Lā Honua no ka Maʻi Tuberculosis 2026: ʻAe! Hiki iā mākou ke hoʻopau i ka maʻi TB

ʻO Malaki 24, 2026 ka lā 31 o ka World Tuberculosis Day. Ua hoʻolaha ka World Health Organization (WHO) i ke kumumanaʻo honua o kēia makahiki e like me"ʻAe! Hiki iā kākou ke hoʻopau i ka maʻi TB!", me ka hoʻoikaika ʻana he mea nui ke alakaʻi aupuni ikaika, ke kūpaʻa politika mau, a me ka hana i hoʻonohonoho ʻia ma nā ʻāpana he mea nui ia no ka hoʻopau ʻana i ka maʻi ahulau maʻi puʻupuʻu (TB).

Ka Holomua Honua a me nā Pilikia i koe

Wahi a ka Global Tuberculosis Report 2025, ua hoʻokō ka kaohi ʻana o ka TB honua i kahi hanana koʻikoʻi i ka makahiki 2024, me nā mea ʻeluaka emi ʻana o ka hanana a me ka makeno ka manawa mua mai ka maʻi ahulau COVID-19.

Ua manaʻo ʻia10.7 miliona kānakaua loaʻa ka maʻi TB i ka makahiki 2024, me 54% kāne, 35% wahine, a me 11% keiki a me nā ʻōpio. Ma waena o kēia mau hihia, ma kahi o619,000 (5.8%)ua loaʻa pū ʻia me ka maʻi HIV, a390,000 (3.6%)he mau TB kūpaʻa i nā lāʻau lapaʻau he nui a i ʻole rifampicin-resistant TB (MDR/RR-TB).

Ua hoʻokumu ʻia ʻo TB ma kahi o1.23 miliona mau makei ka makahiki 2024, e noho mau ana ma ke kumu nui o ka make ma ka honua holoʻokoʻa, e ʻoi aku ana ma mua o COVID-19. Ma hope o ʻekolu mau makahiki o ka piʻi ʻana ma waena o 2021 a me 2023, ua emi ka nui o ka maʻi TB ma ka honua holoʻokoʻa ma kahi o 2% i ka makahiki 2024, e hōʻike ana i ka hoʻōla mālie ʻana o nā lawelawe TB.[1]

Ma ke ʻano he ʻāina,67% o nā hihiaua nui nā ʻāina ʻewalu: India, Indonesia, Philippines, Kina, Pakistan, Nigeria, Democratic Republic of Congo, a me Bangladesh.

ʻOiai ka holomua, ʻo TB ke kumu nui o ka make ma waena o ka poʻe e noho ana me ka maʻi HIV a he mea nui i ka make e pili ana i ke kū'ē ʻana i nā antimicrobial. Ke hoʻomau nei ka nele o ke kālā honua, me kaʻAmelika Hui Pū ʻIa $5.9 bilionaloaʻa i ka makahiki 2024—ma lalo loa o kaʻO ka pahuhopu makahiki he US$22 bilionahoʻonohonoho ʻia no 2027.

Hōʻike kēia mau helu i ka pono wikiwiki e hoʻoikaika i nā papahana kaohi TB ma ka honua holoʻokoʻa, me ka nānā ʻana i ka hoʻonui ʻana i ke komo ʻana i nā diagnostics, ka hoʻomaikaʻi ʻana i nā hopena lapaʻau, a me ka hoʻoponopono ʻana i nā mea hoʻoholo pilikanaka e hoʻokele ai i ka laha ʻana o ka TB. Ke koi mau nei ʻo TB i ka laulima honua ikaika a me ka hoʻokō politika e hoʻokō i nā pahuhopu o ka Hoʻolālā End TB.

ʻO ka Mycobacterium tuberculosis: Pathogenesis a me ka Hoʻokaʻawale ʻana

ʻO Mycobacterium tuberculosis (MTB/M. tuberculosis) ka pathogen mua a maʻamau i kuleana no ka maʻi tuberculosis (TB). Hiki iā ia ke komo i loko o ke kino kanaka ma o ke ala hanu, ke ala ʻai, a i ʻole ka ʻili i hōʻino ʻia a me nā membrane mucous, e hoʻopilikia ana i nā ʻōpū he nui a hoʻoulu i nā ʻano like ʻole o ka TB. ʻO ka TB Pulmonary, i hoʻoili nui ʻia ma o nā kulu liʻiliʻi, ʻoi aku ma mua o 80% o nā hihia TB. ʻO nā hōʻailona maʻamau e komo pū me ka ʻū ʻana, ka hana ʻana o ka sputum, a me ka hemoptysis. Ma hope o ka maʻi ʻana i loko o nā māmā, hiki i ka bacteria ke laha ma ke kahe koko i nā ʻōnaehana he nui, e alakaʻi ana paha i ka TB skeletal, urinary, a i ʻole gastrointestinal.[2]

