Te Rā o te Mate Kohi o te Ao 2026: Āe! Ka taea e tātou te whakamutu i te mate kohi

Ko te 24 o Poutū-te-rangi, 2026 te 31 o ngā Rā Mate Kohi o te Ao. Kua panuitia e te Whakahaere Hauora o te Ao (WHO) te kaupapa matua o tēnei tau, arā,"Āe! Ka taea e tātou te whakamutu i te mate kohi!", me te whakanui i te mea nui te kaha o te kaiārahi kāwanatanga, te whakapau kaha tonu ki te ao tōrangapū, me te mahi tahi a te tini me te mano, hei whakamutu i te mate urutā kohi (TB).

Te Ahunga Whakamua o te Ao me ngā Wero e Toe Ana

E ai ki te Global Tuberculosis Report 2025, i tutuki i te whakahaeretanga o te mate kohi o te ao tētahi tohu nui i te tau 2024, me ngā mea e ruate hekenga o te mate me te matemō te wā tuatahi mai i te mate urutā COVID-19.

He whakatau tata10.7 miriona tāngatai pāngia e te mate kohi i te tau 2024, tae atu ki te 54% o ngā tāne, 35% o ngā wāhine, me te 11% o ngā tamariki me ngā taiohi. I roto i ēnei kēhi, tata ki619,000 (5.8%)i pangia ngātahitia e te HIV, ā,390,000 (3.6%)he TB ātete-maha-rongoa, he TB ātete-rifampicin rānei (MDR/RR-TB).

I pā mai te mate kohi tata ki1.23 miriona ngā matengai te tau 2024, koia tonu te tino take o te mate urutā puta noa i te ao, e hipa ana i te COVID-19. Whai muri i te toru tau o te pikinga i waenga i te tau 2021 me te tau 2023, kua heke te maha o ngā mate kohi o te ao tata ki te 2% i te tau 2024, e whakaatu ana i te whakaoranga āta haere o ngā ratonga kohi.[1]

I te taha whenua,67% o ngā takei kohikohia ki ngā whenua e waru: Īnia, Initonīhia, Philippines, Haina, Pakitāne, Nigeria, Democratic Republic of the Congo, me Bangladesh.

Ahakoa te ahunga whakamua, ko te TB tonu te tino take o te mate i waenga i te hunga e ora ana me te HIV, ā, he tino take nui hoki mō te mate e pā ana ki te ātete ki ngā huakita. Kei te ngoikore tonu te pūtea ā-ao, me te mea anakeUS$5.9 pirionae wātea ana i te tau 2024—he iti iho i teTe whāinga ā-tau mō te US$22 pirionawhakaritea mō te tau 2027.

E whakaatu ana ēnei tatauranga i te hiahia nui ki te whakapakari i ngā kaupapa whakahaere mate kohi puta noa i te ao, me te arotahi ki te whakawhānui ake i te urunga atu ki ngā tātaritanga, te whakapai ake i ngā putanga maimoatanga, me te aro atu ki ngā take pāpori e akiaki ana i te horapa o te mate kohi. Kei te hiahia tonu te mate kohi ki te mahi tahi pakari o te ao me te whakapau kaha ki te ao tōrangapū kia tutuki ai ngā whāinga o te Rautaki Whakamutu i te Mate Kohi.

Mycobacterium tuberculosis: Te Mate me te Whakarōpūtanga

Ko te Mycobacterium tuberculosis (MTB/M. tuberculosis) te mate tuatahi me te tino noa e pā ana ki te mate kohi (TB). Ka taea e ia te uru ki te tinana tangata mā te ara manawa, te ara nakunaku, te kiri kua pakaru me ngā kiriuhi mucous, ka pangia ngā whekau maha, ka puta ai ngā momo momo kohi rerekē. Ko te kohi pūkahukahu, e horapa ana mā roto i ngā pata, neke atu i te 80% o ngā take kohi. Ko ngā tohu noa ko te maremare, te whakaputa huware, me te hemoptysis. I muri i te pangia o ngā pūkahukahu, ka horapa pea ngā huakita mā roto i te toto ki ngā pūnaha maha, ka arahi pea ki te kohi angaanga, mimi, puku rānei.[2]

Ko te MTB he wāhanga o te puninga Mycobacterium, kei roto i ēnei:

• Te matatini Mycobacterium tuberculosis (MTBC): Kei roto ko te M. tuberculosis, te M. bovis, te M. africanum, te M. canettii, me te M. microti, me ētahi atu. Ahakoa ko te M. tuberculosis te tino take o te mate TB, ka taea hoki e te M. bovis me te M. africanum te whakaputa i te mate.
• Ngā huakita kore-koiora (NTM).
• Ko te Mycobacterium leprae, te pūtake o te repera.

Ngā Huarahi Tātari Taiwhanga

He mea nui te tātaritanga tika me te wā tika mō te whakahaere whai hua o te mate kohi. E whakanui ana te Whakahaere Hauora o te Ao i tērāKua tino hurihia e ngā hangarau tātaritanga ngota tere te kitenga o te mate kohi mā te āhei i te tautuhi tino tairongo me te motuhake o ngā mate pukupuku me te kimi i te ātete rongoā i te wā kotahi.[1].

