Ukuhlolwa kwaselabhorethri kokuxilongwa kwe-COVID-19 okusebenzayo njengamanje njengoba kwelulekwa izinhlaka zamazwe omhlaba zochwepheshe kuyabuyekezwa futhi kuyahlolwa.
I-COVID-19 isifo, eyadabuka eWuhan China, isithinte amazwe angaphezu kuka-208 kuze kube manje. Umphakathi wesayensi emhlabeni wonke ubekwe inselelo enkulu ezinyangeni ezimbalwa ezedlule, ukuthuthukisa izivivinyo zokuxilonga ngoba Covid-19 ukutholwa kwezifo ukuze kuhlolwe iziguli kanye nabantu abasolwayo ukuze kulawuleke ngempumelelo futhi kulawulwe ubhubhane.
Ngaphambi kokuthi sihlole izindlela zamanje nezindlela ezisetshenziswayo ukuze kutholwe i-COVID-19, ake siqale siqonde ukuthi yini ebangela i-COVID-19 nokuthi umuntu uzenza kanjani izivivinyo zokuxilonga ukuze ahlole iziguli lesi sifo. Isifo se-COVID-19 sibangelwa i-RNA evaleleke kahle igciwane okuyi-zoonotic, okusho ukuthi zinganqamula imingcele yezinhlobo zezilwane ziye kubantu, futhi zingabangela, kubantu, ukugula kusukela emakhazeni kuya ezifweni ezinzima kakhulu njenge-MERS kanye ne-SARS. Igciwane elidala i-COVID-19 manje seliqanjwe ngokuthi i-SARS-CoV-2 yiKomidi Lamazwe Ngamazwe Le-Taxonomy of Virus (ICTV), njengoba lifana ncamashi naleli elidale ukuqubuka kwe-SARS (SARS-CoVs). Ukuhlolwa kokuxilonga kwesifo se-COVID-19 kungathuthukiswa ngezindlela eziningi.
Indlela ethandwa kakhulu nesetshenziswa njengamanje emhlabeni wonke ukuthuthukisa isivivinyo sokuxilonga esikwazi ukubona igciwane le-SARS-CoV-2 uqobo. Lokhu test kusekelwe ekutholweni kwe-genome yegciwane kusampula yesiguli nge-RT-real time PCR (reverse transcriptase-real time Polymerase Chain Reaction). Lokhu kuhlanganisa ukuguqulwa kwe-RNA yegciwane ibe i-DNA kusetshenziswa i-enzyme ebizwa ngokuthi i-reverse transcriptase bese kukhuliswa i-DNA kusetshenziswa isethi ethile yama-primer kanye ne-fluorescent probe, ebophezela endaweni ethile ku-DNA yegciwane, kusetshenziswa i-Taq polymerase futhi ithola isignali ye-fluorescent. Lokhu kuhlola kubizwa ngokuthi yi-NAATs (Nucleic Acid Amplification Tests). Le nqubo ingaba wusizo kakhulu ekutholeni kusenesikhathi ukuba khona kwe-nucleic acid kusampula yesiguli, ngisho nasezigulini ezingenazimpawu ezingabonisi zimpawu zesifo se-COVID-19 (ikakhulukazi esikhathini sokufukamela esiyizinsuku eziyi-14-28) nasengxenyeni yakamuva. kanye nalapho isifo sesishaywe umoya.
Izinkampani ezahlukene emhlabeni jikelele bezisebenza emjahweni wokulwa nesikhathi phakathi nezinyanga ezimbalwa ezedlule ukuthuthukisa ukuhlolwa kokuxilonga okusekelwe ku-NAAT ukuze kutholwe i-SARS-CoV-2 esekelwe ku-CDC (Center for Disease Control), Atlanta, USA kanye nemihlahlandlela ye-WHO ( 1, 2). Iziphathimandla zezempilo emhlabeni wonke bezigunyaza lezi zivivinyo ukuthi zisetshenziswe ezimeni eziphuthumayo ukuze kutholwe i-SARS-CoV-2. Izakhi zofuzo zegciwane okuhloswe ngazo kuze kube manje zihlanganisa ufuzo lwe-N, E, S kanye ne-RdRP, kanye nokulawula okufanele nokungalungile. Amasampula esiguli azoqoqwa ukuze enze ukuhlolwa okunjalo asuka emgudwini wokuphefumula ophezulu (i-nasopharyngeal ne-oropharyngeal swab) kanye/noma umgudu wokuphefumula ophansi (isikhwehlela kanye/noma i-endotracheal aspirate noma i-bronchoalveolar lavage). Nokho, kuyenzeka futhi kutholakale igciwane kwamanye amasampula, okuhlanganisa indle negazi. Amasampula adinga ukuqoqwa ngokushesha ngendlela efanele kuthathwe zonke izinyathelo zokuphepha ezidingekayo futhi kulandelwe izinqubo ze-biosafety (ngokweziqondiso ezibekwe yi-WHO[1]), ezigulini ezihlangabezana nencazelo yecala elisolwayo le-COVID-19, ukuyigcina nokuyipakisha. kahle uma idinga ukuhanjiswa isiwe esikhungweni sokuxilonga bese icutshungulwa (kukhishwe i-RNA kukhabhinethi ye-biosafety ku-BSL-2 noma indawo efanayo) ngokushesha ngendlela yokuqinisekisa ubuqotho besampula. Konke lokhu kufanele kwenziwe kuqala ukuze kuphathwe kangcono emtholampilo kanye nokulawula ukubheduka kwezifo.