ʻO MTB kekahi ʻāpana o ka genus Mycobacterium, nona nā:

• ʻO ka Mycobacterium tuberculosis complex (MTBC): Loaʻa iā M. tuberculosis, M. bovis, M. africanum, M. canettii, a me M. microti, a me nā mea ʻē aʻe. ʻOiai ʻo M. tuberculosis ke kumu nui o ka TB, hiki iā M. bovis lāua ʻo M. africanum ke hoʻoulu i ka maʻi.
• ʻO ka mycobacteria ʻaʻole tuberculous (NTM).
• ʻO ka Mycobacterium leprae, ke kumu o ka maʻi lēpera.

Nā ʻAno Hana Hōʻoia Laboratory

He mea nui ka ʻike pololei a me ka manawa kūpono no ka kaohi pono ʻana i ka maʻi TB. Ke hoʻoikaika nei ka World Health Organization i kēlāUa hoʻololi nui nā ʻenehana diagnostics molekala wikiwiki i ka ʻike ʻana iā TB ma o ka hiki ʻana ke ʻike maopopo a kikoʻī i nā pathogens i ka manawa like e ʻike ai i ke kūʻē ʻana i ka lāʻau.[1].

- ʻO ka Microscopy a me ka Moʻomeheue: ʻO ka moʻomeheu ke kūlana gula no ka ʻike ʻana i ka maʻi TB, no ka mea, hiki iā ia ke ʻike maopopo i nā meaola ola a kākoʻo i ka hoʻāʻo ʻana i ka hiki ke hoʻopilikia i ka lāʻau a me ka nānā ʻana i ka genomic. Eia nō naʻe, ma muli o ka lohi o ka ulu ʻana o Mycobacterium tuberculosis, pono pinepine nā hopena i 2-8 mau pule, e kaupalena ana i kona pono lapaʻau i ka hoʻoholo wikiwiki ʻana.

-Hoʻāʻo Immunological: ʻO nā ʻano hana immunological, me ka hoʻāʻo ʻili tuberculin (TST) a me nā hoʻāʻo hoʻokuʻu interferon-gamma (IGRAs), ʻike i nā pane pale o ka mea hoʻokipa i ka maʻi TB. ʻOiai he mea pono no ka ʻike ʻana i ka maʻi latent, ʻaʻole hiki i kēia mau hoʻāʻo ke hoʻokaʻawale pono ma waena o ka maʻi hana a me ka maʻi mua a no laila he palena ko lākou kikoʻī diagnostic i nā hoʻonohonoho kaumaha kiʻekiʻe.

-Nā Hōʻoia Molekala (NAAT): Paipai ʻia nā hoʻokolohua e pili ana i ka DNA e like me ka nucleic acid amplification (NAAT) no ko lākou ʻike kiʻekiʻe a me ke kikoʻī.

-Ka Hoʻonohonoho ʻana o ka Hanauna Hou i Manaʻo ʻia (tNGS): Hāʻawi nā ʻenehana hoʻonohonoho i kuhikuhi ʻia i ka ʻike kiʻekiʻe o nā mutations e pili ana i ke kū'ē. Paipai nā alakaʻi WHO iā tNGS ma ke ʻano he mea hana holomua no ka ʻike ʻana i ke kū'ē ʻana i ka lāʻau lapaʻau ma hope o ka hōʻailona ʻana, e kākoʻo ana i nā hoʻolālā lapaʻau pololei [3].

-Ka Hoʻonohonoho ʻana o ka Hanauna Hou Metagenomic (mNGS): ʻO ka hoʻonohonoho ʻana o Metagenomic e hiki ai ke ʻike kūʻokoʻa i kahi ākea o nā pathogens me ka ʻole o ke koho mua ʻana i ka pahuhopu. He mea waiwai nui kēia ʻano hana i nā hiʻohiʻona lapaʻau paʻakikī a maopopo ʻole paha, me nā maʻi i hui pū ʻia a me nā poʻe maʻi immunocompromised, kahi e lawa ʻole ai nā diagnostics maʻamau.