- Te Matawai me te Ahureae: Ko te ahurea tonu te paerewa koura mō te tautuhi i te mate kohi, nā te mea ka taea te tautuhi tuturu i ngā rauropi ora, ā, ka tautoko i te whakamātautau ngoikore ki ngā rongoā me te tātaritanga ira. Heoi, nā te puhoi o te tipu o te Mycobacterium tuberculosis, ko ngā hua e 2-8 wiki te roa, ā, ka whakawhāiti i tōna whai huatanga haumanu i roto i te whakatau tere.

-Whakamātautau Ārai Mate: Mā ngā tikanga ārai mate, tae atu ki te whakamātautau kiri tuberculin (TST) me ngā whakamātautau tukunga interferon-gamma (IGRA), ka kitea ngā urupare ārai mate o te tangata ki te mate TB. Ahakoa he pai mō te tautuhi i te mate huna, kāore e taea e ēnei whakamātautau te wehewehe pono i waenga i te mate hohe me te mate o mua, nō reira he iti noa te motuhaketanga o te tātaritanga i roto i ngā tautuhinga taumaha.

-Tātaritanga Ngota (NAAT): E taunakitia ana ngā whakamātautau e hangai ana ki te ira pēnei i te whakanui waikawa karihi (NAAT) nā te mea he tino tairongo, he tino motuhake hoki.

-Te Raupapa Whakatipuranga-Whanaketanga Whaiaro (tNGS): Mā ngā hangarau raupapatanga kua arotahihia ka taea te tautuhi i ngā whakarerekētanga e pā ana ki te ātete me te tino mārama. E taunaki ana ngā aratohu a te WHO i te tNGS hei taputapu matatau mō te kimi ātete rongoā i muri i te tātaritanga, hei tautoko i ngā rautaki maimoatanga tika [3].

-Raupapatanga Whakatipuranga-Whai Muri o te Metagenomic (mNGS): Mā te raupapatanga metagenomic ka taea te kite i te whānuitanga o ngā mate pukupuku me te kore e whiriwhiri i te ūnga i mua. He tino whai hua tēnei huarahi i roto i ngā āhuatanga haumanu uaua, kāore rānei i te mārama, tae atu ki ngā mate whakauru me ngā tūroro ngoikore te pūnaha ārai mate, ina kore pea e ranea ngā tātaritanga tikanga.

E whakamārama ana te WHO he mea nui te whakaū i te moroiti hei tīmatanga i te rongoā tika me te whakapai ake i ngā putanga o te tūroro, me te whakaū anō hoki i te hiranga o te whakauru i ngā tātaritanga ngota ngota matatau ki roto i ngā kaupapa whakahaere mate kohi [1].

Ngā Otinga Tātaritanga Ngota Whānui mai i te Macro me te Micro-Test

1.Te Kitenga PCR Maha mō te TB me te Ātete ki te RongoāTB

Ina he whakapae kaha kei te pāngia koe e te mate kohi (TB),HWTS-RT147e taunakitia ana te whakamātautau mō te kitenga kounga o te mate MTB me te mate kohi ātete-maha-rongoā (MDR-TB). Ka tautuhia e tēnei whakamātautau ngā whakarerekētanga ira i roto i teira rpoB, e hua ake ai te ātete ki te rifampicin (RIF), me ngā whakarerekētanga ira i roto i tengā ira katG me InhA, e pā ana ki te ātete ki te isoniazid (INH). Ka whakaratohia he whakamātautau kotahi-wā whai hua mō te MTB me te MDR-TB, me te whakauru i te mana kounga ā-roto hei whakaiti i ngā hua kino-hē, kia tere ai, kia tika ai hoki ngā hua.

2.Te Raupapa Whaiaro a PTNseq mō ngā Mate Pūngāwerewere Manawa me te Tātari Ātete

I roto i ngā mate urutā whakauru (tae atu ki ngā mate urutā o te ara manawa o runga me o raro, te mate kohi, me ngā mate urutā mau tonu), i te wā rānei e hiahiatia ana he tātaritanga ira ātete rongoā (hei tauira, te whakapae kohi ātete rongoā), ko teRaupapa PTNseq mō te kimi ira tere-whakawhiti kua arotahihiaka taea te whakamahi. I runga i te hangarau raupapatanga arotahi matatau, ka whakamahia e PTNseq te PCR ultra-multiplex hei whakarei ake i ngā raupapatanga ūnga motuhake, me te raupapatanga tere-rahi me te hangarau nanopore o te whakatupuranga tuatoru mō te tautuhi whānui i ngā mate me te whakatau ātete rongoā.

