kumuntu onezinhlungu zesifuba
- I-X-ray yekhanda ukuze ubheke i- pneumonia kumuntu onomkhuhlane nomkhuhlane
- Gcwalisa inani legazi ukuze ubheke i-anemia kumuntu onokukhathala
- I-Breop biopsy kumuntu one- mammogram engavamile yokuhlola
Inhloso yokuhlola ukuhlola ukuhlola isifo ngaphambi kokuba izimpawu noma izimpawu zivele ukuze uvumele ukwelashwa okusheshayo.
Okulandelayo yizibonelo zokuhlolwa kokuhlolwa okuvunyelwe yi-US Preventive Services Task Force:
- I-colonoscopy, sigmoidoscopy, noma i-stool test ukuthola umdlavuza we-colorectal kubantu abadala eminyakeni engama-50 noma ngaphezulu abangenayo izimpawu noma izimpawu zesifo.
- Ukuhlolwa kwegciwane lesandulela ngculazi kwabasha kanye nabantu abadala abaneminyaka engama-15 kuya kwengu-65 abangenayo izimpawu noma izimpawu ze-HIV.
- Ukuhlolwa kwe-type 2 yesifo sikashukela kubantu abadala abangenakuqhathaniswa nokucindezelwa kwegazi okuqhubekayo (okuphathwayo noma okungaphenduliwe) okukhulu kunama-135/80 mm Hg
- Ukuhlola isifo se-sickle cell ezinganeni ezisanda kuzalwa
Izivivinyo zokuhlola zilokhu zithuthukiswa ukuze zandise izinga labo lokuvikelwa. Isibonelo, esimweni somdlavuza wesibeletho-esibangelwa i-papillomavirus yomuntu (HPV)-ukutholakala kwamandla manje kungase kusekelwe ukuhlola ukuhlolwa kwePap okujwayelekile kanye nokuhlolwa kwe-HPV DNA. Imiphumela yamuva yokutadisha ibonisa ukuthi ukuhlolwa kwe-HPV kuzwela kakhulu. Ngakho-ke, ochwepheshe abaningi baphikisana ngokuthi kufanele kube yikhokhnoloji yokuqala yokuhlola.
Yini eyenza ukuhlolwa okuhle kokuhlola?
Ngenxa yokuthi sinesimo esibucayi sokuhlola isifo noma ukungavamile, lokho akusho ukuthi ukuhlolwa kufanelekile ukuhlolwa. Isibonelo, ukuhlolwa kwesithombe somzimba wonke kuzothola ukungajwayelekile kubantu abaningi, kodwa akukhuthazwa njengesivivinyo sokuhlola abantu abanempilo enhle. Ukuhlolwa kufaneleka kuphela ukuhlolwa uma kwenziwa ngomongo ofanele, okubandakanya imibuzo mayelana nesifo ngokwayo, abantu abangenwa yisifo, kanye nokwelashwa okukhona.
U-Wilson noJungner bachaze indlela yokuhlola uhlelo oluhle lokuhlola ukuhlolwa kwiphepha labo eliphawulekayo lika-1968.
I-World Health Organization yamukele lezi zindlela ezingu-10 ezisasebenza njengesisekelo sezingxoxo eziningi eziphathelene nezinhlelo zokuhlola namuhla.
- Isimo esidingekayo kufanele sibe inkinga yezempilo ebalulekile.
- Kumelwe kube nokwelashwa okwamukelwe iziguli ezinezifo eziqashelwayo.
- Izikhungo zokuxilongwa nokuphathwa kufanele zitholakale.
- Kumelwe kube nesigaba esivele esivele esivele esivele noma sesimangalisa.
- Kufanele kube nokuhlolwa okufanele noma ukuhlolwa.
- Isivivinyo kufanele samukeleke kubantu.
- Umlando wemvelo wesimiso, kufaka phakathi ukuthuthukiswa okuvela esivumelwaneni esilandelayo kuze kube sesifo, kufanele uqondwe ngokwanele.
- Kumelwe kube nenqubomgomo evumelwane mayelana nokuthi ubani okufanele aphathe njengeziguli.