Hoʻomaopopo hou ʻo WHO he mea nui ka hōʻoia microbiological no ka hoʻomaka ʻana i ka lāʻau kūpono a me ka hoʻomaikaʻi ʻana i nā hopena o ka mea maʻi, e hoʻoikaika ana i ke koʻikoʻi o ka hoʻohui ʻana i nā diagnostics molekala holomua i nā papahana kaohi TB [1].

Nā Hoʻonā Diagnostic Molecular Piha mai Macro & Micro-Test

1.ʻIke ʻana i ka Multiplex PCR no ka TB a me ke kū'ē ʻana i nā lāʻau lapaʻauTB

I ka wā e loaʻa ai kahi kānalua lapaʻau ikaika o ka maʻi puʻupuʻu (TB), ʻo kaHWTS-RT147ua paipai ʻia ka hoʻāʻo no ka ʻike ʻana i ka maʻi MTB a me ka maʻi tuberculosis multi-drug-resistant (MDR-TB). Hōʻike kēia hoʻāʻo i nā mutations i loko o kagene rpoB, e alakaʻi ai i ke kū'ē ʻana o ka rifampicin (RIF), a me nā mutations i loko onā genes katG a me InhA, e pili ana i ke kū'ē ʻana o ka isoniazid (INH). Hāʻawi ia i kahi hoʻāʻo kūpono, hoʻokahi manawa no MTB a me MDR-TB, e hoʻokomo pū ana i ka mana maikaʻi kūloko e hōʻemi i nā hopena wahaheʻe-maikaʻi ʻole, e hōʻoiaʻiʻo ana i nā hopena wikiwiki a pololei.

2.Ka Hoʻonohonoho ʻana i hoʻolālā ʻia e PTNseq no nā maʻi hanu a me ka hoʻopili ʻana i ke kū'ē

I nā hihia o nā maʻi hanu hui ʻia (me nā maʻi ʻōpū hanu o luna a me lalo, ka maʻi puʻupuʻu, a me nā maʻi hanu mau), a i ʻole ke koi ʻia ka nānā ʻana i ka gene pale lāʻau (e laʻa me ka maʻi puʻupuʻu i manaʻo ʻia he pale lāʻau), ʻo kaʻO ka moʻo PTNseq o ka ʻike ʻana i nā gene throughput kiʻekiʻe i kuhikuhi ʻiahiki ke hoʻopili ʻia. Ma muli o ka ʻenehana hoʻonohonoho i kuhikuhi ʻia, hoʻohana ʻo PTNseq i ka ultra-multiplex PCR e hoʻonui i nā kaʻina kikoʻī, i hui pū ʻia me ka hoʻonohonoho throughput kiʻekiʻe a me ka ʻenehana nanopore hanauna ʻekolu no ka ʻike piha ʻana i nā pathogen a me ka profiling pale lāʻau.

Hoʻohana ka ʻōnaehana i nā primers i hoʻopaʻa ʻia a kiʻekiʻe ke kikoʻī no ka hoʻonui ʻana o nā genes i manaʻo ʻia. Kākoʻo ʻia e kahi waihona ʻikepili ponoʻī a me nā algorithms bioinformatics akamai, hāʻawi ia i ka ʻike pololei ʻana o ka pathogen me ke kūʻē ʻana i ka lāʻau lapaʻau a me ka nānā ʻana i ka gene virulence. Hoʻemi ka hoʻonui ʻia i kuhikuhi ʻia i ka hoʻopilikia ʻana mai ka DNA host, e hoʻomaikaʻi ana i ka ʻike i nā laʻana me ke kūlana kanaka kiʻekiʻe a hiki ke ʻike pono i nā pahuhopu paʻakikī e like meʻO ka maʻi puʻupuʻu Mycobacterium, nā fungi, nā bacteria intracellular, nā virus RNA, a me nā genes pale a virulence paha.

Hoʻokō ʻo PTNseq i kahi palena o ka ʻike ʻanaa hiki i ka 100 kope/mLa me nā uhi175 mau maʻi hanu maʻamau, me 76 mau bacteria, 73 mau virus, 19 mau fungi, 7 mycoplasmas, a meʻO Chlamydia, ʻO Rickettsia, a me 54 mau genes pale lāʻauAia i loko o ka panela kaʻO ka maʻi puʻupuʻu Mycobacteriumnā mycobacteria paʻakikī a nui ʻaʻole tuberculous.