Ka whakamahia e te pūnaha ngā paraime kua patenttia, he tino motuhake, mō te whakanui i ngā ira ūnga. Mā te tautoko a te pātengi raraunga motuhake me ngā rauropi koiora atamai, ka whakaratohia he tautuhi tika i ngā mate me te ātete rongoā me te tātari ira kaha. Ka whakaitihia e te whakarei ake kua arotahia te pokanoa mai i te DNA manaaki, ka whakapai ake i te aro ki ngā tauira he nui te papamuri tangata, ā, ka taea ai te kimi whai hua i ngā ūnga uaua pēnei i teTe mate kohi Mycobacterium, harore, huakita ā-roto, huaketo RNA, me ngā ira ātete, ira kaha rānei.

Ka tutuki i te PTNseq te rohenga o te kitengatae noa ki te 100 tārua/mLme ngā uhi175 ngā mate manawa noa, tae atu ki te 76 ngā huakita, te 73 ngā huaketo, te 19 ngā harore, te 7 ngā mycoplasmas, meChlamydia, Riketia, me ngā ira ātete rongoā e 54Kei roto i te röpü teTe mate kohi Mycobacteriumngā mycobacteria nui kāore i te mate kohi, he matatini hoki.

Ka whakakotahi te raupapa PTNseq i te aro nui me te whai huatanga utu, te whakapai ake i ngā reiti kimi mate me te tautoko i te rongoā paturopi takitahi me te āwhina ki te whakaiti i te ātete paturopi. Kua whakauruhia ki te pūnaha whakarite whare pukapuka raupapatanga ira aunoa (AIOS), ka whakaratohia he otinga ngāwari, i roto i te hōhipera me te wā hurihanga tere tae atu ki te 6.5 hāora mai i te tauira ki te hua.

3. Te Raupapa Metagenomic mō te Kitenga i ngā Mate Pūtaiao Whānui

Ina kāore i te mārama te tautuhi haumanu,Te kimi ira tere-rahi mō ngā mate mNGSka taea te mahi i runga i ngā tauira rerekē mai i te tūroro, tae atu ki te wai horoi bronchoalveolar, te huware, ngā ūkui korokoro, te toto, te rerenga pleural, te pupuhi, me ngā tauira kiko. Ka whakamahia e tēnei huarahi te hangarau raupapatanga metagenomic, ka tukuna ngā tauira rerekē ki te maimoatanga-mua kua tohua, ā, ka whai muri ko te tango waikawa karihi mā te whakamahi i ngā pirepire karāhe me ngā whākōkī nakunaku pakitara, hei whakarei ake i te whai huatanga o te tango. Ka urutauhia te raupapatanga ki ngā tūāpapa maha, kia nui ai te rahinga raraunga hei whakapai ake i te aro o te mNGS me te pono o te huihuinga. Ka tātarihia ngā raraunga mā te whakamahi i tētahi pātengi raraunga i hangaia e ia anō me ngā rauropi atamai hei kite.neke atu i te 20,000 ngā mate urutā, tae atu ki ngā huakita, ngā harore, ngā huaketo, me ngā pirinoa, e whakarato ana i ngā mōhiohio mō ngā moroiti mate e whakapaetia ana. He pai tēnei tikanga mō ngā tūroro uaua ki te tautuhi, e tino mate ana, e ngoikore ana rānei te pūnaha ārai mate, tae atu ki te tautuhi iMTBmatatinimeNTM, tae atu ki ngā mate whakauru. Ka whakapai ake i ngā tere kitenga o ngā mate, ā, ka āwhina ki te ārahi i te whakamahinga o ngā paturopi haumanu, kia taea ai te tautuhi tika i te mate.

Whakamutunga

Ahakoa te nui o ngā ahunga whakamua kua tutuki, kei te noho tonu te mate kohi hei wero nui mō te hauora o te ao, inā koa i roto i te horopaki o te ātete ki ngā rongoā, ngā āputa pūtea, me te kore taurite o te urunga atu ki ngā tātaritanga.

E whakanui ana te WHO ko te whakawhānui ake i te urunga atu ki ngā tātaritanga ngota tere me ngā hangarau raupapatanga matatau he mea nui hei whakatutuki i ngā whāinga o te Rautaki Whakamutu i te Mate Kohi. Mā te auahatanga tonu, te haumitanga, me te mahi tahi ā-ao, ehara te whakamutu i te Mate Kohi i te wawata, engari he whāinga ka taea te whakatutuki.

Ngā Tohutoro:

1. Te Whakahaere Hauora o te Ao. Pūrongo mō te Mate Kohi o te Ao 2024/2025: Whakamātautau Tātaritanga me te Maimoatanga.
2. Te Whakahaere Hauora o te Ao. Pukapuka ā-ringa a te WHO mō te Kōwhiri i ngā Whakamātautau Tātaritanga Tere i Tūtohutia e te WHO mō te Kite i te Mate Kohi me te Mate Kohi Ātete-Rongoā.
3. Te Whakahaere Hauora o te Ao. Ngā Aratohu Whakakotahi a te WHO mō te Mate Kohi: Wāhanga 3 – Te Tātaritanga (Whakahōu 2024).