- Izindleko zokuthola icala (kufaka phakathi ukuxilongwa nokuphathwa kweziguli ezitholakalayo) kufanele zilinganiswe ngokwezomnotho ngokuphathelene nezindleko ezingenzeka ekunakekelweni kwezempilo njengobazonke.
- Ukuthola amacala kufanele kube inqubo eqhubekayo hhayi iphrojekthi "ye-once kanye nayo yonke"
Qaphela ukuthi imigomo engenhla ayigxile ekuhloleni ngokwayo, kodwa kunalokho umongo lapho isetshenziselwa khona. Uma ngisho neyodwa yezinqubo ezingavunyelwanga, amathuba amancane aphansi ukuthi ukuhlolwa kokuhlolwa okunikeziwe kuzothuthukisa impilo yabantu bethu.
Ukuziphendukela Kwezimpawu Zokuhlola
UWilson noJungner babengahlosile izindlela zabo ezihlongozwayo ukuba zibe yimpendulo yokugcina, kodwa kunalokho ukugqugquzela ingxoxo eqhubekayo. Ubuchwepheshe buqhubeka nokuqhubeka, okusivumela ukuba sithole izifo eziningi futhi zisencane kakhulu. Kodwa ukutholakala kwesifo noma ukungavamile akuphuzi ngaso sonke isikhathi impilo. (Isibonelo, kuyini inzuzo yokuhlolwa kwesifo uma kungekho ukwelashwa?) Iziphakamiso ezihlolisisiwe zokuhlunga zihlongozwa ukuthi zizobhekana nezinkinga zokunakekelwa kwezempilo namuhla.
Ukuhlola i-genetic kubuye kube yindawo ebalulekile yentuthuko, kubandakanya ukuhlolwa kokubeletha ngaphambi kokubeletha. Izivivinyo eziningi zezakhi zofuzo manje zitholakale, futhi ochwepheshe bokunakekelwa okuyisisekelo kudingeka bakwazi ukweluleka iziguli zabo ukuze bakwazi ukwenza izinqumo ezinolwazi. Abanye ochwepheshe baxwayisa ukuthi ukuhlolwa kofuzo akufanele kwenziwe njalo. Iziguli zidinga ukuqaphela izinzuzo nezingozi ngaphambi kokuzithatha. Ngaphezu kwalokho, abantu abanengozini enkulu yokuthuthukisa isimo sezakhi zofuzo bangase bazuze kakhulu ekubhekiseni nezinye izingxenye zempilo yabo, njengokudla okunempilo, izimo zemvelo, nokuzivocavoca.
Umbuzo obalulekile okumele ubuze ngaphambi kokwamukela noma yikuphi ukuhlolwa kwezinhloso zokuhlola "Ingabe ukuhlolwa kokuhlola kuholela ekutheni impilo yonke ibe ngcono?"
> Imithombo:
> Anne Andermann et al. Ukubuyekeza kabusha i-Wilson ne-Jungner ku-Age Genomic: Ukubukezwa Kwezinkinga Zokuhlola Phakathi Neminyaka Engu-40 Eyedlule. I-Bulletin ye-World Health Organization 2008; 86 (4): 241-320.
> Harris R et al. Ukucabangela iMigomo Yokuhlola Izinhlelo Zokuhlola Eziphakanyisiwe: Ukuzindla Kusuka Ku-4 Amanje Namalungu Amandulo E-US Preventive Services Task Force. I-Epidemiol Rev (2011) 33 (1): 20-35.
> Tota J, uBentley J, Ratnam S, et al. Ukwethulwa kwe-Molecular HPV Ukuhlolwa njenge-Primary Technology ekuhlolweni kwesifo somdlavuza wesibeletho: Ukufakazela Ubufakazi bokushintsha i-Paradigm yamanje. Imithi Evikelayo , 2017; 98 (Issue Esikhethekile: Ama-Paradigms avulekayo ekuhlolweni kwekhanda lomlomo wesibeletho): 5-14.
> I-US Preventive Services Task Force. Izincomo ze-USPSTF ne-B. I-Wilson JMG ne-Jungner G. Izimiso kanye nokujwayela ukuhlola izifo. Amaphepha Ezempilo Emphakathini No. 34. I-Geneva: I-World Health Organization; 1968.