Hoʻohui ka moʻo PTNseq i ke koʻikoʻi kiʻekiʻe me ka uku kūpono, hoʻomaikaʻi i nā helu ʻike pathogen a kākoʻo i ka lāʻau antimicrobial pilikino me ke kōkua ʻana i ka hōʻemi ʻana i ke kūʻē antimicrobial. Hoʻohui ʻia me ka ʻōnaehana hoʻomākaukau waihona puke sequencing gene piha piha (AIOS), hāʻawi ia i kahi hopena maʻalahi, i loko o ka haukapila me ka manawa hoʻohuli e like me 6.5 mau hola mai ka laʻana a i ka hopena.

3. Ka Hoʻonohonoho ʻana o Metagenomic no ka ʻIke ʻana i nā Pathogen Broad-Spectrum

I ka wā ʻaʻole maopopo ka hōʻailona lapaʻau,ʻIke ʻana i ka gene throughput kiʻekiʻe o ka pathogen mNGShiki ke hana ʻia ma nā ʻano laʻana like ʻole mai ka mea maʻi, me ka wai holoi bronchoalveolar, sputum, nā swabs ʻāʻī, ke koko, ka pleural effusion, ka pus, a me nā laʻana ʻiʻo. Hoʻohana kēia ʻano hana i ka ʻenehana hoʻonohonoho metagenomic, kahi e hana ai nā laʻana like ʻole i ka mālama mua ʻana i ukali ʻia e ka unuhi ʻana o ka waikawa nucleic me ka hoʻohana ʻana i nā momi aniani a me nā enzymes digesting paia, e hoʻonui ana i ka pono o ka unuhi ʻana. Hoʻololi ʻia ka hoʻonohonoho ʻana i nā kahua he nui, e hōʻoia ana i ka nui o ka ʻikepili no ka hoʻomaikaʻi ʻana i ka ʻike mNGS a me ka pono o ka hui ʻana. Hoʻopili ʻia ka ʻikepili me ka hoʻohana ʻana i kahi waihona ʻikepili i kūkulu ʻia a me nā algorithms akamai e ʻike ai.ma luna o 20,000 mau maʻi pathogens, me nā bacteria, fungi, virus, a me nā parasites, e hāʻawi ana i ka ʻike e pili ana i nā microorganism pathogenic i manaʻo ʻia. He kūpono kēia ʻano hana no nā poʻe maʻi paʻakikī ke ʻike, maʻi koʻikoʻi, a i ʻole nā ​​​​​​maʻi immunocompromised, me ka ʻike ʻana oMTBpaʻakikīa meNTM, a me nā maʻi i hui pū ʻia. Hoʻomaikaʻi nui ia i nā helu ʻike pathogen a kōkua i ke alakaʻi ʻana i ka hoʻohana ʻana i nā antibiotic i kuhikuhi ʻia i ka lāʻau lapaʻau, e hiki ai ke ʻike pololei i ka maʻi.

Hopena

ʻOiai ua holomua nui ka holomua, ke noho nei ka maʻi puʻupuʻu he pilikia nui no ke olakino honua, ʻoiai hoʻi i loko o ke ʻano o ke kūʻē ʻana i nā lāʻau lapaʻau, nā hakahaka kālā, a me ke komo like ʻole ʻana i nā hōʻailona.

Ua hoʻoikaika ʻo WHO he mea nui ka hoʻonui ʻana i ke komo ʻana i nā diagnostics molekala wikiwiki a me nā ʻenehana sequencing holomua no ka hoʻokō ʻana i nā pahuhopu o ka End TB Strategy. Me ka hoʻomau ʻana o ka hana hou, ka hoʻopukapuka kālā, a me ka laulima honua, ʻaʻole ia he makemake hou ka hoʻopau ʻana i ka TB, akā he pahuhopu hiki ke hoʻokō ʻia.

Nā Kuhikuhi:

1. ʻAhahui Ola Honua. Hōʻike ʻana i ka maʻi puʻupuʻu honua 2024/2025: Hoʻāʻo ʻana a me ka mālama ʻana i ka maʻi.
2. ʻAhahui Ola Honua. Puke Paipai WHO no ke Koho ʻana i nā Hoʻāʻo Diagnostic Wikiwiki i ʻōlelo ʻia e WHO no ka ʻIke ʻana i ka maʻi Tuberculosis a me ka maʻi Tuberculosis Pale Lāʻau.
3. ʻO ka Hui Ola Honua. Nā Alakaʻi i Hoʻohui ʻia e WHO no ka Maʻi Tuberculosis: Module 3 - Diagnosis (2024 Update).