I te mutunga o te tau 1995, i whakaritea e te Whakahaere Hauora o te Ao (WHO) te 24 o Poutū-te-rangi hei Rā mō te Mate Kohi o te Ao.
1 Te mārama ki te mate kohi
Ko te mate kohi (TB) he mate kai mau tonu, e kiia ana ko te "mate kai". He mate kai mau tonu e horapa ana, e hua mai ana i te mycobacterium tuberculosis e uru ana ki te tinana tangata. Kāore e pāngia e te tau, te ira tangata, te iwi, te mahi me te rohe. He maha ngā okana me ngā pūnaha o te tinana tangata ka pāngia e te mate kohi, ā, ko te mate kohi te mea tino noa.
He mate pāwera mau tonu te mate kohi i puta mai i te Mycobacterium tuberculosis, e uru ana ki ngā whekau o te tinana katoa. Nā te mea ko te pukahukahu te wāhi e pangia ai, e kiia ana ko te mate kohi.
Neke atu i te 90% o te mate kohi ka horapa mā te ara manawa. Ka pangia ngā tūroro kohi e te maremare, te tihe, te haruru nui, ka puta mai ngā pata kohi (e kiia ana e te rongoā he microdroplets) mai i te tinana ka hongihia e te hunga hauora.
2 Te rongoā i ngā tūroro mate kohi
Ko te rongoā te tūāpapa o te rongoā kohi. Ki te whakaritea ki ētahi atu momo mate kitakita, ka roa ake pea te rongoā kohi. Mō te kohi pūkahukahu e kaha ana te rongoā, me tango ngā rongoā ārai-kohi mō te 6 ki te 9 marama pea. Ko ngā rongoā motuhake me te wā rongoā ka whakawhirinaki ki te tau o te tūroro, te hauora whānui me te ātete rongoā.
Ina ātete ngā tūroro ki ngā rongoā raina tuatahi, me whakakapi ki ngā rongoā raina tuarua. Ko ngā rongoā e whakamahia whānuitia ana mō te rongoā i te mate kohi pūkahukahu kāore e ātete ki te rongoā ko te isoniazid (INH), te rifampicin (RFP), te ethambutol (EB), te pyrazinamide (PZA) me te streptomycin (SM). E rima ēnei rongoā e kiia ana he rongoā raina tuatahi, ā, he whai hua mō te neke atu i te 80% o ngā tūroro mate kohi pūkahukahu hou kua pangia.
3 Ngā pātai me ngā whakautu mō te mate kohi
P: Ka taea te rongoā i te mate kohi?
A: 90% o ngā tūroro e pangia ana e te mate kohi pūkahukahu ka taea te whakaora i muri i tā rātou tohe ki te rongoā auau me te whakaoti i te maimoatanga kua whakaritea (6-9 marama). Me whakatau e te tākuta tetahi huringa maimoatanga. Ki te kore koe e tango i te rongoā i te wā tika me te whakaoti i te maimoatanga, ka ngāwari te arahi ki te ātete rongoā o te mate kohi. Kia puta te ātete rongoā, ka roa te maimoatanga, ā, ka ngāwari te arahi ki te kore angitu o te maimoatanga.
P: He aha ngā mea me aro atu ngā tūroro kohi i te wā e rongoatia ana?
A: Kia kitea tō mate kohi, me whiwhi koe i te maimoatanga ārai-kohi i te wā e taea ai, me whai i ngā tohutohu a te tākuta, me tango i te rongoā i te wā tika, me tirotiro i ia wā, me te hanga i te whakapono ki a koe anō. 1. Kia aro ki te okiokinga me te whakapakari i te kai; 2. Kia aro ki te akuaku whaiaro, me te hipoki i tō waha me tō ihu ki ngā tauera pepa ina maremare, ina tihe rānei; 3. Whakaitihia te haere ki waho, ā, me mau he kopare ina me haere koe ki waho.
P: Kei te horapa tonu te mate kohi i muri i te whakaoranga?
A: I muri i te maimoatanga paerewa, ka tere te heke o te kaha o te pangia e ngā tūroro kohi pūkahukahu. I muri i ētahi wiki o te maimoatanga, ka tino heke te maha o ngā huakita kohi i roto i te huware. Ko te nuinga o ngā tūroro he kohi pūkahukahu kore-pangia ka whakaoti i te maimoatanga katoa e ai ki te mahere maimoatanga kua whakaritea. I muri i te taenga ki te paerewa whakaora, kāore he huakita kohi e kitea i roto i te huware, nō reira kāore e pangia.
P: Kei te horapa tonu te mate kohi i muri i te whakaoranga?