Isikhathi sokutholwa kokuhlolwa okuhlukahlukene okusekelwe ku-NAAT okutholakalayo okwakhiwa izinkampani ezinkulu zokuxilonga emhlabeni wonke siyahluka ukusuka kumaminithi angu-45 kuya emahoreni angu-3.5. Intuthuko ehlukahlukene iyenziwa kulezi zivivinyo ukuze ziguqulwe zibe izivivinyo zokunakekelwa futhi kuzuzwe imiphumela efiselekayo ngesikhathi esincane ngangokunokwenzeka ngaphandle kokuphazamisa ukunemba kwemiphumela, ukuze kwandiswe inani lokuhlolwa okungenziwa ngosuku.
Ezinye izinketho zokuhlola zokuxilonga ziyi izivivinyo zokuxilonga ngokushesha (RDTs) ukuthi zithole ama-antigen/amaprotheni egciwane avezwa ebusweni bezinhlayiya zegciwane le-SARS-CoV-2 njengoba ziphindaphinda kumaseli aphethe futhi abangele izifo noma amasosha omzimba asabela ekuthelelekeni; lokhu kuhlola kuthola ukuba khona kwamasosha omzimba egazini labantu okukholakala ukuthi bangenwe yi-COVID-19 (3).
Ukunemba nokukhiqizwa kabusha kwe-RDT ukuze kutholwe ama-antigen egciwane kuncike ezicini eziningana ezihlanganisa isikhathi kusukela ekuqaleni kokugula, ukugcwala kwegciwane kusampula, ikhwalithi nokucutshungulwa kwesampula, kanye nokwakheka kwama-reagents akhona kusethi yokuhlola. Ngenxa yalokhu okuguquguqukayo, ukuzwela kwalezi zivivinyo kungase kuhluke kusuka ku-34% kuya ku-80%. Umphumela omkhulu walolu khetho ukuthi igciwane lidinga ukuba sesigabeni salo sokuphindaphindeka kanye nelokutheleleka ukuze lithole amaprotheni egciwane.
Ngokufanayo, ukuhlola okuthola amasosha omzimba abamba iqhaza kusekelwe emandleni okusabela kwamasosha omzimba okuncike ezintweni ezifana neminyaka yobudala, isimo somsoco, ubukhali besifo, kanye nemithi ethile noma izifo ezicindezela amasosha omzimba. Umphumela omkhulu walolu khetho ukuthi amasosha omzimba akhiqizwa ezinsukwini kuya emavikini ngemva kokutheleleka ngegciwane le-SARS-CoV-2 futhi umuntu kufanele alinde isikhathi eside kangako ukuze enze ukuhlolwa. Lokhu kusho ukuthi ukuhlonzwa kokutheleleka nge-COVID-19 okusekelwe ekuphenduleni kwe-antibody ngokuvamile kuyokwenzeka kuphela esigabeni sokululama, lapho amathuba amaningi okungenelela emtholampilo noma okuvimbela ukudluliswa kwezifo esedlulile.
Njengamanje, ama-RDT okukhulunywe ngawo ngenhla agunyazwe kuphela esimisweni socwaningo hhayi ukuxilongwa komtholampilo ngenxa yokuntuleka kwedatha (3, 4). Njengoba idatha eyengeziwe yezifo eziwumshayabhuqe itholakala ku-COVID-19, ama-RDT engeziwe azothuthukiswa futhi agunyazwe njengezindawo zokuhlola ukunakekelwa endaweni yomtholampilo njengoba engakwazi ukunikeza imiphumela ngemizuzu eyi-10-30 ngokuphambene nokuhlolwa okusekelwe ku-NAAT okuthathwa ngokwesilinganiso ngokwesilinganiso. amahora ambalwa ukuthola lesi sifo.
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References:
1. WHO, 2020. Izincomo Zesu Lokuhlola Iselabhorethri ye-COVID-19. Isiqondiso Sesikhashana. 21 March 2020. Itholakala ku-inthanethi ku- https://apps.who.int/iris/bitstream/handle/10665/331509/WHO-COVID-19-lab_testing-2020.1-eng.pdf Ifinyelelwe ngomhla ka-09 Ephreli 2020
2. I-CDC 2020. Ulwazi lwamalabhorethri. Isiqondiso Sesikhashana Selabhorethri Itholakala ku-inthanethi ku- https://www.cdc.gov/coronavirus/2019-nCoV/lab/index.html Kufinyelelwe ngomhla ka-09 Ephreli 2020.
3. WHO, 2020. Iseluleko Ngokusetshenziswa Kwezivivinyo Zamaphuzu Okunakekela. Isayensi Kafushane. 08 Ephreli 2020. Itholakala ku-inthanethi ku- https://www.who.int/news-room/commentaries/detail/advice-on-the-use-of-point-of-care-immunodiagnostic-tests-for-covid-19 Kufinyelelwe ngomhla ka-09 Ephreli 2020.
4. ECDC, 2020. Uhlaka Lwesimo Sokuhlola Esisheshayo Sokuxilongwa Kwe-COVID-19 e-EU/EEA. 01 April 2020. Isikhungo saseYurophu sokuvimbela nokulawula izifo. Itholakala ku-inthanethi ngo https://www.ecdc.europa.eu/en/publications-data/overview-rapid-test-situation-covid-19-diagnosis-eueea Ifinyelelwe ngomhla ka-09 Ephreli 2020
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