A: I muri i te maimoatanga paerewa, ka tere te heke o te kaha o te pangia e ngā tūroro kohi pūkahukahu. I muri i ētahi wiki o te maimoatanga, ka tino heke te maha o ngā huakita kohi i roto i te huware. Ko te nuinga o ngā tūroro he kohi pūkahukahu kore-pangia ka whakaoti i te maimoatanga katoa e ai ki te mahere maimoatanga kua whakaritea. I muri i te taenga ki te paerewa whakaora, kāore he huakita kohi e kitea i roto i te huware, nō reira kāore e pangia.
Rongoā mō te mate kohi
Kei a Macro & Micro-Test ngā hua e whai ake nei:
Te kimi i teWaikawa karihi MTB (Mycobacterium tuberculosis)
1. Mā te whakaurunga o te mana whakahaere kounga tohutoro ā-roto ki roto i te pūnaha ka taea te aroturuki whānui i te tukanga whakamātautau me te whakarite i te kounga whakamātautau.
2. Ka taea te whakakotahi i te whakanui PCR me te ine hihi-ā-rangi.
3. Te tairongo teitei: ko te rohenga iti rawa o te kitenga he 1 huakita /mL.
Te kimi i tete ātete ki te isoniazid i roto i te MTB
1. Mā te whakaurunga o te mana whakahaere kounga tohutoro ā-roto ki roto i te pūnaha ka taea te aroturuki whānui i te tukanga whakamātautau me te whakarite i te kounga whakamātautau.
2. I whakamahia he pūnaha ā-whaiaro mō te aukati ira whakaputa uri, ā, i whakamahia hoki te tikanga mō te whakakotahi i te hangarau ARMS me te ine hihi kanapa.
3. Te tairongo teitei: ko te rohenga iti rawa o te kitenga ko te 1000 huakita/mL, ā, ka taea te kite i ngā momo ātete-rongoā koretake me te 1% neke atu rānei o ngā momo whakarerekētanga.
4. Te tino motuhaketanga: Kāore he tauhohenga whakawhiti me ngā whakarerekētanga o (511, 516, 526 me te 531) e whā ngā pae ātete rongoā o te ira rpoB.
Te Kimi i ngā Ira Whakarerekētanga oTe Ātete ki te MTB me te Rifampicin
1. Mā te whakaurunga o te mana whakahaere kounga tohutoro ā-roto ki roto i te pūnaha ka taea te aroturuki whānui i te tukanga whakamātautau me te whakarite i te kounga whakamātautau.
2. I whakamahia te tikanga pihi rewa i honoa ki te inenga kanapa kati kei roto ngā turanga RNA mō te kimi i te whakanui i roto i te vitro.
3. Te tairongo teitei: ko te iti rawa o te rohenga kitenga he 50 huakita /mL.
4. Te tino motuhaketanga: kāore he tauhohenga whakawhiti ki te ira tangata, ētahi atu mate pukupuku mycobacterium kāore i te mate kohi me ngā mate pukupuku niumōnia; I kitea ngā wāhi whakarerekētanga o ētahi atu ira ātete-rongoā o te mate pukupuku mycobacterium momo-mohoao, pērā i te katG 315G>C\A me te InhA -15 C>T, ā, kāore i whakaatuhia e ngā hua he tauhohenga whakawhiti.
Te kimi waikawa karihi MTB (EPIA)
1. Mā te whakaurunga o te mana whakahaere kounga tohutoro ā-roto ki roto i te pūnaha ka taea te aroturuki whānui i te tukanga whakamātautau me te whakarite i te kounga whakamātautau.
2. Ka whakamahia te tikanga whakanui pāmahana pumau o te whakamātautau nakunaku whākōkī, ā, he poto te wā kimi, ā, ka taea te whiwhi hua kimi i roto i te 30 meneti.
3. I te whakakotahitanga me te kaihoko tuku tauira Macro & Micro-Test me te tātari whakanui waikawa karihi pāmahana pumau Macro & Micro-Test, he ngawari ki te whakahaere, ā, he pai mō ngā momo whakaaturanga.
4. Teitei o te aro: ko te iti rawa o te rohe kitenga he 1000Copy/mL.
5. Teitei o te motuhaketanga: Kāore he tauhohenga whakawhiti ki ētahi atu mycobacteria o te matatini mycobacteria kore-tuberculosis (pērā i te Mycobacterium kansas, Mycobacterium Sukarnica, Mycobacterium marinum, me ētahi atu) me ētahi atu pathogens (pērā i te Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, me ētahi atu).
Wā tuku: Maehe-22-2024